Risk factors for neonatal sepsis among neonates in the neonatal intensive care unit at Hawassa University Comprehensive Specialized Hospital and Adare General Hospital in Hawassa City, Ethiopia.

Background: Neonatal sepsis (NS) is a serious blood bacterial infection in children of 28 days or younger, manifested by systemic signs and symptoms of infection. Neonatal sepsis has become one of the leading causes of admission and death in developing countries like Ethiopia. Understanding different risk factors for neonatal sepsis is essential for early diagnosis and treatment. So, this study aimed to assess the risk factors for neonatal sepsis among neonates at Hawassa University Comprehensive Specialized Hospital and Adare General Hospital in Hawassa City, Ethiopia. Methods and materials: A case-control study design was employed on 264 neonates (66 cases and 198 controls) in Hawassa University Comprehensive Specialized Hospital and Adare General Hospital from April to June 2018. Data were collected by interviewing the mothers and reviewing neonates' medical records. The data were edited, cleaned, coded, and entered into Epi info version 7 and were transported and analyzed using SPSS version 20. The odds ratios (ORs) with 95% confidence intervals (CIs) were used to assess the significance of the associations. Result: A total of 264 neonates (66 cases and 198 controls) with 100% response rate. The mean (±SD) age of mothers was 26 ± 4.042 years. The majority (84.8%) of the cases were found in children under 7 days, with a mean age of 3.32 days ± 3.376 SD. Factors such as prolonged rupture of the membrane [AOR = 4.627; 95% CI (1.997-10.72)], history of the urinary tract or sexually transmitted infections [AOR = 2.5; 95% CI (1.151-5.726)], intrapartum fever [AOR = 3.481; 95% CI (1.18-10.21)], foul smelling liquor [AOR = 3.64; 95% CI (1.034-12.86)], and low APGAR score in the fifth minute [AOR = 3.38; 95% CI (1.107-10.31)] were the independent predictors of neonatal sepsis. Conclusion: Prolonged rupture of the membrane, intrapartum fever, urinary tract infection, foul-smelling liquor, and low APGAR score were independent risk factors of neonatal sepsis, and this study also observed that the onset of neonatal sepsis was higher in the first week of a neonate's life. Routine sepsis evaluation must focus on neonates born with the aforementioned characteristics and make interventions for babies born with these risk factors.

Antiepileptic Drug Adherence and Its Associated Factors among Epilepsy Patients on Follow-ups at Amanuel Mental Specialized Hospital, Ethiopia.

Background: Medication adherence is a fundamental determinant of effective treatment. However, people with epilepsy have poor compliance with their treatment because of the chronic nature of the disease. Limited studies have been conducted to address antiepileptic medication adherence in Africa, including Ethiopia. Thus, the aim of this study was to assess antiepileptic drug adherence and its asociated factors among patients with epilepsy attending outpatient department of Amanuel Mental Specialized Hospital. Methods: A cross-sectional study design was conducted on 439 patients with epilepsy in Amanuel Mental Specialized Hospital. Medication adherence reporting scale-5 (MARS-5) was used to assess adherence to antiepileptic drugs. The Oslo social support, Jacob perceived stigma scale, and hospital anxiety and depression scale (HADS) were the instruments used to assess associated factors. Simple and multiple linear regression analysis models were fitted. Then, the adjusted unstandardized beta (ß) coefficient at a 95% confidence level was used. Results: The mean(SD) score of antiepileptic medication adherence was 16.38(±3.76) with 95%CI:(16.03, 16.72). Depressive symptoms (ß= -1.35, 95% CI: (-2.04, -0.65)), anxiety symptoms (ß=-1.12,95%CI:(-1,79,-0.44), perceived stigma (ß= -1.64, 95% CI:-2.16,-1.12), being single (ß=-0.67, 95%CI:-1.20,-0.14), presence of seizure per month(ß=-2.11,95% CI: (-2.81,-1.41) and antiepileptic drug adverse effect(ß=-0.07,95%CI:-0.11,-0.03) were factors associated with anti-epileptic medication adherence. Conclusions: The results suggest that the mean score of adherence to antiepileptic drugs was poor as compared to other settings. Antiepileptic medication adherence screening tool should be included in the patient's treatment protocol.

