Neglected tropical disease meets neglected community: Street children's susceptibility to scabies in Addis Ababa, Ethiopia.

Scabies is a neglected tropical disease (NTD) with high prevalence rate in resource-limited settings. Though street children are susceptible because of lack of sanitation and contact with vectors, few attempts have been made to identify the lived experience of street children with scabies in the global south. This study explored perceived susceptibility to scabies and related lived experiences of street children in Addis Ababa. Using in-depth interviews, we collected qualitative data from selected children of the street to identify their understanding of the causes of scabies, their experiences of managing the condition, and their health-seeking behavior. Informants were recruited to include maximum variation in terms of age, sex, and experience of infestation. The study showed that scabies was common among street children and that the infestation has physical, psychological and social impacts. Study participants believed that scabies had its origin in their living conditions (including poor environmental sanitation and lack of personal hygiene), with lice playing a significant role as vectors of transmission. The informants reported visiting modern healthcare facilities, traditional healers and self-care in response to infestation. By uncovering the embodied experience of a stigmatized skin NTD in a neglected community in the global south, this study contributes to combating neglect and addressing health disparities. Having identified living conditions as the major factor contributing to susceptibility, efforts need to be exerted to change street children's living situations and other structural conditions through reunification with their families or other communities, reintegration and other exit strategies.

Health seeking behavior of street connected children in Addis Ababa, Ethiopia.

Background: Street children are the most neglected segments of the society with limited access to healthcare services. The vulnerability of street children to various health risks has been found by previous studies but little is known about their perceived susceptibility, preventive behavior and illness responses. Hence, the purpose of this study was to identify the health seeking behavior of street children in Addis Ababa. The study focuses on perceived susceptibility to various health risks, sources of health risks, and behaviors pertaining to responding to perceived risks and experienced health problems among the most marginalized groups in Addis Ababa. Methods: Using a mixed research approach, quantitative and qualitative data were collected through survey and interview methods from selected street children. SPSS and NVivo software were used to analyze the quantitative and qualitative data, respectively. Results: Whereas the street children perceive to be susceptible for ill-health risks related with their living situations, responding to the perceived susceptibility mainly by maintaining personal hygiene and undertaking physical exercises have been identified. The study also revealed that street children were found to be vulnerable for the situations affecting their health and wellbeing mainly due to self-reported engagements in risky behaviors such as smoking cigarette (67.3%), sniffing glue or benzene (68.2%), sharing of personal materials having the potential of transmitting diseases from one person to another (25.5%), and unprotected sexual activities (14.1%). Experiences of visiting healthcare facilities in response to illness symptoms have also constituted an aspect of the health seeking behavior of the street children. Conclusion: Awareness of the presence of health risks and perceived susceptibility to the risks promoted both preventive behavior and positive compliance in relation to illness response among children of the street in Addis Ababa.

The Preferences of Modes of Child Delivery and Associated Factors Among Pregnant Women in Southern Ethiopia.

Background: The purpose of the study was to identify the choice of mode of delivery and the factors associated with such preferences among pregnant women attending antenatal care services in Southern Ethiopia. Methods: Using an institutional-based cross-sectional survey, quantitative data were collected from randomly selected pregnant women in Southern Ethiopia. A semi-structured questionnaire was distributed to pregnant women who had been attending antenatal healthcare services in purposively selected public and private healthcare facilities in Shashemene town. The completed cases were inserted into SPSS version 26 in which both descriptive and inferential statistical techniques were used to analyze the data. Results: It was found that 75.4% of respondents replied that they prefer vaginal delivery while 24.6% had chosen cesarean section. Personal conviction motivated by the need to experience the labor process, the belief in it being a natural method, the perception that it is better for the wellbeing of both the mother and the child, previous experience of delivery by vaginal method, fear or the need to avoid episiotomy, and economic concerns have been mentioned as reasons for the choice of vaginal delivery. Moreover, respondents' choice of the mode of delivery is significantly associated with religion, age, number of children, pregnancy experience, previous mode of delivery, self-rated social class status, autonomy to decide about mode of delivery, and type of healthcare organization of antenatal care attendance. Conclusion: Although vaginal delivery has remained the most preferred mode of delivery among most pregnant women, about a quarter of pregnant women have reported that they prefer to deliver by cesarean section, a prevalence rate which is higher than the national average, indicating that the choice of cesarean section is still increasing among women.

