Epidemiological survival pattern, risk factors, and estimated time to develop tuberculosis after test and treat strategies declared for children living with human immune deficiency virus.

BACKGROUND: Due to their age category and the immune-suppressing effects of HIV, children were more vulnerable to experience endogenous reactivation of latent bacilli in the lung and increased risk of active tuberculosis incidence. The aim of this study is to assess the survival pattern, risk factors, and estimated time to develop TB after children started ART at selected health facilities of North Wollo, Ethiopia, from November 1, to September 30, 2021. METHODS: Facility-based retrospective cohort study was employed from November 1 to September 30, 2021. Cox proportional hazard regression model was used to assess factors associated with incidence of tuberculosis. AHR with 95% CI was used to declare statistical significance for tuberculosis incidence. RESULTS: During follow-up, 54 (10.9%) new cases of tuberculosis was reported. At the end of follow-up period, overall cumulative survival probability was determined as 43.8% (95%CI: 28.2-54.3). WHO clinical stage III&IV (AHR: 2.4 (95% CI: 1.4, 4.7), Hgb≤10 gm/dl (AHR = 2.2: (95%CI: 1.12-5.8), missed isoniazid preventive therapy (AHR = 2.5 (95%CI: 1.56-10.3) and Viral Load (≥400 cell/ml) (AHR = 2.02 (95%CI: 2.03-6.8) were significant risk factors for tuberculosis incidence. CONCLUSION: Nearly ten % of HIV-positive children experienced new cases of tuberculosis with median time of 25(IQR = ±12) months. It would be better to give special attention to children who missed isoniazid preventive therapy with WHO stages III&IV Viral load (≥400 cells/ml), and Hgb≤10 gm/dl to prevent tuberculosis incidence and prolonged quality of life.

Burden of lower respiratory infections and associated risk factors across regions in Ethiopia: a subnational analysis of the Global Burden of Diseases 2019 study.

OBJECTIVE: This analysis is to present the burden and trends of morbidity and mortality due to lower respiratory infections (LRIs), their contributing risk factors, and the disparity across administrative regions and cities from 1990 to 2019. DESIGN: This analysis used Global Burden of Disease 2019 framework to estimate morbidity and mortality outcomes of LRI and its contributing risk factors. The Global Burden of Disease study uses all available data sources and Cause of Death Ensemble model to estimate deaths from LRI and a meta-regression disease modelling technique to estimate LRI non-fatal outcomes with 95% uncertainty intervals (UI). STUDY SETTING: The study includes nine region states and two chartered cities of Ethiopia. OUTCOME MEASURES: We calculated incidence, death and years of life lost (YLLs) due to LRIs and contributing risk factors using all accessible data sources. We calculated 95% UIs for the point estimates. RESULTS: In 2019, LRIs incidence, death and YLLs among all age groups were 8313.7 (95% UI 7757.6-8918), 59.4 (95% UI 49.8-71.4) and 2404.5 (95% UI 2059.4-2833.3) per 100 000 people, respectively. From 1990, the corresponding decline rates were 39%, 61% and 76%, respectively. Children under the age of 5 years account for 20% of episodes, 42% of mortalities and 70% of the YLL of the total burden of LRIs in 2019. The mortality rate was significantly higher in predominantly pastoralist regions-Benishangul-Gumuz 101.8 (95% UI 84.0-121.7) and Afar 103.7 (95% UI 86.6-122.6). The Somali region showed the least decline in mortality rates. More than three-fourths of under-5 child deaths due to LRIs were attributed to malnutrition. Household air pollution from solid fuel attributed to nearly half of the risk factors for all age mortalities due to LRIs in the country. CONCLUSION: In Ethiopia, LRIs have reduced significantly across the regions over the years (except in elders), however, are still the third-leading cause of mortality, disproportionately affecting children younger than 5 years old and predominantly pastoralist regions. Interventions need to consider leading risk factors, targeted age groups and pastoralist and cross-border communities.

Rate, risk factors and estimations of time to develop severe acute malnutrition after children receiving antiretroviral therapy at selected health facilities in northwest Ethiopia.

