Burden of chemical poisoning and contributing factors in the case of the Amhara Region, Ethiopia.

BACKGROUND: This study aimed to evaluate the burden of chemical poisoning and its associated factors at the Chemical, Biological, Radiological, and Nuclear (CBRN) pilot surveillance sites in the Amhara region, Northwest Ethiopia. The analysis of burdens and contributing factors is intended to inform targeted interventions and enhance public health strategies. METHODS: A cross-sectional study was conducted at TibebeGhionComprehensive Specialized Hospital(TGCSH) and FelegeHiwot Comprehensive Specialized Hospital(FHCSH) in the Amhara region of Ethiopia from June to November 2021. Data were collected using structured tools and analyzed with SPSS version 26. Descriptive statistics assessed the burden of chemical poisoning, while Chi-square analysis identified significant factors associated with the burden of chemical poisoning. RESULTS: The study reported a total of 184 chemical poisoning cases at TGCSH and FHCSH in the Amhara region, with a case fatality rate of 17%. The most affected age group was 16 to 25 years, and females accounted for 60% of the cases. Geographic distribution showed that Bahir Dar had the highest incidence, contributing to 64.7% of the cases, while the South Gondar zone, particularly the Fogera district, accounted for 30.88%. Organophosphates emerged as the most prevalent toxic agents, responsible for 53% of the cases. Chi-square analysis highlighted several significant associations with a higher burden of chemical poisoning, including being female (X² = 4.463, p = 0.035), being 35 years or younger (X² = 4.629, p = 0.031), ingestion of rodent poison (X² = 4.154, p = 0.042), intentional poisoning (X² = 7.488, p = 0.006), and inhalation exposure (X² = 4.154, p = 0.042) and educational level (X² = 5.764, p = 0.016). CONCLUSIONS AND RECOMMENDATIONS: The study reveals a significant burden of chemical poisoning in the Amhara Region, Ethiopia, with a 17% fatality rate, predominantly impacting young adults and females, particularly in areas with high pesticide use, such as Bahir Dar and South Gondar. Key issues include cases with no antidotes, inhalation exposure, and intentional poisoning. RECOMMENDATIONS: Implement stricter chemical regulations, limit pesticide sales, enhance community education on safe handling, and improve mental health support for high-risk groups. Develop sustained CBRN surveillance systems and conduct further research on regional disparities and chemical agent assessments.

A mixed-method study examined the reasons why pregnant women late initiate antenatal care in Northeast Ethiopia.

BACKGROUND: Timely initiation of antenatal care visits is crucial for ensuring optimal care and health outcomes for women and children. However, late antenatal care initiation among pregnant women in low-income countries including Ethiopia is acknowledged in the literature. Therefore, this study examined why pregnant women initiate antenatal care late in Northeast Ethiopia. METHODS: This study was done using a mixed design approach that included phenomenology and retrospective cross-sectional designs. A retrospective cross-sectional study was deployed among randomly selected 632 medical charts of women who had antenatal care visit in Legambo District primary hospital and health centers. Kaplan Meier curve was used to estimate survival time. Bi-variable and multivariable Cox-proportional hazard regression models were fitted using R-studio-1.2.5033 to identify independent predictors of antenatal care initiation time. Six vignette-based focused group discussions were held with pregnant women who had been purposefully selected. Then, a qualitative content analysis that was informed by the phenomenological theory was done. RESULTS: This study indicated that only 195 (30.9%) of women timely initiated their antenatal care follow-up. In a survival analysis, all 632 women contributed 12,474 person-weeks giving a timely antenatal care initiation rate of 15.6 per 1000 person-weeks. According to the multivariable Cox regression models, late antenatal are initiation was found among pregnant women with an unknown last normal menstruation period, no living children, no bad obstetric history, not accompanied by their partner during antenatal care visit, and who lived in a >5-kilometer radius of health facility. In a qualitative analysis, being uncertain whether the pregnancy had occurred, believing that they have a very low probability of experiencing any complications, negative experience with healthcare providers, negative influence from their immediate contacts such as the mother and mother-in-law, and socio-cultural beliefs like "Qare" were found as major reasons why they started antenatal care follow-up late. CONCLUSION: Most pregnant women in Legambo district, northeastern Ethiopia, initiate their antenatal care visits late. Based on the findings of this study, strengthening the pregnant women identification program and performing regular pregnant women's conference will help to achieve early initiation of antenatal care visits. To lessen the negative influence of their immediate contacts, it will also good to include these old moms and husbands in the conference of pregnant women.

Civil servants' physical activity status and its associated factors in Northeast Ethiopia: applying Health Belief Model.

Background: Identifying the associated factors of the physical activity of civil servants is necessary to increase the practice of physical activity. However, limited studies addressed associated factors of civil servants' physical activity status in Ethiopia. Hence, this study assessed civil servants' physical activity status and associated factors in Northeast Ethiopia. Methods: An institution-based cross-sectional study design was conducted from 28 February to 13 March 2020 and measured physical activity using WHO physical activity definition. Four hundred and eight civil servants were interviewed using a systematic random sampling technique. A descriptive statistics and multivariable logistic regression model were used. Result: The percentage of physical activity for the civil servants of the study was only 2.38, with the prevalence of physical activity status of 64.0% (95% CI 60.4% to 67.61%). Perceived self-efficacy (adjusted OR (AOR)=1.98, 95% CI 1.15 to 4.12), cues to action (AOR=2.12, 95% CI 1.04 to 3.22) and being a health professional (AOR=2.19, 95% CI 1.13, 4.23) were main associated factors of physical activity. However, physical activity was not affected by respondents' sex (AOR=1.01, 95% CI 0.67 to 1.83), educational status (AOR=0.23, 95% CI 0.03 to 1.91), perceived barrier (AOR=0.97, 95% CI 0.91 to 1.04) or perceived benefit (AOR=1.02, 95% CI 0.95 to 1.09). Conclusion: The health profession, self-efficacy and cues to action were the main associated factors of physical activity. Hence, the Sports Bureau and Health Bureau should pay attention to providing information by focusing on improving self-confidence and creating a positive attitude toward physical activity.