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Zemenu Tessema

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Papers by Zemenu Tessema

Malaria among mine workers in Tanjung Agung Muara Enim District, South Sumatra, Indonesia: an analysis of environmental risk factors

Proceedings of the 3rd Sriwijaya International Conference on Environmental Issues, SRICOENV 2022, October 5th, 2022, Palembang, South Sumatera, Indonesia

Malaria is still a public health concern in Tanjung Agung, Muara Enim District, South Sumatra, In... more Malaria is still a public health concern in Tanjung Agung, Muara Enim District, South Sumatra, Indonesia, although the third SDG aims to eliminate the disease by 2030. This study aimed to identify the environmental factors that put mining workers at a higher risk of malaria. It was a cross-sectional study. The study included 92 selected participants. Bivariate analysis revealed a correlation between malaria and mosquito mosquito breeding (p-value = 0.039), mosquito resting sites (p-value = 0.018), and house wall conditions (pvalue = 0.028). Multivariate analysis revealed that a housewall was the most significant risk factor, with PR = 0.267, 95% confidence interval (0.089-0.797), and p-value = 0.006. Understanding the interactions between the mosquito resting behaviour patterns of malaria mosquitoes is essential for planning adequate vector control. As demonstrated by these results, malaria elimination requires reducing mosquito resting malaria vectors.

Trends and determinants of home delivery in Ethiopia: further multivariate decomposition analysis of 2005–2016 Ethiopian Demographic Health Surveys

BMJ Open, 2020

ObjectiveThis study aimed to assess the trends and factors that had contributed to the change in ... more ObjectiveThis study aimed to assess the trends and factors that had contributed to the change in home delivery in Ethiopia over the last decade.Design, setting and analysisA nationally representative repeated cross-sectional survey was conducted using 2005, 2011 and 2016 Ethiopian Demographic and Health Surveys. Multivariate decomposition logistic regression analysis was employed to identify significant factors that have been contributed to the change in home delivery. Level of statistical significance was declared at a two-sided p value <0.05.Outcome measureTrends of home delivery.ParticipantsA total of 33 482 women were included.ResultsHome delivery has been decreased by 21% over the last decade in Ethiopia. In the last decade, 39% of the decrements in home delivery attributed to change in women’s compositional characteristics. Antenatal care visits, educational status of the women and husband, birth order, religion, wealth index and distance from a health facility were the mai...

Estimating the impact of birth interval on under-five mortality in east african countries: a propensity score matching analysis

Archives of Public Health

Background Under-five mortality remains a global public health concern, particularly in East Afri... more Background Under-five mortality remains a global public health concern, particularly in East African countries. Short birth interval is highly associated with under-five mortality, and birth spacing has a significant effect on a child’s likelihood of survival. The association between short birth intervals and under-five mortality was demonstrated by numerous observational studies. However, the effect of short birth intervals on under-five mortality has not been investigated yet. Therefore, this study aimed to investigate the impact of short birth intervals on under-five mortality in East Africa using Propensity Matched Analysis. Methods A secondary data analysis was conducted based on the most recent Demographic and Health Survey (DHS) data of 12 East African countries. A total weighted sample of 105,662 live births was considered for this study. A PSM analysis was carried out to evaluate the effect of short birth intervals on under-five mortality. Under-five mortality was the outco...

Minimum acceptable diet feeding practice and associated factors among children aged 6–23 months in east Africa: a multilevel binary logistic regression analysis of 2008–2018 demographic health survey data

Archives of Public Health

Background Despite the proportion of receiving a minimum acceptable diet (minimum meal frequency ... more Background Despite the proportion of receiving a minimum acceptable diet (minimum meal frequency and minimum dietary diversity) is lower in east Africa, there is limited evidence on minimum acceptable diet. Therefore, this study aimed to investigate the minimum acceptable diet and associated factors among children aged 6–23 months in east Africa. Methods A secondary data analysis of the most recent Demographic and Health Survey (DHS) data of 12 east African countries was done. A total weighted sample of 34, 097 children aged 6–23 months were included. A multilevel binary logistic regression model was applied. The Intra-class Correlation Coefficient (ICC) and Median Odds Ratio (MOR) were calculated to assess the clustering effect. Besides, deviance was used for model comparison as the models are nested models. Both crude and adjusted Odds Ratio (OR) with a 95% Confidence Interval (CI) were reported as potential predictors of minimum acceptable diet feeding practice. Results The preva...

Spatial pattern and Factors associated with khat chewing among adult males 15-59 years in Ethiopia, EDHS 2016. Generalized Estimating Equation Approach

Background Khat chewing has become prevalent in the world due to the improvement of road and air ... more Background Khat chewing has become prevalent in the world due to the improvement of road and air transportation. In Ethiopia, khat chewing is more prevalent and wildly practiced by men. Khat has a negative effect on social, economic and mental health. Therefore, this study aims to show spatial patterns and factors associated with khat chewing among male adults 15-59 years in Ethiopia. Methods A total of 12,594 men who chew khat in their were included in this study. ArcGIS version 10.7 software was used to visualize spatial pattern chewing khat among adult men in Ethiopia. The Bernoulli model was applied using Kilduff SaTScan version 9.6 software to identify significant purely spatial clusters for chewing khat in Ethiopia. The robust standard error method of generalized estimating equations was used for the binary outcome variable from the clustered data and adjusted odds ratios with 95% confidence interval were reported. Results A total of 12,594 participants were included in the an...

