Severe Acute Malnutrition among Children in Bale Zone Southeast Ethiopia: Treatment Outcome and its Determinant Factors.

OBJECTIVE: To assess the treatment outcomes of severe acute malnutrition (SAM) and its associated factors in children aged 6-59 months in Bale zone, Southeast Ethiopia. DESIGN: A multi-institutionally-based, retrospective cross-sectional study design was conducted, based on records from September 11, 2014 to September 11, 2017. Simple random sampling was used to select the records. A pretested extraction format was used to collect information from the logbook and patient records. Treatment outcome was dichotomized into recovery and censored. Bivariate and multivariable logistic regression analyses were used to analyze the data. Odds ratios with 95% CIs were calculated to determine the association between each independent variable and treatment outcome. RESULTS: A total of 763 records were completed and reviewed. Of these, 711 (93.2%) were recovered from SAM. Provision of deworming treatment (aOR = 6.5; 95% CI: 2.8-15.1), education given to the mother/caregiver (aOR = 8.8; 95% CI: 4.2-18.4), age range 6-24 months (aOR = 0.37; 95% CI: 0.17-0.81), presence of anemia (aOR = 0.33; 95% CI: 0.14-0.78), and use of nasogastric (NG) tube (aOR = 0.42; 95% CI: (0.21-0.85) were associated with recovery from SAM. CONCLUSIONS: Recovery rate of SAM children in this study was in line with international standards. Deworming, maternal education status, child's age, anemia, and NG tube use were associated with recovery. Attention should be given to deworming all children, disease control, and prevention of anemia and other comorbidities.

Sepsis Risk Factors in Neonatal Intensive Care Units of Public Hospitals in Southeast Ethiopia, 2020: A Retrospective Unmatched Case-Control Study.

Background: Neonatal sepsis is a significant contributor to neonatal morbidity and mortality worldwide. It is more prevalent in developing countries. Thus, understanding the risk factors for neonatal sepsis is critical to minimizing the incidence of infection, particularly in Ethiopia. The purpose of this study was to identify the risk factors for neonatal sepsis in neonates admitted to neonatal intensive care units of public hospitals in Southeast Ethiopia in 2020. Method: An institution-based, retrospective unmatched case-control study was conducted on 97 cases and 194 controls in neonatal intensive care units of public hospitals in Southeast Ethiopia. A pretested, structured questionnaire was used to collect the data. Data was entered using EpiData 3.1 and analyzed using SPSS version 23. Bivariable and multivariable logistic regression analyses were performed to identify associated factors. An adjusted odds ratio with a 95% confidence interval was used to determine the degree of association, and statistical significance was declared at a p value of < 0.05. Results: In this study, 97 cases and 194 controls were included. About two-thirds (63.9%) of cases were with early onset neonatal sepsis (<7 days). Mode of delivery with spontaneous vaginal delivery (AOR:5.032; 95% CI (1.887-13.418)), type of birth attendant (traditional birth attendant) (AOR: 4.407 95% CI (1.213,16.004)), history of STI/UTI (AOR:2.543; 95% CI (1.313,4.925)), intrapartum fever (AOR:4.379; 95% CI (2.170,8.835)), APGAR score at the 5thminute < 7 (AOR:4.832; 95% CI (1.862,12.537)), neonate received resuscitation (AOR:3.830; 95% CI (1.753,8.369)), low birth weight (AOR:6.101; 95% CI (2.124,17.525)) were the identified risk factors for neonatal sepsis. Conclusion: Both maternal and neonatal factors contribute to the risk of neonatal sepsis. Spontaneous vaginal delivery, birth attended by the traditional birth attendant, history of STI/UTI, presence of intrapartum fever, low APGAR score at the 5th minute, neonate receiving resuscitation, and low birth weight were identified as independent risk factors for neonatal sepsis. Prompt identification of the aforementioned factors and management should be sought for all newborns.

Determinants of implanon discontinuation among women who ever used implanon in Shashemene district, west Arsi zone, Southern Ethiopia: unmatched case control study.

