Covid-19 Vaccine Side Effects and Its Associated Factors Among Healthcare Workers at Dessie Hospital, Ethiopia.

Background: Vaccines are a powerful choice to stop disease outbreaks, including covid-19. However, people are hesitant to take vaccinations due to uncertainty about side effects. So, this study aimed to assess covid-19 vaccine side-effect and its associated factors among healthcare workers in Dessie comprehensive specialized hospital, in Ethiopia. Methods: An institution-based cross-sectional study was conducted at Dessie Comprehensive and Specialized Hospital among 351 vaccinated healthcare workers from April 25 to May 25, 2021. Self-administrated questionnaires were used by consented health workers. Variance inflation factor (VIF) was used to assess the multicollinearity of independent variables. Bivariable and multivariable binary logistic regression were used to identify significant factors of vaccine side effects. The adjusted odds ratio (AOR) with a 95% confidence interval (CI) was reported as the effect size. Statistical significance was considered at p-value <0.05. Results: Overall, of vaccinated healthcare workers, 56.98% (95% CI, 50.86-61.26%) experienced at least one side effect. The majority of the side effects were fever (44.44%), headache (39.03%), fatigue (27.35%), injection site pain (25.93%), and nausea (24.22%). Healthcare workers with (≥10 years) of work experience (AOR: 3.74, 95% CI, 1.32-10.59), Hesitancy to take the first dose of the Covid-19 vaccine (AOR: 3.01, 95% CI, 1.82-4.99), underlying chronic disease (AOR: 14.41, 95% CI, (5.07-40.92)), being on antihypertensive medication (AOR: 0.15; 95% CI (0.02-0.93)), and unsafe perception of vaccine safety (AOR:3.50; 95% CI, 1.43-8.57) were independent factors of Covax vaccine side effect development. Conclusion: Overall, common vaccine side effects were identified in healthcare workers who have taken the Covax vaccine. Healthcare workers with (≥10 years) of work experience, Hesitancy to take the first dose, unsafe perception of vaccine safety, and underlined chronic disease were predictors of vaccine side effect occurrence. So, providing vaccine-related information to the community to be vaccinated is mandatory to reduce hesitancy and flaws regarding vaccine safety.

Knowledge and practice regarding the behavioural risks of cancer among college students in Ethiopia.

In recent years, morbidity and mortality due to cancer has been increasing in Ethiopia, putting it among the most important public health issues. Cancer and associated complications can be prevented provided that effective interventions are put in place to control risk factors. Therefore, this study aimed to assess the level of knowledge and practice of preventable behavioural risk factors of cancer. We conducted a cross-sectional study among 200 college students in Northeast Ethiopia utilising quantitative methods of data collection. Data on socioeconomic characteristics, health belief variables, knowledge and behavioural risk factors (alcohol consumption, tobacco smoking, physical activity and dietary practice) were collected. The level of knowledge and practice was summarised using descriptive statistics. To investigate the variation in knowledge and practice across sociodemographic characteristics, we performed Pearson Chi-square test or Fisher's exact test. The majority (81.0%) of participants was male and 82.0% were in the age group of 18-24 years. More than half (61.0%) of them had poor knowledge about the behavioural risk factors of cancer. Nearly one-third (30.5%) consume alcohol, whereas 16.0%, 18.0% and 20.0%, respectively, smoke tobacco, consume street food and packed-fried snacks daily. Alcohol consumption (p = 0.02) and level of vigorous physical activity (p = 0.001) were significantly higher among males than females. Alcohol consumption, tobacco smoking and unhealthy dietary practice were remarkably high, whereas knowledge towards the behavioural risk factors was low. Therefore, health education and collaborative action between different sectors are needed to counter the emerging problem. The trial is registered in ClinicalTrials.gov (https://register.clinicaltrials.gov) NCT04269018.

Factors associated with unmet supportive care needs of oncology patients at Dessie Referral Hospital, 2020.

