Loneliness and its associated factors among university students during late stage of COVID-19 pandemic: An online cross-sectional study.

BACKGROUND: The COVID-19 pandemic resulted in a number of psychosocial and emotional catastrophes, including loneliness. The associated lockdowns, reduced social support, and insufficiently perceived interactions are expected to heighten the level of loneliness during the pandemic. However, there is a dearth of evidence regarding the level of loneliness and what correlates with loneliness among university students in Africa, particularly in Ethiopia. OBJECTIVES: The general objective of this study was to assess the prevalence and associated factors of loneliness among university students during the COVID-19 pandemic in Ethiopia. METHODS: A cross-sectional study was undertaken. An online data collection tool was distributed to voluntary undergraduate university students. The sampling technique used was snowball sampling. Students were requested to pass the online data collection tool to at least one of their friends to ease data collection. SPSS version 26.0 was used for data analysis. Both descriptive and inferential statistics were used to report the results. Binary logistic regression was used to identify factors associated with loneliness. A P-value less than 0.2 was used to screen variables for the multivariable analysis, and a P-value less than 0.05 was used to declare significance in the final multivariable logistic regression. RESULT: A total of 426 study participants responded. Out of the total, 62.9% were males, and 37.1% attended fields related to health. Over three-fourths (76.5%) of the study participants encountered loneliness. Females (adjusted odds ratio (AOR): 1.75; 95% confidence interval (CI): 1.01, 3.04), non-health-related departments (AOR: 1.94; 95% CI: 1.17, 3.35), ever encountering sexual harassment (AOR: 3.32; 95% CI: 1.46, 7.53), sleeping problems (AOR: 2.13; 95% CI: 1.06, 4.30), perceived stress (AOR: 6.40; 95% CI: 1.85, 22.19) and poor social support (AOR: 3.13; 95% CI: 1.10, 8.87) were significantly associated with loneliness. CONCLUSION AND RECOMMENDATION: A significant proportion of students were victims of loneliness during the COVID-19 pandemic. Being female, working in non-health-related fields, having sleeping problems, encountering sexual harassment, perceived stress, and poor social support were significantly associated with loneliness. Interventions to reduce loneliness should focus on related psychosocial support to reduce stress, sleeping disturbances, and poor social support. A special focus should also be given to female students.

Household drinking water quality and its predictors in flood-prone settings of Northwest Ethiopia: A cross-sectional community-based study.

Globally, the deterioration of drinking water quality is a major public health problem that contributes to the spread of disease and causes death. Therefore, it is important to have regular quality control monitoring. This study aimed to assess the level of physicochemical and bacteriological quality of household drinking water and its contributing factors in flood-prone settlements of South Gondar Zone, Ethiopia. A community-based cross-sectional study was conducted in flood-prone settings of Northwest Ethiopia from January 17 to March 30, 2021. Structured questionnaires were used to gather the sociodemographic, environmental, and behavioral data. A total of 675 drinking water samples were collected from water storage containers of selected households. Logistic regression models were used for both univariate and multivariable studies. The survey included a total of 675 households. The mean values of pH (5.9 ± 1.03), turbidity (6.7 ± 2.21 NTU), and free residual chlorine (0.02 ± 0.01 mg/l) did not meet the WHO recommended limits for drinking water. The prevalence of fecal contamination of drinking water in the study area was 62.2% with [95% CI (53-60%)]. Family size [AOR = 2.205, 95% CI (1.375-3.536), absence of latrine [AOR = 3.449, 95% CI (1.349-8.823)], and lack of a separate container to draw water from its storage [AOR = 0.454, 95% CI (0.249-0.827)] were significant predictors for fecal contamination of household drinking water. In conclusion, the water quality in terms of pH, turbidity, residual chlorine, and bacteriological parameters was poor and not suitable for consumption. High prevalence of fecal contamination of water was found, and it was significantly associated with family size, the absence of a latrine, and the lack of a separate cap to take water from the storage. Therefore, continuous chlorination and monitoring its concentration, educating the community on how to use stored water, educating the advantage of having a latrine, and promoting point-of-use treatments such as filtration and boiling are needed.

Prevalence of diarrheal disease and associated factors among under-five children in flood-prone settlements of Northwest Ethiopia: A cross-sectional community-based study.