Factors Associated With HIV Preventive Behavior Among Adults in Majang Zone of Gambella Region, Southwest Ethiopia.

Background: HIV-positive people can spread the virus through unprotected sex; however, HIV can be avoided if populations are educated about the risks. In underdeveloped nations, evidence suggests that the ABC method for HIV prevention is quite effective. As a result, the goal of this study was to determine the magnitude of HIV prevention behavior among adults in the Majang zone of Southwest Ethiopia, as well as the factors that influence it. Methods: A community-based cross-sectional study was carried out from March 1st to May 31st, 2019. The data were collected through a face-to-face interview using a modified validated questionnaire among systematically selected study participants. The collected data were coded and entered using Epidata manager version 4.0.2.101 and analyzed using SPSS version 21. A logistic regression analysis was computed to determine the association using crude and adjusted odds ratios at 95% confidence intervals. The level of significance was declared at a p-value less than 0.05. Results: Of the 772 adults interviewed, the proportion of adults who had good HIV preventive behavior was 51.8%, 95% CI [48.3-55.3%]. Two hundred forty (31.9%) were used abstinence as a type of HIV preventive behavior followed by being faithful (16.1%) and consistent condom use (7.3%). The study also found that respondents with the age group ≥27 years old (AOR = 1.56, 95% CI [1.3-3.12]), marital status (being married (AOR = 6.30, 95% CI [4.48-11.4]), and divorced/widowed (AOR = 5.50, 95% CI [2.60-12.4]) and having good knowledge of HIV prevention methods (AOR = 2.18, 95% CI [1.71-4.00]) were the factors associated with good HIV preventive behavior. Conclusion and Recommendation: In the study area, overall HIV prevention behavior was average. The characteristics linked with successful HIV prevention behavior among adults in the Majang community included increasing age, being married or divorced/widowed, and having a solid understanding of HIV prevention approaches. As a result, policy-level and multi-sectorial intervention approaches from all stakeholders are necessary to develop short- and long-term strategies to address the problem and improve the community's quality of life.

Antiepileptic Drug Adherence and Its Associated Factors among Epilepsy Patients on Follow-ups at Emanuel Mental Specialized Hospital, Ethiopia

Medication adherence is a fundamental determinant of effective treatment. However, people with epilepsy have poor compliance with their treatment because of the chronic nature of the disease. Limited studies have been conducted to address antiepileptic medication adherence in Africa, including Ethiopia. Thus, the aim of this study was to assess antiepileptic drug adherence and its asociated factors among patients with epilepsy attending outpatient department of Amanuel Mental Specialized Hospital. METHODS: A cross-sectional study design was conducted on 439 patients with epilepsy in Amanuel Mental Specialized Hospital. Medication adherence reporting scale-5 (MARS-5) was used to assess adherence to antiepileptic drugs. The Oslo social support, Jacob perceived stigma scale, and hospital anxiety and depression scale (HADS) were the instruments used to assess associated factors. Simple and multiple linear regression analysis models were fitted. Then, the adjusted unstandardized beta (ß) coefficient at a 95% confidence level was used. RESULTS: The mean (SD) score of antiepileptic medication adherence was 16.38(±3.76) with 95%CI:(16.03, 16.72). Depressive symptoms (ß= -1.35, 95% CI: (-2.04, -0.65)), anxiety symptoms (ß=-1.12,95%CI:(-1,79, -0.44), perceived stigma (ß= -1.64, 95% CI: -2.16, -1.12), being single (ß=-0.67, 95%CI: -1.20, -0.14), presence of seizure per month (ß=-2.11,95% CI: (-2.81, -1.41) and antiepileptic drug adverse effect (ß=-0.07,95%CI: -0.11, -0.03) were factors associated with anti-epileptic medication adherence. CONCLUSION: The results suggest that the mean score of adherences to antiepileptic drugs was poor as compared to other settings. Antiepileptic medication adherence screening tool should be included in the patient's treatment protocol

Prevalence of common mental disorder and associated factors among mothers of under five year children at Arbaminch Town, South Ethiopia, 2019.

