Factors associated with hypertension among diabetic patients in Gamo Zone, Southern Ethiopia, 2021: case-control study.

The prevalence of hypertension in diabetic patients is nearly twice that of non-diabetic patients. The presence of both hypertension and diabetes accelerates complications and raises the risk of death. Thus, identifying determinants of hypertension in diabetic patients is critical for preventing the development of devastating acute and chronic complications, as well as diabetes-related death. Methods and materials: A case-control study was carried out in public hospitals of Gamo Zone, Southern Ethiopia. To select study participants, a systematic random sampling technique was used. The KOBO toolbox was used to collect data, which was then exported to the IBM SPSS version 25 software package for analysis. Bivariate and multivariable logistic regression analyses were performed to identify factors associated with hypertension in diabetes patients, and variables in the multivariable logistic regression analysis with a P value less than 0.05 were declared significantly associated at a 95% CI. Results: In this study, age greater than or equal to 50 years [adjusted odd ratio (AOR)=4.08, 95% CI (1.41, 11.82)], higher body mass index [AOR=3.23, 95% CI (1.40, 7.66)], and higher waist to hip ratio [AOR=2.15, 95% CI (1.12, 4.13)] were significantly associated with hypertension in diabetic patients. Conclusions: This study found that factors associated with hypertension among diabetic patients included older age (>50 years), a high waait to st#to#hip ratio, and a higher body mass index. The concerned health authorities and healthcare providers in the study area should focus on those identified factors to prevent hypertension among diabetic patients.

Dangers associated with assuming robustness of scale reliability and validity: Psychometric properties of the Barkin Index of Maternal Functioning with Ethiopian mothers.

This study was conducted to assess the psychometric properties of the Barkin Index of Maternal Functioning (BIMF) in an Ethiopian context. Data were obtained from 202 women with a child less than 1 year of age. Narrow standard deviations characterized responses to most BIMF items, but a handful of items had wider standard deviations associated with bimodality. Most interitem correlations were < |.15|, and 13 of the 20 BIMF items did not load satisfactorily on any factor in exploratory factor analyses. Two factors emerged from the remaining items, one with three items and the other with four. Although poor reliability results relating to internal (interitem) and temporal consistency could be attributed to limited variability in the data, a number of concerns are raised about the BIMF itself, including its content validity, instructions, response options, and usefulness in healthcare settings. Suggestions are made for improving the assessment of maternal functioning in Ethiopia and other contexts. More generally, this research demonstrates that researchers should not assume that the psychometric properties and appropriateness of scales will remain robust when those scales are used in contexts that differ from the contexts in which they were created.

Perceived Social Support and Associated Factors Among Adults Living with HIV/AIDS Attending ART Clinic at Public Hospitals in Gamo Zone, Southern Ethiopia 2021.

Background: HIV/AIDS remains one of the world's serious public health challenges. Patients with limited support from their family and community often experience social damage, poor adherence, compliance and are prone to additional psychosocial problems. This study aimed to assess the level of perceived social support and factors among adults living with HIV/AIDS. Methods: Facility-based mixed study (sequential explanatory) design was conducted among 423 adults living with HIV/AIDS attending chronic care follow-up at public hospitals in Gamo zone, southern Ethiopia. Respondents were selected by systematic sampling technique. The bivariable and multivariable ordinal logistic regression was used to determine associated factors. All assumptions applied to ordinal logistic regression including multicollinearity, proportional odds, model fitness and pseudo R2 were checked. Level of significance was declared at p-values <0.05 and 95% CI. Results: Proportion of perceived social support of participants was 128 (30.7%), 197 (47.2%) and 92 (22.1%) with low, moderate and high levels of perceived social support, respectively. Females [(APOR = 2.42, 95% CI:(1.63-3.58), P < 0.001)], no formal education [(AOR = 0.49, 95% CI: (0.30-0.789), P = 0.004)], fair adherence [(APOR = 2.07, 95% CI: (1.17-3.49), P = 0.006)], no comprehensive knowledge about HIV [(APOR = 0.40, 95% CI: (0.26-0.62), P < 0.001)], and no disclosure status [(APOR = 0.64, 95% CI: (0.43-0.95), P = 0.028] were significantly associated with perceived social support. Qualitative findings revealed that disclosure and adherences involving income generation activities are beneficial to perceived social support. Conclusion: This study showed that one from three of the participants had low perceived social support. Low perceived social support was associated with adherence, disclosure status of individual, educational status and knowledge about HIV/AIDS. Family, friends, health care providers and significant others should provide necessary support and inform people living with HIV/AIDS (PLWHA) about social support.

