Incidence and Predictors of Severe Adverse Drug Reactions among Patients on Antiretroviral Drugs in Harari Regional State, Eastern Ethiopia.

Background: The introduction of combination antiretroviral therapy improves the quality and longevity of people living with HIV/AIDS. However, adverse drug reactions associated with antiretroviral therapy compromise the resulting benefits and have been reported differently worldwide, including Ethiopia. Severe adverse drug reactions are one of the major public health concerns for the reason that they can potentially impede the benefit of antiretroviral therapy and put the patient's survival at risk. Despite many successes achieved with the introduction of the combined antiretroviral therapy, the majority of the patients on antiretroviral therapy experience adverse drug reactions associated with the drugs. Consequently, little is known about the problem in the current study area. This is, therefore, to study incidence and predictors of severe adverse drug reactions among patients on antiretroviral drugs in the Harari region, Eastern Ethiopia. The aim of this study was to assess the incidence and predictors of severe adverse drug reactions among patients on antiretroviral therapy from February 25, 2022, to March 25, 2022, in the Harari region, Eastern Ethiopia. Methods: A hospital-based retrospective cohort study was conducted among 449 randomly selected medical records of people living with HIV on first-line antiretroviral therapy. Collected data were entered into EpiData version 3.1 and exported to STATA version 15 for analysis. Kaplan-Meier survival curve with log-rank test was used to compare survival curves for categorical independent variables. A p value ≤0.05 was declared as significant, and an adjusted hazard ratio was used to report the effect size using the multivariate Cox proportional hazard model. Result: The overall incidence density of the severe adverse reactions was 7.22 per 1000 months (95% CI: 5.5, 9.6). After adjusting for all potential confounders using multivariable Cox proportional hazard ratio, advanced clinical diseases (AHR = 3.44; 95% CI: 1.54, 7.65), HIV/tuberculosis confections (AHR = 2.38; 95% CI: 1.23, 4.62), and being female (AHR = 3.12; 95% CI: 1.57, 6.18) were significantly associated with the experience of severe adverse drug reactions. Conclusion: In this study, the incidence of severe adverse reactions was consistent with the previous studies, and advanced World Health Organization (WHO) clinical stage, HIV/TB confection, and being female were the independent predictors of the severe adverse drug reactions.

Predictor of anemia among pregnant women attending antenatal clinics at Hiwot Fana Comprehensive Specialized Hospital, Eastern Ethiopia: a case-control study.

BACKGROUND: Anemia during pregnancy is a public health problem and is related to negative birth outcomes, especially in developing countries. The main aim of this study was to assess predictors of anemia among pregnant women attending antenatal clinics at Hiwot Fana Comprehensive Specialized University Hospital, Eastern Ethiopia. METHODS: Unmatched case-control study design was employed among 352 individuals. A face-to-face interview was used to gather data, and each pregnant woman's antenatal care follow-up record cards were reviewed in addition to the interview. EpiData version 3.1 and IBM SPSS version 26 was used for data entry and analysis, respectively. Bivariable and multivariable analyses were conducted to identify predictors of anemia, a p-value of <0.05 was considered a statistically significant association. RESULT: The common determinants for anemia in pregnant mothers were: rural residency (AOR = 2.25, 95% CI: 1.14-4.8), no formal education (AOR = 4.4, 95% CI: 1.94-9.9), inter-pregnancy interval (AOR = 2.7, 95% CI: 1.24-5.8), and mid-upper arm circumference (AOR = 5.0, 95% CI: 2.0-12.7). CONCLUSION: In this study, the identified determinant factors for anemia were: rural residency, maternal educational status, inter-pregnancy-interval, and mid-upper arm circumference. Therefore, providing health education and promotion for pregnant women regarding anemia by focusing on rural residents and counseling to lengthen their birth spacing is an important task. Moreover, counseling on taking iron supplementation as suggested and consuming a diet rich in iron during antenatal care will be recommended.

Incidence and predictors of attrition among adults receiving first line anti-retroviral therapy at public health facility in Adea Berga district, Oromia, Ethiopia.

