Posttraumatic stress disorder in a war-affected area of Northeast Ethiopia: a cross-sectional study.

BACKGROUND: Post-Traumatic Stress Disorder (PTSD) is a chronic condition that affects a significant proportion of war survivors following war and conflict. If PTSD is not managed, it can lead to decreased quality of life and impairments in daily functioning and lead to death. This study aimed to assess the prevalence of post-traumatic stress disorder and its associated factors among residents in a war-affected area, Dessie Town, Northeast Ethiopia. METHODS: A community-based cross-sectional study was conducted among adult residents in the war-affected area, Dessie Town. A total of 615 individuals were selected by a systematic random sampling method. PTSD was assessed using the Post-Traumatic Stress Disorder Checklist, Civilian Version. Multivariable logistic regressions were used to measure the associated factors. Associations between variables were described using odds ratios, 95% confidence intervals, and a p-value less than 0.05. RESULTS: The prevalence of PTSD was 34.5% (95% CI: 31-38). Female sex (AOR: 1.82; CI: 1.18-2.82), divorced or widowed (AOR: 2.12, CI: 1.23-3.66), having only primary schooling (AOR: 2.17; CI: 1.25-3.78), depression (AOR: 2.03; CI: 1.34-3.08), experienced ill health without medical care during the wartime (AOR: 2.97; CI: 1.43-6.16), forced separation from family (AOR: 1.90; CI: 1.16-3.12), and experienced stressful life events (AOR: 1.60; CI: 1.06-2.42) were significantly associated with PTSD. CONCLUSION: A significant rate of PTSD was found among residents of the war-affected area, Dessie Town. One in three people was experiencing PTSD. As a result, post-war mental health early screening and intervention is a priority, particularly for females, those who are separated or divorced, and those who have experienced stressful life events due to the war.

Methamphetamine exposure and depression-A systematic review and meta-analysis.

ISSUES: Methamphetamine use is a public health concern that has been associated with comorbid mental health problems. We aim to better understand the relationship between methamphetamine use and depression by: (i) systematically reviewing and meta-analysing the risks of depression by methamphetamine use; and (ii) investigating the risk of unmeasured confounding. APPROACH: A systematic review and meta-analysis were conducted following PRISMA guidelines. EMBASE, PsycINFO and PubMed were searched to identify human studies reporting on the association between methamphetamine or amphetamine use and depressive outcomes. The data were summarised narratively and meta-analysed, stratified by cross-sectional and longitudinal estimates. Unmeasured confounding was assessed by E-values analyses. KEY FINDINGS: From the 6606 studies that came up from the search, 14 eligible studies were included in the narrative review and had data for meta-analysis. A significant association was found between any use of methamphetamine and any depression outcomes in cross-sectional (odds ratio [OR] = 1.66 [95% confidence interval [CI] 1.34, 2.05]) and longitudinal estimates (OR = 1.18 [95% CI 1.08, 1.28]). People with a methamphetamine use disorder had significantly higher odds of depression than those without (OR = 2.80 [95% CI 1.40, 5.90]). The E-values ranged from 1.28 to 6.30 for cross-sectional studies and from 2.37 to 3.21 for longitudinal studies. CONCLUSION: Based on limited data, people who used methamphetamine have higher odds of depression than people who do not. There were mostly a low to moderate risk of unmeasured confounding in the longitudinal study results. Future longitudinal studies conducted using causal framework methods are warranted.

Depression among people with chronic skin disease at Boru Meda Hospital in Northeast Ethiopia.

BACKGROUND: The comorbidity of depression with chronic skin disease negatively affects the quality of life and disease prognosis, creating an immense burden on patients, families, and the wider community. However, there are limited studies conducted on the prevalence of depression and associated factors among people with chronic skin disease in Ethiopia. OBJECTIVE: This study aimed to assess the prevalence and associated factors of depression among people with chronic skin disease at Boru Meda Hospital, Northeast Ethiopia. METHODS: An institutional-based cross-sectional study was carried out from March 10- April 18, 2021, among a total of 381 people with chronic skin disease. The Patient Health Questioner-9 was used to assess depression. A logistic regression analysis model with an adjusted odds ratio was used to assess the strength of associations between the outcome and predictor variables. P-value < 0.05 was considered statistically significant. RESULT: The magnitude of depression among people with chronic skin disease was 23.6% (95%Cl: 19.8%, 28.6%). We identified significantly increased odds of depression among participants with rural residence (AOR = 3.45, 95% CI: 1.64, 7.28), duration of illness above 5 years (AOR = 3.59, 95% CI: 1.31, 9.85), comorbid medical illness AOR = 2.51, 95% CI: 1.06, 5.98), family history of mental illness (AOR = 3.39, 95% CI: 1.11, 10.41), non-adherence to chronic skin disease medications (AOR = 3.53, 95% CI: 1.20, 10.41), low self-image (AOR = 4.69, 95% CI: 2.25, 9.77), and perceived stigma (AOR = 4.61, 95% CI: 2.14, 9.92). CONCLUSION: Depression was common among patients with chronic skin diseases. This study has indicated a need for proper screening of depression in the current medical treatment of patients with chronic skin disease in Boru Meda Hospital, Northeast Ethiopia.

