Self-care behavior and associated factors among adult heart failure patients in outpatient cardiac follow-up unit at Wachemo University Nigist Eleni Comprehensive Specialized Hospital, Southern Ethiopia.

BACKGROUND: Heart failure is a serious medical condition that occurs when the heart is unable to pump sufficient blood to meet the needs of the tissues. Good self-care is an essential behavior in long term management and maintenance of physiologic stability, better medical and person-centered outcomes. Poor self-care behavior deteriorates the outcomes of heart failure patients. However, there were no sufficient evidences that illustrate the topic in the country, including the study area. METHODOLOGY: Institutional based cross-sectional study was conducted among 250 heart failure patients from July 5-August 4, 2021. All adult heart failure patients who fulfill the inclusion criteria and have appointment during study period were included in the study. Interview and medical chart review was used to collect data. Epidata version 3.1 and SPSS version 20 were used for data entry and analysis respectively. Bivariate and multivariable analysis was computed. The model fitness was checked by Hosmer and Lemeshow test. RESULTS: From the total patients, 240 were interviewed with the response rate of 96%. Among these, 140(58.3%) [95% CI: 52.6, 64.9] had poor self-care behavior. Age>54: 9.891 [2.228, 43.922], poor knowledge: 6.980[1.065, 45.727], depression: 4.973[1.107, 22.338], low social support: 6.060[1.373, 26.739], insomnia: 4.801[1.019, 22.622] and duration with heart failure <1 year: 5.782[1.438, 23.247] were factors associated with poor self-care behavior. CONCLUSION: In this study, more than half of participants attending at Wachemo University Nigist Eleni Comprehensive Specialized Hospital in outpatient cardiac follow-up unit had poor self-care behavior. Of the study variables, older age, poor knowledge, depressive symptoms, low social support, insomnia and short duration with heart failure were related with poor self-care behavior. Thus, the findings highlight importance of assessing level of self-care behavior and implicate direction to take action to enhance level of self-care behavior.

Epidemiology of hyperglycemia during pregnancy in Ethiopia: prevalence, associated factors, and feto-maternal outcomes: systematic review and meta-analysis.

BACKGROUND: Hyperglycemia in pregnancy (HIP) is a significant medical complication affecting pregnant women globally and is considered a public health burden due to the negative outcomes it can cause for both mother and infant. The aim of this systematic review and meta-analysis was to examine the prevalence, risk factors, and feto-maternal outcomes of HIP in Ethiopia. METHODS: To gather relevant information for this study, both published and unpublished studies were searched for in several major databases, including PubMed, Embase, HINARI, Web of Science direct, and Google Scholar, as well as other sources. The Joanna Briggs Institute (JBI) tool was used to evaluate the methodological quality of the findings from these studies. Data was then extracted and summarized using a template in Microsoft Excel software, and the extracted data was analyzed using Stata software version 16.0. If significant heterogeneity was found between studies, subgroup analyses were conducted to further examine the data. RESULT: Eighteen studies were included in this systematic review and meta-analysis, involving a total sample size of 50,816 pregnant women in Ethiopia. The prevalence of HIP among pregnant women varied considerably across the primary studies, ranging from 0.4 to 26.2%. The pooled prevalence of HIP among pregnant women in Ethiopia was found to be 6.9% (95% C 2.2-11.6). Pregnant women with a family history of diabetes had 2.5 times higher odds of developing HIP compared to those without a family history of diabetes (OR = 2.49; 95% CI = 2.02, 2.96). However, there was no significant association found between HIP and maternal obesity (OR 2.31, 95% CI = 0.85, 3.78) or previous history of abortion (OR 3.89; 95% CI 0.85, 6.94). The common fetal outcomes associated with HIP were admission to the intensive care unit (46.2; 95% CI 27.4, 65.1), macrosomia (27.3%; 95% CI 9.4%, 45.1%), and preterm birth (16.9; 95% CI 12.5, 21.3). Additionally, hypertensive disorders of pregnancy (28.0%; 95% CI 15.2, 40.8) and operative delivery (51.4%; 95% CI 35.9, 66.8) were more common among women with HIP in Ethiopia. CONCLUSION: Although there was some variation between studies, the meta-analysis revealed that approximately seven out of 100 pregnant women in Ethiopia had HIP. A family history of diabetes was found to be a significant predictor of HIP in Ethiopia. Additionally, HIP was associated with various serious adverse outcomes for both mothers and infants in Ethiopia. These findings highlight the need for national guidelines to ensure that pregnant women are uniformly screened for HIP.

Prevalence of Protozoan Pathogens Among Diarrheic Children Under 5 Years in Public Hospital of Ethiopia During the Global COVID 19 Pandemic.

