Appropriate Use of Primary Statin Preventive Therapy Among Patients with High Atherosclerosis-Related Cardiovascular Disease Risks: Cross-Sectional Study, Northeast Ethiopia.

Background: Atherosclerosis-related cardiovascular diseases (coronary heart diseases, ischemic stroke, and peripheral vascular diseases) account for the majority of deaths in diabetic and other high-risk patients. Statin therapy reduces major vascular events, coronary death or nonfatal myocardial infarction, coronary revascularization, and ischemic stroke. However, a gap exists between guideline recommendations and the clinical practice of primary statin preventive therapy. This was a cross-sectional study that aimed to determine the prevalence and some associated risk factors of. Purpose: This study was intended to assess the magnitude of primary statin preventive therapy and associated factors among patients with high atherosclerosis-related cardiovascular disease risks. Patients and Methods: An institutional-based cross-sectional study design was conducted by a consecutive sampling technique from February 1, 2023, to May 30, 2023. Face-to-face interviews using a structured questionnaire, document review, and laboratory measurements were implemented to collect data. Data entered into Epi Data were analysed by STATA version 14 and summarized by using frequency tables and graphs. Binary and multivariate logistic regression analyses were performed and checked for association at a p value of <0.05. Results: A total of 389 patients were included in this study. Diabetes mellitus (43.75%), hypertension (47.3%), and chronic kidney disease (9.25%) were commonly identified diseases. One hundred sixty-seven (42.93%, CI: 38.07-47.92) patients with high atherosclerosis-related cardiovascular disease (ASCVD) risks were on primary statin preventive therapy. Duration of diabetes mellitus (AOR=1.33, CI: 1.1569-1.528), treating physician (AOR=3.875, CI: 1.368-10.969), follow-up regularity (AOR=3.113, CI: 1.029-9.417) and ten-year atherosclerosis-related cardiovascular disease risk score (AOR=1.126, CI: 1.021-1.243) were found to be significantly associated with the use of primary statin preventive therapy. Conclusion and Recommendations: The magnitude of patients who were on primary statin preventive therapy was relatively low (42.93%). Improving the regular follow-up and making senior physicians (internists) attend patients at medical follow-up clinics would likely improve the number of patients who are on primary statin preventive therapy.

Determinants of maternal near-miss among women admitted to public hospitals in North Shewa Zone, Ethiopia: A case-control study.

Background: A maternal near-miss (MNM) refers to a woman who presents with life-threatening complications during pregnancy, childbirth, or within 42 days of termination of pregnancy but survived by chance or due to the standard care she received. It is recognized as a valuable indicator to examine the quality of obstetrics care as it follows similar predictors with maternal death. Ethiopia is one of the sub-Saharan African countries with the highest rate of maternal mortality and morbidity. Thus, studying the cause and predictors of maternal near-miss is vital to improving the quality of obstetric care, particularly in low-income countries. Objective: To identify determinants of maternal near-miss among women admitted to public hospitals in North Shewa Zone, Ethiopia, 2020. Methods: A facility-based unmatched case-control study was conducted on 264 women (88 cases and 176 controls) from February to April 2020. Data were collected using pretested interviewer-administered questionnaires and a review of medical records. Data were entered into Epi-data version 4.2.2 and exported to SPSS version 25 for analysis. Variables with a p-value <0.25 in the bivariable analysis were further analyzed using multivariable logistic regression analysis. Finally, variables with a p-value <0.05 were considered statistically significant. Result: Severe pre-eclampsia (49.5%) and postpartum hemorrhage (28.3%) were the main reasons for admission of cases. Educational level of women (AOR = 4.80, 95% CI: 1.78-12.90), education level of husbands (AOR = 5.26; 95% CI: 1.46-18.90), being referred from other health facilities (AOR = 4.73, 95% CI: 1.78-12.55), antenatal care visit (AOR = 2.75, 95% CI: 1.13-6.72), cesarean section (AOR = 3.70, 95% CI: 1.42-9.60), and medical disorder during pregnancy (AOR = 12.06, 95% CI: 2.82-51.55) were found to significantly increase the risk of maternal near-miss. Whereas, the younger age of women significantly decreased the risk of maternal near miss (AOR = 0.26, 95% CI: 0.09-0.75). Conclusion: Age, educational level, antenatal care follow-ups, medical disorder during pregnancy, mode of admission, and mode of delivery were significant predictors of maternal near-miss. Socio-demographic development, use of ANC services, early detection and management of medical diseases, reducing cesarean section, and improving the referral systems are crucial to minimizing the maternal near-miss.

