Construct validity and reliability Amharic version of perceived stress scale (PSS-10) among Defense University students.

BACKGROUND: Perceived stress scale (PSS) is the most widely used tool for assessing stressful life events and its management. However, its validity and Reliability in Ethiopian Amharic language is not assessed. OBJECTIVE: To translate the perceived stress scale (version PSS-10) and assess its validity among Defense University students in Bishoftu, Ethiopia. METHOD: From March to May 2020, an anonymous, self-managed questionnaire was used to collect the data on 758 undergraduate students of Defense University in Bishoftu, Ethiopia. Exploratory and Confirmatory factor analyses were employed to assess the factor structure and construct validity of Amharic version of the PSS-10. Composite reliability coefficient and Item total correlation were calculated to assess the internal consistency of Amharic version of the PSS-10. RESULT: Exploratory factor analysis resulted in a two-dimensional PSS-10 with Eigenvalues of 3.4 and 1.6, which explained 50.7% of the variance. Confirmatory factor analysis indicates a good model fit of the two correlated factors (Comparative fit index (CFI) = 0.96 with root mean square error of approximation (RMSEA) = 0.04[0.03-0.06] and standardize root mean residual (SRMR) = 0.040). The internal consistency of PSS-10 and the Negative factor were in acceptable range, whereas the Positive factor was marginally acceptable (0.77, 0.78, and 0.68) respectively. CONCLUSION: The Amharic translated version of PSS-10 was found to be a valid and reliable instrument to measure the perceived stress level among university students.

Impact of COVID-19 on HIV services and anticipated benefits of vaccination in restoring HIV services in Ethiopia: A qualitative assessment.

Background: HIV services were inevitably disrupted and affected due to COVID-19. There are many challenges in implementing appropriate HIV services, particularly in the provision of health care and the link between people living with HIV/AIDS and retention in care. The study investigated the impact of COVID-19 on HIV services and the anticipated benefit of the COVID-19 vaccination on HIV service restoration in North Shewa, Oromia, Ethiopia. Methods: A qualitative descriptive study approach was used to explore how healthcare delivery evolved during the outbreak of COVID-19 in Ethiopia. Sixteen antiretroviral therapy (ART) clinics were selected from 13 districts and one administrative town in Ethiopia. From them, 32 ART providers were purposively selected based on their experience in ART provision. Data were collected from June to July 2021 using in-depth interviews. A thematic analysis approach was used to analyze the data, based on themes and subthemes emerging from the data. ATLAS.ti software was used for coding. Results: Healthcare for people living with HIV was interrupted due to the COVID-19 pandemic. Medical appointments, HIV testing and counseling services, opportunistic infection treatment, medicine supply, and routine viral load and CD4 T-cell count tests were interrupted. Due to a shortage of healthcare staff, outreach testing services and home index testing were discontinued and HIV testing was limited only to hospitals and health centers. This has substantially affected accessibility to HIV testing and reduced the quality of HIV service delivery. Telehealth and less frequent visits to health facilities were used as alternative ways of delivering HIV services. The COVID-19 vaccination campaign is expected to restore healthcare services. Vaccination may also increase the confidence of healthcare providers by changing their attitudes toward COVID-19. Conclusions: The COVID-19 pandemic has substantially impacted HIV services and reduced the quality of HIV care in Ethiopia. Health facilities could not provide routine HIV services as they prioritize the fight against COVID-19, leading to an increase in service discontinuation and poor adherence.

Magnitude of NNM and associated factors among Newborns delivered at the North Shewa zone Public Health Hospital, Central Ethiopia: A multi-level analysis.

