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Article ; Online: Prevalence and Barriers to Ending Female Genital Cutting: The Case of Afar and Amhara Regions of Ethiopia.

Abebe, Sintayehu / Dessalegn, Muluken / Hailu, Yeshitila / Makonnen, Misrak

International journal of environmental research and public health

2020 Volume 17, Issue 21

Abstract: Female genital cutting (FGC) remains highly prevalent in Ethiopia, in spite of a slowly decreasing trend over the last decade. In an effort to inform and strengthen FGC interventions in Ethiopia, this study aimed to assess FGC prevalence in cross- ... ...

Abstract	Female genital cutting (FGC) remains highly prevalent in Ethiopia, in spite of a slowly decreasing trend over the last decade. In an effort to inform and strengthen FGC interventions in Ethiopia, this study aimed to assess FGC prevalence in cross-administrative border* districts and to explore barriers to ending FGC. A mixed methods, cross-sectional study was employed in three districts in the Afar and Amhara regions in Ethiopia. A sample of 408 women with female children under the age of 15 were included in the study. Additionally, 21 key informant interviews and three focus group discussions were held with local government officials and community stakeholders. The study found that the prevalence of FGC among mothers interviewed was 98%. Seventy-four percent of the female children of participants had undergone FGC. Of the youngest (last born) female children, 64.7% had experienced FGC. The participation of respondents in cross-administrative FGC practices ranged from 4% to 17%. Quantitative analysis found that knowledge and attitude towards FGC, level of literacy, place of residence, and religious denomination were associated with FGC practice. The study also found that the lack of participatory involvement of local women in programs that aim to end FGC and the lack of suitable legal penalties for those who practice FGC exacerbate the problem. A significant proportion of participants support the continuation of FGC practices in their communities. This finding indicates that FGC practice is likely to persist unless new approaches to intervention are implemented. It is recommended that a comprehensive response that couples community empowerment with strong enforcement of legislation is administered in order to effectively end FGC in Ethiopia by 2025, in alignment with the national plan against Harmful Traditional Practices. * Cross-administrative border means a border between two regional states in Ethiopia. In this document, it refers to the movement of people between Amhara and Afar regional states.
MeSH term(s)	Attitude ; Child ; Circumcision, Female/statistics & numerical data ; Cross-Sectional Studies ; Emigration and Immigration ; Ethiopia/epidemiology ; Female ; Focus Groups ; Humans ; Male ; Prevalence
Language	English
Publishing date	2020-10-29
Publishing country	Switzerland
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ISSN	1660-4601
ISSN (online)	1660-4601
DOI	10.3390/ijerph17217960
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Trends of preeclampsia/eclampsia and maternal and neonatal outcomes among women delivering in addis ababa selected government hospitals, Ethiopia: a retrospective cross-sectional study.

Wagnew, Maereg / Dessalegn, Muluken / Worku, Alemayehu / Nyagero, Josephat

The Pan African medical journal

2016 Volume 25, Issue Suppl 2, Page(s) 12

Abstract: Introduction: The burden of preeclampsia has been a major concern worldwide, particularly in developing countries such as Ethiopia. Preeclampsia is associated with substantial maternal complications, both acute and long-term. The aim of this research ... ...

