Immediate postpartum intrauterine contraceptive device utilization and associated factors among women who gave birth in public health facilities of Adama town, Ethiopia

Objectives

The evidence on utilization of immediate postpartum intrauterine contraceptive devices (IPPIUCDs) and its associated factors are limited in Ethiopia. Hence, this study intended to assess IPPIUCD utilization and related factors among women who gave birth in Adama town public hospitals, Ethiopia.

Method

A facility-based cross-sectional study was done among 493 postpartum mothers at selected government health facilities in Adama town from January 20 to February 20, 2021. All women who gave birth in selected government health facilities and within 48 h of postpartum were included in the study. Data were collected using an interviewer-administered questionnaire. Logistic regression models were used to identify the factors associated with IPPIUCD utilization. Adjusted odds ratios (AORs) with 95% confidence interval (CI) were calculated to measure the strength of association and statistical significance was declared at p < 0.05.

Result

In this study, 22.1% (95% CI: 17.3-25.2) of the mothers used IPPIUCDs within 48 h of giving birth. Having three or more children (AOR = 4.18, 95% CI: 1.79-9.79), having no desire to have another child (AOR = 3.9, 95% CI: 1.86-8.17), counseling after delivery (AOR = 3.1 95% CI: 1.52-6.34), and having good knowledge about PPIUCD (AOR = 3.82, 95% CI: 1.94-7.49) were significantly associated with IPPIUCD utilization.

Conclusion

The utilization of IPPIUCD in this study was low. Strategies to raise pregnant mothers' awareness of IPPIUCD through mass media, and integrating standard counseling on immediate postpartum intrauterine device (IPPIUD) during antenatal care, and the immediate postpartum period are required to improve IPPIUD utilization.

The effects of digital platform expectations, information schema congruity and behavioural factors on mobility as a service (MaaS) adoption

Purpose

Mobility as a service (MaaS) is a new model of bundling personal transport options from multiple providers to provide frictionless service. The model integrates information and service to enable users to search, book and pay through a single digital platform. The aim of MaaS is to minimize individual car ownership and revolutionize personal mobility habits in favour of sustainable modes. Thus, it is important to understand consumers' readiness for MaaS. This study explains the factors that influence MaaS adoption.

Design/methodology/approach

A comprehensive review of the related literature has been conducted, leading to the development of a conceptual model for investigating the key factors that influence MaaS adoption. The model draws upon the digital platform, schema congruity and planned behaviour theories. The model is then tested using structural equation modelling and survey data collected from 331 respondents.

Findings

The findings indicate that MaaS information schema congruity, the digital platform's personalizability, customizability, functional integration, network integration and governance of data together with attitude towards MaaS and subjective norm concerning MaaS influence MaaS adoption. Furthermore, MaaS digital platform expectation and MaaS information schema congruity contribute to users' attitude towards MaaS use.

Originality/value

The paper highlights the design and informational attributes of MaaS platforms that influence their adoption and contributes an integrated research model that links digital platform characteristics, behavioural factors and information schema congruity. Future research can use the constructs and measures we developed in this study to build deeper understanding of what contributes to the success of digital platforms.

Effects of structured exercises on selected psychological domains in individuals with type 2 diabetes mellitus in Southern Ethiopia institution-based study

Background

Psychological disorders are common among individuals with type 2 diabetes mellitus. The effect of exercise training on psychological disorders like anxiety and depression has not been well studied in Ethiopia. The objective of this study was to assess the effect of structured aerobic and resistance exercises on psychological domains among people with type 2 diabetes mellitus in southern Ethiopia.

Method

We began by approaching 97 type 2 diabetic patients who regularly attend follow-up clinics. The 24 study participants were randomly assigned to one of four groups: aerobic exercise (n = 6), resistance exercise (n = 6), combined aerobic and resistance exercise (n = 6), and control group (n = 6). For each arm, the interventions were a structured workout package that was completed without interrupting usual clinical follow-up. The control groups, on the other hand, were kept as follow-up clinical cases with daily routine work. A paired t-test was performed to compare the means and mean differences of each exercise group’s pretest and posttest. A Tukey’s post hoc test was performed to compare mean differences between groups. The significance level was set at P < 0.05.

Result

A more significant change was obtained in the combined aerobic and resistance exercise on anxiety and depression (p = 0.006), social dysfunction (p = 0.009), loss of confidence (p = 0.012) in particular, and psychological wellbeing (p = 0.010) in general. Resistance exercise alone had a significant impact on social dysfunction (p = 0.010), anxiety and depression (p = 0.017), and psychological well-being (p = 0.012) in general. Changes in social dysfunction (p = 0.010), anxiety and depression (p = 0.030), and psychological well-being (p = 0.018) were also influenced by aerobic exercise. The study found no significant change in depression and anxiety among control groups.

Conclusion

As a result, the combined effect of aerobic and resistance exercise had a greater influence on improving anxiety and depression, social dysfunction, loss of confidence in particular, and psychological well-being in general among patients with type 2 diabetes. In other words, the present evidence proves the betterment of combined aerobic and resistance exercises alone followed by resistance exercise alone and aerobic exercise alone compared with non-exercise groups seems to upgrade psychological wellbeing by setting up three main benefits named as: (1) anti-anxiety and depression effects; (2) anti-social dysfunction effects; and (3) anti-loss of confidence effects. This suggests that patients with diabetes who exercise regularly enhance their psychological well-being.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13102-022-00574-3.

Suicidal ideation, attempt and associated factors among people living with cancer in Ethiopia: a cross-sectional study

BACKGROUND

Suicide and cancer are serious public health problems worldwide, and people living with cancer are at high risk of having suicidal behaviors, such as ideation, plan and attempt. Patients with cancer had high possibilities of having suicidal ideation and attempt which lead to poor adherence of medication, worsening of their medical illness, and end the life. Even though people are affected by cancer in Ethiopia, there are limited studies regarding suicidal problem among patients with cancer. Therefore, this study was aimed to assess the magnitude and associated factors of suicidal ideation and attempt among people living with cancer in Ethiopia.

METHODS

Institutional-based cross-sectional study was conducted among total of 416 participants. Outcome variables were assessed using suicidality module of World health organization (WHO) composite international diagnostic interview (CIDI). Data were analyzed using SPSS-20 and bivariate and multivariate logistic regressions were conducted and variables with P value less than 0.05 were considered as statistically significant with corresponding 95% CI.

