Sexual partner referral and associated factors among patients with sexually transmitted disease in Jabi Tehnan district and Finote Selam town.

BACKGROUND: Partner referral (or contact tracing) is an essential approach for preventing sexually transmitted infections. Even though this approach has been used in Ethiopia, there is a scarcity of evidence in Ethiopia particularly in this study area. METHODS: A cross-sectional study was conducted among 397 patients with curable sexually transmitted diseases. Factors associated to the practice of sexual partner referral were explored where variables having a p-value of <0.05 in multivariable analysis were considered statistically significant. RESULT: Referrals for sexual partners were found to be 42.4% in this study (95% CI: 35.3, 45.3). Not expecting the end of the relationship among regular partnerships (AOR: 4.8; 95% CI: 1.9, 12.4), perceived risk of reinfection (AOR: 3.0; 95% CI: 1.8, 5.3), perceived self-efficacy (AOR: 3.8; 95% CI: 2.4, 6.3), intention to refer partners (AOR: 3.7; 95% CI: 2.0, 6.4), and knowledge of sexually transmitted infections (AOR: 3.0; 95% CI: 1.8, 5.0) were significantly associated with sexual partner referral. CONCLUSIONS: This study showed that sexual partner referral was low. Perceived risks of reinfection, perceived self-efficacy, anticipating the end of a relationship, intention to refer partners, and knowledge of sexually transmitted infections were significant predictors of sexual partner referral. Intervention endeavors need to consider factors pointed out in this study to improve sexual partner referral.

Sexual and Reproductive Health Problems and Needs of Street Youths in East Gojjam Zone Administrative Towns, Ethiopia: Exploratory Qualitative Study.

Background: About 600,000 children are estimated to depend on street life in Ethiopia. Estimates conclude that about 65% of street children hardly have any access to sexual and reproductive health (SRH) services. However, sexually transmitted infections including HIV/AIDS among street children have been reported as being very high and some studies showed that it can be higher than that of female sex workers, truck drivers and prisoners. Objective: The aim of this study is to explore the sexual and reproductive health problems of street youths and their need in East Gojjam Zone, Ethiopia, 2019. Methods: An explanatory qualitative study design was conducted on street youths residing in East Gojjam Zone town administrations from February to March, 2019. Purposively selected street youths and positioned individuals who were residing in East Gojjam Zone town administrates were included in the study. The data were collected through focus group discussion and in-depth interview and analyzed thematically. Result: A total of 85 street youths and 8 individuals who were working with street children participated in this study. Most street youths had no clear information towards sexual and reproductive health. The existing reproductive health problems were sexual violence, sexually transmitted infection, unplanned pregnancy, abortion and substance abuse. Most street youths were interested in getting sexual and reproductive health information and other services by concerned bodies similar to the general population. Accessibility of job opportunities was also one of their needs to prevent the existing sexual and reproductive health problems. Conclusion and Recommendation: Most street youths were sexually active and attempted unsafe sexual practice which exposed them to sexually transmitted infections, unplanned pregnancies and abortions. So a special reproductive health service is needed to avert these problems.

Incidence and predictors of mortality among neonates referred to comprehensive and specialized hospitals in Amhara regional state, North Ethiopia: a prospective follow-up study.