Abstract	Introduction: The burden of preeclampsia has been a major concern worldwide, particularly in developing countries such as Ethiopia. Preeclampsia is associated with substantial maternal complications, both acute and long-term. The aim of this research was to determine the magnitude and trends of preeclampsia/ eclampsia, maternal complications, and neonatal complications among women delivering babies at selected government hospitals in Ethiopia. Methods: Data were collected retrospectively by reviewing the five-year medical records for 2009 to 2013, using data abstraction tools, to identify mothers with preeclampsia/eclampsia. A total of 1,809 cases were reviewed for general characteristics of the mother, delivery details, and any complications. Descriptive analyses were employed. In addition, extended Mantel Haenszel chi square for linear trend was used to check for significance of the trends. Results: The five year average proportion of preeclampsia/eclampsia was 4.2% (95%CI 4.02%, 4.4%). The proportion of women with preeclampsia was 2.2% in 2009 and increased to 5.58% in 2013 (p<0.001), which was a 154% increase. Of the 1,809 mothers with preeclampsia/eclampsia, 36% (95%CI 33.85%, 38.28%) experienced at least one maternal complication; there was an increase of 26.5% (p<0.01) over the five year period. The main complications were HELLP (variant of preeclampsia with hemolysis, elevated liver enzymes, and low platelet count) syndrome, 257 (39.5%); aspiration pneumonia, 114 (17.5%); pulmonary edema, 114 (17.5%); and abruption placentae, 100 (15.3%). At least one neonatal complication occurred in 66.4% (95%CI 64.24%, 68.59%) of deliveries during the five-year study. A decreasing trend in neonatal complications was observed from 2009 (76%) to 2013 (66%), which showed a percentage change over time of negative 13.2%. The most common neonatal complications were stillbirths, which accounted for 363 (30.2%); prematurity, with 395 (32.8%); respiratory distress syndrome, with 456 (37.9%); and low birth weight, with 363 (30.2%). Conclusion: There was an increasing trend of preeclampsia/eclampsia and maternal complications over a five year period in selected maternity governmental hospitals. In contrast, neonatal complications experienced a significant decrease over the five-year period. It is essential to raise awareness among mothers in the community regarding early signs and symptoms of preeclampsia/eclampsia and to design a better tracking system for antenatal care programs.
MeSH term(s)	Adult ; Cross-Sectional Studies ; Eclampsia/epidemiology ; Ethiopia/epidemiology ; Female ; HELLP Syndrome/epidemiology ; Humans ; Infant, Newborn ; Infant, Newborn, Diseases/epidemiology ; Pre-Eclampsia/epidemiology ; Pregnancy ; Pregnancy Complications/epidemiology ; Retrospective Studies ; Young Adult
Language	English
Publishing date	2016
Publishing country	Uganda
Document type	Journal Article
ZDB-ID	2514347-5
ISSN	1937-8688 ; 1937-8688
ISSN (online)	1937-8688
ISSN	1937-8688
DOI	10.11604/pamj.supp.2016.25.2.9716
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Article ; Online: Gender Inequality and the Sexual and Reproductive Health Status of Young and Older Women in the Afar Region of Ethiopia.

Dessalegn, Muluken / Ayele, Mhiret / Hailu, Yeshitila / Addisu, Genetu / Abebe, Sintayehu / Solomon, Haset / Mogess, Geteneh / Stulz, Virginia

International journal of environmental research and public health

2020 Volume 17, Issue 12

Abstract: The main purpose of this research was to analyze gender context in the Afar region of Ethiopia and propose a set of strategies or actions to improve adolescent and youth health. Using a pre-established gender analysis framework, an explorative ... ...

Abstract	The main purpose of this research was to analyze gender context in the Afar region of Ethiopia and propose a set of strategies or actions to improve adolescent and youth health. Using a pre-established gender analysis framework, an explorative qualitative study was conducted in five districts. Sixteen key informants and eight focus group discussions were conducted among adult women and men of young adolescents and youth. The study revealed that younger and older women are the most disadvantaged groups of the society. This is due to the high workload on women and girls (housekeeping, building a house and taking care of cattle and children), they also are less valued, have no control over resources and have no part in decision making, including their personal life choices. As a result, they rarely access school and health facilities. They are forced get married according to arranged marriage called "absuma." As such, they suffer from multiple reproductive health problems. Women have poor decision-making autonomy, lack control over resources, have limited participation in socio-economic practices, and experience child and early forced marriage, and this poor service utilization has exposed them to the worst sexual and reproductive health outcomes.
MeSH term(s)	Adolescent ; Adult ; Aged ; Child ; Ethiopia ; Female ; Health Status Disparities ; Humans ; Reproduction ; Reproductive Health ; Sexism ; Sexual Health ; Socioeconomic Factors ; Women's Health
Language	English
Publishing date	2020-06-26
Publishing country	Switzerland
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ISSN	1660-4601
ISSN (online)	1660-4601
DOI	10.3390/ijerph17124592
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Article ; Online: Predictors of multidrug resistant tuberculosis among adult patients at Saint Peter Hospital Addis Ababa, Ethiopia.

