Survival of HIV/AIDS patients treated under ART follow-up at the University hospital, northwest Ethiopia

INTRODUCTION@#The survival of HIV/AIDS patients on antiretroviral therapy (ART) is determined by a number of factors, including economic, demographic, behavioral, and institutional factors. Understanding the survival time and its trend is crucial to developing policies that will result in changes. The aim of this study was to compare the survival estimates of different subgroups and look into the predictors of HIV/AIDS patient survival.@*METHODS@#A retrospective cohort study of HIV/AIDS patients receiving ART at the University of Gondar teaching hospital was carried out. To compare the survival of various groups, a Kaplan-Meier survival analysis was performed. The Cox proportional hazards model was used to identify factors influencing HIV/AIDS patient survival rates.@*RESULTS@#In the current study, 5.91% of the 354 HIV/AIDS patients under ART follow-up were uncensored or died. Age (HR = 1.051) and lack of formal education (HR = 5.032) were associated with lower survival rate, whereas family size of one to two (HR = 0.167), three to four (HR = 0.120), no alcoholic consumption (HR = 0.294), no smoking and chat use (HR = 0.101), baseline weight (HR = 0.920), current weight (HR = 0.928), baseline CD4 cell count (HR = 0.990), baseline hemoglobin (HR = 0.800), and no TB diseases were associated with longer survival rate.@*CONCLUSIONS@#Fewer deaths were reported in a study area due to high patient adherence, compared to previous similar studies. Age, educational status, family size, alcohol consumption, tobacco and chat usage, baseline and current weight, baseline CD4 cell count, baseline hemoglobin, and tuberculosis (TB) diseases were all significant predictors of survival of HIV/AIDS patients.

Substance use and associated factors among preparatory school students in Kolfe-Keranyo sub-city of Addis Ababa, Ethiopia

BACKGROUND@#Substance abuse is a worldwide problem that primarily affects adolescents, resulting in chronic health complications as well as psychosocial challenges and economic losses. However, the magnitude of the problem and the factors that contribute to it are not well studied in Ethiopia, particularly in the study area. As a result, this study was carried out to determine the prevalence and associated factors of substance use among preparatory school students in the Kolfe-Keraniyo sub-city of Addis Ababa, Ethiopia.@*METHODOLOGY@#An institution-based cross-sectional study of 383 randomly selected preparatory school students in the Kolfe-Keraniyo sub-city was conducted. The data were gathered using a pretested self-administered structured questionnaire. Multivariable binary logistic regression analysis was employed to identify factors associated with substance use based on the adjusted odds ratio (AOR) and 95% confidence interval (CI) with p values less than 0.05.@*RESULT@#This study revealed that the lifetime prevalence of substance use among preparatory students in Kolfe-Keraniyo sub-city, Addis Ababa, Ethiopia, was 26.5% (95% CI, 22.2, 30.7%). Specifically, 16% drunk alcohol, 9.6% smoked cigarette, and 9.4% chewed khat. The 16.3% were current users, of which 8.3% were drinkers, 6.4% were smokers, and 5.9% were khat chewers. Substance use was significantly associated with being male (AOR, 3.3; 95% CI, 1.284, 8.613), having alcohol drinking family member (AOR, 4.0; 95% CI, 1.704, 9.196), having khat chewing family member (AOR, 2.87; 95% CI, 1.161, 7.070), poor school substance use controlling rule (AOR, 6.64; 95% CI, 1.863, 23.687), availability of substance retailing shops in residential areas (AOR, 2.9; CI, 1.303, 6.606), strong relationship with parents (AOR, 0.005; 95% CI, 0.001, 0.026), and being member of school mini-media (AOR, 0.177; 95% CI, 0.048, 0.657).@*CONCLUSION@#According to the findings of this study, one-quarter of the study participants were substance users. Alcohol, khat, and cigarettes were all commonly used substances. Gender, parent-child relationship, family member substance use history, school substance use controlling rules, school mini-media and pro-social involvement, and the availability of substance retailing shops were all strongly associated with substance use. Strengthening school rules on substance use, controlling substance retailing shops near schools and residential areas, and providing students with health education are all strategies for reducing substance use among students.

