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Belete MB, Bitew A, Mulatu K. Viral load suppression and its predictor among HIV seropositive people who receive enhanced adherence counseling at public health institutions in Bahir Dar, Northwest Ethiopia. Retrospective follow-up study. PLoS One 2024; 19:e0303243. [PMID: 38739646 PMCID: PMC11090359 DOI: 10.1371/journal.pone.0303243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Accepted: 04/23/2024] [Indexed: 05/16/2024] Open
Abstract
BACKGROUND For those HIV seropositive people with high viral loads, the World Health Organization recommends more counseling before changing ART regimens. A high viral load can lead to increased HIV transmission and lower survival rates. Clients with viral loads above 1000 copies/mL should receive enhanced adherence counseling for 3-6 months before switching. Despite enhanced adherence counseling programs, most countries struggle with viral load suppression. Little is known about viral load suppression in Ethiopia and the research area after counseling. OBJECTIVE This study aims to assess viral load suppression and its predictors among HIV-positive individuals receiving enhanced adherence counseling in Bahir Dar, Northwest Ethiopia, in 2022. METHODS An institution-based retrospective follow-up study was conducted among randomly selected 546 clients on Enhanced Adherence Counseling at public health facilities in Bahir Dar city. The Epicollect5 mobile application was used to collect the data, which was then exported to Stata version 14 for analysis. A Log-Binomial regression model was fitted for each explanatory variable. Variables having a p-value <0.25 in bivariate analysis were entered into a multivariable Log-Binomial regression model. Finally, an adjusted risk ratio with a 95% confidence interval and a p-value <0.05 was used to measure the strength of the prediction. RESULTS Following enhanced adherence counseling, 312 (57.1%) people had their viral load suppressed. Absence of recurrent OI (ARR 1.40; CI 1.03-1.91), EAC stay less than 3 months (ARR 1.54; CI 1.19-1.99), EAC stay 3-6 months (ARR 1.38; CI 1.12-1.69), once-daily ARV dose regimen (ARR 1.28; CI 1.03-1.58), baseline viral load of 2879.00 copies/ml (ARR 1.30, CI 1.06-1.60), being orthodox Tewahido Christian (ARR 0.37; CI 0.18-0.75) were significant predictors of viral load suppression after Enhanced Adherence Counseling. CONCLUSION AND RECOMMENDATION Most importantly, this study found that most people had suppressed viral loads after receiving enhanced adherence counseling. Significant predictors of viral load suppression included recurrent OI, length of stay on EAC, daily ARV dosing regimen, baseline viral load, and religion. Clients with a high baseline viral load and those who experience recurring opportunistic infections should get extra care during EAC sessions.
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Affiliation(s)
- Minyichil Birhanu Belete
- Department of Pediatrics and Child Health Nursing, School of Health Sciences, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Abebayehu Bitew
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Kebadnew Mulatu
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
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Tefera T, Bogale KA, Tegegn Y, Azene AG, Mulatu K, Wassie GT. Determinants of podoconiosis among residents of Machakle District East Gojjam Zone Amhara Region Ethiopia. PLoS Negl Trop Dis 2023; 17:e0011686. [PMID: 37797041 PMCID: PMC10581460 DOI: 10.1371/journal.pntd.0011686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 10/17/2023] [Accepted: 09/27/2023] [Indexed: 10/07/2023] Open
Abstract
BACKGROUND Podoconiosis (endemic non-filarial elephantiasis) is a chronic disease characterized by the development of persistent swelling of plantar foot initially; which progresses to the dorsal foot and lower leg slowly or in a number of acute episodes to reach the knee. About 4 million people are said to be affected by the disease worldwide and it is deemed a serious public health problem in at least 10 African countries including Ethiopia. Therefore this study aimed to identify the determinants of podoconiosis among residence in Machakel district. METHOD Unmatched case control study design was conducted at Machakel district from August 30 to September 30, 2022. The sample size calculated using Epi-info software yielded 211 controls and 106 cases (317 study participants). Simple random sampling technique was used to select the cases using registration books of the district. Data were entered to Epi info version 7 and exported to SPSS version 22 for statistical analysis. Binary logistic regression was used to identify explanatory variables. RESULT A total of 312 study participants (104 cases and 208 controls) were included giving a response rate of 98.42%. Bare foot (AOR, 5.83 [95% CI: 2.34-14.50]), female sex (AOR, 4.25 [95% CI: 2.22-8.14]), family history of podoconiosis (AOR: 3.01(95% CI: 1.41-6.42) and age group 41-60 (AOR: 5.05(95% CI: 2.35-10.83), and 61-80 AOR 15.74 95% CI: (5.56-44.55) were determinants of Podoconiosis. CONCLUSION AND RECOMMENDATION Barefoot, sex, family history of podoconiosis and age were determinants of Podoconiosis. District health office should encourage at risk populations especially older people and individuals with family history of podoconiosis about shoe wearing practice all the time and not to expose their skin and feet.
