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.

Symptoms of posttraumatic stress, anxiety, and depression, along with their associated factors, among Eritrean refugees in Dabat town, northwest Ethiopia, 2023.

BACKGROUND: Refugee populations are forcibly displaced from their homes as a consequence of natural disasters and armed conflicts. Eritreans, initially displaced to the Maiayni camp within the Tigray region, have faced further relocation to Dabat town due to the conflict between the Tigray People Liberation Front (TPLF) and Ethiopian government forces. Subsequently, another conflict has arisen between the Amhara Popular Force (Fano) and Ethiopian government forces in Dabat town, disrupting its stability. These collective challenges in the new environment may contribute to the development of symptoms such as posttraumatic stress disorder (PTSD), anxiety, and depression. Currently, there is a lack of available data on these symptoms and their associated variables in Dabat Town. Thus, the objective of this study was to assess the prevalence of PTSD, anxiety, and depression symptoms, along with associated factors, among Eritrean refugees in Dabat town, northwest Ethiopia. This will provide significant evidence for developing and implementing mental health intervention strategies that specifically address the particular difficulties faced by refugees. METHOD: A community-based cross-sectional study was carried out from July 25 to September 30, 2023, in the Eritrean refugee camp in Dabat town. A systematic random sampling method was employed to select a total of 399 Eritrean refugees with 100 response rate. Data were collected using the standard validated Depression, Anxiety, and Stress Scale (DASS-21) questionnaire, which included socio-demographic characteristics. Summary statistics such as frequency and proportion were utilized to present the data in tables and figures. Binary logistic regression was employed to identify associated factors, and variables with a p-value (p ≤ 0.05) were considered statistically significant factors. RESULT: The findings of this study indicated that 45% (95% CI: 35.6-48.23), 33.6% (95% CI: 31.66-37.45), and 37.3% (95% CI: 35.56-40.34) of the participants had symptoms of depression, anxiety, and PTSD, respectively. Sex, age, employment status, lack of food or water, experience of torture or beating, and imprisonment emerged as statistically significant predictors of depression. Employment status, murder of family or friends, rape or sexual abuse, torture or beating, and lack of housing or shelter were statistically significantly associated with anxiety. PTSD was found to be significantly associated with sex, length of stay at the refugee camp, lack of housing, shelter, food, or water, experience of rape or sexual abuse, abduction, employment status, and murder of family or friends. CONCLUSIONS AND RECOMMENDATION: The results of this study revealed that more than one-third of Eritreans living in the refugee camp in Dabat town had symptoms of PTSD, anxiety, and depression. This prevalence is higher than the previously reported studies. Various factors, including age, gender, monthly income, unemployment, experiences of rape or sexual abuse, witnessing the murder of family or friends, being torched or beaten, imprisonment, and deprivation of basic needs such as food, shelter, and water, were identified as contributors to the development of depression, anxiety, and PTSD. This research underscores the need for both governmental and non-governmental organizations to secure the provision of essential necessities such as food, clean water, shelter, clothing, and education. This study also suggested that Eritrean refugees be legally protected from rape, sexual abuse, arson, detention without cause, and kidnapping. Moreover, the study calls for health service providers to develop a mental health intervention plan and implement strategies to deliver mental health services at healthcare facilities for Eritrean refugees in the Dabat town Eritrean refugee camp.

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.

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.

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.

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.

Measles second dose vaccine utilization and associated factors among children aged 24-35 months in Sub-Saharan Africa, a multi-level analysis from recent DHS surveys.

BACKGROUND: Although a safe and effective vaccine is available, measles remains an important cause of mortality and morbidity among young children in Sub-Saharan Africa (SSA). The WHO and UNICEF recommended measles-containing vaccine dose 2 (MCV2) in addition to measles-containing vaccine dose 1 (MCV1) through routine services strategies. Many factors could contribute to the routine dose of MCV2 coverage remaining far below targets in many countries of this region. This study aimed to assess the prevalence of MCV2 utilization among children aged 24-35 months and analyze factors associated with it by using recent nationally representative surveys of SSA countries. METHODS: Secondary data analysis was done based on recent Demographic and Health Surveys (DHS) data from eight Sub-Saharan African countries. In this region, only eight countries have a record of routine doses of measles-containing vaccine dose 2 in their DHS dataset. The multilevel binary logistic regression model was fitted to identify significantly associated factors. Variables were extracted from each of the eight country's KR files. 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 measles-containing vaccine dose 2 utilization. RESULT: The pooled prevalence of MCV2 utilization in SSA was 44.77% (95% CI: 27.10-62.43%). In the multilevel analysis, mothers aged 25-34 years [AOR = 1.15,95% CI (1.05-1.26), mothers aged 35 years and above [AOR = 1.26, 95% CI (1.14-1.41)], maternal secondary education and above [AOR = 1.27, 95% CI (1.13-1.43)], not big problem to access health facilities [AOR = 1.21, 95% CI (1.12-1.31)], four and above ANC visit [AOR = 2.75, 95% CI (2.35-3.24)], PNC visit [AOR = 1.13, 95% CI (1.04-1.23)], health facility delivery [AOR = 2.24, 95% CI (2.04-2.46)], were positively associated with MCV2 utilization. In contrast, multiple twin [AOR = 0.70, 95% CI (0.53-0.95)], rural residence [AOR = 0.69, 95% CI (0.57-0.82)] and high community poverty [AOR = 0.66, 95% CI (0.54-0.80)] were found to be negatively associated with MCV2 utilization. CONCLUSIONS AND RECOMMENDATIONS: Measles-containing vaccine doses 2 utilization in Sub-Saharan Africa was relatively low. Individual-level factors and community-level factors were significantly associated with low measles-containing vaccine dose 2 utilization. The MCV2 utilization could be improved through public health intervention by targeting rural residents, children of uneducated mothers, economically poor women, and other significant factors this study revealed.

