Malaria incidence and assessment of entomological indices among resettled communities in Ethiopia: a longitudinal study.

BACKGROUND: Population resettlement has been considered among factors that may increase risk of malaria transmission. This study reports, the impact of resettlement on malaria incidence and entomological indices among communities resettled in suburbs of Jimma town, southwestern Ethiopia. METHODS: A cohort of 604 study participants (302 resettlers and 302 non-resettlers) was monthly followed-up from September to November 2013 using active case detection. Moreover, longitudinal entomological study was conducted from June to November 2013. Anopheline mosquitoes were collected using CDC light traps and pyrethrum spray catches. Sporozoite ELISA was performed to determine Plasmodium infection rates. RESULTS: Overall, 112 malaria cases were recorded during the three-month follow-up, of which 74.1% of the cases were from resettlement villages. Plasmodium falciparum incidence from resettlement and non-resettlement villages was 52.5 and 14.5/1,000 person-months at risk, respectively. Resettlement villages were three times at higher risk of Plasmodium infection (OR = 2.8, 95% CI: 1.22-6.48). Anopheles gambiae s.l. was the predominant (86.6%) of all the collected anopheline mosquito species. Plasmodium sporozoite rate in the resettlement and non-resettlement villages was 2.1 and 0.72%, respectively. Plasmodium falciparum entomological inoculation rate (EIR) for An. gambiae s.l. in the resettlement and non-resettlement villages was 13.1 and 0 infective bites/person/night, respectively. Both sporozoite rate and EIR were significantly higher in the resettlement villages (p < 0.05). CONCLUSION: Resettled communities were at higher risk of malaria infection as compared to non-resettled communities. Special attention should be given to malaria control interventions during resettlement programmes.

Intention to voluntary HIV counseling and testing (VCT) among health professionals in Jimma zone, Ethiopia: the theory of planned behavior (TPB) perspective.

BACKGROUND: Voluntary HIV Counseling and Testing (VCT) forms one of the cornerstones of HIV prevention strategies. It is imperative to understand HIV testing correlates and their theoretical underpinnings in order to promote VCT uptake. The aim of this study was to predict the intention to VCT and associated factors among health professionals in Jimma zone, Ethiopia using the theory of planned behavior. METHODS: An institution based cross-sectional quantitative study among a sample of 336 health professionals in 12 selected districts of Jimma, Ethiopia was conducted in 2012. The constructs and principles of the theory of planned behavior (TPB) were measured. Data were collected using structured questionnaire on self administered basis. A multivariable linear regression model was used to predict the role of independent variables/TPB constructs on the intention to use VCT using SPSS version 16.0. RESULTS: The components of TPB independently explained the variance in intention to VCT by 30.3%. Both components of TPB and socio-demographic characteristic in the final model explained 32.7% of variance in the intention to use VCT services. Significant proportions (33.0%) of the respondents have never been tested for HIV. The respective indirect components of the TPB predicted the direct components. The strongest predictors of intention to VCT were subjective norm (ß=0.39, p<0.001) and attitude (ß= 0.19, p<0.001) whereas, none of the socio-demographic variables were significantly predicted the intention to use VCT. Past VCT experience did not have significant statistical association with VCT use intention. CONCLUSIONS: Behavioral intention to use VCT was a function of attitude and perceived social pressure. Demographic related social determinants were not barriers for VCT use intention. Most health workers test their blood by themselves. Strategies to empower health professionals on social pressure resistance and programs targeted at changing negative attitude on VCT use can enhance intention of health professionals to use VCT.

Mothers' experiences and satisfactions with health extension program in Jimma zone, Ethiopia: a cross sectional study.

