Determinants of iodine deficiency in school children in different regions of Ethiopia

Objective: To determine the magnitude of goitre in school children and measure indicators of iodine deficiency including the most commonly consumed staple foods.Design: A cross-sectional study.Setting: Ten villages from four administrative regions of Ethiopia.Subjects: A total of 2485 randomly selected elementary school children were examined for clinical signs of goitre. Indicators of iodine deficiency disorders (IDD) assessed were urinary iodine excretion (UIE) rate, iodine concentration in water, the commonly consumed individual foods of plant origin and milk, and bacterial contamination of drinking water.Results: The gross prevalence (mean of male and female values) among school children was 53.3%. The prevalence was higher in females (56.1%) than in males (50.8%). The highest prevalence (82 and 91%, respectively) were observed in the villages of Lotte and Kodowono and the lowest (31%) in the village of Abossara. Of the urinary measurements, 70% of the samples showed moderate and 30% mild iodine deficiency. Levels of iodine in water and individual food samples were low in general. Breast milk iodine content was similarly low and related to the maternal daily iodine intake which may affect the nutritional status of the nursing infant. The study also provides further evidence that coliforms and E. coli isolated from drinking water contribute to the high incidence of endemic goitre other than iodinedeficiency.Conclusion: It is difficult to obtain a sufficient iodine intake in the survey villages as the individual foods are very low in the element. However, IDD can be prevented by ensuring normal iodine nutrition through instituting ways that avail iodinated salt to the surveypopulation

The goitre rate, its association with reproductive failure, and the knowledge of iodine deficiency disorders (IDD) among women in Ethiopia: Cross-section community based study

<p>Abstract</p> <p>Background</p> <p>Iodine deficiency is severe public health problem in Ethiopia. Although urinary iodine excretion level (UIE) is a better indicator for IDD the goitre rate is commonly used to mark the public health significance. The range of ill effect of IDD is however beyond goitre in Ethiopia. In this study the prevalence of goitre and its association with reproductive failure, and the knowledge of women on Iodine Deficiency were investigated.</p> <p>Methods</p> <p>A cross-section community based study was conducted during February to May 2005 in 10998 women in child bearing age of 15 to 49 years. To assess the state of iodine deficiency in Ethiopia, a multistage "Proportional to Population Size" (PPS) sampling methods was used, and WHO/UNICEF/ICCIDD recommended method for goitre classification.</p> <p>Results</p> <p>Total goitre prevalence (weighted) was 35.8% (95% CI 34.5–37.1), 24.3% palpable and 11.5% visible goitre. This demonstrates that more than 6 million women were affected by goitre.</p> <p>Goitre prevalence in four regional states namely Southern Nation Nationalities and People (SNNP), Oromia, Bebshandul-Gumuz and Tigray was greater than 30%, an indication of severe iodine deficiency. In the rest of the regions except Gambella, the IDD situation was mild to moderate. According to WHO/UNICEF/ICCIDD this is a lucid indication that IDD is a major public health problem in Ethiopia. Women with goitre experience more pregnancy failure (X²= 16.5, p < 0.001; OR = 1.26, 1.12 < OR < 1.41) than non goitrous women. Similarly reproductive failure in high goitre endemic areas was significantly higher (X²= 67.52; p < 0.001) than in low. More than 90% of child bearing age women didn't know the cause of iodine deficiency and the importance of iodated salt.</p> <p>Conclusion</p> <p>Ethiopia is at risk of iodine deficiency disorders. The findings presented in this report emphasis on a sustainable iodine intervention program targeted at population particularly reproductive age women. Nutrition education along with Universal Salt Iodization program and iodized oil capsule distribution in some peripheries where iodine deficiency is severe is urgently required.</p

Impact of Education on Knowledge and Practice of Kala Azar Preventive Measures among Seasonal and Migrant Agricultural Workers in Northwest Ethiopia.

