Prevalence and Associated Factors of Sensorineural Hearing Impairment Among Patients with T2DM in Amhara Region, Northwest Ethiopia, 2022: A Multi-Centered Cross-Sectional Study.

Background: Generally, people with type 2 diabetes mellitus in various countries experience a significant rate of sensorineural hearing impairment. Nonetheless, there is scant evidence of sensorineural hearing impairment among type 2 diabetes mellitus patients in Northwest Ethiopian. Therefore, the objective of this study was to evaluate the occurrence rate and contributing factors of sensorineural hearing impairment in type 2 diabetics at comprehensive and specialized referral hospitals in Northwest Ethiopia. Methods: A facility-based cross-sectional study design was carried out from May 3, 2022, to June 14, 2022, on 846 study participants in Ethiopia, with a response rate of 99.65%. The research subjects were chosen by simple random sampling techniques. Data was gathered by using audiometric measurements and structured interview-administered questionnaires and then entered into EPI data version 4.6. Finally, it was exported to STATA 14 for analysis. Binary logistic regression, chi-square test, and odds ratio were done to verify the assumptions and degree of association. Ultimately, factors exhibiting a p-value < 0.05 with a 95% CI were regarded as significant predictors of hearing impairment. Results: The magnitude of sensorineural hearing impairment in this investigation was 50.49% (95% CI: 45.67%, 55.26%). Factors significantly associated with sensorineural hearing impairment were age (AOR=1.10, 95% CI: 1.07, 1.14), hyperlipidemia (AOR=2.86, 95% CI: 1.05, 7.82), duration of diabetes (AOR=2.26, 95% CI: 1.26, 4.06), hypertension (AOR=1.94, 95% CI: 1.02, 3.69) and regular physical exercise (AOR=0.25, 95% CI: 0.09, 0.68). Conclusions and Recommendations: In this study, relatively high rates of sensorineural hearing impairment were observed. Stakeholders should establish routine hearing screening, and participants will advise to incorporate regular physical exercise into their routines.

Common mental disorders and associated factors among adult chronic kidney disease patients attending referral hospitals in Amhara Regional State.

Common mental disorders (CMDs) are a wide term that includes disorders like depression, anxiety, and somatic manifestations. Chronic kidney disease (CKD) patients are at high risk of developing a common mental disorders, which leads to a lower survival rate, poor clinical outcome, longer hospitalization, increased health-care utilization, difficulty adhering to medications, an increased risk of initiation of dialysis, poor quality of life, and an increased risk of mortality. However, there is limited study done related to common mental disorders and associated factors among chronic kidney disease patients in Ethiopia. This study aimed to assess the prevalence of common mental disorders and associated factors among chronic kidney disease patients attending referral hospitals in Amhara Regional State. An institution-based cross-sectional study design was conducted at the University of Gondar Comprehensive Specialized and Felege Hiwot Referral Hospitals from January to April 2020. The study participants were selected using systematic random sampling techniques. Common mental disorders were assessed using the Self-Reporting Questionnaire-Falk Institute (SRQ-F) tool. Data were entered into Epi Data Version 3.0 then exported into STATA 14 for analysis. Both bivariable and multi-variable binary logistic regressions were done to identify factors associated with common mental disorders. In multivariable logistic regression analysis, variables with a p-value of ≤ 0.05 were declared as a statistically associated with common mental disorders. In this study, 424 CKD patients were included, with a response rate of 100%. Among screened CKD patients, 40.8% was positive for common mental disorders, with a 95% CI (36-45%). Independent predictors of common mental disorders among CKD patients were poor social support [(AOR 3.1, 95% CI (1.67-5.77)], family history of mental disorders, [AOR 3.6, 95% CI (1.12-11.8)], comorbidity [AOR 1.7, 95% CI (1.03-2.78)], being female [AOR 2.69, 95% CI (1.72-4.20)], and duration of CKD (AOR 3.5; 95% CI (2.28-5.54). Two out of five CKD patients screened for CMDs were found to be positive. Common mental disorders were more common among CKD patients with poor social support, a family history of mental disorders, comorbidity, being female, and the duration of CKD. Therefore, screening CKD patients for common mental disorders is recommended.

Sleep Quality and Associated Factors among Pregnant Women Attending Antenatal Care Unit at the Referral Hospitals in Oromia National Regional State, Ethiopia, 2021: A Multicenter Cross-Sectional Study.

INTRODUCTION: Poor sleep quality during pregnancy leads to adverse neonatal outcomes such as low birth weight, intrauterine growth retardation, preterm birth, and operative birth. Though it has many consequences, a limited study was conducted on the prevalence and associated factors of poor sleep quality among pregnant women in Ethiopia. OBJECTIVE: This study is aimed to determine poor sleep quality and associated factors among pregnant women attending antenatal care units at the selected referral hospitals. METHODS: Institution-based cross-sectional study was used from April 20 to June 10, 2021. A The data were collected through systematic random sampling. The Pittsburgh Sleep Quality Index (PSQI) was used to assess the outcome variable based on interview. RESULTS: Out of 423, almost 414 participated in the study with a response rate of 97.9%. The prevalence of poor sleep quality was 54.6% (95% CI: 49.7%, 59%). Based on the trimester; about 44.8%, 36.8%, and 64.2% were observed poor sleep quality in the first, second, and third trimesters, respectively. Third trimester [AOR (Adjusted Odd Ratio) = 4.33; 95% CI (Confidence Interval) (1.43, 13.7)], primigravida [AOR = 4.03; 95% CI (2.59, 7.97)], para ≥2 [AOR = 1.95: 95% CI (1.09, 3.48)], depression [AOR = 4.59: 95% CI (2.31, 9.15)], and perceived stress [AOR = 1.15: 95% CI (1.1, 1.22)] were factors significantly associated. CONCLUSION: One in every two pregnant women has poor sleep quality. Depression, perceived stress, gestational age, gravida, and parity were identified as associated factors with poor sleep quality. Therefore, healthcare providers should work on screening and counseling for sleep problems during prenatal checkups.