Magnitude and associated factors of menstrual irregularity among undergraduate students of Debre Berhan University, Ethiopia.

BACKGROUND: Menstrual irregularity is a common problem among women aged from 21 to 25 years. Previously published work on menstrual irregularity used inconsistent definition which results in a difference in prevalence. Therefore the study aimed to assess the magnitude and associated factors of menstrual irregularity among undergraduate students of Debre Berhan University, Ethiopia. METHODS: A cross-sectional study design was carried out among 660 undergraduate female students at Debre Berhan University. To get representative study participants, a stratified sampling technique was used. To collect the data self-administered questionnaire was used. Physical examination and anthropometric measurement were also done. Data were analyzed by using SPSS version 21. Logistic regression analysis was done. A significant association was declared at a p-value less than 0.05. RESULT: A total of 620 students participated in the present study with a response rate of 93.9%. Out of the total study participants, 32.6% (95% CI 29-36.5) participants had irregular menstrual cycle. Significant association was found between anemia (AOR = 2.1; 95%CI 1.337-3.441), alcohol intake (AOR = 2.4; 95%CI 1.25-4.666), < 5 sleep hours (AOR = 5.4; 95%CI 2.975-9.888), 6-7 sleep hours (AOR = 1.9; 95%CI 1.291-2.907), Perceived stress (AOR = 3.3; 95%CI 1.8322-5.940), iodine deficiency disorder (IDD) (AOR = 3.9; 95%CI 1.325-11.636) and underweight (AOR = 1.8; 95%CI 1.109-2.847) with menstrual irregularity. CONCLUSION: The finding of this study reported a low magnitude of menstrual irregularity as compared to previous studies. Students should adopt healthier lifestyle practices (weight control, stress control, anemia control, and avoid alcohol intake) to control menstrual irregularity.

Menstrual irregularity is a common problem among university students. It affects their daily activities. But it lacks attention, especially in developing countries. Additionally, menstrual irregularity is defined differently by different researchers which results in a difference in prevalence. So it is difficult to compare. Therefore this study aims to assess the magnitude and associated factors of menstrual irregularity among undergraduate students of Debre Berhan University, Ethiopia. To avoid the inconsistent definition of menstrual irregularity which is used by different researchers, we used the standard of menstrual irregularity definition which was prepared by the international federation of obstetrics and gynecologist in 2018.This study uses across sectional study design among 660 undergraduate students of Debre Berhan University, Ethiopia. A self-administered questioner which includes socio-demographic data, menstrual-related questions, lifestyle and behavioral questions, and medical history questions were used to collect data. Besides, physical examination and anthropometric measurement were done.Of a total 620 students who participated in the study: 202 (32.6%) had menstrual irregularity. Factors that had significant association with menstrual irregularity were, anemia (AOR = 2.1; 95%CI 1.337­3.441), alcohol intake (AOR = 2.4; 95%CI 1.25­4.666), < 5 sleep hours (AOR = 5.4; 95%CI 2.975­9.888), 6­7 sleep hours (AOR = 1.9; 95%CI 1.291­2.907), Perceived stress (AOR = 3.3; 95%CI 1.8322­5.940), iodine deficiency disorder (IDD) (AOR = 3.9; 95%CI 1.325­11.636) and underweight (AOR = 1.8; 95%CI 1.109­2.847). In conclusion, the finding of this study reported a low magnitude of menstrual irregularity as compared to previous studies.

Assessment of the prevalence of intestinal parasitic infections and associated habit and culture-related risk factors among primary schoolchildren in Debre Berhan town, Northeast Ethiopia.