BACKGROUND: Despite tremendous work has been done on demand creation, capacity building and ensuring the logistics of Implanon; its discontinuation rate remained high in Ethiopia; the prevalence is reported to be 31% in Shashemene District. However, the factors contributing to the high prevalence of early Implanon discontinuation were not well understood in our study setting. OBJECTIVE: This study aimed to identify the determinants of implanon discontinuation among women who had ever used Implanon in Shashemene District, Southern Ethiopia. METHODS: A community-based unmatched case-control study was conducted among randomly selected 264 women (88 cases and 176 controls) in Shashemene District, Southern Ethiopia, from April 12 to May 18, 2021. A systematic random sampling technique was used to select the respondents. Cases were women who discontinued Implanon before 3 years and controls were those who used implanon for 3 full years. A pre-tested, interviewer-administered structured questionnaire was used to collect data. Bivariable and multivariable binary logistic regression analyses were performed to identify determinants of Implanon discontinuation. An odds ratio (OR) with a 95% confidence interval (CI) was used to estimate the strength of the association, and significance was declared at a P value of less than 0.05. RESULT: The mean age of the respondents was 28.23 (± 5.46) years: 27.27 (± 5.38) years for cases and 28.70 (± 5.5) years for controls. Women with no formal education [AOR = 3.09, 95% CI: (1.20, 8.00)], fewer than four children [AOR = 2.47, 95% CI: (1.20, 5.08)], no history of abortion [AOR = 2.84, 95% CI: (1.25, 6.46)], being new acceptors [AOR = 2.14, 95% CI: (1.02, 4. 49)], being counseled for less than fifteen minutes [AOR = 2.47, 95% CI: (1.29, 4.70)], not discussing it with a partner [AOR = 2.88, 95% CI: (1.42, 5.84)] and experiencing side effects [AOR = 0.35, 95% CI: (0.17, 0.71)] were significantly associated with discontinuation of implanon. CONCLUSION: Women with no formal education, having less than four children, history of abortion, new acceptors, duration of counseling, discussion with partner, and side effects were determinants of Implanon discontinuation among women. There is a need to ensure adequate pre-implantation counseling and appropriate management of side effects. Furthermore, interventions should target new acceptors and those without formal education.

Postabortion Contraceptive Utilization, Preferences, and Associated Factors among Women Receiving Abortion Care Services in Health Facilities of Ambo Town, Ethiopia.

Background: The World Health Organization recommends the use of effective contraception for the prevention of unintended pregnancy and unsafe abortion. The main aim of postabortion contraceptive services is to prevent recurrent pregnancy and ultimately mitigate the associated maternal mortality. Objective: To assess postabortion contraceptive utilization (PACU) and postabortion contraceptive preferences (PACP) and the associated factors among women receiving abortion care services in Ambo town, Oromia Region, Western Ethiopia. Methods: A cross-sectional study was conducted at the health facilities in Ambo town from 22 July to 24 September 2021. The data was collected using a structured questionnaire. Bivariate and multivariable logistic regression was done to determine the factors associated with postabortion contraceptive utilization and preferences. Results: Out of 388 participants who were included in the final analysis, 262 (67.5%) had utilized postabortion contraceptives of which 173 (66%) received contraceptive methods of their primary preference. The multivariate logistic regression showed that cohabiting couples showed lower utilization (AOR = 0.15; 95% CI: 0.06-0.21; p value = 0.004) than married ones and planning to have an additional child within 1-3 years (AOR = 7.41; 95% CI: 2.18-11.41; p value = 0.005) or after 3-5 years (AOR = 6.67: 95% CI: 5.12-10.18; p value = 0.033) was identified to be significantly associated with postabortion contraceptive utilization. Having a secondary education level (AOR = 3.06; 95% CI: 1.54-6.07; p value = 0.001) and having experience of domestic violence (AOR = 2.19; 95% CI: 1.27-3.81; p value = 0.005) were significantly associated with unsatisfied postabortion contraceptive preference. Conclusions and Recommendations. About two-thirds of the women who were given abortion services received postabortion contraceptives whereas almost two-thirds of them received a contraceptive method of their primary preference. Marital status, duration before additional child planned, and being counseled on contraceptive determined postabortion contraceptive utilization. Having a secondary education level and having experienced domestic violence were significantly associated with unsatisfied PACP.

Knowledge, attitude, and practice of preconception care and associated factors among obstetric care providers working in public health facilities of West Shoa Zone, Ethiopia: A cross-sectional study.