Severe acute malnutrition (SAM) affects up to 50 % of children with HIV, especially those who reside in resource-constrained healthcare setting like Ethiopia. During subsequent follow-up of children factors related to incidence of SAM after antiretroviral therapy (ART) is set on, however, there is no prior evidence. An institution-based retrospective cohort study was employed among 721 HIV-positive children from 1 January to 30 December 2021. Data were entered using Epi-Data version 3.1 and exported to STATA version 14 for analysis. Bi-variable and multivariable Cox-proportional hazard models were employed at 95 % confidence intervals to identify significant predictors for SAM. According to this result, the overall mean (±sd) age of the participants was found to be 9⋅83 (±3⋅3) years. At the end of the follow-up period, 103 (14⋅29 %) children developed SAM with a median time of 30⋅3 (13⋅4) months after ART initiation. The overall incidence density of SAM was found to be 5⋅64 per 100 child (95 % CI 4⋅68, 6⋅94). Children with CD4 counts below the threshold [AHR 2⋅6 (95 % CI 1⋅2, 2⋅9, P = 0⋅01)], disclosed HIV status [AHR 1⋅9 (95 % CI 1⋅4, 3⋅39, P = 0⋅03)] and Hgb level ≤10 mg/dl [AHR 1⋅8 (95 % CI 1⋅2, 2⋅9, P = 0⋅03)] were significant predictors for SAM. Significant predictors of acute malnutrition were having a CD4 count below the threshold, children who had previously reported their HIV status, and having haemoglobin <10 mg/dl. To ensure better health outcomes, healthcare practitioners should improve earlier nutritional screening and consistent counselling at each session of care.

Non-Pharmacological Pain Management Practice and Associated Factors Among Nurses Working at Comprehensive Specialized Hospitals.

Introduction: Non-pharmacological pain management practices are very important for the successful treatment of pain. It has an impact on the patient's quality of life and the family's financial situation owing to missed workdays, direct medical expenses, and incapacity from pain. Objective: Therefore, this study is intended to assess non-pharmacological pain management practice and associated factors among nurses working at comprehensive specialized hospitals in northwest, Ethiopia. Methods: Institution-based cross-sectional study design was employed from May 30 to June 30, 2022. A stratified random sampling technique was used to select 322 study participants. A binary logistic regression model was used to identify factors associated with non-pharmacological pain management practice. Variables with a P-value less than .25 in the bi-variable analysis were entered into the multivariable logistic regression analysis and a P-value of less than .05 was considered as having a statistically significant association. Results: A total of 322 nurses participated, with a response rate of 98.8%. It was found that 48.1% (95% CI: 42.65, 53.62) of nurses had good practice in non-pharmacological pain management. Pain assessment tool availability (AOR = 1.68 [95% CI: 1.02, 2.75]) (P = .04), good pain assessment practice (AOR = 1.74 [95% CI: 1.03, 2.84]) (P = .03), favorable attitude (AOR = 1.71 [95% CI: 1.03, 2.95]) (P = .03), and age (26-35) (AOR = 4.46 [95% CI: 1.24, 16.18]) (P = .02) were factors significantly related to non-pharmacological pain management practice. Conclusion: According to this work, the prevalence of non-pharmacological pain management practices was found to be low. Good pain assessment practices, availability of pain assessment tools, favorable attitude, and age (26-35) years were significant factors of non-pharmacological pain management practice. Hospitals are better give training on non-pharmacological pain management methods for nurses as they are important to treat pain holistically, increase patient satisfaction, and are cost-effective.

Fatigue and associated factors among adult cancer patients receiving cancer treatment at oncology unit in Amhara region, Ethiopia.

INTRODUCTION: Fatigue is one of the most commonly and frequently reported symptoms by cancer patients. The cause of fatigue is multifactorial in origin, and its impact varies in range from affecting patients' daily social life, and physical, mental, economic, and social well-being to becoming a threat to their quality of life. Therefore every cancer patient needs to be screened for fatigue and considered as one of the vital signs. OBJECTIVE: To assess the prevalence of fatigue and associated factors among adult cancer patients, receiving cancer treatment at the oncology unit in Amhara region, Ethiopia, 2022. METHOD: Institutional-based, cross-sectional study was conducted among adult cancer patients receiving cancer treatment from May 9th-June 8th, 2022. A stratified random sampling technique was used to select study participants. Data were entered into Epi data version 4.6 and then exported to the SPSS statistical package version 23 for further analysis. Both bivariable and multivariable logistic regression analyses were carried out. P-values <0.05 in multivariable logistic regression were considered statistically significant. RESULTS: The prevalence of cancer-related fatigue was 77.3% at 95% CI (73.1-81.1) with nonresponse rate of 1.97% (9). Poor social support (AOR = 3.62; 95% CI: 1.53-8.60), anxiety (AOR = 3.13; 95% CI: 1.54-6.36), physical inactivity (AOR = 3.67; 95% CI: 1.74-7.54), underweight (AOR = 2.03; 95% CI: 1.05-3.90), anemia (AOR = 2.01; 95% CI: 1.04-3.90), surgery as a treatment modality (AOR = 0.21; 95% CI: 0.06-0.78), combination therapy (AOR = 3.56; 95% CI: 1.68-7.54), treatment less than 3 cycle (AOR = 4.43; 95% CI: 1.53-12.80), and treatment 3-5 cycle (AOR = 3.55; 95% CI: 1.38-9.09) were significantly associated factors with cancer related fatigue. CONCLUSION: Psychosocial assessment and intervention, nutritional support, early intervention of anemia, and promoting exercise are the key elements to minimizing fatigue among cancer patients.

