Incidence of mortality and risk factors among adult stroke patients in public hospitals Jigjiga town Somali region, Ethiopia: Cohort study design.

Background: A stroke is a sudden loss of blood supply to the brain, leading to permanent tissue damage caused by embolism, thrombosis, or hemorrhagic events. Almost 85% of strokes are ischemic strokes. Objective: To assess the incidence of mortality and risk factors among adult stroke patients in public hospitals of Jigjiga town, Somali Region, Ethiopia. Methods: An institution-based retrospective cohort study was conducted from 25 May to 15 June 2022 at Sheikh Hassen Yabare Referral Hospital and Karamara Hospital. Data were entered using Epi-Data version 4.3 and exported to be analyzed using SPSS 20 statistical software. Kaplan-Meier was used to estimate mean survival time, and a predictor with a p-value < 0.05 was considered to have a significant in multivariate Cox regression. Results: About 480 stroke patients' charts were included in this study; among those, 229 (53.3%) were male stroke patients, and 259 (60.2%) had an ischemic stroke. The overall incidence rate was 7.15 deaths per 1000 person-day observations. The overall median survival time for adult stroke patients was 120 days. GCS level b/n 3-8 has a lower survival time with a mean survival time of 57 days (95% CI: 48.8-66.7) as compared to those who had GCS level 9-12 with a mean survival time of 103 days (95% CI: 93.4-112.9). Age ⩾ 71 (AHR = 1.9; 95% CI: 1.02-3.45), presence of pneumonia (AHR = 2.7; 95% CI: 1.52-4.63), and history of hypertension (AHR = 2.07; 95% CI: 1.08-3.89) were the predictors of mortality among stroke patients. Conclusion: According to the findings of this study, the incidence of mortality was high, at 7.15 per 1000 person-years. The presence of pneumonia, decreased GCS, age ⩾ 7, and history of hypertension were predictors of mortality in adult stroke patients.

Determinants of Adverse Birth Outcomes in Public Hospitals of the Somali Region, Eastern Ethiopia: A Multicenter Unmatched Case-Control Study.

Background: Pregnancy outcomes that differ from normal live births are known as adverse pregnancy outcomes. Adverse pregnancy outcomes also have significant effects on the infant's family and society. There is limited data on adverse outcomes in eastern Ethiopia, particularly in the Somali region. Objectives: This study aimed to assess the determinants of adverse birth outcomes in the Somali Region Hospitals. Design: A hospital-based unmatched case-control study was conducted to conduct this study. Methods: A hospital-based unmatched case-control study was conducted between June and July 2021 in pregnant women who attended public hospitals in the Somali region. A total of 327 (109 cases and 218 controls) participants were included in this study. Women who gave birth with at least 1 adverse birth outcome were considered cases, and those who gave birth with normal birth outcomes were considered controls. Cases were recruited consecutively, and controls were selected using systematic sampling methods. Data was gathered using interviews, record reviews, using the pretested standard tools. The data were entered into EpiData version 3.1 and analyzed with SPSS version 22. Multivariable regression analysis with an adjusted odds ratio and a 95% confidence interval was used to identify the factors associated with adverse birth outcomes. Finally, P-values less than .05 were used to identify significantly associated predictors. Results: In the current study, rural residency [AOR = 2.80; 95%CI:(1.61-4.87)] lack of ANC follow-up [AOR = 3.27; 95%CI: (1.77-6.02)], pregnancy-induced hypertension [AOR = 3.28; 95%CI: (1.74-6.17)] being anemic mothers [AOR = 3.51; 95%CI: (2.02-6.07)] and khat chewing [AOR = 4.54; 95%CI: (2.12-9.70)] were identified as determinants of adverse birth outcome. Conclusions: In the current study, rural residency, lack of ANC, being anemic in indexed pregnancies, pregnancy-induced hypertension, and khat chewing were determinants of adverse birth outcomes. Therefore, efforts should be made to enhance ANC follow-up, iron and folic acid supplementation, early treatments of pregnancy-induced hypertension, and information on the risk of chewing khat.

Prevalence, Antimicrobial Drug Resistance and Associated Risk Factors of Streptococcus Pneumoniae Bacteria Infection Among Under-Five Children With Acute Lower Respiratory Tract Infection Attending Sheik Hassan Yebere Referral Hospital, Jig-Jiga, Ethiopia.