BACKGROUND: Although mothers are the fundamental unit of interventions in Health Extension Program in Ethiopia, their experiences and satisfactions with the service remain unstudied. Therefore, this study was aimed to assess mothers' experiences and satisfaction with health extension service. METHODS: A community based cross sectional study was conducted in Jimma Zone, Oromiya, Ethiopia. Three hundred Seventy-nine mothers were participated in the study. The study was conducted in four randomly selected rural villages. Systematic sampling technique was used to identify respondents. As part of the data collection process, four focus group discussions were conducted with mothers. SPSS 17.0 and ATLASti.4.1. Softwares were used for data analysis. RESULTS: One hundred Sixty nine (51.7%) of the respondents had an experience of interactions with health extension workers during one year prior to the survey, while 271 (71.5%) of them reported that they received visits from health extension workers during the same period. 298 (78.6%) of the respondents received information at least on one of the Health extension packages. In fact, they had better exposure to personal hygiene and environmental sanitation packages. Even though health extension program is being run by female workers alone, it was believed that the involvement of men is vital to the success of the program. Mothers thought that men are more courageous and professionally competent to deal with complex matters. They also tended to criticize health extension program for lacking curative services and health extension workers are less competent. The greater emphasis laid on outreach services was not supported. 286 (75.5%) of the respondents rated their relationship with health extension workers as positive. Similarly, higher satisfaction was reported though the program has problems. Age, perceived skill to diagnose community problems, perceived respect, involvement of husband and being recognized as a model family were significantly predicted satisfactions with health extension services. CONCLUSIONS: Most mothers had good relationship, were satisfied with and had positive attitude towards health extension program though the program was criticized for not including curative services and the less attention given to static services at health post. Stakeholders are required to reconsider these issues.

Sexual and reproductive health literacy among young people in Sub-Saharan Africa: evidence synthesis and implications.

BACKGROUND: Sexual and reproductive health literacy is a key to attaining and maintaining sexual and reproductive health, especially among young people in low-income countries, such as sub-Saharan Africa. While the importance of sexual and reproductive health literacy is gaining wider recognition, studies on the topic have been mainly concentrated in high-income (developed) countries. OBJECTIVE: The aim of this study was to provide a coherent summary and synthesis of the available evidence on sexual and reproductive health literacy among young people in sub-Saharan Africa, with implications for policy, interventions, and research. METHODS: The review was conducted using the Joanna Briggs Institute's methodology for reviews and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses reporting guideline to enhance the clarity and transparency of the reporting process. PubMed, CINAHL, AJOL, AIM, and Google Scholar were searched for evidence from 18 March to 20 May 2022. RESULTS: The search provided 2,682 articles in total, of which only 24 met the eligibility criteria and were included in this review. The findings revealed persistent sexual and reproductive health information/knowledge gaps, poor sexual and reproductive health-related knowledge and practices, lack of exercising sexual and reproductive health knowledge, and multiple determinants of sexual and reproductive health literacy among young people, ranging from personal to larger structural conditions. CONCLUSION: The review found that sexual and reproductive health literacy among young people in sub-Saharan Africa is concerning and has not been fully researched. A deeper understanding of the issue is essential for designing and implementing effective interventions to improve sexual and reproductive health literacy and health outcomes among young people.

Health Literacy Among Young People in Africa: Evidence Synthesis.

Background: Health literacy has critical health implications. Health literacy in young people is a pressing matter as it determines their current and future health. Although health literacy research is increasing, there are limited health literacy studies from Africa. The aim of this study was to provide a coherent summary and synthesis of the available health literacy studies among young people in Africa. Methods: A systematic scoping review was chosen to attain the aim of this study. PubMed, CINAHL, AJOL, JBI EBP, EBSCO, and Google Scholar were searched for evidence. Based on JBI's methodology for reviews, a three-step search strategy was employed. The search was conducted up to April 20, 2022. The PRISMA flow diagram guideline was used to ensure a transparent reporting of the review process. Results: The search for evidence identified 386 records, of which 53 were selected and their full texts were assessed for eligibility. Nine studies matched the eligibility criteria. The main findings of the eligible studies are: health literacy levels, association between health literacy and health outcomes, and predictors of health literacy among young people. Low health literacy was common among young people, and there was a significant association between low health literacy and negative health outcomes among this group. Health literacy among young people was impacted by a wide range of socio-demographic factors. Conclusion: Health literacy studies among young people in Africa were rare. Although the reviewed studies shed some light on health literacy levels, the association between health literacy and health outcomes, and the predictors of health literacy among young people, they may not give an accurate picture of health literacy among young people, for several reasons. Both primary and secondary health literacy studies are needed to fully understand the issue, and to develop and guide policies and interventions in Africa.

Health Literacy in Ethiopia: Evidence Synthesis and Implications.

