ResearchPad - ethiopia https://www.researchpad.co Default RSS Feed en-us © 2020 Newgen KnowledgeWorks <![CDATA[Breeding practices and trait preferences of smallholder farmers for indigenous sheep in the northwest highlands of Ethiopia: Inputs to design a breeding program]]> https://www.researchpad.co/article/elastic_article_7865 The aim of this study was to identify breeding practices and trait preferences for indigenous sheep in three districts (Estie, Farta and Lay Gayient) located in the northwest highlands of Ethiopia. Questionnaire survey and choice experiment methods were used to collect data from 370 smallholder farmers. Respondents were selected randomly among smallholder farmers who own sheep in the aforementioned districts. A generalized multinomial logit model was employed to examine preferences for sheep attributes, while descriptive statistics and index values were computed to describe sheep breeding practices. Having the highest index value of 0.36, income generation was ranked as the primary reason for keeping sheep, followed by meat and manure sources. The average flock size per smallholder farmer was 10.21 sheep. The majority of the smallholder farmers (91%) have the experience of selecting breeding rams and ewes within their own flock using diverse criteria. Given the highest index value of 0.34, body size was ranked as a primary ram and ewe selection criteria, followed by coat color. Furthermore, choice modeling results revealed that tail type, body size, coat color, growth rate, horn and ear size have shown significant influences on smallholder farmers’ preference for breeding rams (P<0.01). The part-worth utility coefficients were positive for all ram attributes except ear size. For breeding ewes, mothering ability, coat color, body size, lambing interval, growth rate, tail type and litter size have shown significant effects on choice preferences of smallholder farmers (P<0.05). Moreover, significant scale heterogeneity was observed among respondents for ewe attributes (P<0.001). Overall, the results implied that sheep breeding objectives suitable for the northwest highlands of the country can be derived from traits such as linear body measurement, weight and survival at different ages, and lambing intervals. However, selection decisions at the smallholder level should not only be based on estimated breeding values of traits included in the breeding objective but instead, incorporate ways to address farmers’ preference for qualitative traits.

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<![CDATA[Adherence to antiretroviral therapy and associated factors among Human immunodeficiency virus positive patients accessing treatment at Nekemte referral hospital, west Ethiopia, 2019]]> https://www.researchpad.co/article/elastic_article_7637 Antiretroviral therapy has a remarkable clinical effect in reducing the progress of Acquired Immune Deficiency Syndrome. The clinical outcome of Anti-Retroviral therapy depends on strict adherence. Poor adherence reduces the effectiveness of antiretroviral therapy and increases viral replication. With changes in service delivery over time and differences in socio-demographic status from region to region, it is essential to measure adherence. Therefore, this study aimed to assess adherence to antiretroviral therapy and its associated factors among HIV/AIDS patients accessing treatment at Nekemte referral hospital, West Ethiopia.MethodsInstitutional based cross-sectional study was conducted on 311 HIV/AIDS patients from March 01 to March 30, 2019. The study participants were selected by a simple random sampling method and interviewed using structured questionnaires. Bivariable logistic regression was conducted to find an association between each independent variable and adherence to antiretroviral medication. Multivariable logistic regression was used to find the independent variables which best predict adherence. The statistical significance was measured using odds ratio at a 95% confidence interval with a p-value of less than 0.05.ResultsOut of a total of 311 patients sampled, 305 were participated in the study, making a response rate of 98.07%. From these 305 study participants,73.1% (95% CI = 68.2, 78.0) were adherent to their medication. Having knowledge about HIV and its treatment (AOR = 8.24, 95% CI: 3.10, 21.92), having strong family/social support (AOR = 6.21, 95% CI: 1.39, 27.62), absence of adverse drug reaction (AOR = 5.33, 95% CI: 1.95, 14.57), absence of comorbidity of other chronic diseases (AOR = 5.72, 95% CI: 1.91, 17.16) and disclosing HIV status to the family (AOR = 5.08, 95% CI: 2.09, 12.34) were significantly associated with an increased likelihood of adherence to antiretroviral medication.ConclusionThe level of adherence to antiretroviral therapy was found low compared to WHO recommendation. The clinician should emphasize reducing adverse drug reaction, detecting and treating co-morbidities early, improving knowledge through health education, and encouraging the patients to disclose their HIV status to their families. ]]> <![CDATA[High prevalence of caesarean birth among mothers delivered at health facilities in Bahir Dar city, Amhara region, Ethiopia. A comparative study]]> https://www.researchpad.co/article/Nc10b7a7b-4e34-4c06-9bc7-b9eb28d75615

Objective

The study aimed to assess and compare the prevalence of caesarean birth and associated factors among women gave birth at public and private health facilities in Bahir Dar city, Amhara region, Ethiopia.

Methods

An institution-based comparative cross-sectional study design was conducted from March1-April 15, 2019 at health facility provide emergency obstetrics service in Bahir Dar city. Study participants 724(362 for each public and private facility) were recruited using a systematic random sampling technique. Structured interview administered questionnaires and chart review checklist were used to collect data. The data were entered into Epi info version 7.2 and analyzed using SPSS version 23.0 software. A binary logistic regression model was fitted and an adjusted odds ration with 95% CI was used to determine the presence and strength of association between independent variables and cesarean birth.

