Intimate partner violence against HIV-Positive women on ART follow-up and associated factors in public health facilities of western Ethiopia

INTRODUCTION

Intimate partner violence is the most pervasive but less recognized problem which affects millions of women world. It is more common among marginalized individuals including women affected by HIV. However, there is limited information regarding this problem among HIV-Positive Women in Ethiopia. Thus, the study was aimed to assess the magnitude and factors associated with intimate partner violence among HIV positive women in western Ethiopia.

METHODS

A facility-based cross-sectional study was conducted among HIV-positive women on ART follow-up in Nekemte town. A total of 420 women were selected by the simple random sampling technique and an interviewer-administered questionnaire was used for data collection. The data were entered to EpiData version 3.1 and analyzed by SPSS version 20. Univariable and mult- variable logistic regression analysis with their corresponding odds ratio (95%CI) were computed, and statistical significance was declared at p < 0.05.

RESULTS

The magnitude of intimate partner violence among HIV-positive Women during Lifetime and since diagnosed with HIV was 49.29%, [(95% CI: 44.3-53.6%)] and 41.67%, [(95% CI: 37.1-45.7%)] respectively. Skipping daily ART medication ≥ 6 times/month [AOR = 3.56; (95% CI 1.18, 10.74)], experiencing controlling behavior by a partner[AOR = 6.37; (95% CI 3.26, 12.44)], women inter-parental witness of violence [AOR = 1.74; (95% CI 1.09, 2.79)], women having favorable attitude that justify wife-beating [AOR = 1.76; (95% CI 1.06, 2.94)]and non-disclosure of test result to partner [AOR 0.38; (95% CI 0.22, 0.66)] were factors associated with intimate partner violence since diagnosed with HIV.

CONCLUSION

The magnitude of intimate partner violence among HIV-positive Women on ART follow-up was found to be high in the study area. Therefore, integrating intimate partner violence victim screening with ART services, empowering HIV-positive women, and increasing their awareness of sexual and reproductive rights is needed.

Burden of intestinal parasitic infections and associated factors among pregnant women in East Africa: a systematic review and meta-analysis

BACKGROUND

The ultimate goal of preventing intestinal parasites among pregnant women is to reduce maternal and newborn morbidity and mortality. Numerous primary studies were conducted in East Africa presented intestinal parasite infection and associated factors among pregnant women. However, the pooled finding is not known. Therefore, this review aimed to identify the pooled prevalence of intestinal parasite infection and its determinants among pregnant women in East Africa.

METHODS

Articles published from 2009 to 2021 were searched in PubMed, Web of Science, EMBASE, and HINARI databases. The search for unpublished studies such as thesis and dissertations was checked in Addis Ababa University and Africa Digital Library. PRISMA checklist was used to report the review. Articles published in the English Language were considered. The data were extracted by two authors using data extraction checklists on Microsoft excel. Heterogeneity among the included studies was checked using I² statistics on forest plots. Sensitivity and sub-group analyses were conducted to assess the presence of primary studies, and study characteristics responsible for the observed heterogeneity.

RESULTS

Of the 43 identified articles, about 23 articles were removed due to duplications. Then, by assessing the abstracts and full texts, four articles were removed because they failed to meet the eligibility criteria. Finally, 16 articles were included in the systematic and meta-analysis.The pooled prevalence of intestinal parasites among pregnant women in East Africa was 38.54 (28.77, 48.32). In this study, variables like residing in rural areas (OR: 3.75; CI: 1.15,12.16), availability of latrine(OR: 2.94; 95% CI: 2.22, 3.91), eating raw fruits/vegetables (OR: 2.44; 95% CI: 1.16, 5.11). and sources of water as unprotected sources (OR: 2.20; 95% CI: 1.11,4.35) show statistically significant association with the increased burden of intestinal parasites among pregnant women.

CONCLUSION

The burden of intestinal parasite infection among pregnant women in East Africa was high. Therefore, efforts should be made in deworming pregnant women at the community and institutional level by stakeholders to reduce the burden of intestinal parasite infections and related complications.

