Family quality of life for families of children with disabilities in African contexts: a scoping review.

BACKGROUND: Family Quality of Life (FQOL) is an important outcome for families of children with disabilities and is influenced by context and culture. Minimal research explores FQOL in African contexts. PURPOSE: This scoping review identifies factors contributing to FQOL for families of children with disabilities in African contexts. METHOD: We were guided by Arksey and O'Malley's scoping review framework, searching for research papers from the following electronic databases: CINAHL, Embase, Medline, Global Health, and PsycINFO. Using pre-determined eligibility criteria, two authors independently reviewed articles for inclusion via Covidence, a reference manager that facilitates blind reviewing. Two other authors independently extracted data from studies using a data-charting form based on Zuna and colleagues' FQOL framework. Reviewers met regularly for discussion to reach consensus. RESULTS: Fifty-three articles met the inclusion criteria, and findings demonstrated a broad variety of factors contributing to FQOL within the FQOL framework related to family unit factors, individual member factors, and external support factors. We found that poverty, stigma, and spirituality were particularly prominent factors affecting FQOL negatively and positively in African contexts. CONCLUSION: Whilst there are universal factors that contribute to FQOL, recognising the influence of context-specific factors (i.e. poverty, stigma, spirituality) is important in order to provide effective, culturally relevant support that enhances FQOL for families of children with disabilities in African contexts.

Assessment of Computer Vision Syndrome and Personal Risk Factors among Employees of Commercial Bank of Ethiopia in Addis Ababa, Ethiopia.

Background: Computer vision syndrome (CVS) is an amalgam of visual symptoms caused by continued use of computers. Worldwide, up to 70 million workers are at risk for computer vision syndrome resulting in reduced productivity at work and reduced quality of life. Bank employees are among the risky workers with unknown magnitude of the syndrome. Therefore, the main aim of this study was to determine the prevalence of CVS and its associated personal factors among employees of Commercial Bank of Ethiopia. Methods: A total of three hundred and fifty-nine bank workers participated in the study between February and March 2018. A self-administered structured questionnaire was used to collect sociodemographic data, CVS symptoms, and its personal factors. Snellen chart tool was used to measure blurred vision. Data entry and analysis were performed via Epi Info™ 7 and Statistical Package for the Social Sciences (SPSS) version 21. Binary logistic regression and multivariable logistic regression were performed to assess the association and control the potential confounders. Result: The prevalence of computer vision syndrome in the last 12 months among the total study subjects, 359 (98% response rate), was 262 (74.6%) (95% confidence interval [CI] = 70.1, 79.5). Risk factors that could not be intervened with were sex (AOR: 1.8; 95% CI (1-3)) and age group (AOR: 3.11; 95% CI (1.2-8)). Causal factors that could be intervened with were use of electronic materials outside work (AOR: 3.11; 95% CI (1.15-8.36). Protective factor that could be intervened with was habit of taking a break (AOR: 0.44; 95% CI (0.3-0.8)). Conclusion and Recommendation. Three-fours of the employees were at risk. Sex, age, habit of taking a break, and use of electronic materials outside work environment were significantly associated with the presence of CVS. Remedial actions need to be considered at individual level.

Temporary Hearing Loss and Associated Factors Among Ayka Addis Textile Factory Workers in Oromia Region, Ethiopia: A Cross-Sectional Study.

INTRODUCTION: The development of modern automated machines in industries has considerably decreased the physical burden of workers in addition to increasing the productivity of the industries resulting in noise pollution. Noise exposure above the limit value of 90 dB (A) is known to cause temporary hearing loss among exposed workers. MATERIALS AND METHODS: Institutional-based cross-sectional study design was employed for a total of 406 study participants using a simple random sampling technique from January 15 to April 30, 2019. The data collection methods were observational checklist and a self-administered questionnaire. The collected data were entered into EpiData software version 4.2 and exported to SPSS software version 21 for analysis. Bivariate and multivariable logistic analyses wwere used to identify the associated factors. Statistical significance was declared using a 95% confidence interval and a p-value of less than 0.05. RESULTS: A total of 388 study participants were included in the study with a response rate of 95.6%, of which 254 (65.5%) were females. The overall temporary hearing loss among the textile factory workers was found to be 49% with COR=1.53; 95% CI (1.15-2.03). The workers from the spinning department were 2.38 times more likely to develop temporary hearing loss after exiting from work than workers from the dyeing department (95% CI= (1.16-4.90). Similarly, workers from the knitting department were 3.67 times more likely to develop temporary hearing loss after exiting from work than workers from the dyeing department (95% CI=1.42-9.47). CONCLUSION: The present study demonstrated that the workforce in the spinning and knitting departments of the textile factory had a high prevalence of temporary hearing loss than the workers in dyeing and garment working sections. Therefore, the textile factory should provide hearing protection devices to the workers.

