Antiseizure adverse drug reaction and associated factors among epileptic patients at Jimma Medical Center: a prospective observational study.

A growing body of evidence suggests that adverse drug reactions (ADRs) are a major cause of morbidity and mortality in the healthcare system. Fifteen to twenty-five percent of patients with epilepsy discontinued antiseizure drugs (ASDs) within 6 months of therapy owing to intolerable adverse drug reactions. In Ethiopia, the prevalence of antiseizure adverse drug reactions and associated factors was not extensively conducted in advanced settings like Jimma Medical Centers. Hence, the objective of this study is to assess patterns of adverse drug reactions and associated factors among ambulatory epileptic patients at tertiary hospitals in Ethiopia. A hospital-based prospective observational study was spanned for 1 year. Two hundred ninety patients were consecutively recruited into the study from all epileptic patients attending the ambulatory clinic. Relevant data were collected through patient interviews and medical chart reviews. The causality assessment was done by using the Naranjo Probability Scale. Epi-Data manager version 4.6.0.4 was used for data entry and statistical analysis was performed by Statistical Package for Social Science version 25.0 (SPSS). Stepwise backward logistic regression analysis was done to identify factors that increase the risk of antiseizure adverse drug reactions. The mean (± SD) age of the participants were 29.91(± 11.26) years. The overall prevalence of ADR was 33.8% (95% CI 29.2-39.9%). A total of 110 adverse drug reactions were identified among 98 patients with an average of 1.12 per patient. ADRs were frequently reported with phenobarbital (52.04%) and phenytoin (34.70%). The commonly identified adverse drug reactions were epigastric pain (27.55%) and central nervous system drowsiness (23.46%). Comorbidity (AOR = 5.91, 95% CI (2.14-16.32), seizure-free period of fewer than 2 years (AOR = 1.94, 95% CI (1.18-3.19), and polytherapy (AOR = 1.35, 95% CI (1.80-2.26) were significantly associated with adverse drug reactions. This trial had a comparatively high percentage of adverse medication reactions. Adverse medication reactions were more common in patients with polytherapy, comorbidities, and seizure-free durations less than two years. Therefore, medical practitioners should advise patients who exhibit these traits on how to reduce or avoid bad drug responses or provide comfort in the event of small incidents.

Cultural sensitivity and associated factors among nurses in southwest Ethiopia: a cross-sectional study.

BACKGROUND: Because of the rapidly rising cultural diversity, the ability to recognize cultural diversity is extremely important to all healthcare professionals, especially to nurses. However, there is a paucity of information regarding the cultural sensitivity of nurses in Ethiopia. Hence, this study aimed to assess cultural sensitivity and associated factors among nurses working at Jimma Medical Center, Oromia Regional State, Southwest Ethiopia. METHODS: Health-facility-based cross-sectional study was conducted among 244 nurses selected by simple random sampling from May 20th to June 20th, 2020. A structured, self-administered questionnaire was used to collect data. Data were analysed using Statistical Product and Service Solution Version 26.0. Bivariate binary logistic regression analyses were used to select variables for the final model. Multivariable binary logistic regression analysis was used to identify factors associated with cultural sensitivity. Statistical significance was declared at [Formula: see text]0.05, and adjusted odds ratio with respective 95% CI was used to report significant covariates. RESULTS: Out of the total sample, 236 nurses participated in this study, giving a response rate of 96.72%. Nurses who were culturally sensitive while delivering routine nursing services were found to be 40.3% (95% CI (34.3, 46.6)). Level of education ([AOR (95% CI)], [4.846 (1.188, 19.773)]), interpersonal communication ([AOR (95% CI)], [4.749 (1.334, 16.909)]), and intercultural communication ([AOR (95% CI)], [51.874 (13.768, 195.45)]) were positively and significantly associated with the cultural sensitivity of nurses. CONCLUSION: Cultural sensitivity is found to be low in the study area. Increasing level of education, effective interpersonal communication abilities, and intercultural communication abilities positively predict cultural sensitivity of nurses. It is helpful for nurses to improve their knowledge of transcultural nursing theories and cultural understanding.

COVID-19-related dysfunctional anxiety and associated factors among adolescents in Southwest Ethiopia: a cross-sectional study.

