Investigating the Determinants of Malaria Outbreak in Nono Benja Woreda, Jimma Zone, Ethiopia: A Case-Control Study.

Background: Malaria is one of the most widespread infections worldwide, particularly in developing countries. Accordingly, Jimma Zone is one of the widely affected areas by malaria in Ethiopia. In 2020 woreda health offices have reported the possible malaria epidemic that needs further investigation. Accordingly, this study aims to characterize the scope, pinpoint determinants connected to the Nono Benja woreda malaria outbreak, and implement suitable public health management measures. Methods: A descriptive cross-sectional study was followed by an unmatched case-control study with a 1:1 ratio of cases to controls. The sample size of 136 individuals (68 cases and 68 controls) was used. The collected data was imported into Epi-data version 3.1 and analyzed using SPSS version 25.0. By doing multivariate logistic regression association was determined at 95% confidence intervals P value of 5%. Results: A total of 687 instances were identified, giving an overall attack incidence of 1%. The assault rate ranged from 51.6 per 1000 people in Benja rural to 1.1 per 1000 people in Dhokonu Kebele. But there were no recorded deaths. Plasmodium falciparum and Plasmodium vivax were the major types of Plasmodium species reported. From independent variables absence of ITNS [AOR 3.98 (CI = 1.11-24.8)], residing in an unsprayed home [AOR = 3.83 (CI = 1.04-14.08], presence of stagnant water in residential area [AOR = 4.25, CI (1.37-12.24113.10)], and lack of awareness on malaria prevention [AOR = 8.28 (CI 2.31-29.73)] were significantly associated with Malaria outbreak. Conclusion: A number of factors, including lack of ITNS, lack of malaria health education, stagnant water, and IRS (indoor residual spray), were significantly linked with the occurrence of malaria outbreaks. The woreda health office should therefore provide ITNS to the community, use indoor residual spray, and disseminate health information regarding efficient and long-lasting malaria preventive and control techniques.

Modeling determinants of time-to-premarital cohabitation among Ethiopian women using parametric shared frailty models.

BACKGROUND: Premarital cohabitation is rampant and currently practiced worldwide, particularly in sub-Saharan Africa. It is a known cause of marital instability and divorce. It is also associated with intimate partner violence and harms the psychology of children in later life. However, in Ethiopia, there has been limited attention given to premarital cohabitation. OBJECTIVE: The main goal of this study was to identify the determinants of time-to-premarital cohabitation among Ethiopian women. METHODS: The 2016 EDHS data was used to achieve the study's goal. The survival information of 15683 women was analyzed based on their age at premarital cohabitation. The regional states of the women were used as a clustering effect in the models. Exponential, Weibull, and Log-logistic baseline models were used to identify factors associated with age at premarital cohabitation utilizing socioeconomic and demographic characteristics. RESULTS: The median age of premarital cohabitation was found to be 18 years. Surprisingly, 72.7% of participants were cohabitated in the study area. According to the Log-logistic-Gamma shared frailty model, place of residence, occupation, educational status, and being pregnant were found to be factors determining the time to premarital cohabitation. CONCLUSION: Premarital cohabitation among Ethiopian women was higher compared to women in the sub-Saharan Africa and East Africa. Place of residence, occupation, educational status, and being pregnant were found to be factors determining the time for premarital cohabitation. Therefore, we recommend the concerned bodies set out strategies to educate women about the influencing factors and dangers of premarital cohabitation.

Modeling Survival Time to Death among Stroke Patients at Jimma University Medical Center, Southwest Ethiopia: A Retrospective Cohort Study.

Background: Stroke is a life-threatening condition that occurs due to impaired blood flow to brain tissues. Every year, about 15 million people worldwide suffer from a stroke, with five million of them suffering from some form of permanent physical disability. Globally, stroke is the second-leading cause of death following ischemic heart disease. It is a public health burden for both developed and developing nations, including Ethiopia. Objectives: This study is aimed at estimating the time to death among stroke patients at Jimma University Medical Center, Southwest Ethiopia. Methods: A facility-based retrospective cohort study was conducted among 432 patients. The data were collected from stroke patients under follow-up at Jimma University Medical Center from January 1, 2016, to January 30, 2019. A log-rank test was used to compare the survival experiences of different categories of patients. The Cox proportional hazard model and the accelerated failure time model were used to analyze the survival analysis of stroke patients using R software. An Akaike's information criterion was used to compare the fitted models. Results: Of the 432 stroke patients followed, 223 (51.6%) experienced the event of death. The median time to death among the patients was 15 days. According to the results of the Weibull accelerated failure time model, the age of patients, atrial fibrillation, alcohol consumption, types of stroke diagnosed, hypertension, and diabetes mellitus were found to be the significant prognostic factors that contribute to shorter survival times among stroke patients. Conclusion: The Weibull accelerated failure time model better described the time to death of the stroke patients' data set than other distributions used in this study. Patients' age, atrial fibrillation, alcohol consumption, being diagnosed with hemorrhagic types of stroke, having hypertension, and having diabetes mellitus were found to be factors shortening survival time to death for stroke patients. Hence, healthcare professionals need to thoroughly follow the patients who pass risk factors. Moreover, patients need to be educated about lifestyle modifications.