Background: Diarrheal illnesses are a long-standing public health problem in developing countries due to numerous sanitation issues and a lack of safe drinking water. Floods exacerbate public health issues by spreading water-borne infectious diseases such as diarrhea through the destruction of sanitation facilities and contamination of drinking water. There has been a shortage of studies regarding the magnitude of diarrheal disease in flood-prone areas. Therefore, this research aimed to evaluate the prevalence of diarrheal disease and its predictors among under-five children living in flood-prone localities in the south Gondar zone of Northwest Ethiopia. Method: A community-based cross-sectional research was carried out in flood-prone villages of the Fogera and Libokemkem districts from March 17 to March 30, 2021. Purposive and systematic sampling techniques were used to select six kebeles and 717 study units, respectively. Structured and pretested questionnaires were used to collect the data. A multivariable analysis was performed to determine the predictors of diarrheal disease, with P-value <0.05 used as the cut-off point to declare the association. Result: The prevalence of a diarrheal disease among under-five children was 29.0%. The regular cleaning of the compound [AOR: 2.13; 95% CI (1.25, 3.62)], source of drinking water [AOR: 2.36; 95% CI: (1.26, 4.41)], animal access to water storage site [AOR: 3.04; 95% CI: (1.76, 5.24)], vector around food storage sites [AOR: 9.13; 95% CI: (4.06, 20.52)], use of leftover food [AOR: 4.31; 95% CI: (2.64, 7.04)], and fecal contamination of water [AOR: 12.56; 95% CI: (6.83, 23.20)] remained to have a significant association with diarrheal diseases. Conclusion: The present study found that the prevalence of the diarrheal disease among under-five children was high. Routine compound cleaning, the source of drinking water, animal access to a water storage site, vectors near food storage sites, consumption of leftover food, and fecal contamination of water were significant predictors of diarrheal disease. Therefore, it is advised to provide improved water sources, encourage routine cleaning of the living area, and offer health education about water, hygiene, and sanitation.

Health professionals' practice to care cytotoxic drug handling and associated factors: The case of university of gondar specialized hospital.

BACKGROUND: Health care professionals are potential to be in contact with cytotoxic drugs during their daily work activ-ities. The study aimed to assess the practice of health professionals to care for cytotoxic drugs and associated factors in the University of Gondar Specialized Hospital. METHODS: Cross-sectional study design was employed. EPI Info 7 was used for data entry and then exported into SPSS 20 for statistical analysis. Frequencies and mean with standard deviation were computed. Logistic regression had been performed to find out associated factors. Crude' and adjusted Odds' ratio with 95% uncertainty interval was done. Variables with a p < 0.05 were declared as significant factors for practice of cytotoxic drug handling. RESULTS: The study used four-hundred and twelve health professionals took part in the study with 97.4% response rate. The mean age of study participants was 29.9 years ranging from 20-60 years and twenty (53.4%) participants were males. One hundred and fifty-five (37.6%) health professionals had good cytotoxic drug handling practice. Attending an average of 4-9 patients per day (AOR = 2.12, 95% CI: 1.05, 4.22), Medium work stress (AOR = 2.01, 95% CI: 1.04, 3.90), availability of cytotoxic drug handling manual (AOR = 2.51: 95% CI: 1.22, 5.12), and good knowledge (AOR = 4.09, 95% CI: 2.35, 7.11) were significantly associated with cytotoxic drug handling practice. CONCLUSION: The practice of cytotoxic drug handling care was low. It demands the engagement of the health sector to avert such inadequate practice and has to focus on delivering knowledge and logistics for the practice of cytotoxic drug handling.

Work-related stress and associated factors among garment workers in Bole Lemi Industrial Park of Addis Ababa, Ethiopia: a multi-center institution-based cross-sectional study.

BACKGROUND: Work-related stress (WRS) is a growing problem around the world that affects the health and well-being of employees. However, evidence of work-related stress in Ethiopia, particularly among garment industry employees, is scarce. This study aimed to assess the prevalence and associated factors of work-related stress among garment workers in the Bole Lemi industrial park in Addis Ababa, Ethiopia. METHODS: A multi-center institutional-based cross-sectional study was conducted from February 01 to March 31, 2021. A total of 605 study participants were selected using a stratified random sampling technique. A pre-tested, interviewer-administered standardized questionnaire was used to collect data. The logistic regression model was employed to identify determinant factors for work-related stress, and statistical significance was declared at a p-value < 0.05. RESULTS: The magnitude of work-related stress in garment workers was 44.1% (95% CI: 40.0, 48.0). Being within the age group of 25 - 34 years (AOR = 0.57, 95% CI: 0.36, 0.90) and receiving induction training (AOR = 0.35, CI: 0.20, 0.62) were protective factors with stress. Whereas lack of family support (AOR = 2.72, CI: 1.60, 4.64), lack of job satisfaction (AOR = 4.26, CI: 2.77, 6.57), and khat chewing (AOR = 3.14, CI: 1.35, 7.32) were positively associated with work-related stress. CONCLUSION: Work-related stress is prevalent among garment workers in the study setting. Being between the ages of 25-34 years and receiving induction training were protective factors against stress, while a lack of family support, a lack of job satisfaction, and khat chewing practices were positively associated with work-related stress. Therefore, improving family support and job satisfaction, providing induction training during employment, and providing psychological support for substance users to bring about changes are mandatory in Bole Lemi Industrial Park, Ethiopia.

Perceived stress and associated factors among university students in Ethiopia during the late stage of the COVID-19 pandemic: A cross-sectional study.

