Knowledge, Attitude and Associated Factors of Monkeypox Infection Among Healthcare Workers in Injibara General Hospital, Northwest Ethiopia.

Background: Fighting health threats, especially the rise of new infectious diseases, is one of the main responsibilities of healthcare workers. However, their knowledge and attitudes toward monkeypox have not yet been assessed. Therefore, this study aimed to assess the knowledge, attitude, and factors associated with monkeypox infection among healthcare workers at Injibara General Hospital, Northwest Ethiopia. Methods: Institution-based cross-sectional study was conducted from December 1-30, 2022. Data were collected using a structured self-administered questionnaire. A simple random sampling technique was used to select study participants. Descriptive statistics and multivariable logistic regression analyses were computed. The degree of association was interpreted using an odds ratio with a 95% confidence interval and a p-value < 0.05. Results: Among the 200 healthcare workers who participated, 38.5% (95% CI: 32.5%-45%) and 62% (95% CI: 55-68.5%) had good knowledge and positive attitudes regarding monkeypox respectively. Having a master's degree or above (AOR = 11.25: 95% CI: 2.03-62.33), being vaccinated against COVID-19 (AOR = 2.60: 95% CI: 1.37-4.94), and having access to information about monkeypox (AOR = 3.37: 95% CI: 1.33-8.50) were the factors associated with good knowledge. Furthermore, a positive attitude was significantly associated with being 30 years of age or older (AOR = 2.95: 95% CI: 1.55-5.60) and having access to information about monkeypox (AOR = 4.14: 95% CI: 2.06, 8.30). Conclusion: Both good knowledge and positive attitudes were relatively low among healthcare workers. Factors such as age, education level, COVID-19 vaccination status, and access to information about monkeypox were significantly associated with the knowledge and attitude of healthcare workers. To enhance the knowledge and attitude of healthcare workers, hospitals should consider offering educational upgrades, hosting educational events like seminars, conferences, webinars, and campaigns, and ensuring comprehensive coverage of the topic in medical curricula.

Undiagnosed hypertension and associated factors among long-distance bus drivers in Addis Ababa terminals, Ethiopia, 2022: A cross-sectional study.

INTRODUCTION: Hypertension is a major public health problem that is often unrecognized, and its detection and control should be prioritized. The level of undiagnosed hypertension and its associated factors among long-distance bus drivers in Ethiopia is unknown. OBJECTIVE: This study aimed to assess the magnitude of undiagnosed hypertension and its associated factors among long-distance bus drivers in Addis Ababa bus terminals. METHODS: A facility-based cross-sectional study was conducted on 391 long-distance bus drivers from December 15, 2021, to January 15 2022 at five cross-country bus terminals in Addis Ababa. A standardized and structured questionnaire was adapted based on the WHO stepwise approach to a non-communicable disease study and translated into Amharic. Data were coded, cleaned, and entered using Epi-data version 4.6 and exported to SPSS version 26. Logistic regression analysis was performed. Variables with a P-value < 0.25 in the bivariable analysis were selected for multivariable logistic regression analysis. Independent variables with a P-value < 0.05 were considered statistically significant. The magnitude of association between independent and dependent variables was measured by odds ratio with a 95% confidence interval. RESULTS: In this study, 391 study participants were involved with a response rate of 97.1%. The prevalence of undiagnosed hypertension was 22.5% (CI: 18.7%, 26.6%). Poor level of knowledge (AOR: 2.00, CI: 1.08, 3.70), long duration of driving per day (AOR: 2.50, 95% CI: 1.37-4.56), habit of chewing of chat (AOR: 2.61, 95% CI: 1.44, 4.73), regular alcohol consumption (AOR = 3.46; 95% CI: 1.70, 7.05), overweight (AOR:3.14, 95%CI: 1.54,6.42) obesity (AOR: 3.21, 95% CI 1.35, 7.61) and regular physical exercise (AOR: 0.16, 95% CI: 0.09, 0.29) were statistically significantly associated with undiagnosed hypertension. CONCLUSION: This study revealed that the prevalence of undiagnosed hypertension among long-distance bus drivers was 22.5%, which was associated with modifiable behavioral factors, lack of regular physical exercise, lack of adequate awareness and high body mass index. RECOMMENDATION: Stakeholders must implement the necessary preventive measures. These include increasing the level of awareness of hypertension among long-distance drivers and developing prevention of hypertension strategies and policies focusing on lifestyle and behavioral modifications.

Incidence and predictors of hyperglycemic emergencies among adult diabetic patients in Bahir Dar city public hospitals, Northwest Ethiopia, 2021: A multicenter retrospective follow-up study.

