Abnormal uterine bleeding and its associated factors among reproductive-age women who visit the gynecology ward in Dilla University General Hospital, Southern Ethiopia, 2022.

BACKGROUND: Abnormal uterine bleeding, a frequent gynecological problem among women of reproductive age, significantly affects their health and quality of life. Despite its problem, research on its extent and contributing factors in Ethiopia is scarce. Hence, this study is designed to determine the magnitude and factors associated with abnormal uterine bleeding among women visiting Dilla University General Hospital, Dilla, Ethiopia. METHODS: A cross-sectional study design was conducted with 380 women of reproductive age at Dilla University General Hospital. A systematic sampling method was employed to select the participants for the study. A structured interview administered questionnaire and checklist were used to collect the data. Stata V.14 software was used for cleaning, coding, ensuring completeness and accuracy, and further analysis. Bivariate and multivariable logistic regression analyses were used. Finally, the variables that have a p-value of < 0.05 were considered statistically significant. RESULTS: In this study, the magnitude of abnormal uterine bleeding was 24.21% (95% CI, 20.14-28.79). History of sexually transmitted disease [AOR = 1.44, 95% CI: (1.33, 4.75)], history of anemia [AOR = 3.92, 95% CI: (1.20, 12.74)]., history of alcohol consumption [AOR = 2.49, 95% CI: (1.22, 5.06)], and perceived stress level [AOR = 1.30, 95% CI: (1.15, 1.69)] were found to be significantly associated with abnormal uterine bleeding. CONCLUSIONS: The magnitude of abnormal uterine bleeding was 24.2% in the study setting. Factors such as a history of sexually transmitted disease, anemia, alcohol consumption, and perceived stress level were identified as significant risk factors for abnormal uterine bleeding. Addressing these factors is crucial for management. Further research and interventions targeting these risks are needed to enhance health outcomes. The study provides valuable insights for future interventions.

Obstetric fistula repair failure and its associated factors among women who underwent repair in sub-Saharan Africa. A systematic review and meta-analysis.

BACKGROUND: Obstetric fistula repair failure can result in increased depression, social isolation, financial burden for the woman, and fistula care programs. However, there is limited, comprehensive evidence on obstetric fistula repair failure in Sub-Saharan African countries. This systematic review and meta-analysis aimed to determine the pooled prevalence of obstetric fistula repair failure and associated factors among women who underwent surgical repair in Sub-Saharan African countries. METHODS: To identify potential articles, a systematic search was done utilizing online databases (PubMed, Hinari, and Google Scholar). The Preferred Reporting Items for Systematic Review and Meta-Analysis Statement (PRISMA) guideline was used to report the review's findings. I2 test statistics were employed to examine study heterogeneity. A random-effects model was used to assess the pooled prevalence of obstetric fistula repair failure, and the association was determined using the log odds ratio. Publication bias was investigated using the funnel plot and Egger's statistical test at the 5% level of significance. Meta-regression and subgroup analysis were done to identify potential sources of heterogeneity. The data were analyzed using STATA version 17 statistical software. RESULTS: A total of 24 articles with 9866 study participants from 13 Sub-Saharan African countries were included in this meta-analysis. The pooled prevalence of obstetric fistula repair failure in sub-Saharan Africa was 24.92% [95% CI: 20.34-29.50%]. The sub-group analysis by country revealed that the highest prevalence was in Angola (58%, 95% CI: 53.20-62.80%) and the lowest in Rwanda (13.9, 95% CI: 9.79-18.01%). Total urethral damage [OR = 3.50, 95% CI: 2.09, 4.91], large fistula [OR = 3.09, 95% CI: (2.00, 4.10)], duration of labor [OR = 0.45, 95% CI: 0.27, 0.76], and previous fistula repair [OR = 2.70, 95% CI: 1.94, 3.45] were factors associated with obstetric fistula repair failure. CONCLUSION: Women who received surgical treatment for obstetric fistulas in Sub-Saharan African countries experienced more repair failures than the WHO standards. Obstetric fistula repair failure was affected by urethral damage, fistula size, duration of labor, types of fistula, and history of previous repairs. Therefore, we suggest policy measures specific to each country to provide special attention to the prevention of all risk factors, including poor nutrition, multiparty, obstructed labor, and maternal age, which can result in conditions like large fistulas, urethral damage, and repeat repair, in order to reduce obstetric fistula repair failure.

Willingness to pay for Social Health Insurance and associated factors among Public Civil Servants in Ethiopia: A systematic review and meta-analysis.