Determinants of perinatal mortality at tertiary hospitals in East Wollega, Western Ethiopia: a case-control study

OBJECTIVE

This study was performed to determine predisposing factors of perinatal mortality among deliveries at tertiary hospitals in East Wollega, Western Ethiopia.

METHODS

This institutional-based unmatched retrospective case-control study involved 810 samples (270 perinatal deaths and 540 controls) selected from the study hospitals. For each case, two controls were selected. Data were collected using a pretested structured questionnaire. Data were entered into EpiData Version 3.1 and exported to SPSS Version 25 for analysis. Descriptive analysis and logistic regression were performed. The adjusted odds ratio with 95% confidence interval was calculated, and statistical significance was declared at a P-value of <0.05.

RESULTS

The statistical analysis revealed the following independent determinants of perinatal mortality: rural residence, lack of antenatal care, preterm delivery, induction of labor, presence of obstetric complications, breech presentation, shoulder presentation, low birth weight, congenital malformation, and not using a partograph.

CONCLUSION

Given the determinant factors of perinatal mortality in the study area, health facilities are recommended to implement appropriate antenatal care, intrapartum care, and neonatal care to prevent perinatal mortality. They are also advised to use partographs and ensure better access to antenatal care facilities.

Menstrual hygiene management practice and its associated factors among in-school adolescent girls in Western Ethiopia

BACKGROUND

Adolescent girls should practice good menstrual hygiene to enhance their health and educational attainment. However, socio-cultural restrictions and limited water, sanitation, and hygiene in school environments continued to make it difficult for in school adolescent females to practice good menstrual hygiene management. So, the main aim of this study was to assess menstrual hygiene management practice and its associated factors among in-school adolescent girls in the secondary schools of Gimbi town, western Ethiopia.

METHODS

A school-based cross-sectional study was conducted among 378 adolescent girls in Gimbi town secondary schools. The study participants were selected by using stratified random sampling techniques. Pretested self-administered Afan Oromo questionnaire with sociodemographic characteristics, information and knowledge about menstruation, and practice of menstrual hygiene management, as well as observational checklist to assess school environment were used to collect the data. Data were cleaned, coded, and entered into Epi-info version 7.2.0.4 and exported to SPSS version 25 for statistical analysis. Multivariable logistic regression analysis was used to identify factors associated with the practice of menstrual hygiene management and P-values less than 0.05 was used to declare statistical significance.

RESULTS

Out of 378 respondents, 163 (43.1%) (38-48) of adolescent girls had good menstrual hygiene management practice. Being urban resident (AOR = 3.48, (95% C.I:1.99-6.08), having mother with secondary level of education (AOR = 2.71, 95%CI: 1.15,6.42), having mother with educational level of college and above (AOR = 3.30, 95%CI1.28,8.50), having discussion about menstruation with parents (AOR = 2.42,95%CI:1.45,4.04), and having knowledge about menstruation (AOR = 2.94, 95% CI: 1.69-5.13) were factors associated with good menstrual hygiene management practice.

CONCLUSION

In this study, good menstrual hygiene management practice is low among in school adolescent girls. Place of residence, maternal educational level, discussion about menstrual issue with parent, and having knowledge about menstruation were factors associated with good menstrual management practice. Stakeholders should give appropriate awareness and health education related to menstrual hygiene for adolescent girls at all levels.

Essential newborn care practices and associated factors among home delivered mothers in Guto Gida District, East Wollega zone

BACKGROUND

Essential Newborn Care is a set of strategic and cost-effective interventions planned to improve the health of newborns through the care they receive from birth up to 28 days. In the current study area, little is known about the prevalence of essential newborn care practices and its associated factors. This study was aimed to assess the prevalence of essential newborn care practice and its associated factors among home-delivered mothers in Guto Gida district, western Ethiopia.