Results

The response rate was 98.3% and 97.2% for public and private health facilities respectively. The prevalence of caesarean birth in private health facilities was 198 (56.3%) (95%CI: 50.9, 61.4) and in public health facilities was 98 (27.5%) (95%CI: 22.8, 32.2). Overall prevalence of caesarean birth was 296 (41.8%) (95%CI: 38.4, 45.5). Breech presentation (AOR = 3.64; 95%CI:1.49, 8.89), urban residence (AOR = 6.54; 95%CI:2.59, 16.48) and being referred (AOR = 2.44; 95%CI:1.46, 4.08) were variables significantly associated with caesarean birth among public facilities whereas age between 15–24 (AOR = 0.20, 95% CI; 0.07, 0.52), government employe (AOR = 2.28; 95%CI: 1.39,3.75), self-employed (AOR = 3.73; 95%CI:1.15,8.59), para one (AOR = 6.79; 95%CI:2.02, 22.79), para two (AOR = 3.88; 95% CI:1.15,13.08), and wealth index being highest level of wealth asset AOR = 5.39; 95%CI:1.08, 26.8) in private health facility associated with caesarean birth.

Conclusions

We concluded that there is high prevalence of caesarean birth both in private and public facility. There is a statistically significant difference in the prevalence of caesarean birth in public and private health facilities.

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<![CDATA[Financial risk protection at the bedside: How Ethiopian physicians try to minimize out-of-pocket health expenditures]]> https://www.researchpad.co/article/5c6c7593d5eed0c4843cfec0

Background

Out-of-pocket health expenditures can pose major financial risks, create access-barriers and drive patients and families into poverty. Little is known about physicians’ role in financial protection of patients and families at the bedside in low-income settings and how they perceive their roles and duties when treating patients in a health care system requiring high out-of-pocket costs.

Objective

Assess physicians’ concerns regarding financial welfare of patients and their families and analyze physicians’ experiences in reducing catastrophic health expenditures for patients in Ethiopia.

Method

A national survey was conducted among physicians at 49 public hospitals in six regions in Ethiopia. Descriptive statistics were used.

Results

Totally 587 physicians responded (response rate 91%) and 565 filled the inclusion criteria. Health care costs driving people into financial crisis and poverty were witnessed by 82% of respondants, and 88% reported that costs for the patient are important when deciding to use or not use an intervention. Several strategies to save costs for patients were used: 37–79% of physicians were doing this daily or weekly through limiting prescription of drugs, limiting radiologic studies, ultrasound and lab tests, providing second best treatments, and avoiding admission or initiating early discharge. Overall, 75% of the physicians reported that ongoing and future costs to patients influenced their decisions to a greater extent than concerns for preserving hospital resources.

Conclusion

In Ethiopia, a low-income country aiming to move towards universal health coverage, physicians view themselves as both stewards of public resources, patient advocates and financial protectors of patients and their families. Their high concern for family welfare should be acknowledged and the economic and ethical implications of this practice must be further explored.

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<![CDATA[Prevalence and determinants of antenatal depression in Ethiopia: A systematic review and meta-analysis]]> https://www.researchpad.co/article/5c75ac84d5eed0c484d0895e

Background

Maternal depression is the most prevalent psychiatric disorder during pregnancy, can alter fetal development and have a lasting impact on the offspring's neurological and behavioral development. However, no review has been conducted to report the consolidated magnitude of antenatal depression (AND) in Ethiopia. Therefore, this review aimed to systematically summarize the existing evidence on the epidemiology of AND in Ethiopia.

Methods

Using PRISMA guideline, we systematically reviewed and meta-analyzed studies that examined the prevalence and associated factors of AND from three electronic databases (PubMed, EMBASE, and SCOPUS). We used predefined inclusion criteria to screen identified studies. A qualitative and quantitative analysis was employed. Heterogeneity across the studies was evaluated using Q and the I² test. Publication bias was assessed by funnel plot and Egger’s regression test.

Results

In this review, a total of 193 studies were initially identified and evaluated. Of these, five eligible articles were included in the final analysis. In our meta-analysis, the pooled prevalence of AND in Ethiopia was 21.28% (95% CI; 15.96–27.78). The prevalence of AND was highest in the third trimester of pregnancy at 32.10% and it was 19.13% in the first trimester and 18.86% in the second trimester of pregnancy. The prevalence of AND was 26.48% and 18.28% as measured by Beck depression inventory (BDI) and the Edinburgh Postnatal Depression Scale (EPDS), respectively. Moreover, the prevalence of AND was 15.50% for the studies conducted in the community setting and it was 25.77% for the studies conducted in the institution-based setting. In our qualitative synthesis, we found that those pregnant women who had a history of stillbirth, complications during pregnancy, previous history of depression, no ANC follow-up, irregular ANC follow-up, not satisfied by ANC follow-up, and monthly income <1500 Ethiopian birr were linked with a greater risk of developing ANC. We also found that those women who experienced partner violence during pregnancy, food insecurity, medium and low social support, and those who were unmarried, age group 20–29, house wives and farmers were associated with a higher risk of developing ANC.