Pooled prevalence and determinants of modern contraceptive utilization in East Africa: A Multi-country Analysis of recent Demographic and Health Surveys

PLOS ONE, 2021

Background According to the 2017 estimate, around 214 million reproductive-age women in developin... more Background According to the 2017 estimate, around 214 million reproductive-age women in developing regions who want to avoid pregnancy do not use a modern contraceptive method. Although there are studies done on factors associated with modern contraceptive utilization in individual East African countries, as to our search of the literature, there is limited evidence on the pooled prevalence and determinants of modern contraceptive utilization in the East African region. Therefore, this study aimed to estimate the pooled prevalence and determinants of modern contraceptive utilization in the East African region. Methods The pooled prevalence of modern contraceptive utilization and the strength of determinants were estimated using STATA version 14. Intra-class Correlation Coefficient (ICC), Median Odds Ratio (MOR), Proportional Change in Variance (PCV), and deviance were used for model fitness and comparison. The multilevel logistic regression model was fitted to identify determinants ...

Joint modeling of time to diabetic retinopathy and change in fasting blood sugar among type 2 diabetic patients, Northwest Ethiopia

Scientific Reports, 2022

This study aimed to assess changes in fasting blood sugar (FBS) levels, time to diabetic retinopa... more This study aimed to assess changes in fasting blood sugar (FBS) levels, time to diabetic retinopathy (DR) and its predictors among type 2 diabetes patients in Ethiopia. An institution-based retrospective follow-up study was conducted at the University of Gondar Comprehensive Specialized Hospital. The linear mixed effect model and Cox proportional hazard models were fitted separately, and later, the two models were fitted jointly using R software. Variables with a p value 1 antidiabetic oral agent (AHR = 4.90; 95% CI 1.07–20.0) and more than 10 years duration (AHR = 0.17, 95% CI 0.06–0.46) were predictors of time to DR. This study revealed that the current value of FBS and the rate of FBS change were significantly associated with the time to DR.

Spatial distribution and factors associated with modern contraceptive use among women of reproductive age in Nigeria: A multilevel analysis

PLOS ONE, 2021

Background Evidence suggests that in countries with high fertility and fecundity rates, such as N... more Background Evidence suggests that in countries with high fertility and fecundity rates, such as Nigeria, the promotion of modern contraceptive use prevents approximately 32% and 10% of maternal and child mortality, respectively. Therefore, this study aimed to assess the spatial distribution of modern contraceptive use and its predictors among women of reproductive age in Nigeria. Methods The study employed a cross-sectional analysis of population-based data involving 24,281 women of reproductive age in Nigeria. The study adopted both multilevel and spatial analyses to identify the predictors of modern contraceptive use and its spatial clustering among women in Nigeria. Results Modern contraceptive use among the study population in Nigeria ranged from 0% to 75%, with regional variations. The spatial analysis showed that areas with a low proportion of modern contraceptive use were Sokoto, Yobe, Borno, Katsina, Zamfara, Kebbi, Niger, Taraba and Delta. Areas with a high proportion of mo...

Multi-Level Analysis and Spatial Interpolation of Distributions and Predictors of Childhood Diarrhea in Nigeria

Environmental Health Insights, 2021

Background: Diarrhea is one of the health problems contributing to Nigeria’s under-5 mortality ra... more Background: Diarrhea is one of the health problems contributing to Nigeria’s under-5 mortality rate, ranked as the eighth highest globally. As our search is concerned, there is limited evidence on the spatial distribution of childhood diarrhea in Nigeria. Therefore, this study aimed to examine the spatial distribution and predictors of diarrhea among under-5 children in Nigeria. Materials and Methods: Using data from the child’s recode file of the 2018 Nigeria Demographic and Health Survey, a sample of 28 583 children of women of reproductive age was considered as the sample size for this study. The outcome variable used in this study was childhood diarrhea. We employed both multilevel and spatial analyses to ascertain the factors associated with childhood diarrhea as well as its spatial clustering. Results: The regional distribution of the prevalence of diarrhea among children in Nigeria ranged from 0% to 62%. The hotspots for childhood diarrhea were in Yobe, Bauchi, Gombe, Kano, S...

Correction to: Prevalence and predictors of alcohol use among adult males in Ethiopia: multilevel analysis of Ethiopian Demographic and Health Survey 2016

Tropical Medicine and Health, 2020

An amendment to this paper has been published and can be accessed via the original article.