Acute childhood diarrhea is one of the leading causes of childhood morbidity and mortality in sub-Saharan African countries. Entamoeba histolytica and Giardia lamblia are the common cause of childhood diarrhea in the region. However, there are only few studies on protozoa causing diarrhea in sub-Saharan African countries. This study was conducted to investigate the relative prevalence and explore risk factors of E. histolytica and G. lamblia among diarrheic children of under 5 years in a public hospital of Ethiopia. A retrospective study was conducted among diarrheic children at Hiwot Fana hospital, Ethiopia. Records of all diarrheic children less than 5 years who had sought medical treatment in the hospital from September 1, 2020 to December 31, 2022 were included. Data were collected from 1257 medical records of the children using a structured data-collection format. Data were entered into an Excel sheet and exported into SPSS version 22 for data processing and analysis. Descriptive statistical tests, Chi-square, and logistic region analysis were applied to determine predictors of protozoa infections. Of the 1257 cases, 962 (76.5%) had watery diarrhea and the remaining 239 (19.0%) had dysentery. The combined prevalence of E. histolytica and G. lamblia among diarrheic children was 11.8% (95% CI: 9.6-13.4). As the age of children increased, the frequency of these two protozoan infections was significantly increased compared to children with other causes. There were more diarrhea cases during the summer season including those associated with E. histolytica and G. lamblia. This study revealed that 1 in 10 causes of diarhhea among young children in the study area was likely caused by E. histolytica and G. lamblia. These findings call for community-based safe water and food safety interventions in order to reduce childhood diarrhea caused by protozoan infections in resource-poor settings.

Health extension workers' level of job satisfaction in western Hararghe Zone, eastern Ethiopia: an institutional-based cross-sectional study.

Background: There is a concern that job dissatisfaction among health extension workers (HEWs) reduces the benefit of investment in the execution of health extension programs. Hence, the purpose of this study was to explore the level of job satisfaction and factors affecting it among the HEWs in the West Hararghe Zone, Oromia Regional State, eastern Ethiopia. Method: An institutional-based cross-sectional study was conducted among 416 randomly selected health extension workers from 20 September 2020 to 20 October 2020. A pretested, structured questionnaire was used to collect the data. STATA 14.2 was used for data analysis. Bivariable and multivariable binary logistic regression analyses were also performed. Statistical significance was set at P < 0.05. Results: The overall level of satisfaction of health extension workers was 51.8% [95% confidence interval (CI): 46.97%, 56.6%]. Earning more than 5,260 ETB as salary [adjusted odds ratio (AOR) = 1.69, 95% CI: 1.01, 2.85], working more than 10 km from the district town (AOR = 1.59, 95% CI: 1.01, 2.53), receiving supportive supervision (AOR = 1.64, 95% CI: 1.06, 2.55), and not living with parents (AOR = 1.94, 95% CI: 1.24, 3.04) were significantly associated factors with HEW job satisfaction. Conclusion: Nearly half of the health extension workers were dissatisfied with their jobs. Supportive supervision, compensation, distance, and parental home location were all predictors of job satisfaction. It is critical to establish intervention tactics that may satisfy and motivate HEWs to expand health coverage, strengthen health extension programs, and improve service delivery.

Global prevalence of musculoskeletal disorders among sanitary workers: a systematic review and meta-analysis.

Objectives. Sanitary workers are more likely to experience musculoskeletal disorders (MSDs) due to a lack of ergonomics principles and poor job design. Thus, this systematic review and meta-analysis aimed to quantify MSDs among sanitary workers. Methods. The PRISMA and PICOS protocols were used for flow diagrams and review questions, respectively. Articles published between 2000 and 2022 were eligible. The keywords '(Musculoskeletal Disorders) AND (Solid waste collectors *OR Street sweepers *OR Sewage workers *OR health facilities cleaners)' and MeSH terms were utilized. The data were analyzed using STATA version 17 with a 95% confidence interval (CI). Results. A total of 158 papers were qualified, with 26 studies from 17 countries and a total of 6586 sanitary workers. The global prevalence of MSDs among sanitation workers was 40.52% (95% CI [32.47, 48.67]; p < 0.05). It was 43.32% (95% CI [31.98, 54.68]; p < 0.05) in high-income countries and 38.58% (95% CI [26.94, 50.18]; p < 0.05) in low-income countries. By subgroup analysis, it was 45.12% (95% CI [32.57, 57.67]; p < 0.05) for solid waste collectors, which is the highest prevalence among other workers. Conclusion. Current evidence shows that sanitation workers have a higher prevalence of occupationally associated MSDs, which might be lowered by using ergonomic work design principles.

