Health related quality of life and its predictors among postpartum mother in Southeast Ethiopia: A cross-sectional study.

Background: Post-childbirth, woman's health-related quality of life (HRQOL) is significantly impacted, leading to decreased daily activity, reduced self-care, challenges with breastfeeding and baby weaning, and increased medical costs for both mother and newborn.This study aimed to assess the HRQOL and its predictors among postpartum women in Southeast Ethiopia. Methods: A cross-sectional study was conducted in Southeast Ethiopia between March and May 2022, involving randomly selected sample of 794 postpartum women attending immunization services in public health facilities. Data was collected using a validated questionnaire, and descriptive statistics were computed. A bivariable and multivariable logistic regression model was fitted to predict HRQOL, with odds ratios and 95% confidence intervals used to estimate associations. Results: The study revealed that the overall HRQOL, physical component summary, and mental component summary of quality of life had mean scores of 43.80 ± 27.88, 45.39 ± 28.58, and 42.20 ± 28.15(mean ± SD) respectively. Walking to the health facility (AOR = 2.09; 95% CI: (1.31,3.31); using public transport (AOR = 2.58; 95% CI = 1.69-3.93); having the fear of COVID-19 (AOR = 1.46; 95% CI = 1.08-1.99); having health facility admission history during the recent pregnancy (AOR = 1.62; 95% CI = 1.08-2.44); having postpartum depression (PPD) (AOR = 2.13; 95% CI = 1.57-2.89) were predictors of a lower level of overall HRQOL among postpartum women. Conclusion: The study found that nearly half of postpartum women in Ethiopia have lower HRQOL, with factors such as transport use, recent baby's pregnancy admission history, and postpartum depression (PPD) significantly affecting their overall, physical, and mental HRQOL. Fear of COVID-19 was found to be significantly associated with lower overall and physical HRQO. The implementation of appropriate strategies addressing identified factors is crucial for enhancing the HRQOL among postpartum women in Ethiopia.

Effect of nutrition education on dietary diversity and academic achievement among adolescent school girls in North Shoa Zone, Oromia, Ethiopia.

OBJECTIVES: Globally, adolescent students, particularly girls, are severely affected by malnutrition, in part because of their specific biological needs, and that they have not been considered a health and nutrition priority. Hence, this study was designed to evaluate the effect of a health belief model-based nutrition education on the dietary diversity and grades of adolescent school girls in the north Shewa zone, Oromia, Ethiopia. METHODS: A quasi-experimental study was done in the north Shewa zone, Oromia, Ethiopia. Adolescent school girls ages 10 to 19 y old were selected from the zone districts from February 1 to May 30, 2023. The main outcome variables included grades and dietary diversity, which were collected on the baseline and end line from the intervention and control groups. RESULTS: This study revealed that there were statistically significant differences in good nutritional knowledge, 88.1% versus 69.2% (χ2 = 16.835, P < 0.001), good dietary diversity; 77.4% versus 45.9% (χ2 = 33.247, P < 0.001) and grades above average, 90.6% versus 65.4% (χ2 = 29, P < 0.001) among school adolescent girls between the intervention and control groups, respectively. Regarding positive attitude, 84.3% versus 85.5% (χ2 = 0.098, P = 0.876), there was no statistically significant difference between the intervention and control groups. CONCLUSIONS: In this study, the dietary diversity scores and grades of adolescent school girls in the intervention group were higher than those in the control group. Therefore, health belief model-based strategies should be recommended as effective communication channels to improve adolescent school girls' dietary diversity and academic performance.

Effect of nutrition education integrating the health belief model and theory of planned behavior on dietary diversity of pregnant women in Southeast Ethiopia: a cluster randomized controlled trial.

