Abiyie Demelash Gashe

Background: In response to the increasing incidence and prevalence of hypertension, Ethiopia has been piloting hypertension control at the primary health care level in selected sentinel sites. However, no evaluation has been conducted and its success and failures have not been ascertained. Objective: This study aimed to evaluate on whether sentinel hypertension surveillance system in Mojo City were operating efficiently and effectively. Methods: A concurrently embedded mixed design (quantitative or qualitative) study was conducted in 2 sentinel health centers in Mojo city, Oromia region of Ethiopia. The usefulness and 9 system attributes were assessed via key informant interviews, observations, and record reviews. The qualitative data were analyzed manually via thematic analysis, whereas quantitative data were analyzed via SPSS Software version 25.0 (IBM Corp). Results: The study invited 14 key informants, and all were willing to participate in the interview. The completeness and timeliness of reports were 98% and 100%, respectively. The sensitivity, positive predictive value, and representativeness were 45.3%, 92.6%, and 22%, respectively. Nearly three-fourths (10/14, 71%) of key informants perceived the system as flexible, while half thought it as unstable due to factors such as inadequate training and lack of supportive supervision and feedback system. Health facilities did not conduct routine data analysis and interpretation, nor did they use for action. Conclusions: The surveillance system in Mojo city was simple, flexible, acceptable, and predictive but less sensitive, unrepresentative, and unstable. There is a need for implementing routine data analysis and use for action, adequate training, and feedback system for optimizing the system’s performance and to ensure its sustainability.

BACKGROUND Hypertension is one of the rising non-communicable diseases in Ethiopia. To achieve optimal hypertension control, and reduce the risk of cardiovascular complications, Ethiopia had initiated a hypertension program in primary healthcare settings whose effectiveness has not yet been ascertained OBJECTIVE This study aimed to determine the effectiveness of a pilot hypertension program in the Amhara region of Ethiopia METHODS A parallel evaluation design guided by the CDC’s Framework of evaluating public health programs was conducted at four pilot and four non-pilot health facilities in the Amhara region of Ethiopia. Data were collected using checklist with a structured questionnaire from face-to face interviews, record reviews and observations. Data were analyzed using SPSS version 25.0. Statistical comparisons were made using chi-square tests, t-tests, 95% confidence intervals, and p < 0.05 RESULTS Opportunistic blood pressure (BP) screening was significantly higher in pilot facilities (91%, 95% CI: 87.8–93.5%) than in non-pilot facilities (74.4%, 95% CI: 71.2–79.7%). Hypertension detection rate was significantly higher in pilot facilities (19.9%, 95% CI: 16.2–24.0%) compared to non-pilot facilities (14.9%, 95% CI: 11.7–18.6%). Half (51.8%) of the hypertensive patients in the pilot facilities and 42.4% in the non-pilot facilities had controlled BP, with a statistically significant difference in BP control rates between facilities (chi-square, X2=0.823; p < 0.001). Overall, pilot facilities showed better performance in the hypertension prevention (72.8% vs 43.6%), treatment (85.3% vs 55.0%) and control domains (49.8% vs 42.4%). The mean performance across the three domains was higher in pilot facilities (76.1%) compared to non-pilot facilities (51.2%) (t = 2.125; p = 0.042) CONCLUSIONS The pilot program in the Amhara region showed promising results in hypertension prevention, treatment, and control. These results support the scale-up of pilot components into nationwide program such as structured approaches in hypertension management, protocol adherence and integration into community level care

Introduction: Ethiopia is a global hotspot for child malnutrition, with an estimated 1.2 million children under five affected by severe acute malnutrition (SAM) in 2022. In response, the country has integrated SAM into its broader disease surveillance system. In January 2022, the Dubti District Health Office in the Afar Region detected an unusual surge in SAM cases through its surveillance system. This study aimed to assess the extent of the outbreak and identify the associated risk factors.Methods: We conducted an unmatched case–control study involving 258 mother–child dyads from five affected kebeles in the Dubti District of the Afar Region Ethiopia. The descriptive study included all 442 SAM cases from the line list, while 86 cases and 168 controls were selected using a simple random sampling method for the analytic study. The data were entered into EpiData software (version 3.1) and analyzed using SPSS software (version 25.0). Binary logistic regression (LR) analysis was performed to identify risk factors for SAM. Statistically, the results were summarized using an adjusted odds ratio (AOR), 95% confidence intervals (CIs), and a p-value of <0.05.Results: The median age of the cases was 22 months, with an interquartile range of 12–34 months. A total of 39 deaths were reported, with a case fatality rate (CFR) of 8.82%. The identified SAM risk factors included households with more than five members (AOR = 3.341, 95% CI: 1.475–7.563), more than five under-five children (AOR = 4.442, 95% CI: 2.000–9.866), lack of vaccination (AOR = 3.641, 95% CI: 1.618–8.198), pneumonia (AOR = 5.61, 95% CI: 2.488–12.651), diarrhea (AOR = 4.68, 95% CI: 2.169–10.097), lack of access to sanitation and hygiene (AOR = 3.18, 95% CI: 1.462–6.934), and household food insecurity (AOR = 9.46, 95% CI: 2.095–42.712).Conclusion: The study revealed a significant outbreak of SAM, with a CFR of 8.82%. The outbreak was associated with factors such as large family sizes, having multiple under-five children, a lack of vaccination, pneumonia, and diarrhea. These findings emphasize the urgent need to safeguard essential child health services, water supply, sanitation and hygiene, and household food security.