Kala azar occurs among seasonal and migrant agricultural workers in northwest Ethiopia and accounts for almost 60% of the disease burden in the country. We conducted a quantitative study on the level of knowledge and practice of this vulnerable group in relation to kala azar transmission and acceptability of its vector control tools. A total of 403 workers were randomly selected from eight farms using a purposive sampling technique. Knowledge and practice scores were calculated based on 12 and 9 core questions, respectively. Binary logistic regression was used to identify factors associated with knowledge and practice. A large gap in knowledge of the disease and the vector was evident with 61.8%, 24.6%, and 13.6% of the workers having poor, moderate, and good levels of knowledge scores, respectively. Similarly, 95% of the seasonal workers reported poor level of use of protective measures against the bite of the sand fly vector. Good level of knowledge about kala azar and its sand fly vector was statistically associated with formal education (adjusted odds ratio [AOR] = 2.11; 95% CI = 1.17, 3.80; P < 0.05) and previous exposure to health education (AOR = 4.72; 95% CI = 1.99, 11.16; P < 0.001). Despite poor current knowledge and practice, a large proportion of the study participants showed interest in using vector control tools if made available, with 78% of the seasonal and migrant workers expressing some willingness to pay for different measures that can protect against sand fly bites. Therefore, we strongly recommend that comprehensive health education and vector control programs should be provided to these workers

Routine health management information system data in Ethiopia: consistency, trends, and challenges.

Background: Ethiopia is investing in the routine Health Management Information System. Improved routine data are needed for decision-making in the health sector. Objective: To analyse the quality of the routine Health Management Information System data and triangulate with other sources, such as the Demographic and Health Surveys. Methods: We analysed national Health Management Information System data on 19 indicators of maternal health, neonatal survival, immunization, child nutrition, malaria, and tuberculosis over the 2012-2018 time period. The analyses were conducted by 38 analysts from the Ministry of Health, Ethiopia, and two government agencies who participated in the Operational Research and Coaching for Analysts (ORCA) project between June 2018 and June 2020. Using a World Health Organization Data Quality Review toolkit, we assessed indicator definitions, completeness, internal consistency over time and between related indicators, and external consistency compared with other data sources. Results: Several services reported coverage of above 100%. For many indicators, denominators were based on poor-quality population data estimates. Data on individual vaccinations had relatively good internal consistency. In contrast, there was low external consistency for data on fully vaccinated children, with the routine Health Management Information System showing 89% coverage but the Demographic and Health Survey estimate at 39%. Maternal health indicators displayed increasing coverage over time. Indicators on child nutrition, malaria, and tuberculosis were less consistent. Data on neonatal mortality were incomplete and operationalised as mortality on day 0-6. Our comparisons with survey and population projections indicated that one in eight early neonatal deaths were reported in the routine Health Management Information System. Data quality varied between regions. Conclusions: The quality of routine data gathered in the health system needs further attention. We suggest regular triangulation with data from other sources. We recommend addressing the denominator issues, reducing the complexity of indicators, and aligning indicators to international definitions

Iodine nutritional status and risk factors for goitre among schoolchildren in south Tajikistan

Iodine deficiency affects nearly 1.9 billion people worldwide, but it can be prevented by salt iodization. This cross-sectional survey assessed current iodine status, iodized salt coverage and risk factors for goitre among schoolchildren in South Tajikistan.; Ten primary schools in four districts in South Tajikistan were randomly selected. In schoolchildren aged 7 to 11 years, a spot urine sample was collected for measurement of urinary iodine, dried blood spots were collected for measurement of thyroglobulin, and goitre was assessed by palpation. Iodine content of salt samples and local selling points was determined by coloration using rapid test kits and titration method.; Of 623 schoolchildren enrolled, complete data was obtained from 589. The overall median urinary iodine concentration (UIC) was 51.2 mug/L indicating mild-to-moderate iodine deficiency. Among all children, 46.6% (95% Confidence Interval (CI) = 42.4%-50.6%) of children were found to be goitrous (grade 1 goitre: 30.6%, 95% CI = 26.9%-34.5%; grade 2 goitre: 16.0%, 95% CI = 13.1%-19.2%). The risk factor for goitre remaining significant in the multivariable logistic regression model was 'buying salt once a month' (OR = 2.89, 95% CI = 1.01-8.22) and 'buying salt once every six months' (OR = 2.26, 95% CI = 1.01-5.04) compared to 'buying salt every one or two weeks'. The overall median thyroglobulin concentration was elevated at 13.9 mug/L. Of the salt samples from households and selling points, one third were adequately iodised, one third insufficiently and one third were not iodised.; Iodine deficiency remains a serious health issue among children in southern Tajikistan. There is a persisting high prevalence of goitre, elevated thyroglobulin and low UIC despite interventions implemented by Tajikistan and international partners. Quality control of salt iodine content needs to be improved. Continued efforts to raise awareness of the health effects of iodine deficiency are needed to increase consum demand for iodised salt

