Accessing Healthcare Services for People with Physical Disabilities in Hawassa City Administration, Ethiopia: A Cross-Sectional Study.

BACKGROUND: Persons with disabilities experience significant barriers to accessing health care. These barriers may be more serious in countries such as Ethiopia. In this study, we aimed to assess the prevalence of accessibility and associated factors among physically disabled people visiting physical disability associations in Hawassa. METHODS: A cross-sectional study was conducted among 345 randomly selected physically disabled people who visited disability associations in Hawassa. Data were collected from February 1 to 28, 2020 through face-to-face interview using a semi-structured questionnaire. Data analysis was done by SPSS version 23. Statistically significant test was declared using statistical cut-off point of P-value < 0.05. RESULTS: Accessibility to healthcare services among respondents was 83 (25.4%). About three-quarters of these respondents (74.6%) experienced at least one access barrier to healthcare services; 61.5% experienced physical barriers, 62.7% reported barriers related to medical equipment and 59.3% had communication barriers. Male participants (AOR = 3.19, 95% CI: 1.70, 6.99), married individuals (AOR = 2.95, 95% CI: 1.59, 5.49), people whose costs for healthcare services was covered by NGOs (AOR = 3.23, 95% CI: 1.39, 7.51) and participants with no experience of discrimination when accessing healthcare services (AOR = 5.84, 95% CI: 3, 11, 10.95) had more access to healthcare services. CONCLUSION: Accessibility to healthcare services among people with disabilities was poor in the study. It is related with various factors. Therefore, it is important to strengthen inter-sectoral collaboration, promote community health insurance and strengthen the economic capacity of persons with physical disabilities in order to overcome barriers.

Magnitude of parasitic infections and associated factors among pregnant women at health facilities in Hawassa, Southern Ethiopia.

Background: Intestinal parasitic infections (IPIs) are common problems during pregnancy, with adverse outcomes including low birth weight and prenatal mortality. The burden of parasitic infections and its impacts are high among pregnant women in developing countries like Ethiopia. Therefore, this study aimed to assess the burden and associated factors of parasitic infections. Methods: A facility-based cross-sectional study was conducted among 365 randomly selected women attending antenatal clinic at five selected health facilities. Data was collected by a pre-tested questionnaire and stool specimens were collected in clean plastic containers. A combination of direct microscopy and the formol-ether concentration technique was used as soon as the specimen collected. Data entry and analysed for descriptive and logistic regression models by SPSS v.23. The result declared as statistically significant at p < 0.05.   Results: The overall prevalence of IPI was 161 (45.9%). The most frequently identified parasites were Ascaris lumbricoides (27.9%), Schistosoma species (13.7%), Trichuris trichiura (5.1%), Hookworm (4.8%), and Taenia species. (1.4%). The IPIs were associated with women having no formal education [AOR=2.19, 95% CI: 1.05-4.57] or elementary school education [AOR=1.90, 95% CI: 1.11-3.27], as compared with high school educated and above. Monthly income of less than 1920 Ethiopian birr [AOR=2.06, 95% CI: 1.28-3.31], sharing a latrine with neighbours [AOR=1.83, 95% CI: 1.14-2.93], using lake water for washing clothes [AOR=2.24, 95% CI: 1.34-3.74], habit of eating raw vegetables [AOR=2.26, 95% CI: 1.30-3.92] were associated with IPI as compared to their counterparts. Conclusions: Nearly half of the pregnant women were infected with IPs. The health facilities and clinicians need to focus on prevention of IPIs by early diagnosis, treating lake water before use, promote proper latrine utilization and provision of pertinent health education as part of ante-natal care service. It is important to minimize the impact of IPIs on pregnant women and their child.

Stunting and Associated Factors among Under-Five-Age Children in West Guji Zone, Oromia, Ethiopia.

