Predictors of unwillingness to receive COVID -19 vaccines among Ethiopian Medical students.

INTRODUCTION: Medical students are among the potential risky population for the transmission of COVID 19 infections; their willingness to receive COVID 19 vaccine is not well studied. Thus, this study assessed Predictors of Unwillingness to receive COVID -19 vaccines among Ethiopian Medical students. METHODS: From the 25th of May, 2020 to the 26th of June, 2021, an institution-based cross-sectional study was done at Mizan-Tepi University Teaching Hospital,On 313 medical students from each department and batch were chosen using a multistage sampling approach. A bivariate and multivariable logistic regression were done to identify the predictors of Unwillingness to receive COVID -19 vaccines. Figures, tables, and graphs were used to present the findings. The adjusted odds ratio and its 95% confidence interval were provided. RESULTS: In this study 124 (40.7%) 95% CI (35.1,46.4) medical students were not willing to receive the COVID-19 vaccine. And also increased in the age of the student[AOR 0.43, 95% CI; (.29,.63)], Knowledge status about COVID 19 infection transmission, risk factors and control behavior[AOR 1.45, 95% CI; (1.14, 1.85)], perceived susceptibility to COVID 19 infection [AOR 1.70 (1.15, 2.51)], perceived severity of COVID 19 infection[AOR 1.26 (1.01, 1.57)], perceived benefit of COVID 19 vaccine [AOR .58(.38, .88)], positive attitude towards COVID 19 vaccines [AOR .46(.35, .62)], and confidence in safety and efficacy of the vaccine and public authorities decissin in the best interest of the community [AOR 1.93(1.24, 2.99)] were predictors of non-willingness to receive COVID 19 vaccine. CONCLUSION: Non-willingness to accept the COVID 19 vaccine was predicted by student age, elements in the Health belief model such as anticipated susceptibility, severity, and benefit, and a positive attitude and trust in the vaccine.

Prevalence of harmful traditional practices during pregnancy and associated factors in Southwest Ethiopia: a community-based cross-sectional study.

OBJECTIVE: To assess the prevalence of harmful traditional practices during pregnancy and associated factors in Southwest Ethiopia. DESIGN: A community-based cross-sectional study. SETTING: Southwest Ethiopia. PARTICIPANTS: 667 women who were pregnant at the time of the study or gave birth 2 years prior to the study have participated. OUTCOME OF THE STUDY: Harmful traditional practices during pregnancy (yes/no). Harmful traditional practices during pregnancy include abdominal massage, herbal intake or food taboos done on/by pregnant women without health professionals' instruction. RESULTS: The prevalence of harmful traditional practices in the study area was 37%, 95% CI (33.4% to 40.8%). The most commonly practised activities were abdominal massage (72.9%), intake of herbs (63.9%) and food taboos (48.6%). Monthly income (AOR=3.13, 95% CI (1.83 to 5.37), p<0.001), having had no history of child death (AOR=2.74, 95% CI (1.75 to 4.29), p<0.001), women with no formal education (AOR=4.81, 95% CI (2.50 to 9.23), p<0.001), women who had antenatal care (ANC) visits during their last pregnancy (AOR=0.24, 95% CI (0.10 to 0.59), p=0.002) and being multipara (AOR=0.47, 95% CI (0.27 to 0.80), p=0.003) were significantly associated with harmful traditional practices during pregnancy. CONCLUSION: Our study showed that more than one-third of women in Southwest Ethiopia practised harmful traditional practices while they were pregnant. The practices were more common among primiparas, women who had lower educational and financial status, women with no ANC visits, and women with no history of child death. Health education should be given to the community about the complications of harmful traditional practices during pregnancy.

Work-related disease symptoms and occupational injuries among coffee processing industry workers in Bench-Sheko and Kaffa Zones Southwest, Ethiopia: A mixed-method study.