Determinants of early discharge after birth among mothers delivered vaginally at health facilities: further analysis of the Ethiopian demographic health survey.

INTRODUCTION: The majority of maternal and newborn deaths take place during the first few hours and days after birth and thus postnatal contacts should begin as early as possible, especially within the first 24 h, then again within two to three days after delivery. Globally, early postnatal discharge has increased over the past 50 years and currently too. Even if Ethiopia has very low PNC coverage, there is no evidence on who is discharged early. Hence, the aim of this study was to determine the magnitude and the predictors for early postnatal discharge in Ethiopia. METHODS: This study was based on the secondary data analysis using the Ethiopian Demographic and Health survey (EDHS) 2016 data set. The weighted sample of 2,225 delivered mothers were included for the final analysis. The model was best fitted as assessed by Hosmer-Lemeshow test (p value = 0.1988). The variables with P-value ≤ 0.2 in the bi- variable binary logistic regression analysis were included in to the multi-variable binary logistic regression analysis. The Adjusted Odds Ratio (AOR) with 95% confidence interval (95% CI) was computed to assess the strength of association between the outcome and independent variables. The variables with a P-value of less than 0.05 in the multi-variable binary logistic regression analysis were declared as statistically significant predictors of the outcome variable. RESULT: The overall magnitude of early discharge was 70.41% (CI: 68.48, 72.30). Residence (rural; AOR: 0.61, 95% CI: 0.46, 0.80), educational status (No education; AOR: 1.87, 95% CI: 1.19, 2.94), religion (Muslim; AOR: 0.69, 95% CI: 0.55, 0.87, Others; AOR: 0.24, 95% CI: 0.10, 0.57), wealth index (Poor; AOR: 0.77; 95% CI: 0.59, 0.99), marital status (Not married; AOR: 0.29; 95% CI: 0.13, 0.67), ANC visits (No ANC visits; AOR: 0.63; 95% CI: 0.46,0.86), parity (3rd parity; AOR: 1.48; 95% CI: 1.03, 2.11), and size of the child (larger size; AOR: 0.63;95% CI: 0.50,0.79, (smaller size; AOR: 0.72; 95% CI: 0.56,0.92) were independent determinants of early discharge. CONCLUSION: A substantial proportions of mothers in Ethiopia had been discharged early (before 24 h). Residence, education, wealth index, religion, marital status, ANC follow up, parity and size of the child were predictors of early discharge. Adequate hospital stay should be promoted. Since the early discharge in Ethiopia is very high, home based postnatal visit should be strengthened focusing the identified predictors.

Geospatial variations and determinants of contraceptive utilization among married reproductive age women in Ethiopia: spatial and multilevel analysis of Ethiopian Demographic and Health Survey, 2019.

Introduction: Contraception is the most effective method of preventing unwanted pregnancies and their associated disadvantages. It is critical to recognize one's desire to utilize contraceptives before drafting and implementing a good family planning program, especially in developing nations like Ethiopia. Objective: This study aimed to identify the geospatial variations and determinants affecting the utilization of contraceptives among married reproductive age women in Ethiopia. Method: This study was based on an extensive national survey, the Ethiopian Demographic and Health Survey. A total weighted sample of 5,743 married reproductive-age women was included. Because of the hierarchical nature of the DHS data, a spatial analysis multilevel logistic regression model was used to study individual and community-level factors that may influence contraceptives. The Bernoulli model was used by applying Kulldorff methods using the SaTScan software to analyze the purely spatial clusters of contraceptive usage. ArcGIS version 10.3 was used to visualize the distribution of contraceptives. A 95% confidence interval and a p-value of less than 0.05 were used to declare statistical significance. Result: The overall utilization of contraceptives was discovered at 41.25% (39.98, 42.53). Participants age range of 25-34 years [AOR = 0.80, CI: (0.66, 0.96,)] and 35-49 years [AOR = 0.50, CI 95%:(0.66, 0.96)] times less likely to use contraceptives than 15-24 years old respectively. Having primary [AOR = 1.47, CI 95%: (1.25, 1.73)], secondary [AOR = 1.42, CI 95%: (1.09, 1.83)] and higher education level [AOR = 1.92, CI 95%: (1.41, 2.60)], middle wealth [AOR = 1.48, CI 95%: (1.14, 1.90)], richer [AOR = 1.41, CI 95%: (1.07, 1.86)] and richest [AOR = 2.17, CI 95%: (1.52, 3.11)], having 1-4 ANC follow up have [AOR = 1.60, CI 95%: (1.26, 2.03)], gave birth at age of 35-44 [AOR = 0.29, CI 95%: (0.22, 0.37)], having 3-5 children [AOR = 1.26, CI 95%: (1.03, 1.52)], being from community of high level women education [AOR = 1.61, CI 95%: (1.21, 2.15)] were associated positively. Participants from Amhara, Oromia, Benishangul and SNNPR regions have revealed [AOR = 2.40, CI 95%: (1.53, 3.77)], [AOR = 1.64, CI 95%: (1.05, 2.56)], [AOR = 1.62, CI 95%: (1.01, 2.62)] and [AOR = 2.04, CI 95: (1.31, 3.19)], in contrast, Somali and Afar regions have shown [AOR = 011, CI 95%: (0.05, 0.22)] and [AOR = 0.31, CI 95%: (0.18, 0.54)] times less likely to use contraceptive services than Tigray Region respectively. The spatial analysis of contraceptive usage discovered that the northern, central and southern parts of the country had higher utilization of contraceptives than the eastern and northeastern of the country. Conclusion: The study revealed that contraceptive usage among married women is comparatively low, with wide regional variation. Raising awareness among mothers about the importance of antenatal care and assisting mothers who are financially disadvantaged or do not have access to health facilities will aid in providing better family planning services. Improving contraceptive information dissemination at community and regional levels is key to averting potential barriers.

