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Although the literature on khat (Catha edulis Forsk) is fairly extensive, and several authors have stated the potential adverse effects of habitual use of khat on mental, physical and social well-being, very few population based studies... more
Although the literature on khat (Catha edulis Forsk) is fairly extensive, and several authors have stated the potential adverse effects of habitual use of khat on mental, physical and social well-being, very few population based studies exist to substantiate those statements in Ethiopia. A house-to-house survey of a representative sample of 1200 adults from a rural Ethiopian community was conducted from January to September of 1997 to determine the prevalence of khat use and its association with health, nutritional status, mental distress, substance use, family and social functioning and economic well-being. The current prevalence of khat chewing was found to be 31.7%. Muslims more than Christians, males more than females, those between the ages 15 and 34 years more than other age groups were habitual users. The following factors were found to be significantly associated with khat use: physical illness, (OR = 1.52, 95% CI = 1.14-2.02); injuries (OR = 2.31, 95% CI = 1.42-3.79), undernutrition (OR = 1.76, 95% CI = 1.24-2.48), mental distress (OR = 8.30, 95% CI = 5.20-13.31). Family functioning among current khat users was significantly higher than non users (OR = 1.56, 95%-CI = 1.04-2.28). Social functioning and economic well-being were not significantly associated with khat use. It is concluded that a fairly large proportion of the population consumes khat and that this is related to physical and mental ill-health, although family and social functioning, and economic well-being seem to be unrelated to khat use.
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To describe the socio-demographic correlates of bipolar disorder and their interactions. Cross sectional study. Rural population in Ethiopia. We conducted a door-to-door survey of a predominantly rural population of close to 70,000... more
To describe the socio-demographic correlates of bipolar disorder and their interactions. Cross sectional study. Rural population in Ethiopia. We conducted a door-to-door survey of a predominantly rural population of close to 70,000 individuals. A total of 315 cases of bipolar disorder were identified by use of the SCAN and clinical assessment. The lifetime prevalence of biopolar disorder in this population was 0.5% (0.6% for men and 0.4%) for women. Adjusted odds ratios show that males had 80% higher risk of bipolar disoder: OR (95% CI) = 1.81 (1.42, 2.32). Those aged 25-34 years had 45% higher risk than those aged under 25: adjusted OR (95% CI) = 1.45 (1.03, 2.06). Area of residence and educational level were not associated with the disorder. The association of marital status with bipolar disorder was modified by age and sex. Among males the odds of bipolar disorder among the married was 3.6 times higher than those who have never married. Among the age group of 15 to 24 years, those married had a 84% higher risk of disease, while those previously married had a 55% increase. On the other hand the association between marital status and bipolar disorder is reversed in older age groups, with those who have never married having a higher risk compared to those married. The study shows that the prevalence of bipolar disorder in this population is within ranges of prevalence reported in the literature, although on the lower side. It also shows that age, sex and marital status are associated with bipolar disorder and these variables interacts with each other.
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Background Evidence on mortality in severe mental illness (SMI) comes primarily from clinical samples in high-income countries. Aims To describe mortality in people with SMI among a population cohort from a low-income country. Method We... more
Background Evidence on mortality in severe mental illness (SMI) comes primarily from clinical samples in high-income countries. Aims To describe mortality in people with SMI among a population cohort from a low-income country. Method We followed-up 919 adults (from 68 378 screened) with SMI over 10 years. Standardised mortality ratios (SMR) and years of life lost (YLL) as a result of premature mortality were calculated. Results In total 121 patients (13.2%) died. The overall SMR was twice that of the general population; higher for men and people with schizophrenia. Patients died about three decades prematurely, mainly from infectious causes (49.6%). Suicide, accidents and homicide were also common causes of death. Conclusions Mortality is an important adverse outcome of SMI irrespective of setting. Addressing common natural and unnatural causes of mortality are urgent priorities. Premature death and mortality related to self-harm should be considered in the estimation of the global ...