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.

Knowledge of intensive care nurses' towards prevention of ventilator-associated pneumonia in North West Ethiopia referral hospitals, 2021: A multicenter, cross-sectional study.

Introduction: Ventilator-associated pneumonia is a common nosocomial infection that occurs in critically ill patients who are on intubation and mechanical ventilation. Nurses' lack of knowledge may be a barrier to adherence to evidence-based guidelines for preventing ventilator-associated pneumonia. This study aimed to assess the knowledge of intensive care nurses' towards the prevention of ventilator-associated pneumonia. Methods: A multicenter cross-sectional study was conducted among nurses working in the intensive care unit from April to July 2021. A pre-tested and structured questionnaire was used to collect data. All intensive care nurses working in the study area were included in the study. Data was entered into Epi-data 4.1 version (EpiData Association, Denmark) and transferred to STATA version 14 (College Station, Texas 77845-4512 USA) statistical software for analysis. Both bi-variable and multivariable binary logistic regression analysis was used to identify factors associated with knowledge of intensive care unit nurse. Variables with a p-value less than <0.2 in the bi-variable analysis were fitted into the multivariable logistic regression analysis. Both Crude and Adjusted Odds Ratio with the corresponding 95% Confidence Interval was calculated to show the strength of association. In multivariable analysis, variables with a p-value of <0.05 were considered statistically significant. Result: A total of 213 intensive care nurses were included in the study, with a response rate of 204(95.77%). The mean knowledge score of intensive care nurses regarding the prevention of ventilator-associated pneumonia out of 20 questions is (10.1 ± 2.41). There are 98 (48.04%) of the participants have been found to have good knowledge and 106 (51.96%) of them are rendered poor knowledge about the overall knowledge related to the prevention of ventilator-associated pneumonia. Higher academic qualifications and taking intensive care unit training were significantly associated with good knowledge of ventilator-associated pneumonia prevention in multi-variable logistic regression. Conclusion: Our study indicates that the knowledge of intensive care nurses about ventilator-associated pneumonia prevention is not sufficient. Higher academic qualifications and taking intensive care unit training are significantly associated with a good level of knowledge. Therefore it shows the necessity for thorough training and education.

Cognitive impairment and associated factors among mature and older adults living in the community of Gondar town, Ethiopia, 2020.

Cognitive impairment and dementia are age-related major public health concerns in the elderly population. It is a major cause of disability, dependency, and poor quality of life. However, in Ethiopia, the magnitude of this cognitive impairment among the elderly community was not investigated. Hence, this study sought to determine the prevalence of cognitive impairment and associated factors among mature and older adults living in the community of Gondar town, Ethiopia, in 2020. A community-based cross-sectional study was conducted at Gondar town, from February 20 to April 30, 2020. Using a single-stage cluster sampling technique, 403 study participants were recruited. Data was collected by a pretested interviewer-administered structured questionnaire which consisting of sociodemographic variables, the Oslo Social Support Scale, and a Standardized Mini-mental State Examination (SMMSE) tool. Epi data version 3.0 was used to enter coded data and then exported into STATA 14 for analysis. Variables with a p-value < 0.25 in the bi-variable logistic regression were included in the multivariable regression. From multivariable logistic regression, variables having a p-value ≤ 0.05 were declared as statistically significant variables. In this study, a total of 403 study participants were involved, and 393 (97.5%) of them completed the survey. Among older participants screened for cognitive impairment, 43.8% was positive for cognitive impairment with a 95% CI (38.8-48.7%). The majority of the participants were (57.5%) male and (44.8%) aged over 60 years. After adjustment, the variables associated with cognitive impairment were age ≥ 75 years [odds ratio (OR) = 7.03, 95% CI 2.78-17.77] and between 61 and 74 years [OR = 3.18, 95% CI 1.81-5.59], and unable to read and write [OR = 5.05, 95% CI 2.04-12.50], low income level [OR = 2.60, 95% CI 1.26-5.20], being female [OR = 2.52, 95% CI 1.50-4.26], poor social support [OR = 2.50, 95% CI 1.30-4.81], and rural residence [OR = 2.39, 95% CI 1.26-4.51]. The prevalence of older participants who screened positively for cognitive impairment was high at Gondar town. The independent predictors of cognitive impairment among older individuals were older age, being unable to read and write, being female, low income, poor social support, and rural dwelling. Therefore, routine screening and social support, as well as free healthcare services for the mature and older community, are needed. Moreover, we strongly recommend the next researcher to use a diagnosis tool to estimate the actual prevalence of the problems among older people.