RESULTS

The overall magnitude of suicidal ideation and attempt were 16.6% and 5.5%, respectively. Being divorced [(AOR = 2.97, (95% CI 1.22, 7.22)], having depression [(AOR = 2.67, (95%CI 1.34, 5.32)], the first 18 months, since diagnosed cancer [(AOR = 2.57, (95%CI 1.15, 5.75)], severe pain [(AOR = 3.27, (95%CI 1.18, 9.04)] and stage IV cancer [(AOR = 3.35, (95%CI 1.26, 9.04)] were significantly associated with suicidal Ideation. Whereas, female sex [(AOR = 5.32, (95%CI 1.39, 20.25)], having depression [(AOR = 4.8, (95%CI 1.23, 18)] and advanced stage of cancer [(AOR = 6.76, (95%CL 1.2, 37)] were significantly associated with suicidal attempt.

CONCLUSIONS

The magnitude of Suicidal ideation and attempt in this study were high. Health care providers working in cancer treatment unit should give more attention to patients with high suicidal risk factors. Consultation services should be strengthened with psychiatric professionals in oncology treatment clinic.

Mental distress and associated factors among women who experienced gender based violence and attending court in South Ethiopia: a cross-sectional study

BACKGROUND

Gender-based violence is an act that has physical, psychological, and sexual consequences for women. It is a widespread issue, particularly in developing countries, and it causes women mental distress. Despite the fact that gender-based violence has a significant impact on mental distress, there have no study in Ethiopia. As a result, the purpose of this study was to determine the prevalence and associated factors of mental distress among mothers who had experienced gender-based violence and were in court.

METHODS

A cross-sectional study was conducted on 423 samples. The data was entered into Epi-data version 3.01 and analyzed with SPSS version 21. Binary logistic regression was used, and variables with p-values less than 0.05 were considered statistically significant with regard to mental distress at the respective 95% CI.

RESULT

The prevalence of mental distress was found to be 59.6% in this study. Mental distress was associated with factors such as a lack of social support, a lack of formal education, a husband's substance use, rural residence, age greater than 33 years, and a low family income.

CONCLUSION

The prevalence of mental distress is high when compared to the majority of previous findings from other countries. Screening and managing psychological distress in women with a history of violence is preferable, and integrating psychosocial care into court services is recommended.

Health related quality of life and its association with social support among people living with HIV/AIDS receiving antiretroviral therapy in Ethiopia: a systematic review and meta-analysis

Background

People living with HIV/AIDS (PLWHA) are frequently confronted with severe social issues such as rejection, abandonment, criticism, and stigma. This would negatively affect their quality of life. Several studies have been conducted so far to assess factors affecting the health-related quality of life among people living with HIV/AIDS who are on antiretroviral therapy (ART) in Ethiopia. However, to our knowledge, there is no previous study that has summarized the results of the studies that investigated health-related quality of life (HRQOL) among PLWHA in Ethiopia. Therefore, the purpose of this review was to estimate the pooled prevalence of HRQOL and its association with social support among people living with HIV/AIDS (PLWHA) on ART in Ethiopia.

Methods

A systematic search was carried out using several electronic databases (PubMed, Science Direct, Web of Science, and Cochrane electronic), Google Scholar, Google, and a manual search of the literature on health-related quality of life among people living with HIV/AIDS who are on ART. A Microsoft Excel data extraction sheet was used to extract pertinent data from an individual study. To assess the heterogeneity of primary articles, the Cochrane Q test statistics and the I2 test were carried out, and a random effects meta-analysis was used to estimate the pooled prevalence of HRQOL.

Result

Out of the 493 articles reviewed, ten with a total of 3257 study participants were eligible for meta-analysis. The pooled prevalence of HRQOL among people living with HIV/AIDS who are on antiretroviral therapy in Ethiopia was 45.27%. We found that strong perceived social support was significantly associated with higher levels of subjectively perceived HRQOL. PLWHA who were on ART and had good social support were four times more likely to report higher HRQOL when compared to their counterparts [AOR = 4.01, 95% CI 3.07–5.23].

Conclusion

A substantial number of PLWHA had poor HRQOL in Ethiopia. Social support was significantly associated with HRQOL among people living with HIV/AIDS. Hence, it’s recommended to encourage suitable intervention at every follow-up visit, and psycho-social support is also warranted to improve the quality of life.

Magnitude of postpartum hemorrhage and its associated factors in Ethiopia: a systematic review and meta-analysis

BACKGROUND

Postpartum hemorrhage or postpartum bleeding (PPH) is often defined as loss of > 500 ml of blood after vaginal delivery or > 1000 ml after cesarean delivery within 24 h. Postpartum hemorrhage is a leading direct cause of maternal morbidity and mortality in Ethiopia. Therefore, the main objective of this systematic review and meta-analysis was to estimate the pooled magnitude of postpartum hemorrhage and the pooled effect size of the associated factors in Ethiopia.

METHODS

Primary studies were searched from PubMed/MEDLINE online, Science Direct, Hinari, Cochrane Library, CINAHL, African Journals Online, Google and Google Scholars databases. The searching of the primary studies included for this systematic review and meta-analysis was limited by papers published from 2010 to October 10/2021. The data extraction format was prepared in Microsoft Excel and extracted data was exported to Stata Version 16.0 statistical software for analysis. A random effect meta-analysis model was used. Statistical heterogeneity was evaluated by the I2 test and Egger's weighted regression test was used to assess publication bias.

RESULT

A total of 21 studies were included in this meta-analysis. The pooled magnitude of postpartum hemorrhage in Ethiopia was 8.24% [(95% CI 7.07, 9.40]. Older age [OR = 5.038 (95% CI 2.774, 9.151)], prolonged labor [OR = 4.054 (95% CI 1.484, 11.074)], absence of anti-natal care visits (ANC) [OR = 13.84 (95% CI 5.57, 34.346)], grand-multiparty [OR = 6.584 (95% CI 1.902, 22.795)], and history of postpartum hemorrhage [OR = 4.355 (95% CI 2.347, 8.079)] were factors associated with the occurrence of postpartum hemorrhage.