BACKGROUND: Maternal anemia, miscarriage, low birth weight (LBW), preterm birth (PTB), intrauterine growth restriction (IUGR), prenatal and infant mortality, morbidity, and the risk of chronic disease later in life are all increased by a lack of dietary diversity during pregnancy. However, evidence for the effect of nutrition education on the dietary diversity score (DDS) among pregnant women was sparse in Ethiopia, particularly in the study areas. This study aimed to assess the effect of nutrition education on dietary diversity among pregnant women in urban settings in Southeast Ethiopia. METHODS: A community-based two-arm parallel cluster randomized controlled trial was conducted among 447 randomly selected pregnant women attending antenatal care (224 intervention group and 223 control group) at health facilities from February to December 2021. A multistage cluster sampling technique, followed by systematic sampling, was used to select the pregnant women. Pregnant women who participated in the interventions were given nutrition education starting at 16 weeks of gestation and continuing for 6 months. We used a pre-tested, interviewer-administered, structured questionnaire to collect the data. A 24-hour qualitative dietary recall was used to calculate the dietary diversity score (DDS). A multivariable generalized estimating equation (GEE) model was conducted to evaluate the intervention effect. RESULTS: After the intervention, the proportion of adequate dietary diversity was 14.15% higher in the intervention arm compared to the control group (45.09% versus 30.94%, P = 0.002). The overall difference in adequate dietary diversity between the two groups was 8.5%. After adjusting for background characteristics, the multivariable GEE binary logistic model revealed that having received intervention [(AOR = 1.89, 95% CI: 1.27, 2.79)], being literate [(AOR = 3.41, 95% CI: 1.13, 10.23)], and having high wealth [(AOR = 1.60, 95% CI: 1.09, 2.35)] significantly improved adequate dietary diversity. CONCLUSION: The findings indicated that having received the intervention, being literate, and having a high level of wealth significantly improved maternal dietary diversity. Efforts should be made to increase nutrition education using the health belief model (HBM) and the theory of planned behavior (TPB). Moreover, there is a need to improve literacy and economic empowerment through income-generating activities to enhance adequate dietary diversification during pregnancy. TRIAL REGISTRATION: Clinicaltrials.gov (PACTR202201731802989, Retrospectively registered on 24 January 2022).

Severe Acute Malnutrition among Children in Bale Zone Southeast Ethiopia: Treatment Outcome and its Determinant Factors.

OBJECTIVE: To assess the treatment outcomes of severe acute malnutrition (SAM) and its associated factors in children aged 6-59 months in Bale zone, Southeast Ethiopia. DESIGN: A multi-institutionally-based, retrospective cross-sectional study design was conducted, based on records from September 11, 2014 to September 11, 2017. Simple random sampling was used to select the records. A pretested extraction format was used to collect information from the logbook and patient records. Treatment outcome was dichotomized into recovery and censored. Bivariate and multivariable logistic regression analyses were used to analyze the data. Odds ratios with 95% CIs were calculated to determine the association between each independent variable and treatment outcome. RESULTS: A total of 763 records were completed and reviewed. Of these, 711 (93.2%) were recovered from SAM. Provision of deworming treatment (aOR = 6.5; 95% CI: 2.8-15.1), education given to the mother/caregiver (aOR = 8.8; 95% CI: 4.2-18.4), age range 6-24 months (aOR = 0.37; 95% CI: 0.17-0.81), presence of anemia (aOR = 0.33; 95% CI: 0.14-0.78), and use of nasogastric (NG) tube (aOR = 0.42; 95% CI: (0.21-0.85) were associated with recovery from SAM. CONCLUSIONS: Recovery rate of SAM children in this study was in line with international standards. Deworming, maternal education status, child's age, anemia, and NG tube use were associated with recovery. Attention should be given to deworming all children, disease control, and prevention of anemia and other comorbidities.

Isolated breast hydatid cyst: A case report.

A hydatid cyst is a parasitic infestation most frequently caused by the larval tapeworm known as Echinococcus granulosus. Breast hydatidosis is a very uncommon condition that may be the main site or one of its components in cases of extensive hydatidosis. We discussed a 28-year-old female patient who had been experiencing left breast pain for a year prior to her presentation.

Compliance to iron folic acid supplementation and its associated factors among pregnant women attending Antenatal clinic in Wondo district: a cross-sectional study.

Pregnant women are at high risk for iron deficiency anemia due to increased nutrient requirements during pregnancy. Despite high coverage of iron and folic acid supplementation (IFAS), low compliance is reported. The study aimed to assess compliance with IFAS and its associated factors among antenatal care (ANC) attendees in Wondo District, Southern Ethiopia. A facility-based cross-sectional study was conducted among 400 pregnant women. Pregnant women were selected through systematic random sampling. Pre-tested structured questionnaire was used to collect data through face to face interview. Data were entered into Epi-info and exported to Statistical Package for Social Sciences for analysis. The variables with p-value < 0.25 in the bivariable analysis were entered into the multivariable logistic regression model. P values less than 0.05 were considered significant. Results were reported as crude and adjusted odds ratios with 95% confidence intervals. The prevalence of compliance to IFAS was (177, 44.3%). Factors significantly associated with compliance to IFAS were maternal age ≥ 25 years [AOR 2.27, 95% CI (1.21, 4.28)], maternal education [AOR 2.62, 95% CI (1.43, 4. 79)], husband's education [AOR 3.60, 95% CI (2.07, 6.25)], knowledge of anemia [AOR 4.40, 95% CI (2.65, 7.30)], and knowledge of IFA [AOR 2.21, 95% CI (1.40, 3.50)]. This study showed that compliance to IFAS was low. Maternal age, maternal education, husband's education, knowledge about anemia and iron folic acid was found to be significantly associated with adherence to IFAS. Emphasis should be placed on young, uneducated mothers and their husbands.