Dyslipidemia and its predictors among adult workers in eastern Ethiopia: An institution-based cross-sectional study.

INTRODUCTION: Dyslipidemia is a modifiable major risk factor for coronary heart disease. Although, the prevalence of dyslipidemia in high-income countries has been well documented, there is dearth of information about the dyslipidemia among working adults in sub-Saharan African countries including Ethiopia. Therefore, this study aimed to determine the magnitude of dyslipidemia and its associated factors among Haramaya University employees, in Eastern Ethiopia. METHODS: A cross-sectional study was conducted among 1,200 university employees aged 20 to 60 years. Study participants were selected using a simple random sampling method. Data were collected face-to-face interview using a semi-structured questionnaire. Dyslipidemia was defined as unhealthy levels of one or more lipid profile such as high-density lipoprotein, low-density lipoprotein, triglycerides or total cholesterol. Data were entered into Epidata version 3.1 and analyzed using STATA version 16.1 software. Modified Poisson regression with robust variance was used to estimate adjusted prevalence ratios (APR) with its 95% confidence intervals. Statistical significance was declared at P-value < 0.05. RESULTS: Of 1,164 participants, 59.6% participants had at least one lipid abnormality (i.e., 57.9% among men and 61.5% among women). Of which, 36.8% had high total cholesterol (TC), 21.6% had low high density lipoprotein cholesterol (HDL-c), 22.4% had high low density lipoprotein cholesterol (LDL-c), and 32.6% had high triglyceride (TG). We found that overweight/obesity, sedentary behavior, alcohol consumption, having hypertension and age 45 and above years were significant predictors of dyslipidemia. However, those who served fruit and vegetables more than five per day had significantly reduced prevalence ratio of dyslipidemia. CONCLUSIONS: The high prevalent dyslipidemia among university employees is an important public health problem. Hence, tailored interventions to reduce overweight/obesity, hypertension, alcohol consumption and low fruit and vegetable intake have paramount importance to tackle dyslipidemia particularly among older age.

Occurrence of Diarrheagenic Pathogens and Their Coinfection Profiles in Diarrheic Under Five Children and Tracked Human Contacts in Urban and Rural Settings of Eastern Ethiopia.

Diarrheagenic Escherichia coli, Campylobacter, Nontyphoidal Salmonella, and Shigella are common cause of childhood diarrhea in countries like Ethiopia, but data on their sources and coinfection profiles is limited. A cross sectional study was conducted from November 2021 to January 2023 to determine the prevalence, coinfection, and monthly occurrence rates of major diarrheagenic bacteria in diarrheic under five children and asymptomatic contacts at urban and rural settings in Ethiopia. A total of 345 stool samples were collected from; 262 diarrheic children visiting Hiwot Fana Hospital, Kersa, and Adelle Health Centers; and 83 caretakers and siblings through case based contact tracing. Samples were analyzed using standard laboratory procedures and the overall prevalence of enteric pathogens was 26.96%, with the highest isolation rate during the winter and peaks of 73.91% in February. The occurrence of the pathogens in children and tracked contacts was 27.86 and 24.09%, respectively. In our study, 8.53% coinfection and 23.66% single pathogen infection was recorded in diarrheic children. The study also showed 4.51 and 3.88% of diarrhea in children from urban and rural had attributed to bacterial coinfection, respectively. The most prevalent pathogen in diarrheic children was Diarrheagenic E. coli (10.31%), and followed by Campylobacter. On the other hand, Diarrheagenic E. coli was the second dominant bacteria following Shigella in the traced contacts, with prevalence of 8.43% and 9.64%, respectively. Based on the study site, the prevalence of Diarrheagenic E. coli and Nontyphoidal Salmonella was higher in children from urban than those from rural. However, the occurrence of each pathogen had no significant differences (P > .05) between settings. The high pathogens occurrence rate in the current study indicates the need for strong control strategies and better child carrying and treatment of diarrheal diseases at both urban and rural settings. Further studies on possible sources and factors attributing to the occurrence of enteric pathogens in children are also recommended.

Adolescent breakfast skipping is associated with poorer academic performance: a school-based study from Hidhabu Abote District, Ethiopia.