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Affiliation(s)
- Teshome Tefera
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Kassawmar Angaw Bogale
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Yiteka Tegegn
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Abebaw Gedef Azene
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Kebadnew Mulatu
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Gizachew Tadesse Wassie
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
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Ali A, Mulatu K, Feleke SF, Wassie GT. Prevalence of chronic kidney disease and associated factors among patients with underlying chronic disease at Dessie Referral Hospital, East Amhara Region, Ethiopia. Front Epidemiol 2023; 3:1154522. [PMID: 38455919 PMCID: PMC10910998 DOI: 10.3389/fepid.2023.1154522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 06/22/2023] [Indexed: 03/09/2024]
Abstract
Background Chronic kidney disease is defined as a reduction in glomerular filtration rate below 60 ml/min per 1.73 m2 and presence of albuminuria over a period of time. Globally, 10%-15% of populations are affected by chronic kidney disease. Studies conducted in Jimma, Addis Ababa, and the Tigray region were conducted on a single chronic disease and did not include human immune viruses. In addition, there has been no such study conducted in the Amhara region. Therefore, the aim of this study was to determine the magnitude and associated factors of chronic kidney disease among chronic patients who are followed up at an outpatient department. Methods An institutional-based cross-sectional study of 480 chronic patients was conducted at Dessie Referral Hospital, Dessie, Ethiopia between 15 March and 16 April 2020. Data were entered into Epidata and exported to SPSS version 25 for analysis. Binary logistic regression models were performed to identify factors associated with chronic kidney disease. The variables with a p-value ≤0.25 were considered to be a candidate for multivariable logistic regression. A p-value ≤0.05 was considered a statistically significant association. Results The magnitude of chronic kidney disease among the study participants was 21.3%. Variables such as hypertension [adjusted odds ratio (AOR): 2.6, 95% CI: 1.58-4.27], use of non-steroidal anti-inflammatory drugs (AOR: 2.4, 95% CI: 1.41-3.97), smoking (AOR: 4.4, 95% CI: 2.65-7.34), routine physical activity (AOR: 0.6, 95% CI: 0.35-0.94), and obesity (AOR: 3.0, 95% CI: 1.76-5.05) were significantly associated with the chronic kidney disease. Conclusion This study found that the magnitude of chronic kidney disease in the study area was high. Hypertension, use of non-steroidal anti-inflammatory drugs, smoking, routine physical activity, and obesity were found to be significant factors for chronic kidney disease.
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Affiliation(s)
- Ahmed Ali
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Kebadnew Mulatu
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Sefineh Fenta Feleke
- Department of Public Health, College of Health Sciences, Woldia University, Woldia, Ethiopia
| | - Gizachew Tadesse Wassie
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
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Tesfaw K, Kindie W, Mulatu K, Bogale EK. Utilisation of cervical cancer screening and factors associated with screening utilisation among women aged 30-49 years in Mertule Mariam Town, East Gojjam Zone, Ethiopia, in 2021: a cross-sectional survey. BMJ Open 2022; 12:e067229. [PMID: 36414295 PMCID: PMC9685227 DOI: 10.1136/bmjopen-2022-067229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To assess the practice of cervical cancer screening and its associated factors among women aged 30-49 years. DESIGN Community-based cross-sectional survey. SETTING Mertule Mariam Town, Northwest Ethiopia, 1 May-20 June 2021. PARTICIPANTS Women aged 30-49 years who were living in the study area were eligible for inclusion. A systematic random sampling technique was used to select study participants. A total of 488 respondents participated in the study. Data were collected by using interviewer-administered structured questionnaires. Data were entered into EpiData V.3.1 and then exported to SPSS V.25 for analysis. Bivariable and multivariable logistic regression analyses were done. OUTCOME MEASURES Prevalence of cervical cancer screening and factors associated with screening utilisation. RESULTS The prevalence of cervical cancer screening was found to be 14.1%. Age (≤16 years) at first sexual intercourse (adjusted OR 14.89, 95% CI 6.21 to 35.74), history of sexually transmitted disease (11.65, 4.56 to 29.78), having multiple sexual partners (11.65, 4.56 to 29.78), having good knowledge about cervical cancer screening (4.72, 2.33 to 9.56) and having a family history of cervical cancer (4.72, 2.33 to 9.56) were statistically significantly associated factors for utilisation of cervical cancer screening. CONCLUSION Utilisation of cervical cancer screening was low in Northwest Ethiopia. Educational status, age at first sexual intercourse, history of multiple sexual partners, sexually transmitted disease, family history of cervical cancer and knowledge about cervical cancer screening were significant factors for utilisation of cervical cancer screening.