Background: Pneumonia is inflammation of the lung. The Streptococcus pneumoniae (S. pneumoniae) is commensal in the upper airway and can cause infection to under-five children. The bacteria is gram-positive diplococci, catalase negative, and optochin sensitive. The bacteria is the leading cause of bacterial pneumonia among under-five children. No similar data is reported from the current study area. Objective: To determine prevalence, antimicrobial drug resistance and associated factors of S. pneumoniae infection among under-five children with acute lower respiratory tract infection attending Sheck Hassan Yebere Referral Hospital from March 1 to April 30, 2021 Jig-Jiga, Ethiopia. Methods: A cross-sectional study was conducted among 374 study participants selected by convenience sampling method. A structured questionnaire was used to collect child data. Nasopharyngeal/oropharyngeal swabs were collected and diagnosed to isolate S. pneumoniae by using culture then identified by biochemical examination. Later antimicrobial drug resistance testing was performed by Kirby-Bauer disk diffusion method. All data were entered on epi-data 3.1 then exported to SPSS version 22 to calculate analysis. Statistically significant value was found by calculating an adjusted odds ratio with p-value ≤ 0.05 in a multivariate logistic regression model. Results: Among 374 under-five children, 180 (48.1%) were males and 109 (29.2%) were from low income families. The overall prevalence of S. pneumoniae infection in the study was 18% (95% CI 14.4-22.2). No window (AOR=2.8 CI 1.1-7.6), no/non-exclusive breast-feeding (AOR= 2.1 CI 1.1-4.1), and previous URTI (AOR= 3.2 CI 1.7-6.1) were significantly associated with S. pneumoniae infection. The isolated organism showed drug resistance for Cotrimoxazole (35%), and Tetracycline (34%). Conclusion: The prevalence and antimicrobial resistance in this study were comparatively high. No window, non-exclusive breast-feeding and previous URTI were associated with S. pneumoniae infection. The isolated S. pneumoniae showed high drug resistance to cotrimoxazole and tetracycline.

Neonatal Sepsis and Associated Factors Among Neonates Admitted to Neonatal Intensive Care Unit in General Hospitals, Eastern Ethiopia 2020.

Introduction: Globally, the major cause of neonatal mortality and morbidity is neonatal sepsis, which is defined as a clinical course marked by systemic inflammation in the presence of infection in a newborn. There are limited data concerning neonatal sepsis in eastern Ethiopia. As a result, this study aimed to determine the prevalence of neonatal sepsis and associated factors among neonates admitted to intensive care units at general hospitals in Eastern Ethiopia. Methods: A hospital-based cross-sectional study with retrospective document review was conducted among newborns hospitalized in neonatal intensive care units. Using simple random sampling, the charts of 356 newborns who were hospitalized between January and December 2019 were included, and data were collected using a pretested checklist. Data were entered into Epi data version 3.1 and analyzed with SPSS version 22. Results: The overall prevalence of neonatal sepsis was 45.8% (95% CI 40.7, 51.4). Prolonged rupture of the membrane (AOR = 2.38, 95% CI: [1.27-4.45]), vaginal delivery (AOR = 1.78, 95%, CI: [1.09, 2.96]) APGAR score <7 (AOR = 4.55, 95% CI: [2.49-8.29]), prelacteal feeding (AOR = 3.54, 95% CI: [1.68-8.23]), and mechanical ventilation (AOR = 4.97,95%CI: [2.78-8.89]) were predictors associated with neonatal sepsis. Conclusion: In this study, the prevalence of neonatal sepsis was high, and factors associated with neonatal sepsis included prolonged rupture of membrane, mode of delivery, low APGAR score, prelacteal feeding and mechanical ventilation. As a result, maternal and neonatal care should be enhanced to lower the risk of neonatal sepsis.

Neonatal mortality and associated factors among neonates admitted to neonatal intensive care unit at public hospitals of Somali Regional State, Eastern Ethiopia: A multicenter retrospective analysis.