Visual Impairment and Its Associated Factors Among Hypertensive Patients in Amhara Region Referral Hospitals, Ethiopia.

Background: Visual impairment is one of the most common long-term effects of high blood pressure. It affects one's quality of life, independence, and mobility. There is a paucity of information regarding the prevalence of visual impairment due to hypertension in Ethiopia. Therefore, this study aimed to determine the prevalence of visual impairment and its associated factors among hypertensive patients in referral hospitals of the Amhara region, Ethiopia, 2021. Methods: An institution-based cross-sectional study was conducted among 423 study participants, which were selected by systematic random sampling technique. Data were collected by using an interviewer-administered structured questionnaire and physical measurements. The collected data were entered into Epi-data version 4.6. Then, exported into SPSS Version 26 for analysis. The crude and adjusted odds ratios and 95% Confidence intervals were calculated. Both bivariable and multivariable logistic regression analyses were done. Variables with a p-value of ≤0.05 were stated as significantly associated with visual impairment. Results: The overall prevalence of visual impairment among hypertensive patients was 32.4% (95% CI: 27.9-37.9). Duration of hypertension ≥ 5 years (AOR =3.06, 95% CI: 1.86-4.95), history of ocular trauma (AOR =2.50, 95% CI: 1.3-4.73), and ever alcohol drinking (AOR = 2.72, 95% CI: 1.32-5.62) were significantly associated with visual impairment. Conclusion: Nearly one-third of hypertensive patients were visually impaired from the study participants. Duration of hypertension ≥5 years, history of ocular trauma, and ever alcohol drinking was significantly associated with visual impairment among hypertensive patients. Therefore, in addition to providing medical care and follow-up services for hypertension patients, health education is needed for early and proper management of visual impairment, and to decrease their level of alcohol consumption. Furthermore, better to do this study by prospective cohort study design to identify cause-and-effect relationships.

Chronic constipation and its associated factors in patients with type-2 diabetes: A multicenter cross-sectional study.

INTRODUCTION: Diabetes is one of the global public health concern and constipation is frequently seen among gastrointestinal symptoms in diabetes. Despite the fact that constipation is common, doctors and/or patients disregard it. This study aimed to determine the prevalence and contributing factors of constipation in patients with diabetes. METHODS: Multi-center cross-sectional study was carried out and the data was analyzed using STATA 14. Binary and multilevel logistic regressions were also carried out to identify associated to factors. Factors having a p-value of less than 0.05 were deemed statistically significant in the final model. RESULTS: 206 diabetics participated in the survey. The mean age of the participants was 52.7 years (SD ± 11.9). The prevalence of constipation was 16% (95% CI: 10.97-21.07). Age (AOR = 13.56; 95% CI: 1.71, 107.21), females (AOR = 4.58; 95% CI: 1.76, 11.87), the duration of the diabetes (AOR = 3.16; 95% CI: 1.21, 8.24), and psychological distress (AOR = 12.49, 95% CI: 1.53, 101.8) were significant factors. CONCLUSION: The magnitude of constipation was considerable, and it was linked to psychological distress, longer-lasting diabetes, being a woman, and ageing. Patients with type-2 diabetes need to receive careful treatment in order to reduce the severity of the condition and its additional complications.

Prevalence of anemia and associated factors among adult hypertensive patients in Referral Hospitals, Amhara Regional State.

Anemia is a risk factor for adverse cardiovascular disease outcomes in hypertensive patients. Chronic anemia increases preload, reduces afterload, and leads to increased cardiac output in hypertension patients. In the long term, this may result in maladaptive left ventricular hypertrophy, which in turn is a well-recognized risk factor for cardiovascular disease outcomes and all-cause mortality in hypertension. Low hemoglobin and hematocrit levels might be strongly indicate hypertensive end-organ damage, specifically kidney failure. Therefore, this study determined the prevalence of anemia and associated factors among hypertensive patients in Referral Hospitals, Amhara Regional State, Ethiopia, in 2020. An institution-based cross-sectional study was conducted in Amhara Regional Referral Hospitals from February 20 to April 30, 2020. Random and systemic sampling techniques were used to select 428 study participants. Data were entered and coded in to Epi data version 3.0 and then exported into STATA 14 for analysis. In bivariable logistic regression, variables with a p-value of < 0.25 were included in multivariable logistic regression. Using a 95% confidence interval, variables having a p-value ≤ 0.05 in multivariable logistic regression were declared as statistically significant variables. In this study, a total of 428 study participants were involved with 99.5% response rate. The prevalence of anemia among hypertensive patients was 17.6%, with a 95% CI (14.3-21.5%). Estimated glomerular filtration rate (eGFR) < 90 ml/min (AOR = 2.77, 95% CI 1.56- 4.92)], duration of hypertension (HTN) ≥ 5 years (AOR = 2.37, 95% CI 1.36-4.15), uncontrolled blood pressure (AOR = 1.91, 95% CI 1.08-3.35), and higher pulse pressure (AOR = 1.05 (95% CI 1.02-1.08) were significantly associated with anemia. Nearly one out of five hypertensive patients had anemia. Impaired estimated glomerular filtration rate, duration of HTN, blood pressure status, and pulse pressure were the independent predictors of anemia among hypertensive patients. Screening hemoglobin level at a regular interval is recommended for the hypertensive patients to take an appropriate intervention.

Determinants of knowledge of the highest conception probability period among reproductive age women in Low-Income African countries: A multilevel analysis based on the recent Demographic and Health Survey.