The magnitude of mental distress and associated factors among a school of medicine and college of health sciences students at Debre Markos University, 2021.

INTRODUCTION: Mental distress is a collection of mental health abnormalities characterized by symptoms of anxiety, depression, insomnia, fatigue, irritability, forgetfulness, difficulty in concentrating, and somatic symptoms. It affects society as a whole and no group is immune to mental distress; however, students have a significantly high level of mental distress than their community peers. The study is aimed to assess the magnitude of mental distress and associated factors among a school of medicine and college of health sciences students. OBJECTIVE: To assess the magnitude of mental distress and associated factors among a school of medicine and college of health sciences students at Debre Markos University, 2021. METHODS: Institution-based cross-sectional study design was employed from March 15-29, 2021. A simple random sampling technique was used to select 475 study participants. A binary logistic regression model was used to identify factors associated with mental distress. Variables with a p-value less than 0.25 in the bivariable analysis were entered into multivariable logistic regression analysis and a P-Value of less than 0.05 was considered as having a statistically significant association. RESULT: The magnitude of mental distress among students was found to be 35.4%, 95%CI (31%, 40%). Female sex [AOR = 1.95; 95%CI (1.24-3.06)], financial distress[AOR = 1.64; 95%CI (1.062.54)], feeling of insecurity [AOR = 2.49; 95% CI (1.13-3.54)], lack of interest to department [AOR = 2.00; 95%CI (1.75-4.36)] and cumulative grade point average less than expected [AOR = 2.63; 95%CI (1.59-4.37)]were significant variables with mental distress. CONCLUSION: The magnitude of mental distress was high. Sex, financial distress, feeling of insecurity, lack of interest in the department, and cumulative grade point average less than expected were significant variables with mental distress, so special attention on mental health promotion is required from policymakers, college officials, parents, and other Non-Governmental organizations.

Quality of intrapartum care at Public Health Institutions of North Achefer District, North West Ethiopia: a mixed method study.

BACKGROUND: Ending preventable maternal, and neonatal morbidity and mortality cannot be achieved without quality care interventions during the intrapartum and postpartum period. Poor quality care during the intrapartum and postpartum period contributes high burden of maternal and neonatal morbidity. Therefore, the current study aimed to assess the quality of intrapartum care and its associated factors in public health facilities in North Achefer District, North West Ethiopia. METHOD: A mixed-type institution-based cross-sectional study design was conducted from November 7 to December 6, 2019. Simple random sampling and purposive sampling were used to select study participants for quantitative and qualitative studies respectively. Data were coded and entered into Epi data version 4.4.2 software and exported to SPSS version 25 for analysis. Variables with a p-value of less than and equal to 0.25 were entered into multivariable regression analysis and variables with p values < 0.05 were considered statistically significant factors of the quality of intrapartum care. The qualitative data were analyzed by using thematic content analysis. Finally, qualitative findings were used to supplement the quantitative result. RESULT: The finding showed that, 27.3% (95% CI: 26.6-28) of mothers received good quality intrapartum care. Presence of long-distance (AOR = 0.19; 95% CI = 0.06, 0.66), health care facility (AOR = 0.07; 95% CI = 0.02, 0.20), and partograph utilization (AOR = 4.9; 95% CI = 1.82, 13.14) were factors associated with the quality of intrapartum care. CONCLUSION: The proportion of intrapartum quality care was low. Distance, partograph utilization, and type of health facility were factors associated with quality of intrapartum care. The district, zonal health offices, and regional health bureau should provide capacity building and follow up on partograph utilization, and increase the accessibility of ambulances.