Time to diabetic neuropathy and its predictors among newly diagnosed type 2 diabetes mellitus patients in Northwest Ethiopia

The Egyptian Journal of Neurology, Psychiatry and Neurosurgery, 2021

Introduction Despite the high number of patients suffering from the negative impact of diabetic n... more Introduction Despite the high number of patients suffering from the negative impact of diabetic neuropathy (DN) in Ethiopia, evidence regarding the time to DN and its predictors are not well document in Ethiopia. Therefore, the current study aimed to determine time to DN and its predictors among newly diagnosed type 2 diabetes patients (T2DM) in North West Ethiopia. Methods Institutional based retrospective cohort study was conducted among 463 T2DM. Cox proportional hazard model was fitted to identify predictors of time to DN. The adjusted hazard ratio (AHR) with its 95% confidence interval was used to declare the presence and strength of association. Results From a total 463 study participants, 77 (16.63%), (95% CI 13.23%, 20.03%) had developed diabetic neuropathy. The median time to develop DN was 233.77 months. About 40 (51.95%) diabetic neuropathy cases occurred within 6 years of diagnosis of diabetic mellitus. The incidence density was 2.01/100 PY with 95% CI of [1.60, 2.53]. I...

Pooled prevalence and associated factors of health facility delivery in East Africa: Mixed-effect logistic regression analysis

PLOS ONE, 2021

Background Many mothers still give birth outside a health facility in Sub-Saharan Africa particul... more Background Many mothers still give birth outside a health facility in Sub-Saharan Africa particularly in East African countries. Though there are studies on the prevalence and associated factors of health facility delivery, as to our search of literature there is limited evidence on the pooled prevalence and associated factors of health facility delivery in East Africa. This study aims to examine the pooled prevalence and associated factors of health facility delivery in East Africa based on evidence from Demographic and Health Surveys. Methods A secondary data analysis was conducted based on the most recent Demographic and Health Surveys (DHSs) conducted in the 12 East African countries. A total weighted sample of 141,483 reproductive-age women who gave birth within five years preceding the survey was included. All analyses presented in this paper were weighted for the sampling probabilities and non-response using sampling weight (V005), primary sampling unit (V023), and strata (V0...

Spatial Patterns and Multilevel Analysis of Factors Associated with Antenatal Care Visits in Nigeria: Insight from the 2018 Nigeria Demographic Health Survey

Healthcare, 2021

Despite global progress towards antenatal care (ANC) uptake, ANC utilization in a number of count... more Despite global progress towards antenatal care (ANC) uptake, ANC utilization in a number of countries in sub-Saharan Africa, such as Nigeria, is low. Although several studies have identified the determinants and factors associated with ANC services utilization in Nigeria, there is a gap in knowledge about the spatial patterns in ANC use. Therefore, this study aims to map the spatial distribution and factors associated with ANC visits in Nigeria. A cross-sectional dataset was obtained from the 2018 Nigeria Demographic and Health Survey. A total of 20,003 women aged 15–49 were considered in this study. Both spatial and multilevel analyses were carried out. The results were presented in spatial maps and adjusted odds ratios (aOR) at a 95% confidence interval (CI). Hot spot areas (high proportion of an incomplete ANC visit) were located in Sokoto, Kebbi, Zamfara, Katsina, Kano, Jigawa, Bauchi, Niger, Borno, Gombe, and Bayelsa. Regional disparities in incomplete ANC visits were found in ...

Spatial Distributions and Determinants of High-risk Fertility Behavior among Women in Ethiopia: Further Analysis from 2016 Ethiopia Demographic Health Survey

Background: High-risk fertility behavior associated with numerous unfavorable child and maternal ... more Background: High-risk fertility behavior associated with numerous unfavorable child and maternal health outcomes such as chronic undernutrition, anemia, and child mortality. Although different studies have been conducted to assess the magnitude and effects of high-risk fertility behaviors, there are limited shreds of evidence about the geographical distributions and determinants in Ethiopia. Therefore, this study aimed to assess the spatial distributions and determinants of high-risk fertility behavior among reproductive-age women in Ethiopia. Method: This study was based on secondary data analysis from the 2016 Ethiopia Demography and Health Survey. Information about 11,022 women who gave birth five years preceding the survey were extracted from the kid’s record (KR) file. For the spatial analysis ArcGIS 10.6 and Sat ScanTM 9.6, were used and for multilevel analysis, STATA 14.1 was used. Mixed effect Multivariable multilevel logistic regression model was fitted to identify determin...

