Cardiovascular diseases (CVDs), principally ischemic heart disease (IHD) and stroke, are the leading cause of global mortality and a major contributor to disability. This paper reviews the magnitude of total CVD burden, including 13 underlying causes of cardiovascular death and 9 related risk factors, using estimates from the Global Burden of Disease (GBD) Study 2019. GBD, an ongoing multinational collaboration to provide comparable and consistent estimates of population health over time, used all available population-level data sources on incidence, prevalence, case fatality, mortality, and health risks to produce estimates for 204 countries and territories from 1990 to 2019. Prevalent cases of total CVD nearly doubled from 271 million (95% uncertainty interval [UI]: 257 to 285 million) in 1990 to 523 million (95% UI: 497 to 550 million) in 2019, and the number of CVD deaths steadily increased from 12.1 million (95% UI:11.4 to 12.6 million) in 1990, reaching 18.6 million (95% UI: 17.1 to 19.7 million) in 2019. The global trends for disability-adjusted life years (DALYs) and years of life lost also increased significantly, and years lived with disability doubled from 17.7 million (95% UI: 12.9 to 22.5 million) to 34.4 million (95% UI:24.9 to 43.6 million) over that period. The total number of DALYs due to IHD has risen steadily since 1990, reaching 182 million (95% UI: 170 to 194 million) DALYs, 9.14 million (95% UI: 8.40 to 9.74 million) deaths in the year 2019, and 197 million (95% UI: 178 to 220 million) prevalent cases of IHD in 2019. The total number of DALYs due to stroke has risen steadily since 1990, reaching 143 million (95% UI: 133 to 153 million) DALYs, 6.55 million (95% UI: 6.00 to 7.02 million) deaths in the year 2019, and 101 million (95% UI: 93.2 to 111 million) prevalent cases of stroke in 2019. Cardiovascular diseases remain the leading cause of disease burden in the world. CVD burden continues its decades-long rise for almost all countries outside high-income countries, and alarmingly, the age-standardized rate of CVD has begun to rise in some locations where it was previously declining in high-income countries. There is an urgent need to focus on implementing existing cost-effective policies and interventions if the world is to meet the targets for Sustainable Development Goal 3 and achieve a 30% reduction in premature mortality due to noncommunicable diseases.
Introduction Coronavirus disease 2019 (COVID-19) is an emerging respiratory infections and is known to cause illness ranging from the common cold to severe acute respiratory syndrome. At present, the disease has been posing a serious threat to the communities, and it is critical to know the communities’ level of adherence on COVID-19 prevention measures. Thus, this study aimed to identify the predictors of adherence to COVID-19 prevention measure among communities in North Shoa zone, Ethiopia by using a health belief model. Methods Community-based cross-sectional study design was employed. A total of 683 respondents were interviewed using a structured and pre-tested questionnaire. The data were collected by using a mobile-based application called “Google form.” Logistic regression was performed to analyze the data. Estimates were reported in adjusted odds ratios with 95% confidence intervals (CI) and a significant association was declared at p-value of less than 0.05. Result The overall adherence level of the community towards the recommended safety measures of COVID-19 was 44.1%. Self-efficacy (AOR = 0.23; 95% 0.14, 0.36), perceived benefits (AOR = 0.35; 95% 0.23, 0.56), perceived barriers (AOR = 3.36; 95% 2.23, 5.10), and perceived susceptibility of COVID-19 (AOR = 1.60; 95% 1.06, 2.39) were important predictors that influenced the adherence of the community to COVID-19 preventive behaviors. Conclusions In this study, the overall adherence level of the community towards the recommended safety measures of COVID-19 was relatively low. It is vital to consider the communities’ self-efficacy, perceived benefits, perceived barriers and perceived susceptibility of COVID-19 in order to improve the adherence of the community towards the recommended safety measures of COVID-19.
BackgroundIn spite of the availability of guidelines for the management of severe acute malnutrition (SAM) in Ethiopia, high comorbidity and poor treatment outcomes are still observed in therapeutic feeding centers among under -five children with SAM. The aim of this study was to assess comorbidity, treatment outcomes and factors affecting the recovery rate of children aged 1–59 months with SAM admitted into Therapeutic Feeding Centers (TFCs).MethodsA total of 413 records of children with SAM admitted in three selected hospitals from July 2013 to July 2015 G.C were retrospectively reviewed. Descriptive analysis was used to compare performance indicator values with SPHERE project reference standards (the minimum standard to be attained during nutritional therapy). Cox-proportional hazard regression analysis was performed to estimate the predictors of recovery rate at p-value < 0.05.ResultThe mean age of children was 16 months (95% CI, 15.0, 17.0). Out of 413 children with SAM, 231 (55.9%) recovered, 24 (5.8%) died and 16.3% were defaulted from TFCs. The mean weight gain (in gram per weight of kilogram per day) for recovered children was 15.61 g/kg/day (95% CI, 14.15, 17.07). The overall median recovery time for these children was 12 days (95% CI, 11.22, 12.78). Moreover, most (77.5%) of children admitted with SAM were marasmic followed by Kwash (16%). Pneumonia (54.8%), diarrhea (41.8%) and rickets (21.4%) were co-morbidities which affected SAM children. A child being admitted at Mehal Meda Hospital (Adjusted Hazard Ratio (AHR) = 2.01; 95% CI: 1.34, 2.91), edematous form of malnutrition (AHR = 0.59; 95% CI: 0.39, 0.90) and being a child infected with pneumonia (AHR = 0.71; 95% CI: 0.51, 0.98) were predictors of nutritional recovery rate.ConclusionUnder five pneumonia, diarrhea and rickets were co-morbidities that should be prevented. Recovery rate was poor when compared to SPHERE project reference value (which is > 75%). Predictors, namely presence of pneumonia and edematous form of malnutrition reduced nutritional recovery rate. Whereas, being admitted at Mehal Meda Hospital improved recovery rate. Therefore, hospitals should work in collaboration with health extension workers to prevent co-morbidities and strengthen screening and referral of malnutrition cases at community level. Moreover, Zonal Health Department and District Health Offices should facilitate experience sharing among health facilities.