Cannabis use in sub-Saharan Africa: A systematic review and meta-analysis.

BACKGROUND AND AIMS: The most available data on the prevalence of cannabis use come from population surveys conducted in high-income countries in North America, Oceania and Europe. Less is known about the prevalence of cannabis use in Africa. This systematic review aimed to summarize general population-level cannabis use in sub-Saharan Africa since 2010. METHODS: A comprehensive search was conducted in PubMed, EMBASE, PsycINFO and AJOL databases in addition to Global Health Data Exchange and grey literature without language restriction. Search terms related to 'substance', 'Substance-Related Disorders' and 'Prevalence' and 'Africa South of the Sahara' were used. Studies that reported cannabis use in the general population were selected, while studies from clinical populations and high-risk groups were excluded. Prevalence data on cannabis use in the general population of adolescents (10-17 years) and adults (≥ 18 years) in sub-Saharan Africa were extracted. RESULTS: The study included 53 studies for the quantitative meta-analysis and included 13 239 participants. Among adolescents, the life-time, 12-month and 6-month prevalence of cannabis use were 7.9% [95% confidence interval (CI) = 5.4-10.9%], 5.2% (95% CI = 1.7-10.3%) and 4.5% (95% CI = 3.3-5.8%), respectively. The corresponding life-time, 12-month and 6-month prevalence of cannabis use among adults were 12.6% (95% CI = 6.1-21.2%), 2.2% (95% CI = 1.7-2.7%, with data only available from Tanzania and Uganda) and 4.7% (95% CI = 3.3-6.4%), respectively. The male-to-female life-time cannabis use relative risk was 1.90 (95% CI = 1.25-2.98) among adolescents and 1.67 (CI = 0.63-4.39) among adults. CONCLUSIONS: Life-time cannabis use prevalence in sub-Saharan Africa appears to be approximately 12% for adults and just under 8% for adolescents.

Mental health service utilization in a low resource setting: A qualitative study on perspectives of health professionals in Northwest Ethiopia.

BACKGROUND: Mental health services are advocated to move from specialized care to more integrated and accessible primary care settings. The integration of mental health into primary health services is expanding in Ethiopia. However, there is a lack of research on the perspectives of health professionals on mental health services in Ethiopia. This study aimed to explore the perspectives, views, and experiences of health professionals regarding mental health services and the help-seeking behavior of people with mental illness in Northwest Ethiopia. METHODS: This qualitative study included sixteen health professionals. The participants were interviewed using a semi-structured interview guide. Interviews were conducted in Amharic and translated into English. We analyzed the data using reflexive thematic analysis. RESULTS: Five key themes were generated from the interview data: (1) Avoidance of mental healthcare; (2) Low literacy about mental illness; (3) Stigma as a hindrance to accessing mental health services; (4) The role of culture and religion in mental health services; and (5) Lack of government concern about mental health services. CONCLUSION: This study identified important factors related to mental health services in Northwest Ethiopia, from the perspectives of health professionals. Our findings highlighted that the government health agenda needs to prioritize mental health services. The role of religious and cultural healing places in the help-seeking pathway should be given due consideration to ensure success in mental health services provision and utilization.

Prevalence and correlates of cannabis use for medicinal reasons - An Australian cross-sectional study.

