Determinants of Podoconiosis in Bensa District, Sidama Region, Ethiopia: A case control study.

BACKGROUND: Podoconiosis is one of the neglected tropical diseases (NTD) with the greatest potential for elimination. Despite its public health importance, podoconiosis is a poorly understood disease which led to a widespread misconception about its cause, prevention, and treatment. Even though the exact global burden is still to be measured, it is estimated that at least 4 million people are affected with podoconiosis worldwide, of which more than 1.5 million people are in Ethiopia. The objective of this study was to identify the determinants of podoconiosis in Bensa District, Sidama Regional State, Ethiopia. METHODOLOGY/PRINCIPAL FINDINGS: A community-based unmatched case-control study was used to identify the determinants of podoconiosis. The sample size was estimated using the double population proportion formula. An interviewer-administered structured questionnaire was used for data collection. Blood specimens collected from cases were tested by Filariasis Test Strip to exclude lymphatic filariasis. Data were checked for completeness, coded and entered into Epi-data Version 4.6, and exported to the SPSS version 22 software. Variables with a p<0.2 in the bivariate analysis were further analyzed using multivariable binary logistic regression. Multivariable logistic regression analysis was used to examine determinants that could be associated with podoconiosis with a 95% confidence interval. A total of 459 (153 cases and 306 controls) participants were included with a response rate of 100%. Factors such as the age of participant [AOR = 0.34, 95% CI (0.13-0.87)], being female [AOR = 2.90, 95% CI (1.40-6.10)], age at which shoe wearing started [AOR = 0.7, 95% CI (0.03-0.16)], not wearing shoe daily [AOR = 2.26, 95% CI (1.05-4.86)], wearing hard plastic shoe [AOR = 3.38, 95% CI (1.31-10.89)], and family history with a similar disease (leg swelling) [AOR = 10.2, 95% CI (3.97-26.37)] were significantly associated with the occurrence of podoconiosis. CONCLUSIONS/SIGNIFICANCE: The age of the participants, gender, the age at which shoe wearing started, type of shoe the participants' wear, frequency of shoe wearing, traveling barefoot, and family history with similar disease (leg swelling) were significantly associated with the occurrence of podoconiosis. Sidama regional health bureau along with non-governmental organizations working on the neglected tropical disease should plan modalities on awareness creation and comprehensive health education on shoe wearing and foot hygiene.

Prevalence of undernutrition among pregnant women and its differences across relevant subgroups in rural Ethiopia: a community-based cross-sectional study.

BACKGROUND: Maternal undernutrition is one of the commonest public health problems in many low- and middle-income countries where generally more than 20% of women are undernourished. It is more common in rural areas due to unclear factors. Therefore, the aim of this study was to investigate the prevalence of undernutrition in general and in subgroups and determine risk factors among pregnant women in rural Ethiopia. METHODS: A community-based cross-sectional survey was conducted from April 30 to May 30, 2019 on 550 pregnant women who were randomly selected from six districts in southern Ethiopia. Trained and experienced nurses measured undernutrition using mid-upper arm circumference and collected other data. We used multilevel mixed-effect logistic regression to identify factors associated with undernutrition among pregnant women. RESULTS: The prevalence of undernutrition among pregnant women was 38% (95% CI: (34.2-42.3). The odds of undernutrition was higher among women who got pregnant previously (adjusted odds ratio [AOR]: 1.66; 95% CI: 1.02-2.71), who had a history of miscarriage (AOR: 3.18; 95% CI: 1.77-5.70), who practiced food taboos (AOR: 2.23; 95% CI: 1.47-3.39), and who did not get any nutritional counseling during pregnancy (AOR: 2.97; 95% CI: 1.79- 4.95). The prevalence of undernutrition was higher among pregnant women who had multiple risk factors and the difference was statistically significant (p < 0.001). CONCLUSION: Undernutrition is a highly prevalent problem among rural Ethiopian pregnant women, especially with those who avoid food, do not get counseled, and had two or more pregnancies and a history of miscarriage. Improving the integration of nutrition programs with routine healthcare services and encouraging a multi-sectorial intervention strategy would help to reduce maternal undernutrition in the country.

Cervical cancer screening utilization and associated factors among female health workers in public health facilities of Hossana town, southern Ethiopia: A mixed method approach.

BACKGROUNDS: Worldwide, a substantial proportion of women have low cervical cancer screening services utilization. There is a paucity of evidence in utilization of cervical cancer screening services among female health workers and inconsistent findings in Ethiopia. This study aimed to assess the utilization of cervical cancer screening services and associated factors among female health workers in public health facilities of Hossana town, Southern Ethiopia. METHODS: Facility-based cross-sectional study design complemented with the qualitative inquiry was conducted among randomly selected 241 study participants in Hossana town from June 1 to July 1, 2021. Logistic regression models were used to determine the association between dependent and independent variables with the assumption of a variable with a p-value < 0.05 was considered statistically significant. Qualitative data were transcribed verbatim then translated to English and analyzed using open code version 4.03. RESULTS: Out of the total study participants, 19.6% was screened for cervical cancer. Having a diploma level of education (AOR = 0.48;95%CI:0.24,0.98), having three or more children (AOR = 3.65;95%CI:1.44,9.21), having multiple sexual partners(AOR = 3.89;95%CI: 1.38,11.01), and knowledge of cervical cancer screening (AOR = 2.66;95% CI:1.19,5.95) were statistically significantly associated with cervical cancer screening utilization. In-depth interviews suggested additional barriers for low screening utilization including lack of health educational materials, limitation of service to a specific area, service interruption, provider incompetency, and miss-trust and lack of attention by a trained provider. CONCLUSION: Utilization of cervical cancer screening service among female health workers is low. Having a diploma level of education, having three or more children, a history of multiple sexual partners, and knowledge about cervical cancer were predictors of cervical cancer screening utilization. Contextualized health talks and promotion through training with a special focus on low level of knowledge, had lower educational level, and the availability of cervical cancer screening services are critical.