Background: Diabetic ketoacidosis and hyperglycemic hyperosmolar syndrome are the two commonly known life-threatening hyperglycemic emergencies of diabetes mellitus. Despite the growing hyperglycemic emergency impact among adult patients with diabetes, its incidence and predictors have not been well studied in Ethiopia. Thus, this study aimed to assess the incidence and predictors of hyperglycemic emergencies among adult patients with diabetes. Method: A retrospective follow-up study design was conducted among a randomly selected sample of 453 adult patients with diabetes. Data were entered into EPI data version 4.6 and analyzed using STATA version 14.0. A Cox-proportional hazard regression model was fitted to identify the independent predictors of hyperglycemic emergencies, and variables having a p < 0.05 in the multivariable model were considered statistically significant. Result: Among the total adult patients with diabetes included in the study, 147 (32.45%) developed hyperglycemic emergencies. Hence, the overall incidence of hyperglycemic emergencies was 14.6 per 100 person-years observation. The incidence of diabetic ketoacidosis was 12.5 per 100 person-years (35.6 and 6.3 among T1DM and T2DM, respectively). The incidence of the hyperglycemic hyperosmolar syndrome was 2.1 per 100 person-years (0.9 and 2.4 among T1DM and T2DM, respectively). The overall median free survival time was 53.85 months. Type 1 diabetes mellitus [AHR = 2.75, 95% CI (1.68, 4.51)], diabetes duration of ≥ 3 years [AHR = 0.33, 95% CI (0.21, 0.50)], recent acute illness [AHR = 2.99, 95% CI (2.03, 4.43)], presence of comorbidity [AHR = 2.36, 95% CI (1.53, 3.63)], poor glycemic control [AHR = 3.47, 95% CI (2.17, 5.56)], history of medication non-compliance [AHR = 1.85,95% CI (1.24, 2.76)], follow-up frequency of 2-3 months [AHR = 1.79,95% CI (1.06, 3.01)], and without community health insurance [AHR = 1.63, 95% CI (1.14, 2.35)] were significant predictors of hyperglycemic emergencies. Conclusion: The incidence of hyperglycemic emergencies was high. Therefore, giving greater attention to patients with identified predictors could decrease the occurrence of hyperglycemic emergencies and related public health and economic impacts.

Quality of life and associated factors among family caregivers of individuals with psychiatric illness at DRH, South Wollo, Ethiopia, 2020.

Mental illness results in an enormous social and economic burden not only on patients, but also on their families and communities. Many caregivers of patients with mental illnesses suffer from an extremely poor quality of life. In Sub-Saharan Africa, approximately 71% caregivers suffer from economic burden of severe mental illness. To our knowledge, no study has been conducted on quality of life of caregivers in Ethiopia. Therefore, this study aimed to assess the quality of life of family caregivers of patients with mental illness at Dessie Referral Hospital. The institution-based cross-sectional study was conducted among 398 caregivers selected using a consecutive sampling technique. The World Health Organization Quality of Life BREF was used to assess the quality of life. Logistic regression was performed and statistical significance was declared at a p-value < 0.05. 189 (47.5%) of family caregivers had poor quality of life. Being divorced, unable to read and write, primary education, being spouse, sibling and children of the patient, poor social support and high perceived stigma were significantly associated with the outcome variable. Because the magnitude of poor quality of life among family caregivers was high, family intervention programs are highly recommended to improve quality of life among caregivers.

Access to and challenges in water, sanitation, and hygiene in healthcare facilities during the early phase of the COVID-19 pandemic in Ethiopia: A mixed-methods evaluation.

