Determinants of COVID-19 vaccine hesitancy among health care workers in Amhara region referral hospitals, Northwest Ethiopia: a cross-sectional study.

Vaccine hesitancy remains a serious global threat to achieve herd immunity, and this study aimed to assess the magnitude and associated factors of coronavirus disease-19 (COVID-19) vaccine hesitancy among healthcare workers (HCWs) in Amhara regional referral hospitals. A web-based anonymised survey was conducted among 440 HCWs in the Amhara region referral hospitals. The questionnaire was designed using Google Forms and distributed using telegram and e-mail from 15 May to 10 June 2021 to the randomly selected participants in each hospital. The data were analysed with Stata 14.0 and described using frequency tables. A multivariable binary logistic regression model was fitted and model fitness was checked with the Hosmer-Lemeshow goodness of fit test. Out of 440 participants, 418 were willing to participate in the study and the mean age was about 30 years. Overall, 45.9% (n = 192) of participants reported vaccine hesitancy. After applying multivariate analysis, age ≤25 years (adjusted odds ratio (aOR) = 5.6); do not wear a mask (aOR = 2.4); not compliance with physical distancing (aOR = 3.6); unclear information by public health authorities (aOR = 2.5); low risk of getting COVID-19 infection (aOR = 2.8); and not sure about the tolerability of the vaccine (aOR = 3.76) were associated with COVID-19 vaccine hesitancy. A considerable proportion of HCWs were hesitant towards COVID-19 vaccine, and this can be tackled with the provision of clear information about the vaccine.

Prevalence and associated factors of postoperative suxamethonium-induced myalgia in surgical patients at Debre Tabor Comprehensive Specialized Hospital Ethiopia: a cross-sectional study.

Suxamethonium is considered by many to be the best drug for providing ideal intubating conditions, short surgical procedures, and rapid sequence induction. However, its usefulness is limited by the frequent occurrence of adverse effects like postoperative myalgia. Therefore this study aimed to assess the prevalence and associated factors of postoperative suxamethonium-induced myalgia. An institutional-based cross-sectional study was conducted on 210 patients who underwent surgery with general anesthesia. The data was collected by using structured and pretested questionnaires and analyzed using SPSS version 20.0. Logistic regression was conducted to identify significant predictors based on a P-value of less than 0.05 with a 95% confidence level. Among 210 patients the prevalence of suxamethonium-induced postoperative myalgia in the first 48 h was 88 (41.9%). Patients having previous anesthesia and surgical exposure (AOR 5.29, 95% CI 1.86-15.05), patients having a co-existing disease (AOR 2.69, 95% CI 1.08-6.67), patients that had not taken premedication (analgesia) (AOR 4.64, 95% CI 1.69-12.74), anesthesia maintenance using halothane (AOR 4.5 95% CI 1.7-11.4) and relaxation maintained with suxamethonium (AOR 3.1, 95% CI 1.2-8.1) were significantly associated with the prevalence of postoperative myalgia. The magnitude of suxamethonium-induced postoperative myalgia was high. So it is better to do with preventive techniques. As much as possible it is better to avoid using suxamethonium and necessary to use better to Premedicate with nonsteroidal anti-inflammatory drugs and non-depolarizing neuromuscular medications.

Prevalence and factors associated with postoperative sore throat in Ethiopia: A systemic review and meta-analysis, 2023.

Background: Postoperative sore throat (POST) remains a stressful impact of postoperative airway management, and it contributes to mortality and morbidity after general anesthesia. Its pooled prevalence and determinants in Ethiopia have not been fully studied. This study intended to assess the pooled prevalence and risk variables for POST in Ethiopia. Methods: A systematic review and Meta-analysis were performed as per the recommendation of PRISMA. To evaluate the pooled prevalence and factors significantly associated with POST in Ethiopia, electronic databases were searched till November 30/2023 and publications were chosen based on inclusion criteria. To assess the quality of the included studies, the Joanna Briggs Institute criteria was used. STATAMP 17 software was used for all data analysis. Results: Databases were searched for possible research using Medical Subject headings or entries or key phrases. Only 12 articles were included in the final analysis after screening by titles, abstracts, and full text based on the qualifying criteria. The pooled prevalence of POST in Ethiopia is 47.3 %. The determinants of POST in Ethiopia were female sex, repeated attempts at intubation, blood visible on the tip of an endotracheal tube or laryngoscope, prolonged duration of intubation, and using endotracheal intubation over laryngeal mask airway. Conclusion: In Ethiopia, the overall prevalence of postoperative sore throat is substantial. Prolonged intubation for more than 2 h, using ETT over LMA, Sex being female multiple attempts at intubation, and blood seen on the tip of ETT or Laryngoscope were the determinant factors of POST in Ethiopia.