Utilization of non-pneumatic anti-shock garment and associated factors for postpartum hemorrhage management among obstetric care providers in public health facilities of southern Ethiopia, 2020.

BACKGROUND: Delays in care have been recognized as a significant contributor to maternal mortality in low-resource settings. The non-pneumatic antishock garment is a low-cost first-aid device that can help women with obstetric haemorrhage survive these delays without long-term adverse effects. Extending professionals skills and the establishment of new technologies in basic healthcare facilities could harvest the enhancements in maternal outcomes necessary to meet the sustainable development goals. Thus, this study aims to assess utilization of non-pneumatic anti-shock garment to control complications of post-partum hemorrhage and associated factors among obstetric care providers in public health institutions of Southern Ethiopia, 2020. METHODS: A facility-based cross-sectional study was conducted among 412 obstetric health care providers from March 15 -June 30, 2020. A simple random sampling method was used to select the study participants. The data were collected through a pre-tested interviewer-administered questionnaire. A binary logistic regression model was used to identify determinants for the utilization of non-pneumatic antishock garment. STATA version 16 was used for data analysis. A P-value of < 0.05 was used to declare statistical significance. RESULTS: Overall, 48.5% (95%CI: 43.73, 53.48%) of the obstetric care providers had utilized Non pneumatic antishock garment for management of complications from postpartum hemorrhage. Training on Non pneumatic antishock garment (AOR = 2.92; 95% CI: 1.74, 4.92), working at hospital (AOR = 1.81; 95% CI: 1.04, 3.16), good knowledge about NASG (AOR = 1.997; 95%CI: 1.16, 3.42) and disagreed and neutral attitude on Non pneumatic antishock garment (AOR = 0.41; 95%CI: 0.24, 0.68), and (AOR = 0.39; 95% CI: 0.21, 0.73), respectively were significantly associated with obstetric care provider's utilization of Non-pneumatic antishock garment. CONCLUSIONS: In the current study, roughly half of the providers are using Non-pneumatic antishock garment for preventing complications from postpartum hemorrhage. Strategies and program initiatives should focus on strengthening in-service and continuous professional development training, thereby filling the knowledge and attitude gap among obstetric care providers. Health centers should be targeted in future programs for accessibility and utilization of non-pneumatic antishock garment.

Exploring Barriers to Effective Implementation of Public Health Measures for Prevention and Control of COVID-19 Pandemic in Gamo Zone of Southern Ethiopia: Using a Modified Tanahashi Model.

BACKGROUND: Since the occurrence of the COVID-19 pandemic, different public health measures have been implemented to prevent and control the further spread of the disease. However, barriers that influence the effective implementation of public health measures were not explore in Ethiopia especially in study Area. Therefore, this study tried to fill this gap by exploring the barriers to effective implementation of public health measures for prevention and control of the COVID-19 pandemic in the Gamo Zone of southern Ethiopia. METHODS: The study employed a qualitative study with a phenomenology approach among purposely selected 30 individuals in the community and selected institutions. Key informant interview was used to collect the data. The data were transcribed verbatim and translated into the English language. The transcribed data were read several times to clearly understand the content for further analysis. The analysis of the data was conducted based on the modified Tanahashi framework. RESULTS: The study identified different barriers under five main themes: accessibility, acceptability, availability, contact and use, and effective implementation of public health measures related to barriers. The main barriers to effective implementation of public health measures were resistance to change, negligence, lack of community engagement, insufficient training for front line workers, poor supportive supervision, poor law enforcement, and lack of continuous community awareness creation. Beside, acceptability related barriers like cultural and religious norms and availability related barriers like shortage of personal protective equipment and shortage of skilled health professional have also lion share barriers for implementation of the public health measures. CONCLUSION: The study identified different personal, institutional, and societal level barriers for effective implementation of public health measures for the COVID-19 pandemic. Therefore, proper and targeted continuous community awareness creation with further mandatory law enforcement activities should be implemented by the concerned bodies to mitigate individual and societal level barriers. In addition, the government with relevant stakeholders should give due attention to equip and protect the frontline professionals by availing the necessary logistic and provision of continuous capacity-building activities.