Background: According to current estimates, there are 665,723 people in Ethiopia who have human immunodeficiency syndrome. As Ethiopia inches closer to attaining the 95/95/95 targets for treatment coverage and reaching epidemic control, however, attrition from anti-retroviral treatment is still one of the key programmatic challenges. Objective: To assess the incidence of attrition rate and its predictors among adult HIV patients receiving anti retro viral treatment at Public Health Facility in Adea Berga/Enchini District. Method: A 6-year (June 28, 2015 to June 27, 2021) institution-based retrospective cohort study was used to recruit 540 study participants by using simple random sampling. Data were obtained from chart review, coded, entered into Epi Data, and exported to Stata 14.2 software for analysis. At least 1 month missed appointment is considered as attrition and the predictors of attrition were identified using bivariable and multivariable Cox proportional hazard models and an adjusted hazard ratio (AHR). Bivariate and multivariate analyses were conducted to find predictors of attrition, p-value < 0.05 was considered statistically significant. Results: From the total 540 study participant, 158 (29.26%) patients were discontinuing from follow up making the incidence rate of attrition 9.50 per 100 person years .Being WHO clinical stage III or IV (AHR = 1.96,), non-practice of Appointment spacing model (AHR = 3.98), poor or fair ART adherence level (AHR = 6.47), age groups (15-24) years (AHR = 1.73) and Others ART linkage points[index case testing, tuberculosis clinic and referral from private/public health institutions] (AHR = 1.76) were significantly associated. Conclusions: The study showed that the incidence of attrition among adults receiving antiretroviral therapy was high. Patient sociodemographic, clinical, and treatment-related factors were significantly associated with patients on ART.

Loss to follow-up tuberculosis treatment and associated factors among adults attending at public health facilities in Warder District, Somali Regional State, Eastern Ethiopia.

Background: Tuberculosis is a major public health problem worldwide, particularly in resource-limited countries. Loss of follow-up during treatment is one of the major obstacles in the fight against tuberculosis, which has serious implications for patients, their families, communities, and health service providers. Purpose: To assess the magnitude of the loss to follow-up tuberculosis treatment and associated factors among adults attending public health facilities in Warder District, Somali Regional State, eastern Ethiopia from November 02-17, 2021. Methods: A 5-year (from 1 January 2016 to 31 December 2020) retrospective study was conducted on 589 adult tuberculosis treatment records. Data were collected using a structured data extraction format. Data were analyzed using STATA version 14.0 statistical package. Variables with P < 0.05 in the multivariate logistic regression analysis were considered statistically significant. Results: A total of 98 (16.6%) TB patients failed to follow up with their treatment. Age between 55 and 64 years (AOR = 4.4, 95% CI: 1.9-9.9), being male (AOR = 1.8, 95% CI: 1.1-2.9), living more than 10 km away from a public health facility (AOR = 4.9, 95% CI:2.5-9.4), and having a history of tuberculosis treatment (AOR = 2.3, 95% CI: 1.2-4.4) were associated with a higher likelihood of not following up, while having a positive initial smear result (AOR = 0.48, 95% CI: 0.24-0.96) was associated with a lower probability of not following up. Conclusion: One out of six patients was lost to follow-up after initiating their tuberculosis treatment. Hence, improving the accessibility of public health facilities with a special focus on older adults, male patients, smear-negative patients, and retreatment cases is highly warranted among TB patients.

Electronic medical record use and associated factors among healthcare professionals at public health facilities in Dire Dawa, eastern Ethiopia: A mixed-method study.

Background: Despite the significant benefits of digital health technologies (ITs), developing countries are lagging behind their developed counterparts in the adoption of electronic medical records (EMRs) in a healthcare setting. EMRs have long been considered essential elements in improving the quality of healthcare. However, the rate of utilization of EMRs among healthcare providers still remains low, particularly in developing countries. Objective: This study aimed at exploring EMR use and its determinants among healthcare providers at public health facilities in Dire Dawa, eastern Ethiopia. Methods: A quantitative cross-sectional study was conducted among 402 health professionals working at public health facilities supplemented with an exploratory qualitative study in Dire Dawa, Ethiopia. Descriptive summary statistics and binary and multivariable logistic regression analysis were used to explore the determinant factors of EMR use, while qualitative data were thematically analyzed. Results: Overall, about a quarter (26.6%) of health professionals were using electronic medical records. A work experience of 6 years or less [adjusted odds ratio (AOR) = 2.23; 95% confidence interval (CI): [1.15-4.31]], a discussion on EMR (AOR = 14.47; 95% CI: [5.58-7.57]), the presence of an EMR manual (AOR = 3.10; 95% CI: [1.28-7.38]), and a positive attitude toward the EMR system (AOR = 11.15; 95% CI: [4.90-25.36]) and service quality (AOR = 8.02; 95% CI: [4.09-15.72]) were independent determinants of EMR use. Poor collaboration among stakeholders and dependence on the software programs of NGOs were the main challenges cited by key informants. Conclusion: The findings of this study indicate that EMR use by health professionals in the study area is very low. Several organizational, technical, and behavioral factors were identified for this low utilization. Therefore, there is a need to leverage EMRs through continuous technical support and commitment to enhance its use, which has the potential to improve health service performance. Developing locally applicable EMR software should be considered.