BACKGROUND: The provision of equitable and accessible healthcare is one of the goals of universal health coverage. However, due to high out-of-pocket payments, people in the world lack sufficient health services, especially in developing countries. Thus, many low and middle-income countries introduced different prepayment mechanisms to reduce large out-of-pocket payments and overcome financial barriers to accessing health care. Though many studies were conducted on willingness to pay for social health insurance in Ethiopia, there is no aggregated data at the national level. Therefore, this systematic review and meta-analysis aimed to estimate the pooled magnitude of willingness to pay for social health insurance and its associated factors among public servants in Ethiopia. METHOD: Studies conducted before June 1, 2022, were retrieved from electronic databases (PubMed/Medline, Science Direct, African Journals Online, Google Scholar, and Web of Science) as well as from Universities' digital repositories. Data were extracted using a data extraction format prepared in Microsoft Excel and the analysis was performed using STATA 16 statistical software. The quality of the included studies was assessed using the Newcastle-Ottawa Scale for cross-sectional studies. To evaluate publication bias, a funnel plot, and Egger's regression test were utilized. The study's heterogeneity was determined using Cochrane Q test statistics and the I2 test. To determine the pooled effect size, odds ratio, and 95% confidence intervals across studies, the DerSimonian and Laird random-effects model was used. Subgroup analysis was conducted by region, sample size, and publication year. The influence of a single study on the whole estimate was determined via sensitivity analysis. RESULT: To estimate the pooled magnitude of willingness to pay for the Social Health insurance scheme in Ethiopia, twenty articles with a total of 8744 participants were included in the review. The pooled magnitude of willingness to pay for Social Health Insurance in Ethiopia was 49.62% (95% CI: 36.41-62.82). Monthly salary (OR = 6.52; 95% CI:3.67,11.58), having the degree and above educational status (OR = 5.52; 95%CI:4.42,7.17), large family size(OR = 3.69; 95% CI:1.10,12.36), having the difficulty of paying the bill(OR = 3.24; 95%CI: 1.51, 6.96), good quality of services(OR = 4.20; 95%CI:1.97, 8.95), having favourable attitude (OR = 5.28; 95%CI:1.45, 19.18) and awareness of social health insurance scheme (OR = 3.09;95% CI:2.12,4.48) were statistically associated with willingness to pay for Social health insurance scheme. CONCLUSIONS: In this review, the magnitude of willingness to pay for Social Health insurance was low among public Civil servants in Ethiopia. Willingness to pay for Social Health Insurance was significantly associated with monthly salary, educational status, family size, the difficulty of paying medical bills, quality of healthcare services, awareness, and attitude towards the Social Health Insurance program. Hence, it's recommended to conduct awareness creation through on-the-job training about Social Health Insurance benefit packages and principles to improve the willingness to pay among public servants.

Nutritional outcomes of therapeutic feeding program and its predictors among undernourished adult HIV positive patients at healthcare facilities of West Guji Zone, Southern Ethiopia: A retrospective cohort study.

BACKGROUND: For those living with HIV/AIDS, malnutrition is a significant issue everywhere, but it is particularly prevalent in Sub-Saharan Africa. A nutritional support program is becoming a more and more common strategy to prevent malnutrition in HIV-positive persons. Thus, this study aimed to assess nutritional treatment outcomes and their predictors among adult HIV-positive undernourished individuals in West Guji Zone healthcare facilities. METHOD: A facility-based retrospective cohort study was conducted among 348 randomly selected adult HIV- positive patients in the West Guji Zone healthcare facilities between January 2018 and December 2022. Data were collected using the data extraction tool. Entered into Epi Data version 3.1 and exported to SPSS version 26 for analysis. The Kaplan-Meier survival curve and log-rank test were used to predict the time to recovery and to compare survival curves across categorical variables. A Cox proportional hazard regression model was fitted to identify an independent predictor of the recovery rate. Statistical significance was declared at a p-value of < 0.05. RESULTS: In the final analysis 348 undernourished HIV-positive persons were included. Based on preset exit criteria, approximately 198, 56.9% of patients enrolled in the RUTF program were able to recovered, with an incidence of 9.83 (95% CI: 3.12, 13.44) per 100 person-month observations. Being divorced (AHR = 0.21; 95% CI: 0.06, 0.69) and being in the WHO advanced stage (AHR = 0.42; 95% CI: 0.23, 0.79) was a negative predictor. Being in the age range of 18-29 and 30-39 and having a working functional status (AHR = 2; 95% CI: 1.25, 3.23) were positive predictors. CONCLUSION: Nutritional recovery in this study lower than WHO Sphere requirements. Age between 18 and 39 and working functional status were good indicators of nutritional recovery, whereas advanced WHO clinical stage and divorced marital status were negative predictors.

Variability and awareness of obstetric fistula among women of reproductive age in sub-Saharan African countries: A systematic review and meta-analysis.

