| 1. |
- Berhane, Yemane, et al.
(författare)
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A rural Ethiopian population undergoing epidemiological transition over a generation : Butajira from 1987 to 2004
- 2008
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 36:4, s. 436-441
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Tidskriftsartikel (refereegranskat)abstract
- Aims: To describe the epidemiological development of a rural Ethiopian population from 1987 to 2004 in terms of mortality and associated sociodemographic factors. Methods: A rural population comprising 10 communities was defined in 1987 and has since been followed by means of regular household visits. After an initial census, births, deaths and migration events were recorded, together with key background factors, on an open cohort basis. Over 97,000 individuals were observed during a total of over 700,000 person years. Results: The initial population of 28,614 increased by an average of 3.64% annually to 54,426 from 1987 to 2004, and also grew older on average. Birth and mortality rates fell, but were still subject to short-term variation due to external factors. Overall mortality was 13.5 per 1000 person years. Increasing mortality in some adult age groups was consistent with increasing AIDS-related deaths, but a new local hospital in 2002 may have contributed to later falls in overall mortality. Sex, age group, time period, literacy, water source, house ownership and distance to town were all significantly associated with mortality differentials. Conclusions: This population has undergone a complex epidemiological transition during a generation. Detailed long-term surveillance of this kind is essential for describing such processes. Many factors that significantly affect mortality cannot be directly controlled by the health sector and will only improve with general development.
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| 2. |
- Deyessa Kabeta, Negussie, 1966-, et al.
(författare)
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Depression among women in rural Ethiopia as related to socioeconomic factors : a community-based study on women in reproductive age groups
- 2008
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 36:6, s. 589-597
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Several previous studies have reported on socioeconomic and sociodemographic factors associated with depression among women, but knowledge in this area remains scarce regarding women living in extreme poverty in developing countries. OBJECTIVE: The study was aimed at examining the 12-month prevalence of depressive episodes as related to socioeconomic and sociocultural conditions of women in the reproductive age group in rural Ethiopia. METHODS: A community-based cross-sectional study was undertaken among 3016 randomly selected women in the age group 15-49 years. Cases of depression were identified using the Amharic version of the Composite International Diagnostic Interview. A standardized World Health Organization questionnaire was used to measure the socioeconomic status of the women and their spouses. Data were analysed among all women and then separately among currently married women. RESULTS: The 12-month prevalence of depression among all women was 4.4%. After adjusting for common sociodemographic characteristics, only marital status showed a significant association with depressive episode in terms of higher odds ratios (ORs) for divorced/separated women and widowed women than for not-married women (4.05 and 4.24, respectively). Among currently married women, after adjusting for common sociodemographic characteristics, living in rural villages (OR=3.78), a frequent khat-chewing habit (OR=1.61), having a seasonal job (OR=2.94) and being relatively better off in terms of poverty (OR=0.48) were independently associated with depression. CONCLUSIONS: The prevalence of depression among women was in the lower range as compared to studies from high-income countries, but very poor economic conditions were associated with a higher prevalence of depression in this overall very poor setting. This further supports the notion that the relative level of poverty rather than the absolute level of poverty contributes to depression among women. Whether the association with khat chewing and depression is a causative effect or can be explained by self-medication remains unclear.
