BMJ Open (Sep 2023)
Burden of lower respiratory infections and associated risk factors across regions in Ethiopia: a subnational analysis of the Global Burden of Diseases 2019 study
- Alemayehu Hailu,
- Solomon Tessema Memirie,
- Feleke Mekonnen Demeke,
- Biniyam Sahiledengle,
- Abebaw Alemayehu Desta,
- Daniel Atlaw,
- Damtew Solomon,
- Tahir Eyayu,
- Fentabil Getnet,
- Amanuel Yigezu,
- Awoke Misganaw,
- Tezera Moshago Berheto,
- Ally Walker,
- Ababi Zergaw,
- Firehiwot Abebe Gobena,
- Muluken Argaw Haile,
- Dereje Mengistu Tolosa,
- Semagn Mekonnen Abate,
- Mesafint Molla Adane,
- Gizachew Taddesse Akalu,
- Addis Aklilu,
- Dejen Tsegaye,
- Zeleke Gebru,
- Mulusew Andualem Asemahagn,
- Tewachew Awoke,
- Hunegnaw Abebe,
- Niguss Cherie Bekele,
- Melaku Ashagrie Belete,
- Tekleberhan Hailemariam,
- Alemeshet Yirga,
- Setognal Aychiluhm Birara,
- Belay Boda Abule Bodicha,
- Chuchu Churko,
- Lankamo Ena,
- Zinabu Fentaw,
- Daniel Baza Gargamo,
- Mesfin Damtew Gebrehiwot,
- Mathewos Alemu Gebremichael,
- Melaku Getachew,
- Getahun Molla,
- Bereket Beyene,
- Migbar Sibhat,
- Negussie Boti Sidamo,
- Yonatan Solomon,
- Birhanu Wagaye,
- Shambel Wedajo,
- Melat Weldemariam,
- Yazachew Engida Yismaw,
- Moshen Naghavi
Affiliations
- Alemayehu Hailu
- Department of Global Public Health and Primary Care Medicine, University of Bergen, Bergen, Norway
- Solomon Tessema Memirie
- Addis Center for Ethics and Priority Setting, Addis Ababa University, Addis Ababa, Ethiopia
- Feleke Mekonnen Demeke
- Bahir Dar University College of Medical and Health Sciences, Bahir Dar, Ethiopia
- Biniyam Sahiledengle
- Department of Public Health, Madda Walabu University, Balle-Goba, Ethiopia
- Abebaw Alemayehu Desta
- University of Gondar, Gondar, Ethiopia
- Daniel Atlaw
- Madda Walabu University, Bale-Goba, Ethiopia
- Damtew Solomon
- Madda Walabu University, Robe, Ethiopia
- Tahir Eyayu
- Department of Medical Laboratory Sciences, Debre Tabor University, Debre Tabor, Ethiopia
- Fentabil Getnet
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
- Amanuel Yigezu
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
- Awoke Misganaw
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
- Tezera Moshago Berheto
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
- Ally Walker
- Department of Health Metrics Sciences, University of Washington, Seattle, Washington, USA
- Ababi Zergaw
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
- Firehiwot Abebe Gobena
- Ethiopian Health Insurance Service, Addis Ababa, Ethiopia
- Muluken Argaw Haile
- Ethiopian Health Insurance Service, Addis Ababa, Ethiopia
- Dereje Mengistu Tolosa
- Ethiopian Health Insurance Service, Addis Ababa, Ethiopia
- Semagn Mekonnen Abate
- Department of Anesthesiology, Dilla University College of Health Sciences, Dilla, Ethiopia
- Mesafint Molla Adane
- Bahir Dar University College of Medical and Health Sciences, Bahir Dar, Ethiopia
- Gizachew Taddesse Akalu
- St Paul`s Hospital Millennium Medical College, Addis Ababa, Ethiopia
- Addis Aklilu
- Arba Minch University, Arba Minch, Ethiopia
- Dejen Tsegaye
- Adult Health Nursing, Debre Markos University College of Health Science, Debremarkos, Ethiopia
- Zeleke Gebru
- Public Health, Arba Minch University, Arba Minch, Ethiopia
- Mulusew Andualem Asemahagn
- School of Public Health, Bahir Dar University College of Medical and Health Sciences, Bahir Dar, Ethiopia
- Tewachew Awoke
- Bahir Dar University, Bahir Dar, Ethiopia
- Hunegnaw Abebe
- Department of Public Health, Wollo University, Dessie, Ethiopia
- Niguss Cherie Bekele
- Department of Public Health, Wollo University, Dessie, Ethiopia
- Melaku Ashagrie Belete
- Wollo University, Dessie, Ethiopia
- Tekleberhan Hailemariam
- Mekelle University, Mekelle, Ethiopia
- Alemeshet Yirga