Background: Obstetric fistula among women of reproductive age is a significant public health issue in developing countries, including Sub-Saharan Africa. However, the pooled awareness of obstetric fistula among women of reproductive age in Sub-Saharan Africa and its variation between countries have not yet been studied. Hence, the review aims to assess variability and awareness of obstetric fistula among women of reproductive age in Sub-Saharan African Countries. Method: Articles were searched using different electronic databases, such as PubMed, Web of science, science direct (Scopus), Google scholar, and HINARI and manual search without regard to publication date. A random-effects model was used to ascertain the pooled prevalence of obstetric fistula awareness among women of reproductive age in Sub-Saharan Africa. Publication bias was checked by using funnel plot and Egger's test at a 5% level of significance. I2 test statistics was performed to evaluate heterogeneity among included studies. In addition, to identify the possible reason for the potential heterogeneity between the studies, sub-group and meta-regression analyses were conducted. A sensitivity analysis was performed to determine the impact of individual research on the overall results. The data were extracted by using Microsoft excel and analyzed using statistical software STATA/SE version 17. Result: A total of 22 studies with 79,693 women of reproductive age were included in this systematic review and meta-analyses. In Sub-Saharan Africa, the pooled prevalence of awareness towards obstetric fistula among women of reproductive age was 40.85% (95% CI: 33.48, 48.22%). Analysis of the subgroups by specific countries revealed significant variation. The highest awareness of obstetric fistula was found among Tanzanian women of reproductive age (61.10%, 95% CI: 55.87-66.33%), whereas the lowest awareness was found in research from the Gambia (12.80%, 95% CI: 12.20-13.40%).The likelihood of obstetric fistula awareness were lower by a factor of 0.424 among studies with sample sizes greater than 3542 (ß = -0.424 (95% CI: -0.767 to 0.081), p -value <0.05). Conclusion: According to the current review, there is a low level of awareness about obstetric fistula among women of reproductive age in sub-Saharan Africa, and the results of the sub-group analysis by country showed wide variations. Therefore, we emphasize the need for country-specific public health initiatives to raise awareness about obstetric fistula among women of reproductive age, which could reduce the risk of delayed treatment.

Occupational exposure to dust and respiratory symptoms among Ethiopian factory workers: A systematic review and meta-analysis.

BACKGROUND: Occupational respiratory disorders are a major global public health concern among workers exposed to dust particles in dust-generating workplaces. Despite fragmented research findings on the magnitude of respiratory problems and the lack of a national occupational respiratory disease recording and reporting system at the Ethiopian factory, the prevalence of respiratory symptoms among factory workers were unknown. Therefore, the aim of this meta-analysis was to summarize and pool estimates from studies that reported the prevalence of respiratory symptoms and predictors among Ethiopian factory workers who worked in dusty environments. METHODS: A systematic literature searches were conducted using electronic databases (PubMed, Science Direct, African Journals Online, and Web of Science). The primary and secondary outcomes were prevalence of respiratory symptoms and predictors, respectively. The STATA version 17 was used to analyze the data. A random effect meta-analysis model was used. Eggers test with p-value less than 5%, as well as the funnel plot, were used to assess publication bias. RESULTS: The searches yielded 1596 articles, 15 of which were included in the systematic review and meta-analysis. The pooled prevalence of respiratory symptoms among Ethiopian factory workers was 54.96% [95% confidence interval (CI):49.33-60.59%]. Lack of occupational health and safety (OSH) training [Odds Ratio (OR) = 2.34, 95%CI:1.56-3.52], work experience of over 5 years [OR = 3.19, 95%CI: 1.33-7.65], not using personal protective equipment (PPE) [OR = 1.76, 95%CI:1.30-2.39], and working more than eight hours per day [OR = 1.89, 95%CI:1.16-3.05] were all significant predictors of respiratory symptoms. CONCLUSION: The prevalence of respiratory symptom was found to be high in Ethiopian factory workers. To prevent workers from being exposed to dust, regular provision and monitoring of PPE use, workers OSH training, and adequate ventilation in the workplace should be implemented.

Food taboo practices and associated factors among pregnant women in Ethiopia: a systematic review and meta-analysis.

Food taboos have a negative impact on pregnant women and their fetuses by preventing them from consuming vital foods. Previous research found that pregnant women avoided certain foods during their pregnancy for a variety of reasons. This review aimed to determine the pooled prevalence of food taboo practices and associated factors in Ethiopia. In compliance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline, we searched the literature using PubMed/MEDLINE, AJOL (African Journal Online), HINARI, Science Direct, Google Scholar, and Google electronic databases. The random-effects model was used to estimate the pooled prevalence of food taboo and its determinants at a 95% confidence interval with their respective odds ratios. The pooled food taboo practice among Ethiopian pregnant women was 34.22% (95% CI 25.47-42.96), and after adjustment for publication bias with the trim-and-fill analysis, the pooled food taboo practice of pregnant women was changed to 21.31% (95% CI: 10.85-31.67%). Having less than a secondary education level (OR = 3.57; 95% CI 1.43-8.89), having no ANC follow-up (OR = 4.35; 95% CI 1.12-16.94), and being a rural resident (OR = 3.08; 95% CI 1.14-8.28) were the significant factors. Dairy products, some fruits, green leafy vegetables, meat, and honey are among the taboo foods. The most frequently stated reasons for this taboo practice were: fear of producing a big fetus, which is difficult during delivery; attachment to the fetus's body or head; and fear of fetal abnormality.

Malnutrition among the aged population in Africa: A systematic review, meta-analysis, and meta-regression of studies over the past 20 years.

