Violence against housemaids in an Ethiopian town during the early phase of the COVID-19 pandemic: a cross-sectional study.

BACKGROUND: Violence against women is a global public health problem that has numerous adverse effects. However, published literature regarding violence against housemaids during the COVID-19 pandemic in Ethiopia is lacking. The current study aims to explore the experiences of violence and associated factors among housemaids in Ethiopia. The findings may be useful to the design appropriate policies, programs and strategies to reduce the problem. METHODS: A community-based cross-sectional study was conducted from January to March, 2021 in Kombolcha Town, Ethiopia. A total of 215 housemaids aged 14 years and older were included in the study using a simple random sampling technique. A multivariable logistic regression model with 95% CI (confidence interval) was applied to identify significant factors of physical and sexual violence. Variables with a P-value < 0.05 were declared as factors significantly associated with violence. RESULTS: Among 215 housemaids, 33.49% (95% CI: 27.13-39.85%) reported physical violence and 21.4% (95% CI: 15.87-26.92) reported sexual violence during the COVID-19 pandemic. Thus, housemaids aged 19-23 years (AOR = 2.64, 95% CI: 1.01-6.89), who had a male employer (AOR = 2.39, 95% CI: 1.05-5.45), whose employers chewed chat (Catha edulis) (AOR = 3.78, 95% CI: 1.73-8.29), or drank alcohol (AOR = 2.90, 95% CI: 1.17-7.17) experienced more physical violence. Sexual violence was also associated with employers' alcohol consumption (AOR = 9.72, 95% CI: 3.12-20.31), employers' chat chewing (AOR = 7.40, 95% CI: 2.26-14.21) and male employers (AOR = 3.23, 95% CI: 1.22-8.52). CONCLUSION: The findings indicate that one in five housemaids and one in three housemaids experienced sexual violence and physical violence, respectively. Housemaids aged 19-23 years, having a male employer, having an employer who chewed chat (Catha edulis) or who drank alcohol were factors associated with physical violence, whereas employers' alcohol consumption, employers' chat chewing and male employers were factors associated with sexual violence.

Sensitivity and specificity of mid-upper arm circumference for assessment of severe acute malnutrition among children ages 6 to 59 months: Systematic review and meta-analysis.

OBJECTIVES: Sensitivity is the proportion of people classified as diseased (i.e., no false negatives). A test with low sensitivity can be thought of as being too cautious in finding a positive result. METHODS: The Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines were followed for this systematic review and meta-analysis. The databases used were PubMed, Google Scholar, Jane, and African Journals Online. The search terms used were "sensitivity" and "specificity of and mid-upper arm circumference" (MUAC). A Joanna Briggs Institute meta-analysis and checklist for diagnostic test accuracy studies was used for the critical appraisal of the studies. The meta-analysis was conducted using STATA, version 14, software. The pooled sensitivity was computed to present the pooled sensitivity at a 95% confidence interval (CI). RESULTS: A total of 11 individual studies were included in the meta-analysis. The lowest sensitivity of MUAC with the detection of severe acute malnutrition (SAM) was 5% in Vietnam, and the highest sensitivity was at 43.2% in India. The pooled sensitivity of MUAC among children aged <5 y to determine SAM was 20.7% (range, 13.24%-28.25%; P = 0.001). Based on the pooled specificity of MUAC, the detection of SAM was 97.636% (95% CI, 96.339%-98.932%; P = 0.001), and the pooled optimal cutoff point to diagnose SAM was 13.23 cm (95% CI, 12.692-13.763 cm; P = 0.001). CONCLUSIONS: The sensitivity of MUAC is lower compared with the specificity to detect SAM, and varies from area to area.

Validating the diagnostic performance of MUAC in screening moderate acute malnutrition and developing an optimal cut-off for under five children of different regions in Ethiopia.

BACKGROUND: Valid and reliable anthropometric indicator is useful for early detection and treatment for under nutrition. Although, mid upper arm circumference (MUAC) is used for screening of children with moderate acute malnutrition in Ethiopia, its performance for the different ethnic groups has not been evaluated. OBJECTIVE: To determine the diagnostic performance of MUAC for determination of moderate wasting among children of different ethnic background and develop optimal cut-off. METHODS: A community based cross-sectional study was conducted among under five children of the three regions namely: Somalia, Amhara and Gambella Regions. The diagnostic performance of MUAC was validated using weight for height Z-score< -2 as a gold standard binary classifier. Test variable is mid upper arm circumference (MUAC< 12.5cm) and weight for height Z-Score (WHZ) is standard variable. ROC analysis performed based on the assumptions of MUAC value lower the cut-off point indicates the undernutrition. Area under the curve and validity measures (sensitivity and specificity) was generated as parameter estimated. The results were presented using tables and ROC curves. RESULTS: Except in the Gambella region, there was fair agreement between MUC<12.5cm and Weight for Height Z score<-2 in diagnosing wasting in Somali (Sensitivity = 29.3%, Kappa = 0.325, P<0.001) and in Gambella regions (Sensitivity = 16.7%, Kappa = 0.19, P<0.001). In Amhara region there was fair agreement between the two measures in diagnosing moderate acute malnutrition (MAM) (Sensitivity = 16%, Kappa = 0.216). For the Overall sample, the sensitivity of MUAC<12.5cm was 20.6% (Kappa = 0.245, P<0.001. Based on ROC analysis, the optimal cutoff value of MUAC for diagnosing moderate acute malnutrition for the two regions namely for Gambella and Amhara was 13.85cm with sensitivity of 0.99 and 1.00, respectively. However, for Somali Region the optimal cut was 13.75cm (Sensitivity = 0.98 cm and specificity = 0.71). CONCLUSION: Findings revealed that the inter reliability of measurement for MUAC< 12.5cm and WHZ<-2 for diagnosing MAM was low among different ethnic groups with the cut-off varying in each region. The existing cutoff point is less sensitive for diagnosis of MAM. As Ethiopia is home of diverse ethnic groups with different body frame and environmental conditions, the new cut off points developed for each region recommended to be used for screening moderate acute malnutrition to prevent relapse of MAM and reduce chronic malnutrition.