Background: During extensive outbreaks of infectious diseases, people who are impacted, particularly the subgroups of the community who are at an increased risk of mental health problems, may experience increased stress and mental health difficulties. University students are one such susceptible population and are prone to experiencing high levels of stress as compared with the general population. Therefore, this study aimed at assessing perceived stress and identifying its associated factors among university students in Ethiopia during the late stage of the COVID-19 pandemic. Methods: A cross-sectional study was conducted among university students in Ethiopia from 30 May to 30 June 2021. Students were asked to fill out an online survey on Google Forms that included consent, sociodemographic information, the UCLA-8 Loneliness Scale, the standard validated stress scale (PSS-10) questionnaire, and the three-item Oslo Social Support Scale (OSSS-3) to assess social support. The collected data were exported to SPSS 26. Descriptive and analytical statistics were carried out. Binary and multiple logistic regression analyses were performed to find associated factors, and variables with a p-value of 0.05 were considered statistically significant variables. Results: A total of 426 university students were included in the survey, among whom 268 (62.9%) were male participants. The age of the participants ranged from 18 to 37 years. Health-related departments accounted for 37.1% of the participants, while non-health-related departments accounted for 62.9%. The prevalence of stress was 18.3% in the study population. In this study, extreme susceptibility to COVID-19, sleeping problems, poor self-efficacy to prevent COVID-19, and loneliness were significantly associated with perceived stress. Conclusion: Stress was prevalent among university students in Ethiopia during the late stage of the COVID-19 pandemic. Extreme susceptibility to COVID-19, sleeping problems, poor self-efficacy, and loneliness were identified as factors for stress. Therefore, we suggest that universities should provide opportunities for safe social connection, counseling, and guidance for students.

Prevalence of active trachoma and associated factors among school age children in Debre Tabor Town, Northwest Ethiopia, 2019: a community based cross-sectional study.

BACKGROUND: Trachoma is an infectious eye disease caused by Chlamydial trachomatis. It is a major health problem in poor nations, notably in Sub-Saharan Africa. Despite the severity of the problem, there was a scarcity of data on trachoma prevalence and associated factors among school-aged children in Debre Tabor town following SAFE and MDA. OBJECTIVES: The goal of this study was to determine the prevalence of active trachoma and its associated factors among school-aged children in Debre Tabor, Northwest Ethiopia, in 2019. METHODS: A community-based cross-sectional study was used among school-aged children. Structured interview questionnaires, an observational checklist, and a physical examination were used to collect data from study participants who were chosen using a systematic random sampling procedure. IBM SPSS 20 was used to enter data, which was then transferred to IBM SPSS 20 for bivariate and multivariable logistic regression analysis. RESULT: A total of 394 children aged 5-15 had been screened and took part in the study, with 9.9% (95% CI: 6.9, 12.7) testing positive for active trachoma. Having an unimproved larine type (AOR = 5.18; 95%CI: 1.96, 13.69), improper solid waste disposal (AOR = 3.026; 95%CI: 1.17, 7.8), family size greater than four (AOR = 3.4; 95%CI: 1.22, 9.49), not using soap for face washing (AOR = 4.48; 95%CI: 1.46, 13.72) and an unclean face of the child during examination (AOR = 23.93; 95%CI: 8.25, 69.38) were found to be significant predictors of active trachoma. CONCLUSION: Active trachoma among school-age children was high compared to the WHO's definition of trachoma as a public health problem. A family size of four, poor solid waste management, an unimproved type of latrine, an unclean child's face, and not using soap when washing one's face were all significant predictors of active trachoma. Promotion of behavioral determinants through health education programs like keeping facial cleanliness by washing their child's face with soap, managing solid waste properly, and installing improved latrines to reduce active trachoma needs to be in place.

Knowledge of Antimicrobial Resistance and Associated Factors Among Health Professionals at the University of Gondar Specialized Hospital: Institution-Based Cross-Sectional Study.

Background: Antimicrobial resistance is one of the many health challenges worldwide, particularly in resource-limited countries like Ethiopia. Increasing knowledge of health professionals can reduce the occurrence of antimicrobial resistance. In this study, we determined the antimicrobial resistance knowledge and examined the associated factors among the University of Gondar Hospital health professionals. Methods: An institution-based cross-sectional survey was carried out. The samples were randomly recruited. Statistical analysis was performed by using the statistical package for social sciences (SPSS) version 20 after entering the data using Epidemiological information (Epi-Info). To identify associated factors, the authors executed binary logistic regression and multivariate analysis wherein the statistical significance was decided at p < 0.05. Results: Four hundred and twelve health professionals with ages ranging from 20-60 years and mean age of 29.9 years took part in the study. Fifty-three-point-four percent of participants were males. The majority of the total respondents (84.7%, 95% CI: 80.08-88.30) had good knowledge of antimicrobial resistance. It was found that being male (AOR = 1.94, 95% CI: 1.10, 3.52), a work experience of 6-10 years (AOR = 2.45, 95% CI: 1.28, 4.68), having 30-38working hours per week (AOR = 3.93, 95% CI: 1.38, 5.11), and antibiotic intake (AOR = 3.71, 95% CI: 1.75, 7.87) were significant factors of antimicrobial resistance knowledge. Conclusion: In the current study, about 84.5% of health professionals had good knowledge of antimicrobial resistance. Reducing working hours per week and increasing the experience of workers are recommended to increase the knowledge on AMR.

