Blood Pressure Control and Associated Factors among Hypertension Comorbid Type 2 Diabetic Patients in Southeast Ethiopia

Background

Hypertension is the main contributor to the morbidity and mortality of patients with cardiovascular disease. Even though hypertension is very common in comorbid type 2 diabetic patients, it is frequently overlooked. This study aimed to assess blood pressure control and its associated factors among hypertension comorbid type 2 diabetic patients in Bale Zone public hospitals in Southeast Ethiopia.

Methods and Materials

A hospital-based cross-sectional study design was conducted among hypertension comorbid type 2 diabetic patients. The data were collected using an interviewer-administered structured questionnaire and a review of the medical charts of patients. A simple random sampling technique was used to select the study participants. The bivariate and multivariate logistic regression analyses were performed to assess the association between blood pressure control and its associated factors. Independent variables that showed a P < 0.25 in the bivariate analysis was included in the multivariate analysis. Finally, variables with a P < 0.05 were declared statistically significant factors.

Results

The total number of participants in the study was 378. The overall magnitude of uncontrolled hypertension among hypertension comorbid diabetic patients was found to be 82.5% (95% CI: 78.7%, 86.4%). Nonadherence to antihypertensive medication (AOR = 2.45, 95% CI: 1.11, 5.39, P = 0.027), duration of hypertension >10 years (AOR = 5.2, 95% CI: 1.27, 21.38, P = 0.022), participants who attended secondary education (AOR = 3.2, 95% CI: 1.18, 8.87, P = 0.023), and being obese (AOR = 4.1, 95% CI: 1.24, 13.49, P = 0.021) were significantly associated with uncontrolled hypertension.

Conclusion

Uncontrolled hypertension was found to be high among hypertension comorbid type 2 diabetic patients. Patients' adherence to antihypertensive medication, physical activity, and alcohol abstinence should be maximized. Loss of weight is also crucial, as is the early detection and management of comorbidities.

Isolated breast hydatid cyst: A case report

A hydatid cyst is a parasitic infestation most frequently caused by the larval tapeworm known as Echinococcus granulosus. Breast hydatidosis is a very uncommon condition that may be the main site or one of its components in cases of extensive hydatidosis. We discussed a 28-year-old female patient who had been experiencing left breast pain for a year prior to her presentation.

Prevesical hydatid cyst: A case report

Hydatid cyst is a zoonotic disease caused by a tapeworm of the genus Echinococcus granulosus either in its adult or larval forms. Original pelvic cysts are rare; however, the majority of abdominal and pelvic hydatid cysts are believed to result from inadvertent surgical inoculation or spontaneous rupture from a primary hepatic focus. We present a 35-year-old female patient who visited our facility complaining of lower abdominal pain that had persisted for the last 5 months.

Barbers' compliance with biological hazard preventive measures and predictors in selected towns, Southeast Ethiopia: a cross-sectional study

OBJECTIVE

The barber's profession exposes their customers to several health risks. Negligence when using sharp instruments in barbershops can increase the risk of bloodborne infections, resulting in serious health problems for both the barber and the customer. Evidence for compliance with biological hazard preventive measures and predictors among barbers is critical and urgent. Thus, we aimed to assess compliance with biological hazard preventive measures and predictors among barbers in selected towns in Southeast Ethiopia.

METHODS

A cross-sectional study was conducted among 633 randomly selected barbers from 1 March to 30 March 2022. A multistage sampling followed by a systematic sampling and simple random sampling methods were used to select barbershops and barbers, respectively. We used a pretested interviewer-administered questionnaire and an observational checklist to collect data. Multinomial logistic regression analysis was used to identify predictors. An adjusted OR (AOR), along with a 95% CI and p<0.05, was used to estimate the strength of the association.

RESULTS

The good compliance level with biological hazard preventive measures was 47.10% (95% CI: 43.2%, 50.70%). Being married (AOR=3.04, 95% CI: 1.71, 8.56), aged from 25 to 34 years (AOR=2.75, 95% CI: 1.13, 8.06), served for ≤5 years (AOR=1.72, 95% CI: 1.24, 3.85), attending high school and above (AOR=4.32, 95% CI: 1.31, 12.73), being professional (AOR=6.34, 95% CI: 2.03, 11.36), having a positive attitude (AOR=2.95, 95% CI: 1.06, 8.22) and having good knowledge towards biological hazard preventive measures (AOR=3.14, 95% CI: 1.42, 9.25) were significant predictors of moderate and good compliance with biological hazard preventive measures.

CONCLUSION

The study's findings revealed that almost half of the barbers were in good compliance with biological hazard preventive measures. As a result, improving barbers' attitudes and knowledge through on-the-job training is indispensable.

Magnitude of erectile dysfunction and associated factors among adult diabetic men on follow-up at Goba and Robe hospitals, Bale Zone, South East Ethiopia: hospital-based cross-sectional study

PURPOSE

Erectile dysfunction is defined as the inability to achieve and/or maintain an erection of sufficient rigidity and duration to permit satisfactory sexual performance. The purpose of this study is to assess the prevalence of erectile dysfunction and associated factors among adult diabetic men on follow-up at Goba and Robe hospitals, Bale Zone, South East Ethiopia,2022.

METHODS

Hospital-based cross-sectional study design was used among 420 adult diabetic men from March 1 to April 30 using a systematic random sampling technique. An international index of erectile function questionnaire containing five questions was used to assess the outcome variable. The data were entered, edited, and coded using Epidata version 4.6 and analyzed using SPSS version 26. Bivariable and multivariable binary logistic regression analysis were performed to identify factors associated with erectile dysfunction. Adjusted odds ratios with their corresponding 95% confidence interval were computed to estimate the strength of association. Statistical significance was declared at p-value < 0.05.

RESULTS

The prevalence of erectile dysfunction was found to be 354 (84.3%). Multivariable logistic regression revealed that erectile dysfunction is significantly associated with old age (AOR = 12.39, 95% CI:5.10-30.08), inadequate physical activity (AOR = 4.15, 95% CI:1.33-12.97), and being rich (AOR = 2.62, 95% CI = 1.21-5.66).

CONCLUSION

The prevalence of erectile dysfunction in this study population is nearly nine out of ten. Age, inadequate physical activity, and wealth index were independent predictors of erectile dysfunction. Assessment and management of erectile dysfunction in diabetic clinics should be routine medical care.

Bacterial contamination of healthcare workers' mobile phones in Africa: a systematic review and meta-analysis

BACKGROUND

Mobile phones are potential reservoirs for pathogens and sources of healthcare-associated infections. More microbes can be found on a mobile phone than on a man's lavatory seat, the sole of a shoe, or a door handle. When examining patients, frequent handling of mobile phones can spread bacteria. Nevertheless, evidence of bacterial contamination of mobile phones used by healthcare workers in Africa was inconclusive. Thus, this meta-analysis and systematic review was conducted to estimate the pooled prevalence of bacterial contamination of mobile phones used by healthcare workers and the most frequent bacterial isolates in Africa.

METHODS

We systematically retrieved relevant studies using PubMed/MEDLINE, POPLINE, HINARI, Science Direct, Cochrane Library databases, and Google Scholar from July 1, 2023 to August 08, 2023. We included observational studies that reported the prevalence of bacterial contamination of mobile phones among healthcare workers. The DerSimonian-random Laird's effect model was used to calculate effect estimates for the pooled prevalence of bacterial contamination in mobile phones and a 95% confidence interval (CI).

RESULTS

Among 4544 retrieved studies, 26 eligible articles with a total sample size of 2,887 study participants were included in the meta-analysis. The pooled prevalence of mobile phone bacterial contamination among healthcare workers was 84.5% (95% CI 81.7, 87.4%; I2 = 97.9%, p value < 0.001). The most dominant type of bacteria isolated in this review was coagulase-negative staphylococci (CONS) which accounted for 44.0% of the pooled contamination rate of mobile phones used by healthcare workers, followed by Staphylococcus aureus (31.3%), and Escherichia coli (10.7%).