BACKGROUND: Adequate knowledge about the highest conception probability period in the reproductive cycle allows individuals and couples to attain or avoid their fertility probabilities. Poor knowledge of conception probability period leads to undesirable outcomes like unwanted pregnancy, miscarriage, and abortion. Determinants of knowledge of highest conception probability period were not well studied on economically disadvantaged countries. Therefore, our study aimed to identify individual and community level factors of knowledge of the highest conception probability period among women of reproductive age in low income African countries. METHODS: The appended and latest Demographic and Health Survey datasets of 15 low-income African countries was used for analysis. Model fitness was done using the Intraclass correlation coefficient, median odds ratio, and deviance. A model with the lowest deviance (model-III) was selected as the best model. Multilevel logistic regression model was used to identify determinant factors of knowledge of the highest conception probability period. In the final model, adjusted odds ratio with 95% confidence interval was reported and variables with p<0.05 were considered as statistically significant with knowledge of the highest conception probability period. RESULTS: Total weighted sample of 235,574 reproductive aged women with a median age of 27 years were included. The correct knowledge of the highest conception probability period among the study participants was 24.04% (95%CI = 23.87-24.22%). Maternal age groups ((20-24 (AOR = 1.49; 95%CI = 1.44-1.55), 25-29 (AOR = 1.62; 1.56-1.68), 35-39 (AOR = 1.76; 1.68-1.84), 40-44 (AOR = 1.75; 1.67-1.83), and 45-49 (AOR = 1.83; 1.74-1.93)), marital status((currently in union (AOR = 1.75; 1.16; 1.13-1.20), formerly in union (AOR = 1.75; 1.11; 1.06-1.16)), better educational status ((secondary (AOR = 2.08; 2.01-2.14) and higher(AOR = 3.36; 3.18-3.55)), higher wealth index ((middle (AOR = 1.08; 1.04-1.12), richer (AOR = 1.24; 1.20-1.28), and richest (AOR = 1.51; 1.45-1.57)), knowledge of contraceptive methods (AOR = 2.63; 2.49-2.77), current contraceptive use (AOR = 1.14; 1.11-1.16), and urban residency (AOR = 1.26; 1.21-1.29) were statistically significant with knowledge of the highest conception probability period. CONCLUSION: In this study, knowledge of the highest conception probability period among women of reproductive age in low-income African countries was low. Therefore, improving the fertility awareness through comprehensive reproductive education or counseling could be one of the operational ways to control unintended pregnancy.

Prevalence of Diarrhea, Intestinal Parasites, and Associated Factors Among Under-Five Children in Dabat District, Northwest Ethiopia: Multicenter Cross-sectional Study.

Background: Despite global interventions to prevent and control diarrhea, it remains a public health problem leading to childhood morbidity and mortality majorly in developing countries. According to the World Health Organization, data from 2021 indicated that diarrheal disease is responsible for 8% of deaths in children under the age of 5. In the world, more than 1 billion under-five children live in poverty, social exclusion, and discrimination affected by intestinal parasitic infections and diarrhea disease. In sub-Saharan African countries like Ethiopia, diarrheal diseases and parasite infections continue to cause significant and persistent morbidity and mortality in under-five children. Therefore, the purpose of this study was to assess the prevalence and associated factors of intestinal parasites and diarrheal diseases in children under the age of 5 years in Dabat District, Northwest Ethiopia in 2022. Method: A community-based, cross-sectional study was carried out from September 16 to August 18th 2022. Four hundred households with at least one child under the age of 5 years were recruited by simple random sampling technique. Sociodemographic, clinical, and behavioral factors were also collected using pretested interviewer-administered questionnaires. Data was entered into Epi-data version 3.1 and exported to Statistical Package for Social Science (SPSS) version 25 for analysis. Binary logistic regression was performed to identify factors associated with diarrhea and intestinal parasitic infections. The level of significance was computed at a P-value ⩽ .05. Descriptive statistics such as frequency and other summary statistics were used for describing sociodemographic variables and determining the prevalence of diarrhea and intestinal parasites. Tables, figures, and texts were used to present the findings. The variables having a P-value of less than .2 in the bivariable analysis were entered into the multivariable analysis at a P-value of ⩽.5. Results: According to this study, the prevalence of diarrhea and intestinal parasites among under-five children was 20.8% (95% CI: [16.8-37.8] and 32.5% (95% CI: [28.6, 37.8], respectively. In multivariable logistic analysis at a P-value of ⩽.5, the educational level of mothers (Adjusted odds ratio [AOR]: 3.7, 95% CI: [1.52, 8.95], residence (AOR: 4.7, 95% CI: [1.52, 8.09]), undernutrition (AOR: 3.6, 95% CI: [1.09, 11.3]), latrine availability (AOR:3.9, 95% CI: [1.23, 9.56]), types of the latrine (AOR: 5.9, 95% CI: [3.42, 11.66]), water treatment (AOR = 7.6; 95% CI: [6.4, 12.7]), eating uncooked vegetable or fruits (AOR = 4.6; 95% CI: [1.025, 15.2]), and source of water (AOR = 4.5; 95% CI: [2.32,8.92]) were significantly associated with diarrheal disease. Intestinal parasitic infection was also significantly associated with undernutrition (AOR = 3.9; 95% CI: [1.09, 9.67]), latrine availability (AOR = 2.1; 95% CI:[1.32, 9.32]), types of the latrine (AOR = 2.8; 95% CI: [1.92, 8.12]) residence (AOR = 4.7; 95% CI: [1.52, 8.09]), water treatment, source of water for drinking (AOR = 4.5; 95% CI: [2.32, 8.92]), eating uncooked vegetables or fruits (AOR = 6.7:95% CI: [3.9, 9.8]), and deworming children with anti-parasitic medication (AOR = 2.4; 95% CI: [1.34, 5.62]), washing hands after latrine used (AOR = 2.2: 95% CI: [1.06, 3.86]). Conclusion: The prevalence of diarrhea and intestinal parasite among under-five children was 20.8% and 32.5%, respectively. Undernutrition, latrine availability, types of latrines, residence, eating uncooked vegetables or fruits, and source of water for drinking and water treatment were associated with intestinal parasitic infection and diarrheal disease. Deworming children with antiparasitic medications and washing hands after latrine use was also significantly associated with parasitic infection. Hence, awareness creation activities on latrine utilization and building, keeping personal hygiene, safe water supply, feeding cooked vegetables or fruits, taking anti-parasitic medications, practice hand washing habit after toilet use are strongly recommended.

