Tuberculosis treatment delay and associated factors among pulmonary tuberculosis patients at public health facilities in Dale District and Yirgalem Town administration, Sidama Region, South Ethiopia.

BACKGROUND: Tuberculosis (TB) treatment delay is one of the major challenges of TB care in many low-income countries. Such cases may contribute to an increased TB transmission and severity of illness. The aim of this study was to determine the magnitude of patient delay in TB treatment, and associated factors in Dale District and Yirgalem Town administration of Sidama Region, Southern Ethiopia. METHODS: Between January 1-Augst 30/ 2022, we studied randomly selected 393 pulmonary TB cases on Directly Observed Treatment Short course (DOTS) in Dale District and Yirgalem Town Administration. After conducting a pretest, we interviewed participants on sociodemographic, health seeking behavior and clinical factors and reviewed the TB registry. Trained enumerators interviewed to collect data. We entered data in to EPI-info 7 version 3.5.4 and then exported to the Statistical Package for Social Science (SPSS) version 23 for analysis. Multivariable logistic regression was used to identify associated factors of TB and statistical significance was defined using the 95% confidence interval. RESULT: A total of 393 (98%) participants involved in the study. The magnitude of delay in TB treatment among the study participants was 223 (56.7%) (95% CI (51.8 - 61.6%)). Distance of the health facility from home, (adjusted odds ratio (AOR) = 2.04, 95% CI (1.3, 3.2)), seeking antibiotic treatment before being diagnosed for TB (AOR = 2.1, 95% CI (1.3, 3.5)) and the knowledge of TB prevention and treatments (AOR = 5.9, 95% CI (3.6, 9.8)), were factors associated with delay in TB treatment. CONCLUSION: The prevalence of TB treatment delay among pulmonary TB patients in the study setting was high. Delay in TB treatment was associated with knowledge, behavioral and accessibility related factors. Providing health education and active case finding of TB would help in minimizing the delay.

Knowledge about cataract and associated factors among adults in Yirgalem town, Sidama National Regional State, southern Ethiopia, 2020: a community based cross sectional study design.

BACKGROUND: Globally, at least 1 billion people have a vision impairment that could have been easily prevented or easily treated. Cataract is the leading preventable and most treatable causes of blindness and bilateral low vision among adults. Despite being the leading cause of preventable and most treatable blindness, the lack of knowledge about the disease and its option of treatment is still a major barrier in reducing the blindness owing to cataract in the developing countries particularly in Ethiopia. Hence, the aim of this study is to determine the level of knowledge about cataract and associated factors among adults in Yirgalem Town, Sidama National Regional State, Southern Ethiopia, 2020. METHODS: A community-based cross-sectional study design was conducted among randomly selected 599 adult's age 18 years and above from May 10-30, 2020. A multi-stage sampling technique was used to select the study participants. Data were collected using pre-tested and structured face-to-face interview questionnaires. The collected data were entered to Epi data version 3.1 and then exported to SPSS version 21 for analysis. Bi-variable and multivariable logistic regression was used to identify associated factors of knowledge about cataract. Adjusted Odds Ratio (AOR) together with 95% Confidence Interval (CI) was used to declare the statistical association between dependent and independent variables. RESULTS: Of the total study participants, 379 (64.7%), [(95% CI: 60.7-68.6%)] of them had good knowledge about cataract. Age (≥40 years) [AOR = 2.29(95% CI 1.18-4.44)], Elementary school completed [AOR = 2.31(95% CI 1.30-4.10)], High school & above [AOR = 5.55(95% CI 2.81-10.89)], governmental and non-governmental employed [AOR = 5.62 (95% CI 2.78-11.38)], Merchant [AOR = 1.72(95% CI 1.03-2.88)], Positive Attitude [AOR = 3.85(95% CI 2.94-6.47)] were positively significantly associated with knowledge about cataract. Whereas, rural residence [AOR = 0.19 (95% CI: 0.12-0.31)] was negatively associated with knowledge about cataract. CONCLUSIONS: More than one third of the participants still had poor knowledge about cataract. This implies that health facilities should be engaged and raises the awareness of the community and empowers people about eye care needs.

Seroprevalence of Toxoplasma gondii among pregnant women attending antenatal clinics at Hawassa University comprehensive specialized and Yirgalem General Hospitals, in Southern Ethiopia.