Beliefs About Body Weight and Practices of Regulating Food and Physical Exercise Patterns of Children Among Parents in Southern Ethiopia.

Background: The problem of childhood obesity is often associated with cultural values of body weight which includes the belief that voluptuous body size is a sign of good health status and better parental care. We examined the beliefs and behaviors of parents pertaining to preferred body weight of children, including practices of management of feeding and physical exercise patterns of children in southern Ethiopia. Methods: Using cross-sectional survey study design, a structured questionnaire was distributed to randomly selected parents. Quantitative data were collected from 215 respondents, inserted into SPSS software, and analyzed by frequency and percentage distributions, charts, and multinomial logistic regression techniques. Results: Most (59.1%) respondents want their child's body weight to be normal/neither fat nor thin. In addition, 58.2% of the study participants held the opinion that average body size is an indication of good health status. Furthermore, 72.6% of respondents revealed that they control the amount of food their child consumes with the aim of preventing obesity/overweight. Moreover, 79.5% of respondents encourage their children to sometimes walk on foot, instead of always relying on vehicles while 87% of them replied that they regulate the amount of time their children spend watching TV. Above all, parents' preference of voluptuous body size of children is significantly associated with age (OR=61.52.448, P < 0.001, 95%C.I: 57-66.14), educational status (OR = 35.605, P < 0.001; 95%C.I: 6.050-209.524), sex (OR = 0.237, P < 0.05; 95%C.I: 0.078-0.724) and grownup area (OR = 2.869, P < 0.05; 95%C.I: 1.062-7.749). Conclusion: Parents not only have adequate level of awareness regarding the health risks of children's heavy body weight but also engage in the body weight management practices of their children such as by regulating the food consumption patterns of children, encouraging them to undertake physical exercises, and by being role models while doing physical exercises for themselves.

Intention to Receive the Second Round of COVID-19 Vaccine Among Healthcare Workers in Eastern Ethiopia.

BACKGROUND: COVID-19 pandemic has remained one of the leading causes of death which claimed the lives of many well-trained and experienced healthcare professionals. Vaccination is the most effective way of controlling infectious diseases, while success is challenged by individuals and groups who choose to delay or refuse vaccines. The objective of the present study was to assess the intention of healthcare workers in Eastern Ethiopia to receive the second round of COVID-19 vaccine. METHODS: Institution-based cross-sectional survey research design was used to collect quantitative data from a representative sample of healthcare workers in Dire Dawa, Haramaya, and Harar towns of Eastern Ethiopia. The correctly filled questionnaires were selected and entered into SPSS software for further analysis, where frequency tables, percentages, mean, and multinomial logistic regression analysis were used in the process. RESULTS: The findings revealed that most (61.6%) of the research participants are willing to receive the second round of COVID-19 vaccine, and 10.3% reported that they have not decided yet. Moreover, the main reason for respondents' lack of intention to receive the second round of COVID-19 vaccine is the belief that the first round of COVID-19 vaccine is sufficient to prevent infection (27.8%) followed by concern over the safety or side effects of the vaccine (26.6%). Above all, the healthcare workers' intention of taking the second round of COVID-19 vaccine is significantly associated to having children (OR=0.362, P<0.05; 95% CI: 3.279-5465.189), previous interaction with someone infected by COVID-19 (OR=1.480, P<0.05; 95% CI: 3.949-0.055), the perception that COVID-19 causes a severe illness (OR=0.018, P<0.05, 95% CI: 13.489-196.391), and experience of receiving the first round of COVID-19 vaccine (OR=50431.104, P<0.01; 95% CI: 408.789-626.00). CONCLUSION: The present study has shown that healthcare workers in Eastern Ethiopia have a good intention of receiving the second round of COVID-19 vaccine. Nevertheless, the findings have also made it clear that there are still issues to be addressed as far as both willingness to receive the second round of the vaccine and experience of taking the first round of the vaccine are concerned. It is, therefore, important that sufficient training should be given to the healthcare workers in the area in order to raise their level of awareness and enhance their willingness to receive the second round of the vaccine.

