Epilepsy Treatment Outcome and Its Predictors Among Children Who Had Chronic Follow Up at Dessie Comprehensive Specialized Hospital.

Introduction: Epilepsy is a chronic non-communicable disease of the brain that affects millions of people worldwide. A significant number of children are affected globally, and most live in developing countries, often with physical and cognitive disabilities. Regardless of these factors, epilepsy is poorly controlled, particularly in the developing countries. Thus, this study aimed to assess the magnitude of treatment outcomes and its predictors among pediatrics patients with epilepsy who were followed-up at the Dessie Comprehensive Specialized Hospital, Northeast Ethiopia. Methods: Hospital-based cross-sectional study was conducted from 1 June 2022 to 30 August 2022. A total of 200 patients with epilepsy were included in this study. Data were collected through face-to-face interviews, and by reviewing medical records. The collected data were entered into Epi-data version 4.6 and exported to SPSS version 25.0. Descriptive statistics such as frequencies, percentages, means and standard deviations were computed. Binary and multivariate logistic regression analyses were performed. Variables with p < 0.25 in bivariate analysis were entered into multivariable logistic regression. In multivariable analysis, adjusted odd ratio with 95% CI and p-value less than 0.05 were considered statistically significant. Results: Of 200 pediatric patients with epilepsy, 66 (34.5%) had poor treatment outcomes. In the multivariate analysis, 11-15 years of age (AOR = 4.08; 95% CI = 1.202, 13.848), poor treatment adherence (AOR = 3.21; 95% CI = 1.421, 7.249), history of more seizure frequency before starting treatment (AOR = 4.19; 95% CI = 1.984, 8.834) and history of head injury (AOR = 3.03; 95% CI = 1.502, 6.112) were significantly associated with poor treatment outcomes in pediatric patients with epilepsy. Conclusion: Significant proportion of pediatric patients with epilepsy had poor treatment outcomes. Therefore, health-care workers should strictly follow patient treatment especially for pediatric epileptic patients' who have poor treatment adherence, more seizure frequency history, head injury history and whose age were 11-15 years old.

Treatment Outcome, Pattern of Injuries and Associated Factors Among Traumatic Patients Attending Emergency Department of Dessie City Government Hospitals, Northeast Ethiopia: A Cross-Sectional Study.

Background: Traumatic injuries are a major cause of emergency room visits and hospital workload, and they are a global health concern. Therefore, this study aimed to assess the pattern of injuries, treatment outcomes, and associated factors among traumatic patients attending the emergency department of Dessie City Government Hospitals, Northeast Ethiopia. Methods: An institutional-based retrospective cross-sectional study was conducted among 415 traumatic patients selected by using a systematic random sampling technique, from July 1, 2019, to June 30, 2022. Data were collected through document review. The data were presented with frequency tables and graphs. Data were entered using EPI data version 4.6 and exported to SPSS version 26 for analysis. Both bi-variable and multivariable logistic regression analyses were performed to analyze the relationship between the independent variable and the outcome variable. As a measure of association, the adjusted odds ratio was utilized, which has a 95% confidence level. Statistically significant variables were those with a p-value of less than 0.05. Results: From 420 patient charts, 415 traumatic patients' charts were reviewed in this study, with a response rate of 98.8%. The prevalence of good treatment outcomes among traumatic patients was found to be 67% [95% CI: 62.2, 72.0]. In the final multivariable analysis, having comorbidity [AOR=, 0.31 95% CI: 0.16, 0.60], arriving within one hour [AOR=4.79, 95% CI: 2.10, 10.94], arriving two up to twenty-four hours [AOR=2.25, 95% CI: 1.34, 3.78] and being conscious at admission [AOR=1.82, 95% CI: 1.02, 3.26] had a significant association with a good treatment outcome among traumatic patients. Conclusion: Trauma constitutes a major public health problem in our setting and contributes significantly to unacceptably high morbidity and mortality. Interventions should be targeted at urgent injury prevention and management strategies, along with the establishment of a pre-hospital emergency medical service system.