Health professionals' attitude and associated factors toward cytotoxic drug handling in University of Gondar specialized hospital: Institution-based cross-sectional study.

BACKGROUND: Studies have shown that cytotoxic drugs are dangerous to health care workers. Health care professionals' attitude to cytotoxic drugs is vital to apply safety protocols in the prevention of cytotoxicity. The current study aimed to assess health professionals' desirable attitude and associated factors toward cytotoxic drugs handling in the University of Gondar Specialized Hospital. METHODS: An institution-based cross-sectional study was conducted on 412 health professionals from June to August 2019. Simple random sampling was used to select participants and a self-administered questionnaire was used to collect data. Epi Info and SPSS 20 were used for data entry and analysis, respectively. Variables with a p value < 0.05 were declared as determinants. RESULTS: The number of health professionals included was approximately 412. The mean age of participants was 29.9 ± 5.4 years. The proportion of participants with desirable attitude toward cytotoxic drugs handling was 224 (54.4%) (95% confidence interval: 51.95-56.85). Male (adjusted odds ratio = 1.69, 95% confidence interval:[1.08-2.65]), work experience of 5-8 years (adjusted odds ratio = 1.92, 95% confidence interval: [1.10-3.34]), weekly working hours of 44-55 (adjusted odds ratio = 2.25, 95% confidence interval: [1.02-4.96]), medium work stress (adjusted odds ratio = 1.67, 95% confidence interval: [1.01-2.69]), and good practice of cytotoxic drug handling (adjusted odds ratio = 1.67, 95% confidence interval: [1.04-2.67]) were significantly associated with the attitude of health professionals. CONCLUSION: A significant proportion of health care workers did not have desirable attitude to handle cytotoxic drugs. Thus, strategies are suggested to improve the positive attitude of health professionals to cytotoxic drug handling. Female health professionals, those who had work experience of less than 2 years and those with higher work stress demand special attention.

Food Safety Attitude and Associated Factors Among Mothers of Under 5 Children, Debarq Town: Community-Based Cross-Sectional Study, 2019.

BACKGROUND: Food-borne diseases represent a widespread and growing public health problem, both in developed and developing countries. However, this problem has more impact on health and economy in developing countries than in developed countries but reliable data is not available. METHODS: A cross-sectional study was done in 2019 at Debarq town, Amhara region, Northwest Ethiopia. A questionnaire prepared in English after adapted from previous studies then translated in to local language Amharic was used in order to collect the data. Data were checked manually for completeness, coded, and entered in to Epi Info version 7.1 and then exported in to SPSS version 26 statistical package for analyze. Descriptive statistics, percentage, frequency, standard deviation, and mean were analyzed. Likewise, bivariable and multivariable binary logistic regression analysis were done to know the relationship between the independent variables and attitude of food safety among mothers. The variables found having a P-value <.2 in the bivariable analysis were further analyzed in multivariable binary logistic regression. The variables with P-value <.05 were considered as significantly associated with food safety attitude of mothers. RESULTS: About 423 mothers of under-5 children were involved in this study. The mean age of the participants was 39.844 ± 11.02. In this study, educational status (primary education (Adjusted Odds Ratio [AOR]: 2.66; 95% Confidence Interval [CI] [1.42-4.97]), secondary education (AOR: 2.66; 95% CI [3.35-14.05]), and diploma and above (AOR: 4.07; 95% CI [1.65-10.06])), higher income (AOR: 3.58; 95% CI [1.54-8.29]), good food safety knowledge (AOR: 3.08; 95% CI [1.51-6.242]) and good food hygiene practice (AOR: 3.97; 95% CI [2.33-6.75]) were factors associated with food safety attitude in the current study. CONCLUSION: Significant proportion of participants in the study area had poor food safety attitude. Educational status, income, food safety knowledge, and food safety practice were significantly associated with food safety attitude among mothers. Food hygiene practice, knowledge, and level of education should be increased in order to improve food safety attitudes among mothers who were responsible in food processing at household level.

Assessment of Community Pharmacy Professionals' Attitude and Perception Towards Ethical Issues in Amhara Region, Ethiopia: A Cross-Sectional Survey 2020.

