Determinants of nutritional status of children aged 6-59 months in the case of Itang special woreda, Gambella, Ethiopia.

Nutritional status is one of the most important causes of improper physical and mental development in children. The study attempts to assess the factors affecting the severity status of children aged 6-59 months' malnutrition based on the weight-for-age anthropometric index (z-score) and examine between-kebeles-level differences in determinants of the nutritional status of children. A community-based, cross-sectional study design was conducted from October 12 to November 12, 2022. A sample of 397 children aged 6-59 months primary data by applying multi-stage clustered sampling technique was used by considering their heterogeneity. The data were entered by SPSS and analyzed by using R version 3.4.0 and STATA 14.2 statistical software package using a multilevel ordinal logistic regression model and inferences were conducted at a 5% significance level. The results show that birth interval ≥ 24 months (OR = 1.431253, 95% CI 1.221337 1.6763421, P-value = 0.008), economic status of households medium (OR = 16.21466, 95% CI 1.221403 1.423929, P-value = 0.000), economic status of households rich (OR = 223.2856, 95% CI 1.34295 2.582325, P-value = 0.000), employment status of the mother unemployed (OR = 0.2291348, 95% CI 0.0529511 0.9966281, P-value = 0.049), No toilet facility (bush field) (OR = 0.3163329, 95% CI 0.1825356 0.5481975, P-value = 0.000), number of household members (OR = 0.9100682, 95% CI 0.8313481 0.9967315, P-value = 0.042), breastfeeding < 12 months (OR = 0.53803, 95% CI 0.322315 0.898135, P-value = 0.018), educational level of father Primary (OR = 4.601687, 95% CI 1.758009 2.22053, P-value = 0.000), educational level of father Secondary above (OR = 99.65229, 95% CI 2.533502 4.788896, P-value = 0.000) and geographical area (kebeles) were found to be important factors that affect a child's nutritional status between 6 and 59 months. 15% of the overall variation is attributable to the Kebeles level, according to two-level multilevel ordinal logistic regressions with estimates of the variation attributable to the Kebeles level equal to 0.569 and an intraclass correlation coefficient of 0.15. Due to the nature of the response variable random intercept model with random coefficients fitted the data adequately in predicting the severity status of children aged 6-59 months' malnutrition for the multilevel ordinal logistic regression model analysis. So, the researcher recommended that implementing primary health care and nutrition programs that would fit each kebeles' features in Itang Special Woreda to safeguard children from nutritional deficiency.

Fear of childbirth and its associated factors among pregnant women in Dejen Woreda, East Gojjam Zone, Northwest Ethiopia: a community-based cross-sectional study.

Fears of delivery are the uncertainty and worry experienced before, during, and following labor. It hurts women's health and affects 5-40% of all moms globally. If not recognized, it could cause expectant mothers to feel alone and unsupported. Studies on this subject, however, are scarce at the woreda level. Therefore, this study amis to assess the prevalence and associated factors of fear of childbirth among pregnant women in Dejen Woreda, East Gojjam Zone, Northwest Ethiopia. A community-based cross-sectional study was conducted among 575 pregnant women selected by Cluster Sapling from December 15 to December 25, 2022. Data were gathered using a structured questionnaire that was presented by an interviewer. Data were entered using Epi-data version 3.1 and analyzed using SPSS Version 23 statistical software. Descriptive statistics and inferential statistics were done, and ordinary logistic regression was used to examine the associated factor for fear of childbirth. Finally, a P-value < 0.05 was used to determine statistical significance. Among the 575 pregnant women supposed to have participated, 560 agreed and participated in the survey, with a response rate of 97.4%. This study showed that 133(23.8%; CI 20.4-26.8) of the study participants had low fear of childbirth, 67(12%; CI (9.3-14.8 moderate, 217 (38.8%; CI 34.6-42.7) high, 143 (25.5%; CI 21.8-29.1) severe fear of childbirth. Having maternal age 18-24 (adjusted odds ratio/AOR = 1.6; 95% CI (1.1-2.3), p-value = -0.08), occupation daily laborer and other (AOR = 0.3,95%; CI 0.3, 0-74; p-value = 0.004),gestational age in third trimester (AOR = 1.9,95%; CI 1.1-3.4), p-value = 0.022) showed significant factor for a fear of childbirth. Maternal age, occupation, and third-trimester pregnancy were found to be significantly associated with fear of childbirth. Women should engage in special attention to keep them healthy by consistent monitoring during pregnancy. Healthcare providers should identify pregnant women with high fear of childbirth early, offer cognitive behavioral therapy, support psychological and physical well-being, provide early age and preventive measures, and use uniform instruments for assessing women's anxiety, promoting systematic reviews and longitudinal studies.

Time to death and its determinant factors of visceral leishmaniasis with HIV co-infected patients during treatment period admitted at Metema hospital, Metema, Ethiopia: a hospital-based cross-sectional study design.

BACKGROUND: Visceral leishmaniasis is caused by the parasites Leishmania donovani spices complex that can spread to internal organs and the disease is fatal with a fatality rate of nearly 100% if left untreated. Visceral Leishmania-HIV (HIV1) coinfection disease is a new clinical form of leishmaniasis very serious disease in the endemic part of the world. It also served as the primary cause of death in the lowlands of Ethiopia with the endemic Humara and Metema that are located near the Sudanese border. METHODS: A total of 153 visceral leishmaniases with HIV co-infection secondary data was taken from the medical chart of patients from January 2015 to January 2021 and a hospital-based cross-sectional study design was carried out to retrieve relevant information. The data entered by SPSS and analysed using STATA version 14 and R4.2.1 statistical software packages using a non-parametric Model, semi-parametric Cox proportional hazard survival models at 5% significance level. RESULT: Among the total visceral leishmaniasis with HIV co-infected patients 3.27% were females and 96.73% were males, 19 (12.42%) patients died and 134(87.58%) patients were censored. The Cox proportional hazard model result indicates that severe acute malnutrition, baseline CD4+ cell count ≥100, and underweight significantly contributed to the survival time of a patient. Cox proportional hazard model shows that severe acute malnutrition (HR=4.40027, 95% CI= 2.455061 262.7934, P-value=0.007), baseline CD4+cell count ≥100 (HR=0.2714623, 95% CI= 0.0764089 0.9644395, P-value=0.044), and Underweight (HR=4.678169, 95% CI= 1.970097 11.10872, P-value=0.040) significantly contributed to a shorter survival time. CONCLUSION: Visceral leishmaniases with HIV co-infected patients show a large number of deaths occurred in the earlier days of treatment this implies that Visceral leishmaniasis accelerates HIV replication and disease progression death. The researcher suggests that people be aware of the burden posed by those risk factors and knowledgeable about the diseases. So, the researcher recommended that to health workers implement primary health care in those patients and careful consideration of a neglected parasitic disease.