Dessalegn, Muluken / Daniel, Ermias / Behailu, Sileshi / Wagnew, Maereg / Nyagero, Josephat

The Pan African medical journal

2016 Volume 25, Issue Suppl 2, Page(s) 5

Abstract: Introduction: The emergence of multi-drug resistant tuberculosis (MDR-TB) has become a major public health concern that threatens advances made in global TB control efforts. Though the problem is prevalent, it did not receive major attention to generate ...

Abstract	Introduction: The emergence of multi-drug resistant tuberculosis (MDR-TB) has become a major public health concern that threatens advances made in global TB control efforts. Though the problem is prevalent, it did not receive major attention to generate supportive evidence for the prevention and control of MDR-TB. The aim of this study was to identify predictors of MDR-TB in a national TB referral centre in Ethiopia. Methods: An unmatched, case-control study was conducted at St. Peter Hospital to assess risk factors associated with MDR-TB. The study included 103 culture proven, MDR-TB patients referred to the hospital during the study period (cases) and 103 randomly-selected TB patients with confirmed TB who turned negative after treatment (controls). Regressions analyses were used to determine the association of variables. Results: The mean age among cases and controls was 30.5 (±9.26) and 34.73 (±11.28) years, respectively. The likelihood of having MDR-TB was 20.3 times higher among those who had a any previous history of TB treatment (AOR=20.3 [CI 5.13, 80.58]), 15.7 times higher among those who had TB more than once (AOR=15.7 [CI 4.18, 58.71]) compared those who had once, 6.8 times higher among those who had pulmonary TB (AOR=6.8 [CI 1.16, 40.17]) and 16.1 times higher for those who had experienced treatment with a Category II regimen (AOR=16.1 [CI 2.40, 108.56]). HIV infection was less common among cases than controls. Conclusion: This study concluded that special attention should be given to patients with a history of the following: TB more than once, presence of pulmonary TB, and used a Category II treatment regimen, as these were all determining factors for MDR-TB. Thus, this study urges the development and implementation of well-planned and integrated strategies for MDR-TB control and prevention in Ethiopia.
MeSH term(s)	Adult ; Antitubercular Agents/administration & dosage ; Antitubercular Agents/pharmacology ; Case-Control Studies ; Ethiopia/epidemiology ; Female ; HIV Infections/epidemiology ; Humans ; Male ; Middle Aged ; Prevalence ; Regression Analysis ; Risk Factors ; Tuberculosis, Multidrug-Resistant/drug therapy ; Tuberculosis, Multidrug-Resistant/epidemiology ; Tuberculosis, Multidrug-Resistant/microbiology ; Tuberculosis, Pulmonary/drug therapy ; Tuberculosis, Pulmonary/epidemiology ; Young Adult
Chemical Substances	Antitubercular Agents
Language	English
Publishing date	2016-11-26
Publishing country	Uganda
Document type	Journal Article
ZDB-ID	2514347-5
ISSN	1937-8688 ; 1937-8688
ISSN (online)	1937-8688
ISSN	1937-8688
DOI	10.11604/pamj.supp.2016.25.2.9203
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Article ; Online: Reproductive health service utilization and associated factors: the case of north Shewa zone youth, Amhara region, Ethiopia.

Negash, Wassie / Dessalegn, Muluken / Yitayew, Berhanu / Demsie, Mohammed / Wagnew, Maereg / Nyagero, Josephat

The Pan African medical journal

2016 Volume 25, Issue Suppl 2, Page(s) 3

Abstract: Introduction: Many youth are less informed, less experienced and less comfortable in utilizing reproductive health services. In the Sub-Saharan region the adolescents account for a higher proportion of new HIV infections and unmet need for reproductive ... ...

