Peri-conception folic acid supplementation knowledge and associated factors among women visiting Maternal and Child Health clinics in Addis Ababa, Ethiopia.

Back ground: Peri-conception care plays an essential and vital role for the health of the mother, her child and her family. Taking folic acid orally prior to conception and during the early stages of pregnancy plays a significant role in preventing Neural Tube Defects and has been associated with preventing other folic acid sensitive congenital anomalies. There exists problem in different parts of the globe on women's understanding of the importance of folic acid making them not to take this supplement in peri-conception period. Objective: This study aimed at assessing the knowledge of peri-conception folic acid supplementation among women visiting Maternal and Child Health clinics of public health facilities in Addis Ababa, Ethiopia. Methods: Institution based cross-sectional study was conducted from May 15 to June 20/2020 among 226 women visiting Maternal and Child Health clinics of health centers in Addis Ababa. Consecutive sampling technique was used to select study participants. Data were collected through interviewer administered structured questionnaire and analyzed using Statistical Package for Social Sciences version 24. Tables, charts and graphs were used for data presentation. Multivariable logistic regression analysis was done to identify the independent predictors of women's knowledge of folic acid at p-value ≤ 0.05. Results: More than two-third of the study participants, 156 (69.0%) had good knowledge on peri-conception folic acid supplementation and its health benefits. Participants with age 25-30 years were 2.14 times more likely to have good knowledge compared to those aged less than 25 years while women with age greater than 30 years were 5.20 times more likely to have good knowledge compared to those with age less than 25 years. Women who had attended high school were 2.93 times more likely to have good knowledge compared to those with no formal education. Likewise, women who had attended college and above were 4.18 times at odd of having good knowledge on periconception folic acid supplementation compared to those with no formal education. Women who had information on prenatal care were 1.48 times more likely to have good knowledge compared to those who never had no information. Conclusion: Folic acid supplementation knowledge in more than two third of the study participants was good. Participants' age, educational status and information on prenatal care were the independent predictors of knowledge on folic acid supplementation. The Ministry of health, Addis Ababa city health bureau, the study facilities' management as well as Non-Governmental Organizations working on health in the city should focus on means to increase knowledge of peri-conception folic acid health benefits for women with poor knowledge on the same.

Rational Dispensing of Oral Dosage Forms of Medicines to Children and Its Associated Factors in South West Ethiopia.

Introduction: Obstacles encountered when maintaining excellent dispensing practices for children include a lack of age-appropriate dosage forms, a shortage of medications in appropriate strengths for children, a lack of appetizing drugs, and a lack of competence in pediatric pharmacy. These difficulties contribute to ineffective dispensing procedures and an urgent need to study whether oral dose forms of medications are dispensed to children in a rational way. Objective: The purpose of this study is to evaluate the rational dispensing of oral dosage forms of medicines to children, as well as the factors that influence this practice. Methods: Using validated indicators, a cross-sectional study design was utilized to analyze the rational dispensing practice of oral dosage forms of medicines administered to children under the age of 12 years in seven pharmacies and two drug stores over a one-month period. Results and discussions: Out of 810 medicines, 11.7% and 4% were irrationally manipulated, 5.8% and 1.8% needed manipulation, 3.7% and 0.2% were alternatively dispensed, 8.8% and 7.5% of the medicines had correct advice on their label and also 745 medicines were adequately labeled in the hospital and the selected drug stores. In this study, 92% of medicines were adequately labeled and had sufficient advice on their labels, 15.3% of medicines were irrationally manipulated and around 7.7% of the dosage forms needed manipulation during dispensing. The type of medicine retail outlet had a significant effect on the percentage of instances where alternative solid oral dosage forms were dispensed (p = 0.003), the percentage of dosage forms were adequately labeled (p = 0.008), and the percentage of dosage forms were irrationally manipulated before dispensing (p = 0.001). Conclusion: The rational dispensing practice of oral dosage forms of medicines was relatively poor and there is room for improvement.

Adherence to WHO vaccine storage codes and vaccine cold chain management practices at primary healthcare facilities in Dalocha District of Silt'e Zone, Ethiopia.