PURPOSE: The objective of this study was to assess the attitude and perception of community pharmacy professionals' towards ethical issues. METHODS: We have undertaken a cross-sectional study among community pharmacy professionals in three selected towns (Gondar, Bahir Dar, and Debra Markos) of Amhara region in Ethiopia from February to March 2020. All community pharmacy professionals who were giving services during the data collection period were the study population. We used a pretested, semi-structured questionnaire developed from a review of previous study. Epi-info 7.1 was used for data entry, and SPSS version 20 was used for data analysis. Logistic regression was done, and a variable with a p-value < 0.05 with 95% confidence interval was considered to be associated with outcome variable. RESULTS: A total of 305 community pharmacy professionals participated in the study with a response rate of 95.3%. About 252 (82.6%) of respondents received education regarding professional ethics. Majority (89.8%) of the participants had ever accessed ethical information at their work site. Only 145 (47.5%) participants had ever recorded ethical issues in their working site. The most common reasons that obstruct to explain ethical issues to customers were shortage of time (85.9%), unavailability of reliable resources (40.0%), and poor ethical knowledge (37.7%). The reporting rate of respondents is less than 50% for most ethical scenarios. Sex, age, educational status, work experience, number of customers per day, working site, information about ethics, and training about ethics were observed to have a significant association with attitude and perception of community pharmacy professionals towards ethical issues. CONCLUSION: Community pharmacy professionals had poor attitude and perception towards ethical issues. Interventions should be devised to uphold ethical awareness of community pharmacy professionals. A large-scale study is also recommended.

Individual and community-level determinants of knowledge of ovulatory cycle among women of childbearing age in Ethiopia: A multilevel analysis based on 2016 Ethiopian Demographic and Health Survey.

BACKGROUND: Knowledge of the ovulatory cycle (KOC) aids women to refrain and engage in sexual intercourse to avoid and to get pregnancy, respectively. The effect of community-level factors on KOC was not yet known in Ethiopia. Therefore, we aimed to investigate the community- and individual-level determinants of KOC among women of childbearing age. METHODS: We used the 2016 Ethiopian Demographic and Health Survey, and total weighted samples of 15,683 women were included. Intra-class correlation, median odds ratio, and deviance were executed for model comparison in which a model with the lowest deviance was the best model i.e. model III in this case. A multivariable multilevel logistic regression model was employed to identify community- and individual-level factors of correct KOC. In the ultimate model, an adjusted odds ratio (AOR) with a 95% confidence interval was reported and variables with a p<0.05 were considered as statistically significant. RESULTS: In this study, 3,698 [23.58% (95% CI; 22.92-24.25)] participants had correct KOC. Women's age in years, i.e. 20-24 (AOR = 1.46;1.28-1.68) 25-29 (AOR = 1.72; 1.49-1.99), 30-34 (AOR = 2.21; 1.89-2.58), 35-39 (AOR = 1.78; 1.51-2.09), 40-44 (AOR = 1.97; 1.65-2.37), and 45-49 (AOR = 1.78; 1.44-2.19), knowledge of contraceptive methods (AOR = 3.08; 2.07-4.58), increased women's educational level, i.e. higher (AOR = 4.24; 3.54-5.07), secondary (AOR = 2.89; 2.48-3.36), and primary (AOR = 1.57; 1.39-1.78), higher household's wealth index, i.e. richest (AOR = 1.71; 1.35-2.16), richer (AOR = 1.42; 1.16-1.72), middle (AOR = 1.29; 1.07-1.56), and poorer (AOR = 1.24; 1.03-1.48), current contraceptive use (AOR = 1.26; 1.13-1.39), menstruating in the last six weeks (AOR = 1.13; 1.03-1.24), women's media exposure (AOR = 1.20; 1.07-1.35), and being in the community with a high level of media exposure (AOR = 1.53; 1.24-1.88) were statistically significant with KOC. CONCLUSIONS: Knowledge of the ovulatory cycle was low in this study, which demands health education for women of childbearing age. Special attention should be given to teenagers, those with lower educational, and lower economic status. Besides, the strengthening of media campaigns could increase women's KOC, which is crucial for preventing unintended pregnancy.

Correction: Adherence towards COVID-19 mitigation measures and its associated factors among Gondar City residents: A community-based cross-sectional study in Northwest Ethiopia.

[This corrects the article DOI: 10.1371/journal.pone.0244265.].

Knowledge, Attitudes, Practices, and Determinants Towards Wastewater Management in Northwest Ethiopia: A Community-Based Cross-Sectional Study.

