Time to nutritional recovery and its determinants among children aged 6 to 59 months with severe acute malnutrition admitted to stabilization centers of WagHimra Zone, Northeast Ethiopia.

Severe acute malnutrition is a life-threatening condition that contributes to over half of under five deaths in developing countries. Urgent and specialized treatment to improve the time to recovery and recovery rate is very important. However, data regarding time to nutritional recovery is limited in Ethiopia. Hence, this study aimed to determine the average time to recovery and its determinants among children aged 6 to 59 months admitted with SAM to the stabilization centers of Wag Himra zone, northeast Ethiopia. A retrospective cohort study was conducted on 501 patients charts of children with severe acute malnutrition (SAM) admitted to stabilization centers (SCs) from September 2014 to August 2017. The charts were selected using the systematic random sampling technique. Data were extracted from the charts of each child using a pretested standard checklist and entered using Epi data version 3.1 and analyzed by STATA 14. A Cox proportional-hazard regression analysis was carried out to identify determinants of time to recovery. Any statistical test was considered significant at P-values < 0.05. In this study, the overall recovery rate from SAM was 80.4% (95% Confidence Interval [CI]: 76, 84) with the median nutritional recovery time of 11 (Inter Quartile Range [IQR]: 8-18) days. Patients aged 6-23 months (Adjusted Hazard Ratio [AHR] = 0.74, 95%CI: 0.60, 0.92), and had pneumonia (AHR = 0.44; 95% CI: 0.32, 0.59), anemia (AHR = 0.65; 95% CI: 0.52, 0.81) and vomiting (AHR = 0.63, 95% CI: 0.49, 0.82) at admission were less likely to recover quickly compared to those who did not have these conditions or were in other age categories, whereas edematous malnourished children (AHR = 2.85; 95% CI: 2.28, 3.56) were positively and significantly associated with early recovery. The median nutritional recovery time fell within the recommended international standards. However, the length of stay was significantly longer among children with severe wasting, aged 6-23 months, and had vomiting, pneumonia, and anemia at admission than their counterparts. Therefore, interventions should focus on young children with severe wasting, pneumonia, vomiting, and anemia to prevent prolonged stay in the SCs without recovery. Retrospectively registered.

The role of mass media exposure on tuberculosis knowledge and attitude among migrant and seasonal farmworkers in Northwest Ethiopia.

BACKGROUND: Globally, tuberculosis (TB) is the 10th leading cause of death. Despite no country achieved its target, the world health organization (WHO) proposed a 90-90-90 approach to fastening the end TB strategy. Improvement and progression of TB control need good knowledge and a favorable attitude towards the disease. However, interventions designed don't take migrants and seasonal farmworkers into account. Therefore, this study aimed at estimating the level of knowledge and attitude on Tuberculosis among migrant and seasonal farmworkers in northwest Ethiopia. METHODS: Community-based cross-sectional study was conducted in the West Gondar zone from October to November 2018. A two-stage cluster sampling was used to select 949 migrant and seasonal farmworkers. Both bivariate and multivariable logistic regression analyses were performed. A p-value of < 0.05 was used to declare statistical significance. The goodness of fit was checked using Hosmer and Lemeshow test. RESULTS: In this study, (41.8%), (95% CI: 38.73, 45.01) and (50.5%), (95% CI: 47.29, 53.65) of migrants and seasonal farmworkers had good knowledge and a favorable attitude, respectively. The odds of good knowledge among mass media exposed migrants were AOR = 1.42, 95% CI: (1.02, 2.01). Moreover, urban residence and having good knowledge increase the odds of favorable attitude by 1.66, (AOR = 1.7; 95% CI: 1.05, 2.62) and 4.3 (AOR = 4.3, 95%CI: 3.26, 5.75), respectively. CONCLUSION: In this study, the overall knowledge and attitude of migrant and seasonal farmworkers on TB were low. Family size and mass media exposure significantly affect knowledge of the migrants on TB. On the other hand, the attitude was affected by urban residence, health information, and having good knowledge. Health promotion interventions, focused on TB cause, mode of transmission, prevention, and treatment are important to migrant and seasonal farmworkers to improve the knowledge and attitude of migrants and seasonal farmworkers.

Genital self-sampling for HPV-based cervical cancer screening: a qualitative study of preferences and barriers in rural Ethiopia.

BACKGROUND: In the context of WHO's "task shifting" project and growing global consensus on primary HPV-based cervical cancer screening, self-sampling is a promising new tool to expand screening access, uptake and coverage for women worldwide. We aimed to explore perceptions and acceptability of HPV self-sampling-based cervical cancer screening among community members and health professionals in rural northwest Ethiopia and to identify preferences and socio-cultural barriers regarding self-sampling in order to design a suitable high-coverage screening intervention for a rural African setting. METHODS: Four community-based focus group discussions (FGD) were conducted in the rural district of Dabat, Northwest Ethiopia, each comprising 8 to 14 female participants, counting a total of 41 participants. The groups were homogenously composed in terms of their socio-economic status in the community. They included health centre attendees, community members, nurses and health development army leaders (HDAL). Two qualitative data collection experts conducted the interviews in the local language, using a FGD guide with several thematic areas. All participants granted written informed consent prior to the conduct of the interviews. As a concrete example of an existing self-sampling approach for cervical cancer screening we used the Evalyn® Brush. RESULTS: Emerging themes included (i) misconceptions and low awareness about cervical cancer among community residents and primary health care providers in rural northwest Ethiopia, (ii) stigmatization and social exclusion of affected women, (iii) delay in seeking of health care due to poor access and availability of services, and lacking of a concept of early cancer prevention, (iv) need of spousal permission, (v) fear of financial burden and (vi) fear of social marginalization. The self-sampling device was regarded to be acceptable and was judged to be easy to use for most women. The existing Ethiopian health care structure could facilitate a community approach. CONCLUSION: Home-based self-sampling for cervical cancer screening is a socially acceptable and feasible "task shifting" method that will increase cervical cancer screening access and coverage in the Ethiopian study community. Education, awareness creation, community mobilization and family inclusion are identified as key activities to promote, implement and facilitate "task shifting" approaches like self-sampling.