Preconception care is biomedical, social, and behavioural care provided for a woman or couple before conception occurs or throughout their reproductive year. In Ethiopia, it's reported that the majority of health care providers had poor knowledge and practice of preconception care. The institution-based cross-sectional study was conducted among 359 obstetric care providers to assess knowledge, attitude, and practice of preconception care in West Shoa Zone, Ethiopia. A stratified, simple random sampling technique selected five hospitals, 46 health centers, and study participants. Pretested and structured questionnaires were used to collect data. Data were entered into Epidata and exported to SPSS for analysis. Bivariate and multivariate logistic regressions were employed to identify an association between the independent predictors and the outcome variables. In this study, 173(48.2%) and 124(34.5%) of the obstetric care providers had good knowledge and practice of preconception care, respectively. Two-thirds 255(71%) of providers had a favorable attitude toward preconception care. The odds of having good knowledge were higher among Midwives' providers [AOR: 2.03, 95%CI: 1.09-3.77] and had training on HIV testing [AOR: 3.5, 95%CI: 1.9-6.4]. The presence of a library [AOR: 1.7, 95%CI: 1.04-2.85] and internet access [AOR: 3.4, 95%CI: 2.0-5.8] in working health facility had a higher odds of good knowledge about preconception. Degree and above holders [AOR: 3.1, 95%CI: 1.5-6.1] also had higher odds of good preconception knowledge than diploma holders. Similarly, the odds of having good practice of preconception care were higher among health care providers: who did screening for reproductive life plans [AOR: 3.7, 95%CI:1.8-7.4], worked in maternity and child health unit [AOR:4.2,95%CI:2.0-8.6], perceive all health facilities should give preconception care services [AOR:2.3,95%CI:1.2-4.3], and perceive all health care providers should provide preconception services [AOR:3.0, 95%CI: 1.7-5.5]. This study found that more than half of obstetric care providers' had poor knowledge, favorable attitude, and poor practice of preconception care. Provision of training, carrier development, and installation of internet and library services should be enhanced.

COVID-19-related anxiety and knowledge toward its preventive measures among patients with chronic medical illness on follow-up in public hospitals of Bale, East Bale, and West Arsi zones, Ethiopia.

BACKGROUND: Coronavirus disease 2019, also known as 2019-nCoV cluster of acute respiratory illness with unknown causes, which occurred in Wuhan, Hubei Province, in China, was first reported to World Health Organization country office as of December 30, 2019. People with medical illness are at a higher risk for coronavirus disease, and the pandemic influences mental health and causes psychological problems, particularly in those with chronic medical illness. Hence, this study aimed to assess coronavirus disease 2019-related anxiety and the knowledge on its preventive measures among patients with medical illness on follow-up in public hospitals of Bale, East Bale, and Arsi zones. OBJECTIVE: To assess coronavirus disease 2019-related anxiety and knowledge toward coronavirus disease 2019 preventive measures among patients with chronic medical illness on follow-up in public hospitals of Bale, East Bale, and West Arsi zones. METHODS: A hospital-based cross-sectional study was conducted in selected hospitals of Bale and West Arsi zones, Southeast Ethiopia. A total of 633 study participants were included in this study, and data were collected through an interviewer-administered questionnaire. A descriptive summary was computed. Bivariable and multivariable logistic regression analyses were carried out to identify the associated factors. RESULTS: Overall, the prevalence of anxiety among chronic patients in this study was 6.3% (95% confidence interval: 4.6%-8.5%) and 420 (66.35%) had good knowledge on the preventive measures of coronavirus disease 2019. Factors significantly associated with anxiety among chronic patients were being educated (95% confidence interval: adjusted odds ratio = 0.26 (0.09-0.74)), being male (95% confidence interval: 2.69 (1.11-6.53)), and use of mask (95% confidence interval: 0.11 (0.05-0.26)). CONCLUSION: The prevalence of coronavirus disease 2019-related anxiety among chronic patients was high and being males, uneducated, and not using face mask was significantly associated with coronavirus disease 2019-related anxiety.

Completion of the continuum of maternity care and associated factors among women who gave birth in the last 6 months in Chelia district, West Shoa zone, Ethiopia: A community-based cross-sectional study.

