Dawit Getnet Ayele

Prevalence and risk factors of malaria in Ethiopia

BackgroundMore than 75% of the total area of Ethiopia is malarious, making malaria the leading public health problem in Ethiopia. The aim of this study was to investigate the prevalence rate and the associated socio-economic, geographic and demographic factors of malaria based on the rapid diagnosis test (RDT) survey results.MethodsFrom December 2006 to January 2007, a baseline malaria indicator survey in Amhara, Oromiya and Southern Nation Nationalities and People (SNNP) regions of Ethiopia was conducted by The Carter Center. This study uses this data. The method of generalized linear model was used to analyse the data and the response variable was the presence or absence of malaria using the rapid diagnosis test (RDT).ResultsThe analyses show that the RDT result was significantly associated with age and gender. Other significant covariates confounding variables are source of water, trip to obtain water, toilet facility, total number of rooms, material used for walls, and material used for roofing. The prevalence of malaria for households with clean water found to be less. Malaria rapid diagnosis found to be higher for thatch and stick/mud roof and earth/local dung plaster floor. Moreover, spraying anti-malaria to the house was found to be one means of reducing the risk of malaria. Furthermore, the housing condition, source of water and its distance, gender, and ages in the households were identified in order to have two-way interaction effects.ConclusionIndividuals with poor socio-economic conditions are positively associated with malaria infection. Improving the housing condition of the household is one of the means of reducing the risk of malaria. Children and female household members are the most vulnerable to the risk of malaria. Such information is essential to design improved strategic intervention for the reduction of malaria epidemic in Ethiopia.

Multiple correspondence analysis as a tool for analysis of large health surveys in African settings

BACKGROUND More than two thirds of the total population of Ethiopia is estimated to be at risk of malaria. Therefore, malaria is the leading public health problem in Ethiopia. OBJECTIVE To investigate the determinants of malaria Rapid Diagnosis Test (RDT) result and the association between socio-economic, demographic and geographic factors. METHOD The study used data from household cluster malaria survey which was conducted from December 2006 to January 2007. A total of 224 clusters of about 25 households each were selected from the Amhara, Oromiya and Southern Nation Nationalities and People (SNNP) regions of Ethiopia. A multiple correspondence analysis was used to jointly analyse malaria RDT result, socio-economic, demographic and geographic factors. RESULTS The result from multiple correspondence analysis shows that there is association between malaria RDT result and different socio-economic, demographic and geographic variables. CONCLUSION There is an indication that some socio-economic, demographic and geographic factors have joint effects. It is important to confirm the association between socio-economic, demographic and geographic factors using advanced statistical techniques.

Spatial distribution of malaria problem in three regions of Ethiopia

BackgroundThe transmission of malaria is the leading public health problem in Ethiopia. From the total area of Ethiopia, more than 75% is malarious. The aim of this study was to identify socio-economic, geographic and demographic risk factors of malaria based on the rapid diagnosis test (RDT) survey results and produce the prevalence map of the area illustrating variation in malaria risk.MethodsThis study accounts for spatial correlation in assessing the effects of socio- economic, demographic and geographic factors on the prevalence of malaria in Ethiopia. A total of 224 clusters of about 25 households each were selected from the Amhara, Oromiya and Southern Nation Nationalities and People’s (SNNP) regions of Ethiopia. A generalized linear mixed model with spatial covariance structure was used to analyse the data where the response variable was the presence or absence of malaria using the RDT.ResultsThe results showed that households in the SNNP region were found to be at more risk than Amhara and Oromiya regions. Moreover, households which have toilet facilities clean drinking water, and a greater number of rooms and mosquito nets in the rooms, have less chance of having household members testing positive for RDT. Moreover, from this study, it can be suggested that incorporating spatial variability is necessary for understanding and devising the most appropriate strategies to reduce the risk of malaria.

Structured additive regression models with spatial correlation to estimate under-five mortality risk factors in Ethiopia

BackgroundThe risk of a child dying before reaching five years of age is highest in Sub-Saharan African countries. But Child mortality rates have shown substantial decline in Ethiopia. It is important to identify factors affecting under-five mortality.MethodsA structured additive logistic regression model which accounts the spatial correlation was adopted to estimate under-five mortality risk factors. The 2011 Ethiopian Demographic and Health Survey data was used for this study.ResultsThe analysis showed that the risk of under-five mortality increases as the family size approaches seven and keeps increasing. With respect to socio-economic factors, the greater the household wealth, the lower the mortality. Moreover, for older mothers, the chance of their child to dying before reaching five is diminishes.ConclusionThe model enables simultaneous modeling of possible nonlinear effects of covariates, spatial correlation and heterogeneity. Our findings are relevant because the identified risk factors can be used to provide priority areas for intervention activities by the government to combat under-five mortality in Ethiopia.