Obstructive sleep apnea risk and determinant factors among type 2 diabetes mellitus patients at the chronic illness clinic of the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia.

Introduction: Obstructive sleep apnea is a sleep complaint among type 2 diabetes mellitus patients that has a deleterious effect on health with immediate and long-term impacts. Despite its impacts, data on the magnitude and predictors of obstructive sleep apnea among type 2 diabetes mellitus patients in Ethiopia is still limited. Thus, this study was conducted to determine how common a high risk of obstructive sleep apnea is and its predictors among type 2 diabetes mellitus patients receiving follow-up care at the chronic illness follow-up clinic at the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia, 2022. Methods: An institution-based cross-sectional study was conducted. Interviewer-administered questionnaires and physical measurements with standard instruments were used to collect the required data. The collected data were entered into EpiData 4.6 and exported into STATA 14. Both Bivariable and multivariable binary logistic regression analyses were done to identify factors associated with a high risk of obstructive sleep apnea. Variables with a p-value ≤0.05 in the multivariable logistic regression analysis were declared as significantly associated with a high risk of obstructive sleep apnea. Results: A total of 319 type 2 diabetes mellitus patients with a median age of 58 years participated in our current study. The overall prevalence of a high risk of obstructive sleep apnea among the study participants was 31.97% (95%CI: 27.06, 37.32). On multivariable logistic analysis, a neck circumference of ≥40 cm (AOR=4.33, 95%CI 1.37, 13.72), physical inactivity (AOR=2.29, 95%CI 1.15, 4.53), comorbid hypertension (AOR=4.52, 95%CI 2.30, 9.18), and male sex (AOR=8.01, 95%CI 3.02, 21.24) were associated with a high risk of obstructive sleep apnea. Conclusion and recommendation: The prevalence of a high risk of obstructive sleep apnea among type 2 diabetes mellitus patients remains high. A neck circumference of ≥40 cm, physical inactivity, comorbid hypertension, and male sex were significantly associated with a high risk of obstructive sleep apnea among type 2 diabetes mellitus patients. Screening and evaluation of type 2 diabetes mellitus patients for obstructive sleep apnea are recommended to avoid the negative impacts.

Childhood vaccination practices and associated factors among mothers/caregivers in Debre Tabor town, Northwest Ethiopia: A cross-sectional study.

Background: Incomplete immunization and non-immunization increase the risk of disease and death among children. This study aims to assess childhood vaccination practices and associated factors among mothers and caregivers in Debre Tabor town, Amhara region, Ethiopia. Methods: A community-based cross-sectional study design was conducted between February 30 and April 30, 2022. The study participants were proportionally allocated to all six kebeles found in the town. A systematic random sampling technique was used to select the study participants. The collected data were checked and coded and then entered into EpiData Version 3.1 and exported into SPSS Version 26. The results were organized using frequency tables, graphs, and charts, and bivariate and multivariable logistic regression were used to test the association of covariates with childhood vaccination practices. Result: Approximately 422 study mothers and caregivers participated in the study, with a response rate of 100%. The mean age was 30.63 years (11.74), which ranged from 18 to 58 years. More than half of the study participants (56.4%) expressed fears about the side effects of vaccination. A majority (78.4%) of the study participants availed of counseling services about vaccination, and 71.1% of them received regular antenatal care. This study found that approximately 280 [66.4%, 95% confidence interval (CI): 61.8-70.6] mothers/caregivers had a history of good childhood vaccination practices. The factors of the fear of side effects [adjusted odds ratio (AOR) = 3.34; 95% CI: 1.72-6.49], no workload (AOR = 6.08; 95% CI: 1.74-21.22), medium workload (AOR = 4.80; 95% CI: 1.57-14.71), being a mother of child/children (AOR = 2.55; 95% CI: 1.27-5.13), positive attitude (AOR = 2.25; 95% CI: 1.32-3.82), and sound knowledge (AOR = 3.88; 95% CI: 2.26-6.68) were significantly associated with childhood vaccination practices. Conclusion: More than half of the study participants had a history of good childhood vaccination practices. However, the rate of such practices was low among mothers and caregivers. The fear of side effects, workload, motherhood, attitude, and knowledge were all factors associated with childhood vaccination practices. Awareness creation and a consideration of the workload of mothers would be helpful in dispelling fears and increasing the rate of good practices among mothers and caregivers.

Geographical variation of common childhood illness and its associated factors among under-five children in Ethiopia: spatial and multilevel analysis.