Conclusion and recommendations

Our meta-analysis found that the pooled prevalence of AND in Ethiopia was 21.28%. The prevalence of AND was high in the third trimester of pregnancy as compared to the first and second trimesters of pregnancy. The prevalence of AND was high in studies conducted using BDI than EPDS. Studies on the magnitude of AND as well as the possible determinants in each trimester of pregnancy with representative sample size are recommended. Screening of depression in a pregnant woman in perinatal setting might be considered backed by integration of family planning and mental health services. The use of validated and a standard instrument to assess AND is warranted.

Systematic review registration

The protocol for this systematic review and meta-analysis was registered at PROSPERO (record ID=CRD42017076521, 06 December 2017)

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<![CDATA[Client satisfaction with existing labor and delivery care and associated factors among mothers who gave birth in university of Gondar teaching hospital; Northwest Ethiopia: Institution based cross-sectional study]]> https://www.researchpad.co/article/5c648d12d5eed0c484c81ecb

Background

There are many reasons for mothers not receiving modern obstetric care, being dissatisfied by health care deliveries is one of the major factors. There are limited studies about maternal satisfaction with labor and delivery care services in Ethiopia and particularly in the study area. Therefore, the aim of this study was to better understand client satisfaction on existing labor and delivery care service and associated factors among mothers who gave birth in the University of Gondar Teaching Hospital, Ethiopia.

Methods

This institution based cross-sectional study was conducted at the University of Gondar Referral Hospital. 593 mothers who gave birth between July and September 2016 were enrolled. Study participants were selected by systematic random sampling. A standardized, interviewer-administered questionnaire was used to collect data. Descriptive and summary statistics were performed. A linear regression model was fitted and variables having a P value of ≤0.05 in the multivariable model were considered statistically significant.

Result

Overall, 31.3% of mothers were satisfied by the existing labor and delivery care. Living in rural areas (-2.9%; 95% CI: -5.75,-0.12) and the presence of a co-morbidity (-3.2%; 95%CI:-5.70, -0.72) were the factor which have a negative influence on maternal satisfaction. On the other hand, travel time to reach to the hospital (hours) (0.79%; 95% CI: 0.07, 1.52), birth by episiotomy or assisted vaginal delivery (6.3%; 95%CI: 1.56, 11.04), and receiving cost-free maternal health services (6.66%; 95%CI: 3.31, 10.01) were the factors that had positive influence.

Conclusion

The level of satisfaction of laboring mothers with the labor and delivery care services was poor. Rural residency and chronic medical co-morbidity were negatively associated with level of satisfaction while travel time, mode of delivery, and payment free delivery service had a statistically significant positive influence on satisfaction.

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<![CDATA[Community based cross sectional study of podoconiosis and associated factors in Dano district, Central Ethiopia]]> https://www.researchpad.co/article/5c58d630d5eed0c484031865

Background

Podoconiosis, affects lower limb, is an entirely preventable non-communicable tropical disease common in low income countries. Globally it is estimated that there are 4 million peoples with podoconiosis and nationally it is estimated that there are 1.56 million cases of podoconiosis. Even though nationwide mapping has been conducted including the current district under investigation, there are no studies conducted to identify factors associated with podoconiosis in the district. Hence, this study was aimed to determine the prevalence of podoconiosis and associated factors in the west Shewa of Dano district community.

Method

A community based cross sectional study was conducted from March 1 to 26, 2018. Seven kebeles out of the total of twenty-three kebeles found in the district were selected randomly. The total sample size was allocated by probability proportional to size to each kebele based on the number of households they had. Then, systematic random sampling was employed to select 652 study participants from the seven kebeles. Data was collected using interviewer administered structured questionnaire and observation. In addition, a blood sample was collected from the study subjects who had leg swelling for ruling out lymphedema due to lymphatic filarasis by using Immunochromatographic test card. Podoconiosis case was defined as bilateral but asymmetric swelling which develop first in the foot often confined to the lower leg and negative result for immune-chromatographic test (ICT card). The prevalence of podoconiosis was determined and multiple logistic regression model was fitted using SPSS version 23 to identify factors associated with podoconiosis.

Result

The prevalence of podoconiosis in Dano district was found to be 6.3% (95%CI: 5.8, 6.8). Age at first shoe wearing (AOR = 1.08,95% CI = 1.06–1.11), washing practice of feet by water only (AOR = 3.68, 95% CI = 1.47–9.24) and not wearing shoe daily (AOR = 9.32, 95% CI = 4.27–20.4) were found to be significantly associated with increased odds of podoconiosis.

Conclusion

This study revealed that there was significant burden of podoconiosis in the study area. Age at first shoe wearing, washing practice and frequency of shoe wearing were associated with the development of podoconiosis disease. Modalities to enhance the shoe wearing behaviour of the communities should be planned by high level decision makers working in the area of Health. Moreover, collaboration between local government and non-government stakeholders, and integration with existing programs addressing foot hygiene which involves washing feet with soap and water needs to be addressed.

