BackgroundFew studies have examined associations between access to health care and childhood vaccine coverage in remote communities that lack motorised transport. This study assessed whether travel time to health facilities was associated with childhood vaccine coverage in a remote area of Ethiopia.MethodsThis was a cross-sectional study using data from 775 children aged 12–59 months who participated in a household survey between January –July 2010 in Dabat district, north-western Ethiopia. 208 households were randomly selected from each kebele. All children in a household were eligible for inclusion if they were aged between 12–59 months at the time of data collection. Travel time to vaccine providers was collected using a geographical information system (GIS). The primary outcome was the percentage of children in the study population who were vaccinated with the third infant Pentavalent vaccine ([Diphtheria, Tetanus,-Pertussis Hepatitis B, Haemophilus influenza type b] Penta3) in the five years before the survey. We also assessed effects on BCG, Penta1, Penta2 and Measles vaccines. Analysis was conducted using Poisson regression models with robust standard error estimation and the Wald test.ResultsMissing vaccination data ranged from 4.6% (36/775) for BCG to 16.4% (127/775) for Penta3 vaccine. In children with complete vaccination records, BCG vaccine had the highest coverage (97.3% [719/739]), Penta3 coverage was (92.9% [602/648]) and Measles vaccine had the lowest coverage (81.7% [564/690]). Children living ≥60mins from a health post were significantly less likely (adjRR = 0.85 [0.79-0.92] p value < =0.001) to receive Penta3 vaccine compared to children living <30mins from a health post. This effect was not modified by household wealth (p value = 0.240). Travel time also had a highly significant association with BCG (adjRR = 0.95 [0.93-0.98] p value =0.002) and Measles (adjRR = 0.88 [0.79-0.97] p value =0.027) vaccine coverage.ConclusionsTravel time to vaccine providers in health posts appeared to be a barrier to the delivery of infant vaccines in this remote Ethiopian community. New vaccine delivery strategies are needed for the hardest to reach children in the African region.
BackgroundThere is paucity of data on the dietary intake and nutritional status of urban Ethiopians which necessitates comprehensive nutritional assessments. Therefore, the present study was aimed at evaluating the dietary intake and nutritional status of urban residents in Northwest Ethiopia.MethodsThis cross-sectional community based nutrition survey was conducted by involving 356 participants (71.3% female and 28.7% male with mean age of 37.3 years). Subjects were selected by random sampling. Socio demographic data was collected by questionnaire. Height, weight, hip circumference and waist circumference were measured following standard procedures. Dietary intake was assessed by a food frequency questionnaire and 24-h dietary recall. The recommended dietary allowance was taken as the cut-off point for the assessment of the adequacy of individual nutrient intake.ResultsUndernourished, overweight and obese subjects composed 12.9%, 21.3% and 5.9% of the participants, respectively. Men were taller, heavier and had higher waist to hip ratio compared to women (P < 0.05). Fish, fruits and vegetables were consumed less frequently or never at all by a large proportion of the subjects. Oil and butter were eaten daily by most of the participants. Mean energy intakes fell below the estimated energy requirements in women (1929 vs 2031 kcal/day, P = 0.05) while it was significantly higher in men participants (3001 vs 2510 kcal/day, P = 0.007). Protein intake was inadequate (<0.8 g/kg/day) in 11.2% of the participants whereas only 2.8% reported carbohydrate intake below the recommended dietary allowances (130 g/day). Inadequate intakes of calcium, retinol, thiamin, riboflavin, niacin and ascorbic acid were seen in 90.4%, 100%, 73%, 92.4%, 86.2% and 95.5% of the participants.ConclusionsThe overall risk of nutritional inadequacy among the study participants was high along with their poor dietary intake. Hence, more stress should be made on planning and implementing nutritional programmes in urban settings aimed at preventing or correcting micronutrient and some macronutrient deficiencies which may be useful in preventing nutrition related diseases in life.
Despite the growing importance of fertility issues for HIV-infected persons, little is known about their actual fertility desires and intentions. This study was, therefore, aimed at assessing fertility desires and demand for family planning in HIV-positive clients in follow-up care at antiretroviral treatment (ART) unit in Gondar University Hospital, Ethiopia. A cross sectional quantitative study on 389 study subjects (56% females and 44% males living with HIV/AIDS in follow-up care) supplemented by in-depth interview was conducted between November 2007 and January 2008. Eighty-five (49.71%) of the male and seventy-nine (36.3%) of the female participants expressed the desire for children, giving a total of 164 (42.16%) of all participants. Study subjects who had no children and whose partners wants children were more likely to have children desire. During the survey period, 100 (25.7%) of the clients were using different forms of family planning devices and 124 (42.9%) wants to use family planning in the future. The extent of fertility desire and family planning needs of these people has implication for vertical and heterosexual transmission of HIV, the needs for fertility-related counselling, and/or contraception, and advice regarding childbirth.
Background: The high prevalence of diarrheal disease among children and infants can be traced to the use of unsafe water and unhygienic practices. The over all concept adopted for microbiological quality is that no water intended for human consumption shall contain E. coli in 100 ml sample. But, a 1-10 E.coli count per 100 ml is acceptable that needs regular sanitary checks for un chlorinated water. Objectives: To assess the extent of bacterial contamination among protected and unprotected water sources. Methods: A cross-sectional study on drinking water quality in North Gondar region was conducted from May to June 2000. Water samples were taken for bacteriological analysis. Results: Analysis of protected springs, protected wells and water lines showed that 35.7%, 28.6% and 50% of the water samples had E. coli, respectively. On the other hand, 50% of the unprotected wells and springs had a fecal coliform count of 180 and above. Conclusions: The majority of the drinking water sources are either of unacceptable quality or grossly polluted. Regular quality control mechanisms need to be in place to ensure safety of drinking water.
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