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Affiliation(s)
- Kinfemichael Tesfaw
- Integrated Emergency Surgery and Obstetrics, Addis Ababa City Administration Health Bureau, Addis Ababa, Ethiopia
| | - Walelign Kindie
- Department of Integrated Emergency Surgery and Obstetrics, Bahir Dar University, College of Medicine and Health Sciences, Bahir Dar, Ethiopia
| | - Kebadnew Mulatu
- Department of Epidemiology and Biostatistics, Bahir Dar University, College of Medicine and Health Sciences, School of Public Health, Bahir Dar, Ethiopia
| | - Eyob Ketema Bogale
- Halth Promotion and Behavioral Sciences Department, Bahir Dar University, College of Medicine and Health Sciences, School of Public Health, Bahir Dar, Amhara, Ethiopia
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Mesfin D, Mulatu K, Birara A, Shibabaw T, Birhanu D, Yalew W. Anthrax prevention practice and associated factors among farmers in Farta district, South Gondar, Amhara region, Northwest Ethiopia. Heliyon 2021; 7:e08531. [PMID: 34934843 PMCID: PMC8654614 DOI: 10.1016/j.heliyon.2021.e08531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 09/16/2021] [Accepted: 11/29/2021] [Indexed: 11/26/2022] Open
Abstract
Background Anthrax is a zoonotic disease endemic in Ethiopia. Despite anthrax preventive measures are the key activities to control the disease, several outbreaks have occurred in Ethiopia recently. The objective of the study was therefore to assess the anthrax preventive practice and its associated factors among farmers in Farta district, South Gondar zone, Northwest Ethiopia. Method A community-based cross-sectional study was conducted among farmers in Farta District from June 7 to 21/2020. A multi-stage sampling technique, with systematic random sampling, was used to select 1,338 study participants. Data were collected through a face-to-face interview using a structured questionnaire. The data were cleaned, coded, and entered into the Epi-data v 3.1 and then exported to SPSS v 23 for analysis. In the bi-variable regression analysis, the variables having a p-value of less than 0.2 were entered into a multivariable logistic regression to control the effect of confounding. Those independent variables with P-value less than 0.05 were taken as statistically significant factors associated with anthrax prevention practice. Results The proportion of farmers who had good anthrax prevention practice was 35.8% [95% CI 33%, 38%]. Being female (AOR = 2.96; 95% CI 2.18, 4.02), able to read and write (AOR = 1.48, 95% CI 1.08, 2.03), time spent to arrive at a nearby veterinary clinic (AOR = 1.35; 95%CI 1.01, 1.79), heard about anthrax (AOR = 4.54; 95%CI 2.96, 6.95), and had a favorable attitude towards anthrax preventions (AOR = 3.70; 95%CI 2.77, 4.94) were significantly associated with anthrax prevention practice. Conclusions The practice of anthrax prevention was low. Sex, educational status, time spent to arrive at the nearby veterinary clinic, knowledge about anthrax, and attitude towards anthrax prevention were significantly associated with anthrax prevention practice. Health education to create a favorable attitude and the establishment of veterinary clinics in the nearby locations are recommended to improve anthrax preventive practices in the study area.