Pooled prevalence and determinants of skilled birth attendant delivery in East Africa countries: a multilevel analysis of Demographic and Health Surveys

Italian Journal of Pediatrics, 2020

Introduction Skilled health professional assisted delivery is an effective strategy to reduce mat... more Introduction Skilled health professional assisted delivery is an effective strategy to reduce maternal and newborn mortality. Skilled assistant delivery can prevent about 16–33% of maternal and newborn mortality. Despite the commitments of the government to assure home free delivery, majority of the births in Sub-Saharan Africa are attended by traditional birth attendants. As to our search of the literature, there is limited evidence on the prevalence and determinants of skilled delivery in East African countries. Therefore, this study aimed to estimate the pooled prevalence and determinants of skilled birth attendant delivery in East Africa Countries. Methods Pooled analysis was done based on Demographic and Health Surveys conducted in the 12 East African countries from 2008 to 2017. A total weighted sample of 141,483 women who gave birth during the study period was included in the study. The pooled prevalence of skilled birth attendance was estimated using STATA version 14. Intra-...

Author Correction: Mapping local patterns of childhood overweight and wasting in low- and middle-income countries between 2000 and 2017

Nature Medicine, 2020

An amendment to this paper has been published and can be accessed via a link at the top of the pa... more

Geographical variation in determinants of high-risk fertility behavior among reproductive age women in Ethiopia using the 2016 Demographic and Health Survey: a geographically weighted regression analysis

Background: Maternal and child mortalities are the main public health problems worldwide and both... more Background: Maternal and child mortalities are the main public health problems worldwide and both are the major health concern in developing countries such as Africa and Asia. The fertility behavior of women characterized by maternal age, birth spacing, and order, impacts the health of women and children. The aim of this study was to assess the geographically variation in risk factors of high-risk fertility behavior (HRFB) among reproductive-age women in Ethiopia using the 2016 Demographic and Health Survey.Methods: A total of 11,022 reproductive-age women were included in this study. The data were cleaned and weighted by STATA 14.1 software. Bernoulli based spatial scan statistics was used to identify the presence of pure high-risk fertility behavior spatial clusters using Kulldorff’s SaTScan version 9.6 software. ArcGIS 10.7 was used to visualize the spatial distribution of high-risk fertility behavior. Geographically weighted regression analysis was employed by multiscale geograp...

Spatial Distribution and Factors Associated with Khat Chewing among Adult Males 15-59 Years in Ethiopia Using a Secondary Analysis of Ethiopian Demographic and Health Survey 2016: Spatial and Multilevel Analysis

Psychiatry Journal, 2020

Background. Khat chewing has become prevalent in the world due to the improvement of road and air... more Background. Khat chewing has become prevalent in the world due to the improvement of road and air transportation. In Ethiopia, khat chewing is more prevalent and widely practiced by men. Khat has a negative effect on social, economic, and mental health. There is variation in khat cultivation, use, and factors that associated with khat chewing in the Ethiopian regions. Therefore, this study is aimed at showing spatial distribution and factors associated with khat chewing among male adults 15-59 years in Ethiopia. Methods. A total of 12,594 men were included in this study. ArcGIS version 10.7 software was used to show the spatial distribution of chewing khat among adult men in Ethiopia. The Bernoulli model was applied using Kilduff SaTScan version 9.6 software to identify significant purely spatial clusters for chewing khat in Ethiopia. A multilevel logistic regression model was fitted to identify factors associated with khat chewing. A P value < 0.05 was taken to declare statistic...

Factors associated with perceived barriers of health care access among reproductive-age women in Ethiopia: a Secondary data analysis of 2016 Ethiopian Demographic and Health Survey

Background: Health care access is the timely use of personal health services to achieve the best ... more Background: Health care access is the timely use of personal health services to achieve the best health outcomes. Difficulties to access health care among reproductive-age women may lead to different negative health outcomes like death and disability. Therefore, this study aimed to assess factors associated with perceived barriers of health care access among reproductive-age women in Ethiopia. Method: This study was based on the 2016 Ethiopia Demography and Health Survey. Individual women record (IR) file was used to extract the dataset and 15, 683 women were included in the final analysis. A composite variable of health care perceived barriers were created from four questions used to rate health care access perceived barriers among reproductive-age women. The Generalized Estimating Equation (GEE) model was fitted to identify factors associated with health care perceived barriers. Crude and Adjusted odds ratio with a 95% CI computed to assess the strength of association between inde...

Spatial distribution and Determinants of Optimal ANC visit among pregnant women in Ethiopia: Further analysis of 2016 Ethiopia demographic Health Survey

Background Antenatal care (ANC) is essential to improve maternal and newborn health and wellbeing... more Background Antenatal care (ANC) is essential to improve maternal and newborn health and wellbeing. Antenatal care coverage is improving in Africa, since over two-thirds of pregnant women have at least one ANC contact. However, to realize the complete life-saving potential that ANC guarantees for mothers and babies, four visits providing essential proof based mostly interventions square measure neededObjective The aim of this study was to identify determinants for Optimal ANC visit and its spatial distribution among pregnant women in Ethiopia.Method This study was based on 2016 Ethiopia Demography and Health Survey. Individual women record (IR) file was used to extract the data and 8,025 pregnant women were included in the final analysis. The binary response variable considered in this study indicated whether women completed an optimal ANC visit or not from skilled health care provider and coded as 1/0. Sata14 and ArcGIS10.1 software’s were used for analysis. Generalized estimating e...