Research Interests: Poverty, Homicide, Depression, Schizophrenia, Bipolar Disorder, and 11 moreSuicide, Ethiopia, Adolescent, Humans, Accidents, Female, Male, Young Adult, Middle Aged, Adult, and Cohort Studies
One of the major difficulties in mental health research is finding suitable research instruments. In the last few decades questionnaires that are supposed to work in different languages and cultures have been developed by WHO to solve... more
One of the major difficulties in mental health research is finding suitable research instruments. In the last few decades questionnaires that are supposed to work in different languages and cultures have been developed by WHO to solve this problem. One of such instruments is SCAN, an instrument which uses computer algorithm to make a diagnosis. It is meant to be used for semi-structured interview by qualified psychiatrists or clinical psychologists. This and a few other research instruments have been translated and used in clinical and community settings for psychiatric research in Ethiopia over the last few years. In this study computer assisted SCAN Diagnoses and clinical diagnoses made by trainee psychiatrists in Butajira, a rural setting in Ethiopia, were compared Seven hundred twenty nine persons were diagnosed to have schizophrenia and bipolar disorder using both methods. The agreement between the clinical and SCAN derived diagnosis was shown to be 100% for schizophrenia (Kapp...
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This study aimed to estimate the lifetime prevalence and socio-demographic correlates of psychiatric disorders among the Borana semi-nomadic community of the Oromia region of Ethiopia. 1854 people of both sexes, aged 15 years and above,... more
This study aimed to estimate the lifetime prevalence and socio-demographic correlates of psychiatric disorders among the Borana semi-nomadic community of the Oromia region of Ethiopia. 1854 people of both sexes, aged 15 years and above, were interviewed during the survey. The households were selected by using a cluster sampling method proportionate to population size. The interviews were conducted by trained high school graduates using the Oromiffa version of the Composite International Diagnostic Interview (CIDI). The lifetime prevalence of ICD-10 mental disorders, including substance abuse, was 21.6%. Affective disorders were found in 1.7% of the study population, whereas neurotic and somatoform disorders constituted 14%. No cases of schizophrenia were detected. The prevalence of substance use was 10.1%. Studies using other methods, including interview by clinicians, might shed more light on the nature of mental illness in this unique community.
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It is now recognized that surveys of unique communities are important to better understand the epidemiology of mental disorders. The Zeway islanders are completely different from the surrounding cultural groups, in the midst of whom they... more
It is now recognized that surveys of unique communities are important to better understand the epidemiology of mental disorders. The Zeway islanders are completely different from the surrounding cultural groups, in the midst of whom they have been living in isolation for over three centuries. To describe the prevalence and sociodemographic correlates of major mental disorders in this community. Trained and supervised field workers were employed to conduct a door-to-door survey of the entire adult population of the islands using the Amharic CIDI (Composite International Diagnostic Interview). A total of 18.3% of the study subjects were classified as having ICD-10 diagnoses, excluding substance use disorders. The most prevalent CIDI/ICD-10 disorder in the study were neurotic and somatoform disorders (17%). Affective disorders were present in 2.2% while no cases of psychoses were found. The prevalence of tobacco use and alcohol dependence was 0.4% and 1.5%, respectively, with all cases...
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Khat (an evergreen plant with amphetamine-like properties) and alcohol are widely consumed among the youth of Ethiopia. However, their relationship to risky sexual behaviour is not well described. This study was conducted to describe the... more
Khat (an evergreen plant with amphetamine-like properties) and alcohol are widely consumed among the youth of Ethiopia. However, their relationship to risky sexual behaviour is not well described. This study was conducted to describe the magnitude of risky sexual behaviour (unprotected sex and early initiation of sexual activity) and its association with Khat and alcohol consumption in Ethiopian youths. A probabilistic national sample of 20,434 in-school and out-of-school youths aged between 15 and 24 years of age was selected and interviewed regarding their sexual behavior and substance use. Over 20% of out-of-school youth had unprotected sex during the 12-month period prior to interview compared to 1.4% of in-school youth. Daily Khat intake was also associated with unprotected sex: adjusted OR (95% CI) = 2.26 (1.92, 2.67). There was a significant and linear association between alcohol intake and unprotected sex, with those using alcohol daily having a three fold increased odds com...