BACKGROUND: COVID-19 pandemic causes serious threats to people's mental health, particularly it has huge negative mental health outcomes for adolescents. However, there is lack of studies examining COVID-19-related anxiety among adolescents in Ethiopia. Hence, this study was aimed to examine COVID-19-related dysfunctional anxiety and its associated factors among adolescents in Mettu town. METHODS: Community-based cross-sectional study was conducted from September 1 to 30, 2020 among 847 adolescents selected by stratified sampling technique. IBM SPSS Statistics Version 26.0 was used for analysis. Descriptive statistics such as frequency, percentage, mean, and standard deviation were computed. Bivariate and multivariate binary logistic regression analyses were done to identify factors associated with COVID-19-related dysfunctional anxiety. The statistical significance was declared at p ≤ 0.05; and the strength of association was described in terms of adjusted odds ratio. RESULTS: Out of the total sample, 819 adolescents participated in this study. The mean age of the participants was 14.9 (SD = 2.798) years. The magnitude of COVID-19-related dysfunctional anxiety was found to be 20.9% (95% CI (18.1, 23.9)). The finding indicates that sex [(AOR (95% CI)); (0.724 (0.502, 1.043))], having both parents deceased [(AOR (95% CI)); (2.981 (1.138, 7.814))], living alone [(AOR (95% CI)); (2.363 (1.050, 5.321))], having unemployed mothers [(AOR (95% CI)); (1.943 (1.194, 3.163))], absence of close friend [(AOR (95% CI)); (0.377 (0.225, 0.630))], and medical problem [(AOR (95% CI)); (0.408 (0.278, 0.597))] were significantly associated with COVID-19-related anxiety. CONCLUSION: The magnitude of COVID-19-related dysfunctional anxiety was found to be high in the study area. The findings have shown that the likelihood of developing COVID-19-related dysfunctional anxiety was linked to several factors. Provision of continued psychological support for adolescents is extremely encouraged.

Prevalence of homebirth preference and associated factors among pregnant women in Ethiopia: Systematic review and meta-analysis.

BACKGROUND: Homebirth preference is the intention/plan to give birth outside health facilities with the help of unskilled birth attendants. The preference to give birth at home without a skilled birth attendant leads to care-seeking delays, intrapartum mortality, multiple stillbirths, and postpartum morbidities and mortality. Therefore, this study aimed to estimate the pooled prevalence of homebirth preference and associated factors among pregnant women in Ethiopia. METHODS: Search of Google Scholar, Medline, PubMed, Cochrane Library and Web of Science were done for this study from 20th August 2022 to 6th November 2022. For data extraction and analysis, the standardized data extraction checklist and Stata version 14 were used respectively. Sentence as "Cochrane Q test statistics and I2 statistics were used to check heterogeneity of the studies. The pooled prevalence of homebirth preference was estimated using a random-effects model. The association between homebirth preference and independent variables was determined using an odd ratio with a 95% confidence interval. A funnel plot and Egger's test were used to assess publication bias. RESULTS: A total of 976 research articles were identified. Seven studies that fulfilled eligibility criteria were included in this systematic review and meta-analysis. The pooled prevalence of homebirth preference in Ethiopia was 39.62% (95% CI 27.98, 51.26). The current meta-analysis revealed that average monthly income <1800 ETB (OR = 2.66, 95% CI 1.44, 4.90) lack of ANC follow-up (OR = 2.57, 95%CI 1.32, 5.01), being multipara (OR = 1.77, 95%CI 1.39, 2.25), poor knowledge about obstetric danger sign (OR = 5.75, 95%CI 1.o2, 32.42), and not discussing the place of delivery with a partner (OR = 5.89 (95%CI 1.1, 31.63) were significantly associated with homebirth preference. CONCLUSION: This systematic review and meta-analysis examined the substantial prevalence of homebirth preference in Ethiopia which may contribute maternal and child health crisis. The homebirth preference was associated with low average monthly income (<1800 ETB), lack of ANC follow-up, multipara, poor knowledge about obstetric danger signs, and not discussing with their partner the place of delivery. Improving knowledge of pregnant women about the benefit of health facility delivery and obstetric danger signs is necessary to decrease the prevalence of homebirth preference; for these can reduce negative outcomes occurred during delivery.

Why health system diagnosis delay among tuberculosis patients in Illubabor, Oromia region, South West Ethiopia? A qualitative study.