CONCLUSIONS

In this review, the contamination of mobile phones used by HCWs with various bacterial isolates was shown to be considerable. The most prevalent bacteria isolates were coagulase-negative staphylococci, Staphylococcus aurous, and Escherichia coli. The prevalence of bacterial contamination in mobile phones varies by country and sub-region. Hence, healthcare planners and policymakers should establish norms to manage healthcare workers' hand hygiene and disinfection after using mobile phones.

The coexistence of stunting and overweight or obesity in Ethiopian children: prevalence, trends and associated factors

BACKGROUND

Double burden of childhood malnutrition is a condition where undernutrition (stunting) along with overweight and obesity coexist within individuals, households, and populations. It reflects a new layer of malnutrition and an understudied phenomenon in many low-income settings. To date, the prevalence and factors that are associated with concurrent stunting and overweight or obesity (overweight/obesity) (CSO) in the same children have not been well researched in Ethiopia. Hence, this study aimed to assess the prevalence, trends, and factors associated with the coexistence of stunting and overweight or obesity among children aged 0-59 months in Ethiopia.

METHODS

Pooled data from 2005, 2011 and 2016 Ethiopian Demographic and Health Survey (EDHS) were used. A total of 23,756 (weighted sample) children aged 0-59 months were included in the study. Height-for-age z-scores (HAZ) less than - 2 SD and weight-for-height z-scores (WHZ) above 2 SD were calculated, and children were classified as stunted and overweight/obese, respectively. A child who is simultaneously stunted and overweight/obese was considered as having HAZ below - 2 SD and WHZ above 2 SD computed into a variable named CSO, and reported as a binary outcome (yes or no). Multilevel logistic regression analysis that adjusts for sampling weights and clustering was used to identify factors associated with CSO.

RESULTS

The prevalence of stunting, overweight or obesity, and CSO among under-five children was 43.12% [95% CI: (42.50, 43.75%)], 2.62% [95% CI: (2.42, 2.83%)], and 1.33% [95% CI: (1.18, 1.48%)], respectively. The percentage of CSO children was reported to have declined from 2.36% [95% CI: (1.94-2.85)] in 2005 to 0.87% [95%CI: (0.07-1.07)] in 2011, and the same appeared to have increased slightly to 1.34% [95%CI: (1.13-1.59)] in 2016. Children who were currently breastfeeding [AOR: 1.64, 95%CI: (1.01-2.72)], born to an overweight mother [AOR: 2.65, 95%CI: (1.19-5.88)], and lived in families with 1-4 household members [AOR: 1.52, 95%CI: (1.02-2.26)] were significantly associated with CSO. At the community level the odds of having CSO were higher among children included from EDHS-2005 [AOR: 4.38, 95%CI: (2.42-7.95)].

CONCLUSION

The study revealed that less than 2% of children had CSO in Ethiopia. CSO was linked to factors at both the individual (i.e. breastfeeding status, maternal overweight, and household size) and community-levels. Overall, the study findings indicated the necessity of focused interventions to simultaneously address double burden of childhood malnutrition in Ethiopia. To further combat the double burden of malnutrition, early identification of at-risk children, including those born to overweight women and children living with multiple household members, is indispensable.

Concurrent wasting and stunting among under-five children in the context of Ethiopia: A generalised mixed-effects modelling

Concurrent wasting and stunting (WaSt) is a condition where both wasting and stunting exist in a child at the same time. This study aimed to assess the prevalence of WaSt and to identify potential associated factors in Ethiopia.  A total of 33,650 children aged between 0 and 59 months were included in the analysis from the four waves of the Ethiopian Demographic and Health Survey. A mixed-effects logistic regression model was used to identify the determinants of WaSt. The prevalence of WaSt was found to be 4.7% (95% confidence interval [CI]: (4.5-4.9)), with respectively 2.5% (95% CI: 2.1-3.1) and 4.9% (95% CI: 4.7-5.2) among children in urban and rural settings. Children: (i) in the age group 12-23 months (adjusted odds ratio [AOR]: 4.16, 95% CI: (3.20-5.42)) and 24-59 months (AOR: 3.08, 95% CI: (2.28-4.17)); (ii) who were perceived by their mothers to be smaller than normal at birth (AOR: 1.98, 95% CI: (1.57-2.50)); (iii) had diarrhoea (AOR: 1.38, 95% CI: (1.11-1.71)); and (iv) fever in the past 2 weeks (AOR: 1.38, 95% CI: (1.10-1.71)) reported higher odds of WaSt. Being a female child (AOR: 0.57, 95% CI: (0.48-0.69)), having received measles vaccination (AOR: 0.71, 95% CI: (0.55-0.89)), having a mother with a normal body mass index (18.5-24.9 kg/m² ) (AOR: 0.57, 95% CI: (0.48-0.68)), having a wealthier household (AOR: 0.67, 95% CI: (0.50-0.90)), and living in rural setting (AOR: 0.49, 95% CI: (0.32-0.74)) were associated with reduced odds of WaSt. The prevalence of WaSt was high, with approximately 1 in 20 Ethiopian children suffering from the condition and needing a prompt response to minimize the poor health and developmental outcomes. Children perceived by their mother to be smaller than normal at birth, older children, and babies with diarrhoea and fever had higher odds of WaSt.

COVID-19 vaccine acceptance and associated factors in 13 African countries: A systematic review and meta-analysis

Background

The COVID-19 pandemic has severely affected the entire world, especially sub-Saharan Africa. As a result, researchers and government agencies are working to create effective COVID-19 vaccinations. While vaccination campaigns are moving rapidly in high-income nations, COVID-19 is still ruthlessly affecting people in low-income nations. However, this difference in the spread of the disease is not because of a lack of a COVID-19 vaccine but mainly due to people's reluctance. As a result, this review summarized the data on COVID-19 vaccination adoption and factors related among nations in sub-Saharan Africa.

Method

Comprehensive searches were conducted using PubMed, Embase, Medline, Web of Science, Google Scholar, and the Cochrane Library databases. The risk of bias and methodological quality of each published article that fit the selection criteria were evaluated using Critical Appraisal Checklist tools. All statistical analysis was done by STATA 16.

Results

This review was based on 29 studies with 26,255 participants from sub-Saharan Africa. Using a random-effects model, the pooled prevalence of COVID-19 vaccine acceptance among study participants was 55.04% (95 % CI: 47.80-62.27 %), I2 = 99.55%. Being male [POR = 1.88 (95% CI: 1.45, 2.44)], having a positive attitude toward the COVID-19 vaccine [POR = 5.56 (95% CI: 3.63, 8.51)], having good knowledge in the COVID-19 vaccine [POR = 4.61 (95% CI: 1.24, 8.75)], having government trust [POR = 7.10 (95% CI: 2.37, 21.32)], and having undergone COVID-19 testing in the past [POR = 4.41 (95%CI: (2.51, 7.75)] were significant predictor variables.

Conclusion

This analysis showed that respondents had a decreased pooled prevalence of COVID-19 vaccination acceptance. Sex, attitude, knowledge, government trust, and COVID-19 testing were statistically significantly correlated characteristics that affected the acceptability of the COVID-19 vaccine. All stakeholders should be actively involved in increasing the uptake of the COVID-19 vaccine and thereby reducing the consequences of COVID-19. The acceptance of the COVID-19 vaccination can be increased by using this conclusion as an indicator for governments, healthcare professionals, and health policymakers in their work on attitude, knowledge, government trust, and COVID-19 testing.

