Determinants of virological failure among HIV clients on second-line antiretroviral treatment at Felege-hiwot and University of Gondar comprehensive specialized hospitals in the Amhara Region, Northwest Ethiopia: A case-control study.

BACKGROUND: Second-line HIV treatment failure has become increasing worldwide, mainly in sub-Sahara Africa including Ethiopia. Even though the problem becomes increasing, inadequate information was available about its magnitude and associated factors in the current study area. OBJECTIVE: To assess the factors of second-line Anti-Retroviral Treatment virological failure among second-line ART users. METHOD AND MATERIALS: Institutional-based unmatched case-control study design was conducted from September to December 2021 at Felege Hiowt and University of Gondar Comprehensive Specialized Hospitals; Amhara region, Northwest Ethiopia. A total of 216 patients (60 cases and 156 controls) were recruited by a simple random sampling technique with a 1:3 cases-to-controls ratio. Patients who had two viral load results >1000 copies/ml within a 3-month interval after taking ART drugs for at least 6 months were cases and those who had ≤1,000 copies/ mL were controls. The sample size was calculated by using Epi-Info version 7.2.4. Structured questionnaires were used to gather the required information. SPSS version 26 was used to summarize the findings. In bivariate logistic regression model, Variables with two-tailed P-value ≤ 0.25 at 95% confidence interval were transferred into multivariate binary logistic regression model and P value at ≤ 0.05 was set as statistically significant. RESULTS: Out of 216 patients recruited, 212 have participated with a response rate of 98.2%. From these participants, 117(55.2%) were males and 187(88.2%) were urban dwellers. Among the total respondents, 208(98.1%) had age > 24 years, 200(94.3) were at HIV clinical stage I, 72(34%) had poor ART adherence and 112(52.8) did not disclose their HIV status. Likewise, most of the patients 147(69.37) didn't use condoms. The associated factors were not disclosing HIV status (AOR = 3.4, 95% CI: 1.52-7.79), medium adherence (AOR = 3.7, 95% CI = 1.3-10.7), poor adherence level (AOR = 5.27, 95% CI: 2.2-12.5), not using condoms (AOR = 4.47, 95% CI: 1.63-12.2) and Viral load (>150 copies/ml) when switched to second-line ART (AOR = 3.56, 95% CI: 1.5-8). CONCLUSION AND RECOMMENDATIONS: Non-disclosure, poor or medium adherence, not using condoms and high Viral load (>150 copes/ml) when switched to second-line ART were the main factors for second-line Anti-Retroviral Treatment virological failure. Disclosure about HIV status, using condoms and improving treatment adherence level are crucial to reduce second-line virological failure.

Risk Factors of Cooking-related Burn Injury Among Under-Four Children in Northwest Ethiopia: A Community-Based Cross-Sectional Study.

OBJECTIVE: To investigate the prevalence and risk factors of cooking-related child burn injury. METHODS: A cross-sectional community-based study was conducted among a total of 5830 children with their respective caretakers in randomly selected 100 clusters. Data were collected through face-to-face interviews using a structured questionnaire. Logistic regression was used to identify the risk factors and adjusted odds ratios were used as measures of effect. RESULTS: The prevalence of cooking-related child burn injury was 6.2% (95% CI: 5.5-6.8). This burden was linked with risk factors such as lower literacy of caretaker, family size, using traditional cook stove, long cooking time, and presence of extra indoor burning events as well as lack of separate kitchen, child supervision, and injury prevention awareness. CONCLUSION: Children experience a high burden of burn injury. Thus, stakeholders should work to reduce this burden by controlling the aforementioned risk factors.

Prevalence and risk factors of cooking-related burn injury among under-five-years old children in a resource-limited setting: a community-based cross-sectional study in Northwest Ethiopia.

Cooking-related child burn injury causes a greater health burden in low-and-middle-income countries. Therefore, a community-based cross-sectional study was conducted among 5830 under-five-years old children in a resource-limited community in Northwest Ethiopia to determine the prevalence and risk factors of this child health problem. Data were collected by trained nurses using a questionnaire and the logistic regression analysis method was applied to identify factors linked with burn injury. Injury prevalence was 6.2% (95% CI:5.5-6.8); and this burden was linked with several risk factors such as lower literacy status of caretakers [AOR = 2.21 (95% CI:1.05-4.67)], overcrowding [AOR = 2.35(95% CI:1.25-4.43], lack of separate kitchen [AOR =2.19 (95% CI:1.56-3.07)], using traditional cookstove [AOR = 2.04 (95% CI:1.23-3.36)], and lack of child supervision [AOR = 2.27 (95% CI:1.63-3.17)]. In conclusion, children experience a high burden of burn injury. Thus, stakeholders should work to reduce child burn injury by modifying the aforementioned risk factors.

