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Yehuala TZ, Agimas MC, Derseh NM, Wubante SM, Fente BM, Yismaw GA, Tesfie TK. Machine learning algorithms to predict healthcare-seeking behaviors of mothers for acute respiratory infections and their determinants among children under five in sub-Saharan Africa. Front Public Health 2024; 12:1362392. [PMID: 38962762 PMCID: PMC11220189 DOI: 10.3389/fpubh.2024.1362392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Accepted: 06/03/2024] [Indexed: 07/05/2024] Open
Abstract
Background Acute respiratory infections (ARIs) are the leading cause of death in children under the age of 5 globally. Maternal healthcare-seeking behavior may help minimize mortality associated with ARIs since they make decisions about the kind and frequency of healthcare services for their children. Therefore, this study aimed to predict the absence of maternal healthcare-seeking behavior and identify its associated factors among children under the age 5 in sub-Saharan Africa (SSA) using machine learning models. Methods The sub-Saharan African countries' demographic health survey was the source of the dataset. We used a weighted sample of 16,832 under-five children in this study. The data were processed using Python (version 3.9), and machine learning models such as extreme gradient boosting (XGB), random forest, decision tree, logistic regression, and Naïve Bayes were applied. In this study, we used evaluation metrics, including the AUC ROC curve, accuracy, precision, recall, and F-measure, to assess the performance of the predictive models. Result In this study, a weighted sample of 16,832 under-five children was used in the final analysis. Among the proposed machine learning models, the random forest (RF) was the best-predicted model with an accuracy of 88.89%, a precision of 89.5%, an F-measure of 83%, an AUC ROC curve of 95.8%, and a recall of 77.6% in predicting the absence of mothers' healthcare-seeking behavior for ARIs. The accuracy for Naïve Bayes was the lowest (66.41%) when compared to other proposed models. No media exposure, living in rural areas, not breastfeeding, poor wealth status, home delivery, no ANC visit, no maternal education, mothers' age group of 35-49 years, and distance to health facilities were significant predictors for the absence of mothers' healthcare-seeking behaviors for ARIs. On the other hand, undernourished children with stunting, underweight, and wasting status, diarrhea, birth size, married women, being a male or female sex child, and having a maternal occupation were significantly associated with good maternal healthcare-seeking behaviors for ARIs among under-five children. Conclusion The RF model provides greater predictive power for estimating mothers' healthcare-seeking behaviors based on ARI risk factors. Machine learning could help achieve early prediction and intervention in children with high-risk ARIs. This leads to a recommendation for policy direction to reduce child mortality due to ARIs in sub-Saharan countries.
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Affiliation(s)
- Tirualem Zeleke Yehuala
- Department Health Informatics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Muluken Chanie Agimas
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Nebiyu Mekonnen Derseh
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Sisay Maru Wubante
- Department Health Informatics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Bezawit Melak Fente
- Department of General Midwifery, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Getaneh Awoke Yismaw
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tigabu Kidie Tesfie
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Zeleke G, Mekonnen A, Abuhay T, Agimas MC. Proportion of early treatment seeking for sexually transmitted infections and associated factors among patients attending youth friendly service in Bahir Dar City health centers, Northwest, Ethiopia. Reprod Health 2024; 21:85. [PMID: 38879531 PMCID: PMC11179198 DOI: 10.1186/s12978-024-01794-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 04/15/2024] [Indexed: 06/19/2024] Open
Abstract
BACKGROUND Sexually transmitted infection is a common public health issue of youths and is characteristically transmitted through sexual intercourse. Even though early treatment for sexually transmitted infection is very important to reduce further complications and economic burden, studies to identify the proportion and the possible factor of early treatment seeking is rare in Ethiopia. OBJECTIVE To assess the proportion of early treatment seeking for sexually transmitted infections and associated factors among patients attending youth friendly service in Bahir Dar city health centers, northwest, Ethiopia 2023. METHOD Institutional based Cross-sectional study was used among 407 participants from April 25 to May 24 /2023. A systematic random sampling technique was used to select the participants. An interview-administered questionnaire was used for data collection, whereas Epi-data version 4.6.0.2 and the statistical package for statistical science version 23 were used for data entry and analysis respectively. A frequency table and bar chart were used for descriptive analysis. Multiple binary logistic regression was employed to identify the factors at p-value of <0.05. The necessary assumption of the model was also checked by the Hosmer and Lemishow test. RESULTS The response rate of this study was 391 (96.1%) and the proportion of early treatment for sexually transmitted infection was 108 (27.6%, 95%CI; 23-32). Good knowledge about sexually transmitted infection (AOR=1.98, 95CI%; 1.13-3.47) know about their HIV status (AOR=1.95, 95%CI; 1.13-3.36), perceive severity of sexually transmitted infection (AOR=11.23, 95%CI; 6.15-20.45), and not fear the stigma about being infected with sexually transmitted infection (AOR=2.29, 95%CI; 1.32-3.96) were the significantly associated factors for early treatment of sexually transmitted infection. CONCLUSION AND RECOMMENDATION: The proportion of early treatment for sexually transmitted infection in Bahir Dar city was low. Knowledge about STIs, testing/ knowing HIV status, perception of the severity about sexually transmitted infection, and fear of stigma about sexually transmitted infection were the statistically significant factors for early treatment of sexually transmitted infection. So the government better give attention to health education and other health promotion activities to increase the knowledge of youths about sexually transmitted infection and to change their perception of sexually transmitted infection.
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Affiliation(s)
- Getachew Zeleke
- Han health center, Bahir Dar health department, Bahir Dar, Amhara region, Ethiopia
| | - Alemtshay Mekonnen
- Department of reproductive health, college of medicine and health sciences, Bahir Dar university, Bahir Dar, Bahir Dar, Ethiopia
| | - Tigist Abuhay
- Department of reproductive health, college of medicine and health sciences, Bahir Dar university, Bahir Dar, Bahir Dar, Ethiopia
| | - Muluken Chanie Agimas
- Department of Epidemiology and Biostatistics, institute of public health, college of medicine and health sciences, university of Gondar, Gondar, Ethiopia.
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Begna O, Gemede HF, Motuma A, Shibiru T, Tilahun T, Bobo FT, Fite MB. Willingness to join community-based health insurance and its associated factors among households in Nekemte City, Ethiopia. A community-based cross-sectional study. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2024; 43:71. [PMID: 38769540 PMCID: PMC11106978 DOI: 10.1186/s41043-024-00553-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 04/27/2024] [Indexed: 05/22/2024]
Abstract
INTRODUCTION Ethiopia has been implementing community-based health insurance programs since 2011 to improve health care financing system. However, the prevalence of household willingness to join the community-based health insurance (CBHI) program and its associated factors are less explored in urban area. Therefore, this study was aimed to assess the prevalence of willingness to join community-based health insurance program and its associated factors among households in Nekemte City, Ethiopia. METHODS A community-based cross-sectional study was conducted on 422 randomly selected households in Nekemte City, Ethiopia. Bivariate and multivariable analyses were performed to see the association between the independent and outcome variables using binary logistic regression model. Association was described using an adjusted odd ratio (AOR) and a 95% confidence interval (CI). Finally, p-value < 0.05 was considered the cut-off point for declaring a significant. RESULTS Among 422 study participants, 320 (75.83%) [95% CI = 71.5-79.8%)] of the households were willing to join community-based health insurance program. The willingness to join for community-based health insurance was 3.11 times more likely among households who were in the richest quintile (AOR = 3.11; 95% CI = 1.08-8.93), 3.4 times more likely among those who were merchants (AOR = 3.40;1.33, 8.69), 2.52 times more likely among those who had history of chronic illness in the household (AOR = 2.52; 95% CI = 1.43-4.45), 4.09 times more likely among those who had the awareness about the scheme (AOR = 4.09; 95% CI = 1.97-8.47) and 3.29 times more likely among those who had the experience of borrow for medical care (AOR = 3.29; 95% CI = 1.48-7.30). CONCLUSION Nearly three fourth of the households were willing to join community-based health insurance program, however, about one fourth of households were not willing, which is a significant public health problem. Being merchant, having awareness about the scheme, being in the richest wealth quintile, having experience of borrowing for medical care, and having history of chronic illness in the household were factors found to be significantly associated with willingness to join community based health insurance in the study area. Therefore, strengthening awareness creation at community level about the benefit package and principle of the program would increase their demand for the community-based health insurance scheme.
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Affiliation(s)
- Olkeba Begna
- Oromia regional health bureau, Addis Abeba, Ethiopia
| | - Habtamu Fekadu Gemede
- Department of Food Technology and Nutrition, Wollega University, P.O. Box 395, Nekemte, Ethiopia
| | - Aboma Motuma
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Tesfaye Shibiru
- School of medicine, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Temesgen Tilahun
- School of medicine, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Firew Tekle Bobo
- Department of Public Health, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Meseret Belete Fite
- Department of Public Health, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia.
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Yimam W, Prem K, Anteneh S, Wolie H. Health-seeking behaviors and determinants among herpes zoster patients in South Wollo public hospitals, Ethiopia, 2022. Heliyon 2024; 10:e25205. [PMID: 38322839 PMCID: PMC10845723 DOI: 10.1016/j.heliyon.2024.e25205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 01/19/2024] [Accepted: 01/23/2024] [Indexed: 02/08/2024] Open
Abstract
Background Health-seeking behavior towards herpes zoster is vital to find an appropriate remedy for patients and utilization of timely healthcare services can have an impact on good health outcomes. The study aimed to assess the health-seeking behavior and determinants among Herpes Zoster patients in public hospitals, South Wollo, Ethiopia. Method A hospital-based cross-sectional study was conducted from September 1, 2022, to November 30, 2022. The simple random sampling technique was used to select 419 participants. Pretested, structured questionnaires and patient interviews were used to collect the data. The bivariable analysis was done and variables with p-value <0.25 were further examined using a multivariable logistic regression model. AOR with a 95 % CI and a P-value <0.05 at a 5 % level of significance were considered. Results About 55.6 % of patients had poor health-seeking behavior towards herpes zoster, with a response rate of 99.1 %. Distance from health facilities (AOR = 4.9; 95 % CI: 1.33-10.35), being rural residence (AOR = 0.3; 95 % CI: 0.17-0.40), being illiterate (AOR = 5.9; 95 % CI: 3.40-10.32), poor self-care adherence (AOR = 1.8; 95 % CI = 1.14-3.07), moderate depression (AOR = 7.3; 95 % CI: 4.10-11.50), moderate (AOR = 0.3; 95 % CI: 0.10-0.70) and severe anxiety (AOR = 0.1; 95 % CI: 0.01-0.63), and duration more than seven days of herpes zoster (AOR = 3.1; 95 % CI = 1.42-6.97) were statistically significant. Conclusion Nearly half of the study participants had poor health-seeking behavior. Being a rural resident and illiterate, poor self-care adherence, moderate and severe anxiety, moderate depression, and duration of more than 7 days were significantly associated. with health-seeking behavior towards Herpes Zoster. Proper guidance, psychological support, and awareness creation about Herpes Zoster severity and complications.
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Affiliation(s)
- Wondwossen Yimam
- College of Medicine & Health Sciences (CMHS), Wollo University (WU), Ethiopia
| | - Kumar Prem
- Department of Adult Health Nursing, CMHS, WU, Ethiopia
| | | | - Hawa Wolie
- Department of Comprehensive Nursing, CMHS, WU, Ethiopia
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de Morais M, Sousa S, Marques J, Moniz M, Duarte R, Leite A, Soares P. Investigating the role of symptom valorisation in tuberculosis patient delay in urban areas in Portugal. BMC Public Health 2023; 23:2421. [PMID: 38053129 PMCID: PMC10696854 DOI: 10.1186/s12889-023-17319-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 11/23/2023] [Indexed: 12/07/2023] Open
Abstract
BACKGROUND Diagnosis delay contributes to increased tuberculosis (TB) transmission and morbimortality. TB incidence has been decreasing in Portugal, but median patient delay (PD) has risen. Symptom valorisation may determine PD by influencing help-seeking behaviour. We aimed to analyse the association between symptom valorisation and PD, while characterising individuals who disregarded their symptoms. METHODS A cross-sectional study was conducted among TB patients in Lisbon and Oporto in 2019 - 2021. Subjects who delayed seeking care because they did not value their symptoms or thought these would go away on their own were considered to have disregarded their symptoms. PD was categorised using a 21-day cut-off, and a 30-day cut-off for sensitivity analysis. We estimated the effect of symptom valorisation on PD through a directed acyclic graph. Then, a multivariable regression analysis characterised patients that disregarded their symptoms, adjusting for relevant variables. We fitted Poisson regression models to estimate crude and adjusted prevalence ratios (PR). RESULTS The study included 75 patients. Median PD was 25 days (IQR 11.5-63.5), and 56.0% of participants had PD exceeding 21 days. Symptom disregard was reported by 38.7% of patients. Patients who did not value their symptoms had higher prevalence of PD exceeding 21 days compared to those who valued their symptoms [PR 1.59 (95% CI 1.05-2.42)]. The sensitivity analysis showed consistent point estimates but wider confidence intervals [PR 1.39 (95% CI 0.77-2.55)]. Being a smoker was a risk factor for symptom disregard [PR 2.35 (95% CI 1.14-4.82)], while living in Oporto [PR 0.35 (95% CI 0.16-0.75)] and having higher household incomes [PR 0.39 (95% CI 0.17-0.94)] were protective factors. CONCLUSIONS These findings emphasise the importance of symptom valorisation in timely TB diagnosis. Patients who did not value their symptoms had longer PD, indicating a need for interventions to improve symptom recognition. Our findings also corroborate the importance of the socioeconomic determinants of health, highlighting tobacco as a risk factor both for TB and for PD.
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Affiliation(s)
- Margarida de Morais
- NOVA National School of Public Health, Public Health Research Centre, NOVA University Lisbon, Lisbon, Portugal.