BACKGROUND: Breakfast is regarded as "the most important meal of the day," suggested to positively affect learning in children and adolescent in terms of cognitive and school performance. Yet, studies in LMIC settings are few and show very inconsistent results. OBJECTIVE: To assess the prevalence and correlates of breakfast skipping and its association with school performance among randomly selected in-school adolescents in Hidhabu Abote Wereda, North Shewa Zone, Central Ethiopia. METHODS: A cross-sectional study was conducted from November to December 2020. A total of 422 participants were selected randomly from high schools of Hidhabu Abote Wereda. Data were entered in to Epiata version 3.1 and exported to SPSS version 24 for analysis. Bivariate and multivariate binary logistic regression analysis identified factors that were significantly associated with the breakfast skipping. Odds ratio along with 95% Confidence interval was estimated to measure the strength of the association and level of statistical significance declared at p-value less than 0.05. RESULTS: The magnitude of breakfast skipping was 41.3%, (95% CI (36.6-46.0)]. There was statistically significant association between breakfast skipping and overall academic performance [AOR: 5.18, 95% CI (1.54-7.46)], mathematics performance (3.88, 95% CI (1.34-11.22)], and English language performance scores [2.92, 95% CI (1.38-7.58)]. Being female [AOR = 1.857, 95% CI (1.05-3.27)], household food insecurity [AOR: 2.478, 95% CI (1.36-4.51)], and less maternal education [AOR 1.89, 95% CL (3.38-7.77)] were independently associated with breakfast skipping. The primary reasons given for breakfast skipping were lack of time, lack of appetite in morning, and concerns around weight gain. CONCLUSION: Nearly half of in-school adolescents were skipped breakfast meals, and reportedly in most cases for reasons unrelated to lack of food access. Students who skipped breakfast had lower levels of school performance.

Co-occurrence of hypertension and type 2 diabetes: prevalence and associated factors among Haramaya University employees in Eastern Ethiopia.

Background: Both hypertension (HTN) and diabetes are public health concerns in low- and middle-income countries, particularly in sub-Saharan African countries. The co-occurrence of HTN and diabetes is associated with an increased risk of mortality, morbidity, and reduced productivity in the working force. In Ethiopia, there is limited evidence on the co-occurrence of HTN and type 2 diabetes (T2DM). Therefore, this study was conducted to assess the co-occurrence of HTN and T2DM and their associated factors among Haramaya University employees in Eastern Ethiopia. Methods: A cross-sectional survey was conducted among 1,200 employees at Haramaya University using a simple random sampling technique from December 2018 to February 2019. Demographic and behavioral factors were collected on a semi-structured questionnaire, followed by measurement of anthropometry and blood pressure. Blood glucose and lipid profile measurements were performed by collecting 6 ml of venous blood samples after 8 h of overnight fasting. Data were entered into EpiData 3.1 version and analyzed using Stata 16 software. Bivariable and multivariable logistic regressions were applied to observe the association between independent variables with co-occurrence of HPN and T2DM using odds ratio, 95% confidence interval (CI), and p-values of ≤ 0.05 were considered statistically significant. Results: The prevalence of HTN and T2DM was 27.3 and 7.4%, respectively. The co-occurrence of HTN and T2DM was 3.8%. The study found that being older (AOR = 3.97; 95 % CI: 1.80-8.74), khat chewing (AOR = 2.76; 95 % CI: 1.23-6.18), body mass index ≥ 25 kg/m2 (AOR = 5.11; 95 % CI: 2.06-12.66), and sedentary behavior ≥8 h per day (AOR = 6.44; 95 % CI: 2.89-14.34) were statistically associated with co-occurrence of HTN and T2DM. On the other hand, consuming fruits and vegetables (AOR = 0.10; 95 % CI: 0.04-0.22) and a higher level of education (AOR = 0.39; 95% CI: 0.17-0.89) were negatively statistically associated with the co-occurrence of HTN and T2DM. Conclusion: The co-occurrence of HTN and T2DM was prevalent among the study participants. This may create a substantial load on the healthcare system as an end result of increased demand for healthcare services. Therefore, rigorous efforts are needed to develop strategies for screening employees to tackle the alarming increase in HTN and T2DM in university employees.

Incidence and predictors of chronic kidney disease among patients with diabetes treated at governmental hospitals of Harari Region, eastern Ethiopia, 2022.