CONCLUSIONS

The pooled magnitude of postpartum hemorrhage among post-natal mothers in Ethiopia was moderately high. The finding of this study will strongly help different stakeholder working in maternal and child health to focus on the main contributors' factors to reduce post-partum hemorrhage among postnatal mothers. Health professionals attending labor and delivery should give more attention to advanced aged mothers, grand-multipara mothers and mothers who had a history of post-partum hemorrhage due to higher risk for postpartum hemorrhage. Encouraging to continue ANC visit and prevent prolonged labor should also be recommended to decrease postpartum hemorrhage.

Stressful life experience of the first married women in polygamous families in Gedeo zone, South Ethiopia: a qualitative study, 2021

INTRODUCTION

Polygamy is commonly referred to as the union of a man with multiple women or the practice of having more than one wife at a time. In Ethiopia, polygamy has practiced in all regions. In particular, the stress of polygamous family life predisposes mothers to psychological problems. Being a serious public health issue, the stressful experience among polygamous women was not known in Ethiopia.

AIM

To explore a stressful life experience among first married polygamous women in Gedeo Zone, South Ethiopia, 2021.

METHODS

This study was conducted using a phenomenological study approach from February 20-30, 2021. A purposive sampling method was used and an in-depth interview was conducted. Data were collected from 13 first married women from polygamous.

FINDINGS

Three themes emerged from the study including reaction to polygamy, socio-economic challenges in polygamy, and bonds of families in polygamy families. The finding indicated that the status of life experience among first married women in a polygamous family was stressful. They experienced various degrees of psychological difficulties including anger, mistrustfulness, emotional distress, loneliness, emptiness, unhappiness, and lack of intimacy with their husbands.

CONCLUSION AND RECOMMENDATIONS

This study highlighted how polygamy is a complex issue and common practice in the Gedeo zone. There has to be a mechanism for serious follow-up to educate women properly. A long-lasting measure to empower women in the economy, social, political, and creating a level of consciousness to resist polygamy is important.

Under-nutrition and associated factors among children infected with human immunodeficiency virus in sub-Saharan Africa: a systematic review and meta-analysis

Background

In the developing world, such as the sub-Saharan African region, HIV/AIDS has worsened the impact of under-nutrition in children. HIV infected children are highly vulnerable to under-nutrition. Therefore, the objective of this systematic review and meta-analysis was to estimate the pooled prevalence of under-nutrition, and the pooled effect sizes of associated factors among HIV-infected children in sub-Saharan Africa.

Methods

The primary studies for this review were retrieved from PubMed/ MEDLINE online, Science Direct, Hinari, web of science, CINHAL, EMBASE, WHO databases, Google, and Google Scholar databases. The articles selected for this meta-analysis were published between 2010 and 2020. The last search date was 18 October 2021. The data was extracted in Microsoft Excel format and exported to STATA Version 14.0. A random effect meta-analysis model was used. Heterogeneity was evaluated by the I² test. The Egger weighted regression test was used to assess publication bias.

Results

We retrieved 847 records from these databases. Of which records, 813 were excluded due to different reasons and 34 studies were included in the final analysis. The pooled prevalence of stunting, underweight and wasting in HIV infected children was 46.7% (95% CI; 40.36–53.07, I² = 98.7%, p < 0.01), 35.9% (95% CI; 30.79–41.02, I² = 97.4% p < 0.01), and 23.0% (95% CI; 18.67–27.42, I² = 96.9%, p < 0.01) respectively. The advanced WHO HIV/AIDS clinical staging (III&IV) [OR = 6.74 (95%: 1.747, 26.021), I² = 94.7%] and household food insecurity were associated with stunting [OR = 5.92 (95% CI 3.9, 8.87), I² = 55.7%]. Low family economic status [OR = 4.737 (95% CI: 2.605, 8.614), I² = 31.2%] and increased feeding frequency [OR = 0.323 (95% CI: 0.172, 0.605), I² = 69.8%] were significantly associated with under-weight. Anemia [OR = 2.860 (95% CI: 1.636, 5.000), I² = 74.8%] and diarrhea in the previous month [OR = 4.117 (95% CI: 2.876, 5.894), I² = 0.0%] were also associated with wasting among HIV infected children in sub-Saharan Africa.

Conclusions

The pooled prevalence of under-nutrition among HIV infected children was high. Nutritional assessment and interventions need great attention as a part of HIV care for HIV positive children. The implementation of policies and strategies established by national and international stakeholders in ART care centres should take a maximum emphasis on reducing under-nutrition among HIV infected children.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13690-021-00785-z.

Prevalence of dysmenorrhea and associated factors among students in Ethiopia: A systematic review and meta-analysis

BACKGROUND

Dysmenorrhea is one of the most common gynecological complaints among adolescent women. It has been associated with short-term absenteeism in school and has a negative impact on academic and daily activities. Therefore, the aim of the study was to show the evidence on the magnitude and correlates of dysmenorrhea in Ethiopia.

METHOD

In this systematic review and meta-analysis, we searched the literature from different databases such as PubMed/Medline, Science Direct, PsycINFO, and Cochrane library. We also used unpublished literature from Google, Google Scholar. The quality of the included articles was assessed using the Newcastle-Ottawa Scale. Data were extracted using a Microsoft Excel data extraction format. STATA version 14 statistical software was used for data analysis. To assess the heterogeneity of the primary articles, the Cochrane Q test statistics and the I² test were carried out. Publication bias was inspected by funnel plot, and Egger's test was performed to confirm the presence of publication bias. A random-effects meta-analysis was used to estimate the pooled prevalence of dysmenorrhea and its associated factors.

RESULT

A total of 12 studies were included in the final meta-analysis. The pooled prevalence estimate of dysmenorrhea among female students in Ethiopia is 71.69% (66.82%-76.56%). In our systematic review, among factors associated with dysmenorrhea, the family history of dysmenorrhea was frequently reported in included studies. Therefore, dysmenorrhea was significantly associated with a family history of dysmenorrhea (adjusted odds ratio = 4.69 (95% confidence interval: 2.80-7.85)).

CONCLUSION

The pooled prevalence estimate of dysmenorrhea among students was much higher in Ethiopia. Health professionals and teachers should educate and support students to follow their menstrual cycle regularly in the event of irregular periods. There should be an awareness of the negative consequences of dysmenorrhea to reduce the physical and psychological stresses that affect women and their families.

