Prevalence of Milk Teeth Extraction and Enabling Community Factors Among Under Five-Year-Old Children in Alle Special Woreda, SNNPR, Ethiopia, 2022: Community-Based Cross-Sectional Study; Based on Theory of Planned Behavior Model.

Background: Milk tooth extraction (MTE) is one of the most common harmful traditional practices performed by traditional healers without anesthesia and unsterile materials. The acute and chronic complications of this practice greatly affect the health of children. In order to develop effective preventive measures towards this harmful practice, the extent of the problem and factors contributing to the practice should be verified. The objective of this study was to assess the prevalence and associated factors of MTE among under five-years-old children in Alle special Woreda. Methods: A community-based cross-sectional survey was undertaken at Alle Special Woreda among 363 women using a multi-stage stratified sampling method. Data was collected using semi-structured questionnaires and data entry was done with Epi-data version 4.4.3.1, while data management and analysis were done with STATA version 14.0. Univariate and multivariate binary logistic regression models were used while model's fitness was checked by Hosmer and Lemeshow test. Variables having a p-value of less than 0.05 were declared statistically significant in the final model. Result: Milk teeth extraction was practiced on 58.68% (95% CI:0.5,0.6) of children. Age of the child less than 12 months, AOR:1.27 (95% CI:1.02,1.6), maternal occupation (housewife) AOR:1.3 (95% CI:1.04,65), paternaleducational, level (illiterate) AOR:1.4 (95% CI:1.2,1.9), residence (rural) AOR:3.6 (95% CI:1.08,12.4), positive attitude AOR:1.65 (95% CI:1.01,2.8) and intentions AOR: 1.82 (95% CI:1.1,3.3) towards MTE practice showed statistically significant association with MTE practice. Conclusions and Recommendations: It was found that milk teeth extraction practice was the most common practice in the study area, with a prevalence of 58.68%. Age of the child, maternal occupation, paternal educational level, residence, having a positive attitude and intentions toward MTE practice all had a statistically significant (P value less than 0.05) association with MTE practice. Society's barriers, such as knowledge, attitude, and practice (KAP) related, health facility related, and peer and social pressure-related factors, were identified. All stakeholders should put great emphasis on the elimination of this harmful practice.

Perceived Social Support and Associated Factors Among Adults Living with HIV/AIDS Attending ART Clinic at Public Hospitals in Gamo Zone, Southern Ethiopia 2021.

Background: HIV/AIDS remains one of the world's serious public health challenges. Patients with limited support from their family and community often experience social damage, poor adherence, compliance and are prone to additional psychosocial problems. This study aimed to assess the level of perceived social support and factors among adults living with HIV/AIDS. Methods: Facility-based mixed study (sequential explanatory) design was conducted among 423 adults living with HIV/AIDS attending chronic care follow-up at public hospitals in Gamo zone, southern Ethiopia. Respondents were selected by systematic sampling technique. The bivariable and multivariable ordinal logistic regression was used to determine associated factors. All assumptions applied to ordinal logistic regression including multicollinearity, proportional odds, model fitness and pseudo R2 were checked. Level of significance was declared at p-values <0.05 and 95% CI. Results: Proportion of perceived social support of participants was 128 (30.7%), 197 (47.2%) and 92 (22.1%) with low, moderate and high levels of perceived social support, respectively. Females [(APOR = 2.42, 95% CI:(1.63-3.58), P < 0.001)], no formal education [(AOR = 0.49, 95% CI: (0.30-0.789), P = 0.004)], fair adherence [(APOR = 2.07, 95% CI: (1.17-3.49), P = 0.006)], no comprehensive knowledge about HIV [(APOR = 0.40, 95% CI: (0.26-0.62), P < 0.001)], and no disclosure status [(APOR = 0.64, 95% CI: (0.43-0.95), P = 0.028] were significantly associated with perceived social support. Qualitative findings revealed that disclosure and adherences involving income generation activities are beneficial to perceived social support. Conclusion: This study showed that one from three of the participants had low perceived social support. Low perceived social support was associated with adherence, disclosure status of individual, educational status and knowledge about HIV/AIDS. Family, friends, health care providers and significant others should provide necessary support and inform people living with HIV/AIDS (PLWHA) about social support.