BACKGROUND: The main target of tuberculosis control and prevention is to detect incident cases as quickly as possible and also to prevent the occurrence of disease. It is also the responsibility of the health facility to screen the contacts, identifying children for prophylactic therapy. However, the target is difficult to meet due to issues within health facilities that cause health system diagnostic delays. Despite this, there is no information explored why health system diagnostic delays among tuberculosis patients. METHOD: A qualitative study was conducted by using different data collection methods and sources. Seventeen DOT providers, five laboratory professionals, six program managers, and seven Tuberculosis patients were interviewed. In addition, 22 governmental health facilities were observed for the availability of resources. Data obtained from the in-depth interviews was transcribed, coded, categorized, and thematized manually. RESULT: Health system Diagnosis delays reasons were related with sample collection procedures, poor competency of health professionals, in addition to absences or scarcity of health professionals, medical products, and basic infrastructure. We found 18 health facilities without skilled personnel in the OPD, 7 health facilities with a broken microscope, and almost all health facilities without a separate room for sputum examination. Furthermore, 12 (54.5%) and 14 (63.6%) health facilities lacked access to water and electric power, respectively. CONCLUSION: Many reasons for TB diagnosis delays have been identified in the study area. Poor competence of health workers and scarcity of resources were identified. Depending on the finding, we suggest strengthening the health workers' training. Concrete strategies need to be designed to retain professionals. Training on human resource planning and budget preparation is needed for front-line managers. Managers have to work on the maintenance of diagnostic tools and facilitate transportation. The rural health facilities need to use another alternative power source.

Access to maternal health services during COVID-19 pandemic, re-examining the three delays among pregnant women in Ilubabor zone, southwest Ethiopia: A cross-sectional study.

BACKGROUND: All women require access to high-quality care during pregnancy, labor, and after childbirth. The occurrence of delay at any stage is one of the major causes of maternal mortality. There is, however, a scarcity of data on women's access to maternal health services during the COVID-19 pandemic. Therefore, the goal of this study was to assess the magnitude of delays in maternal health service utilization and its associated factors among pregnant women in the Ilubabor zone during the COVID-19 pandemic. METHODS: A facility-based cross-sectional study was conducted among 402 pregnant women selected by systematic random sampling. Data were analyzed using IBM SPSS Statistics version 26. Descriptive and summary statistics were used to describe the study population. Bivariate and multivariable logistic regression analyses were performed to identify factors associated with the outcome variables. Adjusted odds ratio with respective 95% CI was used to report significant covariates. RESULTS: A total of 402 pregnant women participated in this study. The median age of the respondents was 25 years (IQR = 8). On average, a woman stays 1.76 hours (SD = 1.2) to make a decision to seek care. The prevalence of first, second and third delay were 51%, 48%, and 33.3%, respectively. Being unmarried [AOR (95% CI)], [0.145 (0.046-0.452)], being unemployed [AOR (95% CI)], [4.824 (1.685-13.814)], age [AOR (95% CI)], [0.227 (0.089-0.0579)], fear of COVID-19 [AOR (95% CI)], [1.112 (1.036-1.193)], urban residence [AOR (95% CI)], [0.517 (0.295-0.909)], and lack of birth preparedness [AOR (95% CI)], [6.526 (1.954-21.789)] were significantly associated with first delay. Being unmarried [AOR (95% CI)], [5.984 (2.930-12.223)], being unemployed [AOR (95% CI)], [26.978 (3.477-209.308)], and age [AOR (95% CI)], [0.438 (0.226-0.848)] were significantly associated with second delay. Having lengthy admission [AOR (95% CI)], [7.5 (4.053-13.878)] and non-spontaneous vaginal delivery [AOR (95% CI)], [1.471 (1.018-1.999)] were significantly associated with third delay. CONCLUSION: This study identified a significant proportion of mothers experiencing delays, although there were no data to suggest exacerbated delays in utilizing maternal health services due to fear of the COVID-19 pandemic. The proportion of maternal delay varies with different factors. Improving the decision-making capacity of women is, therefore, essential.

The magnitude and associated factors of childbirth fear among pregnant women attending antenatal care at public hospitals in Ethiopia: a cross-sectional study.