BACKGROUND: The main elements of effective vaccine cold chain management at the immunization service delivery point are well-trained vaccine cold chain handlers, vaccine storage equipment, and appropriate vaccine management procedures. Vaccine cold chain handlers must have enough expertise to provide the correct vaccine at the right time, maintain vaccine potency, and minimize vaccination failures. The study assessed knowledge of vaccine cold chain handlers on vaccine cold chain management, adherence to the WHO vaccine storage codes and vaccine cold chain management practice at primary health facilities in Dalocha district of Silt'e zone. METHOD: Institutional-based cross-sectional study was done at twenty-eight primary health facilities. One hundred forty primary health workers were drawn from four health centers and twenty-four health posts operating in Dalocha woreda of Silt'e zone, SNNPR, Ethiopia. A self-administered questionnaires and on-spot observation checklists were adapted from the WHO and WHO-UNICEF-effective vaccine management assessment tools to collect data from cold chain unit of the primary healthcare facilities. Data were entered to EPI data version 3.1; exported and analyzed using SPSS version 22. Statistical analysis was carried out to determine the level of knowledge, adherence to WHO cold chain management guideline and vaccine handling practice. The relationship that the knowledge of primary healthcare workers, primary healthcare workers training status, primary healthcare facilities' adherence to WHO vaccine storage codes, and length of work experience of primary health care workers have with the vaccine management practice were also explored RESULT: Above Half (54%) of the respondents have satisfactory knowledge of vaccine cold chain management. One hundred (71.4%) vaccine cold chain handlers did point correctly to the recommended range of temperature (2°C -8°C) for vaccine storage. Around two-thirds (63.6%) of them were aware of the twice-daily temperature recordings. Nearly half, (46.2%) of primary healthcare facilities have experienced poor adherence to the WHO storage practice codes. Around three-fifths of the observed primary healthcare facilities have registered undesirable vaccine management practices. The primary healthcare workers who received training on vaccine cold chain management (χ2 = 0.058, p=0.015), served at primary health care facilities for more five years (χ2 =18.545, p≤0.001), shown good adherence to WHO vaccine storage code (χ2 =18.545, p≤0.001), have sufficient knowledge on vaccine cold chain management (χ2=4.210, p≤0.031) were all significantly associated with desirable vaccine cold chain management practice. CONCLUSION: There is a gap in vaccine cold chain handlers' knowledge about vaccine cold chain management and less than desirable adherence to WHO vaccine storage codes at primary healthcare facilities in Dalocha district. The majority of the observed primary health facilities have registered poor vaccine management practices. Everyone who has a stake in the cold chain management of vaccines should do their share, individually and collectively, to guarantee that everyone reaps the benefits of an effective cold chain.

Attitude and practice toward traditional medicine among hypertensive patients on follow-up at Mizan-Tepi University Teaching Hospital, Southwest Ethiopia.

Introduction: Traditional medicine has been used for the management of common mild conditions such as headache, diarrhea, and common cold as well as in the treatment of chronic diseases including hypertension. The usage of this medicine is regarded as acceptably safe with most Ethiopian people. Attitude and practices toward traditional medicine are crucial elements of hypertension control and its favorable outcome expectation. This study aimed at assessing the attitude and practice toward traditional medicine among hypertensive patients on follow-up at Mizan-Tepi University Teaching Hospital, Southwest Ethiopia. Method: Facility-based cross-sectional study was conducted from 1st December 2020 to 30th December 2020 among 173 hypertensive patients. A consecutive sampling technique was used to select study participants. Data were collected through interviewer-administered structured questionnaire and analyzed using Statistical Package for the Social Sciences software version 23. Multivariable logistic regression analysis was done to identify the independent predictors of patients' attitude toward traditional medicine and their traditional medicine use at a p value ⩽0.05. Results: Eighty-seven (50.29%) of the total 173 approached patients were found to have good attitude toward traditional medicine. Ninety-seven (56.07%) participants had used traditional medicine at least once in their lifetime and 45 (46.39%) patients used traditional medicine and modern medicine concomitantly. Participants' residence (adjusted odds ratio = 2.79, confidence interval = 1.01-7.74, p-value = 0.049) and educational status (adjusted odds ratio = 1.76, confidence interval = 1.61-5.09, p-value = 0.032) had significant association with attitude toward traditional medicine, while patients' age (adjusted odds ratio = 1.43, confidence interval = 1.32-4.96, p-value = 0.039), residence (adjusted odds ratio = 2.18, confidence interval = 1.10-4.32, p-value = 0.025), and occupation (adjusted odds ratio = 3.38, confidence interval = 1.55-7.38, p-value = 0.002) had significant association with their traditional medicine use. Conclusion: Half of the study participants had good attitude toward traditional medicine, and nearly, one-fourth of the participants had practiced traditional medicine along with modern medicine. Health service providers should be aware of traditional medicine use and advise patients on the dosing of traditional medicine.