Background: Chronic kidney disease (CKD) is the leading cause of morbidity and mortality in diabetic patients. However, limited evidence is available about its incidence and predictors in Ethiopia, specifically in the Harari region. Methods: A retrospective follow-up study was conducted among 520 diabetes patients who followed their treatment at governmental hospitals in the Harari region between 1 September 2012, and 30 May 2022. The risk of developing CKD was calculated with a 95% CI, and the risk was stratified by type of diabetes mellitus. Predictors of CKD were determined using the Gompertz regression model with the baseline Cox model. Results: Data from 494 patients were included in the final analysis with 26 (5%) excluded. A total of 51 patients (10.32%) developed CKD over the 10-year follow-up period with an incidence rate of 2.16 cases (95% CI 1.64-2.84) per 100 person-years of observation. The risk of CKD was increased by three times (AHR: 3.09, 45 95% CI: 1.56, 6.14) among patients older than 60 years and by more than three times (AHR: 3.53, 95% CI: 1.43, 8.71) among patients with diabetes mellitus for longer than 5 years of stay with the diabetes mellitus. Moreover, the risk of CKD was increased four-fold among patients with high-density lipoprotein cholesterol (HDL-C) levels <40 mg/dL (AHR: 3.84, 95% CI, 1.80-8.18) and those with positive baseline proteinuria (AHR: 3.77, 95% CI: 1.43-8.71). Conclusion: We found that one in ten diabetic patients had developed CKD within 10 years of the diabetes mellitus diagnosis. Advanced age, longer duration of diabetes, lower baseline HDL-C level, and proteinuria had increased the hazards of developing CKD. We recommend a more focused follow-up of older adult patients with advanced disease status at baseline for optimal control of diabetes mellitus that prevents its furthering to CKD.

Seroprevalence of visceral leishmaniasis and its associated factors among asymptomatic pastoral community of Dire District, Borena zone, Oromia Region, Ethiopia.

Visceral leishmaniasis (VL) is a vector-borne protozoan neglected tropical disease. In some parts of Ethiopia, it is a public health problem and its main causative agent is the Leishmania donovani complex. The objective of the study was to determine the seroprevalence of VL and factors associated among the asymptomatic pastoral community of Dire District, Borena Zone, Oromia Region, Ethiopia. A community-based study was conducted among 432 pastoralist communities from June to July 2021. A systematic random sampling method was used to select households. Pretested structured questionnaires and face-to-face interviews were used to collect data. A single finger-prick blood sample was collected and tested for Leishmania donovani complex using an immune-chromatographic test (rk39-ICT). A logistic regression model was used to assess factors associated with VL infection and a p-value of < 0.05 was considered statistically significant. A total of 432 study participants were included (their mean age was 26.69) and 218 (50.5%) were females. The overall seroprevalence of VL was 33/432(7.6%) (95%CI: 5.32-15.60). Sero-prevalence was significantly associated with high family size (>5) (adjusted odds ratios (AOR) = 5.134; 95% CI: 2.032-9.748), sleeping or/and staying under acacia tree (AOR = 2.984; 95%CI = 1.074-8.288), presence of cracked house walls (AOR = 1.801; 95%CI: 1.026-4.926), presence of termite hills (AOR = 1.938; 95%CL: 1.002-7.050), availability of water points (AOR = 3.893; 95%CI: 1.034-7.426) and presence of domestic animals (AOR = 2.124; 95% CI: 2.341-5.108). It is recommended that community awareness on the transmission and prevention methods of Leishmania donovani complex and taking appropriate interventions on the identified factors play a greater role to prevent and control infection in the area. Further investigation is also needed to characterize the pathogens and risk factors and tackle the problem.

Long sedentary time is associated with worsened cardiometabolic risk factors among university employees in Eastern Ethiopia.

Sedentary time is associated with increased risks of detrimental health outcomes. Prolonged sedentary time associates with cardiometabolic risk factors and increased mortality regardless of physical activity. Therefore, the purpose of this study was to examine the associations of sedentary time and cardiometabolic risk factors among university employees in Eastern Ethiopia. A cross-sectional study was conducted among 1200 participants. Data were collected using the World Health Organization STEPS survey instrument, and sedentary behavior questionnaire in hour per day. Sedentary time is the time spent for any duration (minutes per day or hours per day) by considering a local context. Study participants were asked how many minutes or hours they spent in sedentary time at work, their leisure time and in transportation. Finally, the total sedentary time was calculated by the sum of the individual spent in sedentary time at work, leisure, and transportation. Cardiometabolic risk factors were assessed with blood samples analysis and anthropometric measurements. The associations between sedentary time and cardiometabolic risk factors were examined using linear regression models. An adjusted coefficient (ß) with the 95% confidence interval (CI) was used to report the results. p value < 0.05 was considered for statistical significance. The mean age of the study participants were (35 ± 9.4 years). Almost half of the study participants, 566 (48.6) were women and 598 (51.4%) were men. As the total sedentary time was increased by one unit, the body mass index increased by ß = 0.61; (95% CI 0.49-0.71),waist circumference increased by ß = 1.48; (95% CI 1.14-1.82), diastolic blood pressure increased by ß = 0.87; (95% CI 0.56-1.18), systolic blood pressure increased by ß = 0.95; (95% CI 0.45-1.48), triglycerides increased by ß = 7.07; (95% CI 4.01-10.14), total cholesterol increased by ß = 3.52; (95% CI 2.02-5.02), fasting plasma glucose increased by ß = 4.15; (95% CI 5.31-4.98) and low-density lipoprotein cholesterol increased by ß = 2.14; (95% CI 0.96-3.33) with the effects of other variables maintain constant. These findings depict the need for strategies that policymakers should promote physical activity and encouraging the breaking up of prolonged sedentary time to reduce cardiometabolic risk factors among university employees in Ethiopia.

