Correlates of Sedentary Time Among Children and Adolescents in Ethiopia: A Cross-Sectional Study.

PURPOSE: To assess the correlates of sedentary time among children and adolescents in Ethiopia. METHODS: The study was conducted in representative samples of children and adolescents in the capital city of Ethiopia, Addis Ababa. Multivariable logistic regression models were used to determine associations of sedentary time and predictor variables. RESULTS: The mean sedentary time was 4.61 (95% confidence interval [CI], 4.35-4.86) hours per day. Overall, the prevalence of high sedentary time (>3 h/d) was 68.2% (95% CI, 64.2-72.2). Results of multivariable logistic regression analyses showed a statistically significant association between high sedentary time and female household head (adjusted odds ratio [AOR] = 0.50; 95% CI, 0.32-0.80), literate mothers (AOR = 1.98; 95% CI, 1.26-3.11), child attending public school (AOR = 1.79; 95% CI, 1.12-2.85), children who belonged to the poor and rich household wealth tertiles compared with medium wealth tertile (AOR = 2.30; 95% CI, 1.42-3.72 and AOR = 2.04; 95% CI, 1.14-3.65, respectively), and those families that did not have adequate indoor play space for children (AOR = 0.45; 95% CI, 0.29-0.72). CONCLUSION: The study found that time spent sedentary was high in the study area as compared with other studies of similar settings. Several modifiable factors were identified that can be targeted in interventions to reduce sedentary time in the study setting.

Association of maternal psychological distress with children with overweight/obesity in Ethiopia.

BACKGROUND: Poor maternal mental health is a major risk factor for adverse offspring health outcomes, including overweight/obesity status. Maternal mental distress is highly prevalent and associated with parenting practices influencing child weight. To date, there is little information documented in Ethiopia on maternal mental distress and children with overweight/obesity status. This study examined the association between maternal mental distress and children with overweight/obesity among mother-child dyads in Addis Ababa, Ethiopia. METHODS: An observational population-based cross-sectional study was conducted among mother-child dyads in representative samples in Addis Ababa, Ethiopia. Maternal mental distress was measured using the Self-Reporting Questionnaire (SRQ)-20. Child/adolescent overweight/obesity was defined as more than 1 SD above the median World Health Organization (WHO) growth reference. Multivariate logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS: The prevalence of maternal mental distress and children with overweight/obesity was estimated to be 10.1% and 28.8%, respectively. After adjusting for confounders, including maternal education, maternal occupation, average monthly household income, maternal body mass index (BMI) and the number of household members/family size, maternal psychological distress was not associated with offspring overweight/obesity status (adjusted OR [aOR] = 0.54; 95% CI: 0.25, 1.14). CONCLUSIONS: There is no evidence of an association between maternal psychological distress and children with overweight/obesity. This lack of association might be attributable to our cross-sectional study design. Future epidemiologic studies, particularly those using prospectively collected data, are warranted to examine better the effects of maternal psychological distress on offspring body weight.

COVID-19 Vaccine Acceptance Level in Ethiopia: A Systematic Review and Meta-Analysis.

Background: The coronavirus disease 2019 pandemic has had a devastating impact on the everyday lives of the world's population and to this end, the development of curative vaccines was upheld as a welcome panacea. Despite the undeniable negative impact of the disease on human beings, lower than expected proportions of people have taken up the vaccines, particularly in the developing non-Western world. Ethiopia represents an interesting case example, of a nation where COVID-19 vaccine acceptance levels have not been well investigated and a need exists to assess the overall level of vaccine acceptance. Methods: A systematic multidatabase search for relevant articles was carried out across Google Scholar, Web of Science, Science Direct, Hinari, EMBASE, Boolean operator, and PubMed. Two reviewers independently selected, reviewed, screened, and extracted data by using a Microsoft Excel spreadsheet. The Joanna Briggs Institute prevalence critical appraisal tools and the modified NewcastleOttawa Scale (NOS) were used to assess the quality of evidence. All studies conducted in Ethiopia, reporting vaccine acceptance rates were incorporated. The extracted data were imported into the comprehensive meta-analysis version 3.0 for further analysis. Heterogeneity was confirmed using Higgins's method, and publication bias was checked by using Beggs and Eggers tests. A random-effects meta-analysis model with a 95% confidence interval was computed to estimate the pooled prevalence. Furthermore, subgroup analysis based on the study area and sample size was done. Results and Conclusion. After reviewing 67 sources, 18 articles fulfilled the inclusion criteria and were included in the meta-analysis. The pooled prevalence of COVID-19 vaccine acceptance in Ethiopia was 57.8% (95% CI: 47.2%-67.8%). The level of COVID-19 vaccine acceptance in Ethiopia was at a lower rate than necessary to achieve herd immunity. The highest level of vaccine acceptance rate was reported via online or telephone surveys followed by the southern region of Ethiopia. The lowest vaccine acceptance patterns were reported in Addis Ababa.

