Psychological distress among people living with chronic medical illness and the general population, Northwest Ethiopia: A comparative cross-sectional study.

BACKGROUND: Psychological distress is often linked to and negatively affects the outcomes of chronic medical conditions; however, data on psychological distress and its predictors among individuals with chronic medical illnesses are scarce in developing countries like Ethiopia. The main objective of this study was to assess the magnitude and predictors of psychological distress among people living with chronic medical illness and the general population. METHODS: A comparative cross-sectional study was conducted in Mecha demographic research center, Northwest Ethiopia. The participants were selected from the general population and outpatient departments. Kessler-10 (K-10) was used to assess psychological distress. RESULT: The magnitude of psychological distress among people living with chronic medical illness and those from the general population was 62.0% and 35.1%, respectively. The odds of psychological distress in people living with chronic medical illness was three times more than the one in the general population. Divorced marital status, family history of chronic medical illness, and low social support were statistically significantly associated with psychological distress in both groups. CONCLUSION: The magnitude of psychological distress was significantly higher among people living with chronic medical illness. Routine screening of such cases for psychological distress during their visits for their medical illness helps take appropriate therapeutic interventions.

Level of dietary adherence and determinants among type 2 diabetes population in Ethiopian: A systemic review with meta-analysis.

BACKGROUND: The beneficial effect of the dietary practice is significant reduction in the risk of developing diabetes related complication. Dietary practice among type 2 diabetes is not well-implemented in Ethiopia. Up to now, in the nation, several primary observational studies have been done on dietary adherence level and its determinants among type 2 diabetes. However, a comprehensive review that would have a lot of strong evidence for designing intervention is lacking. So, this review with a meta-analysis was conducted to bridge this gap. METHODS: A systematic review of an observational study is conducted following the PRISMA checklist. Three reviewers have been searched and extracted from the World Health Organization- Hinari portal (SCOPUS, African Index Medicus, and African Journals Online databases), PubMed, Google Scholar and EMBASE. Articles' quality was assessed using the Newcastle-Ottawa Scale by two independent reviewers, and only studies with low and moderate risk were included in the final analysis. The review presented the pooled proportion dietary adherence among type2 diabetes and the odds ratios of risk factors favor to dietary adherence after checking for heterogeneity and publication bias. The review has been registered in PROSPERO with protocol number CRD42020149475. RESULTS: We included 19 primary studies (with 6, 308 participants) in this meta-analysis. The pooled proportion of dietary adherence in the type 2 diabetes population was 41.05% (95% CI: 34.86-47.24, I2 = 93.1%). Educational level (Pooled Odds Ratio (POR): 3.29; 95%CI: 1.41-5.16; I2 = 91.1%), monthly income (POR: 2.50; 95%CI: 1.41-3.52; I2 = 0.0%), and who had dietary knowledge (POR: 2.19; 95%CI: 1.59-2.79; I2 = 0.0%) were statistically significant factors of dietary adherence. CONCLUSION: The overall pooled proportion of dietary adherence among type 2 diabetes in Ethiopia was below half. Further works would be needed to improve dietary adherence in the type 2 diabetes population. So, factors that were identified might help to revise the plan set by the country, and further research might be required to health facility fidelity and dietary education according to diabetes recommended dietary guideline.

Incidence of Pneumonia and Predictors Among Human Immunodeficiency Virus Infected Children at Public Health Institutions in the Northwest Part of Ethiopia: Multicenter Retrospective Follow-Up Study.