BACKGROUND: Stunting is one of the most important public health problems in Ethiopia. It remains a problem of greater magnitude particularly in rural and low-income areas. It reflects chronic nutritional deficiencies and illness that occur during the most critical periods for growth and development in early life. It needs proper intervention to save the future, unless it resulted in diminished cognitive and physical development for the rest of their lives. Therefore, this study aimed to assess the prevalence of stunting and associated factors among under-five children in West Guji Zone, Oromia, Ethiopia. METHOD: A community-based cross-sectional study was conducted among 767 under-five children who were included in this study by using a multistage sampling technique in 12 kebeles from 3 selected districts. Data were collected from a mother/caregiver of the child by using a structured pretested questionnaire. Standardized anthropometric measurements were used to measure length, weight, and height of a child. Data were entered into Epi Info software version 3.5.1 and exported to SPSS version 23 for analysis for descriptive and logistic regression models. RESULT: The prevalence of stunting was 244 (31.8%) with 95% CI (28.6-35.2) among under-five-age children. The under-five children whose fathers had a polygamous marriage (AOR = 4.92, 95% CI: 3.46, 7.00), being female sex (AOR = 1.74, 95% CI: 1.23, 2.47), having below 4 meal frequencies (AOR = 2.95, 95% CI: 1.56, 5.58), not vaccinated (AOR = 1.75, 95% CI: 1.15, 2.67), and from poor households' wealth status (AOR = 3.03, 95% CI: 1.63, 5.63) and also from severely food insecure household (AOR = 2.92, 95% CI: 1.36, 6.24) were short for their age compared with their counterparts. CONCLUSION: Nearly one-third of the under-five children were stunted in the study area which needs intervention on child-feeding practice to avoid sex discrimination in the community. In addition to this health officials in collaboration with other sectors, it is needed to act together to improve enforcement of the law for polygamous marriage, the household's wealth status, and food security for the better health of a child and future.

Magnitude of Opportunistic Infections and Associated Factors Among HIV-Positive Adults on ART at Selected Public Hospitals in Sidama National Regional State, Southern Ethiopia.

BACKGROUND: Opportunistic infections are late complications of HIV infection due to the depletion of the immune system. It is a major public health problem and high morbidity AIDS patients die of AIDS-related infections in developing countries like Ethiopia. Identification of opportunistic infections (OIs) is important to develop a specific intervention. Therefore, the aim of this study was to assess the burden and associated factors of opportunistic infections. METHODS: A facility-based cross-sectional study was conducted on 420 randomly selected HIV/AIDS patients taking anti-retroviral therapy. Data were collected from selected hospitals in Sidama Regional State based on population proportion to size. Data were collected by a pre-tested questionnaire and a pre-tested checklist from the medical records of patients. Data were entered and analyzed for descriptive and logistic regression models by SPSS v.23. The result declared as statistically significant at p < 0.05. RESULTS: The magnitude of opportunistic infections was 39.6%. Major identified OIs were oral candidiasis 23.2%, recurrent bacterial pneumonia 21.5%, herpes zoster 6.3%, and pulmonary tuberculosis 6.0%. The magnitude of opportunistic associated with older age [AOR=3.50, 95% CI:1.85, 6.61], no formal education [AOR=4.54, 95% CI:1.81, 11.37], initial CD4 count less than 200 cells/mm3 [AOR=3.10, 95% CI:1.61, 5.96], who interrupt ART medicines [AOR=3.21, 95% CI:1.86, 5.56] and khat chewing [AOR=4.24, 95% CI:2.07, 8.68] when compared to their counterparts. CONCLUSION: The overall magnitude of opportunistic infections was high when compared with other studies. Health officials and clinicians need to give attention to the strengthening of the provision if ART with prophylaxis on early stage and adherence, implementation of the TB/HIV collaboration activity, and early initiation of ART to reduce opportunistic infections.

Undiagnosed Hypertension and Associated Factors Among Adults in Hawela Tula Sub-City, Hawassa, Southern Ethiopia: A Community-Based Cross-Sectional Study.

