Factors associated with COVID-19 vaccine uptake among health professionals in Debre Markos town public health facilities, Northwest Ethiopia.

Globally, the COVID-19 pandemic has significantly increased morbidity and mortality. Health professionals are at the frontline of COVID-19 pandemic exposure and are identified as a priority target group that needs to receive COVID-19 vaccines. Data on Ethiopian healthcare workers' use of the COVID-19 vaccine and associated factors, however, are scarce. Using a simple random sampling method, 398 health professionals were recruited through an institutional-based cross-sectional study design. Health professionals working in Debre Markos town public health facilities filled out a self-administered questionnaire that had been pretested to obtain the data. Then, the data were entered into Epi data version 4.2; and analyzed by SPSS 25. Descriptive statistics and multivariable logistic regression analysis were computed after model assumptions were checked. The adjusted odds ratio with 95% CI was calculated and statistical significance was declared at P-value < 0.05 after model adequacy was checked using the Hosmer-Lemeshow test. The uptake of the COVID-19 vaccine among health professionals was 61.56% (95% CI: 56.67%, 66.23%). Factors associated with the uptake of the COVID-19 vaccine were age > = 35 years (AOR: 4.39, 95% CI: 1.89, 10.19), having a higher income (>9056 Birr) (AOR: 1.79, 95% CI: 1.03, 3.10), who practiced COVID-19 Prevention methods (AOR: 2.39, 95% CI: 1.51, 3.77), Adulthood previous other immunization histories (AOR: 1.63, 95% CI: 1.15, 2.56) and having a chronic disease (AOR:1.90,95% CI: 1.07, 3.74). This study revealed that the uptake of the COVID-19 vaccine was low. Age > = 35 years, having a higher income, who practiced COVID-19 prevention methods, having adulthood previous immunization histories, and having chronic disease were statistically significantly identified factors for COVID-19 vaccine uptake. Therefore, policymakers and health managers should think about the requirement of immunization of healthcare workers and develop plans for administering the COVID-19 vaccine.

In-hospital mortality and its predictors among adult stroke patients admitted in Debre Markos Comprehensive Specialized Hospital, Northwest Ethiopia.

Introduction: Stroke is the second-leading global cause of death next to ischemic heart disease. The burden of stroke mortality, morbidity, and disability is increasing across the world. In Ethiopia, evidence on the survival status of adult stroke patients is insufficient. The purpose of this study is to estimate in-hospital mortality and its predictors among adult stroke patients. Methods: Institution-based retrospective follow-up study was conducted on adult stroke patients who were admitted to Debre Markos Comprehensive Specialized Hospital from 1 November 2015 to 31 October 2020. Through simple random sampling, 382 patient charts were selected from 1125 stroke patients for 5 years follow-up period. Data were entered using EpiData™ version 4.1 and exported to Stata/SE™ version 14 for cleaning, coding, categorizing, and analysis. Predictor variables were selected using 95% confidence interval with a corresponding adjusted hazard ratio. Results: In this study, 219 (57.33%) males and the mean (standard deviation) age of 57.65 ± 14.3 years. The in-hospital mortality rate of stroke was 12.8%; the median (interquartile range) time to mortality and Glasgow Coma Scale were 7 (4-13) days and 14 (11-15), respectively. The incidence of in-hospital mortality was 29/1000, 11/1000, 8/1000, and 13.6/1000 person-days in the first, second, third, and end of follow-up weeks, respectively. Pneumonia (adjusted hazard ratio = 3.51 (95% confidence interval = 1.86, 6.61)), hemorrhagic stroke (adjusted hazard ratio = 2.03 (95% confidence interval = 1.03, 3.99)), moderate impairment Glasgow Coma Scale (9-12) (adjusted hazard ratio = 2.16 (95% confidence interval = 1.08, 4.29)), severe impairment Glasgow Coma Scale (3-8) (adjusted hazard ratio = 2.38 (95% confidence interval = 1.01, 5.67)), history of hypertension (adjusted hazard ratio = 2.01 (95% confidence interval = 1.08, 3.74)), and increased intracranial pressure (adjusted hazard ratio = 2.12 (95% confidence interval = 1.10, 4.07)) were statistically significant predictors for in-hospital mortality. Conclusion: In-hospital mortality of stroke was relatively high, and the median time to mortality was 8 days. Pneumonia, hemorrhagic stroke, Glasgow Coma Scale, history of hypertension, and increased intracranial pressure were identified predictors.

A prospective follow-up study on how long newborns are fasting in Debre Markos Comprehensive Specialized Hospital, Ethiopia, 2020.