BACKGROUND: Inadequate water, sanitation, and hygiene (WASH) in healthcare facilities (HCFs) have an impact on the transmission of infectious diseases, including COVID-19 pandemic. But, there is limited data on the status of WASH facilities in the healthcare settings of Ethiopia. Therefore, this study aimed to assess WASH facilities and related challenges in the HCFs of Northeastern Ethiopia during the early phase of COVID-19 pandemic. METHODS: An institution-based cross-sectional study was conducted from July to August 2020. About 70 HCFs were selected using a simple random sampling technique. We used a mixed approach of qualitative and quantitative study. The quantitative data were collected by an interviewer-administered structured questionnaire and observational checklist, whereas the qualitative data were collected using a key-informant interview from the head of HCFs, janitors, and WASH coordinator of the HCFs. The quantitative data were entered in EpiData version 4.6 and exported to Statistical Package for Social Sciences (SPSS) version 25.0 for data cleaning and analysis. The quantitative data on access to WASH facilities was reported using WHO ladder guidelines, which include no access, limited access, and basic access, whereas the qualitative data on challenges to WASH facilities were triangulated with the quantitative result. RESULTS: From the survey of 70 HCFs, three-fourths 53 (75.7%) were clinics, 12 (17.2%) were health centers, and 5 (7.1%) were hospitals. Most (88.6%) of the HCFs had basic access to water supply. The absence of a specific budget for WASH facilities, non-functional water pipes, the absence of water-quality monitoring systems, and frequent water interruptions were the major problems with water supply, which occurred primarily in clinics and health centers. Due to the absence of separate latrine designated for disabled people, none of the HCFs possessed basic sanitary facilities. Half (51.5%) of the HCFs had limited access to sanitation facilities. The major problems were the absence of separate latrines for healthcare workers and clients, as well as female and male staffs, an unbalanced number of functional latrines for the number of clients, non-functional latrines, poor cleanliness and misuse of the latrine. Less than a quarter of the HCFs 15 (21.4%) had basic access to handwashing facilities, while half 35 (50%) of the HCFs did not. The lack of functional handwashing facilities at expected sites and misuse of the facilities around the latrine, including theft of supplies by visitors, were the two most serious problems with hygiene facilities. CONCLUSION: Despite the fact that the majority of HCFs had basic access to water, there were problems in their sanitation and handwashing facilities. The lack of physical infrastructure, poor quality of facilities, lack of separate budget to maintain WASH facilities, and inappropriate utilization of WASH facilities were the main problems in HCFs. Further investigation should be done to assess the enabling factors and constraints for the provision, use, and maintenance of WASH infrastructure at HCFs.

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.

The effect of lack of ANC visit and unwanted pregnancy on home child-birth in Ethiopia: a systematic review and meta-analysis.

Although extensive efforts were made to improve maternal and child health, the magnitude of home child-birth is considerably high in Ethiopia. Therefore, this meta-analysis aimed to estimate the effect of lack of ANC visit and unwanted pregnancy on home child-birth among reproductive-age women in Ethiopia. International databases, including Cochrane Library, Google Scholar, PubMed, Global Health, HINARI, and CINAHL were searched systematically to identify studies reporting the prevalence of home child-birth and its association with lack of ANC visit and unwanted pregnancy among reproductive-age women in Ethiopia. STATA/SE version-14 was used to analyze the data and Der Simonian and Liard's method of random effect model was used to estimate the pooled effects. The heterogeneity between study and publication bias was assessed by using I-squared statistics and Egger's test respectively. A total of 19 studies with 25,228 study participants were included in this meta-analysis. The pooled prevalence of home child-birth among reproductive-age women in Ethiopia was 55.3%. Sever heterogeneity was exhibited among the included studies (I2 = 99.8, p = 0.000). The odds of home child-birth among mothers who have no ANC visit was 3.64 times higher compared to their counterparts [OR = 3.64, 95%, CI: (1.45, 9.13)]. There was significant heterogeneity among the included studies (I2 = 94%, p = 0.000). However, there was no statistical evidence of publication bias in the pooled effect of lack of ANC visit on home child-birth (P = 0.302). Women who experienced unwanted pregnancy were 3.02 times higher to give birth at home compared to women with a wanted pregnancy [OR = 3.02, 95%CI: (1.19, 7.67)]. Severe heterogeneity was exhibited (I2 = 93.1%, p = 0.000) but, there was no evidence of significant publication bias in the pooled effect of unwanted pregnancy on home child-birth (P = 0.832). The proportion of home child-birth among reproductive-age women in Ethiopia remains high. Lack of ANC visit and unwanted pregnancy had a significant effect on the practice of home child-birth. Strengthening behavioral change communication programs should be the primary focus area to improve institutional delivery service utilization among women with lack of ANC visit and unwanted pregnancy.

Prevalence and associated factors of needle stick and sharps injuries among healthcare workers in northwestern Ethiopia.