- Central Lisbon Public Health Unit, Regional Health Administration of Lisbon and Tagus Valley, Lisbon, Portugal.
| | - Sofia Sousa
- Multidisciplinary Unit for Biomedical Research, Biomedical Sciences Institute Abel Salazar, University of Porto, Oporto, Portugal
| | - Jéssica Marques
- NOVA National School of Public Health, Public Health Research Centre, NOVA University Lisbon, Lisbon, Portugal
| | - Marta Moniz
- NOVA National School of Public Health, Public Health Research Centre, Comprehensive Health Research Centre, NOVA University Lisbon, Lisbon, Portugal
| | - Raquel Duarte
- Epidemiological Investigation Unit, Public Health Institute, University of Porto, Oporto, Portugal
- Laboratory for Integrative and Translational Investigation in Populational Health, Oporto, Portugal
- Biomedical Sciences Institute Abel Salazar, University of Porto, Oporto, Portugal
- Clinical Investigation Unit, Regional Health Administration of the North, Oporto, Portugal
- Pneumology Service, Vila Nova de Gaia/Espinho Hospital Centre, Vila Nova de Gaia, Portugal
| | - Andreia Leite
- NOVA National School of Public Health, Public Health Research Centre, Comprehensive Health Research Centre, NOVA University Lisbon, Lisbon, Portugal
- Department of Epidemiology, National Institute of Health Doutor Ricardo Jorge, Lisbon, Portugal
| | - Patrícia Soares
- NOVA National School of Public Health, Public Health Research Centre, Comprehensive Health Research Centre, NOVA University Lisbon, Lisbon, Portugal
- Department of Epidemiology, National Institute of Health Doutor Ricardo Jorge, Lisbon, Portugal
- Centre for Vectors and Infectious Diseases Research, National Institute of Health Doutor Ricardo Jorge, Águas de Moura, Portugal
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Endalamaw A, Gilks CF, Ambaw F, Assefa Y. Socioeconomic inequality and contributors in accepting attitudes toward people living with HIV among adults in Ethiopia from 2005 to 2016: a population-based cross-sectional study. BMJ Open 2023; 13:e074694. [PMID: 38040424 PMCID: PMC10693865 DOI: 10.1136/bmjopen-2023-074694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 11/03/2023] [Indexed: 12/03/2023] Open
Abstract
INTRODUCTION The public's accepting attitude toward people living with HIV is crucial in reducing HIV-related stigma and discrimination, increasing people's access to HIV service. This study examines the inequalities in accepting attitudes toward people living with HIV in Ethiopia from 2005 to 2016. METHODS This cross-sectional study was based on the 2005, 2011 and 2016 Ethiopian Demographic Health Surveys. A total of 17 075, 28 478 and 25 542 adults were included in the 2005, 2011 and 2016 surveys, respectively. Socioeconomic inequality was investigated using the concentration curve and Erreygers' concentration index (ECI), which is scaled from -1 (pro-poor) to +1 (pro-rich). The ECI was decomposed to identify the contributors to socioeconomic inequality using generalised linear regression with the logit link function. RESULTS Accepting attitude toward people living with HIV was 17.9% (95% CI: 16.6%, 19.3%) in 2005, which increased to 33.5% (95% CI: 31.8%, 35.3%) in 2011 and 39.6% (95% CI: 37.6%, 41.9%) in 2016. ECI was 0.342 (p<0.001), 0.436 (p<0.001) and 0.388 (p<0.001), respectively, for 2005, 2011 and 2016. The trend line illustrates socioeconomic inequality seems diverging over time, with an increasing ECI of 0.005 every year (r=0.53; p=0.642; slope=0.005). CONCLUSIONS The current study found that there was pro-rich inequality from 2005 to 2016. People with higher socioeconomic status had a better attitude toward people living with HIV. Comprehensive knowledge about HIV/AIDS, education status, residence, and access to electronic and paper-based media, as well as HIV testing, contribute to a better accepting attitude toward people living with HIV. It is of utmost importance for the country to enhance accepting attitude toward people living with HIV to reduce stigma and discrimination. This requires whole-system response according to the primary healthcare approach toward ending the epidemic of HIV/AIDS in the country.
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Affiliation(s)
- Aklilu Endalamaw
- School of Public Health, the University of Queensland, Brisbane, Queensland, Australia
- College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Amhara, Ethiopia
| | - Charles F Gilks
- School of Public Health, the University of Queensland, Brisbane, Queensland, Australia
| | - Fentie Ambaw
- College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Amhara, Ethiopia
| | - Yibeltal Assefa
- School of Public Health, the University of Queensland, Brisbane, Queensland, Australia
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Getahun SB, Berhe S, Mekonnen B, Melaku G. Reasons for Not Seeking Healthcare Among Students with Dysmenorrhea: A Qualitative Study. Int J Womens Health 2023; 15:1733-1744. [PMID: 38020940 PMCID: PMC10649844 DOI: 10.2147/ijwh.s437233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Accepted: 11/08/2023] [Indexed: 12/01/2023] Open
Abstract
Background Dysmenorrhea is a significant health burden for women and a global public health issue. Despite its notable prevalence and impact, dysmenorrhea is mostly poorly identified, treated, and accepted as normal by patients themselves. To create strategies that enable care seeking and ideal symptom management for dysmenorrhea, it is vital to have a better understanding of the reasons why women do not seek medical attention. This study aimed to explore the reasons for not seeking healthcare among students with dysmenorrhea at Dilla University in 2023. Methods A qualitative phenomenological study was conducted with purposively selected Colleges of Dilla University students with dysmenorrhea. An individual in-depth interview with a semi-structured interview guide was used to collect data from March 1-30/2023. Snowball sampling was used to obtain study participants, and sampling was determined based on the level of data saturation. The interviews were conducted in a separate private room at Dilla University. Data analysis was started simultaneously with data collection and thematic analysis was performed. ATLAS. ti 9 qualitative software was used to support the data analysis and management. Results The study enrolled 20 students with dysmenorrhea, with a mean age of 21.55 years and a mean age of menarche of 14.45 years. It explored three themes for reasons for not seeking healthcare: sociocultural and personal factors, healthcare system-related perceptions and experiences, and preference for self-management of symptoms. The study also reported myths and misconceptions, negative attitudes and experiences, and self-care practices as barriers to accessing and utilizing health care services. Conclusion This study identified various reasons for not seeking healthcare among students with dysmenorrhea. Most of these reasons indicate that there is insufficient awareness and misconception of dysmenorrhea and its management. Therefore, this study advances the literature on dysmenorrhea and emphasizes the need for more awareness, education, and quality healthcare services for students with dysmenorrhea. The study also proposes future research directions to address the problem of dysmenorrhea among female students in Ethiopia.
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Affiliation(s)
- Senait Belay Getahun
- Department of Midwifery, College of Health Sciences and Medicine, Dilla University, Dilla, Ethiopia
| | - Semarya Berhe
- School of Nursing and Midwifery, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Bazie Mekonnen
- School of Nursing and Midwifery, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Getnet Melaku
- Department of Midwifery, College of Health Sciences and Medicine, Dilla University, Dilla, Ethiopia
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Gidado S, Musa M, Ba'aba AI, Okeke LA, Nguku PM, Hadejia IS, Hassan IA, Bande IM, Onuoha M, Ugbenyo G, Godwin N, Usman R, Manu JI, Mohammed AM, Abdullahi MM, Bammami MI, Nuorti P, Atkins S. Factors associated with health-seeking patterns among internally displaced persons in complex humanitarian emergency, Northeast Nigeria: a cross-sectional study. Confl Health 2023; 17:54. [PMID: 37940958 PMCID: PMC10630990 DOI: 10.1186/s13031-023-00552-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 11/01/2023] [Indexed: 11/10/2023] Open
Abstract
BACKGROUND Currently, over two million persons are internally displaced because of the complex humanitarian emergency in Nigeria's northeast region. Due to crowded and unsanitary living conditions, the risk of communicable disease transmission, morbidity, and mortality among this population is high. This study explored patterns and factors associated with health-seeking among internally displaced persons (IDPs) in northeast Nigeria to inform and strengthen disease surveillance and response activities. METHODS In a cross-sectional study conducted during June-October 2022, we employed stratified sampling technique to select 2,373 IDPs from 12 IDPs camps. A semi-structured tool was used to collect data on health-seeking patterns, socio-demographics, households, and IDPs camps characteristics. We classified health-seeking patterns into three outcome categories: 'facility care' (reference category), 'non-facility care' (patent medicine vendors, chemists, traditional healers, religious centers), and 'home care/no care'. We performed complex survey data analysis and obtained weighted statistical estimates. Univariate analysis was conducted to describe respondents' characteristics and health-seeking patterns. We fitted weighted multivariable multinomial logistic regression models to identify factors associated with health-seeking patterns. RESULTS Of 2,373 respondents, 71.8% were 18 to 39 years old, 78.1% were females, and 81.0% had no formal education. Among the respondents, 75.7% (95% CI: 72.9-78.6) sought 'facility care', 11.1% (95% CI: 9.1-13.1) sought 'non-facility care', while 13.2% (95% CI: 10.9-15.4) practiced 'home care/no care'. Respondents who perceived illness was severe (Adjusted Odds Ratio (AOR) = 0.15, [95% CI: 0.08-0.30]) and resided in officially-recognized camps (AOR = 0.26, [95% CI: 0.17-0.39]) were less likely to seek 'non-facility care' compared to 'facility care'. Similarly, respondents who resided in officially-recognized camps (AOR = 0.58, [95% CI: 0.36-0.92]), and received disease surveillance information (AOR = 0.42, [95% CI: 0.26-0.67) were less likely to practice 'home care/no care' rather than seek 'facility care'. CONCLUSIONS This population exhibited heterogeneous patterns of health-seeking at facility and non-facility centers. Perception of illness severity and camps' status were major factors associated with health-seeking. To enhance surveillance, non-facility care providers should be systematically integrated into the surveillance network while ramping up risk communication to shape perception of illness severity, prioritizing unofficial camps.
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Affiliation(s)
- Saheed Gidado
- Health Sciences Unit, Faculty of Social Sciences, Tampere University, Tampere, Finland.
| | - Melton Musa
- African Field Epidemiology Network, Borno State Field Office, Maiduguri, Nigeria
| | | | - Lilian Akudo Okeke
- African Field Epidemiology Network, Adamawa State Field Office, Yola, Nigeria
| | - Patrick M Nguku
- African Field Epidemiology Network, Country Office, Abuja, Nigeria
| | - Idris Suleman Hadejia
- Department of Community Medicine, Ahmadu Bello University, Zaria, Kaduna State, Nigeria
| | - Isa Ali Hassan
- Borno State Ministry of Health, Maiduguri, Borno State, Nigeria
| | - Ibrahim Muhammad Bande
- Department of Disease Control and Immunization, Yobe State Primary Health Care Board, Damaturu, Yobe State, Nigeria
| | - Martins Onuoha
- Nigerian Correctional Service, Adamawa State Office, Yola, Adamawa State, Nigeria
- Nigeria Field Epidemiology and Laboratory Training Program, Abuja, Nigeria
| | - Gideon Ugbenyo
- African Field Epidemiology Network, Country Office, Abuja, Nigeria
| | - Ntadom Godwin
- Epidemiology Division, Federal Ministry of Health, Abuja, Nigeria
| | | | | | | | | | | | - Pekka Nuorti
- Health Sciences Unit, Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Salla Atkins
- Health Sciences Unit, Faculty of Social Sciences, Tampere University, Tampere, Finland
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Agyemang-Duah W, Rosenberg MW. Healthcare utilization among informal caregivers of older adults in the Ashanti region of Ghana: a study based on the health belief model. Arch Public Health 2023; 81:187. [PMID: 37872631 PMCID: PMC10591341 DOI: 10.1186/s13690-023-01200-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 10/09/2023] [Indexed: 10/25/2023] Open
Abstract
BACKGROUND Existing global evidence suggests that informal caregivers prioritize the health (care) of their care recipients (older adults) over their own health (care) resulting in sub-optimal health outcomes among this population group. However, data on what factors are associated with healthcare utilization among informal caregivers of older adults are not known in a sub-Saharan African context. Guided by the Health Belief Model (HBM), the principal objective of this study was to examine the association between the dimensions of the HBM and healthcare utilization among informal caregivers of older adults in the Ashanti Region of Ghana. METHODS Data were extracted from a large cross-sectional study of informal caregiving, health, and healthcare survey among caregivers of older adults aged 50 years or above (N = 1,853; mean age of caregivers = 39.15 years; and mean age of care recipients = 75.08 years) in the Ashanti Region of Ghana. Poisson regression models were used to estimate the association between the dimensions of the HBM and healthcare utilization among informal caregivers of older adults. Statistical significance of the test was set at a probability level of 0.05 or less. RESULTS The results showed that 72.9% (n = 1351) of the participants were females, 56.7% (n = 1051) were urban informal caregivers and 28.6% (n = 530) had no formal education. The results further showed that 49.4% (n = 916) of the participants utilized healthcare for their health problems at least once in the past year before the survey. The final analysis showed a positive and statistically significant association between perceived susceptibility to a health problem (β = 0.054, IRR = 1.056, 95% CI = [1.041-1.071]), cues to action (β = 0.076, IRR = 1.079, 95% CI = [1.044-1.114]), self-efficacy (β = 0.042, IRR = 1.043, 95% CI = [1.013-1.074]) and healthcare utilization among informal caregivers of older adults. The study further revealed a negative and statistically significant association between perceived severity of a health problem and healthcare utilization (β= - 0.040, IRR = 0.961, 95% CI= [0.947-0.975]) among informal caregivers of older adults. The results again showed that non-enrollment in a health insurance scheme (β= - 0.174, IRR = 0.841, 95% CI= [0.774-0.913]) and being unemployed (β= - 0.088, IRR = 0.916, 95% CI= [0.850-0.986]) were statistically significantly associated with a lower log count of healthcare utilization among informal caregivers of older adults. CONCLUSION The findings of this study to a large extent support the dimensions of the HBM in explaining healthcare utilization among informal caregivers of older adults in the Ashanti Region of Ghana. Although all the dimensions of the HBM were significantly associated with healthcare utilization in Model 1, perceived barriers to care-seeking and perceived benefits of care-seeking were no longer statistically significant after controlling for demographic, socio-economic and health-related variables in the final model. The findings further suggest that the dimensions of the HBM as well as demographic, socio-economic and health-related factors contribute to unequal healthcare utilization among informal caregivers of older adults in the Ashanti Region of Ghana.
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Affiliation(s)
- Williams Agyemang-Duah
- Department of Geography and Planning, Queen's University, Kingston, ON, K7L 3N6, Canada.
| | - Mark W Rosenberg
- Department of Geography and Planning, Queen's University, Kingston, ON, K7L 3N6, Canada
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Akter S, Banna MHA, Brazendale K, Sultana MS, Kundu S, Disu TR, Alshahrani NZ, Tareq MA, Hassan MN, Islam Khan MS. Determinants of health care seeking behavior for childhood infectious diseases and malnutrition: A slum-based survey from Bangladesh. J Child Health Care 2023; 27:395-409. [PMID: 35164525 DOI: 10.1177/13674935211057714] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study aimed to explore the magnitude and determinants of health care seeking behaviors for common infectious disease and malnutrition among Bangladeshi under-five children living in slum areas. A cross-sectional study of 300 children-caregiver dyads was conducted in an urban slum of Bangladesh. Data were collected via a structured questionnaire with accompanying anthropometric assessments of children administered by research staff. Multiple logistic regression was employed to identify associated factors of health care seeking behaviors. Only 44.7% and 13.0% of respondents sought care for childhood infectious diseases and malnutrition, respectively. Being a male child, 2-5 years old, having ≤5 family members, monthly family income >125$, and living in close proximity to a health facility were found to be potential determinants of health care seeking behavior for childhood infectious diseases. Mother/caregivers with poor nutritional information knowledge and who had a child 2-5 years old reported engaging in less care seeking behaviors regarding their child's malnutrition compared to their counterparts. Caregivers of children under the age of 5 years old reported low participation in health care seeking behaviors in relation to childhood infectious disease and malnutrition. Families living in slums require additional support targeting health and nutritional educational programs.