Objective: It is important to know the prevalence and source of medicinal cannabis use in the population because non-prescribed medicinal use of cannabis products places individuals at higher risk of harms. We estimated the prevalence and correlates of the use of cannabis for medicinal purposes in Australia, three years after Australians were given legal access. Design: Cross-sectional. Setting: The 2019 Australian National Drug Strategy Household Survey. Participants: Participants were 22,015 Australians aged 14 or above. Outcome measure: Self-reported cannabis use in the last 12 months for medicinal purposes only, both medicinal/recreational reasons, or recreationally only. Those who reported medicinal use were asked if it had been prescribed by a doctor. Prevalence estimates were weighted to the population and multinomial logistic regression examined the correlates. Results: The prevalence of any medicinal cannabis use in the past year was 2.6%. Only 0.8% of the sample reported using cannabis solely for medicinal reasons, 95.9% of whom did not have a prescription. A self-reported diagnosis of cancer was associated with medicinal use only. Self-reported chronic pain was associated with both medicinal only and medicinal/recreational use. Medicinal cannabis use was associated with opioids use. Conclusions: In 2019, the prevalence of cannabis use solely for medicinal reasons remains under 1%, was more common among people with specific medical conditions, but most individuals do not have a prescription. The prevalence of self-reported medicinal cannabis use in Australia is low and there is limited use of the legal pathway for medicinal cannabis.

Mood and Anxiety Symptoms in Persons Taking Prescription Opioids: A Systematic Review with Meta-Analyses of Longitudinal Studies.

OBJECTIVE: To review evidence from longitudinal studies on the association between prescription opioid use and common mood and anxiety symptoms. DESIGN: We conducted a systematic review and meta-analysis according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. METHODS: We searched PubMed, Embase, and PsycINFO for search terms related to opioids AND (depression OR bipolar OR anxiety OR post-traumatic stress disorder [PTSD]). Findings were summarized narratively, and random-effects meta-analyses were used to pool effect sizes. RESULTS: We identified 10,290 records and found 10 articles that met our inclusion criteria. Incidence studies showed that people who used prescription opioids had an elevated risk of any mood outcome (adjusted effect size [aES] = 1.80 [95% confidence interval = 1.40-2.30]) and of an anxiety outcome (aES = 1.40 [1.20-1.80]) compared with those who did not use prescription opioids. Associations with depression were small and not significant after adjustment for potential confounders (aES = 1.18 [0.98-1.41]). However, some studies reported an increased risk of depressive symptoms after increased (aES = 1.58 [1.30-1.93]) or prolonged opioid use (aES = 1.49 [1.19-1.86]). CONCLUSIONS: Mental health should be considered when opioids are prescribed because some patients could be vulnerable to adverse mental health outcomes.

What is the short-term remission rate for people with untreated depression? A systematic review and meta-analysis.

BACKGROUND: Depression is one of the prevalent mental illnesses and leading cause of global disease burden. However, most people with depression do not access treatment. Remission without treatment may occur in some cases of depression. This study aimed to estimate the short-term remission (natural recovery) from untreated depression. METHODS: A systematic review and meta-analysis was registered on PROSPERO and conducted following PRISMA guidelines. EMBASE, PsycINFO, and PubMed were searched, supplemented with an additional hand search to identify studies reporting natural recovery from untreated depression. Study selection and screening were carried out by three independent reviewers. Methodological quality assessment of the included studies was conducted. Remission was defined as no longer meeting the diagnostic criteria or scoring below the cut off points of the validated tools as reported by the included studies. The data were synthesized using narrative summary and random-effects meta-analysis. RESULTS: Sixteen waitlist-controlled trial studies were included in the systematic review and meta-analysis. The duration of follow-up ranged from 4 to 12 weeks with a median duration of 8 weeks. The overall pooled remission from untreated depression was 12.5%, 95% confidence interval (7.8, 18.0%). Due to lack of published data, we were unable to determine if the severity of depression symptoms was associated with remission rates. CONCLUSIONS: Short-term remission from depression without treatment is uncommon. Across studies, 8 - 18% of people remitted without treatment within 12 weeks. Waitlist control groups may not represent all persons with depression.

Estimating the global treatment rates for depression: A systematic review and meta-analysis.