BACKGROUND: Hypertension (HTN) is a major public health problem and often it is unnoticed. Undiagnosed HTN may lead to a high burden of cardiovascular diseases and complications such as stroke and heart attack. In this study, we aimed to assess the prevalence and associated factors of undiagnosed HTN. METHODS: From February to June 2019, a community-based cross-sectional study was conducted on 383 randomly selected adults in Hawela Tulla Sub-city, Hawassa, southern Ethiopia. Data were collected by pretested questionnaires, and physical measurements of weight, height and blood pressure were collected through standardized procedures adapted from WHO STEPS survey tools. Data entry and analysis were carried out using SPSS version 23 statistical software. Descriptive analysis and logistic regression models were used to describe the results. Logistic regression analysis results were declared statistically significant if the P-value was below 0.05 and the 95% CI did not cross the null value. RESULTS: The prevalence of undiagnosed HTN among the respondents was 12.3%. Only 152 (39.7%) of the study population knew the symptoms of HTN. Males (adjusted odds ratio [AOR] =2.5, 95% CI: 1.2, 5.2; P=0.016), people with a family history of HTN (AOR=2.7, 95% CI: 1.0, 7.0; P= 0.044), people who chewed khat (AOR=4.6, 95% CI: 2.0, 10.2; P<0.001), overweight or obese individuals (AOR=3.5, 95% CI: 1.7, 7.3; P=0.001) and people with diabetes mellitus (AOR=3.2, 95% CI: 1.1, 9.3; P=0.036) had a higher risk of undiagnosed HTN than their counterparts. CONCLUSION: Identification of people with the risk factors of undiagnosed HTN and delivering health education to reduce the risky behaviors could reduce the burden and consequences of HTN. Integrating interventions at the community level may be important.

Sexual and Reproductive Health Services Utilization and Associated Factors among College Students at West Arsi Zone in Oromia Region, Ethiopia.

BACKGROUND: Young people are challenged with sexual and reproductive health (SRH) problems due to limited access to services and information. It contributes a high burden of sexually transmitted disease, unsafe abortion, and premature mortality, especially in low-income countries like Ethiopia. Hence, this study aimed at assessing the SRH service utilization and associated factors among college students at West Arsi Zone in Oromia region, Ethiopia. METHODS: Institutional-based cross-sectional study was conducted among 519 randomly selected college students from January 01, 2019, up to April 30, 2019. Data were collected through self-administered pretested questionnaires. Data entry and analysis for descriptive and logistic regression models were performed by using SPSS (version 23). The result was declared as statistically significant at p < 0.05. RESULTS: The utilization of at least one SRH service in the last twelve months was seen in 304 (58.6%) students. Mainly information and counseling (81.3%), voluntary testing and counseling for HIV (80.6%), condom service (37.2%), pregnancy test (35.5%), family planning services (33.2%), and abortion care services (26.0%) were most frequently utilized. The students' aged between 20 and 24 years [AOR = 2.05, 95% CI: 1.38-3.06], female students [AOR = 1.92, 95% CI: 1.30-2.82], those not living with family [AOR = 1.54, 95% CI: 1.05-2.26], those who discussed about SRH with family/friends [AOR = 1.92, 95% CI: 1.31-2.82], and those who participated in school clubs [AOR = 1.75, 95% CI: 1.19, 2.58] more frequently used SRH service compared with their counterparts. CONCLUSIONS: The utilization of SRH services was low when compared with other studies and needs improvements to tackle RH-related problems. It requires pertinent health education and the SRH club at higher educational institutions is crucial.

Sero-prevalence of hepatitis B virus markers and associated factors among children in Hawassa City, southern Ethiopia.

BACKGROUND: Hepatitis B virus (HBV) infection is one of the major public health problems worldwide. Limited information exists about the epidemiology of HBV infection in Ethiopia. This study aimed to assess sero-prevalence of HBV markers and associated factors in children living in Hawassa City, southern Ethiopia. METHODS: A community-based cross-sectional study was conducted among 471 children in Hawassa City, southern Ethiopia from May to September, 2018. A total of 471 children were included in the study using a multistage sampling technique. Data on demographic and risk factors were gathered using structured questionnaires. Blood samples were collected and sera were screened for hepatitis B surface antigen (HBsAg), antibody to core antigen (anti-HBc), and antibody against surface antigen (anti-HBs) using enzyme-linked immunosorbent assay. RESULTS: The sero-prevalence of HBsAg, anti-HBc, and anti-HBs markers among children were 4.4, 19.5 and 20.0%, respectively. Children at higher risk of having HBsAg marker were those who had a history of injectable medications (AOR 5.02, 95% CI: 1.14, 22.07), a family history of liver disease (AOR 6.37, 95% CI: 1.32, 30.74), a HBsAg seropositive mothers, (AOR 11.19, (95% CI: 3.15, 39.67), and had no vaccination history for HBV (AOR, 6.37, 95% CI: 1.32, 30.74). Children from families with low monthly income, who were home delivered, unvaccinated for HBV or with HBsAg seropositive mother had increased risk of having anti-HBc. CONCLUSIONS: The study findings showed an intermediate endemicity of HBV infection in the study setting. The observed rate of residual HBV infection with low rate of immunized children after HBV vaccination was high. Hence, introducing birth dose vaccine, safe injection practice and improving immunization coverage during pregnancy as part of the antenatal care package should be considered. Furthermore, governmental and non-governmental organizations should give attention on timely measures for the prevention of ongoing vertical transmission from mother to child as well as early horizontal transmission of HBV in Hawassa City, Ethiopia.