Abstract	Introduction: Many youth are less informed, less experienced and less comfortable in utilizing reproductive health services. In the Sub-Saharan region the adolescents account for a higher proportion of new HIV infections and unmet need for reproductive health (RH) services. This study assessed reproductive health service utilization and associated factors among the youth in Amhara Region, Ethiopia. Methods: A community based cross-sectional study was conducted from June 15-July 30, 2014. Three hundred ninety one youth were selected by systematic random sampling technique and interviewed using structured questionnaire. Data were anlyzed using SPSS windows version 20. Multiple logistic regression was done to control potential confounding variables. P-values <0.05 were considered statistically significant. Results: Three hundred and nighty one in-school and out-of-school youth were interviewed; 256 (65.5%) participants were in school and 209 (53.5%) were males. Almost all respondents (93.9%) had heard about reproductive health services and a third 129 (33%) had ever practiced sexual intercourse and 54.7% of them had utilized at least one reproductive health services. Never had sexual intercourse (AOR=3.693, 95%CI: 1.266, 10.775), families that asked their children about friends (parental monitoring) (AOR=1.892, 95%CI: 1.026, 3.491), know where service provided (AOR=3.273, 95%CI: 1.158, 9.247), youths who reads newspaper readers (AOR=3.787, 95%CI: 1.849were independent predictors of youth reproductive service utilization at 95 % CI and p-value <0.05%. Conclusion: Even though the youth have information about reproductive health services, youth reproductive health services utilization is very low. Therefore, building life skill, facilitating parent to child communication, establishing and strengthening of youth centres and increasing awareness for youth about those services are important steps to improve adolescents' reproductive health (RH) service utilization.
MeSH term(s)	Adolescent ; Cross-Sectional Studies ; Ethiopia ; Female ; Health Knowledge, Attitudes, Practice ; Health Services Needs and Demand ; Humans ; Logistic Models ; Male ; Parent-Child Relations ; Patient Acceptance of Health Care/statistics & numerical data ; Reproductive Health Services/utilization ; Schools ; Sexual Behavior/statistics & numerical data ; Students/statistics & numerical data ; Surveys and Questionnaires ; Young Adult
Language	English
Publishing date	2016
Publishing country	Uganda
Document type	Journal Article
ZDB-ID	2514347-5
ISSN	1937-8688 ; 1937-8688
ISSN (online)	1937-8688
ISSN	1937-8688
DOI	10.11604/pamj.supp.2016.25.2.9712
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Article ; Online: Peer communication on sex and sexual health among youths: a case of Debre Berhan university, Ethiopia.

Gezahegn, Takele / Birhanu, Zewdie / Aman, Mamusha / Dessalegn, Muluken / Abera, Asmamaw / Nyagero, Josephat

The Pan African medical journal

2016 Volume 25, Issue Suppl 2, Page(s) 8

Abstract: Introduction: Friends are considered an important source of advice and information about sex. Conversations about sex among young people tend to generate norms that influence positive or negative pressure on individuals to conform to group standards. ... ...