The effect of conflict on child and adolescent health in Amhara region, Ethiopia: Cross-Sectional Study.

BACKGROUND: Currently, conflict become common phenomenon in the world affecting the lives of millions of children. Due the continued conflict in Ethiopia millions of children are suffering from extreme levels of violence, lack of basic humanitarian needs, and lack of health services. OBJECTIVE: This study was designed to assess the effect of conflict on child and adolescent health in Amhara region, September 2022. METHODS: A community-based cross-sectional study was employed among children agedd < 18 years in conflict affected areas of Amhara region. The sample size was determined using a single population proportion formula. Data was collected through face-to-face interviews of children or child legal guardians. Data was cleaned, verified, and entered into EpiData version 3.1 and analysis was done using SPSS version 24 statistical software. RESULT: Seven hundred and ninety-eight children agedd less than 18 years were involved with a response rate of 94.33 percent. More than one thirds (276, 34.59%) of children were displaced due to the conflict. Three hundred and thirty one (41.48%) children get diseased with the majority didn't receive treatment. More than two thirds (557, 69.80%) of children had experienced violence of different types. One hundred and thirty four (41.23%) children had acute malnutrition with two third (66.42%) of them had severe acute malnutrition. CONCLUSION: Conflict had deadly impacts on the lives of children and adolescents. It causes massive displacement, lack of basic humanitarian needs, extreme level of violence, hunger and malnutrition, and lack of health services. The government and other national and international humanitarian aids should give special attention to children living in war zone of Amhara region. In addition, rehabilitation services and resilience training should be designed and provided to children affected by the conflict.

Knowledge, Practice, and Factors Affecting Sunlight Exposure of Infants Among Mothers at Governmental Health Facilities in Dessie Town, Ethiopia, 2021.

Background: Human being needs sunlight for physical and mental well-being. Sunlight helps the body to produce vitamin D, an important vitamin for skeletal development, immune function, and blood cell formation. So, the community should be counseled to get sufficient sun exposure and vitamin D supplementation to uphold the serum 25 (OH) D levels. This study designed to assess the mothers' knowledge, practice, and factors affecting the sunlight exposure of their infants. Methods: A facility-based cross-sectional study was conducted at governmental health facilities in Dessie Town, 2021. A total of 398 mothers were interviewed using semi structured questionnaires. Data were entered into the EPI data version 3.1 and analyzed using SPSS 23. Binary and multivariate logistic regression analyses were also performed. In multivariate analysis, a significant association was considered at P-value of <.05. Results: Response rate was 98.9%. About 76.6% and 58.9% of the mothers had poor knowledge and poor practice regarding sunlight exposure of infants respectively. Mothers' occupation (aOR = 0.124, 95% CI = 0.042, 0.365), mothers' source of information (aOR = 18.604, 95% CI = 7.564, 45.75), and attitude (aOR = 2.773, 95% CI = 1.474, 5.215) had showed a significant association with mothers' knowledge. On the other hand, mothers' age (aOR = 3.191, 95% CI = 1.334, 7.633), mothers occupation (aOR = 4.226, 95% CI = 2.321, 7.694), and baby age (aOR = 1.989, 95% CI = 1.260, 3.140) had a significant association with their practice about sunlight exposure of infants. Conclusion: Mothers' knowledge and practice of sunlight exposure of infants are poor in Dessie Town. Hence measures should be taken to increase and improve mothers' responsiveness of sunlight exposure of infants.

Determinants of cutaneous leishmaniasis among students in Delanta district, Northeast Ethiopia: A case-control study.