Research Interests: Sexual Behaviour, Risk Taking, Ethiopia, Adolescent, Probability, and 17 moreStudents, Humans, Substance Use, Female, Alcohol Drinking, Male, Sexual Behavior, Social Environment, Alcohol Consumption, Adult, Public health systems and services research, Age Factors, Sexual Activity, Alcohol Use, Coitus, Adolescent Behavior, and Unsafe Sex
The SF-36 health survey, a generic measure of health related quality of life (HRQOL), has been translated, evaluated in various languages and used in over 40 countries worldwide, although it has not been used in Ethiopia. To measure the... more
The SF-36 health survey, a generic measure of health related quality of life (HRQOL), has been translated, evaluated in various languages and used in over 40 countries worldwide, although it has not been used in Ethiopia. To measure the reliability and validity of the SF-36, to establish general population norms for various sex and age groups, to describe the effects of socio-demographic factors on SF-36 scores, and SF-36 scores in patients with major mental disorders. Following the standard procedures of forward and back translation and adaptation, an Amharic SF-36 was developed This was subsequently used in a health survey of a general rural population of 1.990 in Butajira. The instrument was also used to interview a group of patients with schizophrenia, bipolar and depressive disorders. Mean scores of all of the eight domains of the SF-36 general population of Butajira decreased (indicating poorer HRQOL) with increasing age in both males and females. The odds of being in the lowe...
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To describe the major sociodemographic correlates of schizophrenia, and their interactions, in a rural population of Ethiopia. We have recently completed a study in Butajira to identify cases of major mental disorders for description of... more
To describe the major sociodemographic correlates of schizophrenia, and their interactions, in a rural population of Ethiopia. We have recently completed a study in Butajira to identify cases of major mental disorders for description of course and outcome. A total of 318 cases of schizophrenia were identified by a door-to-door survey of a predominantly rural population of close to 68,500 individuals. Cases were confirmed by use of the SCAN and clinical assessment. The study showed that being male, under 35 years of age, unmarried, educated and living in an urban area were factors all associated with schizophrenia independently of each other. The risk of schizophrenia associated with being male was much higher in those aged 35 and over compared to those under 35 years of age. The risk of schizophrenia among males was higher in those not married (never married, separated, divorced or widowed) compared to those who were married. The association of marital status with schizophrenia was ...
Research Interests: Demography, Schizophrenia, Risk, Ethiopia, Adolescent, and 16 moreHumans, Female, Male, Developing World, Social Environment, Mental Disorder, Middle Aged, Adult, Odds ratio, Clinical Assessment, Educational Status, Rural Area, Cross Sectional Studies, Marital Status, Urban Area, and Psychiatric Status Rating Scales
A review of the information on the HIV epidemic in Ethiopia is important to guide policy and action. Published and unpublished reports and surveillance data from records of governmental and non-governmental institutions were examined to... more
A review of the information on the HIV epidemic in Ethiopia is important to guide policy and action. Published and unpublished reports and surveillance data from records of governmental and non-governmental institutions were examined to assess the extent of the epidemic. It appears that the HIV/AIDS epidemic has affected a large segment of the urban population. Surveillance data from pregnant women attending antenatal clinics indicate a decreasing trend in the prevalence of HIV in Addis Ababa. Similarly, data from blood donors from the majority of transfusion centres in the country indicate a decrease in prevalence. However, further studies will be required to establish the validity of these findings. Currently available data are not adequate to accurately measure the level of infection in rural areas where 85% of the population live. Outside of Addis Ababa, in places where ANC-based sentinel surveillance are operational, the systems are not fully supported by quality control. Thus,...
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Research Interests: Epidemiology, Death, Methodology, Tropical Medicine, Communicable Diseases, and 13 moreEthiopia, Adolescent, Tropical medicine (Health Sciences), Humans, Female, Male, Lung Diseases, Common Cold, Middle Aged, Adult, Public health systems and services research, Sensitivity and Specificity, and Acquired immunodeficiency syndrome
Hospital statistics of causes of death for developing countries may be biased when the utilization of hospital services is low or selective. Using Addis Ababa, Ethiopia as an example, we argue that hospital data can be useful for... more
Hospital statistics of causes of death for developing countries may be biased when the utilization of hospital services is low or selective. Using Addis Ababa, Ethiopia as an example, we argue that hospital data can be useful for demonstrating general cause-specific mortality patterns. In addition, a comparison of hospital statistics with data from a surveillance of burials allows for the identification of weaknesses in health services provision. We find a low level of hospital services utilization during terminal illness. Despite similarities in the cause of death structure in the different data sources, hospital statistics under-estimate the prevalence of infectious diseases. In addition, we identify an important gender bias in the utilization of health services in the direction of males being significantly more likely to die in medical facilities than females.