BACKGROUND: Intestinal parasitic infections (IPIs) are still among the major public health issues in developing countries. Assessing the prevalence of IPIs and potential risk factors in different localities is essential to enhance control strategies. To date, no prevalence assessment study was conducted in Debre Berhan town. Therefore, the aim of this study was to assess the prevalence of IPIs and associated habit and culture-related risk factors among primary schoolchildren in Debre Berhan town, Northeast Ethiopia. METHOD: School based cross-sectional study was conducted from April to June 2017. A total of 645 children aged 6-15 years were selected from six primary schools in Debre Berhan town via a multistage random sampling technique. A structured questionnaire was used to collect data about sociodemographic and potential risk factor variables. Fresh stool samples were collected from each child and examined using direct smear and formal-ether concentration technique. RESULT: Among the 645 children participated in the study, 341 (52.9%) were infected by one or more intestinal parasites. Helminths (33.8%) were more prevalent than protozoa (20%). Double parasitic infection rate was 0.9%. The predominant parasites were Ascaris lumbricoides (22.6%), Entamoeba histolytica/dispar/moshkovskii (18.1%) and Hymenolepis nana (5.7%). Multivariable logistic regression analysis showed that age of child (6-9 years), family size (above 5), mother's illiteracy and primary education, father's illiteracy, urban-farmer father, manual-worker father, not washing hands before eating, unclean fingers, open defecation site (ODS) near residence, latrine type, cultural response to dropped food (cleaning and eating; 'kiss and replace'), habit of playing with waste water, habit of playing with soil, habit of sucking fingers and habit of eating when playing were significantly associated with IPIs (p< 0.05). Likewise, age (6-9 years), mother's illiteracy, urban-farmer father, not washing hands before eating, ODS near residence, tradition of cleaning and eating dropped food, habit of playing with soil, sucking fingers and eating when playing were identified as significant risk factors of A. lumbricoides infection. CONCLUSION: High prevalence of IPIs among the study participants demands improvement of environmental sanitation, personal hygiene, and health education regarding the potential habit and culture-related risk factors.

Immunization coverage of 12-23 months old children and its associated factors in Minjar-Shenkora district, Ethiopia: a community-based study.

BACKGROUND: Childhood vaccinations have been shown to be effective in protecting children against vaccine-preventable diseases. The systematic investigation of the causes of incomplete immunization is critical for the full immunization and develop health system interventions to improve immunization coverage. To date, no community-based immunization coverage assessment study was conducted in Minjar-shenkora district. Therefore, the aim of this study was to assess the immunization coverage and its factors among 12-23 months old children in Minjar-shenkora district, Ethiopia. METHODS: Community-based cross-sectional study was conducted from September to November 2017. A total of 566 children aged 12-23 months and their mothers/caregivers were successfully interviewed using structured and pre-tested questionnaire. A stratified sampling technique was employed. Study participants were selected systematically. Data were entered into Epi data version 3.1 and exported into SPSS version 21 for analysis. Logistic regression analyses were done. A significant association was declared at a p-value less than 0.05. RESULTS: Three fourth (75.6%) of 12-23 months old children were fully vaccinated. Incorrect appointment date (46.4%), the experience of child sickness with previous vaccination (35.2%) and disrespectful behavior of health professionals (14.3%) were the most common reasons cited by mothers/caregivers for incomplete vaccination of children. Being unmarried (AOR = 3.52, CI = 2.61, 9.15), not being a member of health development army (AOR = 3.31, CI = 2.01, 11.65) and traveling time greater than two hours on foot (AOR = 2.46, CI = 5.01, 17.18) were predictors of incomplete immunization. CONCLUSIONS: Child immunization coverage was still below the governmental plan of 90% in 2020. Being unmarried, not being a member of health development army and traveling time greater than two hours on foot were predictors of incomplete immunization. Strengthen health development army programmatic interventions in the community will improve child vaccination completion in the district. The issue of long travel time should be addressed by increasing the number of new vaccination sites/clusters in the district.