Spatial distribution and determinants of bottle feeding among children 0-23 months in Ethiopia: spatial and multi-level analysis based on 2016 EDHS.

BACKGROUND: Bottle feeding is associated with diarrheal disease morbidity and mortality and risk of pyloric stenosis, especially in developing countries. Even though, World Health Organization (WHO) recommended avoiding bottle feeding among children, still higher magnitude was reported in developing countries. This study aimed to assess the spatial distribution and determinants of bottle feeding among children 0-23 months in Ethiopia. METHODS: This study was conducted based on Ethiopian Demographic and Health Surveys data (EDHS). The data were weighted using sampling weight for probability sampling and non-response to restore the representativeness of the data and get valid statistical estimates. Then a total of 4,275 weighted samples of under two years children were used to investigate the study. The data were cleaned using MS excel and extracted and analyzed using STATA V.16 software. A multilevel binary logistic regression model was fitted. P-value < 0.05 was taken to declare statistical significance. A spatial analysis was done using ArcGIS and SaTScan software. RESULTS: The prevalence of bottle feeding practice among under two years children in Ethiopia were 13.5% (95%CI: 11.16, 15.29) and ranges from the lowest 5.16% (95% CI: 3.28, 78.73) Amhara region to the highest 55.98% (95% CI: 47.98, 61.46) Addis Ababa region. Women with secondary and above education status [AOR=2.49; 95%CI; 1.66, 3.74], women from richest household [AOR=1.33; 95%CI; 1.01, 1.78], child 12-23 months age [AOR= 1.59; 95%CI; 1.23, 2.05], multiple birth [AOR=4.30; 95%CI; 1.88, 9.84], rural residence [AOR=0.49; 95%CI; 0.16, 0.82] and large central region [AOR= 0.15; 95%CI; 0.08, 0.27] have significantly associated with bottle feeding. Addis Ababa, Central Oromia, Dire Dewa, Somali and Harari regions were the hot spot areas for bottle feeding practice among under two years children. CONCLUSION AND RECOMMENDATIONS: The prevalence of bottle feeding practices in Ethiopia is relatively moderate. Maternal education, wealth index, child age, multiple births, residence and region were significant predictors of bottle feeding. These findings highlight that, the Ministry of Health Ethiopia (MOH), policymakers, and other stakeholders had better give prior attention to preventable factors such as empowering women, enhancing household wealth status to decreasing bottle feeding practice in Ethiopia.

Predictors of dream enactment behavior among medical students: The case of the University of Gondar, Ethiopia.

INTRODUCTION: Dream enactment behavior is one of the features of rapid eye movement sleep behavior disorder. It might be a manifestation of neurodegenerative diseases and can lead to fall associated injuries. There is no evidence of dream enactment behavior and its associated factors in Ethiopia. Hence, this study targeted to pinpoint the predictors of dream enactment behavior among Medical students at the University of Gondar. METHODS: The cross-sectional survey was carried out at the University of Gondar among Medical students selected by simple random sampling technique from Dec 2020 to Feb 2021. We used a structured pretested questionnaire to collect the data and dream enactment behavior was evaluated using rapid eye movement sleep behavior disorder single question. Descriptive statistics were computed, and determinant factors were identified using binary logistic regression model. In the final model, explanatory variables with a p<0.05 were considered as predictors (statistically significant) of the dream enactment behavior. The strength of association was determined using adjusted odds ratio (AOR) with its 95% CI. RESULTS: Four-hundred and twelve students took part in the study with 97.4% response rate. The mean age of participants was 20.82(±1.88) years and 291(70.63%) were males. The prevalence of dream enactment was 34.47% (95% CI: 30.02-39.20). Daytime sleepiness score (AOR = 1.104; 95% CI: 1.053-1.160), age (AOR = 1.15; 95% CI: 1.019-1.290), monthly pocket money (AOR = 0.9991; 95% CI: 0.9985-0.9997), alcohol drink (AOR = 2.71; 95% CI: 1.076-6.846), and perceived stress (AOR = 3.854; 95% CI: 1.802-8.242) were statistically significant factors of dream enactment behavior. CONCLUSIONS: In this study, the magnitude of dream enactment behavior was high which was significantly associated with daytime sleepiness score, age, monthly pocket money, alcohol drink, and perceived stress all of which are modifiable except age. The University of Gondar has to plan a strategy to avert the condition via the prevention of the determinant factors. Students need to reduce stress and avoid alcohol drink. We strongly urge forthcoming scholars to ascertain association of dream enactment and academic performance of university students.