BACKGROUND: Nowadays, malnutrition among the advanced age (60 years and older) population is becoming a public health problem worldwide, especially in low-income countries including Africa. Hence, the prevalence in Africa is still not known. So, this review aimed to assess the pooled prevalence of under-nutrition among the advanced age population in Africa. METHODS: A study search was carried out using databases (such as African Journals Online, Web of Science, Global Index Medicus, Embess, and PubMed) and gray literature following PRISMA guidelines from April 20, 2022, to May 30, 2022, with no restriction on date of publication. We used a standardized extraction format to compile eligible studies as per the inclusion criteria. Then, systematic review and meta-analysis were employed using a random effect model to obtain the pooled prevalence of malnutrition among aged population living in Africa. The counter-funnel plot and at the 5% significance level, Egger's test and Begg's test were used to check for publication bias. Furthermore, a meta-regression analysis was carried out to identify the relationship between the outcome of interest and different predictors. RESULTS: A total of 731 studies were identified and 28 met the inclusion criteria, which were conducted in 17 African countries. The pooled prevalence of under-nutrition in Africa was 17% (95%CI; 13.5-20.6). The prevalence of malnutrition among the elderly varied significantly across countries, ranging from 1.8% (95% CI; 0.96-2.63) in South Africa to 39.47% (95% CI; 31.70-47.24) in Kenya. According to meta-regression analysis, the likelihood of a malnutrition problem would be reduced by a factor of 9.84 (ß = -9.84, 95 percent CI; _-14.97, -4.70, P = 0.00) in upper-middle income countries. In addition, based on the publication year, malnutrition has decreased by a factor of 0.75 (ß = -0.75, 95%CI:-1.49, -0.01, P = 0.04) from 1998 to 2021. CONCLUSION: There is a high prevalence of malnutrition among the aged population. So, this underserved population should be targeted for intervention programs and/or integrated into maternal and child nutrition programs.

The epidemiology of road traffic accidents and associated factors among drivers in Dilla Town, Southern Ethiopia.

Background: Data on the magnitude of road traffic accidents (RTAs) were mostly obtained through police records and hospital registration data. However, insufficient data reporting masked the gravity of the problem, and little attention was paid to the magnitude and correlation of road traffic accidents from the driver's perspective. Therefore, this study aimed to assess the prevalence of RTA and related factors among drivers. Methods: A community-based cross-sectional study involving 316 drivers was conducted in Southern Ethiopia. The participants were chosen using a systematic random sample technique, and the data were obtained using an interview-administered structured questionnaire. To analyze the data, SPSS software (version 20) was employed. In addition to descriptive statistics, binary logistic regression analysis was also employed to find factors connected to traffic accidents. RTA factors were considered statistically significant if they had a P-value of 0.05 or below in the multivariate analysis. Result: The RTA among drivers was 126 (39.9%) (95% confidence interval (CI): 34.2-45.6%) in the previous year. The following factors were associated with RTA: vehicle maintenance (AOR = 0.11, 95% CI: 0.09, 0.96), media utilization (AOR = 0.38, 95% CI: 0.18, 0.65), participation in driving-related training (AOR = 0.73, 95% CI: 0.28, 0.91), punishment for prior traffic violations (AOR = 0.56, 95% CI: 0.47, 0.83), and risky driving behavior (AOR = 7.89, 95% CI: 3.22, 12.38). Conclusion: Two-fifths of the drivers were involved in a traffic accident. Risky driving behaviors, vehicle maintenance, media usage, attending driving-related training in the previous 2 years, and prior experience with traffic police punishment or warning were all strongly linked to road traffic accidents. In light of these statistics, the Federal Ministry of Transport of Ethiopia and other stakeholders should support making it mandatory for drivers to check their vehicles' safety, provide them with safety training, raise awareness about vehicle maintenance and risky driving behaviors, and enforce strict penalties for traffic violations.

Community-Based Health Insurance Membership Renewal Rate and Associated Factors among Households in Gedeo Zone, Southern Ethiopia.

Background: Community-based health insurance (CBHI) scheme is an emerging strategy to achieve universal health coverage and protect communities in developing countries from catastrophic financial expenditure at the service delivery point. However, high membership discontinuation from the CBHI scheme remained the challenge to progress toward universal financial protection in resource-constrained countries. Therefore, this study assessed the community-based health insurance membership renewal rate and associated factors in the Gedeo zone, Southern Ethiopia. Methods: We conducted a community-based cross-sectional study among households in the Yirga Chafe district, Gedeo zone, Southern Ethiopia, from September 10 to 30, 2021. We used a multistage simple random sampling to recruit 537 respondents. We entered data into Epi-Info 7 and exported it to SPSS version 25 for analysis. We used a logistic regression model to determine factors associated with the CBHI scheme membership renewal. Variables with a P value of <0.05 and a 95% confidence level were considered to be significantly associated with the outcome variable. Results: We found the respondents' CBHI membership renewal rate was 82.68%. Those who enrolled in the CBHI scheme >3years (AOR = 3.12; 95% CI: 1.40-6.97), having illnesses in the last three months (AOR = 2.97; 95% CI: 1.47-5.99), the CBHI premium affordability (AOR = 12.64; 95% CI: 3.25-49.38), good knowledge of the CBHI scheme (AOR = 21.11; 95% CI: 10.63-41.93), perceived quality of health service (AOR = 4.21; 95% CI: 1.52-11.68), and favorable attitude towards the CBHI scheme (AOR = 3.89, 95% CI: 1.67-9.04) were significantly associated with the CBHI program membership renewal rate. Conclusion: In our study, we found the magnitude of CBHI members who discontinued their CBHI scheme membership was high. Besides, we found that the affordability of the CBHI premium, respondents' attitude, and knowledge of the CBHI program were predictor factors for dropout from the CBHI membership. Therefore, the government should consider the economic status of communities during setting the CBHI program contribution. Moreover, awareness creation through health education should be provided to improve participants' knowledge and perception of the CBHI program.

