Sleep quality among patients with chronic illness in Ethiopia: systematic review and meta-analysis.

Background: Poor sleep quality impedes the progression of chronic illnesses, while chronic illnesses themselves are caused by poor sleep quality. Despite this fact, there is no research that has been conducted in Ethiopia that provides a thorough estimate of the self-reported sleep quality among patients with chronic illnesses. In order to present a complete picture of poor sleep quality among diabetes, hypertension, heart failure, cancer, HIV/AIDS and epilepsy patients, this systematic review and meta-analysis was carried out. Methods: Systematic review and meta-analysis was conducted to estimate the quality of sleep among patients with chronic illness in Ethiopia. The Preferred Reporting Items for Systematic Review and Meta Analysis standard was followed in the reporting of this systematic review and meta-analysis. An extensive exploration of digital repositories, including PubMed, EMBASE, Cochrane, Africa Journal of Online, Google Scholar, and an advanced Google search, was conducted to obtain published studies until December 1st, 2023 detailing poor sleep quality of patients with chronic illness. STATA version 17 commands were used to create the pooled estimate. The I2 test and Egger's test, respectively, were used to identify the presence of heterogeneity and publication bias. To manage heterogeneity, a subgroup analysis and random effect model were used. Results: A total 21 articles with a total of 7393 participants were included in the final systematic review and meta-analysis. The pooled estimate of poor sleep quality among patients with chronic illness was 52% (95% of CI: 48%, 59%; I2 = 97.26%). In subgroup analysis, the highest pooled estimate of poor sleep quality was observed in cancer patients 63% (95% CI: (95% CI: 45% - 80%). Regarding to data collection period, the highest pooled estimate of poor sleep quality was seen during spring 68% (95% CI: 42% - 94%). Conclusions: Patients with chronic illnesses in Ethiopia had a high pooled estimate of poor sleep quality. Patients with cancer had the highest pooled estimate of poor-quality sleep compared with other patients. Patients with chronic illnesses had trouble sleeping in the spring, according to this systematic review and meta-analysis. Therefore, attention and intervention should be given to enhance the quality of sleep for patients with chronic illnesses.

Self-care practice and associated factors among hypertensive follow-up patients at East Gojam zone public hospitals, North West Ethiopia, 2021.

Uncontrolled hypertension leads to cardiovascular complications and organ damage. Self-care practice is crucial for the prevention and management of hypertension by improving quality of life, preventing complications and decreasing health care expenditure. The study aimed to assess self-care practice and its associated factors among hypertensive follow up patients at East Gojjam Zone public hospitals; in Northwest Ethiopia. Quantitative cross-sectional study design and qualitative phenomenological approach were applied. The quantitative result was supported by in-depth interview. Out of 480 patients included in the study, 49% have good self-care practices. Out of the total participants 44.6% have poor in antihypertensive medication adherence, 92.5% have low in diet management, 82.8% were poorly practiced physical activity and 62.5% poor practice to weight management. Participants who cannot read and write (AOR = 3.1, 95% CI: 1.6-5.9), and have no comorbidity (AOR = 0.4, 95% CI: 0.2-0.6), uncontrolled blood pressure status (AOR = 2.1, 95% CI: 1.2-3.6), poor social support status (AOR = 2.5, 95% CI: 1.5-4.3) and unfavorable attitude (AOR = 3.1, 95% CI: 1.9-5.2) are the factors for poor self-care practice. During interview; family meal preparation habits, inadequate information about self-care practice during follow-up time, inconvenient working environment, pressure during social events to share food, negligence, and poor self-efficacy were highly described as challenges for practicing and sustaining self- care. The level of hypertension self-care practices was found to be low. Therefore, hypertension self-care practices should be strengthened throughout their follow-up time, and creating awareness in the community is highly encouraged.

Prevalence of depression and associated factors among pregnant women attending antenatal care in public health institutions of Awabale Woreda, East Gojjam Zone, Northwestern Ethiopia: A cross-sectional study.