Households' access to an improved latrine and its associated factors among households of sanitation marketing products users and non-users, Northeast Amhara, Ethiopia.

Sanitation marketing is an approach to increase access to the improved latrine on a large scale which helps households to promote proper utilization of sanitary facilities. It helps to close the huge sanitation access gap in developing countries like Ethiopia. This study aimed to assess households' access to an improved latrine and its associated factors among sanitation marketing product users and non-users in Dessie Zuria District, Northeast Amhara, Ethiopia. A community-based comparative cross-sectional study was conducted among 640 households, in 2021. Multi-stage sampling techniques and a structured questionnaire were used. Data were checked, coded, and entered into Epi-info version 7 and exported to Statistical Package for Social Sciences version 23.0 for analysis. Binary logistic regression was employed to determine factors associated with improved latrine access. The study revealed that overall 59.8% of the households had access to improved latrines. Of this, 75.2% (95% Confidence Interval (CI): 70, 80) of households were Sanitation marketing products users; and 44.2% (95% CI: 39, 50) of households were from non-users of Sanitation marketing products. Being female household head, Adjusted Odds Ratio (AOR = 4.3, 95% CI: 1.69, 10.59); urban residence, AOR = 2.5, 95% CI: 1.23, 5.19; water access, AOR = 3.3, 95% CI: 1.63, 6.57 were significantly associated with access to the improved latrine in sanitation marketing products users households, while being a female household head, AOR = 7.3, 95% CI: 3.68, 14.39; urban residence, AOR = 2.8, 95% CI: 1.64, 4.77; water access, AOR = 2.4, 95% CI: 1.44, 4.10 were significantly associated with access to the improved latrine in non-user households of sanitation marketing products. Access to improved latrines is still a big problem in both households of sanitation marketing product users and sanitation marketing product non-users. Gender, residence, water access, supportive supervision, knowledge, and availability of sanitation hardware stores were found to be significant predictors of household access to an improved latrine. Hence, evaluating policies and strategies of sanitation marketing approach on improved sanitation facilities is recommended.

Anthrax prevention practice and associated factors among farmers in Farta district, South Gondar, Amhara region, Northwest Ethiopia.

BACKGROUND: Anthrax is a zoonotic disease endemic in Ethiopia. Despite anthrax preventive measures are the key activities to control the disease, several outbreaks have occurred in Ethiopia recently. The objective of the study was therefore to assess the anthrax preventive practice and its associated factors among farmers in Farta district, South Gondar zone, Northwest Ethiopia. METHOD: A community-based cross-sectional study was conducted among farmers in Farta District from June 7 to 21/2020. A multi-stage sampling technique, with systematic random sampling, was used to select 1,338 study participants. Data were collected through a face-to-face interview using a structured questionnaire. The data were cleaned, coded, and entered into the Epi-data v 3.1 and then exported to SPSS v 23 for analysis. In the bi-variable regression analysis, the variables having a p-value of less than 0.2 were entered into a multivariable logistic regression to control the effect of confounding. Those independent variables with P-value less than 0.05 were taken as statistically significant factors associated with anthrax prevention practice. RESULTS: The proportion of farmers who had good anthrax prevention practice was 35.8% [95% CI 33%, 38%]. Being female (AOR = 2.96; 95% CI 2.18, 4.02), able to read and write (AOR = 1.48, 95% CI 1.08, 2.03), time spent to arrive at a nearby veterinary clinic (AOR = 1.35; 95%CI 1.01, 1.79), heard about anthrax (AOR = 4.54; 95%CI 2.96, 6.95), and had a favorable attitude towards anthrax preventions (AOR = 3.70; 95%CI 2.77, 4.94) were significantly associated with anthrax prevention practice. CONCLUSIONS: The practice of anthrax prevention was low. Sex, educational status, time spent to arrive at the nearby veterinary clinic, knowledge about anthrax, and attitude towards anthrax prevention were significantly associated with anthrax prevention practice. Health education to create a favorable attitude and the establishment of veterinary clinics in the nearby locations are recommended to improve anthrax preventive practices in the study area.

Having a latrine facility is not a guarantee for eliminating open defecation owing to socio-demographic and environmental factors: The case of Machakel district in Ethiopia.