BACKGROUND: Depression is considered a global crisis due to its high prevalence and associated disabilities. The burden posed by depression could be reduced by increasing access to timely treatment. Limited information is available on treatment rates of depression, particularly in low- and middle-income countries. This study aimed to estimate the treatment rates for depression in the general adult population by World Bank income classification. METHODS: We searched PubMed, EMBASE, PsycINFO, and CINAHL, supplemented with hand-search of reference lists to identify community-based studies. The overall treatment rate for depression was estimated from studies that reported any treatment (behavioral or pharmacological treatments) in healthcare or informal non-healthcare settings. Data were pooled using a random-effects meta-analysis model. Subgroup analyses by income classification were completed. Meta-regression was conducted by study characteristics. The protocol was pre-registered at PROSPERO (CRD42020161683). RESULTS: We included 65 studies comprising 1.1 million participants from 79 countries and territories. The global 12-month/lifetime pooled treatment rate was 34.8% (95% confidence interval: 29.9, 39.9%). The treatment rates were 48.3% (43.0, 53.6%) in high-income countries, 21.4% (15.1, 27.7%) in middle-income countries, and 16.8% (11.3, 23.0%) in low-income countries. Among the treated samples, 12-month minimally adequate treatment was estimated to be 40%. LIMITATION: We reported a substantial level of between-study heterogeneity, which was partially explained by study characteristics in the meta-regression. CONCLUSION: Globally, approximately one-third of people with depression receive treatment. Three in five treated people with depression did not receive minimally adequate treatment. Depression treatment rates are considerably lower in low-and middle-income countries.

Depressive symptoms among people with HIV/AIDS in Northwest Ethiopia: comparative study.

OBJECTIVES: The objective of this study was to compare depressive symptoms among people with HIV/AIDS and the general population sample. We also assessed the factors associated with depressive symptoms. DESIGN: A comparative cross-sectional study was conducted. SETTINGS: Antiretroviral therapy clinics in three primary healthcare facilities and semi-urban area in Northwest Ethiopia. PARTICIPANTS: A total of 1115 participants (558 people with HIV/AIDS and 557 comparison group) aged 18 years and above were recruited. A total of 1026 participants (530 people with HIV/AIDS and 496 comparison group) completed the interview. We excluded people with known HIV-positive status from the comparison group. OUTCOME MEASURE: Patient Health Questionnaire (PHQ-9) was used to assess depressive symptoms. The proportion of depressive symptoms was compared between samples of the general population and people with HIV/AIDS using χ2 statistics. Multivariable logistic regression analysis was done to examine the associated factors. RESULTS: The overall prevalence of depressive symptoms was 13.3% (11.2%-15.4%). The prevalence was significantly higher in people with HIV/AIDS compared with the community sample (16.6% vs 12.3%), p=0.001. The difference was also significant in the multivariable logistic regression (OR 1.7). For the overall sample, depressive symptoms were significantly associated with older age, being single, divorced/widowed marital status, and poor social support. CONCLUSIONS: Depressive symptoms were higher in people with HIV/AIDS compared with the general population. It is necessary to include mental healthcare and screening for depression in routine HIV/AIDS care.

Perceived stigma and associated factors among adults with problematic substance use in Northwest Ethiopia.

BACKGROUND: Substance use-related problems including cigarette smoking and alcohol use are among leading preventable risk factors for premature death. However, people with these problems did not get the appropriate treatment they need. Stigma against substance use could be the potential barrier for people with problematic substance use to seek professional help. Therefore, the objective of this study was to investigate magnitude and associated factors of perceived stigma towards problematic substance use. METHODS: A total of 2400 participants were screened using the Cut down, Annoyed, Guilty, and Eye-opener (CAGE) Adapted to Include Drugs (CAGE-AID) questionnaire. We found 540 participants screened positive for problematic substance use (alcohol, hashish, tobacco and khat) and interviewed them for perceived stigma using Perceived Stigma of Substance Abuse Scale (PSAS). Logistic regression was used to examine associated factors with perceived stigma. RESULTS: Three hundred forty-five (63.9%) participants reported perceived stigma above the mean value of Perceived Stigma of Substance Abuse Scale (PSAS). Variables positively associated with perceived stigma were lower wealth and joblessness, history of separation from family members before age of 18 years, poly-substance misuse and awareness about economic crisis of substance use. CONCLUSION: Approximately, three in five people with problematic substance use perceived having been stigmatized by others. Health planning for problematic substance use should focus on stigma.

Lifetime relapse and its associated factors among people with schizophrenia spectrum disorders who are on follow up at Comprehensive Specialized Hospitals in Amhara region, Ethiopia: a cross-sectional study.

