The Magnitude of Common Mental Disorders and Associated Factors Among Cancer Patients at Black Lion Specialized Hospital, Addis Ababa, Ethiopia: Cross- Sectional Study.

BACKGROUND: Common mental disorders (CMD) are the most usual reactions following cancer diagnosis causing significant psychological sufferings. Even though research-based evidence is necessary for mental health promotion and intervention activities, there is a scarcity of evidence in Ethiopia to assist policy makers' efforts in reforming mental health care particularly that of cancer patients. OBJECTIVE: The main objective of this research is to assess the magnitude of common mental disorders and associated factors among cancer patients who have a follow-up treatment at Black Lion Specialized Hospital, Addis Ababa, Ethiopia. METHOD: Institutional-based cross-sectional study was conducted from August 1 to September 30, 2020. A systematic random sampling technique was used to select 396 study participants. A Self-Reporting Questionnaire (SRQ-20) and interviewer-administered structured questionnaire were employed to collect data. Data were analyzed using descriptive statistics and logistic regression. Odds ratios with 95% confidence intervals was used to report the findings. RESULT: A total of 396(230 men and 160 women) participants took part in the study. The overall magnitude of CMD among cancer patients was found to be 70.3%, of which the rate was 73.5% among women and 67.8% among men, in the last 4 weeks. Being women (AOR = 1.74; 95%CI: 1.00, 3.02), unemployed (AOR = 3.035, 95% CI: 1.37, 6.72), average monthly income of less than 1600 Ethiopian Birr (AOR = 2.838; 95%CI: 1.58, 5.08), being on cancer treatment for more than 5 years (AOR = 2.653, 95% CI: 1.39, 5.03), poor social support (AOR = 3.618, 95% CI: 1.33, 9.80), and current use of substances (AOR = 6.852; 95% CI: 2.038, 23.034) were the factors significantly associated with CMD. CONCLUSION AND RECOMMENDATION: Common mental disorders are one of the major health concerns among cancer patients. Common mental disorders were found to be more common in females and among current users of a psychoactive substance. Therefore, cancer patients need special attention of not only physicians but also that of mental health professionals for possible detection and early treatment of mental disorders. Rendering social and economic support may reduce the negative effects of the illness.

Status of family planning integration to HIV care in Amhara regional state, Ethiopia.

BACKGROUND: Preventing unintended pregnancies among HIV positive women is one component of HIV prevention strategies. However, programs to prevent mother-to-child transmission (PMTCT) of HIV started in antenatal care. The objective of this study was to examine the status of family planning integration to HIV care from client and facility perspectives and identify factors associated with current family planning use. METHODS: A facility-based cross-sectional study was conducted from December 2017 to April 2018. Data were coded and double entered into EPI Info version 3.5.4 and exported to STATA version 14 for analysis. Bi-variable and multivariable logistic regression analyses were conducted to assess the association of variables with the current family planning use. RESULTS: A total of 518 HIV-positive women were included in the study. Among HIV-positive women, 35.3% had an unmet need for family planning, and 21.4% responded that their pregnancies were unwanted. About two-thirds (68.1%) of women were using a modern family planning method at the time of the study. Among women who were currently using family planning, 88.8% got the service from a family planning clinic in the same facility, and only 1.1% got the service from the HIV care unit. Women who were not knowledgeable on PMTCT (AOR 0.47, 95% CI = 0.24-0.90), divorced or separated women (AOR 0.19, 95% CI = 0.10-0.37) and women in the age group of 25-34 years (AOR 0.42, 95% CI = 0.20-0.88) and 35-49 years (AOR 0.41, 95% CI = 0.17-0.99) were less likely to use modern family planning methods compared with those women who were knowledgeable, married and women in the age group of 15-24 years. Besides, women with higher income (AOR 2.12, 95% CI = 1.26-3.57) were more likely to use modern family planning methods compared with women with lower incomes. CONCLUSION: This study indicated that there is a high unmet need for family planning among HIV-positive women and low family planning services integration in the PMTCT/ART clinics. Efforts should be strengthened to tackle the factors which hinder the use of modern family planning and improve family planning service integration.

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.