METHODS

A community-based cross-sectional study was conducted in Guto Gida district from September 5 to 15, 2020. Data were collected by interviewing 601 systematically selected home-delivered women. Descriptive statistics were employed to describe frequency and percent. Binary logistic regression analysis was employed to identify candidate variables for the final model. Variables with p-value less than 0.25 at bivariate logistic regression were considered as the candidate variable and entered into multivariable logistic regression model. Finally, multivariable logistic regression was employed to identify associated factors at p-value less than 0.05, and the strength of association was described by adjusted odds ratios with 95% CI.

RESULTS

The study shows that the level of essential newborn care practices was 168 (28%) (23.9-31.4). In this study, women in the first wealth quantile (AOR [95% CI] = 0.64 [0.34-0.97]), women who had one live birth (AOR [95% CI] = 0.51 [0.22-0.87]), women who lost their neonate before the study period (AOR [95% CI] = 0.11 [0.05-0.22]) were less likely to practice essential newborn care. Women who were advised on essential newborn care practice during a home visit by health extension workers (AOR [95% CI] = 3.45[1.56-7.26]), women who attended antenatal care during their current pregnancy (AOR [95% CI] = 1.79 (1.21-3.36]), and women who were attended at their birth by health extension workers (AOR [95% CI] = 3.29 [2.13-5.94]) were more likely to practice essential newborn care.

CONCLUSIONS

In this study, the prevalence of essential newborn care practice was low (28%), as compared with the World Health Organization recommendation that it should be 100%. The wealth quantile, number of live births, home visits by health extension workers, antenatal care, birth attendant, and neonatal death were independent predictors of essential newborn care practices.

Quality of antenatal care in selected public health facilities of West Ethiopia

Background

Ante natal care (ANC) is a key entry point for a pregnant woman to receive abroad range of promotion and preventive health services. Quality of ANC has paramount role to ensure better maternal and neonatal outcome.

Objective

To assess the quality of antenatal care services at public health facilities of western Ethiopia.

Methods

Facility-based cross-sectional study was conducted from May 30th to June 30th, 2016. All public health facilities in the Kellem Wollega Zone of West Ethiopia were audited, 316 medical records were reviewed, and 316 pregnant women were interviewed. The data was entered using EPI Data version 3.1 and analyzed using SPSS version 20.0. Descriptive statistics, binary, and multiple logistic regressions were conducted. Variables with a P-value of <0.05 were considered as statistically significant associated factors.

Results

A total of 316 pregnant women were enrolled in the study. All facilities were categorized as “good” by the possession of necessary equipment, 3/4 by basic amenities and 87.34% by general and gynecologic examination. The information was provided for 222(86.21%), which is categorized as poor. About 252 (79.7%) of the women were satisfied with ANC. A urine sample taken during ANC visit [(AOR= 3.36 (95 % CI= 1.70, 6.61)], and counseling on nutrition during pregnancy [(AOR= 2.27 (95 % CI=1.16, 4.45)] were predictors of client satisfaction on ANC.

Conclusions

In this study quality of ANC was labeled good for structural aspects and poor for process aspects of quality. In terms of outcome aspects, the majority of pregnant women were satisfied with the ANC they received. A urine sample taken during the ANC visits and being counseled on nutrition during pregnancy were predictors for client satisfaction on ANC. Concerned bodies need to improve laboratory tests and information provision.

Determinants of uterine rupture at public hospitals of western Ethiopia: A case–control study

Introduction:

Uterine rupture is a separation of the entire thickness of the uterine wall with the extrusion of fetal parts to the peritoneal cavity. It contributes to high maternal and perinatal mortality in Ethiopia. This study was aimed to identify determinants of uterine rupture among mothers who gave birth at East Wollega Zone public hospitals.

Methods:

A facility-based unmatched case–control study was conducted among 239 samples (47 cases and 192 controls) from 5 June 2019 to 30 September 2019. Cases were those with uterine rupture, and controls were those free from uterine rupture. Cases were selected consecutively, and controls were selected using a systematic sampling method. For analysis, data were entered into Epi-data version 3.1 and exported to SPSS version 20. Descriptive statistics were performed to describe the variables. Binary and multivariable logistic regression were used in the analysis. The outputs were presented using an adjusted odds ratio with 95% confidence intervals.