BACKGROUND: Toxoplasmosis is caused by infection with the protozoan parasite Toxoplasma gondii. It is acquired by consumption of raw or undercooked meat containing tissue cyst, food or water contaminated with oocyst and congenital infection through the placenta leading to serious congenital abnormalities in the fetus like miscarriage, stillbirth, intrauterine death and neurologic defects. Therefore; this study was aimed to determine the prevalence of toxoplasmosis infection and its possible risk factors associated with pregnant women attending antenatal clinics in Hawassa and Yiregalem Hospitals, Southern Ethiopia. METHODS: A hospital-based cross-sectional study was conducted from December 2016 to May 2017. The study was done in antenatal care clinics of Hawassa and Yiregalem Hospitals in Southern, Ethiopia. Five hundred pregnant women were interviewed with a pretested structured questionnaire to collect risk factors and socio-demographic data. Blood samples were collected and serum was separated and tested for anti- Toxoplasma gondii antibodies using ELISA (Enzyme-linked Immunosorbent Assay). Data were analyzed using SPSS version 20 statistical software. The risk factors were tested for significance using Bivariate and multivariate analysis. P-value < 0.05 was considered statistically significant. RESULTS: The weighted prevalence of this study was 81.8% for the anti- Toxoplasma gondii antibody. Almost all participants (99.6%) had no information about the disease. A significant association was observed between seroprevalence and contact with domestic cats (OR = 1.206, 95% CI (1.627-2.206, P = 0.043), consumption of raw meat (OR = 0.848, 95% CI: 1.517-2.941, P = 0.019) and unpasteurized milk (OR = 0.871, 95% CI 1.531-2.221, P = 0.032). A significant association was not observed between seroprevalence and age, history of abortion, and blood transfusion. CONCLUSIONS: The findings of this study demonstrated a relatively higher prevalence of seropositivity than studies reported from other countries. Existence of domestic cats at home, consumption of undercooked meat and unpasteurized milk were identified as risk factors for T. gondii infection. Therefore, a health education program to increase the mother's knowledge about toxoplasmosis towards avoiding eating undercooked meat, contact with cats and consumption of unpasteurized milk during pregnancy is recommended. Furthermore, our results suggested that the implementation of newborn screening and follow-up testing can lead to reducing of toxoplasmosis associated complications.

Sex difference in survival status among antiretroviral therapy users in Yirgalem general hospital, Sidama zone, south nations nationalities and peoples' region (SNNPR), Ethiopia: retrospective cohort study.

BACKGROUND: Antiretroviral treatment (ART) has been shown to enhance the survival of people living with HIV worldwide. In Ethiopia, the number of ART users has increased from 47,422 in 2005 to 703,516 in 2017; yet, early mortality of patients has presented challenges to the success of the ART program. Because of gender roles, it is assumed that females are at risk of dying earlier after the start of the medications. Hence, this study aimed to assess the sex difference in the survival status among the ART users. METHODS: A retrospective cohort study was conducted in March 2017 among sample of 687 ART users registered from 2010 to 2015. Data were extracted from patient records by using a structured checklist. The extracted data were analyzed by STATA version 13. Survival analysis and Cox regression were used to determine survival status and identify associated factors. RESULTS: Among 685 reviewed records of ART users, 20 males and 64 females died in the 5 years period of ART initiation. This makes the overall 5 years survival rate of 84.23%. Females had lower survival probability (80.10%) as compared to males (91.18%) (Adjusted Hazard Ratio (AHR) = 1.79; 95% CI: 1.04, 3.06). Divorced individuals as compared to married (AHR = 2.09; 95% CI: 1.10, 3.97), individuals with less education (AHR = 2.54 95% CI: 1.29, 4.98) or those who attended only primary education (AHR = 2.07; 95% CI: 1.18, 3.65) as compared to those who attended secondary or above had low survival probability. Those who never disclosed their HIV status (AHR = 3.62; 95% CI: 1.25, 10.46) as compared to disclosed, bedridden individuals as compared to normal functional status (AHR = 2.7; 95% CI: 1.24, 5.89) and those who had tuberculosis (TB)-co infection (AHR = 2.60; 1.48, 4.45) had lower rates of survival. CONCLUSION: Females were at higher risk of dying within 5 years of ART initiation as compared to males. Hence, intervention to further reduce mortality should take sex differences into account. Behavioral interventions and HIV counseling service should also be strengthened to improve rate of disclosure and functional status as well as reduce TB co-infections.