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<![CDATA[District-level health management and health system performance]]> https://www.researchpad.co/article/5c5df34ad5eed0c4845810c0

Strengthening district-level management may be an important lever for improving key public health outcomes in low-income settings; however, previous studies have not established the statistical associations between better management and primary healthcare system performance in such settings. To explore this gap, we conducted a cross-sectional study of 36 rural districts and 226 health centers in Ethiopia, a country which has made ambitious investment in expanding access to primary care over the last decade. We employed quantitative measure of management capacity at both the district health office and health center levels and used multiple regression models, accounting for clustering of health centers within districts, to estimate the statistical association between management capacity and a key performance indicator (KPI) summary score based on antenatal care coverage, contraception use, skilled birth attendance, infant immunization, and availability of essential medications. In districts with above median district management capacity, health center management capacity was strongly associated (p < 0.05) with KPI performance. In districts with below median management capacity, health center management capacity was not associated with KPI performance. Having more staff at the district health office was also associated with better KPI performance (p < 0.05) but only in districts with above median management capacity. The results suggest that district-level management may provide an opportunity for improving health system performance in low-income country settings.

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<![CDATA[Breakthrough tuberculosis disease among people with HIV – Should we be worried? A retrospective longitudinal study]]> https://www.researchpad.co/article/5c61e8ddd5eed0c48496f299

Introduction

Isoniazid preventive therapy (IPT) is a proven means to prevent tuberculosis (TB) disease among people living with HIV (PLHIV). However, there is a concern that patients often develop tuberculosis disease while receiving IPT, defined here as breakthrough tuberculosis, which may affect treatment outcome. In this study, we assessed the magnitude and determinants of breakthrough tuberculosis.

Methods

A multisite retrospective longitudinal study from the year 2005 to 2014 involving 11 randomly selected hospitals from the Addis Ababa, SNNPR (Southern Nations Nationalities and Peoples Region), and Gambela regions of Ethiopia was carried out to assess the occurrence of breakthrough tuberculosis. Cox regression analysis was used to study factors associated with breakthrough TB.

Results

4,484 patients in chronic HIV care received IPT. Eighty percent of the same number received antiretroviral therapy (ART). Tuberculosis developed in 88 of 4,484 (2%) patients of which 24 (0.5%) were diagnosed while receiving IPT. Breakthrough TB incidence was 1106 per 100,000 person-years (PY) (95% CI: 742–1651) while TB incidence after completing IPT was 624 per 100,000 PY (95% CI: 488–797). Seven of the 24 (29%) breakthrough TB cases were diagnosed within the first month of IPT initiation. Of 15 patients who developed breakthrough TB while on ART, nine (60%) were diagnosed within the first six months of ART initiation. Having high CD4 cell count and being on ART were associated with having lower risk of developing TB and breakthrough TB.

Conclusion

Breakthrough TB was uncommon in the study setting. Even then, taking ART reduced the risk of its occurrence. Slightly more than a quarter of the cases of breakthrough TB occurred in the first month of treatment and may be existing undiagnosed TB cases which were missed during diagnostic work-up.

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<![CDATA[Metabolic syndrome among residents of Mizan-Aman town, South West Ethiopia, 2017: A cross sectional study]]> https://www.researchpad.co/article/5c5ca2e3d5eed0c48441ec78

Introduction

Globally, it is estimated that around 20–25% adult population has metabolic syndrome. Individuals who have metabolic syndrome are up to five times more susceptible for chronic diseases than those who have no metabolic syndrome. In Ethiopia there is no sufficient information regarding the magnitude and factors of metabolic syndrome. The aim of this study is to assess prevalence and associated factors of metabolic syndrome among residents of Mizan-Aman town, South West, Ethiopia.

Methods

The community based cross-sectional study was held at Mizan-Aman town residents. Systematic random sampling was employed to select each household and lottery method was used to select one individual from the household. Data were cleaned, coded and entered by EPI-INFO version 3.5.4 and were transported to SPSS version 20 for further analysis. To indicate the strength of association, odds ratios (OR) and 95% confidence intervals (95% CI) were used.

Results

In this study from a total of 558 respondents 534 were completed the interview correctly, which gives a response rate of 95.7%. The overall prevalence of metabolic syndrome was 9.6%. Multivariate logistic regression revealed that physical inactivity [AOR = 2.61, 95% CI (1.22, 5.58)], age from 18 to 28 years [AOR = 0.36, 95% CI (0.14, 0.90)], being male [AOR = 0.46, 95% CI (0.22, 0.96)] and educational status with cannot write and read [AOR = 0.15, 95% CI (0.04,0.53)], from grade 1 to 8 [AOR = 0. 17, (0.11,0.55)], from grade 9 to12 [AOR = 0.11, (0.03, 0.38)] and from diploma to degree [AOR = 0. 13, (0.01, 0.36)] were significantly associated with metabolic syndrome.

Conclusion

The prevalence of metabolic syndrome in this study was found to be high. Age, physical activity, educational status and sex were significantly associated with metabolic syndrome. Physical activity was found to be the means of metabolic syndrome prevention.

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<![CDATA[Magnitude of road traffic accident related injuries and fatalities in Ethiopia]]> https://www.researchpad.co/article/5c59fea3d5eed0c4841351e4

Background

In many developing countries there is paucity of evidence regarding the epidemiology of road traffic accidents (RTAs). The study determines the rates of injuries and fatalities associated with RTAs in Ethiopia based on the data of a recent national survey.