Unmet need for contraception among married adolescent girls and young women in Haramaya Health and demographic surveillance system, Eastern Ethiopia.

Background: The prevalence of unmet need for contraception is the highest in low- and middle-income countries (LMIC). Contraceptive use among young married or unmarried women is lower than that among older women in developing countries. Previous studies generalized the findings to all women of reproductive age and have not investigated psychosocial factors that influence contraceptive use. This study aimed to identify factors associated with unmet need for contraception among young married women in the Haramaya Health and Demographic Surveillance System (HDSS), eastern Ethiopia. Methodology: A cross-sectional, community-based study of young married women aged 15-24 years was conducted. A simple random sampling method was used to select 550 young married women. Data were collected using a pretested structured questionnaire. Using adjusted odds ratio (AOR) with a 95% confidence interval (CI), factors associated with unmet need for contraception were identified using multivariable logistic regression analysis. Results: The overall prevalence of unmet need for contraception was 154 (30.3%). Adolescents (15-19) (AOR = 2.05, 95% CI: 1.16-3.62), husbands' negative attitude toward contraception (AOR = 2.1, 95% CI: 1.05-4.46), and no previous use of contraception (AOR = 3.9, 95% CI: 2.29-6.71) were significantly and positively associated with unmet need for contraception. On the contrary, young women with secondary education or higher (AOR = 0.55, 95% CI: 0.28-1.084) were negatively and significantly associated with unmet need for contraception. Conclusion: The prevalence of unmet need for contraception among young women in Haramaya was high. Unmet need was affected by age, husbands' attitude toward contraceptives, the educational status of women, and previous use of contraception. This study underscored the need to improve girls' educational status to empower them in making contraceptive use decisions with their partners. Programs should also engage male partners who are perceived as key decision-makers when it comes to contraceptive use.

Why mothers die: Analysis of verbal autopsy data from Kersa Health and Demographic Surveillance System, Eastern Ethiopia.

Background: Despite registering tremendous improvement as part of the Millennium Development Goals, Ethiopia has still one of the highest numbers of maternal mortality. Although maternal mortality is one of the commonest indicators for comparison or measuring progress, its measurement remained a challenge. In a situation where, vital registration is not in place and only few women gave birth in facilities, alternative data sources from population-based surveys are essential to describe maternal deaths. In this paper, we reported estimates of maternal mortality and causes in a predominantly rural setting in eastern Ethiopia. Methods: Data were used from the ongoing prospective open cohort of Kersa Health and Demographic Surveillance System (HDSS), located in eastern Ethiopia. At enrolment, detailed sociodemographic and household conditions were recorded for every member, followed by household visit every six months to identify any vital events: births, deaths, and migration. Whenever a death was reported, additional information about the deceased - age, sex, pregnancy status, and perceived cause of deaths - were collected through interview of the closest family member(s). Then, the probable cause of death was assigned using an automated verbal autopsy system (InterVA). In this paper, we included all deaths among women during pregnancy, childbirth or within 42 days of termination of pregnancy. To describe the trends, we calculated annual maternal mortality ratio (MMR) along with their 95% Confidence Interval (CI). Results: From 2008 to 2019, a total of 32 680 live births and 720 deaths among reproductive age women were registered. Of the 720 deaths, 158 (21.9%) were during pregnancy or within 42 days of termination of pregnancy, corresponding with an MMR of 484 per 100 000 live births. The three leading causes of deaths were pregnancy related sepsis, obstetric haemorrhage and anaemia of pregnancy. There was non-significant reduction in the MMR from 744 in 2008 to 665 in 2019, with three lowest ratios recorded in 2013 (172 per 100 000 live births), 2009 (280 per 100 000 live births) and 2016 (285 per 100 000 live births). Conclusions: There was no significant decrement of MMR during the study period. Most deaths occurred at home from pregnancy related sepsis and haemorrhage implicating the unfinished agenda of ensuring skilled delivery and appropriate postnatal management.