Frailty status and associated factors among older PLHIV in Southern Ethiopia.

BACKGROUND: Studies addressing frailty are limited in the global south, including Ethiopia. We estimated the prevalence of frailty and associated factors among older people living with HIV (PLHIV) attending a large Comprehensive Specialized Hospital in southern Ethiopia. METHODS: A systematic sample of 187 PLHIV and 187 HIV-negative controls > 50 years old were recruited between October 1 and November 30, 2021. Data on socio-demographic, behavioural and clinical characteristics were collected using a structured questionnaire. Frailty assessments were completed using the brief frailty instrument (B-FIT-2), which consists of 6 components. Scoring 5-6 points was frail, 2-4 points were pre-frail and below 2 was considered as non-frail. Logistic regression model was used to measure association between variables. RESULTS: Median (IQR) age was 53 (50, 80) for PLWH and 59 (55-66) for controls. Prevalence of frailty was 9.1% for PLHIV Versus 5.9% for controls. A significant proportion of PLHIV was pre-frail; 141 (75.4%) compared to controls 110 (58.8%). Pre-frailty status was associated with HIV diagnosis (adjusted odds ratio (aOR) 4.2; 95% CI 1.8-9.9), low age (aOR 0.3; 95% CI 0.1-0.6), lower educational attainment (aOR 2.2; 95% CI 1.0-4.9), being farmer (aOR 3.2; 95% CI 1.0-10.2) and having high or low body mass index (BMI) (aOR 11.3; 95% CI 4.0-25.8). HIV diagnosis (aOR 9.7; 95% CI 1.6-56.8), age (aOR 0.2; 95% CI 0.1-0.7), lower educational attainment (aOR 5.2; 95% CI 1.5-18.2), single status (aOR 4.2; 95% CI 1.3-13.6), farmer (aOR 19.5; 95% CI 3.5-109.1) and high or low BMI (aOR 47.3; 95% CI 13.8-161.9) predicted frailty. CONCLUSION: A high proportion of frailty and pre-frailty was observed in a cohort of older PLHIV attending care in Southern Ethiopia. Future research should focus on interventions targeting factors associated with frailty.

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.

Prelacteal feeding and associated factors among newborns in rural Sidama, south Ethiopia: a community based cross-sectional survey.

BACKGROUND: The practice of giving prelacteal feeds deprive a newborn of valuable nutrients and expose the newborn to risks of infection. Despite its negative health outcomes, prelacteal feeding prevails in Ethiopia. Therefore, the current study was undertaken to assess the prevalence of prelacteal feeding practices and its associated factors in a rural community in south Ethiopia. METHODS: We conducted a community based cross-sectional study of 597 mothers of children aged less than six months. Mothers were selected using a multistage cluster sampling technique from Hawela Tula, a rural catchment under Hawassa City Administration. Newborns exposed to any foods, substances or drinks other than human milk before the initiation of breastfeeding or during the first three days of birth were regarded as receiving prelacteal feeds. Descriptive summaries were done to present the main findings; bivariate and multivariate logistic regression analyses were undertaken to identify variables associated with prelacteal feeding practices. RESULTS: Among the total infants, 25.5% (95% confidence interval [CI] 23.5%, 27.5%) were found to be exposed to prelacteal feeds. Boiled water (36.8%) and fresh butter (32.2%) were the top two prelacteal foods. The prevalence of prelacteal feeding was higher among infants whose mothers are housewives, and among infants born to mothers aged between 21 and 34 years. Almost two-third (64.3%) of mothers who exposed their newborn to prelacteal feeds did so with advice from their parents. Mothers who had poor knowledge on breastfeeding were nine times more likely to practice prelacteal feeding compared to those with good knowledge (adjusted odds ratio [AOR] 8.9, 95% CI 4.2, 18.7). Lack of knowledge on the risks associated with prelacteal feeding (AOR 6.8; 95% CI 2.6, 17.8) and misconceptions about breastfeeding (AOR 8.1; 95% CI 3.9, 16.6) were associated with prelacteal feeding. However, mothers' place of delivery and attendance at breastfeeding counseling sessions showed no association with the practice of prelacteal feeding. CONCLUSIONS: Prelacteal feeding is commonly practiced in the study area. Raising women's awareness on the consequences of prelacteal feeding is warranted. Involving parents of women when promoting optimal infant feeding practices should be emphasized.