Determinants of Poor Sleep Quality During the COVID-19 Pandemic Among Women Attending Antenatal Care Services at the Health Facilities of Debre Berhan Town, Ethiopia: An Institutional-Based Cross-Sectional Study.

Background: Women's ability to get sleep can be affected by pregnancy-related hormonal changes or other external stressful situations like the coronavirus disease 2019 (COVID-19). Objective: The objective of this study was to assess the proportion of poor sleep quality during the COVID-19 pandemic and its determinants among pregnant women attending antenatal care (ANC) services. Methods: An institutional-based cross-sectional study was conducted among 423 women attending ANC services at the health facilities in Debre Berhan Town, Ethiopia, from May to June 2020. A systematic random sampling technique was used to select the required samples. The tool consisted of questions that assessed (1) socio-demographic characteristics, obstetric and health care service-related characteristics; and media exposure to get information regarding COVID-19 infection; (2) To assess sleep quality; the Pittsburgh Sleep Quality Index (PSQI) was applied. And a global score of >5 indicates poor sleep quality, and a global score of ≤5 indicates good sleep quality. Result: The overall prevalence of poor sleep quality was 62.8%, and was associated with pregnant women aged ≥46 years (AOR = 4.27), being in the third trimester (AOR = 2.51), being multigravida (AOR = 2.72), and having co-morbidity (AOR = 3.57). Conclusion: The prevalence of poor sleep quality among pregnant women during the pandemic was found to be high. Advanced maternal age, third trimester pregnancy, being multigravida, and having comorbidity were determinants of poor sleep quality among pregnant women during the COVID-19 pandemic.

Prevalence of anaemia and its associated factors among HIV-infected adults at the time of ART initiation at Debre Markos Comprehensive Specialized Hospital, Northwest Ethiopia: a retrospective cross-sectional study.

OBJECTIVE: The aim of this study was to assess the prevalence of anaemia and its associated factors at the time of antiretroviral therapy (ART) initiation among HIV-infected adults at Debre Markos Comprehensive Specialized Hospital. METHODS: An institution-based retrospective cross-sectional study was conducted among 473 patients' charts enrolled from 2014 to 2018 at Debre Markos Comprehensive Specialized Hospital. Patients' chart numbers were selected from the computer using a simple random sampling technique. Data were entered using Epi Info V.7.2.2.6 and analysed with Stata V.14.0. Anaemia prevalence at the time of ART initiation was computed and described using frequency tables. To identify factors for anaemia, bivariate and multivariate logistic regression models were fitted. Model fitness was checked using the Hosmer-Lemeshow goodness-of-fit test. RESULTS: From 473 patients' charts, 468 charts were included in the analysis, and a total of 164 anaemia cases were recorded. The overall prevalence of anaemia among HIV-infected adults at the time of ART initiation was 35.04% (95% CI: 30.84% to 39.49%). After multivariate analysis, an increased risk of anaemia was seen among males (adjusted OR (AOR)=2.45; 95% CI: 1.51 to 3.98); those not attending formal education (AOR=2.38; 95% CI: 1.12 to 5.05); those who had baseline CD4+ T cell count ≤200 cells/mm3 (AOR=4.67; 95% CI: 2.78 to 7.85); had body mass index (BMI) <18.5 kg/m2 (AOR=2.43; 95% CI: 1.42 to 4.16) and had ambulatory/bedridden baseline functional status (AOR=2.69; 95% CI: 1.41 to 5.12). CONCLUSION: The current study showed that a significant proportion of HIV-infected adults developed anaemia at the time of ART initiation. Hence, giving special attention to those who have not attended formal education, were males, had decreased baseline CD4+ T cell count, had lower BMI and patients with ambulatory/bedridden baseline functional status is crucial to reduce the health impact of anaemia. The result will provide insight into the development of new anaemia preventive strategies.