BACKGROUND: Common mental disorders are the major public healthproblem that affects mothers with young children. Although there were a number of studies done on maternal mental health problems, they were largely focused on perinatal period. However, there is scarcity of information on the magnitude and correlates of these mental health problems beyond perinatal period and due concern is not given mainly in LMICs including our country. OBJECTIVE: To assess the prevalence and factors associated with common mental disorderamong mothers of under-five year children at Arbaminch town, South Ethiopia, 2019. METHODS: A community based cross-sectional study was conducted in May and June 2019 at Arbaminch town. A systematic random sampling technique was used to select 776 participants. The Self-Reporting Questionnaire (SRQ-20) was used to assess common mental disorder (CMD). Data was coded and entered in EPIDATA3.1 and analyzed using SPSS version 25. Bivariable and multivariable logistic regression were used to identify factors associated to common mental disorder. P-values less than 0.05 were considered statistically significant and strength of the association was presented by adjusted odds ratio with 95% confidence interval. RESULT: The prevalence of common mental disorder among mothers with children aged below five years was 36.6% with (95% CI, 33.2, 39.9). Being single/divorced/widowed [AOR = 3.64, 95% CI:(1.47, 8.99), chronic medical illness [AOR = 3.25, 95% CI:(2.10, 5.04)], exposure to two/more stressful events [AOR = 1.62, 95% CI:(1.11, 2.36)], poor social support [AOR = 2.59, 95% CI:(1.62, 4.14)], mothers living with cigarette smoker husband [AOR = 2.03, 95% CI:(1.19, 3.47)], and mothers physically abused by their spouse [AOR = 2.36, 95% CI:(1.49, 3.74)] were factors associated with common mental disorder. CONCLUSION AND RECOMMENDATION: The prevalence of common mental disorder was high among mothers with children aged below five years compared to the general population. Being single/divorced/widowed, chronic medicalillness, exposure to two/more stressful events, poor social support, mothers living with cigarette smoker husbandand physically abuse by their spouse were factors associated with common mental disorder. Early detection and management of these maternal mental health problems is vital for mothers' wellbeing as well as growth and development of children.

Help-Seeking Preferences to Informal and Formal Source of Care for Depression: A Community-Based Study in Northwest Ethiopia.

BACKGROUND: Globally, 350 million people are suffering from depression. Many people suffering from depression use different sources of help for their problems. People with different mental health problems seek help from formal and/or informal sources. This gives crucial information on community beliefs and perception regarding their preference for help. This study helps to guide effective planning and provision of mental health services, and health policy of the country to explore the community's preference to different sources of help. OBJECTIVE: The aim was to contrast patterns of formal and informal help-seeking preferences for depression among residents of Aykel town, Northwest Ethiopia. METHODS: This cross-sectional population-based study included 832 participants. We used a major depressive disorder case vignette and general help-seeking questionnaire (GHSQ) to assess preference to seek help. Study participants were selected by multistage cluster sampling technique. An independent sample t-test and analysis of variance test (ANOVA) was performed. RESULTS: A total of 656 subjects (78.8%) showed high propensity to intimate partner, and 655 (78.7%) of the study subjects had high propensity to mental health professional. The mean score of the residents' preference to seek help from informal sources was 3.41±0.60. The mean score of preference to seek help from formal sources was 3.18±0.75. A total of 276 (33.2%) subjects showed high propensity to both informal and formal sources of help. The results also showed there was a mean score difference in preference for informal help between subjects with strong social support and low and moderate social support (P<0.001). CONCLUSION: The result suggests that the majority of the residents had a higher preference to seek help from informal sources than formal sources of care. Providing and strengthening both formal and informal sources of help in conjunction are crucial to get a more qualified and effective care for depressed patients.