Tetanus Toxoid Vaccination Coverage and Associated Factors among Childbearing Women in Ethiopia: A Systematic Review and Meta-Analysis

BACKGROUND

Tetanus is a bacterial disease caused by the Clostridium tetani, which is a highly fatal, noncommunicable, and toxin-mediated disease. Globally, maternal and neonatal tetanus is a public health problem due to low maternal tetanus toxoid immunization. Ethiopia has the highest neonatal mortality and morbidity related to tetanus due to low tetanus toxoid immunization and the high number of home deliveries. The main objective of this systematic review and meta-analysis was to estimate the pooled coverage of at least two doses of tetanus toxoid immunization, and the pooled effect sizes of associated factors in Ethiopia.

METHODS

Primary studies for this review were searched from the PubMed/MEDLINE online, ScienceDirect, Hinari, Google, and Google Scholar databases. Primary articles published from 2010 up to August 30, 2020, were included in this meta-analysis. Data were extracted in Microsoft Excel format and exported to STATA Version 14.0. A random-effects meta-analysis model was used to estimate the pooled coverage of two or more tetanus toxoid immunizations and its associated factors. Heterogeneity was evaluated by the I 2 test. Egger's weighted regression test was used to assess publication bias.

RESULTS

We retrieved 212 records; of these, 199 articles were excluded for reasons. Finally, 14 studies were included in this meta-analysis. The pooled estimate of receiving at least two doses of tetanus toxoid immunization coverage in Ethiopia was 52.2% (95% CI: 42.47-61.93, I 2 = 98.4%). Antenatal care (OR = 7.8 (95% CI: 3.2, 19.2), I 2 = 96.3%), media exposure (OR = 8.3 (95% CI: 2.1, 33.3), I 2 = 98.1%), distance from the health facility (OR = 2.64 (95% CI: 1.1, 6.6), I 2 = 94.1%), educational status of women (OR = 4.7 (95% CI: 2.07, 9.56), I 2 = 94.2%), and educational status of husbands (OR = 2.995 (95% CI: 1.194, 7.512), I 2 = 92.5%) were factors significantly associated with receiving at least two doses of tetanus toxoid immunization coverage in Ethiopia.

CONCLUSIONS

The coverage of tetanus toxoid immunization among childbearing women was low in Ethiopia. Strengthening maternal health service utilization (antinatal care and institutional delivery) to the nearest health facility even in health posts and empowering education for both women and their husbands is recommended to increase tetanus toxoid immunization coverage in Ethiopia.

Sleep quality and associated factors among pregnant women attending antenatal care at Jimma Medical Center, Jimma, Southwest Ethiopia, 2020: cross-sectional study

BACKGROUND

Sleep is a natural physiological process vital for the physical and mental wellbeing of pregnant women and their fetuses. Even though poor sleep quality is a common problem among pregnant women, it is not studied in developing countries including Ethiopia. Therefore, this study was aimed to assess the poor sleep quality and associated factors among pregnant women attending antenatal care at Jimma medical center, Jimma, Southwest Ethiopia, 2020.

METHODS

A cross-sectional study design was conducted among 415 pregnant women at Jimma Medical Center (JMC). The study subjects were selected using a systematic random sampling technique. Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality using face-to-face interviews. SPSS version 25 was used to analyze data. Bivariate and multivariable logistic regressions were done to identify factors related to sleep quality. In multivariable logistic regression variables with a p-value less than 0.05 was considered significant and, adjusted OR (AOR) with 95% CI was used to present the strength of the association.

RESULTS

The prevalence of poor sleep quality among pregnant women was found to be 30.8% (95% CI (26.5, 35.2). In multivariable analysis, age ≥ 30 years old (AOR = 1.94;95%CI:1.03,3.66), Multigravida (AOR = 1.90;95%CI:1.90,3.32),depression (AOR = 4.26;95%CI:2.54,7.14),stress (AOR = 1.85;95%CI:1.20,3.02) were variables significantly associated with poor sleep quality.

CONCLUSION

This study found a high prevalence of poor sleep quality among pregnant women. Older age, gravidity, depression, and stress were associated with poor sleep quality. It is better to have routine sleep pattern screening and teach sleep hygiene practice for pregnant women.

Health professional's job satisfaction and its determinants in Ethiopia: a systematic review and meta-analysis

Background

Health professional’s job satisfaction is directly related to patient satisfaction and quality of care. Without satisfied health professionals the health system is not functional, and the national and global health related plans are not achieved. However, little is known on the level of health professional’s job satisfaction in sub Saharan African countries including Ethiopia. In addition, in Ethiopia there is no summarized evidence helped us an input to design strategies. Therefore, we aimed to assess the pooled prevalence of health professional’s job satisfaction and its determinants in Ethiopia.

Methods

Articles were searched from PubMed, PsycINFO, Hinari, Science Direct, web of science and African journal of online (AJOL) databases, Google and Google scholar. A standardized Microsoft excel spread sheet and STATA software version 16 were used for data extraction and analysis respectively. We followed the Preferred Reporting Items for Systematic reviews and Meta-Analysis to write this report. A random effect meta-analysis model was used to determine the pooled prevalence of job satisfaction. I² was done to check heterogeneity. Egger’s test and funnel plot were conducted to detect publication bias. Subgroup analysis was also conducted. Association was expressed through pooled odd ratio with a 95% CI.

Result

In this review and meta-analysis, a total of 29 studies were included. The pooled prevalence of health professional’s job satisfaction was 46.17% [95% CI (43.08, 49.26)]. The heterogeneity and publication bias test results were I² = 87.3%, P <  0.001 and Eggers’, P = 0.16. Female sex; OR: 2.20 [95% CI (1.63, 2.97)], working environment; OR: 9.50 [95% CI (6.25, 14.44)], opportunity for professional growth and development; OR: 5.53 [95% CI (1.56, 19.56)], staff relationship; OR: 3.89 [95% CI (1.65, 9.17)] and supportive supervision; OR: 5.32 [95% CI (1.77, 15.92)] were associated with health professional’s job satisfaction.

Conclusion

More than half of professionals were dissatisfied with their jobs. Therefore, the ministry of health and stakeholders better to design strategies to increase the level of satisfaction. Furthermore, it is better to strengthen staff relationship and making the working environment more attractive and equipped.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13690-021-00664-7.