The association of household and child food insecurity with overweight/obesity in children and adolescents in an urban setting of Ethiopia.

BACKGROUND: Existing evidence on the association between food insecurity and childhood obesity is mixed. In addition, literature from developing countries in general and Ethiopia in particular on the nexus and impact of household and child food insecurity on childhood obesity in the context of urbanization remains limited. The objective of this study was to explore the association between household and child food insecurity and childhood obesity in an urban setting of Ethiopia. METHODS: An observational population based cross-sectional study was conducted in five sub-cities of Addis Ababa. Multi-stage sampling techniques were employed to identify the study unit from the selected sub-cities. Multivariable logistic regression models with robust estimation of standard errors were utilized to determine the associations. Interactions by age and sex in the associations explored were tested. RESULTS: A total of 632 children and adolescents-parent dyads were included in the study. About 29.4% of those in food secure households and 25% of those in food insecure households were overweight/obese. Similarly, 29.8% of food secure children and 22% of food insecure children were overweight/obese. Household and child food insecurity status were not significantly associated with child and adolescent overweight or obesity in the final adjusted models. CONCLUSIONS: Household and childhood food insecurity status were not associated with child and adolescent overweight/obesity in the study setting. Interventions aimed at combating overweight and obesity in the study setting should target children and adolescents irrespective of their food security status.

Evaluation of the implementation of a PhD capacity-building program for nurses in South Africa.

BACKGROUND: Nursing is experiencing a significant deficit in research capacity needed to meet future global healthcare demands-there is a call to double the number of nurses and healthcare professionals with a doctorate. AIM: The aim of this research was to evaluate the implementation of a national PhD capacity-building program for academic and practice-based nurses and other healthcare professionals in South Africa. METHODS: An implementation science framework was used. Implementation of the program across two national, longitudinal cohorts of participants was studied. Evidence of enablers and barriers to implementation was obtained from multiple data sources, including the curriculum for the program, regular evaluation reports from program participants and program facilitators after each stage of the PhD curriculum delivery, and meeting notes. Supplementary sources included rates of PhD candidate recruitment, retention, and successful completion. RESULTS: Evidence for the presence of enablers for successful implementation was found, including stakeholder consultation and buy-in, leadership, resources, staff capacity, and implementation teams. No evidence of an implementation plan, a supportive organizational culture, or effective ongoing communication at Stage 4 of the implementation process was found. Barriers to implementation included external environmental factors, resistance to change, and vested interests. DISCUSSION: Within the context of a recognized worldwide shortage of nursing scientists, the application of an implementation science framework to evaluate the initial stages of a national PhD development program rollout provided information on how effective implementation can be strengthened and how barriers to success can be overcome.

Posttraumatic stress disorder among spouses of patients discharged from the intensive care unit after six months.

The Intensive Care Unit (ICU) can be traumatic, not only for patients, but also their closest relatives, especially spouses. Within Botswana, a developing country with very few ICUs and not so sophisticated machinery or a generalised lack of counselling for relatives, the ICU experience can be more traumatic. This study reports on the proportion of spouses who continued to experience mental distress, including the incidence of posttraumatic stress disorder, at six months after the discharge of their spouse from an intensive care unit. Mixed data collected approaches were used on a convenience sample of 28 spouses of patients who had been hospitalised at the Princess Marina Hospital ICU, Gaborone, Botswana, in the six months prior to the interview sessions. Participants were interviewed six months after the discharge of their spouse from the Intensive Care Unit using the PCL-S (PTSD Checklist). All the patients had been mechanically ventilated and had been hospitalised in the ICU for more than three days. Fifteen spouses reported intrusive memories of ICU and avoided reminders of the experience six months later. Ten spouses reported feeling anxious for a short while after their spouse's discharge but that they had come to terms with the experience. In order to mitigate the trauma experienced by spouses the study suggests that pre- and post-counselling for close relatives, especially spouses, should be implemented at the point of hospitalisation, during admission, and after discharge for a period of at least six months.