BACKGROUND: Globally, waste management has been a major public health problem. Public knowledge, attitudes, practices (KAP) and participation are key elements of any waste management program. In Ethiopia, however, the level of KAP and associated factors regarding wastewater management (WWM) at the household level are not well studied and understood. This study was, therefore, conducted to assess the knowledge, attitude, practice and associated factors of wastewater management (WWM) among the residents in Gondar town, Ethiopia. METHODS: A community-based cross-sectional study was conducted during March and April, 2016. A total of 422 participants were selected using the systematic random sampling technique. A structured questionnaire was employed to collect data which were entered and analyzed using the Statistical Package for Social Science (SPSS) version 20. A multivariable binary logistic regression analysis was used to ascertain the significance of associations at <0.05 p-value and the adjusted odds ratio (AOR) with a 95% confidence interval (CI). RESULTS: Among 422 study participants included, 63.5%, 43.4%, and 48.6% of them had good knowledge, attitudes, and self-reported practices regarding WWM, respectively. Knowledge of participants was significantly associated with house rent (AOR 1.12, 95% CI (1.22, 3.69), civil servant (AOR 5.47, 95% CI (1.87, 8.02), and positive attitudes (AOR 2.69, 95% CI (1.68, 4.30), while space availability (AOR 1.84, 95% CI (1.23, 2.75), and good knowledge (AOR 2.46, 95% CI (1.61, 3.77) were associated factors of attitudes. Moreover, good knowledge (AOR 1.32, 95% CI (1.87, 2.02), and positive attitudes (AOR 1.03, 95% CI (1.01, 2.34) were significantly associated factors of self-reported practices. CONCLUSION: Limited knowledge, attitudes and practices were seen among study population. A great emphasis on improvement of knowledge, attitudes and practices towards WWM is necessary. Moreover, it would be better to qualitatively explore variables which explain the qualitative attributes of the community, like community Attitudes and knowledge.

Duration of exposure and educational level as predictors of occupational respiratory symptoms among adults in Ethiopia: A systematic review and meta-analysis.

INTRODUCTION: Occupational respiratory symptoms are manifestations of respiratory diseases because of exposure to dust or chemicals such as asbestos, silicon and aluminium in the workplace like cement factory, tannery, textile and/or street sweeping, all of which affect the health condition and productivity. In Ethiopia, several primary studies were conducted regarding the magnitude of occupational respiratory symptoms with the prevalence of 68.89% in street sweepers and associated factors with inconsistent results. This meta-analysis aimed to pool the prevalence of respiratory symptoms and their associated factors among Ethiopian adults working in different workplaces. METHODS: PubMed, African Journals Online, Google Scholar, Cochrane Library and Direct Google were systematically searched to identify primary studies. Two authors performed data abstraction and quality assessment for each included study independently. Cochran's Q-statistic and I2 (I-squared) statistic were used to check heterogeneity. DerSimonian and Laird random-effects models were used to estimate the pooled prevalence and associated factors of respiratory symptoms. Publication bias was checked by funnel plot and Egger's test, and also sensitivity analyses were performed. RESULTS: Ten primary studies with 3441 study participants were included for the narrative synthesis and meta-analysis of the pooled prevalence of occupational respiratory symptoms. The pooled prevalence of overall occupational respiratory symptom was 54.58% (95% CI: 45.37-63.79). Dry cough was the most encountered respiratory symptom [34.93, 95% CI: 29.52-40.35], followed by breathlessness [28.67%, 95% CI: 20.13-37.22]. Work experience of over 5 years [OR = 2.24, 95% CI: 1.21-4.16] and educational level of Grade 8 and lower [OR = 1.28, 95% CI: 1.06-1.55] were significantly associated with occupational respiratory symptoms. CONCLUSION: In this review, the pooled prevalence of occupational respiratory symptoms was high. The findings of this study dictate the need for the implementation of workplace safety measures. Special attention is required to employees with lower educational level and longer duration of work experience. PROSPERO REGISTRATION: CRD42020176826.

Factors associated with births protected against neonatal tetanus in Africa: Evidences from Demographic and health surveys of five African countries.

INTRODUCTION: Maternal and neonatal tetanus remains a global public health problem affecting mainly the poorest and most marginalized subpopulations. In spite of the problem, studies conducted on the associated factors of births protected against neonatal tetanus are scarce in Africa. Therefore, this study aimed to identify both individual and community-level factors associated with births protected against neonatal tetanus in the region. METHODS: The most recent Demographic and Health Survey datasets of five African countries (Ethiopia, Burundi, Comoros, Zimbabwe and Zambia) were used to investigate the associated factors of births protected from neonatal tetanus. STATA Version 14 statistical software was used for the analysis. The data were weighted before doing any statistical analysis and deviance was used for model comparison. Multilevel binary logistic regression was used to identify the associated factors of births protected against neonatal tetanus. Finally, the adjusted odds ratio (AOR) with its 95% confidence interval (CI) was calculated for each potential factors included in the multivariable multilevel logistic regression model. RESULTS: A total weighted sample of 30897 reproductive age women who had a birth within 5 years preceding the survey were included in the analysis. Those women with age of 20-34 (AOR = 1.32, 95%CI: 1.18-1.48) and 35-49 years (AOR = 1.26, 95% CI: 1.10-1.44), high community level of women education (AOR = 1.13, 95%CI: 1.04-1.23), being from poorer(AOR = 1.23, 95% CI: 1.14-1.33), middle (AOR = 1.31, 95%CI: 1.21-1.43), richer (AOR = 1.21, 95%CI: 1.11-1.32) and richest households (AOR = 1.59, 95%CI: 1.44-1.74), having antenatal care follow up (AOR = 9.62, 95% CI: 8.79-10.54), not perceiving distance to health facility as a big problem (AOR = 1.18, 95% CI: (1.11-1.25) had higher odds of having births protected against neonatal tetanus. CONCLUSION: Both individual and community level factors were found to be associated with births protected against neonatal tetanus in Africa. This suggests that a variety of factors are affecting births protected against neonatal tetanus in the region. Hence, the impact of these factors should be recognized while developing strategies to reduce neonatal tetanus in the region.