The Psychological Impacts During the Initial Phase of the COVID-19 Outbreak, and its Associated Factors Among Pastoral Community in West Omo Zone, South-West Ethiopia, 2020: A Community-Based Study.

BACKGROUND: COVID-19 is a global pandemic and a major health crisis affecting several nations. Such outbreaks are associated with adverse mental health consequences to any group of the population. Despite its negative effects, no study has addressed the potential psychological impacts of the COVID-19 outbreak among the pastoral community. This study aims to assess psychological experiences during the early stages of the COVID-19 outbreak and the factors that contributed to it among pastoral community residents in West Omo, South-West Ethiopia. METHODS: A community-based cross-sectional study was carried out from May to June 2020. The study subjects were selected through a multistage sampling technique. Data were collected through face-to-face interviews, and entered into EpiData 3.1, then exported to SPSS version 24 for statistical analysis. The psychological impact was assessed by the Depression, Anxiety and Stress Scale (DASS-21). P-value < 0.20 during bi-variable analysis was considered as a candidate for multivariable logistic regression. Independent factors of depression, anxiety, and stress were assessed using adjusted odds ratio with 95% confidence level s at P-value < 0.05 cut-off point. RESULTS: A total of 845 eligible pastoral residents were interviewed, with a 94.4% response rate. The prevalence of a positive response for anxiety, depression and stress was 30.8%, 26.3% and 24.4%, respectively. Being female was highly associated with developing anxiety and depression. Anxiety was found to be three times more prevalent among the respondents with ≥ 3 family members. Furthermore, participants with a history of mental illness, poor social support, and a high perceived life threat were also at a higher risk of experiencing anxiety, depression, and stress. CONCLUSION: The prevalence of positive depression, anxiety and stress results were high. As a result, special attention should be paid, by governmental and non-governmental health organizations, to psychosocial and mental health programs for pastoral residentsduring the COVID-19 pandemic.

Covid-19 Pandemic-Related Stress and Coping Strategies Among Adults with Chronic Disease in Southwest Ethiopia.

BACKGROUND: The outbreak of the novel coronavirus disease 2019 (COVID-19) pandemic presented a great threat to the physical and mental health of the general population. Patients with chronic disease have always been vulnerable to stressful life conditions. Therefore, determining the perceived stress and coping strategies among chronic disease patients is crucial to minimize the mental health consequences related to the outbreak. OBJECTIVE: This study aimed to determine COVID-19-related stress and coping strategies among adults with chronic disease in southwest Ethiopia. METHODS: An institution-based cross-sectional study was conducted among 613 randomly selected adults with chronic disease in southwest Ethiopia. A multiple linear regression analysis was used to determine the relationship between the COVID-19-related stress score and coping strategy types, and independent sample t-tests and ANOVA tests were conducted. Statistical significance was accepted at p-values <0.05. RESULTS: More than two-thirds of study participants (68.4%) were moderately stressed, 13.9% were severely stressed, and 17.8% had low levels of perceived stress. Active coping (ß=1.238, 95% CI: 0.0 to 2.477), denial (ß=3.678, 95% CI: 2.44 to 4.915), behavioral disengagement (ß=3.669, 95% CI: 2.193 to 5.146), self-blame (ß=1.722, 95% CI: 0.146 to 3.297), and religion (ß=3.443, 95% CI: 2.028 to 4.858) coping strategies positively predicted the COVID-19-related stress score. Only the acceptance coping strategy (ß=-2.710, 95% CI: -3.926 to -1.493) negatively predicted the COVID-19-related stress score. CONCLUSION: Significant numbers of participants suffered from moderate to severe perceived stress levels due to the COVID-19 outbreak. Both adaptive and maladaptive coping strategy types were significantly associated positively and negatively with perceived stress score among adults with chronic disease. There were significant differences in the mean scores of perceived stress and categories of variables such as family size, duration of disease, and age of the participants.