Health-Related Quality of Life and Associated Factors Among Covid-19 Survivors. Experience from Ethiopian Treatment Centers.

Background: The pandemic of the novel coronavirus (Covid-19), which is extremely stressful and has an adverse effect on people's health-related quality of life (HRQoL), poses a serious threat to global public health. As a result, this study evaluated the health-related quality of life and associated factors among Covid-19 patients who were discharged from Ethiopian treatment centers. Methods: We conducted a multi-center, cross-sectional study among 493 Covid-19 survivors who had been discharged from treatment centers between 1st January 2020, and 20th October 2021. We collected respondents' data using validated Amharic version EuroQol 5-dimensional-5 levels (EQ-5D-5L) questionnaire along with medical records of the patients. Differences in HRQOL scores between patient subgroups were tested by Mann-Whitney U or Kruskal-Wallis test, and the multivariable betaMix regression was used to investigate factors associated with HRQOL scores. Results: The EQ-5D and VAS median score for Covid-19 survivors was 0.940 (IQR: 0.783-0.966) and 87 (IQR: 70-91) respectively. Overall, married individuals, old-aged, individuals who had low educational status, high monthly income, comorbidities, admitted to the Intensive care Unit, received intranasal oxygen care, and prolonged hospitalization had lower utility scores and EQ-VAS scores compared to their counterparts. In multivariate betaMix regression, respondents' health status at admission, old age, chronic obstructive pulmonary disease, asthma, and hospital length of stay were significantly associated with the lower EQ-5D-Index value and EQ-VAS score. Conclusion: We found that Covid-19 infection had a persisting impact on the physical and psychosocial health of Covid-19 survivors. Age, having asthma and chronic obstructive pulmonary disease, having a worsening health state upon admission, and a prolonged hospital length of stay were significantly associated with the lower EQ-5D and EQ-VAS score. Therefore, the cost-effective psychological treatment such as cognitive behaviour therapy should be encouraged after hospitalization to improve the post-Covid-19 depression and fatigue.

Is Ethiopian community-based health insurance affordable? Willingness to pay analysis among households in South Central, Ethiopia.

BACKGROUND: Community-based Health Insurance (CBHI) is a voluntary prepayment mechanism that guarantees the provision of basic healthcare services without financial barriers to underserved segments of the population in developing countries. The Government of Ethiopia launched the CBHI program to protect the community from high out-of-pocket health expenditure and improve health service utilization a decade ago. However, to improve the quality of healthcare services delivery in health facilities and cover the changing costs of healthcare, the government should revise the contribution of the CBHI scheme. Therefore, we determined the willingness to pay for a CBHI scheme and associated factors among rural households of Lemu and Bilbilo district, South Central Ethiopia. METHODS: We conducted a community-based cross-sectional study design to assess willingness to pay for the CBHI scheme and its associated factors among households in Lemu and Bilbilo districts, South Central Ethiopia. We used a double bounded contingent valuation method to elicit households' willingness to pay for the CBHI scheme. Data were coded, cleaned, entered into Statistical Package for Social Science (SPSS) version 25, and exported to STATA 16 for analysis. A logistic regression analysis was conducted to determine the presence of statistically significant associations between the willingness to pay for the CBHI scheme and independent variables at a p-value <0.05 and Adjusted odds ratio (AOR) values with 95% CI. Finally, we checked the fitness of the model using Hosmer and Lemeshow's goodness-of-fit test. RESULTS: Of the 476 study participants, 82.9% (95% CI: 79.2%, 86.01%) were willing to pay for the CBHI scheme and only 62% of them can afford the average amount of 358.32ETB ($7.68) per household per annum. Primary education (AOR = 3.17; 95% CI: 1.74-5.80), secondary and above education (AOR = 4.13; 95% CI: 1.86-9.18), large family size (AOR = 2.75; 95% CI: 1.26-5.97), monthly income of 500-1000ETB (AOR = 3.75; 95% CI: 1.97-7.13) and distance to public health facilities (AOR = 2.14, 95% CI: 1.04-4.39 were significantly associated with willingness to pay for the CBHI scheme. CONCLUSION: In this study, around 83% of respondents were willing to pay for the CBHI and meet the government expectation for 2020. The study also revealed that educational status, family size, monthly income, and distance from the health facilities were significant factors associated with WTP for the CBHI scheme. In addition, we found that a large number of the respondents couldn't afford the average amount of money that the participants were willing to pay for the CBHI scheme. So, the government should consider the economic status of the communities while revising the CBHI scheme premium not to miss those who cannot afford the contribution.