Background: Neonatal near miss refers to a condition where a newborn is close to death within the first 28 days of life but ultimately survives either by chance or because of the quality of care they received. It is considered a major public health problem that contributes to the global burden of disease in less developing countries. For every death due to NMM, many others develop a severe complication. Despite this grim reality, there seems to be a gap in terms of the magnitude of and predictors of NNM in Ethiopia, where the previous study focused on neonatal death investigation. This study aimed to determine the magnitude of NNM and its determinants among the neonates delivered in the North Shewa zone, Central Ethiopia. Methods: A facility-based cross-sectional study was conducted using a systematic random sampling technique among 747 newly delivered babies in the North Shewa zone public hospital from January 30 to June 30, 2021. Neonatal near misses were identified with the help of the World Health Organization labeling criteria. Collected data were coded, entered, and cleaned by using Epi data 4.4.6 and analyzed using SPSS software (version 26) for analysis. Descriptive statistics were used to compute summary statistics and proportions. Variables at a cutoff value of 0.25 on bivariate and 0.05 on multivariate logistic regression were used to identify predictors. Result: The prevalence of NNM was 35.3% (95% CI = 31.9-38.6) per 1,000 live births. Participant occupation [AOR: 0.55, CI: 0.33-0.90], marital status [AOR: 2.19; CI: 1.06-4.51], instrumental delivery [AOR: 1.98; CI: 1.10-3.55], intrapartum hemorrhage [AOR: 2.27; CI: 1.03-5.01], abortion history [AOR: 1.59; CI: 1.03-2.44], mal-presentation [AOR: 1.77; CI: 1.14-2.77], premature rupture of membrane [AOR: 2.36; CI: 1.59-3.51], and pregnancy-related infection [AOR: 1.99; CI: 1.14-3.46] were found to have statistically significant association. Conclusion and recommendation: One-third of neonates face serious neonatal health conditions. Given this, addressing modifiable obstetric risk factors through providing skilled and quality care to mothers during pregnancy and during and after childbirth was important for improving neonatal health. Additionally, strengthening antenatal care services to minimize the infection occurring during pregnancy through the provision of appropriate services and counseling about the consequences of abortion was essential in reversing the problem.

Early and Subsequent Epidemic Characteristics of COVID-19 and Their Impact on the Epidemic Size in Ethiopia.

In Ethiopia, multiple waves of the COVID-19 epidemic have been observed. So far, no studies have investigated the characteristics of the waves of epidemic waves in the country. Identifying the epidemic trend in Ethiopia will inform future prevention and control of COVID-19. This study aims to identify the early indicators and the characteristics of multiple waves of the COVID-19 epidemics and their impact on the overall epidemic size in Ethiopia. We employed the Jointpoint software to identify key epidemic characteristics in the early phase of the COVID-19 epidemic and a simple logistic growth model to identify epidemic characteristics of its subsequent waves. Among the first 100 reported cases in Ethiopia, we identified a slow-growing phase (0.37 [CI: 0.10-0.78] cases/day), which was followed by a fast-growing phase (1.18 [0.50-2.00] cases/day). The average turning point from slow to fast-growing phase was at 18 days after first reported. We identified two subsequent waves of COVID-19 in Ethiopia during 03/2020-04/2021. We estimated the number of COVID-19 cases that occurred during the second wave (157,064 cases) was >2 times more than the first (60,016 cases). The second wave's duration was longer than the first (116 vs. 96 days). As of April 30th, 2021, the overall epidemic size in Ethiopia was 794/100,000, ranging from 1,669/100,000 in the Harari region to 40/100,000 in the Somali region. The epidemic size was significantly and positively correlated with the day of the phase turning point (r = 0.750, P = 0.008), the estimated number of cases in wave one (r = 0.854, P < 0.001), and wave two (r = 0.880, P < 0.001). The second wave of COVID-19 in Ethiopia is far greater, and its duration is longer than the first. Early phase turning point and case numbers in the subsequent waves predict its overall epidemic size.

Altered Expression of Aggrecan, FAM20B, B3GALT6, and EXTL2 in Patients with Osteoarthritis and Kashin-Beck Disease.

OBJECTIVE: The objective of this study was to investigate the expression of enzymes involved in synthesis and modification of chondroitin sulfate (CS) in knee cartilage tissue of patients with osteoarthritis (OA) and Kashin-Beck disease (KBD). METHODS: The knee articular cartilage samples were obtained from 18 age- and gender-matched donors with 6 each in KBD, OA, and control groups. Hematoxylin and eosin (HE) staining, toluidine blue (TB) staining, and immunohistochemical (IHC) staining were performed to estimate the expression level and localization of aggrecan, along with FAM20B, GalT-II, and EXTL2, which are associated with CS synthesis and modification. Rank-based analyses of variance test was used for the multiple comparisons of discrepancy in the positive staining rate among the 3 groups. RESULTS: In HE and TB staining results, damaged morphology, decreased chondrocyte numbers and proteoglycans were observed in OA and KBD groups compared with the control group. In line with these trends, the positive staining rates of aggrecan were lower in KBD and OA groups than in the control group. Meanwhile, the positive staining rates of CS chain modifying enzymes FAM20B, GalT-II, and EXTL2 decreased in OA and KBD groups. CONCLUSIONS: In conclusion, it was demonstrated that altered expression of CS chain modifying enzymes in OA and KBD groups influenced the synthesis procession of CS and could contribute to the damage of cartilage. Further investigation of these enzymes can provide new theoretical and experimental targets for OA and KBD pathogenesis studies.