Breast self-examination practice and its determinants among women in Ethiopia: A systematic review and meta-analysis.

BACKGROUND: The survival rate from breast cancer is lowest in African countries and the distribution of breast self-examination practice of and its determinants are not well investigated in Ethiopia. Therefore, this systematic review and meta-analysis was designed to determine the pooled prevalence of breast self-examination and its associated factors among women in Ethiopia. METHODS: Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was followed for this systematic review and meta-analysis. The databases used were; PUBMED, Cochrane Library, Google Scholar, CINAHL, African Journals Online, Dimensions and Summon per country online databases. Search terms used were; breast self-examination, breast cancer screening, early detection of breast cancer and Ethiopia. Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI) was used for critical appraisal of studies. The meta-analysis was conducted using STATA 15 software. The pooled meta-analysis was computed to present the pooled prevalence and relative risks (RRs) of the determinate factors with 95% confidence intervals (CIs). RESULTS: We identified 2,637 studies, of which, 40 articles (with 17,820 participants) were eligible for inclusion in the final meta-analysis. The pooled estimate of breast self-examination in Ethiopia was 36.72% (95% CI: 29.90, 43.53). The regional distribution breast self-examination ranged from 21.2% (95% CI: 4.49, 37.91) in Tigray to 61.5% (95% CI: 53.98, 69.02) in Gambela region. The lowest prevalence of breast self-examination was observed among the general population (20.43% (95% CI: 14.13, 26.72)). Women who had non-formal educational status (OR = 0.4 (95% CI: 0.21, 0.77)), family history of breast cancer (OR = 2.04 (95% CI: 1.23, 3.39)), good knowledge of breast self-examination (OR = 4.8 (95% CI: 3.03, 7.6)) and favorable attitude toward breast self-examination (OR = 2.75, (95% CI: 1.66, 4.55)) were significantly associated with practice of breast self-examination. CONCLUSIONS: Only a third of women in Ethiopia practiced breast examination despite WHO guidelines advocating for this practice among all women of reproductive age. Intervention programs should address the factors that are associated with breast self-examination. Population specific programs are needed to promote breast self-examination.

Level of and associated factors for non-adherence to anti-tuberculosis treatment among tuberculosis patients in Gamo Gofa zone, southern Ethiopia: cross-sectional study.

BACKGROUND: Non-adherence to anti-TB treatment is one of the crucial challenges in improving tuberculosis (TB) treatment outcomes and reducing healthcare costs. The poor adherence to anti-TB treatment among patients with TB is a major problem in Ethiopia. This study aimed to assess the level of and associated factors for non-adherence to anti-TB therapy among patients with tuberculosis in the Gamo Gofa Zone. METHODS: A cross-sectional study was conducted at Gamo Gofa Zone from July 20 - August 30, 2017. A multi-stage sampling technique was used. The study included 289 patients who were on anti-TB treatment. Data were collected by trained data collectors using a structured and pre-tested questionnaire through interviews. A multiple logistic regression model was fitted using SPSS 23 to identify factors associated with non-adherence to anti-TB treatment at a 5% significance level. RESULTS: We found that 16.5% of the participants were non-adherent for anti-TB treatment. Failure to disclose one's TB status to his or her family (AOR = 31.7; 95% CI: 9.1-111.1), having no information on the expected adverse events (AOR = 31.1; 95% CI: 7.5-128.3), past anti-TB treatment history (AOR = 5.3; 95% CI: 1.5-18.8) and a smoking cigarette (AOR = 11.7; 95% CI: 3.2-43.03) were found to be associated with a higher odds of being non-adherent to anti-TB treatment. CONCLUSIONS: The level of non-adherence to anti-TB treatment among TB patients was high. Health care providers should counsel TB patients on the expected adverse events and measures to be taken when patients face the expected adverse events. They should also counsel their patients to disclose their TB status to his or her family and for ceasing cigarette smoking.