Methods

The study is based on the secondary data of the Ethiopian Demographic and Health Survey conducted in 2016. The survey collected information about occurrence injuries and accidents including RTAs in the past 12 months among 75,271 members of 16,650 households. Households were selected from nine regions and two city administrations of Ethiopia using stratified cluster sampling procedure.

Results

Of the 75,271 household members enumerated, 123 encountered RTAs in the reference period and rate of RTA-related injury was 163 (95% confidence interval (CI): 136–195) per 100,000 population. Of the 123 causalities, 28 were fatal, making the fatality rate 37 (95% CI: 25–54) per 100,000 population. The RTA-related injuries and fatalities per 100,000 motor vehicles were estimated as 21,681 (95% CI: 18,090–25,938) and 4,922 (95% CI: 3325–7183), respectively. Next to accidental falls, RTAs were the second most common form of accidents and injuries accounting for 22.8% of all such incidents. RTAs contributed to 43.8% of all fatalities secondary to accidents and injuries. Among RTA causalities, 21.9% were drivers, 35.0% were passenger vehicle occupants and 36.0% were vulnerable road users including: motorcyclists (21.0%), pedestrians (12.1%) and cyclists (2.9%). Approximately half (47.1%) of the causalities were between 15–29 years of age and 15.3% were either minors younger than 15 years or seniors older than 64 years of age. Nearly two-thirds (65.0%) of the victims were males.

Conclusion

RTA-related causalities are extremely high in Ethiopia. Male young adults and vulnerable road users are at increased risk of RTAs. There is a urgent need for bringing road safety to the country's public health agenda.

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<![CDATA[Epidemiology and factors associated with peripheral neuropathy among HIV infected patients in Gondar, Ethiopia: A cross-sectional study]]> https://www.researchpad.co/article/5c59fec5d5eed0c484135428

Background

Antiretroviral therapy has surely increased the life expectancy of people living with HIV. However, long term complications like HIV associated sensory neuropathy has a negative impact on quality of life among people living with HIV (PLHIV). In Ethiopia, lack of data on magnitude of the burden and predictors of HIV associated sensory neuropathy in many resource limited setting has led to under diagnosis and eventually under management of HIV-SN. Hence, this study was set out to establish the burden of HIV-associated sensory neuropathy and, its association with demographic, health and clinical characteristics among people living with HIV in Ethiopia.

Methods

Cross-sectional study was conducted to assess the prevalence of HIV-associated sensory neuropathy and the associated factors among adult HIV patients at University of Gondar Teaching Hospital, Gondar, Ethiopia. Brief Peripheral Neuropathy Screening tool validated by AIDs Clinical trial group was used for screening HIV-associated sensory neuropathy. Data were analyzed descriptively and through uni- and multivariate logistic regression.

Results

In total 359 adult PLHIV with a mean age of 36.5± 9.07 years participated, their median duration of HIV infection was 60 months (IQR 36–84) and their median CD4 count 143cells/μL (IQR 69.5–201.5). Age above 40 years, anti-tuberculosis regimen, tallness, and exposure to didanosine contained antiretroviral therapy were found to be associated with HIV-associated sensory neuropathy (AOR 1.82, 1.84, 1.98 and 4.33 respectively).

Conclusions

More than half of the HIV patients who attended HIV care clinic at University of Gondar hospital during the study period were found to present with peripheral sensory neuropathy. Higher age, tallness, TB medication, and didanosine in ART were significantly associated with HIV-SN as screened by effective diagnostic (BPNS) tool.

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<![CDATA[Prevalence and determinant factors of unintended pregnancy among pregnant women attending antenatal clinics of Addis Zemen hospital]]> https://www.researchpad.co/article/5c5b52cfd5eed0c4842bd074

Introduction

Unintended pregnancy is a pregnancy which is not wanted and/or not planed at the time of conception. It has a major consequence on mothers’ and newborns’ health and its prevalence remains a major health problem in Ethiopia. This study was aimed to assess the prevalence and determinants of unintended pregnancy among pregnant women attending antenatal clinics of Addis Zemen hospital.

Methods

An institutional-based cross-sectional study was employed in Addis Zemen hospital from April 01 to May 30, 2018. The sampled 398 pregnant mothers were selected by systematic random sampling. The data were collected using a-pretested structured questionnaire via face to face interview and the collected data were analyzed by using SPSS Version-20. The data were summarized with frequency and cross-tabulation. Both binary and multiple logistic regressions were used in order to identify predictor variables using odds ratio at 95% confidence interval.

Results

All of 398 mothers answered the questionnaire making the response rate 100%. The prevalence of unintended pregnancy was 26.1% (CI;22.1, 30.4). Women who were multigravid (AOR; 4.7: CI; 2.3, 6.8), women who were multipara (AOR; 2.8: CI; 2.6, 9.7), and women who were from rural (AOR; 2.6: CI; 1.5, 4.6) were more likely experienced unintended pregnancy than their counterparts. Women who were Muslim (AOR; 0.79: CI; 0.6, 0.90) and women who attended secondary education (AOR; 0.58: CI; 0.42, 0.78) were less likely experienced unintended pregnancy.

Conclusion and recommendation

The prevalence of unintended pregnancy is high in the study area. Educational status, parity, gravity, residence, and religion were the most important predictor variables of unintended pregnancy. Reducing the prevalence of unintended pregnancy especially in the rural area is recommended.