Prevalence and associated factors of stunting among under-five children in Ethiopia: Application of marginal models analysis of 2016 Ethiopian demographic and health survey data.

BACKGROUND: Stunting, short for age, affects the overall growth and development of the children. It occurs due to chronic under nutrition. Stunting vastly occurs in impoverished regions of the world, including Ethiopia. OBJECTIVE: This study aimed to investigate the prevalence and correlates of stunting among under-five children in Ethiopia using marginal models. METHODS: Data were taken from the 2016 Ethiopian Demographic Health Survey, which is a nationally representative survey of children in the 0-59 month age group. For marginal models, generalized estimating equations and alternating logistic regression models were used for the analysis. RESULTS: The prevalence of stunting among the under-five children was 34.91% in the area. The proportion was slightly higher among male (36.01%) than female (33.76%) child. The Alternating Logistic Regression model analysis revealed that the child's age, the mother's education level, the mother's body mass index, the place of residence, the wealth index, and the previous birth interval were found to be significant determinants of childhood stunting, and the result shows that children born with a lower previous birth interval (less than 24 months) were more likely to be stunted than those born within a higher birth interval. Children in rural Ethiopia were more likely to be stunted than children in urban Ethiopia. CONCLUSION: This study found that more than one third of children were stunted in the area. The study also determined that child's age, the mother's education, the mother's body mass index, the place of residence, the wealth index, and birth interval influence stunting. Therefore, it is better enhancing the nutritional intervention programs.

Prevalence and associated factors of insomnia symptoms during the COVID-19 pandemic lockdown among Mettu town residents.

BACKGROUND: Insomnia is a prevalent sleep disorder that affects people all over the world. Creating suitable interventions will require a better understanding of the magnitude and determinants of insomnia. This study aimed to assess the prevalence and associated factors of insomnia symptoms among residents of Mettu town during the pandemic lockdown. METHODOLOGY: A community-based cross-sectional study was conducted among residents of Mettu town from October 1st to October 15th, 2020. Residents who lived in Mettu town at least for six months were included. To determine the prevalence and determinants of insomnia symptoms, both descriptive and inferential analyses were used. The chi-squared test of association and logistic regression was used to identify predictors of insomnia symptoms among residents of Mettu town. We used SPSS version 25 for all statistical analyses. PRINCIPAL FINDINGS: The prevalence of depressive symptoms among residents of Mettu town was 52.6%. According to results of multivariable binary logistic regression, being female [AOR = 3.677, 95%CI: 2.124-6.365], being aged between 19 and 40 [AOR = 13.261, 95%CI: 6.953-25.291], being aged above 41 [AOR = 2.627, 95%CI: 1.120-6.159], smoking [AOR = 15.539, 95%CI: 7.961-30.329], satisfaction with information available [AOR = 0.310, 95%CI: 0.168-0.570], fear Corona Virus Disease 2019 (COVID-19), [AOR = 2.171, 95%CI: 1.262-3.733], feeling alienated from others [AOR = 3.288, 95%CI: 1.897-5.699], having somatic symptoms [AOR = 2.298, 95% CI: 1.360-3.884], having depressive symptoms [AOR = 1.841, 95% CI: 1.073-3.160], and experiencing psychological distress [AOR = 1.962, 95% CI: 1.173-3.281] were significantly associated with insomnia symptoms. CONCLUSION: In this study, the prevalence of insomnia symptoms was found to be high among residents of Mettu town. Being female, being aged between 19 and 40, being aged above 41 years, smoking, fear of Corona Virus Disease 2019, feeling alienated from others, having somatic symptoms, having depressive symptoms, and experiencing psychological distress were all associated with an increased risk of developing insomnia symptoms while being satisfied with the information available decreased the risk of insomnia symptoms among residents of Mettu town. Interventions should be put in place to promote healthy sleep among residents of Mettu town.

The Prevalence and Predictors of Depressive, Anxiety, and Stress Symptoms Among Tepi Town Residents During the COVID-19 Pandemic Lockdown in Ethiopia.