Community Perception and Attitude Towards People with Schizophrenia Among Residents of Arba Minch Zuria District, Arba Minch Health and Demographic Surveillance Sites System (AM-HDSS), Ethiopia: Cross-Section Study.

BACKGROUND: Mental health disorders have identified as being one of the public health issues throughout the world. Recent evidence reveals that more than 21 million people diagnosed with schizophrenia. However, there is little information about community perception and attitude towards people with Schizophrenia in Ethiopia. OBJECTIVE: The aim of this study was to assess the community perception and attitude towards people with Schizophrenia among residents of Arba Minch Zuria Districts, Southern Ethiopia. METHODS: A community-based cross-sectional study was conducted among 617 randomly selected adults. Interviewer-administered standard tool was used to collect the data. Descriptive statistics like frequency, mean, and median computed. A binary logistic regression model used to identify factors affecting community perception and attitude towards people with schizophrenia. RESULTS: Of the study population, 469 (76%) of respondents had good perception and 390 (63.2%) had positive attitudes towards people with schizophrenia. The study participants identified talkativeness and self-neglect behaviors as the most common manifestations of schizophrenia. Besides, this study identified substance misuse and head injury as the perceived cause and spiritual or traditional methods as a preferred treatment for people with schizophrenia. Moreover, the study participants preferred spiritual or traditional methods for the treatment of schizophrenia. Young age [AOR=2.03, 95% CI: 1.21, 3.40], females [AOR=2.32, 95% CI: 1.58, 3.41], good perception towards people with schizophrenia [AOR=4.95, 95% CI: 3.25, 7.54] and no formal educational status [AOR=2.75, 95% CI: 1.33, 5.70], and primary education [AOR=3.72, 95% CI: 1.87, 7.39] were significantly associated with the attitude towards people with schizophrenia. CONCLUSION: The findings of this study indicate that approximately one-third of the residents had unfavorable attitudes towards people with schizophrenia. Therefore, giving special attention to male, elders and those who were educated, and individuals who have poor perceptions of people with schizophrenia is crucial.

Community Perception and Attitude towards people with Depression among Adults Residing in Arba Minch Health and Demographic Surveillance Site (AM-HDSS), Southern Ethiopia.

BACKGROUND: Negative perception and attitude of community prevents many people with depression and their caregivers from seeking help and receiving adequate treatment due to fear of social reaction and may try to hide the illness. The reasons for negative attitudes are not consistent across communities or cultures. Therefore, understanding the level of community perception and attitude towards people with depression is important to develop an intervention to reduce the impact of mental illness. METHODS: A community-based cross-sectional study was conducted among 617 randomly selected adults. The data was collected using structured, pre-tested, and interviewer-administered questionnaires. Descriptive statistics like frequency, mean, and median were performed. Bi-variable and multivariable logistic regression analyses were performed to identify the factors that affect the community attitude towards people with depression. RESULTS: Of the study population, 325(52.7%) had a good perception and 246(39.9%) had a positive attitude towards people with depression. The majority of study participants frequently identified as the perceived cause of depression was substance misuse, loss of loved one, and conflict within a family. In addition, psychosocial treatment was the most preferred treatment for people with depression in the study area. Marital status and educational status were significantly associated with the community attitude towards people with depression. CONCLUSION: Giving special attention to people with substance misuse, loss of loved one, and conflict within a family is very vital for the prevention of depression. In addition, future mental health promotion activities should focus on cause and common manifestation of depression to improve the attitude toward people with depression.