Utilization of the Integrated Management of Newborn and Childhood Illness (IMNCI) protocol and associated factors among health care workers in health centers of South Gondar Zone, Northwest Ethiopia: an institution-based mixed study.

Introduction: Globally, 11 million children have died before reaching their fifth birthday. The introduction of the Integrated Management of Newborn and Childhood Illness (IMNCI) protocol reduces the morbidity and mortality rates among children under the age of 5. However, the share of neonatal mortality is increasing. As a result, the United Nations has established sustainable development goals to reduce national neonatal death rates through the utilization of the Integrated Management of Newborn and Childhood Illness protocol as the main tool for 12 per 1,000 live births by 2030. However, the death rate from preventable causes has increased owing to the low utilization of the protocol. Objective: The objective of this research is to assess the utilization of the IMNCI protocol and associated factors among healthcare workers (HCW) in health centers at the South Gondar Zone, Northwest Ethiopia, in 2022. Methods: The institution-based mixed study design was conducted from November to December 2022 at the South Gondar Zone, Amhara. A total of 422 HCW were selected using a computer-generated random-number generator. Data were cleaned and entered into EpiData 3.1 software and analyzed using SPSS version 25.0. Binary logistic regression was used to identify candidates for multivariable logistic analysis with p-value < 0.2, and for multivariable analysis, p-value < 0.05, with a 95% confidence interval, was considered significant. Thematic analysis was used for the qualitative data. Results: In total, 417 respondents were included in the final analysis. The overall response rate was 98.8%, and the mean age was 30.01 years. The results showed that the proportion of IMNCI utilization was 63.1%. The odds of the utilization of IMNCI protocol among HCW who took training were 3.13 times higher than those among HCW who did not take training [adjusted odds ratio (AOR) = 3.13, 95% CI: 1.594, 6.147]. The lack of drugs reduces the utilization of the IMNCI protocol by 75.7% compared with the use of drugs (AOR = 0.243, CI: 95%:0.128, 0.464). HCW who always referred to the chart booklet during case management were 3.34 times more likely to utilize the IMNCI protocol (AOR = 3.34, 95% CI: 1.99, 5.60) compared with those who did not refer to the chart booklet. Conclusions and recommendations: The utilization of the IMNCI protocol was low. A shortage of medical consumables and equipment attitude and training were identified as factors that affected the utilization of the protocol. Therefore, the availability of necessary logistics and training for employees with regular supportive supervision and monitoring should be conducted with the integration of sectors at the district and zone levels.

Determinants of Multi-drug resistant Tuberculosis in four treatment centers of Eastern Amhara, Ethiopia: A case-control study.

INTRODUCTION: Tuberculosis is the major global burden of disease contributing about 2% of the global challenges. Poor tuberculosis treatment increased risk of multi-drug resistance tuberculosis occurence. Thus, we aimed to identify determinants of mult-drug resistant tuberclosis in treatment centers of Eastern Amhara, Ethiopia. METHODOLOGY: Facility based unmatched case-control study was employed in East Amhara, Ethiopia. Cases were tuberculosis patients confirmed for mult-drug resistant tuberclosis while controls were tuberculosis patients with confirmed tuberculosis but susceptible to first line drugs. Respondents were selected using simple random sampling technique. Bivariable and multivariable analysis was conducted to identify diterminants at level of statistical significance p < 0.05. RESULTS: We enrolled 450 tuberculosis patients. Rural residents (AOR = 3, 95% CI: 1.4-6.0; p = 0.024), family size greater than five (AOR = 3.7, 95% CI: 1.6-8.6; p = 0.0098), having single room (AOR = 4.1, 95% CI:1.8-9.0; p = 0.027), room without window (AOR = 3.8, 95% CI: 1.6-8.5); p = 0.043), contact history of known mult-drug resistant tuberclosis patient (AOR = 5.1, 95% CI: 2.2-12.0; p = 0.02), history of tuberculosis treatment (AOR = 5.7, 95%CI: 2.6-12.9; p = 0.008), window opening practice (AOR = 3.7, 95% CI: 1.4-9.8; p = 0.005), tuberculosis treatment failure (AOR = 7.3, 95% CI: 5.2-7.8; p = 0.035) and tuberculosis relapse (AOR = 5,95% CI: 1.6-15.2; p = 0.019) were determinants of mult-drug resistant tuberclosis. CONCLUSIONS: Socio-demographic (residence, family size), environmental (number of rooms, number of windows in a room, opening window practice) and clinical (history of tuberculosis treatment, treatment failure and having contact with known tuberculosis patient) variables were the identified determinants for increased multi-drug resistance tuberculosis.