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Affiliation(s)
- Sumaiya Akter
- Department of Food Microbiology, Faculty of Nutrition and Food Science, Patuakhali Science and Technology University, Patuakhali, Bangladesh
| | - Md Hasan Al Banna
- Department of Food Microbiology, Faculty of Nutrition and Food Science, Patuakhali Science and Technology University, Patuakhali, Bangladesh
| | - Keith Brazendale
- Department of Health Sciences, University of Central Florida, Orlando, FL, US
| | - Mst Sadia Sultana
- Department of Public Health and Informatics, Jahangirnagar University, Savar, Dhaka, Bangladesh
| | - Satyajit Kundu
- Faculty of Nutrition and Food Science, Patuakhali Science and Technology University, Patuakhali, Bangladesh
| | | | - Najim Z Alshahrani
- Department of Family and Community Medicine, Faculty of Medicine, University of Jeddah, Jeddah, Saudi Arabia
| | - Md Abu Tareq
- Department of Food Microbiology, Faculty of Nutrition and Food Science, Patuakhali Science and Technology University, Patuakhali, Bangladesh
| | - Md Nazmul Hassan
- Department of Environmental Sanitation, Faculty of Nutrition and Food Science, Patuakhali Science and Technology University, Patuakhali, Bangladesh
| | - Md Shafiqul Islam Khan
- Department of Food Microbiology, Faculty of Nutrition and Food Science, Patuakhali Science and Technology University, Patuakhali, Bangladesh
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Getahun GK, Kinfe K, Minwuyelet Z. The role of community-based health insurance on healthcare seeking behavior of households in Addis Ababa, Ethiopia. Prev Med Rep 2023; 34:102234. [PMID: 37273522 PMCID: PMC10238827 DOI: 10.1016/j.pmedr.2023.102234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 04/11/2023] [Accepted: 05/08/2023] [Indexed: 06/06/2023] Open
Abstract
Community-based health insurance is a new and promising concept for delivering easily accessible, affordable, and efficient healthcare services. More importantly, a significant risk pooling arrangement between the wealthy and poor. So far, little has been done regarding community-based health insurance and healthcare seeking behavior in developing countries. Therefore, the aim of this study was to assess healthcare seeking behavior of households due to the introduction of the scheme and associated factors in Addis Ababa. Community-based cross-sectional study was conducted among 270 male and 207 female respondents. The data was collected using standardized and pretested questionnaire and it was analyzed using SPSS software. A bivariate and multivariable logistic regression analysis was applied to determine the relationship between healthcare seeking behavior and determinant variables. Finally, statistical association was declared with a p-value of less than 0.05 in the multivariable logistic regression analysis. The proportion of people who had appropriate healthcare-seeking behavior was 47.31% (95 %CI: 43.27-51.39%). Furthermore, having more than four children [AOR: 0.171, 95%, CI:(0.403-0.99)], being Muslim [AOR: 1.712, 95 %CI: (1.117 2.625)], owning a government house [AOR: 4.472, 95%, CI: (2.037-9.819)], and having under-five children [AOR: 0.548, 95%, CI: (0.375-0.801)] were factors significantly associated with healthcare-seeking behavior. Even though this study was conducted in an urban area, it showed that the magnitude of appropriate healthcare-seeking behavior was low. Therefore, the government of Ethiopia should work to improve housing conditions and family planning provision for the residents to improve the healthcare seeking behavior of community-based health insurance users.
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Bekele M, Urgessa M, Kumsa K, Sinba E. Contributing factors of delay in seeking treatment for childhood diarrheal diseases in Berbere Woreda, Ethiopia: an unmatched case-control study. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2023; 42:65. [PMID: 37430362 DOI: 10.1186/s41043-023-00411-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 07/06/2023] [Indexed: 07/12/2023]
Abstract
BACKGROUND A major cause of diarrheal illness mortality is a failure to seek immediate medical assistance. There is currently no evidence on the reasons that induce caregivers in Berbere Woreda to delayed seeking timely treatment for under-five children with diarrheal illnesses. As a result, the goal of this study was to identify determinants of delay in seeking timely treatment for childhood diarrheal diseases in Berbere Woreda, Bale Zone Oromia Region, South Eastern Ethiopia. METHODS An unmatched case-control study on 418 child caregivers was conducted from April to May 2021. Cases were 209 children and their caregivers who sought treatment after 24 h of the onset of diarrheal disease symptoms, and controls were 209 children and their mothers/caregivers who sought treatment within 24 h of the onset of diarrheal disease symptoms. Data were collected through interviews and chart reviews using consecutive sampling. A multivariable logistic regression analysis was carried out, with variables with a P-value of 0.05 considered statistically significant. The Hosmer-Lemshow goodness of fit test was used to validate the model, and the variance inflation factor (VIF) was used to test for multi-collinearity. RESULTS In this study, we found that among 418 participants, determinants of delay in seeking timely treatment for childhood diarrheal diseases included mothers with more than two under-five children (AOR = 2.23, 95% CI 1.21-4.11), Divorce (AOR = 2.62, 95% CI 1.087-2.76), age of children < 24 months (AOR = 1.597, 95%,CI (1.008-2.531), and preference for a government health facility for treatment (AOR = 2.56, 95% CI 1.51-4.34). Besides, the odds of mothers aged 25-34 years being two times more likely to delay seeking timely treatment for 5 children with diarrhea were 1.537 (0.560-4.213). CONCLUSIONS Age of children, age of mothers, number of children, preference of health facilities, and marital status were factors influencing the failure to seek treatment within 24 h of recognizing diarrhea in children under the age of five.
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Affiliation(s)
- Mebratu Bekele
- Negelle Health Center, Negelle Town, West Arsi Zone, Ethiopia
| | - Megersso Urgessa
- Department of Public Health, School of Health Science, Shashemene Campus, Madda Walabu University, P.O.BOX: 238, Shashemene, Ethiopia.
| | - Kebede Kumsa
- Department of Public Health, School of Health Science, Shashemene Campus, Madda Walabu University, P.O.BOX: 238, Shashemene, Ethiopia
| | - Edao Sinba
- Department of Public Health, School of Health Science, Shashemene Campus, Madda Walabu University, P.O.BOX: 238, Shashemene, Ethiopia
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Alemu W, Cimiotti JP. Meta-Analysis of Medication Administration Errors in African Hospitals. J Healthc Qual 2023; 45:233-241. [PMID: 37276257 DOI: 10.1097/jhq.0000000000000396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
ABSTRACT The incidence of medication administration errors (MAEs) and associated patient harm continue to plague hospitals worldwide. Moreover, there is a lack of evidence to address this problem, especially in Africa. This research synthesis was intended to provide current evidence to decrease the incidence of MAEs in Africa. Standardized search criteria were used to identify primary studies that reported the incidence and/or predictors of MAEs in Africa. Included studies met specifications and were validated with a quality-appraisal tool. The pooled incidence of MAEs in African hospitals was estimated to be 0.56 (CI: 0.4324-0.6770) with a 0.13-0.93 prediction interval. The primary estimates were highly heterogeneous. Most MAEs are explained by system failure and patient factors. The contribution of system factors can be minimized through adequate and ongoing training of nurses on the aspects of safe medication administration. In addition, ensuring the availability of drug use guidelines in hospitals, and minimizing disruptions during the medication process can decrease the incidence of MAEs in Africa.
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Zepre K. The level of household satisfaction with community-based health insurance and associated factors in Southern Ethiopia. Front Public Health 2023; 11:1165441. [PMID: 37457275 PMCID: PMC10348874 DOI: 10.3389/fpubh.2023.1165441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 06/05/2023] [Indexed: 07/18/2023] Open
Abstract
Background Community-based health insurance (CBHI) is a program intended to prevent financial hardship brought on by the cost of medical care. All of Ethiopia's regions are implementing it; however, it has not yet been researched how the program is being received by the local population. This study's objective is to determine how satisfied Southern Ethiopian households are with community-based health insurance programs and connected variables. Methods A community-based cross-sectional study was conducted from April to May 2021. Information was gathered from 528 households (HHs) selected at random in the Gurage Zone of Southern Ethiopia using a questionnaire. Bivariate and multivariate logistic regression, as well as descriptive statistics, were applied. p values less than 0.05 was used as a cutoff point for identifying the self-determining factors. Results The adjusted odds ratio (AOR) for HHs with the poorest wealth status was 2.40 (95% confidence interval:1.14-4.90); for HHs with a good knowledge of the CBHI, it was 1.81 (95% CI: 1.87-3.40); and for households with illness in the past 3 months, it was 5.22 (95% CI: 2.91-9.34). Recurrent visits to the facility (AOR:5.04, 95% CI:1.18-23.44), a Model household in rural health extension program (AOR:3.21, 95% CI:1.76-5.85), being enrolled in the scheme for three years or less (AOR:0.55, 95% CI: 0.30-0.95), and having faith in the leadership of the governing board (AOR:10.53, 95% CI:4.690-23.54) and the availability of the prescribed medication (AOR:14.64, 95% CI:5.37-39.84) were the significant influencing factors. Conclusion This study revealed several variables that affected HHs' satisfaction with CBHI. We strongly advise all responsible parties to focus on increasing HH knowledge of the CBHI scheme, supporting HHs to serve as role models for rural health extension packages, and completing the CBHI pledged package to improve HHs' satisfaction with the CBHI scheme, which may then play a role in the sustainability of CBHI.
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Geta ET, Wakjira A, Hailu WB. Disparities in modern health service utilization across socio-demographic and economic inequalities among households in Gida Ayana district, Oromia Regional state, Ethiopia: a community-based cross-sectional study. BMC Health Serv Res 2023; 23:597. [PMID: 37291621 PMCID: PMC10251700 DOI: 10.1186/s12913-023-09527-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 05/09/2023] [Indexed: 06/10/2023] Open
Abstract
BACKGROUND Health care disparities (HCD) occur across a broad range of dimensions and achieving equity in health care is a strenuous task. To overcome the disparities, countries worldwide have started implementing varies policies. HCD remains a challenge in the health care system of Ethiopia. Hence, the study aimed to estimate the disparities in health care utilization (HCU) among households. METHODS A community-based cross-sectional study was conducted from February 01 to April 30, 2022, among households in Gida Ayana District, Ethiopia. A single population proportion formula was used to determine the 393sample size, and participants were selected using systematic sampling. Data was entered into Epi-data 4.6 and exported to SPSS 25 for analysis. Descriptive analysis and binary and multivariable logistic regressions were performed. RESULTS Of the 356 households that participated in the study, 321 (90.2%) of them reported at least one member of their family perceived morbidity in the last six months. The overall level of HCU determined was 207(64.5%), 95% confidence interval (CI),59.0-69.7%. Urban residents (AOR = 3.68, 95% CI = 1.94-6.97), attending secondary school and above (AOR = 2.79, CI = 1.27-5.98), rich (AOR = 2.47, CI = 1.03-5.92), small families (AOR = 2.83, CI = 1.26-6.55), and insured (AOR = 4.27, CI = 2.36-7.71) significantly contributed to HCD. CONCLUSIONS Households' overall level of HCU for perceived morbidity was moderate. However, significant disparities were observed in HCU across place of residence, wealth status, level of education, family size, and health insurance. Hence, strengthening the strategy of financial protection by implementing health insurance that focuses on the socio-demographic and economic status of households is recommended to reduce the disparities.
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Affiliation(s)
- Edosa Tesfaye Geta
- Department of Public Health, Institute of Health Science, Wollega University, Nekemte, Ethiopia.
| | - Abebe Wakjira
- Gida Ayana hospital, East Wollega zone, Ayana, Oromia Regional State, Ethiopia
| | - Wase Benti Hailu
- Department of Public Health, Institute of Health Science, Wollega University, Nekemte, Ethiopia
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Total delay and associated factors among tuberculosis patients in Jimma Zone, Southwest Ethiopia. PLoS One 2023; 18:e0281546. [PMID: 36757943 PMCID: PMC10045582 DOI: 10.1371/journal.pone.0281546] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 01/25/2023] [Indexed: 02/10/2023] Open
Abstract
BACKGROUND Delays in diagnosis and treatment of tuberculosis (TB) increases severity of illness and continued transmission of TB in the community. Understanding the magnitude and factors associated with total delay is imperative to expedite case detection and treatment of TB. The aim of this study was to determine the length and analyze factors associated with total delay. METHODS Analytic cross-sectional study was conducted in Jimma Zone, Southwest Ethiopia. All newly diagnosed TB patients > 15 years of age were included from randomly selected eight districts and one town in the study area. A structured questionnaire was applied to collect socio-demographic and clinical data. The median total delay was used to dichotomize the sample into delayed and non-delayed patient categories. Logistic regression analysis was used to analyse the association between independent and outcome variables. A p-value < 0.05 were considered statistically significant. RESULTS A total of 1,161 patients were included in this study. The median total delay was 35 days. Patients who had swelling or wound in the neck region were more likely to be delayed than their counterpart [adjusted odds ratio (AOR) = 3.02, 95% confidence interval (CI): 1.62, 5.62]. Women were more likely to experience longer total delay (AOR = 1.46, 95% CI:1.00, 2.14) compared to men. Patients who had poor knowledge of TB were more likely to be delayed compared to those who had good knowledge (AOR = 3.92, 95% CI: 2.65, 5.80). CONCLUSION The present study showed long total delay in diagnosis and treatment of TB. Targeted interventions that enhance TB knowledge and practice, expedite early suspect identification, referral and management of all forms of TB is imperative to reduce total delay in diagnosis and treatment of TB.
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Abuosi AA, Ackon SK, Anaba EA. Health-seeking behaviours of young women with sexually transmitted infections: Analysis of the 2014 Ghana Demographic and Health Survey. PLoS One 2022; 17:e0277205. [PMID: 36342944 PMCID: PMC9639832 DOI: 10.1371/journal.pone.0277205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 10/22/2022] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Young people are at a disproportionately higher risk for sexually transmitted infections (STIs) due to biological factors, low awareness and limited access to sexual and reproductive health information and services. Untreated STIs can lead to major complications, including HIV, congenital infections, infertility, permanent disability and mortality. This study aimed to identify the salient factors associated with health-seeking behaviours of young women with a history of STIs in Ghana. METHODS We analysed data from the 2014 Ghana Demographic and Health Survey. In all, we analysed data from a weighted sample of 742 young women with a history of STIs. At the univariate level, frequencies and percentages were computed, while Chi-square analysis was computed at the bivariate level. Both crude and adjusted odds ratios were computed at the multivariable level using binary logistic regression. RESULTS The findings showed that the majority (72%) of the participants sought treatment for STIs. Among the participants who sought treatment for STIs (n = 532), 26% sought treatment at a public hospital/polyclinic, 34% sought treatment at a chemical/drug store and 10% self-medicated. Seeking treatment for STIs was significantly associated with older age (20-24yrs), and higher socioeconomic and educational status. CONCLUSION This study demonstrated that majority of the young women sought treatment for STIs. Seeking treatment for STIs was influenced by socio-demographic factors. These findings have implications for sexual and reproductive health policies and interventions in Ghana.