Tuberculosis and HIV are the leading causes of adult death in northwest Ethiopia: evidence from verbal autopsy data of Dabat health and demographic surveillance system, 2007-2013.

BACKGROUND: Reliable data on causes of death form the basis for building evidence on health policy, planning, monitoring, and evaluation. In Ethiopia, the majority of deaths occur at home and civil registration systems are not yet functional. The main objective of verbal autopsy (VA) is to describe the causes of death at the community or population level where civil registration and death certification systems are weak and where most people die at home without having had contact with the health system. METHODS: Causes of death were classified and prepared based on the International Classification of Diseases (ICD-10). The cause of a death was ascertained based on an interview with next of kin or other caregivers using a standardized questionnaire that draws information on signs, symptoms, medical history, and circumstances preceding death. The cause of death, or the sequence of causes that led to death, is assigned based on the data collected by the questionnaire. The complete VA questionnaires were given to two blinded physicians and reviewed independently. A third physician was assigned to review the case when disagreements in diagnosis arose. RESULTS: Communicable diseases (519 deaths [48.0%]), non-communicable diseases (377 deaths [34.8%]), and external causes (113 deaths [10.4%]) were the main causes of death between 2007 and 2013. Of communicable diseases, tuberculosis (207 deaths [19.7%]), HIV/AIDS (96 deaths [8.9%]) and meningitis (76 deaths [7.0%]) were the most common causes of death. CONCLUSION: Tuberculosis, HIV/AIDS, and meningitis were the most common causes of deaths among adults. Death due to non-communicable diseases showed an increasing trend. Increasing community awareness of infections and their interrelationships, tuberculosis case finding, effective local TB programs, successful treatment, and interventions for HIV are supremely important.

Determinants to antiretroviral treatment non-adherence among adult HIV/AIDS patients in northern Ethiopia.

BACKGROUND: Adhering 95% and above of antiretroviral therapy reduces the rate of disease progression and death among people's living human immunodeficiency virus. Though manifold factors have reported as determinant factors of antiretroviral therapy adherence status, perhaps determinants of non-adherence differ up on the activities of patients in the study setting. METHODS: An institution based unmatched case-control study was conducted in Aksum town. Individuals who had a 6-month follow-up with complete individual information were included in the study. Document review and interviewer based techniques were used to collect the data. Binary logistic regression analysis was used to identify the determinant factors of non-adherence. RESULTS: A total of 411 (137 cases and 274 control) study participants were included in the study. The majority of them were male in sex. Having 2 years and above duration on ART [AOR = 7, 95% CI (2.2, 22.6)], history of adverse effect [AOR = 6.9, 95% CI (1.4, 32.9)], substance use [AOR = 5.3, 95% CI (1.4, 20.0)], living with parents [AOR = 3.4, 95% CI (1.2, 10.3)], having depression symptom [AOR = 3.3, 95% CI (1.4, 7.5)], <350 cells/mm3 cluster of differentiation 4 count [AOR = 3.2, 95% CI (1.8, 5.8)] and low dietary diversity [AOR = 2, 95% CI (1.1, 3.7)] were found significant determinants of non-adherence to antiretroviral drug. CONCLUSION: Program, social and individual related factors showed a statistically significant associated with non-adherence to antiretroviral therapy. Managing lifestyle by developing self-efficacy of individuals and treating related threat to improve adherence status of antiretroviral therapy is recommended in this study.

Prevalence of disability and associated factors in Dabat Health and Demographic Surveillance System site, northwest Ethiopia.