Malaria among mine workers in Tanjung Agung Muara Enim District, South Sumatra, Indonesia: an analysis of environmental risk factors

Proceedings of the 3rd Sriwijaya International Conference on Environmental Issues, SRICOENV 2022, October 5th, 2022, Palembang, South Sumatera, Indonesia

Malaria is still a public health concern in Tanjung Agung, Muara Enim District, South Sumatra, In... more Malaria is still a public health concern in Tanjung Agung, Muara Enim District, South Sumatra, Indonesia, although the third SDG aims to eliminate the disease by 2030. This study aimed to identify the environmental factors that put mining workers at a higher risk of malaria. It was a cross-sectional study. The study included 92 selected participants. Bivariate analysis revealed a correlation between malaria and mosquito mosquito breeding (p-value = 0.039), mosquito resting sites (p-value = 0.018), and house wall conditions (pvalue = 0.028). Multivariate analysis revealed that a housewall was the most significant risk factor, with PR = 0.267, 95% confidence interval (0.089-0.797), and p-value = 0.006. Understanding the interactions between the mosquito resting behaviour patterns of malaria mosquitoes is essential for planning adequate vector control. As demonstrated by these results, malaria elimination requires reducing mosquito resting malaria vectors.

Trends and determinants of home delivery in Ethiopia: further multivariate decomposition analysis of 2005–2016 Ethiopian Demographic Health Surveys

BMJ Open, 2020

ObjectiveThis study aimed to assess the trends and factors that had contributed to the change in ... more ObjectiveThis study aimed to assess the trends and factors that had contributed to the change in home delivery in Ethiopia over the last decade.Design, setting and analysisA nationally representative repeated cross-sectional survey was conducted using 2005, 2011 and 2016 Ethiopian Demographic and Health Surveys. Multivariate decomposition logistic regression analysis was employed to identify significant factors that have been contributed to the change in home delivery. Level of statistical significance was declared at a two-sided p value <0.05.Outcome measureTrends of home delivery.ParticipantsA total of 33 482 women were included.ResultsHome delivery has been decreased by 21% over the last decade in Ethiopia. In the last decade, 39% of the decrements in home delivery attributed to change in women’s compositional characteristics. Antenatal care visits, educational status of the women and husband, birth order, religion, wealth index and distance from a health facility were the mai...

Estimating the impact of birth interval on under-five mortality in east african countries: a propensity score matching analysis

Archives of Public Health

Background Under-five mortality remains a global public health concern, particularly in East Afri... more Background Under-five mortality remains a global public health concern, particularly in East African countries. Short birth interval is highly associated with under-five mortality, and birth spacing has a significant effect on a child’s likelihood of survival. The association between short birth intervals and under-five mortality was demonstrated by numerous observational studies. However, the effect of short birth intervals on under-five mortality has not been investigated yet. Therefore, this study aimed to investigate the impact of short birth intervals on under-five mortality in East Africa using Propensity Matched Analysis. Methods A secondary data analysis was conducted based on the most recent Demographic and Health Survey (DHS) data of 12 East African countries. A total weighted sample of 105,662 live births was considered for this study. A PSM analysis was carried out to evaluate the effect of short birth intervals on under-five mortality. Under-five mortality was the outco...

Minimum acceptable diet feeding practice and associated factors among children aged 6–23 months in east Africa: a multilevel binary logistic regression analysis of 2008–2018 demographic health survey data

Archives of Public Health

Background Despite the proportion of receiving a minimum acceptable diet (minimum meal frequency ... more Background Despite the proportion of receiving a minimum acceptable diet (minimum meal frequency and minimum dietary diversity) is lower in east Africa, there is limited evidence on minimum acceptable diet. Therefore, this study aimed to investigate the minimum acceptable diet and associated factors among children aged 6–23 months in east Africa. Methods A secondary data analysis of the most recent Demographic and Health Survey (DHS) data of 12 east African countries was done. A total weighted sample of 34, 097 children aged 6–23 months were included. A multilevel binary logistic regression model was applied. The Intra-class Correlation Coefficient (ICC) and Median Odds Ratio (MOR) were calculated to assess the clustering effect. Besides, deviance was used for model comparison as the models are nested models. Both crude and adjusted Odds Ratio (OR) with a 95% Confidence Interval (CI) were reported as potential predictors of minimum acceptable diet feeding practice. Results The preva...

Spatial pattern and Factors associated with khat chewing among adult males 15-59 years in Ethiopia, EDHS 2016. Generalized Estimating Equation Approach

Background Khat chewing has become prevalent in the world due to the improvement of road and air ... more Background Khat chewing has become prevalent in the world due to the improvement of road and air transportation. In Ethiopia, khat chewing is more prevalent and wildly practiced by men. Khat has a negative effect on social, economic and mental health. Therefore, this study aims to show spatial patterns and factors associated with khat chewing among male adults 15-59 years in Ethiopia. Methods A total of 12,594 men who chew khat in their were included in this study. ArcGIS version 10.7 software was used to visualize spatial pattern chewing khat among adult men in Ethiopia. The Bernoulli model was applied using Kilduff SaTScan version 9.6 software to identify significant purely spatial clusters for chewing khat in Ethiopia. The robust standard error method of generalized estimating equations was used for the binary outcome variable from the clustered data and adjusted odds ratios with 95% confidence interval were reported. Results A total of 12,594 participants were included in the an...

