Anti-retro viral therapy adverse drug reaction and associated factors among human immuno deficiency virus infected adult patients at Nigist Eleni Mohammed Memorial hospital, South Ethiopia.

BACKGROUND: Recent increases in access to HAART have made the management of drug toxicities an increasingly crucial component of HIV care in developing countries. The aim of this study was to determine prevalence of antiretroviral therapy adverse drug reactions and associated factors among HIV-infected adult patients at Nigist Eleni Mohammed memorial hospital. METHODS: A cross sectional study was conducted by retrospective review of patients' medical records. From a total 721 adult patient records, 231 patients record were selected by simple random sampling technique. The study was conducted April 15-25, 2015.The association between dependent and independent variables was measured by using OR at 95% CI. P-value <0.05 was considered as statistically significant. RESULT: About 53(22.9%) patients developed ADRs (adverse drug reactions). Female (AOR=2.72, CI=1.177-6.30), patients with WHO stage III and IV (AOR= 13.06, CI=4.17-40.90) were found more likely to develop ADRs. Commonly identified ADRs were fatigue (18.1%), diarrhea (7.7%), nausea (6.5%), headache (3.6%) and anemia (2%). CONCLUSION: Nearly one in five patients develop ADRs. Sex of respondents, WHO stage and functional status were associated with ADRs. The health care providers should give due attention to ambulatory, bedridden, and WHO stage III and IV patients.

Determinants of preterm birth among mothers who gave birth in East Africa: systematic review and meta-analysis.

BACKGROUND: Preterm birth (PTB) can be caused by different factors. The factors can be classified into different categories: socio demographic, obstetric, reproductive health, medical, behavioral and nutritional related. The objective of this review was identifying determinants of PTB among mothers who gave birth in East African countries. METHODS: We have searched the following electronic bibliographic databases: PubMed, Google scholar, Cochrane library, AJOL (African journal online). Cross sectional, case control and cohort study published in English were included. There was no restriction on publication period. Studies with no abstracts and or full texts, editorials, and qualitative in design were excluded. Funnel plot was used to check publication bias. I-squared statistic was used to check heterogeneity. Pooled analysis was done by using fixed and random effect model. The Joanna Briggs Critical Appraisal Tools for review and meta-analysis was used to check the study quality. RESULTS: A total of 58 studies with 134,801 participants were used to identify determinants of PTB. On pooled analysis, PTB was associated with age < 20 years (AOR 1.76, 95% CI: 1.33-2.32), birth interval less than 24 months (AOR 2.03, 95% CI 1.57-2.62), multiple pregnancy (AOR 3.44,95% CI: 3.02-3.91), < 4 antenatal care (ANC) visits (AOR 5.52, 95% CI: 4.32-7.05), and absence of ANC (AOR 5.77, 95% CI: 4.27-7.79). Other determinants of PTB included: Antepartum hemorrhage (APH) (AOR 4.90, 95% CI: 3.48-6.89), pregnancy induced hypertension (PIH) (AOR 3.10, 95% CI: 2.34-4.09), premature rupture of membrane (PROM) (AOR 5.90, 95% CI: 4.39-7.93), history of PTB (AOR 3.45, 95% CI: 2.72-4.38), and history of still birth/abortion (AOR 3.93, 95% CI: 2.70-5.70). Furthermore, Anemia (AOR 4.58, 95% CI: 2.63-7.96), HIV infection (AOR 2.59, 95% CI: 1.84-3.66), urinary tract infection (UTI) (AOR 5.27, 95% CI: 2.98-9.31), presence of vaginal discharge (AOR 5.33, 95% CI: 3.19-8.92), and malaria (AOR 3.08, 95% CI: 2.32-4.10) were significantly associated with PTB. CONCLUSIONS: There are many determinants of PTB in East Africa. This review could provide policy makers, clinicians, and program officers to design intervention on preventing occurrence of PTB.

Prevalence of active trachoma and associated factors among children aged 1 to 9 years in rural communities of Lemo district, southern Ethiopia: community based cross sectional study.

