Prevalence of major depressive disorder and its associated factors among adult patients with neurolathyrism in Dawunt District, Ethiopia; 2022: community-based cross-sectional study.

INTRODUCTION: Major Depressive Disorder (MDD) is one of the commonest mental disorders affecting more than 250 million people globally. Patients with chronic illnesses had higher risks for developing MDD than the general population. Neurolathyrism is a chronic illness characterized by lifelong incurable spastic paralysis of lower extremities; causing permanent disability. It is highly prevalent in Dawunt district, Ethiopia; with a point prevalence of 2.4%. Despite this, there were no previous studies assessing the prevalence of MDD among patients with neurolathyrism in Ethiopia. OBJECTIVE: To assess the prevalence of MDD and to identify its associated factors among patients with neurolathyrism in Dawunt district, Ethiopia. METHODS: A community based cross-sectional study was conducted on 260 samples in Dawunt district from February 01 to March 30/ 2021. Multistage sampling technique was used to select study participants. The patient Health Questionnaire-9 (PHQ-9) depression screening tool was used to diagnose MDD. PHQ-9 is a standardized depression screening tool and a PHQ-9 score of ≥ 10 has a sensitivity and specificity of 88.0% [95% CI (83.0-92.0%)] and 85.0% [95% CI (82.0-88.0%)] for screening MDD. Data were collected by interview; entered to EpiData version 4.2.0; exported to SPSS version 25.0 for analysis; descriptive statistics and binary logistic regression model were used; AOR with 95% CI was used to interpret the associations; and finally results were presented by texts, charts, graphs, and tables. RESULTS: A total of 256 adult patients with neurolathyrism were participated; and the prevalence of MDD was found to be 38.7%. Being female [AOR = 3.00; 95% CI (1.15, 7.84)], living alone [AOR = 2.77; 95% CI (1.02-7.53)], being on neurolathyrism stage-3 [AOR = 3.22; 95% CI (1.09, 9.54)] or stage-4 [AOR = 4.00; 95% CI (1.28, 12.48)], stigma [AOR = 2.69; 95% CI (1.34, 5.39)], and lack of social/ family support [AOR = 3.61; 95% CI (1.80, 7.24)] were found to have statistically significant association with an increased odds of MDD; while regular exercise and ever formal counselling were found to have statistically significant association with a decreased odds of MDD. CONCLUSION: The prevalence of MDD among neurolathyrism patients in Dawunt district was high. Lack of social support, stigma, not getting formal counselling, and not involving in regular exercise were modifiable risk factors. Therefore, social support, reducing stigma, formal counselling, and encouraging regular exercise might help to reduce the burden of MDD among neurolathyrism patients.

Attitude of nurses towards palliative care and its associated factors in Ethiopia, systematic review and meta-analysis.

INTRODUCTION: Palliative care significantly improves the distressing symptoms of patients, especially those with cancer, heart disease, renal disease, and liver disease. The need for palliative care is increasing worldwide due to the growing burden of chronic disease. Nurses with an unfavorable attitude towards palliative care cannot skillfully assess the patient's needs, do not communicate effectively, and do not address the patient's problems adequately. Therefore, this study was aimed to assess the nurse's level of attitude towards palliative care in Ethiopia. METHODS: Several databases were searched to find available articles. Microsoft Excel was used to extract and sort the data before it was exported to STATA/MP 17.0 for analysis. A weighted inverse variance random-effects model with a 95% confidence interval was employed to pool the data. Egger's test and Cochrane I2 statistics were used to assess heterogeneity and publication bias, respectively. Subgroup analysis was carried out to identify the source of heterogeneity. A log-odds ratio was employed to show the relationship between nurses' level of attitude towards palliative care and its related factors. P-value less than 0.05 was considered statistically significant. RESULT: In Ethiopia, the pooled prevalence of favorable attitudes of nurses towards palliative care was 66.13% (95% CI: 54.00-78.27). The highest percentage of favorable attitudes towards palliative care among nurses was found in research studies done in Addis Ababa (80.31%; 95% CI: 72.00-88.63). Training on palliative care was significantly associated with the level of a nurse's attitude towards palliative care. Therefore, nurses who received palliative care training had a 2.5 times higher chance of having a favorable attitude towards palliative care than nurses who did not receive training on palliative care (AOR = 2.55; 95% CI: 2.28-2.82). CONCLUSION: One-third of nurses had unfavorable attitude towards palliative care. Nurses who took palliative care training had a more favorable attitude than nurses who did not take palliative care training. Routine palliative care training is needed for nurses to improve their level of attitude towards palliative care.

Prevalence of Neurolathyrism and its associated factors in Grass pea cultivation areas of Dawunt District, North-eastern Ethiopia; 2022: a community based multilevel analysis.

INTRODUCTION: Neurolathyrism is an upper motor neuron disorder characterized by spastic paraparesis, which is caused by the prolonged over-consumption of grass pea. It is a devastating disease with great impacts on physical, social, mental, and economical health. OBJECTIVE: To determine the prevalence of neurolathyrism and its associated factors in grass pea cultivation areas of Dawunt wereda. METHODS: Community based cross-sectional study design was conducted from February 01- March 30, 2021 on 631 Households with a total of 3,350 individuals. Two-stage random sampling technique was used to select participants. Multilevel binary logistic regression was used to identify factors associated with neurolathyrism. Statistical significance was declared at p < 0.05; and AOR with 95% CI was used to interpret the results. RESULTS: The household and population level prevalence of neurolathyrism in Dawunt district were 9.2% (7.2-11.7%) and 2.4% (2.0-2.3.0%) respectively. Age (AOR = 7.4 ( 2.6-20.6)), male sex (AOR = 7.8 (3.9, 15.4)), and marital status (AOR = 4.0 (1.3-12.8)) were the individual level variables; family size (AOR = 12.6 (3.0-52.8)), annual grass pea production (AOR = 5.0 (2.3-11.0)), ever feeding only grass pea (AOR = 8.8(3.5-22.2)), ever feeding immature seeds of grass pea (AOR = 6.28 (2.80, 14.08)), high grass pea to other cereals mixing ratio (> 3:1) (AOR = 6.1 (1.1, 33.5)) were the household level variables found to have significant association with neurolathyrism. CONCLUSION: The prevalence of neurolathyrism was found to be high. Ever feeding only grass pea, Grass pea to other cereals mixing ratio (using ratio of 1:1 or more), and Ever feeding immature grass pea seeds were the modifiable risk factors for neurolathyrism.