Magnitude of kangaroo mother care practice and its associated factors in Tigray region, northern Ethiopia, 2019: cross-sectional study design.

Introduction: kangaroo mother care is an evidence based approach care of preterm and low birth weight infants carried skin-to-skin with the parents that can decrease morbidity and mortality of infant. Country level adoption and practice of kangaroo mother care has been limited and global coverage remains low and few studies have examined the reasons for low practice. The aim of this study was to assess the magnitude of kangaroo mother care practice and its associated factors in Tigray, northern Ethiopia, 2019. Methods: an institutional-based cross-sectional study design was conducted in public general hospitals of Tigray, northern Ethiopia, 2019. Two-stage sampling technique was used and an interviewer-administered questionnaire were used to collect the necessary information. The data were cleaned and entered using epi-Data version 3.1 then exported to stoical package for social science (SPSS) version 22.0 for analysis. Bivariate logistic regression and multivariable analysis were carried out at adjusted odds ratios (AOR) with 95% CI and significance level p-value (<0.05). Results: out of the total 844 selected mothers with their infants, 840 were participated in the study yielding to a response rate of 99.5%, of these respondent's kangaroo mother care practice was found to be 70.2%. Being mothers housewife [(AOR=4.12, 95% CI: (1.5, 0.11)], maternal age [(AOR=9.3, 95% CI: (2.5, 33.9 )], currently mode delivery [(AOR=5.39, 95% CI: (2.3, 12.25)], number of children [(AOR=8.38, 95%: (4.6, 15.3)], mother having ≥5 children [(AOR=18.2, 95%CI: (9.4, 35.4)], antenatal care [(AOR=3.299 95%CI: (1.54, 7.07)] were factors at p-value (<0.05) significantly associated with kangaroo mother care practice. Conclusion: in this study, maternal age, parity, antenatal care, occupation and mode of delivery were factors that influence kangaroo mother care practice in the study area, so healthcare providers, policymakers and other stakeholders should give special focuses on those influencing factors.

Determinants of Preeclampsia among Women Attending Delivery Services in Public Hospitals of Central Tigray, Northern Ethiopia: A Case-Control Study.

BACKGROUND: Preeclampsia occurs in up to 5% of all pregnancies, in 10% of first pregnancies, and 20-25% of women with a history of chronic hypertension. OBJECTIVE: This study aims to assess the determinants of preeclampsia among women attending delivery services in public hospitals of central Tigray, Ethiopia. METHODS: Hospital-based unmatched case-control study design was conducted. Women diagnosed with preeclampsia were cases, and women who had no preeclampsia were controls admitted to the same hospitals. A systematic sampling technique was used to select study participants for both cases and controls. The data were entered in EPI data 3.1 statistical software and, then, exported to SPSS Version 22 for cleaning and analysis. RESULTS: Family history of hypertension (AOR: 2.60; 95% CI: 1.15, 5.92), family history of preeclampsia (AOR: 5.24; 95% CI: 1.85, 14.80), history of diabetes mellitus (AOR: 4.31; 95% CI: 1.66, 11.21), anemia (AOR: 3.23; 95% CI: 1.18, 8.86), history of preeclampsia on prior pregnancy (AOR: 5.55; 95% CI: 1.80, 17.10), primigravida (AOR: 5.41; 95% CI: 2.85, 10.29), drinking alcohol during pregnancy (AOR: 4.06; 95% CI: 2.20, 7.52), and vegetable intake during pregnancy (AOR: 0.39; 95% CI: 0.21, 0.74) were significantly associated with preeclampsia. CONCLUSION: This study concludes that a family history of hypertension and preeclampsia; a history of diabetes mellitus and anemia; and a history of preeclampsia on prior pregnancy, primigravida, and drinking alcohol were found to be risk factors for preeclampsia. However, vegetable intake was found to be a protective factor for the development of preeclampsia.

Prevalence of Undernutrition and Associated Factors among Pregnant Women in a Public General Hospital, Tigray, Northern Ethiopia: A Cross-Sectional Study Design.