Anxiety and associated factors among Ethiopian health professionals at early stage of COVID-19 pandemic in Ethiopia.

INTRODUCTION: In late 2019, a new coronavirus disease known as COVID-19 (novel coronavirus disease 2019) was identified. As there is no any drug to treat this pandemic, the healthcare professionals are disproportionately at higher risk. The mental health outcome is expected to be high. Anxiety is expected to have a significant impact on health professionals, especially among those who work without adequate resources for self-protection. OBJECTIVES: The objectives of this research was to assess self-reported anxiety symptoms and associated factors among Ethiopian healthcare professionals in the early stages of the pandemic. METHODS: We have conducted an online cross-sectional study to collect information from healthcare professionals in Ethiopia during the early stage of the outbreak from April 7, 2020 to May 19, 2020. GAD-7 was used for measurement of anxiety. We have used a cut of point of 10 and above to report anxiety symptoms. We have used Google Forms for online data collection and SPSS-22 for analysis. To determine associated factors for anxiety, a binary logistic regression model was used. Variables with p-value < 0.2 during the bivariable binary logistic regression were exported for further analysis in the multivariable binary logistic regression. Finally, variables with p-value <0.05 were considered as significantly associated with the outcomes. RESULTS: Three hundred and eighty-eight healthcare professionals filled the online questionnaire; Majority (71.1%) were males. Significant number of respondents (78.9%) reported lack of adequate personal protective equipment (PPE) at the work place. The prevalence of anxiety was 26.8%. Being female (AOR: 1.88; 95% C.I:1.11, 3.19), visiting/treating 30-150 patients per day (AOR: 3.44; 95% C.I:1.51, 7.84), those employed at private healthcare institutions (AOR: 2.40; 95% C.I:1.17, 4.90), who do not believe that COVID-19 is preventable (AOR: 2.04; 95% C.I:1.04, 4.03) and those who reported lack of PPE (AOR: 1.98; 95% C.I:1.04, 3.79) were more likely to be anxious. CONCLUSIONS: The anxiety prevalence among healthcare professionals in Ethiopia during early stage of COVID-19 pandemic was high. This study shows that lack of preventive equipment, being female, contact with many patients, low self-efficacy and working in private health facilities were risk factors for anxiety. Anxiety prevention among health professionals during COVID-19 pandemic requires a holistic approach including provision of sufficient PPE, improving self-efficacy and addressing problems both at public and private institutions and focusing more on female health professionals.

Depression, anxiety, stress and their associated factors among Ethiopian University students during an early stage of COVID-19 pandemic: An online-based cross-sectional survey.

BACKGROUND: The occurrence of the Coronavirus Disease 2019 (COVID-19) affects the mental health situation of almost everyone, including University students who spent most of their time at home due to the closure of the Universities. Therefore, this study aimed at assessing depression, anxiety, stress and identifying their associated factors among university students in Ethiopia during the early stage of the COVID-19 pandemic. METHODS: We invited students to complete an online survey using Google forms comprising consent, socio-demographic characteristics, and the standard validated depression, anxiety, and stress scale (DASS-21) questionnaire. After completion of the survey from June 30 to July 30, 2020, we exported the data into SPSS 22. Both descriptive and analytical statistics were computed. Associated factors were identified using binary logistic regression and variables with a p-value <0.05 were declared as statistically significant factors with the outcome variables. RESULTS: A total of 423 students completed the online survey. The prevalence of depression, anxiety, and stress in this study was 46.3%, 52%, and 28.6%, respectively. In the multivariable model, female sex, poor self-efficacy to prevent COVID-19, those who do not read any material about COVID-19 prevention, lack of access to reading materials about their profession, and lack of access to uninterrupted internet access were significantly associated with depression. Female sex, lower ages, students with non-health-related departments, those who do not think that COVID-19 is preventable, and those who do not read any materials about COVID-19 prevention were significantly associated with anxiety. Whereas, being female, students attending 1st and 2nd years, those who do not think that COVID-19 is preventable, presence of confirmed COVID-19 patient at the town they are living in, and lack of access to reading materials about their profession were significantly associated with stress. CONCLUSIONS: Depression, anxiety, and stress level among University students calls for addressing these problems by controlling the modifiable factors identified and promoting psychological wellbeing of students.

Hypertriglyceridemia and Other Plasma Lipid Profile Abnormalities among People Living with Diabetes Mellitus in Ethiopia: A Systematic Review and Meta-Analysis.