Early marriage and women's empowerment: the case of child-brides in Amhara National Regional State, Ethiopia.

BACKGROUND: Women, especially those who marry as children, experience various forms and degrees of exclusion and discrimination. Early marriage is a harmful traditional practice that continues to affect millions around the world. Though it has declined over the years, it is still pervasive in developing countries. In Ethiopia, Amhara National Regional State (or alternatively Amhara region) hosts the largest share of child-brides in the country. This study aimed at assessing the effects of early marriage on its survivors' life conditions - specifically, empowerment and household decision-making - in western Amhara. METHODS: This study employed community-based cross-sectional study design. It adopted mixed method approach - survey, in-depth interview and focus group discussion (FGD) - to collect, analyse and interpret data on early marriage and its effects on household decision-making processes. The survey covered 1278 randomly selected respondents, and 14FGDs and 6 in-depth interviews were conducted. Statistical procedures - frequency distribution, Chi-square, logistic regression - were used to test, compare and establish associations between survey results on women empowerment for two groups of married women based on age at first marriage i.e., below 18 and at/after 18. Narratives and analytical descriptions were integrated to substantiate and/or explain observed quantitative results, or generate contextual themes. RESULTS: This study reported that women married at/after 18 were more involved in household decision-making processes than child-brides. Child-brides were more likely to experience various forms of spousal abuse and violence in married life. The study results illustrated how individual-level changes, mainly driven by age at first marriage, interplay with structural factors to define the changing status and roles of married women in the household and community. CONCLUSION: Age at first marriage significantly affected empowerment at household level, and women benefited significantly from delaying marriage. Increase in age did not automatically and unilaterally empowered women in marriage, however, since age entails a cultural definition of one's position in society and its institutions. We recommend further research to focus on the nexus between the household and the social-structural forms that manifest at individual and community levels, and draw insights to promote women's wellbeing and emancipation.

Computer Vision Syndrome and Associated Factors among Computer Users in Debre Tabor Town, Northwest Ethiopia.

Background: Globally, computer is one of the common office tools used in various institutions. Using computer for prolonged time led to the users at greater health risk of computer vision syndrome (CVS). Computer vision syndrome is the leading occupational health problem of the twenty-first century. About 70 percent of computer users are suffered from CVS. Besides the health problems, CVS causes inefficiency at workplace and deteriorate quality of work. The problem of CVS and its risk factors are not well known in Ethiopia. Method: A cross-sectional study was conducted to assess the prevalence of CVS and associated factors among computer user government employees in Debre Tabor town from February to March, 2016. Multistage random sampling method was applied to select 607 study participants, and the data were collected by using a structured questionnaire. Computer vision syndrome was measured by self-reported method. Bivariate and multivariable binary logistic regression analyses were performed using SPSS version 20. Significance level was obtained at 95% CI and p value < 0.05. Results: The prevalence of CVS was 422 (69.5%) with 95% CI of 65.60, 73.0%. Blurred vision, eyestrain, and eye irritation were the commonest reported symptoms of CVS with proportion of 62.60%, 47.63%, and 47.40%, respectively. Occupation: officer (adjusted odds ratio (AOR) = 4.74) and secretary (AOR = 9.17), daily computer usage (AOR: 2.29), and preexisting eye disease (AOR = 3.19) were risk factors for CVS. However, computer users with high payment, who took regular health break, and with good knowledge on computer safety measures were less impacted by CVS. Conclusion: The prevalence of computer vision syndrome was found to be higher in Debre Tabor town. Monthly income, occupation, daily computer usage, regular health break, knowledge, and preexisting eye disease were predictor variables for CVS. Optimizing exposure time, improving awareness on safety measures, and management support are important to tackle CVS.

Socio-demographic factors and availability of piped fountains affect food hygiene practice of food handlers in Bahir Dar Town, northwest Ethiopia: a cross-sectional study.