BACKGROUND: Despite the high burden of disability in Ethiopia, little is known about it, particularly in the study area. Hence, this study aimed to investigate the prevalence and factors associated with disability at Dabat Health and Demographic Surveillance System (HDSS) site, northwest Ethiopia. METHOD: A population-based study was conducted from October to December 2014 at Dabat HDSS site. A total of 67,395 people were included in the study. The multivariable binary logistic regression analysis was employed to identify factors associated with disability. The Adjusted Odds Ratio (AOR) with a 95% Confidence Interval (CI) was estimated to show the strength of association. A p-value of <0.05 was used to declare statistical significance. RESULTS: One thousand two hundred twenty-eight individuals were reported to have a disability giving a prevalence rate of 1.82%, of which, about 39% was related to a vision disability. The high odds of disability were observed among the elderly (≥50 years) [AOR: 4.49; 95% CI: 1.95, 10.33], severely food in-secured [AOR: 2.11; 95% CI: 1.59, 2.80], and separated marital status [AOR: 7.52; 95% CI: 1.18, 47.84]. While having a paid job [AOR: 0.46; 95% CI: 0.28, 0.77], being in the richest quintile [AOR: 0.55; 95% CI: 0.41, 0.75], and high engagement in work-related physical activities [AOR: 0.36; 95% CI: 0.27, 0.49] were inversely associated with the disability. CONCLUSION: Disability is a major public health problem, and the burden is noticeable in the study area. Vision disability is the highest of all disabilities. Thus, efforts must be made on educating the public about disability and injury prevention. Measures that reduce disability should target the elderly, the poorer and the unemployed segment of the population.

Prevalence and associated factors of circumcision among daughters of reproductive aged women in the Hababo Guduru District, Western Ethiopia: a cross-sectional study.

BACKGROUND: Female genital mutilation is currently a public health problem which needs investigation and immediate action. Ethiopia is the second-ranked African country in terms of having higher numbers of circumcised girls. This study aimed to determine prevalence and associated factors of circumcision among daughters of reproductive aged women. METHODS: A community based cross-sectional study was conducted on 610 mothers. The total sample was allocated proportionally in three randomly selected kebeles based on the number of reproductive age mothers with at least one daughter under 15 years old. A systematic random sampling technique was used to draw the respondents. A structured and interviewer administered questionnaire was used to collect data. Logistic regression analyses were used to see the association of different variables. RESULTS: Out of 610 mothers, 293 (48 %) had at least one circumcised daughter. Having a good knowledge about genital mutilation (Adjusted Odds Ratio [AOR] =0. 14, 95 % CI: 0.09-0.23), positive attitude (AOR = 0. 26, 95 % CI: 0.16-0.43), being literate (AOR = 0.50, CI: 0.28-0.91) and living in urban area (AOR = 0.30, 95 % CI: 0.17-0.51) had a lower odds of female genital mutilation. In addition, not knowing genital mutilation as a crime (AOR = 5, 95 % CI: 3.07-8.19), and being in the age group of 40-49 (AOR = 2.56, 95 % CI: 1.40-4.69) had a higher odds of having circumcised daughter. Furthermore, fathers being traditional religion followers (AOR = 0.22, 95 % CI: 0.07-0.74) had less odds of having a circumcised daughter as compared to those who follow Ethiopian Orthodox Christian. CONCLUSIONS: In this study, about half of the mothers had at least one circumcised daughter. Mothers' knowledge, attitude, age, residence, educational status and fathers' religion were significantly associated with female genital mutilation. Hence, convincing mothers about the ill effects of circumcision and working with religious leaders is recommended.

Health extension program factors, frequency of household visits and being model households, improved utilization of basic health services in Ethiopia.

BACKGROUND: Ethiopia has implemented a nationwide primary health program (the Health Extension Program) at the grassroots level since 2003. The aim of the program is to increase public access to basic health services, mainly by producing model households. These are households which attend at least 75% of the training given by health extension workers and implement at least 75% of the Health Extension Program packages. This study was conducted to assess the extent of the Health Extension Program utilization by the community, and to identify factors associated with it. METHODS: A community-based cross-sectional study was conducted to assess the utilization of the health extension program. Data were collected from 1320 mothers using a structured questionnaire. Multilevel logistic regression was used to identify factors associated with the utilization of the program. RESULT: Health extension workers conducted frequent visits to 52.7% (95% CI = 50.0 to 55.4%) of the households, and 78.5% (95% CI = 76.2 to 80.7%) mothers visited health posts. Mothers who had frequent household visits by health extension workers were 1.289 more likely to visit the health posts (AOR = 1.289, 95% CI = 1.028 to1.826) than mothers who did not get frequent visits. Mothers from model households (3 years after graduation) were 2.410 times more likely to visit health post (AOR = 2.150, 95% CI = 1.058 to 4.365) compared to mothers from non-model households. Mothers who felt that they understood the Health Extension Program packages were 1.573 times more likely to visit the health posts (AOR = 1.573, 95% CI = 1.056 to 2.343) than mothers who did not feel they understood the program packages. Mothers from higher income families were 2.867 times more likely to visit health posts (AOR = 2.867, 95% CI = 1.630 to 5.040) compared to mothers from lower income families. CONCLUSIONS: Conducting continuous home visits of non-model households and following up the existing model households, producing more model households by giving model-family training to non-model households, and strengthening the information, education, and communication package are crucial in the implementation of the HEP to increase basic health services utilization.