Research Interests: Sociology, Anthropology, Research Methodology, Methodology, Developing Countries, and 32 morePopulation Dynamics, Communicable Diseases, Health, Public Health, Ethiopia, Adolescent, Social Science & Medicine, Maternal Mortality, Population, Humans, Burial, Developing Country, Health Service utilization, Infectious Disease, Accidents, Health Services, Female, Male, Data Collection, Gender Bias, Aged, Prevalence, Middle Aged, Autopsy, Adult, Public health systems and services research, Cardiovascular Diseases, Sub Saharan Africa, Hospital Mortality, Wounds and Injuries, Social Science, and Population Statistics
Research Interests: Psychology, Cognitive Science, Coping Strategies, Schizophrenia, Bipolar Disorder, and 20 moreSocial Interaction, Family, Stress, Ethiopia, Adolescent, Humans, Developing Country, Coping, Female, Male, Impact, Social Psychiatry, Social Environment, Clinical Sciences, Aged, Middle Aged, Adult, Family Intervention, Cost of Illness, and Epidemiologic Studies
Research Interests: Psychology, Cognitive Science, Schizophrenia, Developing Countries, Ethiopia, and 20 moreAdolescent, Rural Health, Humans, Female, Male, Social Psychiatry, Clinical Sciences, Prevalence, Middle Aged, Adult, Sex Factors, Health surveys, Disease Progression, Traditional Society, Female To Male, Attempted Suicide, Affective Disorder, Age of Onset, Socioeconomic Factors, and Psychiatric Status Rating Scales
Research Interests: Psychology, Cognitive Science, Psychiatry, Schizophrenia, Nonparametric Statistics, and 21 moreStigma, Family, Social Perception, Ethiopia, Mental Illness, Humans, Female, Stereotyping, Male, Attitude, Social Psychiatry, Social Environment, Mental Disorder, Clinical Sciences, Scopus, Mood Disorders, Middle Aged, Adult, Superstitions, Affective Disorder, and Age Groups
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Research Interests: Demography, Schizophrenia, Risk, Ethiopia, Adolescent, and 16 moreHumans, Female, Male, Developing World, Social Environment, Mental Disorder, Middle Aged, Adult, Odds ratio, Clinical Assessment, Educational Status, Rural Area, Cross Sectional Studies, Marital Status, Urban Area, and Psychiatric Status Rating Scales
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Research Interests: Demography, Research Methodology, Health Planning, Evaluation, Developing Countries, and 27 moreCommunity Health, Health, Public Health, Community, Ethiopia, Adolescent, Rural Health, Population, Humans, Child, Developing Country, Female, Male, Health information, Infant, Rare Event, Life Expectancy, Aged, Middle Aged, Longitudinal Studies, Adult, Health Problems, Public health systems and services research, Surveillance System, Population distribution, Child preschool, and health status indicators
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Research Interests: Psychology, Cognitive Science, Psychiatry, Epidemiology, Depression, and 24 morePersonality Assessment, Bereavement, Developing Countries, Public Health, Ethiopia, Adolescent, Medicine, Humans, Developing Country, Female, Male, Social Isolation, Depressive Disorder, The, Differential Diagnosis, Ethnic Groups, Clinical Sciences, Prevalence, Middle Aged, Risk Factor, Adult, Health surveys, Cross Sectional Studies, and Attempted Suicide
Research Interests: Demography, Epidemiology, Community-Based Mental Health Services, Bipolar Disorder, Ethiopia, and 15 moreAdolescent, Humans, Affective Disorders, Female, Male, Prevalence, Middle Aged, Questionnaires, Adult, Urban Population, Low Income Countries, Cross Sectional Studies, General Population, Age of Onset, and Severity of Illness Index
Research Interests: Genetics, Geography, Mental Health, Schizophrenia, Bipolar Disorder, and 24 morePublic Health, Community, Ethiopia, Comparative Study, Humans, Affective Disorders, Female, Male, Genotype X Environment Interaction, Social Isolation, Genetic determinism, Social Environment, Etiology, Prevalence, Middle Aged, Affective, Adult, Sex Factors, Clinical Assessment, Age Factors, Isolated heart, Substance-Related Disorders, Age of Onset, and Psychiatric Status Rating Scales
