Isoniazid Preventive Therapy Uptake and Its Effect on Tuberculosis Incidence Among People Living with HIV in Illubabor and Buno Bedelle Zones, South-West Ethiopia, 2022: A Retrospective Cohort Study.

Introduction: Tuberculosis (TB) remains the leading cause of death among human immune deficiency virus (HIV) patients. Based on the 2020 global TB report, Ethiopia was among the 30 high TB and TB/HIV burden countries. This study filled gaps regarding IPT uptake in the study area and representative sample determination for assessing TB incidence and its predictors at public health facilities in Illubabor and Buno Bedelle zones, south-west Ethiopia. Methods: This retrospective cohort study was conducted among people living with HIV (PLHIV) who were on antiretroviral therapy (ART) at public health facilities in Illubabor and Buno Bedelle zones, south-west Ethiopia. Both isoniazid preventive therapy (IPT) exposed and unexposed PLHIV were followed from the date of ART initiation until the date of TB diagnosis of the most recent visit prior to the end of follow-up. The Cox proportional hazard model was employed to identify variables that predicted the incidence of TB at a P value of <0.05. Results: Data were collected on 421 PLHIV, with a response rate of 97.4%. The median (interquartile range (IQR)) age of the study participants was 32 (28-40) year. The incidence rate of pulmonary TB was 3.1 per 1000 person-months (95% CI: 2.4-3.9). The incidence rate of TB among IPT-exposed PLHIV was 1.45 per 1000 person-months, but it was 6.2 per 1000 person-months in the unexposed group. Patient's residence, IPT exposure, baseline ART adherence, baseline hemoglobin level, baseline CD4+ cell, recent hemoglobin level, recent CD4+ cell, recent BMI, and recent WHO HIV clinical stage were independently associated with the incidence of TB. Conclusion: Healthcare professionals working in ART clinics should routinely assess HIV-positive individuals for changes in clinical indicators and environmental exposures like living conditions, which will help HIV-positive individuals in reducing their risk for TB. Likewise, patients attending ART clinics should receive counseling on a regular basis.

Intention to Use Maternal Waiting Homes and Related Factors among Pregnant Women in Metu Woreda, Western Ethiopia.

Background: Maternity Waiting Homes are houses built in the healthcare settings that lodge pregnant women in their term state of pregnancy to prevent labor and delivery-related complication. This study aimed to estimate the extent of pregnant women's intention to use Maternal Waiting Homes and identify its associated factors in Metu Woreda, Western Ethiopia. Methods: A community-based cross-sectional study was conducted from March 1-30, 2018. We used a systematic sampling method to select the study participants and Binary logistic regression analysis was used to identify factors associated with the intention of the women to use Maternal Waiting Homes. Results: A total of (97%) of respondents' questionnaires were found complete and analyzed for this study. Almost half (48.8%) of the pregnant women who participated in the study were planned to use Maternal Waiting Homes in their prospective delivery. Based on multivariate logistic regression analysis; being illiterate and/or less educated in their educational status, having a history of using Maternal Waiting homes, and receiving a number of times antenatal care services were found statistically significantly associated with intention of the women to use Maternal Waiting Homes. Conclusions: It is trivial that more than half of the pregnant women who participated in the study were unintended to use Maternal Waiting Homes. Educational status, a number of times attending antenatal care services and experience of using Maternal Waiting Homes were found statistically significantly associated with women's intention to use Maternal Waiting Homes.

Respectful maternity care during facility-based child birth and associated factors in public health facilities of Ilu AbaBor zone, Southwest Ethiopia.

BACKGROUND: Current data suggest that far more women around the world are exposed to abuse by health care providers while receiving maternity care. This predisposes them to psychological distress; abstain from accessing health facilities for care and end up with avoidable death and disability. OBJECTIVE: To assess the level of respectful care during delivery among mothers giving birth in public health facilities in Ilu AbaBor, Southwest Ethiopia, 2019. MATERIALS AND METHODS: An institution-based cross-sectional study was conducted among 285 randomly selected mothers in the post-natal ward from 17 health facilities in 2019. Data were collected through interviewer-administered pre-tested questionnaires. The collected data were entered into Epi-data version 3.1 statistical and analyzed by SPSS version 21. Both bivariable and multivariable logistic regression models were employed. RESULTS: The proportion of respectful care during maternity care in health care institutions of Ilu Ababor zone was 47.3%. In the multivariable logistic regression; age (AOR 0.25, 95% CI 0.08, 0.81), occupation (AOR 4.16: (1.34, 12.9)), planned pregnancy (AOR 0.28: (0.12, 0.67)), mode of delivery (AOR 0.05: (0.01, 0.33)), and receiving care from providers who had a compassionate and respectful care training (AOR 0.13: (0.06, 0.25)) were independent predictors of respectful care. CONCLUSIONS: The proportion of respectful care of the health institution in the Ilu Ababor zone was low compared to the other studies. Variables like; age, occupational status, pregnancy plan, mode of delivery, facing complications during labor and delivery, and taking compassionate and respectful care training were independent predictors of respectful maternity care. This study recommended that the responsible stakeholders should strengthen monitoring and evaluation of the practice and mainstreaming of respectful maternity care, give training for health professionals, and develop guidelines used to monitor, report, and track barriers to the practice of maternity care.