Antibiotics self-medication practices among health care professionals in selected public hospitals of Addis Ababa, Ethiopia.

BACKGROUND: Self-medication is the first option and response to most illness episodes. Use of antimicrobials without health care professionals' guidance may result in greater probability of inappropriate use, missed diagnosis, delays in appropriate treatment, pathogen resistance and increased morbidity. There is no sector in the health care community which is immune to drug abuse or misuse of which the worst offenders include physicians, nurses and pharmacy professionals. Self-medication among health care professionals may be an indicator that the health professional is neglecting his or her own health. This represents serious issues for both patients and the professionals. OBJECTIVE: To assess self-medication practices with antibiotics among health care professionals in selected hospitals of Addis Ababa, Ethiopia. METHOD: Facility based cross-sectional study was conducted from April to May, 2017 among 317 health care professionals. Convenient sampling technique was used to select study participants. Data were collected through self-administered questionnaire and analyzed using Statistical Package for Social Sciences software version 20. Binary logistic regression analysis was done to check the relationship between the dependent variable (antibiotic self-medication) and selected independent variables (sex, age, marital status, income, professional qualification and work experience). RESULTS: The prevalence of self-medication with antibiotics among health care professionals in one month recall period was found to be 72 (22.7%). The main reasons given for this practice were being familiar with the treatment options, 31 (43.1%) and need for rapid relief, 25 (34.7%). Respiratory problems, 29 (40.3%) and gastro intestinal problems, 28 (38.9%) were the most common illnesses for which self-medication with antibiotics was practiced while penicillins, 30 (41.6%) and fluoroquinolones, 29 (40.3%) constituted the two most commonly used antibiotics for the same. None of the variables had significant association with the practice of self-medication with antibiotics. CONCLUSION: Self-medication with antibiotics was common among the study participants. Efforts should be made by health authorities including Drug and Therapeutics Committee, Drugs Regulatory Authority, Hospitals' management and other stakeholders to ensure safe usage of antibiotics.

HIV/AIDS services quality in health centers of East Shoa zone, Oromia, Ethiopia.

Background: HIV/AIDS is a major public health, social and economic problem in Ethiopia. However, little has been done on assessment of the quality of the services given to patients in this country. Objective: To assess the quality of HIV/AIDS services in health centers of East Shoa Zone, Oromia region, Ethiopia. Method: Cross sectional survey was undertaken in selected health centers of East Shoa Zone between February and May, 2017. Data was collected using researcher administered structured questionnaire, logistics indicators assessment tool and observation check list. SPSS for windows version 20 was utilized in the analysis of the collected data. Results: The study facilities were providing various services to HIV/AIDS patients. All (100%) and 6(75%) facilities respectively had shortage of trained human power required to give ART and TB services. Regarding ARV medicines availability, majority of the study facilities, 5 (62.50%) reported that they had the stockout of AZT300/3TC150/NVP200 in six months prior to study while 4 (66.7%) of the facilities had the stockout of NVP 240ml (50mg/5ml) syrup on day of visit. Among anti-TB medicines, E100 was out of stock in three facilities (37.5%) on day of visit and INH100 had been out of stock in 4 (50%) of the facilities in six months prior to the study. From OIs medicines, Cotrimoxazole 960mg tablet stockedout in 4 (66.70%) on day of visit and in 5 (83.30%) health centers in six months prior to the study. Considerable number of study facilities, 4 (66.70%) had the stockout of tramadol 50mg tablet on day of visit and ibuprofen 400mg tablet in six months prior to the study, 5 (71.40%). Conclusion: The studied facilities were challenged by different factors including, scarcity of human power, stockout of various HIV/AIDS related medicines and inability to make patients adhere to the services given by the facilities. The consequences of these factors can be dangerous to the patients as well as to the wider public and hence making available the appropriate human resource and HIV/AIDS related commodities including medicines should be the priority for the health facilities and the region to improve the quality of HIV/AIDS services in the study area.