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Affiliation(s)
- Dereje Mesfin
- Bahir Dar City Administration Health Department, Ethiopia
| | - Kebadnew Mulatu
- Bahir Dar University, College of Medicine and Health Science, School of Public Health, Department of Epidemiology and Biostatistics, P.O. Box 79, Ethiopia
| | - Amsalu Birara
- Bahir Dar University, College of Medicine and Health Science, School of Public Health, Department of Environmental Health, P.O. Box 79, Ethiopia
| | - Tebkew Shibabaw
- Bahir Dar University, College of Medicine and Health Science, School of Public Health, Department of Environmental Health, P.O. Box 79, Ethiopia
| | - Dereje Birhanu
- Bahir Dar University, College of Medicine and Health Science, School of Public Health, Department of Public Health Nutrition, P.O. Box 79, Ethiopia
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Zena D, Elfu B, Mulatu K. Prevalence and Associated Factors of Precancerous Cervical Lesions among Women in Ethiopia: A Systematic Review and Meta-Analysis. Ethiop J Health Sci 2021; 31:189-200. [PMID: 34158766 PMCID: PMC8188114 DOI: 10.4314/ejhs.v31i1.21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Background Cervical cancer remains the most common cancer of women worldwide. Its burden is more serious in developing countries. It is also the second common cancer deaths of women in Ethiopia followed by breast cancer. The aim of this study was to determine the pooled prevalence and associated factors of precancerous cervical lesions among women in Ethiopia. Methods We systematically searched published and unpublished articles reported from 2010 to 2019 using a comprehensive search of electronic databases including PubMed and Google scholar for grey literature from August 1 to September 1, 2019. The methodological qualities of included studies were evaluated using Joanna Briggs Institute meta-analysis of Statistics Assessment. The pooled prevalence estimate was calculated using MedCalc software-version 19.0.7, and the pooled odd ratios for predictors was calculated using RevMan software version 5.3. Results The pooled prevalence of precancerous cervical lesions among women in Ethiopia was 13.4% (95% CI:10.63% 16.37%). Statistically significant heterogeneity between studies was detected (I2=83.1%, P < 0.001). Among all measured associated factors: numbers of women life time sexual partners > 1, OR=2.5 (95% CI:3.70,4.76), being HIV positive women, OR=2.4 (95% CI:1.33,4.61) and women having history of STI, OR=2.0 (95% CI:1.02,3.87) had statistically significant association with precancerous cervical lesions among women in Ethiopia Conclusion The pooled prevalence of precancerous cervical lesions among women in Ethiopia was high as compared to the 5-year worldwide cervical cancer prevalence. Women having more than one life time sexual partners, being HIV positive women and women having history of STI had a statistically significant association with precancerous cervical lesions.
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Affiliation(s)
- Dereje Zena
- Family Guidance Association of Ethiopia, North West Branch
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Ahmed A, Mulatu K, Elfu B. Prevalence of malaria and associated factors among under-five children in Sherkole refugee camp, Benishangul-Gumuz region, Ethiopia. A cross-sectional study. PLoS One 2021; 16:e0246895. [PMID: 33606756 PMCID: PMC7894890 DOI: 10.1371/journal.pone.0246895] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 01/27/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Under-five year children are the most vulnerable group affected by malaria, they accounted for 61% of all malaria deaths worldwide. Sherkole refugee camp is stratified under high risk for malaria. Knowledge on malaria prevalence and associated factors among under-five children in Sherkole refugee camp is lacking. METHODS AND MATERIALS Institution-based cross-sectional survey was conducted among under-five children in Sherkole refugee camp from October to November 2019. Total sample size was 356. Stratified random sampling technique was employed to select the study participants. Standardized questionnaire was used to collect data. Care StartTM Malaria Rapid diagnostic test which detect histidine-rich protein 2 of P. falciparum and plasmodium lactate dehydrogenase of P. vivax was used to diagnose malaria. Bivariate and multivariable logistic regression analysis was done to identify factors associated with malaria. RESULTS A total of 356 participants were included in this study with response rate of 97.5%. The prevalence malaria was 3.9% (95% CI = 2.0-6.2). Outdoor stay at night (AOR = 3.9, 95% CI = 1.14-13.8), stagnant water near to house (AOR = 4.0, 95% CI = 1.14-14.6), and the number of under-five children per household (AOR = 3.0, 95% CI = 1.03-13.0) were found to increase the odds of getting malaria. Whereas, insecticide treated net (ITN)utilization (AOR = 0.22, 95% CI = 0.06-0.61) and Health information about malaria (AOR = 0.29, 95% CI = 0.06-0.65) reduce the odds of getting malaria. CONCLUSIONS AND RECOMMENDATIONS Malaria remains the major public health problem in Sherkole Refugee camp. Outdoor stay at night, stagnant water near to house, and number of under-five children per household were the risk factors for malaria. Health information dissemination that focuses on avoiding outdoor stay at night, eliminating stagnant water & using ITN, and considering number of under-five children per household during ITN distribution should be take into account.