BACKGROUND: Dyslipidemia is one of the leading causes of cardiovascular complications in diabetes mellitus (DM) patients. Though it is a major public health problem in Ethiopia, there is no a nation-wide study to determine dyslipidemia among DM patients yet. Therefore, this systematic review and meta-analysis intended to estimate the prevalence of hypertriglyceridemia and other plasma lipid abnormalities among people living with DM in Ethiopia. METHODS: We systematically searched PubMed, Google Scholar, African Journals Online, Hinari, and direct Google. Studies conducted until May 9, 2020, that reports the prevalence of dyslipidemia among people living with DM were included. The DerSimonian and Laird random-effects model was used to determine the pooled prevalence of lipid profile abnormalities. Heterogeneity was checked using the I 2 statistic, whereas publication bias was tested by funnel plot and Egger's test. Besides, subgroup and sensitivity analyses were performed. RESULTS: We used 18 primary studies, including 4961 participants living with DM, which met the eligibility criteria for the meta-analysis of hypertriglyceridemia. The estimate of hypertriglyceridemia (≥150 mg/dl) was 48.15% (95% CI: 38.15-58.15, I 2 = 98.4%) after performing the main meta-analysis using the random-effects model. The subgroup analysis showed a higher pooled estimate of hypertriglyceridemia among T2DM (57.80% (95% CI: 50.50-65.10), I 2 = 92.5%), studies that used probability sampling technique (59.09% (95% CI: 43.58-74.59), I 2 = 98.6%, p < 0.001), and studies from primary data sources (51.43% (95% CI: 40.72-62.13), I 2 = 98.0%, p < 0.001). Moreover, the estimated pooled prevalence of the total plasma cholesterol (TC ≥ 200 mg/dl) was 34.08% (95% CI: 28.41-39.75, I 2 = 92.4%), LDL - C ≥ 100 mg/dl was 41.13% (95% CI: 27.15-55.11, I2 = 98.8%), and HDL ≤ 40 mg/dl for men and ≤ 50 mg/dl for women was 44.36% (95% CI: 31.82-56.90, I 2 = 98.8%). CONCLUSIONS: The pooled prevalence of hypertriglyceridemia and other lipid abnormalities among DM patients was relatively high in Ethiopia. It strongly suggests the need to give maximal attention to the adherence of DM management to reduce the circulatory lipid profile abnormalities and subsequent complications. Prospero Registration. CRD42020182291.

Knowledge and attitude of the communities towards COVID-19 and associated factors among Gondar City residents, northwest Ethiopia: A community based cross-sectional study.

BACKGROUND: COVID-19 is the novel coronavirus responsible for the ongoing global outbreak of acute respiratory disease and viral pneumonia. In order to tackle the devastating condition of the virus, countries need to attack the virus with aggressive and targeted tactics. Thus, to strengthen the COVID-19 mitigation measures and to give rapid response, there is an urgent need to understand the public's knowledge and attitude about of the pandemic at this critical moment. OBJECTIVE: This study was aimed to assess the knowledge and attitude of communities about COVID-19 and associated factors among Gondar City residents. METHODS: A community based cross-sectional study was done among 623 respondents in Gondar city from April 20-27/2020. Data were collected using a structured questionnaire adapted from different literatures. The data were entered using Epi data version 3.1 and then exported into STATA version 14 for analysis. Bi-variable and multivariable binary logistic regression were performed. Adjusted odds ratio with 95% CI was used to declare statistically significant variables on the basis of p value less than 0.05 in the multivariable binary logistic regression model. RESULTS: The overall knowledge and attitude of the community towards COVID19 was 51.85% [95% CI (47.91%-55.78%)] and 53.13% [95% CI (49.20, 57.06%)], respectively. In this study, being married [AOR = 0.60 at 95% CI: (0.42, 0.86)], educational level; primary [AOR = 3.14 at 95% CI: (1.78,5.54)], secondary [AOR = 2.81 at 95% CI: (1.70,4.63)], college and above [AOR = 4.49 at 95% CI: 7.92, 13.98)], and family size [AOR = 1.80, at 95% CI: (1.05, 3.08)] were emerged as statistically significant factors impacting the knowledge of the community about COVID-19. Besides, educational level; primary [AOR = 1.76 at 95% CI: (1.03, 3.01)], secondary [AOR = 1.69 at 95% CI: (1.07, 2.68)], and college & above [AOR = 2.38 at 95% CI: (1.50, 3.79)], and family size; four to six members [AOR = 1.84 at 95% CI (1.27, 2.67)], above seven members [AOR = 1.79 at 95% CI (1.08, 2.96)] were factors identified as significantly attribute for positive attitude of the communities towards COVID-19. CONCLUSION: More than half of the respondents had better knowledge and attitude regarding COVID-19. Higher educational level and larger family size were significant factors predominantly affecting the knowledge and attitude of the communities towards COVID-19.