Determinants of implanon discontinuation among women who ever used implanon in Shashemene district, west Arsi zone, Southern Ethiopia: unmatched case control study.

BACKGROUND: Despite tremendous work has been done on demand creation, capacity building and ensuring the logistics of Implanon; its discontinuation rate remained high in Ethiopia; the prevalence is reported to be 31% in Shashemene District. However, the factors contributing to the high prevalence of early Implanon discontinuation were not well understood in our study setting. OBJECTIVE: This study aimed to identify the determinants of implanon discontinuation among women who had ever used Implanon in Shashemene District, Southern Ethiopia. METHODS: A community-based unmatched case-control study was conducted among randomly selected 264 women (88 cases and 176 controls) in Shashemene District, Southern Ethiopia, from April 12 to May 18, 2021. A systematic random sampling technique was used to select the respondents. Cases were women who discontinued Implanon before 3 years and controls were those who used implanon for 3 full years. A pre-tested, interviewer-administered structured questionnaire was used to collect data. Bivariable and multivariable binary logistic regression analyses were performed to identify determinants of Implanon discontinuation. An odds ratio (OR) with a 95% confidence interval (CI) was used to estimate the strength of the association, and significance was declared at a P value of less than 0.05. RESULT: The mean age of the respondents was 28.23 (± 5.46) years: 27.27 (± 5.38) years for cases and 28.70 (± 5.5) years for controls. Women with no formal education [AOR = 3.09, 95% CI: (1.20, 8.00)], fewer than four children [AOR = 2.47, 95% CI: (1.20, 5.08)], no history of abortion [AOR = 2.84, 95% CI: (1.25, 6.46)], being new acceptors [AOR = 2.14, 95% CI: (1.02, 4. 49)], being counseled for less than fifteen minutes [AOR = 2.47, 95% CI: (1.29, 4.70)], not discussing it with a partner [AOR = 2.88, 95% CI: (1.42, 5.84)] and experiencing side effects [AOR = 0.35, 95% CI: (0.17, 0.71)] were significantly associated with discontinuation of implanon. CONCLUSION: Women with no formal education, having less than four children, history of abortion, new acceptors, duration of counseling, discussion with partner, and side effects were determinants of Implanon discontinuation among women. There is a need to ensure adequate pre-implantation counseling and appropriate management of side effects. Furthermore, interventions should target new acceptors and those without formal education.

Magnitude of erectile dysfunction and associated factors among adult diabetic men on follow-up at Goba and Robe hospitals, Bale Zone, South East Ethiopia: hospital-based cross-sectional study.

PURPOSE: Erectile dysfunction is defined as the inability to achieve and/or maintain an erection of sufficient rigidity and duration to permit satisfactory sexual performance. The purpose of this study is to assess the prevalence of erectile dysfunction and associated factors among adult diabetic men on follow-up at Goba and Robe hospitals, Bale Zone, South East Ethiopia,2022. METHODS: Hospital-based cross-sectional study design was used among 420 adult diabetic men from March 1 to April 30 using a systematic random sampling technique. An international index of erectile function questionnaire containing five questions was used to assess the outcome variable. The data were entered, edited, and coded using Epidata version 4.6 and analyzed using SPSS version 26. Bivariable and multivariable binary logistic regression analysis were performed to identify factors associated with erectile dysfunction. Adjusted odds ratios with their corresponding 95% confidence interval were computed to estimate the strength of association. Statistical significance was declared at p-value < 0.05. RESULTS: The prevalence of erectile dysfunction was found to be 354 (84.3%). Multivariable logistic regression revealed that erectile dysfunction is significantly associated with old age (AOR = 12.39, 95% CI:5.10-30.08), inadequate physical activity (AOR = 4.15, 95% CI:1.33-12.97), and being rich (AOR = 2.62, 95% CI = 1.21-5.66). CONCLUSION: The prevalence of erectile dysfunction in this study population is nearly nine out of ten. Age, inadequate physical activity, and wealth index were independent predictors of erectile dysfunction. Assessment and management of erectile dysfunction in diabetic clinics should be routine medical care.

Bacterial contamination of healthcare workers' mobile phones in Africa: a systematic review and meta-analysis.