BACKGROUND: Undernutrition is a global health problem, particularly in pregnant women. Despite the limited studies performed in different parts of Ethiopia, the information about the prevalence of undernutrition of pregnant women in the current study area is not documented. Therefore, this study aimed to assess the prevalence of undernutrition and associated factors in pregnant women. METHODS: An institution-based cross-sectional study design was conducted in the Tigray region from August 01 to December 30, 2018. Study subjects were selected by systematic sampling technique from the respective hospitals. An interviewer-administered questionnaire was used to collect the data. Data were cleaned and entered using Epi-Data version 3.1 and then exported to statistical package for social science (SPSS) version 23.0 for analysis. Multivariate analyses were carried out, and adjusted odds ratios (AORs) with 95% CI and significance level (p value) <0.05 were considered. RESULTS: Out of the total 844 selected pregnant women, 840 participated in the study, yielding a response rate of 99.5%; of this, respondent's undernutrition prevalence was found to be 40.6% with 95% confidence interval (38.93% and 42.27%). Agriculture as occupation (AOR = 2.6, 95% CI: 1.5, 4.5), women who wanted the pregnancy (AOR = 0.25, 95% CI: 0.14, 0.448), no history malaria during pregnancy (AOR = 0.291, 95%: (0.152, 0.555)), coffee intake during pregnancy (AOR = 1.6, 95% CI: 1.04, 2.69), and hemoglobin < 11 g/dl (AOR = 4.9, 95% CI: 3.09, 7.8) were the factors that were significantly associated with undernutrition, p value (<0.05). CONCLUSION: In this study, occupation, history of having malaria during pregnancy, wanted type pregnancy, coffee intake during pregnancy, and hemoglobin < 11 g/dl were factors significantly associated with undernutrition in pregnant mothers. So, healthcare providers, policymakers, and other stakeholders should give special focus on these factors.

Prevalence and factors associated with uncontrolled hypertension among adult hypertensive patients on follow-up at Northern Ethiopia, 2019: cross-sectional study.

INTRODUCTION: uncontrolled hypertension is a major risk factor for cardiovascular, renal, and cerebrovascular morbidities and mortalities. This study aims to assess the prevalence and factors associated with uncontrolled hypertension among adult hypertensive patients. METHODS: hospital-based cross-sectional study was conducted. Systematic random sampling technique was used to select 396 hypertensive patients. Respondents were interviewed and their medical charts were reviewed using pretested structured questionnaire. Bivariable logistic regression was employed to examine the crude associations between the outcome variable and determinant variables. This was followed by multivariable logistic regression analysis using those variables with P-value ≤ 0.25 in the bivariable analysis. RESULTS: of the total 396 hypertensive patients the prevalence of uncontrolled hypertension was found to be 48.6%. One fourth (26.1%), 231(59.1%), 289(73.9%), and 151(38.6%) hypertensive respondents were non adherent to anti-hypertensive medication, physical exercise, low salt diet, and weight management respectively. Age ≥50 years old (AOR = 2.33, 95%CI: 1.25, 4.35), non-adherence to anti-hypertensive medication, (AOR = 1.82 95%CI: 1.08, 3.04), non-adherence to physical exercise (AOR = 1.79 95%CI: 1.13, 2.83), non-adherence to low-salt diet (AOR = 1.98 95%CI: 1.18,3.31), and non-adherence to weight management (AOR = 2.06, 95%CI: 1.31, 3.23) were significantly associated with uncontrolled hypertension. CONCLUSION: the prevalence of uncontrolled hypertension was high. Older hypertensive patients, non-adherent to their medications, physical inactivity, non-adherent to low salt diet and non-adherent to weight management were more likely to have uncontrolled hypertension. Therefore, more effort should be dedicated to those identified modifiable risk factors to maximize blood pressure control.

The burden, admission, and outcomes of COVID-19 among asthmatic patients in Africa: protocol for a systematic review and meta-analysis.

BACKGROUND: Coronavirus disease 2019 outbreak is the first reported case in Wuhan, China in December 2019 and suddenly became a major global health concern. According to the European Centre for Disease Prevention and Control, on August 4, 2020 the reported cases of coronavirus disease 2019 were 18,456,952 cases worldwide, 11,691,229 recovered with 697,719 deaths. Evidence on Burden, admission and outcome of Coronavirus Disease in 2019 among Asthmatic patients has not been published in Africa. This research protocol will, therefore, be driven to conduct systematic review and meta-analysis of the Coronavirus Disease in 2019 burden, admission and outcome among Asthmatic patients in Africa. METHODS: All observational studies among Asthmatic patients in Africa and written without language limitation will be included. A search technique was applied using Databases (PubMed / MEDLINE, EMBASE, HINARI, Cochrane Library, World Health Organization COVID-19 database, Africa Wide Knowledge and Web of Science). Two independent authors carried out data extraction and assess the risk of bias using a predetermined and structured method of data collection. We will use random-effects to estimate the overall pooled burden, admission and outcome of COVID-19 Asthmatic patients in Africa. To assess possible publication bias, funnel plot test and Egger's test methods will be used. This systematic and meta-analysis review protocol will be reported based on the Preferred Reporting Items for Systematic reviews and Meta-Analysis protocol guidelines. DISCUSSION: The description will be used to show the COVID-19 distribution data by interest variables such as residence, setting, and person-level characteristics. The findings of this review will notify health care professionals about the burden, admission and outcome of COVID - 19 in asthmatic patient, while providing evidence to bring about the requisite improvements in clinical practice for asthmatic patients. SYSTEMATIC REVIEW REGISTRATION: This review is registered in the PROSPERO International Prospective Register of Systematic reviews with the registration number of CRD42020202049.

