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OBJECTIVE: To assess the treatment outcomes of severe acute malnutrition (SAM) and its associated factors in children aged 6-59 months in Bale zone, Southeast Ethiopia. DESIGN: A multi-institutionally-based, retrospective cross-sectional study design was conducted, based on records from September 11, 2014 to September 11, 2017. Simple random sampling was used to select the records. A pretested extraction format was used to collect information from the logbook and patient records. Treatment outcome was dichotomized into recovery and censored. Bivariate and multivariable logistic regression analyses were used to analyze the data. Odds ratios with 95% CIs were calculated to determine the association between each independent variable and treatment outcome. RESULTS: A total of 763 records were completed and reviewed. Of these, 711 (93.2%) were recovered from SAM. Provision of deworming treatment (aOR = 6.5; 95% CI: 2.8-15.1), education given to the mother/caregiver (aOR = 8.8; 95% CI: 4.2-18.4), age range 6-24 months (aOR = 0.37; 95% CI: 0.17-0.81), presence of anemia (aOR = 0.33; 95% CI: 0.14-0.78), and use of nasogastric (NG) tube (aOR = 0.42; 95% CI: (0.21-0.85) were associated with recovery from SAM. CONCLUSIONS: Recovery rate of SAM children in this study was in line with international standards. Deworming, maternal education status, child's age, anemia, and NG tube use were associated with recovery. Attention should be given to deworming all children, disease control, and prevention of anemia and other comorbidities.
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Anemia , Desnutrição Aguda Grave , Criança , Humanos , Lactente , Pré-Escolar , Estudos Retrospectivos , Etiópia/epidemiologia , Estudos Transversais , Resultado do Tratamento , Desnutrição Aguda Grave/epidemiologia , Desnutrição Aguda Grave/terapiaRESUMO
BACKGROUND: Every year, large number of women are suffering from cervical cancer. Particularly women living with HIV are at high-risk of being suffered with it. Early testing of high-risk human papillomavirus infection can significantly reduce the incidence of cervical cancer. However, lack of early and regular testing has been identified as one of the major problems among risky populations. METHODS: Institutional-based cross-sectional study design was conducted among women living with HIV in Shashemene town public health facilities with a total sample size of 406 from February 1-March 30, 2022. Systematic random sampling technique was employed to select the study subjects. A structured questionnaire and checklist was used to collect data. The collected data were cleaned, coded, and entered into Epi-info version 7.2.5 and exported to statistical package for social science version 24 for analysis. Finally, bi-variable and multivariable logistic regression analyses were performed to identify determinants of high-risk human papillomavirus. Odds ratio with 95% confidence interval was used to test association between exposure and outcome under study and p-value < 0.05 was considered significant. RESULTS: The prevalence of high-risk HPV infections among study participant was 173(35.2%) with 95% CI (30.5%-40.1%). Prevalence of high-risk HPV type 16, 18 and other high-risk HPV types were 62(15.3%), 23(5.7%) and 58(14.3%), respectively. Having history of sexually transmitted infections [AOR = 3.120; 95% CI (1.977-4.923)], Endline CD4 count < 200 cells/mm3 [AOR = 3.072; 95% CI(1.009-9.350)], Endline HIV viral-load ≥ 50 copies/ml [AOR = 3.446; 95% CI(1.368-8.683)] and more than one-lifetime sexual partner [AOR = 2.112; 95% CI(1.297-3.441)] were significantly associated with high-risk HPV infections. CONCLUSION: More than one third of women living with HIV had high-risk HPV. Having history of STI, low CD4 count, high viral load and multiple sexual partners were associated with high risk HPV. HIV positive women with these risk factors should be given special consideration in clinical and public health intervention.