Work-Related Musculoskeletal Symptoms and Associated Factors Among Academic Staff in Ethiopian Universities

BACKGROUND

Work-related musculoskeletal symptoms (WMSs) are common injuries or pains that primarily affect various body structures. It is difficult to estimate the burden of WMSs in developing countries such as Ethiopia due to a lack of evidence, particularly among university academic staff. There is a universal and rapidly growing need for information about WMSs, as this is the main challenge to public health and economic burden. The purpose of this study was to determine the magnitude of work-related musculoskeletal symptoms and their associated factors among academic staff in Ethiopian universities.

METHODS

From February 2 to March 24, 2021, a web-based cross-sectional study was conducted among 422 academic staff members working in Ethiopian universities. A structured and self-administered Google Form questionnaire was sent and shared with the academic staff via their email addresses, Facebook, and Telegram accounts. Using a p-value of <0.05 and a 95% confidence interval, multivariable logistic regression was used to identify factors associated with the outcome variable.

RESULTS

Around 321 (77.2%) of the 416 participants were reported to have work-related musculoskeletal symptoms at least in one part of the body (95% CI: 73.1, 81.5%), with 28.1% reporting lower back pain. Respondents working in second-stage universities (AOR = 7.35, 95% CI 3.21, 16.79), being 44 years old or older (AOR = 7.89, 95% CI 2.10, 21.57), having a Ph.D. (AOR = 7.09, 95% CI 1.50, 17.93), engaging in physical activity (AOR = 3.32, 95% CI 1.43, 7.74), and working on a computer (AOR = 6.89, 95% CI 2. 0.72, 19.15) were the factors associated with work-related musculoskeletal symptoms.

CONCLUSION

Almost three-quarters of academic staff reported work-related musculoskeletal symptoms in this survey. Factors such as university establishment stage, age, educational status, physical activity, and frequent computer use were found to be significantly associated with work-related musculoskeletal symptoms.

Prevalence and Factors Associated with Diabetic Retinopathy among Adult Diabetes Patients in Southeast Ethiopia: A Hospital-Based Cross-Sectional Study

BACKGROUND

Diabetic retinopathy (DR) is the most prevalent microvascular consequence of diabetes mellitus, and it can result in blindness that is irreversible. Due to delayed diagnosis and limited access to diabetic care, the situation is even worse in developing countries. Scientific evidence on the prevalence of DR and its associated factors among diabetes patients in low-income countries, such as Ethiopia, is limited. This study aimed to determine the prevalence of DR and associated factors among adult diabetes patients in southeast Ethiopia.

METHODS

A hospital-based cross-sectional study was conducted among diabetes patients who visited Madda Walabu University Goba Referral Hospital. Fundus and slit-lamp examination were performed for screening of DR. Multivariate binary logistic regression was computed to identify factors associated with DR.

RESULTS

A total of 256 patients (144 men, 56.2%) aged 50.15±15.71 years were included in the study. The prevalence of any DR was 19.9% (95% CI 15.4%-25.3%), mild nonproliferative diabetic retinopathy (NPDR) 10.9% (95% CI 7.6%-15.4%), moderate NPDR 5.9% (95% CI 3.5%-9.5%), severe NPDR 0.9% (95% CI 0.2%-3.9%), and proliferative DR 2.3% (95% CI 1.0%-5.1%). Duration of diabetes ≥10 years (AOR 10.22, 95% CI 1.70-61.44), central obesity (AOR 5.42, 95% CI 1.38-21.19), overweight/obese (AOR 2.65, 95% CI 1.02-6.92), lower high-density lipoprotein (HDL) cholesterol (AOR 5.82, 95% CI 1.86-18.24), moderate triglyceride:HDL cholesterol ratio (AOR 4.13, 95% CI 1.13-15.15), and urban dwelling (AOR 2.84, 95% CI 1.04-7.78) were significantly associated with DR.

CONCLUSION

One in every five DM patients had DR. Sociodemographic, anthropometric, and blood lipids were independently associated with DR. To reduce the burden of diabetes, strategies that focus on lifestyle modifications targeted at identified modifiable risk factors are essential.

Association between water, sanitation and hygiene (WASH) and child undernutrition in Ethiopia: a hierarchical approach

Background

Undernutrition is a significant public health challenge and one of the leading causes of child mortality in a wide range of developing countries, including Ethiopia. Poor access to water, sanitation, and hygiene (WASH) facilities commonly contributes to child growth failure. There is a paucity of information on the interrelationship between WASH and child undernutrition (stunting and wasting). This study aimed to assess the association between WASH and undernutrition among under-five-year-old children in Ethiopia.

Methods

A secondary data analysis was undertaken based on the Ethiopian Demographic and Health Surveys (EDHS) conducted from 2000 to 2016. A total of 33,763 recent live births extracted from the EDHS reports were included in the current analysis. Multilevel logistic regression models were used to investigate the association between WASH and child undernutrition. Relevant factors from EDHS data were identified after extensive literature review.

Results

The overall prevalences of stunting and wasting were 47.29% [95% CI: (46.75, 47.82%)] and 10.98% [95% CI: (10.65, 11.32%)], respectively. Children from households having unimproved toilet facilities [AOR: 1.20, 95% CI: (1.05,1.39)], practicing open defecation [AOR: 1.29, 95% CI: (1.11,1.51)], and living in households with dirt floors [AOR: 1.32, 95% CI: (1.12,1.57)] were associated with higher odds of being stunted. Children from households having unimproved drinking water sources were significantly less likely to be wasted [AOR: 0.85, 95% CI: (0.76,0.95)] and stunted [AOR: 0.91, 95% CI: (0.83, 0.99)]. We found no statistical differences between improved sanitation, safe disposal of a child’s stool, or improved household flooring and child wasting.

Conclusion

The present study confirms that the quality of access to sanitation and housing conditions affects child linear growth indicators. Besides, household sources of drinking water did not predict the occurrence of either wasting or stunting. Further longitudinal and interventional studies are needed to determine whether individual and joint access to WASH facilities was strongly associated with child stunting and wasting.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-022-14309-z.

Prevalences of diabetic foot ulcer and foot self-care practice, and associated factors in adult patients with diabetes in south-east Ethiopia

OBJECTIVE

We aimed to assess the prevalences of foot ulcer and foot self-care practices, and identify associated factors in adult patients with diabetes attending a referral hospital in south-east Ethiopia.

METHODS

We performed a cross-sectional study of 267 diabetic patients. Multivariable binary logistic regression was used to identify factors associated with diabetic foot ulcer and foot self-care practice.

RESULTS

The prevalence of diabetic foot ulcer was 11.2% (95% confidence interval [CI] 7.42-15.05). One hundred and forty-four (53.9%; 47.9, 59.9) patients demonstrated good foot self-care. Living rurally (adjusted odds ratio 2.27; 95% CI: 1.86-6.97), lack of regular exercise (3.91; 1.51-10.10), peripheral neuropathy (2.77; 1.05-7.33) and foot calluses (5.69; 1.74-18.59) were associated with diabetic foot ulcer. Urban inhabitants (2.01; 1.09-3.69), patients with diabetes for >10 years (2.92; 1.48-5.77), women (2.95; 1.66-5.22), and patients with a glucometer at home (2.05; 1.09-3.85) were more likely to have good foot self-care practice.

CONCLUSION

The prevalence of diabetic foot ulcer was 11.2%. This prevalence is lower than those identified in other Ethiopian studies. However, patient awareness regarding foot self-care practice and risk reduction should be improved.

Incidence and risk factors of gestational diabetes mellitus in Goba town, Southeast Ethiopia: a prospective cohort study

OBJECTIVE

Gestational diabetes mellitus (GDM) is becoming a public health concern in low/middle-income countries, and is known to cause severe morbidity and mortality for mothers and newborns. However, evidence reported for the incidence and risk factors of GDM is scant in Ethiopia. We aimed to assess the incidence of, and risk factors for, GDM in Goba town, Southeast Ethiopia.