INTRODUCTION: Pneumonia is an inflammation of the lung parenchymal structure secondary to hematogens spread of pathogens, inhalation, or aspiration. It is also one of the most frequently occurring opportunistic infections in HIV-infected children. In Ethiopia, data on the incidence and predictors of opportunistic infection, especially pneumonia, among HIV-infected children is very limited. Hence, this study aimed to assess the incidence of pneumonia and predictors among HIV-infected children at public health institutions in the Northwest part of Ethiopia. METHODS: An institution-based retrospective cohort study was conducted among 342 HIV-infected children at public health institutions from January 1, 2013 to December 30, 2020. Log rank test was used to compare the survival curves between different explanatory variables. Bivariable Cox proportional hazards regression model was employed for each explanatory variable to check the association with the outcome variable. Variables found to have a p-value of < 0.25 in the bivariable analysis were candidates for the multi-variable proportional hazard model. Cox proportional hazards model was used at 5% level of significance to identify predictors of pneumonia. RESULTS: This study included 342 records of HIV-infected children who started antiretroviral therapy between the periods of January 1, 2013 to December 30, 2020. The overall incidence rate of pneumonia during the follow-up time was 5.57 (95% CI: 4.4, 7.0) per 100 child-years of observation. Those children who did not take cotrimoxazole preventive therapy (AHR: 3, 95% CI: 1.40, 6.44), being underweight at baseline (AHR: 2.6, 95% CI: 1.41, 4.86), having baseline advanced disease (clinical stages III and IV) (AHR: 2.8, 95% CI: 1.30, 6.04), and presenting with recently detected viral load (AHR: 5.9, 95% CI: 2.53, 14.06), were more likely to develop pneumonia. CONCLUSION: Pneumonia incidence rate was high. Providing prophylaxis and nutritional supplementation for those children with baseline advanced disease stage, low weight for age and detectable viral load would reduce pneumonia occurrence.

Undernutrition and Its Associated Factors Among Human Immunodeficiency Virus Infected Children on Follow Up in Amhara Region Referral Hospitals, Ethiopia, 2020.

Background. Undernutrition is a global problem and the biggest threat to human life and economic progress. It is the main cause of child morbidity and mortality especially in sub-Saharan Africa including Ethiopia. The severity of the problem is even worse when children are infected with human immunodeficiency virus. However the seriousness of the problem, there were limited studies conducted in the study area. Therefore, this study was conducted to assess the magnitude of undernutrition and its associated factors among HIV-infected children on follow up in Amhara Region Referral Hospitals. Methods. A facility-based cross-sectional study was conducted from February to April 2020. The data were collected through an interviewer-administered questionnaire. The collected data were coded and entered into Epi data 3.1 and exported to SPSS 26.0 for analysis. P-value <.05 was considered as statically significant. Results. The magnitude of undernutrition in this study was 30.3%. Dietary diversity (AOR = 1.73; CI 1.07-2.81), nutritional counseling (AOR = 2.42; CI 1.45-4.04), family size (AOR = 0.50; CI 0.27-0.93), WHO staging (AOR = 1.77; CI 1.08-2.88), and adherence to antiretroviral therapy (AOR = 1.75; CI 1.06-2.87) were predictors of undernutrition. Conclusions. Nearly one-third of the children included in this study had undernutrition. Poor dietary diversity, adherence to ART, nutritional counseling, family size, and WHO staging were factors significantly associated with undernutrition. Early screening and treatment of opportunistic infections, close attention to dietary counseling for caregivers and proper feeding habits will alleviate the problem.

Level of nurses' knowledge on pressure ulcer prevention: A systematic review and meta-analysis study in Ethiopia.

OBJECTIVE: Pressure ulcers (PU) are injuries to the skin and underlying tissue because of prolonged pressure. It affects millions of people in the world. One of the major nursing roles is to prevent patients from developing PU. Inadequate knowledge of nurses' toward PU can have a significant effect on preventive care strategies. Therefore, the aim of this meta-analysis study was to assess the overall level of nurses' knowledge about the prevention of pressure ulcers. METHODS: A systemic review of primary research was undertaken and nurses' knowledge on pressure ulcer prevention was evaluated. All original cross-sectional studies conducted only in Ethiopia in the English language were included in this meta-analysis. After extraction, the data analysis was done using STATA version 11 statistical software. Based on heterogeneity between the studies, the data were analyzed using a random effects model. RESULTS: In this systematic review and meta-analysis, all the studies on nurses' knowledge on the prevention of PU were reviewed based on the PRISMA statement. The overall knowledge of nurses' on pressure ulcer prevention was 46.24 % (95 % CI: 26.63-65.85). CONCLUSION: The overall knowledge of nurses' on pressure ulcer prevention was low in this meta-analysis study. Sustainable training about the prevention of PU is very important for all nurses.