Undernutrition and associated factors among elderly people served in Public Servants Social Security Agency in Harar, Eastern Ethiopia.

Objective: Undernutrition in the elderly has adverse effects on physiological functions and various clinical outcomes. In Ethiopia, similar to many developing countries, there is a dearth of epidemiological data on the nutritional status of the elderly. This study aimed to assess the magnitude of undernutrition and associated factors among the elderly population enrolled in the Public Servants Social Security Agency in Harar, eastern Ethiopia. Method: A cross-sectional study was carried out among 337 elderly adults from June to August 2020. The Mini Nutritional Assessment Tool Short Form assessed the nutritional status of the elderly. Data were entered in Epi Data software version 3.1 and transferred to SPSS version 20 for analysis. Ordinal logistic regression assessed factors associated with undernutrition, using variables with a p value less than 0.05 as statistically significant. Result: The magnitude of undernutrition was 16.6% and 45.1% were at risk of undernutrition. Being unable to read and write (odds ratio (OR) = 3.64; 95% confidence interval (CI), 1.98-6.72), elderly with morbidities (OR = 2.05; 95% CI, 1.15-3.64), low dietary diversity score (OR = 3.52; 95% CI, 1.63-7.60), and elderly who were food insecure (OR = 0.59; 95% CI, 0.37-0.95) were significantly associated with undernutrition. Conclusion: The magnitude of undernutrition among the elderly is a public health issue. Independent predictors include educational status, morbidity, dietary diversity, and food insecurity. Intervention programs need to focus on the elderly's nutrition, access to healthy foods, and other health issues.

Uncertainties in the path to 2030: Increasing trends of under-five mortality in the aftermath of Millennium Development Goal in Eastern Ethiopia.

BACKGROUND: Although Ethiopia was applauded for achieving the Millennium Development Goal (MDG) target of reducing child mortality, whether the gains sustained beyond the MDG era was rarely studied. In this study, we reported the trends and determinants of under-five mortality (U5M) from 2015 to 2020 in a population based cohort under the Kersa Health and Demographic Surveillance System (HDSS), eastern Ethiopia. METHODS: We followed pregnant women and their pregnancy outcomes from 2015 to 2020. Each year, data related to death and live births among the follow up population was retrieved. Automated verbal autopsy (InterVA-4) was used to assign the cause of death and Stata 14 was used for analysis. U5M rate was calculated as death among under five children divided by all live births during the study period and described per 1000 live births along with 95% Confidence Interval (CI). A multivariable Cox proportional regression model was used to identify determinant of U5M using adjusted hazard ratio (AHR). Finally, P value <0.05 was considered for declaring statistically significant association. RESULTS: From January 2015 to December 2020, a total of 28 870 live births were registered under the Kersa HDSS, of whom 1335 died before their fifth birthday. The overall U5M rate was 46.3 per 1000 live births (95% confidence interval (CI) = 43.79-48.79), with significant increase from 27.9 in 2015 to 54.7 in 2020 (P < 0.041). Diarrheal diseases, acute respiratory tract infection including pneumonia, meningitis and encephalitis, and HIV related deaths were the leading causes of U5M. The hazard of death was higher among children born to poor household (AHR = 1.52; 95% CI = 1.27-1.81), rural residents (AHR = 6.0; 95% CI = 3.65-9.91), born to adolescent mothers (AHR = 1.41; 95% CI = 1.02-1.95), whose mother didn't receive antenatal care (AHR = 1.43; 95% CI = 1.21-1.69), were born preterm (AHR = 14.1; 95% CI = 9.96-19.89) and had low birth-weight (AHR = 1.74; 95% CI = 1.39-2.18). CONCLUSION: We found high level of U5M rate with an increasing trend in the aftermath of the praised MDG4 achievement. Achieving the ambitious U5M of 25 per 1000 live births by 2030 requires addressing diarrheal disease, and respiratory tract infections, and HIV/AIDS. Reasons behind the persistent increase over the study period require further inquiry.