Food Insecurity and Its Associated Factors Among Lactating Mothers in Yirgalem Town, South Ethiopia: A Community-Based Cross-Sectional Study.

Background: Food insecurity is a state in which people do not have both physical and economic access to sufficient food to meet their dietary needs. Food insecurity affects all nations despite that it is high in Africa, particularly in Ethiopia. There is limited information on the magnitude of food insecurity and its associated factors among lactating mothers in Ethiopia. Therefore, the purpose of this study was to determine the magnitude of food insecurity and associated factors among lactating mothers in Yirgalem Town, South Ethiopia. Methods: A community-based cross-sectional study design was conducted on five randomly selected Kebeles and 557 lactating mothers who were selected using a simple random sampling technique from January 10 to April 30, 2022. The data were collected using interviewer administered questionnaires. Bi-variable and multivariable logistic regression analysis was used in the analysis. Family folder documentation was used to know the number of lactating mothers found in each Kebeles. Food insecurity was measured by household food insecurity access scale (version 3). Dietary diversity was assessed by the 24-hour dietary recall method. Results: The magnitude of food insecurity among lactating mothers was 58.2%. Low minimum dietary diversity score, mothers with two and below antenatal care, mothers who had more than two children under 5 years, no home gardening practice, and having meals two and below were significantly associated with food insecurity. Conclusion: The magnitude of food insecurity was 58.2% in the study area. Therefore, the agricultural and health sectors should work collaboratively to improve home gardening practices, dietary diversity practices and maternal health services are highly recommended to reduce food insecurity.

Prevalence of depressive symptoms and their associated factors among older adults in Yirgalem town, Southern Ethiopia: A community-based cross-sectional study.

Background: Depression is a serious mental health issue and the largest contributor to disability worldwide. Elderly people with depression are significantly more likely to experience negative outcomes such as poor physical health, strained social relationships, and decreased quality of life. Studies on geriatric depression are limited in developing nations like Ethiopia. Objectives: The purpose of this study was to determine the prevalence of depressive symptoms and associated factors among older adults in Yirgalem, Southern Ethiopia, in 2022. Methods: A community-based cross-sectional study was conducted on a sample of 628 older adults in Yirgalem town from May 15 to June 15, 2022. The study subjects were selected using a multi-stage systematic sampling technique. Data were collected using the 15-item Geriatric depression scale through face-to-face interviews. The collected data were edited, cleaned, coded, and entered into Epi data version 4.6 software and analyzed using STATA version 14. Bivariable and multivariate logistic regression analysis was computed to identify factors associated with depression, and statistical significance was declared at a 95% confidence interval with a P-value less than 0.05. Results: A total of 620 older adults were included in the study, with a response rate of 97.8%. The prevalence of depressive symptoms among older adults was 51.77% (95% CI: 47.83-55.69). Being a woman (AOR = 2.3, 95% CI: 1.56-3141); being of more advanced age: 70-79 years old (AOR = 1.92, 95% CI: 1.20-3.07), 80-89 years old (AOR = 2.15, 95% CI: 1.27-3.65), 90 and older (AOR = 3.77, 95% CI: 1.95-7.79); living alone (AOR = 1.99, 95% CI = 1.17-3.41); having a chronic illness (AOR = 3.24, 95% CI: 1.06-4.46); having anxiety (AOR = 3.40; 95% CI: 2.25-5.14); and having poor social support (AOR = 3.56, 95% CI: 2.09-6.04) were statistically associated with depressive symptoms at a P-value of less than 0.05. Conclusion: This study found that depression affects more than half of the elderly residents in the study area. More advanced age, being a woman, living alone, having a chronic illness, having anxiety, and having poor social support were all strongly linked to depression. There is a need to integrate counseling and psychiatric services into the community healthcare system.

Postpartum Hemorrhage and its Associated Factors Among Women who Gave Birth at Yirgalem General Hospital, Sidama Regional State, Ethiopia.