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Affiliation(s)
- Aaron Asibi Abuosi
- Department of Public Administration and Health Services Management, University of Ghana Business School, Accra, Ghana
| | | | - Emmanuel Anongeba Anaba
- Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, Accra, Ghana
- * E-mail:
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Abuhay HW, Yenit MK, Wolde HF. Incidence and predictor of diabetic foot ulcer and its association with change in fasting blood sugar among diabetes mellitus patients at referral hospitals in Northwest Ethiopia, 2021. PLoS One 2022; 17:e0274754. [PMID: 36227947 PMCID: PMC9560537 DOI: 10.1371/journal.pone.0274754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 09/05/2022] [Indexed: 11/05/2022] Open
Abstract
Background Diabetes mellitus is one of the global public health problems and fasting blood sugar is an important indicator of diabetes management. Uncontrolled diabetes can lead to diabetic foot ulcers, which is a common and disabling complication. The association between fasting blood glucose level and the incidence of diabetic foot ulcers is rarely considered, and knowing its predictors is good for clinical decision-making. Therefore, the aim of this study was to determine the incidence and predictors of diabetic foot ulcers and its association with changes in fasting blood sugar among diabetes mellitus patients at referral hospitals in Northwest Ethiopia. Methods A multicenter retrospective follow-up study was conducted at a referral hospital in Northwest Ethiopia. A total of 539 newly diagnosed DM patients who had follow-up from 2010 to 2020 were selected using a computer-generated simple random sampling technique. Data was entered using Epi-Data 4.6 and analyzed in R software version 4.1. A Cox proportional hazard with a linear mixed effect model was jointly modeled and 95% Cl was used to select significant variables. AIC and BIC were used for model comparison. Result A total of 539 diabetes patients were followed for a total of 28727.53 person-month observations. Overall, 65 (12.1%) patients developed diabetic foot ulcers with incidence rate of 2.26/1000-person month observation with a 95% CI of [1.77, 2.88]. Being rural (AHR = 2.30, 95%CI: [1.23, 4.29]), being a DM patient with Diabetic Neuropathy (AHR = 2.61, 95%CI: [1.12, 6.06]), and having peripheral arterial disease(PAD) (AHR = 2.96, 95%CI: [1.37, 6.40]) were significant predictors of DFU. The time-dependent lagged value of fasting blood sugar change was significantly associated to the incident of DFU (α = 1.85, AHR = 6.35, 95%CI [2.40, 16.79]). Conclusion and recommendation In this study, the incidence of DFU was higher than in previous studies and was influenced by multiple factors like rural residence, having neuropathy, and PAD were significant predictors of the incidence of DFU. In addition, longitudinal changes in fasting blood sugar were associated with an increased risk of DFU. Health professionals and DM patients should give greater attention to the identified risk factors for DFU were recommended.
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Affiliation(s)
- Habtamu Wagnew Abuhay
- Epidemiology Program, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- * E-mail:
| | - Melaku Kindie Yenit
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Haileab Fekadu Wolde
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Factors influencing healthcare-seeking behaviour of South African adolescents. J Public Health (Oxf) 2022. [DOI: 10.1007/s10389-021-01572-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Shewarega ES, Fentie EA, Asmamaw DB, Negash WD, Fetene SM, Teklu RE, Aragaw FM, Alemu TG, Eshetu HB, Belay DG. Sexually transmitted infections related care-seeking behavior and associated factors among reproductive age women in East Africa: a multilevel analysis of demographic and health surveys. BMC Public Health 2022; 22:1714. [PMID: 36085047 PMCID: PMC9463758 DOI: 10.1186/s12889-022-14120-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 09/01/2022] [Indexed: 12/04/2022] Open
Abstract
Background Sexually transmitted infections are serious global public health issue, and their consequences contribute significantly to population morbidity and mortality, especially in Sub-Saharan Africa. However, there is limited information about the sexually transmitted infections related care-seeking behavior in East Africa. Therefore, this study aimed to assess the pooled prevalence of sexually transmitted infections related care-seeking behavior, and associated factors among reproductive-age women in East Africa using the recent Demographic and Health Survey. Methods This study was based on recent Demographic and Health Survey of 8 East African countries from 2008/09 to 2018/2019. A total weighted sample of 12,004 reproductive-age women who reported sexually transmitted infections or symptoms of sexually transmitted infections in the last 12 months wereincluded. A multi-level mixed-effect logistic regression model was used and a P-value of < 0.05 was considered a statistically significant level for identification of individual and community level factors and AOR with a 95% l CI was computed. Result The overall prevalence of sexually transmitted infections related care-seeking behavior among reproductive-age women in East African countries was 54.14% [95% CI: 53.25%, 55.03%]. In multilevel analysis: being age 25–34 [AOR = 1.27 95%CI: 1.15–1.41], 35–49 [AOR = 1.26 95%CI: 1.13–1.41], women who attained secondary or above education [AOR = 1.27, 95% CI: 1.09, 1.47], being in rich household [AOR = 1.27, 95% CI 1.14, 1.41], women who were currently pregnant [AOR = 1.29, 95% CI 1.13, 1.47], who had been tested for HIV [AOR = 1.99, 95% CI 1.70, 2.33], women who had one and more than one sexual partner [AOR = 1.18, 95% CI 1.05, 1.34], women who lived in urban area [AOR = 1.16, 95% CI: 1.03, 1.31] and who perceived distance from the health facility was not a big problem was [AOR = 1.13, 95% CI 1.04, 1.23] were significantly associated with sexually transmitted infections related care-seeking behavior. Conclusion sexually transmitted infections related care-seeking behavior is relatively low as compared with other studies.. This study revealed that individual-level variables such as women's age, educational status, household wealth index, pregnancy status, ever been tested for HIV, number of sexual partners, and community-level variables such as residence and distance from a health facility were associated with sexually transmitted infections related care-seeking behavior. Therefore, public health interventions targeting uneducated women, poor households, and adolescents, as well as improving counseling and awareness creation during HIV/AIDS testing and Antenatal care visits, are vital to improving sexually transmitted infections care seeking behavior.
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Ayalew HG, Liyew AM, Tessema ZT, Worku MG, Tesema GA, Alamneh TS, Teshale AB, Yeshaw Y, Alem AZ. Spatial variation and factors associated with home delivery after ANC visit in Ethiopia; spatial and multilevel analysis. PLoS One 2022; 17:e0272849. [PMID: 36007083 PMCID: PMC9409554 DOI: 10.1371/journal.pone.0272849] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 07/27/2022] [Indexed: 11/18/2022] Open
Abstract
Introduction Institutional delivery is crucial to reduce maternal and neonatal mortality as well as serious morbidities. However, in Ethiopia, home delivery (attended by an unskilled birth attendant) after antenatal care (ANC) visit is highly in practice. Therefore, this study aimed to assess the spatial variation and determinants of home delivery after antenatal care visits in Ethiopia. Method A secondary data analysis was conducted using the 2019 mini Ethiopian demographic and health survey. A total of 2,923 women who had ANC visits were included. Spatial analysis was done by using GIS 10.7 and SaTscan 9.6. The risk areas for home delivery from GIS and spatial scan statistics results were reported. A multi-level logistic regression model was fitted using Stata14 to identify individual and community-level factors associated with home delivery after ANC visit. Finally, AOR with 95% CI and random effects were reported. Result Home delivery after ANC visit was spatially clustered in Ethiopia(Moran’s index = 0.52, p-value <0.01). The primary clusters were detected in Oromia and SNNP region (LLR = 37.48, p < 0.001 and RR = 2.30) and secondary clusters were located in Benishangul Gumuz, Amhara, Tigray and Afar (LLR = 29.45, p<0.001 and RR = 1.54). Being rural resident (AOR = 2.52; 95%CI 1.09–5.78), having no formal education (AOR = 3.19;95% CI 1.11–9.16), being in the poor (AOR = 2.20;95%CI 1.51–3.22) and middle wealth index (AOR = 2.07;95% CI 1.44–2.98), having one ANC visit (AOR = 2.64; 95% CI 1.41–4.94), and living in the agrarian region (AOR = 3.63; 95%CI 1.03–12.77) had increased the odds of home delivery after ANC visit. Conclusion and recommendation Home delivery after ANC visit was spatially clustered in Ethiopia. Factors like maternal education, wealth index, number of ANC visits, residency and region were significantly associated with home delivery after ANC visit. Therefore, it is better to increase the number of ANC contact by giving health education, especially for women with low levels of education and better to improve the wealth status of women. A special strategy is also vital to reduce home delivery after ANC visit in those high-risk regions.
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Affiliation(s)
- Hiwotie Getaneh Ayalew
- Department of Midwifery, School of Nursing and Midwifery, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
- * E-mail:
| | - Alemneh Mekuriaw Liyew
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences and Comprehensive Specialized Hospital, University of Gondar, Gondar, Ethiopia
| | - Zemenu Tadesse Tessema
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences and Comprehensive Specialized Hospital, University of Gondar, Gondar, Ethiopia
| | - Misganaw Gebrie Worku
- Department of Human Anatomy, College of Medicine and Health Sciences and Comprehensive Specialized Hospital, University of Gondar, Gondar, Ethiopia
| | - Getayeneh Antehunegn Tesema
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences and Comprehensive Specialized Hospital, University of Gondar, Gondar, Ethiopia
| | - Tesfa Sewunet Alamneh
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences and Comprehensive Specialized Hospital, University of Gondar, Gondar, Ethiopia
| | - Achamyeleh Birhanu Teshale
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences and Comprehensive Specialized Hospital, University of Gondar, Gondar, Ethiopia
| | - Yigizie Yeshaw
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences and Comprehensive Specialized Hospital, University of Gondar, Gondar, Ethiopia
- Department of Human Physiology, College of Medicine and Health Sciences and Comprehensive Specialized Hospital, University of Gondar, Gondar, Ethiopia
| | - Adugnaw Zeleke Alem
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences and Comprehensive Specialized Hospital, University of Gondar, Gondar, Ethiopia
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Improvement in Quality of Life through Self-Management of Mild Symptoms during the COVID-19 Pandemic: A Prospective Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116652. [PMID: 35682238 PMCID: PMC9180648 DOI: 10.3390/ijerph19116652] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 05/27/2022] [Accepted: 05/28/2022] [Indexed: 12/11/2022]
Abstract
The COVID-19 pandemic has inhibited people's help-seeking behaviors (HSBs). In particular, older people in rural communities experienced limited access to medical care, which negatively affected their quality of life (QOL). Within HSB, self-management of mild symptoms may mitigate the difficulties experienced by older people in rural communities. However, few studies have examined the relationship between self-management and QOL. Therefore, we conducted a prospective cohort study to clarify this relationship. Our participants were over 65 years of age and lived in rural communities. QOL was measured with the EuroQol 5-Dimension 5-Level (EQ-5D-5L). Demographic data and QOL were collected from participants via questionnaires in 2021 and 2022. The exposure group showed a significantly greater change in EQ-5D-5L health status index scores than the control group (p = 0.002). In addition, the exposure group scored significantly lower than the control group on the EQ-5D-5L dimension "usual activities" in 2021 and on all dimensions in 2022. Thus, self-management of mild symptoms may improve QOL among older people in rural communities during the COVID-19 pandemic. Educational interventions for this population regarding self-management could improve QOL for entire communities.
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Association between Self-Medication for Mild Symptoms and Quality of Life among Older Adults in Rural Japan: A Cross-Sectional Study. Medicina (B Aires) 2022; 58:medicina58060701. [PMID: 35743965 PMCID: PMC9227455 DOI: 10.3390/medicina58060701] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 05/23/2022] [Accepted: 05/24/2022] [Indexed: 12/12/2022] Open
Abstract
Self-medication, a help-seeking behavior to control individual symptoms, can be promoted to prevent the overuse of medical care and improve self-management among older adults. However, evidence regarding the association between self-medication and quality of life (QOL) is lacking. The purpose of this study is to investigate the association between QOL and the usage of self-medication among rural older adults. This cross-sectional study included participants older than 65 years in rural Japanese communities. Data were collected using a questionnaire regarding self-medication trends, the EQ-5D-5L to assess QOL, and a demographics questionnaire. Participants were divided into exposure and control groups based on their tendencies toward self-medication usage. Differences in the demographics between groups were adjusted using propensity score matching. Results: The health status in the exposure group was statistically significantly better than that in the control group in the dimensions of movement, self-care, and usual activities. Conversely, the pain/discomfort and anxiety/depression dimensions were not statistically significantly different. The quality of self-medication behaviors for mild symptoms can be improved with practical knowledge of and access to home remedies and over-the-counter drugs. Educational interventions and system development for better self-medication for mild symptoms and medical care for critical symptoms in rural contexts can be effective in improving QOL among rural older adults.
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Magnitude and Predictors of In-Hospital Stroke Mortality in Ethiopia: A Systematic Review and Meta-Analysis. Stroke Res Treat 2022; 2022:7202657. [PMID: 35656388 PMCID: PMC9155958 DOI: 10.1155/2022/7202657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 04/02/2022] [Accepted: 05/06/2022] [Indexed: 11/17/2022] Open
Abstract
Introduction Stroke is the second leading cause of mortality worldwide, accounting for approximately 5.5 million deaths each year. Due to demographic and health changes, the epidemiology of stroke is shifting from industrialized to low- and middle-income nations. Ethiopia is a developing country with a population that reflects this shift. Therefore, this systematic review and meta-analysis are aimed at evaluating the extent of in-hospital mortality of both ischemic and hemorrhagic stroke in Ethiopia and determining relevant factors associated with the mortality. Methods Observational studies published as of July 15, 2020, that reported the magnitude, predictors, and causes of in-hospital mortality of stroke were systematically and comprehensively retrieved using the PRISMA 2020 criteria from databases such as PubMed/MEDLINE, Science Direct, and Google Scholar. The review papers were chosen based on the study methodology (facility-based observational), the study area (Ethiopia), the study population (adult patients with stroke), the outcome (in-hospital mortality), and the fact that they were published in English. Result A total of 3709 patients with stroke were included in this systematic review and meta-analysis, which included 19 publications. In-hospital mortality was 14.03 percent on average in the studies, with reports ranging from 6.04 percent to 37.37 percent. Patients with hemorrhagic type stroke, admission Glasgow Coma Scale less than or equal to 12, impaired mental status, National Institutes of Health Stroke Scale stroke level greater than 13, prolonged hospital stay, any incontinence, pneumonia, and/or swallowing trouble had an increased risk of death after stroke. Conclusion The magnitude of in-hospital mortality of patients with stroke in Ethiopia is high. The assessment of the level of consciousness is vital for clinical management and as an indicator of prognosis. Patients with unfavorable prognostic signs, such as entry Glasgow Coma Scale, National Institutes of Health Stroke Scale stroke level > 13, hemorrhagic stroke, pneumonia, incontinence, and dysphagia, should be given priority.
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Merkeb Alamneh Y, Getachew M, Atnaf A, Abebaw A. Mothers’ health care-seeking behavior and associated factors for common childhood illnesses in Ethiopia: A systematic review and meta-analysis. SAGE Open Med 2022; 10:20503121221099019. [PMID: 35615524 PMCID: PMC9125608 DOI: 10.1177/20503121221099019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 04/19/2022] [Indexed: 11/16/2022] Open
Abstract
Objective: This review is aimed to estimate the pooled prevalence of mothers’ health care-seeking behavior and associated factors in Ethiopia. Methods: International databases were systematically searched for studies that were published between 2008 and 2019. Data were extracted in Microsoft Excel 2019 and then exported to STATA version 14 for further analysis. Publication bias was determined by funnel plot, Begg’s test, and Egger’s test. Heterogeneity between the studies was checked by I2 statistic. The pooled proportion was estimated using random-effects meta-analysis model. Results: This review and meta-analysis included 14 studies from a total of 581 papers that were screened. The pooled proportion of mothers’ health care-seeking behavior in Ethiopia was 50.24% (95% CI: 37.13%, 63.35%). Health facility distance (OR = 2.07), awareness about common childhood illnesses (OR = 2.06), educational levels (OR = 1.82), and income (OR = 2.07) were significantly associated variables. Conclusion: The overall health care-seeking behavior of mothers for common childhood illnesses in Ethiopia is low. Accordingly, educating mothers/caregivers about the importance of health care-seeking behavior and increasing the proximity of health facilities were recommended to improve health care-seeking behavior.