Trend and Determinants of Mortality Among Women of Reproductive Age: A Twelve-Year Open Cohort Study in Eastern Ethiopia.

Background: With only less than a decade left till 2030, it is essential to research the burden and trends of women of reproductive age (WRA) mortality in order to design appropriate interventions toward achieving goal three of the sustainable development goals (SDGs), good health and well-being. For several low-income countries, such data are often lacking or sometimes extrapolated from non-representative facility-based studies. In this paper, we presented trends, causes, and determinants of mortality among reproductive-age women under follow-up for 12 years through the Health and Demographic Surveillance System (HDSS) located in eastern Ethiopia. Methods: We used 12 years of (2008 to 2019) open cohort data of women aged 15-49 living in Kersa HDSS in Eastern Ethiopia. In the HDSS, data on socio-demographic and basic household conditions are recorded for every household member at enrollment, and data on vital events such as births, deaths, and migration were collected and updated biannually as the event happened. Mortality was determined by automated verbal autopsy (InterVA) algorism. We assessed trends in women's reproductive age mortality and the associated determinants using crude and adjusted Cox regression models. Results: In the 12-years cohort, we followed 74,790 women of reproductive age for 339,909.26 person-years-at-risk of observation (PYO), of whom 919 died. Overall, the standardized mortality rate was 270 per 100,000 PYO. There was a notable increase in mortality in the first 3 years (2009 to 2011) which then declined significantly (p = 0.0001) until 2019. Most of the deaths were caused by HIV/AIDS (27.88%) and pulmonary tuberculosis (10.62%). In the adjusted Cox regression analysis, the hazard of death was higher among rural residents (AHR, 2.03: 95% CI: 1.60-2.58), unemployed women (AHR, 1.50: 95% CI: 1.19-1.89), and women with no formal education (AHR, 1.24: 95% CI: 1.01-1.52). Conclusion: The study showed a high number of women of reproductive age are still dying mainly due to causes for which preventable strategies are known and have been successfully implemented. The study identified that the main causes of death were related to HIV/AIDS and tuberculosis, and there was a higher hazard of mortality among rural residents, unemployed women, and those with no formal education, who need effective implementation in achieving the SDG three.

Predictors of Mortality Among Adult HIV-Infected Patients Taking Antiretroviral Therapy (ART) in Harari Hospitals, Ethiopia.

INTRODUCTION: Despite the world has made efforts, the reduction of acquired immunodeficiency syndrome (AIDS) related mortality by giving antiretroviral therapy (ART), still HIV/AIDS is killing people while they are on ART. However, the current progress and associated factors of mortality among ART-taking patients are hardly available. Therefore, this study was aimed to determine predictors of mortality among HIV-infected adult patients after starting antiretroviral therapy in Harar Hospitals, Harari region, Ethiopia. METHODS: A facility-based retrospective cohort study was employed with randomly selected 610 medical records of HIV patients on antiretroviral therapy (ART). Adjusted hazard ratio (AHR) with 95% confidence interval (CI) was used to identify predictors of mortality using multivariate Cox proportional hazard model. RESULTS: Among 610 medical records analyzed with a total of 1410.7 follow-up years, 67 (11%) deaths were found giving an overall mortality rate of 4.75 per 100 person-years. The independent predictor of mortality identified was ambulatory/bedridden functional status (AHR=2.48; 95% CI: 1.43-4.28), taking other than Tenofovir-based regimen (AHR=2.5,95% CI; 1.04-5.94), not taking isoniazid preventive therapy (IPT) (AHR=2.8; 95% CI: 1.61,4.71), hemoglobin <11g/dl (AHR=3.33,95% CI 1.94-5.69), and poor adherence to ART (AHR= 3.62, 95% CI: 1.87-7.0). CONCLUSION: This study demonstrated that poor ART adherence, not taking IPT, and initiating ART with a non-Tenofovir-based regimen and low hemoglobin count were significantly associated with the risk of death. For this reason, addressing these all significant predictors is essential to prevent early death.

Survival and Predictors of Mortality Among HIV Positive Adult Patients on Highly Active Antiretroviral Therapy in Public Hospitals of Kambata Tambaro Zone, Southern Ethiopia: A Retrospective Cohort Study.