BACKGROUND: Globally, postpartum hemorrhage (PPH) is one of the leading causes of maternal mortality. In developing countries, it accounts for more than 30% of all maternal deaths. So, understanding its burden in the health care setting is significant. Thus, this study aimed to assess the magnitude of PPH and its associated factors among women who gave birth at Yirgalem General Hospital, Sidama Region, Ethiopia. METHODS: A cross-sectional study was conducted from March 12 to 26, 2020 among randomly selected 298 women. Data were collected using an interviewer-administered, structured, and pretested questionnaire. EpiData version 3.1 and SPSS version 20 were used to enter and analyze the data, respectively. Descriptive statistics, bivariable, and multivariable logistic regression analysis were done. Adjusted odds ratio with 95% confidence interval (CI) was used to measure the presence and strength of association between the independent and the outcome variables. A P-value ≤.05 was considered to declare statistical significance. RESULT: The magnitude of PPH was 9.4% [95% CI: 6.0, 12.8]. Prolonged labor (≥24 h) [AOR = 3.4, 95% CI: 1.1, 9.9], giving birth by cesarean section [AOR = 5.8, 95% CI: 1.1, 22.0], and instrumental vaginal delivery [AOR = 3.7, 95% CI: 1.1, 12.7], and having a history of the uterine atony [AOR = 4.8, 95% CI: 1.4, 16.6] during their last delivery were factors significantly associated with PPH. CONCLUSION: The magnitude of PPH was high. Healthcare professionals should manage the progress of labor and take all necessary measures at right time. Also, giving attention to the safety of delivery-related procedures and early related potential risks is crucial.

Prevalence of Intestinal Parasite Infection and its Association with Anemia among Children Aged 6 to 59 Months in Sidama National Regional State, Southern Ethiopia.

BACKGROUND: Previous studies conducted in Ethiopia revealed anemia as a severe public health problem among under-5 children but failed to associate with parasite infection. This study was aimed at assessing the prevalence of intestinal parasite infection (IP) and its association with anemia among children aged 6 to 59 months in Yirgalem General Hospital, Southern Ethiopia. METHOD: Institution based cross-sectional study was conducted in 2020 on 367 children aged 6 to 59 months. Trained data collectors administered the questionnaire. Blood was collected and analyzed for hemoglobin using the HemoCue 301. The stool samples were collected and analyzed. Association between IP and anemia was measured using multivariable analysis. The outputs are presented using an adjusted odds ratio (AOR) with 95% confidence intervals. RESULTS: The prevalence of anemia was 48.8% (95% CI: 43.7, 53.9). Anemia was of mild, moderate, and severe type in 24.5%, 21.5%, and 2.8% of the children respectively. The prevalence of IP was 43.3% (95% CI: 38.2, 48.3). The odds of anemia were higher among children infected with IP (AOR = 3.19, 95% CI: 1.97, 5.17), large family size (AOR = 2.13, 95% CI: 1.26, 3.59), low-income level (AOR = 2.05, 95% CI: 1.25, 3.35), and MUAC < 11 cm (AOR = 3.27, 95% CI: 1.85, 5.81). CONCLUSIONS: The prevalence of IP was high. Anemia has severe public health significance. IP infection, income level, family size, and MUAC level were associated with anemia in children. Strengthening existing programs to prevent childhood anemia, and IP recommended.

Incidence and pattern of stroke among patients admitted to medical ward at Yirgalem General Hospital, Sidama Regional State, Southern-Ethiopia.

INTRODUCTION: In the current days, stroke has become one of the common reasons for admission in many health care setups and becoming an alarming public health problem in Ethiopia. Hence, this study aimed to assess the incidence and associated factors of stroke among patients admitted to the medical wards in Yirgalem hospital. METHODS: An institution-based retrospective cross-sectional study design was carried out from 01 January 2017, to 30 December 2019. Admitted adult patients' medical charts were used to collect all required information using structured checklists. Data were analyzed using statistical package for social sciences (SPSS) version 20 software, and a p value < 0.05 was accepted as statistically significant. RESULT: From a total of 3016 admitted patients, the incidence of stroke was 3.15% (n = 95). Of the 95 stroke cases, 58.9% were males and 69.5% of them were urban dwellers. 62.1% (59/95) of the stroke patients had an ischemic stroke, whereas 37.9% (36/95) had a hemorrhagic stroke. Patients with age ⩾ 65 years, smokers, hypertension, and type-II diabetes had significantly higher ischemic stroke when compared to patients with hemorrhagic stroke (62.7% vs 30.5%, p = 0.008), (49.1% vs 11.1%, p ⩽ 0.0001), and (71.2%vs 13.9%, p < 0.0001), respectively. While patients with hypertension had a significantly higher rate of hemorrhagic stroke when compared to patients with ischemic stroke (88.9% vs 61%, p = 0.003). CONCLUSION: The majority of stroke patients had cardiovascular problems and hypertension. More than 44% and 34.7% of them had a history of alcoholism and smoking. Therefore, proper management of hypertension, lifestyle modification, early screening and management of strok risks and avoiding risk-full personal behaviors like smoking and alcoholism are important tools to limit or prevent stroke-related morbidity and mortality.