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Infecções por HIV , Infecções por Papillomavirus , Infecções Sexualmente Transmissíveis , Neoplasias do Colo do Útero , Humanos , Feminino , Infecções por HIV/complicações , Infecções por HIV/epidemiologia , Neoplasias do Colo do Útero/epidemiologia , Neoplasias do Colo do Útero/complicações , Infecções por Papillomavirus/epidemiologia , Infecções por Papillomavirus/complicações , Papillomavirus Humano , Etiópia/epidemiologia , Prevalência , Estudos Transversais , Instalações de SaúdeRESUMO
BACKGROUND: Access to outpatient therapeutic feeding programs (OTP) for all children who have uncomplicated severe acute malnutrition (SAM) remains a global public health priority. Identifying predictors that determine time-to-recovery from severe acute malnutrition optimize therapeutic success. However, reliable evidence on the determinants of time to recovery at health posts was not available in Nagele Arsi district of South Ethiopia. OBJECTIVE: This study was aimed to identify determinants of time-to-recovery from uncomplicated SAM among children aged (6-59) months treated at an OTP in health posts of Nagele Arsi district, Southern Ethiopia. METHODS: Institutional based retrospective cohort study was conducted among 357 children treated in Negele Arsi district from July1, 2018 to June 30, 2020. The children were selected using simple random sampling from 20 health posts. SAM treatment outcomes were compared against international SPHERE standards. The average time-to-recovery was estimated using Kaplan-Meier survival curve and the independent predictors of time to recovery were determined using multivariable Cox-proportional hazard model. The strength of the association was done using adjusted hazard ratio (AHR) with 95% confidence intervals. Statistical significance was declared at p value < 0.05. The results were presented by text, tables and figures. RESULT: A total of 284 (79.6%) children recovered during follow up. The mean weight gain for recovered children was 4.7 + 2.4 g/kg/day. The median time-to-recovery was 44 days 95% CI (42.7-45.3). Children who received Amoxicillin, AHR =2.574, 95% CI (1.879-3.525); de-wormed, AHR = 1.519, 95% CI (1.137-2.031); received Vitamin A, AHR = 2.518, 95% CI, (1.921-3.301) and new admissions, AHR = 1.823, 95%CI, (1.224-2.715) were more likely to recover. However, those who admitted with non-edema, AHR = 0.256, 95% CI, (0.189-0.346); had cough at admission, AHR = 0.513, 95 CI, (0.366-0.719) and had diarrhea at admission AHR = 0.5, 95% CI, 0.5 (0.350-0.712) were less likely to recover. CONCLUSION AND RECOMMENDATION: The recovery rate was within the acceptable ranges of International Sphere Standards. Those children who had cough and diarrhea should be given due attention from health extension workers and program planners. Appropriate provision of routine medication and timely intervention of co-morbidity are needed to increase chance of early recovery.
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Pacientes Ambulatoriais , Desnutrição Aguda Grave , Criança , Humanos , Lactente , Estudos Retrospectivos , Tosse , Desnutrição Aguda Grave/terapia , Diarreia , EtiópiaRESUMO
BACKGROUND: Human immunodeficiency virus (HIV) positive status disclosure is an essential component of Pediatric care and long term disease management. Children have a right to know their HIV diagnosis result. However, Pediatric HIV disclosure is complex and varies in different communities. This study aimed to assess the prevalence of HIV-positive status disclosure to infected children and associated factors among caregivers of infected children. METHODOLOGY: A facility based mixed methods research design study was conducted in Bale Zone of South East Ethiopia. Randomly selected caregivers of HIV-positive children were interviewed using structured questionnaires for quantitative study and 17 in-depth interviews of health care workers and caregivers were conducted for qualitative data. Content analysis was done for qualitative data and logistic regression analysis was used to see the association between different variables and HIV-positive disclosure status. Odds ratio with 95% CI was computed to determine the presence and strength of the associated factors. RESULTS: A total of 200 caregivers of school aged (6-14 years) children participated in the study. Only 57 (28.5%) of the care givers disclosed HIV-positive status to the child for whom they were caring. The main reason for disclosure delay was due to fear of negative consequences, perception on maturity of the child, and fear of social rejection and stigma. Having social support [AOR = 2.7, 95% CI: (1.1-6.4)], caring for a child between 10 and 14 years with HIV [AOR = 6.5, 95% CI: (2.1-20.2)], a child diagnosed with HIV at age > 5 years [AOR = 2.8, 95% CI: (1.1-7.1)], and children on antiretroviral therapy (ART) with follow-up for > 5 years [AOR = 4.7, 95% CI: (1.8-11.2)] had significant association with HIV- positive status disclosure to infected children. CONCLUSION: The frequency of HIV infection disclosure to infected children was very low in our cohort. Having social support, having an older child with HIV, a long period of ART follow-up and HIV diagnosis after age of five years were positively associated with HIV-positive status disclosure to infected children. Giving age appropriate counselling to children, social support to the caregivers and working on related factors are very important to improve the observed low disclosure status.