Patient delay and associated factors among tuberculosis patients in Gamo zone public health facilities, Southern Ethiopia: An institution-based cross-sectional study.

BACKGROUND: Delayed tuberculosis diagnosis and treatment increase morbidity, mortality, expenditure, and transmission in the community. Early diagnosis and initiation of treatment are essential for effective TB control. Therefore, the main objective of this study was to assess the magnitude and factors associated with patient delay among tuberculosis patients in Gamo Zone, Southern Ethiopia. METHODS: A cross-sectional study was conducted in Gamo Zone, Southern Ethiopia from February to April 2019. Fifteen health facilities of the study area were selected randomly and 255 TB patients who were ≥18 years of age were included. Data were collected using a questionnaire through face-to-face interviews and analyzed using SPSS version 20.0. Patient delay was analyzed using the median as the cut-off value. Multivariable logistic regression analysis was fitted to identify factors associated with patient delay. A p-value of ≤ 0.05 with 95% CI was considered to declare a statistically significant association. RESULTS: The median (inter-quartile range) of the patient delay was 30 (15-60) days. About 56.9% of patients had prolonged patients' delay. Patient whose first contact were informal provider (adjusted odds ratio [AOR]: 2.24; 95% confidence interval [CI] 1.29, 3.86), presenting with weight loss (AOR: 2.53; 95%CI: 1.35, 4.74) and fatigue (AOR: 2.38; 95%CI: 1.36, 4.17) and body mass index (BMI) categories of underweight (AOR: 1.74; 95%CI: 1.01, 3.00) were independently associated with increased odds of patient delay. However, having good knowledge about TB (AOR: 0.44; 95% CI: 0.26, 0.76) significantly reduce patients' delay. CONCLUSION: In this study, a significant proportion of patients experienced more than the acceptable level for the patient delay. Knowledge about TB, the first action to illness, presenting symptoms, and BMI status were identified factors associated with patient delay. Hence, raising public awareness, regular training, and re-training of private and public healthcare providers, involving informal providers, and maintenance of a high index of suspicion for tuberculosis in the vulnerable population could reduce long delays in the management of TB.

Effects of antenatal care service utilization on maternal near miss in Gamo Gofa zone, southern Ethiopia: retrospective cohort study.

BACKGROUND: Antenatal care (ANC) provides an opportunity to prevent, identify and intervene maternal health problems. Maternal near miss (MNM), as an indicator of maternal health, is increasingly gaining global attention to measure these problems. However, little has been done to measure the effect of ANC on MNM in Ethiopia. Therefore, this study is aimed at determining the effect of ANC on MNM and its associated predictors at Gamo Gofa zone, southern Ethiopia. METHODS: Employing a retrospective cohort study design, 3 years data of 1440 pregnant mothers (480 ANC attendant and 960 non-attendant) were collected from all hospitals in the zone. Taking ANC visit as an exposure variable; we used a pretested checklist to extract relevant information from the study participants' medical records. Characteristics of study participants, their ANC attendance status, MNM rates and associated predictors were determined. RESULTS: Twenty-five (5.2%) ANC attendant and seventy-one (7.4%) non-attendant mothers experienced MNM, (X2 = 2,46, df = 2, p = 0.12). The incidence rates were 59.6 (95% CI: 40.6-88.2) and 86.1 (95%CI: 67.3-107.2)/1000 person-years for the ANC attendant and non-attendant mothers, respectively. Mothers who were living in rural areas had higher hazard ratio of experiencing MNM than those who were living in urban areas, with an adjusted hazard ratio (AHR) of 1.68 (95% CI, 1.01, 2.78). CONCLUSION: ANC attendance tended to reduce MNM. However, late initiation and loss to follow-up were higher in the current study. Therefore, on time initiation and consistent utilization of ANC are required.