Victimizations and surviving of workplace violence against waitresses in southern Ethiopia.

Women are obliged to take on vulnerable forms of employment that fail to protect their basic labor rights. Exposure to workplace violence is especially high for those women who work within the agriculture, the hotels, restaurants and catering, the transport as well as the manufacturing sectors. In this context, we explored workplace violence against women working as waitresses in various hotels, restaurants, cafeterias and grocery stores of Wolaita Sodo town, southern Ethiopia. Cross-sectional study was undertaken with descriptive and exploratory study designs. Qualitative data were collected by using in-depth interview method in which 16 waitresses were interviewed. Data were voice recorded, transcribed, and analyzed searching themes and patterns in the data. While we found that waitresses are highly exposed to workplace violence, the level of exposure to the violence varies across various circumstances, including working in large and small towns, the situation of the owners/supervisors, public's insight of the position, waitresses' ability to speak the local language, the role of the waitresses, customers' behavior and the specific context in which waitresses work. Waitresses were generally exposed to all forms of violence including spitting, throwing objects, simple physical assault, touching on private parts, and intimidation, among which verbal abuse and emotional exploitations are found to be the most common. Furthermore, the results revealed that though waitresses rarely experienced violence from female customers, the most common perpetrators involved in the practice were males. Amid widespread exposure of waitresses to all forms of workplace violence, ignorance, mostly motivated by fear of losing one's job, has been the common way waitresses respond to the violence. The study implies the vulnerability state of waitresses partly due to lack of adequate awareness regarding the rights and obligations expected of an employee when working in such organizations. This is again exacerbated by the lack of formal employment procedures in such organizations. Therefore, awareness creation and supervisory activities are expected from the media, workers' and social security office of the government, police and other concerned bodies.

Willingness of youth without disabilities to have romantic love and marital relationships with persons with disabilities.

People with disabilities face attitudinal barriers including prejudice, stereotypes, and low expectations. Many young people without disabilities may doubt that people with disabilities can be fulfilling partners in any loving adult relationship. The objective of the present research was to assess the willingness of non-disabled youth to engage in conjugal relationships with persons with disabilities in Wolaita Sodo town, Ethiopia. Both descriptive and explanatory study designs were used and quantitative data were collected. A self-administered questionnaire was designed and distributed to randomly selected 403 (202 females & 201 males) unmarried youth. Data analysis was undertaken using SPSS software in which both descriptive and inferential statistical techniques were utilized for data presentation. The result showed that most (85.5%) of the young people without disabilities participated in the survey were not willing to have any type of personal relationships with persons with disabilities and the main reason for 44.2% of these respondents being the fear of reaction from family members. Furthermore, it was found that the level of willingness of youth without disabilities to engage in romantic love and marital relationships was not influenced by the socio-economic status of people with disabilities. Moreover, the result of binary logistic regression analysis showed that the willingness of respondents to have marital and romantic love relationship with persons with disabilities is significantly associated to the sex (OR = 2.376; P < 0.05; 95%CI = 1.210, 4.664), raised-up area (OR = 2.512; P < 0.01; 95%CI = 1.319, 4.783), age (OR = 2.886; P < 0.05; 95%CI = 1.012, 8.228) and the presence of person with disability in the family (OR = 3.945; P < 0.01; 95%CI = 1.648, 9.442) of respondents. The findings of the present research demonstrate that people with disabilities have continued to face stereotypes and discriminations. Such stereotypes extend to assuming them as asexual and unfit to carryout roles that arise from love or marital relationships which violates the rights of PWDs to form their own family and have children. It is therefore, important to raise the awareness of young people about the differences between disability and sexuality and that physical disability has nothing to do with sexuality and relationship formation.

Willingness to Take COVID-19 Vaccine Among People Most at Risk of Exposure in Southern Ethiopia.