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Cuidadores , Soropositividade para HIV , Revelação da Verdade , Adolescente , Adulto , Antirretrovirais/uso terapêutico , Criança , Estudos Transversais , Etiópia , Feminino , Soropositividade para HIV/tratamento farmacológico , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Fatores SocioeconômicosRESUMO
BACKGROUND: Loss to follow-up (LTFU) among paediatric patients living with HIV presents a significant challenge to the global scale-up of life-saving antiretroviral therapy (ART). OBJECTIVES: This study aims to estimate LTFU incidence and its determinants among children with HIV on ART in Shashemene town public health institutions, Oromia, Ethiopia. DESIGN: A retrospective cohort study from 1 January 2015 to 30 December 2020. SETTING: This study was conducted in Shashemene town, Oromia, Ethiopia. PARTICIPANTS: Medical records of 269 children receiving ART at health facilities in Shashemene town were included. METHODS: Data from patients' medical records were collected using a standardised checklist. EpiData V.3.1 was employed for data entry, while Statistical Package for the Social Sciences (SPSS) V.25 facilitated analysis. The Kaplan-Meier survival curve was used for estimation of survival time. To measure association, adjusted HRs (AHRs) with 95% CIs were calculated. Both bivariable and multivariable Cox proportional hazards regression models were employed to identify predictors of LTFU. RESULTS: Of the 269 children living with HIV included in the final analysis, 43 (16%) were lost to follow-up. The overall incidence rate of LTFU was 3.3 (95% CI 2.4 to 4.4) per 100 child-years of observation. Age less than 5 years (AHR 0.03, 95% CI 0.00 to 0.36), non-orphan status of the child (AHR 0.13, 95% CI 0.05 to 0.34), < 30 min distance to health facility (AHR 0.24, 95% CI 0.08 to 0.73), disclosed HIV status (AHR 0. 32, 95% CI 0.13 to 0.80), history of opportunistic infection (AHR 3.54, 95% CI 1.15 to 10.87) and low CD4 count (AHR 5.17, 95% CI 2.08 to 12.85) were significant predictors of LTFU. CONCLUSION: The incidence rate of LTFU was lower compared with other studies in Ethiopia. This result indicated that age less than 5 years, non-orphans, low CD4, disclosed HIV status and distance from health facility were predictors of LTFU.