BACKGROUND: Mobile phones are potential reservoirs for pathogens and sources of healthcare-associated infections. More microbes can be found on a mobile phone than on a man's lavatory seat, the sole of a shoe, or a door handle. When examining patients, frequent handling of mobile phones can spread bacteria. Nevertheless, evidence of bacterial contamination of mobile phones used by healthcare workers in Africa was inconclusive. Thus, this meta-analysis and systematic review was conducted to estimate the pooled prevalence of bacterial contamination of mobile phones used by healthcare workers and the most frequent bacterial isolates in Africa. METHODS: We systematically retrieved relevant studies using PubMed/MEDLINE, POPLINE, HINARI, Science Direct, Cochrane Library databases, and Google Scholar from July 1, 2023 to August 08, 2023. We included observational studies that reported the prevalence of bacterial contamination of mobile phones among healthcare workers. The DerSimonian-random Laird's effect model was used to calculate effect estimates for the pooled prevalence of bacterial contamination in mobile phones and a 95% confidence interval (CI). RESULTS: Among 4544 retrieved studies, 26 eligible articles with a total sample size of 2,887 study participants were included in the meta-analysis. The pooled prevalence of mobile phone bacterial contamination among healthcare workers was 84.5% (95% CI 81.7, 87.4%; I2 = 97.9%, p value < 0.001). The most dominant type of bacteria isolated in this review was coagulase-negative staphylococci (CONS) which accounted for 44.0% of the pooled contamination rate of mobile phones used by healthcare workers, followed by Staphylococcus aureus (31.3%), and Escherichia coli (10.7%). CONCLUSIONS: In this review, the contamination of mobile phones used by HCWs with various bacterial isolates was shown to be considerable. The most prevalent bacteria isolates were coagulase-negative staphylococci, Staphylococcus aurous, and Escherichia coli. The prevalence of bacterial contamination in mobile phones varies by country and sub-region. Hence, healthcare planners and policymakers should establish norms to manage healthcare workers' hand hygiene and disinfection after using mobile phones.

Barbers' compliance with biological hazard preventive measures and predictors in selected towns, Southeast Ethiopia: a cross-sectional study.

OBJECTIVE: The barber's profession exposes their customers to several health risks. Negligence when using sharp instruments in barbershops can increase the risk of bloodborne infections, resulting in serious health problems for both the barber and the customer. Evidence for compliance with biological hazard preventive measures and predictors among barbers is critical and urgent. Thus, we aimed to assess compliance with biological hazard preventive measures and predictors among barbers in selected towns in Southeast Ethiopia. METHODS: A cross-sectional study was conducted among 633 randomly selected barbers from 1 March to 30 March 2022. A multistage sampling followed by a systematic sampling and simple random sampling methods were used to select barbershops and barbers, respectively. We used a pretested interviewer-administered questionnaire and an observational checklist to collect data. Multinomial logistic regression analysis was used to identify predictors. An adjusted OR (AOR), along with a 95% CI and p<0.05, was used to estimate the strength of the association. RESULTS: The good compliance level with biological hazard preventive measures was 47.10% (95% CI: 43.2%, 50.70%). Being married (AOR=3.04, 95% CI: 1.71, 8.56), aged from 25 to 34 years (AOR=2.75, 95% CI: 1.13, 8.06), served for ≤5 years (AOR=1.72, 95% CI: 1.24, 3.85), attending high school and above (AOR=4.32, 95% CI: 1.31, 12.73), being professional (AOR=6.34, 95% CI: 2.03, 11.36), having a positive attitude (AOR=2.95, 95% CI: 1.06, 8.22) and having good knowledge towards biological hazard preventive measures (AOR=3.14, 95% CI: 1.42, 9.25) were significant predictors of moderate and good compliance with biological hazard preventive measures. CONCLUSION: The study's findings revealed that almost half of the barbers were in good compliance with biological hazard preventive measures. As a result, improving barbers' attitudes and knowledge through on-the-job training is indispensable.

The coexistence of stunting and overweight or obesity in Ethiopian children: prevalence, trends and associated factors.