Incidence and predictors of mortality within the first year of antiretroviral therapy initiation at Debre-Markos Referral Hospital, Northwest Ethiopia: A retrospective follow up study.

BACKGROUND: Acquired Immunodeficiency Syndrome (AIDS) is one of the most fatal infectious diseases in the world, especially in Sub-Saharan Africa, including Ethiopia. Even though Antiretroviral therapy (ART) significantly decreases mortality overall, death rates are still highest especially in the first year of ART initiation. OBJECTIVE: To assess the incidence and predictors of mortality within the first year of ART initiation among adults on ART at Debre-Markos Referral Hospital, Northwest Ethiopia. METHODS: A retrospective follow-up study was conducted among 514 newly enrolled adults to ART from 2014 to 2018 at Debre-Markos Referral Hospital. Patients' chart number was selected from the computer using a simple random sampling technique. Data were entered into EPI- INFO 7.2.2.6 and analyzed using Stata 14.0. The mortality rate within the first year was computed and described using frequency tables. Both bivariable and multivariable Cox-proportional hazard models were fitted to show predictors of early mortality. RESULTS: Out of 494 patient records included in the analysis, a total of 54 deaths were recorded within one year follow-up period. The overall mortality rate within 398.37 person years (PY) was 13.56 deaths/100 PY with the higher rate observed within the first three months. After adjustment, rural residence (Adjusted Hazard Ratio (AHR) = 1.97; 95% CI: 1.05-3.71), ≥ 6 months pre-ART duration (AHR = 2.17; 95% CI: 1.24-3.79), ambulatory or bedridden functional status at enrolment (AHR = 2.18; 95% CI: 1.01-4.74), and didn't take Cotrimoxazole preventive therapy (CPT) during follow-up (AHR = 1.88; 95% CI: 1.04-3.41) were associated with early mortality of adults on ART. CONCLUSION: Mortality within the first year of ART initiation was high and rural residence, longer pre-Art duration, ambulatory or bedridden functional status and didn't take CPT during follow-up were found to be independent predictors. Hence, giving special attention for patients from rural area and provision of CPT is crucial to reduce mortality.

Prevalence and associated factors of post dural puncture headache among parturients who underwent cesarean section with spinal anesthesia: A systemic review and meta-analysis, 2021.

INTRODUCTION: PDPH is a headache that develops after dural puncture which worsens in an upright position, and improves with lying down. It could affect maternal satisfaction and health care quality. The prevalence and factors of PDPH vary based on different literature and there is no previous meta-analysis done. METHODS: This study was done by searching studies from databases PubMed/MEDLINE, Google scholar, and google. Data were extracted by three reviewers independently by using Microsoft Excel and then exported to STATA™ 16 version statistical software for analysis. Heterogeneity assessed using the I2 statistic. With a random model meta-analysis, the pooled prevalence of post-dural puncture headache and its associated factors (POR) with a 95% confidence interval was estimated. RESULT: Eight studies with a total of 175, 652 study participants were included to estimate the pooled prevalence of PDPH following cesarean section under spinal anesthesia. The pooled prevalence of PDPH in this meta-analysis was found to be 23.47% with 95% CI (10.53, 36.42). Having normal BMI, multiple attempts of spinal injection and spinal injection with a needle size of less than or equal to 22 gauge were positively associated with the PDPH with AOR and 95% CI of 1.22 (1.09, 1.35), 3.50 (1.55, 5.44) and 7.36 (4.93, 9.80) respectively. CONCLUSION: The pooled prevalence of PDPH among parturients who gave birth with the cesarean section under spinal anesthesia is estimated to be 23.47%. Having normal BMI, multiple attempts of spinal injection, and spinal injection with a needle size of less than or equal to 22 gauge were positively associated with the PDPH.

Assessment of Staffing and Service Provision in the Post-Anesthesia Care Unit of Hospitals Found in Amhara Regional State, 2020.