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Infecções por HIV , Perda de Seguimento , Humanos , Etiópia/epidemiologia , Infecções por HIV/tratamento farmacológico , Infecções por HIV/epidemiologia , Feminino , Masculino , Estudos Retrospectivos , Criança , Pré-Escolar , Lactente , Incidência , Adolescente , Fatores de Risco , Fármacos Anti-HIV/uso terapêutico , Antirretrovirais/uso terapêutico , Modelos de Riscos Proporcionais , Estimativa de Kaplan-MeierRESUMO
BACKGROUND: Children with inadequate iron consumption had slower growth, weaker immunity, and poor cognitive development. Although the public health importance of iron-rich consumption in Ethiopia is known, evidence for iron-rich food consumption and predictors among children aged 6-59 months old in Ethiopia is sparse. This study aimed to assess iron-rich food consumption and predictors among children aged 6-59 months old in Ethiopia. METHODS: This study used Ethiopia mini demographic and health survey 2019 (EMDHS-2019) data with a total weighted sample size of 5,112 among children aged 6-59 months old. A multilevel mixed effect logistic regression analysis was used to identify predictors of good iron-rich food consumption. RESULTS: The proportion of good consumption of iron-rich foods among children aged 6-59 months was 27.99% (24.22, 32.10%). The findings revealed that children born to mothers who completed primary education [AOR = 1.88, 95% CI: 1.11, 3.19], a higher education [AOR = 4.45, 95% CI: 1.28, 15.48], being born to the poorer family [AOR = 1.89, 95% CI: 1.04, 3.43], richer [AOR = 2.12, 95% CI: 1.03, 4.36], and richest [AOR = 3.57, 95% CI: 1.29, 9.93] were positively associated with good iron-rich food consumption among children aged 6-59 months old. Nevertheless, being 24-59 month-old children [AOR = 0.58, 95% CI: 0.44, 0.72], residents of the Afar [AOR = 0.23, 95% CI: 0.08, 0.67], Amhara region [AOR = 0.30, 95% CI: 0.14, 0.65], and Somali region [AOR = 0.01, 95% CI: 0.01, 0.07] were negatively associated with good iron-rich food consumption among children aged 6-59 months old. CONCLUSION: The finding revealed that there was low consumption of iron-rich foods among children aged 6-59 months in Ethiopia compared to reports from East African countries. Improving women's literacy and economic empowerment would improve iron-rich food consumption among children aged 6-59 months old. This study's findings would have implications for policymakers in Ethiopia to enhance iron-rich food consumption.
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Inquéritos Epidemiológicos , Ferro , Humanos , Etiópia , Lactente , Feminino , Masculino , Pré-Escolar , Ferro/análise , Comportamento Alimentar , Ferro da Dieta/administração & dosagem , Ferro da Dieta/análiseRESUMO
Background: Neonatal sepsis is a significant contributor to neonatal morbidity and mortality worldwide. It is more prevalent in developing countries. Thus, understanding the risk factors for neonatal sepsis is critical to minimizing the incidence of infection, particularly in Ethiopia. The purpose of this study was to identify the risk factors for neonatal sepsis in neonates admitted to neonatal intensive care units of public hospitals in Southeast Ethiopia in 2020. Method: An institution-based, retrospective unmatched case-control study was conducted on 97 cases and 194 controls in neonatal intensive care units of public hospitals in Southeast Ethiopia. A pretested, structured questionnaire was used to collect the data. Data was entered using EpiData 3.1 and analyzed using SPSS version 23. Bivariable and multivariable logistic regression analyses were performed to identify associated factors. An adjusted odds ratio with a 95% confidence interval was used to determine the degree of association, and statistical significance was declared at a p value of < 0.05. Results: In this study, 97 cases and 194 controls were included. About two-thirds (63.9%) of cases were with early onset neonatal sepsis (<7 days). Mode of delivery with spontaneous vaginal delivery (AOR:5.032; 95% CI (1.887-13.418)), type of birth attendant (traditional birth attendant) (AOR: 4.407 95% CI (1.213,16.004)), history of STI/UTI (AOR:2.543; 95% CI (1.313,4.925)), intrapartum fever (AOR:4.379; 95% CI (2.170,8.835)), APGAR score at the 5thminute < 7 (AOR:4.832; 95% CI (1.862,12.537)), neonate received resuscitation (AOR:3.830; 95% CI (1.753,8.369)), low birth weight (AOR:6.101; 95% CI (2.124,17.525)) were the identified risk factors for neonatal sepsis. Conclusion: Both maternal and neonatal factors contribute to the risk of neonatal sepsis. Spontaneous vaginal delivery, birth attended by the traditional birth attendant, history of STI/UTI, presence of intrapartum fever, low APGAR score at the 5th minute, neonate receiving resuscitation, and low birth weight were identified as independent risk factors for neonatal sepsis. Prompt identification of the aforementioned factors and management should be sought for all newborns.