Survival and predictors of mortality among severe acute malnourished under-five children admitted at Felege-Hiwot comprehensive specialized hospital, northwest, Ethiopia: a retrospective cohort study.

BACKGROUND: Malnutrition is still a global public health problem contributing for under-five morbidity and mortality. The case is similar in Ethiopia in which severe acute malnutrition is the major contributor to mortality being an underlying cause for nearly 45% of under-five deaths. However, there is no recent evidence that shows the time to death and public health importance of oxygen saturation and chest in drawing in the study area. Therefore, estimated time to death and its predictors can provide an input for program planners and decision-makers. METHODS: A facility -based retrospective cohort study was conducted among 488 severe acute malnourished under-five children admitted from the 1st of January 2016 to the 30th of December 2019. The study participants were selected by using simple random sampling technique. Data were entered in to Epi-Data version 3.1 and exported to STATA version15 statistical software for further analysis. The Kaplan Meier was used to estimate cumulative survival probability and a log-rank test was used to compare the survival time between different categories of explanatory variables. The Cox-proportional hazard regression model was fitted to identify predictors of mortality. P-value< 0.05 was used to declare statistical significance. RESULTS: Out of the total 488 randomly selected charts of children with severe acute malnutrition, 476 records were included in the final analysis. A total of 54(11.34%) children died with an incidence rate of 9.1death /1000 person- days. Failed appetite test (AHR: 2.4; 95%CI: 1.26, 4.67), altered consciousness level at admission (AHR: 2.4; 95%CI: 1.08, 4.67), oxygen saturation below 90% (AHR: 3.3; 95%CI: 1.40, 7.87), edema (AHR 2.9; 95%CI: 1.45, 5.66) and HIV infection (AHR: 2.8; 95%CI: 1.24, 6.36) were predictors of mortality for children diagnosed with severe acute malnutrition. CONCLUSION: The overall survival status of severe acute malnourished children was low as compared to national sphere standards and previous reports in the literature. The major predictors of mortality were oxygen saturation below 90%, altered consciousness, HIV infection, edema and failed appetite test. Therefore, early screening of complications, close follow up and regular monitoring of sever acute malnourished children might improve child survival rate.

Non-adherence to self-care and associated factors among diabetes adult population in Ethiopian: A systemic review with meta-analysis.

BACKGROUND: Self-care practice among people with diabetes is not well-implemented in Ethiopia. So far, in Ethiopia, several observational studies have been done on self-care practice and its determinants in people with diabetes. However, a comprehensive review that would have a lot of strong evidence for designing intervention is lacking. So, this review with a meta-analysis was conducted to bridge this gap. METHODS: A systematic review of an observational study is conducted following the PRISMA checklist. Three reviewers have been searched and extracted from the World Health Organization's Hinari portal (SCOPUS, African Index Medicus, and African Journals Online databases), PubMed, Google Scholar and EMBASE. Articles' quality was assessed using the Newcastle-Ottawa Scale by two independent reviewers, and only studies with low and moderate risk were included in the final analysis. The review presented the pooled proportion of non-adherence to self-care practice in people with diabetes and the odds ratios of risk factors hindering to self-care practice after checking for heterogeneity and publication bias. The review has been registered in PROSPERO with protocol number CRD 42020149478. RESULTS: We included 21 primary studies (with 7,134 participants) in this meta-analysis. The pooled proportion of non-adherence to self-care in the diabetes population was 49.91 (95% CI: 44.73-55.08, I2 = 89.8%). Male (Pooled Odds Ratio (POR): 1.84 95%CI; 1.04-2.64, I2 = 15.0%), having private glucometer (POR: 2.71; 95%CI: 1.46-3.95, I2 = 0.0%), short-term Diabetes Mellitus (DM) duration (POR: 3.69; 95%CI: 1.86-5.52, I2 = 0.0%), DM complication (POR: 2.22; 95%CI: 1.48-2.95, I2 = 0.0%), treatment satisfaction (POR: 1.8; 95% CI: 1.15-2.44, I2 = 0.0%), received diabetes self-management education (POR: 2.71; 95% CI: 1.46-3.95, I2 = 0.0%) and poor self-efficacy (POR: 3.09; 95% CI: 1.70-4.48, I2 = 0.0%) were statistically significant factors of non-adherence to self-care practice. CONCLUSIONS: The overall pooled proportion of non-adherence to self-care among adult diabetes in Ethiopia was high. Further works would be needed to improve self-care practice in the diabetes population. So, factors that were identified might help to revise the plan set by the country, and further research might be required to health facility fidelity and each domain of self-care practice according to diabetes self-management guideline.