Effects of water, sanitation and hygiene (WASH) education on childhood intestinal parasitic infections in rural Dembiya, northwest Ethiopia: an uncontrolled before-and-after intervention study

BACKGROUND@#Soil-transmitted helminthes (STH) infections are among the most common infections worldwide and affect the most deprived communities. Adequate water, sanitation, and hygiene (WASH) prevents environmental contamination, thereby preventing transmission of STH. Cognizant of this, WASH education was implemented in rural Dembiya to reduce intestinal parasitic infections. This study was, therefore, conducted to assess the impacts of the intervention on households' WASH conditions and prevalence of intestinal parasitic infections.@*METHOD@#An uncontrolled before-and-after intervention study was used. Cross-sectional studies were done before and after the intervention. Two hundred twenty-five and 302 under five children were recruited randomly at the baseline and endline, respectively. Data were collected using a structured questionnaire and observational checklists. Direct stool examination and Kato-Katz methods were used to identify parasites in the stool. We used percent point change and prevalence ratio (PR) to see the effects of the intervention on WASH conditions and prevalence of intestinal parasitic infections respectively. Pearson chi-squared and Fisher's exact tests were used to test for statistically significant percentage point changes of WASH conditions. The effect of the intervention on intestinal parasitic infections was statistically tested on the basis of PR with 95% confidence interval (CI).@*RESULTS@#The baseline prevalence of intestinal parasitic infections was 25.8%, and the endline prevalence was 23.8%. The prevalence of intestinal parasitic infections was not significantly decreased at the endline compared with the baseline [PR = 0.92, 95% CI = (0.62, 1.38)]. Ascaris Lumbricoides was the most prevalent parasitic infection both at the baseline and endline. The proportion of children who had good hygienic condition increased from 1.3% at the baseline to 34.4% at the end line (p <  0.05). The percentage of mothers/care givers who washed hands at different pick times was significantly increased from 24.4% at the baseline to 68.2% at the endline (p <  0.001). The proportion of households who practiced home-based water treatment was significantly increased from 7.6% at the baseline to 47% at the endline (p <  0.001). The proportion of households who used sanitary latrine was increased from 32% at the baseline to 49% at the endline (p <  0.05).@*CONCLUSION@#This before-and-after intervention study found that households' WASH performance was significantly improved at the endline compared with the baseline. The endline prevalence of intestinal parasitic infections was slightly lower than the baseline prevalence; however, the reduction was not statistically significant. The local health office needs to strengthen the WASH education program, mobilize the community to construct WASH facilities, and support the community to sustain households' WASH performance.

Sanitation predictors of childhood morbidities in Ethiopia: evidence from Dabat Health and Demographic Surveillance System

BACKGROUND@#Failure to provide adequate sanitation services to all people is perhaps the greatest development failure. Globally, billions of people have no access to improved sanitation facilities. Though the link between sanitation and childhood morbidities is established globally, the evidence is limited in rural parts of Ethiopia. This survey was, therefore, designed to determine the prevalence of common childhood morbidities and to identify sanitation predictors in rural parts of northwest Ethiopia.@*METHODS@#A re-census reconciliation, which is a cross-sectional design, was employed from October to December 2014. All households found in the research and demographic sites were included as study subjects. A questionnaire and an observational checklist were used to collect data. Households' sanitation performances, house type, illumination, household energy sources, water supply, and waste management were assessed. The occurrence of childhood morbidities was determined from the occurrence of one or more water, sanitation, and hygiene (WASH) preventable diseases. Multivariable binary logistic regression analysis was done to identify the association of sanitation factors with childhood morbidities on the basis of adjusted odds ratio (AOR) with 95% confidence interval (CI) and p value < 0.05.@*RESULTS@#About 575 (7.00%) of under-five children had hygiene- and sanitation-related diseases. Gastrointestinal and respiratory health problems accounted for 287 (49.91%) and 288 (50.09%), respectively. Childhood morbidities among under-five children were associated with poor housing condition [AOR = 1.27, 95% CI = (1.04, 1.54)], dirty cooking energy sources [AOR = 1.52, 95% CI = (1.22, 1.89)], volume of water below 20 l/p/d [AOR = 1.95, 95% CI = (1.19, 3.18)], and narrow-mouthed water storage containers [AOR = 0.73, 95% CI = (0.56, 0.96)].@*CONCLUSION@#A significant proportion of under-five children had childhood morbidities in the study area. Housing condition, cooking energy sources, volume of water collected, and type of water storage containers were factors associated with the occurrence of childhood morbidities. Enabling the community to have the access to a safe and continuous supply of water and proper disposal of wastes, including excreta, is necessary with particular emphasis to the rural communities and semi-urban areas to reduce the occurrence of childhood morbidities.