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Pregnant women are at high risk for iron deficiency anemia due to increased nutrient requirements during pregnancy. Despite high coverage of iron and folic acid supplementation (IFAS), low compliance is reported. The study aimed to assess compliance with IFAS and its associated factors among antenatal care (ANC) attendees in Wondo District, Southern Ethiopia. A facility-based cross-sectional study was conducted among 400 pregnant women. Pregnant women were selected through systematic random sampling. Pre-tested structured questionnaire was used to collect data through face to face interview. Data were entered into Epi-info and exported to Statistical Package for Social Sciences for analysis. The variables with p-value < 0.25 in the bivariable analysis were entered into the multivariable logistic regression model. P values less than 0.05 were considered significant. Results were reported as crude and adjusted odds ratios with 95% confidence intervals. The prevalence of compliance to IFAS was (177, 44.3%). Factors significantly associated with compliance to IFAS were maternal age ≥ 25 years [AOR 2.27, 95% CI (1.21, 4.28)], maternal education [AOR 2.62, 95% CI (1.43, 4. 79)], husband's education [AOR 3.60, 95% CI (2.07, 6.25)], knowledge of anemia [AOR 4.40, 95% CI (2.65, 7.30)], and knowledge of IFA [AOR 2.21, 95% CI (1.40, 3.50)]. This study showed that compliance to IFAS was low. Maternal age, maternal education, husband's education, knowledge about anemia and iron folic acid was found to be significantly associated with adherence to IFAS. Emphasis should be placed on young, uneducated mothers and their husbands.
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Anemia , Ferro , Feminino , Gravidez , Humanos , Adulto , Ferro/uso terapêutico , Gestantes , Estudos Transversais , Suplementos Nutricionais , Conhecimentos, Atitudes e Prática em Saúde , Ácido Fólico/uso terapêutico , Cuidado Pré-NatalRESUMO
BACKGROUND: Despite tremendous work has been done on demand creation, capacity building and ensuring the logistics of Implanon; its discontinuation rate remained high in Ethiopia; the prevalence is reported to be 31% in Shashemene District. However, the factors contributing to the high prevalence of early Implanon discontinuation were not well understood in our study setting. OBJECTIVE: This study aimed to identify the determinants of implanon discontinuation among women who had ever used Implanon in Shashemene District, Southern Ethiopia. METHODS: A community-based unmatched case-control study was conducted among randomly selected 264 women (88 cases and 176 controls) in Shashemene District, Southern Ethiopia, from April 12 to May 18, 2021. A systematic random sampling technique was used to select the respondents. Cases were women who discontinued Implanon before 3 years and controls were those who used implanon for 3 full years. A pre-tested, interviewer-administered structured questionnaire was used to collect data. Bivariable and multivariable binary logistic regression analyses were performed to identify determinants of Implanon discontinuation. An odds ratio (OR) with a 95% confidence interval (CI) was used to estimate the strength of the association, and significance was declared at a P value of less than 0.05. RESULT: The mean age of the respondents was 28.23 (± 5.46) years: 27.27 (± 5.38) years for cases and 28.70 (± 5.5) years for controls. Women with no formal education [AOR = 3.09, 95% CI: (1.20, 8.00)], fewer than four children [AOR = 2.47, 95% CI: (1.20, 5.08)], no history of abortion [AOR = 2.84, 95% CI: (1.25, 6.46)], being new acceptors [AOR = 2.14, 95% CI: (1.02, 4. 49)], being counseled for less than fifteen minutes [AOR = 2.47, 95% CI: (1.29, 4.70)], not discussing it with a partner [AOR = 2.88, 95% CI: (1.42, 5.84)] and experiencing side effects [AOR = 0.35, 95% CI: (0.17, 0.71)] were significantly associated with discontinuation of implanon. CONCLUSION: Women with no formal education, having less than four children, history of abortion, new acceptors, duration of counseling, discussion with partner, and side effects were determinants of Implanon discontinuation among women. There is a need to ensure adequate pre-implantation counseling and appropriate management of side effects. Furthermore, interventions should target new acceptors and those without formal education.