BACKGROUND: Assessment of supportive care needs for cancer patients and identifying factors affecting these needs is important for the implementation of supportive care programmes, as the burden of cancer is increasing in Ethiopia. OBJECTIVE: To determine the prevalence and associated factors of unmet supportive care needs of cancer patients at Dessie Referral Hospital, Dessie, South Wollo, North East Ethiopia, 2020. METHODS: A cross-sectional study design was implemented among 405 cancer patients from February to 30 July 2020, at Dessie Referral Hospital. The data were collected using a validated supportive care needs survey questionnaire through face to face interview and data extraction tools. Both descriptive and inferential statistics were used and bi-variable and multivariable logistic regressions were used to describe the association between dependent and independent variables. Thus, a p-value of less than 0.05 was considered statistically significant. RESULT: From the total 405 participants, 275 (67.5%) were females with a mean age of (mean ± standard deviation) 48.6 ± 15.4 years. Unmet supportive care needs were higher among psychological needs (81.0%, 95% (confidence interval) CI = 77.0-84.9) and physical needs (74.6%, 95% CI = 70.1-79.0). Old age was associated with unmet physical and psychological needs domain than young age (adjusted odds ratio (AOR) = 1.03; 95% CI: 1.01-1.06), (AOR = 1.06; 95% CI: 1.03-1.09), respectively. High household income was significantly associated with health information needs (AOR = 2.22; 95% CI: 1.33-13.93), remission status (AOR = 0.37; 95% CI: 0.22-0.62) was associated with patient/supportive care needs, late stage cancer was also significantly associated with physical, psychological and health information needs of patients (AOR = 2.19; 95% CI: 1.18-4.06), (AOR = 2.3; 95% CI: 1.18-4.57) and (AOR = 2:95%; CI: 1.03-3.86), respectively. Besides, source of information had a statistically significant association with psychological, health information and patient care needs domain (AOR = 2.61; 95% CI: 1.15-5.93), (AOR = 3.1; 95% CI: 1.65-5.82) and (AOR = 2.2; 95% CI: 1.25-3.87), respectively. CONCLUSION AND RECOMMENDATION: This study shows that the prevalence of unmet supportive care needs in cancer patients is high in each domain. Age, income, cancer stage, cancer site, treatment option, time since diagnosis and sources of information were associated across one or more unmet supportive care needs domains. Therefore, the government and health professionals should work together to improve the unmet needs of cancer patients.

Prevalence and associated factors of needle stick and sharps injuries among healthcare workers in northwestern Ethiopia.

BACKGROUND: Needle stick and sharp injuries (NSSIs) are a common problem among healthcare workers (HCWs). Although the factors related to NSSIs for HCWs are well documented by several studies in Ethiopia, no evidence has been reported about the magnitude of and factors related to NSSIs in hospitals in northwestern Ethiopia. METHODS: An institution-based cross-sectional study was carried out from January to March 2019 among 318 HCWs in three randomly-selected hospitals of the eight hospitals found in South Gondar Zone. Sample sizes were proportionally allocated to professional categories. Study participants were selected by systematic random sampling methods using the monthly salary payroll for each profession as the sampling frame. Data were collected using a self-administered questionnaire. The outcome of this study was the presence (injured) or absence of NSSIs during the 12 months prior to data collection. A binary logistic regression model with 95% confidence interval (CI) was used for data analysis. Variables from the bi-variable analysis with a p-value ≤ 0.25 were retained into the multivariable analysis. From the multivariable analysis, variables with a p-value less than 0.05 was declared as factors significantly associated with NSSIs. MAIN FINDINGS: The prevalence of NSSIs was 29.5% (95% CI: 24.2-35.5%) during the 12 months prior to the survey. Of these, 46.0% reported that their injuries were moderate, superficial (33.3%) or severe (20.7%). About 41.4% of the injuries were caused by a suture needle. Factors significantly associated with NSSIs were occupation as a nurse (adjusted odds ratio [AOR] = 2.65, 95% CI: 1.18-4.26), disposal of sharp materials in places other than in safety boxes (AOR = 3.93, 95% CI: 2.10-5.35), recapping of needles (AOR = 2.27, 95% CI: 1.13-4.56), and feeling sleepy at work (AOR = 2.24, 95% CI: 1.14-4.41). CONCLUSION: This study showed that almost one-third of HCWs had sustained NSSIs, a proportion that is high. Factors significantly associated with NSSIs were occupation as a nurse, habit of needle recapping, disposal of sharp materials in places other than in safety boxes and feeling sleepy at work. Observing proper and regular universal precautions for nurses during daily clinical activities and providing safety boxes for the disposal of sharp materials, practicing mechanical needle recapping and preventing sleepiness by reducing work overload among HCWs may reduce the incidence of NSSIs.

Performance of individual dietary diversity score to identify malnutrition among patients living with HIV in Ethiopia.

