Solomon Weldemariam Gebrehiwot

Importance: The increasing burden due to cancer and other noncommunicable diseases poses a threat to human development, which has resulted in global political commitments reflected in the Sustainable Development Goals as well as the World Health Organization (WHO) Global Action Plan on Non-Communicable Diseases. To determine if these commitments have resulted in improved cancer control, quantitative assessments of the cancer burden are required. Objective: To assess the burden for 29 cancer groups over time to provide a framework for policy discussion, resource allocation, and research focus. Evidence Review: Cancer incidence, mortality, years lived with disability, years of life lost, and disability-adjusted life-years (DALYs) were evaluated for 195 countries and territories by age and sex using the Global Burden of Disease study estimation methods. Levels and trends were analyzed over time, as well as by the Sociodemographic Index (SDI). Changes in incident cases were categorized by changes due to epidemiological vs demographic transition. Findings: In 2016, there were 17.2 million cancer cases worldwide and 8.9 million deaths. Cancer cases increased by 28% between 2006 and 2016. The smallest increase was seen in high SDI countries. Globally, population aging contributed 17%; population growth, 12%; and changes in age-specific rates, -1% to this change. The most common incident cancer globally for men was prostate cancer (1.4 million cases). The leading cause of cancer deaths and DALYs was tracheal, bronchus, and lung cancer (1.2 million deaths and 25.4 million DALYs). For women, the most common incident cancer and the leading cause of cancer deaths and DALYs was breast cancer (1.7 million incident cases, 535 000 deaths, and 14.9 million DALYs). In 2016, cancer caused 213.2 million DALYs globally for both sexes combined. Between 2006 and 2016, the average annual age-standardized incidence rates for all cancers combined increased in 130 of 195 countries or territories, and the average annual age-standardized death rates decreased within that timeframe in 143 of 195 countries or territories. Conclusions and Relevance: Large disparities exist between countries in cancer incidence, deaths, and associated disability. Scaling up cancer prevention and ensuring universal access to cancer care are required for health equity and to fulfill the global commitments for noncommunicable disease and cancer control.

BACKGROUND: Short birth interval is known to have a negative effect on perinatal, neonatal and child health outcomes. In Ethiopia, 29% of births are short birth intervals at less than 24 months. Even though optimum birth spacing is considered as an essential factor for the health of women and their children, to the best of the authors' knowledge studies conducted on short birth interval are insufficient to inform policy makers. Therefore, the aim of this study was to assess short birth interval and associated factors among women of child bearing age in Tigray, Ethiopia. METHODS: A community based cross-sectional study was conducted in Tselemti district among women of child bearing age from January 28 to February 28, 2016. Systematic sampling technique was used to select participants. Data were collected through face to face interviews and analyzed using SPSS version 20.0. Odds ratio along with 95% CI was computed to ascertain association between the outcome and predictor variables. A p-value of < 0.05 was considered as cut off point to assess significance of associations in the multivariable analysis. RESULTS: The overall prevalence of short birth interval among women of child bearing age was 187 (23.3%). Sub-optimum breastfeeding (AOR = 7.01; 95% CI: 3.64, 13.46), non-use of contraceptive (AOR = 2.44; 95% CI: 1.55, 3.82), being Muslim (AOR = 2.02; 95% CI: 1.20, 3.40) and not having desire to had the last child (AOR = 3.63; 95% CI: 2.23, 5.91) were factors associated with short birth interval. CONCLUSION: Even though currently coverage of family planning use has increased, this study showed that short birth interval is still a concern for Ethiopian women due to factors such as: religion, suboptimum breastfeeding, unwanted pregnancy and non-use of contraceptives. Improving the accessibility and coverage of contraceptive use and involvement of religious leaders in family planning programs are essential strategies to be considered.

Abstract Ethiopia is highly susceptible to the effects of climate change and variability. This study evaluated the performances of 37 CMIP6 models against a gridded rainfall product of Ethiopia known as Enhancing National Climate Services (ENACTS) in simulating the observed rainfall from 1981 to 2014. Taylor Skill Score was used for ranking the performance of individual models for mean monthly, June–September, and February–May seasonal rainfall. Comprehensive rating metrics (RM) were used to derive the overall ranks of the models. Results show that the performances of the models were not consistent in reproducing rainfall distributions at different statistical metrics and timeframes. More than 20 models simulated the largest dry bias on high topographic and rainfall-receiving areas of the country during the June–September season. The RM-based overall ranks of CMIP6 models showed that GFDL-CM4 is the best-performing model followed by GFDL-ESM4, NorESM2-MM, and CESM2 in simulating rainfall over Ethiopia. The ensemble of these four Global Climate Models showed the best performance in representing the spatiotemporal patterns of the observed rainfall relative to the ensembles of all models. Generally, this study highlighted the existence of dry bias in climate model projections for Ethiopia, which requires bias adjustment of the models, for impact assessment.

