Health care providers' preparedness and health care protection against the third wave of COVID-19 pandemics in a resource-limited setting in Southwest Ethiopia: a multi-center cross-sectional study.

Introduction: the provision of quality health care during the COVID-19 pandemic depends largely on the health of health care providers. Health care providers as frontline caregivers dealing with infected patients play a significant role in limiting the outbreak of the disease by implementing safety and prevention practices. However, low and middle-income countries experience barriers to preparedness due to limited resources. Methods: an institutional-based cross-sectional study was conducted among 326 health care providers from August 10-25, 2021 in Gurage zonal public hospitals. A simple random sampling technique was used to select the study participants. A pretested self -administered structured questionnaire was used as a data collection tool. The data were entered into the Epi-data 3.1 and exported to Statistical package for the social sciences (SPSS) version 25.0 for analysis. Both descriptive statistics and inferential statistics were presented. Results: this study showed that 53.1%, of health care providers, had adequate preparation against COVID-19 pandemics. The finding showed that monthly income, occupation, and working experience were found to be significantly associated with health care providers' preparedness. Nearly one-quarter (24.8%), 28.3%, 34.5%, and 39.8% of health care providers had access to facemasks, alcohol sanitizer, glove, and isolation gowns respectively. Conclusion: the levels of health care providers' preparedness and health care protection against the third wave COVID-19 pandemic were found to be low. Based on our findings, the government and other stakeholders should design interventions to increase health care providers' preparedness to respond to the ongoing pandemic and purchase an adequate supply of personal protective equipment to protect the health care providers.

Anemia and its predictors among chronic kidney disease patients in Sub-Saharan African countries: A systematic review and meta-analysis.

INTRODUCTION: Anemia is a serious complication of chronic kidney disease (CKD) with a significant adverse outcome on the burden and progression of the disease. Hence, the study intended to assess the pooled prevalence of anemia and its predictors among CKD patients in Sub-Saharan African nations. METHODS: To identify the relevant studies systematic searches were carried out in Medline, EMBASE, HINARI, Google Scholar, Science Direct, and Cochrane Library. From selected studies, data were taken out with a standardized data extraction format prepared in Microsoft Excel. Inverse variance (I2) tests were employed to evaluate the heterogeneity across the included studies. Due to substantial heterogeneity among the studies, a random-effects meta-analysis technique was employed to estimate the pooled prevalence of anemia. Subgroup analysis, sensitivity analysis, and meta-regression analysis were carried out to search the possible bases of heterogeneity. Funnel plot symmetry, Begg's test, and Egger's regression test were employed to assess the existence of publication bias. In addition, factors associated with anemia among CKD patients were examined. All statistical analyses were carried out with STATA™ Version 14 software. RESULTS: A total of 25 studies with 5042 study participants were considered in this study. The pooled prevalence of anemia among CKD patients was estimated to be 59.15% (95% CI, 50.02-68.27) with a substantial level of heterogeneity as evidenced by I2 statistics (I2 = 98.1%; p < 0.001). Stage of CKD (3-5) (pooled odds ratio (POR) = 5.33, 95% CI:4.20-6.76), presence of diabetes mellitus (POR = 1.75, 95% CI: 1.10-2.78), hemodialysis history (POR = 3.06, 95% CI: 1.63-5.73), and female sex (POR = 2.50, 95% CI: 1.76-3.55) were significantly related with anemia. CONCLUSIONS: More than half of CKD patients were suffering from anemia. Stage of CKD, presence of DM, hemodialysis history, and being female sex were factors associated with anemia among CKD patients.

Lifespan and Associated Factors of Peripheral Intravenous Cannula Among Hospitalized Children in Public Hospitals of the Gurage Zone, Ethiopia, 2021.

Background: Peripheral intravenous cannulas are routinely used in hospital-admitted children requiring intravenous therapy. The majority of peripheral IVC lines are removed before completion of therapy due to cannula complications in children. Peripheral intravenous cannula securing is a painful procedure for children, so recognizing the variables associated with the peripheral intravenous cannula lifespan would help decrease the complications and increase the duration of cannula patency. Objective: The main aim of this study was to determine the lifespan and associated factors of peripheral intravenous cannula among hospitalized children in Gurage zone public hospitals, Ethiopia, 2021. Methods: We conducted an institution-based cross-sectional study design among 422 admitted children in public hospitals of the Gurage zone using a systematic random sampling technique. We collected data from interviews of parents using structured questionnaires and direct observations using checklists. The data was coded and entered into EPI-DATA version 3.1 and exported to SPSS version 25 for analysis. Bivariable and multivariable analysis was used by using a binary logistic regression model. Finally, the variables with a p-value of <0.05 with a 95% confidence interval (CI) from the multivariable analysis were considered statistically significant. Results: One hundred and sixty-six children (41.4%) had a short cannula lifespan (below 30 h). Multivariable logistic regression analysis showed that neonatal intensive care unit (NICU) [AOR = 4.975; 95% CI (2.811-8.805)], reason for removal (complication) [AOR = 3.277; 95% CI (1.924-5.583)], fluid [AOR = 2.285; 95% CI (1.274-4.100)], and blood transfusion [AOR = 2.407; 95% CI (1.005-5.572)] were the statistically significant variables associated with the lifespan of a peripheral intravenous cannula. Conclusion and Recommendation: The proportion of the short lifespan of the peripheral intravenous cannula was higher in hospitalized children and health care providers better to use low concentration electrolytes, low osmotic pressure, and weak alkalinity fluid. The cannula access might be the responsibility of the health-trained staff, and conserving immediate removal upon the presence of a signal that indicates a complication.