BACKGROUND: At birth, continuous flow of nutrients to the fetus in utero interrupted due to cut of the route /umbilical cord/. Instead of the cord, breast-mouth connection will be the next route in the extra uterine life. Nevertheless, limited data in our locality show the duration for how long immediate newborns are fasting. OBJECTIVE: This study aimed to assess time to initiation of breastfeeding and its predictors among postnatal mothers within 12 hours of birth in Debre Markos Comprehensive Specialized Hospital, North West Ethiopia, 2020. METHODS: A Facility based prospective follow-up study was conducted among 475 participants who were selected using systematic random sampling techniques. To collect the data, techniques including interview, chart review and observation were used. Data was entered to Epi-data version 3.1 and analyzed by STATA 14 software. A cox proportional hazards regression model was fitted to identify predictors for survival time. Results of the final model were expressed in terms of adjusted hazard ratio (AHR) with 95% confidence interval, statistical significance was declared with P-value is less than 0.05. RESULTS: Newborns were fasting breast-milk for the median time of 2 hours. In this study, 25% of participants initiated breastfeeding within 1 hour, pre-lacteal while 75% initiated within 3 hours. Gave birth to multiple babies (AHR 0.37, 95% CI (0.19, 0.69)), operative delivery (AHR 0.77, 95% CI (0.62, 0.96)), got advice on timely initiation of breastfeeding immediately after delivery (AHR 0.79, 95% CI (0.63, 0.97)), pre-lacteal feeding initiation (AHR 10.41, 95% CI (2.82, 38.47)) and neonatal sickness (AHR 0.08, 95% CI (0.03-0.19)) were statistically significant predictors for time to initiation of breastfeeding. CONCLUSION: Fifty percent of mothers initiated breastfeeding within 2 hours. Most of them didn't initiate breastfeeding based on world health organization's recommendation, within one hour after delivery. Multiple birth, operative delivery, getting advice on timely initiation of breastfeeding immediately after delivery, giving pre-lacteal feeding and neonatal sickness were found to be predictors of time to initiation of breastfeeding.

COVID-19 and Global Health Security: Overview of the Global Health Security Alliance, COVID-19 Response, African Countries' Approaches, and Ethics.

Public health emergencies can arise from a wide range of causes, one of which includes outbreaks of contagion. The world has continued to be threatened by various infectious outbreaks of different types that have global consequences. While all pandemics are unique in their level of transmission and breadth of impact, the 2019 coronavirus disease (COVID-19) pandemic is the deepest global crisis of the 21st century, which has affected nearly every country globally. Yet, going forward, there will be a continued need for global health security resources to protect people around the world against increasing infectious disease outbreaks frequency and intensity. Pandemic response policies and processes all need to be trusted for effective and ethical pandemic response. As the world can learn during the past few years about frequent infectious disease outbreaks, (these) diseases respect no borders, and, therefore, our spirit of solidarity must respect no borders in our efforts to stop the ongoing COVID-19 pandemic and be better prepared to respond effectively to a health crisis in the future.

Knowledge, attitude, practice, and factors associated with prevention practice towards COVID-19 among healthcare providers in Amhara region, northern Ethiopia: A multicenter cross-sectional study.

Healthcare providers (HCPs) are at an increased risk of getting COVID-19 as a result of their front-line works. Health behaviors of HCPs can influence prevention and control actions implemented in response to the pandemic. Hence, this study aimed to assess the knowledge, attitude, and practice (KAP) and factors associated with prevention practice towards COVID-19 among healthcare providers in Amhara region, northern Ethiopia. A multicenter cross-sectional study was conducted among 422 HCPs in selected public health facilities of Amhara region, between 20th September and 20th October 2020. Data related to HCP's KAP and socio-demographic characteristics were collected using a pre-tested self-administered questionnaire. Bloom's cut-off ≥ 80%, ≥90%, and ≥75% was used to determine adequate knowledge, positive attitude, and good prevention practice, respectively. Data were analyzed using SPSSS version 25.0. A multivariable logistic regression analysis was performed to identify factors significantly associated with COVID-19 prevention practice. Statistical significance was determined at a p-value of < 0.05 and the presence of association was described using odds ratio (OR) with their 95% confidence interval (CI). Overall, 368 (89.8%), 387 (94.4%), and 326 (79.5%) HCPs had adequate knowledge, positive attitude, and good prevention practice towards COVID-19, respectively. Factors significantly associated with good COVID-19 prevention practice were being a Nurse in profession (AOR = 2.13, 95% CI = 1.13-3.99), having < 5 years of working experience (AOR = 0.46, 95% CI = 0.24-0.86), using social media (AOR = 6.20, 95% CI = 2.33-16.51) and television and or radio (AOR = 4.03, 95% CI = 1.56-10.38) as sources of COVID-19 information. HCPs had adequate knowledge, positive attitude and good prevention practice towards COVID-19. Being a Nurse, having < 5 years of working experiences, using social media and television and or radio were factors associated with good prevention practice. Thus, developing HCP's professional carrier through training opportunities, sharing experiences and using verified information sources are crucial to better improve COVID-19 prevention practice.