Although substantial progress has been made in reducing child mortality over the last three decades, the magnitude of the problem remains immense. Ethiopia is one of the countries with a high under-five mortality rate due to childhood illnesses including acute respiratory infections, diarrhea, and fever that varies from place to place. It is vital to have evidence of the factors associated with childhood illnesses and the spatial distribution across the country to prioritize and design targeted interventions. Thus, this study aimed to investigate the spatial cluster distribution and associated factors with common childhood illnesses. Secondary data analysis based on the 2016 Ethiopian Demographic and Health Survey data was carried out. A total weighted sample of 10,417 children was included. The study used ArcGIS and SaTScan software to explore spatial distribution. For associated factors, a multilevel binary logistic regression model was fitted using STATA V.14 software. Adjusted Odds Ratios (AOR) with a 95% Confidence Interval (CI) and p-value ≤ 0.05 in the multivariable model were used to declare significant factors associated with the problem. ICC, MOR, PCV, and deviance (-2LLR) were used to check model fitness and model comparison. In this study, the prevalence of common childhood illnesses among under-five children was 22.5% (95% CI: 21.6-23.3%). The spatial analysis depicted that common childhood illnesses have significant spatial variation across Ethiopia. The SaTScan analysis identified significant primary clusters in Tigray and Northern Amhara regions (log-likelihood ratio (LLR) = 60.19, p < 0.001). In the multilevel analysis, being rural residence [AOR = 1.39, 95% CI (1.01-1.98)], small child size at birth [AOR = 1.36, 95% CI (1.21-1.55)], high community poverty [AOR = 1.26, 95% CI (1.06-1.52)], mothers aged 35-49 [AOR = 0.81, 95% CI (0.69-0.94)], the household had electricity [AOR = 0.77, 95% CI (0.61-0.98)], the household had a refrigerator [AOR = 0.60, 95% CI (0.42-0.87)], improved drinking water [AOR = 0.82, 95% CI (0.70-0.95)], improved toilet [AOR = 0.72, 95% CI (0.54-0.94)], average child size at birth [AOR = 0.83, 95% CI (0.75-0.94)] were significantly associated with common childhood illnesses. Common childhood illnesses had spatial variations across Ethiopia. Hotspot areas of the problem were found in the Tigray, Northern Amhara, and Northeast SNNPR. Both individual and community-level factors affected common childhood illnesses distribution and prevalence in Ethiopia. Therefore, public health intervention should target the hotspot areas of common childhood illnesses to reduce their incidence in the country.

Predictors of underage pregnancy among women aged 15-19 in highly prevalent regions of Ethiopia: a multilevel analysis based on EDHS, 2016.

Under age (teenage) pregnancy is a pregnancy that occurs under the age of 20 years old. Its magnitude is increasing globally. It is much higher in low-income countries compared to high-income countries. Teenage pregnancy exposed teenagers to various obstetric and perinatal complications. However, its predictors are not well investigated in highly prevalent regions of Ethiopia. Therefore, this study assessed individual and community-level predictors of teenage pregnancy using a multi-level logistic regression model. An in-depth secondary data analysis was performed using the fourth Ethiopian Demographic and Health Survey (EDHS) 2016 data set. A weighted sample of 2397 teenagers was included in the final analysis. Multi co linearity and chi-square tests were checked and variables which did not fulfill the assumptions were excluded from the analysis. Four models were fitted. Variables with p value ≤ 0.2 in the bi-variable multilevel logistic regression were included in the multivariable multilevel logistic regression. The adjusted odds ratio (AOR) with a 95% confidence interval (95% CI) was computed. Variables with a p value of less than 0.05 in the multi-variable multilevel logistic regression were declared as statistically significant predictors. A total of 2397 weighted participants aged from 15 to 19 were involved. About 15% of teenagers were pregnant. Age [17 (AOR = 9.41: 95% CI 4.62, 19.13), 18 (AOR = 11.7: 95% CI 5.96, 23.16), 19 (AOR = 24.75: 95% CI 11.82, 51.82)], primary education (AOR = 2.09: 95% CI 1.16, 3.76), being illiterate (AOR = 1.80: 95% CI 1.19, 2.73), religion [being Muslims (AOR: 2.98:95% CI 1.80, 4.94), being Protestants (AOR = 2.02: 95% CI 1.20, 3.41)], contraceptive non use (AOR = 0.18: 95% CI 0.11, 0.31), a high proportion of family planning demand (AOR = 3.52: 95% CI 1.91, 6.49), and a high proportion of marriage (AOR = 4.30: 95% CI 2.25, 8.21) were predictors of teenage pregnancy. Age, educational status, religion, contraceptive non-use, literacy proportion of marriage and proportion of demand for family planning were the most significant predictors of teenage pregnancy. The ministry of education shall focus on universal access to education to improve female education. The government should work in collaboration with religious fathers to address reproductive and sexual issues to decrease early marriage and sexual initiation. Especial attention should be given to teenagers living in a community with a high proportion of marriage.

Occupational Noise-Induced Pre-Hypertension and Determinant Factors Among Metal Manufacturing Workers in Gondar City Administration, Northwest Ethiopia.

Introduction: Cardiovascular disorders are one of the commonly recognized occupational diseases in the developed world. Individuals chronically exposed to noise at workplaces had a higher risk of developing elevated arterial blood pressure. There are limited studies in Ethiopia regarding this topic and thus this study determined the prevalence and determinant factors of occupational noise-induced pre-hypertension among metal manufacturing workers in Gondar city administration, Northwest Ethiopia. Methods: An institution-based cross-sectional study design was carried out. In this study, 300 study participants were recruited by census sampling method. A sound level meter was used to measure the working area noise level. A semi-structured pre-tested interviewer-administered questionnaire was used to collect sociodemographic and clinical data. Blood pressure was measured in a quiet room in the morning using a mercurial sphygmomanometer. Both bivariable and multi-variable binary logistic regressions were used to identify factors associated with noise-induced prehypertension. Adjusted odds ratio with 95% confidence interval was reported, and variables with p < 0.05 were considered as statistically associated factors with pre-hypertension. Results: The prevalence of noise-induced pre-hypertension was 27.7% (95% CI: 22.7-32.7). In multivariable logistic regression, working area noise level (AOR = 3.8, 95% CI: 6.8-8.9), 45-65 years' age (AOR = 9.8, 95% CI: 5.4-12.9), years of work experience ((6-10 years (AOR = 2.8, 95% CI: 1.98-5.90 and >10 years (AOR = 4.8, 95% CI: 7.8-9.75)), being a cigarette smoker (AOR = 3.6, 95% CI: 1.36-9.77), and alcohol consumption (AOR = 2.4, 95% CI: 1.06-1.04) were significantly associated with noise-induced prehypertension. Conclusion: Workers in metal manufactures who were exposed to noise levels >85 dB developed elevated blood pressure. The odds of having prehypertension were increased by years of work experience, advanced age, smoking, and alcohol consumption. Our findings recommended that the real-world preventive strategies should be taken to lower the risk of noise-induced pre-hypertension hastened by occupational noise exposure.