Misconceptions About COVID-19 and Associated Factors Among Residents of Dilla Town, Southern Ethiopia.

BACKGROUND: Despite the implementation of various coronavirus disease 2019 (COVID-19) prevention and control strategies, the rate of COVID-19 is alarmingly increasing in Ethiopia as well as worldwide. The success of COVID-19 prevention measures is highly influenced by a lack of knowledge and misconceptions. This study aimed to assess misconceptions about COVID-19 and associated factors among residents of Dilla Town, southern Ethiopia. METHODS: A community-based cross-sectional study was conducted from December 1 to 30, 2020. Data were collected from 415 individuals using structured interviewer-based questionnaires. Logistic regression analyses were used to identify the relationship between the dependent and independent variables. RESULTS: The proportion of respondents who have a high misconception about COVID-19 was 41.1%. Study participants who had poor knowledge were 2.1 (95% confidence interval [CI]: 1.1-3.8) times more likely to have a misconception about COVID-19 than their counterparts. Respondents who had access to information from more than 2 sources were 3.29 (with 95% CI: 1.2-9.2) times less likely to have a misconception about COVID-19 when compared with those who had access to 2 or fewer information sources. CONCLUSIONS: A significant proportion of people have misconceptions about COVID-19 in the study area. To resolve these misconceptions, health sectors and stakeholders need to improve the residents' knowledge by delivering COVID-19-related information from credible sources on a routine basis.

Predictors of Hand-Washing Practices at Critical Times Among Mothers of Under-5 Years Old Children in Rural Setting of Gedeo Zone, Southern Ethiopia.

Background: Various communicable and infectious diseases could be contained by proper hand washing leading to a reduction in mortality and morbidity of children. Objective: To assess predictors of hand-washing practices at critical times among mothers of under 5 years old children in rural setting of Gedeo zone, Southern Ethiopia. Method: An institutional-based cross-sectional survey was conducted among 422 women with children under the age of 5 attended the Dilla Zuria health facility and were chosen using a systematic sampling method. Data was gathered using pre-tested interview-administered structured questionnaires. Data was entered into EPI info version 17 and analyzed using SPSS version 25. Binary logistic regression was employed to identify the association between dependent and independent variables. Finally, for variables with a P < .05 in multivariable analysis, adjusted odds ratio (AOR) with a 95% confidence interval (CI) was determined and interpreted. Results: The hand washing practice of mothers at critical times was 44.9% [95% CI: 40.1, 49.7%]. The pertinent predictors were favorable attitude [AOR = 7.77, 95% CI: 4.56, 10.37], availability of water source near the household [AOR = 5.31, 95% CI: 3.56, 10.37], and constant availability of soaps at household [AOR = 2.32, 95% CI: 1.33, 6.70]. Conclusion: In our study, hand-washing practices at critical times was low. The pertinent predictors were attitude, the presence of a water source near the household, and the presence of soap. Therefore, it is advised to encourage domestic hygiene education to improve mothers' attitudes and to increase the availability of water and soap close to the household to promote handwashing with soap and water at critical times.

Assessment of Households' Willingness to Join and Pay for Improving Waste Management Practices in Gedeo Zone, Southern Ethiopia.

Background: Waste management has become a serious challenge in urban areas of developing countries. However, managing municipal solid waste generated is the most costly urban service and needs community engagement in management of municipal solid wastes. Therefore, this study determined willingness to join and pay for improving solid waste management services and associated factors among households of Gedeo zone, Southern Ethiopia. Method: We performed a community-based cross-sectional study design to assess willingness to join and pay for improved solid waste management and its predictors among residents in Gedeo zone, Southern Ethiopia. Multivariate logistic regression analysis was computed to identify the factors associated with willingness to join and pay for improved solid waste management services. An adjusted odds ratio (AOR) with a 95% confidence interval (CI) was used to report an association, and a p < 0.05 was used to declare a statistically significant association. Result: Of 552 study participants, 91.5% (95% CI: 89.2, 93.8) were willing to join and 86.3% (95% CI: 83.3, 89.4) of them were willing to pay for improving solid waste management services. Having a large family size, higher educational status, positive attitude, and good knowledge of waste management services, access to waste management services, and amount of waste generated per week were positively associated with willingness to support improved solid waste management services. In addition, we found that respondents with high educational status, monthly income, who had good knowledge of waste management, access to waste management services, and the amount of waste generated per week were significant predictors of willingness to pay for improved solid waste management. Conclusion: This study found that a significant number of the respondents were willing to support and pay for improved solid waste management services. A higher probability of willingness to support and pay for solid waste management services among residents who had access to waste management services and good knowledge of solid waste management was observed. Therefore, wide-range awareness creation through mini media should be used to address poor knowledge. In addition, establishing more temporary waste collection sites in every corner of cities is needed to encourage households to support and pay for improved solid waste management services.