Determinants of Virological Failure Among HIV-Infected Children on First-Line Antiretroviral Therapy in West Gojjam Zone, Amhara Region, Ethiopia.

BACKGROUND: Viral load monitoring is a golden indicator for diagnosing treatment failure in patients with HIV. HIV-infected children are considered a priority group for routine viral load monitoring. Globally, the World Health Organization recommends 95% of HIV patients have viral suppression. Factors leading to virological failure are not well understood and studied. This study aimed to determine virological failure among HIV-infected children on first-line antiretroviral therapy in the West Gojjam Zone, Amhara region. Ethiopia. METHODS: An institutional-based unmatched case-control study was carried out from October 1 to October 15, 2020, among HIV-infected children on first-line antiretroviral therapy. The study included 94 cases and 276 controls, with a total sample size of 370 out of 378 HIV-infected children. A structured English version checklist was used to collect data through chart review. The data were entered using Epi-data 4.2 and exported into SPSS version 20 for analysis. Descriptive statistics were conducted to summarize the sample characteristics. Bivariate and multivariate analyses were used to describe each explanatory variable's association with the outcome variable. A bivariate analysis with a p-value < 0.25 was selected for multivariate analysis. Adjusted odds ratio with 95% confidence intervals was conducted, and p-value < 0.05 was considered statistically significant. RESULTS: Non-disclosure (AOR = 4.26; 95% CI: 2.09, 8.70), baseline viral load >1000 copies/mL (AOR = 10.82; 95% CI: 5.4, 21.67), recent poor adherence (AOR, 6.05, 95% CI, 1.70, 21.55) and missed clinical appointments (AOR = 8.03; 95% CI: 3.88, 16.65) were factors independently associated with virological failure. CONCLUSION: Disclosure of HIV status of patients early, according to their age and adherence to counseling, should be emphasized. Efforts should be strengthened to trace back for missed clinical appointments and strictly follow-up with antiretroviral (ARV) medication for a baseline viral load >1000 copies/mL that helps to boost immunity and suppress viral replication.

Episiotomy practice and associated factors among mothers who gave birth at public health facilities in Metema district, northwest Ethiopia.

BACKGROUND: Episiotomy is a surgical incision of the perineum to hasten the delivery. There is a scarce of information related to episiotomy practice, and its associated factors, in developing countries, including Ethiopia. Thus, this study was aimed to determine the level of episiotomy practice and to identify its determinants at public health facilities of Metema district, northwest, Ethiopia. METHODS: Institutional-based cross sectional study was conducted among 410 delivered mothers from March 1 to April 30, 2020. We recruited study participants using systematic random sampling technique. Data were entered to Epi data version 3.1 and exported to STATA version 14 for statistical analysis. Stepwise backward elimination was applied for variable selection and model fitness was checked using Hosmer and Lemshows statistics test. Adjusted odds ratio with the corresponding 95% confidence interval was used to declare the significance of variables. RESULTS: In this study, the magnitude of episiotomy practice was found 44.15% (95% CI 39.32-48.97). Vaginal instrumental delivery (AOR 3.04, 95% CI 1.36-6.78), perineal tear (AOR 3.56, 95% CI 1.68-7.55), age between 25 and 35 (AOR 0.11, 95% CI 0.05-0.25), birth spacing less than 2 years (AOR 4.76, 95% CI 2.31-9.83) and use of oxytocin (AOR 2.73, 95% CI 1.19-6.25) were factors significantly associated with episiotomy practice. CONCLUSIONS: Magnitude of episiotomy practice in this study is higher than the recommended value of World Health Organization (WHO). Instrumental delivery, age, oxytocin, birth spacing and perineal tear were significant factors for episiotomy practice. Thus, specific interventions should be designed to reduce the rate of episiotomy practice. Plain English summary The routine use of episiotomy practice is not recommended by WHO. A study that compares routine episiotomy with restrictive episiotomy suggests that the latter is associated with less posterior perineal trauma, less need for suturing, and fewer complications related to healing. In addition, though, the rate of episiotomy has been declined in developed countries, still it remains high in less industrialized countries. The data for this study were taken at public health facilities of Metema district, northwest, Ethiopia. We included a total of 410 delivered mothers. The magnitude of episiotomy practice was found 44%. This result was higher than the recommended value of WHO. The WHO recommends an episiotomy rate of 10% for all normal deliveries. The result of this study showed that episiotomy practice is common among mothers whose age group are 18-24. In addition, mothers whose labor were assisted by instrumental vaginal delivery are more likely to have episiotomy as compared to those delivered by normal vaginal delivery. Laboring mothers who had used oxytocin were about three times more likely to be exposed for episiotomy than laboring mothers who did not use oxytocin drug. Moreover, episiotomy practice was nearly five times more likely among mothers who had birth spacing of 2 years and less as compared to mothers who had birth spacing of more than 2 years.