Levels and predictors of anxiety, depression, and stress during COVID-19 pandemic among frontline healthcare providers in Gurage zonal public hospitals, Southwest Ethiopia, 2020: A multicenter cross-sectional study.

INTRODUCTION: The provision of quality health care during the COVID-19 pandemic depends largely on the health of health care providers. However, healthcare providers as the frontline caregivers dealing with infected patients, are more vulnerable to mental health problems. Despite this fact, there is scarce information regarding the mental health impact of COVID-19 among frontline health care providers in South-West Ethiopia. OBJECTIVE: This study aimed to determine the levels and predictors of anxiety, depression, and stress during the COVID-19 pandemic among frontline healthcare providers in Gurage zonal public hospitals, Southwest Ethiopia, 2020. METHODS: An institutional-based cross-sectional study was conducted among 322 health care providers from November 10-25, 2020 in Gurage zonal health institutions. A simple random sampling technique was used to select the study participants. A pretested self -administered structured questionnaire was used as a data collection technique. The data were entered into the Epi-data version 3.01 and exported to SPSS version 25.0 for analysis. Both descriptive statistics and inferential statistics (chi-square tests) were presented Bivariable and Multivariable logistic regression analyses were made to identify variables having a significant association with the dependent variables. RESULTS: The results of this study had shown that the overall prevalence of anxiety, depression and stress among health care providers during the COVID-19 pandemic was 36%, [95% CI = (30.7%- 41.3%)], 25.8% [95% CI = (21.1%- 30.4%)] and 31.4% [95% CI = (26.4%- 36.0%)] respectively. Age, Adjusted Odds Ratio [AOR = 7.9], Educational status, [AOR = 3.2], low monthly income [AOR = 1.87], and presence of infected family members [AOR = 3.3] were statistically associated with anxiety. Besides this, gender, [AOR = 1.9], masters [AOR = 10.8], and degree holder [AOR = 2.2], living with spouse [AOR = 5.8], and family [AOR = 3.9], being pharmacists [AOR = 4.5], and physician [AOR = (0.19)], were found to be statistically significant predictors of depression among health care providers. Our study finding also showed that working at general [AOR = 4.8], and referral hospitals [AOR = 3.2], and low monthly income [AOR = 2.3] were found to be statistically significant predictors of stress among health care providers. CONCLUSION: Based on our finding significant numbers of healthcare providers were suffered from anxiety, depression, and stress during the COVID-19 outbreak. So, the Government and other stakeholders should be involved and closely work and monitor the mental wellbeing of health care providers.

Association of glycemic control and anthropometric measurement among type 2 diabetes mellitus: a cross-sectional study.

INTRODUCTION: Maintaining good glycemic control is the main therapeutic target for diabetes mellitus (DM) patients. Nevertheless, due to complex factors, the majority of patients worldwide persist poorly controlled. Hence the study was conducted to determine the association of anthropometric measurement and other factors with glycemic control among type 2 DM patients. METHODS: An institutional-based cross-sectional study was conducted among 366 type 2 DM patients from October-1 to November 30/2019. Data were collected by a pre-tested structured questionnaire and data abstraction format. The collected data were edited in Epi-data-4.4.1.0 and exported to SPSS-25 for analysis. The degree of association was assessed using logistic regression analysis and expressed in terms of p value and odds ratio with a 95%CI. p value < 0.05 was considered statistically significant. RESULTS: Of the total 366 participants, (66.1%) had poor glycemic control. Increased waist circumference (AOR 2.37, 95% CI 1.28-4.40 for overweight and AOR 3.31, 95% CI 1.28-8.58 for obesity), long duration of DM (AOR 2.12, 95% CI 1.14-3.95 for 5-10 years and AOR 5.67, 95% CI 1.76-11.30 for > 10 years), occupation (AOR 3.74, 95% CI 1.94-7.23 for government employee and AOR 4.90, 95% CI 2.19-10.94 for private employee), and family history of DM (AOR 1.93, 95% CI 1.08-3.43), were significantly associated with poor glycemic control. CONCLUSION: Nearly two-thirds of study participants had poor glycemic control. Increased waist circumference, long duration of DM, occupational status, and family history of DM were independently associated with poor glycemic control. Therefore, type 2 DM patients with these identified factors should be strictly monitored to maintain good glycemic control.