Background: Occupational injuries have become one of the most critical rooting causes paying to infirmities and life-threatening conditions in developed and developing countries. Workers in the coffee industry face some occupational health and safety issues. However, there is limited evidence on this important public health issue. Hence, this research was conducted to assess work-related disease symptoms and occupational injuries among coffee processing workers in Southwest, Ethiopia. Methods: A cross-sectional study supplemented with a qualitative method was done. A total of 721 workers were involved in the study for quantitative information. In addition, we performed a total of 22 in-depth and five key informant interviews for generating qualitative evidence. Quantitative data was collected by an interview-based questionnaire which is adapted from similar studies. We conducted descriptive, binary logistic, and multivariable regression analysis as necessary, to ascertain the factors affecting occupational injuries. We collected qualitative data guided by an interview guide, transcribed verbatim, and analyzed using ATLAS ti version-8 by applying a content analysis approach. Finally, quotes from participants that had exemplary ideas were triangulated along with quantitative findings. Result: The overall prevalence rate of work-related symptoms and occupational injuries among coffee processing workers were 21.7 and 13.4% respectively. Age group 30-39 and 40-49 (Adjusted odds ratio (AOR) 1.95, 95% CI 1.37, 2.79, (AOR 3.28, 95% CI 1.89, 5.69, respectively, income level (AOR 0.24, 95% CI 0.16, 0.36, p = 0.000), experience (AOR 1.64, 95% CI 1.04, 2.60, p = 0.034), and smoking cigarette (AOR 5.59, 95% CI 2.78, 11.26, p = 0.000) were significantly associated with the work-related symptom. In addition, training related to the job (AOR 11.88, 95% CI1.34, 105.57, p = 0.026) was significantly associated with occupational injuries among coffee processing industry workers. Conclusion: The prevalence of work-related symptoms and occupational injuries was high among coffee processing industry workers in southwest Ethiopia. Therefore, there is a need for regulations for both government and industry owners to advance the occupational conditions and ergonomic structure of coffee processing industries.

Public health interventions on prescription redemptions and secondary medication adherence among type 2 diabetes patients: systematic review and meta-analysis of randomized controlled trials.

BACKGROUND: Despite the inadequate filling of prescriptions among chronic care patients has been a problem, little is known about the intervention effect on it. OBJECTIVE: The aim of this systematic review and meta-analysis (SRMA) was to investigate the effectiveness of various public health interventions on primary and secondary medication adherence among T2DM patients. METHODS: Searching was done from the major databases; Cochrane Library, Medline/PubMed, EBSCOhost, and SCOPUS. A hand search was made to find grey works of literature. Articles focused on interventions to enhance primary and secondary medication among type 2 diabetes mellitus patients were included. After screening and checking eligibility, the methodological quality was assessed. Secondary medication adherence was synthesized descriptively due to measurement and definition variations across studies. Finally, a meta-analysis was made using the fixed effects model for primary medication adherence. RESULTS: 3992 studies were screened for both primary and secondary medication adherences. Among these, 24 studies were included in the analysis for primary (5) and secondary (19) medication adherence. Pooled relative medication redemption difference was RD = 8% (95% CI: 6-11%) among the intervention groups. Age, intervention, provider setting, and IDF region were determinant factors of primary medication adherence. About two-thirds of the studies revealed that interventions were effective in improving secondary medication adherence. CONCLUSION: Both primary and secondary medications were enhanced by a variety of public health interventions for patients worldwide. However, there is a scarcity of studies on primary medication adherence globally, and in resource-limited settings for the type of adherences. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s40200-021-00878-0.

Pregnancy danger signs: Knowledge and health-seeking behavior among reproductive age women in southwest Ethiopia.

BACKGROUND: Warning signs of pregnancy are not reliably predictable. But, knowing these early warning signs is very important for pregnant women to eliminate serious complications and start treatment immediately. The higher level of maternal mortality can be reduced by providing quality maternity service and empowering women with good knowledge of the danger signs of pregnancy and promoting appropriate health-seeking behavior. Therefore, this study aimed to assess the knowledge of pregnancy danger signs and health-seeking behavior among reproductive age women in southwest Ethiopia. METHOD: A cross-sectional study was carried out with 526 randomly selected women from 1 to 30 January 2019. The data were collected through face-to-face interviews and analyzed using Statistical Package for the Social Sciences version 21. Both bivariate and multivariable logistic regression analyses were conducted to determine factors associated with the outcome variable. The level of significance was declared at a p-value < 0.05. RESULTS: The proportion of mothers who had good knowledge of pregnancy danger signs were 43.2%. The majority (65%) of those surveyed mentioned vaginal bleeding as a pregnancy danger sign. The factors associated with good knowledge of pregnancy danger signs were husbands with secondary education and above (adjusted odds ratio = 2.52, 95% confidence interval (1.08-5.91) monthly income ⩾ 1000 Ethiopian Birr (adjusted odds ratio = 2.64, 95% confidence interval (1.48-4.71) being multigravida (adjusted odds ratio = 2.14, 95% confidence interval (1.17-3.94) and last delivery at the health facility (adjusted odds ratio = 6.84, 95% confidence interval (4.02-11.63) The proportion of mothers who experienced pregnancy danger signs and had good health-seeking behavior was 72.7%. CONCLUSION: The knowledge of pregnancy danger signs among reproductive age women was low in the study area. This indicates the large proportions of women who do not know the danger signs are likely to delay in deciding to seek care when they face the problem. Therefore, empowering women, improving the quality of health information about danger signs during antenatal care follow-up, and promoting institutional delivery are the recommended interventions.