BACKGROUND: Antenatal depression is a serious health problem and has negative consequences for the mother, fetus, and the entire family. However, it is a neglected component of care especially bay health care providers for women in pregnancy. The purpose of this study was to assess the prevalence of depression and associated factors among pregnant women attending antenatal clinics in public health institutions, in the Awabale Woreda. METHOD: An institutional-based cross-sectional study was conducted in 2018 and a stratified sampling technique was used to select the study health institutions. All seven public health institutions in Awabale District were included to select 393 mothers and the sample size was proportionally allocated based on the number of target mothers. We used EpiData version 3.1software for data entry and SPSS version 20 software for cleaning and analysis. A Bivariable logistic regression analysis was used to identify the association between each outcome variable and the factor. Again, a multivariable logistic regression analysis was employed to identify factors associated with each outcome variable, and variables with a p-value less than 0.05 were taken as significant variables. Edinburgh Postnatal Depression Scale was used to declare the presence of antenatal depression with a cut point score of 13 and above. RESULT: This study showed that 63(17.8%) pregnant mothers had antenatal depressive symptoms. Women who were employed 85% reduced to develop antenatal depression than housewives [AOR = 0.15(0.001-0.25)]. Pregnant women who attended high school and above educational level were 18 times more likely to develop antenatal depression than women who had no formal education [AOR18.15 (2.73-120.76)]. Women who had poor husband feeling on the current pregnancy were 4.94 more likely to develop antenatal depression than women who had good partner feeling on the current pregnancy [AOR = 4.94(95%CI: 1.78-13.72)]. Women who had a history of depression were 8.2 times to develop antenatal depression than women who had no history of depression [AOR = 8.22 (95%CI: 2.87-23.57)]. CONCLUSION: This study revealed that approximately one-fifth of pregnant women developed antenatal depression. Women's occupational status, educational status, previous history of depression, and poor husband feeling on the current pregnancy were the significant factors of antenatal depression.

Alcohol consumption and its determinants among pregnant women in Gozamin district, Amhara, Ethiopia, 2020.

Objective: Alcohol consumption during pregnancy can cause many major severe illnesses to both mothers and their offspring. Despite this, many pregnant women consume both homemade and manufactured alcoholic beverages. We conducted this study to assess the prevalence and determinants of alcohol consumption among pregnant women in Gozamin district, Amhara, Ethiopia, in 2020. Methods: Community-based cross-sectional study was employed from 1 to 30 November, 2020. The participants were recruited using a stratified multi-stage sampling technique. A structured and pretested interviewer-administered questionnaire was utilized for data collection. The collected data were entered into Epi-data Version 3.1 and exported to SPSS Version 25 for further analysis. The model fitness was checked by Hosmer and Lemeshow's goodness of fit test. Then, logistic regression models were considered to determine the associations of independent variables with the outcome variable. Variables with p < 0.25 in bivariable logistic regression were considered for multivariable logistic regression. Finally, variables with p < 0.05 in multivariable logistic regression were considered as determinants of alcohol consumption. Result: A total of 555 pregnant women participated in this study, making the response rate of 97.4%. The prevalence of alcohol consumption among the participants was 45.6% (95% confidence interval = 41.4-49.2). The determinants of alcohol consumption among the participants were highest wealth index (adjusted odds ratio = 3.21; 95% CI = 1.68-6.14), pre-pregnancy alcohol consumption (adjusted odds ratio = 3.67; 95% confidence interval = 2.36-5.71), poor social support (adjusted odds ratio = 3.08; 95% confidence interval = 1.60-5.94), and unplanned pregnancy (adjusted odds ratio = 1.66; 95% confidence interval = 1.04-2.66). Conclusion: In this study, the prevalence of alcohol consumption was high among the pregnant women. Our findings suggest introduction of policies and interventions that can help reduce alcohol consumption during pregnancy. The health education priority should be creation of awareness about the negative health impacts of alcohol on the health of pregnant mothers and their offspring.

Magnitude and associated factors of low back pain among nurses working at intensive care unit of public hospitals in Amhara region, Ethiopia.

BACKGROUND: Low back pain is a common public health problem throughout the world with a global prevalence from 28% to 86%. Nurses working in intensive care units are handling people who are critically ill and helpless, which requires more assistance for transferring and handling activities. This possesses a risk for low back pain but little is known about it in Ethiopia. This study aimed to assess the magnitude of low back pain and associated factors among nurses who work at intensive care units in Amhara region public hospitals, North Ethiopia. METHODS: A multi-centered institution-based cross-sectional study was conducted at Amhara region public hospitals from March 1-30, 2020. A simple random sampling technique after proportional allocation was used to select the study participants. Data were collected using a standard modified Nordic musculoskeletal assessment tool. After data were checked for completeness and consistency, it was entered into Epidata version 3.1 and exported to Statistical Package for Social Science software version 26 for analysis. Descriptive statistics were computed. A binary logistic regression model was used to identify factors associated with low back pain. Finally, those variables with a p-value of <0.05 in multivariable analysis were considered statistically significant. RESULT: Study was conducted among 412 intensive care unit nurses giving a response rate of 97.6%. The magnitude of low back pain was 313 (76%) [95% CI: (71.6%-79.9%)]. Being female [AOR = 2.674 (1.404, 5.076)], unavailability of assistive device for patient handling [AOR = 2.139 (1.035, 4.410)], lack of training on intensive care [AOR = 2.017 (1.092, 3.943)], lack of regular exercise [AOR = 2.164 (1.164, 4.108)] and job stress [AOR = 3.66 (1.955, 6.498)] were factors significantly associated with low back pain. CONCLUSIONS: In this study the magnitude of low back pain was high. Being female, unavailability of an assistive device for patient handling, lack of training on intensive care, lack of regular exercise and job stress were factors associated with low back pain. Policymakers and concerned bodies should emphasize the accessibility of assistive devices for patient care, provision of training on intensive care, and adaptive working environment for intensive care unit nurses.