BACKGROUND: Human Immune Deficiency Virus (HIV) infection remains the leading cause of morbidity and mortality. In Ethiopia, despite test and treat all HIV positives are adopted, a significant number of people eligible for Anti-Retroviral Therapy (ART) show up with advanced disease and at lower CD4 count. There is currently paucity of studies conducted that investigate predictors of mortality among adults on ART in the study area. OBJECTIVE: To explore Survival and predictors of mortality among adult HIV-positive patients on ART in Kambata Tambaro Zone, Ethiopia, from August 2013 to February 2019. METHODS: A health facility-based retrospective cohort study was conducted among records of 467 adult HIV-positive patients on ART selected using simple random sampling. Data were collected using standardized abstraction tool. Kaplan-Meier, Log rank tests and Cox regression model was applied to estimate survival status and identify predictors of mortality, respectively. RESULTS: Of the total 467 study subjects, 59 (12.63%) of them died in the study period. The median follow-up time of the cohort was 40.1 (IQR=13.6-59.0) months. The mortality rate of the cohort was 4.1 per 100 PYO. The overall survival probability of the cohort was 84.38% (95 CI=80.08-87.82) at 66 months. Bedridden function AHR=3.0 (95% CI, 1.44-6.64), Fair-adherence AHR=3.3 (95% CI, 1.50-7.07), Poor-adherence AHR=3.8 (95% CI, 1.88-7.96), presence of OIs AHR=4.2 (95% CI, 1.98-8.50), Late diagnosis (CD4 count >/=350) AHR=3.0 (95% CI, 1.91-6.42) and Immunologic failure AHR=3.5 (95% CI, 1.41-6.29) were independent predictors of time to death in Cox-Regression. CONCLUSION: Late Diagnosis, poor adherence, being bedridden, having OI and Immunologic failure were independently associated with time to death. Early diagnosis to start treatment and emphasizing on close follow-up care to improve treatment adherence should be given special emphasis.

Low contraceptive utilization among young married women is associated with perceived social norms and belief in contraceptive myths in rural Ethiopia.

INTRODUCTION: Despite the increasingly wider availability of contraceptives and the high levels of unmet need for family planning in rural Ethiopia, contraceptive utilization among young married women is low. Studies on associated factors in Ethiopia so far have been focused on individual factors with little emphasis on socio-cultural factors. This study aimed to assess the association between contraceptive utilization and socio-cultural factors among young married women in Eastern Ethiopia. METHODS: A community-based survey was conducted among young married women aged 14-24 years. A total of 3039 women were interviewed by trained data collectors using a structured questionnaire. Adjusted Odds Ratio (AOR) with 95% Confidence Intervals (CI) was used to identify factors associated with contraceptive utilization using multivariable logistic regression analysis. RESULTS: The current contraceptive prevalence rate was 14.1% (95% CI: 12.8-15.5). Perceived social approval (AOR = 1.90; 95% CI = 1.60-2.30) and perception of friends' contraceptive practice (AOR = 1.34; 95% CI: 1.20-1.54) were significantly and positively associated with contraceptive utilization. On the contrary, increased score of belief in contraceptive myths was significantly and negatively associated with contraceptive use (AOR = 0.60; 95% CI: 0.49-0.73). Moreover, recent exposure to family planning information (AOR = 1.67; 95% CI: 1.22-2.28), ever-mother (AOR = 9.68; 95% CI: 4.47-20.90), and secondary and above education level (AOR = 1.90; 95% CI: 1.38-2.70) were significantly associated with higher odds of contraceptive utilization. CONCLUSION: Only about one-in-seven young married women were using contraceptive methods. Socio-cultural factors significantly influence young married women's contraceptive utilization. Interventions to address social norms and pervasive myths and misconceptions could increase the use of contraceptive methods in young married women.

Clinical Outcome and Predictors of Intestinal Obstruction Surgery in Ethiopia: A Cross-Sectional Study.