BACKGROUND: Open defecation practice problem is rampant in most rural areas of developing countries, including Ethiopia. To combat this problem, the Ethiopian government implemented different sanitation interventions including Community-Led Total Sanitation and Hygiene (CLTSH). The CLTSH approach is mainly aimed to eradicate open defecation practice through mobilizing the community to construct a latrine facility and utilize it. Although this intervention has significantly improved households' access to a latrine facility, its impact on bringing behavioral change such as avoiding open defecation is not well studied. OBJECTIVE: Our study aimed to assess the prevalence of open defecation among households having their latrine and its determinant factors in rural settings in Northwest Ethiopia. METHODS: A community-based cross-sectional study was conducted in Machakal district from September 1 to 30, 2019. A total of 472 household heads who had a latrine facility and systematically selected from six rural Kebeles of the district, were involved in the study. The data were collected using a structured questionnaire and observational checklist tools through face-to-face interviews and observation methods. Bivariate and multivariable logistic regression models were run to identify the factors that influence open defecation practice. During the multivariable analysis, statistical significance was declared at the p-value of <0.05 with 95% CI. RESULTS: The prevalence of open defecation practice among household heads who had latrine facility was 27.8% (95% CI, [23.1-32.8]). Female gender (AOR = 2.94, 95% CI [1.13-7.68]), not attending of formal education (AOR = 3.10, CI 95% [1.34-7.13]), having >5 family members (AOR = 1.72, CI 95% [1.05-2.80]), presence of under-five child (AOR = 3.64 CI 95% [2.14-6.21]), preferring leaf as anal cleaning material (AOR = 3.18, CI 95% [1.67-6.08]), having unclean latrine (AOR = 2.15, CI 95% [1.34-3.44]), and having latrine that needs maintenance (AOR = 2.50 CI 95% [1.52-4.11]) variables were associated with open defecation practice. CONCLUSIONS: Among the total respondents, finding more than a quarter of open defecators is concerning for a district that achieved greatly in terms of latrine coverage. This indicates the above-mentioned factors contributed to influence household heads to defecate openly despite having latrines. Therefore, the government and partners need to focus on designing strategies that effectively address determinant factors of open defecation.

Predicting binge drinking among university students: Application of integrated behavioral model.

BACKGROUND: Binge drinking is a pattern of harmful use of alcohol and it is defined as four drinks for women and five drinks for men in about 2 hours. This behavior causes public health problems like damaging different body organs. OBJECTIVE: To assess binge drinking and associated factors among Bahir Dar University students in Northwest Ethiopia. METHOD: A cross sectional study was conducted in November 2017. Systematic sampling technique was used to select 422 participants. Structured questionnaire was used to collect data. Linear and Logistic regression models were used to predict the role of explanatory variables on behavioral intention and binge drinking, respectively. Independent variables with a p-value of <0.05 at 95% confidence interval were considered as statistically significant in the final model. RESULT: A total of 413 students participated in this study and 33.4%(95% CI: 28.3-38.9) were engaged in binge drinking. Experiential attitude, instrumental attitude, and self-efficacy were found to be significant predictors of intention to binge drinking (p<0.05). Experiential attitude, environmental constraint, injunctive norm, and knowledge predictors were significantly associated with binge drinking (p<0.05). CONCLUSION: Our study indicated that one-third of the students practiced binge drinking. This behavior was associated with experiential attitude, injunctive norm, environmental constraints, and knowledge factors. Additionally, experiential attitude, instrumental attitude, and self-efficacy constructs had explained behavioral intention. This implies focusing on the abovementioned determinant factors is imperative while designing intervention strategy.

Diatom community structure in relation to environmental factors in human influenced rivers and streams in tropical Africa.

The contemporaneous effect of natural and anthropogenic factors involved in a watershed contribution to the seasonal and spatial variation of diatom community composition is widely discussed in the scientific literature. Yet, there is a paucity of scientific evidence indicating the effect of these factors on diatoms in tropical African regions characterized by distinct dry and wet seasons and season associated human activities like rainfed agriculture are commonly practiced. We applied multivariate techniques to determine the spatio-temporal drivers of diatom assemblage and diatom species richness in human influenced rivers and streams in Ethiopia. We simultaneously collected water and diatom samples from 24 sampling points during the wet (July) and dry (February) seasons. Both water and diatom samples were processed following standard procedures. We identified 169 species belonging to 45 genera in the studied lotic systems. We found that both season and land use factors were important in defining diatom composition (PERMANOVA, p<0.05) and species richness (ANOVA, p<0.05) patterns. Diatom community composition was driven by conductivity, dissolved oxygen, pH, and turbidity parameters (Monte Carlo permutation test, p<0.05). Besides, diatom species richness was driven by dissolved oxygen, soluble reactive phosphorus, and turbidity (GLMM, p<0.05). The study highlighted physicochemical parameters influenced by seasonal variation and human activity determined the composition of diatoms. This implies that the unique feature of heavy rain during the rainy season in the region followed by extensive flooding aggravated by the steep slope from the highlands to the lowlands plays a major role in shaping the diatom autecology in the region. Therefore, in applying biomonitoring in such regions considering the effect of runoff and dilution is imperative.