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| 3. |
- Deyessa Kabeta, Negussie, 1966-
(författare)
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Intimate partner violence and depression among women in rural Ethiopia
- 2010
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: Several studies have reported socioeconomic, socio-demographic factors, including violence against women to be associated with depression among women, but knowledge in the area among women living under extreme poverty in developing countries remains scarce. Relationship between intimate partner violence and women’s literacy in societies where violence is normative is complex, there are only limited data describing this difference in the distribution of violence exposure by residency and literacy. Few studies have addressed consequences of maternal depression and experiencing violence among women on children’s survival. Objective: The aim of this thesis is to determine prevalence of depressive episode and examine its association with violence by intimate partner and socioeconomic status It also assesses contribution of residency and literacy of women on vulnerability to physical violence by intimate partner, and independent effect of intimate partner violence and maternal depression on the risk of child death in rural Ethiopia. Methods: A community-based cross-sectional study was undertaken among 3016 randomly selected women in the age group between 15-49 years conducted from January to December 2002. A cohort study was done through following up women who gave birth to a live child within a year of the survey, in rural Ethiopia. Analysis was made using all the 3016 women, 1994 of the married women and 561 of women who gave birth within a year of the data collection time. Cases of depression were identified using the Amharic version of the Composite International Diagnostic Interview, experience of physical, sexual and emotional violence by intimate partner was made using the WHO multi-country study on women’s life events, and child death was measured by continuous demographic surveillance data from the Butajira Rural Health Program. Result: The twelve-month prevalence of depression was estimated to be 4.4%. In the analyses being currently married, divorced and widowed women, living in rural villages, having frequent khat chewing habit, having seasonal job and living in extreme poverty were factors independently associated with depression. Similarly, among the married women, experiencing physical violence, childhood sexual abuse, emotional violence and spousal control were factors independently associated with depressive episode. Women in the overall study area had beliefs and norms permissive towards violence against women. Violence against women was more prevalent in rural communities, in particular, among rural literate women and rural women who married a literate spouse. In this study, maternal depression was associated with under five child death. Although no association was seen between experiencing violence and child death, the risk of child death increases when maternal depression is combined with physical and emotional violence. Conclusion: Prevalence of depression among women was still in the lower range as compared to studies from high-income countries. Though depression is associated with socio-demographic factors and extreme poverty, the association is complex. The high prevalence of violence against women could be a contributing factor for preponderance of depression among women than in men. Urbanization and literacy are thought to promote changes in attitudes and norms against intimate partner violence. However, literacy within rural community might expose women to the higher risk of violence. Improving awareness of clinicians and public health workers on the devastating consequences of violence against women and depression is essential in order to identify and take measure when violence and maternal depression co-occurred.
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| 4. |
- Deyessa Kabeta, Negussie, 1966-, et al.
(författare)
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Intimate partner violence and depression among women in rural Ethiopia : a cross-sectional study
- 2009
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Ingår i: Clinical Practice and Epidemiology in Mental Health. - : Bentham Science Publishers Ltd.. - 1745-0179. ; 5:1, s. 8-
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Studies from high-income countries have shown intimate partner violence to be associated with depression among women. The present paper examines whether this finding can be confirmed in a very different cultural setting in rural Ethiopia.METHOD: A community-based cross-sectional study was undertaken in Ethiopia among 1994 currently married women. Using the Composite International Diagnostic Interview (CIDI), cases of depressive episode were identified according to the ICD-10 diagnosis. Using a standardized questionnaire, women who experienced violence by an intimate partner were identified. A multivariate analysis was conducted between the explanatory variables and depressive status of the women, after adjusting for possible confounders.RESULTS: The 12-month prevalence of depressive episode among the women was 4.8% (95% CI, 3.9% and 5.8%), while the lifetime prevalence of physical intimate partner violence was 49.5%. Physical violence (OR=2.56, 95% CI, 1.61, 4.06), childhood sexual abuse (OR=2.00, 95% CI, 1.13, 3.56), mild emotional violence (OR=3.19, 95% CI, 1.98, 5.14), severe emotional violence (OR= 3.90, 95% CI, 2.20, 6.93) and high spousal control of women (OR=3.30, 95% CI, 1.58, 6.90) by their partners were independently associated with depressive episode, even after adjusting for socioeconomic factors.CONCLUSIONS: The high prevalence of intimate partner violence, a factor often obscured within general life event categories, requires attention as an independent factor for depression, and thus to find new possibilities of prevention and treatment in terms of public health strategies, interventions and service provision.
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| 5. |
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| 6. |
- Deyessa Kabeta, Negussie, 1966-, et al.