Background: The continuum of maternity care is a continuity of care that a woman receives during pregnancy, childbirth, and the postpartum period from skilled providers in a comprehensive and integrated manner. Despite existing evidence regarding maternal healthcare services discretely, the continuum of maternity care and its associated factors are not well-known in Ethiopia. Objective: This study assessed the completion of the maternity continuum of care and associated factors among women who gave birth 6 months prior to the study in the Chelia district. Methods: A community-based cross-sectional study with a stratified random sampling technique was conducted among 428 mothers at 10 randomly selected kebeles. Pretested and structured questionnaires were used to collect data. Bi-variable and multivariable logistic regression analyzes were performed to identify associated factors. Adjusted odds ratio with its 95% confidence interval was used to determine the degree of association, and statistical significance was declared at a p-value of <0.05. Results: In this study, 92 (21.5%) mothers completed the continuum of maternity care. Secondary and above education of mothers (AOR = 4.20, 95% CI:1.26-13.97), ≤30 min spent on walking by foot (AOR = 4.00, 95% CI: 1.67-9.58), using an ambulance to reach health facility (AOR = 3.68, 95% CI: 1.23-11.06), para ≥5 mothers (AOR = 0.21, 95% CI: 0.05-0.90), planned pregnancy (AOR = 3.29, 95% CI: 1.02-10.57), attending pregnant women's conference (AOR = 13.96, 95% CI: 6.22-31.30), early antenatal care booking (AOR = 3.30, 95% CI: 1.54-7.05), accompanied by partners (AOR = 3.64, 95% CI: 1.76-7.53), and informed to return for postnatal care (AOR = 3.57, 95% CI: 1.47-8.70) were the factors identified. Conclusion: In this study, completion of the maternity continuum of care was low. Therefore, appropriate strategic interventions that retain women in the continuum of maternity care by targeting those factors were recommended to increase the uptake of the continuum of maternity care.

Factors associated with maternal near-miss at public hospitals of South-East Ethiopia: An institutional-based cross-sectional study.

INTRODUCTION: Maternal near-miss precedes maternal mortality, and women are still alive indicating that the numbers of near-misses occur more often than maternal mortality. This study aims to assess the prevalence of maternal near-miss and associated factors at public hospitals of Bale zone, Southeast Ethiopia. METHODS: Facility-based cross-sectional study design was carried out from 1 October 2018 to 28 February 2019, among 300 women admitted to maternity wards. A structured questionnaire and checklist were used to collect data. Epi-info for data entry and statistical package for social science for analysis were used. The descriptive findings were summarized using tables and text. Adjusted odds ratio with 95% confidence interval and p-value < 0.05 were used to examine the association between the independent and dependent variables. RESULT: The prevalence of maternal near-miss in our study area was 28.7%. Age < 20 years, age at first marriage < 20 years, husbands with primary education, and being from rural areas are factors significantly associated with the prevalence of maternal near-miss. The zonal health department in collaboration with the education department and justice office has to mitigate early marriage by educating the community about the impacts of early marriage on health.

Compliance towards infection prevention measures among health professionals in public hospitals, southeast Ethiopia: a cross-sectional study with implications of COVID-19 prevention.

INTRODUCTION: The new coronavirus disease 2019 is an emerging respiratory disease caused by the highly contagious novel coronavirus which has currently overwhelmed the world. Realizing a comprehensive set of infection prevention measures is a key to minimize the spread of this virus and its impacts in all healthcare settings. Therefore, this study was aimed to assess the compliance towards COVID-19 preventive measures and associated factors among health professionals in selected public hospitals, southeast Ethiopia. METHODS: A descriptive hospital-based cross-sectional study was conducted among 660 health professionals in public hospitals of southeast Ethiopia from October 1 to 31, 2020. A multistage sampling technique was used to select the study participants. Data were collected by interview using structured and pretested questionnaires. Ordinary logistic regression modeling was used to estimate the crude and adjusted odds ratio. To declare the statistical significance of factors associated with the outcome variable, P-value < 0.05 and 95% confidence interval were used. RESULTS: A total of 654 health professionals were involved in the study; of whom, 313 participants were nurses. The overall good compliance and knowledge of health professionals regarding COVID-19 preventive measures were 21.6 and 25.5%, respectively. Working in the general hospital (AOR = 0.55; 95% CI 0.38, 0.79), service year (AOR = 2.10; 95% CI 1.35, 3.21), knowledge (AOR = 1.80; 95% CI 1.14, 2.89), and water availability (AOR = 3.26; 95% CI 2.25, 4.72) were some of the factors found to have a statistically significant association to compliance of health professionals regarding COVID-19 preventive measures. CONCLUSION: In this study, nearly one fifth of health professionals had good compliance towards COVID-19 prevention practices. Thus, a consistent supply of COVID-19 prevention materials, facilities, and improving the knowledge of health professionals through on and off-job training are crucial.