Respect during maternity care advocates that females' experiences of delivering are a crucial part of service standard: autonomy, dignity, feelings, choices, and preferences must be valued. If a facility is not providing care properly, it affects utilization of maternity services and their satisfaction is also affected by the way they are treated.Two hundred eighty-one (281) post-natal women participated in this research, giving a 98.5% response rate. Most (34.2%) of mothers were in the age category of 25 to 29 years, attained at least primary education (40.9%) while most (87.2%) of them are married, housewives (32%) in occupation, Oromo (66.9%) in ethnicity with a monthly income of less than 1200 ETB (52.3%) and urban (51.2%) residents.In conclusion, the proportion of respectful care at the health institution of Ilu Ababor zone is 47.3%, which is low. Age, occupational status, pregnancy plan, mode of delivery, facing complications during labor and delivery, and taking respectful care training were independent predictors of respectful care at the health facilities. This study recommended that the responsible stakeholders should strengthen monitoring and evaluation of the practice and mainstreaming of respectful maternity care, give training for health professionals, and develop guidelines used to monitor, report, and track barriers to the practice of maternity care.

Nutritional practice of pregnant women in Buno Bedele zone, Ethiopia: a community based cross-sectional study.

BACKGROUND: Worthy health and welfare is part of the goals set by united nation. Dietary practice is visible activities or conducts of eating habit performed by a person. Poor maternal nutrition during pregnancy were associated with higher risk of having a preterm labour, low birth-weight, Intrauterine growth restrictions and facing threats to their own wellbeing and survival. OBJECTIVE: To assess the nutritional practice of pregnant women in Buno Bedele zone. METHODS: A community-based cross-sectional study design was deployed to conduct this study from November 1-30, 2019 in the Buno Bedele zone, Ethiopia. The study included 592 pregnant women and a proportional sample of the size of the population was allocated to each 32 kebeles. A structured interviewer administered pretested tool was utilized for data collection. Data entry was conducted using EPI-data version 3.4 and cleaned, edited and analyzed using the SPSS version 24.0. The data were presented in the form of text, frequencies, tables and figures while logistic regression was used to discover the association between dependent and independent variables. RESULT: This study found that about 185 (31.2%) pregnant mothers had good dietary practice. The mothers' educational status (AOR = 1.33, 95% CI 0.34, 2.08), income (AOR = 5.7, 95% CI, 5.1, 6.65), dietary knowledge (AOR = 3.03, 95% CI 1.98, 4.18) and pregnancy intervals (AOR = 4.16 95% CI 2.74, 6.49) were factors found to be affecting the nutritional practices of pregnant women. CONCLUSION AND RECOMMENDATION: Only 31.2% of pregnant women had good dietary practice. This indicated that the majority of study participants had a poor dietary practice, which is a concern because having poor dietary practice contributes to maternal and neonatal mortality and morbidity. To increase their nutrition practices to have a healthy pregnancy. We need to focus on; nutrition education on basic nutrients, community mobilization on dietary practices using media, work on barriers, and advocating nutrition practice activities.

Worthy health and welfare is part of the goals set by united nation. Dietary practice is visible activities or conducts of eating habit performed by a person. To have healthy and appropriate working of the body, eating balanced diet is very crucial. This study found that about 185 (31.2%) pregnant mothers had good dietary practice. The mothers' educational status, income, dietary knowledge and pregnancy intervals were factors found to be affecting the nutritional practices of pregnant women. The finding indicated that the majority of study participants had a poor dietary practice, which is a concern because having poor dietary practice contributes to maternal and neonatal mortality and morbidity. To avert the problem this results healthy pregnancy. We need to focus on; nutrition education on basic nutrients, community mobilization on a diet using media, work on barriers and advocating nutrition practice.

Unintended Pregnancy and Associated Factors Among HIV Positive Women in Ilu Aba Bora zone, South Western Ethiopia: A Facility-Based Cross-Sectional Study.

BACKGROUND: Unintended pregnancy reflects the existence of unprotected sex. Understanding factors associated with unintended pregnancy among HIV-positive women is very important to design strategies for the prevention of further transmission and infection with the virus. However, there is scarce information in this regard. Given the degree of HIV prevalence among women and the current antiretroviral therapy scale up in Ethiopia, it is important to understand factors associated with un-intended pregnancy in order to prevent mother to child HIV transmission (MTCT). METHODS: An institution-based cross-sectional study design was employed. The sample size was 353; all HIV/AIDS sero-positive reproductive age group (15-49) women having any pregnancy history after their diagnosis and having started HAART were included and simple random sampling was used to select study participants. Data collection period was from March 9 to April 13, 2019. RESULTS: The prevalence of unintended pregnancy among the participants was 40.9%. In the multivariate logistic regression, unemployment (AOR, 3.36; 95% CI: 1.55-7.26), not being knowledgeable on MTCT and prevention of MTCT (PMTCT) (AOR, 3.18; 95% CI: 1.92-5.24), and having had no discussion on reproductive health issues (AOR, 1.83; 95% CI: 1.09-3.07) are factors significantly associated with unintended pregnancy occurrence among HIV-positive women on antiretroviral therapy. CONCLUSION AND RECOMMENDATION: The prevalence of unintended pregnancy among the women in the study is high. To avoid unintended pregnancies, HIV-infected women need access to effective family planning services and risk reduction discussions during routine care visits.