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<![CDATA[Dietary and non-dietary determinants of linear growth status of infants and young children in Ethiopia: Hierarchical regression analysis]]> https://www.researchpad.co/article/5c6448c0d5eed0c484c2ed4a

Introduction

Childhood growth faltering remains a major public health problem in developing countries. We aimed to identify the distal, underlying, and proximal dietary and non-dietary factors associated with length-for-age (LFA) of infants and young children in Ethiopia.

Methods

We used a nationally representative sample of 2,932 children aged 6–23 months from the Ethiopian demographic and health survey (EDHS) conducted in 2016. Hierarchical regression analysis was done to identify the factors associated with LFA.

Findings

Pastoral residence (adjusted β (aβ) = -0.56, 95%CI = -0.82, -0.31, P<0.001) and poorest household wealth category (aβ = -0.57, 95%CI = -0.66, -0.48, P<0.001) were the basic factors negatively associated with LFA. Among underlying factors, maternal wasting (aβ = -0.43, 95%CI = -0.58, -0.28, P<0.001), and unimproved toilet facility (aβ = -0.48, 95%CI = -0.73, -0.23, P<0.001) were negatively associated with LFA. Proximal factors found positively associated with LFA were dietary diversity (aβ = 0.09, 95%CI = 0.043, 0.136, P<0.001), meal frequency (aβ = 0.04, 95%CI = 0.00, 0.08, P = 0.042), and vitamin A supplementation (aβ = 0.16, 95%CI = 0.03, 0.29, P = 0.020). Male sex (aβ = -0.26, 95%CI = -0.39, -0.14, P<0.001), age (aβ = -0.12, 95%CI = -0.13, -0.10, P = 0.001), small birth size (aβ = -0.45, 95%CI = -0.62, -0.29, P<0.001), and not currently breastfeeding (aβ = -0.29, 95%CI = -0.47, -0.11, P = 0.003) were negatively associated with LFA.

Conclusion

LFA was associated with various influences at distal, underlying, and proximal levels. A multi-pronged approach, addressing the various factors comprehensively, would represent an important consideration to promote linear growth in early childhood in Ethiopia.

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<![CDATA[Prevalence and determinants of anti-tuberculosis treatment non-adherence in Ethiopia: A systematic review and meta-analysis]]> https://www.researchpad.co/article/5c40f75ed5eed0c484385fc9

Background

Tuberculosis is a global public health problem. One of the overarching dilemmas and challenges facing most tuberculosis program is non-adherence to treatment. However, in Ethiopia there are few studies with variable and inconsistent findings regarding non-adherence to treatment for tuberculosis.

Methods

This systematic review and meta-analysis was conducted to determine the prevalence of non-adherence to tuberculosis treatment and its determinants in Ethiopia. Biomedical databases including PubMed, Google Scholar, Science Direct, HINARI, EMBASE and Cochrane Library were systematically and comprehensively searched. To estimate the pooled prevalence, studies reporting the prevalence of adherence or non-adherence to tuberculosis treatment and its determinants were included. Data were extracted using a standardized data extraction tool prepared in Microsoft Excel and transferred to STATA/se version-14 statistical software for further analyses. To assess heterogeneity, the Cochrane Q test statistics and I2 test were performed. Since the included studies exhibited high heterogeneity, a random effects model meta- analysis was used to estimate the pooled prevalence of non-adherence to tuberculosis treatment. Finally, the association between determinant factors and non-adherence to tuberculosis treatment was assessed.

Results

The result of 13 studies revealed that the pooled prevalence of non-adherence to tuberculosis treatment in Ethiopia was found to be 21.29% (95% CI: 15.75, 26.68). In the subgroup analysis, the highest prevalence was observed in Southern Nations and Nationalities of Ethiopia, 23.61% (95% CI: 21.05, 26.17) whereas the lowest prevalence was observed in Amhara region, 10.0% (95% CI: 6.48, 13.17.0;). Forgetfulness (OR = 3.22, 95% CI = 2.28, 4.53), fear side effect of the drugs (OR = 1.93, 95% CI = 1.37, 2.74), waiting time ≥ 1 hour during service (OR = 4.88, 95% CI = 3.44, 6.91) and feeling distance to health institution is long (OR = 5.35, 95% CI = 4.00, 7.16) were found to be determinants of non-adherence to tuberculosis treatment.

Conclusion

In this meta-analysis, the pooled prevalence of non-adherence to tuberculosis treatment in Ethiopia was high. Forgetfulness, fear of side effect of the drugs, long waiting time (≥1 hour) during service and feeling distance to health institution is long were the main risk factors for non-adherence to tuberculosis treatment in Ethiopia. Early monitoring of the side effects and other reasons which account for missing medication may increase medication adherence in patients with tuberculosis in Ethiopia.

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<![CDATA[Low use of long-lasting insecticidal nets for malaria prevention in south-central Ethiopia: A community-based cohort study]]> https://www.researchpad.co/article/5c40f7a4d5eed0c4843864fc

Introduction

A decline in malaria morbidity and mortality has been documented in Ethiopia since 2005 following a scale-up of the distribution of long-lasting insecticidal nets (LLINs). However, universal access to LLINs ownership and use has not yet been achieved. This study aimed to determine ownership and use of LLINs over time in south-central Ethiopia.