Correction: Intimate partner violence and its associated factors among pregnant women in Bale Zone, Southeast Ethiopia: A cross-sectional study.

[This corrects the article DOI: 10.1371/journal.pone.0214962.].

Intimate partner violence and its associated factors among pregnant women in Bale Zone, Southeast Ethiopia: A cross-sectional study.

BACKGROUND: Intimate partner violence (IPV) against women is a major public health concern in low income countries. Violence against pregnant women has adverse effects on maternal and newborn outcomes. This study aimed to assess the prevalence and associated factors of intimate partner violence in Southeast Ethiopia pregnant women. METHODS: Institutional based cross-sectional study was conducted on pregnant women who were attending antenatal care (ANC) in Bale Zone health institution during study period. Face to face interviews were conducted using a pre-tested structured questionnaire. Data related to socio-demographic characteristic, pregnancy and reproductive history, intimate partner behavior and IPV encountered during recent pregnancy was gathered for this study. Descriptive analysis and logistic regression were used for the data analysis. Odds ratio with 95% CI was computed to determine the presence and strength of associated factors with IPV. RESULTS: A total of 612 pregnant women participated in the study. Of these, 361 (59.0%) pregnant women faced at least one type of IPV during the recent pregnancy. Physical violence (20.3%), sexual violence (36.3%), psychological/emotional violence (33.0), controlling behavior violence (30.4%) and economic violence (27.0) were the type of IPV encountered by participants. An intimate partners who were drank alcohol [AOR = 2.9; 95% CI: (1.5-5.4)], partners who were chewed Khat [AOR = 1.7; 95% CI: (1.1-2.6)], partners who were smoked cigarette [AOR = 2.6; 95% CI: (1.4-4.9)], partners who had aggressive behavior [AOR = 2.8; 95% CI: (1.7-4.6)], having partner age ≥30 year old [AOR = 1.8; 95% CI: (1.2-2.9)], unwanted pregnancy [AOR = 3.3; 95% CI: (1.9-5.5)] and history of adverse pregnancy outcome [AOR = 2.1; 95% CI: (1.2-3.6)] that were the factors that significantly associated with IPV of the pregnant women. CONCLUSION: The prevalence of IPV during pregnancy was high among the study participants. Intimate partners' use of substance, intimate partners' aggressive behavior, older intimate partners, unwanted pregnancy and history of adverse birth outcome were identified as associated factors for IPV. IPV needs to be considered during ANC service and integrated into the sexual and reproductive health education. Community-based interventions should be advocated as a way of health promotion. Counseling, awareness creation, service provision and program design on IPV is mandatory to minimize the victim.

First aid knowledge, attitude, practice, and associated factors among kindergarten teachers of Lideta sub-city Addis Ababa, Ethiopia.

BACKGROUND: Injuries are very common and can occur at any point of time in a day. Unintended injuries in kindergarten children are the most common and need immediate life saving care which is known as first aid. This study aimed to investigate knowledge, attitude, practice, and associated factors of first aid among kindergarten teachers of Lideta sub-city Addis Ababa, Ethiopia. METHOD: A cross-sectional study was conducted among kindergarten teachers. Data was collected using pretested, structured and self-administered questionnaire S1 File. The collected data was entered in to Epi Data version 3.1 software and analyzed using SPSS version 20. Logistic regression analysis was used to identify association between kindergarten teachers' knowledge and attitudes towards first aid and different variables. Odds ratios with 95% CI and p<0.05 were computed to determine the presence of the association. RESULT: One hundred and ninety-four teachers participated in the study with a response rate of 95%. Only 40% of the teachers were knowledgeable and 75% of them had positive attitude for first aid. Eighty percent of teachers encountered with children in need of first aid. Kindergarten teachers older than 35 years [AOR = 4.2, 95%CI: (1.02, 16.9)], five years' experience [AOR = 3.1, 95%CI: (1.2, 7.6)], having previous first aid training [AOR = 3.1, 95%CI: (1.2, 7.7)], source of first aid information and teachers serving in private kindergarten are associated with having knowledge of first aid. Long time experience, type of kindergarten, previous training, and exposure to children in need of first aid were positive association with attitude towards first aid. CONCLUSION: Low first aid knowledge and high positive attitude among kindergarten teachers. Having long time experience, being older age, previous first aid training, and serving in private kindergarten were positively associated with first aid knowledge and positive attitude. Creating awareness and including first aid courses in the kindergarten teachers' curriculum need to be considered.