BACKGROUND: Despite the advancement in the healthcare system, the impact of surgical interventions on public health systems will continue to grow. But predicting the outcome is challenging. Concerns related to unexpected outcomes and delays in the diagnosis of postoperative complications are the major issue. Intestinal obstruction is a common life-threatening surgical condition followed by fatal and nonfatal postoperative complications. This study was aimed at assessing results after surgery for intestinal obstruction in a hospital of Ethiopia. Methodology. An institutional-based cross-sectional study was conducted among 254 postoperative patients admitted with intestinal obstruction from January 1, 2014, to December 31, 2017. Data were coded and entered into EpiData 4.2.0.0 software and exported to the Statistical Package for the Social Sciences version 22 for analysis. A binary logistic regression model was used for analysis. All variables with a p value < 0.25 during bivariable analysis were considered for multivariable logistic regression analysis. RESULTS: The magnitude of poor surgical outcome of intestinal obstruction was 21.3% for patients enrolled into this investigation. The age group of ≥55 years (adjusted odds ratio (AOR) = 2.9, 95% CI: 1.03, 8.4), duration of illness of ≥24 hrs (AOR = 3.1, 95% CI: 1.03, 9.4), preoperative diagnosis of a gangrenous large bowel (AOR = 3.6, 95% CI: 1.3, 9.8), and a gangrenous small bowel (AOR = 4.2, 95% CI: 1.3, 13.7) were significantly associated with poor surgical outcome. CONCLUSIONS: The magnitude of poor surgical outcome was high. Age, late presentation of illness, and gangrenous bowel obstructions were significantly associated with poor outcomes. So, concern should be given in early detection and follow-up of patients who came late and older patients.

Modern Contraceptive Utilization and Its Associated Factors among Indigenous and Nonindigenous Married Women of Reproductive Age Group in Jigjiga Town, Eastern Ethiopia, 2018.

BACKGROUND: The use of birth control and its promotion has potential benefits of reducing poverty, maternal, and child mortality. However, there is limited evidence regarding modern contraceptive utilization among indigenous and nonindigenous married women of the reproductive age group in Ethiopia. Therefore, this study aimed to assess the magnitude of modern contraceptive utilization and its associated factors among indigenous and nonindigenous married women in Eastern Ethiopia. Methodology. A community based comparative cross-sectional study design was conducted among married women of the reproductive age group from February 01 to March 01/2018 in Jigjiga town, Eastern Ethiopia. A total of 1004 married women were selected using a simple random sampling method. The collected data were entered into EpiData software version 3.1 and exported to SPSS version 22.0 for analysis. Bivariable and multivariable logistic regression analyses were used to identify the associated factors. Statistical significance was declared using 95% confidence interval and p value of less than 0.05. RESULT: A total of 987 study participants were included in the study with a response rate of 98.3%. The overall prevalence of modern contraceptive utilization among married reproductive age group women was found to be 19.9% (95% CI (17.4%-22.3%) with 26.5% and 11.4% for nonindigenous and indigenous women, respectively. Primary level of education (AOR 0.84; 95% CI (0.15-0.85) p 0.0001) and Somali in ethnicity (AOR 0.75; 95% CI (0.15-0.94) p 0.03) were associated factors among indigenous group, while age group 30-34 years (AOR 1.56; 95% CI (1.31-9.52) p 0.02) and being a housewife in occupation (AOR 0.49; 95% CI (0.42-0.96) p 0.04) were the associated factors among the nonindigenous group. CONCLUSION: Overall utilization of modern contraceptives was approximately one-fifth, with markedly lower use among indigenous participants. One-third of nonindigenous and less than one-seventh of indigenous were utilizing modern contraceptive methods. There is a need to further explore and understand the factors across indigenous and nonindigenous women for the use of modern contraceptives; hence, a longitudinal study is desirable.

Time of recovery and associated factors of children with severe acute malnutrition treated at outpatient therapeutic feeding program in Dire Dawa, Eastern Ethiopia.