Alcohol use and its determinants among adults living with HIV/AIDS in Ethiopia: a systematic review and meta-analysis

Background

Alcohol use is a common practice of almost all communities worldwide and it is more common among persons with HIV infection. Alcohol consumption among people with HIV/AIDS may result in poor treatment adherence, further immunity suppression and increase the risk of comorbid illness (diseases) which collectively diminish the anti-retroviral therapy responses. Although there are separate studies conducted regarding alcohol use among people with HIV/AIDS in Ethiopia, the finding results are highly variable and inconsistent. Therefore, conducting a systematic review and meta-analysis has a paramount importance to show the pooled prevalence of alcohol use and to identify its determinants among people with HIV/AIDS.

Methods

A systematic search of electronic databases of PubMed/Medline, Science Direct, Hinnari and Cochrane library was employed. Additionally, the grey literature was searched from Google and Google Scholar. Data were extracted using a standardized data extraction format prepared in Microsoft Excel . STATA-version 14 statistical software was used for analysis. Heterogeneity of primary studies was found as evaluated using the I² test result. As a result, a random-effect meta-analysis model was used to estimate the pooled prevalence of alcohol use.

Results

A total of 22 primary studies which comprises 8,368 study participants were included in this systematic review and meta-analysis. The pooled prevalence of lifetime, current and hazardous alcohol use among HIV patients in Ethiopia were 36.42% [95% CI (19.96, 52.89)], 19.00% [95% CI (12.98, 25.01)] and 21.64% [95% CI (12.72, 30.55)], respectively. Khat chewing [OR = 3.53, (95% CI 1.31, 9.51)] and cigarette smoking [OR = 7.04, (95% CI 3.53, 14.04)] were found as statistically significant determinants of hazardous alcohol use among people with HIV infection.

Conclusions

The result of this review showed that alcohol drinking is highly practiced among people with HIV/AIDS in Ethiopia. The magnitude of alcohol use was highly variable based on the screening methods used to measure alcohol use. Comorbid substance use (khat and cigarette) increases the risk of alcohol consumption among HIV patients. This suggests a need for designing appropriate and culturally applicable intervention programs and policy responses.

Trial registration PROSPERO 2019, “CRD42019132524.”

Supplementary Information

The online version contains supplementary material available at 10.1186/s12954-021-00503-6.

Magnitude and correlates of sleep quality among undergraduate medical students in Ethiopia: cross –sectional study

Purpose

Poor quality of sleep has a negative effect on academic performance of medical students. Quantity and quality of sleep in addition to average sleep time are strongly linked with students’ learning abilities, poor academic performance and poor interpersonal relationship which predispose them to mental illnesses. This study is aimed to assess magnitude and correlates of sleep quality among medical students in Ethiopia.

Method

An institutional based cross-sectional study was conducted among 576 undergraduate medical students. Data was collected by using interviewer administered structured questionnaires. Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality. The collected data were entered in to Epi-data version 3.1and analyzed using SPSS version 20. Logistic regression was used to identify the potential determinants of quality of sleep among undergraduate medical students. P-values less than 0.05 were considered statistically significant and strength of the association was presented by adjusted odds ratio with 95% C.I.

Result

The prevalence of poor sleep quality among undergraduate medical students was 62% (95%CI, 57.9, 65.3). The mean age (±SD) of the respondents was 21.5(±2.4), with age ranging from 18 to 28 and about 310 (53.8%) were males. Factors like, being depressed (AOR = 1.92,95%CI 1.16,3.19), poor social support (AOR = 5.39,95%CI 2.33,2.49), being stressed (AOR = 2.04,95%CI 1.26,3.31), and poor sleep hygiene (AOR = 3.01,95%CI 1.75,5.18) were associated with poor sleep quality at p-value < 0.05. Findings also showed that, one unit increase in grade point average was associated with 81.5% decrease (AOR = 0.185, 95%CI 0.13, 0.28) in poor sleep quality.

Conclusion

A substantial proportion of medical students are affected by poor sleep quality. Routine screening of sleep quality, sleep hygiene, depression and stress is warranted. Moreover, it is better to educating medical students about proper sleep hygiene and the consequences of poor sleep.

Knowledge and attitude towards epilepsy among rural residents in southern Ethiopia: a cross-sectional study

BACKGROUND

Although epilepsy is one of the most prevalent neurological problems, it is highly surrounded by stigma and prejudice, which results in negative attitude towards the illness. Due to numerous misconceptions and beliefs attributed towards epilepsy, most people in rural communities have poor understanding and perception about epilepsy. Studying knowledge and attitude of this major neurologic problem among rural residents is crucial to add knowledge and show area of interventions. Therefore, the aim of this study was to assess the knowledge and attitude towards Epilepsy among rural residents in Ethiopia.

METHODS

This was a community based cross-sectional study conducted in rural parts of Gedeo zone, Southern Ethiopia. A total of 732 randomly selected adult residents were interviewed using a pre-tested questionnaire. The collected data were entered to Epi-data version 3.1 and analyzed using SPSS version 20. Descriptive statistics and logistic regressions were performed. Multivariable binary logistic regression analysis was conducted to determine the presence of a statistically significant association between explanatory variables and outcome variables at corresponding 95% CI.

RESULTS

The magnitude of poor knowledge and unfavorable attitude towards epilepsy were 27.0 and 51.6%, respectively. Participants who can't read and write, having stigma related to epilepsy, participants who did not live with epileptic patients; unfavorable attitude and age were factors associated with poor knowledge towards epilepsy. On the other hand, Stigma related to epilepsy, poor knowledge, age and perceiving epilepsy as a God punishment for sinful activities were variables significantly associated with unfavorable attitude of epilepsy.

CONCLUSIONS

There is a gap regarding the knowledge and attitude towards epilepsy among community residents in southern Ethiopia. This demonstrates a need for community educational program regarding epilepsy which can increase community awareness particularly in rural areas to decrease stigma and negative beliefs towards epilepsy.

Magnitude, Symptom Presentation and Correlates of Psychological Distress Among People with Epilepsy in Southern Ethiopia: A Cross-Sectional Study

BACKGROUND

Psychological distress is a common co-morbid condition among people with epilepsy. Untreated comorbid psychosocial problems are associated with increased morbidity and health-care costs, and negatively affects treatment outcome of people with epilepsy. Therefore, the aim of this study was to describe the prevalence of psychological distress and to identify its associated factors among people with epilepsy attending outpatient treatment in Gedeo zone public hospitals, Southern Ethiopia.