BACKGROUND: Trachoma, caused by Chlamydia trachomatis is the leading infectious cause of blindness. It is transmitted via personal contact with infected ocular and nasal secretions by hands, fomites and eye- seeking flies. Active trachoma is more common among children aged 1 to 9 years. The objective of this study was determining the prevalence of active trachoma and associated factors among children aged 1 to 9 years in rural community of Lemo district. METHODS: Community-based cross-sectional study was conducted from March to April, 2018 in rural community of Lemo district. Multistage sampling technique was used to select 589 study participants. Data were collected by using structured pre-tested questionnaire, physical examination and observation. Binocular loupe was used to identify active trachoma cases. The data were entered by using EPi-data version 3.1 and analyzed by SPSS. Binary logistic regression was used to assess factors associated with active trachoma. Variables with p-value < 0.05 in the multivariable analysis were used to declare significance of association. RESULT: Eighty seven (15.2%) children were positive for active trachoma. Absence of solid waste disposal pit (AOR = 2.20, 95% CI (1.12-4.37), do not use latrine as reported by respondent (AOR = 7.53, 95% CI (2.86-19.84), do not use soap for face washing as reported by respondent (AOR =2.3, 95% CI (1.32-4.12), washing face frequency as reported by respondent (AOR = 1.86, 95% CI (1.06-3.26), and family size greater than five (AOR = 1.96, 95% CI (1.06-3.67) were significantly associated with active trachoma. CONCLUSION: Active trachoma among children aged 1 to 9 years is high. Do not use latrine, do not use soap for face washing, and face washing frequency in a day as reported by respondents and family size were associated with active trachoma. Access to adequate water and sanitation can be important components in working towards eliminating trachoma as a public health problem. Therefore, prompt measures must be taken by concerned bodies to increase access to adequate water and sanitation facilities.

Option B plus antiretroviral therapy adherence and associated factors among HIV positive pregnant women in Southern Ethiopia.

BACKGROUND: Adherence to Option B plus Antiretroviral Therapy plays a vital role in preventing mother to child transmission of Human Immunodeficiency Virus and development of drug resistance. This study was aimed to assess adherence to option B plus ART and associated factors among HIV positive pregnant women at public Hospitals in Southern Ethiopia. METHODS: Facility based cross sectional study was conducted on HIV positive pregnant mothers attending public health facilities' antenatal care unit. Systematic random sampling technique was employed to select 290 HIV positive pregnant women enrolled in the Option B plus program. Data were collected by using structured questionnaire. Bivariate and multivariable logistic regression analysis were used to identify factors associated with option B plus ART adherence. P-value less than 0.05 was considered as cut of point to declare statistical significance. RESULTS: The overall adherence to option B plus ART among HIV positive pregnant women was 236 (81.4%). Three in twenty, (14.8%) participants were none adherent to Option B plus ART due to difficulty in adopting time schedule and forgetting to take medication. During first trimester of pregnancy, 16 (5.5%) were stopped taking ART medication due to side effects. Pregnant women who started ART at the time of HIV diagnosis [AOR = 1.99, 95% CI: (1.02, 3.95)], and who had five or more antenatal care visits [AOR = 4.10, 95% CI (1.65, 10.02)] were more likely to adhere to option B plus ART. Women who should travel 30-60 min on foot to access ART from service delivering facilities were less likely to adhere to option B plus [AOR = 0.39, 95% C I: (0.17, 0.88)]. CONCLUSIONS: The overall adherence to option B plus ART was suboptimal. Measures that improve recalling ability of individuals to take ART on time, and minimize ART side effects during first trimester of pregnancy need to be given emphasis. The study finding indicates the need for reconsidering the ad-hoc focused antenatal care visit at policy and program level by increasing the number of follow up visit with proper counseling on ART adherence benefits, and improving service accessibility.

Proximate determinants of fertility in Ethiopia; an application of revised Bongaarts model.