Background and Aims: Cutaneous leishmaniasis (CL) is the most common form of leishmaniasis that causes skin lesions on exposed parts of the body. It is endemic in over 170 districts and highly prevalent in the northern and southern parts of Ethiopia. Thus, the aim of this study was to assess the determinants of CL among students of Wegeltena secondary school in Delanta district, Northeast Ethiopia. Methods: This unmatched case-control study was conducted from January 4 to 20, 2021 at Wegeltena secondary school. Cases were students who had an active lesion of CL and controls were students who had never been infected with CL (no active lesions). A simple random sampling technique was utilized to select participants in the control group. Data were collected by using a pretested, interviewer-administered structured questionnaire. Bivariable and multivariable logistic regression analyses were performed and variables were declared determinants of CL at a p value of <0.05. Results: A total of 225 students (58 cases and 167 controls) participated in the study. The mean age of cases and controls was 18.6 (SD ± 0.99 years) and 18.5 years (SD ± 1.17 years), respectively. In this study, 74.1% of cases and 51.5% of controls have been living in rural areas. Furthermore, being male (adjusted odds ratio [AOR] = 4.11; 95% confidence interval [CI]: 1.94-8.69), rural residents (AOR = 2.95; 95% CI: 1.33-6.52), living in areas where caves (AOR = 3.63; 95% CI: 1.24-10.59), nearby forest (AOR = 4.04; 95% CI: 1.42-11.51), and hyrax available (AOR = 2.43; 95% CI: 1.16-5.08) were significantly associated with CL. Conclusion: In our study, sociodemographic and environmental factors were found to be determinants of CL. Therefore, reducing outdoor activities, wearing protective clothes, use of insecticide-treated nets, and destruction of sand fly breeding sites shall be implemented targeting the rural population that resides in areas where forests, caves, and hyraxes are prominent.

Knowledge, Practice and Associated Factors of Health Care Workers on Prevention of Catheter-Associated Urinary Tract Infections in South Wollo Zone Public Hospitals, Northeast Ethiopia.

Introduction: Health care providers are responsible for inserting and maintaining urinary catheters. Hence, it is very important that health care professionals need to be skillful and knowledgeable to prevent urinary tract infection for those patients undergoing indwelling catheter. Thus, this study aimed to assess knowledge, practice and associated factors of health care workers on prevention of catheter-associated urinary tract infections in South Wollo zone public hospitals, Northeast Ethiopia. Methods: An institution-based cross-sectional study design was employed by using a simple random sampling technique among 413 health care workers. Data were entered into Epi-Data version 4.6 and were exported to SPSS version 26 for analysis. Bivariable logistic regression analyses were performed, and variables with P-value less than 0.25 were fitted to multivariable logistic regression. In multivariable regression analysis, variables having p-value <0.05 were declared as significant factors for outcome variable. Results: Out of the total 413 health care workers, 298 (72.2%) had adequate knowledge and 233 (56.4%) had adequate level of practice towards catheter-associated urinary tract infection prevention. Received training [AOR = 2.33, 95% CI: 1.404-3.889] and being bachelor degree holder [AOR = 1.90, 95% CI: 1.084-3.359] were significantly associated with adequate knowledge. On the other hand, being master and doctor [AOR = 4.71, 95% CI: 1.768-12.56], adequate level of knowledge [AOR = 2.90, 95% CI: 1.785-4.723], received training [AOR = 2.09, 95% CI: 1.315-3.338] and work experience ≥20 years [AOR = 5.82, 95% CI: 1.497-22.69] were significantly associated with adequate level of practice. Conclusion: A substantial proportion of health care workers had inadequate knowledge and practice towards catheter-associated urinary tract infection prevention. Therefore, health care workers should strictly follow infection prevention guidelines and should update their knowledge and practice by taking short and long term training.

Knowledge, Attitude, and Practice towards COVID-19 among Mothers in Dessie Town, Northeast Ethiopia, 2020.