Evaluation of Red Blood Cell Parameters as a Biomarker for Long-Term Glycemic Control Monitoring Among Type 2 Diabetic Patients in Southwest Ethiopia: A Cross-Sectional Study.

OBJECTIVE: The main aim of this study was to assess red blood cell parameters as a biomarker for long-term glycemic monitoring among T2 DM patients. METHODS: Facility-based cross-sectional study through a consecutive sampling technique was conducted among 124 T2 DM patients at the chronic illness follow-up clinic of Jimma Medical Center (JMC) from July 27 to August 31, 2020. A structured questionnaire was used to collect socio-demographic and clinical-related data. Five milliliters of the blood specimen were collected from each eligible T2 DM patient. Glycated hemoglobin (HbA1c) and red blood cell parameters were determined by Cobas 6000 and DxH 800 fully automated analyzers, respectively. Data were entered into EpiData software version 3.1 and exported to SPSS 25 version for analysis. Independent t-test and Pearson's correlation coefficient were used to address the research questions. A P-value <0.05 was considered statistically significant. RESULTS: The mean age of study participants was 51.84± 11.6 years. Moreover, 60.5% of T2 DM patients were in poor glycemic control. There was a significant mean difference between good and poor glycemic controlled T2 DM patients in red blood cell count (4.79±0.5 vs 4.38±0.8), hemoglobin (14.13±1.4 vs 13.60±1.6), mean corpuscular volume (89.52±4.7 vs 92.62±7.5), mean corpuscular hemoglobin (29.63±1.6 vs 30.77±2.9), and red cell distribution width (13.68±1.1 vs 14.63±1.2) respectively. Red blood cell count was inversely correlated (r=-0.280, p=0.002) with HbA1c while mean corpuscular volume (r=0.267, p=0.003), mean corpuscular hemoglobin (r=0.231, p=0.010), and red cell distribution width (r= 0.496, p=0.000) were positively correlated with level of HbA1c. CONCLUSION: Red cell count, mean corpuscular volume, mean corpuscular hemoglobin, and red cell distribution width could be useful indicators to monitor the glycemic status of T2 DM patients instead of HbA1c, though large prospective studies should be considered.

Dietary diversity and associated factors among children aged 6-23 months in Sinan Woreda, Northwest Ethiopia: a cross-sectional study.

BACKGROUND: Child malnutrition accounted by poor dietary diversity is common in developing countries contributing for child morbidity and mortality. It also has an impact on child growth and development. Almost all nutritional related problems are preventable by implementing infant and child feeding strategies. The first two years of life are particularly important to reverse the nutritional problems by achieving dietary diversity feeding.The study aimed to assess dietary diversity and its associated factors among 6-23 months old children in Sinan Woreda, Northwest Ethiopia. METHODS: We conducted community based cross-sectional study among children aged 6-23 months in Sinan Woreda from February 16 to March 10, 2016. Random sampling technique was used to select 740 samples. Data on children's dietary diversity of the last 24 h were collected through interview of mothers. Data were entered into EpiData version 3.1 and analysis was performed using SPSS version 20. The bivariate and multivariable logistic regression analyses were done to identify the independent factors associated with sub-optimal dietary diversity among children aged 6-23 months. RESULTS: Seven hundred thirty six samples were included in the analysis with the response rate of 99%. Optimum dietary diversity was observed in 13% children. The dominant food groups consumed were grains. Availability of media sources at household [Adjusted Odds Ratio (AOR) = 2.77 (1.65-4.68)], availability of cow milk in the household [AOR = 2.39 (1.31-4.35)], women's involvement in decision-making at household level [AOR = 2.07 (1.02-4.20)], institutional delivery service utilization [AOR = 2.40 (1.24-4.67)], receiving assisted delivery service [AOR = 2.36 (1.12-4.98)], receiving postnatal care [AOR = 2.07 (1.18-3.63)], distance far from the health center [AOR = 3.11 (1.66-5.83)] and meal frequency being four and above [AOR = 3.31 (1.53-7.18)] were associated with dietary diversity. CONCLUSION: This study concluded that optimum dietary diversity among children aged 6-23 months in Sinan Woreda is low. Meal frequency is positively associated with dietary diversity. Women involvement at household decision making improves dietary diversity of children. Ensuring maternal health service utilization can contribute for better dietary diversity of children aged 6-23 months. Large scale an interventional based research has to be conducted.