BACKGROUND: World population is growing at about 80 million people each year. Ethiopia is the 12th most populous country in the world. Existing literatures showed that the role of proximate determinants in inhibiting the total fertility has not yet been determined from the DHS data in the country. This study may provide evidence based information regarding the observed changes in total fertility. The objective of this study was assessing proximate determinants of fertility and the role of selected socio-economic variables in influencing fertility in Ethiopia. METHODS: The EDHS data of 2011 and 2016 were used in our study. A total of 16,515 eligible women included in 2011 and 15,683 in 2016 surveys made up the sample for the study. The roles of each of the four proximate determinants in declining fertility have been determined. The background variables selected for the analysis include: region of residence, educational status, wealth index and place of residence. The Bongaart model is used to explain the observed socio-economic differentials in fertility during the two survey years. RESULTS: In 2011, index of marriage inhibited fertility by 37.8%, however in 2016 it inhibited fertility by 34.4%. In 2011, contraceptive use reduced fertility by 28.5% while in 2016 it reduced fertility by 30.7%. The index of postpartum infecundity decreased fertility by 34.7% in 2011 and by 34.5% in 2016. Foetal wastage inhibited fertility by 9.2% in both survey years. The total fertility rate in 2016 was 4.14 whereas the projected total fertility in 2020 will be 3.2 children per woman. CONCLUSION: Among the four proximate determinants of fertility, the contribution of index of marriage was the highest in inhibiting fertility in 2011. On the other hand, the contribution of postpartum infecundability was the highest in inhibiting fertility in 2016. The contribution of the index of contraceptive in inhibiting fertility increased from 28.5% in 2011 to 30.7% in 2016. The index of foetal wastage contributed the least in both 2011 and 2016 survey years. Therefore, strategies have to be designed to promote the contraceptive use and breast feeding practices among the reproductive women.

Magnitude of stunting and its determinants in children aged 6-59 months among rural residents of Damot Gale district; southern Ethiopia.

OBJECTIVE: The objective of this study is assessing magnitude of stunting and its predictors among children aged 6-59 months in Damot Gale district, South Ethiopia. Community based cross sectional study was done at Damot Gale district. About 398 children aged 6-59 months were included in the study. Kebele (small administrative unit) and household were chosen by two-phase cluster sample design. Structured questionnaire was used to gather the data. Anthropometric measurement was also used to get the data. SPSS version 20 was used to analysis the data. RESULTS: About 41.7% of children were stunted. Children aged 36-47 months [AOR 6.22; 95% CI (1.81-21.36)], and 48-59 months [AOR 7.27; 95% CI (1.22-43.19)], sex of the child [AOR 20.79; 95% CI (7.50-57.65)], birth order [AOR 6.42; 95% CI (1.68-24.48)], mother education [AOR 0.06; 95% CI (0.02-0.14)], having toilet facility [AOR 0.059; 95% CI (0.02-0.18)], washing hand by soap [AOR 16.21; 95% CI (5.11-51.4)] and ANC [AOR 0.045; 95% CI (0.01-0.13)] were associated with stunting.

Health seeking behavior and its determinants for cervical cancer among women of childbearing age in Hossana Town, Hadiya zone, Southern Ethiopia: community based cross sectional study.

BACKGROUND: Cervical cancer is one of the most easily preventable forms of female cancers if early screening and diagnosis is made. Low awareness level about the disease and risk factors, beliefs about the disease, poor access to preventive services, affordability of the service and current health service system can influence decision to seek health care services for cervical cancer. The objective of this study was to determine health seeking behaviour and determinant factors for cervical cancer in Hossana town. METHODS: Our study was carried out in Hossana town using community based cross-sectional study design. The study population was women of childbearing age (15-49 years) who had the chance of being randomly selected from the source population. Five hundred ninety five women of childbearing age were included in the study. Systematic random sampling technique was employed to select the study units. Structured and pretested questionnaire was used to collect the data. The collected data were cleaned and entered by EPI info version 3.5.4 and analysed by SPSS version 16. We considered P-value < 0.05 to decide statistically significant association between the independent and dependent variables. RESULTS: The prevalence of health seeking behaviour for cervical cancer among the study participants was only 14.2%. Respondents' poor knowledge [AOR: 7.25, 95% CI: (1.87, 28.08)], not ever received information [AOR: 52.03, 95% CI: (13.77, 196.52)] and not actively searching information about cervical cancer [AOR: 14.23, (95%CI: (3.49, 57.95)] were significantly associated factors with not seeking health for prevention and control of cervical cancer. CONCLUSION: The prevalence of health seeking behaviour for cervical cancer is low. Respondent' poor knowledge, not ever received information, and not actively searching information about cervical cancer are significantly associated with not seeking health for cervical cancer prevention and control. This study stressed the importance of increasing knowledge, promoting active search of health information and experiences of receiving information from different sources regarding health seeking behaviour.