Background: Coronavirus disease 2019 (COVID-19) is a highly infectious disease causing a catastrophic effect, and many of us are worried to find a new normal. Many burdens are occurring in households, predominantly to women and mothers. Women worldwide are naive on COVID-19 symptoms, transmission, and prevention measures and worried on being exposed to coronavirus. The study aimed to assess the mother's knowledge, attitude, and practice towards COVID-19. Methods: A community-based cross-sectional study was conducted from July 22 to August 7, 2020, in Dessie town, Ethiopia. A total of 634 mothers were included in the study. Multistage cluster sampling was used to take the proper sample. An interviewer-administered pretested structured questionnaire was used. Data were entered into EpiData, version 3.1, and analyzed by using SPSS, version 23. Both binary and multivariate logistic regression analyses were performed to find factors associated with dependent variables. The mean score was used to grade the knowledge, attitude, and practice towards COVID-19. Result: A total of 610 mothers participated in this study, making that a 96.2% response rate. More than half of the respondents 319 (50.3%) were in the age of 28-38 years. About 438 (71.8%) attended grades 1-12. About 531 (87.5%) were married, and most respondents 399 (65.4%) were housewives. The mean scores of knowledge, attitude, and practice were 15.36 (SD = 3.059), 6.4 (1.779), and 7.38 (3.068), respectively. Moreover, about 442 (72.5%), 354 (58%), and 338 (55.4%) of the respondents had good knowledge, a favorable attitude, and good practice on COVID-19, respectively. Conclusion: Almost three-fourths of the mothers had good knowledge of COVID-19. However, more than two-fifths of the participants had an unfavorable attitude and poor practice on COVID-19 preventive measures, which may put a high risk of infection that could worsen maternal morbidity and mortality during this pandemic. Therefore, health education programs for mobilizing and improving COVID-19-related knowledge, attitude, and practice are urgently needed, especially for those mothers who have low access to information due to home duty.

Case of multiple furuncular myiasis in Northeast Ethiopia.

Human myiasis is a neglected disease caused by parasitic infestation of the skin, cavities, and other body parts by larvae (maggots) of a wide variety of dipteran flies. Here, we present a case of multiple furuncular myiasis caused by Cordylobia anthropophaga in a 61-year-old woman from Northeast Ethiopia.

Adherence to Self-Care among Patients with Hypertension in Ethiopia: A Systematic Review and Meta-Analysis.

Background: Self-care adherence for hypertensive patients is a cornerstone for the control of it and prevention of its complications. However, there are inconsistent findings for self-care adherence of hypertensive patients in Ethiopia. Thus, this systematic review and meta-analysis was done to determine the pooled estimate self-care adherence. Methods: This systematic review and meta-analysis was reported based on the Preferred Reporting Items for Systematic Review and Meta-Analysis guideline. An intensive search of online databases such as PubMed (MEDLINE), CINHAL, Google Scholar, and advanced Google search was made to access both published and unpublished articles that report self-care adherence among hypertensive patients in Ethiopia. The pooled estimate was done with STATA version 11 metan commands in a 95% confidence interval. The presence of heterogeneity and publication bias were detected by I2 and Egger's test, respectively. A random-effect model was obtained, and subgroup analysis was done for the management of heterogeneity. Result: A total of 24 articles with a total of 7224 participants were included in the final systematic review and meta-analysis. The pooled estimate of overall self-care adherence among hypertensive patients was 36.98% (95% CI: 27.13-46.83). In subgroup analysis, the highest overall self-care adherence was observed in the Amhara region at 53% (95% CI: 46.54, 59.47). The pooled estimate of self-care dimensions such as medication adherence, low-salt diet, physical activity, smoking abstinence, alcohol abstinence, and weight management was 62.71%, 65.96%, 47.28%, 92.53%, 67.59%, and 52.54%, respectively. Conclusion: The pooled estimate of good self-care adherence among hypertensive patients was low. From the dimensions of self-care, the lowest level was in physical activity and the highest level was in smoking abstinence. Comparing all regions, the lowest level of overall self-care adherence was observed in Addis Ababa, Tigray region, and South Nations and Nationalities of Ethiopia. Screening of adherence to self-care and health education should be provided to every patient during every visit.