BACKGROUND: Needle stick and sharp injuries (NSSIs) are a common problem among healthcare workers (HCWs). Although the factors related to NSSIs for HCWs are well documented by several studies in Ethiopia, no evidence has been reported about the magnitude of and factors related to NSSIs in hospitals in northwestern Ethiopia. METHODS: An institution-based cross-sectional study was carried out from January to March 2019 among 318 HCWs in three randomly-selected hospitals of the eight hospitals found in South Gondar Zone. Sample sizes were proportionally allocated to professional categories. Study participants were selected by systematic random sampling methods using the monthly salary payroll for each profession as the sampling frame. Data were collected using a self-administered questionnaire. The outcome of this study was the presence (injured) or absence of NSSIs during the 12 months prior to data collection. A binary logistic regression model with 95% confidence interval (CI) was used for data analysis. Variables from the bi-variable analysis with a p-value ≤ 0.25 were retained into the multivariable analysis. From the multivariable analysis, variables with a p-value less than 0.05 was declared as factors significantly associated with NSSIs. MAIN FINDINGS: The prevalence of NSSIs was 29.5% (95% CI: 24.2-35.5%) during the 12 months prior to the survey. Of these, 46.0% reported that their injuries were moderate, superficial (33.3%) or severe (20.7%). About 41.4% of the injuries were caused by a suture needle. Factors significantly associated with NSSIs were occupation as a nurse (adjusted odds ratio [AOR] = 2.65, 95% CI: 1.18-4.26), disposal of sharp materials in places other than in safety boxes (AOR = 3.93, 95% CI: 2.10-5.35), recapping of needles (AOR = 2.27, 95% CI: 1.13-4.56), and feeling sleepy at work (AOR = 2.24, 95% CI: 1.14-4.41). CONCLUSION: This study showed that almost one-third of HCWs had sustained NSSIs, a proportion that is high. Factors significantly associated with NSSIs were occupation as a nurse, habit of needle recapping, disposal of sharp materials in places other than in safety boxes and feeling sleepy at work. Observing proper and regular universal precautions for nurses during daily clinical activities and providing safety boxes for the disposal of sharp materials, practicing mechanical needle recapping and preventing sleepiness by reducing work overload among HCWs may reduce the incidence of NSSIs.

COVID-19 knowledge, attitude and frequent hand hygiene practices among taxi drivers and associated factors in urban areas of Ethiopia.

BACKGROUND: Although several studies have been conducted on COVID-19 knowledge, attitude and prevention practices among healthcare workers and the general population, there has not been any study among taxi drivers in Ethiopia, including Dessie City and Kombolcha Town, the lack of which hinders providing evidence-based interventions to this target group. Thus, this study was designed to contribute to proper planning of COVID-19 intervention measures among taxi drivers in Dessie City and Kombolcha Town, Ethiopia. METHODS: A cross-sectional study was conducted among 417 taxi drivers in Dessie City and Kombolcha Town during July to August, 2020. The data was collected using a structured questionnaire and an observational checklist. The collected data was checked, coded and entered to EpiData version 4.6 and exported to Statistical Package for the Social Sciences (SPSS) version 25.0 for data cleaning and analysis. The outcome variables of this study were good or poor knowledge, positive or negative attitude and good or poor frequent hand hygiene practices towards COVID-19. Bivariate (Crude Odds Ratio [COR]) and multivariable (Adjusted Odds Ratio [AOR]) logistic regression analysis were employed to identify factors significantly associated with good knowledge, positive attitude and good frequent hand hygiene practices among taxi drivers. Significance level of variables was declared at a p < 0.05 from the adjusted analysis. MAIN FINDINGS: Out of the total 417 taxi drivers, 69.8% [95% CI: 65.2-73.9], 67.6% [95%CI: 63.1-72.2] and 66.4% [95% CI: 62.1-71.0] of the drivers had good knowledge, positive attitude and good frequent hand hygiene practices, respectively. Educational level (AOR = 7.55, 95% CI = 4.55-12.54), place of residence (AOR = 5.41, 95% CI = 1.4-20.08) and attitude towards COVID-19 prevention (AOR = 1.67, 95% CI = 1.02-2.74) were factors associated with good knowledge about COVID-19. Further, age of taxi drivers greater than 30 years (AOR = 3.01, 95% CI = 1.76-5.13), educational level of secondary or above (AOR = 3.16, 95% CI = 1.88-5.31), income (AOR = 3.36, 95% CI = 1.48-7.61), and knowledge about COVID-19 (AOR = 2.1, 95% CI = 1.21-3.54) were factors associated with positive attitude towards COVID-19 prevention. In addition, attitude towards COVID-19 (AOR = 5.5, 95% CI = 3.40-8.88) and educational level (AOR = 1.84, 95% CI = 1.15-2.95) were the factors associated with good frequent hand hygiene practices. CONCLUSION: We concluded that the rates of good knowledge, positive attitude and good frequent hand hygiene practices were relatively low among taxi drivers in Dessie City and Kombolcha Town. We strongly recommended providing training about COVID-19 prevention measures for taxi drivers that considers age, education status and attitude areas essential to improve their knowledge, attitude and frequent hand hygiene practices to prevent the spread of COVID-19.

Depressive symptoms and associated factors among HIV positive patients attending public health facilities of Dessie town: A cross-sectional study.