BACKGROUND: Neonatal mortality remains a public health problem in the developing world. Globally, around 2.5 million neonatal deaths are reported annually with the highest mortality concentrated in sub-Saharan Africa and South Asia. In comparison with countries demonstrating the lowest neonatal mortality, the risk of mortality is over 30 times higher in sub-Saharan Africa. Ethiopia is among the countries with a high neonatal mortality rate, and the burden of this mortality remains unreported in many pastoralist areas such as Somali Regional State, Eastern Ethiopia. We aimed to investigate factors associated with neonatal mortality in public Hospitals of the Somali Regional State in Eastern Ethiopia. METHODS: A facility-based cross-sectional study was conducted from May 1st to 30th, 2020 in three public Hospitals of Somali Regional State in Eastern Ethiopia. A total of 510 neonates admitted to neonatal intensive care units from January 2018 to December 2019 were enrolled in the study. The charts of neonates were randomly selected and retrieved. Data were collected using a pretested and validated structured questionnaire. The collected were entered into Epidata version 3.1 and exported to SPSS version 22 (IBM SPSS Statistics, 2013) for further analysis. Descriptive statistics were carried out using frequency tables, proportions, and summary measures. Predictors were assessed using a multivariable logistic regression analysis model and reported using adjusted odds ratio (AOR) with 95% Confidence Interval (CI). Statistical significance was considered at a p-value <0.05. RESULTS: Overall, the neonatal mortality was 18.6% [95%CI (15.31, 22.30)], equating to a rate of 186 per 1000 live births. The most common causes of mortality were prematurity (44.6%), low birth weight (33.5%), and birth asphyxia (27.6%). In the final model of multivariable analysis, predictors such as: lack of antenatal care follow-up[AOR = 3.71, 95%CI (2.13, 6.44)], neonatal sepsis [AOR = 1.84, 95%CI (1.07, 3.19], preterm birth [AOR = 2.20, 95%CI (1.02, 4.29], and birth asphyxia [AOR = 2.40, 95%CI(1.26,4.43)], and birth weight of less than 2500gms[AOR = 3.40, 95%CI(1.92, 6.01)] were statistically associated with neonatal mortality. CONCLUSION: In this study, the neonatal mortality rate was high compared to national and global targets because one in five neonates dies due to preventable causes. Modifiable and non-modifiable risk factors were identified as predictors. This result calls for all stakeholders to provide due attention to low birth weight and premature babies. Early identification and management of birth asphyxia and neonatal sepsis are also very crucial to reduce the risks of neonatal deaths.

Prevalence of Cigarette Smoking and Associated Factors Among Adolescents in Eastern Ethiopia, 2020.

BACKGROUND: Cigarette smoking is one of the leading causes of preventable morbidity and mortality globally, and it is accountable for many causes of premature deaths. Despite the negative consequences of cigarette smoking, studies to identify factors associated with cigarette smoking are scanty and little is known about this practice in the Somali region so far, so this study aimed to assess the prevalence of cigarette smoking and associated factors among adolescents in the Gode, eastern Ethiopia 2020. METHODS: A community-based cross-sectional study design was employed among 341 adolescents in the Godey administration of the Somali Region, Eastern Ethiopia from July to August 2020. A systematic sampling technique was used to select study participants. Data were collected using a pretested interviewer administered questionnaire. The collected data were entered with Epi-Data version 3.1 and exported to SPSS version 22 software for statistical analysis. Multivariable logistic regression analyses were done to identify the true effect of predictor variables on the outcome variable after controlling for possible confounders. Statistical significance was declared at a p-value < 0.05. RESULTS: Over all, the prevalence of current cigarette smoking among adolescents was found to be 21.1% (95% CI: (16.7-25.5). Having smoker parents [AOR = 2.57, 95% CI: (1.32-5.02)], whose friends smoke cigarette [AOR = 4.78, 95% CI: (2.12-10.76)], and currently chewing khat [AOR = 6.01, 95% CI: (2.96-12.23)] were significantly associated predictors of current cigarette smoking in the final model of multivariable analysis. CONCLUSION: The prevalence of cigarette smoking was relatively high in this study area. This study reported having smokers' parents, having smokers' friends and chewing khat were found to be independent predictors for cigarette smoking. Therefore, effective smoking prevention and intervention programs are required in this area.

Determinants of short birth interval among ever married reproductive age women living in Jigjiga, Eastern Ethiopia 2020 (unmatched case-control study).

OBJECTIVES: A short birth interval is a universal public health problem resulting in adverse maternal, neonatal, and child outcomes. Therefore, the aim of this study was to identify determinants of short birth interval among ever married reproductive age mothers who live in Jigjiga city administration, Eastern Ethiopia, 2020. METHODS: A community-based unmatched case-control study was used among 194 cases and 194 controls in Jigjiga city administration from September to December 2020. Cases were women with short birth interval (less than 3 years) and controls were women with optimum birth interval (3-5 years). Simple random sampling technique was employed to select cases and controls. Data were entered into Epi data version 4.2 and analysis with SPSS version 22. Binary logistic regression with 95% confidence interval at p < 0.05 is used to declare significantly associated predictors of short birth interval. RESULT: This study reported that women who have not attended formal education (adjusted odds ratio = 5.28, 95% confidence interval: (2.25-12.36)), attended primary education (adjusted odds ratio = 2.79, 95% confidence interval: (1.46-5.34)), women who married to a polygamous husband (adjusted odds ratio = 3.69, 95% confidence interval: (1.80-7.58)), having a history of neonatal death (adjusted odds ratio = 2.15, 95% confidence interval: (1.07-4.32)), preceding child being female (adjusted odds ratio = 3.69, 95% confidence interval: (2.02-6.72)), and never used contraceptive methods (adjusted odds ratio = 3.69, 95% confidence interval: (2.02-6.72)) were identified as determinants of the short birth interval. CONCLUSION: Short birth intervals were associated with educational level of the women, sex of the baby, husband marriage types, history of neonatal death, and contraceptive utilization. Strategy should be engaged to enhance women education, contraceptive uses, and to decrease neonatal death.