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Affiliation(s)
- Abdulmuneim Ahmed
- Department of Field Epidemiology, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia
| | - Kebadnew Mulatu
- Department of Field Epidemiology, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia
| | - Berhanu Elfu
- Department of Epidemiology and Biostatics, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia
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Meshesha HM, Nigussie ZM, Asrat A, Mulatu K. Determinants of virological failure among adults on first-line highly active antiretroviral therapy at public health facilities in Kombolcha town, Northeast, Ethiopia: a case-control study. BMJ Open 2020; 10:e036223. [PMID: 32713849 PMCID: PMC7383949 DOI: 10.1136/bmjopen-2019-036223] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE To identify determinants of virological failure among HIV-infected adults on first-line highly active antiretroviral therapy at public health facilities in Kombolcha town, Northeast, Ethiopia, in 2019. METHODS An unmatched case-control study was conducted from April to May 2019. About 130 cases and 259 controls were selected by simple random sampling. Data were extracted from charts of patients using a structured checklist. Multiple logistic regression analysis was performed to identify possible factors. Hosmer-Lemeshow goodness of fit test was used to check the model. Finally, independent predictor variables of virological failure were identified based on adjusted OR (AOR) with 95% CI and a p value of 0.05. RESULTS The odds of virological failure were 2.4-fold (AOR=2.44, 95% CI 1.353 to 4.411) higher in clients aged <35 years compared with older clients, fivefold (AOR=5.00, 95% CI 2.60 to 9.63) higher in clients who did not disclose their HIV status, threefold (AOR=2.99, 95% CI 1.33 to 6.73) higher in clients with poor adherence, and 7.5-fold (AOR=7.51, 95% CI 3.98 to 14.14) higher in clients who had recent CD4 count of ≤250 cells/mm3. CONCLUSION AND RECOMMENDATION This study revealed that age, marital status, occupation, disclosure status, baseline functional status, missed clinic visit, current antiretroviral therapy regimen, adherence to treatment and recent CD4 count were significantly associated with virological failure. Therefore, adherence support should be strengthened among clients. Missed clinic visits should also be reduced, as it could help clients better adhere to treatment, and therefore boost their immunity and suppress viral replication.
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Affiliation(s)
- Habtamu Mengist Meshesha
- Ethiopian Field Epidemiology Training Program, Bahir Dar University, Bahir Dar, Amhara Region, Ethiopia
| | - Zelalem Mehari Nigussie
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medical and Health Sciences, Bahir Dar University, Bahir Dar, Amhara region, Ethiopia
| | - Anemaw Asrat
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medical and Health Sciences, Bahir Dar University, Bahir Dar, Amhara region, Ethiopia
| | - Kebadnew Mulatu
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medical and Health Sciences, Bahir Dar University, Bahir Dar, Amhara region, Ethiopia
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Ayalew F, Atnafu DD, Bedimo M, Mulatu K. Determinants of community-led ivermectin treatment adherence for onchocerciasis control in Western Ethiopia: a case-control study. Trop Med Health 2020; 48:22. [PMID: 32336928 PMCID: PMC7168851 DOI: 10.1186/s41182-020-00210-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 04/08/2020] [Indexed: 11/30/2022] Open
Abstract
Background Onchocerciasis is an infection of a filarial worm which is endemic in Sub-Saharan Africa, including Ethiopia. Annual mass treatment with high coverage over for a long period of time should lead to a complete interruption of transmission and the ultimate elimination of the parasite. However, in Ethiopia, the required coverage levels were not achieved. Thus, the aim of this study was to identify the possible determinants of onchocerciasis treatment adherence in Assossa District. Methods A case-control study was conducted among 528 respondents (176 cases and 352 controls). Cases were respondents who took all five doses of treatments, and controls were those who took at most four does of ivermectin treatments (missed at least one or more doses). Structured questionnaire was used for data collection. Each possible factor for treatment adherence, with a P value < 0.2 obtained in the bi-variable logistic regression was entered into the multivariable logistic regression models to control the confounding factors. p value < 0.05 was used as cut-off-point for a variable to become a significant determinant of treatment adherence in multivariable logistic regression. Results Participation in selecting drug distributers [AOR = 2.7, 95%CI (1.7–4.1)], measuring height for dose determination [AOR = 3.6, 95%CI (1.9–6.7)], perceived risk of getting onchocerciasis [AOR = 2.1, 95%CI (1.6–2.7)], living near running water [AOR = 1.7, 95%CI (1.1–2.8)], and perceived needs of support for intake of ivermectin [AOR = 3.2, 95%CI(2.1–4.9)] were independent predictors for t treatment adherence. Conclusions Treatment adherence was influenced by participation in selecting drug distributers, measuring height for dose determination, perceived risk of getting onchocerciasis, living near running water and perceived needs of support for intake of ivermectin. To improve intake of the drug and its adherence, the community should be empowered to make decisions, and counseling family members and sensitizing those living far from river sides is commendable. Health information about onchocerciasis should be strengthening to increase risk perception.