Perception and predictors of quality of life among HIV patients attending art clinics in northwest Ethiopia: a prospective longitudinal study.

BACKGROUND: In treating HIV as a chronic disease, monitoring changes of quality of life of patient's overtime is important for clinicians and policy makers. However, to our knowledge little research attention has been directed towards examining the longitudinal change of quality of life overtime in sub-Saharan Africa. OBJECTIVE: To examine longitudinal changes in quality of life among patients initiated ART METHOD: A prospective longitudinal follow-up study was conducted from December 2009 to August 2011 to evaluate the changes in quality of life and how this relates with baseline socio-demographic and clinical characteristics among consecutive adult ART naïve patients attending ART clinic. Quality of life was measured by WHOQOL-HIV BREF. RESULT: All quality of life domain scores improved significantly during 12 month follow-up in the ART program. At each follow-up visit, scores were significantly higher than baseline scores (p < 0.001). Predictors of improved quality of life were male gender, disclosure of HIV status, starting ART at higher CD4, > 200 cells/µL, and good baseline overall quality of life, whereas predictors of poor quality of life were starting ART with advanced disease stage and tuberculosis co-infection. CONCLUSION: This study demonstrated that the quality of life improved overtime for HIV-infected individuals receiving ART which is consistent with previous studies. It also provided information regarding the predictive effects of baseline socio-demographic and clinical factors on the changes in quality of life at the 12-month follow-up time. The finding of the study has implications of starting ART at a higher CD4 and early stage of the disease for better quality of life outcomes.

Pelvic floor disorders among women in Dabat district, northwest Ethiopia: a pilot study.

INTRODUCTION AND HYPOTHESIS: Pelvic floor disorders affect many women in high-income countries. Since little is known about such disorders in Africa, this study aimed at assessing the prevalence and risk factors in an Ethiopian community. We also assessed the validity of a prolapse questionnaire. METHODS: A community-based cross-sectional study was conducted among 395 women, recruited by a systematic random sampling technique. Women were interviewed about symptoms of urinary incontinence, faecal incontinence and pelvic organ prolapse by female nurses. Additionally, pelvic examinations were performed in 294 (74.2%) participants to assess anatomical prolapse using the simplified Pelvic Organ Prolapse Quantification staging system. Descriptive statistics and logistic regression analyses were employed. RESULTS: The median age of participants was 35.0 years. Thirty-one women reported urinary incontinence (7.8%), 25 (6.3%) symptomatic pelvic organ prolapse and 2 (0.5%) faecal incontinence. Anatomical pelvic organ prolapse stage II-IV was detected in 162 (55.1%) of women who underwent pelvic examination. The questionnaire for prolapse assessment had poor validity (38.3% sensitivity and 95.4% specificity) even in cases of clinically relevant prolapse (stage III or IV). After adjustment, carrying heavy objects for 5 or more hours a day, history of prolonged labour and highland rural residence were associated with anatomical pelvic organ prolapse. CONCLUSIONS: Self-reported incontinence seems low in northwest Ethiopia. The prevalence of symptomatic prolapse was low despite a high prevalence of prolapse signs. Notably, heavy carrying and prolonged labour increased the risk of anatomical prolapse stage II-IV. The methods of assessing pelvic floor disorders in a low-income context need further development.

Predictors of perinatal mortality in rural population of Northwest Ethiopia: a prospective longitudinal study.