BACKGROUND: Acceptance of a vaccine or hesitancy towards it have great public health implications as they partly determine the extent to which people are exposed to infections that could have otherwise been prevented. The present study examined the willingness of primary and secondary school teachers, bank employees, and university instructors in southern Ethiopia to take a Covid-19 vaccine and the factors associated with their willingness. METHODS: An institutional-based cross-sectional study design was used with a quantitative research approach. Primary data were gathered mainly through the use of a survey research method in which a self-administered questionnaire was distributed to randomly selected research participants in Wolaita Sodo town. Data analysis was conducted using statistical techniques, including percentages, frequency distributions, and logistic regression analysis. RESULTS: Research participants generally had a low (46.1%) willingness to take a COVID-19 vaccine. The main reason for most (37%) respondents' hesitancy to take the vaccine is found to be the concern over the safety and/or the side effects of the vaccine (37%), followed by doubt about the vaccine's effectiveness (20.7%), and lack of adequate information (12.7%). Moreover, 38.9% of survey participants revealed that they would like to take a COVID-19 vaccine other than AstraZeneca whereas 61.1% of respondents replied that they do not want to take any kind of COVID-19 vaccine. Furthermore, respondents' willingness to take a COVID-19 vaccine is significantly associated with attitude towards the vaccine (OR = 2.830; 95% CI = 1.834-4.368), belief that Covid-19 exists in the study area (OR = 0.221; 95% CI = 0.083-0.589), the perception that prevalence and death rate reports of the government are real (OR = 0.365; 95% CI = 0.197-0.676), status of chronic diseases (OR = 2.883; 95%CI = 1.039-7.999), and having a close relative/friend ever infected by COVID-19 (OR = 2.602; 95% CI = 1.117-6.063). CONCLUSION: The findings of the research demonstrated that there is generally low willingness to take a COVID-19 vaccine among university instructors, bank employees, and primary and secondary school teachers in southern Ethiopia. Therefore, the federal ministry of health, Ethiopian food and drug controlling agency, the media, and all other concerned organizations should create increased awareness about the safety/side effects issues and the need to take the vaccine.

Changing Patterns of Compliance with Protective Behavioral Recommendations in the Post First-Round COVID-19 Vaccine Period Among Healthcare Workers in Southern Ethiopia.

BACKGROUND: Healthcare providers are facing an increasing threat as a result of confronting COVID-19. The aim of the present study was to assess the changes in compliance with the protective behavioral recommendations after taking the first round of COVID-19 vaccine among healthcare workers in Southern Ethiopia. METHODS: A cross-sectional study design was used in which quantitative data were collected using a survey method. A self-administered questionnaire was distributed to a sample of healthcare workers who were selected through a multi-stage cluster sampling technique. From the 403 healthcare workers who participated in the survey, 236 properly completed and returned the questionnaires. After inserting it into SPSS software, data were analyzed using frequency tables, percentage distributions, and logistic regression coefficients. RESULTS: While 30.5% of the healthcare workers disclosed a decreasing experience of wearing mask, 30.1% revealed that their experience of regularly washing hands has decreased after taking the first round of COVID-19 vaccine. The main reasons for not regularly wearing a mask are its inconvenience (60%), the need to appear indifferent (38.5%), and that they cannot afford to buy one due to its cost (15.4%). Above all, respondents' level of compliance with regular wearing of a mask is significantly associated with sex (OR = 3.165, P<0.05; 95% CI: 1.186-8.448), the type of organization in which they are currently working (OR = 3.553, P<0.05; 95% CI: 1.185-10.647), knowing someone ever infected by COVID-19 (OR = 0.091, P<0.001; 95% CI: 0.030-0.275), and the belief that COVID-19 causes a severe illness (OR = 0.249, P<0.05; 95% CI: 0.299-2.615). CONCLUSION: We have found significant reductions in adherence to the usual protective mechanisms. Therefore, increased access to the personal protective materials, including water, should be created and the healthcare workers should be continuously informed about the serious consequences of ignorance of self-protective behavior.

Perceptions and Experiences of COVID-19 Vaccine Side-Effects Among Healthcare Workers in Southern Ethiopia: A Cross-Sectional Study.