HIVAIDS services quality in health centers of East Shoa zone, Oromia, Ethiopia

Background: HIV/AIDS is a major public health, social and economic problem in Ethiopia. However, little has been done on assessment of the quality of the services given to patients in this country. Objective: To assess the quality of HIV/AIDS services in health centers of East Shoa Zone, Oromia region, Ethiopia. Method: Cross sectional survey was undertaken in selected health centers of East Shoa Zone between February and May 2017. Data was collected using researcher administered structured questionnaire, logistics indicators assessment tool and observation check list. SPSS for windows version 20 was utilized in the analysis of the collected data. Results: The study facilities were providing various services to HIV/AIDS patients. All (100%) and 6(75%) facilities respectively had shortage of trained human power required to give ART and TB services. Regarding ARV medicines availability, majority of the study facilities, 5 (62.50%) reported that they had the stockout of AZT300/3TC150/NVP200 in six months prior to study while 4 (66.7%) of the facilities had the stockout of NVP 240ml (50mg/5ml) syrup on day of visit. Among anti-TB medicines, E100 was out of stock in three facilities (37.5%) on day of visit and INH100 had been out of stock in 4 (50%) of the facilities in six months prior to the study. From OIs medicines, Cotrimoxazole 960mg tablet stocked out in 4 (66.70%) on day of visit and in 5 (83.30%) health centers in six months prior to the study. Considerable number of study facilities, 4 (66.70%) had the stockout of tramadol 50mg tablet on day of visit and ibuprofen 400mg tablet in six months prior to the study, 5 (71.40%). Conclusion: The studied facilities were challenged by different factors including, scarcity of human power, stockout of various HIV/AIDS related medicines and inability to make patients adhere to the services given by the facilities. The consequences of these factors can be dangerous to the patients as well as to the wider public and hence making available the appropriate human resource and HIV/AIDS related commodities including medicines should be the priority for the health facilities and the region to improve the quality of HIV/AIDS services in the study area

Antiretroviral treatment failure and associated factors among HIV patients on the first-line antiretroviral therapy at Mizan-Tepi University teaching hospital, Southwest Ethiopia: A cross-sectional study.

ABSTRACT: The use of Antiretroviral therapy (ART) has become a standard of care for the treatment of HIV infection. The therapy restores immune function and reduces HIV-related adverse outcomes. However, treatment failure erodes this advantage and leads to an increased morbidity and compromised quality of life in HIV patients. Thus, this study aimed to assess anti-retroviral treatment failure and associated factors among HIV patients on the first line ART at Mizan-Tepi University Teaching Hospital. A cross-sectional study was undertaken among adult patient who have been on ART and attending ART Clinic of Mizan-Tepi University Teaching Hospital from September 2014 to September 2018. Data were collected retrospectively by reviewing patients' medical charts using a standard structured questionnaire. Data were entered into Epi data version 4.0.2 and then exported to SPSS version 21.0 for analysis. To identify the predictors of anti-retroviral treatment failure, multiple stepwise backward logistic regression analysis were done. P value < .05 was considered as statistically significant. Among 221 patients included in the study, 118 (53.39%) were females. The mean weight of study participants at ART initiation was 57.04 kg. Of the 221 patients on the first line ART, 10 (4.5%) experienced treatment failure. Of these patients, 5 (50%) and 3 (30%) experienced virological failure and clinical failure, respectively. Functional status (AOR: 3, CI: [1.13-6.5], P < .001) and low baseline CD4 cell count (AOR: 4.3, CI: [3.4-10.6], P < .0001) were found to be an independent predictors of treatment failure. The rate of first-line ART treatment failure in the study setting was substantial. Functional status and low baseline CD4 cell count were found to be an independent predictors of virological, clinical and immunological failure. Therefore, more attention should be given for the lifestyle of pateints' on ART and maximize virological tests for monitoring treatment failures.