DESIGN

Prospective cohort study.

SETTING

Goba town, Southeast Ethiopia.

PARTICIPANTS

Four hundred eighty pregnant women on antenatal care follow-up from 30 April to 30 September 2021.

PRIMARY AND SECONDARY OUTCOMES

Incidence and risk factors of GDM using fasting capillary blood glucose. Log-binomial model was used to identify the risk factors of GDM. Adjusted relative risk (aRR), along with 95% CIs, were calculated to estimate the strength of associations.

RESULTS

The cumulative incidence rate of GDM in this study was 15.7% (95% CI: 12.3% to 19.2%). Being unemployed (aRR=2.73; 95% CI: 1.36 to 5.47), having a family history of diabetes mellitus (DM) (3.01; 2.09 to 4.35), low physical activity (2.43; 1.11 to 5.32), inadequate dietary diversity (1.48; 1.29 to 1.92), anaemia (2.51; 1.32 to 3.54) and antenatal depression (4.95; 3.35 to 7.31) were significantly associated with GDM.

CONCLUSION

The cumulative incidence of GDM was relatively high among the study participants. Having antenatal depression symptoms, low physical activity, inadequate dietary diversity, being unemployed, anaemia and a family history of DM were significant risk factors for GDM.

Geographical variation and correlates of substance use among married men in Ethiopia: spatial and multilevel analysis from Ethiopian Demographic and Health Survey 2016

OBJECTIVE

The use of substances has become one of the world's most serious public health and socioeconomic issues. Most nations in sub-Saharan Africa, including Ethiopia, are undergoing significant economic transitions, creating a favourable environment for socially destructive substance use. This study aimed to determine the geographical variation, prevalence and correlates of substance use among ever-married men in Ethiopia.

DESIGN

A community-based cross-sectional survey was undertaken from 18 January 2016 to 27 June 2016.

DATA SOURCE

Data were used from the 2016 Ethiopian Demographic and Health Survey (EDHS).

DATA EXTRACTION AND ANALYSIS

Data from the 2016 EDHS was used, and a total of 7793 ever-married men were involved in the analysis. The spatial autocorrelation statistic (Global Moran's I) was used to determine whether substance use was dispersed, clustered or randomly distributed. A multilevel logistic regression model was used to identify the correlates with substance use, and statistical significance was declared at p<0.05 and 95% CI.

RESULTS

Of all ever-married men, 72.5% (95% CI 71.5% to 73.4%) were currently using at least one of the three substances (alcohol, cigarettes and chat). The highest hotspot areas of substance use were observed in Ahmara and Tigray regions. The age (adjusted OR, AOR 1.80; 95% CI 1.32 to 2.45), educational status (AOR 0.64; 95% CI 0.51 to 0.82), occupation (AOR 1.36; 95% CI 1.05 to 1.76), watching television (AOR 1.50; 95% CI 1.25 to 1.81) and living in the city (AOR 2.25; 95% CI to 1.36 to 3.74) were individual and community-level correlates found to have a statistically significant association with substance use.

CONCLUSION

In this study, nearly three-fourths of married men used one of the three substances. Given these findings, it is critical to reducing the problem by improving modifiable individual-level variables such as educational status and reducing substance advertising.

Prevalence of depression and associated factors among people living with HIV/AIDS in public hospitals of Southeast Ethiopia

BACKGROUND

Depression is the most frequent mental health condition among human immune deficiency virus or acquired immune deficiency syndrome (HIV/AIDS) patients. It has been related to negative health outcomes. This could lead to hospitalization and an increase in medical expenses. This study aimed to assess the prevalence of depression and associated factors among HIV/AIDS patients in public hospitals Bale Zone, Southeast Ethiopia.

METHODS

A hospital-based cross-sectional study design was randomly employed among 554 study participants. A systematic random sampling technique was used to select the study subjects. A structured Patients Health Questionnaires- 9 was used to measure the depression status of HIV/AIDS patients. Data were collected using a pretested interviewer administered structured questionnaire as well as review of patients medical charts or records. Descriptive statistics were computed. Multivariable logistic regression analyses were conducted identify factors associated with the prevalence of depression. Adjusted odds ratio (AOR), along with a 95% confidence interval (CI), was used to estimate the strength of the association. A p-value of < 0.05 was considered statistically significant.

RESULTS

The prevalence of depression among the study participants was found to be 44.9% (95% CI: 40.79%, 49.1%). Perceived HIV related stigma is the single most dominant predictor of depression [(AOR = 8.2, 95% CI: (4.96, 13.68)], low income level [(AOR = 3.1, 95% CI: (1.59, 6.22)] Experiencing any form of a side effect of highly active anti-retroviral therapy (HAART) [(AOR = 1.5, 95% CI: (1.04, 2.56)], having normal BMI [(AOR = 0.49, 95% CI: (0.29, 0.8)] being HIV patients at WHO clinical stage II [(AOR = 0.44, 95% CI: (0.22, 0.9)], were significantly associated with prevalence of depression.

CONCLUSION

The study revealed that the prevalence of depression among people living with HIV in the study settings was high, almost two out of every five HIV patients were depressed. Low income level, side effect to HAART, and having HIV related stigma were more likely to suffer from depression.

Prevalence of visual impairment due to refractive error among children and adolescents in Ethiopia: A systematic review and meta-analysis

Introduction

Globally, the prevalence of refractive error was 12%, and visual impairment due to refractive error was 2.1%. In sub-Saharan Africa, the prevalence of refractive error and visual impairment due to refractive error was 12.6% and 3.4%, respectively. In Ethiopia, the prevalence of visual impairment due to refractive error varies from 2.5% in the Gurage zone to 12.3% in Hawassa city. Hence, this Meta-analysis aimed to summarize the pooled prevalence of visual impairment due to refractive error in Ethiopia.

Methods

A systematic search of the literature was conducted by the authors to identify all relevant primary studies. All articles on the prevalence of visual impairment due to refractive error in Ethiopia were identified through a literature search. The databases used to search for studies were PubMed, Science Direct, POPLINE, HENARI, Google Scholar, and grey literature was searched on Google until December 15, 2021. In this meta-analysis, the presence of publication bias was evaluated using funnel plots and Begg’s tests at a significance level of less than 0.05. The sensitivity analysis was conducted to check for a single study’s effect on the overall prevalence of refractive error.

Result

About 1664 studies were retrieved from initial electronic searches using international databases and google searches. A total number of 20,088 children and adolescents were included in this meta-analysis. The pooled prevalence of visual impairment due to refractive error in Ethiopia using the random effects model was estimated to be 6% (95% CI, 5–7) with a significant level of heterogeneity (I² = 94.4%; p < 0.001). The pooled prevalence of visual impairment due to refractive was analyzed by subtypes, and pooled prevalence was estimated to be 4%, 5.2%, and 1% for myopia, hyperopia, and astigmatism, respectively.

Conclusion

The pooled prevalence of visual impairment due to refractive error was high in Ethiopia. About one in twenty-five Ethiopian children and adolescents are affected by visual impairment due to myopia.

Prevalence of central obesity and its associated risk factors among adults in Southeast Ethiopia: A community-based cross-sectional study

Background

Obesity and overweight are known public health problems that affect populations across the world. These conditions have been associated with a wide range of chronic diseases including type 2 diabetes mellitus, cardiovascular disease, and cancers. In Ethiopia, the literature regarding the burden of central (abdominal) obesity is scarce. This study aimed to fill this gap by assessing the prevalence and risk factors associated with central obesity among adults in Ethiopia.

Methods

From May to July 2021, a community-based cross-sectional survey was conducted on a sample of 694 adults aged ≥18 years in administrative towns of Bale zone, Southeast Ethiopia. Multi-stage sampling followed by systematic random sampling was employed to identify study participants. Waist and hip circumferences were measured using standard protocols. The World Health Organization STEPS wise tool was used to assess risk factors associated with central obesity. Bi-variable and multi-variable binary logistic regression were used to identify factors associated with central obesity. Adjusted odds ratios (AOR) and their corresponding 95% confidence intervals (CI) have been reported to estimate the strength of associations.

