Papers by Fikrewold Bitew
Introduction: Nursing documentation is essential evidence-based work for nurses. One of the quali... more Introduction: Nursing documentation is essential evidence-based work for nurses. One of the qualities of a healthcare service delivery system has been measured using standard documentation practice. Hence, appropriate nursing documentation practice is crucial for legal value, patients, and communication for nurses and other disciplines, but limited reports in the study area. This study aimed to assess nursing documentation practice & associated factors among nurses working at the University of Gondar comprehensive specialized hospital, Gondar, Ethiopia, 2022. Methods:An institution-based quantitative supported by a qualitative study was conducted from June to July 2022 at the University of Gondar comprehensive specialized hospital. A simple random data collection technique was used for quantitative data. A pre-tested self-administered questionnaire & chart review were used for data collection. Two days of training were given to data collectors and supervisors. The data were cleaned,...
Environmental Pollution, 2021
Paratuberculosis-infected cattle initially develop an effective cell-mediated immune response tha... more Paratuberculosis-infected cattle initially develop an effective cell-mediated immune response that declines as the disease progresses. Blood is one of best sources for characterizing the inflammatory status of infected cows and for studying mediators related to chronic diseases. The aim of this study was to evaluate the cowlevel association between blood cytokine concentration, the influence of serum on immune cell proliferation, and dairy cows naturally infected with Mycobacterium avium ssp. paratuberculosis (MAP). Positive animals (n = 41) from 19 herds were selected on the basis of 2 positive fecal culture results and divided into 2 groups: single-positive, or serum ELISA-negative cows (n = 32), and double-positive, or cows that gave positive results for both mycobacterial culture and serum ELISA (n = 9). Negative animals (n = 39) were selected from paratuberculosis-negative herds in which at least 80% of the animals had been diagnosed as negative by fecal culture and ELISA and that did not produce positive results during the 2-yr study. Analysis of plasma levels of the cytokines IL-4, IL-10, IL-17, IFN-γ, and osteopontin was performed, revealing distinct patterns. The ELISApositive cows with MAP shedding had similar plasma concentrations of IL-4 and IL-10 but elevated levels of IFN-γ, IL-17, and osteopontin, which is indicative of inflammatory disease in these subclinical positive cows. In vitro MAP infection of bovine macrophages showed increased gene expression of tumor necrosis factor-α, IL-1β, IL-6, IL-23, and transforming growth factor-β as early as 6 h postinfection for all of the cytokines involved in the establishment of a T-helper type-17 immune response. To determine the systemic influence of serum on immune cell functions, lymphoproliferation assays were also performed in presence of JD serum. The serum from shedding cows showed 15% less proliferation. These results indicate that infected cows have a lower systemic capacity to maintain a protective immune response and that, as the disease progresses, an emerging T-helper type-17 immune response is established.
Background: The aim of this study is to examine individual and contextual factors associated with... more Background: The aim of this study is to examine individual and contextual factors associated with high-risk sexual behaviour in sub-Saharan Africa. Heterosexual relationships represent the major route of HIV/AIDS infection in Africa. Thus, understanding sexual behaviour is an essential step toward any effort to reduce the spread of the HIV/AIDS epidemic. Methods: We applied multilevel logistic regression analyses on Demographic and Health Survey (DHS) data for 262,727 respondents (level 1) nested with 10,914 communities (level 2) from 26 sub-Saharan countries (level 3). Results: In all 26 countries studied, men were significantly more likely than women to have reported premarital sex. Except for Congo and Ethiopia, men were also significantly more likely to have reported non-spousal sex. At the community and country levels, there was statistically significant clustering of reported high-risk sexual behaviour. The following individual factors were associated with higher odds of reporting premarital and non-spousal sex: male gender, higher educational attainment and higher wealth status. The following contextual factors were associated with higher odds of reporting premarital and non-spousal sex: ethnic diversity, urban residence and small household size. Conclusion: We found that community and societal measures of social disorganization are important predictors of high-risk sexual behaviour. Thus, interventions aimed at reducing highrisk sexual behaviour should be implemented not only at the level of the individual but also at the community and societal levels.