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Affiliation(s)
- Yoseph Merkeb Alamneh
- School of Medicine, Department of Biomedical Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Melese Getachew
- Department of Pharmacy, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Aytenew Atnaf
- Department of Medical Laboratory Science, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Abtie Abebaw
- Department of Medical Laboratory Science, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
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Yabeyu AB, Haile KT, Belay YB, Tegegn HG. Limited Public Knowledge of Chronic Kidney Disease in a Resource-Limited Setting: A Cross-Sectional Study. Int J Gen Med 2022; 15:4997-5003. [PMID: 35601006 PMCID: PMC9121986 DOI: 10.2147/ijgm.s364632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 05/09/2022] [Indexed: 11/23/2022] Open
Abstract
Background Methods Results Conclusion
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Affiliation(s)
- Abdella Birhan Yabeyu
- Department of Pharmacy, Ambo University, Ambo, Ethiopia
- Correspondence: Abdella Birhan Yabeyu, Email
| | - Kaleab Taye Haile
- Department of Pharmaceutics and Social Pharmacy, University of Gondar, Gondar, Ethiopia
| | - Yared Belete Belay
- Department of Pharmaceutics and Social Pharmacy, Mekelle University, Mekelle, Ethiopia
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Older People's Help-Seeking Behaviors in Rural Contexts: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063233. [PMID: 35328920 PMCID: PMC8951636 DOI: 10.3390/ijerph19063233] [Citation(s) in RCA: 33] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 03/02/2022] [Accepted: 03/09/2022] [Indexed: 02/06/2023]
Abstract
Help-seeking behavior (HSB) is vital for older people to sustain their health. As people in aging societies increasingly demand management of their multiple symptoms, communities should encourage HSBs. In rural communities, insufficient healthcare and human resources influence older people’s health. However, no related comprehensive evidence exists so far. This study investigates the present condition of older people’s HSBs in rural contexts in aging societies. We conducted a systematic review by searching six databases (PubMed, Cochrane Library, EMBASE, Medline, and Web of Science) for original studies regarding HSBs of older people in rural contexts published until January 2022. Extracted articles were analyzed based on participants, settings, HSB causes and contents, and older people’s HSB outcomes in rural contexts. Sixteen studies were included in the systematic review: seven investigated the associations between HSBs and participants’ backgrounds, and three the quality of life. Six studies investigated HSB perception, diagnosis, clarifying HSB contents, professional care trend, self-rated health, and mortality. Unlike few studies investigating the association between HSBs and health-related outcomes, this systematic review explains the current evidence regarding rural older people’s HSBs. Due to insufficient evidence from longitudinal studies in clarifying interventions for effective HSBs, future studies should use observational and interventional designs.
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28
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Koné S, Fink G, Probst-Hensch N, Essé C, Utzinger J, N’Goran EK, Tanner M, Jaeger FN. Determinants of Modern Paediatric Healthcare Seeking in Rural Côte d’Ivoire. Int J Public Health 2022; 66:1604451. [PMID: 35173568 PMCID: PMC8842662 DOI: 10.3389/ijph.2021.1604451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 12/10/2021] [Indexed: 11/16/2022] Open
Abstract
Objectives: To determine factors that influence healthcare seeking among children with fatal and non-fatal health problems. Methods: Last disease episodes of surviving children and fatal outcomes of children under 5 years of age were investigated by means of an adapted social autopsy questionnaire administered to main caregivers. Descriptive analysis and logistic models were employed to identify key determinants of modern healthcare use. Results: Overall, 736 non-fatal and 82 fatal cases were assessed. Modern healthcare was sought for 63.9% of non-fatal and 76.8% of fatal cases, respectively. In non-fatal cases, young age, caregiver being a parent, secondary or higher education, living <5 km from a health facility, and certain clinical signs (i.e., fever, severe vomiting, inability to drink, convulsion, and inability to play) were positively associated with modern healthcare seeking. In fatal cases, only signs of lower respiratory disease were positively associated with modern healthcare seeking. A lack of awareness regarding clinical danger signs was identified in both groups. Conclusion: Interventions promoting prompt healthcare seeking and the recognition of danger signs may help improve treatment seeking in rural settings of Côte d’Ivoire and can potentially help further reduce under-five mortality.
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Affiliation(s)
- Siaka Koné
- Centre Suisse de Recherches Scientifiques en Côte d’Ivoire, Abidjan, Côte d’Ivoire
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
- *Correspondence: Siaka Koné,
| | - Günther Fink
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Nicole Probst-Hensch
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Clémence Essé
- Centre Suisse de Recherches Scientifiques en Côte d’Ivoire, Abidjan, Côte d’Ivoire
- Institut d’Ethnosociologie, Université Félix Houphouët-Boigny, Abidjan, Côte d’Ivoire
| | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Eliézer K. N’Goran
- Centre Suisse de Recherches Scientifiques en Côte d’Ivoire, Abidjan, Côte d’Ivoire
- Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d’Ivoire
| | - Marcel Tanner
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Fabienne N. Jaeger
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
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Scott J, Nolan MS, Mberikunashe J, Tapera O, Kanyangarara M. Health service utilization in Manicaland Province, Zimbabwe during the COVID-19 pandemic: results from a cross-sectional household survey. JOURNAL OF GLOBAL HEALTH REPORTS 2022. [DOI: 10.29392/001c.31599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Affiliation(s)
- Julia Scott
- Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Melissa S Nolan
- Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Joseph Mberikunashe
- National Malaria Control Program, Ministry of Health and Child Care, Harare, Zimbabwe
| | - Oscar Tapera
- Sadtap Health Research Institute, Harare, Zimbabwe
| | - Mufaro Kanyangarara
- Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
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30
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Li Y, Li W, Wu Z, Yuang J, Wei Y, Huang C, Huang D. Findings About Patient Preferences for Medical Care Based on a Decision Tree Method Study Design for Influencing Factors. INQUIRY: THE JOURNAL OF HEALTH CARE ORGANIZATION, PROVISION, AND FINANCING 2022; 59:469580221092831. [PMID: 35499502 PMCID: PMC9067033 DOI: 10.1177/00469580221092831] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Aim: This study aimed to investigate the influencing factors of the medical-seeking behavior of patients in a hospital in Nanning and descriptively analyze the main factors to further improve the medical system and optimize the allocation of health resources. Subject and methods: The willingness to seek medical treatment questionnaire survey was conducted on patients who were in the outpatient clinic of a hospital in Nanning from Jun 2018 to Aug 2019. The patients’ basic information was analyzed descriptively using the SPSS 23.0 software package, and the influencing factors of the willingness to seek medical treatment were analyzed by univariate analysis method. In addition, the importance of influencing factors in patient preference to seek medical treatment was explored by constructing a decision tree model. Results: A total of 3428 questionnaires were valid and the effective rate was 93.78%. Region, age, occupation, educational level, monthly income, insurance type, and disease type demonstrated diverse influences on the medical expenses of patients. In addition, differences were found between occupation and patient insurance situation, personal willingness to seek medical treatment, reasons for visiting the hospital, medical selection standard, preferred medical treatment location for common diseases, waiting time, treatment time, and manner of understanding the disease. Conclusion: Increasing attention has been paid on the patients’ preference for medical treatment and their satisfaction with medical services. Medical institutions should reasonably allocate the proportion of medical insurance reimbursement and diversify the registration and appointment methods. Patients should be treated in different periods and properly allocated to improve the service mechanism of primary medical institutions. In addition, it is necessary to improve the medical publicity model and the efficiency of medical services according to the needs of patients, so as to relieve the pressure of medical treatment in large general hospitals.
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Affiliation(s)
- Yu Li
- School of Information and Management, Guangxi Medical University, Nanning, China
| | - Wen Li
- School of Basic Medical Sciences, Guangxi Medical University, Nanning, China
| | - Zhihui Wu
- School of Basic Medical Sciences, Guangxi Medical University, Nanning, China
| | - Jianhui Yuang
- School of Basic Medical Sciences, Guangxi Medical University, Nanning, China
- The Laboratory of Biomedical Photonics and Engineering, Guangxi Medical University, Nanning, China
| | - Yanling Wei
- School of Information and Management, Guangxi Medical University, Nanning, China
| | - Chao Huang
- School of Information and Management, Guangxi Medical University, Nanning, China
| | - Daizheng Huang
- School of Information and Management, Guangxi Medical University, Nanning, China
- School of Basic Medical Sciences, Guangxi Medical University, Nanning, China
- The Laboratory of Biomedical Photonics and Engineering, Guangxi Medical University, Nanning, China
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31
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Areru HA, Dangisso MH, Lindtjørn B. Large local variations in the use of health services in rural southern Ethiopia: An ecological study. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000087. [PMID: 36962269 PMCID: PMC10021478 DOI: 10.1371/journal.pgph.0000087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 05/01/2022] [Indexed: 11/18/2022]
Abstract
Ethiopia is behind schedule in assuring accessible, equitable and quality health services. Understanding the geographical variability of the health services and adjusting small-area level factors can help the decision-makers to prioritize interventions and allocate scarce resources. There is lack of information on the degree of variation of health service utilisation at micro-geographic area scale using robust statistical tools in Ethiopia. Therefore, the objective of this study was to assess the health service utilisation and identify factors that account for the variation in health service utilisation at kebele (the smallest administrative unit) level in the Dale and Wonsho districts of the Sidama region. An exploratory ecological study design was employed on the secondary patient data collected from 1 July 2017 to 30 June 2018 from 65 primary health care units of the fifty-four kebeles in Dale and Wonsho districts, in the Sidama region. ArcGIS software was used to visualise the distribution of health service utilisation. SaTScan analysis was performed to explore the unadjusted and covariate-adjusted spatial distribution of health service utilisation. Linear regression was applied to adjust the explanatory variables and control for confounding. A total of 67,678 patients in 54 kebeles were considered for spatial analysis. The distribution of the health service utilisation varied across the kebeles with a mean of 0.17 visits per person per year (Range: 0.01-1.19). Five kebeles with health centres had a higher utilisation rate than other rural kebeles without health centres. More than half (57.4%) of the kebeles were within a 10 km distance from health centres. The study found that distance to the health centre was associated with the low health care utilisation. Improving the accessibility of health services by upgrading the primary health care units could increase the service use.
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Affiliation(s)
- Hiwot Abera Areru
- School of Public Health, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
- Global Public Health and Primary Care, Centre for International Health, University of Bergen, Bergen, Norway
| | - Mesay Hailu Dangisso
- School of Public Health, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
| | - Bernt Lindtjørn
- School of Public Health, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
- Global Public Health and Primary Care, Centre for International Health, University of Bergen, Bergen, Norway
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Kbede AG, Alemayew M, Tafere Y, Mulu GB. Determinants of Delayed Treatment-seeking for Diarrheal Diseases among Mothers with under-five Children in North Western Ethiopia, 2020: A case-control Study. Ethiop J Health Sci 2021; 31:1163-1174. [PMID: 35392338 PMCID: PMC8968381 DOI: 10.4314/ejhs.v31i6.11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 08/31/2021] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Delays in seeking timely proper care pay a large number of deaths from diarrhea in children. Timely and appropriate health care seeking in under-five children with diarrhea reduces life-threatening complications. This study aimed to investigate determinants of delayed treatment-seeking for diarrheal diseases among mothers with under-five children. METHOD In Debre Markos public health facilities, a facility-based case-control study was conducted among 412 mothers ((137 cases and 274 controls) from September 1 to October 15, 2020. Consecutive sampling was employed to select cases and controls. Data was collected using a semi-structured interviewer-administered questionnaire. Data were entered into Epi- Data version 4.2.1 and exported to STATA version 14 for analysis. Predictors with P-value <0.25 in the bivariable logistic regression model were candidates for multivariable logistic regression. Pvalue <0.05 was used to declare statistical significance. Finally, results were presented in the form of texts and tables. RESULT From 412 selected participants, 408 mothers (136 cases and 272 controls) were included. Female children [AOR 1.85(95% CI 1.15-2.98)], Child age < 24 months [AOR 1.64 (95% CI 1.01-2.65)], mothers'/caregivers without formal education [AOR 4.61 (95% CI 2.03-10.44)], poorest wealth index category [AOR 4.24 (95% CI 1.90-9.48)], absence of health insurance [AOR 3.04 (95% CI 1.60-5.78)], and self-medication [AOR 3.6 (95% CI 1.75-7.4)] were determinants of delayed treatment-seeking. CONCLUSION Being female, young age, educational status of the mother, lowest wealth index category, self-medication, and absence of health insurance were determinants of delayed treatment-seeking for diarrheal diseases. Preventive care programs should target age, low socioeconomic status, and a low educational class of the mother.
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Affiliation(s)
- Abebaw Getu Kbede
- Department of Public Health, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Mulunesh Alemayew
- Department of Public Health, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Yilkal Tafere
- Department of Public Health, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Getaneh Baye Mulu
- Department of Nursing, College of Health Sciences, Debre Berhan University, Debre Berhan, Ethiopia
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Zhi L, Yin P, Ren J, Wei G, Zhou J, Wu J, Shen Q. Running an Internet Hospital in China: Perspective Based on a Case Study. J Med Internet Res 2021; 23:e18307. [PMID: 34342267 PMCID: PMC8485192 DOI: 10.2196/18307] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 11/25/2020] [Accepted: 08/02/2021] [Indexed: 11/13/2022] Open
Abstract
Internet hospitals, as a new forum for doctors to conduct diagnosis and treatment activities based on the internet, are emerging in China and have become integral to the development of the medical field in conjunction with increasing reforms and policies in China's medical and health system. Here, we take the Internet Hospital of the First Affiliated Hospital, Zhejiang University (FAHZU Internet Hospital) as an example to discuss the operations and functional positioning of developing internet hospital medical services in relation to physical hospitals. This viewpoint considers the platform operation, management, and network security of FAHZU Internet Hospital, and summarizes the advantages and limitations in the operation to provide a reference for other areas with interest in developing internet hospitals.