BACKGROUND: Depressive symptoms are the most common psychiatric complication of Human Immunodeficiency Virus (HIV) infection. They are associated with poor drug adherence, treatment failure, and increase the risk for suicide. There was limited evidence of depressive symptoms among HIV-positive patients in the study area. So, this study aimed to determine the prevalence of depressive symptoms and associated factors among HIV-positive patients attending public health facilities of Dessie town, North-central Ethiopia, 2019. METHOD: A cross-sectional study was conducted on 380 HIV-positive patients attending ART clinics in Dessie town, North-central Ethiopia, 2019. Samples were selected using systematic random sampling and the data were collected by using structured, pretested, and interviewer-administered questionnaires. Patient Health Questionnaire (PHQ-9) at a cut-off point of 5 was used to assess depressive symptoms. The data were entered by Epi data version 3.1 and analyzed by SPSS version 25. A binary logistic regression model was used to identify factors associated with depressive symptoms. The Adjusted Odds Ratio (AOR) along with a 95% Confidence Interval (CI) was estimated to measure the association. The level of significance was declared at a p-value of less than 0.05. RESULT: The prevalence of depressive symptoms among HIV positive patients was 15.5% (95% CI: (12.4%, 19.2%)). Age 40-49 years compared to 30-39 years (AOR = 2.96, 95% CI: (1.01, 8.68)), age ≥50 years compared to 30-39 years (AOR = 3.81, 95% CI: (1.05, 13.8)), having perceived stigma (AOR = 10.2, 95%CI: (4.26, 24.4)) taking medication other than Antiretroviral Therapy (ART) (AOR = 2.58, 95% CI: (1.25, 5.33)) and history of opportunistic infections (AOR = 5.17, 95% CI: (1.31, 20.4)) were factors associated with depressive symptoms. CONCLUSION: The prevalence of depressive symptoms was low compared to previous studies. Age, perceived stigma, taking medication other than ART, and history of opportunistic infections were factors associated with depressive symptoms. Health education and counseling programs should be strengthened and target older patients, patients who took medications other than ART, patients who experienced perceived stigma and patients with a history of history opportunistic infections.

Adherence to antihypertensive medications among adult hypertensive patients attending chronic follow-up units of Dessie Referral Hospital, Northeastern Ethiopia: A cross-sectional study.

ABSTRACT: Hypertension is the leading cause of increased morbidity and mortality rates worldwide. Despite adherence to therapies is the important determinant of treatment success to reduce apparent resistant hypertension, maintaining good adherence to antihypertensive medications remained the most serious challenge. Thus, this study aimed to assess adherence to antihypertensive medications among adult hypertensive patients in Dessie Referral Hospital.A cross-sectional study design was conducted among hypertensive patients during May and June 2020. The study participants were selected using a systematic random sampling technique. The collected data were entered into EpiData version 4.4 and exported to SPSS version 25.0 software for data cleaning and analysis. Data were analyzed using bivariable and multivariable logistic regression at a 95% confidence interval (CI). A variable that has a P-value < .05 was declared as statistically significant. Hosmer-Lemeshow test was used to test goodness-of-fit and multicollinearity was tested.The overall good adherence to antihypertensive medications was 51.9%; 95% CI: (46.8-58.3%) and poor adherence was 48.1%. Factors associated with good adherence were: sex-female adjusted odd ratio (AOR) = 1.31; 95% CI (1.06-2.52), occupational status-employed AOR = 2.24; 95% CI (1.33-3.72), good knowledge of the disease AOR = 2.20; 95% CI (1.34-3.72) and good self-efficacy AOR = 1.38; 95% CI (1.20-2.13).This study revealed that almost half of the hypertensive patients in Dessie Referral Hospital had good antihypertensive medication adherence. Sex, occupational status, knowledge, and self-efficacy were factors associated with good adherence. Therefore, health education should be given to patients on the importance of complying with medication and patients should be monitored by health extension workers.

Emergency and Disaster Handling Preparedness Among Front Line Health Service Providing Nurses and Associated Factors at Emergency Department, at Amhara Regional State Referral Hospitals, Ethiopia.

INTRODUCTION: Globally around 1.6 million individuals have died as a result of disasters per year. These disruptive events that happen in the world each day result in damage to individuals, families, and communities. METHODS: An institution-based cross-sectional study was conducted. All frontline health-care providers at the emergency departments of Amhara Regional State Referral Hospitals during the study period were considered as studied subjects. Data were collected through a self-administered technique. Once all essential data were collected, data were coded and entered into epidata manager (v4.6.0.2) statistical software. SPSS version 26 was used to analyze the findings of this paper. RESULTS: The result of this research study showed that 66.7% were males and 33.3% were females with mean age of respondents being 31.2 ± 5.8. Among respondents, 54% (52.9) % did not have an understanding of disaster preparedness. As a result, the majority of participants, 52 (51%), have inadequate knowledge. Most respondents have adequate attitude (57.8%) and only a few, 12 (11.8%), of respondents were very familiar with regard to disaster and disaster handling preparedness. In multivariate logistic regression, receiving training on the subject (P = 0.000, AOR: 15.109. 95% CI: 3.525-64.769), respondents receiving simulation in the subject of disaster (P = 0.015, AOR: 4.855, 95% CI: 1.366-17.260) and having a direct personal/professional experience of disaster (P = 0.003, AOR: 5.703, 95% CI: 1.825-17.823) were significantly associated. CONCLUSION AND RECOMMENDATION: Disaster handling preparedness, knowledge and familiarity levels were below those expected for emergency department nurses. Capacity building through training, education and simulation is essential.