Evaluation of Cold Chain Management Performance for Temperature-Sensitive Pharmaceuticals at Public Health Facilities Supplied by the Jimma Pharmaceuticals Supply Agency Hub, Southwest Ethiopia: Pharmaceuticals Logistic Management Perspective Using a Multicentered, Mixed-Method Approach.

BACKGROUND: Effective and efficient cold chain management maximizes utilization of healthcare resources, reduces cold chain products wastage, and improves the quality of health services. It eventually guarantees that clients receive cold chain products they need at service delivery points. The objective of this study was to evaluate cold chain management performance for temperature-sensitive medicines at public health facilities in Southwest Ethiopia supplied by the Jimma Pharmaceuticals Fund and Supply Agency hub. Method and Materials. The study used an institution-based cross-sectional study design. Forty-seven (47) public health facilities in Southwest Ethiopia were evaluated using checklists adopted from the Logistic Indicators Assessment Tool, Vaccine Management Assessment Tool, and Logistic System Assessment Tool. RESULTS: The study revealed that the mean availability of essential cold chain products was 72.1 ± 14.8% while the average stock-out rate was 26.2 ± 8.6%. The median stock-out duration was 23 ± 21 days for all visited public health facilities. Two hundred and sixty-three (43.06 ± 15.3%) of the public health facilities' stock records were found accurate, and the wastage rate due to expiration was 9.2 ± 7.8% for all visited health facilities. Thirty public health facilities (63.8 ± 36.2%) had acceptable storage conditions. Conclusions and Recommendations. Supply chain performance at the study facilities was not adequate overall, and focused efforts need to be directed at managing the availability of critical cold chain medicines. Some cold chain management challenges demand the attention of the top management, while the rest can be addressed by operational management at the facilities through provision of appropriate training and supervision of the cold chain pharmaceutical handlers.

Medication Counseling Practices in Medicine Retail Outlets Found in Bench Sheko Zone, Southern Nations, Nationalities, and Peoples' Region, South West Ethiopia.

OBJECTIVE: The objectives of this research were to investigate pharmacy professionals' counseling practices as well as to evaluate pharmacy professionals' counseling skills and the content of counseling services provided to patients visiting medicine retail outlets. METHODS: A facility-based observational cross-sectional study was used to assess medication counseling practice by pharmacy professionals. Data were gathered through an observation and a semi-structured questionnaire. Epi data version 4.0.2 was used to enter data, which was subsequently exported to SPSS version 21.0 for analysis. ANOVA and post hoc statistical analyses were used to investigate the association between independent and dependent variables; and a 0.05 p-value was considered. RESULTS: This study has a total of 105 pharmacy professionals that were included in the analysis. The majority of those who responded were between the ages of 25 and 29. The most common drug information offered by pharmacy staff to patients was frequency of administration (90%), length of therapy (90%), and unit dose dispensed, according to the current study (86%). Pharmacy professionals' age was significant on components of counseling practice as on mentioning the name of drugs during dispensing the medication (p=0.000), the route of administration (p=0.000), a drug dose (p=0.003), frequency of drug administration (p=0.016), proper medicine storage (p=0.024), type of dosage form (p=0.025), and duration of treatment (p=0.012). In comparison with the other age groups, an age greater than 40 years was significant on components of counseling practice (p=0.001) as a factor associated with penurious counseling practice than the other groups. CONCLUSION: This study shows that counseling practice is still quite low in comparison to what is expected. Some of the issues that affect counseling include a high patient load, the lack of a private counseling room, a lack of updated drug knowledge, and a lack of experience were factors that influence counseling.

Cost-Effectiveness Analysis of Metronidazole versus Metronidazole with Diloxanide Furoate in the Treatment of Amoebiasis in Ethiopia.