Assessment of Psychological Distress and Associated Factors among Hospitalized Patients During the COVID-19 Pandemic at Selected Hospitals in Southwest Ethiopia.

BACKGROUND: The aim of this study was to assess the prevalence of psychological distress and associated factors among hospitalized patients during the COVID-19 pandemic at three selected hospitals in southwest Ethiopia. METHODS: An institution-based cross-sectional study design was conducted among hospitalized patients during the COVID-19 pandemic at Mizan-Tepi University Teaching Hospital, Tepi General Hospital, and Gebre Tsadik Shawo General Hospital, southwest Ethiopia from May 10 to August 10, 2020. Sample size was computed using a single-proportion formula, and systematic sampling was employed to recruit study participants. Data were collected using a structured interviewer-administered questionnaire. Psychological distress was assessed with the Kessler Psychological Distress Scale, which has been validated in Ethiopia. SPSS 21.0 was used for analysis. Descriptive statistics were calculated to characteristize the study population. Predictors of psychological distress were identified by logistic regression analyses. RESULTS: Among the 337 study participants enrolled, about 41% were aged 25-34 years. The overall prevalence of psychological distress was 57.9% (95% CI 52.8%-63.5%). Being female (AOR 3.69, 95% CI 2.08-6.55), having high (AOR 5.45, 95% CI 2.35-12.66) and medium perceived life threat (AOR 3.37, 95% CI 1.75-6.48), poor (AOR 3.97, 95% CI 1.70-9.29) and moderate social support (AOR 3.17, 95% CI 1.36-7.41), and current khat use (AOR 4.16, 95% CI 1.67-10.35) were statistically associated with psychological distress during the COVID-19 pandemic at P value <0.05. CONCLUSION: The prevalence of psychological distress was high among hospitalized patients during the COVID-19 pandemic. The study findings highlight the need to develop psychological support strategies to improve mental health and psychological resilience.

Prevalence and Associated Factors of Psychological Distress among Nurses in Public Hospitals, Southwest, Ethiopia: A cross-sectional Study.

Background: Psychological distress is a state of emotional suffering and also characterized by somatic symptoms. Health care workers more prone psychological distress than general population. However, little attention was paid on psychological distress among nurses particularly in Ethiopia. Therefore, this study aimed at assessing the prevalence of psychological distress and its' associated factors among nurses in public hospitals, Southwest Ethiopia. Method: An institutional-based cross-sectional study was conducted from February 1st, 2018 to April 1st, 2018. All 282 eligible nurses in the selected public hospitals were enrolled. Data was collected using the predesigned tool like Self-Reporting Questionnaire version 20. Data were entered using EPI INFO version 7 and was exported to statistical packages for social science (SPSS) version 21.0 for analysis. Logistic regression analysis was employed and variables with a P-value of < 0.05 were considered as statistically significant. Result: A total of 282 eligible nurses were enrolled in the study with mean age of 28.71 [SD ±7.047]. The prevalence of psychological distress among nurses was 78(27.7%). Predictor variables like; nurses with job title of staff nurse, less working experience, poor interaction with staffs, fatigue, poor social support, perfectionism, and insomnia were more prone to develop the psychological distress. Conclusion: The study revealed that a considerable proportion of nurses had psychological distress. Therefore, it needs to develop psychological support strategies to improve the mental health resilience of nurses.

Quality of Life and Associated Factors Among Patients with Epilepsy Attending Outpatient Department of Saint Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia, 2019.