BACKGROUND: Relapse in psychiatric disorders is highly distressing that posed a huge burden to the patients, family, and society. It interrupts the process of recovery and may increase the risk of resistance to treatment. Relapse detection and taking preventive measures against its possible factors are crucial for a better prognosis. OBJECTIVE: To assess lifetime relapse and its associated factors among people with schizophrenia spectrum disorders who are on follow-up at Comprehensive Specialized Hospitals in Amhara region, Ethiopia. METHOD: An institution-based cross-sectional study was conducted from July 13-August 13, at Comprehensive Specialized Hospitals in Amhara region, Ethiopia, 2020. Data were collected from 415 randomly selected participants using an interviewer administered questionnaire. Relapse was determined using participants' medical records and a semi-structured questionnaire. Data were analyzed using Statistical Package for Social Sciences (SPSS) version 25. Logistic regression analysis was done to identify the explanatory variables of relapse. Variables with P-value < 0.05 were considered significantly associated with relapse. RESULT: The magnitude of lifetime relapse was 57.4% (95% CI = 53-62%). Relapse was significantly associated with comorbidity of another mental illness (AOR = 1.84, 95% CI = 1.06, 3.18), non-adherence to medication (AOR = 2.23, 95% CI = 1.22, 4.07), shorter duration on treatment (AOR = 1.71, 95% CI = 1.05, 2.81), and experiencing stressful life events (AOR = 2.42, CI = 1.2, 4.66). CONCLUSION: In the current study, more than half of the participants had lifetime relapses. Comorbid mental illnesses, non-adherence, duration of treatment ≤ 5 years, and experiencing stressful life events were factors associated with relapse. This requires each stakeholder to give concern and work collaboratively on the respective factors that lead to relapse.

Treatment rates for alcohol use disorders: a systematic review and meta-analysis.

AIMS: To estimate the treatment rate for alcohol use disorders (AUDs) in the general adult population. Treatment rates were also considered in relation to economic differences. METHODS: Systematic review and meta-analysis. We searched PubMed, EMBASE, PsycINFO and CINAHL databases to identify studies that reported treatment rates for alcohol use disorders in the general population. Independent reviewers screened the articles based on predefined inclusion criteria. Data were extracted using a standardized data extraction form. We conducted quality assessments of the included studies. The overall treatment rates were estimated from studies that reported any treatment for AUDs from healthcare or informal non-healthcare settings (any treatment). We estimated the separate treatment rates for each diagnostic category as reported in the primary studies: AUD as a single disorder, alcohol abuse and alcohol dependence. Data were pooled using a random-effect model. RESULTS: Thirty-two articles were included to estimate the treatment rates (percentage treated among the total number of people with AUDs). The pooled estimate of people with AUDs who received any treatment were 14.3% (95% CI: 9.3-20.3%) for alcohol abuse, 16.5% (95% CI: 12-21.5%) for alcohol dependence and 17.3% (95% CI: 12.8-22.3%) for AUD. A subgroup analysis by World Bank economic classification of countries found that the treatment rate for AUD was 9.3% (95% CI: 4.0-15.7%) in low and lower-middle-income countries. CONCLUSION: Globally, approximately one in six people with AUDs receives treatment. Treatment rates for AUDs are generally low, with even lower rates in low and lower-middle-income countries.

Suicidal behavior among people with epilepsy in Northwest Ethiopia: A comparative cross-sectional study.

INTRODUCTION: Premature mortality is common in people with epilepsy, but the causes vary where suicide is considered as one of the commonest. OBJECTIVE: The objective of this study was to compare suicidal behavior between people with epilepsy and the general population and identify associated factors in Northwest Ethiopia. METHODS: We have conducted a comparative cross-sectional study in Northwest Ethiopia. We have selected people with epilepsy from outpatient departments and the comparisons from the general population. Suicidal behavior was assessed by the revised version of Suicidal Behaviors Questionnaire (SBQ-R). Logistic regression was implemented to look for associations between factors and the dependent variable. RESULTS: The prevalence of suicidal behavior in people with epilepsy was 18.2%, significantly higher than the community sample, which was 9.8% (p-value = .001). This difference persists in the multivariable logistic regression model by which the odds of suicidal behavior in people with epilepsy was two times more as compared to the community sample. Other variables positively associated with suicidal behavior for the overall sample were depressive symptoms, no formal education, divorced/widowed marital status, and higher perceived criticism. Better social support was protective factor for suicidal behavior. CONCLUSION: The proportion of suicidal behavior is twofold higher in people with epilepsy than the general population. Routine screening for suicide risk should be an integral part of epilepsy treatment.