PATIENTS AND METHODS

This was an institution-based cross-sectional study conducted at Gedeo zone public hospitals from July 1st to October 1st, 2019. Self-reporting questionnaire was used to screen individuals with epilepsy for the presence of co-morbid psychological distress. A face to face interview was conducted among 321 anti-epileptic medication followers. The collected data were entered into Epi-Data version 3.1 and then exported to SPSS version 20 for further analysis. Binary logistic regression was computed to identify factors associated with psychological distress. Statistically, significant association was set at p-values of <0.05 in the final model with a corresponding 95% confidence interval.

RESULTS

The prevalence of psychological distress was found to be 38.3% with 95% CI (34.1, 42.7) among people with epilepsy attending outpatient follow-up in Gedeo zone public hospitals. Being female [OR=1.57 (95% CI: 1.01-4.80)], uncontrolled seizures [OR=1.96 (95% CI: 1.21-3.18)], and longer duration of illness [OR= 3.16 (95% CI: 1.75-5.73)] were variables found to have statistically significant association with psychological distress.

CONCLUSION

The findings of this study revealed that more than one-third of people with epilepsy screened positive for psychological distress. Therefore, this demonstrates a need to design and implement programs focusing on the prevention, early screening, and providing appropriate interventions for psychological distress among people with epilepsy.

Determinants of Preeclampsia Among Pregnant Mothers Attending Antenatal Care (ANC) and Delivery Service in Gedeo Zone, Southern Ethiopia: Case Control-Study

BACKGROUND

The maternal morbidity and mortality related to preeclampsia are increasing in developing countries; figures have been estimated to be between 1.8% and 16.7%, including in Ethiopia. However, there is limited research regarding the determinants of preeclampsia in Gedeo Zone.

OBJECTIVE

The aim of the study was to determine the predictors of preeclampsia among pregnant mothers attending ANC and delivery services in southern Ethiopia.

METHODS

A facility-based unmatched case-control study was conducted in Gedeo Zone. Pregnant mothers attending ANC and delivery service were selected consecutively until the allotted 243 (162 controls and 81 cases) sample size was fulfilled. The collected data were checked for completeness and entered into Epi-data software version 3.1, and exported to statistical package for social science (SPSS) version 20 for analysis. Multivariable logistic regression was employed and a P-value of less than 0.05 with a 95% confidence interval was used to declare the significant association of the independent variables and the outcome variable.

RESULTS

A total of 240 mothers, 80 (33.3%) of cases and 160 (66.70%) of controls, responded, with a response rate of 98.76%. The mean age of the participants among both groups was 27.40 with a standard deviation of ±5.02. Attending education [adjusted odd ratio (AOR) = 0.49; 95% CI (0.006, 0.398)], being a house wife [AOR = 13; 95% CI (1.260, 140.15)], an age range of 20-34 years [AOR = 0.071; 95% CI (0.015, 0.32)], a family history of diabetes mellitus [AOR = 0.28.2; 95% CI (0.081, 0.985)], a family history of hypertension [AOR = 0.124; 95% CI (0.047, 0.325)], did not eat fruit during pregnancy [AOR = 3.355; 95% CI (1.112, 10.126)], and a maternal history of preeclampsia [AOR = 0.162; 95% CI (0.041, 0.640)] were found to be variables significantly associated among mothers with preeclampsia.

CONCLUSION

The determinant factors for preeclampsia were being a housewife, having a history of hypertension, diabetes mellitus, and preeclampsia among family members. Strengthening early detection and prevention of predictors, improvement of protective factors, and further follow-up study were recommended.

Prevalence and determinants of alcohol use among adults living with HIV/AIDS in Ethiopia: a systematic review protocol

BACKGROUND

Alcohol use is a challenging problem which attributes to more than 5% of the overall global burden of disease. It is more common among persons with HIV infection than the general population. Although there are separate studies regarding people with HIV/AIDS in Ethiopia, their results are highly variable and discrepant. The objectives of this study will be to evaluate the prevalence of alcohol use and to identify its associated factors among people with HIV/AIDS in Ethiopia.

METHODS

A systematic search of electronic databases (from inception onwards) of PubMed/MEDLINE, Embase, PsycINFO, and Cochrane Library will be conducted. Moreover, grey literatures will be searched from different sources (such as Google Scholar, OpenGrey, and World Health Organization websites). Reference lists of the selected articles will also be searched manually. Observational studies (cross-sectional, case-control, cohort) reporting the prevalence of alcohol use and/or its associated factors among adults with HIV/AIDS in Ethiopia will be included. The primary outcomes will be the prevalence of alcohol use among HIV/AIDS population. Secondary outcomes will be the determinants of alcohol use described in the included studies. Two reviewers will independently screen all citations and full-text articles and extract data. The studies' methodological quality (or bias) will be appraised using an appropriate tool. If feasible, we will conduct a random effects meta-analysis of observational data. Heterogeneity of primary studies will be assessed using the I² test. Prevalence estimates will be stratified according to gender, age, and geographical location. Small-study effects (publication bias) also will be examined.

DISCUSSION

Our systematic review and meta-analysis will prevail the pooled prevalence of alcohol use and its determinants among people with HIV/AIDS in Ethiopia. The finding of this study will be helpful to design appropriate preventive and interventional strategies for alcohol use among people with HIV/AIDS. This can have direct or indirect policy responses and clinical implications.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO CRD42019132524.

Treatment-Seeking Behavior Towards Epilepsy Among Rural Residents in Ethiopia: A Cross-Sectional Study

BACKGROUND

Even though a large number of patients live with epilepsy, few of them receive effective treatment. Most people with epilepsy, particularly those from rural communities, do not seek medical care as they are convinced that solutions lie only with traditional healers (traditional leaders, prophets and community elders). Therefore, studying treatment-seeking behavior regarding this major neurological problem would provide additional knowledge and help to identify a gap which needs to be addressed when tackling related problems.

PARTICIPANTS AND METHODS

This rural community-based cross-sectional study was conducted in Gedeo zone, Ethiopia, among 755 participants. Data were collected using face-to-face interview-based questionnaires. Collected data were entered into EpiData version 3.01 and analyzed using SPSS version 20. Bivariate and multivariate logistic regression analysis was conducted to identify associated factors. The strengths of associations were presented as adjusted odds ratios with 95% confidence intervals.