Magnitude and Its Associated Factors of Urinary Tract Infection among Adult Patients Attending Tigray Region Hospitals, Northern Ethiopia, 2019.

BACKGROUND: Urinary tract infection is a major public health problem in terms of morbidity and mortality worldwide. It ranks as the number one infection which leads to an antibiotic prescription after a physician's visit. However, there are limited studies done on UTI in Ethiopia. Hence, this study was aimed to assess the magnitude of urinary tract infection and its associated factors among adult patients attending hospitals of the Tigray region, Ethiopia. Methods and Material. A hospital-based cross-sectional study was conducted from April to May 2019. Systematic random sampling technique was used to select 472 participants from five randomly selected hospitals in Tigray region. A pretested structured questionnaire through face-to-face interview and patient chart review checklist was used to collect data. Data were analyzed by SPSS version 21. A binary logistic regression model was used to test the association between dependent and independent variables. RESULT: The magnitude of urinary tract infection was 86 (18.2%) (95% CI: 14.6%-21.6%). After adjustment of the independent variables, the significant factors associated with urinary tract infection were being female (AOR = 3.50; 95% CI: 1.88-6.51), urine passing frequency < five times in a day (AOR = 2.32; 95% CI: 1.08-4.96), having diabetes mellitus (AOR = 4.03; 95% CI: 1.69-9.63), history of urinary tract infection (AOR = 4.40; 95% CI: 2.31-8.39), <7 glasses of water intake per day (AOR = 2.16; 95% CI: 1.02-4.58), and history of urinary obstructive diseases (AOR = 2.67; 95% CI: 1.03-6.90). Conclusion and Recommendation. The magnitude of urinary tract infection was considerably high. The factors associated with urinary tract infection were sex, less urine passing frequency, diabetes mellitus, low water intake, history of urinary tract infection, and urinary obstructive diseases. Therefore, patients having DM, previous history of UTI, and urinary obstructive diseases should be routinely screened for urinary tract infection and provided with education on voiding urine at least five times a day and on increasing daily water intake.

Predictors of poor adherence to antidiabetic therapy in patients with type 2 diabetes: a cross-sectional study insight from Ethiopia.

BACKGROUND: Poor adherence to the medical regimen is a major clinical problem in the management of patients with diabetes. This study sought to investigate the level of medication adherence to antidiabetic therapy and to identify possible predictors of poor adherence. METHODS: A hospital based cross-sectional study was conducted from July 2018 to June 2019 among randomly selected follow-up T2D patients at a hospital diabetes clinic. Data were collected through patient interviews, followed by medical chart review. Adherence to antidiabetic therapy that we assessed patients' responses using validated Brief Medication Questionnaire (BMQ). To identify predictors of poor medication adherence, binary logistic regression analyses were performed using SPSS version 25. Statistical significance was set at p value ≤ 0.05. RESULTS: Of the total 357 study participants, 25% were non-adherent to their antidiabetic therapy. Predictors statistically associated with poor adherence were; being female gender (AOR = 1.71, 95% CI 1.01-2.76), and presence of at least one diabetic complication (AOR = 2.02, 95% CI 1.02-3.22). Participants with having at least primary level of education were more likely to adhere to anti-diabetes medication (AOR = 0.42, 95% CI 0.18-0.96). The most common self-reported reasons for non-adherence were forgetfulness, unavailability of medication plus the unaffordability of anti-diabetes medications. CONCLUSIONS: The proportion of participants' adherent to anti-diabetes therapies was suboptimal. Being female, the presence of chronic diabetic complications and having no formal education were the main predictors of poor adherence. Strategies that aimed at improving adherence to antidiabetic medications deemed to be compulsory.

Prevalence and associated factors of chronic kidney disease among adult hypertensive patients in Tigray teaching hospitals: a cross-sectional study.

OBJECTIVE: The aim of this study was to assess the prevalence of chronic kidney disease and to identify associated factors of chronic kidney disease among hypertensive patients. A cross-sectional study was conducted among selected 578 hypertensive patients. Data were collected using face to face interviewing questionnaires and from medical chart review. Binary logistic regression analyses were performed and analyzed using SPSS version 23.0. RESULT: Of the total 578 hypertensive patients the prevalence of chronic kidney disease was found to be 128 (22.1%). Of these hypertensive patients, patients with uncontrolled blood pressure, overweight/obesity, dyslipidemia and diabetic mellitus, 43.3%, 33.7%, 27.3% and 28.2 respectively. After adjustment, the independent variables the significant associated factors of chronic kidney disease among hypertensive patients were age [AOR (95% CI 1.43 (1.07-1.81)], uncontrolled hypertension 4.434 [AOR (95% CI 9.45 (1.34, 14.73)], overweight/obese [AOR (95% CI 7.422 (2.72, 20.28)], dyslipidemia [AOR (95% CI) 13.749 (5.69, 33.215)], diabetic mellitus [AOR (95% CI) 2.137 (1.07, 4.26)]. In conclusion, the prevalence of chronic kidney disease was considerably high. The major associated factors of chronic kidney disease were age, uncontrolled hypertension, overweight/obese, diabetic mellitus and dyslipidemia.