Predictors of Survival Time Among HIV-Infected Adults After Initiating Anti-Retroviral Therapy in Kombolcha Town: A 5-Year Retrospective Cohort Study.

Background: Antiretroviral therapy (ART) enhances the survival of HIV-infected patients by reducing viral load and increasing CD4. As CD4 count increases, patients are more protected against opportunistic infections. In developing countries including Ethiopia, there were limited studies about the survival benefit of ART particularly no study in Kombolcha Town. Thus, this study was aimed to address the gap. Methods: A hospital-based retrospective cohort study was employed in Kombolcha town among 510 patients' records from January 2015 to December 2019. A systematic random sampling technique was used to select patient records. The collected data were checked, coded, and entered into Epidata version 4.6 and exported to Statistical Package for Social Sciences version 26 for data cleaning and analysis. Kaplan-Meier was used to estimate the probability of category of each predictor and a log rank test was used to compare survival curves. Bivariate and multivariate Cox-regression were employed using a 95% CI and variables with p-value <0.05 were declared as predictors of poor survival time. Results: In this cohort, out of 510 HIV-infected patients, 39 (7.65%) were died, and 471 (92.35%) were censored. Fair drug adherence (AHR=6.88, 95% CI: 4.31-24.04), Poor drug adherence (AHR=9.58, 95% CI: 8.72-30.97), CD4 count <50 cell/µL (AHR=9.38, 95% CI: 1.48-59.31), CD4 count 50-99 cell/µL (AHR=9.67, 95% CI: 1.80-51.73), bedridden (AHR=9.5, 95% CI: 4.49-18.66), opportunistic infections (AHR=4.58, 95% CI: 1.20-5.65), weight <60kg (AHR=2.48, 95% CI:1.59, 10.38), WHO stage III (AHR=3.56, 95% CI: 1.71-17.89), WHO stage IV (AHR=4.42, 95% CI:1.75-25.93) were predictors of poor survival time. Conclusion: The Kaplan-Meier result showed that the estimated median survival time of patients after ART initiation in Kombolcha town was higher (32 months) as compared to other studies. Poor drug adherence, WHO stage III & IV, Lower baseline CD4 count, presence of opportunistic infections, weight <60kg, and being bedridden were predictors of poor survival time. Thus, early initiation of ART ought to be encouraged among HIV-infected patients and good patient counseling on the level of adherence should be strengthened.

Knowledge, attitude and prevention measures of students towards cutaneous leishmaniasis in Delanta district, Northeast Ethiopia.

BACKGROUND AND AIMS: Leishmaniasis is a neglected tropical disease which causes significant morbidity and mortality, particularly in developing countries. Cutaneous leishmaniasis (CL) is the main form of leishmaniasis that affects the skin. Knowledge and perception of people about leishmaniasis has a great impact to prevent the disease in endemic areas. Hence, the aim of this study was to assess the knowledge, attitude and preventive measures of Wegeltena secondary school students towards CL in Delanta district, one of the endemic areas in Northeast Ethiopia. METHODS: A facility-based cross-sectional study was conducted from January 4 to 20, 2021 at Wegeltena secondary school in Delanta district, Northeast Ethiopia. A pre-tested, interviewer administered structured questionnaire was used to collect the data. Multivariable logistic regression analysis was utilized to measure the degree of association between outcome and independent variables. Statistically significant association with the outcome variables was declared at a p-value of <0.05. RESULTS: A total of 388 students were participated in the study. In overall, 27.6% and 34.5% of participants had good knowledge and favorable attitude towards CL, respectively. Being grade 12 (AOR = 2.56; 95% CI: 1.23-5.29) and dwelling in urban areas (AOR = 1.78; 95% CI: 1.09-2.89) were determinants of good knowledge. However, female sex (AOR = 1.96; 95% CI: 1.21-3.18) and had good knowledge about CL (AOR = 3.75; 95% CI: 2.26-6.21) were significantly associated with favorable attitude of respondents towards the disease. CONCLUSION: In this study, nearly three-fourth of participants had poor knowledge about CL and two-third of them had unfavorable attitude towards the disease. Level of education and residence were determinants of respondents' knowledge about CL. Moreover, sex and level of knowledge about CL were determinants of respondents' attitude towards the disease. Therefore, an intensified health education program shall be implemented in schools that are found in endemic areas.