Results

The overall prevalence of central obesity using waist circumference was 39.01% [(95% CI: 35.36–42.76; 15.44% for men and 53.12% for women)]. Multi-variable binary logistic regression analysis revealed that female sex (AOR = 12.93, 95% CI: 6.74–24.79), Age groups: 30–39 years old (AOR = 2.8, 95% CI: 1.59–4.94), 40–49 years (AOR = 7.66, 95% CI: 3.87–15.15), 50–59 years (AOR = 4.65, 95% CI: 2.19–9.89), ≥60 years (AOR = 12.67, 95% CI: 5.46–29.39), occupational status like: housewives (AOR = 5.21, 95% CI: 1.85–14.62), self-employed workers (AOR = 4.63, 95% CI: 1.62–13.24), government/private/non-government employees (AOR = 4.68, 95% CI: 1.47–14.88), and skipping breakfast (AOR = 0.46, 95% CI: 0.23–0.9) were significantly associated with central obesity.

Conclusions

Abdominal obesity has become an epidemic in Bale Zone’s towns in Southeastern Ethiopia. Female sex, age, being employed were positively associated with central obesity, while skipping breakfast was a protective factor.

Earning pocket money and girls' menstrual hygiene management in Ethiopia: a systematic review and meta-analysis

BACKGROUND

Many adolescent girls in Ethiopia and elsewhere missed school during their monthly cycles due to a lack of affordable menstrual absorbent materials or money to buy sanitary pads. So far, few studies have looked into the relationship between earning pocket money and maintaining good menstrual hygiene. Hence, this systematic review and meta-analysis aimed to synthesize the best available evidence regarding the association between earning pocket money and menstrual hygiene management among adolescents in Ethiopia.

METHODS

We systematically searched PubMed, Hinari, Science Direct, Cochrane Library, ProQuest, POPLINE, African Journal Online, Direct of Open Access Journals, and Google Scholar for studies examining the association between earning pocket money and menstrual hygiene management among adolescent girls in Ethiopia, without restriction in a publication year. The Joanna Briggs Institute quality assessment tool for the cross-sectional studies was used to assess the quality of included studies. A prefabricated checklist, including variables: first author, publication year, sample size, type of questionnaire, and the region was used to extract data from the selected articles. A random-effect meta-analysis model was used to estimate the pooled odds ratio (OR) of the association between earning pocket money and menstrual hygiene management. The heterogeneity and publication bias was assessed by using I² test statistics and Egger's test, respectively.

RESULTS

Data from nine studies involving 4783 adolescent girls were extracted. The meta-analysis revealed that adolescent girls who earned pocket money from their parents or relative had 1.64 times higher odds of having good menstrual hygiene management than their counterparts [pooled OR = 1.64, 95% CI: 1.16-2.34, I²:66.7%, n = 7 (number of studies)]. Similarly, the likelihood of having good menstrual hygiene management was lower by 49% among adolescent girls who did not receive any pocket money from their parents compared to their counterparts (pooled OR = 0.51, 95% CI: 0.35-0.74, I²:48.4%, n = 2).

CONCLUSIONS

The findings revealed that adolescent girls who earned pocket money were more likely to practice good menstrual hygiene management. Progress toward better menstrual hygiene will necessitate consideration of this factor.

Food hygiene practices and determinants among food handlers in Ethiopia: a systematic review and meta-analysis

Background

Food-borne diseases are a major public health concern worldwide, particularly in low and middle-income countries (LMICs), such as Ethiopia. Poor food hygiene practices primarily exacerbate food-borne illness transmission. Prior studies on the food hygiene practices among food handlers in Ethiopia were inconsistent. Therefore, this meta-analysis and systematic review aimed to estimate the pooled proportion of good food hygiene practices and identify the determinants in Ethiopia.

Methods

The preferred reporting items for systematic review and meta-analysis (PRISMA) instruments were used, and a systematic search was performed in the PubMed/MEDLINE, POPLINE, HINARI, Science Direct, Cochrane Library databases, and Google Scholar were systematically last searched on the 24th February 2022 for relevant articles. Only the observational studies that reported the proportion of good food hygiene practices and their associated factors among food handlers were included. The quality of the included studies was assessed by two independent authors. Articles with unclear methodologies and did not report the overall proportions of good food hygiene practice were excluded. The effect estimates for pooled proportion and pooled odds ratio (POR) along with a 95% confidence interval (CI) were determined conducting using DerSimonian–Laird's random effect model.

Results

Among 817 retrieved studies, 23 eligible articles with a total sample size of 7153 study participants were included in the meta-analysis. The pooled proportion of good food hygiene practices among food handlers was 50.5% [95% CI: (41.6, 59.4%]; I² = 98.7%, p value = 0.001]. Food handlers with formal education (POR = 4.60, 95% CI: 3.05, 6.93), good knowledge (POR = 1.98, 95% CI: 1.26, 3.11), training (POR = 3.52, 95% CI: 2.35, 5.28), and a positive attitude (POR = 3.41, 95% CI: 2.52, 4.61) about food hygiene components, as well as regular medical checkups (POR = 6.75, 95% CI: 4.49) were significantly associated with good food hygiene practice.

Conclusions

Only half of Ethiopia's food handlers had good food hygiene practice.

Implication of the study

The key elements of effective food hygiene practice that will aid in the development of feasible interventions to increase food handler compliance with food hygiene components have been identified.

Supplementary Information

The online version contains supplementary material available at 10.1186/s41182-022-00423-6.

Individual and community-level determinants of underweight among lactating mothers in Ethiopia: A multilevel analysis

Background

Determining the nutritional status of lactating women is important because underweight lactating mothers will have low energy levels and reduced cognitive abilities, which will affect the inadequate care of their young children. Thus, malnutrition is passed down from generation to generation, perpetuating the vicious cycle. There is scarce national data on determinants of underweight among lactating mothers in Ethiopia. Hence, this study aimed to identify individual and community-level determinants of underweight among lactating mothers in Ethiopia.

Methods

Data from the Ethiopian Demographic and Health Survey (EDHS) from 2016 were used. A total of 3848 lactating mothers were included in this study, and a multilevel, multivariable logistic regression model was fitted to identify determinants of underweight among lactating mothers.

Results

The odds of being underweight among rural lactating mothers were 65% higher (AOR = 1.65, 95% CI = 1.13, 2.41) than lactating mothers in the urban area. The odds of being underweight among lactating mothers who have toilet facilities were 33% lower (AOR = 0.67, 95%CI = 0.54, 0.83) compared with those do not have toilet facilities. Those mothers in the age group of 25–34 years and greater than 35 years had (AOR = 0.61,95%CI = 0.48, 0.79), and (AOR = 0.66, 95%CI = 0.47, 0.95) times lower chance of being underweight compared with those who had 15–24 years of age, respectively. The likelihood of being underweight among lactating mothers in high community poverty (AOR = 1.40, 95%CI = 1.08, 1.82) was higher than the lower community poverty level.

Conclusion

Underweight among lactating mothers was significantly associated with individual-level (age and toilet facilities) variables and community-level (residence and community poverty). Therefore, focusing on these identified factors could improve underweight among lactating mothers in Ethiopia.

Utilization of provider-initiated HIV testing and counselling in Ethiopia: a systematic review and meta-analysis

Background

Provider-initiated HIV testing, and counseling (PITC) is a service in which health professionals provide HIV testing to all patients in health facilities. Provider-initiated HIV testing, and counseling is an important opportunity for early screening of individuals, and it is fundamental for both HIV treatment and prevention. Although there are studies conducted in different parts of Ethiopia, their findings are variable. Therefore, this systematic review and meta-analysis aimed to summarize the pooled utilization of PITC in Ethiopia.