Association between dietary Intake, eating behavior, and childhood obesity among children and adolescents in Ethiopia.

Introduction: The upsurge of overweight/obesity (OW/OB) among children and adolescents is as a result of complex interactions between lifestyle behaviours and socioeconomic factors. The objective of this study was to determine socioeconomic and sociodemographic factors, dietary intake and eating behaviours of children and adolescents in Ethiopia and their association with OW/OB. Methods: A cross-sectional study was conducted among 632 children and adolescents-parent dyads. To identify overweight/obese among children and adolescents, body mass index-for-age Z-scores by sex and age relative to WHO 2007 reference was calculated using WHO AnthroPlus software. A multivariable logistic regression model fitted to determine the adjusted associations between the outcome and the predictors selected from the bivariate analyses. Data analysis was carried out using STATA V.15.0. Results: The proportion of participants with low, medium and high dietary diversity scores was 7.28%, 22.5%, and 70.2%, respectively. Participants aged 13-18 years were less likely to be overweight or obese [adjusted OR (aOR) = 0.40; 95%CI: 0.26, 0.64] to those aged 5-12 years. Children in a family with the richest or highest socioeconomic status (SES) were more likely to be overweight or obese than those in families with the poorest or lowest status. Children and adolescents who consumed soft drinks (sugar-sweetened beverages) four or more times per week [aOR = 3.24; 95%CI: 1.13, 7.95] were more likely to be overweight or obese to those who did not consume soft drinks. Conclusions: The study identified factors such as younger age (<12 years), high SES and consumption of soft drinks as key contributors to overweight and obesity among children and adolescents. Therefore, interventions targeting behavioural prevention and reduction of overweight and obesity among children and adolescents should be cognizant of the above factors during implementation in order to achieve desired outcomes, further guided by exploratory qualitative studies to identify public perceptions and attitudes affecting dietary practices.

Othello syndrome. Preventing a tragedy when treating patients with delusional disorders.

Othello syndrome, sometimes referred to as delusional, pathological, morbid, or erotic jealousy, is a rare delusional disorder with high-risk implications. This article provides an overview of Othello syndrome and includes an individual example as well as a review of the literature. Pharmacological interventions and dialectical behavior therapy are discussed as options for pathological jealousy. Nursing considerations and assessment strategies of delusional jealousy are described for identification and evaluation of risk factors. Patient safety is addressed, and collaborative interventions are proposed for treatment. Staff development for the treatment team is advocated to help staff identify delusional patients and act prudently to avert possible tragic consequences associated with Othello syndrome.

Oral Health Screening Status of Diabetes Patients in Selected Hospitals of Addis Ababa, Ethiopia, 2018.

OBJECTIVE: The study assessed the oral health screening status of diabetes patients and its associated factors in selected public hospitals of Addis Ababa, 2018. PATIENTS AND METHODS: An institutional-based cross-sectional study was conducted on 388 diabetes patients selected on the bases of a systematic random sampling method from March to May 2018 at two selected public hospitals in Addis Ababa. Data were collected with a pre-tested, structured, and translated questionnaire. Bi-variable and multivariable logistics regression were undertaken to identify predictors of oral health screening among diabetes with their respective 95% CI and a p-value of less than 5% level of significance. RESULTS: The oral health screening status among diabetes patients in this study was 21.1%. The odds of having had an oral health screening was 82.4% higher in those with an educational status of college and above than those who cannot read and write and it was ten and five folds higher in participants with a monthly income of less than 750 birr than those with above 2,000 birr and those who brushed their tooth twice or more times a day than occasionally, respectively. The odds of having had an oral health screening was 17, four, and five folds higher among participants with perceived susceptibility, perceived severity, and benefit, respectively, whilst it was 8.8% lower in participants with a perceived barrier and it was as high as 19.782 times among participants with malocclusion. CONCLUSION: A lower level of oral health screening was observed. A higher educational level, a lower monthly income, a higher frequency of tooth brushing per day, positive perceptions of susceptibility, severity, and benefits, and presence of malocclusions were statistically associated with a higher frequency of oral health screening. Concerned bodies were recommended to work on the identified predictors and improve the oral health screening of diabetes patients.