BACKGROUND: Double burden of childhood malnutrition is a condition where undernutrition (stunting) along with overweight and obesity coexist within individuals, households, and populations. It reflects a new layer of malnutrition and an understudied phenomenon in many low-income settings. To date, the prevalence and factors that are associated with concurrent stunting and overweight or obesity (overweight/obesity) (CSO) in the same children have not been well researched in Ethiopia. Hence, this study aimed to assess the prevalence, trends, and factors associated with the coexistence of stunting and overweight or obesity among children aged 0-59 months in Ethiopia. METHODS: Pooled data from 2005, 2011 and 2016 Ethiopian Demographic and Health Survey (EDHS) were used. A total of 23,756 (weighted sample) children aged 0-59 months were included in the study. Height-for-age z-scores (HAZ) less than - 2 SD and weight-for-height z-scores (WHZ) above 2 SD were calculated, and children were classified as stunted and overweight/obese, respectively. A child who is simultaneously stunted and overweight/obese was considered as having HAZ below - 2 SD and WHZ above 2 SD computed into a variable named CSO, and reported as a binary outcome (yes or no). Multilevel logistic regression analysis that adjusts for sampling weights and clustering was used to identify factors associated with CSO. RESULTS: The prevalence of stunting, overweight or obesity, and CSO among under-five children was 43.12% [95% CI: (42.50, 43.75%)], 2.62% [95% CI: (2.42, 2.83%)], and 1.33% [95% CI: (1.18, 1.48%)], respectively. The percentage of CSO children was reported to have declined from 2.36% [95% CI: (1.94-2.85)] in 2005 to 0.87% [95%CI: (0.07-1.07)] in 2011, and the same appeared to have increased slightly to 1.34% [95%CI: (1.13-1.59)] in 2016. Children who were currently breastfeeding [AOR: 1.64, 95%CI: (1.01-2.72)], born to an overweight mother [AOR: 2.65, 95%CI: (1.19-5.88)], and lived in families with 1-4 household members [AOR: 1.52, 95%CI: (1.02-2.26)] were significantly associated with CSO. At the community level the odds of having CSO were higher among children included from EDHS-2005 [AOR: 4.38, 95%CI: (2.42-7.95)]. CONCLUSION: The study revealed that less than 2% of children had CSO in Ethiopia. CSO was linked to factors at both the individual (i.e. breastfeeding status, maternal overweight, and household size) and community-levels. Overall, the study findings indicated the necessity of focused interventions to simultaneously address double burden of childhood malnutrition in Ethiopia. To further combat the double burden of malnutrition, early identification of at-risk children, including those born to overweight women and children living with multiple household members, is indispensable.

Concurrent wasting and stunting among under-five children in the context of Ethiopia: A generalised mixed-effects modelling.

Concurrent wasting and stunting (WaSt) is a condition where both wasting and stunting exist in a child at the same time. This study aimed to assess the prevalence of WaSt and to identify potential associated factors in Ethiopia.  A total of 33,650 children aged between 0 and 59 months were included in the analysis from the four waves of the Ethiopian Demographic and Health Survey. A mixed-effects logistic regression model was used to identify the determinants of WaSt. The prevalence of WaSt was found to be 4.7% (95% confidence interval [CI]: (4.5-4.9)), with respectively 2.5% (95% CI: 2.1-3.1) and 4.9% (95% CI: 4.7-5.2) among children in urban and rural settings. Children: (i) in the age group 12-23 months (adjusted odds ratio [AOR]: 4.16, 95% CI: (3.20-5.42)) and 24-59 months (AOR: 3.08, 95% CI: (2.28-4.17)); (ii) who were perceived by their mothers to be smaller than normal at birth (AOR: 1.98, 95% CI: (1.57-2.50)); (iii) had diarrhoea (AOR: 1.38, 95% CI: (1.11-1.71)); and (iv) fever in the past 2 weeks (AOR: 1.38, 95% CI: (1.10-1.71)) reported higher odds of WaSt. Being a female child (AOR: 0.57, 95% CI: (0.48-0.69)), having received measles vaccination (AOR: 0.71, 95% CI: (0.55-0.89)), having a mother with a normal body mass index (18.5-24.9 kg/m2 ) (AOR: 0.57, 95% CI: (0.48-0.68)), having a wealthier household (AOR: 0.67, 95% CI: (0.50-0.90)), and living in rural setting (AOR: 0.49, 95% CI: (0.32-0.74)) were associated with reduced odds of WaSt. The prevalence of WaSt was high, with approximately 1 in 20 Ethiopian children suffering from the condition and needing a prompt response to minimize the poor health and developmental outcomes. Children perceived by their mother to be smaller than normal at birth, older children, and babies with diarrhoea and fever had higher odds of WaSt.

Determinants of undernutrition among young children in Ethiopia.