Method

All studies conducted on utilization of provider-initiated HIV testing and counseling at outpatient departments (OPD), inpatient departments (IPD), antenatal clinic care (ANC), and tuberculosis (TB) clinics in Ethiopia are eligible for these meta-analyses. A systematic search of the literature was conducted by the authors to identify all relevant primary studies. The databases used to search for studies were PubMed, Science Direct, POPLINE, HENARI, Google Scholar, and Scopus. The extracted data were imported into STATA version 14 software for statistical analysis. The risk of bias was assessed using the Joana Briggs Institute (JBI) criteria for prevalence studies. The heterogeneity among all included studies was assessed by I² statistics and the Cochran’s Q test. Pooled utilization along with its corresponding 95% CI was presented using a forest plot.

Result

About 1738 studies were retrieved from initial electronic searches using international databases and Google, and a total of 10,676 individual clients were included in the meta-analysis. The pooled utilization of PITC in Ethiopia using the random effects model was estimated to be 78.9% (95% CI 73.87–83.85) with a significant level of heterogeneity (I² = 98.5%; P < 0.001). Subgroup analysis conducted on PITC showed the highest percentage among studies conducted in Addis Ababa (93.5%), while lower utilization was identified from a study conducted in the Tigray Region (35%).

Limitation of the study

The drawbacks of this review and meta-analysis were being reported with significant heterogeneity, and the protocol was not registered.

Conclusion

About 21% of health facility clients missed opportunities for PITC in Ethiopia.

Supplementary Information

The online version contains supplementary material available at 10.1186/s41182-022-00420-9.

COVID-19-related anxiety and knowledge toward its preventive measures among patients with chronic medical illness on follow-up in public hospitals of Bale, East Bale, and West Arsi zones, Ethiopia

Background

Coronavirus disease 2019, also known as 2019-nCoV cluster of acute respiratory illness with unknown causes, which occurred in Wuhan, Hubei Province, in China, was first reported to World Health Organization country office as of December 30, 2019. People with medical illness are at a higher risk for coronavirus disease, and the pandemic influences mental health and causes psychological problems, particularly in those with chronic medical illness. Hence, this study aimed to assess coronavirus disease 2019-related anxiety and the knowledge on its preventive measures among patients with medical illness on follow-up in public hospitals of Bale, East Bale, and Arsi zones.

Objective

To assess coronavirus disease 2019-related anxiety and knowledge toward coronavirus disease 2019 preventive measures among patients with chronic medical illness on follow-up in public hospitals of Bale, East Bale, and West Arsi zones.

Methods

A hospital-based cross-sectional study was conducted in selected hospitals of Bale and West Arsi zones, Southeast Ethiopia. A total of 633 study participants were included in this study, and data were collected through an interviewer-administered questionnaire. A descriptive summary was computed. Bivariable and multivariable logistic regression analyses were carried out to identify the associated factors.

Results

Overall, the prevalence of anxiety among chronic patients in this study was 6.3% (95% confidence interval: 4.6%-8.5%) and 420 (66.35%) had good knowledge on the preventive measures of coronavirus disease 2019. Factors significantly associated with anxiety among chronic patients were being educated (95% confidence interval: adjusted odds ratio = 0.26 (0.09-0.74)), being male (95% confidence interval: 2.69 (1.11-6.53)), and use of mask (95% confidence interval: 0.11 (0.05-0.26)).

Conclusion

The prevalence of coronavirus disease 2019-related anxiety among chronic patients was high and being males, uneducated, and not using face mask was significantly associated with coronavirus disease 2019-related anxiety.

Antiretroviral Treatment Adherence Level and Associated Factors Among Adult HIV-Positive Patients on Both HIV/AIDS Care Models: Comparative Study in Selected Hospitals of Western Ethiopia, 2019

Background

Many studies investigating antiretroviral treatment (ART) adherence found the majority of patients had suboptimal adherence for a variety of different reasons. The study aimed to compare the ART adherence level and associated factors among adult human immune deficiency virus (HIV) positive patients on both care models in selected hospitals.

Methods

An institution-based comparative cross-sectional study was conducted among 463 HIV positive patients on ART. The study samples were selected using systematic random sampling, and pretested semi-structured interviewer administered questionnaire was used to collect data. Binary and multivariable logistic regression analyses were used to see the association between outcome and predictors using odds ratio with a 95% confidence interval to estimate the strength of the association.

Results

The study had a response rate of 445 (96.1%). Of the study participants, 325 (73%) and 120 (27%) were from the routine and appointment spacing models, respectively. Patients on the appointment spacing model had higher levels of optimum adherence (87.5% vs 74.27%, respectively; p = 0.006). Patients’ satisfaction with health service delivery (OR = 0.31, 95%: CI 0.11–0.84), antiretroviral drug dosage taken per day (OR = 3, 95%: CI 1.16–8.1), disclosure of HIV status (OR = 0.30, 95%: CI 0.09–0.93), distance from patient residency to health facility (OR = 0.11, 95%: CI 0.03–0.34), the memory aids used (OR = 0.02, 95%: CI 0.01–0.05), and type of HIV/AIDS care model (OR= 0.24, 95%: CI 0.1–0.6) were factors significantly associated with ART adherence level.

Conclusion

ART patients on the appointment spacing model had higher optimum ART adherence levels than those on the routine schedule due to factors like satisfaction status, disclosure status, type of memory aid used, type of ART care model used, and distance from the care facility. Therefore, promoting adherence enablers and alleviating barriers of ART adherence will improve ART adherence levels.

The Role of Household Flooring on Childhood Diarrhea Among Children 0 to 23 Months of Age in Ethiopia: A Nationally Representative Cross-Sectional Study Using a Multi-Level Mixed Effect Analysis

INTRODUCTION

Household flooring has been associated with diarrhea, but few studies have examined the association between childhood diarrhea and type of household flooring considering the individual and community level characteristics. We aimed to determine if household flooring was associated with childhood diarrhea among children 0 to 23 months of age in Ethiopia.

METHODS

Data from the fourth round of the Ethiopian Demographic and Health Survey (EDHS) conducted in 2016 is used to carry out the analysis. The EDHS was large, cross-sectional by design and nationally representative. In the current analysis, we included children 0 to 23 months of age (n = 4552) with their mother and 636 community clusters. To get information about the occurrence of diarrhea, mothers/caregivers were asked, "Has (NAME) had diarrhea in the last 2 weeks?" The response to this question was recorded as, "yes" or "no." A multilevel binary logistic regression model was fitted to identify factors associated with childhood diarrhea.

RESULTS

The overall prevalence of diarrhea among children 0 to 23 months of age in Ethiopia was 15.5% (95% CI [confidence interval] 14.4-16.5). No association was found between childhood diarrhea and type of household flooring (adjusted odds ratio [AOR] 1.05, 95% CI 0.59-1.88). The adjusted odds also showed that the age of the child, having an acute respiratory infection (ARI), and size of the child at birth were associated with diarrhea.

CONCLUSION

We found no association between childhood diarrhea and the type of household flooring. Further research with strong research design is needed to determine the effect of household flooring on childhood diarrhea.

Trends of unsuccessful treatment outcomes and associated factors among tuberculosis patients in public hospitals of Bale Zone, Southeast Ethiopia: A 5-year retrospective study

INTRODUCTION

Tuberculosis (TB) is a curable disease caused by the tubercle bacillus and its treatment is designed to cure, interrupt transmission, and prevent drug resistance. These aims have not yet been achieved in many regions of the world, particularly in developing countries like Ethiopia. Thus, this study was designed to assess the trends of unsuccessful treatment outcomes and associated factors among patients with TB in two public hospitals in the Bale zone, southeast Ethiopia.