Factors affecting enrollment status of households for community based health insurance in a resource-limited peripheral area in Southern Ethiopia. Mixed method.

BACKGROUND: Despite the efforts made by the government of Ethiopia, the community-based health insurance (CBHI) enrollment rate failed to reach the potential beneficiaries. Therefore, this study aimed to assess the enrollment status of households for community-based health insurance and associated factors in peripheral areas of Southern Ethiopia. METHODS: We conducted a community based cross-sectional study design with both quantitative and qualitative methods. Systematic random sampling was employed to select 820 households from 27, April to 12 June 2018. A pretested structured questionnaire, in-depth interview, and focus group discussion guiding tool were used to obtain information. A binary logistic regression model was used to assess the association between independent and outcome variables. A P-Value of less than 0.05 was taken as a cutoff to declare association in multivariable analysis. Qualitative data were analyzed manually using the thematic analysis method. RESULTS: Out of 820 households, 273[33.30%; 95% CI: 29.9-36.20] were enrolled in the community based health insurance scheme. Having good knowledge [AOR = 13.97, 95%CI: 8.64, 22.60], having family size of greater than five [AOR = 1.88, 95% CI: 1.15, 3.06], presence of frequently ill individual [AOR = 3.90, 95% CI: 2.03, 7.51] and presence of chronic illness [AOR = 3.64, 95% CI: 1.67, 7.79] were positively associated with CBHI enrollment. In addition, poor quality of care, lack of managerial commitment, lack of trust and transparency, unavailability of basic logistics and supplies were also barriers for CBHI enrollment. CONCLUSION AND RECOMMENDATION: The study found that lower community based health insurance enrollment status. A higher probability of CBHI enrollment among higher health care demanding population groups was observed. Poor perceived quality of health care, poor managerial support and lack of trust were found to be barriers for non-enrollment. Therefore, wide-range awareness creation strategies should be used to address adverse selection and poor knowledge. In addition, trust should be built among communities through transparent management. Furthermore, the quality of care being given in public health facilities should be improved to encourage the community to be enrolled in CBHI.

Effects of comprehensive sexuality education on the comprehensive knowledge and attitude to condom use among first-year students in Arba Minch University: a quasi-experimental study.

OBJECTIVE: To assess the effect of comprehensive sexuality education on the comprehensive knowledge and attitude to condom use among first-year students at Arba Minch University. RESULTS: A total of 832 students participated at a baseline, and 820 students participated at the posttest. This study found that there was a significant effect on changing students' knowledge and attitude towards a condom. In the education group, the students' average change of comprehensive condom knowledge score was 0.229 higher than the average score of students' in the control group (ATE = 0.229, 95% CI 0.132 to 0.328; p < 0.001). The average change of attitude toward condom score of students' in the education group was 1.834 higher than the average change score of students' in the control group (ATE = 1.834, 95% CI 1.195 to 2.772; p < 0.001).This study provides further evidence on the effectiveness of comprehensive sexuality education in terms of knowledge and attitude towards a condom. Therefore, the implementation of this education should be strengthened in order the prevent youths from STI/HIV and unintended pregnancies.

Adherence to Iron-Folate Supplementation and Associated Factors among Pastoralist's Pregnant Women in Burji Districts, Segen Area People's Zone, Southern Ethiopia: Community-Based Cross-Sectional Study.