BACKGROUND: We examined the perceptions of healthcare workers about the side-effects of COVID-19 vaccine and the types of side-effects they experienced in the post-vaccination period. METHODS: An institutional-based cross-sectional survey research design was used in which a semi-structured questionnaire was distributed to collect quantitative data from healthcare workers in Southern Ethiopia that were selected on the basis of a multi-stage cluster sampling technique. After inserting the completed cases into SPSS software, descriptive statistical techniques, such as frequencies, percentages, charts and inferential statistical tool, particularly binary logistic regression analysis, were used to analyze and present the data. RESULTS: Majority (43.6%) of respondents perceive that COVID-19 vaccine will have muscle pain around the injection site, followed by fever (39.9%), problems of blood clots (37.8%), headache (35.6%), fatigue (33.5%), and aching limbs (16%). And 63.6%) of them reported that they have experienced muscle pain around the injection site after receiving the COVID-19 vaccine, followed by fatigue (42%), headache (37.2%), fever (34.2%), redness around the injection site (21.6%), and swelling around the injection site (17.8%). Moreover, 25% reported that the fear of potential side-effects of COVID-19 vaccine inhibited them from taking the vaccine. Above all, it is found that respondents' expectation of COVID-19 vaccine to have such serious side-effects is significantly associated to their educational status (OR = 0.229; P < 0.01; 95%C.I.: 0.080-0.651). CONCLUSION: While the expectations of most of the healthcare workers regarding the side-effects of the vaccine are parallel to the normal reactions of the vaccine, a significant proportion of the study participants have reported that they perceive COVID-19 vaccine will have life-threatening side-effects. Such fears have also played a role in affecting vaccine uptake. Therefore, the Ministry of Health, and other concerned government bodies should create further awareness on COVID-19 vaccine and related safety issues.

Compliance With Protective Behavioral Recommendations in the Outbreak of COVID-19 Among People Working in the Urban-Based Informal Economy in Southern Ethiopia.

Regardless of the advocacies made by the media and numerous organizations about the need for preventing the spread of COVID-19, there still exists a gap as far as compliance to regular implementation of the preventive mechanisms within communities is concerned. The purpose of the present study was, therefore, to examine compliance to personal protective behavioral recommendations to contain the spread of COVID-19 among urban residents engaged in the informal economic activities in Wolaita Sodo town, Southern Ethiopia. A cross-sectional study design was used where quantitative data were collected through the survey research method. Three hundred and eighty-four participants of the urban-based informal economy were randomly selected and contacted in their own natural settings with an interviewer-administered questionnaire. Data were inserted into SPSS software for analysis that involved both descriptive and inferential statistics, including frequency and percentage distributions, binomial and multinomial logistic regressions. The results of the research indicated that only 35.4% of the respondents regularly wore a mask. In addition, 54.9% of the survey participants disclosed that they do not clean their hands with disinfectants after touching objects under circumstances where they cannot get access to water and soap. Moreover, the most commonly reported reason of respondents for non-compliance to regular wearing of a mask has been its inconvenience or discomfort (62.8%), followed by the need to appear indifferent because most people around them do not wear a mask (25.2%). Furthermore, experiences of the respondents of regularly wearing a mask are significantly associated with regular attendance of the media regarding the preventive mechanisms of COVID-19 (OR = 0.224; P < 0.001; 95%C.I: 0.109-0.460), knowledge of someone ever infected by COVID-19 (OR = 0.402; P < 0.05; 95%C.I: 0.190-0.851), the belief that COVID-19 causes a severe illness (OR = 0.444; P < 0.05; 95%C.I: 0.201-0.980), and perception of the likelihood of dying as a result of infection by COVID-19 (OR = 0.374; P < 0.01; 95% C.I: 0.197-0.711). The authors have found a low level of compliance to the recommended safety measures, especially wearing of masks. It is, therefore, important that continued efforts of raising awareness should be done by all the concerned bodies. Above all, urban safety net programs that aim at keeping such social groups at home, at least during the critical wave of the pandemic, should also be strengthened.