Public health risks related to food safety issues in the food market: a systematic literature review

BACKGROUND@#Food safety in the food market is one of the key areas of focus in public health, because it affects people of every age, race, gender, and income level around the world. The local and international food marketing continues to have significant impacts on food safety and health of the public. Food supply chains now cross multiple national borders which increase the internationalization of health risks. This systematic review of literature was, therefore, conducted to identify common public health risks related to food safety issues in the food market.@*METHODS@#All published and unpublished quantitative, qualitative, and mixed method studies were searched from electronic databases using a three step searching. Analytical framework was developed using the PICo (population, phenomena of interest, and context) method. The methodological quality of the included studies was assessed using mixed methods appraisal tool (MMAT) version 2018. The included full-text articles were qualitatively analyzed using emergent thematic analysis approach to identify key concepts and coded them into related non-mutually exclusive themes. We then synthesized each theme by comparing the discussion and conclusion of the included articles. Emergent themes were identified based on meticulous and systematic reading. Coding and interpreting the data were refined during analysis.@*RESULTS@#The analysis of 81 full-text articles resulted in seven common public health risks related with food safety in the food market. Microbial contamination of foods, chemical contamination of foods, food adulteration, misuse of food additives, mislabeling, genetically modified foods (GM foods), and outdated foods or foods past their use-by dates were the identified food safety-related public health risks in the food market.@*CONCLUSION@#This systematic literature review identified common food safety-related public health risks in the food market. The results imply that the local and international food marketing continues to have significant impacts on health of the public. The food market increases internationalization of health risks as the food supply chains cross multiple national borders. Therefore, effective national risk-based food control systems are essential to protect the health and safety of the public. Countries need also assure the safety and quality of their foods entering international trade and ensure that imported foods conform to national requirements.

Prevalence and associated factors of scabies among schoolchildren in Dabat district, northwest Ethiopia, 2018

BACKGROUND@#Scabies is a skin infestation caused by the mite Sarcoptes scabiei that causes a pruritic skin eruption. In Ethiopia, the disease is common especially during natural or manmade disasters such as flooding, drought, civil war and conflict, poor water supply and sanitation, and overcrowding living condition. Though scabies is becoming a major public health problem, especially in low resource settings, there has been no study that reported the prevalence of scabies in the study area. The aim of this study, therefore, was to assess the prevalence of scabies and associated factors among students in primary schools in Dabat district, northwest Ethiopia.@*METHOD@#An institutional-based cross-sectional study was employed to determine the prevalence of scabies and associated factors among schoolchildren in Dabat district. A total of 494 students selected by a multi-stage sampling technique were included in this study. Scabies was diagnosed by medical practitioners based on lesions observed on body surfaces after a physical examination. Bivariable and multivariable binary logistic regression analyses were performed using SPSS version 20. Significance level was obtained at p value < 0.05.@*RESULT@#The prevalence of scabies was 9.3% (46/494) with 95% CI (5.66%, 12.94%). Among schoolchildren who were infested by scabies, 65.22% (30/46) had a mild, 28.26% (13/46) had moderate, and 6.52% (3/46) had severe lesions. Studying at a rural school (AOR = 2.99, 95% CI 1.33, 6.71), had illiterate father (AOR = 5.11, 95% CI 2.25, 11.58), being grade level 1-4 (AOR = 3.91, 95% CI 1.69, 9.05), rarely taking a bath (AOR = 3.54, 95% CI 1.36, 9.25), contact with a person with itching symptom (AOR = 2.66, 95% CI 1. 21, 5.83), a family member with itchy symptoms (AOR = 4.76, 95% CI 2.20, 10.28), not living with both parents (AOR = 2.49, 95% CI 1.02, 6.06), and using water only for hand washing (AOR = 4.38, 95% CI 1.78, 10.76) were factors associated with scabies infestation among schoolchildren.@*CONCLUSION@#The prevalence of human scabies among schoolchildren in Dabat district northwest Ethiopia was high. The school localization, first cycle level of education, paternal educational status, frequency of taking a bath, and contact with a person having itchy lesions, presence of a family member with itchy lesion, and type of frequently used hand washing material were the factors significantly impacting the occurrence of scabies. Special attention should be given to students at first cycle education as they are at the highest risk of infestation.