Perception of COVID-19 Prevention Methods Efficacy and Intention to Use Among Patients with Chronic Disease in Dessie Town, Northeast Ethiopia: A Multicentered Cross-sectional Study.

BACKGROUND: In Ethiopia, people infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have been increasing dramatically. COVID-19 precaution measures are essential for highly susceptible groups. However, it was not known previously to what extent chronic disease patients were perceived to know about the efficacy of prevention measures. Hence, the aim of this study was to assess perception of patients with chronic disease toward the efficacy of COVID-19 preventive measures and their intention to carry out those measures. METHODS: A multicentered institutional-based cross-sectional study was conducted among 413 patients attended in selected hospitals of Dessie town from July 21 to August 5, 2020. Hospitals were selected using the lottery method and systematic random sampling was utilized to select study participants. An interviewer-administered structured questionnaire was used to collect the data and the tool had four dimensions which include sociodemographic, clinical profile and risk assessment, perceived efficacy of prevention measures, and patient's intention to carry out measures. In multivariable analysis, variables were declared statistically significant at a p-value of <0.05. RESULTS: In this study, the mean age of participants was 48.2 years (SD ±15.8 years) and 52.1% were females. In overall, 42.1% of participants had low perception on the efficacy of prevention measures and 28.3% had low intention to carry out measures. In this study, young adults (AOR=2.48; 95%CI: 1.42-4.31), male gender (AOR=2.75; 95%CI: 1.73-4.37), low literacy (AOR=3.42; 95%CI: 1.47-7.94) and face mask nonusers (AOR=1.64; 95%CI: 1.03-2.61) were significantly associated with low perceived efficacy of COVID-19 prevention methods. CONCLUSION: In this study, a significant proportion of patients had low perception about the efficacy of COVID-19 prevention measures and nearly one-third of them had low intention to carry out prevention measures. Therefore, health education programs about efficacy of preventive measures should be provided by health professionals targeting high risk groups.

Low Blood Donation Practice of Health Sciences College Students in Northeast Ethiopia: A Cross-Sectional Study.

INTRODUCTION: Blood transfusion is a basic and an emergency intervention in health care facilities which has a great role in reducing significant morbidity and mortality. However, there is a major shortage of blood and blood products in developing countries including Ethiopia. This study aimed to assess practice of blood donation and associated factors among health science college students in Dessie town, northeast Ethiopia. METHODS: An institution-based cross-sectional study was conducted among health science college students from May to June 2019. A pre-tested and self-administered structured questionnaire was used for data collection. Multivariable logistic regression analysis model was applied to identify independent predictors of blood donation practice at the level of significance below 0.05. RESULTS: Overall, 12.4% (95% CI: 9.5-15.5) of participants had been donated blood at least once in their lifetime. However, 59.2% of participants have willingness to donate blood in the future. In this study, older age (≥25years) (AOR=2.30, 95% CI: 1.18-4.46), had family history of blood transfusion (AOR=3.55, 95% CI: 1.71-7.36), had knowledge (AOR=2.09, 95% CI: 1.04-4.17) and favorable attitude (AOR=2.41, 95% CI: 1.01-5.75) about blood donation were significantly associated with practice of donating blood. CONCLUSION: In this study, blood donation practice of health sciences college students was found to be low. Age, family history of blood transfusion, knowledge and attitude towards blood donation were independent predictors of blood donation practice. Therefore, Red Cross societies, Dessie town health office, health science colleges and other stakeholders should enhance the awareness of college students regarding the importance of donating blood.