Hand washing practice among public primary school children and associated factors in Harar town, eastern Ethiopia: An institution-based cross-sectional study.

Background: Hand washing with soap and water reduces the risk of diarrheal episode by 28-48% and acute respiratory infection by 20-50%. However, there is limited evidence on hand washing practices among students in Eastern Ethiopia, particularly in Harari town. Therefore, this study aimed to determine hand washing practice among primary school students and associated factors in Harar town, Eastern Ethiopia. Methods: An institution-based cross-sectional study was applied among 670 students in Harar town from June 1 to 30, 2021. A multi-stage sampling was employed; 6 out of 20 schools were selected through simple random sampling, while eligible children from each school was selected by probability proportional to size sampling method. Data were collected using a pre-tested questionnaire with a face-to-face interview technique and via observation. The data were analyzed using SPSS software version 23. Binary and mult-variable analysis were used to determine the association between factors and outcome variable. Finally, a p-value of < 0.05 was considered to declare a statistically significant association. Results: A total of 670 participants were included in the study, of which 248 (37.0%) had washed their hands [95% CI: 33.3-40.06]. Being in grade 8 Adjusted Odd Ratio[AOR = 4.9; 95% Confidence Interval (CI): 2.28-10.52], living in an urban area [AOR = 3.49; 95% CI: 1.29-9.40], having role models (parents [AOR = 4.41; 95% CI: 1.79-10.86], teachers [AOR = 3.69; 95% CI: 1.39-8.81], and health professionals [AOR = 3.17, 95% CI: 1.17-8.63]), availability of hand washing facility [AOR = 3.62; 95% CI: 1.57-8.34], access to soap and water [AOR = 2.89; 95% CI: 1.39-5.98] and being membership of water sanitation and hygiene (WASH) club [AOR = 2.39; 95% CI: 1.41-4.03] were found to be significantly associated with hand washing practice. Conclusions: The current study found that nearly a third of students practiced proper hand washing. Hand washing practice was influenced by students' grade level, residence, referents (role models for hand washing), presence of a hand washing facility, access to water and soap, and membership of WASH club. Therefore, the finding revealed that there is a need to improve hand-washing practices in schools by concerned agencies.

Antiretroviral therapy non-adherence among children living with HIV in Dire Dawa, Eastern Ethiopia: a case-control study.

BACKGROUND: In 2018, nearly 90% of the global children living with human immunodeficiency virus (HIV) were in sub-Saharan Africa (SSA). Compared to the adult population, antiretroviral therapy (ART) coverage among children was limited. However, adherence remained a problem among children though they had limited access to ART. This study was conducted to identify the risk factors of non-adherence to ART among children aged 6 to 17 years. METHODS: This case-control study was conducted in 2020 using data obtained from clinical record reviews and self-reported data from 272 caregivers of HIV-infected children aged 6-17 years. Cases and controls represented children with poor versus children with good adherence to ART, respectively. Good adherence was defined based on a past 30-day physician adherence evaluation of taking ≥ 95% of the prescribed doses. Binary logistic regression was used to identify factors associated with non-adherence to ART. All statistical tests are defined as statistically significant at P-values < 0.05. RESULTS: Of the 272 children, for whom data were obtained, 78 were cases and 194 were controls; females accounted for 56.3%, 32% attended secondary school, and for 83.1%, the reporting caregivers were biological parents. Non-adherent children had higher odds of association with the following risk factors: a caregiver who is a current substance user (aOR = 2.87, 95% CI: 1.44, 5.71), using AZT-and ABC-based regimen compared to the TDF-regimen (AZT-based, aOR = 4.12, 95% CI: 1.43, 11.86; ABC-based, aOR = 5.58, 95% CI: 1.70, 18.30), and had an increase in viral load from baseline compared to those remained undetectable (remained at or decreased to < 1000, aOR = 4.87, 95% CI: 1.65, 14.33; remained at ≥ 1000, aOR = 9.30, 95% CI: 3.69, 23.46). In contrast, non-adherent children had 66% lower odds of being at early adolescent age compared to 6-9 years old (10-14 years, aOR = 0.34, 95% CI: 0.12, 0.99) and had 70% lower odds of being aware of their HIV status (aOR = 0.30, 95% CI: 0.13, 0.73). CONCLUSION: Technical support to caregivers to build disclosure self-efficacy, identifying the appropriate regimen for children, counseling on viral load suppression on subsequent visits, and helping caregivers avoid or reduce substance use may help improve the problem of children's non-adherence to ART.