(författare)
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Violence against women in relation to literacy and area of residence
- 2010
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Ingår i: Global Health Action. - : Informa UK Limited. - 1654-9716 .- 1654-9880. ; 3:2070
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: This study explores violence against women in a low-income setting in relation to residency and literacy. SETTING: The study was conducted within the Butajira Rural Health Programme (a Health and Demographic Surveillance Site), which includes rural and semi-urban settings in south-central Ethiopia. DESIGN: This is a community-based cross-sectional study and is part of the WHO Women's Health and Life Events multi-country study. It included 1,994 randomly selected married women. METHODS: A standardised WHO questionnaire was used to measure physical violence, residency, literacy of the woman and her spouse, and attitudes of women about gender roles and violence. Analyses present prevalence with 95% confidence intervals and odds ratios derived from bivariate and multivariate logistic regression models. RESULTS: In urban and rural areas of the study area, the women were of varying ages, had varying levels of literacy and had spouses with varying levels of literacy. Women in the overall study area had beliefs and norms favouring violence against women, and women living in rural communities and illiterate women were more likely to accept such attitudes. In general, violence against women was more prevalent in rural communities. In particular, violence against rural literate women and rural women who married a literate spouse was more prevalent. Literate rural women who were married to an illiterate spouse had the highest odds (Adj. OR = 3.4; 95% CI: 1.7-6.9) of experiencing physical violence by an intimate partner. CONCLUSION: Semi-urban lifestyle and literacy promote changes in attitudes and norms against intimate partner violence; however, within the rural lifestyle, literate women married to illiterate husbands were exposed to the highest risks of violence.
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| 7. |
- Isaksson, Johan, et al.
(författare)
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Early adversity and psychiatric symptoms : a prospective study on Ethiopian mothers and their children
- 2017
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Ingår i: BMC Psychiatry. - : Springer Science and Business Media LLC. - 1471-244X. ; 17
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Maternal exposure to adversity during the perinatal period has been associated with increased susceptibility for psychiatric symptoms in the offspring. The aim of this study was to investigate a possible developmental effect of maternal perinatal stressors on emotional and behavioural symptoms in the offspring in a developing country.METHODS: We followed an Ethiopian birth cohort (N = 358), assessing intimate partner violence (IPV) and maternal psychiatric symptoms during the perinatal period and at follow-up 10 years later, as a proxy for adversity, and maternal ratings on the Child Behavior Checklist (CBCL) 10 years later as the outcome.RESULTS: Among the women, exposure to IPV was common (60.6%) during the perinatal period and predicted IPV (29.9% of the mothers) at follow-up (ρ = 0.132; p = 0.012). There was also an association between maternal psychiatric symptoms at the two time points (ρ = 0.136; p = 0.010) and between maternal symptoms and IPV. Current maternal symptoms of anxiety and depression (β = 0.057; p < 0.001), but not during the perinatal period, were associated with child CBCL-scores.CONCLUSION: Our findings do not support the hypothesis that early adversity increase susceptibility for psychiatric symptoms. However, the findings emphasize the public health problem of IPV in this population, adding to the women's mental health problem.
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| 8. |
- Kebede, D, et al.
(författare)
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Onset and clinical course of schizophrenia in Butajira-Ethiopia--a community-based study.
- 2003
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Ingår i: Social Psychiatry and Psychiatric Epidemiology. - : Springer. - 0933-7954 .- 1433-9285. ; 38:11, s. 625-631
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Tidskriftsartikel (refereegranskat)abstract
- Background: There are reports on favourable course and outcome of schizophrenia in lowincome countries. The aim of the present study was to examine onset and clinical course of the illness in a community-based sample in rural Ethiopia based on crosssectional information. Method: A two-stage survey was carried out in Butajira-Ethiopia, a predominantly rural district. Altogether 68,378 individuals aged 15–49 years were CIDI-interviewed, of whom 2,159 were identified as cases according to the CIDI interview with regard to psychotic or affective disorders. Key informants identified another group of 719 individuals as being probable cases and a total of 2,285 individuals were SCAN-interviewed. The present paper reports on cases with schizophrenia. Results: There were 321 cases of schizophrenia giving an estimated lifetime prevalence of 4.7/1,000). Of the cases,83.2% (N = 267) were males. Mean age of first onset of psychotic symptoms for males was 23.8 (sd 8.6) compared to 21.0 (sd 7.8) for females (P = 0.037; 95 %CI 0.16–5.47). Over 80% had negative symptoms and over 67% reported continuous course of the illness. Less than 10% had a history of previous treatment with neuroleptic medication. About 7% were vagrants, 9 % had a history of assaultive behaviour,and 3.8% had attempted suicide. The male to female ratio was nearly 5:1. Conclusion: This large community-based study differs from most previous studies in terms of higher male to female ratio, earlier age of onset in females and the predominance of negative symptoms.
