Awraris Hailu Bilchut

BACKGROUND: The health risks associated with moderate alcohol consumption continue to be debated. Small amounts of alcohol might lower the risk of some health outcomes but increase the risk of others, suggesting that the overall risk depends, in part, on background disease rates, which vary by region, age, sex, and year. METHODS: For this analysis, we constructed burden-weighted dose-response relative risk curves across 22 health outcomes to estimate the theoretical minimum risk exposure level (TMREL) and non-drinker equivalence (NDE), the consumption level at which the health risk is equivalent to that of a non-drinker, using disease rates from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2020 for 21 regions, including 204 countries and territories, by 5-year age group, sex, and year for individuals aged 15-95 years and older from 1990 to 2020. Based on the NDE, we quantified the population consuming harmful amounts of alcohol. FINDINGS: The burden-weighted relative risk curves for alcohol use varied by region and age. Among individuals aged 15-39 years in 2020, the TMREL varied between 0 (95% uncertainty interval 0-0) and 0·603 (0·400-1·00) standard drinks per day, and the NDE varied between 0·002 (0-0) and 1·75 (0·698-4·30) standard drinks per day. Among individuals aged 40 years and older, the burden-weighted relative risk curve was J-shaped for all regions, with a 2020 TMREL that ranged from 0·114 (0-0·403) to 1·87 (0·500-3·30) standard drinks per day and an NDE that ranged between 0·193 (0-0·900) and 6·94 (3·40-8·30) standard drinks per day. Among individuals consuming harmful amounts of alcohol in 2020, 59·1% (54·3-65·4) were aged 15-39 years and 76·9% (73·0-81·3) were male. INTERPRETATION: There is strong evidence to support recommendations on alcohol consumption varying by age and location. Stronger interventions, particularly those tailored towards younger individuals, are needed to reduce the substantial global health loss attributable to alcohol. FUNDING: Bill & Melinda Gates Foundation.

BACKGROUND: Neck pain is a highly prevalent condition that leads to considerable pain, disability, and economic cost. We present the most current estimates of neck pain prevalence and years lived with disability (YLDs) from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) by age, sex, and location, with forecasted prevalence to 2050. METHODS: Systematic reviews identified population-representative surveys used to estimate the prevalence of and YLDs from neck pain in 204 countries and territories, spanning from 1990 to 2020, with additional data from opportunistic review. Medical claims data from Taiwan (province of China) were also included. Input data were pooled using DisMod-MR 2.1, a Bayesian meta-regression tool. Prevalence was forecast to 2050 using a mixed-effects model using Socio-demographic Index as a predictor and multiplying by projected population estimates. We present 95% UIs for every metric based on the 2·5th and 97·5th percentiles of 100 draws of the posterior distribution. FINDINGS: Globally, in 2020, neck pain affected 203 million (95% uncertainty interval [UI] 163-253) people. The global age-standardised prevalence rate of neck pain was estimated to be 2450 (1960-3040) per 100 000 population and global age-standardised YLD rate was estimated to be 244 (165-346) per 100 000. The age-standardised prevalence rate remained stable between 1990 and 2020 (percentage change 0·2% [-1·3 to 1·7]). Globally, females had a higher age-standardised prevalence rate (2890 [2330-3620] per 100 000) than males (2000 [1600-2480] per 100 000), with the prevalence peaking between 45 years and 74 years in male and female sexes. By 2050, the estimated global number of neck pain cases is projected to be 269 million (219-322), with an increase of 32·5% (23·9-42·3) from 2020 to 2050. Decomposition analysis of the projections showed population growth was the primary contributing factor, followed by population ageing. INTERPRETATION: Although age-standardised rates of neck pain have remained stable over the past three decades, by 2050 the projected case numbers are expected to rise. With the highest prevalence in older adults (higher in females than males), a larger effect expected in low-income and middle-income countries, and a rapidly ageing global population, neck pain continues to pose a challenge in terms of disability burden worldwide. For future planning, it is essential we improve our mechanistic understanding of the different causes and risk factors for neck pain and prioritise the consistent collection of global neck pain data and increase the number of countries with data on neck pain. FUNDING: Bill & Melinda Gates Foundation and Global Alliance for Musculoskeletal Health.