Epidemiology of obesity and overweight in sub-Saharan Africa: a protocol for a systematic review and meta-analysis.

INTRODUCTION: Globally, overweight and obesity were estimated to cause 3.4 million deaths, 3.9% of years of life lost and 3.8% of disability-adjusted life years in 2010. Despite the fact that obesity and overweight is a problem of high-income countries, low- and middle-income countries (LMICs), in particular urban settings of sub-Saharan African countries, face the challenge of an increasing trend. The aim of this systematic review and meta-analysis will be to determine the prevalence of obesity and overweight individuals in sub-Saharan Africa and to help guide policy planners in the decision-making process for the increase in non-communicable diseases in Africa. METHODS AND ANALYSES: A comprehensive systematic review and meta-analysis of published studies on the prevalence of obesity and overweight in sub-Saharan Africa will be conducted. A computerised internet search using Medline/PubMed, Google Scholar and EMBASE databases and reference lists of previous prevalence studies and detailed search strategy and cross-checking of reference lists of published peer-reviewed articles will be conducted to identify all epidemiological and/or clinical studies published in English and French. We will use the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) statement for reporting. The overall effect (pooled estimated effect size) of the prevalence of obesity and overweight will be analysed using the Der Simonian-Laird random effects meta-analysis (random effects model) and the obesity proportion (with 95% CI) will be measured. ETHICS AND DISSEMINATION: The underlying work is based on systematic reviews of published data and thus doed not require ethical review approval. The findings of the systematic review will be disseminated in different conferences and seminars and will be published in a reputable and refereed international peer-reviewed journal. PROSPERO REGISTRATION NUMBER: CRD42017064942.

Female perspectives of male partners' inclusion in the prevention of mother-to-child HIV transmission programme in KwaZulu-Natal.

BACKGROUND: The South African government intervened by implementing the prevention of mother-to-child transmission programme (PMTCT) to curb the HIV transmission from mother to child during and after pregnancy. The PMTCT programme has been at the forefront of global prevention efforts since 1998. Without treatment, the risk of transmission ranges from one in five to one in two newborns; however, the risk of mother-to-child transmission can be reduced to as low as 2%-5% with evidenced interventions. Sub-Saharan Africa, and most particularly South Africa, is the most affected by the pandemic despite having the largest financial investment in PMTCT services across the continent. OBJECTIVES: The objectives of the study were to describe and explore the female perspectives of male inclusion in the prevention of mother-to-child HIV transmission programme in KwaZulu-Natal. METHODOLOGY: A qualitative, descriptive, explorative study was conducted through in-depth individual interview of pregnant women until data saturation. RESULTS: The findings of the study revealed that the existing design of public hospitals was not wholly conducive to facilitating male inclusion in maternal and child health services. Resources were largely insufficient to support the participation of pregnant mothers and any attempts to support the inclusion of males needed to be based on a clear increase in service provision. CONCLUSION: The study recommended male partners' inclusion in the prevention of mother- to-child HIV transmission to support effective management of HIV in pregnancy and PMTCT programmes. The inclusion of men will provide the holistic support needed by pregnant women on PMTCT programmes.

Disclosure of HIV status to sexual partners by people living with HIV.