Pneumococcal nasopharyngeal carriage and antimicrobial susceptibility profile in children under five in southern Ethiopia.

Background: Streptococcus pneumonia causes high morbidity and mortality, particularly in children under five. Nasopharyngeal (NP) carriage predisposes individuals to pneumococcal infection and horizontal spread within the community. Overuse of antibiotics has been linked to increased risk of antimicrobial resistance to S. pneumonia. We investigated NP carriage rate and resistance to commonly prescribed antibiotics in under-five children visiting a public referral center in southern Ethiopia. Methods: In total, 413 under 5 children who visited the outpatient department for a health check-up, immunization or acute mild illnesses underwent NP sampling. Parent/caregiver surveys were administered at the clinic. Sterile plastic applicator rayon tipped swabs were used for NP sampling. Antimicrobial susceptibility testing was performed using modified the disk diffusion method. Results: S. pneumonia NP carriage was observed in 39% [95% confidence interval (CI): 34.4-43.8]. Living with one or more sibling (AOR (adjusted odds ratio) 1.95: 95% CI: 1.01, 3.76), age group of 3-23 months (AOR 2.31: 95% CI: 1.07, 4.98), co-sleeping with family (AOR 2.09, 95% CI: 1.16, 3.79), attendance at kindergarten/day-care (AOR 1.84: 95% CI: 1.09, 3.11) and malnutrition independently increased S. pneumonia carriage at the individual level. S. pneumonia was highly resistant to Oxacillin (38.5%), Tetracycline (37.3%), and Trimethoprim-sulfamethoxazole (34.2%). Multi-drug resistance was observed in 42.2% of isolates. Conclusions: A high streptococcal NP carriage rate was observed in under-five children. The high level of resistance to commonly used antibiotics calls for enhancing national surveillance of resistance patterns and enforce antibiotic stewardship efforts.

Prevalence of chlamydia trachomatis infection among reproductive age women in sub Saharan Africa: a systematic review and meta-analysis.

BACKGROUND: Chlamydia trachomatis is the most common curable sexual transmitted bacterial infection in the world, including Sub-Saharan Africa. There is nil systematic review and meta-analysis on Chlamydia trachomatis infection in Sub-Saharan Africa among reproductive age women. Therefore, this study was carried out to determine the pooled prevalence of chlamydia trachomatis infection in Sub-Saharan Africa among reproductive age women. METHODS: A comprehensive literature search was conducted from biomedical data bases: Medline, PubMed, EMBASE, Google scholar, HINARI and Cochrane Library using a special index search terms (medical subject headings (MeSH), title and abstract. The Cochrane Q test and I2 statistics was used to test heterogeneity and publication bias was assessed using Begg's and Egger's tests. Results were presented in tables, figures and funnel plot. Data were pooled in a meta-analysis using a random effects model. RESULTS: Twenty-four studies were included in this meta-analysis. There was a high level of heterogeneity among studies. The pooled prevalence of Chlamydia trachomatis infection in Sub-Saharan Africa among reproductive age women was 7.8% (95% CI: 5.6-10.6). CONCLUSION: This review showed that Chlamydia trachomatis infection is high in Sub-Saharan Africa among reproductive age group women. This evidence suggests that governmental and non-governmental organization shall give attention for primary prevention of this infection. Likewise, in resource limited countries policy makers, stakeholders and health care providers' due attention for Chlamydia trachomatis specific and rapid diagnostic test, treatment in any medical out and in patient clinics for reproductive age women.