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Anemia is predicted to affect 38% (32 million) of pregnant women worldwide. However, evidence for utilization and compliance with iron supplementation and predictors during pregnancy in low-income countries, including Ethiopia, is sparse and inconclusive. Therefore, we aimed to assess utilization and compliance with iron supplementation and predictors among pregnant women in Robe Town, Southeast Ethiopia. A community-based cross-sectional study was employed among randomly selected 445 pregnant women attending antenatal care at health facilities from May to July 2015. A systematic random sampling was used to select respondents. Data were collected using a pre-tested, interviewer-administered, structured questionnaire. Bivariable and multivariable logistic regression analyses were conducted to identify predictors of compliance with iron supplementation. An odds ratio, along with a 95% confidence interval (CI), was used to estimate the strength of the association. In this study, 54% [95% CI (49.4, 58.4%)], 45.2% [95% CI (40.9, 49.4%)], 4.3% [95% CI (2.5, 6.3%)], and 2.2% [95% CI (1.1, 3.6%)] of women received iron supplements during their first, second, third, and fourth antenatal care visits, respectively. The level of compliance with iron supplementation was 92.4% [95% CI (89.9, 94.6%)]. Having a formal education (AOR = 4.45, 95% CI 1.41, 13.99), being in the high wealth quintile (AOR = 0.18, 95% CI 0.05, 0.68), medium wealth quintile [(AOR = 0.33, 95% CI (0.11, 0.98)], receiving iron supplements for free (AOR = 3.77, 95% CI 1.33, 10.69), not experiencing discomfort related to iron supplements intake (AOR = 2.94, 95% CI 1.17, 7.39), having comprehensive knowledge about anemia (AOR = 2.62, 95% CI 1.02, 6.70), being knowledgeable about iron supplements (AOR = 3.30, 95% CI 1.12, 9.76), having information about importance of iron supplementation during pregnancy (AOR = 2.86; 95% CI 1.04, 7.87), and ever being visited by urban health extension workers (AOR = 0.31; 95% CI 0.12, 0.83) was significantly associated with compliance with iron supplementation during pregnancy. The utilization of iron supplementation during pregnancy was low, with relatively high compliance with the supplements. Thus, comprehensive nutrition education and free provision of iron supplementation are crucial tools to increase utilization and compliance with iron supplementation during pregnancy. Further research with a strong study design using golden standard methods is warranted.
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Anemia , Gestantes , Estudos Transversais , Suplementos Nutricionais , Etiópia , Feminino , Ácido Fólico , Humanos , Ferro/uso terapêutico , Gravidez , Cuidado Pré-Natal/métodosRESUMO
INTRODUCTION: Maternal near-miss precedes maternal mortality, and women are still alive indicating that the numbers of near-misses occur more often than maternal mortality. This study aims to assess the prevalence of maternal near-miss and associated factors at public hospitals of Bale zone, Southeast Ethiopia. METHODS: Facility-based cross-sectional study design was carried out from 1 October 2018 to 28 February 2019, among 300 women admitted to maternity wards. A structured questionnaire and checklist were used to collect data. Epi-info for data entry and statistical package for social science for analysis were used. The descriptive findings were summarized using tables and text. Adjusted odds ratio with 95% confidence interval and p-value < 0.05 were used to examine the association between the independent and dependent variables. RESULT: The prevalence of maternal near-miss in our study area was 28.7%. Age < 20 years, age at first marriage < 20 years, husbands with primary education, and being from rural areas are factors significantly associated with the prevalence of maternal near-miss. The zonal health department in collaboration with the education department and justice office has to mitigate early marriage by educating the community about the impacts of early marriage on health.