Late antenatal care initiation and its contributors among pregnant women at selected public health institutions in Southwest Ethiopia.

INTRODUCTION: early commencement of antenatal care by pregnant women as well as regular visits has the potential to affect maternal and fetal outcomes positively. Even with antenatal care, the intervention requires fewer resources; however, most pregnant women in sub-Saharan Africa have begun late for antenatal care services. This study aimed to assess the magnitude and contributors of late antenatal care initiation among pregnant women at selected public health institutions of the Bench-Sheko Zone in southwest Ethiopia. METHODS: a cross-sectional study was conducted among 509 pregnant women attending the Antenatal Care (ANC) service at selected public health institutions. The data were collected using a structured and pre-tested questionnaire. The data were entered using Epi-data version 3.1 and analyzed using SPSS version 22. A binary logistic regression analysis was computed to determine the association using crude and adjusted odds ratios at 95% confidence intervals. Independent variables with a p-value of less than 0.05 in the multivariable logistic regression model were considered significant. RESULTS: of the 509 respondents interviewed, 337 (66%) reported late antenatal care initiation. The factors associated with late antenatal care initiation were mothers aged 25 years and above (AOR = 1.59, 95% CI [1.02, 2.48]), attended below secondary school (AOR =2.33, 95% CI [1.05, 5.19]), unplanned pregnancy (AOR=2.25, 95%CI [1.34, 3.77]), pregnancy recognition by missing period (AOR=0.61, 95%CI [0.39, 0.93]), perceived right time of ANC after 4 months (AOR=2.29, 95% CI [1.36, 3.85]), and did not get advice to have ANC (AOR=1.64, 95% CI [1.10, 2.45]). CONCLUSION: the majority of pregnant women initiate their first antenatal care lately. We can conclude that late antenatal care initiation is a major problem in the study area. Therefore, providing continuous health education on the importance of initiating antenatal care visits early to prevent unwanted pregnancy outcomes is an important segment of intervention that can be done through health extension workers.

Knowledge and attitude towards blood donation among college students in Southwest Ethiopia.

INTRODUCTION: blood donation (BD) is affected by several factors, among which people's knowledge and attitude are the key determinants. However, the level of knowledge and attitude towards BD in Ethiopia is not yet well studied. Therefore, this study aimed to assess the level and factors associated with knowledge and attitude towards blood donation among health science college students in Southwest Ethiopia. METHODS: a cross-sectional study was conducted among 394 health science students from June 1st to 15th 2019. The data were collected using a structured self-administered questionnaire. The data were entered using EPI-data version 4.2.0.0 and analyzed using SPSS version 20. The correlation analysis was done to determine the association between the knowledge sum score and the attitude sum score. A binary logistic regression analysis was done to determine the association between the dependent and independent variables. RESULTS: the proportions of good knowledge and positive attitude towards BD were 69.3%, 95% CI (64.8%-73.4%) and 58.1%, 95% CI (52.3%-63.0%) respectively. The study also found that age ≥23 years (adjusted odds ratio (AOR)=1.67, 95% CI (1.04-2.67)), having a father with primary and secondary school and above (AOR=2.24, 95% CI (1.20-4.17) and AOR=2.26, 95% CI (1.26-4.06) respectively) and ever donated blood (AOR=3.64, 95%CI (2.26-5.85)) were factors associated with good knowledge of blood donation. Being a rural resident (AOR=1.59, 95% CI (1.01-2.40)) and graduating class student (AOR=0.56, 95% CI (0.34-0.96)) were factors associated with a positive attitude towards blood donation. The knowledge-related questions´ sum score value was positively correlated with the attitude-related questions' sum score value (r=0.30, P<0.001). CONCLUSION: the knowledge and attitude towards BD among the study population are a substantial deficiency. Therefore, more effort is needed to increase the level of knowledge and attitude towards BD by inculcating short training courses for these groups of population in the existing curriculum.

Effect of diabetes self-management education (DSME) on glycated hemoglobin (HbA1c) level among patients with T2DM: Systematic review and meta-analysis of randomized controlled trials.