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Affiliation(s)
- Lihua Zhi
- Department of Internet Hospital Office, The First Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, China
| | - Pei Yin
- Department of General Practice, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jingjing Ren
- Department of General Practice, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Guoqing Wei
- Department of Medical Administration, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jun Zhou
- Department of Internet Hospital Office, The First Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, China
| | - Jun Wu
- Department of Internet Hospital Office, The First Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, China
| | - Qun Shen
- Department of Internet Hospital Office, The First Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, China
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Ng'ambi W, Mangal T, Phillips A, Colbourn T, Nkhoma D, Mfutso-Bengo J, Revill P, Hallett TB. A cross-sectional study on factors associated with health seeking behaviour of Malawians aged 15+ years in 2016. Malawi Med J 2021; 32:205-212. [PMID: 34457205 PMCID: PMC8364791 DOI: 10.4314/mmj.v32i4.5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction Health seeking behaviour (HSB) refers to actions taken by individuals who are ill in order to find appropriate remedy. Most studies on HSB have only examined one symptom or covered only a specific geographical location within a country. In this study, we used a representative sample of adults to explore the factors associated with HSB in response to 30 symptoms reported by adult Malawians in 2016. Methods We used the 2016 Malawi Integrated Household Survey dataset. We fitted a multilevel logistic regression model of likelihood of ‘seeking care at a health facility’ using a forward step-wise selection method, with age, sex and reported symptoms entered as a priori variables. We calculated the odds ratios (ORs) and their associated 95% confidence intervals (95% CI). We set the level of statistical significance at P < 0.05. Results Of 6909 adults included in the survey, 1907 (29%) reported symptoms during the 2 weeks preceding the survey. Of these, 937 (57%) sought care at a health facility. Adults in urban areas were more likely to seek health care at a health facility than those in rural areas (AOR = 1.65, 95% CI: 1.19–2.30, P = 0.003). Females had a higher likelihood of seeking care from health facilities than males (AOR = 1.26, 95% CI: 1.03–1.59, P = 0.029). Being of higher wealth status was associated with a higher likelihood of seeking care from a health facility (AOR = 1.58, 95% CI: 1.16–2.16, P = 0.004). Having fever and eye problems were associated with higher likelihood of seeking care at a health facility, while having headache, stomach ache and respiratory tract infections were associated with lower likelihood of seeking care at a health facility. Conclusion This study has shown that there is a need to understand and address individual, socioeconomic and geographical barriers to health seeking to increase access and appropriate use of health care and fast-track progress towards Universal Health Coverage among the adult population.
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Affiliation(s)
- Wingston Ng'ambi
- University of Malawi, College of Medicine, Health Economics and Policy Unit, Lilongwe, Malawi
| | | | | | | | - Dominic Nkhoma
- University of Malawi, College of Medicine, Health Economics and Policy Unit, Lilongwe, Malawi
| | - Joseph Mfutso-Bengo
- University of Malawi, College of Medicine, Health Economics and Policy Unit, Lilongwe, Malawi
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Potential Help-Seeking Behaviors Associated with Better Self-Rated Health among Rural Older Patients: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18179116. [PMID: 34501707 PMCID: PMC8430707 DOI: 10.3390/ijerph18179116] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Revised: 08/27/2021] [Accepted: 08/27/2021] [Indexed: 11/16/2022]
Abstract
Help-seeking behaviors (HSB) for mild symptoms vary because of differences in health care resources and patients' backgrounds. Potential HSBs for lay and professional care use are related to patients' health conditions. However, there is a lack of evidence of the relation between them. This study examined the relation between patients' potential HSBs and self-rated health (SRH). The cross-sectional study involved 169 patients, aged above 65 years, who visited a Japanese rural clinic. A validated checklist was used to assess potential patients' HSBs. A chi-square test and logistic regression were performed to examine the relation between patients' self-rated health and HSB regarding lay and professional care use. Participants were 77.5 years old, on average (SD = 8.3). Results reveal that having regular exercise habits (OR = 2.42, p = 0.04), adequate sleep (OR = 4.35, p = 0.006), work (OR = 2.59, p = 0.03), high socioeconomic status (OR = 6.67, p = 0.001), and using both lay and professional care (OR = 2.39, p = 0.046) were significantly correlated with high self-rated health. Living alone was negatively correlated with higher SRH (OR = 0.23, p = 0.015). To improve rural patients' health care, in addition to improving their health management skills, potential HSB for mild symptoms should be investigated and interventions that consider patients' socioeconomic factors and living conditions should be implemented.
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The Association between the Self-Management of Mild Symptoms and Quality of Life of Elderly Populations in Rural Communities: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168857. [PMID: 34444606 PMCID: PMC8394535 DOI: 10.3390/ijerph18168857] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 08/12/2021] [Accepted: 08/19/2021] [Indexed: 01/18/2023]
Abstract
Maintaining people’s health based on their help-seeking behavior (HSB) regarding mild symptoms is essential. An effective HSB, especially self-management, can facilitate the attainment of appropriate healthcare resources and affect health outcomes such as quality of life (QOL). However, clear evidence regarding the relationship between self-management, mild symptoms, and QOL is unavailable. Therefore, this cross-sectional study investigated this association in a rural elderly population. The participants, aged over 65 years, were living in rural communities. The primary outcome of QOL was examined using the EuroQol 5-Dimension 5-Level (EQ-5D-5L). After adjusting for propensity score matching, 298 participants in the self-management usage group were matched with 298 in the group not using self-management. The most frequent HSB trend was consulting with primary care physicians, followed by self-care, consulting with families, utilizing home medicines, and buying medicines. The EQ-5D-5L scores were statistically higher in the self-management usage group than in the other group. The HSBs with a trend of using self-management were related to a high QOL. Self-management of symptoms along with other HSBs can improve elderly HSBs in rural contexts. Educational interventions and system development for HSBs in rural contexts could be effective in enhancing the QOL of rural elderly populations.
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Dharmawan Y, Fuady A, Korfage I, Richardus JH. Individual and community factors determining delayed leprosy case detection: A systematic review. PLoS Negl Trop Dis 2021; 15:e0009651. [PMID: 34383768 PMCID: PMC8360380 DOI: 10.1371/journal.pntd.0009651] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 07/14/2021] [Indexed: 11/27/2022] Open
Abstract
Background The number of new leprosy cases is declining globally, but the disability caused by leprosy remains an important disease burden. The chance of disability is increased by delayed case detection. This review focusses on the individual and community determinants of delayed leprosy case detection. Methods This study was conducted according to the PRISMA guidelines (Preferred Reporting Items for Systematic Reviews and Meta-Analysis). The study protocol is registered in PROSPERO (code: CRD42020189274). To identify determinants of delayed detection, data was collected from five electronic databases: Embase.com, Medline All Ovid, Web of Science, Cochrane CENTRAL, and the WHO Global Health Library. Results We included 27 papers from 4315 records assessed. They originated in twelve countries, had been published between January 1, 2000, and January 31, 2021, and described the factors related to delayed leprosy case detection, the duration of the delayed case, and the percentage of Grade 2 Disability (G2D). The median delay in detection ranged from 12 to 36 months, the mean delay ranged from 11.5 to 64.1 months, and the percentage of G2D ranged from 5.6 to 43.2%. Health-service-seeking behavior was the most common factor associated with delayed detection. The most common individual factors were older age, being male, having a lower disease-symptom perception, having multibacillary leprosy, and lack of knowledge. The most common socioeconomic factors were living in a rural area, performing agricultural labor, and being unemployed. Stigma was the most common social and community factor. Conclusions Delayed leprosy case detection is clearly correlated with increased disability and should therefore be a priority of leprosy programs. Interventions should focus on determinants of delayed case detection such as health-service-seeking behavior, and should consider relevant individual, socioeconomic, and community factors, including stigmatization. Further study is required of the health service-related factors contributing to delay. Leprosy remains an important public health problem with many new leprosy patients diagnosed with visible physical deformities, indicating a long delay in the detection of cases. For effective prevention programs, it is important to know the factors at the level of the individual and the community that contribute to the delay. We reviewed all published studies that reported individual and community factors related to delayed case detection in leprosy and included 27 studies in our analysis, published between January 1, 2000, and January 31, 2021. Health-service-seeking behavior was the most common factor associated with delay in case detection. The most common individual factors were older age, being male, having a lower disease-symptom perception, having multibacillary leprosy, and lack of knowledge about leprosy. The most common socioeconomic factors were living in a rural area, performing agricultural labor, and being unemployed. Stigma was the most common social and community factor associated with detection delay. The presence of physical disability in newly diagnosed leprosy patients is clearly related to the delay in detecting these patients. Leprosy control interventions should take factors related to detection delay into account more comprehensively. Also, there is a need to study health service-related factors that contribute to detection delay of leprosy patients.
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Affiliation(s)
- Yudhy Dharmawan
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Faculty of Public Health, Universitas Diponegoro, Semarang, Indonesia
- * E-mail: , (YD)
| | - Ahmad Fuady
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Community Medicine, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Ida Korfage
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Jan Hendrik Richardus
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
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Areru HA, Dangisso MH, Lindtjørn B. Low and unequal use of outpatient health services in public primary health care facilities in southern Ethiopia: a facility-based cross-sectional study. BMC Health Serv Res 2021; 21:776. [PMID: 34362376 PMCID: PMC8344135 DOI: 10.1186/s12913-021-06846-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Accepted: 07/28/2021] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Outpatient department visits per individual for each year are one of the core indicators of healthcare delivery to assess accessibility or quality of services. In addition, this study aimed to assess health service utilisation and disease patterns in southern Ethiopia, by including the health authorities' suggestions to improve the services. No study has assessed this in Ethiopia previously. METHODS An institution-based cross-sectional design study was done in 65 primary health care units in Dale and Wonsho districts, in Sidama region, for all patients visiting health facilities from 1 July 2017 to 30 June 2018. We estimated the utilisation rate as visits per person per year, the odds ratio for health use and proportions of diseases' diagnoses. The results of our study were presented to local health authorities, and their suggestions for improvements were incorporated into the analysis. RESULT A total of 81,129 patients visited the health facilities. The annual outpatient health service utilisation was 0.18 (95% CI: 0.18-0.19) new visits per person per year. The health service utilisation rate per year for the rural population was lower than the urban utilisation by 91% (OR = 0.09; 95% CI: 0.08-0.09). Children in the age group of 5-14 years had lower odds of health service utilisation by 78% (OR = 0.22; 95% CI: 0.21-0.23), compared to children under 5 years of age. Females were four times (OR = 4.17; 95% CI: 4.09-4.25) more likely to utilise health services than males. Febrile illness constituted 17.9% (14,847 of 83,148) of the diagnoses in all age groups. Almost half of the febrile cases, 46.5% (3827 of 8233), were among children under 5 years of age. There were very few cases of non-communicable diseases diagnosed in the health facilities. The health authorities suggested improving diagnostic capacities at health centres, enhancing health professionals' skill and attitudes, and improving affordability and physical accessibility of the services. CONCLUSION The health service utilisation rate was low in Sidama. The use of health services was lower among rural residents, men, children and elderly, and health post users. Improving the quality, affordability and accessibility of the health services, by involving responsible stakeholders could increase service usage.
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Affiliation(s)
- Hiwot Abera Areru
- School of Public Health, College of Medicine and Health Sciences, Hawassa University, P.O.BOX: 1560, Hawassa, Ethiopia
- Global Public Health and Primary Care, Centre for International Health, University of Bergen, Bergen, Norway
| | - Mesay Hailu Dangisso
- School of Public Health, College of Medicine and Health Sciences, Hawassa University, P.O.BOX: 1560, Hawassa, Ethiopia
| | - Bernt Lindtjørn
- School of Public Health, College of Medicine and Health Sciences, Hawassa University, P.O.BOX: 1560, Hawassa, Ethiopia
- Global Public Health and Primary Care, Centre for International Health, University of Bergen, Bergen, Norway
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Gutema G, Ali S, Suleman S. Trends of community-based systemic antibiotic consumption: Comparative analyses of data from Ethiopia and Norway calls for public health policy actions. PLoS One 2021; 16:e0251400. [PMID: 33989309 PMCID: PMC8121293 DOI: 10.1371/journal.pone.0251400] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 04/18/2021] [Indexed: 11/18/2022] Open
Abstract
Studies on antibiotic utilization trends are invaluable because they offer data for evaluation of impacts of antimicrobial stewardship policies. Such studies help determine correlations between the use of specific antibiotic classes and trends in emergence of resistance (resistance-epidemiology). This study aims to quantify the consumption systemic antibiotics (J01)—in defined daily doses (DDD) per 1000 inhabitants per day (DID)—in Ethiopia’s public healthcare sector (2016–2020). By so doing, it attempts to capture the extent of population exposure to antibiotics in the country. Data were also compared with those from Norway to establish rough estimate of the country’s status vis-à-vis some globally acknowledged better practices with regard to optimal use of antibiotics. Raw data obtained from registers of Ethiopian Pharmaceutical Supply Agency were converted into DDD, per the standard methodology recommended by WHO. To control for population size, antibiotics consumption data were presented as DID. Since official population census data for Ethiopia were not available for the study period, population projection data from the World Bank were used. Community-based consumption of systemic antibiotics increased from 11.02 DID in 2016 to 12.83 DID in 2020 in Ethiopia—an increase by 16.4%. Moreover, analysis of a log-linear regression model showed that the average growth rate in the community-based systemic antibiotics consumption per year between 2016 and 2020 was about 3.3% (R2 = 0.89). The highest percentage change in community-based systemic antibiotics consumption happened for glycopeptides (J01XA) and the fourth generation cephalosporins (J01DE)—1300% and 600% compared to the baseline year (2016), respectively. At product level, 9 antibiotics constituted the common domain in the list of medication cocktails in the drug utilization 90% (DU90%) for the study period. Community-based consumption of systemic antibiotics for Ethiopia and Norway showed opposite trends, calling for public health policy actions in Ethiopia.
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Affiliation(s)
- Girma Gutema
- Institute of Pharmaceutical Sciences, University of Oslo, Oslo, Norway.,Faculty of Health Sciences, Rift Valley University, Adama, Oromia, Ethiopia
| | - Seid Ali
- Swiss Tropical and Public Health Institute, University of Basel, Basel, Switzerland
| | - Sultan Suleman
- Department of Pharmaceutical Analysis and Regulatory Affairs, Jimma University, Jimma, Oromia, Ethiopia
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Abebe H, Wagnew F, Zeleke H, Tefera B, Tesfa S, Fetene T. Magnitude of visual impairment and associated factors among patients attending ophthalmic clinics of Debre Markos referral hospital, north West Ethiopia. BMC Ophthalmol 2021; 21:96. [PMID: 33607949 PMCID: PMC7893842 DOI: 10.1186/s12886-021-01863-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 01/27/2021] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Globally, visual impairment affects about 285 million (4.25%) people, of those, 266.4 million were adults aged 18 years and above. Ethiopia is one of developing countries estimated to have high prevalence of visual impairment which have an enormous socio-economic impact. Also there is limited available information regarding with the magnitude of visual impairment among adults in our country at large and east Gojjam zone in specific. Therefore the aim of this study was to assess the magnitude of visual impairment and its associated factors among patients attending Debre Markos Referral Hospital ophthalmic clinics in east Gojjam zone, North West Ethiopia. METHODS An institutional-based cross-sectional study was conducted at Debre Markos Referral Hospital which is the only hospital in east gojjam zone with ophthalmic care service from March 1 to 30, 2020 by using systematic random sampling technique to select study participants after informed consent was obtained. Data were collected by interview with 5% pretested, structured questionnaire and ocular examinations. Data were cleaned, coded and entered to Epi-data version-3.1, and analyzed using Statistical Package for Social Science software version 26. The descriptive statistics was presented in tables, text and graphs. Bivariable and multivariable logistic regression analysis to identify factors associated with visual impairment was conducted. Covariates with P-value < 0.05 were considered statistically significant. RESULTS A study was conducted among 312 study participants with 96% response rate. The magnitude of visual impairment was 114 (36.5%) [95% CI, (33.8, 39.2%)]. Age > 50 years [AOR = 3.82; 95% CI (1.56, 9.35)], rural residency [AOR = 4.33 95% CI (1.30, 14.44)], inability to read and write [AOR = 3.21; 95% CI (1.18, 8.73)] and Cataract [AOR = 4.48; 95% CI (1.91, 10.52)] were factors significantly associated with visual impairment. CONCLUSIONS The overall magnitude of visual impairment was found to be high. Older age, rural residency, inability to read and write and cataract were associated with visual impairment. Increasing literacy, expanded cataract surgery, as well as community based visual acuity screening especially for elders and rural residents is crucial. Zonal police makers should give emphasis on prevention of visual impairment to decrease economic, social and political burden of visual disability.