Determinants of BCG vaccination coverage in Ethiopia: a cross-sectional survey.

OBJECTIVE: The objective of this study is to assess the determinants of BCG vaccination in Ethiopia from 2016 Ethiopia Demographic and Health Survey (EDHS). SETTING: Since Ethiopia has nine regional states and two administrative cities, sample was taken from all the divisions. The population-based sample was intended to provide estimates of key indicators for the country. PARTICIPANT: The sampling frame used for the 2016 EDHS is the Ethiopia Population and Housing Census. From 15 683 women recorded in EDHS dataset, women with no child (n=10 379) were excluded from the study. Therefore, the total sample size for this study was 5304 women. The outcome variable was BCG immunisation status of children. RESULT: Out of the study participants (n=5304), the majority were in between 20 and 34 years of age (73.8%). The median age of the respondents was 28.4 (SD=±6.5) years old. Prevalence of BCG vaccination was 63.6% (n=3373) and BCG vaccination coverage in urban residents was higher (88%) than rural residents (57.3%). Mothers' age between 20 up to 34 (Adjusted odds ratio (AOR)=1.48; 95% CI: 1.13 to 1.93) and between 35 up to 49 (AOR=1.83; 95% CI: 1.35 to 2.46) were more likely to vaccinate their child's than those mothers' age less than 20. Mothers settled in urban areas were two times more likely to vaccinate their child's than those living in rural areas (AOR=1.94; 95% CI: 1.45 to 2.60). Mothers with greater antenatal visits show higher BCG vaccination, Antenatal Care (ANC) 4 and above (AOR=3.48; 95% CI: 2.91 to 4.15). BCG vaccination is higher for mothers delivered at non-governmental organisation health facility than home (AOR=2.9; 95% CI: 1.69 to 4.96). Maternal occupation and wealth index also had a significant association with BCG vaccination. CONCLUSION: BCG vaccination coverage, in this study, was lower and determinant factors for BCG vaccination were residence, mother's age, place of delivery, mother's antenatal visit, wealth index and mother's occupation.

Risk of HIV and associated factors among infants born to HIV-positive women in northwest Ethiopia

Background: The high rate of HIV morbidity and mortality among pregnant and lactating women, and their infants, is still major health problem in Ethiopia. This study aims to assess the risk and determinants of mother-tochild transmission of HIV among infants born from HIV-positive mothers in West Gojjam Zone, northwestEthiopia.Methods: A facility-based, cross-sectional study was carried at prevention of mother-to-child transmission (PMTCT) clinics in West Gojjam Zone. The study participants were HIV-exposed infants enrolled at PMTCT clinics from 01 January to 30 December 2017 who had a recorded DNA-PCR result. The data sources were PMTCT logbooks and patient charts. Data were entered into Epi Info (version 7) and analyzed using SPSS (version 20.0). Both bivariate and multivariate analyses were carried out to identify associations.Results: A total of 636 infant records were included in the study. There were 39 cases (6.1%, 95% CI: 4.2, 8.2) of transmission of HIV from mother to child. Home delivery (AOR = 4.0, 95% CI: 1.5, 12), infant not receiving antiretroviral prophylaxis at birth (AOR =5.0, 95% CI: 1.6, 17.1), episiotomy (AOR = 5.1, 95% CI: 1.9, 15.1), andmixed infant feeding practices (AOR = 6.0, 95% CI: 2.1, 16.4) were significantly associated with mother-to-child transmission of HIV in the study.Conclusions and recommendations: The risk of HIV infection among infants born from HIV-positive mothers was high. Predictors for mother-to-child transmission of HIV were episiotomy, home delivery, mixed feeding and absence of antiretroviral prophylaxis at birth