Level of implementation of district health information system 2 at public health facilities in Eastern Ethiopia.

Objective: The major aim of this study was to assess the level of District health information system 2 (DHIS 2) implementation in the public health facilities (HFs) in Dire Dawa City Administration. Methods: This study was employed both quantitative (cross-sectional) and qualitative (phenomenological) study designs. All public HFs found in Dire Dawa City Administration and health workers were participated in the study. Quantitative data were collected using a pre-tested, structured, self-administered questionnaire. The collected data were entered into Epi-Data and analyzed using STATA version 14 software. A descriptive summary was computed using proportion and frequencies. Qualitative data were collected from in-depth interview with key informants (KIs), and the results were then analyzed thematically. Results: The overall implementation level of DHIS 2 was 80%, which shows good implementation. The main difficulties encountered in implementing DHIS 2 were a lack of power backup (64.3%), unreliable internet connectivity (43%), and a lack of training (34.6%). According to an in-depth interview with a 32-year-old professional, "…there is offline and online DHIS 2 software for data collection and reporting that is an opportunity for the health center, but there is a challenge of interruption of electricity lost unsaved data and hinder data to enter and view for making a decision…." Conclusion: The level of DHIS 2 implementation in this study was good compared to other studies in Ethiopia. However, more than half of the HFs require infrastructure maintenance and support.

Practicalities of implementing burden of disease research in Africa: lessons from a population survey component of our multi-partner FOCAL research project.

BACKGROUND: Collaborative research is being increasingly implemented in Africa to study health-related issues, for example, the lack of evidence on disease burden, in particular for the presumptive high load of foodborne diseases. The FOCAL (Foodborne disease epidemiology, surveillance, and control in African LMIC) Project is a multi-partner study that includes a population survey to estimate the foodborne disease burden in four African low- and middle-income countries (LMICs). Our multi-partner study team had members from seven countries, all of whom contributed to the project from the grant application stage, and who play(ed) specific roles in designing and implementing the population survey. MAIN TEXT: In this paper, we applied Larkan et al.'s framework for successful research partnerships in global health to self-evaluate our project's collaboration, management, and implementation process. Our partnership formation considered the interplay and balance between operations and relations. Using Larkan et al.'s seven core concepts (i.e., focus, values, equity, benefit, communication, leadership, and resolution), we reviewed the process stated above in an African context. CONCLUSION: Through our current partnership and research implementing a population survey to study disease burden in four African LMICs, we observed that successful partnerships need to consider these core concepts explicitly, apply the essential leadership attributes, perform assessment of external contexts before designing the research, and expect differences in work culture. While some of these experiences are common to research projects in general, the other best practices and challenges we discussed can help inform future foodborne disease burden work in Africa.

Neonatal Mortality Rate and Its Determinants: A Community-Based Panel Study in Ethiopia.

Background: The Sustainable Development Goals specifically target a reduction in neonatal mortality rates. However, the highest neonatal mortality rates occur in sub-Saharan Africa, including Ethiopia. Although several factors contributing to these high rates have been explored, there continues to be a general dearth of studies and inconsistencies of factors to understand the problem. Therefore, this study aimed to identify the prevalence and factors associated with neonatal mortality in Ethiopia. Methods: A panel study was conducted among 2,855 pregnant or recently postpartum women selected using the multistage cluster sampling technique from October 2019 to September 2020. Data were collected by experienced and trained female resident enumerators and coded, cleaned, and analyzed using STATA version 16.1 software. We used the Kaplan-Meier survival curve to show the pattern of neonatal deaths during the first 28 days of life. Frequencies and rates were reported along with the percentages and using a 95% confidence interval, respectively. The Cox proportional hazard regression model was used to explore the association of explanatory and outcome variables. Finally, an adjusted hazard ratio with a 95% confidence interval was used to report the results, with a p < 0.05 to declare statistical significance. Results: The neonatal mortality rate was 26.84 (95% CI: 19.43, 36.96) per 1,000 live births. Neonates born to rural resident mothers (AHR = 2.18, 95% CI: 1.05, 4.54), mothers of advanced age (AHR = 2.49, 95% CI: 1.19, 5.21), and primipara mothers (AHR = 3.16, 95% CI: 1.52, 6.60) had a higher hazard of neonatal mortality. However, neonates born to women who attended technical and vocational level education (AHR = 0.08, 95% CI: 0.01, 0.62) had a lower hazard of neonatal mortality. Conclusions: The neonatal mortality rate in Ethiopia is high, with increased risk among specific subsets of the population. The findings highlight that neonatal survival can be improved through tailored interventions for rural residents, emerging regions, and primipara women by improving female education and avoiding pregnancy at an advanced maternal age to achieve Sustainable Development Goal target 3.2.