Pooled prevalence and determinants of modern contraceptive utilization in East Africa: A Multi-country Analysis of recent Demographic and Health Surveys

PLOS ONE, 2021

Background According to the 2017 estimate, around 214 million reproductive-age women in developin... more Background According to the 2017 estimate, around 214 million reproductive-age women in developing regions who want to avoid pregnancy do not use a modern contraceptive method. Although there are studies done on factors associated with modern contraceptive utilization in individual East African countries, as to our search of the literature, there is limited evidence on the pooled prevalence and determinants of modern contraceptive utilization in the East African region. Therefore, this study aimed to estimate the pooled prevalence and determinants of modern contraceptive utilization in the East African region. Methods The pooled prevalence of modern contraceptive utilization and the strength of determinants were estimated using STATA version 14. Intra-class Correlation Coefficient (ICC), Median Odds Ratio (MOR), Proportional Change in Variance (PCV), and deviance were used for model fitness and comparison. The multilevel logistic regression model was fitted to identify determinants ...

Joint modeling of time to diabetic retinopathy and change in fasting blood sugar among type 2 diabetic patients, Northwest Ethiopia

Scientific Reports, 2022

This study aimed to assess changes in fasting blood sugar (FBS) levels, time to diabetic retinopa... more This study aimed to assess changes in fasting blood sugar (FBS) levels, time to diabetic retinopathy (DR) and its predictors among type 2 diabetes patients in Ethiopia. An institution-based retrospective follow-up study was conducted at the University of Gondar Comprehensive Specialized Hospital. The linear mixed effect model and Cox proportional hazard models were fitted separately, and later, the two models were fitted jointly using R software. Variables with a p value 1 antidiabetic oral agent (AHR = 4.90; 95% CI 1.07–20.0) and more than 10 years duration (AHR = 0.17, 95% CI 0.06–0.46) were predictors of time to DR. This study revealed that the current value of FBS and the rate of FBS change were significantly associated with the time to DR.

Spatial distribution and factors associated with modern contraceptive use among women of reproductive age in Nigeria: A multilevel analysis

PLOS ONE, 2021

Background Evidence suggests that in countries with high fertility and fecundity rates, such as N... more Background Evidence suggests that in countries with high fertility and fecundity rates, such as Nigeria, the promotion of modern contraceptive use prevents approximately 32% and 10% of maternal and child mortality, respectively. Therefore, this study aimed to assess the spatial distribution of modern contraceptive use and its predictors among women of reproductive age in Nigeria. Methods The study employed a cross-sectional analysis of population-based data involving 24,281 women of reproductive age in Nigeria. The study adopted both multilevel and spatial analyses to identify the predictors of modern contraceptive use and its spatial clustering among women in Nigeria. Results Modern contraceptive use among the study population in Nigeria ranged from 0% to 75%, with regional variations. The spatial analysis showed that areas with a low proportion of modern contraceptive use were Sokoto, Yobe, Borno, Katsina, Zamfara, Kebbi, Niger, Taraba and Delta. Areas with a high proportion of mo...

Multi-Level Analysis and Spatial Interpolation of Distributions and Predictors of Childhood Diarrhea in Nigeria

Environmental Health Insights, 2021

Background: Diarrhea is one of the health problems contributing to Nigeria’s under-5 mortality ra... more Background: Diarrhea is one of the health problems contributing to Nigeria’s under-5 mortality rate, ranked as the eighth highest globally. As our search is concerned, there is limited evidence on the spatial distribution of childhood diarrhea in Nigeria. Therefore, this study aimed to examine the spatial distribution and predictors of diarrhea among under-5 children in Nigeria. Materials and Methods: Using data from the child’s recode file of the 2018 Nigeria Demographic and Health Survey, a sample of 28 583 children of women of reproductive age was considered as the sample size for this study. The outcome variable used in this study was childhood diarrhea. We employed both multilevel and spatial analyses to ascertain the factors associated with childhood diarrhea as well as its spatial clustering. Results: The regional distribution of the prevalence of diarrhea among children in Nigeria ranged from 0% to 62%. The hotspots for childhood diarrhea were in Yobe, Bauchi, Gombe, Kano, S...

Correction to: Prevalence and predictors of alcohol use among adult males in Ethiopia: multilevel analysis of Ethiopian Demographic and Health Survey 2016

Tropical Medicine and Health, 2020

An amendment to this paper has been published and can be accessed via the original article.