Unpacking the agroclimatic challenges and determinants of sweetpotato seed conservation and multiplication strategies by smallholder farmers in Southern Ethiopia

Sweetpotato is increasingly important in sub-Saharan Africa due to its yield potential under sub-optimal growing conditions. But lack of planting material (seed) at the onset of the rains is a major constraint. This study examined smallholder strategies for sweetpotato seed conservation and multiplication, their agroclimatic determinants, and farmers’ perceived drought risk at four sites (Dilla, Chuko, Hawassa, Sodo) in Ethiopia using informant interviews, a survey of 278 households, and agroclimatic statistics. Conservation practices were dictated by farming system and agroecological conditions. The long-term mean length of dry period when multipliers must conserve seeds ranged between 103 and 131 days across sites. Seed multipliers faced high uncertainty of rainfall onset that varied from the end of February to mid-May. Estimated probabilities of moderate and severe droughts affecting seed conservation ranged from 36–75%, and 15–58%, respectively. In drier sites, age of multiplier, land-holding size, sweetpotato production experience and access to extension were positively associated with being a vine multiplier. Knowledge of indigenous conservations strategies should inform seed system intervention design

Unpacking the agroclimatic challenges and determinants of sweetpotato seed conservation and multiplication strategies by smallholder farmers in Southern Ethiopia

Sweetpotato is increasingly important in sub-Saharan Africa due to its yield potential under sub-optimal growing conditions. But lack of planting material (seed) at the onset of the rains is a major constraint. This study examined smallholder strategies for sweetpotato seed conservation and multiplication, their agroclimatic determinants, and farmers’ perceived drought risk at four sites (Dilla, Chuko, Hawassa, Sodo) in Ethiopia using informant interviews, a survey of 278 households, and agroclimatic statistics. Conservation practices were dictated by farming system and agroecological conditions. The long-term mean length of dry period when multipliers must conserve seeds ranged between 103 and 131 days across sites. Seed multipliers faced high uncertainty of rainfall onset that varied from the end of February to mid-May. Estimated probabilities of moderate and severe droughts affecting seed conservation ranged from 36–75%, and 15–58%, respectively. In drier sites, age of multiplier, land-holding size, sweetpotato production experience and access to extension were positively associated with being a vine multiplier. Knowledge of indigenous conservations strategies should inform seed system intervention design

Characterization of Bamboo Culm as Potential Fibre for Composite Development

This study aims to evaluate how age, harvesting seasons, and culm height affect the properties of various bamboo species. The properties of bamboo fibres for composite development in Ethiopia have not been investigated so far. In this study, the properties of Y. alpina and B. oldhamii were scientifically investigated for bamboo culm structural applications and bamboo fibre composite development based on age and the harvesting season. Y. alpina was collected at Injibara and Mekaneselam which are located in east Gojjam and south wollo, whereas B. oldhamii was collected at Kombolcha which is located in south Wollo, Ethiopia. Three representatives of bamboo plants were collected in the three regions, namely from three age groups, across two harvesting months. The highest and lowest moisture content and shrinkage were measured at the ages of one year and three years, respectively, whereas basic densities were measured at the ages of three years and one year. The harvest month of November yields higher moisture content and shrinkage but lower basic densities compared to February. Yushania alpina has a higher moisture content and shrinkage but lower basic densities compared to Bamusa oldhamii. The current research demonstrates that the three-year-old groups and the harvesting month of February produce yields more suited for construction and structural purposes due to the ensuing good dimensional stability after drying. From the highest to the lowest percentage of the degree of crystallinity of the yield, it is that derived from Inj., followed by Meka., and then Kombolcha, respectively. Bamboo fibres have high powder crystals and degradation temperatures which make them suitable for composite development at two year old. Yushania alpina has a higher degree of crystallinity and degradation temperature of cellulose compared to Bambusa oldhamii