Occupational Injuries and Associated Factors Among Municipal Solid Waste Collectors in Harar Town, Eastern Ethiopia: A Cross Sectional Study.

Background: Municipal solid waste collection is one of the most dangerous jobs in the world since it exposes the workers involved to occupational hazards and predisposes them to certain occupation-related morbidities. Occupational injuries among municipal solid waste collectors have not been adequately addressed or reported in developing countries, including Ethiopia. Therefore, this study aimed to determine the prevalence of occupational injuries and associated factors among municipal solid waste collectors in Harar Town, Ethiopia. Methods: A cross-sectional study was conducted in Harar town, Eastern Ethiopia from May 25, 2021 to June 25, 2021. Three hundred eighty-nine (389) municipal solid waste collectors were selected using a simple random sampling method. A self-administered structured questionnaire and an observational checklist were used to collect the data. The collected data was analyzed using SPSS version 20. Bivariate and multivariable logistic regression were used to determine the association between independent variables and the outcome variable. A P-value of <.05 was considered as a cut-off point for statistical significance. Results: The current study found that about 60.4% of municipal solid waste collectors were exposed to occupational injuries. Furthermore, the study found a statistically significant association between the prevalence of occupational injuries and having a primary education [AOR = 0.10, 95% CI (0.03-0.38)], a secondary education [AOR = 0.04, 95% CI (0.03-0.45)], work experience [AOR = 5.975, (95% CI (2.01-17.75)], the use of personal protective equipment [AOR = 0.09, (95% CI: 0.02-0.46)], and training [AOR = 0.10, 95% CI (0.03-0.30)]. Conclusions: The current study found that more than three-fifth of municipal solid waste collectors were exposed to occupational injury. Furthermore, the current study found that there was an statistical relationship between the prevalence of occupational injuries and having a primary education, a secondary education, work experience, the use of personal protective equipment, and training. Before and after hiring solid waste collectors, employers should provide personal protective equipment and tailored training on safety measures.

Poor adherence to highly active antiretroviral therapy and associated factors among people living with HIV in Eastern Ethiopia.

Objective: Sustained adherence to highly active antiretroviral therapy is necessary to suppress viral replication and improve immunological and clinical outcomes. Although different studies tried to identify factors affecting adherence to highly active antiretroviral therapy, there are few studies after initiation of test and start strategy and the first-line drug regimen change in the study area. Therefore, this study aimed to determine the level of adherence to highly active antiretroviral therapy and associated factors among people living with HIV in Eastern Ethiopia. Methods: Institutional-based cross-sectional study design was conducted from 2 March 2020, to 30 March 2020. A total of 501 study participants were recruited using systematic random sampling. Data were collected using face-to-face interviews at the end of the clinic visit and a review of participants' medical records. The level of adherence to highly active antiretroviral therapy was measured using the eight-item Morisky Medication Adherence Scale. The score ranges from 0 to 8, and a score of less than 8 indicates poor adherence. The data were entered into EpiData and exported to STATA for further analysis. The binary logistic regression analysis model was employed to identify associated factors. The association was reported with an adjusted odds ratio and a 95% confidence level. The significance level was declared at p = 0.05. Results: A total of 501 participants participated in the study, giving a response rate of 98.2%. The majority (314 or 62.7%) of study participants were females. The participants' mean (standard deviation) age was 38.17 (8.75). The level of poor adherence to highly active antiretroviral therapy was found to be 33.73% (confidence interval: 29.70, 38.00). Age category 35 to 44 (1.65 (confidence interval: 1.02, 2.69)), no shortage of highly active antiretroviral therapy (0.46 (confidence interval: 0.28, 0.75)), substance use (1.67 (confidence interval: 1.11, 2.25)), having moderate depressive symptoms (4.00 (confidence interval: 1.94, 8.48)), and moderate anxiety symptoms (5.22 (confidence interval: 2.31, 8.84)) were significantly associated with the poor adherence to highly active antiretroviral therapy among adult people living with HIV. Conclusion: The level of poor adherence to highly active antiretroviral therapy was found to be high in this study. Poor adherence to highly active antiretroviral therapy was significantly associated with age, availability of highly active antiretroviral therapy drugs, substance usage, depressive symptoms, and anxiety symptoms. Improving the adherence levels requires stringent counseling, assuring continuous drug availability, and timely screening and management of depression and anxiety.