Background: Health literacy plays a pivotal role in healthcare utilization and health-related lifestyle choices. This makes health literacy a pressing concern, particularly in low-income countries like Ethiopia, where there are intricate health challenges. Despite its significance, there is a dearth of studies on the issue in Ethiopia. This study aimed to provide a comprehensive synthesis of the available evidence on health literacy in Ethiopia, and to discuss the implications for healthcare practice, health promotion, and research endeavors. Methods: A systematic scoping review was conducted to achieve the purpose of this study. A comprehensive search of databases such as PubMed, CINAHL, AJOL, and PLOS Global Public Health was conducted for eligible evidence. Searches were conducted from May 12 to September 9, 2022. The PRISMA flow diagram guideline was utilized to ensure transparent reporting of the reviews process. The data extraction tool used was based on the JBI methodology guidance for reviews. Results: The search in total yielded 543 records. However, only 16 studies met the eligibility criteria after a thorough screening process. All eligible studies were conducted in health facilities and schools with limited scopes. The main findings of the eligible studies focused on health literacy levels, health information sources, and health literacy determinants among the studies participants. Many of the studies reported low health literacy levels and multiple predicting factors ranging from personal to socioeconomic conditions among the respondents. Conclusion: This review has provided critical insights into the state of health literacy in Ethiopia. There is a need for comprehensive research and the development of context-appropriate health literacy measurements tailored to the Ethiopian context, as well as evidence-based health literacy interventions. Prioritizing health literacy as a key research and intervention area is essential for improving the health of individuals and populations and achieving health-related Sustainable Development Goals in Ethiopia.

Predicting intention to use voluntary HIV counseling and testing services among health professionals in Jimma, Ethiopia, using the theory of planned behavior.

BACKGROUND: To endorse involvement in voluntary HIV counseling and testing (VCT), it is essential to recognize factors that influence people in deciding whether to access VCT services and their underlying route factors. Theory of planned behavior (TPB) constitutes a proficient framework for predicting behaviors and intentions. OBJECTIVE: The aim of the study reported here was to assess the predicting ability of TPB in determining the intended use of VCT services among health professionals in Jimma, southwest Ethiopia. METHODS: This was an institution-based cross-sectional quantitative study of a sample of 336 health professionals in 12 selected districts of Jimma, southwest Ethiopia between February 5 to March 28, 2012. Data were collected using structured questionnaire self-administered by the study participants. A hierarchal multivariable linear regression model was used to predict the role of TPB constructs that can influence the intention to use VCT services. RESULTS: The constructs of TPB explained the variability in intention to use VCT by 27% (R (2) adjusted = 0.27). The standardized regression coefficients showed that the strongest predictor of intention to use VCT was subjective norms (ß = 0.32, P < 0.0005) followed by attitude (ß = 0.21, P < 0.002). Perceived behavioral control was not a significant predictor of intention to use VCT among the study group (P = 0.12). CONCLUSION: The study revealed the possibility of describing the intention to use VCT among health professionals using TPB, with perceived social pressure being the leading predictor. In light of this, health intervention programs should be designed to develop health professionals' ability to resist norms that oppose the use of VCT and to change community-held norms against VCT use, provided they help individuals develop a positive attitude toward the services.

HIV Sero-Prevalence Trend among Blood Donors in Jimma University Specialized Hospital, Southwest Ethiopia.

BACKGROUND: HIV/AIDS epidemics continue unchecked in African countries at all level of society bearing the heaviest burden of the scourge. Different researches have been done to see the progress of disease from time to time However, information that shows the trend of HIV among the healthy population over a period of time in Ethiopia is very limited. METHODS: A descriptive retrospective cross-sectional study was carried out to see the trend of HIV Sero-positivity and associated socio-demographic factors. The data was retrieved from records of people who donated blood during the period of January 2007 to December 2010, at Jimma University Specialized Hospital (JUSH). Data on socio-demographic variables and serologic status of the subjects were abstracted from their records using structured format. Then the data were cleaned, edited and entered into computer and analyzed by Microsoft Excel sheet. Then Chi-Square (X(2)) Statistical test was used for testing associations and P value less or equal to five percent (P ≤ 0.05) was considered significant. RESULTS: A total of 3788 subjects had donated blood from 2007 to 2010 of which 3034 (80.1 %) were males. Thirty nine (1%) of the donors were positive for HIV upon screening by Enzyme Linked Immuno Sorbent Assay (ELISA) method. The prevalence of HIV infection was 1.2% for males and 0.5% for females. The age specific prevalence was highest in the age group 30-39 years (2.2%) followed by 40 - 49 (1.4%). HIV sero-prevalence was higher among rural dwellers (1.4%) than urban (0.8%); drivers and their assistants (2.8%), and daily laborers (2.6%) had higher prevalence. Similarly, those who donated blood for replacement purpose had higher sero-prevalence (1.5%) as compared to those on voluntary basis (0.3%). CONCLUSION: There is decreasing trend of sero-positivity over the years, with higher prevalence among sexually active age groups and rural dwellers.