Methods

A cohort of 17,142 individuals residing in 3,006 households was followed-up from October 2014 to January 2017 (121 weeks). New PermaNet2.0 LLINs were given to households in October 2014. Once per week, the LLIN use status was documented for each individual. A survey was conducted after 110 weeks of LLIN distribution to determine LLIN ownership. A multilevel negative binomial regression model was fitted to identify significant predictors of LLIN use.

Results

At baseline, the LLIN ownership was 100%. After 110 weeks only 233 (8%) of the households owned at least one LLIN. The median proportion of LLIN use per individuals during the study period was only 14%. During the first year (week 1–52) the average LLIN use per individuals was 36% and during the second year (week 53–104) it was 4.6%. More frequent LLIN use was reported among age group [5–14 years (adjusted IRR = 1.13, 95% CI 1.04–1.22), 15–24 years (adjusted IRR = 1.33, 95% CI 1.23–1.45), ≥25 years (adjusted IRR = 1.99, 95% CI 1.83–2.17)] compared to <5 years, and household head educational status [read and write (adjusted IRR = 1.17, 95% CI 1.09–1.26), primary (adjusted IRR = 1.20, 95% CI 1.12–1.27), secondary or above (adjusted IRR = 1.20, 95% CI (1.11–1.30)] compared to illiterate. Having a family size of over five persons (adjusted IRR = 0.78, 95% CI 0.73–0.84) was associated with less frequent use of LLINs compared to a family size of ≤5 persons.

Conclusions

The study showed a low LLIN ownership after 110 weeks and a low LLIN use during 121 weeks of follow-up, despite 100% LLIN coverage at baseline. The study highlights the need to design strategies to increase LLIN ownership and use for setting similar to those studied here.

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<![CDATA[Uterine rupture among mothers admitted for obstetrics care and associated factors in referral hospitals of Amhara regional state, institution-based cross-sectional study, Northern Ethiopia, 2013-2017]]> https://www.researchpad.co/article/5c1028c2d5eed0c484248048

Background

Maternal morbidity and mortality have been one of the most challenging health problems that concern the globe over the years. Uterine rupture is one of the peripartum complications, which cause nearly about one out of thirteen maternal deaths. This study aimed to assess the prevalence and associated factors of uterine rupture among obstetric case in referral hospitals of Amhara Regional State, Northern Ethiopia.

Methods

Institution based cross sectional study was conducted from Dec 5-2017-Jan 5–2018 on uterine rupture. During the study randomly selected 750 charts were included by using simple random sampling method. Data were checked, coded and entered into Epi info version 7.2 and then exported to SPSS Version 20 for Analysis. Binary Logistic regression was used to identify the predictors of uterine rupture and 95% Confidence Interval of odds ratio at p-value less than 0.05 was taken as a significance level.

Result

The overall prevalence of uterine rupture was 16.68% (95% CI: 14%, 19.2%). Distance from health facility >10km (Adjusted Odds Ratio (AOR) = 2.44; 95%CI:1.13,5.28), parity between II and IV (AOR = 7.26;95% (3.06,17.22)) and ≥V (AOR = 12.55;95% CI 3.64,43.20), laboring for >24hours(AO = 3.44; 95% CI:1.49,7.92), with referral paper(AOR = 2.94;95%CI:1.28,6.55) diagnosed with obstructed labor (AOR = 4.88;95%CI: 2.22,10.70), precipitated labor (AOR = 3.59;95%CI:1.10,11.77), destructive delivery (AOR = 5.18;95%: 1.22,20.08), No partograph (AOR = 5.21; 95% CI: 2.72,9.97), CPD(AOR = 4.08;95%CI:1.99,8.33), morbidly adherent placenta (AOR = 9.00;95%:2.46,27.11), gestational diabetic militias (AOR = 5.78; 95%CI:1. 12,20 .00 ), history of myomectomy(AOR = 5.00;95%CI:1.33,18.73), induction and augmentation of labor (AOR = 2.34;95%:1.15,4.72) obstetric procedure (AOR = 2.54;95%: 1.09,5.91), previous caesarian deliveries 4.90 (2.13,11.26) were found to be significantly associated with uterine rupture.

Conclusion

This finding showed that the prevalence of uterine rupture is higher. A more vigilant approach to prevent prolonged and obstructed labor, use of partograph, quick referral to a well-equipped center and prevention of other obstetrics complications need to be focused on.

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<![CDATA[Magnitude and factors associated with late antenatal care booking on first visit among pregnant women in public health centers in central zone of Tigray Region, Ethiopia: A cross sectional study]]> https://www.researchpad.co/article/5c117be0d5eed0c48469ac09

Background

Antenatal care (ANC) is a care given for pregnant women and is a good opportunity to deliver maternal health interventions. Even though pregnant women should start their first antenatal care within 12 weeks of gestational age, many pregnant women start their first ANC late. So, the aim of this study is to determine magnitude of late ANC booking at first visit and factors associated with it.