Individual and community-level factors associated with iron-rich food consumption among children aged 6-23 months in Rwanda: A multilevel analysis of Rwanda Demographic and Health Survey.

BACKGROUND: Iron-rich food consumption has an invaluable effect for neonatal and fetal brain development as well as metabolic activities. Despite the public health importance of the consumption of iron-rich foods, there was no study, that assessed iron-rich food consumption in Rwanda. Therefore this study aimed to assess iron-rich food consumption and associated factors among children aged 6-23 months using Rwanda Demographic and Health Survey (RDHS). METHODS: Secondary data analysis was done using RDHS-2019/20. Total weighted samples of 2455 children aged 6-23 months were included. Data coding, cleaning, and analysis were performed using Stata 16. Multilevel binary logistic regression were performed to identify factors associated with iron-rich food consumption. Adjusted Odds Ratio (AOR) with a 95% CI, and p-value <0.05 were used to declare statistical significance. RESULTS: The prevalence of good iron-rich food consumption was 23.56%(95% CI: 21.92,25.28). Northern province of Rwanda (AOR = 0.26,95%CI: 0.15,0.46), mothers secondary education and above (AOR: 2.37, 95% CI: 1.41, 4.01), married mothers (AOR:1.31, 95% CI: 1.01,1.71), rich wealth status (AOR = 2.06, 95% CI: 1.48, 2.86), having post-natal visit (AOR = 1.45, 95% CI: 1.10,1.91), mothers media exposure (AOR: 1.75, 95% CI: 1.22, 2.52) and drugs given for intestinal parasite (AOR = 1.37, 95% CI: 1.04, 1.80) were associated with iron-rich food consumption. CONCLUSIONS: This study shows that overall iron-rich foods consumption was low in Rwanda. The residing in the North province, mother's secondary and higher educational status, married marital status, rich and middle wealth status, having media exposure, drugs given for intestinal parasites, and having child's post-natal checkup were variables significantly associated with iron-rich food consumption. The region-based intervention will improve the consumption of iron-rich food. In addition, health policies and programs should target educating mothers/caregivers, encouraging parents to live together, improving their wealth status, working on mass media access by the women, and encouraging mothers post-natal checkups to improve iron-rich food consumption.

Factors associated with healthcare-seeking behavior for symptomatic acute respiratory infection among children in East Africa: a cross-sectional study.

BACKGROUND: Although there has been promising progress in the reduction of child mortality from ARI, the magnitude is high yet, especially in East Africa. Since mothers/guardians decide upon the type and frequency of healthcare services for children, their good healthcare-seeking behavior could prevent acute respiratory infections (ARI) related mortality and morbidity. This study aimed to investigate the pooled prevalence and factors associated with healthcare-seeking behavior of children younger than five years with ARI symptoms by using data from nationally representative surveys of East Africa. METHODS: We analyzed secondary data based on the eleven East African Demographic and Health Survey data. Both Individual and community level variables were considered for this study and a multilevel binary logistic regression model was fitted to identify associated factors of children's healthcare-seeking behavior for ARI symptoms. STATA V.14 software was used to clean, recode and analyze the data. All variables with a p-value = 0.2 in the bi-variable analysis were considered for the multivariable multilevel analysis. Adjusted OR (AOR) with 95% CI was reported to reveal significantly associated factors in the multivariable multilevel analysis. RESULT: The overall prevalence of healthcare-seeking behavior of under-five children for ARI symptoms was 64.4% in East Africa. In the multilevel analysis, the following characteristics were found to be the most important factors of children healthcare seeking behavior for ARI symptoms (P < 0.05): Rural residence [AOR = 0.51, 95% CI (0.37-0.65)], high community level media usage [AOR = 1.63, 95% CI (1.49-1.79)], high community level women education [AOR = 1.51, 95% CI (1.39-1.66)], primary education [AOR = 1.62, 95% CI (1.45-1.82)], secondary education and above [AOR = 1.99, 95% CI (1.71-2.32)], working mother [AOR = 1.33, 95% CI (1.20-1.48)], unmarried women [AOR = 1.15, 95% CI (1.04-1.27)], media access [AOR = 1.43, 95% CI (1.20-1.58)], richest [AOR = 1.39, 95% CI (1.29-1.51)], distance to health facility not a big problem [AOR = 1.11, 95% CI (1.02-1.21)], Place of delivery at health facilities [AOR = 1.77, 95% CI (1.60-1.95)], age of child 7-23 months [AOR = 1.59, 95% CI (1.39-1.82)], age of child 24-59 months [AOR = 1.24, 95% CI (1.09-1.41)] in comparison with children aged 0-6 months, family size > 10 [AOR = 1.53, 95% CI (1.22-1.92)]. CONCLUSIONS AND RECOMMENDATIONS: The overall prevalence of children's healthcare-seeking behavior for ARI symptoms was found relatively low in East Africa, ARI symptoms were determined by individual-level variables and community-level factors. Targeted interventions are needed to improve socioeconomic and health systems to overcome the problem of acute respiratory infection in children. Special attention is required to empower local health staff and health facilities to provide proper diagnosis and management of ARI cases in East Africa.

Factors associated with diabetic retinopathy screening and regular eye checkup practice among diabetic patients attending Felege Hiwot Specialized Hospital.