Knowledge, Attitudes, and Practices of Hand Washing among Aderash Primary Schoolchildren in Yirgalem Town, Southern Ethiopia.

BACKGROUND: Hand washing is a simple, convenient, and cost-effective means to limit the transmission of communicable diseases. Improving the practice of hand washing is vital to decrease hygiene-related morbidity and mortality, particularly in developing countries. As such, this study aimed to assess knowledge, attitudes, and practices of hand washing among schoolchildren in Aderash primary school, Yirgalem town. METHODS: A cross-sectional study was conducted on 279 schoolchildren from March to May 2019. A pretested structured questionnaire was applied to collect all relevant information using simple random sampling. Data entry and clearance was done with Epi-Info version 7 and exported to SPSS version 20 for analysis. Adjusted ORs with 95% CI were used to assess statistically significant variables (p<0.05). RESULTS: Overall, 62.7% of schoolchildren had adequate knowledge of hand washing, 61.3% exhibited positive attitudes toward hand washing and 39.1% had good hand-washing practices. Over three quarters (89%) of them had good knowledge of washing hands with soap. About 24%, 56.6%, 9.3%, 6.5%, and 3.6% of children reported washing hands after defecation, before meals, after meals, after work, and after play, respectively. In addition, 73.8% of them reported washing hands with soap if their hands looked dirty or smelled bad. Urban dwelling increased knowledge of hand washing of 1.3-fold (95% CI 1.2-2.85). CONCLUSION: Even though >60% of children had adequate knowledge and exhibited positive attitudes toward hand washing, proper hand-washing practices was <40%. Therefore, much effort should be directed toward improving children's understanding of the benefits of proper hand washing in schools.

Preoperative anxiety among adult patients undergoing elective surgery: a prospective survey at a general hospital in Ethiopia.

BACKGROUND: Major life changes are among factors that cause anxiety, and one of these changes is surgery. Hospitalization, regardless of disease, is known to provoke anxiety in the patient admitted for surgery. Anxiety is an unpleasant disturbing experience that involves way of thinking of tension, apprehension, uneasiness and high autonomic activity. Patients with high levels of anxiety require higher doses of anesthetic induction agents and recover poorly. The objective of this study was to investigate the prevalence of preoperative anxiety and its predictors among adult patients scheduled for elective surgery. METHODOLOGY: Institutional based cross sectional study was conducted using interviewer administered structured questionnaire in Yirgalem zonal hospital in Ethiopia from November 1, to December 30, 2018 on 407 patients scheduled for elective surgery. The study included all patients with age greater than 18 years who were undergoing surgery. Patients with known anxiety disorder and unable to communicate were excluded from the study. State and trait anxiety inventory (STAI) measurement scale was used to assess preoperative anxiety. Statistical analysis was performed using SPSS version 22. Binary logistic regression analysis was performed to determine the predictors of preoperative anxiety. The strength of the association was presented using AOR with 95% confidence interval and p-value < 0.05 was considered as statistically significant. RESULTS: Among a total of 402 patients enrolled in the study 228 (56.7%) were male. The prevalence of preoperative anxiety among scheduled patients for elective surgery was 47.0%. Having strong social support (AOR = .16 CI = 0.07, 0.34), harm from doctor or nurse mistake (AOR = 5.03, CI = 2.85, 8.89), unexpected result of operation (AOR = 3.03, CI = 1.73, 5.19), unable to recover (AOR = 2.96, CI = 1.18, 4.87), and need of blood transfusion (AOR = 2.76, CI = 1.65, 4.62) were significantly associated with preoperative anxiety. CONCLUSION: In the current study the prevalence of preoperative anxiety was high (47%). Having strong social support, unexpected result of operation, harm from doctor or nurse mistake, need of blood transfusion, and unable to recover were found to be statistically significant for preoperative anxiety. Patients need to be assessed regularly for anxiety during the preoperative visit.