Results:

Two hundred thirty-nine (47 cases and 192 controls) mothers who gave birth in public hospitals in the East Wollega zone were interviewed, making a response rate of 100%. Living in an urban area (adjusted odds ratio = 0.219, 95% confidence interval: 0.067, 0.717), prolonged labor (adjusted odds ratio = 5.401, 95% confidence interval: 1.825, 15.981), obstructed labor (adjusted odds ratio = 4.333, 95% confidence interval: 1.276, 14.715), previous history of C/S (adjusted odds ratio = 6.5261, 95% confidence interval: 1.889, 22.554), and having no history of female genital cutting (adjusted odds ratio = 0.190, 95% confidence interval: 0.053, 0.682) were predictors of uterine rupture.

Conclusion:

In this study, socio-demographic, maternal nutrition, obstetric, and health system-related factors were identified as risks of uterine rupture. Particular emphasis should be given to modifiable risk factors to reduce maternal morbidity and mortality in the study area.

Family and Social Support Among Patients on Anti-Retroviral Therapy in West Wollega Zone Public Hospitals, Western Ethiopia: A Facility-Based Cross-Sectional Study

Background

Poor family and social support is a problem for patients taking antiretroviral therapy (ART), but it protects them against the negative consequences of stress, reducing morbidity and mortality among peoples living with human immunodeficiency virus (PLWHIV).

Objective

This study aimed to assess family and social support and the associated factors among patients on antiretroviral therapy in West Wollega Public Hospitals.

Methods

A facility-based cross-sectional study design was conducted among 329 respondents attending antiretroviral therapy (ARV) clinics in West Wollega Public Hospitals from September 1–30, 2020. Data were collected by simple random sampling methods using an interviewer-administered questionnaire. Bivariate and multivariate logistic regression analysis was used. The strength and presence of statistical association were assessed using adjusted odds ratio with a 95% confidence interval.

Results

About 266 (66.4%) of the respondents had low family and social support. Being female sex [AOR (95% CI)=0.066 (0.013–0.338)], failing to discuss with family or society [AOR (95% CI)=0.275 (0.100–0.753)], lack of information on support [AOR (95% CI)=0.314 (0.104–0.951)], and non-disclosure of HIV status to family [AOR (95% CI)=0.227 (0.084–0.916)] were associated with family and social support.

Conclusion

In this study, family and social support to people living with HIV/AIDS is low. Being female sex, feelings of negative treatment, lack of discussion on support, lack of information about support, and failure to disclose HIV status were associated with low family and social support. Information, education, and communication should be intensified to increase the awareness of the community, family, and people living with HIV related to support for people living with HIV.

Determinants of uterovaginal prolapse in Western Ethiopia

INTRODUCTION AND HYPOTHESIS

Uterovaginal prolapse is a significant public health concern in developing countries like Ethiopia where access to health care is limited. It significantly affects women's health and productivity. Thus, it is very important to identify determinant factors and take preventive actions.

METHODS

A hospital-based unmatched case-control study was conducted on 86 cases and 258 controls who attended gynecologic outpatient departments in Nekemte town from May 1 to July 30, 2019. Cases were women with grade II, III and IV uterovaginal prolapse while controls were women free from uterovaginal prolapse but with other gynecologic diseases. Data were collected using pretested interviewer-administered questionnaires, and measurements on height and weight were taken to calculate the women's body mass index. Data were entered using Epi Data version 3.1, and analysis was carried out by SPSS version 20. Descriptive, bivariate and multivariable logistic regressions were performed. The adjusted odds ratio with a 95% confidence interval was used, and statistical significance was declared at p < 0.05.

RESULTS

This study revealed age ≥ 40 years (AOR = 10.49; 95% CI: 4.03, 27.35), duration of labor ≥ 24 h (AOR = 8.32; 95% CI: 3.58, 19.33), instrumental delivery (AOR = 7.40; 95% CI: 1.21, 45.28), non- utilization of family planning (AOR = 3.14; 95% CI: 1.32, 7.47) and underweight (BMI < 18.5 kg/m²) (AOR = 5.30; 95% CI: 1.83, 15.33) were determinants of uterovaginal prolapse.