Effect of a self-care educational intervention to improve self-care adherence among patients with chronic heart failure: a clustered randomized controlled trial in Northwest Ethiopia.

BACKGROUND: As the burden of cardiovascular disease increases in sub-Saharan Africa, there is a growing need for low-cost interventions to mitigate its impact. Providing self-care health education to patients with chronic heart failure (CHF) is recommended as an intervention to prevent complications, improve quality of life, and reduce financial burdens on fragile health systems. However, little is known about health education's effectiveness at improving CHF self-management adherence in sub-Saharan Africa. Therefore the present study aimed to assess the effectiveness of an educational intervention to improve self-care adherence among patients with CHF at Debre Markos and Felege Hiwot Referral Hospitals in Northwest Ethiopia. METHODS: To address this gap, we adapted a health education intervention based on social cognitive theory comprising of intensive four-day training and, one-day follow-up sessions offered every four months. Patients also received illustrated educational leaflets. We then conducted a clustered randomized control trial of the intervention with 186 randomly-selected patients at Debre Markos and Felege Hiwot referral hospitals. We collected self-reported data on self-care behavior before each educational session. We analyzed these data using a generalized estimating equations model to identify health education's effect on a validated 8-item self-care adherence scale. RESULTS: Self-care adherence scores were balanced at baseline. After the intervention, patients in the intervention group (n = 88) had higher adherence scores than those in the control group (n = 98). This difference was statistically significant (ß = 4.15, p < 0.05) and increased with each round of education. Other factors significantly associated with adherence scores were being single (ß = - 0.25, p < 0.05), taking aspirin (ß = 0.76, p < 0.05), and having a history of hospitalization (ß = 0.91, p < 0.05). CONCLUSIONS: We find that self-care education significantly improved self-care adherence scores among CHF patients. This suggests that policymakers should consider incorporating self-care education into CHF management. TRIAL REGISTRATION NUMBER: PACTR201908812642231.

Magnitude of visual impairment and associated factors among patients attending ophthalmic clinics of Debre Markos referral hospital, north West Ethiopia.

BACKGROUND: Globally, visual impairment affects about 285 million (4.25%) people, of those, 266.4 million were adults aged 18 years and above. Ethiopia is one of developing countries estimated to have high prevalence of visual impairment which have an enormous socio-economic impact. Also there is limited available information regarding with the magnitude of visual impairment among adults in our country at large and east Gojjam zone in specific. Therefore the aim of this study was to assess the magnitude of visual impairment and its associated factors among patients attending Debre Markos Referral Hospital ophthalmic clinics in east Gojjam zone, North West Ethiopia. METHODS: An institutional-based cross-sectional study was conducted at Debre Markos Referral Hospital which is the only hospital in east gojjam zone with ophthalmic care service from March 1 to 30, 2020 by using systematic random sampling technique to select study participants after informed consent was obtained. Data were collected by interview with 5% pretested, structured questionnaire and ocular examinations. Data were cleaned, coded and entered to Epi-data version-3.1, and analyzed using Statistical Package for Social Science software version 26. The descriptive statistics was presented in tables, text and graphs. Bivariable and multivariable logistic regression analysis to identify factors associated with visual impairment was conducted. Covariates with P-value < 0.05 were considered statistically significant. RESULTS: A study was conducted among 312 study participants with 96% response rate. The magnitude of visual impairment was 114 (36.5%) [95% CI, (33.8, 39.2%)]. Age > 50 years [AOR = 3.82; 95% CI (1.56, 9.35)], rural residency [AOR = 4.33 95% CI (1.30, 14.44)], inability to read and write [AOR = 3.21; 95% CI (1.18, 8.73)] and Cataract [AOR = 4.48; 95% CI (1.91, 10.52)] were factors significantly associated with visual impairment. CONCLUSIONS: The overall magnitude of visual impairment was found to be high. Older age, rural residency, inability to read and write and cataract were associated with visual impairment. Increasing literacy, expanded cataract surgery, as well as community based visual acuity screening especially for elders and rural residents is crucial. Zonal police makers should give emphasis on prevention of visual impairment to decrease economic, social and political burden of visual disability.