Time to diabetic neuropathy and its predictors among newly diagnosed type 2 diabetes mellitus patients in Northwest Ethiopia

The Egyptian Journal of Neurology, Psychiatry and Neurosurgery, 2021

Introduction Despite the high number of patients suffering from the negative impact of diabetic n... more Introduction Despite the high number of patients suffering from the negative impact of diabetic neuropathy (DN) in Ethiopia, evidence regarding the time to DN and its predictors are not well document in Ethiopia. Therefore, the current study aimed to determine time to DN and its predictors among newly diagnosed type 2 diabetes patients (T2DM) in North West Ethiopia. Methods Institutional based retrospective cohort study was conducted among 463 T2DM. Cox proportional hazard model was fitted to identify predictors of time to DN. The adjusted hazard ratio (AHR) with its 95% confidence interval was used to declare the presence and strength of association. Results From a total 463 study participants, 77 (16.63%), (95% CI 13.23%, 20.03%) had developed diabetic neuropathy. The median time to develop DN was 233.77 months. About 40 (51.95%) diabetic neuropathy cases occurred within 6 years of diagnosis of diabetic mellitus. The incidence density was 2.01/100 PY with 95% CI of [1.60, 2.53]. I...

Pooled prevalence and associated factors of health facility delivery in East Africa: Mixed-effect logistic regression analysis

PLOS ONE, 2021

Background Many mothers still give birth outside a health facility in Sub-Saharan Africa particul... more Background Many mothers still give birth outside a health facility in Sub-Saharan Africa particularly in East African countries. Though there are studies on the prevalence and associated factors of health facility delivery, as to our search of literature there is limited evidence on the pooled prevalence and associated factors of health facility delivery in East Africa. This study aims to examine the pooled prevalence and associated factors of health facility delivery in East Africa based on evidence from Demographic and Health Surveys. Methods A secondary data analysis was conducted based on the most recent Demographic and Health Surveys (DHSs) conducted in the 12 East African countries. A total weighted sample of 141,483 reproductive-age women who gave birth within five years preceding the survey was included. All analyses presented in this paper were weighted for the sampling probabilities and non-response using sampling weight (V005), primary sampling unit (V023), and strata (V0...

Spatial Patterns and Multilevel Analysis of Factors Associated with Antenatal Care Visits in Nigeria: Insight from the 2018 Nigeria Demographic Health Survey

Healthcare, 2021

Despite global progress towards antenatal care (ANC) uptake, ANC utilization in a number of count... more Despite global progress towards antenatal care (ANC) uptake, ANC utilization in a number of countries in sub-Saharan Africa, such as Nigeria, is low. Although several studies have identified the determinants and factors associated with ANC services utilization in Nigeria, there is a gap in knowledge about the spatial patterns in ANC use. Therefore, this study aims to map the spatial distribution and factors associated with ANC visits in Nigeria. A cross-sectional dataset was obtained from the 2018 Nigeria Demographic and Health Survey. A total of 20,003 women aged 15–49 were considered in this study. Both spatial and multilevel analyses were carried out. The results were presented in spatial maps and adjusted odds ratios (aOR) at a 95% confidence interval (CI). Hot spot areas (high proportion of an incomplete ANC visit) were located in Sokoto, Kebbi, Zamfara, Katsina, Kano, Jigawa, Bauchi, Niger, Borno, Gombe, and Bayelsa. Regional disparities in incomplete ANC visits were found in ...

Spatial Distributions and Determinants of High-risk Fertility Behavior among Women in Ethiopia: Further Analysis from 2016 Ethiopia Demographic Health Survey

Background: High-risk fertility behavior associated with numerous unfavorable child and maternal ... more Background: High-risk fertility behavior associated with numerous unfavorable child and maternal health outcomes such as chronic undernutrition, anemia, and child mortality. Although different studies have been conducted to assess the magnitude and effects of high-risk fertility behaviors, there are limited shreds of evidence about the geographical distributions and determinants in Ethiopia. Therefore, this study aimed to assess the spatial distributions and determinants of high-risk fertility behavior among reproductive-age women in Ethiopia. Method: This study was based on secondary data analysis from the 2016 Ethiopia Demography and Health Survey. Information about 11,022 women who gave birth five years preceding the survey were extracted from the kid’s record (KR) file. For the spatial analysis ArcGIS 10.6 and Sat ScanTM 9.6, were used and for multilevel analysis, STATA 14.1 was used. Mixed effect Multivariable multilevel logistic regression model was fitted to identify determin...

Pooled prevalence and determinants of skilled birth attendant delivery in East Africa countries: a multilevel analysis of Demographic and Health Surveys

Italian Journal of Pediatrics, 2020

Introduction Skilled health professional assisted delivery is an effective strategy to reduce mat... more Introduction Skilled health professional assisted delivery is an effective strategy to reduce maternal and newborn mortality. Skilled assistant delivery can prevent about 16–33% of maternal and newborn mortality. Despite the commitments of the government to assure home free delivery, majority of the births in Sub-Saharan Africa are attended by traditional birth attendants. As to our search of the literature, there is limited evidence on the prevalence and determinants of skilled delivery in East African countries. Therefore, this study aimed to estimate the pooled prevalence and determinants of skilled birth attendant delivery in East Africa Countries. Methods Pooled analysis was done based on Demographic and Health Surveys conducted in the 12 East African countries from 2008 to 2017. A total weighted sample of 141,483 women who gave birth during the study period was included in the study. The pooled prevalence of skilled birth attendance was estimated using STATA version 14. Intra-...