CONCLUSION

Age ≥ 40 years, prolonged labor, instrumental delivery, non-utilization of family planning and underweight were identified as determinant factors of uterovaginal prolapse. Thus, family planning service utilization and appropriate and timely obstetric care are advisable.

Prevalence of anemia and its associated factors among pregnant women attending antenatal care follow up at Wollega University referral hospital, Western Ethiopia

Background

Even if anemia is a worldwide public health problem affecting numerous people in all age groups, particularly the burden of the problem is higher among pregnant women. Anemia is estimated to contribute to more than 115,000 maternal deaths and 591,000 prenatal deaths globally per year. Maternal mortality is the prime health indicator in any society. Therefore, determining the prevalence of anemia and assessing its associated factors among pregnant women might help for the intervention of the problem.

Objective

The objective of this study was to determine the prevalence of anemia and its associated factors among pregnant women attending Antenatal Care (ANC) at Wollega University Referral Hospital, Western Ethiopia.

Methods and materials

Institution based cross-sectional study was conducted at antenatal care (ANC) departments of Gynecology and Obstetrics, and MCH at Wollega University Referral Hospital from July 15–22, 2019. A systematic random sampling technique was used to select the study unit. The data were collected using questionnaires, physical examination, and laboratory investigation. After collection, the data were entered using Epi Data version 3.1 and analyzed using SPSS version 20 statistical software. Bivariate and multivariate logistic regression analysis was performed to identify predictors of anemia. Finally, the result was presented using text, tables, and charts.

Results

The overall prevalence of anemia using a cut off level of hemoglobin < 11 g/dl (< 33% Haematocrit) was 51 (17.8%). Out of all anemic pregnant women, 19 (37.25%) were mildly anemic, 24 (47%) were moderately anemic and 8 (15.68%) were severely anemic. Multivariable logistic regression analysis revealed that Birth interval of less than 2 years (AOR = 2.56 CI [2.84–4.52]), history of malarial attack in the past 12 months (AOR = 2.585 CI [1.181–5.656]) and engaging into daily laborer occupation (AOR = 8.33 CI [2.724–25.497]) showed significant association with maternal anemia.

Conclusions

The prevalence of anemia among pregnant women in this study is high. Having a birth interval of < 2 years, having a history of malarial attack in the past 12 months, and being engaged in daily laborer occupation were factors associated with anemia among pregnant women. Thus, contraceptive methods and information to space children, information, and services to prevent malaria and economically empowering women is needed to prevent anemia among pregnant women in the study area.

Low back pain and associated factors among civil service sectors office workers in Southern Ethiopia

Background: Low back pain is one of the most common work-related health problems among office workers. Low back pain has been identified as one of the most costly disorders among the worldwide working population. However, there is a lack of information on associated factors with low back pain which makes people not to work properly.  Objectives: This study was aimed to assess the prevalence and factors associated with low back pain among civil service sectors office workers in Southern Ethiopia. Methods: Institution based cross-sectional study was conducted among 625civil service sectors office workers, who work in the sitting position, in Sodo town, Southern Ethiopia from March 10 to June 20, 2017. The sampling frame was obtained from civil service office and simple random sampling technique was used for each stage. Data was collected by using a pretested structured questionnaire adapted from Standardized Nordic musculoskeletal Questionnaires and modified Oswestry through face to face interview and by using checklist for observations, which was measured by diploma nurses. Descriptive statistics like frequency, percentage, mean, median and standard deviation were conducted. Also, binary logistic regression was conducted and variables with p<=0.20 in bivariate analysis were fitted into the multiple logistic regression models to identify factors associated with low back pain. Variables with P value <0.05 were considered as statistically significant predictors of low back pain. Results: Out of the calculated sample size, 625 participants responded making a response rate of 99%. The 12-month prevalence of low back pain among civil service sectors office workers in this study was (38.4%) 95% CI: (0.34, 0.42).This study found that, being obese (AOR [95%CI] =6.3[4.29 - 9.09]), having smoking history (AOR [95%CI] =5.2[2.57 - 10.82]), poor sitting posture (AOR [95%CI] =2.6[1.61-4.30]), having job stress (AOR [95%CI] =5.9[3.44-10.25]), having no rest break during workday (AOR [95%CI]=3.2[1.82-5.62]), sitting >6 hours per day (AOR [95%CI]=16.08[14.4-19.3]) and frequently using computer (AOR [95%CI]=4.3[2.09-5.47]) are significantly associated with low back pain. Conclusion and recommendations: The 12-month prevalence of low back pain in this study is high (38.4%).Therefore, healthy lifestyle habits, good awareness of sitting posture and better ergonomic facilities and psychosocial support to workers were recommended to decrease the effects of predisposing factors of low back pain.