Incidence and predictors of diabetic ketoacidosis among children with diabetes in west and east Gojjam zone referral hospitals, northern Ethiopia, 2019.

BACKGROUND: Recurrent diabetic ketoacidosis in patients with known diabetes mellitus remains a relevant problem in pediatrics with an incidence of 1-10% per patient. Children may die because of cerebral edema and had a significant mortality (24%) and morbidity (35%). OBJECTIVE: We assessed the incidence and predictors of diabetic ketoacidosis among diabetes children at East and West Gojjam zone referral hospitals, North West Ethiopia, 2019. METHODS: An institution-based retrospective follow up study was conducted on children who were registered from January 1, 2014, to January 1, 2019. Epi data version 3.1 & Stata 14 were used for data entering and analysis respectively. RESULT: Out of 354 children included in the study, 207 (58.5%) developed diabetic ketoacidosis. The overall incidence rate of diabetic ketoacidosis was 2.27/100 children/month of observation. Age < 5 years (AHR: 3.52, 95% CI (2.25, 5.49), non-adherence (AHR: 1.54, 95% CI (1.11, 2.14), inappropriate insulin storage (AHR: 1.36, 95% CI (1.008, 1.85), presence of upper respiratory tract infections during diabetic ketoacidosis diagnose (AHR: 2.22, 95% CI (1.11, 4.45) and preceding gastroenteritis (AHR: 2.18, 95% CI (1.07, 4.44) were significant predictors. CONCLUSION: Age < 5 years old, non-adherence, inappropriate insulin placement at home, preceding gastroenteritis, and presence of upper respiratory tract infections at the time of diabetic ketoacidosis development were significant predictors. Hence, assessing and close monitoring as well as strengthened diabetic education should be given for the above predictors.

Determinants of Diabetic Complication Among Adult Diabetic Patients in Debre Markos Referral Hospital, Northwest Ethiopia, 2018: Unmatched Case Control Study.

BACKGROUND: Diabetes mellitus is a group of common metabolic disorders that share the phenotype of hyperglycemia, and are caused by a complex interaction of genetics and environmental factors. Diabetes mellitus produces change in the blood vessels and therefore affects almost every part of the body. METHODS: A hospital-based unmatched case control study was conducted from February 2018 to April 2018 at Debre Markos Referral Hospital. Data were collected from 204 individuals, 136 controls and 68 cases using an interviewer-administered questionnaire and patient chart. Data were entered into EPI-data 3.1 software and exported to SPSS version 21 for analysis. Descriptive analysis including mean, median and proportions was carried out. In bivariate analysis, variables below 0.25 significance level were selected for multivariable analysis. For multivariable analysis, a backward model was selected and 95% confidence interval variables with P-values below 0.05 in multivariable analysis were declared as significant variables. RESULTS: Of the total respondents, 68 were cases and 136 were controls, with an overall response rate of 98.55%. Of these respondents, 57.4% and 57.8% were males and type 1 diabetic patients, respectively. This study found that ages of 38-47 (AOR= 5.60 (1.62-19.38)) and >47 (AOR=4.81 (1.32-17.5)), income of 1000-1499 (AOR=3.10 (1.05-9.08)), self-reported drug adherence (AOR=5.146 (1.651-16.04)), FBS of 70-130 mg/dL 0.095 (0.022-0.414) and ≥131 mg/dL (0.05 (0.011-0.223)) and type 1 diabetic mellitus (AOR=4.73 (1.765-12.72)) were significantly associated with diabetes mellitus complications. CONCLUSION AND RECOMMENDATIONS: The study identified important determinants of diabetic complications. Poor glycemic control, poor adherence, and income were found to be modifiable determinants; on the other hand, age and type of diabetic mellitus are non-modifiable determinants of diabetic complications. Clinicians should implement a comprehensive care plan that will address patients' adherence and glycemic control problems.

Patient Experience in Nursing Care and Associated Factors Among Adult Admitted Patients in Debre Markos and Dessie Referral Hospitals, Amhara Region, Ethiopia, 2019.