Effect of intimate partner violence on birth outcomes.

BACKGROUND: Violence by intimate partner during pregnancy has many adverse pregnancy outcomes. Thus, that's why we sought to determine association between intimate partner violence during pregnancy and adverse birth outcomes. METHODS: A facility based cross-sectional study was conducted among 183 recently delivered women from March 31-April 30, 2014 in public health facilities of Hossana Town. The data were collected through structured questionnaire and record review. Women who were not mentally and physically capable of being interviewed and those admitted for abortion were excluded. Ethical clearance was obtained from Jimma University. Logistic regression analysis was employed to determine the association between intimate partner violence and adverse birth outcomes. RESULTS: About 23 % of women experienced intimate partner violence during pregnancy. The result of this study indicated an association of intimate partner violence with low birth weight of the new born (AOR:14.3,95% CI: (5.03, 40.7). Intimate partner violence was not associated with still birth, pre-term birth and Apgar score less than 7 at 5 minutes. CONCLUSION: The findings of this study showed that intimate partner violence during pregnancy was associated with a low birth weight of the new born. Health sectors should train health care providers on how to screen, counsel, treat and follow up abused women.

Prevalence of malnutrition and associated factors in children aged 6-59 months among rural dwellers of damot gale district, south Ethiopia: community based cross sectional study.

BACKGROUND: Malnutrition remains one of the most common causes of morbidity and mortality among children throughout the world. This study aimed to assess prevalence of malnutrition and associated factors among children aged 6-59 months in Damot Gale, South Ethiopia. METHODS: A community based cross sectional study was conducted on 398 children aged 6-59 months in the Damot Gale district. A two-stage cluster sample design was used to select kebele and households. Anthropometric measurements and structured questionnaires were used to collect data. Bivariate and multivariate logistic regression was done by using SPSS version 20. RESULTS: The results of this study indicated that 27.6% of children were under-weight and 9% were wasted. Being male (AOR: 1.90; 95% CI: (1.10-3.32), children with shorter birth interval (AOR:2.89;95% CI: (1.23-6.80), children who had sickness some times for past 2 weeks (AOR:0.42; 95% CI:(0.10-0.93) and children whose mothers attended ANC (AOR:0.29; 95% CI: (0.16-0.52) were associated with underweight. Children whose mother's main occupation was non-farm (AOR: 7.06;95% CI: (1.31-38.21), presence of diarrhea (AOR:39.5, 95% CI: (13.68-114.30), and children whose mothers attended ANC (AOR:0.18,95% CI: (0 .18 (0.07-0.45) were associated with wasting. CONCLUSION: The prevalence of malnutrition in the study area was high. Health extension workers and stakeholders should give due concern on promotion of proper nutrition in the community.

Mortality and morbidity trends and predictors of mortality in under-five children with severe acute malnutrition in Hadiya zone, South Ethiopia: a four-year retrospective review of hospital-based records (2012-2015).