There is a lack of uniformity in developing and validating indicators of nutritional status among People Living with Human Immunodeficiency Virus (PLHIV). Experiences from low and middle-income countries are scant, and differences in methodological and analytical approaches affect the comparability and generalizability of findings. Therefore, this study investigated the performance of individual diversity score (IDDS) as a proxy indicator of nutritional status among PLHIV. We conducted a facility-based cross-sectional study among 423 PLHIV who were under Antiretroviral Treatment (ART) at clinics in Bahir-Dar, Ethiopia. We collected data on sociodemographic, dietary, clinical, and anthropometric measures. Dietary intake was assessed using 24-Hour dietary recall. Body Mass Index (BMI) was calculated to assess the nutritional status of study subjects. The receiver operating characteristic (ROC) curve analysis was used to assess the ability of the IDDS and Minimum Dietary Diversity for Women (MDD-W) to detect poor nutritional status. Furthermore, sensitivity, specificity, Predictive Values (PPs), and Likelihood Ratios (LRs) were calculated at different cut-off points. IDDS showed good reliability with Cronbach's Alpha of 0.76. The Area Under the Curve (AUC) of IDDS was 78.5 (95%CI 73.9-83.4). At the IDDS cut-off of 4, the sensitivity and specificity of IDDS to indicate nutritional status were 88.0% (95%CI 81.0-93.0) and 71.0% (95%CI 66.0-76.0), respectively. The AUC of MDD-W was 74.1%, and at the cut-off of 4 the sensitivity and specificity of MDD-W to indicate undernutrition were 73.0% and 72.0%, respectively. Both IDDS and MDD-W have good accuracy as a proxy indicator for measuring the nutritional status of PLHIV. In the prevention of undernutrition among PLHIV especially in a resource-limited setting, IDDS and MDD-W can be used to assess nutritional status.

The effect of mobile text messages on knowledge and perception towards cancer and behavioral risks among college students, Northeast Ethiopia: A randomized controlled trial protocol.

BACKGROUND: Cancer is an emerging public health problem in Ethiopia. A significant proportion of premature cancer deaths are preventable. The socioeconomic impact of cancer can be considerably reduced provided that effective interventions are put in place to control risk factors. Text-messaging has been currently targeted as a simple and efficient tool for providing people with health information. OBJECTIVE: To evaluate the effectiveness of mobile text messages in improving knowledge and perception on cancer and behavioral risks among college students. METHODS: Design: a single-blind, 2-arm randomized controlled trial will be used. Setting: the study will be conducted among public colleges in Dessie town, Northeast Ethiopia. Study population: students who are studying in all public colleges. Intervention: a text message related to cancer risk factors once a day for two months. Control groups will receive general health messages daily for two months. Data: Socioeconomic characteristics, health belief variables, and behavioral risk factors of cancer will be collected before and after the intervention. Text messages will be provided based on the health belief model (HBM). Primary outcomes: cancer risk knowledge score and risk perception will be measured at baseline and 6 months post-randomization. Secondary outcomes: a change in mean healthy diet score, physical activity level, alcohol intake, and tobacco use will be measured at baseline-, 3, and 6 months post-randomization. Analysis: We will compute descriptive statistics for each outcome pre and post-intervention. To test the change in knowledge and perception, paired t-test will be used. Analysis of Covariance will be used to test over group comparison. TRIAL REGISTRATION: ClinicalTrials.gov (https://register.clinicaltrials.gov) NCT04269018.

Urban-rural disparities in institutional delivery among women in East Africa: A decomposition analysis.

BACKGROUND: Though institutional delivery plays a significant role in maternal and child health, there is substantial evidence that the majority of rural women have lower health facility delivery than urban women. So, identifying the drivers of these disparities will help policy-makers and programmers with the reduction of maternal and child death. METHODS: The study used the data on a nationwide representative sample from the most recent rounds of the Demographic and Health Survey (DHS) of four East African countries. A Blinder-Oaxaca decomposition analysis and its extensions was conducted to see the urban-rural differences in institutional delivery into two components: one that is explained by residence difference in the level of the determinants (covariate effects), and the other components was explained by differences in the effect of the covariates on the outcome (coefficient effects). RESULTS: The findings showed that institutional delivery rates were 21.00% in Ethiopia, 62.61% in Kenya, 65.29% in Tanzania and 74.64% in Uganda. The urban-rural difference in institutional delivery was higher in the case of Ethiopia (61%), Kenya (32%) and Tanzania (30.3%), while the gap was relatively lower in the case of Uganda (19.2%). Findings of the Blinder-Oaxaca decomposition and its extension showed that the covariate effect was dominant in all study countries. The results were robust to the different decomposition weighting schemes. The frequency of antenatal care, wealth and parity inequality between urban and rural households explains most of the institutional delivery gap. CONCLUSIONS: The urban-rural institutional delivery disparities were high in study countries. By identifying the underlying factors behind the urban-rural institutional birth disparities, the findings of this study help in designing effective intervention measures targeted at reducing residential inequalities and improving population health outcomes. Future interventions to encourage institutional deliveries to rural women of these countries should therefore emphasize increasing rural women's income, access to health care facilities to increase the frequency of antenatal care utilization.