BACKGROUND: The outpatient therapeutic feeding program is one dimension of the Community Based Management of Acute Malnutrition (CMAM) that provides screening, diagnostic and treatment services for children with Severe Acute Malnutrition (SAM). However, little is known about the program outcomes and factors affecting time to recovery. OBJECTIVES: To determine median time of recovery and associated factors among under-five children with SAM treated at outpatient therapeutic feeding unit in Dire Dawa, Eastern Ethiopia from January 1st, 2013 to December 31st, 2016. METHODS: A facility-based retrospective cohort study supplemented with qualitative inquiry was conducted to analyze the records of 713 under-5 children with SAM that were randomly selected from four health centers and one hospital in Dire Dawa. In-depth interviews were conducted with five health professionals. Data was collected from the nutrition registration log book by using structured check lists. The collected data were entered into EPI-data version 3.1 software and exported to SPSS version 23 for analysis using Kaplan Meir and Cox proportional hazard regression. RESULTS: The overall recovery rate was 569 (79.8%). Eighty (11.2%) defaulted, 27 (3.8%) were non-responders, 4 (0.6%) died and 15 (2.1%) were transferred-out. The median recovery time was 8.7 weeks (IQR: 5.0-14 weeks). Children with an admission weight of ≥7kg (AHR = 1.73, 95% CI: (1.41-2.14), children who were dewormed (AHR = 1.44, 95% CI: (1.01-2.06) and children with weight gain of ≥8g/kg/day (AHR = 5.76, 95% CI: (4.51-7.38) had higher probability of recovering faster. However, marasmic children stayed longer in treatment (AHR = 0.51, 95% CI: (0.37-0.71) and a low Plumpy Nut consumption rate (g/day) (AHR = 0.79) was associated with longer time of stay on treatment. CONCLUSION: The recovery rate was within the level specified in the Sphere International standards which is >75%. A higher weight at admission, taking deworming and a steady weight gain were positively associated with a fast recovery time. Appropriate nutritional therapy and management of SAM as per the national protocol will be helpful to overcome lower weight gain and higher length of stay on treatment.

Unmet Need for Contraception Among Young Married Women in Eastern Ethiopia.

PURPOSE: Addressing the contraceptive needs of young married women is critical to improve their health and well-being. In patriarchal societies, young married women are under intense pressure to demonstrate their fecundity. Therefore, research that specifically address the needs for contraception of young married women have been generally given less emphasis in Ethiopia. This study assessed the extent of unmet needs for contraception and its associated factors among young married women in Eastern Ethiopia. METHODS: A community-based cross-sectional study was conducted among young married women (14-24 years of age) in Eastern Ethiopia. Data were collected using a structured questionnaire. The prevalence ratio (PR) with 95% confidence intervals (CIs) was calculated, and factors associated with unmet needs for contraception were identified using log-binomial regression statistical model. RESULTS: Among 2933 young women interviewed, the unmet need for contraception was 1014 (34.6%; 95% CI, 32.9%-36.4%). The prevalence of unmet needs for contraception decreased with increased young women's household decision-making autonomy score (APR= 0. 76; CI=0.62-0.94). Exposure to family planning (FP) information during the last 12 months (APR= 1.24; CI=1.1-1.42), age 18 or more years (APR=1.25; CI=1.04-1.5), multiparty (APR= 1. 9; CI=1.7-2.1) and desire to have 5 children or lesser than 5 children (APR= 1. 2; CI=1.06-1.32) were associated with higher prevalence of unmet needs for contraception. CONCLUSION: One-third of married young women had unmet needs for contraception. More efforts to empower women to make decisions that affect their own life and providing appropriate family planning information are necessary to reduce the burden of unmet needs among young married women in rural settings in Ethiopia.

Patterns of sexual risk behavior among undergraduate university students in Ethiopia: a cross-sectional study.

INTRODUCTION: As part of the young age bracket, undergraduate university students are exposed to a range of risky behaviors including HIV/AIDS. Given the paucity of data among the risk behaviors of African university students, this study was conducted to examine the sexual risk behaviors of this group in Ethiopia. METHODS: A self-administered questionnaire was used to collect information on socio-demographic and sexual risk behavior characteristics among 1,286 undergraduate students at Haramaya University, Ethiopia from March to April, 2010. Multivariate logistic regression models were used to derive adjusted odds ratios (OR) and 95% confidence intervals (95% CI). RESULTS: About 355 (28%; 95% CI 25.5-30.5) students reported to have had sexual intercourse at least once. More proportion of male students ever had sex compared to females (OR 4.8; 95% CI 3.4-6.8, p<0.001). One fifth (22.8%) of these students had their sexual debut after they joined university. About six percent of students with sexual experience reported having had intercourse with same-sex partners. Half of the males with sexual experience had intercourse with a commercial sex worker. About 60% of students reported to have used a condom rarely. CONCLUSION: Our findings indicate that there is a high level of sexual risk behavior among the study population. Significant proportion of students were sexually active, the majority started sexual intercourse before they joined university. We recommend awareness campaigns and interventions on sexual and reproductive health issues for high school and university students in Ethiopia.