Facemask wearing to prevent COVID-19 transmission and associated factors among taxi drivers in Dessie City and Kombolcha Town, Ethiopia.

BACKGROUND: The World Health Organization (WHO) has pointed out that urban taxi drivers and their passengers are at higher risk of transmitting coronavirus disease 19 (COVID-19) due to frequent contact among many people. Facemask wearing is one of the preventive measures recommended to control the transmission of the virus. A lack of evidence of the proportion of facemask wearing among taxi drivers and associated factors in Ethiopia, including Dessie City and Kombolcha Town, hinders the design of targeted interventions to advocate for facemask use. This study was designed to address this gap. METHODS: A cross-sectional study was conducted among 417 taxi drivers in Dessie City and Kombolcha Town from July to August, 2020. The study participants were selected using a simple random sampling technique after proportionally allocating the sample size from the total number of taxi drivers working in Dessie City and Kombolcha Town. The data were collected by trained data collectors using a structured questionnaire and an on-the-spot observational checklist. The collected data were checked, coded and entered to EpiData version 4.6 and exported to Statistical Package for Social Sciences (SPSS) version 25.0 for data cleaning and analysis. Bivariate (Crude Odds Ratio [COR]) and multivariable (Adjusted Odds Ratio [AOR]) logistic regression analyses were employed using 95% CI (confidence interval). From bivariate logistic regression analysis, variables with p-value < 0.250 were retained into multivariable logistic regression analysis. Then, from the multivariable analysis, variables with p-value < 0.050 were declared as factors significantly associated with facemask wearing among taxi drivers in Dessie City and Kombolcha Town. MAIN FINDINGS: The proportion of taxi drivers who wore a facemask was 54.68% [95%CI: 50.10-59.7%]. The majority (58.3%) of drivers were using cloth facemasks, followed by N95 facemasks (24.5%) and surgical facemasks (17.3%). Out of the total 417 taxi drivers, more than two-thirds (69.8%) of them had a good knowledge about COVID-19 and 67.6% of taxi drivers had a positive attitude towards taking precautions against transmission of COVID-19. Three-fourths (74.1%) of the taxi drivers believed that wearing a facemask could prevent COVID-19. More than half (52.5%) felt discomfort when wearing a facemask. Almost three-fourths (72.2%) of taxi drivers felt that the presence of local government pressure helped them to wear a facemask. We found that marital status [AOR = 3.14, 95%CI: 1.97-5.01], fear of the disease [AOR = 2.1, 95%CI: 1.28-3.47], belief in the effectiveness of a facemask [AOR = 5.6, 95%CI: 3.1-10.16] and feeling government pressure [AOR = 3.6, 95%CI: 2.16-6.13] were factors significantly associated with wearing a facemask. CONCLUSION: We found that the proportion of facemask wearers among taxi drivers was relatively low in Dessie City and Kombolcha Town. In order to increase that number, government bodies should work aggressively to encourage more taxi drivers to wear a facemask. We also recommend that government and non-government organizations work very closely together to implement strategies that promote facemask use, including increasing the availability of inexpensive facemasks, and monitoring and controlling facemask use.

Adherence to Lifestyle Modifications and Associated Factors Among Adult Hypertensive Patients Attending Chronic Follow-Up Units of Dessie Referral Hospital, North East Ethiopia, 2020.