BACKGROUND: Childbirth fear affects 5-40% of all mothers around the world, and there is mounting evidence that it has harmful impacts on women's health. It could potentially lead pregnant women to feel isolated and unsupported if not identified. But studies addressing this issue are limited in Ethiopia. Therefore, this study was aimed at assessing the magnitude and associated factors of childbirth fear among pregnant women attending antenatal care at public hospitals in West Wollega Zone. METHODS: Facility-based cross-sectional study was conducted among 304 pregnant women selected by systematic random sampling from 20 March to 20 April 2020. A structured interviewer-administered questionnaire was adapted and used to collect data. Data were entered into EpiData version 3.1 and exported to IBM SPSS statistics version 26 for analysis. Descriptive statistics were done to calculate frequencies, mean scores, and standard deviation. Bivariate and multivariable logistic regression was used to identify factors associated with childbirth fear. Variables with p < 0.25 in bivariate analyses were selected for multivariable analysis. Finally, statistical significance was declared at p < 0.05. RESULTS: Out of the total of 304 participants, 298 completed the interview making the response rate 98%. The overall prevalence of childbirth fear was 28.9% with 95% CI (23.5, 34.2). Mean age of the respondents was 27.60 (SD ± 4.56) years. Having previous pregnancy complications [AOR (95% CI)], [6.949 (2.060 - 23.445), presence of long time during childbirth [AOR (95% CI)], [4.765 (1.161 - 19.564)], presence of episiotomy [AOR (95% CI)], [4.197 (1.107 - 15.917)], low social support [AOR (95% CI)], [.011 (.003 - .050)] were significantly associated with childbirth fear. CONCLUSION: Pregnant women in the study area have a significant level of childbirth fear. Previous pregnancy complications, prolonged labor, labor pain, previous perineal tear, and social support were all found to be significantly linked with childbirth fear. This calls for the need to identify and develop interventions for women to reduce childbirth fear during pregnancy.

Utilisation of district health information system and its associated factors among health professionals working at public health facilities of the southwest of Ethiopia: cross-sectional survey.

OBJECTIVES: To assess utilisation of district health information system and its associated factors among health professionals in the southwest of Ethiopia, 2020. SETTING: Public health facilities in the southwest of Ethiopia. PARTICIPANTS: A facility-based cross-sectional study was conducted among a sample of 260 participants. MAIN OUTCOME MEASURES: The main outcome measure was utilisation of the district health information system. RESULTS: Overall, 149 (57.3%) of study participants had good utilisation of district health information systems (95% CI 50 to 64.2). Sufficient skills (Adjusted Odds Ratio (AOR) 3.83, 95% CI 1.92 to 7.64), being trained (AOR 3.90, 95% CI 1.95 to 7.79), high motivation (AOR 3.93, 95% CI 1.99 to 7.76), feedback provided (AOR 2.93, 95% CI 1.53 to 5.77) and regular supervision (AOR 3.06, 95% CI 1.56 to 6.01) were associated with utilisation of district health information systems. CONCLUSIONS: In general, more than half of the respondents had good utilisation of district health information systems. Providing regular supportive supervision and feedback, having good skills on district health information system use, high motivation and being trained on district health information system will help to bring good utilisation of district health information system for decision making.

Perceived transcultural self-efficacy and its associated factors among nurses in Ethiopia: A cross-sectional study.

BACKGROUND: Transcultural self-efficacy is a nurse's perception of his or her own ability to accomplish activities effectively for culturally diverse clients. This self-efficacy may be affected by different factors, either positively or negatively. Quality care can be improved significantly when nurses provide patient-centered care that considers cultural background of the patients. Thus, this study aimed to assess perceived transcultural self-efficacy and its associated factors among nurses working at Jimma Medical Center. METHODS: Facility-based cross-sectional study with both quantitative and qualitative methods of data collection was conducted among 244 nurses and 10 key informants from 20 May to 20 June 2020. Bivariate and multivariable linear regression analyses were used to identify factors associated with transcultural self-efficacy. Qualitative data were coded and analyzed thematically. Quantitative results were integrated with qualitative results. RESULTS: A total of 236 nurses participated in the study making the response rate 96.7%. The mean transcultural self-efficacy score was 2.89 ± 0.59. Sex, work experience, intercultural communication, cultural sensitivity, interpersonal communication, and cultural motivation were significantly associated with transcultural self-efficacy. Ten in-depth interviews were conducted and the findings of qualitative data yielded four major themes. CONCLUSION: The level of perceived transcultural self-efficacy was moderate among nurses. Transcultural self-efficacy of nurses varies with several factors including sex, experience, intercultural communication, cultural sensitivity, interpersonal communication, and cultural motivation. This calls for the need to offer transcultural nursing training for nurses.