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Near Miss , Complicações na Gravidez , Adulto , Estudos Transversais , Etiópia/epidemiologia , Feminino , Hospitais Públicos , Humanos , Mortalidade Materna , Gravidez , Complicações na Gravidez/epidemiologia , Adulto JovemRESUMO
OBJECTIVE: Adverse birth outcomes, which include stillbirth, preterm birth, low birthweight, congenital abnormalities, and stillbirth, are the leading cause of neonatal and infant mortality worldwide. We assessed adverse birth outcomes and associated factors among mothers who gave birth in Bale zone hospitals, Oromia, Southeast Ethiopia. METHODS: We used systematic random sampling in this cross-sectional study. We identified factors associated with adverse birth outcomes using bivariate analysis and multivariable logistic regression analysis. RESULTS: The proportion of adverse birth outcomes among participants was 21%. Of 576 births, 70 (12.2%) were low birthweight, 49 (8.5%) were preterm birth, 45 (7.8%) were stillbirth, and 18 (3.1%) infants had congenital anomalies. Inadequate antenatal care (adjusted odds ratio [AOR] = 6.58, 95% confidence interval [CI] 3.25-13.32), multiple pregnancy (AOR = 4.74, 95% CI 1.55-14.45), premature rupture of membranes in the current pregnancy (AOR = 2.31, 95% CI 1.26-4.21), hemoglobin level < 11 g/dL (AOR = 3.22, 95% CI 1.85-5.58), and mid-upper arm circumference less than 23 cm (AOR = 5.93, 95% CI 3.49-10.08) were all significantly associated with adverse birth outcomes. CONCLUSIONS: Approximately one in five study participants had adverse birth outcomes. Increasing antenatal care uptake, ferrous supplementation during pregnancy, and improving the quality of maternal health services are recommended.
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Mães , Nascimento Prematuro , Estudos Transversais , Etiópia/epidemiologia , Feminino , Hospitais , Humanos , Lactente , Recém-Nascido , Gravidez , Nascimento Prematuro/epidemiologiaRESUMO
BACKGROUND: Late presentation for HIV/AIDS care is defined as individuals newly presenting for HIV/AIDS care with a CD4 count below 350 cells/µl or presenting for care with WHO clinical staging of stage III or IV. Globally, around 21.7 million people living with HIV/AIDS were receiving ART in 2017, with an increase of 2.3 million since 2016. Despite this progress, most people start ART late in their disease progression. OBJECTIVE: This study aims to identify predictors of late presentation for HIV/AIDS among people living with HIV and attending ART clinics in West Arsi Zone public health institutions, South Ethiopia, 2019. METHODOLOGY: A facility-based unmatched case-control study was conducted among people living with HIV attending ART clinics in West Arsi Zone public health institutions, with a total sample size of 500 (167 cases and 333 controls). The sample size was calculated using Epi info version 7 and participants were selected using the case-based control selection sampling technique. Descriptive statistics were carried out to summarize the data. Bi-variate binary logistic regression analysis was carried for selecting candidate variables for multivariate binary logistic regression. A p-value of <0.05 was taken to declare the presence of a statistical association between outcomes and explanatory variables. RESULTS: Rural residence (AOR=7.74 95% CI (3.4-17.6)), being single (AOR=0.18 95% CI (0.06-0.49)) symptom(s) at first HIV diagnosis (AOR=7.69 95% CI (4.09-14.4)), no private house (AOR=5.09 95% CI (2.47-10.45)), fear of losing job (AOR=4.12 95% CI (2.04-8.31)), alcohol consumption (AOR=4.35 95% CI (2.18-8.69), and having chronic medical illness (AOR=5.04 95% CI (2.48-10.24)) were identified as having significant associations with late presentation of HIV/AIDS care. CONCLUSION: Rural residence, fear of losing a job, and chronic medical illness were potential risk factors for late presentation of HIV/AIDS care. Being single is the only protective factor for the late presentation of HIV/AIDS care.
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[This corrects the article DOI: 10.1371/journal.pone.0214962.].