COVID-19 infection prevention practices among a sample of food handlers of food and drink establishments in Ethiopia.

BACKGROUND: Cases of coronavirus disease (COVID-19) are increasing at an alarming rate throughout the world, including Ethiopia. Food handlers in food and drink establishments are at high risk of exposure to the virus due to their many daily contacts with customers. Since there is a paucity of evidence about infection prevention practices and associated factors among this high-risk group in Ethiopia including in Dessie City and Kombolcha Town, this study was designed to address this gap. METHOD: An institution-based cross-sectional study was conducted among 422 food handlers in Dessie City and Kombolcha Town food and drink establishments in July and August 2020. The study participants were selected using a simple random sampling technique. Data were collected by trained data collectors using a pretested structured questionnaire and an on-the-spot observational checklist. Data were entered into EpiData version 4.6 and exported to STATA version 14.0 for data cleaning and analysis. Data were analyzed using bivariable and multivariable logistic regression model at 95% confidence interval (CI). From the bivariable analysis, variables with a p-value <0.25 were retained into multivariable analysis. Finally, variables that had a p-value <0.05 were declared as factors significantly associated with good infection prevention practices of COVID-19 among food handlers. MAIN FINDINGS: The overall rate of good practice in infection prevention among food handlers was 43.9% (95% CI: 39.2-48.4%). Among the total 401 food handlers, 79.8% had good knowledge and 58.4% had a favorable attitude about COVID-19 infection prevention. Factors significantly associated with good COVID-19 infection prevention practices were: educational status of college or above (AOR = 1.97; 95% CI: 1.32-3.75), food handling work experience greater than five years (AOR = 2.55; 95% CI: 1.43-5.77), availability of written guidelines within the food and drink establishment (AOR = 2.68; 95% CI: 1.52-4.75), and taking training about infection prevention (AOR = 3.26; 95% CI: 1.61-6.61). CONCLUSION: Our findings showed that around one-third of food handlers had good infection prevention practices. Thus, to reduce COVID-19 transmission, integrated work is urgently needed to further improve food handlers' good practices, knowledge and attitude about infection prevention through providing health education, training and by making written infection prevention guidelines available in food and drink establishments.

Prevalence of Hypertension and Associated Factors Among Adults in Debre Berhan Town, North Shoa Zone, Ethiopia, 2020.

INTRODUCTION: Hypertension is a serious medical condition that significantly increases the risks of heart, brain, kidney, and other diseases. The prevalence is highest in Africa (27%) and lowest in America (18%). Hypertension is a major reason for premature death worldwide; this is why it will become a targeted non-communicable disease by 2025. OBJECTIVE: To assess the prevalence of hypertension and associated factors among adults in Debre Berhan town, Amhara region, Ethiopia. METHODS: A community-based cross-sectional study was conducted among 680 participants who were selected by a systematic sampling technique. Data were checked, cleaned, and entered into Epi-data then exported to SPSS-23 for analysis. Hosmer-Lemeshow test was used to check the model fitness. Binary logistic regression analysis was used to see the association between dependent and independent variables. All variables with p <0.25 were taken into the multivariable model to minimize the possible confounders. The multi collinearity test was carried out to see the correlation between independent variables by using a variance inflation factor (VIF). The odds ratio along with 95% CI were estimated to measure the strength of association and to identify factors associated with hypertension using multivariable logistic regression. Descriptive statistics in the form of tables, figures, percent with measure of central tendency and dispersion with multivariable analysis were used to report the findings and to identify the factors associated with the outcome variable at a p<0.05. RESULTS: Among 680 participants, the prevalence of hypertension was 27.5%. Sex, being male (AOR: 1.77, 95% CI: 1.12-2.81), alcohol consumption (AOR: 2.76: 95% CI: 1.87-4.05), physical exercise (AOR: 2.17, 95% CI: 1.28-3.71), being overweight (AOR: 1.99, 95% CI: 1.11-3.58), and family history of hypertension (AOR: 2.10, 95% CI: 1.43-3.08) were found to be significantly associated with hypertension. CONCLUSION AND RECOMMENDATION: Prevalence of hypertension in Debre Berhan town was relatively high compared with other studies. So, it is necessary to emphasize intervention in the community for behavioral change, in order to minimize alcohol consumption and to encourage adoption of regular physical exercise, with the existing health system and partners working on hypertension.