Incidence of death and its predictors among neonates admitted with sepsis in referral hospitals, northwest Ethiopia, a prospective cohort study.

Background: Each year, approximately 2.7 million neonates die in their first month of life worldwide, and the majority of these deaths occur in low-income countries. According to the Global Burden of Disease estimation, 1.3 million annual incident cases of neonatal sepsis were reported worldwide, resulting in 203,000 sepsis-attributable deaths. Little is known about the time to death of neonates and predictors after admission with a diagnosis of sepsis. This study aimed to assess the incidence and predictors of death among neonates admitted to the neonatal intensive care unit with a diagnosis of sepsis in referral hospitals in Northwest Ethiopia. Methods: A multicenter prospective follow-up study was conducted from November 11 to December 7, 2021. A stratified random sampling technique was employed to select 412 neonates. Neonates admitted with sepsis were followed until they develop event for a maximum of 28 days of age. A face-to-face interview was conducted with the mother of the neonate using a pretested and structured questionnaire, and neonatal charts were reviewed to collect baseline factors. Data were entered into Epi-data version 4.6 and exported to STATA version 14 for analysis. A bivariable and multivariable exponential Cox regression model was fitted to identify predictors of death. The adjusted hazard ratio (AHR) with 95% CI was calculated, and statistical significance was declared at a P-value of 0.05 in the multivariable analysis. Results: A total of 75 (18.47%) neonates died during the study period, with a 95% CI of 14.82-22.60. The incidence rate of death was 28 (95% CI, 22, 35) per 1,000 person-days of observation, with a total follow-up time of 2,677 person-days of observation. Birth weight (<2,500 g) (AHR = 2.12, 95% CI: 1.01, 4.43), prematurity (AHR = 2.06, 95% CI: 1.02, 4.15), duration of labor >24 h (AHR = 3.89, 95% CI: 1.38, 11.01), breast feeding (AHR = 0.43, 95% CI: 0.23, 0.80), having respiratory distress syndrome (AHR = 1.77, 95% CI: 1.02, 306), oxygen saturation less than 90% (AHR = 2.23, 95% CI: 1.02, 306) were significant predictors of death among neonates admitted with sepsis. Conclusion and recommendation: The incidence of neonatal mortality in this study was high. Early detection and appropriate management of patients' presentations like respiratory distress syndrome and low oxygen saturation are necessary to reduce neonatal sepsis-related mortality. Special attention should be given to low birth weight and premature neonates and mothers should be encouraged to breastfeed their newborns after delivery.

Parents' willingness to vaccinate their daughters with human papillomavirus vaccine and associated factors in Debretabor town, Northwest Ethiopia: A community-based cross-sectional study.

The Human Papilloma Virus (HPV) is the primary causative agent of cervical cancer. Vaccination against the HPV infection is an effective prevention measure for HPV-related diseases. This study aimed to assess parents' willingness to vaccinate their daughters with Human Papillomavirus vaccine and associated factors in Debre Tabor town. A community-based cross-sectional study was conducted among parents of daughters in Debre Tabor town, and a cluster sampling technique was used to select 738 study participants. A structured and interviewer-administered questionnaire was used to collect the data. Data were entered into EPI data version 4.6 and exported to SPSS version 26 for analysis. Multivariable logistic regression was done and a p-value of ≤ 0.05 was used to declare the level of significance. In this study, parents' willingness for HPV vaccination was found to be 79.10% (95% CI: 76.00, 82.00). Parents having media exposure, had good knowledge of HPV infection, and HPV vaccine, positive attitude, and positive perceived behavioral control toward the HPV vaccine had statistically significant association with willingness for the HPV vaccination of their daughters. Parents' willingness to HPV vaccination for their daughters was higher compared with a previous study done in the setting. Parental knowledge and their beliefs on HPV vaccination, and media exposure play an important role in the HPV vaccination of adolescents. Strengthening community-based education and effective promotion through multimedia on HPV infection and its prevention, addressing parental safety concerns and promoting their positive beliefs about the vaccine are important to increase parents' willingness.

Work-related burnout and its associated factors among midwives working at public hospitals in northwest Ethiopia: a multi-centered study.

Introduction: Work-related burnout (WRB) is defined as the degree of physical and psychological fatigue and exhaustion that is perceived by the person as related to work. Midwives are vulnerable to work-related burnout due to their physically and emotionally demanding nature of their job. It affects the health of professionals and the quality of care provided. However, there is limited evidence on the burden and predictors associated with work-related burnout among midwives in developing countries, including Ethiopia. This study investigated the burden and contributing factors of work-related burnout among midwives in northwest Ethiopia. Methods: A facility-based cross-sectional study was conducted from February 7 to April 30, 2022. A simple random sampling method was used to enroll 640 study participants. The Copenhagen burnout inventory tool was used to assess the magnitude of work-related burnout. A self-administered questionnaire was used to collect data, which was then entered into Epi Data 4.6 software and exported to SPSS version 25 for analysis. A multivariable logistic regression analysis model was fitted to identify factors associated with work-related burnout. The Adjusted Odds Ratio (AOR) with 95% confidence interval (CI) was reported to declare the factors that are significantly associated with work-related burnout. Results: The prevalence of work-related burnout was found to be 60.47% (95% CI = 56.6-64.2). Workplace violence (AOR = 3.33, CI: 2.02, 5.48), working hours over 60 h a week (AOR = 4.55, CI: 2.78, 7.43), emotional demand of the job (AOR = 8.85, 95% CI: 4.48, 17.47), exposure to blood and body fluids/sharp injuries (AOR = 5.13, CI: 3.12, 7.13), good superior support (AOR = 0.38, CI: 0.23, 0.63), Job rotation of ≤6 months (AOR = 2.30, CI: 1.28, 4.14) and being stressed (AOR = 2.64, CI: 1.63, 4.26) were all found to be strongly linked to work-related burnout. Conclusion and recommendation: This study found a significant level of work-related burnout among midwives working in public hospitals. Experiencing workplace violence, a job rotation of less than or equals to six months, working hours over 60 h a week, good superior support, exposure to blood and body fluids or needle stick injuries and experiencing stress were significant factors that influenced work-related burnout. Therefore, reducing prolonged working hours, promoting supportive management, creating a safe working environment, and applying effective stress prevention strategies are some of the interventions to prevent or alleviate work-related burnout.