Methods

Institutional based cross sectional study design was conducted in central zone of Tigray Region, Ethiopia from November 1/2017 to January 30/2018 among total of 632 pregnant women. Stratified multi stage cluster sampling method was used to select health centers and systematic random sampling technique was used during the selection of study units. Data were collected using interview administer questionnaire by face to face. The collected data were entered into EPI info-7. Later on, it was exported to STATA-14 for further analysis. Proportion was used to estimate the magnitude of late ANC booking. Bivariable and multivariable analysis were done to see factors associated with the magnitude of late ANC booking.

Results

The magnitude of late ANC booking at first visit were 85.67% (95%, CI: 82.89, 88.45). Factors that were independently associated with the late ANC booking at first visit in multivariable analysis were; having home delivery in previous delivery (AOR = 2.2, 95%, CI: 1.1, 4.49), women who had no previous ANC follow up (AOR = 3.43, 95%, CI: 1.32, 8.92) and women with poor knowledge about the advantage and service availability of ANC (AOR = 3.9, 95%, CI: 1.83, 8.29).

Conclusion

In summary, most of pregnant women were not started their first ANC at the recommended time. Home delivery and history of ANC in previous pregnancy as well as women with poor knowledge about ANC were associated with late ANC booking at first visit. Health workers should work on avoiding home delivery and increasing the knowledge of pregnant women on ANC may help on reducing late ANC booking at first visit.

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<![CDATA[Application of the Andersen-Newman model of health care utilization to understand antenatal care use in Kersa District, Eastern Ethiopia]]> https://www.researchpad.co/article/5c12cfa5d5eed0c484914b19

Background

In Ethiopia, the uptake of antenatal care services has been low. Moreover, there is less frequent and late attendance of antenatal care among women who attend. Using the Anderson-Newman model of health care utilization, this study identified factors that either facilitate or impede antenatal care utilization in Kersa district, Eastern Ethiopia.

Method

A community-based cross-sectional study was conducted. A total of 1294 eligible women participated in the study. Data were collected using face to face interviews with a pre-tested structured questionnaire administered with a digital survey tool. Data were collected in a house to house survey of eligible women in the community. Bivariate and multivariate logistic regression analyses were used to examine the predisposing, enabling and need factors associated with antenatal care utilization.

Result

Out of the 1294 respondents, 53.6% (95% CI: 50.8%, 56.3%) attended antenatal care at least once during their last pregnancy. Only 15.3% attended four or more antenatal care visits and just 32.6% attended prior to the 12th week of gestation. Educational status, previous use of antenatal care and best friend’s use of maternal care were significant predisposing factors associated with at least one antenatal care visit. Type of kebele, wealth index and husband’s attitude towards antenatal care were significant enabling factors associated with at least one antenatal care consultation. Health Extension Workers providing home visits, perceived importance of ANC and awareness of pregnancy complications were significant need factor associated with at least one antenatal care consultation. Husband’s attitude towards ANC, head of the household, awareness of pregnancy complications, and history of abortion were predictors of attending four or more antenatal care visits.

Conclusion

More than half of the women attended at least one antenatal care visit. A sizable proportion of women had infrequent and delayed antenatal care. Intervention efforts to improve antenatal care utilization should involve the following: improving women’s educational achievement, peer education programs to mobilize and support women, programs to change husbands’ attitudes, ameliorate the quality of antenatal care, increasing the Health Extension Worker’s home visits program, and increasing the awareness of pregnancy complications.

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<![CDATA[Impact of Six Years Community Directed Treatment with Ivermectin in the Control of Onchocerciasis, Western Ethiopia]]> https://www.researchpad.co/article/5989d9f6ab0ee8fa60b7015f

Background

The African Program for Onchocerciais Control (APOC) with a main strategy of community directed treatment with ivermectin (CDTI) was established with the aim of eliminating Onchocerciasis as a disease of public health and socio-economic importance. The study area was a hyper endemic area just before the implementation of CDTI. It has been implemented for six years in this district but yet not been evaluated. So, the objective of this study was to evaluate the impact of six years CDTI on parasitological and clinical indices of Onchocerciasis

Methods

This study employed a pre-post impact evaluation design. The minimum sample size for this study was 1318; the respondents were selected by multi-stage sampling technique. Data on socio-demographic characteristics using a semi-structured questionnaire, clinical examination for skin signs and symptoms of Onchocerciasis and two bloodless skin snips from each side of the gluteal fold were taken from the entire study participants. SPSS version 16.0 and Medcalc version 12.2.1.0 were used for analysis.

Result

The microfilaridermia reduced from the pre-intervention value of 74.8% to 40.7%, indicating a 45.6% reduction, mean intensity from 32.1(SD = 61.5) mf/mg skin snip to 18.7(SD = 28.7)indicating 41.75% reduction, CMFL from 19.6 mf/mg skin snip to 4.7 indicating 76% reduction. The result also showed that microfilaridermia and mean intensity decreased as the number of treatment taken increased. Pruritis, leopard skin, onchocercomata and hanging groin reduced by 54.4%, 61.3%, 77.7% and 88.5% respectively.

Conclusions

The implementation of CDTI significantly reduced the parasitological and clinical indices of Onchocerciasis, so, efforts should be made to improve the annual treatment coverage and sustainability of CDTI to drastically reduce the micro filarial load to the level the disease would no longer be a public health problem.

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