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Affiliation(s)
- Fikadu Ayalew
- 1School of Public Health, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia
| | - Desta Debalkie Atnafu
- 2Department of Health System and Health Economics, School of Public Health, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia
| | - Melkamu Bedimo
- 3Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia
| | - Kebadnew Mulatu
- 3Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia
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Bante SA, Getie SA, Getu AA, Mulatu K, Fenta SL. Uptake of pre-cervical cancer screening and associated factors among reproductive age women in Debre Markos town, Northwest Ethiopia, 2017. BMC Public Health 2019; 19:1102. [PMID: 31412831 PMCID: PMC6692942 DOI: 10.1186/s12889-019-7398-5] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Accepted: 07/30/2019] [Indexed: 12/25/2022] Open
Abstract
Background Cervical cancer remains a major cause of morbidity and mortality among women, particularly in low-resource countries like Ethiopia. Early screening for pre-cervical cancer is a key intervention in reduction of maternal deaths. We assessed uptake of pre-cervical cancer screening and its associated factors among women of reproductive age in Debre Markos town in northwest Ethiopia. Methods A community-based, cross-sectional study was conducted among 517 women of reproductive age. A multistage sampling technique was used to select study participants. Kebeles (sub-districts) were selected by a simple random sampling technique.Data was entered using Epi Info and analyzed by SPSS. Variables in binary logistic regression with a P value < 0.2 were fitted to multivariable logistic regression. Significant variables were declared at 95% CI and an AOR of P value < 0.05. Results A total of 517 women were interviewed with100% response rate. Results revealed only 108 women (20.9%) [95% CI =17.6–24.6] had been screened for pre-cervical cancer. Participants ages 35–49 [AOR = 3.21, 95% CI: 1.40, 7.39] informed by health professionals about cervical cancer [AOR = 6.65, 95% CI: 3.64, 12.15], positive attitude to screening [AOR = 3.38, 95% CI: 1.92, 7.61], visited health institution once or more in a year [AOR = 6.72, 95% CI: 2.40, 18.79], visited health institution once or more in two years [AOR = 3.76, 95% CI = 1.39, 10.19], history of sexually transmitted infections [AOR = 2.37, 95% CI: 1.11, 5.07] and family history of cervical cancer [AOR = 4.95, 95%CI: 1.62,15.15] were significantly associated with pre-cervical cancer screening. Conclusion Uptake of pre-cervical cancer screening was found to be low among women of reproductive age. Age, attitude, informed by health provider, visiting health institution, history of sexually transmitted infections and family history of cervical cancer were found to be significantly associated with higher uptake of screening. To scale up currently limited uptake of pre-cervical cancer screening, community health education should be undertaken, leading to attitude change for young women.
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Affiliation(s)
- Simachew Animen Bante
- Department of Midwifery, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia.
| | - Simegnew Asmer Getie
- Department of Midwifery, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Almaz Aklilu Getu
- Department of Midwifery, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Kebadnew Mulatu
- Department of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Selamawit Lake Fenta
- Department of Midwifery, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
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