Author Correction: Mapping local patterns of childhood overweight and wasting in low- and middle-income countries between 2000 and 2017

Nature Medicine, 2020

An amendment to this paper has been published and can be accessed via a link at the top of the pa... more

Geographical variation in determinants of high-risk fertility behavior among reproductive age women in Ethiopia using the 2016 Demographic and Health Survey: a geographically weighted regression analysis

Background: Maternal and child mortalities are the main public health problems worldwide and both... more Background: Maternal and child mortalities are the main public health problems worldwide and both are the major health concern in developing countries such as Africa and Asia. The fertility behavior of women characterized by maternal age, birth spacing, and order, impacts the health of women and children. The aim of this study was to assess the geographically variation in risk factors of high-risk fertility behavior (HRFB) among reproductive-age women in Ethiopia using the 2016 Demographic and Health Survey.Methods: A total of 11,022 reproductive-age women were included in this study. The data were cleaned and weighted by STATA 14.1 software. Bernoulli based spatial scan statistics was used to identify the presence of pure high-risk fertility behavior spatial clusters using Kulldorff’s SaTScan version 9.6 software. ArcGIS 10.7 was used to visualize the spatial distribution of high-risk fertility behavior. Geographically weighted regression analysis was employed by multiscale geograp...

Spatial Distribution and Factors Associated with Khat Chewing among Adult Males 15-59 Years in Ethiopia Using a Secondary Analysis of Ethiopian Demographic and Health Survey 2016: Spatial and Multilevel Analysis

Psychiatry Journal, 2020

Background. Khat chewing has become prevalent in the world due to the improvement of road and air... more Background. Khat chewing has become prevalent in the world due to the improvement of road and air transportation. In Ethiopia, khat chewing is more prevalent and widely practiced by men. Khat has a negative effect on social, economic, and mental health. There is variation in khat cultivation, use, and factors that associated with khat chewing in the Ethiopian regions. Therefore, this study is aimed at showing spatial distribution and factors associated with khat chewing among male adults 15-59 years in Ethiopia. Methods. A total of 12,594 men were included in this study. ArcGIS version 10.7 software was used to show the spatial distribution of chewing khat among adult men in Ethiopia. The Bernoulli model was applied using Kilduff SaTScan version 9.6 software to identify significant purely spatial clusters for chewing khat in Ethiopia. A multilevel logistic regression model was fitted to identify factors associated with khat chewing. A P value < 0.05 was taken to declare statistic...

Factors associated with perceived barriers of health care access among reproductive-age women in Ethiopia: a Secondary data analysis of 2016 Ethiopian Demographic and Health Survey

Background: Health care access is the timely use of personal health services to achieve the best ... more Background: Health care access is the timely use of personal health services to achieve the best health outcomes. Difficulties to access health care among reproductive-age women may lead to different negative health outcomes like death and disability. Therefore, this study aimed to assess factors associated with perceived barriers of health care access among reproductive-age women in Ethiopia. Method: This study was based on the 2016 Ethiopia Demography and Health Survey. Individual women record (IR) file was used to extract the dataset and 15, 683 women were included in the final analysis. A composite variable of health care perceived barriers were created from four questions used to rate health care access perceived barriers among reproductive-age women. The Generalized Estimating Equation (GEE) model was fitted to identify factors associated with health care perceived barriers. Crude and Adjusted odds ratio with a 95% CI computed to assess the strength of association between inde...

Spatial distribution and Determinants of Optimal ANC visit among pregnant women in Ethiopia: Further analysis of 2016 Ethiopia demographic Health Survey

Background Antenatal care (ANC) is essential to improve maternal and newborn health and wellbeing... more Background Antenatal care (ANC) is essential to improve maternal and newborn health and wellbeing. Antenatal care coverage is improving in Africa, since over two-thirds of pregnant women have at least one ANC contact. However, to realize the complete life-saving potential that ANC guarantees for mothers and babies, four visits providing essential proof based mostly interventions square measure neededObjective The aim of this study was to identify determinants for Optimal ANC visit and its spatial distribution among pregnant women in Ethiopia.Method This study was based on 2016 Ethiopia Demography and Health Survey. Individual women record (IR) file was used to extract the data and 8,025 pregnant women were included in the final analysis. The binary response variable considered in this study indicated whether women completed an optimal ANC visit or not from skilled health care provider and coded as 1/0. Sata14 and ArcGIS10.1 software’s were used for analysis. Generalized estimating e...