BACKGROUND AND AIMS: Type 2 Diabetes mellitus (T2DM) has been a global public health issue causing in physical, financial and psychosocial crises. The aim of this systematic review and meta-analysis (SRMA) was to evaluate the Diabetes Self-Management Education or Support (DSME/S) on glycosylated hemoglobin (HbA1c) among T2DM patients. METHODS: This SRMA was made according to preferred reporting Items for systematic review and Meta-analysis (PRISMA) guidelines. The relevant articles were searched from four databases: Cochrane Library, MEDLINE (EBSCOhost), MEDLINE/PubMed and SCOPUS. Quality assessment was carried out. Pooled standard mean difference in HbA1c were calculated to obtain the effect size with random effect assumption. Subgroup analysis was conducted for assessing heterogeneity among the studies. RESULTS: A total of 1312 studies were identified from databases. Among these 25 studies met inclusion criteria. From these 20 were included in the meta-analysis. In meta-analysis a pooled standard mean difference in HbA1c was -0.604 (95% confidence interval = -0.854 -0.353, I2 = 90.3, p < 0.001). In subgroup analysis a significant reduction was seen among studies with less than four months, upper middle followed by lower middle income countries (LMICs), Western Pacific (WP) followed by Middle Eastern and Northern African (MENA) regions with moderate to substantial heterogeneity. CONCLUSION: However, there is paucity of studies in underdeveloped countries. Therefore, further studies validated to these contexts are needed to evaluate the DSME effectiveness. TRIAL REGISTRATION: PROSPERO database CRD42020124236.

Prevalence and Factors Associated with Early Sexual Initiation among College Students in Southwest Ethiopia.

BACKGROUND: Early age at first sexual practice is a public health issue and now common around the world especially in the developing countries. The development of effective strategies to reduce the adverse consequences of early sexual initiation becomes real when sufficient data is available. Therefore, this study is aimed at assessing the prevalence and factors associated to early sexual initiation among college students in southwest Ethiopia. METHODS: A cross-sectional study was conducted among 453 college students in southwest Ethiopia from April to May 2018. A two-stage stratified sampling technique was used to select the study participants. The data were collected using structured pretested self-administered questionnaire. The collected data were entered using Epi-Data version 4.2.0.0 and analyzed using SPSS version 20. Logistic regression models were fitted to assess the effect of independent variables on the outcome variable. Significance was declared at p < 0.05 in the multivariable logistic regression analysis. RESULTS: The proportion of early sexual initiation among college students was 17.9%, 95% CI (14.4%-24.4%). The mean age of sexual intercourse was 17.6 (±2 SD) years. Nearly three-fourths (73.4%) of the respondent's reason for early sexual intercourse was falling in love. More than half (62.2%) of the respondents used a condom for their first sexual intercourse. The factors associated with early sexual initiation were being female (AOR = 2.09and 95% CI [1.17-2.35]), chewing khat (AOR = 7.05 and 95% CI [3.81-13.1]), exposed to pornographic materials at age < 18 years (AOR = 3.57 and 95% CI [1.94-6.89]), and poor knowledge of sexually transmitted diseases (AOR = 8.69 and 95% CI [3.52-21.5]). CONCLUSION: The prevalence of early sexual initiation among college students was alarmingly high. This may be associated with a huge burden of poor sexual and reproductive health. Therefore, creating awareness of the factors and related negative sexual and reproductive health effect of early sexual initiation for young peoples through the use of mass media (television and radio), school teachers, and parents plays a paramount importance.

The effectiveness of diabetes self-management education (DSME) on glycemic control among T2DM patients randomized control trial: systematic review and meta-analysis protocol.

BACKGROUND: Type 2 Diabetes mellitus (T2DM) has been a global pandemic resulting in physical, financial and psychosocial crises. Thus, it is important to investigate pooled effectiveness of Diabetes Self-Management Education (DSME) on glycemic control among T2DM patients. OBJECTIVE: The aim of this systematic review and meta-analysis is to investigate the association between DSME or Support (DSME/S) and glycemic control among T2DM patients. METHODS: The systematic review and meta-analysis will include studies conducted throughout the world from 2010 to 2019. T2DM patients and their clinical, anthropometric, biomarkers from baseline to end line will be recorded. We will search all relevant articles from five databases namely; Cochrane Library, BioMed Central, MEDLINE (EBSCOhost), MEDLINE/PubMed and SCOPUS. Key terms will be used for questing relevant articles. Further efforts will be made to check quality of studies base on quality assessment instruments. Finally, the report will be made according Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) guidelines. Pooled standard mean difference in HbA1c will be used to calculate the effect size between the variables with random effects analysis assumption. Further subgroup analysis will be carried out for assessing the risk difference among groups. CONCLUSION: Based on the existing and eligible researches this systematic review and meta-analysis will bring the best evidence on the effectiveness of DSME/S on glycemic control among the T2DM patients. Moreover, the subgroup analysis will inform the effectiveness heterogeneity based on continent, International Diabetes Federation (IDF) region, intervention period, World bank economic classification and glycemic markers used to follow the patients. The proposed review has been registered in the International PROSPERO website with registration number CRD42020124236.