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| 9. |
- Negash, Alemayehu, 1962-, et al.
(författare)
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Neurological soft signs in bipolar I disorder patients
- 2004
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Ingår i: Journal of Affective Disorders. - 0165-0327 .- 1573-2517. ; 80:2/3, s. 221-230
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Tidskriftsartikel (refereegranskat)abstract
- Background: Neurological soft signs (NSS) have been reported to be more prevalent in patients with schizophrenia compared to other psychiatric and non-psychiatric controls. However, this issue in bipolar I disorder seems to be understudied. Aims: The aims of the study were to examine the extent to which NSS are associated with bipolar I disorder cases compared to healthy controls, to assess the possible relationship between NSS and clinical dimensions of the disorder, and to explore the association of sociodemographic characteristics with the occurrence of NSS in cases with this disorder. Methods: Predominantly treatment naïve cases of bipolar I disorder from rural communities were assessed for NSS using the Neurological Evaluation Scale (NES). Results: This study showed that patients with bipolar I disorder performed significantly worse on two NES items from the sensory integration subscale, on one item from motor coordination and on four items from the ‘others’ subscale, the highest difference in performance being in items under the sequencing of complex motor acts subscale. Clinical dimensions and sociodemographic characteristics appeared to have no relationship with NES total score. Conclusions: Bipolar I disorder patients seem to have more neurological dysfunction compared to healthy controls particularly in the area of sequencing of complex motor acts. In addition, the finding suggests that NSS in bipolar I disorder are stable neurological abnormalities established at its onset or may be essential characteristic features of the disorder representing stable disease process that existed long before its onset.
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| 10. |
- Shibre, Teshome, et al.
(författare)
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Schizophrenia : illness impact on family members in a traditional society--rural Ethiopia.
- 2003
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Ingår i: Social Psychiatry and Psychiatric Epidemiology. - : Springer. - 0933-7954 .- 1433-9285. ; 38:1, s. 27-34
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Tidskriftsartikel (refereegranskat)abstract
- Background: Studies have consistently shown that both the subjective and objective dimensions of burden among family members of schizophrenia patients and other psychiatric disorders are prevalent. However, as most of these reports were from western societies, we lack information on the subject in developing countries. Method: The study was conducted within the framework of the ongoing epidemiological study of course and outcome of schizophrenia and bipolar disorders in a rural population of 15–49 years of age. Three hundred and one cases of schizophrenia and their close relatives participated in the study. Results: Family burden is a common problem of relatives of cases with schizophrenia. Financial difficulty is the most frequently endorsed problem among the family burden domains (74.4 %). Relatives of female cases suffered significantly higher social burden (Z = 2.103; p = 0.036). Work (Z = 2.180; p = 0.029) and financial (Z = 2.088; p = 0.037) burdens affected female relatives more often than males. Disorganised symptoms were the most important factors affecting the family members in all family burden domains. Prayer was found to be the most frequently used coping strategy in work burden (adj. OR = 1.99; 95 % CI = 1.08–3.67; p = 0.026). Conclusion: Negative impact of schizophrenia on family members is substantial even in traditional societies such as those in Ethiopia where family network is strong and important. The scarce existing services in the developing countries should include family interventions and support at least in the form of educating the family members about the nature of schizophrenia illness and dealing with its stigma and family burden.
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