BACKGROUND: Perinatal mortality is one of the serious challenges in meeting maternal and child Millennium Development Goals in developing countries. Identifying its predictors is an important step to develop focused and appropriate health interventions for reducing perinatal deaths. This study therefore aims at identifying predictors of perinatal mortality in a rural setting in northwest Ethiopia. METHODS: A prospective longitudinal study was conducted at Dabat Health and Demographic Surveillance site, northwest Ethiopia, from November 2009 to August 2011. Data were collected by interviewing the mothers or guardians of eligible children. Multiple logistic regressions were employed to identify potential predictors. RESULTS: A total of 1752 eligible children were included in the study. Perinatal mortality rate in the study population was 50.22 per 1000 (95% CI: 39.99, 60.46) total births. In multiple logistic analysis, previous still birth [(AOR = 8.38, 95% CI: 3.94, 17.83)], twin birth [(AOR = 7.09, 95% CI: (3.22, 15.61)], not receiving tetanus toxoid vaccine during the index pregnancy [(AOR = 3.62, 95% CI: 1.57, 8.34)], short birth interval of less than 24 months [(AOR = 2.58, 95% CI: (1.61, 4.13)], maternal illiteracy [(AOR = 4.83, 95% CI: (1.45, 16.05)] and mothers' running own business [(AOR = 5.40, 95% CI: 1.40, 27.96)] were the main predictors associated with increased risk of perinatal death. CONCLUSIONS: Predictors of perinatal death in the study area are easily recognizable and potentially preventable with the existing maternal health programs. Efforts need to be intensified in expanding maternal and newborn health services to significantly reduce perinatal mortality in rural settings.

Long distance travelling and financial burdens discourage tuberculosis DOTs treatment initiation and compliance in Ethiopia: a qualitative study.

BACKGROUND: Timely tuberculosis treatment initiation and compliance are the two key factors for a successful tuberculosis control program. However, studies to understand patents' perspective on tuberculosis treatment initiation and compliance have been limited in Ethiopia. The aim of this study is to attempt to do that in rural Ethiopia. METHODS: This qualitative, phenomenological study conducted 26 in-depth interviews with tuberculosis patients. A thematic content analysis of the interviews was performed using the Open Code software version 3.1. RESULTS: We found that lack of geographic access to health facilities, financial burdens, use of traditional healing systems and delay in diagnosis by health care providers were the main reasons for not initiating tuberculosis treatment timely. Lack of geographic access to health facilities, financial burdens, quality of health services provided and social support were also identified as the main reasons for failing to fully comply with tuberculosis treatments. CONCLUSIONS: This study highlighted complexities surrounding tuberculosis control efforts in Dabat District. Challenges of geographic access to health care facilities and financial burdens were factors that most influenced timely tuberculosis treatment initiation and compliance. Decentralization of tuberculosis diagnosis and treatment services to peripheral health facilities, including health posts is of vital importance to make progress toward achieving tuberculosis control targets in Ethiopia.

Knowledge and utilization of information communication technology (ICT) among health science students at the University of Gondar, North Western Ethiopia.

BACKGROUND: Despite the relatively huge ICT investment and policy deployment in higher institutions in Ethiopia, there is still scant information about the success of implementation of the Information Communication Technology (ICT) in the higher education. This study, therefore, was carried out with an aim to assess knowledge and utilization of Information Communication Technology (ICT) among medicine and health science students and its associated factors in Gondar College of Medicine and Health sciences, University of Gondar. METHODS: A cross-sectional study was conducted at the College of Medicine and Health Sciences, University of Gondar, Ethiopia. Data regarding socio-demographic characteristics of the students, level of knowledge and utilization of ICT were collected by means of a self-administered questionnaire. Data was analyzed using SPSS version 13. RESULTS: A total of 1096 students responded giving a response rate of 97.8%. The mean age of the study participants was 20.3 (±1. 3) years. Females constitute only 26% of the respondents. The majority (79%) were fulltime students. Only half of the respondents (51%) had ICT knowledge and only 46% students utilized ICT while 47% of the respondents never used electronic communication (e.g. email or chat room) and 39% of the respondents never used Microsoft office (e.g. word (®) or WordPerfect (®)). ICT knowledge [AOR = 2.5, 95% CI: 1.7-3.5], family educational background [AOR = 4.36, 95% CI: 2.16-8.80], and perceived quality of training [AOR = 1.9, 95% CI: 1.3-2.8] showed strong and positive associations with ICT utilization. Students from urban areas were more likely to utilize ICT compared with those from rural areas [AOR = 2.7, 95% CI: 2.097, 3.497], and information technology training was found to be positively associated with ICT utilization [AOR = 2. 07, 95% CI: 1.18, 3.62]. CONCLUSIONS: The result showed that students' knowledge was inadequate and utilization of ICT was poor. Therefore, the university should sustain professional development to improve teaching, to raise student performance and equip the college with student centered ICT computer labs to increase students' ICT utilization.