Utilization of long-acting and permanent contraceptive methods and associated factors among married women in Adama town, Central Ethiopia: community based cross-sectional study

Background

Long-acting and permanent contraceptive methods have clear advantages over short-acting methods of contraception that benefit both clients and health systems. Despite this importance, studies show that the proportion of women currently using long acting and permanent contraceptive methods are significantly lower than the proportion using short-acting methods.

Objective

The main aim of the study was to assess the level of utilization of long acting and permanent contraceptive methods and associated factors among married women in Adama town.

Methodology

Community Based Cross-Sectional Study was conducted in four kebeles of Adama town from April 15–30, 2015. Multistage sampling technique was used to select the study participants. The collected data was cleaned and entered using Epi info 3.5.3 and analyzed using statistical package for social science version 20.0. Factors associated with utilization of long acting and permanent contraceptive methods were identified using logistic regression model.

Result

In this study, the magnitude of long acting and permanent contraceptive methods was 20.9%. Implant, Intra-Uterine devices (IUDs) and tubal ligation accounted for 16.1, 4.6, and 0.2% respectively. Current use of long acting and permanent contraceptive methods was higher among women who had high knowledge (AOR = 5.26, 95% CI = 1.90–14.69), positive attitude (AOR = 3.25, 95% CI = 1.60–6.58) and women who had 3–4 children (AOR [95%CI] =2.3[1.14–4.63]) compared to those who had no child.

Conclusion

Current use of long acting and permanent contraceptive methods in Adama town was low. Level of knowledge, attitude about the methods, and number of children were factors affecting utilization of long acting and permanent contraceptive methods. Targeted Information Education Communication Intervention should be intensified to improve the utilization of these methods.

Adrenal responsiveness in pre- and postpartum dairy cows

Adrenal responsiveness was evaluated by injecting 10 multiparous dairy cows with 200 IU adrenocorticotropin between -13 and -2 days prepartum (I) and postpartum between 24 and 40 h (II) and 21 and 24 days (III). Concentrations of glucocorticoids following injection were influenced by day of injection, temperature, and minimum percent relative humidity but not by breed, breed X injection day interaction, or age of cow. Likewise differences in regressions for adrenal response and mean response (ng/ml) for the three injections were nil. Mean concentrations at peak (45, 60, and 120 min postinjection samples) adjusted for preinjection concentrations also did not differ for the three periods of injection. Mean concentrations of glucocorticoids in plasma for daily samples between -13 and -2 days prepartum were 5.3 +/- .4 (n = 61), reached a peak of 14.8 +/- .3 ng/ml the day of calving, and remained high for 2 days postpartum. Estradiol increased through prepartum sampling from 23.3 to 339.6 +/- 94.1 pg/ml the day of calving, then declined abruptly. Progestins began to decline about -5 days prepartum from mean concentration of 4.09 +/- .62 (n = 25) and attained low concentrations (.30 +/- .06 ng/ml) 2 days postpartum. Although there was a surge of glucocorticoids at parturition, this was not associated with a modification in adrenal responsiveness or with prepartum concentrations of other steroid hormones of plasma. Adrenal potential in prepartum and postpartum dairy cows appears well maintained.