INTRODUCTION: Amoebiasis is one of the world's most prevalent and fatal infectious diseases. Several surveys revealed that amoebiasis is one of the most widely distributed diseases in Ethiopia. The combination of metronidazole with diloxanide furoate represents a new approach for the treatment of the infection. OBJECTIVE: This study aimed to analyze the cost-effectiveness of diloxanide plus metronidazole compared with metronidazole alone in the treatment of amoebiasis in Ethiopia. METHODS: An analytical decision model was used to analyze costs and effectiveness from a societal perspective by taking adult amoebic patients as the study population with a time horizon of two months. The potential impacts of uncertainty in single parameters were explored in one-way sensitivity analyses. RESULTS: Metronidazole with diloxanide had a higher cost and effect compared to metronidazole alone with an incremental cost-effectiveness ratio (ICER) of 8 US$ per amoebic case cured. The result was sensitive to the decrease in the effectiveness of metronidazole with diloxanide. CONCLUSION: This study revealed the addition of diloxanide to standard treatment to be a more effective and more costly treatment strategy. Therefore, a decision for choosing the medication should be based on the ability of patients to pay for the treatment.

Prevalence of Hepatitis B Virus Among Pregnant Women on Antenatal Care Follow-Up at Mizan-Tepi University Teaching Hospital and Mizan Health Center, Southwest Ethiopia.

BACKGROUND: Hepatitis B virus(HBV) infection is a global public health problem, even though its prevalence is disproportionately high in low- and middle-income countries. Mother-to-child transmission is a major route of HBV transmission in endemic areas. This study aimed to assess the prevalence of HBV and its determinants among pregnant women attending antenatal care at Mizan-Tepi University Teaching Hospital and Mizan Health Center, Southwest Ethiopia. METHODS: A cross-sectional study was conducted between January 13th 2020 and February 5th 2020 among 370 pregnant women. The sample size was proportionally allocated to each health institution according to the total pregnant women on antenatal care at the respective health institution and a consecutive sampling technique was used to select study participants. Serum hepatitis B surface antigen (HBsAg) was tested using a rapid diagnostic test. Data were analyzed using Statistical Package for Social Sciences (SPSS) software version 22. Multiple logistic regression analysis was done to identify the independent predictors of HBsAg serostatus at p-value <0.05. RESULTS: Three hundred seventy of the total 375 pregnant women participated in the study resulting in a response rate of 98.7%. Twenty-two (5.9%) of the pregnant women screened were found positive for HBsAg (prevalence=5.9%; 95% CI: 3.9-8.80%). History of contact with jaundice patients (AOR=9.87; 95% CI: 2.98-32.65), sharing sharp materials (AOR=3.96; 95% CI: 1.23-11.08) and history of multiple sexual partners (AOR=6.77; 95% CI: 2.44-18.78) were significantly associated with Hepatitis B Virus infection. CONCLUSION: The endemicity of hepatitis B virus seroprevalence is intermediate in the study settings. Factors associated with hepatitis B virus serostatus were behavioral; hence, modification of these factors may help to prevent the infection.

Adverse Drug Reaction and Its Predictors Among Psychiatric Patients Taking Psychotropic Medications at the Mizan-Tepi University Teaching Hospital.

INTRODUCTION: Psychotropic medications are crucial in the treatment of a variety of psychiatric disorders. Use of second-generation antipsychotics (SGA) has been associated with many adverse events. Assessment and monitoring of ADRs is required to develop appropriate interventional strategies to manage, prevent and minimize the risks of undesirable effects and thus improve quality of life and adherence, avoid relapse, and reduce treatment costs. OBJECTIVE: The objectives of this study were to assess adverse drug reactions and its predictors in psychiatric patients taking psychotropic medications from the outpatient pharmacy of MTUTH. METHODS: A cross-sectional study design was conducted using a structured questionnaire interviewing a psychiatric patient. One way ANOVA and bivariate logistic regression was computed for all independent variables to identify variables that fit for multivariate logistic regression. A p-value less than 0.05 was considered significant. RESULTS AND DISCUSSIONS: A total of 101 patients (91.8%) experienced one or more types of ADR in the current study. There was a statistically significant relationship between ADRs management and age, marital status, educational status, occupation, and monthly income of the study participants. The odds of having experienced autonomic adverse drug reactions experience among respondents aged 30 years and older higher than those under 30 years. Participants taking multiple medications were more likely to face psychiatric adverse drug reactions compared to those taking a single medication. Patients taking multiple psychotropic medications were ten times more likely to develop autonomic adverse drug reactions compared to those taking a single drug. CONCLUSION: The study revealed a moderate incidence of ADR in patients attending the psychiatric OPD. Age and number of antipsychotics were predictors of ADR (autonomic and psychiatric). This study revealed that there is a gap in the role of clinicians in the monitoring and reporting of ADRs.