Mothers' satisfaction with referral hospital delivery service in Amhara Region, Ethiopia.

BACKGROUND: A woman's satisfaction with the delivery service may have immediate and long-term effects on her health and subsequent utilization of the services. Providing satisfying delivery care increases service utilization. The objective of this study is to assess the satisfaction of mothers with referral hospitals' delivery service and identify some possible factors affecting satisfaction in Amhara region of Ethiopia. METHODS: A hospital-based cross-sectional survey that involved an exit interview was conducted from September to November 2009 in three referral hospitals in Ethiopia. A total of 417 delivering mothers were enrolled in the study. Client satisfaction was measured using a survey instrument adopted from the Donabedian quality assessment framework. We collect data systematically from every other postnatal woman who delivered in the referral hospitals. Multivariate and binary logistic regression was applied to identify the relative effect of each explanatory variable on the outcome (satisfaction). RESULTS: The proportion of mothers who were satisfied with delivery care in this study was 61.9%. Women's satisfaction with delivery care was associated with wanted status of the pregnancy, immediate maternal condition after delivery, waiting time to see the health worker, availability of waiting area, care providers' measure taken to assure privacy during examinations, and amount of cost paid for service. CONCLUSIONS: The overall satisfaction of hospital delivery services in this study is found to be suboptimal. The study strongly suggests that more could be done to assure that services provided are more patient centered.

Sexual violence at each stage of human trafficking cycle and associated factors: a retrospective cohort study on Ethiopian female returnees via three major trafficking corridors.

OBJECTIVES: Evidence showed that the prevalence of sexual violence during the whole human trafficking period was high. However, the distribution of sexual violence along the stages of the trafficking cycle is unclear. This study aimed to determine the prevalence of sexual violence at each stage of trafficking and factors associated with it among Ethiopian trafficked females. DESIGN: A retrospective cohort study was conducted to study trafficking returnees regarding their previous experiences at each stage of trafficking. SETTINGS: Data were collected at immigration offices in three border towns of Ethiopia located bordering Sudan, Kenya and Djibouti. PARTICIPANTS: Six hundred and seventy-one women who were trafficked from Ethiopia were recruited into the study consecutively. They were recruited when they came back home via the three border towns either by deportation or voluntary return. OUTCOME MEASURE: The outcome variable was sexual violence. RESULTS: The prevalence of sexual violence was estimated at 10% (95% CI 7.9 to 12.5) during predeparture, 35.0% (95% CI 31.5 to 38.7) travelling period, 58.1% (95% CI 54.2 to 61.8) at destination and 19.5% (95% CI 15.2 to 24.6) detention stages. The odds of sexual violence among returnees aged 14-17 years was about twofold when compared with that of women aged 26-49 years (adjusted OR (AOR)=1.97; 95% CI 1.11 to 3.52). Similarly, being smuggled initially (AOR=1.54; 95% CI 1.09 to 1.93), restricted freedom (AOR=1.45; 95% CI 1.13 to 1.86) and time spent at each stage of trafficking (AOR=1.028; 95% CI 1.024 to 1.033) were positively associated with sexual violence. CONCLUSIONS: The prevalence of sexual violence at each stage of trafficking after departure was high. This could imply that victims might be affected by subsequent negative sexual health outcomes. Young age, initially being smuggled and time spent at each stage of the trafficking process were positively associated with the events of sexual violence. Efforts must be made on modifiable factors such as 'smuggling' to minimise subsequent sexual violence during trafficking.

Model-based prediction of CD4 cells counts in HIV-infected adults on antiretroviral therapy in Northwest Ethiopia: A flexible mixed effects approach.

