Colostrum avoidance practice and associated factors among mothers of infants less than six months in Chencha District: cross-sectional study.

BACKGROUND: Colostrum avoidance is failure to feed first breast milk to a newborn baby for the first 2 to 3 days after delivery. The problem of avoiding colostrum is prevalent in Ethiopia. But it is not adequately addressed yet. Therefore, the purpose of this study was to assess prevalence of colostrum avoidance practices and associated factors among mothers of infants aged less than six months; and to explore barriers for colostrum feeding in ChenchaZuria District. METHODS: A community-based cross-sectional study supplemented with a qualitative study was conducted in August 2020. The quantitative data were collected from 674 mothers selected by systematic sampling using a structured questionnaire. Both bi-variable and multi-variable binary logistic regression analysis was used to identify factors associated with the colostrum avoidance practices. The statistical significance was declared at a p-value < 0.05. The qualitative data were collected using in-depth interviews from breastfeeding mothers and thematic analysis was done manually. RESULT: The prevalence of the colostrum avoidance practice was 15.3% (95% CI: 11.4%- 18.2%). Late initiation of breastfeeding (AOR 4.15 95% CI 2.51-6.84), giving pre-lacteal feeding (AOR 3.16 95% CI 1.93-5.15), not using of postnatal care (PNC) service (AOR 1.79 95% CI 1.05-3.04), and having poor maternal knowledge regarding colostrum. (AOR 1.88 95% CI 1.14-3.08) were factors significantly associated with the colostrum avoidance practices. And in the qualitative part, cultural beliefs and misconceptions, community influence, and complementary feeding practices were found to be facilitators for the colostrum avoidance. CONCLUSION: About one in seven mothers practiced colostrum avoidance. Factors that contributed to the colostrum avoidance practices were breastfeeding initiation, pre-lacteal feeding, PNC utilization, and maternal knowledge regarding colostrum. Thus, efforts to prevent colostrum avoidance practices should focus on strengthening and promoting PNC services utilization, timely initiation of breastfeeding, and improving awareness creation activities on the importance of colostrum feeding and risks of pre-lacteal feeding.

Predictors of Loss to Follow-Up among HIV-Infected Adults after Initiation of the First-Line Antiretroviral Therapy at Arba Minch General Hospital, Southern Ethiopia: A 5-Year Retrospective Cohort Study.

BACKGROUND: Loss to follow-up (LTFU) from antiretroviral therapy (ART) reduces treatment benefits and leads to treatment failure. Hence, this study was aimed at determining the incidence of loss to follow-up and predictors among HIV-infected adults who began first-line antiretroviral therapy at Arba Minch General Hospital. METHODS: We carried out an institutional-based retrospective cohort study, and data were collected from the charts of 508 patients who were selected using a simple random sampling technique. All the data management and statistical analyses were conducted using STATA version 14. Cumulative survival probability was estimated and presented in the life table, and the Kaplan-Meir survival curves were compared using the log-rank test. The Cox proportional hazard model was used to identify the independent predictors. RESULTS: We followed 508 patients for 871.9 person-years. A total of 46 (9.1%) experienced loss to follow-up, yielding an overall incidence rate of 5.3 (95% CI: 3.9-7.1) per 100 person-years. The cumulative survival probability was 90%, 88%, 86%, and 86% at the end of one, two, three, and four years, respectively. The predictors identified were age less than 35 years (adjusted hazard ratio (aHR = 1.96; 95% CI: 1.92-4.00)), rural residence (aHR = 1.98; 95% CI: 1.02-3.83), baseline body weight greater than 60 kilograms (aHR = 2.19; 95% CI: 1.11-4.37), a fair level of adherence (aHR = 11.5; 95% CI: 2.10-61.10), and a poor level of adherence (aHR = 12.03; 95% CI: 5.4-26.7). CONCLUSIONS: In this study, the incidence rate of loss to follow-up was low. Younger adults below the age of 35 years, living in rural areas, with a baseline weight greater than 60 kilograms, which had a fair and poor adherence level were more likely to be lost from treatment. Therefore, health professionals working in ART clinics and potential stakeholders in HIV/AIDS care and treatment should consider adult patients with these characteristics to prevent LTFU.