Level of Undernutrition and Its Determinants Among Children Aged 12-59 Months in Wolaita District, Ethiopia.

BACKGROUND: Undernutrition remains one of the most common causes of morbidity and mortality among children throughout the world particularly in developing countries. The present study aimed to assess the magnitude and associated factors of undernutrition among children aged 12-59 months. METHODS: A community-based cross-sectional study was conducted in Wolaita district from May to June 2015. Multi-stage stratified systematic random sampling procedure was used. Data were collected using a pretested interviewer-administered questionnaire from 626 children aged 12-59 months. Height and weight were measured by trained data collectors and WHO Anthro version 3.2.2 software was used. Data were entered into Epi Info version 3.3.5 and were exported and analyzed using SPSS version 21. Multivariable logistic regression model with a step-wise method was used to determine the predictors of undernutrition. RESULTS: One third (34.1%; 95% CI 30.4-37.9%) of children were stunted while 6.9% and 11.9% of them were wasted and underweight, respectively, based on WHO Z score <-2. Children live in mother-headed households which often use unprotected sources of water and children who did not get minimum dietary diversity were more likely to be stunted compared to their counterparts. Children residing in rural residences, being a male child, having less power for mother decision-making, presence of diarrhea in the last 2 weeks of the survey and who did not get the minimum dietary diversity were found to be significant determinants of underweight. Children living rural, male sex, their order of birth being 5th and above and who had not got the minimum meal frequency were more likely to be wasted than their counterparts. CONCLUSION AND RECOMMENDATION: Undernutrition has a high prevalence in under-5-year-old children of Wolaita district. Under nutrition was associated with female-headed households, unprotected sources of water, below the minimum dietary diversity, rural residence, participation of mother in decision-making, presence of diarrhea, and minimum meal frequency. Thus, nutritional intervention programs in Wolaita district in Ethiopia should focus on these factors.

Child development and nutritional status in 12-59 months of age in resource limited setting of Ethiopia.

BACKGROUND: Early years of life are period of maximal growth and development of human brain. Development of young child is influenced by biological endowment and health of child, nutritional status of child, relationships with primary caregivers, family, and support systems in the community. This study was aimed to assess childhood development in relation to their nutritional status. METHOD: Community-based cross-sectional study was employed. Multi-stage systematic random sampling technique was used to select 626 children aged 12-59 months with mother/caregivers' pairs in Wolaita district in 2015. Child development assessment was done using third edition of age and stage questionnaire. Height and weight were measured by trained data collectors then the WHO Anthro version 3.2.2 software was used to convert nutritional data indices. Data were entered into Epi-info version 3.3.5 and was exported and analyzed using STATA version 14. Correlation and multiple logistic regression were used. RESULT: High risk of developmental problem in children were 19.0% with 95% CI (16.06%, 22.3%), and it is expressed as communication 5.8%, gross motor 6.1%, fine motor 4.0%, personal social 8.8%, and problem solving 4.1%. One-third (34.1%) of the study participants were stunted while 6.9% and 11.9% of them were wasted and underweight respectively. Weight-for-age (WAZ) and height-for-age positively correlated with all five domains of development, i.e., with communication, gross motor, fine motor, personal social, and problem solving (r = 0.1 - 0.23; p < 0.0001, and r = 0.131 - 0.249; p < 0.0001) respectively. CONCLUSION AND RECOMMENDATION: Overall child development was directly related with nutritional status. So, available resources should be offered to decrease children undernutrition. Further assessment on childhood development of children is necessary.

Community's Perception and Attitude towards People with Epilepsy in Ethiopia.