BACKGROUND: Neonatal mortality is a major global public health problem. Ethiopia is among seven countries that comprise 50 % of global neonatal mortality. Evidence on neonatal mortality in referred neonates is essential for intervention however, there is no enough information in the study area. Neonates who required referral frequently became unstable and were at a high risk of death. Therefore, this study aimed to assess the incidence and predictors of mortality among referred neonates. METHOD: A prospective follow-up study was conducted among 436 referred neonates at comprehensive specialized hospitals in the Amhara regional state, North Ethiopia 2020. All neonates admitted to the selected hospitals that fulfilled the inclusion criteria were included. Face-to-face interviews, observations, and document reviews were used to collect data using a semi-structured questionnaire and checklists. Epi-data™ version 4.2 software for data entry and STATA™ 14 version for data cleaning and analysis were used. Variables with a p-value < 0.25 in the bi-variable logistic regression model were selected for multivariable analysis. Multivariable analyses with a 95% confidence level were performed. Variables with P < 0.05 were considered statistically significant. RESULT: Over all incidence of death in this study was 30.6% with 95% confidence interval of (26.34-35.16) per 2 months observation. About 23 (17.83%) deaths were due to sepsis, 32 (24.80%) premature, 40 (31%) perinatal asphyxia, 3(2.33%) congenital malformation and 31(24.03%) deaths were due to other causes. Home delivery [AOR = 2.5, 95% CI (1.63-4.1)], admission weight < 1500 g [AOR =3.2, 95% CI (1.68-6.09)], travel distance ≥120 min [AOR = 3.8, 95% CI (1.65-9.14)], hypothermia [AOR = 2.7, 95% CI (1.44-5.13)], hypoglycemia [AOR = 1.8, 95% CI (1.11-3.00)], oxygen saturation < 90% [AOR = 1.9, 95% (1.34-3.53)] at admission time and neonate age ≤ 1 day at admission [AOR = 3.4, 95% CI (1.23-9.84) were predictors of neonatal death. CONCLUSION: The incidence of death was high in this study. The acute complications arising during the transfer of referral neonates lead to an increased risk of deterioration of the newborn's health and outcome. Preventing and managing complications during the transportation process is recommended to increase the survival of neonates.

Magnitude of Low Birth Weight and Associated Factors among Newborns Delivered in Dangla Primary Hospital, Amhara Regional State, Northwest Ethiopia, 2017.

BACKGROUND: Low birth weight is defined as a live born infant weighs less than 2 500 g regardless of gestational age. Globally, the prevalence of low birth weight ranges from 3% to 15%. Birth weight plays an important role in infant mortality, morbidity, development, and future health. The prevalence of low birth weight in Ethiopia was estimated to be 14% which is one of the highest percentages in the world. So, the aim of this study is to assess magnitude and associated factors of low birth weight among newborns delivered at Dangla Primary Hospital, Amhara Region, Ethiopia. METHODS: An institution-based cross-sectional study was conducted at Dangla Primary Hospital from September 27 to June 10, 2017. Systematic random sampling technique was used to select the 232 study participants. A structured and pretested questionnaire was used to collect data. Data quality was assured by pretesting, training, and frequent supervision. Descriptive statistics were performed for the descriptive part of the study. Binary and multiple logistic regression analyses were conducted to identify independent predictors of low birth weight. Those variables and p-value < 0.25 were included in the multivariable logistic regression for controlling the possible effect of confounders. Finally, variables which had significant association were identified on the basis of AOR, with 95%CI and with P-value <0.05. RESULTS: Magnitude of low birth weight was 10.3 %. Previous history of low birth weight [AOR = 3.2, 95% CI: (1.13-9.9)], additional food intake during the last pregnancy [AOR = 5.0, 95% CI: (1.2-16.2)], and preterm delivery [AOR = 2.1, 95% CI: (3.1-19.2)] were independent predictors of low birth weight. CONCLUSION: Magnitude of low birth weight in Dangla Primary Hospital was high. So, strengthening counseling systems for women through quality antenatal care on advantage of additional food intake and previous bad obstetric outcome is necessary to alleviate the delivery of low birth weight neonates in the study area.

Prevalence of diabetes mellitus among tuberculosis patients in Sub-Saharan Africa: a systematic review and meta-analysis of observational studies.

BACKGROUND: Tuberculosis and diabetes mellitus are significant global public health challenges. In Sub-Saharan Africa, study findings regarding prevalence of diabetes mellitus amongst tuberculosis patients have been inconsistent and highly variable. Therefore, this systematic review and meta-analysis estimates the overall prevalence of diabetes mellitus among tuberculosis patients in Sub-Saharan Africa. METHODS: Four international databases (PubMed, Google Scholar, Science Direct and Cochrane Library) were systematically searched. We included all observational studies reporting the prevalence of DM among TB patients in Sub-Saharan Africa. All necessary data for this review were extracted using a standardized data extraction format by two authors (CT and AA1). STATA Version 14 statistical software was employed to conduct meta-analysis. The Cochrane Q test statistics and I2 test were used to assess the heterogeneity of the studies. Finally, a random effects meta-analysis model was computed to estimate the pooled prevalence of diabetes mellitus in TB patients. Besides, subgroup analysis was done based on different factors. RESULTS: In the meta-analysis, sixteen studies fulfilled the inclusion criteria and were included. The findings of these 16 studies revealed that the pooled prevalence of diabetes mellitus among tuberculosis patients in Sub-Saharan Africa was 9.0% (95% CI: 6.0, 12.0%). The highest prevalence of diabetes mellitus among tuberculosis patients was found in Nigeria (15%), followed by Tanzania (11%), and then Ethiopia (10%). Besides, the prevalence of diabetes mellitus among HIV infected TB patients was (8.9%) which is slightly higher than HIV uninfected (7.7%) TB patients. CONCLUSION: Diabetes mellitus among tuberculosis patients in Sub-Saharan Africa was significantly high. Moreover, this study found that there was a high prevalence of DM among HIV infected than uninfected TB patients. It is strongly recommended to screen for DM among TB patients and special emphasis should be given for early screening of DM among TB/HIV co-infected patients.