BACKGROUND: As a result of the coronavirus disease 2019 (COVID-19) outbreak, many countries have imposed movement restrictions and implemented lockdowns. However, evidence from a variety of nations showed that the COVID-19 outbreak and its associated quarantine measures triggered a wide range of psychological problems, such as anxiety, depression, and stress in the general population. As a result, the purpose of this study was to determine the prevalence and predictors of depression, anxiety, and stress symptoms among Tepi town residents during the pandemic lockdown. METHODOLOGY: A community-based cross-sectional survey was conducted among residents of Tepi town from September 15 through September 25, 2020, and residents who have lived in Tepi town for at least 6 months were included. We have employed the depression, anxiety, and stress scale 21 (DASS-21) to evaluate depression, anxiety, and stress. The Chi-squared test of association and logistic regression were used to identify factors associated with depression, anxiety, and stress among residents of Tepi town. For all statistical analysis, we used (IBM) SPSS version 25. RESULTS: According to the current study, the prevalence of depression, anxiety, and stress symptoms were 37.7%, 39.0%, and 44.2%, respectively, among residents of Tepi town. Estimated odds of having depression, anxiety, and stress were as follows: for being female 6.315, 4.591, and 3.155; smoking 1.787, 1.883, and 1.787; sleep problem 2.613, 2.254, and 1.721; chewing Khat 2.156, 2.053, and 2.110; quarantine for 14 days 2.251, 1.902, and 1.960; and frequent use of social media 3.126, 1.849, and 3.126 times more likely as compared to their corresponding reference group respectively. The odds of developing depression and anxiety respectively were as follows: for alcohol consumption 2.438 and 1.797 times higher than their corresponding reference group respectively. Those exposed to COVID-19 were 3.870 times more likely to develop depression symptoms. Estimated odds of having anxiety and stress symptoms for fear of COVID-19 were 1.776 and 1.835; social interactions altered were 3.197 and 2.069, moderate levels of hope were 2.687 and 2.849 respectively. The odds ratio for those taking traditional preventive medicine, and having family members infected with COVID-19 were 2.475 and 1.837 times more likely to experience anxiety symptoms respectively. CONCLUSION: In this study, the prevalence of depression, anxiety, and stress symptoms was found to be high among residences in Tepi town. Being female, chewing Khat, smoking, being quarantined for 14 days, frequently using social media, and having sleeping problems were all found to be significantly associated with an increased risk of developing depression, anxiety, and stress symptoms, whereas alcohol consumption and family members infected by COVID-19 were considerably linked to depression and anxiety symptoms. Fear of COVID-19, influence on social interaction and having a moderate level of hope were substantially related to stress and anxiety symptoms, while taking preventive medicine was found to be a significant factor in anxiety symptoms among Tepi town residences. Interventions should be made to improve the mental health of Tepi residents.

Survival rate and predictors of mortality among TB/HIV co-infected adult patients: retrospective cohort study.

Nowadays, Tuberculosis remains the major cause of HIV-associated mortality, which accounts for 1 out of every 5 HIV-related mortality worldwide. This study aimed to determine the survival rate and predictors of mortality among TB/HIV co-infected patients. An institution-based retrospective cohort study was undertaken on adult TB/HIV co-infected individuals between 1st February 2014 and 30th January 2022 at Mettu Karl Referral Hospital. A Cox regression model was used to identify predictors of survival time to death among TB/HIV co-infected patients. This study comprised 402 TB and HIV co-infected adult patients. Among these, 84 (20.9%) died, and 318 (79.1%) were censored. The study subjects have been followed up for 6920 person-months with an overall median survival time of 17.6 months. The overall incidence rate was 12.1 per 1000 person months [95% CI: 9.77-14.98]. The results of a multivariable Cox regression analysis showed that being at an older age, urban residence, WHO clinical stage II & IV, CD4 count of ≥ 200 cells/mm3, bedridden functional status, using INH, and using CPT were associated with the survival time of TB and HIV co-infected patients at a significance level of alpha = 0.05. This retrospective study found that high mortality of TB/HIV co-infected patients occurred in the earlier months of treatment initiation. Close monitoring of patients with low CD4, who do not utilize CPT, who are in advanced WHO stages, and who have poor functional levels can help them improve their health and live longer.

Modeling Time to Death of Patients with Multidrug-Resistant Tuberculosis at Saint Peter's Specialized Hospital.

BACKGROUND: Currently, the worldwide prevalence and incidence of multidrug-resistant tuberculosis (MDR-TB) is drastically increasing. The main objective of this study was modeling the time-to-death of patients with MDR-TB at St. Peter's Specialized Hospital, Addis Ababa, Ethiopia, by using various parametric shared frailty models. STUDY DESIGN: A retrospective study design was used. METHODS: The study population was TB patients with MDR at St. Peter's Specialized Hospital from January 2016 through December 2019. Exponential, Weibull, and log-normal were used as baseline hazard functions with the gamma and inverse Gaussian frailty distributions. All the models were compared based on Akaike's Information Criteria. RESULTS: The overall median time to death was 11 months and 123 (33.5%) patients died. Patients who lived in rural areas had shorter survival time than those who lived in urban areas with an accelerated factor of 0.135 (P=0.002). Patients with a history of anti-TB drug consumption had a short survival time than those without such a history with an accelerated factor of 0.02 (P=0.001). The variability (heterogeneity) of time to death of patients in the region for the selected model (Weibull-inverse Gaussian shared frailty model) was =0.144 (P=0.027). CONCLUSION: The MDR-TB patients with weight gain, khat and alcohol consumption, clinical complication of pneumothorax and pneumonia, extrapulmonary TB, and history of anti-TB drug consumption as well as those who lived in rural areas had a shorter survival time, compared to others. There was a significant heterogeneity effect in the St. Peter's Specialized Hospital. The best model for predicting the time to death of MDR-TB patients was Weibull-inverse Gaussian shared frailty model.