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BACKGROUND: Intimate partner violence (IPV) against women is a major public health concern in low income countries. Violence against pregnant women has adverse effects on maternal and newborn outcomes. This study aimed to assess the prevalence and associated factors of intimate partner violence in Southeast Ethiopia pregnant women. METHODS: Institutional based cross-sectional study was conducted on pregnant women who were attending antenatal care (ANC) in Bale Zone health institution during study period. Face to face interviews were conducted using a pre-tested structured questionnaire. Data related to socio-demographic characteristic, pregnancy and reproductive history, intimate partner behavior and IPV encountered during recent pregnancy was gathered for this study. Descriptive analysis and logistic regression were used for the data analysis. Odds ratio with 95% CI was computed to determine the presence and strength of associated factors with IPV. RESULTS: A total of 612 pregnant women participated in the study. Of these, 361 (59.0%) pregnant women faced at least one type of IPV during the recent pregnancy. Physical violence (20.3%), sexual violence (36.3%), psychological/emotional violence (33.0), controlling behavior violence (30.4%) and economic violence (27.0) were the type of IPV encountered by participants. An intimate partners who were drank alcohol [AOR = 2.9; 95% CI: (1.5-5.4)], partners who were chewed Khat [AOR = 1.7; 95% CI: (1.1-2.6)], partners who were smoked cigarette [AOR = 2.6; 95% CI: (1.4-4.9)], partners who had aggressive behavior [AOR = 2.8; 95% CI: (1.7-4.6)], having partner age ≥30 year old [AOR = 1.8; 95% CI: (1.2-2.9)], unwanted pregnancy [AOR = 3.3; 95% CI: (1.9-5.5)] and history of adverse pregnancy outcome [AOR = 2.1; 95% CI: (1.2-3.6)] that were the factors that significantly associated with IPV of the pregnant women. CONCLUSION: The prevalence of IPV during pregnancy was high among the study participants. Intimate partners' use of substance, intimate partners' aggressive behavior, older intimate partners, unwanted pregnancy and history of adverse birth outcome were identified as associated factors for IPV. IPV needs to be considered during ANC service and integrated into the sexual and reproductive health education. Community-based interventions should be advocated as a way of health promotion. Counseling, awareness creation, service provision and program design on IPV is mandatory to minimize the victim.
Assuntos
Violência por Parceiro Íntimo/estatística & dados numéricos , Abuso Físico/estatística & dados numéricos , Gestantes/psicologia , Delitos Sexuais/estatística & dados numéricos , Adolescente , Adulto , Estudos Transversais , Etiópia/epidemiologia , Feminino , Humanos , Violência por Parceiro Íntimo/psicologia , Modelos Logísticos , Masculino , Idade Materna , Razão de Chances , Abuso Físico/psicologia , Gravidez , Resultado da Gravidez/epidemiologia , Resultado da Gravidez/psicologia , Gravidez não Desejada/psicologia , Cuidado Pré-Natal , Prevalência , Delitos Sexuais/psicologia , Parceiros Sexuais/psicologia , Fatores Socioeconômicos , Adulto JovemRESUMO
BACKGROUND: Injuries are very common and can occur at any point of time in a day. Unintended injuries in kindergarten children are the most common and need immediate life saving care which is known as first aid. This study aimed to investigate knowledge, attitude, practice, and associated factors of first aid among kindergarten teachers of Lideta sub-city Addis Ababa, Ethiopia. METHOD: A cross-sectional study was conducted among kindergarten teachers. Data was collected using pretested, structured and self-administered questionnaire S1 File. The collected data was entered in to Epi Data version 3.1 software and analyzed using SPSS version 20. Logistic regression analysis was used to identify association between kindergarten teachers' knowledge and attitudes towards first aid and different variables. Odds ratios with 95% CI and p<0.05 were computed to determine the presence of the association. RESULT: One hundred and ninety-four teachers participated in the study with a response rate of 95%. Only 40% of the teachers were knowledgeable and 75% of them had positive attitude for first aid. Eighty percent of teachers encountered with children in need of first aid. Kindergarten teachers older than 35 years [AOR = 4.2, 95%CI: (1.02, 16.9)], five years' experience [AOR = 3.1, 95%CI: (1.2, 7.6)], having previous first aid training [AOR = 3.1, 95%CI: (1.2, 7.7)], source of first aid information and teachers serving in private kindergarten are associated with having knowledge of first aid. Long time experience, type of kindergarten, previous training, and exposure to children in need of first aid were positive association with attitude towards first aid. CONCLUSION: Low first aid knowledge and high positive attitude among kindergarten teachers. Having long time experience, being older age, previous first aid training, and serving in private kindergarten were positively associated with first aid knowledge and positive attitude. Creating awareness and including first aid courses in the kindergarten teachers' curriculum need to be considered.