Factors associated with underweight among lactating women in Womberma woreda, Northwest Ethiopia; a cross-sectional study.

BACKGROUND: Ensuring nutritional status of women is important because the malignant effects of malnutrition are procreated to the next generation through women and their off-springs. Malnutrition causes 3.5 million death of women and children each year and almost 11% of the disease burden in the world. Therefore, this study was conducted to assess nutritional status and factors associated with underweight among lactating women in Womberma woreda, Northwest Ethiopia, 2016. METHODS: A Community-based cross-sectional study was carried out in Womberma woreda, Northwest Ethiopia. A total of 668 lactating women who have 6-24 months of child were included in the study. Study participants were selected using a multistage sampling technique. Data were collected using interview-administered questionnaire. Body mass index (BMI) was used to measure the nutritional status of lactating women. Women's body weight and height were measured using the standard anthropometric measurement procedures. Data were entered using EpiData software and analysis was done using SPSS software. Descriptive, bivariate and multivariable logistics regression analysis were used to present the findings. Variables with a p-value less than 0.05 on multiple variable logistic regression were taken as significant variables. RESULTS: Lactating women with normal nutritional status (BMI = 18.5-24.99 kg/m2) were 498 (74.5%), and underweight women (BMI < 88.5 kg/m2) were 170(25.4%). Respondents with less than five family size (AOR: 0.46, 95% CI: 0.26, 0.81, p-value = 0.007), women whose age of first pregnancy was less than 18 years old (AOR: 3.72, 95% CI: 2.33, 6.49 at p-value = 0.0001), home delivery for the recent child birth (AOR: 2.36, 95% CI: 1.50, 3.72 at p-value = 0.0001), and the absence of nutritional education programs in the community (AOR: 5.5, 95% CI: 1.8, 16.79 at p-value = 0.003) were the significant variables with underweight of lactating women. CONCLUSIONS: Nutritional status of lactating women in the study area was poor. One fourth of lactating women was underweight. Factors associated with underweight of lactating women include; respondents with less than five family size, women whose age of first pregnancy was less than 18 years old, home delivery for the recent childbirth, and the absence of nutritional education programs in the community. Early childbearing and short birth intervals between births should be discouraged. Programs which encourage institutional delivery and community-based nutritional education are important to improve women nutritional status.

Prevalence of timely breastfeeding initiation and associated factors in Dembecha district, North West Ethiopia: a cross-sectional study.

BACKGROUND: Early initiation of breastfeeding is a simple and cost effective intervention to advance the health of mothers and newborn babies. A large number of neonatal deaths could be prevented if infants were breastfed. However, there is poor practice related to breastfeeding initiation within the first one hour of birth, and the factors affecting it are not well understood. This study was conducted to assess the prevalence of timely breastfeeding initiation and associated factors in Dembecha district, North West Ethiopia. METHODS: A cross-sectional study design was conducted from August to September 2015. Multistage sampling techniques were used to select a total of 739 mothers who had children under 2 years of age. A pretested structured questionnaire was used to collect data. Descriptive analysis, bivariate and multiple logistic regression analysis were performed. RESULTS: The level of timely initiation of breastfeeding was 73.1 %. The magnitude of prelacteal feeding and colostrum feeding in this study was 11.9 and 76.2 % respectively. Timely initiation of breastfeeding was significantly associated with the presence of four and above antenatal appointments during the last pregnancy (Adjusted Odds Ratio [AOR] 3.1; 95 % Confidence Interval [CI] 1.2, 8.0), access to mass media such as radio or television (AOR 1.54; 95 % CI 1.10, 2.20), and mothers who were attended by traditional birth attendant during their last birth (AOR 0.23; 95 % CI 0.07, 0.75). CONCLUSIONS: The level of timely initiation of breastfeeding was relatively good compared with previous studies in Ethiopia, although more than quarter of mothers didn't start breastfeeding within the first one hour of birth. Timely initiation of breastfeeding was significantly associated with the presence of four and above antenatal care during the last pregnancy, access to mass media (e.g. radio, television), and last child attended by traditional birth attendant. Programs should encourage mothers to use skilled birth attendants at birth, emphasise the importance of feeding colostrum and to initiate breastfeeding within one hour after childbirth.