BACKGROUND: Epilepsy is strongly associated with an impaired quality of life. Patients suffering from epilepsy have a poorer quality of life than both the general population and many other chronic disease sufferers. However, attention is not given on the quality of life of people with epilepsy other than focusing on symptom reduction. This increases the frequency of seizures, impacts on the ability to perform and increases health-related costs. The aim of this study was to assess quality of life and associated factors among patients with epilepsy attending the outpatient department of Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia. METHODS: An institution-based cross-sectional study design was conducted between May and June 2019 at Amanuel Mental Specialized Hospital. A systematic random sampling technique was used to get a total number of 447 samples. Data on quality of life was assessed through interviews using the World Health Organization Quality of Life-Brief (WHOQOL-BREF) Version. The collected data were coded, entered into EpiData 3.1, and analyzed by using SPSS version 20. Simple and multiple linear regression analysis models were fitted and the unstandardized ß coefficient at 95% confidence interval was employed. The statistical significance was accepted at p-value <0.05. RESULTS: The mean score of quality of life was 61.1±11.6 (95%CI: 59.05, 61.23). Perceived stigma (ß=-2.13, 95%CI:-2.96, -1.30), frequent seizure (ß=-3.16, 95%CI: -4.27, -2.04), AED adherence (ß=1.24, 95%CI: 1.10, 1.30), antiepileptic drug side effect (ß=-0.32, 95%CI: -0.38, -0.26), anxiety (ß-1.91, 95%CI: -2.95, -0.86), depression (ß=-3.59, 95%CI: -4.67, -2.52), poor social support (ß=-2.51, 95%CI: -3.62, -1.40) and moderate social support (ß=-1.60, 95%CI: -2.58, -0.62) were significantly associated factors with quality of life. CONCLUSION: The finding from this study indicated that quality of life of patients with epilepsy were moderate. Perceived stigma, frequent seizure, comorbid depression and anxiety, antiepileptic drug nonadherence, antiepileptic drug side effect and poor social support were the predictors of quality of life.

Health-Related Quality of Life and Associated Factors Among Type Two Diabetic Patients on Follow-Up in Dessie Comprehensive Specialized Hospital, Dessie, North East Ethiopia, 2020.

BACKGROUND: Diabetes mellitus is a disorder of carbohydrate metabolism and it is highly related with diminished HRQOL in Ethiopia; diabetic related complications especially bring major negative impacts on HRQOL. OBJECTIVE: To assess HRQOL and associated factors among type two diabetic patients in Dessie Comprehensive Specialized Hospital, north east Ethiopia, 2020. METHODS: Institutional-based cross-sectional study design was conducted on 417 patients through systematic random sampling technique from February 08 to April 08, 2020. WHO HRQOL 26 items were used to measure outcome variable. Face-to-face interview, document review and measurement were implemented to collect data. The data were analyzed by IBM SPSS Statistics version 25 and summarized by using tables. Simple linear regression analysis was done and forwarded to multivariable linear regression analysis at p-value <0.25. Next multivariable linear regression analysis was done and variables whose p-value less than 0.05 with unstandardized B-coefficient were declared significant predictor variables. RESULTS: The mean scores of physical domain, psychological domain, environmental domain and social domain were 48±6.7 (47-49), 52±4.2 (50-52.3), 48.9±3.4 (48-50.4) and 49±4 (48-50), respectively. As age increased by one year, patients' physical HRQOL decreased by 0.031 factor, keeping effect of other variables constant [-0.031, 95% CI (-0.050 to-0.013)]. As duration of diabetes increased by one year, patients' physical HRQOL increased by 0.034 factor, keeping effect of other variables constant [0.034, 95% CI (0.004 to 0.065)]. In general, age, depression, perceived social stigma, self-employed, having two complications, widowed, insulin and oral anti-diabetic medication affected HRQOL negatively and duration of diabetes in physical domain and university level of education in environmental domain affected HRQOL positively. CONCLUSION AND RECOMMENDATION: The mean score of health-related quality of life in physical health domain, psychological health domain, social health domain and environmental health domain was recorded nearly half score point out of a hundred. Health professionals should follow a holistic approach to management to address negatively associated predictor variables with HRQOL.