METHODS

A 5-year retrospective data among 1281 patients with TB who registered and started treatment (from July 2013 to June 2018/19) in two selected Bale zone hospitals was retrieved. Together with descriptive statistics, binomial and multinomial logistic regression modeling were carried out using STATA version 14 to estimate the odds ratio.

RESULTS

The overall unsuccessful TB treatment outcomes in this study was 10.4% and moderately decreased over the year of treatment (from 14.1% to 8.4%, x2 = 7.35, and p = 0.011). Approximately 34 (7.6%) of pulmonary positive and 34 (7.4%) of pulmonary negative TB patients had experienced treatment failure and death, respectively. The level of the hospital, patients with smear-negative and extrapulmonary, transferred in, aged, and human immunodeficiency virus status were found to have a statistically significant association with unsuccessful treatment outcomes of patients with TB.

CONCLUSION

In this study, approximately one-tenth of patients with TB had unsuccessful treatment outcomes that moderately declined over the year of treatment. Strengthening control efforts like counseling during the intensive and continual phases of treatment and scheduling home visits is recommended.

Geographical variation and factors associated with unsafe child stool disposal in Ethiopia: A spatial and multilevel analysis

Background

Unsafe disposal of children’s stool makes children susceptible to fecal-oral diseases and children remain vulnerable till the stools of all children are disposed of safely. There is a paucity of data on spatial distribution and factors associated with unsafe child stool disposal in Ethiopia. Previous estimates, however, do not include information regarding individual and community-level factors associated with unsafe child stool disposal. Hence, the current study aimed (i) to explore the spatial distribution and (ii) to identify factors associated with unsafe child stool disposal in Ethiopia.

Methods

A secondary data analysis was conducted using the recent 2016 Ethiopian demographic and health survey data. A total of 4145 children aged 0–23 months with their mother were included in this analysis. The Getis-Ord spatial statistical tool was used to identify high and low hotspots areas of unsafe child stool disposal. The Bernoulli model was applied using Kilduff SaTScan version 9.6 software to identify significant spatial clusters. A multilevel multivariable logistic regression model was fitted to identify factors associated with unsafe child stool disposal.

Results

Unsafe child stool disposal was spatially clustered in Ethiopia (Moran’s Index = 0.211, p-value< 0.0001), and significant spatial SaTScan clusters of areas with a high rate of unsafe child stool disposal were detected. The most likely primary SaTScan cluster was detected in Tigray, Amhara, Afar (north), and Benishangul-Gumuz (north) regions (LLR: 41.62, p<0.0001). Unsafe child stool disposal is more prevalent among households that had unimproved toilet facility (AOR = 1.54, 95%CI: 1.17–2.02) and those with high community poorer level (AOR: 1.74, 95%CI: 1.23–2.46). Higher prevalence of unsafe child stool disposal was also found in households with poor wealth quintiles. Children belong to agrarian regions (AOR: 0.62, 95%CI 0.42–0.91), children 6–11 months of age (AOR: 0.65, 95%CI: 0.52–0.83), 12–17 months of age (AOR: 0.68, 95%CI: 0.54–0.86), and 18–23 months of age (AOR: 0.58, 95%CI: 0.45–0.75) had lower odds of unsafe child stool disposal.

Conclusions

Unsafe child stool disposal was spatially clustered. Higher odds of unsafe child stool disposal were found in households with high community poverty level, poor, unimproved toilet facility, and with the youngest children. Hence, the health authorities could tailor effective child stool management programs to mitigate the inequalities identified in this study. It is also better to consider child stool management intervention in existing sanitation activities considering the identified factors.

Determinants of Incomplete Vaccination Among Children Aged 12 to 23 Months in Gindhir District, Southeastern Ethiopia: Unmatched Case-Control Study

Background

Incomplete vaccination can put children at greater risk of acquiring vaccine-preventable diseases. In Ethiopia, vaccination coverage against vaccine-preventable diseases is still a significant and persistent public health challenge. Thus, the aim of this study was to identify the determinants of incomplete childhood vaccination among children aged 12-23 months in Gindhir District, Southeast Ethiopia.

Methods

A community-based unmatched case-control design was employed among children aged 12-23 months from 1 to 28 February 2020. A total of 254 cases and 508 controls were included using the stratified random sampling technique. Cases included children aged 12-23 months who missed at least one dose of the routine vaccination, and controls were the children with complete vaccination with all required doses. Binary logistic regression analyses were used to identify the independent factors for children's incomplete vaccination status.

Results

Of all assessed determinants, maternal knowledge about vaccination (AOR=0.50, 95% CI: 0.31, 0.80), educational status (AOR=2.61, 95% CI: 1.19, 5.67), average monthly income (AOR=0.33, 95% CI: 0.15, 0.77), model family (AOR = 2.50, 95% CI: 1.51, 4.14), taking TT vaccine (AOR= 0.45 95% CI: 0.29, 0.78), number of under five children (AOR= 4.90 95% CI: 1.72, 13.93) and birth order (AOR= 6.33, 95% CI: 1.89, 14.87) were found to have statistically significant association with childhood incomplete vaccination.

Conclusion

In this study, the mother's education, model family, birth order, average monthly income, and knowledge were some of the independent determinants of incomplete childhood vaccination. Improving maternal knowledge, income, and educational status should be the expectable measure to reduce incomplete vaccination.

Compliance towards infection prevention measures among health professionals in public hospitals, southeast Ethiopia: a cross-sectional study with implications of COVID-19 prevention

INTRODUCTION

The new coronavirus disease 2019 is an emerging respiratory disease caused by the highly contagious novel coronavirus which has currently overwhelmed the world. Realizing a comprehensive set of infection prevention measures is a key to minimize the spread of this virus and its impacts in all healthcare settings. Therefore, this study was aimed to assess the compliance towards COVID-19 preventive measures and associated factors among health professionals in selected public hospitals, southeast Ethiopia.

METHODS

A descriptive hospital-based cross-sectional study was conducted among 660 health professionals in public hospitals of southeast Ethiopia from October 1 to 31, 2020. A multistage sampling technique was used to select the study participants. Data were collected by interview using structured and pretested questionnaires. Ordinary logistic regression modeling was used to estimate the crude and adjusted odds ratio. To declare the statistical significance of factors associated with the outcome variable, P-value < 0.05 and 95% confidence interval were used.

RESULTS

A total of 654 health professionals were involved in the study; of whom, 313 participants were nurses. The overall good compliance and knowledge of health professionals regarding COVID-19 preventive measures were 21.6 and 25.5%, respectively. Working in the general hospital (AOR = 0.55; 95% CI 0.38, 0.79), service year (AOR = 2.10; 95% CI 1.35, 3.21), knowledge (AOR = 1.80; 95% CI 1.14, 2.89), and water availability (AOR = 3.26; 95% CI 2.25, 4.72) were some of the factors found to have a statistically significant association to compliance of health professionals regarding COVID-19 preventive measures.

CONCLUSION

In this study, nearly one fifth of health professionals had good compliance towards COVID-19 prevention practices. Thus, a consistent supply of COVID-19 prevention materials, facilities, and improving the knowledge of health professionals through on and off-job training are crucial.

A Multilevel Analysis of Factors Associated with Childhood Diarrhea in Ethiopia

BACKGROUND

Childhood diarrhea is the major contributor to the deaths of children under the age of 5 years in Ethiopia, but evidence at the national level to identify the contributing factors associated with diarrhea by considering the clustering effects is limited. Hence, this study aimed to identify factors associated with childhood diarrhea at the individual and community levels.

METHODS

A secondary data analysis was conducted using the 2011 and 2016 Ethiopian Demographic and Health Survey (EDHS) data. A total of 23 321 children with their mothers were included in this study, and multilevel logistic regression models were applied for the data analysis.