Semiparametric models for malaria rapid diagnosis test result

BackgroundMore than 75% of the total of Ethiopia is malarious. Therefore, malaria is a leading public health problem in Ethiopia. This study aims to identify socio-economic, geographic and demographic factors contributing to the spread of malaria and is based on the results of a malaria Rapid Diagnosis Test survey.MethodsThe data used in this study originates from the baseline malaria indicator survey, conducted in the Amhara, Oromiya and Southern Nation Nationalities and People (SNNP) regions of Ethiopia from December 2006 to January 2007. The study applies the method of generalized additive mixed model (GAMM) to analyse data. The response variable is the presence or absence of malaria, using the malaria Rapid Diagnosis Test (RDT).ResultsThe results provide an improved insight into the distribution of malaria in relation to the age of affected people, the altitude, the total number of rooms, the total number of mosquito nets, family size, and the number of months that their rooms have been sprayed. The results confirm that positive malaria RDT test results are high for children under 15 years and for older persons. Gender, source of drinking water, time needed to fetch water, toilet facilities, main materials used for the construction of walls, floors and roofs, and use of mosquito nets were all found to have a significant impact on the results of the malaria rapid diagnosis test.ConclusionThe result of the analysis identifies poor socio-economic conditions as a major contributing factor or determinant for the spread of malaria. With the correct use of mosquito nets, indoor residual spraying with insecticide and other preventative measures, the incidence of malaria could be decreased. In addition, improving housing conditions is a means to reduce the risk of malaria. Other measures such as creating awareness of the use of mosquito nets, indoor residual spraying with insecticide, and malaria transmission, can lead to a further reduction in the number of malaria cases.

Indirect child mortality estimation technique to identify trends of under-five mortality in Ethiopia

BACKGROUND In sub-Saharan African countries, the chance of a child dying before the age of five years is high. The problem is similar in Ethiopia, but it shows a decrease over years. METHODS The 2000; 2005 and 2011 Ethiopian Demographic and Health Survey results were used for this work. The purpose of the study is to detect the pattern of under-five child mortality overtime. Indirect child mortality estimation technique is adapted to examine the under-five child mortality trend in Ethiopia. RESULTS From the result, it was possible to see the trend of under-five child mortality in Ethiopia. The under-five child mortality shows a decline in Ethiopia. CONCLUSION From the study, it can be seen that there is a positive correlation between mother and child survival which is almost certain in any population. Therefore, this study shows the trend of under-five mortality in Ethiopia and decline over time.

Using Rasch Modeling to Re-Evaluate Rapid Malaria Diagnosis Test Analyses

The objective of this study was to demonstrate the use of the Rasch model by assessing the appropriateness of the demographic, social-economic and geographic factors in providing a total score in malaria RDT in accordance with the model’s expectations. The baseline malaria indicator survey was conducted in Amhara, Oromiya and Southern Nation Nationalities and People (SNNP) regions of Ethiopia by The Carter Center in 2007. The result shows high reliability and little disordering of thresholds with no evidence of differential item functioning.

Childhood mortality spatial distribution in Ethiopia

ABSTRACT The risk of a child dying before completing five years of age is highest in Sub-Saharan African countries. But Child mortality rates have shown substantial decline in Ethiopia. For this study, the 2000, 2005 and 2011 Ethiopian Demographic Survey (EDHS) was used. Generalized linear mixed model with spatial covariance structure was adapted. The model allowed for spatial correlation, and leads to the more realistic estimate for under-five mortality risk factors. The analysis showed that the risk of under-five mortality shows decline in years. But, some regions showed increase in years. The study highlights the need to implement better education for family planning and child care to improve the under-five mortality situation in some administrative areas.

Determinants of fertility in Ethiopia

BACKGROUND The most important elements to determine the rate of population growth is fertility. Fertility is the main element to affect the welfare of mother. The survival of a child can be affected by high fertility and shorter birth intervals. METHODS For this study, the linear mixed model was used to determine factors affecting fertility status of women in Ethiopia. The 2011 Ethiopian demographic and health survey data was used for this study. RESULTS From the result, materials used for roof, wall and floor were found to have a significant relation to fertility level of women in the last five years. Moreover, family size and births in the last five years were found to have a significant relationship. CONCLUSION Significant variation in fertility level was observed among rural and urban residents of Ethiopia. To reduce the gap of fertility between rural and urban population, it is important to modernize different factors. These factors could be access to education, media, and providing employment opportunities in the modern economic sector. Besides this, it is important to develop and maintain the access of family planning services.

Sorghum production systems and constraints, and coping strategies under drought-prone agro-ecologies of Ethiopia

Sorghum is one of the most important cereal crops worldwide after wheat, rice, maize and barley. Examining the present socio-economic conditions of sorghum-producing farmers in different agro-ecologies in Ethiopia is of importance for the design of improvement strategies. The objectives of this study were to evaluate the sorghum production system and patterns, major production constraints and related coping strategies in north-eastern Ethiopia. Twelve sorghum-growing villages in the North Welo, South Welo and Waghemra districts were surveyed. Descriptive statistics and a generalised additive model were used for data analysis. Constraints affecting the productivity of sorghum include moisture stress, insect pests, striga, farmland shortage, poor soil fertility, diseases, and low-yielding local cultivars. Among the constraints, drought at the grain-filling stage was identified as the most important production problem in the target region. The productivity of sorghum was also hindered by the use of local drought-tolerant but low-yielding landraces, because farmers had been forced to abandon high-yielding and late-maturing landrace cultivars because of the frequent occurrence of drought. To enhance sorghum productivity, farmers’ knowledge and practices, and production constraints need to be integrated from the initial stages of breeding and technology development.