BACKGROUND: Post-anesthesia recovery is a continuous process which is considered to be complete after the patient returns to their preoperative physiological state. Although all patients who have had an operation under anesthesia are in a potentially unstable physiological state, most patients recover safely without significant problems due to better and immediate post-anesthesia care. Therefore, this study aimed to assess the staffing and service provision in the post-anesthesia care unit. METHODS: A multicenter, institution-based cross-sectional study was conducted in post-anesthesia care units from November 28 to December 31, 2020. The data were collected using a questionnaire prepared from standards and guidelines of the American Society of Anesthesiologists, the American Association of Nurse Anesthetists, and the Royal College of Anesthetists by direct observation. RESULTS: Ten hospitals found in Amhara regional state were examined for their staffing of and service provision in their post-anesthesia care units. The total ratio of nurses assigned in post-anesthesia care units to post-anesthesia care unit beds was around 1:3, with a minimum and a maximum ratio of 1:8 and 1:2, respectively. The average number of patients admitted in post-anesthesia care units per week was 98. Eighty percent of the hospitals' post-anesthesia care units had no policy or caregivers for cardiac arrest management. CONCLUSIONS AND RECOMMENDATIONS: Standards, policies, and guidelines are not well prepared and posted so as to be visible to every caregiver. The majority of the hospitals have staff without special training for the management of possible complications in the post-anesthesia care unit. Generally, hospitals need to ensure standardized patient care in the post-anesthesia care unit for better and safer patient outcomes.

The efficacy of TAP block versus ilioinguinal block for post-cesarean section pain management: A systematic review and meta-analysis.

BACKGROUND: Controversy still exists regarding the analgesic efficacy of transverse abdominis plane (TAP) block versus ilioinguinal or iliohypogastric (IL/IH) nerve block for postoperative pain management following cesarean section. This meta-analysis aimed to perform relatively credible pooled results on the efficacy of the TAP versus IL/IH nerve block for postoperative pain management after cesarean section. METHODS: Databases such as: PubMed/MEDLINE, Google scholar, and google were systematically searched. studies compared the analgesic efficacy of TAP versus IL/IH nerve block for postoperative pain management following cesarean section were included. Data were extracted by three reviewers independently by using Microsoft Excel and then exported to STATA™ 16 version statistical software for analysis. We used a random-effects model meta-analysis and the mean difference of analgesic efficacy with a 95 â€‹% confidence interval was reported based on Preferred Reporting Items for systematic reviews and meta-analysis (PRISMA). RESULTS: Five studies with a total of 390 (196 in TAP and 194 in IL/IH) study participants were included in this meta-analysis. No statistically significant difference was observed between the TAP and IL/IH groups in time to first rescue analgesic request, total postoperative analgesic consumption in milligrams of intravenous tramadol equivalence, and post pain severity score at different points of time both rest and movement. CONCLUSION: This meta-analysis revealed that both approaches have similar postoperative analgesic efficacy following cesarean section. we recommend that the clinician may consider either approach for post-cesarean section pain management.

Magnitude and associated factors of intraoperative nausea and vomiting among parturients who gave birth with cesarean section under spinal anesthesia at South Gondar zone Hospitals, Ethiopia.

BACKGROUND: Intraoperative nausea and vomiting are common intraoperative events by which parturient feel discomfort and disturbed after spinal anesthesia. METHODS: Hospital-based cross-sectional study was conducted on mothers who underwent cesarean section with spinal anesthesia. Descriptive analysis and chi-square test were employed. Bivariable and multivariable logistic regressions were used to measure the association of factors with the outcome variable intraoperative nausea and vomiting. A p-value of ≤0.05 was used to decide statistical significance for multivariable logistic regression. RESULT: A total of 246 parturients were participated in this study. The incidence of intraoperative nausea and vomiting was 40.2%. According to multivariable logistic regression, age greater than 30 years (AOR, 6.26; 95%CI, 2.2-17.78; p-value 0.001), primiparous (AOR, 3.72; 95%CI, 1.35-10.24; p-value, 0.011), having motion sickness (AOR, 7.1; 95%CI, 2.75-18.33; p-value 0.001), emergency cesarean sectin (AOR, 9.85; 95%CI, 3.19-30.38; p-value 0.001), oxygen suplimentation (AOR, 0.021; 95%CI, 0.005-0.08; p-value 0.0001) and uterotonic agent (AOR, 2.99; 95%CI 1.24-7.22; p-value 0.015) had statistically significant association with intraoperative nausea and vomiting. CONCLUSION: In our study, the overall incidence of intraoperative nausea and vomiting after spinal anesthesia was 40.2%. Parturients with age greater than 30 years, having motion sickness, didn't get intraoperative supplemental oxygen, oxytocin used for the uterotonic purpose, emergency surgery, and primiparous were at increased risk of intraoperative nausea and vomiting.