Abstract	Introduction: Friends are considered an important source of advice and information about sex. Conversations about sex among young people tend to generate norms that influence positive or negative pressure on individuals to conform to group standards. The aim of the study was to explore peer communication on sex and sexual health. Methods: Grounded theory qualitative study design was employed using focus group discussions and participant observation. Participants were selected using criterion purposive sampling. Semi-structured guides and checklists were used as data collection tools. Information was audio-recorded and transcribed verbatim and uploaded to ATLAS.ti 7 software for coding. Data collection and analysis were undertaken simultaneously using constant comparative analysis. Results: Students talked with peers and sexual partners about sex more than sexual health issues. Common places of talk included dormitory, begtera (near dorm where students meet), and space (reading rooms). Whereas, time of talk, either in a group or with just their close friends or sex partners, included during training, evening and weekend time, during walking together, and break time. Students used verbal and non-verbal and formal and informal communication styles. Conclusion: The content, place, and time for discussions about sex were influenced by gender, social-cultural norms (e.g. religion), rural vs urban living, and the occurrence of sexual health issues (e.g, sexually-transmitted infections or unwanted pregnancies). Priority should be given to designing audience-specific strategies and messages to promote discussions about sex and to encourage safe sexual practices. Primary target groups should include female and rural students, who are predisposed to risky sexual behavior.
MeSH term(s)	Adult ; Communication ; Ethiopia ; Female ; Focus Groups ; Friends ; Grounded Theory ; Humans ; Male ; Peer Group ; Reproductive Health ; Risk-Taking ; Rural Population/statistics & numerical data ; Sexual Behavior/psychology ; Students/psychology ; Students/statistics & numerical data ; Urban Population/statistics & numerical data ; Young Adult
Language	English
Publishing date	2016
Publishing country	Uganda
Document type	Journal Article
ZDB-ID	2514347-5
ISSN	1937-8688 ; 1937-8688
ISSN (online)	1937-8688
ISSN	1937-8688
DOI	10.11604/pamj.supp.2016.25.2.9631
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Article ; Online: Tuberculosis Burden in Ethiopia from 1990 to 2016: Evidence from the Global Burden of Diseases 2016 Study.

Deribew, Amare / Deribe, Kebede / Dejene, Tariku / Tessema, Gizachew Assefa / Melaku, Yohannes Adama / Lakew, Yihune / Amare, Azmeraw T / Bekele, Tolessa / Abera, Semaw F / Dessalegn, Muluken / Kumsa, Andargachew / Assefa, Yibeltal / Kyu, Hmwe / Glenn, Scott D / Misganaw, Awoke / Biadgilign, Sibhatu

Ethiopian journal of health sciences

2019 Volume 28, Issue 5, Page(s) 519–528

Abstract: Background: The burden of Tuberculosis (TB) has not been comprehensively evaluated over the last 25 years in Ethiopia. In this study, we used the 2016 Global Burden of Diseases, Injuries and Risk Factors (GBD) data to analyze the incidence, prevalence ... ...

Abstract	Background: The burden of Tuberculosis (TB) has not been comprehensively evaluated over the last 25 years in Ethiopia. In this study, we used the 2016 Global Burden of Diseases, Injuries and Risk Factors (GBD) data to analyze the incidence, prevalence and mortality rates of tuberculosis (TB) in Ethiopia over the last 26 years. Methods: The GBD 2016 is a mathematical modeling using different data source for Ethiopia such as verbal autopsy (VA), prevalence surveys and annual case notifications. Age and sex specific causes of death for TB were estimated using the Cause of Death Ensemble Modeling (CODEm). We used the available data such as annual notifications and prevalence surveys as an input to estimate incidence and prevalence rates respectively using DisMod-MR 2.1, a Bayesian meta-regression tool. Results: In 2016, we estimated 219,186 (95%UI: 182,977-265,292) new, 151,602 (95% UI: 126,054-180,976) prevalent TB cases and 48,910(95% UI: 40,310-58,195) TB deaths. The age-standardized TB incidence rate decreased from 201.6/100,000 to 88.5/100,000 (with a total decline of 56%) between 1990 to 2016. Similarly, the age-standardized TB mortality rate declined from 393.8/100,000 to 100/100,000 between 1990 and 2016(with a total decline of 75%). Conclusions: Ethiopia has achieved the 50% reduction of most of the Millennium Development Goals (MDGs) targets related to TB. However, the decline of TB incidence and prevalence rates has been comparatively slow. The country should strengthen the TB case detection and treatment programs at community level to achieve its targets during the Sustainable Development Program (SDGs)-era.
MeSH term(s)	Age Factors ; Bayes Theorem ; Cause of Death ; Ethiopia/epidemiology ; Female ; Global Burden of Disease ; Global Health ; Humans ; Incidence ; Male ; Prevalence ; Research Design ; Risk Factors ; Tuberculosis/epidemiology ; Tuberculosis/etiology ; Tuberculosis/mortality
Language	English
Publishing date	2019-01-03
Publishing country	Ethiopia
Document type	Journal Article
ZDB-ID	2705970-4
ISSN	2413-7170 ; 2413-7170
ISSN (online)	2413-7170
ISSN	2413-7170
DOI	10.4314/ejhs.v28i5.2
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Article ; Online: The Burden of HIV/AIDS in Ethiopia from 1990 to 2016: Evidence from the Global Burden of Diseases 2016 Study.