AIM: To identify associated factors of diabetic retinopathy (DR) screening and ey e check-up practice among diabetes mellitus (DM) patients attending Felege Hiwot Specialized Hospital. METHODS: An institution-based cross-sectional study was applied from October 4, 2019 to January 12, 2020 at Felege Hiwot Specialized Hospital. A systematic random sampling technique was used to recruit participants and an interviewer-administered questionnaire was employed to collect the data. The collected data were entered into Epi Info version 7 and transposed to SPSS version 24 for statistical analysis. Descriptive statistics were executed and associated factors were identified using binary logistic regression. The strength of association between the independent and the outcome variable was determined using an adjusted odds ratio (AOR) with 95% confidence interval (CI). RESULTS: Four hundred and six participants partake with a response rate of 95.7% and a mean age of 47±11.5y. The magnitude of DR screening was 308 (75.9%, 95%CI: 71.5%, 79.8%). Higher educational level (AOR=3.25; 95%CI: 1.40, 8.78), good knowledge of DR (AOR=2.50; 95%CI: 1.55, 4.46), and family history of DM (AOR=2.15; 95%CI: 1.41, 3.85) were significantly associated with DR screening. On the other side, rural residence [AOR=3.11 (1.89, 5.02)] and undesirable attitudes toward DR [AOR=5.65 (3.14, 8.76)] were significantly associated with poor regular eye checkup practice. CONCLUSION: Most of the participants are screened for DR. Higher education, family history, and good knowledge are associated with DR screening. In addition, rural residence and undesirable attitudes toward DR are associated with regular eye checkup practice.

Deworming among preschool age children in sub-Saharan Africa: pooled prevalence and multi-level analysis.

BACKGROUND: Sub-Saharan Africa (SSA) preschool age children are more vulnerable to soil-transmitted helminths (STH) which caused millions of morbidity because of low socioeconomic status and lack of clean water and sanitation. Despite this problem, there is minimal evidence on the prevalence and factors associated with deworming medication utilization among preschool age children (pre-SAC) in SSA regions. Hence this study aimed to assess the prevalence and determinants of deworming among preschool age children in SSA. METHODS: Demographic and Health Survey (DHS) data were used for this study with a total weighted 192,652 children aged 24-59 months. Taking deworming medication in the 6 months preceding the interview was our outcome of interest. A multi-level binary logistic regression model was fitted. Adjusted odds ratio (AOR) with 95% confidence interval (CI) was taken to identify significant variables. RESULTS: The prevalence of deworming medication utilization among preschool age children in SSA was 45.03% (95% CI 44.46%, 45.60%), ranging from 41.82% in Malawi to 50.5% in Lesotho. It was 44.91% (95% CI 44.32%, 45.51%) among countries having endemic STH infection and 46.01% (95% CI 43.64%, 48.38%) for none endemic countries. Factors such as; secondary and above women education [AOR = 2.18; 95% CI 2.10, 2.26], occupation [AOR = 1.31; 95% CI 1.27, 1.34], having ≥ 11 family members [AOR = 0.68; 95% CI 0.64, 0.70], household media exposure [AOR = 1.16; 95% CI 1.13, 1.19] and richer wealth status [AOR = 1.23; 95% CI 1.16, 1.27], vitamin A supplementation [AOR = 6.18; 95% CI 6.02, 6.33] and living rural residence [AOR = 0.94; 95% CI 0.92, 0.98] have significantly associated with deworming among preschool age children. CONCLUSIONS: Utilization of deworming medication among pre-SAC children in sub-Saharan Africa is below half. Factors, such as the education status of women, family size, household media exposure, wealth status, diarrhea, vitamin A supplementation, and residence were significant variables. To increase the utilization of deworming medication for pre-SAC, WHO should work as an integrated approach with other stakeholders, by strengthening women's education, and media exposure. Maternal employment should be promoted and prior attention should be given to rural children.

Hypertension and Its Associated Factors Among Long-Distance Truck Drivers in Ethiopia.

Introduction: Hypertension is rising globally and is one of the leading causes of cardiovascular disease. It affects people of different groups; however, owing to a rise in a sedentary lifestyle it is more prevalent among long-distance truck drivers. However, the prevalence of hypertension and its associated factors among truck drivers in Ethiopia is not known. Therefore, this study aimed to determine the prevalence of hypertension and its associated factors among long-distance truck drivers in Ethiopia. Methods: A cross-sectional study was conducted among 415 long-distance truck drivers selected by systematic random sampling technique at Modjo dry port from May 15 to 30, 2021. The data were collected and entered into Epi-data 4.6 then it was exported to SPSS version 25 for analysis. Descriptive statistics, bivariable, and multivariable logistic regression analyses were executed. The odds ratio with a 95% confidence interval was computed. In the final model, a variable with a p ≤ 0.05 was declared as a predictor of hypertension. Results: The prevalence of hypertension among long-distance truck drivers in Ethiopia was 34.7%. The odds of hypertension was higher among drivers who were ≥45 years old [Adjusted odds ratio (AOR) = 4.32; 95% Confidence interval (CI): 2.16, 8.62], obese [AOR= 5.12; 95% CI: 1.33, 19.8], alcohol drinkers [AOR=3.05; 95% CI: 1.27, 7.31], and cigarette smokers [AOR= 3.74; 95% CI: 1.64, 8.51]. Drivers who had regular physical exercise were less likely [AOR=0.33; 95% CI: 0.17, 0.63] to have hypertension than drivers with no physical activity. Conclusion: More than a third of the participants in Ethiopia had hypertension. Higher age, obesity, absence of rest between driving, short sleep duration, smoking, alcohol drinking, and physical inactivity were significantly associated with hypertension. Therefore, health education on lifestyle modifications, sleep habits, and the importance of rest breaks between driving should be considered to prevent hypertension and further complications.