Prevalence and determinants of contraceptive utilization among married women at Dabat Health and Demographic Surveillance System site, northwest Ethiopia.

BACKGROUND: Despite the enormous benefits of family planning services, the contraceptive utilization still remains low in Sub-Saharan Africa. There is regional variation in modern contraceptive utilization in Ethiopia. Therefore, this study was aimed to determine the prevalence of modern contraceptive utilization and determinants in Dabat demographic and health surveillance system site, northwest Ethiopia. METHODS: A re-census was carried out in Dabat Health and Demographic Surveillance System (HDSS) site from October to December 2014. Data of 8271 married women collected in the re-census was used. The outcome variable was current utilization of any modern contraceptive methods whereas socio demographic and economic variables were the potential determinants considered. Bi-variable and multivariable binary logistic regression along with odds ratio and 95% confidence interval were used to describe the strength of association. RESULTS: Prevalence of modern contraceptive utilization among married women in Dabat DHSS site was found to be 32.5% (95%CI: 31.5, 33.5%). After adjusting for covariates; the odds of using modern contraceptive were 2.35 times, 1.91 times, and 1.39 times higher among women of secondary and above educational level, urban residents, and women having six and above living children, respectively. CONCLUSION: Modern contraceptive utilization was found to be very low. Effort has to be applied to improve women's educational level that increases their understanding of reproductive health issues. It is also important to give special emphasis for rural residents, those aged 20-40 years, and those with six or more living children while serving for modern contraceptive methods.

Intention to Screen for Cervical Cancer Among Child Bearing Age Women in Bahir Dar City, North-West Ethiopia: Using Theory of Planned Behavior.

BACKGROUND: Cervical cancer screening is consistently effective in reducing the incidence and mortality rates associated with cervical cancer. However, very few women have received cervical cancer screening in the developing countries including Ethiopia. Therefore, this study aims to assess cervical cancer screening intention and its predictors among child bearing age women in Bahir Dar city, North-West Ethiopia. METHODS: A community-based cross-sectional study was conducted among 832 child bearing age women using a multistage sampling technique between March and April, 2018. Data were collected using a structured questionnaire through face-to-face interviews. Data were entered and analyzed using EpiData and SPSS version 20.0, respectively. Simple and multiple linear regression analyses were done to identify predictors of intention, and P<0.05 was used as a cutoff to determine statistical significance at multiple regressions. RESULTS: Eight hundred and thirty-two (98%) respondents participated in this study. The mean age of the participants was 31±SD 7.23 years, ranging from 18-49 years. The majority (61.4%) of the participants were married. The mean score of intention to receive cervical cancer screening was 10.5±2.03, with a minimum and maximum sore of 5 and 15, respectively. Four hundred and fifty-eight (55%) (95% CI=51.7-58.3) respondents scored above the mean score. Direct perceived behavioral control (ß=0.19, P<0.001), direct subjective norm (ß=0.06, P<0.001), direct attitude (ß=0.15, P<0.001), and past screening experience (ß=0.64, P<0.001) were found to be significant predictors of intention. CONCLUSION: Perceived behavioral control, attitude towards the behavior, subjective norm, and past screening experience were the predictors of intention, and perceived behavioral control was the strongest predictor. Hence, behavioral change communication interventions are crucial to change their attitude and empower them to evaluate their control and normative beliefs.

Determinants of Under-Five Pneumonia at Gondar University Hospital, Northwest Ethiopia: An Unmatched Case-Control Study.

Background: Pneumonia causes about two million under-five deaths each year, accounting for nearly one in five child deaths globally. Knowing the determinants of under-five pneumonia is useful for prevention and intervention programs that are aimed to control the disease. Thus, the main aim of this study was to assess the determinants of under-five pneumonia at Gondar University Hospital, Ethiopia. Methods: An institution-based unmatched case-control study was carried out from April 1 to April 30, 2015, taking a sample size of 435 study participants (145 cases and 290 controls). The researchers used a systematic random sampling technique for selecting cases and controls. Data were entered and cleaned using Epi Info version 7 and exported to SPSS version 20 for analysis. Bivariable analysis was performed, and variables with a p value less than 0.2 were entered into multivariable logistic regression. Determinant factors were identified based on p value less than 0.05 and adjusted odds ratio with 95% confidence interval (AOR with 95% CI). Results: An increased odds of pneumonia was associated with children who had diarrhea in the past fifteen days of data collection (AOR = 6.183; 95% CI: 3.482, 10.977), children's mothers who did not hear about how to handle domestic smoking (AOR = 5.814; 95% CI: 2.757, 12.261), and children of mothers who did not follow proper handwashing practice (AOR = 3.469; 95% CI: 1.753, 6.863). Conclusions: Being infected with diarrhea, not knowing how to handle domestic smoking, and poor compliance with proper handwashing practice were identified as determinants of pneumonia. Dedicated, coordinated, and integrated intervention needs to be taken to enhance proper handwashing practice by mothers/caregivers, improve the indoor air quality, and prevent diarrheal diseases at the community level.