BACKGROUND: Iron deficiency anemia among pregnant women is one of the most common public health problems in developing country particularly in Ethiopia. Iron/folic acid supplementation with optimal adherence is the main cost-effective strategy for prevention and control of iron deficiency anemia in pregnant women. However, level of adherence to iron/folic acid supplementation and its associated factors were not well identified in study area. Therefore, the aim of this study was to determine the level of adherence to iron/folic acid supplementation and associated factors among pregnant women in Burji Districts, southern Ethiopia. METHODS: A community-based cross-sectional study was conducted among 317 pregnant women in Burji Districts from March to April 2017 using interviewer administered questionnaires. Data were entered into Epi Info 3.5.1 and exported to SPSS version 20.0 for analysis. Binary and multivariable logistic regression was used to identify factors associated with iron/folic acid supplementation. Adjusted odds ratio (AOR) with 95% confidence interval (CI) and p-value <0.05 were used to declare statistical significance. RESULTS: Among women participating in the study, 163(51.4%) were adherent to iron/folate acid supplementation. Factors significantly associated with adherence to iron and folic acid supplementation were maternal educational status (AOR: 2.47, 95% CI: 1.13-4.97), early registration for ANC (AOR: 2.49, 95% CI: 1.45 - 4.27), history of anemia during current pregnancy (AOR: 2.02, 95% CI: 1.09-3.72), and knowledge about iron and folic acid supplementation (AOR: 1.96, 95% CI: 1.02-3.76). Forgetfulness and fear of side effects were among the leading reasons of pregnant women for nonadherence to iron and folic acid supplementation. CONCLUSIONS: This study revealed that adherence to iron /folic acid supplementation was found to be 51.4%. Maternal educational status, early registration for ANC, history of anemia during current pregnancy, and knowledge about iron and folic acid supplementation were significant factors associated with adherence to iron/folic acid supplementation among pastoralist's pregnant women. Therefore, anemia prevention strategy should include strengthening giving awareness, counseling, strengthening community health education, and participation in health programs which are necessary to improve the uptake of iron/folic acid supplements.

Client Satisfaction with Delivery Care Service and Associated Factors in the Public Health Facilities of Gamo Gofa Zone, Southwest Ethiopia: In a Resource Limited Setting.

Background. Ensuring patient satisfaction is an important means of secondary prevention of maternal mortality. This study presents findings from a multidimensional study of client satisfaction from the Gamo Gofa Zone in Southwest Ethiopia. Methods. A facility based cross-sectional study using exit interviews was conducted from 2014. Client satisfaction was measured using a survey adopted from the Donabedian quality assessment framework. Thirteen health institutions were randomly sampled of 66 institutions in Gamo Gofa Zone. Logistic regression was used to determine predictors of client satisfaction. Results. The overall satisfaction level of the clients in this study was 79.1% with (95% CI; 75-82). Women attending health centres were more likely satisfied than women attending hospitals (χ (2) = 83.7, df = 12, P < 0.001). The proportion of women who complained about an unfriendly attitude or unresentful care from health workers was higher in the hospitals (χ (2) = 27.4, df = 1, P < 0.001). The presence of support persons during child birth improved client satisfaction (AOR = 6.23 95% CI; 2.75-14.1) and women who delivered with caesarean section are four times more likely satisfied than those who deliver vaginally (AOR 3.6 95% CI; 1.44-9.06). Client satisfaction was reduced if the women had to pay for the services (AOR = 0.27 95% CI; 0.09-81). Conclusions. The study shows that overall satisfaction level is good. More emphasis should be put on giving women friendly care, particularly at the hospitals.

Knowledge and Practice of Clinicians regarding Syndromic Management of Sexually Transmitted Infections in Public Health Facilities of Gamo Gofa Zone, South Ethiopia.

Background. Sexually Transmitted Infections (STIs) are the leading causes of morbidity among young adults. This study assessed the knowledge and practice of clinicians regarding syndromic management of STIs in public health facilities of Gamo Gofa Zone, Southern Ethiopia. Methods. Facility based cross-sectional study with mixed methods of data collection was conducted in public health facilities of Gamo Gofa Zone. The study included 250 clinicians and 12 health facilities, 26 mystery clients were hired, and 120 STI patient cards were reviewed. Data was entered in EPI info version 7.0.1 and analyzed by SPSS version 20. Results. Of the participated clinicians, 32 (12.8%) were trained on syndromic management of STIs. Highest knowledge of clinicians was for urethral discharge (27.2%). Professional category of clinicians and type of health facility (AOR = 0.194; 95% CI = 0.092, 0.412) were determinants of urethral discharge knowledge. Of the cards reviewed, only in 8.3% of cards and 19.23% of mystery clients did the clinicians correctly follow the guideline. Conclusion. Knowledge and practice of clinicians regarding syndromic management of STIs in study area were poor. Efforts should be made to increase the knowledge of clinicians by providing training on syndromic management of STIs and supportive supervision should be regular.