Level of Mothers'/Caregivers' Healthcare-Seeking Behavior for Child's Diarrhea, Fever, and Respiratory Tract Infections and Associated Factors in Ethiopia: A Systematic Review and Meta-Analysis.

Objective: To assess the pooled prevalence of mothers' or caregivers' healthcare-seeking behavior for childhood diarrhea, fever, and respiratory tract infections and associated factors in Ethiopia. Study Design. Systematic review and meta-analysis. Methods: Literature searches were conducted through databases (Google Scholar, PubMed, CINHAL, ScienceDirect, HINARI, and gray literatures) from September 1 to 30, 2021, using key terms in accordance with the PRISMA guidelines. The characteristics of the original articles were described using text and tables. Heterogeneity among the reported prevalence of studies was checked by using a heterogeneity χ 2 test and I2 test. Publication bias was examined by performing Egger's correlation and Begg's regression intercept tests at a 5% significant level. A random-effect model was employed to estimate the pooled prevalence of the outcome variable and its determinants in Ethiopia. Results: Of the total identified studies, 25 studies were included in the review, with a total of 29,993 study participants. The overall pooled prevalence of mothers' or caregivers' health-seeking behavior for childhood diarrhea, fever, and respiratory tract infections was 60.33% (95% CI: 50.14-70.52). The significant factors were residence (AOR = 3.06, 95% CI: 1.11-8.39), wealth index (AOR = 2.18, 95% CI: 1.92-2.48), perceived severity of illness (AOR = 2.7, 95% CI: 1.12-6.51), and knowledge of the illness (AOR = 1.95, 95% CI: 1.37-2.75). Conclusion: This review suggests that the overall pooled prevalence of mothers' or caregivers' HSB for childhood diarrhea, fever, and respiratory tract infections was 60.33%. Residence, wealth index, perceived severity of illness, and knowledge of the illness by mothers were the significant factors. Therefore, providing interventions by considering the above factors will improve the overall seeking behavior.

Determinants of Household-Level Water Treatment Practices in Southern Ethiopia.

Background: Household water treatment and handling is an important component of a global strategy to provide safe water to millions of people who live without adequate water currently. Household water treatment at the point of use also helps to improve drinking water quality for millions who suffer due to contamination of their drinking water. This study aims to assess household-level water treatment practices and associated factors in Southern Ethiopia. Methods: A community-based cross-sectional study was conducted among selected households using a systematical random sampling technique in Bule town. Data was collected using a pretested, structured questionnaire and analyzed using STATA version 16. A variable with a P-value ⩽ .25 in bi-variable regression was entered into multivariable regression and then a variable with a P-value ⩽ .05 was taken as statistically significant. Results: The study found that only 29.9% (with a 95% CI: 25.3-34.6) of households have good water treatment practices for drinking purposes. Regarding predictors of household-level water treatment practices, respondents who had good knowledge were 5 times (AOR = 6.98, 95% CI = 4.01-11.9) more likely to practice household-level water treatment than their counterparts. In addition, respondents who earn more than 3000 ETB per month are twofold more likely to practice household water treatment than those with an average monthly income of less than 1000 ETB (AOR = 2.37, 95% CI = 1.22-4.60). Conclusions: Household-level water treatment was less common in Bule town. The household's monthly income and their knowledge status were found to be the determinants of household-level water treatment practices in the study area.

Assessment of Microbiological Quality of Indoor Air at Different Hospital Sites of Dilla University: A Cross-Sectional Study.

Background: In both residential and hospital indoor environments, humans can be exposed to airborne microorganisms. The hospital's indoor air may contain a large number of disease-causing agents brought in by patients, staff, students, visitors, ventilation, or the outside. Hospitalized patients are at a higher risk of infection due to confined spaces, crowdedness, and poor infection prevention practices, which can accumulate and create favorable conditions for the growth and multiplication of microorganisms. Therefore, the aim of this study was to evaluate the indoor air bacterial load in Dilla University Hospital, Southern Ethiopia. Methods: An institutional-based cross-sectional study design was used to assess the bacterial load in the indoor air at Dilla University Hospital. To determine the bacterial load, a passive air sampling technique was used. The settle plate method was used to collect data, which involved exposing Petri-dishes filled with blood agar media to the indoor air of the sampled rooms for 60 minutes. Result: A total of 72 indoor air samples were collected once a week for 2 weeks at 14-day intervals from 18 rooms in 8 wards, and samples were collected twice a day in the morning and afternoon. The mean bacterial concentrations ranged from 450 to 1585.83 CFU/m3 after 60 minutes of culture media exposure. The mean bacterial concentrations in the obstetrics, surgical, pediatric, gynecology, and medical wards exceeded WHO guidelines. A high indoor air bacterial load was found in 58 (80.6%) of the samples in this study. Gram-positive bacteria in the air were the most common 51 (71%) of the bacterial population measured in all indoor environments. Fungal growth was found in 65 (90.3%) of the samples. Temperatures (26.5°C-28.3°C) and relative humidity (61.1%-67.8%) in the rooms were both above WHO guidelines, creating favorable conditions for bacterial growth and multiplication. Conclusion: The majority of the wards at Dilla University Hospital had bacterial loads in the air that exceeded WHO guidelines. Overcrowding, high temperatures, inadequate ventilation, improper waste management, and a lack of traffic flow control mechanisms could all contribute to a high concentration of bacteria in the indoor air. To control the introduction of microorganisms by patients, students, caregivers, and visitors, it is critical to regularly monitor indoor air bacterial load and implement infection prevention and control measures.