BACKGROUND: Severe acute malnutrition remains one of the most common causes of morbidity and mortality in Sub-Saharan Africa. The objective of this study was to investigate morbidity and mortality trends and factors associated with mortality of under-five children admitted and managed for severe acute malnutrition in NEMMH. METHODS: Four years retrospective cohort study was conducted on 500 under-five children admitted with the diagnosis of severe acute malnutrition. The study population was all under- five children admitted to the inpatient nutrition unit between 2012 and 2015. Data was entered using Epi-Data version 3.1 and exported to SPSS version 16 for analysis. A Kaplan- Meier curve was also used to estimate survival probability of different types of severe acute malnutrition. Cox proportional hazards regression was used to predict the risk of death among predictor while adjusting for other variables. A P-value less than 0.05 was considered as statistically significant. RESULT: A total of 500 children were enrolled into the study. Kwashiorkor was the most frequently recorded morbidity accounting for 43.0%. Pneumonia was seen the commonest form of comorbid disease. It was the most common co-morbidity across all morbidity groups. (27.6% in kwashiorkor, 37.5% in marasmus and 37.7% in marasmic-kwashiorkor). The average length of stay in the hospital was 11 days.Children with new admission were 86% less likely to die than repeated admission given that the children were admitted to paediatric ward (HR: 0.14, 95% CI: (0.06, 0.35). Kaplan Meier survival curves also showed children with marasmus and those with repeated admission had reduced survival rates. The overall mortality rate was 7%. The mortality trends vary irregularly in each year but morbidity trend increased with admission from 2014 to 2015. CONCLUSION: Mortality trends of SAM vary irregularly across the years but morbidity trends increased with admission from 2014 to 2015. An admission type was significantly associated with mortality. Morbidity and co-morbid diseases did not show significant effect on mortality of the children. Health extension workers and stakeholders should give due concern on promotion of proper nutrition in a community.

Prevalence of herbal medicine use and associated factors among pregnant women attending antenatal care at public health facilities in Hossana Town, Southern Ethiopia: facility based cross sectional study.

BACKGROUND: The use of herbal medicine has been on increase in many developing and industrialized countries. More pregnant women use herbal remedies to treat pregnancy related problems due to cost-effectiveness of therapy and easy access of these products. We sought to assess the prevalence of herbal medicine use and associated factors among pregnant women attending antenatal clinics of public health facilities. METHODS: Facility based cross sectional study was conducted among 363 pregnant women attending antenatal clinics from May to June 2015 at public health facilities in Hossana town, Hadiya zone, Southern Ethiopia. Pretested structured questionnaire was used to collect data from each study subject. Bivariate logistic regression analysis was used to see significance of association between the outcome and independent variables. Odds ratios at 95 % CI were computed to measure the strength of the association between the outcome and the independent variables. P-value <0.05 was considered as a statistically significant in multivariate analysis. RESULT: Two hundred fifty eight (73.1 %) of pregnant women used herbal medicine during current pregnancy . The herbal medicines commonly taken during current pregnancy were ginger (55.8 %), garlic (69.8 %), eucalyptus (11.6 %), tenaadam (rutachalenssis) (26.4 %), damakesse (ocimumlamiifolium) (22.8 %), feto (3.5 %) and omore (3.1 %). Being students (AOR: (5.68, 95 % CI: (1.53, 21.13), second trimester of pregnancy (AOR: 0.22, 95 % CI: (0.08, 0.76), sufficient knowledge on herbal medicine (AOR: 0.37, 95 % CI: (0.19, 0.79), no formal education (AOR: 4.41, 95 % CI: (1.11, 17.56), primary education (AOR: 4.15, 95 % CI: (1.51, 11.45) and secondary education (AOR: 2.55, 95 % CI: (1.08,6.03) were significantly associated with herbal medicine use. CONCLUSION: The findings of this study showed that herbal medicine use during pregnancy is a common experience. Commonly used herbal medicines during current pregnancy were garlic, ginger, tenaadam, damakasse and eucalyptus. Educational status, occupation, knowledge on herbal medicine and second trimester of pregnancy were the major factors affecting use of herbal medicine. Health education about the effects of herbal medicine on pregnancy should be given during antenatal care sessions and through media. Health care providers, especially those that are involved in antenatal care should aware of evidence regarding potential benefits or harm of herbal medicinal agents when used by pregnant women.