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Affiliation(s)
- Haimanot Abebe
- Department of Nursing, Wolkite University, Wolkite, Ethiopia
| | - Fasil Wagnew
- Department of Nursing, Debre Markos University, Debre Markos, Ethiopia
| | - Haymanot Zeleke
- Department of Nursing, Debre Markos University, Debre Markos, Ethiopia
| | - Bitew Tefera
- Department of Nursing, Wolkite University, Wolkite, Ethiopia
| | - Shegaw Tesfa
- Department of Nursing, Wolkite University, Wolkite, Ethiopia
| | - Tamene Fetene
- Department of Nursing, Wolkite University, Wolkite, Ethiopia
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Podder D, Dasgupta A, Dobe M, Paul B, Bandyopadhyay L, Pal A. Health Care Seeking Behavior in a Scheduled Tribe Community in India: A Mixed Methods Research Using the Framework of Andersen's Behavioral Model. Asia Pac J Public Health 2021; 33:369-377. [PMID: 33588576 DOI: 10.1177/1010539521993695] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
India's scheduled tribe population very often bears the brunt of inequity in accessing health care. The mixed-method research assessed the health care seeking behavior (HSB) of a tribal community residing in the eastern fringes of Kolkata metropolis. An adult, preferably the head, in 209 households was interviewed followed by qualitative interviews with relevant stakeholders. Conceptual framework of Andersen's behavioral model helped in identifying the potential predisposing, enabling, and need factors that influenced HSB. A total of 25.4% respondents reportedly sought informal care during last illness episode. Multivariable hierarchical-regression model (Nagelkerke R2 = 0.381) showed that respondents' education level [adjusted odds ratio (AOR) = 2.52], household size (AOR = 3.14), nonenrollment to health insurance (AOR = 2.47), decision making by household head (AOR = 2.40), distance from the nearest urban primary health center (AOR = 3.18), and poor perception to illness severity (AOR = 2.24) were significantly associated to inappropriate HSB. Predominant health system barriers that emerged from qualitative interviews were irregular logistics, unfavorable outpatient timing, absence of female doctors, and nonretention of doctors at local urban primary health center. Community level barriers were poor awareness, self-medication practices, poor health insurance coverage, and poor public transportation. Recognition of these determinants may help in developing health promotion interventions tailored to their needs.
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Affiliation(s)
- Debayan Podder
- All India Institute of Hygiene & Public Health, Kolkata, West Bengal, India
| | - Aparajita Dasgupta
- All India Institute of Hygiene & Public Health, Kolkata, West Bengal, India
| | - Madhumita Dobe
- All India Institute of Hygiene & Public Health, Kolkata, West Bengal, India
| | - Bobby Paul
- All India Institute of Hygiene & Public Health, Kolkata, West Bengal, India
| | - Lina Bandyopadhyay
- All India Institute of Hygiene & Public Health, Kolkata, West Bengal, India
| | - Arkaprovo Pal
- All India Institute of Hygiene & Public Health, Kolkata, West Bengal, India
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Do S, Lohmann J, Brenner S, Koulidiati JL, Souares A, Kuunibe N, Hamadou S, Hien H, Winkler V, De Allegri M. Patterns of healthcare seeking among people reporting chronic conditions in rural sub-Saharan Africa: findings from a population-based study in Burkina Faso. Trop Med Int Health 2020; 25:1542-1552. [PMID: 32981177 DOI: 10.1111/tmi.13500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Non-communicable diseases are rapidly becoming one of the leading causes of morbidity and mortality in sub-Saharan Africa. Yet, little is known about patterns of healthcare seeking among people with chronic conditions in these settings. We aimed to explore determinants of healthcare seeking among people who reported at least one chronic condition in rural Burkina Faso. METHODS Data were drawn from a cross-sectional population-based survey conducted across 24 districts on 52 562 individuals from March to June 2017. We used multinomial logistic regression to assess factors associated with seeking care at a formal provider (facility-based care) or at an informal provider (home and traditional treatment) compared to no care. RESULTS 1124 individuals (2% of all respondents) reported at least one chronic condition. Among those, 22.8% reported formal care use, 10.6% informal care use, and 66.6% no care. The presence of other household members reporting a chronic condition (RRR = 0.57, 95%-CI [0.39, 0.82]) was negatively associated with seeking formal care. Wealthier households (RRR = 2.14, 95%-CI [1.26, 3.64]), perceived illness severity (RRR = 3.23, 95%-CI [2.22, 4.70]) and suffering from major chronic conditions (RRR = 1.54, 95%-CI [1.13, 2.11]) were positively associated with seeking formal care. CONCLUSION Only a minority of individuals with chronic conditions sought formal care, with important differences due to socio-economic status. Policies and interventions aimed at increasing the availability and affordability of services for early detection and management in peripheral settings should be prioritised.
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Affiliation(s)
- Stefanie Do
- Leibniz Institute for Prevention Research and Epidemiology, Bremen, Germany.,Heidelberg Institute of Global Health, University Hospital and Faculty of Medicine, Heidelberg University, Heidelberg, Germany
| | - Julia Lohmann
- Heidelberg Institute of Global Health, University Hospital and Faculty of Medicine, Heidelberg University, Heidelberg, Germany.,Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, UK
| | - Stephan Brenner
- Heidelberg Institute of Global Health, University Hospital and Faculty of Medicine, Heidelberg University, Heidelberg, Germany
| | - Jean-Louis Koulidiati
- Heidelberg Institute of Global Health, University Hospital and Faculty of Medicine, Heidelberg University, Heidelberg, Germany
| | - Aurelia Souares
- Heidelberg Institute of Global Health, University Hospital and Faculty of Medicine, Heidelberg University, Heidelberg, Germany
| | - Naasegnibe Kuunibe
- Heidelberg Institute of Global Health, University Hospital and Faculty of Medicine, Heidelberg University, Heidelberg, Germany.,University for Development Studies, Tamale, Ghana
| | - Saidou Hamadou
- The World Bank, Health, Nutrition, Population Global Practice, Washington, DC, USA
| | - Hervé Hien
- Centre Muraz, National Public Health Institute (NPHI), Bobo-Dioulasso, Hauts-Bassins, Burkina Faso.,Research and Heath Science Institute (IRSS), Ouagadougou, Burkina Faso
| | - Volker Winkler
- Heidelberg Institute of Global Health, University Hospital and Faculty of Medicine, Heidelberg University, Heidelberg, Germany
| | - Manuela De Allegri
- Heidelberg Institute of Global Health, University Hospital and Faculty of Medicine, Heidelberg University, Heidelberg, Germany
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Tirore LL, Mulugeta A, Belachew AB, Gebrehaweria M, Sahilemichael A, Erkalo D, Atsbha R. Factors associated with anaemia among women of reproductive age in Ethiopia: Multilevel ordinal logistic regression analysis. MATERNAL AND CHILD NUTRITION 2020; 17:e13063. [PMID: 32761751 PMCID: PMC7729796 DOI: 10.1111/mcn.13063] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 06/08/2020] [Accepted: 06/17/2020] [Indexed: 12/27/2022]
Abstract
Anaemia has prevailed as a mild to severe public health problem in Ethiopian women of reproductive age. Many studies carried out on anaemia have been limited to subnational assessments and subgroups of women. The effects of potential factors thought to affect anaemia and severity levels of anaemia have not been well considered. Therefore, this study identifies individual, household and community level factors associated with anaemia among women of reproductive age in Ethiopia applying multilevel ordinal logistic regression models. Proportional odds assumption was tested by likelihood ratio test. About 35.6% of the variation on anaemia was due to between household and community level differences. Pregnancy (adjusted odds ratio [AOR] = 2.30, 95% confidence interval [CI]: 1.82, 2.91), HIV (AOR = 2.40, 95% CI: 1.76, 3.25), giving birth once (AOR = 1.2, 95% CI: 1.05, 1.40), giving birth more than once (AOR = 1.4, 95% CI: 1.19, 1.71), living with five or more family members (AOR = 1.24, 95% CI: 1.05, 1.47), living in poorest households (AOR = 1.34, 95% CI: 1.2, 1.61) and rural area (AOR = 1.57, 95% CI: 1.28, 1.92) were associated with greater odds of more severe anaemia compared with their respective counter parts. Secondary and above education (AOR = 0.83, 95% CI: 0.70, 0.97) and use of pills, implants or injectable (AOR = 0.67, 95% CI: 0.59, 0.77) were associated with lower odds of more severe anaemia. Anaemia prevention and control programmes need to be strengthened for women living with HIV/AIDS and during pregnancy. Household poverty reduction and social protection services need to be strengthened and integrated in anaemia prevention and management activities in women.
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Affiliation(s)
- Lire Lemma Tirore
- Department of Public Health, College of Medicine and Health Sciences, Wachemo University, Hossana, Ethiopia
| | - Afework Mulugeta
- Department of Nutrition, School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - Abate Bekele Belachew
- Department of Biostatistics, School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - Menaseb Gebrehaweria
- Department of Public Health, College of Medicine and Health Sciences, Adigrat University, Adigrat, Ethiopia
| | | | - Desta Erkalo
- Department of Public Health, College of Medicine and Health Sciences, Wachemo University, Hossana, Ethiopia
| | - Rigeat Atsbha
- Saesie Tsaeda Emba District Health Office, Tigray Regional Health Bureau, Mekelle, Ethiopia
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Llop-Gironés A, Julià M, Chicumbe S, Dulá J, Odallah AAP, Alvarez F, Zahinos I, Mazive E, Benach J. Inequalities in the access to and quality of healthcare in Mozambique: evidence from the household budget survey. Int J Qual Health Care 2020; 31:577-582. [PMID: 30388229 DOI: 10.1093/intqhc/mzy218] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Revised: 08/16/2018] [Accepted: 10/15/2018] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVES To assess the inequalities in the access to and quality of care and its related direct payments. DESIGN Secondary analysis of the cross-sectional Mozambican Household Budget Survey (HBS). SETTING Nationally-representative sample of households in Mozambique. PARTICIPANTS 11 480 households (58 118 individuals) interviewed during HBS 2014/15. INTERVENTION None. MAIN OUTCOME MEASURES Equity, utilization of healthcare, access to quality care and direct payments. RESULTS About 12.2% of women and 10.1% of men of the survey report a perceive health need. About 72.1% of women and 72.9% men use healthcare. Population in a disadvantaged position living in rural areas have less probabilities of using healthcare for equal health compared to the individuals of a wealthier position and living in urban settings. With regard to quality care, 47.7% women and 46.8% men do not report quality problems. No differences for women's wealth. Men in a disadvantaged position report less chances of accessing quality care compared to men of advantaged position. Also, women and men living in rural areas have less probabilities of accessing quality care. Finally, the majority of people who access healthcare paid 1 Mt during their visit. CONCLUSIONS This study tackles a fundamental policy concern for health systems of Sub-Saharan Africa and points to areas that urge action to address the existent of socioeconomic and geographical inequalities in the access to and quality of care for women and men, including the strengthening of health facilities in rural and deprived areas to ensure that access to adequate care of acceptable quality is distributed according to need.
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Affiliation(s)
- Alba Llop-Gironés
- Health Inequalities Research Group-Employment Conditions Network (GREDS-EMCONET), Department of Political and Social Sciences, Universitat Pompeu Fabra, Barcelona, Spain.,Johns Hopkins University, Pompeu Fabra Public Policy Center, Barcelona, Spain
| | - Mireia Julià
- Health Inequalities Research Group-Employment Conditions Network (GREDS-EMCONET), Department of Political and Social Sciences, Universitat Pompeu Fabra, Barcelona, Spain.,Johns Hopkins University, Pompeu Fabra Public Policy Center, Barcelona, Spain
| | - Sergio Chicumbe
- Programa de Sistemas de Saúde, Instituto Nacional de Saúde, Ministry of Health, Estrada national 1, Marracuene
| | - Janeth Dulá
- Programa de Sistemas de Saúde, Instituto Nacional de Saúde, Ministry of Health, Estrada national 1, Marracuene
| | - Anita Aunda Pedro Odallah
- Department of Community Health, Faculty of Medicine, Universidade Eduardo Mondlane, Maputo, Mozambique, Salvador Allende Avenue 702, 257
| | - Francesc Alvarez
- Medicus Mundi Mediterrània, Secretari Coloma st 112, Barcelona, Spain
| | - Ivan Zahinos
- Medicus Mundi Mediterrània, Secretari Coloma st 112, Barcelona, Spain
| | - Elisio Mazive
- National Institute of Statistics of Mozambique, Maputo, Mozambique, Avenue 24 de Julho 1989, 493
| | - Joan Benach
- Health Inequalities Research Group-Employment Conditions Network (GREDS-EMCONET), Department of Political and Social Sciences, Universitat Pompeu Fabra, Barcelona, Spain.,Johns Hopkins University, Pompeu Fabra Public Policy Center, Barcelona, Spain.,Grupo de Investigación Transdisciplinar sobre Transiciones Socioecológicas (GinTRANS2), Universidad Autónoma de Madrid
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Communicative challenges among physicians, patients, and family caregivers in cancer care: An exploratory qualitative study in Ethiopia. PLoS One 2020; 15:e0230309. [PMID: 32168353 PMCID: PMC7069641 DOI: 10.1371/journal.pone.0230309] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Accepted: 02/26/2020] [Indexed: 02/02/2023] Open
Abstract
Background Cancer is a growing concern in Ethiopia. Though communication is essential for the treatment process, few studies have looked at communication in Ethiopian cancer care. Due to the large number of patients and scarcity of resources, it is vital to understand how to manage consultations in order to effectively help as many patients as possible in this challenging work environment. Thus, research is needed to analyze and understand the communicative challenges experienced by physicians, patients, and family caregivers, in order to successfully handle patient care in practice. Objective We explore communication in Ethiopian cancer care and present the main challenges faced by physicians, patients, and family caregivers. Methods This explorative qualitative study was conducted at the Oncology Department of the Tikur Anbessa (Black Lion) Specialized Teaching Hospital (TASH) in Addis Ababa, Ethiopia. A triangulation of data collection methods was used: 91 audio-recorded, semi-structured interviews and 21 video-recordings of authentic interactions during hospital rounds. The aim was to obtain as complete a picture as possible of communication from the perspectives of physicians, patients, and family caregivers. The interviews were analyzed using thematic content analysis and the identified themes were supported by excerpts from the transcribed recordings. Results Eight themes emerged from the data. Workload and time pressure, in combination with restricted space for privacy, limited the possibilities for physicians to deliver detailed information and provide emotional support. Furthermore, patient literacy levels, in combination with no or little cancer awareness, financial problems, reliance on traditional and religious treatments, the stigma of cancer, and a fatalistic attitude, resulted in delays in patients seeking care and participating in positive health behaviors, and, subsequently, often resulted in an unwillingness to openly discuss problems with physicians and adhere to treatment. The study also illustrates the paramount role of family in physician-patient communication in Ethiopia. Though family caregivers provide a valuable interpreting support when patients have limited language skills, they can also prevent patients from sharing information with physicians. Another important finding is that family caregivers were often responsible for making decisions about treatment and avoided telling patients about a poor prognosis, believing that conveying bad news may upset them. All of these themes have important implications for the role of ethically acceptable communication in patient-centered care. Conclusions This study has identified a number of serious challenges for successful and ethically acceptable health communication in Ethiopian cancer care. The study contributes to our understanding of the complexity around the role of family, combined with patients’ dependency on family members for communication, support, and access to care, which creates particular ethical dilemmas for the medical staff. The questions raised by this study concern how to organize consultations to achieve patient-centered health communication, while maintaining a constructive alliance with the family and not jeopardizing the patient’s continued access to care. The integration of communication training for medical students in Ethiopia, with a focus on ethical guidelines for family-centered patient consultation suitable for these circumstances, would be an essential step.