Background. Cervical cancer is a major public health problem in many developing countries. Despite the value of screening to prevent morbidity and mortality from cervical cancer, little available literature shows early detection and treatment to be limited in Ethiopia. The aim of this study was to determine the magnitude of and identify factors associated with women’s intention to screen for cervical cancer using the theory of planned behavior. Methods. A community-based cross-sectional study design supplemented with a qualitative approach was employed. Using multistage sampling, a total of 821 women were used in the study. An interviewer-administered survey questionnaire was used to collect quantitative data, whereas purposively selected 12 female health care providers were included in in-depth interviews. Descriptive statistics and simple and multiple binary logistic regression analysis were used to determine the magnitude of women’s intention, identify associated factors, and explore barriers for intention to cervical cancer screening among Debre Berhan women, Ethiopia. The statistical association was determined at a P value of less than 0.05. Moreover, thematic analysis was used to search the hindrances of women’s intention to screen for cervical cancer. Results. The median age of women who participated in this study was 39 years with IQR of 35 to 42 years. Three hundred sixty-one (361, 45.3%) of women had an intention to screen for cervical cancer within three months from the date of the interview. Positive attitude towards cervical cancer screening (AOR=6.164; 95% CI: 4.048, 9.387), positive subjective norm (AOR=2.001; 95% CI: 1.342, 2.982), and higher perceived behavioral control (AOR=7.105; 95% CI: 4.671, 10.807) were predictors of the women’s intention to screen for cervical cancer. The qualitative finding revealed that women did not like to be screened for cervical cancer because they thought that procedure pinch the cervix and it may result in perforating the uterus that would expose them for infertility. In addition, the qualitative findings supported quantitative results, where the constructs of the theory of planned behavior play an essential role in the betterment of women’s intention. Conclusion. This study showed that women’s intention to screen for cervical cancer was low. Positive attitudes towards cervical cancer screening (CCS), subjective norms, and perceived behavioral control were predictors of women’s intention to screen for cervical cancer. Thus, efforts should be exerted to improve the attitude of women involving influential people, which could improve women’s intention for cervical cancer screening. Moreover, behavioral change communication focusing on the constructs of the theory of planned behavior is crucial.
Background. The new advances for the treatment of HIV infection using Highly Active Antiretroviral Therapy (HAART) have dramatically improved disease prognosis. However, they are living longer with a chronic condition that increases the risk for psychiatric and psychosocial problems. Various studies have linked HIV/AIDS with a number of psychological problems, depression being the most common. Moreover, studies have found that chronically ill people are at increased risk of psychological problems. Thus, this study aimed at assessing the level of psychological distress and its associated factors among people living with HIV/AIDS in selected Hospitals of North Sowa Zone of Amhara region, Ethiopia, 2017. Method. Institution based cross-sectional study design with systematic random sampling method was used. Data was collected by structured interviewer-based Amharic version questionnaire. A total of 422 people living with HIV/AIDS were involved in the study from 1 to 30 May 2017. Data analysis was done with the help of a computer program (SPSS version 16.0). Binary logistic regression analysis was used for bivariate and multivariate analysis. The strength of the association was presented by odds ratio with a 95% confidence interval. Result. The prevalence of psychological distress was 7.8% (95% CI: 5.25%, 10.39%). Being female (AOR = 3.02; 95% CI: 1.16, 7.82), illiterates (AOR = 3.91; 95% CI: 1.31, 6.45), participants who currently use alcohol (AOR = 2.70; 95% CI: 1.23, 5.88), respondents whose CD4 count is less than 500 cells/μl (AOR = 2.28; 95% CI: 1.02, 5.11), and participants who are considered stigmatized (AOR = 2.41; 95% CI: 1.11, 5.22) were positively associated with psychological distress. Conclusion. The prevalence of psychological distress was low as compared to other studies conducted in Ethiopia. This may affect the quality of life of people living with HIV/AIDS and their families. Being female, illiteracy, alcohol use, and having lower CD4 count and perceived stigma increased the odds of psychological distress. Thus, concerned stakeholders should collaborate on the integration of HIV/AIDs treatment and mental health services.
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