Patient experience of nursing care is the perception of the patient about the real existing nursing service. Addressing patient experience of nursing care is very important to improve nursing service quality because it identifies the factors that affect the nursing care quality better than patient satisfaction. Therefore, this study aimed to assess patient experience in nursing care and associated factors among adult admitted patients in Debre Markos and Dessie referral hospitals. An institution-based cross-sectional study was conducted from March 1, 2019, to March 30, 2019, among 528 consecutively selected adult admitted patients. Data were cleaned, coded, and entered in Epi-data version 3.1 then exported to Statistical Package for Social Sciences version 25 for analysis. Multivariate logistic regression, with a 95% CI was used to identify variables that had a significant association. The overall good patient experience in nursing care was 64%. Duration of admission ≥22 days (adjusted odds ratio [AOR] = 2.67, 95% CI = 1.013-7.025) and free service (AOR = 3.69, 95% CI = 2.381-5.730) showed a positive association with patient experience in nursing care. However, admission in gynecology ward (AOR = 0.43, 95%CI = 0.257-0.707), secondary education (AOR = 0.53, 95% CI: 0.308-0.907), and college or above education (AOR = 0.55, 95%CI = 0.320-0.957) showed a negative association with patient experience in nursing care.

Level and factors associated with birth preparedness and complication readiness among semi-pastoral pregnant women in southern Ethiopia, 2016.

OBJECTIVE: The objective of this study was to determine the level of birth preparedness and complication readiness (BPCR) and associated factors among semi-pastoral pregnant women in southern, Ethiopia. RESULT: This dataset contains the full data collected from 746 pregnant women. Birth preparedness and complication readiness among women in southern Ethiopia was 27.1%. The main predictors for BRCP were attending formal education (AOR = 4.65, 95% CI 2.45-8.63), husband occupation [merchant (AOR = 3.83, 95% CI 1.52-9.64)], spouse attending formal education (AOR = 3.35, 95% CI (1.83-6.14), ANC visits > 4 times (AOR = 17.78, 95% CI 7.11-44.47). In addition, knowledge of women at least two danger signs during pregnancy, delivery and after delivery (AOR = 3.32, 95% CI 1.64-6.69), (AOR = 3.13, 95% CI 1.58-6.20) and (AOR = 3.75, 95% CI 1.93-7.28) respectively were significantly associated with BPCR. In conclusion, the proportion of BPCR among women in southern Ethiopia was found to be low.

Exclusive breastfeeding practice and associated factors among mothers in Motta town, East Gojjam zone, Amhara Regional State, Ethiopia, 2015: a cross-sectional study.

BACKGROUND: Exclusive breastfeeding means babies are given only breast milk and nothing else: no other milk, food, drink, not even water for one day (24 hrs) before the survey was conducted. It prevents 13% of childhood mortality; i.e, at least 1.2 million children worldwide would be saved every year. The objective of this study was to assess the prevalence exclusive breastfeeding (EBF) practice and its associated factor among mothers who have infants less than six months of age in Motta town, East Gojjam, Amhara Regional State, Ethiopia. METHOD: A community based quantitative cross-sectional study was conducted from April 7, 2015 to May 7, 2015. A simple random sampling technique was applied after taking all registered mothers who have infants less than six months old from local health extension workers of each kebele. A total of 423 mothers with infant less than six months old were included in this study. The data was collected using an interviewer administered questioaire. Both bivariate and multivariate logistic regression analyses were used to identify factors associated with exclusive breastfeeding practice. RESULT: Prevalence of exclusive breastfeeding was 50.1%. Mothers with young infants aged 0-1 month (Adjusted Odds Ratio [AOR] 3.86: (1.64, 9.07), unemployed mothers (AOR 3.01: 1.46, 6.20), low income mothers (AOR 3.61: 1.75, 7.45), mothers who received breastfeeding counseling in pregnancy (AOR 2.76: 1.52, 4.99), fed colostrum (AOR 3.50: 1.45, 8.45), didn't give prelacteal feeds (AOR 4.48: 1.82, 11.03) and were supported by their husband (AOR 2.67: 1.04, 6.95) were more likely to practice exclusive breastfeeding than their counterparts. CONCLUSIONS: Prevalence of exclusive breastfeeding practice in study area was lower than country recommended level. Age of the child, maternal occupation, income, breastfeeding counseling during antenatal care, husband support of breastfeeding and colostrum feeding were independent predictors of exclusive breastfeeding practice. Recommendations to increase exclusive breastfeeding practice are revising postpartum maternity leave, increasing health professional's habit of breastfeeding counseling through training, involving husbands during counseling, educating mothers and the community as a whole to avoid traditional practices that hinder exclusive breastfeeding up to six months.