Survival analysis of COVID-19 patients in Ethiopia: A hospital-based study.

BACKGROUND: COVID-19 is a global public health problem causing high mortality worldwide. This study aimed to assess time to death and predictors of mortality among patients hospitalized for COVID-19 in the Arsi zone treatment center. METHOD: We performed a retrospective observational cohort study using medical records of laboratory-confirmed COVID-19 cases hospitalized at Bokoji Hospital COVID-19 treatment center from 1st July 2020 to 5th March 2021. We extracted data on the patients' sociodemographic and clinical characteristics from medical records of hospitalized patients retrospectively. We carried out Kaplan Meier and Cox regression analysis to estimate survival probability and investigate predictors of COVID-19 death 5% level of significance. The Adjusted Hazard Ratio (aHR) with 95% Confidence Interval (CI) was estimated and interpreted for predictors of time to death in the final cox model. RESULT: A total of 422 COVID-19 patients treated were analyzed, of these more than one tenth (11.14%) deaths, with a mortality rate of 6.35 cases per 1000 person-days. The majority (87.2%) of deaths occurred within the first 14 days of admission, with a median time-to-death of nine (IQR: 8-12) days. We found patients that age between 31 and 45 years (aHR = 2.55; 95% CI: (1.03, 6.34), older than 46 years (aHR = 2.59 (1.27, 5.30), chronic obstructive pulmonary disease (aHR = 4.60, 95%CI: (2.37, 8.91), Chronic kidney disease (aHR = 5.58, 95%CI: (1.70, 18.37), HIV/AIDS (aHR = 3.66, 95%CI: (1.20, 11.10), admission to the Intensive care unit(aHR = 7.44, 95%CI: (1.82, 30.42), and being on intranasal oxygen care (aHR = 6.27, 95%CI: (2.75, 4.30) were independent risk factors increasing risk of death from COVID-19 disease than their counterparts. CONCLUSION: The risk of dying due to COVID-19 disease was higher among patients with HIV/AIDS, chronic obstructive pulmonary disease, and chronic kidney diseases. We also found that older people, those admitted to ICU, and patients who received intranasal oxygen care had a higher risk of dying due to COVID-19 disease. Therefore, close monitoring hospitalized patients that are old aged and those with comorbidities after hospitalization is crucial within the first ten days of admission.

Health related quality of life and its association with social support among people living with HIV/AIDS receiving antiretroviral therapy in Ethiopia: a systematic review and meta-analysis.

BACKGROUND: People living with HIV/AIDS (PLWHA) are frequently confronted with severe social issues such as rejection, abandonment, criticism, and stigma. This would negatively affect their quality of life. Several studies have been conducted so far to assess factors affecting the health-related quality of life among people living with HIV/AIDS who are on antiretroviral therapy (ART) in Ethiopia. However, to our knowledge, there is no previous study that has summarized the results of the studies that investigated health-related quality of life (HRQOL) among PLWHA in Ethiopia. Therefore, the purpose of this review was to estimate the pooled prevalence of HRQOL and its association with social support among people living with HIV/AIDS (PLWHA) on ART in Ethiopia. METHODS: A systematic search was carried out using several electronic databases (PubMed, Science Direct, Web of Science, and Cochrane electronic), Google Scholar, Google, and a manual search of the literature on health-related quality of life among people living with HIV/AIDS who are on ART. A Microsoft Excel data extraction sheet was used to extract pertinent data from an individual study. To assess the heterogeneity of primary articles, the Cochrane Q test statistics and the I2 test were carried out, and a random effects meta-analysis was used to estimate the pooled prevalence of HRQOL. RESULT: Out of the 493 articles reviewed, ten with a total of 3257 study participants were eligible for meta-analysis. The pooled prevalence of HRQOL among people living with HIV/AIDS who are on antiretroviral therapy in Ethiopia was 45.27%. We found that strong perceived social support was significantly associated with higher levels of subjectively perceived HRQOL. PLWHA who were on ART and had good social support were four times more likely to report higher HRQOL when compared to their counterparts [AOR = 4.01, 95% CI 3.07-5.23]. CONCLUSION: A substantial number of PLWHA had poor HRQOL in Ethiopia. Social support was significantly associated with HRQOL among people living with HIV/AIDS. Hence, it's recommended to encourage suitable intervention at every follow-up visit, and psycho-social support is also warranted to improve the quality of life.