Dietary non-adherence and associated factors among individuals with diabetes who are on treatment follow up at Felege-Hiwot Referral Hospital, Northwest Ethiopia.

Difficulty in adhering to the recommended diet is a common problem in individuals with diabetes mellitus (DM). Dietary non-adherence among diabetic individuals leads to diabetes related complication and death. As far as our search established, there is a scarcity of scientific evidence of dietary non-adherence of individuals with diabetes to the recommended diet in Ethiopia, specifically in the Northwest part of the country. Hence, this study aims to assess the dietary non-adherence and associated factors among individuals with diabetes at Felege-Hiwot Referral Hospital, Bahir Dar city, Northwest Ethiopia. An institution-based cross-sectional study was conducted on 385 systematically selected individuals with diabetes following their treatment from March to April 2017. Quantitative data were collected using a pre-tested and structured questionnaire. The dependent variable association with explanatory variables was determined using logistic regression. Statistical significance was considered at p-value <0.05 with 95% CI. The overall proportion of dietary non-adherence among participants was 46.8% (95% CI: 41.1-52.0). Living rurally (AOR = 3. 75; 95% CI: 2.12-6.63), duration of diabetes less than 5 years (AOR = 2. 81; 95% CI: 1.22-6.50), did not receive nutritional education (AOR = 5. 88; 95% CI: 3.30-10.48), poor social support (AOR = 3. 84; 95% CI: 1.74-8.46) and did not make choices when eating out (AOR = 3. 49; 95% CI: 2.09-5.81) were significantly associated with dietary non-adherence. Nearly half of the individuals with diabetes involved in this study did not adhere to the recommended diet. This problem could be addressed through the provision of nutritional education and strengthening social support to adhere to diabetes dietary recommendations. Therefore, health professional and nutritional educators should take appropriate action to increase the proportion of dietary adherence of individuals with diabetes.

Workload Determines Workplace Stress among Health Professionals Working in Felege-Hiwot Referral Hospital, Bahir Dar, Northwest Ethiopia.

Background: Workplace stress occurs in all professionals but, in particular, health-care professionals are highly prone to workplace stress. Health-care professionals comprise an important group that can be impacted by workplace stress because of their unique work environment. The study was done to determine the level of workplace stress and its associated factors among health-care professionals in Felege-Hiwot Referral Hospital, Bahir Dar, Northwest Ethiopia. Methods: An institutional-based cross-sectional study was conducted among randomly selected health-care professionals in Felege-Hiwot Referral Hospital. Data were collected using a self-administered structured questionnaire by trained data collectors and the supervisor. The collected data were entered into EPI-info version 7 and exported to SPSS version 20 for analysis. Logistic regression was employed to assess the associations between dependent and explanatory variables. Results: This study revealed that prevalence of workplace stress was 68.2%. Health professionals who work 50 hours and more per week and in night shift on sometimes base were more likely to develop workplace stress. Conclusion: The level of workplace stress among health professionals was found to be high. This was due to long working hours and working in night shift. Identifying the source of workplace stress among health professionals should be a great concern for health service managers and other stakeholders.