Knowledge, Attitude, and Practices of Parents About Immunization of Infants and Its Associated Factors in Wadla Woreda, North East Ethiopia, 2019.

INTRODUCTION: Improving infant immunization coverage and timeliness is a key health policy objective in many developing countries such as Ethiopia. Despite this, full immunization coverage in Ethiopia becomes low with the concurrent significant burden of vaccine-preventable diseases among infants. A previously published study acknowledged that parental knowledge, attitude, and practice towards infant immunization are vital issues to improve coverage and influence uptake. OBJECTIVE: To assess parents' knowledge, attitude, practice, and its associated factors regarding immunization of infants at Wadla Woreda, North East Ethiopia, 2019. MATERIAL AND METHODS: A community-based cross-sectional study was employed among 418 parents from March to April 2019 in Wadla Woreda, North East Ethiopia. A stratified sampling technique was used to approach the study subjects. An interviewer-administered structured questionnaire was used. The collected data were cleaned, coded, and entered in EPI-Info 7.2 and transferred to SPSS version 25.0 for analysis. Binary logistic regression analyses were performed to identify variables having a significant association with parental knowledge, attitude, and practice. Variables with a p-value of ≤0.05 and AOR with 95% CI were declared as having a statistically significant association during multivariable logistic regression analysis. RESULTS: In this study, 65.1%, 57.3%, and 55.3% of the parents had good knowledge, a favorable attitude, and good practice towards infant immunization, respectively. Parent's educational status (AOR=5.330), urban residency (AOR=2.788), favorable attitude (AOR=4.308) and got immunization service two-three times (AOR=3.227) and four-five times (AOR=2.254) were statistically associated with knowledge of parents. Parents who attend primary school [AOR=0.451) and secondary school [AOR=0.320), parents who were mothers of the child [AOR=3.813), and respondents who had good knowledge about infant immunization (AOR= 4.592) were significantly associated with a favorable parental attitude. Infant immunization practice was significantly associated with parental education who attend primary school (AOR=2.513), secondary school (AOR=2.546) and higher education (AOR=11.988), parents who had good knowledge of infant immunization (AOR= 4.206), and short waiting time (AOR=3.881). CONCLUSION AND RECOMMENDATION: Parental KAP towards infant immunization was found to be lower than most of the study findings quoted in this study. Improving the knowledge, attitude, and practice of parents about immunization and vaccine-preventable diseases was recommended by providing health education and health promotion interventions.

Platelet Indices and Its Association with Microvascular Complications Among Type 2 Diabetes Mellitus Patients in Northeast Ethiopia: A Cross-Sectional Study.

PURPOSE: Platelet indices have been shown to be associated with complications of diabetes mellitus (DM). However, the clinical relevance of platelet indices for assessing the risk of being microvascular complications among patients with DM is largely overlooked. Hence this study aimed to determine the association of platelet indices with microvascular complications among type 2 DM patients. PATIENTS AND METHODS: A hospital-based cross-sectional study was conducted among 352 type 2 DM patients from April 1 to May 30/2019 at Debre Berhan Referral Hospital. Data were collected by interview, physical measurements, document review, and laboratory tests. Then the data were entered into Epi-data manager-4.4.1.0 and exported into SPSS-25 for analysis. Platelet indices were compared between participants with and without microvascular complications using an independent t-test. A logistic regression model was used to assess the association between microvascular complications and platelet indices. All inferences were considered statistically significant at P<0.05. RESULTS: One hundred seventeen (33.2%) of participants were suffering from at least one microvascular complications. The mean platelet volume (MPV), platelet distribution width (PDW), and platelet-large cell ratio (P-LCR) were significantly increased in DM patients with complications as compared to without complications (13.57±2.17fl vs. 11.76±1.93fl), (16.57±2.49fl vs. 14.97±2.41fl) and (28.09±7.58% vs. 24.19±6.46%), respectively (all are P˂0.001). In multivariate logistic regression analysis, MPV (AOR=1.68, 95% CI: 1.37-2.05), PDW (AOR=1.37, 95% CI: 1.15-1.63), P-LCR (AOR=1.07, 95% CI: 1.01-1.14), age (AOR=1.07, 95% CI: 1.01-1.12), and duration of DM (AOR=1.31, 95% CI: 1.18-1.46) were significantly associated with the presence of microvascular complications. CONCLUSION: MPV, PDW, and P-LCR were significantly higher among type 2 DM patients with microvascular complications. This indicates that platelet indices can be used as prognostic markers of vascular complications and can be used as simple and cost-effective parameters to predict microvascular complications particularly in patients with old age and long duration of DM.