Magnitudes of post-abortion family planning utilization and associated factors among women who seek abortion service in Bahir Dar Town health facilities, Northwest Ethiopia, facility-based cross-sectional study.

INTRODUCTION: Globally an estimated 55.9 million abortions occur each year. The majority of abortions occur due to unintended pregnancies, which is a result of the non-use of family planning methods. World health organization recommends all clients to utilize modern contraceptive methods after any abortion procedure. However, post-abortion family planning utilization is still low in Ethiopia including the study area. Therefore, this study was expected to determine the utilization of post-abortion family planning and associated factors in Bahir Dar city health facilities in Northwest Ethiopia. METHOD: Institution based cross-sectional study was conducted among 408 women from March 1 to April 30, 2019. Data were collected through face-to-face interview using a structured and pre-tested questionnaire. Systematic random sampling was used to select the study participants. Data were cleaned, coded, and entered into epi data and exported to SPSS for further analysis. Both bivariable and multivariable logistic regression were employed. Those variables that had a p-value of less than 0.2 during the bivariate analysis were retained for the multivariable analysis. P-value and confidence interval were used to measure the level of significance on multi-variable analysis and those variables whose P-value, less than 0.05 was considered as statistically significant. RESULTS: The finding of this study showed that the magnitude of post-abortion family planning (PAFP) utilization was 61% with 95% CI (55, 65). Secondary education level(AOR, 4.58; 95% CI (1.96, 10.69)), certificate and above education level (AOR, 3.06; 95% CI (1.32, 7.08)), Manual Vacuum Aspiration(MVA) (AOR, 7.05; 95% CI (2.94, 16.90)), both medication and Manual Vacuum Aspiration (AOR, 5.34; 95% CI (2.56, 11.13)) and received Post Abortion Family Planning (PAFP) counseling (AOR, 5.99; 95% CI (3.23, 11.18)) were significantly associated with PAFP utilization. CONCLUSION: Post-abortion family planning utilization in Bahir Dar health facilities was low compared with the national figure. Secondary and above educational level, respondents who were managed by Manual Vacuum Aspiration (MVA), both Manual Vacuum Aspiration (MVA) and medication and receiving Post Abortion Family Planning (PAFP) counseling were predictors of post-abortion family planning service utilization.

Dietary non-adherence and associated factors among individuals with diabetes who are on treatment follow up at Felege-Hiwot Referral Hospital, Northwest Ethiopia.

Difficulty in adhering to the recommended diet is a common problem in individuals with diabetes mellitus (DM). Dietary non-adherence among diabetic individuals leads to diabetes related complication and death. As far as our search established, there is a scarcity of scientific evidence of dietary non-adherence of individuals with diabetes to the recommended diet in Ethiopia, specifically in the Northwest part of the country. Hence, this study aims to assess the dietary non-adherence and associated factors among individuals with diabetes at Felege-Hiwot Referral Hospital, Bahir Dar city, Northwest Ethiopia. An institution-based cross-sectional study was conducted on 385 systematically selected individuals with diabetes following their treatment from March to April 2017. Quantitative data were collected using a pre-tested and structured questionnaire. The dependent variable association with explanatory variables was determined using logistic regression. Statistical significance was considered at p-value <0.05 with 95% CI. The overall proportion of dietary non-adherence among participants was 46.8% (95% CI: 41.1-52.0). Living rurally (AOR = 3. 75; 95% CI: 2.12-6.63), duration of diabetes less than 5 years (AOR = 2. 81; 95% CI: 1.22-6.50), did not receive nutritional education (AOR = 5. 88; 95% CI: 3.30-10.48), poor social support (AOR = 3. 84; 95% CI: 1.74-8.46) and did not make choices when eating out (AOR = 3. 49; 95% CI: 2.09-5.81) were significantly associated with dietary non-adherence. Nearly half of the individuals with diabetes involved in this study did not adhere to the recommended diet. This problem could be addressed through the provision of nutritional education and strengthening social support to adhere to diabetes dietary recommendations. Therefore, health professional and nutritional educators should take appropriate action to increase the proportion of dietary adherence of individuals with diabetes.