Browsing by Author "Zergaw, Ababi"

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    Economic Burden of Schizophrenia and Bipolar Disorders in Ethiopia
    (Addis Ababa University, 2008-07-22) Zergaw, Ababi; Hailemariam, Damen(PhD)
    In Ethiopia, economic burden of schizophrenia and bipolar disorders was a virgin area of research untapped for the last many decades. On the other hand sporadic epidemiological studies indicate that mental health problems are major public health concern in the country. However, despite high magnitude of the problems, the extent and the longitudinal time change of family and caregiver burden due to schizophrenia and bipolar disorders is unknown. Therefore, this dissertation has tried to give answers to the following research questions: What is the extent of economic burden of schizophrenia and bipolar disorders in Ethiopia? How does burden change overtime in families of patients with schizophrenia and bipolar disorders? Are families with a member with schizophrenia and bipolar disorder face different disease burden compared to families with physical disorders? To answer these research questions one year longitudinal prospective study with economic and family caregiver burden measurements on families of 249 schizophrenia, 190 bipolar, 55 diabetes, hypertension and asthma patients and 659 families who are with other sickness in the community was carried out. Population average generalized estimating equation and time series generalized least squares analyses were used to estimate the extent and the change over time of burden in the families of patients with schizophrenia and bipolar disorders.Using the prevalence based and the human capital approach, economic burden estimations at societal level were also made. As a result in the analysis of six waves of data, families of patients with schizophrenia were found to experience persistent burden for about eighty-three percent of the year. The change in family burden due to time was statistically significant with a mean family burden score of 3.10 (z = -20.86, P>|z|= 0.001). In terms of caregiver characteristics, female caregivers, caregivers in farming occupation, whose monthly living expenses were very little, who had paid more out-ofpocket for mental health services, who were angry at the patient, who were worried about the patient, who were over involved in controlling the patient, and who had lost more days of work were found to be more burdened. Overall in 2005, the total burden of schizophrenia to families in Ethiopia ranged approximately between $2.12 million to $9.97 million. As observed in families of patients with schizophrenia, in a comparative analysis, bipolar patient family caregivers were also found to be more burdened for about 8 to 10 months of the year than family caregivers of patients with diabetes, hypertension and asthma and sick controls in the community. The average difference in family caregiver burden score between bipolar and diabetes, hypertension and asthma patient family caregivers was 4.36 (z = -8.75, P>|z|= 0.001); while the difference due to time between the two groups was 3.42 (z= -4.27, P>|z|= 0.001). Similarly, the average difference in family caregiver burden score between family caregivers of bipolar patient and sick controls in the community was 3.7 (z= -4.88, P>|z| 0.001). In terms of longitudinal caregiver burden difference, bipolar patients family caregivers were found to be more burdened than family caregivers of sick controls in the community with a burden score difference of 2.97 (z= -5.17, P>|z|= 0.001). Over the year, patients with bipolar disorder lost a mean of 93.52 cumulative days of work. Consequently, in the year 2005, bipolar disorder patents living in a community under clinical follow-up lost 112.8 million days of work. In sum the total economic burden of schizophrenia and bipolar disorders in Ethiopia ranged approximately $378.62 to $469.47 million. Out of this total economic burden the direct cost was found to be 1.25 percent to 3.66 percent of the country’s public health expenditure in the year 2005. This amount of burden is very huge for poor countries like Ethiopia. It is a hidden economic loss. Generally the figure shows that the country’s health care system should try to reduce the high level of hidden sufferings of families and caregivers so as to keep the level of burden low. Future studies need to focus more on how to devise feasible intervention strategies to lessen economic and family burden due to schizophrenia and bipolar disorders Key words: schizophrenia; bipolar disorder; caregiver burden; family burden; economic burden; panel data; population average generalized estimating equation; time-series generalized least squares, Ethiopia