BACKGROUND: CD4 cell counts is widely used as a biomarker for treatment progression when studying the efficacy of drugs to treat HIV-infected patients. In the past, it had been also used in determining eligibility to initiate antiretroviral therapy. The main aim of this was to model the evolution of CD4 counts over time and use this model for an early prediction of subject-specific time to cross a pre-specified CD4 threshold. METHODS: Hospital based retrospective cohort study of HIV-infected patients was conducted from January 2009 to December 2014 at University of Gondar hospital, Northwest Ethiopia. Fractional polynomial random effect model is used to model the evolution of CD4 counts over time in response to treatment and to estimate the individual probability to be above a pre-selected CD4 threshold. Human subject research approval for this study was received from University of Gondar Research Ethics Committee and the medical director of the hospital. RESULTS: A total of 1347 patients were included in the analysis presented in this paper. The cohort contributed a total of 236.58 per 100 person-years of follow-up. Later the data were divided into two periods: the first is the estimation period in which the parameters of the model are estimated and the second is the prediction period. Based on the parameters from the estimation period, model based prediction for the time to cross a threshold was estimated. The correlations between observed and predicted values of CD4 levels in the estimation period were 0.977 and 0.982 for Neverapine and Efavirenz containing regimens, respectively; while the correlation between the observed and predicted CD4 counts in the prediction period are 0.742 and 0.805 for NVP and EFV, respectively. CONCLUSIONS: The model enables us to estimate a subject-specific expected time to cross a CD4 threshold and to estimate a subject-specific probability to have CD4 count above a pre-specified threshold at each time point. By predicting long-term outcomes of CD4 count of the patients one can advise patient about the potential ART benefits that accrue in the long-term.

Household food insecurity predisposes to undiversified diet in northwest Ethiopia: finding from the baseline survey of nutrition project, 2016.

OBJECTIVE: Adolescence represents a critical stage of life, characterized by rapid physical growth and development; varying levels of physical, social and psychological maturity; and a transition from total socio-economic dependence to relative independence. Focusing on adolescents' nutrition, especially girls, provides a unique opportunity to break the intergenerational cycles of malnutrition. But, there is little information about the dietary diversity of adolescent girls in Dabat district. Therefore, the survey aimed to assess the prevalence and associated factors of dietary diversity among adolescent girls. RESULTS: The overall prevalence of adequate dietary diversity among adolescent girls was 14.5 (95% CI 12.9, 16.2). The prevalence of adequate dietary diversity among adolescent girls was very low and food insecurity is one of the predisposing factors for low dietary diversity. Therefore, working to enhance household's food security status is recommended to boost dietary diversification of adolescent's girls.

Poor child complementary Feeding Practices in northwest Ethiopia: Finding from the Baseline Survey of Nutrition Project, 2016.

BACKGROUND: Improving infant and young child feeding practices is critical to improved nutrition, health, and development of children. Ethiopia adopted the WHO recommendations of child feeding practices and developed the national guideline. In spite of this fact, only few children start and received appropriate complementary feeding based on the recommendation. Therefore, the study aimed to determine dietary diversity score and its associated factors among under five children at Dabat Health and Demographic Surveillance System site (HDSS), northwest Ethiopia. METHODS: A cross-sectional community based study was carried out from February to June 2016. All children aged 6-59 months old who lived in HDSS site were included in the survey. Odds ratio (OR) with the corresponding 95% confidence interval (CI) was calculated to show the strength of association. Finally, variables with a P-value of < 0.05 were considered statistically significant.. RESULTS: In this study, a total of 3433 children were included. About 34.87% (95%CI: 33.27, 36.49%) of the children received adequately diversified diet. The odds of receiving adequately diversified diet was higher among children whose mother had secondary and above education (AOR = 6.51; 95%CI: 4.95, 8.56), had antenatal care (AOR = 1.90; 95%CI: 1.60, 2.26) and postnatal care visits (AOR = 1.31; 95%CI: 1.00, 1, 72), and children who feed with their family (AOR = 1.39; 95%CI: 1.17, 1.65). However, a lower dietary diversity score was observed among younger children; 6-11 months old (AOR = 0.59; 95%CI: 0.41, 0.85), and children from food insecure household (AOR = 0.76; 95%CI: 0.63, 0.92). CONCLUSIONS: Diversified diet feeding practice is low in Dabat HDSS site. Age of the child, maternal education, antenatal and postnatal care visits, and household food insecurity were significantly associated with dietary diversity of children. Hence, ensuring household food security and enhancing the coverage of maternal health care utilization are recommended to increase dietary diversity of children.