- Department of Pharmacy, Bahir Dar University, Bahir Dar, Ethiopia
- Setognal Aychiluhm Birara
- Department of Public Health, Samara University, Semera, Ethiopia
- Belay Boda Abule Bodicha
- Arba Minch University, Arba Minch, Ethiopia
- Chuchu Churko
- Public Health, Arba Minch University, Arba Minch, Ethiopia
- Lankamo Ena
- Arba Minch University, Arba Minch, Ethiopia
- Zinabu Fentaw
- Department of Epidemiology and Biostatistics, Wollo University, Dessie, Ethiopia
- Daniel Baza Gargamo
- Wolaita Sodo University, Sodo, Ethiopia
- Mesfin Damtew Gebrehiwot
- Wollo University, Dessie, Ethiopia
- Mathewos Alemu Gebremichael
- Arba Minch University, Arba Minch, Ethiopia
- Melaku Getachew
- Haramaya University College of Health and Medical Sciences, Harar, Ethiopia
- Getahun Molla
- University of Gondar Hospital, Gondar, Ethiopia
- Bereket Beyene
- Arba Minch University, Arba Minch, Ethiopia
- Migbar Sibhat
- Department of Nursing, Dilla University College of Health Sciences, Dilla, Ethiopia
- Negussie Boti Sidamo
- Public Health, Arba Minch University, Arba Minch, Ethiopia
- Yonatan Solomon
- Dire Dawa University, Dire Dawa, Ethiopia
- Birhanu Wagaye
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
- Shambel Wedajo
- Wollo University, Dessie, Ethiopia
- Melat Weldemariam
- Department of Medical Laboratory Sciences, Arba Minch University, Arba Minch, Ethiopia
- Yazachew Engida Yismaw
- Bahir Dar University, Bahir Dar, Ethiopia
- Moshen Naghavi
- School of Public Health, University of Washington, Seattle, Washington, USA
- DOI
- https://doi.org/10.1136/bmjopen-2022-068498
- Journal volume & issue
-
Vol. 13,
no. 9
Abstract
Objective This analysis is to present the burden and trends of morbidity and mortality due to lower respiratory infections (LRIs), their contributing risk factors, and the disparity across administrative regions and cities from 1990 to 2019.Design This analysis used Global Burden of Disease 2019 framework to estimate morbidity and mortality outcomes of LRI and its contributing risk factors. The Global Burden of Disease study uses all available data sources and Cause of Death Ensemble model to estimate deaths from LRI and a meta-regression disease modelling technique to estimate LRI non-fatal outcomes with 95% uncertainty intervals (UI).Study setting The study includes nine region states and two chartered cities of Ethiopia.Outcome measures We calculated incidence, death and years of life lost (YLLs) due to LRIs and contributing risk factors using all accessible data sources. We calculated 95% UIs for the point estimates.Results In 2019, LRIs incidence, death and YLLs among all age groups were 8313.7 (95% UI 7757.6–8918), 59.4 (95% UI 49.8–71.4) and 2404.5 (95% UI 2059.4–2833.3) per 100 000 people, respectively. From 1990, the corresponding decline rates were 39%, 61% and 76%, respectively. Children under the age of 5 years account for 20% of episodes, 42% of mortalities and 70% of the YLL of the total burden of LRIs in 2019. The mortality rate was significantly higher in predominantly pastoralist regions—Benishangul-Gumuz 101.8 (95% UI 84.0–121.7) and Afar 103.7 (95% UI 86.6–122.6). The Somali region showed the least decline in mortality rates. More than three-fourths of under-5 child deaths due to LRIs were attributed to malnutrition. Household air pollution from solid fuel attributed to nearly half of the risk factors for all age mortalities due to LRIs in the country.Conclusion In Ethiopia, LRIs have reduced significantly across the regions over the years (except in elders), however, are still the third-leading cause of mortality, disproportionately affecting children younger than 5 years old and predominantly pastoralist regions. Interventions need to consider leading risk factors, targeted age groups and pastoralist and cross-border communities.