Myopia and its associated factors among pregnant women at health institutions in Gondar District, Northwest Ethiopia: A multi-center cross-sectional study.

Background: Myopia is the most common form of uncorrected refractive error with a growing burden worldwide. It is the principal complaint of most women during pregnancy. Although myopia has led to several consequences across the standard life of pregnant women, there is no previous study in Ethiopia regarding this topic. Thus, this study determined the prevalence of myopia and identifies its associated factors among pregnant women attending antenatal care units at governmental health institutions in Gondar City District, Northwest Ethiopia. Methods: An institution-based cross-sectional study design was conducted from 08 February to 08 April 2021. From the selected health centres, study participants were recruited by systematic random sampling technique. A pre-tested, structured-interviewer-administered questionnaire consisting of socio-demographic variables, obstetric and clinical-related variables was used to collect the required data. Non-cycloplegic refraction was performed using trial lenses, trial frames, and retinoscopy in a semi-dark examination room. EpiData 3 and STATA 14 were used for data entry and statistical analysis respectively. Both bivariable and multivariable binary logistic regression analyses were executed to identify associated factors of myopia. Variables with a p-value ≤0.05 in the multivariable logistic regression analysis were declared as statistically significant with myopia. Model fitness was checked by Hosmer and Lemeshow goodness of test (at p > 0.05). Results: A total of four-hundred and twenty-three pregnant women participated with a 100% response rate in this study. The overall prevalence of myopia among pregnant women was 26.48% (95% CI: 22.48-30.91). Eighty-Eight (20.81%) and Eighty-Four (19.85%) of the study participants had myopia in their right and left eyes respectively. The prevalence of myopia was significantly associated with age (AOR = 1.17; 95% CI: 1.09-1.28), the third trimester of gestation (AOR = 2.05, 95% CI: 1.08-3.90), multi & grand multipara (AOR = 3.15; 95% CI: 1.59-6.25), and history of contraceptive use (AOR = 3.30; 95% CI: 1. 50-7.28). Conclusion: The finding of our study shows that there is a higher prevalence of myopia among pregnant women in our study area. Further prospective analytical studies regarding visual systems among pregnant women, particularly as a result of pregnancy, are strongly recommended.

Visual impairment and associated factors among pregnant women attending antenatal care units at health institutions in Gondar City Administration, Northwest Ethiopia.

BACKGROUND: Visual impairment is a major public health concern among women of reproductive age groups in Ethiopia, which is getting worse during pregnancy. Though visual impairment has lots of serious consequences across the life course of pregnant women, there is no previous study on this topic in Ethiopia. Thus, this study determined the prevalence of visual impairment and identified associated factors among pregnant women attending antenatal care units at the governmental health institutions in Gondar City Administration, Northwest Ethiopia. METHODS: An institution-based cross-sectional study was conducted. A systematic random sampling technique was used to recruit the study participants. We used an interviewer-administered questionnaire comprising of socio-demographic, clinical and pregnancy-related variables to collect the required data. Snellen's illiterate "E" chart was used to determine visual impairment. EpiData 3 and Stata 14 were used for data entry and statistical analysis, respectively. Both bivariable and multivariable binary logistic regression analyses were executed to identify associated factors of visual impairment. Variables with a p-value ≤0.05 in the multivariable logistic regression analysis were declared as statistically significant with visual impairment. RESULTS: A total of 417 (response rate = 98.6%) participants were involved in this study, with a median age of 27 years. The overall prevalence of visual impairment was 22.5% (95% CI: 18.5-26.6). Thirty (7.2%) and thirty-two (7.7%) of the study participants had moderate to severe visual impairments in their right and left eyes, respectively. Participants aged from 31 to 49 years (AOR = 2.1; 95% CI: 1.1-4.0), being 3rd trimester (AOR = 2.4; 95% CI: 1.3-4.5), multi & grand multipara (AOR = 2.3; 95% CI: 1.2-4.6), and history of contraceptive use (AOR = 2.7; 95% CI: 1.2-6.3) had higher chance of visual impairment. CONCLUSION: The magnitude of visual impairment among pregnant women was high in the study area. Therefore, routine screening and evaluation of pregnant women for visual condition during antenatal care visits is recommended. Further investigations of visual changes, particularly as a result of pregnancy, are warranted.