BACKGROUND: Sexually transmitted infections are highly prevalent among pregnant women in Africa. Among the incidence of HIV infection in children, 90% of the infection is attributable to their mothers. Ethiopia is one of the countries with an increasing risky sexual behavior and the most affected by the HIV epidemic. If prevention of mother to child transmission focuses on increasing contraception, it will prevent more than 29% of HIV infection at birth. Therefore, the aim of this study was to assess utilization of dual contraceptive method and associated factors among reproductive age women on antiretroviral therapy in selected public hospitals of Mekelle town, Northern Ethiopia. METHODS: Institution based cross-sectional survey was conducted in selected public hospitals of Mekelle among women under antiretroviral therapy from March 1-April 31, 2016. We used a systematic sampling technique to select 331 women. A pretested interviewer administered questionnaire was used for data collection. The data were entered in to Epi data version 3.1 and exported to SPSS version 20 for analysis. Bivariate and multivariable logistic regression analysis was computed. Odds ratio along with 95% CI was computed to ascertain the association. Statistical tests at p-value of < 0.05 were considered as cut off point to determine statistical significance. RESULTS: Only 51(15.7%) of participants have utilized dual contraception method. Being single[AOR 5.43, 95% CI (1.61, 18.32)] and cohabitated [AOR 6.06; 95% CI: (2.16, 16.95)] in marital status, having HIV negative partner [AOR 4.44; 95% CI: (1.23, 16.04)], exposure to post diagnosis counseling [AOR 3.03; 95% CI: 1.34, 6.80], disclosed HIV status [AOR 6.06; 95% CI: (1.78, 20.87)] and discussing safer sex with partner [AOR 6.96; 95% CI: (2.75, 16.62)] were positively associated with utilization of dual contraceptive method. CONCLUSION: The overall magnitude of dual contraceptive use is still low in this study. This will be a great concern on the transmission of the virus from mother to babies and partners and risk of complications following unintended pregnancy. This will continue to present as major public health problems in the region unless future interventions focuses on the barriers through tailored counseling and husband involvement in all aspects of the HIV/AIDS care.

Historically, Ethiopia has experienced recurrent droughts and floods, which may intensify due to climate change. This study has evaluated the performance of 45 models from the Coupled Model Intercomparison Project Phase 6 (CMIP6) in simulating ten extreme precipitation indices against corresponding indices from the Enhancing National Climate Services (ENACTS) during short rainy (February–May, FMAM) and main rainy (June–September, JJAS) seasons for the period 1981–2014 over Ethiopia. Ensemble mean of the top-ranking models are also evaluated against ENACTS in reproducing extreme indices over five Agro-ecological zones (AEZs) of the country. The Taylor Skill Score (TSS) was used to rank the performance of the individual CMIP6 models for JJAS and FMAM seasons with respect to ENACTS while Comprehensive Rating Metrics (RM) were used to compute the overall ranks of the models. Our results show that most CMIP6 models reasonably captured the spatial distribution of the seasonal extreme precipitation indices even though they could not reproduce the magnitude of indices, especially in the highland and high rainfall areas of the country such as Northwest and west parts of the country. However, the biases in lowland and low rainfall regions, such as the eastern and northeastern parts of the country, are smaller compared to other areas. More than 30 CMIP6 models underestimated the extreme indices with the exception of consecutive wet days which is grossly overestimated in the highland and high rainfall areas specifically in western parts of the country. Additionally, EnseMean in the tropical and desert AEZs performs particularly better in simulating extreme indices compared to other AEZs. The ensemble mean of the top-ranking models (EnseMean) generally outperformed both individual models and ensemble of all models in the representation of observed extreme indices across all metrics and seasons. Moreover, the performance of individual models is subject to variation based on the season, and the selected extreme indices. It is also noteworthy that their performance is relatively less influenced by horizontal resolution. Further evaluation, focusing on teleconnections such as ENSO and IOD, is a crucial next step for evaluating models and creating a sub-ensemble.