Patient Satisfaction with HIV and AIDS Services in Mizan-Tepi University Teaching Hospital, Southwest Ethiopia.

BACKGROUND: The World Health Organization and UNAIDS estimated that 36.9 million people were living with HIV in 2017 globally. In the same year, 1.8 million people became newly infected with HIV and 940,000 people died of AIDS-related illnesses. This study aimed to assess patient satisfaction with HIV and AIDS services in Mizan-Tepi University Teaching Hospital (MTUTH), Southwest Ethiopia. METHODS: A cross-sectional study was conducted from December 01/2018 to January 31/2019 among 348 people living with HIV who were on highly active antiretroviral therapy (HAART). A systematic random sampling technique was applied to select the study participants. Face to face interview was employed using structured questionnaires. The questionnaire consisted of socio-demographic factors, clinical factors, and patient satisfaction indicators for HIV and AIDS services. Level of satisfaction was assessed based on 24 Likert-scale items. Logistic regression analysis was carried out to identify the independent predictors of patient satisfaction with the services given. RESULTS: A total of 348 respondents completed the interview, of which 213 (61.20%) were male. The mean age of the respondents was 35.67 (SD=8.40). The overall level of clients' satisfaction with HIV and AIDS services was 55.2%. Educational status of secondary school and above [AOR 2.41, 95% CI: 1.24-4.69], duration of advice above 10 min [AOR 1.74, 95% CI: 1.09-2.79], CD4 count >500 [AOR 2.20, 95% CI: 1.37-3.54], and duration of treatment of 2 years and above [AOR 1.93, 95% CI: 1.07-3.49] were identified as factors significantly associated with client satisfaction. CONCLUSION: Overall, 55.20% of patients were satisfied with HIV and AIDS services given at the ART clinic of MTUTH. Educational status, CD4 count, duration of advice, and duration of treatment were found to be independent predictors of patient satisfaction with ART services. Increasing client satisfaction is important through patient counseling and care.

Adolescent Girl-Mother Communication on Sexual and Reproductive Health Issues Among Students in Fiche Town, Oromia, Central Ethiopia.

Background: Adolescents who have communication about sexual and reproductive health (SRH) with their parents are less likely to participate in risky sexual behaviors and to utilize modern contraceptives. However, communication on SRH issues between adolescents and their parents continues to be below the desired goals in low- and middle-income countries. Objective: To assess SRH communication between adolescent girls and their mothers among students in secondary and preparatory schools in Fiche town, Oromia, Central Ethiopia. Method: An institution-based cross-sectional study was conducted from March 27 to March 30, 2017, using a structured self-administered questionnaire. A total of 181 adolescent female students selected from 2 schools in the town participated in the study. Data were collected on sociodemographic characteristics, student-mother communication, and knowledge about and attitudes toward SRH issues. Multivariable logistic regression analysis was performed, and variables with a P value less than .05 were considered statistically significant. Results: A total of 103 (56.9%) of the students had discussed SRH issues with their mothers. The mothers' educational status (ie, primary school and above, adjusted odds ratio [AOR] = 10.01, 95% CI = 3.55-28.19; the student living with friends, AOR = 5.29, 95% CI = 1.09-25.47; the students' knowledge about SRH issues, AOR = 8.57, 95% CI = 3.61-20.35; and students' attitude toward SRH issues, AOR = 2.79, 95% CI = 1.26-6.15) were identified as independent positive predictors of student-mother communication on selected SRH issues. Conclusion: More than half of the study participants had communication on SRH issues with their mothers. SRH communication was positively associated with maternal educational status, the students' living with friends, and the student's knowledge of and attitude toward SRH issues.