Factors Associated with Delay in Breast Cancer Presentation at the Only Oncology Center in North East Ethiopia: A Cross-Sectional Study.

BACKGROUND: Female breast cancer is becoming an emerging public health problem which accounts for 33% of all cancers in women and 23% of all cancer cases in Ethiopia. The majority of women with breast cancer are diagnosed at later stages due to delayed presentation to seek treatment. OBJECTIVE: To determine the prevalence and factors associated with patient delay at presentation among breast cancer patients at Dessie Referral Hospital, the only oncology center in North East Ethiopia. METHODS: We conducted an institution-based cross-sectional study among 204 female patients with pathology-confirmed breast cancer at the only oncology center of North East Ethiopia from January to June 2020. An interviewer administered questionnaire and a medical record data extraction tool were used to address the objective of the study. Patients were said to be delayed for diagnosis if the time duration between first clinical presentations to first clinical consultation was more than 3 months. Then, bivariable and multivariable logistic regression was employed to analyze the association between dependent and independent variables. RESULTS: Among a total of 209 eligible participants, 5 refused to participate with a response rate of 97.6%. The proportion of patients with delayed presentation was 103 (50.5%), with the median time taken to visit a healthcare provider after recognition of the first symptom was 4 months. Age above 40 years (AOR=4.81; 95% CI=1.26-18.65) P<0.024, college and above educational status (AOR=0.05; 95% CI=0.01-0.77) p<0.036, government employee (AOR=0.19, 95% CI=0.03-0.91) P<0.002, urban residence (AOR= 0.21; 95% CI=0.01-0.82) p<0.001, visit traditional healer (AOR=0.38; 95% CI=0.2-0.69) P<0.0037, and no lump in under armpit (AOR= 9.05; 95% CI=1.14-22.69) P<0.002 were associated with delayed presentation. CONCLUSION: Delays to seek treatment is generally high in our study. Age, educational status, occupation, residence, visiting traditional healer, and absence of lump in under armpit were significant factors for delayed presentation. Intervention programs focusing on reducing delayed presentation should be employed.

Impact of COVID-19 pandemic on vaccination coverage among children aged 15 to 23 months at Dessie town, Northeast Ethiopia, 2020.

Background: Disturbances are occurring in healthcare, trade, and travel, with countries closing off their borders due to the pandemic of coronavirus disease 2019(COVID-19) in the world. The pandemic has its impact on the delivery of important health services, including vaccinations. This study aimed to assess the impact of COVID-19 on vaccination coverage among children aged 15-23 months.Methods: A community-based cross-sectional study was conducted from July 22 to August 7, 2020, in Dessie town, Ethiopia. 633 children with their mother/caregiver were interviewed. Interviewer administered pre-tested structured questioner was used. Data was entered into EPI data and analyzed by using SPSS (Statistical Package for Social Sciences). Both binary and multivariate logistic regression analyses were tested. In multivariate analysis, a significant association was declared at a p-value of < 0.05.Result: Response rate was 96.4%. Based on the vaccination card plus recall, 350 (57.4%) of children finished all recommended vaccines. Age-eligible vaccination coverage during the COVID-19 outbreak was 12.5% lower than before the outbreak. Being a father main caregiver, mother/caregiver who can write and read, and mother/caregiver who educated from grade 1 to 8 mother/caregiver who is divorced, mother/caregiver who spend more than 30 minutes to reach health institution, and mother/caregiver who aware about the benefit of vaccination, about the campaign, and knowledge of COVID-19 each shows statistically significant association with full vaccination status of children.Conclusion: Full vaccination coverage among children aged 15-23 months remains low in Dessie town, which further decreases after the COVID-19 pandemic. Hence, measures should be taken to increase consciousness about vaccination and the COVID-19 pandemic.