INTRODUCTION: Most people with epilepsy suffer from a dual burden. In one hand, they struggle with the symptoms and disabilities on the other hand from misconceptions and stigma associated with it. But there are no recent studies which assess the community's perception and attitude. OBJECTIVE: To assess the perception and attitude of the community towards people with epilepsy and identify associated factors. METHODS: A community-based cross-sectional study was conducted in South Ethiopia from a total of 701 participants. Data were collected with face to face interview using a structured questionnaire developed based on the Health Belief Model (HBM). Data were presented with frequencies, tables, and figures. Univariate and multivariable logistic regression was done to identify significantly important variables. The presence of association was presented by odds ratio and 95% confidence interval. Ethical clearance was obtained from Wolaita Sodo University. RESULTS: The most frequently mentioned perceived causes for epilepsy were stress (91%), substance use (61.8%), and bad spirit (49.8%) while loss of consciousness and falling (80.7%) and sleep problems (78%) were considered symptoms of epilepsy. Only 13.1% of the participants think that they may be susceptible for epilepsy. Six hundred sixty (94.2%) participants will not employ a person with epilepsy while only 47 (6.7%) of the participants will allow a family member to marry a person with epilepsy. In multivariable analysis, understanding the illness as a medical problem was associated with perceived susceptibility and perceived benefit of modern treatment was significantly associated with having a current medical problem. CONCLUSIONS: The knowledge about the cause, possible susceptibility, better treatment options, and attitude of the participants were similar to other low-income settings. The negative attitude was high and multidimensional. All stakeholders must work to increase awareness about the cause, symptoms, and treatment options for epilepsy and to decrease the negative attitude of the community.

Incidence of Post-Traumatic Stress Disorder After Road Traffic Accident.

Background: Post-traumatic stress disorder (PTSD) occurs after exposure to actual or threatened death, serious injury, or sexual violence. Road traffic accident (RTA) is one of the traumatic experiences, which may result in PTSD. But treatment is mainly concentrated on physical health. This may be due to a lack of evidence in low-income countries. Aim: To determine the incidence level and identify risk factors of PTSD after RTA. Methods: Longitudinal panel study was done to assess the incidence of PTSD after RTA. The study was conducted in three orthopedic settings of Bahir Dar town Northwest, Ethiopia. The study was on 299 adult car accident survivors. PTSD Checklist (PCL) civilian version, Sheehan disability assessment scale, Patient Health Question (PHQ-2), and Alcohol Use Disorder Identification Test (AUDIT) were instruments to assess the outcome and associated factors. The generalized linear model with Poisson log-linear method was applied to identify associated factors. Ethical clearance was obtained from Bahir Dar University. Individuals with PTSD symptoms were linked to the psychiatric clinic. Result: One hundred thirty-nine (46.5%) participants had at least three extremely severe symptoms that fulfil criteria B, C, and D of Diagnostic Statistical Manual IV of PTSD. The most frequent severe symptoms were having repeated, disturbing memories, thoughts, or images. Two hundred ten (70.2%) participants reported the extreme impact of the accident on work or schooling and 156 (51.9%) reported extreme problems in social functioning. Alcohol dependence, hazardous alcohol consumption, and harmful use were reported by 7.9%, 15.1%, and 4.7% of the participants, respectively. In the final model witnessing death, severe sleep problem and severe impairment in family functioning were significantly associated with PTSD. Conclusion: Nearly half of RTA survivors develop PTSD. Clinicians need to link these patients to the psychiatry clinic. Special attention should be given to patients who witnessed death, with a serious disability, and previous psychiatric history.

Help seeking behavior for problematic substance uses in north-West Ethiopia.

BACKGROUND: Substance miss use and neuro-psychiatric conditions are a growing public health challenges, but 76 to 85% of people with those disorders in low and middle-income countries did not receive treatment. The aim of this study was to see help seeking behavior and determinant factors in residents with problematic substance uses. METHODS: A total of 2400 participants had screened for problematic substance uses and 548 participants were found positive for problematic substance uses. Then, we had interviewed 548 participants for help seeking behavior by pre-tested modified General Help Seeking Questionnaire. Logistic regression with its corresponding p-value < 0.05; Adjusted odds ratios (AOR) and 95% confidence intervals (CI) have been used. RESULTS: Among five hundred and forty-eight participants with problematic substance use, only one hundred and sixty-eight (30.7%) with 95% CI (27, 35%) had sought help. Age above 35 years [AOR = .47 95% CI (.25, .90)], who had common mental disorders [AOR = 4.12, 95% CI (2.7, 6.3)], who had comorbid medical condition [AOR = 3.0, 95% CI (1.7, 5.3)], and grand-families' history of substance use [AOR = 2.18, 95% CI (1.4, 3.4)] were significantly associated with help seeking behavior. CONCLUSION: Help-seeking behavior was infrequent in people with problematic substance use. Advanced age was a barrier to seek help while medical illnesses, common mental disorders and history of substance use in grand families were found to enforce to seek help.