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Fikire A, Ayele G, Haftu D. Determinants of delay in care seeking for diarrheal diseases among mothers/caregivers with under-five children in public health facilities of Arba Minch town, southern Ethiopia; 2019. PLoS One 2020; 15:e0228558. [PMID: 32053615 PMCID: PMC7018063 DOI: 10.1371/journal.pone.0228558] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Accepted: 01/18/2020] [Indexed: 12/12/2022] Open
Abstract
Background Timely and appropriate health care seeking for diarrhea of under-five children is important to reduce severe and life-threatening complications. However, different findings indicate that mothers of under-five children often delay in seeking care which in turn contributes to the death of large number of children without ever reaching a health facility. Therefore, a proper pinpointing of determinants of delay in seeking care informs intervention strategies for health service planners. Objectives Of this study was to identify the determinants of delay in care seeking for diarrheal disease among mothers/caregivers of under-five children in public health facilities of Arba Minch town, South Ethiopia, 2019. Methods Facility based case control study was conducted from March 4 to April 30, 2019. Total sample size was 400. Cases were selected by systematic random sampling technique while controls were mothers of under-five children with signs and symptoms of diarrhea who came to the same health facility within 24 hours following cases. Data was collected by using pretested structured questionnaire by three data collectors and entered into EpiData V4 and exported to SPSS V23 for further analysis. Bivariable logistic regression was done to identify variables candidate for Multivariable LR at p-value<0.25. Multivariable logistic regression was done and p-value <0.05 and 95%CI of AOR was used to declare statistical significance. Result Female sex[AOR = 1.93, (95%CI: 1.11,3.36)], child age <24 months[AOR = 4.47,95%CI:2.51,7.97)], mothers’/caregivers without formal education[AOR = 6.90, (95%CI:3.10,15.37)], and attended primary school [AOR = 3.12,(95%CI:1.44,6.73)], poorest household wealth index category[AOR = 2.81, (95%CI:1.20,6.58) and poor household wealth index category [AOR = 2.61,(95%CI: 1.12, 6.09)], mothers/caregivers who did not visit health facility to first episode diarrhea [AOR = 4.55, (95%CI:2.41,8.59)], mothers/caregivers who were satisfied in the last six month visit [AOR = 0.29, (95%CI:0.15,0.55)], and poor perceived health care professionals respect[AOR = 4.91, (95%CI:2.64,9.15)] were important determinants of delay in seeking care. Conclusions Sex and age of the child, educational status of the mother/caregiver, poor wealth index category, not visiting health facility at first response, satisfaction with the care and examination, and respect of health care professionals were important determinants of delay in seeking care among mothers/caregivers of under-five children with diarrhea illness. All concerned body should focus interventions on poor and less educated mothers/caregivers with emphasis on female children and <24 months. Health workers are needed to provide respectful service to promote satisfaction level of clients.
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Affiliation(s)
- Alemayehu Fikire
- Public Health Team, Hawassa College of Health Science, Hawassa, Ethiopia
- * E-mail:
| | - Gistane Ayele
- School of Public Health, Arba Minch University, Arba Minch, Ethiopia
| | - Desta Haftu
- School of Public Health, Arba Minch University, Arba Minch, Ethiopia
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Tsadik M, Lam L, Hadush Z. Delayed health care seeking is high among patients presenting with sexually transmitted infections in HIV hotspot areas, Gambella town, Ethiopia. HIV AIDS-RESEARCH AND PALLIATIVE CARE 2019; 11:201-209. [PMID: 31564990 PMCID: PMC6724613 DOI: 10.2147/hiv.s210977] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Accepted: 07/17/2019] [Indexed: 12/03/2022]
Abstract
Background Delayed health care seeking is one of the major impediments to successfully prevent and control sexually transmitted infections (STIs) including HIV. Gambella is one of the HIV hot spot areas and the most HIV prevalent region in the country. Considering the empirical knowledge of the link between STIs and HIV, gathering information on health-seeking behavior and the associated factors among STI patients is helpful to design interventions that enhance early seeking and treatment adherence. Methodology A facility-based cross-sectional study was employed to collect data from 424 STI patients from February 15 to April 15, 2017, using a face-to-face interview. A consecutive sampling method was used until the allocated sample for each facility was fulfilled. A multivariate logistic regression analysis was used to identify factors associated with health-seeking behavior. Results The proportion of delayed health care seeking among patients treated for STIs was 56.8%. Knowledge, number of sexual partners, and perception variables were found significantly associated with early seeking behavior in multivariate logistic regression: patients who had better knowledge of STIs (AOR =1.74, 95% CI =1.10, 2.73), had single sexual partner (AOR =1.83, 95% CI =1.19, 2.78), those who perceived stigma for STIs (AOR =0.52, 95% CI =0.34, 0.79), and perceived severity of STIs (AOR =1.97, 95% CI =1.18, 3.29). Conclusion This study reported a high proportion of delayed health care seeking. This may challenge the prevention and control effort and alarms the potential threat to the spread of STI/HIV in the region. Provision of intensive health education is crucial to improve awareness and to avoid risk behaviors and negative perceptions.
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Affiliation(s)
- Mache Tsadik
- School of Public Health, College of Health Science, Mekelle University, Tigray, Ethiopia
| | - Lul Lam
- Department of Disease Prevention and Control, Gambella Regional Health Bureau, Ethiopia
| | - Zinabu Hadush
- School of Public Health, College of Health Science, Mekelle University, Tigray, Ethiopia
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Gebremariam A, Addissie A, Worku A, Assefa M, Kantelhardt EJ, Jemal A. Perspectives of patients, family members, and health care providers on late diagnosis of breast cancer in Ethiopia: A qualitative study. PLoS One 2019; 14:e0220769. [PMID: 31369640 PMCID: PMC6675093 DOI: 10.1371/journal.pone.0220769] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Accepted: 07/23/2019] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Most women with breast cancer in Ethiopia are diagnosed at an advanced stage of the disease, but the reasons for this have not been systematically investigated. This study, therefore, aimed to explore the main reasons for diagnosis of advanced stage breast cancer from the perspective of patients, family members, and health care providers. METHODS A qualitative study with in-depth interviews was conducted with 23 selected participants at Tikur Anbessa Specialized Hospital, Oncology Clinic using a semi-structured interview guide. These participants were 13 breast cancer patients, 5 family members, and 5 health care providers. Data were transcribed into English, coded and analyzed using thematic analysis. RESULTS Awareness about the causes, risk, initial symptoms, early detection methods, and treatment of breast cancer were uncommon, and misconceptions about the disease prevailed among breast cancer patients and family members. There was a sense of hopelessness and uncertainty about the effectiveness of conventional medicine amongst patients and family members. Consequently, performing spiritual acts (using holy water) or seeking care from traditional healers recurred amongst the interviewees. Not taking initial symptoms of breast cancer seriously by the patients, reliance on traditional medicines, competing priorities, financial hardship, older age, fear of diagnosis of cancer, and weak health systems (e.g., delay in referral and long waiting period for consultation) were noted as the main contributors to late diagnosis. In contrast, persuasion by family members and friends, higher educational attainment, and prior experience of neighboring women with breast cancer were mentioned to be facilitators of early diagnosis of breast cancer. CONCLUSIONS The causes of late diagnosis of breast cancer in Ethiopia are multi-factorial and include individual, cultural, and health system factors. Interventions targeting these factors could alleviate the misconceptions and knowledge gap about breast cancer in the community, and shorten waiting time between symptom recognition and diagnosis of breast cancer.
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Affiliation(s)
- Alem Gebremariam
- Department of Public Health, College of Medicine and Health Sciences, Adigrat University, Adigrat, Ethiopia
- School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Adamu Addissie
- School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Alemayehu Worku
- School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Mathewos Assefa
- Radiotherapy Center, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia
| | - Eva Johanna Kantelhardt
- Institute of Medical Epidemiology, Biostatistics and Informatics, Martin-Luther-University, Halle, Germany
| | - Ahmedin Jemal
- Surveillance and Health Services Research, American Cancer Society, Atlanta, Georgia, United States of America
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Huang M, Zhang H, Gu Y, Wei J, Gu S, Zhen X, Hu X, Sun X, Dong H. Outpatient health-seeking behavior of residents in Zhejiang and Qinghai Province, China. BMC Public Health 2019; 19:967. [PMID: 31324240 PMCID: PMC6642546 DOI: 10.1186/s12889-019-7305-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2019] [Accepted: 07/10/2019] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The eastern and western regions of China are different in many ways such as socioeconomic characteristics and health resource distribution. This study aimed to explore the outpatient health-seeking behavior and compare the influencing factors of residents in Zhejiang and Qinghai Province, which represent the situation in eastern and western China. Thus, this research will provide evidence for health resource allocation and health reform. METHODS A cross-sectional study was conducted on a sample selected from 1600 households in Zhejiang and Qinghai province between 2016 to 2017 by the multi-stage stratified cluster random sampling method. Among the 4231 residents aged 15 years or older in the sample, 566 who reported ill-health were selected for data analysis. Two-week outpatient visits and choice of health institutions were used to measure residents' outpatient health-seeking behavior and assessed using Chi-square tests. The binary logistic regression was adopted to demonstrate the association between explanatory variables and outpatient visits. RESULTS The study revealed that out of the people who reported ill-health, 58 individuals (50.97%) in Zhejiang and 106 (41.41%) in Qinghai went to health institutions to seek medical help (p < 0.05). The difference of residents' choice of health institution between Zhejiang and Qinghai was not statistically significant (p > 0.05). Among these respondents, Self-report severity was the common and significant factor related to their outpatient visits and it had a greater impact on outpatient visits in Zhejiang (4.18, CI 2.23-7.83, p < 0.05). Other factors such as chronic disease, knowledge of medicine and doctors and distance to the nearest health institution were significant influencing factors in Zhejiang, while in Qinghai it was occupation. CONCLUSIONS The outpatient health-seeking behavior and its influencing factors among residents in Zhejiang and Qinghai province were different. The findings suggest the importance of having discrepant health policies in the two provinces. It's necessary to improve health literacy of residents in both provinces, strengthen the accessibility of health services in remote areas of Zhejiang and pay more attention to people with low socioeconomic status in Qinghai.
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Affiliation(s)
- Minzhuo Huang
- Center for Health Policy Studies, Department of Social Medicine, School of Public Health, Zhejiang University School of Medicine, 866 Yuhangtang Rd, Hangzhou, 310058, People's Republic of China.,Sir Run Runshaw Hospital, Zhejiang University, Hangzhou, 310016, People's Republic of China
| | - Hao Zhang
- School of Medicine, Hangzhou Normal University, Hangzhou, 311121, People's Republic of China
| | - Yuxuan Gu
- Center for Health Policy Studies, Department of Social Medicine, School of Public Health, Zhejiang University School of Medicine, 866 Yuhangtang Rd, Hangzhou, 310058, People's Republic of China
| | - Jingming Wei
- Center for Health Policy Studies, Department of Social Medicine, School of Public Health, Zhejiang University School of Medicine, 866 Yuhangtang Rd, Hangzhou, 310058, People's Republic of China
| | - Shuyan Gu
- Center for Health Policy Studies, Department of Social Medicine, School of Public Health, Zhejiang University School of Medicine, 866 Yuhangtang Rd, Hangzhou, 310058, People's Republic of China
| | - Xuemei Zhen
- Center for Health Policy Studies, Department of Social Medicine, School of Public Health, Zhejiang University School of Medicine, 866 Yuhangtang Rd, Hangzhou, 310058, People's Republic of China
| | - Xiaoqian Hu
- Center for Health Policy Studies, Department of Social Medicine, School of Public Health, Zhejiang University School of Medicine, 866 Yuhangtang Rd, Hangzhou, 310058, People's Republic of China
| | - Xueshan Sun
- Center for Health Policy Studies, Department of Social Medicine, School of Public Health, Zhejiang University School of Medicine, 866 Yuhangtang Rd, Hangzhou, 310058, People's Republic of China
| | - Hengjin Dong
- Center for Health Policy Studies, Department of Social Medicine, School of Public Health, Zhejiang University School of Medicine, 866 Yuhangtang Rd, Hangzhou, 310058, People's Republic of China.
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Mulatu HA. Pattern and Presentation of Thyro-Cardiac Disease among Patients with Hyperthyroidism Attending a Tertiary Hospital in Ethiopia: A Cross Sectional Study. Ethiop J Health Sci 2019; 29:887-894. [PMID: 30700956 PMCID: PMC6341434 DOI: 10.4314/ejhs.v29i1.10] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Background Thyro-cardiac disease describes the existence of a combination of thyroid toxicity and significant heart disease in an individual patient. The frequent manifestations of thyro-cardiac disease are hypertension, atrial flutter or fibrillation, pulmonary hypertension and dilated cardiomyopathy. The aim of the study was to determine the pattern and presentation of cardiovascular diseases in patients with hyperthyroidism on follow-up at St. Paul's Hospital endocrine clinic. Methods It was a hospital based cross sectional study that evaluated hyperthyroid patients' on follow-up at St. Paul's Hospital for cardiovascular diseases from May 1st 2017 to October 31st 2017. They had focused history, physical examination, electrocardiographic and echocardiographic evaluation. Results A total of 146 hyperthyroid patients on follow-up were included in the study. The mean age was 47.2 years and females accounted for 93.2% of patients. The mean duration of symptoms before presentation was 42 months. The frequent causes of hyperthyroidism were toxic multi-nodular goitre (88.4%), Graves' disease (6.8%) and toxic adenoma (2.1%). Sixteen (11%) patients had atrial fibrillation and 71 (48.6%) had hypertension. Thyrocardiac disease was detected in 46.6% of patients. The frequent abnormalities were left ventricular hypertrophy (14.4%), mild diastolic dysfunction (10.9%), moderate to severe mitral regurgitation (8.9%), pulmonary hypertension with or without right ventricular dysfunction (8.2%) and dilated cardiomyopathy (4.1%). Conclusion Cardiovascular disease was frequent among patients with hyperthyroidism. The commonest abnormalities were systemic hypertension, pulmonary hypertension with or without isolated right sided heart failure, atrial fibrillation and dilated cardiomyopathy.
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Affiliation(s)
- Hailu Abera Mulatu
- Department of Internal Medicine, Cardiology Unit, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
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