INTRODUCTION: Coronavirus disease 2019 (COVID-19) is an emerging respiratory infections and is known to cause illness ranging from the common cold to severe acute respiratory syndrome. At present, the disease has been posing a serious threat to the communities, and it is critical to know the communities' level of adherence on COVID-19 prevention measures. Thus, this study aimed to identify the predictors of adherence to COVID-19 prevention measure among communities in North Shoa zone, Ethiopia by using a health belief model. METHODS: Community-based cross-sectional study design was employed. A total of 683 respondents were interviewed using a structured and pre-tested questionnaire. The data were collected by using a mobile-based application called "Google form." Logistic regression was performed to analyze the data. Estimates were reported in adjusted odds ratios with 95% confidence intervals (CI) and a significant association was declared at p-value of less than 0.05. RESULT: The overall adherence level of the community towards the recommended safety measures of COVID-19 was 44.1%. Self-efficacy (AOR = 0.23; 95% 0.14, 0.36), perceived benefits (AOR = 0.35; 95% 0.23, 0.56), perceived barriers (AOR = 3.36; 95% 2.23, 5.10), and perceived susceptibility of COVID-19 (AOR = 1.60; 95% 1.06, 2.39) were important predictors that influenced the adherence of the community to COVID-19 preventive behaviors. CONCLUSIONS: In this study, the overall adherence level of the community towards the recommended safety measures of COVID-19 was relatively low. It is vital to consider the communities' self-efficacy, perceived benefits, perceived barriers and perceived susceptibility of COVID-19 in order to improve the adherence of the community towards the recommended safety measures of COVID-19.

BACKGROUND: Human papillomavirus infection, a causative factor for cervical cancer, remains a topic of great interest. About 80% of sexually active women are at risk of acquiring HPV infection while having a 70% global target to eliminate intensive cervical cancer. OBJECTIVE: This study aimed to assess the practice of human papillomavirus vaccination and associated factors among primary school female students in Minjar-Shenkora district, 2020. METHODS: A school-based quantitative cross-sectional study was conducted from February 1 to 30 2020, in primary school female students of Minjar-Shenkora district, North Shoa zone, Ethiopia. A structured self-administered questionnaire was used for data collection. Associations between dependent and independent variables tested in binary and multiple logistic regression and variables with p-value ≤0.25 were entered into multiple logistic regression with considered significant level of P-value ≤0.05 and at 95% confidence interval (CI). RESULTS: A total of 591 students participated in the study with a response rate of 96.3%. Of the total, 393 (66.5%) (CI 0.63-0.7) participants have been vaccinated for HPV. The factors associated with the practice of vaccination were; being knowledgeable about HPV vaccination (AOR, 8.65, CI=5.2-14.3) and a positive attitude towards HPV vaccination (AOR, 1.85, CI=1.18-3). Students in rural areas were 88% less likely to practice HPV vaccine than students in urban areas (AOR, 0.12, CI=0.07 0.21). CONCLUSION AND RECOMMENDATION: Overall, HPV vaccination practice was relatively good (66.5%). Knowledge on HPV vaccination, positive attitude towards HPV vaccination, and being a rural residence were associated with HPV vaccination practice. Families, health-care workers, and schools should work together to improve the knowledge and attitude of the community towards HPV vaccination.

Background: Diarrheal diseases are one of the top (major) leading causes of under-five morbidity, mortality and under nutrition in developing countries. In African countries including Ethiopia, each child on average suffers from five episodes of diarrhea per year while the two-week prevalence ranges from 10% to 40% in different parts of Ethiopia. Objective: To assess prevalence and associated factors for the occurrence of diarrhea diseases among the under-five year's children in Debrebirehan referral hospital. Method: A facility-based cross sectional study design was conducted among 483 children less than 5 years of age who came to Debrebirehan referral hospital from February 1, 2013 to June 30, 2013. Data were collected, entered analyzed by using SPSS statistical software version 16.0. A logistic regression model was used to associated factors for the occurrence of diarrhea diseases. Results: The prevalence of diarrhea among mothers and underfive children was 9.3% and 31.7%, respectively. Occupation of mothers (private workers) [(AOR: 2.004, 95% CI: (1.167 -3.442)], occupation of fathers (farmers) [AOR: 1.427, 95% CI: (1.224 -1.812)], maternal history of recent diarrhea [(AOR: 1.042, 95% CI: (1.015 -1.219)], houses having one room [AOR: 1.297, 95% CI: (1.097 -1.906) and houses having two rooms [AOR: 1.151, 95% CI: (1.032 -1.716)], living with cattle in one house [AOR: 1.297, 95% CI: (1.097 -1.906)], address (rural) [AOR: 2.527, 95% CI: (1.847 -7.538)], feeding of gruel for children [AOR: 3.046, 95% CI: (1.408 -6.587)], feeding of adult's food for children [(AOR: 3.703, 95% CI: (1.324 -10.354)], method of dipping to take water from water containers [AOR: 1.371, 95% CI: (1.137 -1.607) & water storage container without cover [(AOR: 1.304, 95% CI: (1.110 -1.836)] had significant association with diarrheal diseases. Conclusion and Recommendation: In this study, the prevalence of diarrheal diseases was very high and major problem among under-five children. The health institutions efforts should be strengthened to decrease factors which increase diarrheal diseases.