Prevalence of Workplace Violence and Associated Factors Against Nurses Working in Public Health Facilities in Southern Ethiopia.

BACKGROUND: Workplace violence is an important challenge faced by healthcare providers, especially nurses, throughout the world. But this issue is neglected in developing countries, including Ethiopia. Therefore, the objective of this study was to assess the prevalence of workplace violence and associated factors against nurses working in public health facilities. METHODS: A cross-sectional study was conducted in public health facilities in Gamo Gofa zone from February to March 2018. A simple random sampling technique was used to select 354 study respondents from selected public health facilities. The data was collected using a self-administered, pre-tested, and structured questionnaire and analyzed by using SPSS version 21. Descriptive analysis was made and both bi-variable and multivariable logistic regression were applied to identify the factors associated with workplace violence against nurses. RESULTS: Out of the 348 participants, 150 (43.1%) nurses had experienced workplace violence. Among these, 47 (13.5%) had faced physical violence, 98 (28.2%) had verbal abuse, 36 (10.3%) were bullied/mobbed, and 25 (7.2%) faced sexual harassment at least once in the last 12 months. Patients' relatives were the leading perpetrators in physical, verbal violence, and bullying, accounting 55.3%, 46.9%, and 36.1%, respectively. Female nurses (AOR=1.98; 95% CI=(1.21, 3.25), those who live without a spouse (AOR=1.98; 95% CI=(1.22, 3.22), those who drink alcohol (AOR=1.88; 95% CI=(1.03, 3.44), and those who chew chat (AOR=3.24; 95% CI=(1.25, 8.45) were more likely to suffer from workplace violence in public health facilities. CONCLUSION: The prevalence of workplace violence against nurses was high. In addition, the characteristics of the occurrences of different types of violence are different beginning from the perpetrators' characteristics to the measures taken by the nurses. In addition, sex, marital status, drinking alcohol, and chewing chat were found statistically significant factors influencing workplace violence against nurses.

Incidence and Predictors of Initial Antiretroviral Therapy Regimen Change Among HIV-Infected Adults Receiving Antiretroviral Therapy at Arba Minch General Hospital, Southern Ethiopia.

BACKGROUND: The effectiveness of the initial antiretroviral therapy regimen is the key to treatment success. However, regimen change affects this treatment success. Yet, evidence on the incidence and predictors of regimen change is scarce. Therefore, the aim of this study was to assess the incidence and predictors of initial antiretroviral therapy regimen change among HIV-infected adults receiving antiretroviral therapy. METHODS: An institutional-based retrospective cohort study was conducted. Data were collected from patients' charts selected by simple random sampling. Data entered into EpiData version 4.43 and analyzed by STATA version 13. The life table was used to estimate cumulative survival. Kaplan-Meir curve and Log-rank test were used to compare the survival experience of explanatory variables. Cox proportional hazard model was used to identify predictors. RESULTS: Five hundred and eight patients were followed for 871.87 person-years of observation with the median follow-up period of 16.12 months. The incidence rate of initial ART regimen change was 11.36 (95% CI: 9.32-13.83) per 100 person-year and the median survival time is 54 months. Not disclosing HIV status (adjusted hazard ratio (AHR) = 5.41, 95% CI = 2.38-12.27), co-medication with ART (AHR = 4.64, 95% CI = 1.43-15.10), occurrence of side effect on initial regimen (AHR = 7.32, 95% CI = 4.43-12.10), baseline CD4 count <200 cells/mm3 (AHR = 2.18, 95% CI = 1.37-3.47), ambulatory/bedridden baseline functional status (AHR = 3.55, 95% CI = 2.30-5.48) were significant predictors of initial regimen change. CONCLUSION: The incidence rate of initial ART regimen change was found to be low. HIV disclosure status, co-medication with ART, the occurrence of side effects on an initial regimen, low baseline CD4 count, ambulatory and bedridden baseline functional status were found to be predictors.