RESULTS

The prevalence of poor treatment-seeking behavior was 54.6% (95% CI 51.4, 58.2). Poor knowledge (adjusted odds ratio [AOR]=3.21, 95% CI 2.14, 4.81), poor social support (AOR=2.48, 95% CI 1.12, 5.53), unfavorable attitude (AOR=1.84, 95% CI 1.34, 2.54) and having no history of experiencing others' seizures (AOR=2.17, 95% CI 1.47, 3.2) were variables strongly associated with poor help-seeking behavior towards epilepsy.

CONCLUSION

The study showed that more than half of the participants had poor treatment-seeking behavior towards epilepsy. This indicates the need to implement measures to raise community awareness regarding treatment options for epilepsy.

Post-Traumatic Stress Disorder and Associated Factors Among Internally Displaced People in South Ethiopia: A Cross-Sectional Study

BACKGROUND

Displaced people experience different traumatic events. This can have serious and long-lasting consequences in terms of physical and mental health outcome. Post-traumatic stress disorder (PTSD) is the most frequent mental disorder following traumatic exposure. In 2018 Ethiopia saw the highest number of internal displacement, despite this, less attention has been given to mental health among internally displaced people in the country. This study aims to determine the estimated prevalence and associated factors of PTSD among internally displaced people in the Gede'o zone, south Ethiopia.

PARTICIPANTS AND METHODS

A community-based cross-sectional study was conducted between 1 and 30, May 2019 among 636 participants, who were selected using a simple random sampling technique. PTSD was measured by the Post-Traumatic Stress Disorder Checklist for DSM-5 (PCL-5). The association between outcome and independent variables was identified by bi-variable and multivariate logistic regression. Finally, variables with P-value less than 0.05 were considered statistically significant at 95% CI.

RESULTS

A total of 625 participants were interviewed with a response rate of 98.3%. The estimated prevalence of PTSD was 58.4% with 95% CI 55 to 61.9. In the multivariate logistic regression, being female (AOR=2.4, 95% CI 1.6 to 3.4), depression (AOR=2.6, 95% CI 1.2 to 3.9), displaced more than once (AOR=3.7, 95% CI 2.4 to 5.8), destruction of personal property (AOR=1.6, 95% CI 1.04 to 2.44), witness the murder of family (AOR=2, 95% CI 1.2, 3.9), and cumulative trauma (AOR=4, 95% CI 1.7 to 9.6) were significantly associated factors.

CONCLUSION

In the current study, the estimated prevalence of PTSD was high. Ministry of health should plan routine screening and management of PTSD, depression and linking with available mental health service is recommended.

Depression and associated factors among patients with tuberculosis in Ethiopia: a cross-sectional study

PURPOSE

The study aimed to assess the magnitude of depression and associated factors among patients with tuberculosis (TB) visiting outpatient clinics in Ethiopia.

PATIENTS AND METHODS

A cross-sectional study was conducted among 415 TB patients. Study participants were selected through a systematic random sampling technique. Patient Health Questionnaire-9 (PHQ-9) was used to assess depression using face-to-face interviews. Data were analyzed using SPSS version 20. Bivariate and multivariate binary logistic analyses were done to identify associated factors with depression. P-values less than 0.05 were considered statistically significant, and the strength of the association was presented by adjusted OR (AOR) with 95% CI.

RESULTS

The magnitude of depression was found to be 31.1% with 95% CI (26.5-35.7). Extrapulmonary TB [AOR =1.8, 95% CI (1.02, 3.24)], poor social support [AOR =3.3, 95% CI (1.8, 6.03)] and perceived TB stigma [AOR =2.0, 95% CI (1.28, 3.18)] were variables found to be statistically significantly connected with depression.

CONCLUSION

The magnitude of depression was high compared to the general population and some other studies. Therefore, the current study area and other settings which provide TB screening and treatment need to assess patients for depression and provide intervention, giving more emphasis to patients with risk factors.

Green IT beliefs and pro-environmental IT practices among IT professionals

Purpose

– The purpose of this paper is to analyze the beliefs and attitudinal factors that affect the private sphere pro-environmental behavior of information technology (IT) professionals in using personal computers.

Design/methodology/approach

– A research framework that draws from the belief-action-outcome (BAO) framework and that consisted of 11 hypotheses was developed. Data were collected from a sample of 322 IT professionals and analyzed using structural equation modeling.

Findings

– The results identify the pro-environmental personal computing actions that IT professionals are taking and how their Green IT beliefs, attitudes, information acquisition capability, and organizational fields influence their behavior.

Research limitations/implications

– The sample was limited to Australian respondents. The measurement of IT-specific environmental practices was not exhaustive nor were the measures of macro- and micro-antecedents of Green IT belief and attitude.

Practical implications

– National, regional, and international professional associations such as the Association of Information Systems can influence pro-environmental behavior among IT professionals through the creation and dissemination of information that shape both general and IT-specific environmental beliefs.

Originality/value

– The novelty of this work lies in: first, proposing and testing a research framework that can be leveraged in future studies; second, establishing how organizational fields and availability of information contribute to the formation of IT professionals’ environmental beliefs and attitudes; third, applying and suggesting potential extension to the BAO framework to evaluate the association between IT practices and environmental sustainability among IT professionals.

An Empirical Analysis of Antecedents to the Assimilation of Sensor Information Systems in Data Centers

This paper is concerned with studying the antecedents to and the assimilation of sensor information systems (SIS) in Data Centers. Using the Technology Organization and Environment Framework as a guide and drawing from the Natural resource based view and Diffusion of Innovation theories and five case studies, the paper builds a theoretical framework to investigate the factors that explain the assimilation (diversity and intensity) of SIS. The framework is tested based on data collected from a survey of 107 Data Centers. The findings show that the compatibility of SIS, knowledge of Data Centre managers, green data centre orientation and pressure from peers in the industry affect the assimilation of SIS to manage the facility, power and cooling and computing functions of Data Centers. Further the type of Data Centre, whether it is corporate or co-located or managed has a significant influence on both the level of the SIS assimilation as well as the antecedent factors that influence assimilation.

Iodine status among pregnant women in Kuwait

Up to now, little has been known about iodine intake and the prevalence of iodine deficiency (ID), if any, in Kuwait. Urinary iodine excretion (UIE) and changes in thyroid function during pregnancy were thus evaluated.

