Environmental Health

Global economic burden of diabetic related hypoglycemia: a systematic review of cost of illness studies

2026-05-11T11:20:58Z

Global economic burden of diabetic related hypoglycemia: a systematic review of cost of illness studies Bezie, Kebede; Bezuayehu, Alemayehu; Abinet, Abebe Background Currently, diabetic hypoglycemic events are increasing, and this review aimed to synthesize global evidence on the economic burden of hypoglycemia. Method We conducted a systematic search in both databases (PubMed and Scopus) and a forward citation search. We included worldwide studies regardless of publication year. Two independent authors are involved in screening, selection, extraction, and quality appraisal. We used a consensus-based checklist for quality appraisal. We reported the costs in 2024 international dollars. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses, and registered the review with the International Prospective Register of Systematic Reviews (CRD420251069256). Result We reached out to 1235 articles and included 29 in the final report from high- and middle-income countries. Most studies estimated costs using prevalence-based and health system perspectives. The average direct and indirect costs per event per patient ranged from $1.90 to $24,932.73 and $3.46 to $3,339.34, respectively. The average annual direct cost per patient ranged from $1,938.41 to $25,092.76. This direct expense emerged from medications, consultation services, hospitalization, emergency care, and other services. Indirect costs primarily identified productivity losses due to sick leave, late arrivals, and early departures from work, with annual monetary estimates per patient ranging from $2,504.22 to $16,129.64. Patient direct costs were generally higher than the indirect costs. Annual hypoglycemia attributable costs ranged from $1,431.72 to $14,414.20 per patient per year. The annual national economic burden of hypoglycemia was substantial, ranging from $39.04 to $3.03 billion. Diabetes severity, type of diabetes, treatment regimen, and health facility level are sources of cost variation. Conclusion This systematic review concludes that diabetes-related hypoglycemia imposes a substantial economic burden, with both direct and indirect costs being significant. Preventive efforts focusing on hypoglycemia and its contributing factors are crucial to mitigate the financial impact on patients, healthcare providers, and the health system.

Food Hygiene Practices and Associated Factors Among Food Handlers Working at Public Food and Drink Establishments in Mizan‐Aman Town, Bench‐Sheko Zone, Ethiopia, 2023: A Cross‐Sectional Study Design

2026-05-11T11:19:52Z

Food Hygiene Practices and Associated Factors Among Food Handlers Working at Public Food and Drink Establishments in Mizan‐Aman Town, Bench‐Sheko Zone, Ethiopia, 2023: A Cross‐Sectional Study Design Bezuayehu, Alemayehu; Abel, Girma; Smegnew, Gichew; Dereje, Dereje,; Ermias, Ayelew Background and Aims Foodborne illnesses are widespread in both developed and developing countries. Nonetheless, there is a paucity of data about food hygiene practices among food handlers in public catering establishments in Ethiopia, particularly in the study area. Consequently, this research seeks to evaluate the extent of food hygiene practices and the associated factors among food handlers in public food and beverage establishments in Mizan-Aman town, Southwest Ethiopia, in 2023. Methodology This study employed an institution-based cross-sectional design involving 372 food handlers. Participants were selected using a simple random sampling technique from individuals employed at randomly chosen public food catering establishments. The data were subsequently entered into Epi Data Version 3.02 and exported to SPSS Version 20 for further analysis. A binary logistic regression analysis was performed. Variables with a p-value of less than 0.25 were included in a multiple binary logistic regression model. Significant factors were ultimately determined based on a 95% confidence interval (CI) and a p-value of less than 0.05. Results The prevalence of good food hygiene practices among food handlers working in public food and drink establishments in the study area was 64.6%. An average monthly income of ≥ 1100 ETB (AOR = 5.22; 95% CI = 2.40–11.34, p-value < 0.001), attendance at training (AOR = 4.21; 95% CI = 1.74–10.17, p-value = 0.001), and the availability of a separate dressing room (AOR = 4.89; 95% CI = 1.88, 12.72, p-value = 0.001) were significantly associated with good food hygiene practices. Conclusion This study showed the prevalence of good food hygiene practices among food handlers who work in public food and drink establishments in Mizan-Aman town was low. The variables such as average monthly income of ≥ 1100 ETB, ever attended training on food hygiene, and having a separate dressing room in the facility were significantly associated factors for good food hygiene practice in the study area.

Perceptions and practices of household heads toward malaria: a community based cross sectional study in Southwest Ethiopia

2026-05-11T11:17:31Z

Perceptions and practices of household heads toward malaria: a community based cross sectional study in Southwest Ethiopia

Home birth prevalence and associated factors in southwest Ethiopia

2025-03-20T07:15:52Z

Home birth prevalence and associated factors in southwest Ethiopia Tegene, Legese; Samrawit, Sileshi; Abeba, Daniel; Tadesse, Nigusie; Andualem, Henok; Yordanos, Bekele; Samuel, Negash; Besufekad, Mekonnen; Nahom, Solomon; Aychew, Kassie; Wondwossen, Niguse Background/Aim In Ethiopia, antenatal care takes a focused approach, where women are encouraged to give birth in a health facility, as there are no services that provide skilled birth attendants for home births. However, nearly half of mothers booked for antenatal care give birth at home, which is associated with a higher risk of maternal mortality and poor outcomes. This study aimed to assess the prevalence of home birth and associated factors among women in southwest Ethiopia. Methods A community-based cross-sectional study was conducted using simple random sampling. Data were collected from 1 February 2018 to 30 April 2018 from 1831 women who had given birth in the last year in selected zones of southwest Ethiopia, using a structured interviewer-administered questionnaire. The data were cleaned and exported to STATA 14 for analysis, both by bivariate and multivariate logistic regression. P≤ 0.05 at 95% confidence interval of odds ratio was taken as significant in the multivariable model. Results Approximately half (54.5%) of the participants gave birth at home. Rural residence (adjusted odds ratio=0.46, P=0.032), listening to the radio (adjusted odds ratio=0.53, P=0.047), attending 3–5 antenatal care visits (adjusted odds ratio=0.40, P=0.031), being widowed or divorced (adjusted odds ratio=2.89, P=0.045), prolonged labour (adjusted odds ratio=0.76, P=0.021) and waiting time for antenatal care services (adjusted odds ratio=1.85, P=0.042) were significantly associated with home birth. Conclusions More than half of the participants gave birth to their last child at home, and this decision was affected by residence, prolonged labour, antenatal care frequency, media, marital status, and waiting time for antenatal care services. Interventions to increase institutional birth should prioritise those who do not attend antenatal care, are not exposed to media or who are widowed or divorced. Similarly, reducing antenatal care waiting time and encouraging mothers to attend antenatal care are vital to improving rates of institutional birth in Ethiopia.