BACKGROUND: Morbidity and mortality rates of food borne diseases are consistently highest in African due to poor food handling and sanitation practices. Thus, the study aimed to assess food handling practice and associated factors among food handlers of Restaurants in Bahir Dar Town, northwest, Ethiopia. A cross-sectional study was conducted from December, 7/2012 to January, 2/2013 among food handlers working in 106 restaurants in Bahir Dar Town. A structured questionnaire composed of socio-demographic factors, food safety knowledge, working environmental characteristics and food hygiene practice of food handlers was employed to collect the data via interviewing and observations. Binary logistic regression model was fitted to assess factors associated with food hygiene practice after multi-collinearity and outlier were checked and data was clean. Both crude odds ratio (COR) and adjusted odds ratio (AOR) were estimated to show the strength of association. In multivariate analysis, variables with a P value of ≤ 0.05 were considered as statistical significant. RESULTS: About 67.6% [95% confidence interval (CI) 58.8, 76.4] of food handlers had good food hygiene practice, whereas 32.4% of food handlers had poor food hygiene practice. The odds of having good food hygiene practice was higher among food handlers who had received food safety training [AOR: 4.7, 95% CI 1.7, 12.8], had formal education [AOR: 6.4, 95% CI 3.5, 11.5] and work experiences greater than 2 years [AOR: 3.4, 95% CI 1.8, 6.4]. At last, food handlers working in restaurants which had piped fountains for hand wash were 2.1 times more likely to have good food hygiene practice[AOR: 2.1, 95% CI 1.1, 3.8]. CONCLUSION: In this study, the overall food hygiene practice of food handlers is not to the acceptable level. Therefore, endeavors ought to be reinforced to improve food hygiene practices of food handlers through intervention programs such as training and education. Also emphasis should be given on the accessibility of piped fountains for the better food handling practice of food handlers.

Why is patient safety so hard in low-income countries? A qualitative study of healthcare workers' views in two African hospitals.

BACKGROUND: The views of practitioners at the sharp end of health care provision are now recognised as a valuable source of intelligence that can inform efforts to improve patient safety in high-income countries. Yet despite growing policy emphasis on patient safety in low-income countries, little research examines the views of practitioners in these settings. We aimed to give voice to how healthcare workers in two East African hospitals identify and explain the major obstacles to ensuring the safety of patients in their care. METHODS: We conducted in-depth, face to face interviews with healthcare workers in two East African hospitals. Our sample included a total of 57 hospital staff, including nurses, physicians, technicians, clinical services staff, administrative staff and hospital managers. RESULTS: Hospital staff in low-income settings offered broadly encompassing and aspirational definitions of patient safety. They identified obstacles to patient safety across three major themes: material context, staffing issues and inter-professional working relationships. Participants distinguished between the proximal influences on patient safety that posed an immediate threat to patient care, and the distal influences that generated the contexts for such hazards. These included contexts of severe material deprivation, but also the impact of relational factors such as teamwork and professional hierarchies. Structures of authority, governance and control that were not optimally aligned with achieving patient safety were widely reported. CONCLUSIONS: As in high-income countries, the accounts of healthcare workers in low-income countries provide sophisticated and valuable insights into the challenges of patient safety. Though the impact of resource constraints and weak governance structures are particularly marked in low-income countries, the congruence between accounts of health workers in diverse settings suggest that the origins and solutions to patient safety problems are likely to be similar everywhere and are rooted in human factors, resources, culture and behaviour. While additional resources are essential to patient safety improvement in low-income settings, such resources on their own will not be sufficient to secure the changes needed.

Incidence and predictors of tuberculosis among adult people living with human immunodeficiency virus at the University of Gondar Referral Hospital, Northwest Ethiopia.

BACKGROUND: Tuberculosis (TB) is the leading killer of people living with HIV (PLHIV). Many of these deaths occur in developing countries. This study aimed at determining the incidence and predictors of tuberculosis among PLHIV. METHODS: A five year retrospective follow up study was conducted among adult PLHIV. The Cox proportional hazards model was used to identify predictors. RESULTS: A total of 470 patients were followed and produced 1724.13 Person-Years (PY) of observation, and 136 new TB cases occurred during the follow up period. The overall incidence density of TB was 7.88 per 100 PY. It was high (95.9/100PY) in the first year of enrolment. The cumulative proportion of TB- free survivals was 79% and 67% at the end of the first and fifth years, respectively. Baseline WHO clinical stage III (AHR = 2.88, 95% CI = 1.53-5.43), WHO clinical stage IV (AHR = 3.82, 95% CI = 1.86-7.85), CD4 count <50 cell/ul (AHR = 2.13, 95% CI = 1.28-3.53) and ambulatory or bed ridden functional status (AHR = 1.64, 95%CI = 1.13-2.38) were predictors of time to TB occurrence. CONCLUSIONS: TB incidence rate among PLHIV, especially in the first year of enrollment was high. Advanced WHO clinical stage, limited functional status, and low CD4 count (<50 cell cell/ul) were found to be the independent predictors of TB occurrence. Early care seeking and initiation of HAART to improve the CD4 count and functional status are important to reduce the risk of TB infection.