Deribew, Amare / Biadgilign, Sibhatu / Deribe, Kebede / Dejene, Tariku / Tessema, Gizachew Assefa / Melaku, Yohannes Adama / Lakew, Yihune / Amare, Azmeraw T / Bekele, Tolessa / Abera, Semaw F / Dessalegn, Muluken / Kumsa, Andargachew / Assefa, Yibeltal / Glenn, Scott D / Frank, Tahvi / Carter, Austin / Misganaw, Awoke / Wang, Haidong

Ethiopian journal of health sciences

2018 Volume 29, Issue 1, Page(s) 859–868

Abstract: Background: The burden of HIV/AIDS in Ethiopia has not been comprehensively assessed over the last two decades. In this study, we used the 2016 Global Burden of Diseases, Injuries and Risk factors (GBD) data to analyze the incidence, prevalence, ... ...

Abstract	Background: The burden of HIV/AIDS in Ethiopia has not been comprehensively assessed over the last two decades. In this study, we used the 2016 Global Burden of Diseases, Injuries and Risk factors (GBD) data to analyze the incidence, prevalence, mortality and Disability-adjusted Life Years Lost (DALY) rates of Human Immunodeficiency Virus / Acquired Immune Deficiency Syndrome (HIV/AIDS) in Ethiopia over the last 26 years. Methods: The GBD 2016 used a wide range of data source for Ethiopia such as verbal autopsy (VA), surveys, reports of the Federal Ministry of Health and the United Nations (UN) and published scientific articles. The modified United Nations Programme on HIV/AIDS (UNAIDS) Spectrum model was used to estimate the incidence and mortality rates for HIV/AIDS. Results: In 2016, an estimated 36,990 new HIV infections (95% uncertainty interval [UI]: 8775-80262), 670,906 prevalent HIV cases (95% UI: 568,268-798,970) and 19,999 HIV deaths (95% UI: 16426-24412) occurred in Ethiopia. The HIV/AIDS incidence rate peaked in 1995 and declined by 6.3% annually for both sexes with a total reduction of 77% between 1990 and 2016. The annualized HIV/AIDS mortality rate reduction during 1990 to 2016 for both sexes was 0.4%. Conclusions: Ethiopia has achieved the 50% reduction of the incidence rate of HIV/AIDS based on the Millennium Development Goals (MDGs) target. However, the decline in HIV/AIDS mortality rate has been comparatively slow. The country should strengthen the HIV/AIDS detection and treatment programs at community level to achieve its targets during the Sustainable Development Program (SDGs)-era.
MeSH term(s)	Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Cost of Illness ; Ethiopia/epidemiology ; Female ; Global Burden of Disease/statistics & numerical data ; HIV Infections/epidemiology ; Humans ; Incidence ; Infant ; Male ; Middle Aged ; Prevalence ; Risk Factors ; Young Adult
Language	English
Publishing date	2018-12-30
Publishing country	Ethiopia
Document type	Journal Article
ZDB-ID	2705970-4
ISSN	2413-7170 ; 2413-7170
ISSN (online)	2413-7170
ISSN	2413-7170
DOI	10.4314/ejhs.v29i1.7
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Article ; Online: National mortality burden due to communicable, non-communicable, and other diseases in Ethiopia, 1990-2015: findings from the Global Burden of Disease Study 2015.

Population health metrics

2017 Volume 15, Page(s) 29

Abstract: Background: Ethiopia lacks a complete vital registration system that would assist in measuring disease burden and risk factors. We used the Global Burden of Diseases, Injuries, and Risk Factors Study 2015 (GBD 2015) estimates to describe the mortality ... ...