RESULTS

The odds of diarrhea among female children were 13% lower (AOR = 0.87; 95% CI: 0.79-0.94) compared with male children. The odds of diarrhea among children aged between 13 and 24 months were 31% higher than (AOR = 1.31; 95% CI: 1.17-1.47) their younger counter parts. Children aged ⩾25 months (AOR = 0.50; 95% CI: 0.45-0.56), those whose mothers were unemployed (AOR = 0.79; 95% CI: 0.73-0.87), and children live in households between 2 and 3 under-5 children (AOR = 0.87; 95% CI: 0.79-0.96) were associated with lower odds of experiencing diarrhea. The odds of diarrhea among children whose mother had no formal education were 49% higher than (AOR = 1.49; 95% CI: 1.08-2.07) their counterparts. Besides, children residing in city administrations (AOR = 0.69; 95% CI: 0.58-0.82) had lower odds of experiencing diarrhea than children living in agrarian regions.

CONCLUSIONS

At the individual level (sex and age of the child, mother's employment status, and educational level, and the number of under-5 children) and the community-level (contextual region) were found to be significant factors associated with childhood diarrhea in Ethiopia.

Utilization of Health Facility-Based Delivery Service Among Mothers in Gindhir District, Southeast Ethiopia: A Community-Based Cross-Sectional Study

Facility-based delivery service is recognized as intermediation to reduce complications during delivery. Current struggles to reduce maternal mortality in low-and-middle income countries, including Ethiopia, primarily focus on deploying skilled birth attendants and upgrading emergency obstetric care services. This study was designed to assess utilization of health facility-based delivery service and associated factors among mothers who gave birth in the past 2 years in Gindhir District, Southeast Ethiopia. A community-based cross-sectional study design was conducted in Gindhir District from March 1 to 30, 2020, among 736 randomly selected mothers who gave birth in the past 2 years. A multistage sampling technique was used to select the study participants and a pretested, structured questionnaire was used to collect data through face-to-face interviews. The collected data were managed and analyzed using SPSS version 23. Of the 736 mothers interviewed, 609 (82.7%), 95% CI: 80.1, 85.5%, of them used health facilities to give birth in the past 2 years for their last delivery. Mothers who lived in rural areas had 4 or more ANC visits, received 3 or more doses of the TT vaccine, and had good knowledge of maternal health services were found to have a statistically significant association with facility-based delivery service utilization. In Gindhir District, mothers have been using health facility-based delivery services at a high rate for the past 2 years. Higher ANC visits and TT vaccine doses, as well as knowledge of maternal health services and being a rural resident, were all linked to using health facility-based delivery services. As a result, unrestricted assistance must be provided to mothers who have had fewer ANC visits and have poor knowledge on maternal health services.

Incidence and risk factors for hospital-acquired infection among paediatric patients in a teaching hospital: a prospective study in southeast Ethiopia

OBJECTIVES

In order to maximise the prevention of hospital-acquired infections (HAIs) and antimicrobial resistance, data on the incidence of HAIs are crucial. In Ethiopia, data about the occurrence of HAIs among hospitalised paediatric patients are lacking. We aim to determine the incidence and risk factors of HAIs among paediatric patients in Ethiopia.

DESIGN

A prospective cohort study.

SETTING

A teaching hospital in southeast Ethiopia.

PARTICIPANTS

448 hospitalised paediatric patients admitted between 1 November 2018 and 30 June 2019.

PRIMARY AND SECONDARY OUTCOME MEASURES

Incidence and risk factors of hospital-acquired infections.

RESULTS

A total of 448 paediatric patients were followed for 3227 patient days. The median age of the patients was 8 months (IQR: 2-26 months). The incidence rate of HAIs was 17.7 per 1000 paediatric days of follow-up; while the overall cumulative incidence was 12.7% (95% CI 9.8% to 15.8%) over 8 months. Children who stayed greater than 6 days in the hospital (median day) (adjusted risk ratio (RR): 2.58, 95% CI 1.52 to 4.38), and children with underlying disease conditions of severe acute malnutrition (adjusted RR: 2.83, 95% CI 1.61 to 4.97) had higher risks of developing HAIs.

CONCLUSIONS

The overall cumulative incidence of HAIs was about 13 per 100 admitted children. Length of stay in the hospital and underlying conditions of severe acute malnutrition were found to be important factors associated with increased risk of HAIs.

Correct Use of Facemask Among Health Professionals in the Context of Coronavirus Disease (COVID-19)

Purpose

Coronavirus disease (COVID-19) mainly spreads through respiratory droplets and close contacts. Wearing a facemask and other personal protective equipment (PPE) is essential in preventing the spread of COVID-19. However, the use of PPE alone does not provide a sufficient level of protection, and correct use and disposal are required. Hence, this study aimed to assess health professionals’ practice regarding proper use of facemask in the perspectives of COVID-19 prevention.

Methods

A web-based online survey was conducted from June 3, 2020, to August 11, 2020, to assess health professionals’ practice regarding correct use of facemask. The survey tool was prepared in Google form and distributed to the health professionals through their emails and social media pages. Data were analyzed using STATA version 14. A descriptive result was reported using frequency tables and bar charts. Factors associated with correct use of facemask were assessed using binary logistic regression model.

Results

A total of 368 health professionals have participated in this study. All of the participants’ work involves direct contact with patients and 98 (26.6%) of them work in direct contact with COVID-19 patients daily. The level of overall correct use of facemask was 10.1% (95% CI: 7.4–13.6). Two hundred fifty-five (69.3%) do not perform hand hygiene before wearing a facemask and 238 (64.7%) do not perform hand hygiene after removing the facemask. Three hundred twenty-three (87.8%) of the study participants reuse disposable facemasks. The odds of practicing correct use of facemask were more than two times higher among health professionals who received training related to personal protective equipment utilization (AOR= 2.2, 95% CI: 1.1–4.5) compared to their counterparts.

Conclusion

This study revealed that health professionals’ practice regarding the correct use of facemask in the context of COVID-19 prevention is very low. Receiving training related to proper utilization of personal protective equipment was found to favor the correct use of facemask. In this regard, health authorities should provide training to enable the rational and correct use of facemask among healthcare workers.

Which Factors Predict Hospital Length-of-Stay for Children Admitted to the Neonatal Intensive Care Unit and Pediatric Ward? A Hospital-Based Prospective Study

Background. The ability to accurately predict hospital length of stay (LOS) or time to discharge could aid in resource planning, stimulate quality improvement activities, and provide evidence for future research and medical practice. This study aimed to determine the predictive factors of time to discharge among patients admitted to the neonatal intensive care unit (NICU) and pediatric ward in Goba referral hospital, Ethiopia. Methods. A facility-based prospective follow up study was conducted for 8 months among 438 patients. Survival analyses were carried out using the Kaplan Meier statistics and Cox regression model. Results. The median length of hospital stay was 7 days (95% confidence interval (CI): 6.45-7.54) and 6 days (95% CI: 5.21-6.78) for patients admitted to NICU and pediatric ward, respectively. In the multivariable Cox regression, the hazard of neonatal patients with less than 37 weeks of gestational age, low birth weight, and those who develop hospital-acquired infection (HAI) after admission had prolonged time to discharge by 54% [adjusted hazard ratio (AHR): 0.46, (95% CI: 0.31-0.66)], 40% [AHR: 0.60, (95% CI: 0.40-0.90)], and 56% [AHR: 0.44, (95% CI: 0.26-0.74)], respectively. The rate of time to discharge among patients who were admitted to the pediatric ward and had HAI delayed discharge time by 49% [AHR: 0.51, (95% CI: 0.30-0.85)] compared to their counterparts. Conclusion. Hospital-acquired infections prolonged hospital stay among neonates and children admitted to the pediatric ward. On a similar note, low gestational age and low birth weight were found to be the independent predictor of longer hospital stay among neonates.