Magnitude and associated factors of perceived stress and its consequence among undergraduate students of Salale University, Ethiopia: cross-sectional study.

Excessive stress may have a negative impact on students' performance and learning ability. The aim of this study is to assess the magnitude and associated factors of perceived stress and its consequences among undergraduate students at Salale University, Ethiopia. A self-administered cross-sectional study has been conducted among 421 students of Salale University from April 1st to May 30th, 2018. Multiple linear regressions and Spearman's rank correlation were applied. The overall response rate is 95.49 %. The mean perceived stress score (PSS-14) was 29.97 (standard deviation =7.48). Spearman correlation test has shown that perceived stress is significantly but negatively correlated with grade point average [rs = -0.25 (-0.334 - -0.153)] and year of studies [rs = -0.13 (-0.232 - -0.032)]. Increased perceived stress indices are significantly associated with female gender (P < 0.001), grade point average (P < 0.01), academic stressors (P < 0.01), and psychosocial stressors (P < 0.01). Mean of PSS-14 was high among health science students (31.42 ± 9.37) than agricultural (30.78 ± 7.69) and business students (28.04 ± 5.43), however, there were no statistically significant differences. These findings are sufficient to allow a large-scale study to further help better understanding the stress-vulnerability factors of undergraduate students.

Biomedical application of chondroitin sulfate with nanoparticles in drug delivery systems: systematic review.

Chondroitin sulphate captured an increasing amount of attention in the field of drug delivery systems. Nanoparticles and chondroitin sulphate were combined in different ways to form effective target nanocarriers. The study aimed to evaluate the biomedical application of chondroitin sulphate with nanoparticles in drug delivery systems. We searched PubMed, Google Scholar, and MEDLINE for studies that included data for the application of chondroitin sulphate and nanoparticles in targeting drug delivery published in English up to 25 February 2020. OHAT (Office of Health Assessment and Translation) Risk-of-Bias Tool was used to assessing the quality and risk of bias of each study. We performed a qualitative synthesis of findings from included studies. The toxicity of developed drugs has been evaluated using cell viability percentage and 50% inhibitory concentration of drugs. Twenty original articles reported the application of chondroitin sulphate on drug delivery systems were selected. Drug loading and encapsulation efficiency were from 2% to 16.1% and from 39.50% to 93.97%, respectively. The drug release was fast at start time and followed by a slow and sustain released stage. The risk of bias was rated as high in two out of twenty studies. Most of the studies presented baseline characteristics and outcomes appropriately.

Socio-demographic characteristics and associated factors influencing cervical cancer screening among women attending in St. Paul's Teaching and Referral Hospital, Ethiopia.

BACKGROUND: In Ethiopia, cervical cancer is the second most frequent cancer among women aged 15 to 44 years old. Cervical cancer screening is an effective measure to enhance the early detection of cervical cancer for prevention. However, the magnitude of cervical cancer screening is less than 1%. This study aimed to determine the influence of sociodemographic characteristics and related factors on screening. METHOD: A hospital-based cross-sectional study has been conducted from July to September 2017. Data have been collected using interviewer-administered questioner among 425 women (18-49 years age) who visited the family health department at St. Paul's Hospital. Descriptive statistics, chi-square, univariate and multivariate logistic regression were used for data analysis. RESULT: Of the 425 study participants, only 12.2% of women have been screened within the past 3 years. Women in the age range of 40-49 years old were more likely to be screened (36.1%) than women age 18-29 years (8%). Women living in urban were more likely to be screened (15.9%) than women living in rural (3.9%). Other factors including low monthly income, unlikely chance of having cancer, lack of knowledge, and fear test outcome were significantly associated with the low uptake of screening. CONCLUSION: This study revealed that the uptake of cervical cancer screening was low. Women in the potential target population of cervical cancer screening were just a proportion of all studied age groups and screening in them was more common than in younger women. Besides, rural residence, low monthly income, and lack of knowledge were important predictors for low utilization of cervical cancer screening practice.