Risk factors associated with poor health outcomes for children under the age of 5 with moderate acute malnutrition in rural fagita lekoma district, Awi Zone, Amhara, Ethiopia, 2016.

BACKGROUND: Left untreated, moderate acute malnutrition (MAM) in children can lead to severe acute malnutrition, stunting, developmental delays, and death. Despite recent progress the prevalence of malnutrition remains high throughout Ethiopia. The ability to make accurate prognoses and develop effective treatment strategies for children with MAM is currently limited and, as result, a significant proportion of children with MAM fail to recover even with treatment. We seek to address this limitation by assessing the risk factors for poor outcomes among children under the age of 5 with MAM in a rural area of Ethiopia's Amhara Region. This region is considered relatively food secure and does not have food supplementation treatment programs. METHODS: We conducted a prospective cohort study of 404 randomly sampled children, 0-59 months old stratified by household food security status. We followed the study children for approximately 2 months, assessing their health status; and used bivariate and multivariate Cox-proportional hazard regression models to identify risk factors for poor health outcomes. RESULTS: Household food security was significantly associated with low recovery from MAM: 191 (60%) of children in food-insecure and 129 (40%) of children in food-secure households had poor health outcomes. The risk factors found to be significantly associated with poor health outcomes included the duration of exclusive breastfeeding (AHR 1.50, 95%CI: 1.05, 2.15), dietary diversity (AHR 1.74, 95%CI: 1.18, 2.54), and maternal mid-upper arm circumference (AHR=1.36, 95% CI: 1.04, 1.86). Children from pregnancies that were wanted but unplanned had 80% higher incidence of poor health outcomes than others, and children from pregnancies that were both unwanted and unplanned had more than double the incidence of poor health outcomes compared to their counterparts. CONCLUSION: We found that without treatment, the majority of children from food insecure households and over a third of children from food secure households did not recover from MAM. Maternal factors particularly the mother's ability to plan her pregnancy were the main determinants of recovery in this study. Together these findings support arguments for targeting of nutrition support programs to vulnerable households regardless of regional food security status, and for closely integrating robust family planning, and antenatal care services with nutrition interventions.

The Prevalence of Skilled Birth Attendant Utilization and Its Correlates in North West Ethiopia.

The low utilization of skilled birth attendants sustained high maternal mortality. The aim of this study was to assess its magnitude and correlates in Northwest Ethiopia. A study was conducted on 373 randomly selected women who gave birth in the 12 months preceding the survey. Correlates were identified using binary logistic regression. Skilled birth attendance was 18.8%. Inability to perform cultural practices in health facilities (65.5%), expecting smooth delivery (63.4%), and far distance (62%) were the main barriers. Women with urban residence (AOR = 5.46: 95% CI [2.21-13.49]), primary (AOR = 2.10: 95% CI [0.71-6.16]) and secondary-plus (AOR = 6.12: [1.39-26.92]) educational level, four-plus ANC visits (AOR = 17.33: 95% CI [4.22-71.29]), and proximity to health centers (AOR = 5.67: 95% CI [1.47-25.67]) had higher odds of using skilled birth attendants though women with no labor complications had lower odds (AOR = 0.02: 95% CI [0.01-0.05]). Skilled birth attendance use was low. Urban residence, primary-plus level of education, frequent ANC visits, living nearby the health centers, and a problem during labor were positively correlated with skilled birth attendance utilization. Stakeholders should enhance girls' education beyond primary level and ANC services and shorten distances to health facilities.