Research Interests: Epidemiology, Mental Health, Schizophrenia, Bipolar Disorder, Public Health, and 20 moreEthiopia, Adolescent, Comparative Study, Brain, Humans, Affective Disorders, Female, Motor Coordination, Sensory Integration, Male, Social Environment, Prevalence, Middle Aged, Affective, Adult, Minor, Rural Community, Cross sectional Study, Cross Sectional Studies, and Severity of Illness Index
Research Interests: Demography, Psychiatry, Epidemiology, Depression, Developing Countries, and 19 moreRisk Taking, Public Health, Ethiopia, Adolescent, Medicine, Humans, Affective Disorders, Developing Country, Female, Male, Depressive Disorder, Social Environment, Mental health services, Prevalence, Middle Aged, Affective, Adult, Disease Progression, and Rural Community
Research Interests: Psychiatry, Psychometrics, Bipolar Disorder, Quality of life, Developing Countries, and 22 moreEthiopia, Adolescent, Activities of Daily Living, Humans, Outcome, Affective Disorders, Developing Country, Chronic Disease, Female, Male, Follow-up studies, Middle Aged, Affective, Adult, Sex Factors, Age Factors, Health surveys, Cross Sectional Studies, Cohort Studies, Socioeconomic Factors, Statistics as Topic, and Psychiatric Status Rating Scales
Research Interests: Psychology, Community-Based Mental Health Services, Schizophrenia, Bipolar Disorder, Ethiopia, and 17 moreAdolescent, Survey Methods, Humans, Female, Male, Social Psychiatry, Mental Disorder, Clinical Sciences, Mood Disorders, Middle Aged, Questionnaires, Adult, Clinical Assessment, Low Income Countries, Social, Affective Disorder, and General Population
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Research Interests: Epidemiology, Risk Taking, Ethiopia, Adolescent, Pregnancy, and 18 moreHumans, Female, Male, Sexual Behavior, Hiv Infection, Risk factors, Aged, Prevalence, Middle Aged, Adult, Public health systems and services research, Urban Population, Risk Factors, Blood Donors, Cross Sectional Studies, Enzyme Linked Immunosorbent Assay, Health Personnel, and Immunoblotting
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To measure the impact of HIV on mortality in Addis Ababa, Ethiopia. A retrospective review of burials at three cemeteries, 1987-2001 and a prospective surveillance of burials at all (n = 70) cemeteries, February-May, 2001. The age, sex,... more
To measure the impact of HIV on mortality in Addis Ababa, Ethiopia. A retrospective review of burials at three cemeteries, 1987-2001 and a prospective surveillance of burials at all (n = 70) cemeteries, February-May, 2001. The age, sex, and date of burial were recorded; in the absence of denominators, we compared the ratio of deaths of persons 25-49 versus 5-14 years of age per calendar year, using logistic regression, adjusting for sex and site. The age- and sex- specific mortality were calculated and compared with pre-HIV mortality in 1984. Of 17,519 deaths, retrospectively reviewed, complete data were available for 6342 (47%) females and 7269 (53%) males. During 1987-2001, the '25-49' versus '5-14' group all-cause mortality ratio increased by 8.5% per calendar year (P < 0.05). A total of 5101 deaths were recorded in the prospective surveillance. Crude mortality rates were 9.5/1000 per year (men) and 7.1/1000 per year (women). In comparison with 1984, 5.0-times as many men and 5.3-times as many women died in the age group 35-39 years. Attributing the increase in mortality in ages 15-60 to HIV in the period 1984-2001, Ethiopian men and women have a probability of 18.8 and 17.8%, respectively, of dying of HIV before age 60. Burials increased significantly among the '25-49', versus the '5-14' group, during the period 1987-2001. This trend, and a five-times higher mortality in 2001 than in 1984 in those aged 35-39 years demonstrate a severe impact of HIV on mortality. Continuing surveillance of burials is recommended.