Adherence to Antiretroviral Therapy Among HIV-Positive Pregnant Women on followup at Mizan Tepi University Teaching and Tepi General Hospitals, Southwest Ethiopia.

Background: The introduction of highly active antiretroviral therapy has not only improved longevity in human immunodeficiency virus (HIV)-infected individuals but in addition has had a significant impact on the rate of mother-to-child transmission of the infection. Objective: To assess antiretroviral therapy adherence among HIV-positive pregnant women on follow-up at antiretroviral therapy clinic of Mizan Tepi University Teaching and Tepi General Hospitals. Methods: A descriptive cross-sectional study was undertaken in antiretroviral therapy clinics of Mizan Tepi University Teaching and Tepi General Hospitals from April to May 2018. Data were collected through face to face interview using structured and pretested questionnaires and analyzed using Statistical Package for Social Sciences version 20. Results: Majority of the patients had good adherence to their antiretroviral therapy, 68 (66.00%). Medication side effects, 12 (34.00%) and forgetfulness and distance of the hospital from home, each accounting 11 (31.00%) were the main reasons for nonadherence among nonadherent patients. Frequency of counseling (P = .000), CD4 count (χ2 = 37.529, P = .000), World Health Organization's clinical stage (χ2 = 17.515, P = .000), stigma (χ2 = 70.426, P = .000), and family support (χ2 = 46.383, P = .000) were found to be associated with patients' medication adherence. Conclusion: The overall patient adherence to antiretroviral therapy in the study facilities was good. Collaborative work among patients, health care organizations, and the public are necessary to tackle the adherence obstacles and enhance patient adherence to the prescribed medication.

Treatment Outcome and Its Determinants among Patients Admitted to Stroke Unit of Jimma University Medical Center, Southwest Ethiopia.

BACKGROUND: Stroke is a public health problem in Ethiopia. Despite the high prevalence of stroke in Ethiopia, there is a paucity of data with regard to drug treatment, treatment outcome, and risk factors of poor treatment outcome of stroke. Hence, this study is aimed at assessing treatment outcome and its determinants among patients admitted to stroke unit of Jimma University Medical Center (JUMC). METHODS: A two-year hospital-based retrospective cross-sectional study was employed to analyze the medical records of patients admitted with stroke to stroke unit of Jimma University Medical Centre from February 1st, 2016 to March 30th, 2018. Data was entered by Epidata manager version 4.0.2 and analyzed by SPSS version 24. Multivariable logistic regression analysis with the backward stepwise approach was done to identify independent predictors of poor treatment outcome of stroke. Variables with P value less than 0.05 were considered as statically significant determinants of poor treatment outcome. RESULTS: Of 220 patients with stroke admitted to the Jimma University, 67.30% were male. Nearly two thirds (63.18%) of them had poor treatment outcomes. Dyslipidimics were administered to 60% of the patients, and the most popular antiplatelet used was aspirin, which was prescribed to 67.3% the patients. Age ≥ 65 adjusted odd ratio ((AOR): 2.56; 95% CI: 1.95-9.86, P = 0.001), presence of comorbidity (AOR: 5.25; 95% CI: 1.08-17.69, P < 0.001), admission with hemorrhagic stroke (AOR: 18.99; 95% CI: 7.05-42.07, P < 0.001), and admission to the hospital after 24 hour of stroke onset (AOR: 4.98; 95% CI: 1.09-21.91, P = 0.03) were independent predictors of poor treatment outcomes. CONCLUSION: Substantial numbers of stroke patients had poor treatment outcomes. Elderly patients, patients diagnosed with hemorrhagic stroke, patients with comorbidity, and those with delayed hospital admission were more likely to have poor treatment outcome. Hence, frequent monitoring and care should be given for the aforementioned patients. Awareness creation on the importance of early admission should be delivered particularly for patients who have risk factors of stroke (cardiovascular diseases).