BACKGROUND: Hypertension is a major health problem throughout the world which affects over one billion people due to severe complications and inadequate control. Even though lifestyle modification is one of the most effective ways to prevent and control hypertension, only little emphasis has been given for it compared with treating hypertension with medication. Therefore, the aim of this study was to assess adherence to lifestyle modifications and associated factors among hypertensive patients attending Dessie referral hospital. MATERIALS AND METHODS: Institutional-based cross-sectional study design was conducted among 301 hypertensive patients during May and June, 2020. The study participants were selected with a convenient sampling technique due to the COVID-19 pandemic. Data were collected using pre-tested and structured face to face interviewer-administered questionnaire and checked, cleaned and entered into Epi data version 4.4 and exported to SPSS version 25.0 software for analysis. The associations between independent variables and dependent variable were analyzed using binary logistic regression models. RESULTS: A total of 301 respondents participated in the study yielding a response of 100%. The overall adherence in this study was only 23.6%. Independent predictors of adherence to lifestyle modifications were divorced (AOR=0.35; 95% CI (0.13-0.94)) and widowed (AOR=0.27; 95% CI (0.10-0.75)), secondary school education (AOR=4.85; 95% CI (1.54-15.22)), no regular income (AOR=0.22; 95% CI (0.08-0.65)) or monthly income of ≥3000 ETB (AOR=5.58; 95% CI (2.46-12.66)), having co-morbidities (AOR=2.37; CI (1.23-4.57)), good knowledge about the disease (AOR=1.83; CI (0.92-3.65)) and good self-efficacy (AOR=3.64; CI (1.75-7.55)). CONCLUSION AND RECOMMENDATIONS: The overall adherence to recommended lifestyle modifications was very low. The independent predictors were marital status, educational level, monthly income, having co-morbidities, knowledge and self-efficacy. Therefore, multifaceted and collaborative implementation of strategies about lifestyle modifications for hypertension prevention and control are needed to address barriers at the patient, provider, system and community levels.

Sleep Quality and Associated Factors among Diabetes, Hypertension, and Heart Failure Patients at Debre Markos Referral Hospital, Northwest Ethiopia.

BACKGROUND: Chronic illnesses have a negative impact on the quality of sleep; however, patients with chronic illness do not bring sleep issues while they are coming to a health institution for a follow-up. As a result, poor sleep quality among patients with chronic illness is often unrecognized and untreated, and it results to a negative impact on the prognosis of chronic illness. METHODS: An institutional-based cross-sectional study design was employed from February 22, 2018, to April 6, 2018. The total sample size was 396. The study employed a stratified random sampling technique, and study participants were selected by systematic sampling. The data were collected by a Pittsburgh Sleep Quality Index (PSQI) questionnaire which is a validated and standardized tool. The data were analyzed by SPSS version 25; text, tables, and figures were utilized for data presentation. By considering a 95% confidence level and P value of 0.05, binary logistic regression and Kruskal-Wallis test were enrolled. RESULTS: The prevalence of poor sleep quality among diabetes, hypertension, and heart failure patients was 36.5%. The odds of being a poor sleeper are increased when age increased. Patients who have poor perception towards the prognosis of their illness were four times more likely to be a poor sleeper compared to patients with good perception (AOR = 4.21, 95%CI = 1.94-9.13, P = 0.001). Patients who have anxiety were four times more likely to be a poor sleeper compared with patients without anxiety (AOR = 3.69, 95%CI = 2.19-6.20, P = 0.001). The educational level and residence were other factors associated with sleep quality. There was a statistically significant difference of sleep quality between patients with diabetes and hypertension, and diabetes and heart failure (F (2, 384) = 10.92, P = 0.004). Conclusion and Recommendations. In this study, over one-third of patients had poor sleep quality. Age, educational level, residence, perception towards prognosis of illness, and anxiety were factors associated with sleep quality. All health care providers should assess and provide advice about sleep hygiene and influencing factors. Assessment of sleep quality for every diabetes, hypertension, and heart failure patients in every visit should be incorporated in the care package.

Incidence and Predictors of Tuberculosis among Adult Diabetic Patients, Debre Markos Referral Hospital, Northwest Ethiopia, 2018: A Retrospective Cohort Study.

BACKGROUND: Tuberculosis remains a serious global public health problem. It mainly affects the lungs, and occurs in every part of the world. The link between tuberculosis and diabetes mellitus is essential to inform programs and policies, yet there is a scarcity of information in our study area. Therefore, this study aimed to investigate the incidence and predictors of tuberculosis among diabetic patients at Debre Markos Referral Hospital, northwest Ethiopia. METHODS: This institutionally based retrospective cohort study was undertaken among 433 diabetic patients of Debre Markos Referral Hospital between January 2013 and December 2017. All eligible diabetic patients who met the inclusion criteria were included in the study. Data were entered using EpiData version 3.1 and analyzed using Stata version 14. The survival time of diabetic patients was estimated using Kaplan-Meier survival curves, and survival time among different categorical variables compared using the log-rank test. Both bivariate and multivariate Coxproportional-hazard regression models were fitted to identify independent predictors of tuberculosis among diabetic patients. RESULTS: Among the cohort of 43326 (6%) developed tuberculosis during follow-up. The overall tuberculosis-incidence rate was 2.4 per 100 with 95% CI. The total time allotted to follow up the study participants was 1,101.5 person-years. Using multivariate Cox regression analysis, history of alcohol consumption (adjusted incidence ratio 4, 95% CI 1.2-13; P=0.02) and history of tuberculosis (12, 95% CI 3-39; P=0.01) significantly increased the risk of tuberculosis, but normal body-mass index and above (≥18.5 kg/m2) was associated with a rate reduction (0.34, 95% CI 0.14; P=0.80; 0.03) forincidence of tuberculosis. CONCLUSION: In this study, we found a high rate of tuberculosis among diabetic patients. Factors significantly linked with increased risk of tuberculosis included history of alcohol consumption, history of tuberculosis, and low body-mass index. Early screening and treatment for tuberculosis is highly recommended at diabetes mellitus follow-up for patients with these risk factors.