Abstract	Background: Ethiopia lacks a complete vital registration system that would assist in measuring disease burden and risk factors. We used the Global Burden of Diseases, Injuries, and Risk Factors Study 2015 (GBD 2015) estimates to describe the mortality burden from communicable, non-communicable, and other diseases in Ethiopia over the last 25 years. Methods: GBD 2015 mainly used cause of death ensemble modeling to measure causes of death by age, sex, and year for 195 countries. We report numbers of deaths and rates of years of life lost (YLL) for communicable, maternal, neonatal, and nutritional (CMNN) disorders, non-communicable diseases (NCDs), and injuries with 95% uncertainty intervals (UI) for Ethiopia from 1990 to 2015. Results: CMNN causes of death have declined by 65% in the last two-and-a-half decades. Injury-related causes of death have also decreased by 70%. Deaths due to NCDs declined by 37% during the same period. Ethiopia showed a faster decline in the burden of four out of the five leading causes of age-standardized premature mortality rates when compared to the overall sub-Saharan African region and the Eastern sub-Saharan African region: lower respiratory infections, tuberculosis, HIV/AIDS, and diarrheal diseases; however, the same could not be said for ischemic heart disease and other NCDs. Non-communicable diseases, together, were the leading causes of age-standardized mortality rates, whereas CMNN diseases were leading causes of premature mortality in 2015. Although lower respiratory infections, tuberculosis, and diarrheal disease were the leading causes of age-standardized death rates, they showed major declines from 1990 to 2015. Neonatal encephalopathy, iron-deficiency anemia, protein-energy malnutrition, and preterm birth complications also showed more than a 50% reduction in burden. HIV/AIDS-related deaths have also decreased by 70% since 2005. Ischemic heart disease, hemorrhagic stroke, and ischemic stroke were among the top causes of premature mortality and age-standardized death rates in Ethiopia in 2015. Conclusions: Ethiopia has been successful in reducing deaths related to communicable, maternal, neonatal, and nutritional deficiency diseases and injuries by 65%, despite unacceptably high maternal and neonatal mortality rates. However, the country's performance regarding non-communicable diseases, including cardiovascular disease, diabetes, cancer, and chronic respiratory disease, was minimal, causing these diseases to join the leading causes of premature mortality and death rates in 2015. While the country is progressing toward universal health coverage, prevention and control strategies in Ethiopia should consider the double burden of common infectious diseases and non-communicable diseases: lower respiratory infections, diarrhea, tuberculosis, HIV/AIDS, cardiovascular disease, cancer, and diabetes. Prevention and control strategies should also pay special attention to the leading causes of premature mortality and death rates caused by non-communicable diseases: cardiovascular disease, cancer, and diabetes. Measuring further progress requires a data revolution in generating, managing, analyzing, and using data for decision-making and the creation of a full vital registration system in the country.
MeSH term(s)	Adult ; Cause of Death ; Child ; Communicable Diseases/mortality ; Ethiopia/epidemiology ; Female ; Global Burden of Disease ; Global Health ; Humans ; Infant ; Infant Mortality/trends ; Infant, Newborn ; Infant, Newborn, Diseases/mortality ; Maternal Mortality/trends ; Mortality, Premature/trends ; Noncommunicable Diseases/mortality ; Pregnancy ; Pregnancy Complications/mortality ; Wounds and Injuries/mortality
Language	English
Publishing date	2017-07-21
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2127230-X
ISSN	1478-7954 ; 1478-7954
ISSN (online)	1478-7954
ISSN	1478-7954
DOI	10.1186/s12963-017-0145-1
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Article ; Online: National disability-adjusted life years (DALYs) for 257 diseases and injuries in Ethiopia, 1990-2015: findings from the global burden of disease study 2015.

Population health metrics

2017 Volume 15, Issue 1, Page(s) 28

Abstract: Background: Disability-adjusted life years (DALYs) provide a summary measure of health and can be a critical input to guide health systems, investments, and priority-setting in Ethiopia. We aimed to determine the leading causes of premature mortality ... ...