Assessment of Production and Distribution of Printed Information Education Communication (IEC) Materials in Ethiopia and Utilization in the Case of Jimma Zone, Oromiya National Regional State: A Cross Sectional Study.

BACKGROUND: Health promotion and health education activities rely on a variety of well designed and effective printed Information Education Communication materials to help ensure success. However, in Ethiopia, there is no well established evidence that shows the extent to which printed Information Education Communication materials are produced distributed, utilized and the existing needs and gaps. Therefore, the objective of this study was to assess the process of printed Information Education Communication materials production, distribution and utilization and to identify current Information Education Communication needs and gaps. METHODS: Cross sectional study combining quantitative and qualitative approaches was conducted at Federal, Regional (Oromiya), zonal (Jimma) and facility levels. Fourteen health centers within Jimma Zone were randomly selected and 303 health workers working in these health centers were included in the study. Purposive sampling technique was used to identify respondents for in-depth interview. The quantitative data were analyzed by SPSS for windows version 16.0. RESULTS: The materials designed both by the Health Education Extension Center and Oromiya Regional Health Bureau were not fully culture sensitive. Information Education Communication materials inventories had not been practiced, particularly at zonal and health center levels. Furthermore, at zonal and health center level, there were no safe storage places. Chronic shortage of Information Education Communication materials was reported consistently. Only 206 (68.0%) of the participants had ever used printed Information Education Communication material. 146 (48.2%) and 29 (9.6%) of the participants were rated the IEC material they have seen as very good in terms of understablity and the extent to which it takes the local context into account, respectively. Participants who were nurse and laboratory technologist were 0.35 and 0.23 times less likely to use IEC materials than environmental Health experts [AOR=0.35, 95% CI: 0.14-0.85] and [AOR=0.23, 95%CI: 0.07-0.79], respectively. Graduates of private colleges were 10 times more likely to report utilization of IEC materials than graduates of government institutions [AOR=10.46, 95% CI: 3.47-31.50]. CONCLUSION: This study revealed that design, production, distribution and utilization of printed Information Education Communication materials were not in line with the underlying principles of Information Education Communication material development. Thus, all concerned institutions and individuals should work towards to improvement.

Risky driving behaviors for road traffic accident among drivers in Mekele city, Northern Ethiopia.

BACKGROUND: Due to its perception as a disease of development, road traffic accident and related injuries tend to be under recognized as a major health problem in developing countries. However, majority of the world's fatalities on the roads occur in low income and middle income countries. Since the main cause of road traffic accident is attributed to human risky behaviors, it is important to identify significant factors for risky behaviors of drivers. METHODS: A quantitative cross-sectional study with a sample size of 350 drivers was conducted in April 2011. The study was conducted among Taxi, Bajaj (three tire vehicles) and private owned car drivers. After proportion to size allocation for Taxi (75), Baja (103) and private owned car (172) drivers, we used systematic random sampling method to identify illegible study subjects. Data was collected with face to face interview using a pretested questioner. Univariate, bivariate and multivariate analysis was done using SPSS version 16. RESULTS: The mean age of the respondents was 28.7 (SD 9.9). Majority were 339 (96.9%) males. Significant number of the study subjects 233 (66.6%) had risky driving behaviors. More than a quarter 100 (28.6%) had less knowledge about basic traffic signs. Majority of drivers 181 (51.7%) had negative attitude towards risky driving behaviors. Significant percent of them 148 (42.3%) had a habit of using mobile phone while driving vehicle and 28 (9.7%) had experience of driving after drinking alcohol. All the Bajaj, 97(62.6%) house car and 58(37.4%) taxi unfasten their seat belt while driving. Majority 303 (86.6%) followed the recommended speed limit of driving. About 66 (18.9%) of them had experience of punishment or warning by traffic polices in the previous 1 year and 77 (22%) ever had car accident while driving. CONCLUSIONS: Drivers of secondary education and with high average monthly income were more likely to have risky driving behavior. Having supportive attitude towards risky driving behaviors and not getting advice about risky driving from significant others increases the likelihood of developing risky driving behavior. Interventions targeted at developing negative attitude towards risky driving behaviors on drivers and significant others should be implemented to bring positive behavior change. The interventions need to be segmented with educational status and income.