Sick building syndrome and associated risk factors among the population of Gondar town, northwest Ethiopia

BACKGROUND@#Sick building syndrome (SBS) consists of a group of mucosal, skin, and general symptoms temporally related to residential and office buildings of unclear causes. These symptoms are common in the general population. However, SBS symptoms and their contributing factors are poorly understood, and the community associates it with bad sprits. This community-based cross-sectional study was, therefore, conducted to assess the prevalence and associated factors of SBS in Gondar town.@*METHODS@#A community-based cross-sectional study was conducted from March to April 2017. A total of 3405 study subjects were included using multistage and systematic random sampling techniques. A structured questionnaire and observational checklists were used to collect data. SBS was assessed by 24 building-related symptoms and confirmed by five SBS confirmation criteria. Multivariable binary logistic regression analysis was used to identify factors associated with SBS on the basis of adjusted odds ratio (AOR) with 95% confidence interval (CI) and p < 0.05. The Hosmer and Lemeshow goodness of fit test was used to check model fitness, and variance inflation factor (VIF) was also used to test interactions between variables.@*RESULTS@#The prevalence of SBS in Gondar town was 21.7% (95% CI = 20.3-23.0%). Of this, the mucosal symptoms account for 64%, the general symptoms account for 54%, and the skin symptoms account for 10%. From study participants who reported SBS symptoms, 44% had more than one symptom. Headache (15.7%), asthma (8.3%), rhinitis (8.0%), and dizziness (7.5%) were the commonest reported symptoms. SBS was significantly associated with fungal growth in the building [AOR = 1.25, 95% CI = (1.05, 1.49)], unclean building [AOR = 1.26, 95% CI = (1.03, 1.55)], houses with no functional windows [AOR = 1.35, 95% CI = (1.12, 1.63)], houses with no fan [AOR = 1.90, 95% CI = (1.22, 2.96)], utilization of charcoal as a cooking energy source [AOR = 1.40, 95% CI = (1.02, 1.91)], cooking inside the living quarters [AOR = 1.31, 95% CI = (1.09, 1.58)], and incensing and joss stick use [AOR = 1.48, 95% CI = (1.23, 1.77)].@*CONCLUSION@#The prevalence of SBS in Gondar town was high, and significant proportion of the population had more than one SBS symptom. Headache, asthma, rhinitis, and dizziness were the commonest reported SBS symptoms. Fungal growth, cleanliness of the building, availability of functional windows, availability of fan in the living quarters, using charcoal as a cooking energy source, cooking inside the quarters, and incensing habit or joss stick use were identified as factors associated with SBS. Improving the sanitation of the living environment and housekeeping practices of the occupants is useful to minimize the prevalence of SBS.

Childhood intestinal parasitic infection and sanitation predictors in rural Dembiya, northwest Ethiopia

BACKGROUND@#Intestinal parasites are a common problem in the world. The greater proportion of infections is associated with poor water, sanitation, and hygiene (WASH). This study was conducted to assess intestinal parasites, WASH condition, and their association in rural Dembiya, northwest Ethiopia.@*METHODS@#A cross-sectional study was employed. Two hundred twenty-five children aged 6-59 months were included. Mothers were interviewed using a structured questionnaire, and the living environment was observed using checklists. Kato-Katz technique was used to determine the intensity of parasitic infections. Escherichia coli (E. coli) was used as a biological indicator for drinking water quality. Multivariable binary logistic regression analysis was conducted to identify WASH predictors of parasites on the basis of adjusted odds ratio (AOR) with 95% confidence interval (CI) and p < 0.05.@*RESULTS@#The prevalence of intestinal parasites was 25.8% (95% CI = 20.3-32.0%). Ascaris lumbricoides (78%), hookworm (12%), Hymenolepis nana (7%), Enterobius vermicularis (5%), Schistosoma mansoni (3%), Giardia lamblia (3%), and Trichuris trichiuria (2%) were identified infections. Intestinal parasites were associated with poor child hand washing practice [AOR = 3.86, 95% CI = 1.53, 9.75], unprotected water sources [AOR = 7.79, 95% CI = 3.30, 18.40], access to water below 20 l/c/d [AOR = 3.05, 95% CI = 1.28, 7.23], poor food safety[AOR = 4.33, 95% CI = 1.62, 11.58], and poor sanitation [AOR = 5.01, 95% CI = 1.56, 16.16].@*CONCLUSION@#A. lumbricoides, hookworm, H. nana, E. vermicularis, S. mansoni, G. lamblia, and T. trichiuria were identified. Child hand washing practice, service level of water supply, water sources, food safety, and sanitation were associated with intestinal parasites. WASH promotion is needed to prevent infections.