Determinants of active pulmonary tuberculosis in Ambo Hospital, West Ethiopia.

OBJECTIVES: The aim of this study was to determine factors associated with active pulmonary tuberculosis seen in cases in Ambo Hospital, Ethiopia. DESIGN: A facility-based prospective case-control study. SETTING: Patients attending Ambo Hospital from 01 December 2011 to 29 March 2012. PARTICIPANTS: The sample included 312 adult patients attending Ambo Hospital. The main outcome measure was presence of active pulmonary tuberculosis (TB). EXPLANATORY MEASURES: Age, gender, occupation, educational status, marital status, place of residence, patient history of TB, family history of TB, human immunodeficiency virus (HIV) infection, smoking, alcohol intake, khat chewing, body mass index (BMI), employment, diabetes, history of asthma, previous history of worm infestation, history of hospitalisation, number of adults living in the household (HH), person per room, housing condition. RESULTS: A total of 312 study participants, including 104 active pulmonary tuberculosis (PTB) cases (cases) and 208 non-active PTB cases (controls), were recruited for the present study. Having one or more family member with a history of TB (OR = 4.4; 95% CI: 1.50­12.90), marital status (OR = 7.6; 95% CI: 2.2­12.6), male gender (OR = 3.2; 95% CI: 1.4­7), rural residence (OR = 3.3; P = 0.012), being a current or past smoker (OR = 2.8; 95% CI: 1.1­7.2), BMI < 18.5 (OR = 2.1; 95% CI: 1.03­4.2), HIV infection (OR = 8.8; 95% CI: 2.4­23.8) and a history of worm infestation (OR = 6.4; 95% CI: 2.6­15.4) remained significant independent host-related factors for active PTB. CONCLUSION: Patients who came from a compound with more than two HHs were more likely to develop active PTB than those who came from a compound with only one HH. Those who lived in houses with no windows were more likely to develop active PTB than those who lived in houses with one or more windows, had a family history of TB, lived in rural areas. Sex of the patient was a predicting factor. Not being the owner of the house was significantly more associated with active PTB. Measures taken to reduce the prevalence and burden of active PTB should consider these determinant factors.

Determinants of acute diarrhoea among children under five years of age in Derashe District, Southern Ethiopia.

INTRODUCTION: Diarrhoea kills more children than AIDS, malaria, and measles combined. Knowing the determinants of a disease enables us to design an effective intervention. The objective of this study was to identify the determinants of acute diarrhoea and associated factors among children under 5 years of age in Derashe district, south Ethiopia. METHODS: A community based unmatched case-control study supplemented with Focus Group Discussions (FGDs) was employed in rural kebeles (neighborhoods) of the district. Collected data were entered in Epi Info v3.5.3 (wwwn.cdc.gov/epiinfo/info/) and descriptive data analyses were performed using SPSS v16.0 (www.spss.com). Binary logistic regression analysis was used to measure the association between dependent and independent variables, calculating odds ratios and 95% confidence intervals (CI). Statistical significance was set at α ≤0.05. Multivariable analyses were applied to identify the relative effect of explanatory variables on the dependent variable. RESULTS: The study revealed that the occurrence of diarrhoea was significantly associated with lack of latrine ownership (adjusted [A] OR: 2.43, CI:1.19-4.87), lack of home-based water treatment (AOR: 2.25, CI:1.43-3.56), lack of improved water sources (AOR: 1.98, CI:1.16- 2.23) and consumption of left-over food (AOR: 1.65, CI:1.01-2.71). CONCLUSIONS: The determinants of acute diarrhoea were of high preventive value (latrine ownership, availability of home-based water treatment, source of water and consumption of left-over food stored at room temperature), therefore health education on different mechanisms in diarrhoeal disease causation, and prevention methods, is recommended.