Ethiopia is one of the countries in sub-Saharan Africa with the highest burden of childhood undernutrition. Despite the high burden of this scourge, little is known about the magnitude and contributing determinants to anthropometric failure among children aged 0-23 months, a period regarded as the best window of opportunity for interventions against undernutrition. This study examined factors associated with undernutrition (stunting, wasting, and underweight) among Ethiopian children aged 0-23 months. This study used a total weighted sample of 2146 children aged 0-23 months from the 2019 Ethiopian Mini Demographic and Health Survey. The data were cleaned and weighted using STATA version 14.0. Height-for-age (HFA), weight-for-height (WFH), and weight-for-age (WFA) z-scores < - 2 SD were calculated and classified as stunted, wasting, and underweight, respectively. Multilevel mixed-effects logistic regression models adjusted for cluster and survey weights were used. Adjusted odds ratio (AOR) and 95% confidence interval (CI) were estimated. Statistical significance was declared at p < 0.05. The overall weighted prevalence of stunting, wasting, and underweight respectively were 27.21% [95% CI (25.32-29.18)], 7.80% [95% CI (6.71-9.03)], and 16.44% [95% CI (14.90-18.09)] among children aged 0-23 months in Ethiopia. Female children were less likely to be associated with stunting [AOR: 0.68, 95% CI (0.54-0.86)], wasting [AOR: 0.70, 95% CI (0.51, 0.98)], and underweight [AOR: 0.64, 95% CI (0.49, 0.83)] than their male counterparts. Conversely, older children aged 12-17 months [AOR: 2.22, 95% CI (1.52, 3.23)] and 18-23 months [AOR: 4.16, 95% CI (2.75, 6.27)] were significantly at an increased odds of becoming stunted. Similarly, the likelihood of being underweight was higher in older age groups: 6-11 months [AOR: 1.74, 95% CI (1.15, 2.63)], 12-17 months [AOR: 2.13, 95% CI (1.40, 3.24)], and 18-23 months [AOR: 4.08, 95% CI (2.58, 6.44)] compared with the children younger than 6 months. Lower wealth quintile was one of the other significant determinants of stunting and underweight. The study's findings indicated that the most consistent significant risk factors for undernutrition among children aged 0-23 months are: male sex, older age groups and lower wealth quintile. These findings emphasize the importance of strengthening nutrition-specific and sensitive interventions that address the immediate and underlying drivers of childhood undernutrition in early life, as well as targeting low-income households with male children, in order for Ethiopia to meet the Sustainable Development Goals (SDGs) 1,2 and 3 by 2030.

Level of physical activity and its associated factors among adults in southeast Ethiopia: a community-based cross-sectional study.

OBJECTIVE: Insufficient levels of physical activity are a well-known modifiable risk factor for a number of chronic conditions including obesity, type 2 diabetes, cardiovascular diseases and certain malignancies. Little is known about the status of physical activity and its associated factors among adults in low-income countries, including Ethiopia. Therefore, this study aimed to assess the level of physical activity and its associated factors among adults in southeast Ethiopia. DESIGN: Analytical cross-sectional study. SETTING: Community setting in southeast Ethiopia. PARTICIPANTS: 641 adults aged 18-64 years. PRIMARY OUTCOME: Level of physical activity assessed via the Global Physical Activity Questionnaire (GPAQ). RESULTS: The overall prevalence of insufficient physical activity in this study was 29.48% (95% CI: 25.78 to 33.18). Women were more likely to report insufficient physical activity compared with men (39.0% for women and 12.3% for men, p<0.001). Being: a women (adjusted OR (AOR)=3.99, 95% CI: 2.15 to 7.40)), overweight/obese (AOR=1.95, 95% CI: 1.23 to 3.09), ever-married (AOR=2.13, 95% CI: 1.01 to 4.47), a person with no formal education (AOR=1.94, 95% CI: 1.05 to 3.56), a housewife (AOR=3.04, 95% CI: 1.75 to 5.29) and unemployed (AOR=3.30, 95% CI: 1.55 to 7.02) were significantly associated with insufficient physical activity. CONCLUSION: The study revealed that three in 10 adults did not achieve the recommended level of physical activity. For chronic disease prevention in Ethiopia, the Ethiopian Ministry of Health and other stakeholders should pay special attention to strategies to improve the population's physical activity especially among women, housewives, people with no formal education, and married, unemployed and overweight/obese adults.

Association between water, sanitation and hygiene (WASH) and child undernutrition in Ethiopia: a hierarchical approach.