Risk Factors for Anemia Among Pregnant Women Attending the Antenatal Care Unit in Selected Jigjiga Public Health Facilities, Somali Region, East Ethiopia 2019: Unmatched Case-Control Study.

BACKGROUND: Anemia is a significant public health concern in many developing countries, particularly during pregnancy, and it has adverse effects on mother and fetus/baby. OBJECTIVE: To determine the factors associated with anemia among pregnant women attending antenatal care in Jigjiga public health facilities, Somali Region, East Ethiopia. METHODS: An institution-based unmatched case-control study was conducted. The sample size was 228 pregnant women; comprising 114 presenting with anemia and 114 controls. Hemoglobin levels were measured using a portable heme analyzer. Socio-demographic, dietary, medical history, and nutrition-related data were collected using a structured questionnaire. Data were entered into Epidata 3.1 and exported to Statistical Package for the Social Sciences (SPSS) version 23.0 for cleaning and analyses. Bivariate and multivariate logistic regression was performed and statistical significance was considered at a level of p<0.05. RESULTS: Three predictors of anemia among pregnant women were identified in this study. An inadequate intake of red meat (i.e. those who consumed red meat 1-2 times a month [AOR=7.245; 95% CI=(2.007-26.151)] or not at all [AOR=8.690; 95% CI=(1.795-42.072)]), and insufficient consumption of green vegetables (i.e. 1-2 times a week [AOR=2.970; 95% CI=(1.012-8.716)] or 1-2 times a month [AOR=8.057; 95% CI=(2.358-27.526)]) were associated with anemia. Also, having a mid-upper arm circumference (MUAC) of less than 23 cm was strongly associated [AOR=16.432; 95% CI= (5.240-51.526)] with anemia. CONCLUSION: This study revealed three key factors to be associated with anemia among pregnant women in Jigjiga Town, namely reduced intake of red meat and green vegetables, and low MUAC. Interventions including nutrition counselling and enrolling pregnant women with low nutritional status in nutritional programs should be the core components of anemia control strategies, needed to address the high prevalence of anemia during pregnancy in developing countries.

Seroprevalence of Hepatitis B Virus and Associated Factors Among Pregnant Women Attending Antenatal Care in Public Health Facilities in Jigjiga Town, Eastern Ethiopia.

BACKGROUND: Hepatitis B virus (HBV) remains a major global public health problem affecting millions of people across the world. The risk of developing a chronic hepatitis B virus infection is affected by the age at the time of acquiring infection. For instance, around 95% of these infections are acquired during the perinatal period. Although evidences indicate the wider effects of hepatitis B virus and its negative consequences, there are limited studies and a scarcity of data in Eastern Ethiopia. Therefore, this study was aimed at determining seroprevalence of HBV and associated factors among pregnant women attending antenatal care in the public health facilities of Jigjiga town, Eastern Ethiopia, from March 4 to April 4, 2019. METHODS: A facility-based cross-sectional study was employed among pregnant women in the public health facilities of Jigjiga town, Eastern Ethiopia. A total of 589 pregnant women were enrolled in the study using a systematic sampling technique. Data were collected using a pretested interviewer administered questionnaire. Five milliliters of venous blood samples was collected and tested for HBV using ELISA diagnostic test. The collected data were entered in to Epidata version 3.1 and exported to SPSS version 20 for statistical analysis. Descriptive statistics was carried out using frequency tables and summary measures. Multivariable analysis was done to identify the true effects of the selected predictor variables on the outcome variable after controlling for possible confounders. Statistical significance was declared at p-value <0.05. RESULTS: Overall, 8.5% (95% CI: 6.5-10.7) of the study participants were seropositive for HBsAg. Having any surgical history [AOR = 3.41, 95% CI (1.26-9.24)], family history of HBV [AOR = 4.96, 95% CI (2.11-10.60)], history of sharing sharps [AOR = 2.78, 95% CI (1.13-6.83)] and having multiple sexual partners [AOR = 6.12, 95% CI (2.12-17.64)] were significant predictors of HBV infection. CONCLUSION: The seroprevalence of HBV was relatively high in this study area. Having a history of surgery, family history of hepatitis, history of sharing sharps and multiple sexual partners were significantly associated with HBV infection. Therefore, health information dissemination and awareness creation on mode of transmission of HBV are very crucial.