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    Prevalence and Associated Factors of Acute Lower RespiRatory Infection among under Five Children, Yeka Sub City, Addis Abeba, Ethiopia
    (Addis Abeba Universty, 2017-06) Wogderes, Bashaw; Zergaw, Ababi
    Background: Acute lower respiratory tract infections in developing countries cause considerable morbidity, hospitalization and mortality in children aged under five years. In Ethiopia acute respiratory infection is the leading causes of under-five mortality which accounts for 18% of total death among under five children. Objective:To assess risk factors associated with acute lower respiratory infection among under five children in Yeka sub city, Addis Abeba, Ethiopia. Methods: community based cross-sectional study was conducted with a sample size of 447. Data was collected by interview, entered to EPI data version 3.1, and was exported to SPSS version 22 for analysis. Descriptive statistics using frequencies, proportion and tables were used to present the study results. Binary logistic regression analysis was employed to see association between acute lower respiratory infection and different risk factors. To evaluate the association and adjusted odds ratio with 95% confidence interval were computed. Results: The prevalence of acute lower respiratory tract infection was 4.6%. Evidence from this study also showed that house hold with window (AOR=0.2, 95% CI: 0.1-0.6, p-value=0.002) and family size of less than five children (AOR=0.1, 95% CI: 0.01-0.6, p-value=0.01) were preventive risk factors. Conclusions and recommendations: The prevalence of acute lower respiratory infection was low. This study has demonstrated that the preventive factors for acute lower respiratory infection were maternal education to primary or secondary level, household with window and less than five children in the household. These risk factors can be modified by encouraging and increasing community awareness for child spacing and increase and promote female education.
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    Risky Sexual Practice, Accessibility and Utilization of HIV Service among People With Disabilities in Addis Ababa
    (Addis Abeba university, 2011-05) Kumssa, Hanna; Zergaw, Ababi
    Background: HIV/AIDS is known to be one of the most catastrophic diseases that have confronted humanity in living memory. Even though there are segments of disadvantaged social groups who are at risk HIV infection due to their lower level of socio economic capacity it is believed that people with disability are more vulnerable to HIV infection. Objective: To assess the risky sexual practices, accessibility and utilization of HIV service among people with disability in Addis Ababa City Administration. Materials and methods: Between September 2010 and April 2011, a cross sectional community based survey was conducted using interviewer administered questionnaire of 417 people with disabilities found from associations of people with disabilities in Addis Ababa City Administration. This was supplemented with focus group discussions with disabilities for access and utilization of HIV services. The findings were described and analyzed using SPSS version 16. Result: Based on the findings, more than half (60%) of study participants were sexually active and a third of them (28.4%) had initiated sex before 18 years. Almost half (48%) of these did not use condoms consistently and 33.6% had multiple sexual partners. Majority (92.8%) have information for existence of HIV services in the country. About 72% of all participants have ever utilized some kind of HIV services ever. Female respondents were nearly 2.5 times more likely to use condoms than males irrespective of type of disabilities [AOR (95%CI) 2.46 (1.28-4.71)]. Those ever married were 2.5 times more likely to use condoms than singles [AOR (95%CI) 2.54(1.49-4.35)]. Visually impaired participants are about 2 times more likely to have multiple sexual partners than those of physically impaired [AOR (95%CI) 1.90(1.02-3.55)]. In addition, those who were singles are 45% less likely to have multiple sexual partners than those of ever married [AOR (95%CI) 0.55(0.31- 0.97)]. Regarding utilization of HIV services, hearing impaired participants were about two times more likely to have utilized any HIV services than those of visual impaired [AOR (95%CI) 2.12(1.13-3.98)]. Conclusions: In general, the findings in this study showed poor access to information, less convenient of facilities and low utilization of HIV service among people with disabilities. Improving access to information on HIV through targeting PWDs, support to HIV service providers in developing disability sensitive communication materials and improving health service delivery systems to take care of disability are recommended