Family planning use and its associated factors among women in the extended postpartum period in Addis Ababa, Ethiopia.

BACKGROUND: Postpartum period is an important entry point for family planning service provision; however, women in Ethiopia are usually uncertain about the use of family planning methods during this period. Limited studies have been conducted to assess postpartum family planning use in Addis Ababa, in particular and in the country in general. So, this study was conducted to assess postpartum family planning use and its associated factors among women in extended postpartum period in Kolfe Keranyo sub city of Addis Ababa. MATERIALS AND METHODS: A community-based cross sectional study was conducted from May to June 2015 on 803 women who have had live births during the year (2014) preceding the data collection in the sub city. The multi-stage cluster sampling technique was used to select study participants. Data were collected by interviewer administered structured questionnaire, entered into EPI INFO version 7 and analyzed by SPSS Version 20. Bivariable and Multivariable logistic regression models were employed to see the presence and strength of the association between the dependent and independent variables by computing the odds ratios with a 95% confidence intervals and p-values. RESULTS: The prevalence of postpartum family planning use was 80.3% (95% CI: 74.5, 83.1). Marriage, (AOR 0.09, 95% CI: 0.03, 0.22), menses resumption after birth, (AOR 2.12, 95% CI: 1.37, 3.41), length of time after delivery, (AOR 2.37, 95% CI: 1.18, 4.75), and history of contraceptive use before last pregnancy, (AOR 0.12, 95% CI: 0.07, 0.18) were the factors associated with postpartum family planning use. CONCLUSION: The prevalence of postpartum family planning use was high and the main factors associated with it were marriage, menses resumption, length of time after delivery, and history of previous contraceptive use. Therefore women should get appropriate information about the possibility of exposure to pregnancy prior to menses resumption by giving special emphasis to those who had no previous history of contraceptive use and exposure to the other identified factors.

Iodine status five years after the mandatory salt iodization legislation indicates above requirement: a cross sectional study in Northwest Ethiopia.

BACKGROUND: Iodine deficiency is one of a major nutritional problem. The study aimed to assess the iodine status of populations in Dabat district using median urinary iodine concentration (UIC) in school-age children (6-12 years) and compared the results with goiter prevalence. METHODS: The study used a cross-sectional study design. The study was conducted in Dabat district, northwest Ethiopia in May 2016. Spot urine samples were used for the determination of UIC. Manual examination of the thyroid gland was performed to assess presence of goiter. The MBI international Rapid Test Kits (RTK) were used to determine the level of salt iodine content. Children aged 6-12 years were recruited from schools using a multistage stratified sampling. One-way Analysis of Variance (ANOVA) was used to compare mean of log-transformed UIC values among key variables. Significant was determined at P-value less than 0.05. RESULTS: A total of 358 school age children enrolled to the study. The mean age of children was 10.8((Standard Deviation (SD) = 1.45) years and 56.7% were males. The median UIC was 235 µg/l ((Inter Quartile Range (IQR): 161, 320]. Excessive iodine intake and inadequate iodine intake was observed on 29.1 and 8.7% of school aged children, respectfully. The coverage of iodized salt use in school-age children were 66.8%. The UIC was higher in urban children than rural counterparts and in those used adequately iodised salt than inadequately iodized salt (P < 0.05). Thirty-four percent of school-age children had a goiter. The prevalence of grade 1 and grade 2 goiter was 26.5 and 7.5%, respectively. There was a poor agreement between UIC and goiter (k = 0.1) in classifying iodine status of populations. CONCLUSIONS: The study population is classified as above requirements by median UIC in school-age children but severe iodine deficiency by goiter prevalence. Further research investigating the agreement between UIC and goiter prevalence in classifying iodine status of populations with various iodine status is warranted.