BACKGROUND: Undernutrition is a significant public health challenge and one of the leading causes of child mortality in a wide range of developing countries, including Ethiopia. Poor access to water, sanitation, and hygiene (WASH) facilities commonly contributes to child growth failure. There is a paucity of information on the interrelationship between WASH and child undernutrition (stunting and wasting). This study aimed to assess the association between WASH and undernutrition among under-five-year-old children in Ethiopia. METHODS: A secondary data analysis was undertaken based on the Ethiopian Demographic and Health Surveys (EDHS) conducted from 2000 to 2016. A total of 33,763 recent live births extracted from the EDHS reports were included in the current analysis. Multilevel logistic regression models were used to investigate the association between WASH and child undernutrition. Relevant factors from EDHS data were identified after extensive literature review. RESULTS: The overall prevalences of stunting and wasting were 47.29% [95% CI: (46.75, 47.82%)] and 10.98% [95% CI: (10.65, 11.32%)], respectively. Children from households having unimproved toilet facilities [AOR: 1.20, 95% CI: (1.05,1.39)], practicing open defecation [AOR: 1.29, 95% CI: (1.11,1.51)], and living in households with dirt floors [AOR: 1.32, 95% CI: (1.12,1.57)] were associated with higher odds of being stunted. Children from households having unimproved drinking water sources were significantly less likely to be wasted [AOR: 0.85, 95% CI: (0.76,0.95)] and stunted [AOR: 0.91, 95% CI: (0.83, 0.99)]. We found no statistical differences between improved sanitation, safe disposal of a child's stool, or improved household flooring and child wasting. CONCLUSION: The present study confirms that the quality of access to sanitation and housing conditions affects child linear growth indicators. Besides, household sources of drinking water did not predict the occurrence of either wasting or stunting. Further longitudinal and interventional studies are needed to determine whether individual and joint access to WASH facilities was strongly associated with child stunting and wasting.

Utilization and compliance with iron supplementation and predictors among pregnant women in Southeast Ethiopia.

Anemia is predicted to affect 38% (32 million) of pregnant women worldwide. However, evidence for utilization and compliance with iron supplementation and predictors during pregnancy in low-income countries, including Ethiopia, is sparse and inconclusive. Therefore, we aimed to assess utilization and compliance with iron supplementation and predictors among pregnant women in Robe Town, Southeast Ethiopia. A community-based cross-sectional study was employed among randomly selected 445 pregnant women attending antenatal care at health facilities from May to July 2015. A systematic random sampling was used to select respondents. Data were collected using a pre-tested, interviewer-administered, structured questionnaire. Bivariable and multivariable logistic regression analyses were conducted to identify predictors of compliance with iron supplementation. An odds ratio, along with a 95% confidence interval (CI), was used to estimate the strength of the association. In this study, 54% [95% CI (49.4, 58.4%)], 45.2% [95% CI (40.9, 49.4%)], 4.3% [95% CI (2.5, 6.3%)], and 2.2% [95% CI (1.1, 3.6%)] of women received iron supplements during their first, second, third, and fourth antenatal care visits, respectively. The level of compliance with iron supplementation was 92.4% [95% CI (89.9, 94.6%)]. Having a formal education (AOR = 4.45, 95% CI 1.41, 13.99), being in the high wealth quintile (AOR = 0.18, 95% CI 0.05, 0.68), medium wealth quintile [(AOR = 0.33, 95% CI (0.11, 0.98)], receiving iron supplements for free (AOR = 3.77, 95% CI 1.33, 10.69), not experiencing discomfort related to iron supplements intake (AOR = 2.94, 95% CI 1.17, 7.39), having comprehensive knowledge about anemia (AOR = 2.62, 95% CI 1.02, 6.70), being knowledgeable about iron supplements (AOR = 3.30, 95% CI 1.12, 9.76), having information about importance of iron supplementation during pregnancy (AOR = 2.86; 95% CI 1.04, 7.87), and ever being visited by urban health extension workers (AOR = 0.31; 95% CI 0.12, 0.83) was significantly associated with compliance with iron supplementation during pregnancy. The utilization of iron supplementation during pregnancy was low, with relatively high compliance with the supplements. Thus, comprehensive nutrition education and free provision of iron supplementation are crucial tools to increase utilization and compliance with iron supplementation during pregnancy. Further research with a strong study design using golden standard methods is warranted.

Incidence and risk factors of gestational diabetes mellitus in Goba town, Southeast Ethiopia: a prospective cohort study.

OBJECTIVE: Gestational diabetes mellitus (GDM) is becoming a public health concern in low/middle-income countries, and is known to cause severe morbidity and mortality for mothers and newborns. However, evidence reported for the incidence and risk factors of GDM is scant in Ethiopia. We aimed to assess the incidence of, and risk factors for, GDM in Goba town, Southeast Ethiopia. DESIGN: Prospective cohort study. SETTING: Goba town, Southeast Ethiopia. PARTICIPANTS: Four hundred eighty pregnant women on antenatal care follow-up from 30 April to 30 September 2021. PRIMARY AND SECONDARY OUTCOMES: Incidence and risk factors of GDM using fasting capillary blood glucose. Log-binomial model was used to identify the risk factors of GDM. Adjusted relative risk (aRR), along with 95% CIs, were calculated to estimate the strength of associations. RESULTS: The cumulative incidence rate of GDM in this study was 15.7% (95% CI: 12.3% to 19.2%). Being unemployed (aRR=2.73; 95% CI: 1.36 to 5.47), having a family history of diabetes mellitus (DM) (3.01; 2.09 to 4.35), low physical activity (2.43; 1.11 to 5.32), inadequate dietary diversity (1.48; 1.29 to 1.92), anaemia (2.51; 1.32 to 3.54) and antenatal depression (4.95; 3.35 to 7.31) were significantly associated with GDM. CONCLUSION: The cumulative incidence of GDM was relatively high among the study participants. Having antenatal depression symptoms, low physical activity, inadequate dietary diversity, being unemployed, anaemia and a family history of DM were significant risk factors for GDM.