METHODS

Urinary iodide level was measured in random urine samples collected from 326 pregnant women at different gestational trimesters. Blood samples were drawn for free T4 (FT4) and TSH level determination.

RESULTS

Median UIE levels fall within the normal range during all gestational trimesters i.e. >100 microg/l. However, if the new suggested recommendation for pregnant women <140 microg/l, is applied, median UIE values during trimesters 2 and 3 indicate ID. Mean serum TSH levels increased between trimesters 1 and 3 (p<0.05), whereas serum FT4 decreased between first and second trimesters (p<0.05), and this reduction continued at the third trimester. Furthermore, an increase in TSH levels for subjects with mild and moderate ID (Mi and Mo, respectively) were noticed (p<0.05) during the second trimester. However, FT4 levels dropped in subjects with Mi and Mo ID during the first trimester (p<0.05). In conclusion, these results suggest that 56.8% of pregnant women had median UIE level <145 microg/l, associated with high TSH and low FT4 levels.

CONCLUSION

Data obtained may indicate insufficient iodine intake among pregnant women in Kuwait.

Mutually exclusive NRASQ61R and BRAFV600E mutations at the single-cell level in the same human melanoma

Activating BRAF or NRAS mutations have been found in 80% of human sporadic melanomas, but only one of these genetic alterations could be detected in each tumour. This suggests that BRAF and NRAS 'double mutants' may not provide advantage for tumour growth, or may even be selected against during tumorigenesis. However, by applying mutant-allele-specific-amplification-PCR method to short-term melanoma lines, one out of 14 tumours was found to harbour both BRAFV600E and the activating NRASQ61R mutations. On the other hand, analysis of 21 melanoma clones isolated by growth in soft agar from this tumour indicated that 16/21 clones harboured a BRAFV600E, but were wild-type for NRAS, whereas the remaining had the opposite genotype (NRASQ61R/wild-type BRAF). When compared to BRAFV600E clones, NRASQ61R clones displayed reduced growth in soft agar, but higher proliferative ability in vitro in liquid medium and even in vivo after grafting into SCID/SCID mice. These data suggest that NRAS and BRAF activating mutations can coexist in the same melanoma, but are mutually exclusive at the single-cell level. Moreover, the presence of NRASQ61R or BRAFV600E is associated with distinct in vitro and in vivo growth properties of neoplastic cells.

[Sciatica secondary to a presacral abscess as the first manifestation of Crohn's disease]

Presacral abscess is a rare musculoskeletal complication of Crohn's disease. The clinical picture is sometimes insidious and a delay in diagnosis may increase morbidity. Abdominal-pelvic computerized axial tomography (CAT) has proven to be very useful in the diagnosis of this entity, which usually requires surgical treatment. We present the case of a 22-year-old man who presented to hospital for colic-type abdominal pain of 6 months' evolution and intermittent episodes of joint pain. The patient also presented mechanical pain in the right gluteus muscle of two weeks' evolution irradiating to the posterior side of the muscle. Complementary investigations confirmed the suspected diagnosis of Crohn's disease and showed presacral abscess. Treatment was surgical.

Selection and characterization of varicella-zoster virus variants resistant to (R)-9-[4-hydroxy-2-(hydroxymethy)butyl]guanine

(R)-9-[4-Hydroxy-2-(hydroxymethy)butyl]guanine (H2G) is a potent and selective inhibitor of herpesvirus replication. It is a nucleoside analog, and its triphosphate derivative (H2G-TP) is a competitive inhibitor of herpesvirus DNA polymerases. In this study, the antiviral activities of H2G and acyclovir (ACV) and the development of viral resistance to these agents were compared in varicella-zoster virus (VZV)-infected cells. In plaque reduction assays, the 50% effective concentration of H2G for VZV was 60- to 400-fold lower than that of ACV, depending on the virus strain and the cell line tested. The enhanced efficacy of H2G against VZV can be accounted for in part by the fact that the intaracellular H2G-TP level (>170 pmol/10(6) cells) is higher than the intracellular ACV-TP level (<1 pmol/10(6) cells). In addition, H2G-TP has extended half-lives of 3.9 and 8.6 h in VZV-infected MRC-5 and MeWo cells, respectively. To assess the emergence of H2G-resistant VZV in vitro, VZV was passaged in the presence of increasing concentrations of H2G. Earlier in the passage, when the concentration of H2G was relatively low, the predominant variant had the (A)76 deletion in the viral thymidine kinase (TK) gene. This mutant was identical to an ACV-resistant mutant generated in parallel experiments. However, higher concentrations of H2G appeared to favor a novel mutant, which had deletions of two consecutive nucleotides at positions 805 and 806 of the TK gene. All of these changes introduced frameshift mutations in the TK gene resulting in the expression of truncated polypeptides. H2G-resistant viruses were cross-resistant to ACV, and vice versa.

Comparison of safety of glucose oral rehydration solution and maize oral rehydration therapy for home management of diarrhoea in Kenya

Safety margins and variability in the composition of glucose and maize-based oral rehydration therapy (ORT) prepared by mothers in a rural district of Western Kenya, are reported here. In a 2-year longitudinal field study, packets containing glucose ORS and a home solution made with maize and table salts, were provided to the mothers of 6180 children in Kakamega District in two separate sub-locations. Experienced and trained field workers supported by community registered nurses provided training for the preparation and use of ORT during weekly visits to every household. On four occasions separated by 4-6 months, a 5 per cent random sampling was done of the home-prepared solutions actually used for the treatment of children with diarrhoea. The water used for preparing ORT was also sampled. Samples of 174 glucose-based ORT, 148 maize-salt ORT, and 201 samples of water were analysed. Only 2 per cent of the maize-based ORT were above 120 meq/1 sodium (i.e., the safe range of sodium concentration) compared to 17.8 per cent for glucose solutions (p < 0.001). Home water samples contained substantial amounts of salt, which could unpredictably affect the final composition of the ORT solutions. We conclude that maize-salt ORT had a better margin of safety than glucose-based ORS.

Synthesis and antiviral activities of the major metabolites of the HIV protease inhibitor ABT-378 (Lopinavir)

The HIV protease inhibitor ABT-378 (Lopinavir) is metabolized rapidly and extensively by CYP-3A4 catalyzed oxidation. Three of the major metabolites identified were synthesized and their antiviral (HIV) activities determined.