Determinants of Diabetic Complication Among Adult Diabetic Patients in Debre Markos Referral Hospital, Northwest Ethiopia, 2018: Unmatched Case Control Study.

BACKGROUND: Diabetes mellitus is a group of common metabolic disorders that share the phenotype of hyperglycemia, and are caused by a complex interaction of genetics and environmental factors. Diabetes mellitus produces change in the blood vessels and therefore affects almost every part of the body. METHODS: A hospital-based unmatched case control study was conducted from February 2018 to April 2018 at Debre Markos Referral Hospital. Data were collected from 204 individuals, 136 controls and 68 cases using an interviewer-administered questionnaire and patient chart. Data were entered into EPI-data 3.1 software and exported to SPSS version 21 for analysis. Descriptive analysis including mean, median and proportions was carried out. In bivariate analysis, variables below 0.25 significance level were selected for multivariable analysis. For multivariable analysis, a backward model was selected and 95% confidence interval variables with P-values below 0.05 in multivariable analysis were declared as significant variables. RESULTS: Of the total respondents, 68 were cases and 136 were controls, with an overall response rate of 98.55%. Of these respondents, 57.4% and 57.8% were males and type 1 diabetic patients, respectively. This study found that ages of 38-47 (AOR= 5.60 (1.62-19.38)) and >47 (AOR=4.81 (1.32-17.5)), income of 1000-1499 (AOR=3.10 (1.05-9.08)), self-reported drug adherence (AOR=5.146 (1.651-16.04)), FBS of 70-130 mg/dL 0.095 (0.022-0.414) and ≥131 mg/dL (0.05 (0.011-0.223)) and type 1 diabetic mellitus (AOR=4.73 (1.765-12.72)) were significantly associated with diabetes mellitus complications. CONCLUSION AND RECOMMENDATIONS: The study identified important determinants of diabetic complications. Poor glycemic control, poor adherence, and income were found to be modifiable determinants; on the other hand, age and type of diabetic mellitus are non-modifiable determinants of diabetic complications. Clinicians should implement a comprehensive care plan that will address patients' adherence and glycemic control problems.

Timely Initiation of Complementary Feeding and Associated Factors among Mothers of Children Aged 6-24 Months in Dessie Referral Hospital, Northeast Ethiopia, 2019.

BACKGROUND: Timely, appropriate, safe, adequate, and frequent feeding is essential during the transition period for optimal growth and development as well as vulnerability of the child. The age of initiation of complementary feeding needs to be strongly addressed. Thus, the aim of this study was to determine timely initiation of complementary feeding and associated factors among mothers of children aged 6-24 months in Dessie Referral Hospital. METHODS: Institutional-based cross-sectional study was conducted among 280 mothers of children aged 6-24 months. A systematic random sampling technique was employed for selection of study participants by considering the 1st comer as a starting point and then at every 5th interval till the sample size was saturated at exit time. Data were collected using pretested and validated structured interviewer-administered questionnaire. Data were entered to Epi data version 3.1 and exported to SPSS version 20.0 software for analysis. Descriptive statistics and binary logistic regression model were used. RESULTS: Overall response rate was 98.2%. Among 275 mothers with children aged 6-24 months, 36 (13.1%), 179 (65.1%), and 60 (21.8%) mothers started giving complementary feeding for their children early (before six months), timely (at six months), and late (after six months), respectively. Mothers' educational status of grade 9-12 and college and above [AOR = 3.03; 95% CI (1.13-8.14), and AOR = 3.74; 95% CI (1.19-11.70), respectively], getting counsel [AOR = 2.83; 95% CI (1.54-5.21)], and poor knowledge [AOR = 0.37; 95% CI (0.19-0.72)] were found to be independent predictors. CONCLUSIONS: Prevalence of timely initiation of complementary feeding was high as compared to the national prevalence. Mothers' educational status, getting counsel about complementary feeding, and knowledge were factors associated with timely initiation of complementary feeding. Therefore, awareness creation, counseling, and health education should be done on society by concerned bodies to improve timely introduction of complementary feeding level more than this result.