Intimate partner physical violence and associated factors in reproductive age married women in Aksum Town, Tigray, Ethiopia 2018, and community based study.

OBJECTIVE: As reports indicated about 1 in 3 of women worldwide have experienced physical violence but there is no enough reports on the current status of the act in Aksum town so this study intended to identify the prevalence and factors associated with physical violence of reproductive age married women in Aksum town Tigray Ethiopia. RESULT: A total of 398 women were enrolled in the study and making a response rate of 100%. 112 (28.1%) women had physical violence in their lifetime. Educational level of women (AOR = 2.2; 95% CI 1.28, 6.7), Occupation of women's (AOR = 3.8; 95% CI 2.32, 12.8), age of husband (AOR = 5.2; 95% CI 2.3, 11.5), husbands having other wife (AOR = 7.8; 95% CI 4.2, 18.9) and husbands having alcohol habits (AOR = 3.8; 95% CI 1.74, 14.7) had significant association with physical violence.

Immediate newborn care of knowledge, practice and associated factors among health care providers in Northwestern Zonal health facilities Tigray, Ethiopia, 2018.

OBJECTIVE: The aim of this study was to assess the immediate newborn care of knowledge, practice and associated factors among healthcare providers in Northwestern Zonal health facilities Tigray, Ethiopia, 2018. RESULTS: Among the total healthcare providers, who participated in this study, 64.8% had good knowledge and 59.8% of the respondents had a good level of essential newborn care practice. Unavailability of adequate materials (like guidelines, drug, etc.) and training status were significant variables with knowledge and practice of newborn care.

Prescribing pattern of statins for primary prevention of cardiovascular diseases in patients with type 2 diabetes: insights from Ethiopia.

OBJECTIVE: Although most clinical practice guidelines endorsed statin use in type 2 diabetes (T2D) patients for reducing cardiovascular diseases (CVD), little is known about statin utilization in case of Ethiopia. Hence, this study was aimed to evaluate prescribing pattern of statins for primary prevention of CVD in T2D patients. A retrospective study conducted in T2D patients with the age group of 40-75 years. Prescriptions were audited for details of statin use and dose intensity. Descriptive analysis was performed using SPSS version 22.0. RESULTS: We included a total of 323 study subjects. Of those, 55.7% study subjects were found to be received statin for their primary prevention of CVD. Commonly prescribed type of statins was simvastatin (37.2%), atorvastatin (32.8%) and rosuvastatin (15.6%). Low, moderate and high intensive dose of statins were prescribed in 27.8%, 46.1%, and 26.1%, respectively. Of those subjects received statin, 60.6% had on target cholesterol level. Overall, a significant percentage of subjects did not receive their recommended statin for primary prevention of CVD which is below the guidelines' recommendation. Therefore, adherence to guidelines may help to promote the use of statins for primary prevention of CVD in T2D and advance interventions to improve statin prescribing should be considered.

Predictors of poor glycemic control among patients with type 2 diabetes on follow-up care at a tertiary healthcare setting in Ethiopia.

OBJECTIVE: Contemporary clinical guidelines endorsed that glycemic control is the ultimate goal in the management patients with diabetes. The aim of this study was to assess the prevalence of glycemic control and to identify predictors of poor glycemic control in patients with type 2 diabetes (T2D). A cross-sectional study was conducted among systematically selected 357 diabetic patients. Data were collected through direct patients' interviews and medical chart review. Binary logistic regression analyses were performed and analyzed using SPSS version 22.0. RESULTS: Participants' mean age was (± SD) 56.1 ± 11.6 years. Nearly four in five (77.9%) of the participants had comorbidities, mainly of hypertension, and 60.2% had diabetic complications, mainly diabetes neuropathy. Poor glycemic control was found in 68.3% of the participants with a mean (± SD) FBG of 174.1 ± 48.9 mg/dL. Being female gender, having greater body mass index and low medication adherence was significantly associated with poor glycemic control. In conclusion, the overall aspects of glycemic control level of patients were far from the standards. Being female, greater body mass index and poor medication adherence were predictors of poor glycemic control. In response to this finding, an aggressive intervention that targets in improving the glycemic control is required.