Prevalence of central obesity and its associated risk factors among adults in Southeast Ethiopia: A community-based cross-sectional study.

BACKGROUND: Obesity and overweight are known public health problems that affect populations across the world. These conditions have been associated with a wide range of chronic diseases including type 2 diabetes mellitus, cardiovascular disease, and cancers. In Ethiopia, the literature regarding the burden of central (abdominal) obesity is scarce. This study aimed to fill this gap by assessing the prevalence and risk factors associated with central obesity among adults in Ethiopia. METHODS: From May to July 2021, a community-based cross-sectional survey was conducted on a sample of 694 adults aged ≥18 years in administrative towns of Bale zone, Southeast Ethiopia. Multi-stage sampling followed by systematic random sampling was employed to identify study participants. Waist and hip circumferences were measured using standard protocols. The World Health Organization STEPS wise tool was used to assess risk factors associated with central obesity. Bi-variable and multi-variable binary logistic regression were used to identify factors associated with central obesity. Adjusted odds ratios (AOR) and their corresponding 95% confidence intervals (CI) have been reported to estimate the strength of associations. RESULTS: The overall prevalence of central obesity using waist circumference was 39.01% [(95% CI: 35.36-42.76; 15.44% for men and 53.12% for women)]. Multi-variable binary logistic regression analysis revealed that female sex (AOR = 12.93, 95% CI: 6.74-24.79), Age groups: 30-39 years old (AOR = 2.8, 95% CI: 1.59-4.94), 40-49 years (AOR = 7.66, 95% CI: 3.87-15.15), 50-59 years (AOR = 4.65, 95% CI: 2.19-9.89), ≥60 years (AOR = 12.67, 95% CI: 5.46-29.39), occupational status like: housewives (AOR = 5.21, 95% CI: 1.85-14.62), self-employed workers (AOR = 4.63, 95% CI: 1.62-13.24), government/private/non-government employees (AOR = 4.68, 95% CI: 1.47-14.88), and skipping breakfast (AOR = 0.46, 95% CI: 0.23-0.9) were significantly associated with central obesity. CONCLUSIONS: Abdominal obesity has become an epidemic in Bale Zone's towns in Southeastern Ethiopia. Female sex, age, being employed were positively associated with central obesity, while skipping breakfast was a protective factor.

Perforated duodenal ulcer in the third trimester of pregnancy, with survival of both the mother and neonate, in Ethiopia: a case report.

BACKGROUND: Perforated peptic ulcer disease is a serious complication of peptic ulcer disease (PUD) that presents as acute abdomen. It is very uncommon during pregnancy, but its diagnosis in pregnancy is very challenging in general, and more so in the third trimester. Timely diagnosis and prompt surgical intervention can prevent maternal and fetal mortality, but delayed diagnosis is linked with poor maternal and fetal outcomes. The aim of this case report is to emphasize the need for healthcare professionals to consider the differential diagnosis of perforated PUD when presented with cases of acute abdomen in pregnancy and to involve a multidisciplinary team in management for better feto-maternal outcome. CASE PRESENTATION: A 35-year-old pregnant Ethiopian woman, Gravida 7 and Para 6, presented with a sudden onset of right upper quadrant pain, nausea, and vomiting of 7 hours duration at 36 weeks of gestation. She also had contractions and leakage of liquor of two hours duration. Her abdomen was grossly distended, rigid, and diffusely tender, and showed limited movement with respiration. An upright abdominal X-ray demonstrated air under the diaphragm. She was diagnosed with perforated peptic ulcer disease. Labor was augmented, and a 2.9-kg live male neonate was delivered vaginally. Two hours after delivery, laparoscopic omental patch repair was performed. The patient was discharged 7 days after the omental patch repair surgery in stable condition. CONCLUSIONS: Perforated PUD in pregnancy is a rare occurrence, which may account for the delay in diagnosis and management. Obstetricians should keep a high index of suspicion when a pregnant woman presents with acute abdomen. Care provided by obstetricians should be coupled with care provided by other disciplinary teams, in order to reduce maternal and fetal morbidity and mortality.