Background: There is a dearth of literature on predictive models estimating under-five mortality ... more Background: There is a dearth of literature on predictive models estimating under-five mortality risk in Ethiopia. In this study, we develop a spatial map and predictive models to predict the sociodemographic determinants of under-five mortality in Ethiopia. Methods: The study data were drawn from the 2016 Ethiopian Demographic and Health Survey. We used three predictive models to predict under-five mortality within this sample. The three techniques are random forests, logistic regression, and k-nearest neighbors For each model, measures of model accuracy and Receiver Operating Characteristic curves are used to evaluate the predictive power of each model. Results: There are considerable regional variations in under-five mortality rates in Ethiopia. The under-five mortality prediction ability was found to be moderate to low for the models considered, with the random forest model showing the best performance. Maternal age at birth, sex of a child, previous birth interval, water source, health facility delivery services, antenatal and post-natal care checkups, breastfeeding behavior and household size have been found to be significantly associated with under-five mortality in Ethiopia. Conclusions: The random forest machine learning algorithm produces a higher predictive power for under-five mortality risk factors for the study sample. There is a need to improve the quality and access to health care services to enhance childhood survival chances in the country. Background Globally, an estimated 5.4 million children under the age of 5 are said to have died in 2017 alone [1]. Meanwhile, the global under-five mortality rate is said to have declined by 58 percent, from 93 deaths per 1,000 live births in 1990 to 39 in 2017 [1]. Yet still, the under-five mortality rate in low-income countries was 69 deaths per 1000 live births in 2017-almost 14 times the rate in high-income countries (5 deaths per 1000 live births) [1]. It has been observed that more than half of these deaths are due to infectious diseases (such as pneumonia and diarrhea) that are preventable and treatable through simple, affordable interventions [2]. Despite the considerable improvements over the past decades, sub-Saharan Africa remains the region
The Millennium Development Goal of reducing maternal mortality by three-quarters between 1990 and... more The Millennium Development Goal of reducing maternal mortality by three-quarters between 1990 and 2015 (MDG 5) is highly related to women’s nutritional status. Poor maternal nutrition is directly associated with mother’s lack of resistance to infection and to maternal ill health during pregnancy and childbirth, particularly among the poor. Therefore, providing obstetric care alone is not enough unless poor women’s nutritional status is also addressed. Indepth understanding of women’s nutritional status is crucial to reducing maternal mortality and food insecurity. The percentage undernourished is higher in Ethiopia than in any other subSaharan African country. Thus this study focuses on undernutrition in Ethiopia to assess levels and socio-demographic differentials between rural and urban areas, and to analyze determinants. The paper uses the population-level data sets from the 2000 and 2005 Ethiopian Demographic and Health Surveys (EDHS), comprising 13,057and 5,677 non-pregnant and...
Nutritional status is an important determinant of women’s health and wellbeing. However, there ap... more Nutritional status is an important determinant of women’s health and wellbeing. However, there appears to be a dearth of information on the spatial distribution of undernutrition among women in Ghana over time. We, therefore, examined the spatial and temporal variations in undernutrition among non-pregnant Ghanaian women. Drawing on data from the 2003, 2008, and 2014 Ghana demographic and health surveys, we used geospatial techniques to show spatial autocorrelation for undernutrition levels in the study sample. Multilevel logistic regression analysis was also applied to estimate sociodemographic and contextual factors underlying the variations in the country. The results show considerable local clusterings and regional variations in undernutrition levels in the sample coupled with steady improvements within the regions over time. There was also a notable north–south divide in the undernutrition levels among non-pregnant women in the country for the study period. The spatio-temporal ...
Public Health Nutrition
Objective: Child undernutrition is a global public health problem with serious implications. In t... more Objective: Child undernutrition is a global public health problem with serious implications. In this study, estimate predictive algorithms for the determinants of childhood stunting by using various machine learning (ML) algorithms. Design: This study draws on data from the Ethiopian Demographic and Health Survey of 2016. Five machine learning algorithms including eXtreme gradient boosting (xgbTree), k-nearest neighbors (K-NN), random forest (RF), neural network (NNet), and the generalized linear models (GLM) were considered to predict the socio-demographic risk factors for undernutrition in Ethiopia. Setting: Households in Ethiopia. Participants: A total of 9,471 children below five years of age. Results: The descriptive results show substantial regional variations in child stunting, wasting, and underweight in Ethiopia. Also, among the five ML algorithms, xgbTree algorithm shows a better prediction ability than the generalized linear mixed algorithm. The best predicting algorithm ...
Genus
There is a dearth of literature on the use of machine learning models to predict important under-... more There is a dearth of literature on the use of machine learning models to predict important under-five mortality risks in Ethiopia. In this study, we showed spatial variations of under-five mortality and used machine learning models to predict its important sociodemographic determinants in Ethiopia. The study data were drawn from the 2016 Ethiopian Demographic and Health Survey. We used three machine learning models such as random forests, logistic regression, and K-nearest neighbors as well as one traditional logistic regression model to predict under-five mortality determinants. For each machine learning model, measures of model accuracy and receiver operating characteristic curves were used to evaluate the predictive power of each model. The descriptive results show that there are considerable regional variations in under-five mortality rates in Ethiopia. The under-five mortality prediction ability was found to be between 46.3 and 67.2% for the models considered, with the random f...
Genus
Ghana has long prioritized family planning as a key strategy for improving health and socioeconom... more Ghana has long prioritized family planning as a key strategy for improving health and socioeconomic development. However, despite the heavy investments in the sector over the last decade, the family planning program has not successfully improved the country’s family planning indicators. In this study, we describe the spatial and temporal patterns of unmet need for family planning from 2003 to 2014 and mainly estimate the socioeconomic factors affecting it. Using data from the 2003, 2008, and 2014 Ghana Demographic and Health Surveys, we map the regional and temporal trends in unmet need for family planning and used Bayesian multilevel logistic regression models to estimate the effects of individual-level socioeconomic characteristics on unmet need for family planning. The results show that there are considerable regional disparities in unmet need for family planning for the study period. These disparities show diverse trends among the ten regions in the country over the study period...
African Population Studies
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Papers by Fikrewold Bitew