BACKGROUND: Disclosure of one's HIV status to a sexual partner can have significant health implications. From a health promotion point of view, disclosure is seen as a cornerstone for the prevention of HIV transmission between partners. Despite its importance as a strategy for controlling the spread of HIV, there are challenges that inhibit voluntary disclosure. OBJECTIVES: In exploring factors associated with disclosure of HIV status, the study had two complementary objectives related to: (1) investigation of participants' views about HIV-positive status disclosure to sexual partners; and (2) a broader identification of factors that influence disclosure of HIV-positive status. METHOD: The study explored factors associated with disclosure of the HIV status of people living with HIV to their sexual partners. Purposive sampling was used to select 13 participants living with HIV who attended a wellness clinic. Primary data were collected via an in-depth interview with each of the participants. RESULTS: The exploration showed that male participants were notably more reluctant to disclose to their sexual partners for fear of rejection; and secrecy was commonly reported around sexual matters. Female participants (who were in the majority) were relatively more willing to disclose their HIV status to their sexual partners. Despite the complexity of disclosure, all participants understood the importance of disclosure to their sexual partners. CONCLUSION: There is a need for HIV prevention strategies to focus on men in particular, so as to strengthen disclosure counselling services provided to people living with HIV and to advocate strongly for partner testing.

Emergency contraception amongst female college students--knowledge, attitude and practice.

BACKGROUND: Unwanted teenage pregnancies have a notable detrimental impact on the learners' trajectory and have been associated with jeopardising the students' educational progress and future career prospects. These pregnancies are mostly unplanned and unintended and many are terminated, either legally or illegally. AIM: The aim of this study was to explore the contributory role played by the knowledge, attitude and practices of female college students with respect to the utilisation of emergency contraceptives. SETTING: Three tertiary institutions in Dessie, Ethiopia. METHODS: Quantitative self-administered questionnaires were used to collect descriptive data from 352 female college students. RESULTS: The study revealed that there was a high percentage (78.3%) of unwanted pregnancies amongst those engaging in sex. Significantly, nearly half (43.3%) of these unwanted pregnancies resulted in abortion. Only 10% of the students sampled admitted to ever having used emergency contraception. Even though more than half (69.9%) of the students knew about emergency contraception, only 27% of them felt confident that they understood when it was most effective. CONCLUSION: These and other observed findings confirm the need for improvement of female college students' knowledge and timely utilisation of emergency contraception.

Online or not? A comparison of students' experiences of an online and an on-campus class.

Educational discourse has long portrayed online, or e-based, learning and all non-campus-based learning options as second best to traditional face-to-face options. Critically much of the research and debate in this area of study has focused on evidence relating to student performance, attrition and retention with little consideration of the total learning experience, which values both the traditional learning outcome measures side-by-side with student-centered factors, such as students' satisfaction with their learning experience. The objective of this study was to present a synchronous head-to-head comparison between online and campus-based students' experiences of an undergraduate course. This paper reports on a qualitative comparative cross-sectional study, which used multiple data collection approaches to assess student learning and student satisfaction of 61 students who completed a semester of an undergraduate course. Of the 61 students, 34 were enrolled purely as online students, whilst the remaining 27 students studied the same material entirely through the traditional face-to-face medium. Methods included a standardised student satisfaction survey and an 'achievement of learning outcomes' measurement tool. Students on the online cohort performed better in areas where 'self-direction' in learning was indicated, for example self-directed problem-based tasks within the course. Online students gave less positive self-assessments of their perceived content mastery than their campus-based counterparts, despite performing just as well in both summative and formative assignments. A multi-factorial comparison shows online students to have comparable educational success and that, in terms of student satisfaction, online learners reported more satisfaction with their learning experience than their campus-based counterparts.

Risk factors for psychiatric re-hospitalization: an exploration.

Predecessor research suggests that anything from 37% to 53% of hospitalized service users are readmitted within 12 months of discharge. This cycle of frequent admissions represents a serious challenge to clinicians and service users alike. Critically, much of the research in this field has relied exclusively on professional attributions for readmission with little acknowledgement of service user or patient viewpoints. This paper reports on a phenomenological study which used multiple data collection approaches to explore service user and clinician attributions for frequent hospitalization to an identified psychiatric unit over a 24-month index period. Methods included a retrospective review of multi-professional case notes, clinician and service user semi-structured interviews, and focus groups. Service users cited 'situational circumstances', rather than medically accepted relapse indicators such as 'non-adherence with prescribed medication' as the main reasons for readmission. Notable disagreement existed between clinician and service user data sources. Hospitalization is a complex, individually determined experience. Clinicians and service users have differing perspectives on the causal risk factors and this presents complications for those developing relapse prevention strategies. However, a shared appreciation of the multiple realities paves the way for the development of a conceptual risk-factor identification model which may serve as a guide to practitioners in relapse prevention.