Proteomic analysis of knee cartilage reveals potential signaling pathways in pathological mechanism of Kashin-Beck disease compared with osteoarthritis.

The pathological mechanism of Kashin-Beck disease (KBD), an endemic osteoarthritic disease, remains to be poorly understood. This study was designed to identify signaling pathways and crucial proteins involved in the pathological mechanism of KBD compared with osteoarthritis (OA). The knee cartilage samples were collected from gender- and age-matched KBD (n = 9) and OA (n = 9) patients. After pre-processing, samples were labeled with Tamdem Mass Tags 6plex multiplex kit, and analyzed by liquid chromatography-tandem mass spectrometry. Proteomic results were analyzed with gene ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG), and protein-protein interactions (PPI). The differential abundance proteins from KBD and OA were validated using western blot analysis. As a result, A total number of 375 proteins were identified to have differential abundance between KBD and OA, of which 121 and 254 proteins were observed to be up-regulated or down-regulated in KBD group. GO analysis shows that the differential abundant proteins are associated with cell junction and signal transducer activity from extracellular to intracellular. KEGG pathways enrichment and PPI network indicate four major pathways, including extracellular matrix -receptor interaction, focal adhesion, phosphatidylinositol 3-kinase (PI3K)-Protein kinase B (Akt), and Ras signaling pathways were involved in the degeneration of cartilage. Moreover, integrins, laminins, NF-κB and other regulative molecules were found as crucial proteins. In conclusion, our results demonstrated that compared with OA, the differential abundance proteins and signaling pathways may contribute to the occurrence and development of joint damage in KBD. Further investigation of their regulative roles and interaction may provide new insights into the pathological mechanisms and therapeutic targets for KBD.

Assessment of factors affecting vaccine cold chain management practice in public health institutions in east Gojam zone of Amhara region.

BACKGROUND: Maintaining quality of vaccines is one of the main challenges of immunization programs in Ethiopia. The objective of this study is to assess the factor affecting vaccine cold chain management practice in immunization health institutions in East Gojam zone of Amhara region, Ethiopia. METHOD: An institutional based cross-sectional study was conducted from March to April 2017 in ten districts of East Gojam zone of Amhara Region. Descriptive statistics and Logistic regression analysis were carried out to identify factors related to the practice of cold chain management. RESULT: Among 60 health institutions, only 46(76.7%) had functional refrigerators. Twenty-one (35%) had a functional generator for backup service and 28(46.6%) had a car/motorbike for transportation of vaccines in case of refrigerator/power failure. Twenty-nine (48.3%) had known the correct vaccine storage temperature (2 °C - 8 °C) in the refrigerator and the results of this study revealed that only 23(38.3%) of respondents had sufficient knowledge about vaccine cold chain management. The finding of this study also revealed that 35(58.3%) had appropriate vaccine cold chain management practice and the rest 25(41.7%) had inappropriate practice. Logistic regression showed us the knowledge gap and profession were significantly associated with vaccine cold chain management practice at P < 0.05. CONCLUSION: This study indicates that there was a knowledge gap of health workers who are working on cold chain management. There is an urgent need to improve knowledge and practice on cold chain management through improved supervision and training at a different level of health care system.

Knowledge, attitude, and practice of self-medication with antibiotics among community residents in Addis Ababa, Ethiopia.

Background: Self-medication with antibiotics, which may cause significant antibiotic resistance, is predominant in developing countries. The aim of this study is to assess the knowledge, attitude, and practice of self-medication with antibiotics among community residents in Ethiopia. Methods: A cross-sectional study design was conducted from June to August 2017. Knowledge-Attitude-Practice questionnaire was developed and distributed to eligible household respondents in Addis Ababa and its surrounding area. Logistic regression analysis was used to identify factors associated with self-medication with antibiotics. Results: Among the 605 invited participants, 595 respondents were participated in this study (response rate = 98.3%) and 67.3% of the respondents had reported self-medication with antibiotics in the past 6 months. The median score of knowledge about antibiotics was 3 (Inter quarter range: 2-4) of a maximum possible score of 6 and the median score of attitude was 19 (Inter quarter range: 16-22) from a maximum of 29. Self-medication with antibiotics was significantly associated with age, educational status, and average monthly income of the communities. Conclusions: Respondents have inadequate knowledge and inappropriate practice toward rational use of antibiotics. Policies such as restricting the purchase of antibiotics without a medical prescription and educating appropriate use of antibiotics are urgently needed.