Abstract	Background: Disability-adjusted life years (DALYs) provide a summary measure of health and can be a critical input to guide health systems, investments, and priority-setting in Ethiopia. We aimed to determine the leading causes of premature mortality and disability using DALYs and describe the relative burden of disease and injuries in Ethiopia. Methods: We used results from the Global Burden of Diseases, Injuries, and Risk Factors Study 2015 (GBD 2015) for non-fatal disease burden, cause-specific mortality, and all-cause mortality to derive age-standardized DALYs by sex for Ethiopia for each year. We calculated DALYs by summing years of life lost due to premature mortality (YLLs) and years lived with disability (YLDs) for each age group and sex. Causes of death by age, sex, and year were measured mainly using Causes of Death Ensemble modeling. To estimate YLDs, a Bayesian meta-regression method was used. We reported DALY rates per 100,000 for communicable, maternal, neonatal, and nutritional (CMNN) disorders, non-communicable diseases, and injuries, with 95% uncertainty intervals (UI) for Ethiopia. Results: Non-communicable diseases caused 23,118.1 (95% UI, 17,124.4-30,579.6), CMNN disorders resulted in 20,200.7 (95% UI, 16,532.2-24,917.9), and injuries caused 3781 (95% UI, 2642.9-5500.6) age-standardized DALYs per 100,000 in Ethiopia in 2015. Lower respiratory infections, diarrheal diseases, and tuberculosis were the top three leading causes of DALYs in 2015, accounting for 2998 (95% UI, 2173.7-4029), 2592.5 (95% UI, 1850.7-3495.1), and 2562.9 (95% UI, 1466.1-4220.7) DALYs per 100,000, respectively. Ischemic heart disease and cerebrovascular disease were the fourth and fifth leading causes of age-standardized DALYs, with rates of 2535.7 (95% UI, 1603.7-3843.2) and 2159.9 (95% UI, 1369.7-3216.3) per 100,000, respectively. The following causes showed a reduction of 60% or more over the last 25 years: lower respiratory infections, diarrheal diseases, tuberculosis, neonatal encephalopathy, preterm birth complications, meningitis, malaria, protein-energy malnutrition, iron-deficiency anemia, measles, war and legal intervention, and maternal hemorrhage. Conclusions: Ethiopia has been successful in reducing age-standardized DALYs related to most communicable, maternal, neonatal, and nutritional deficiency diseases in the last 25 years, causing a major ranking shift to types of non-communicable disease. Lower respiratory infections, diarrheal disease, and tuberculosis continue to be leading causes of premature death, despite major declines in burden. Non-communicable diseases also showed reductions as premature mortality declined; however, disability outcomes for these causes did not show declines. Recently developed non-communicable disease strategies may need to be amended to focus on cardiovascular diseases, cancer, diabetes, and major depressive disorders. Increasing trends of disabilities due to neonatal encephalopathy, preterm birth complications, and neonatal disorders should be emphasized in the national newborn survival strategy. Generating quality data should be a priority through the development of new initiatives such as vital events registration, surveillance programs, and surveys to address gaps in data. Measuring disease burden at subnational regional state levels and identifying variations with urban and rural population health should be conducted to support health policy in Ethiopia.
MeSH term(s)	Adult ; Cause of Death ; Child ; Child, Preschool ; Communicable Diseases/mortality ; Cost of Illness ; Disabled Persons ; Ethiopia/epidemiology ; Female ; Global Burden of Disease ; Global Health ; Humans ; Infant ; Infant, Newborn ; Life Expectancy ; Male ; Mortality, Premature ; Noncommunicable Diseases/mortality ; Quality-Adjusted Life Years
Language	English
Publishing date	2017-07-21
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2127230-X
ISSN	1478-7954 ; 1478-7954
ISSN (online)	1478-7954
ISSN	1478-7954
DOI	10.1186/s12963-017-0146-0
Database	MEDical Literature Analysis and Retrieval System OnLINE

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