Blood Pressure Control and Associated Factors among Hypertension Comorbid Type 2 Diabetic Patients in Southeast Ethiopia.

Background: Hypertension is the main contributor to the morbidity and mortality of patients with cardiovascular disease. Even though hypertension is very common in comorbid type 2 diabetic patients, it is frequently overlooked. This study aimed to assess blood pressure control and its associated factors among hypertension comorbid type 2 diabetic patients in Bale Zone public hospitals in Southeast Ethiopia. Methods and Materials: A hospital-based cross-sectional study design was conducted among hypertension comorbid type 2 diabetic patients. The data were collected using an interviewer-administered structured questionnaire and a review of the medical charts of patients. A simple random sampling technique was used to select the study participants. The bivariate and multivariate logistic regression analyses were performed to assess the association between blood pressure control and its associated factors. Independent variables that showed a P < 0.25 in the bivariate analysis was included in the multivariate analysis. Finally, variables with a P < 0.05 were declared statistically significant factors. Results: The total number of participants in the study was 378. The overall magnitude of uncontrolled hypertension among hypertension comorbid diabetic patients was found to be 82.5% (95% CI: 78.7%, 86.4%). Nonadherence to antihypertensive medication (AOR = 2.45, 95% CI: 1.11, 5.39, P = 0.027), duration of hypertension >10 years (AOR = 5.2, 95% CI: 1.27, 21.38, P = 0.022), participants who attended secondary education (AOR = 3.2, 95% CI: 1.18, 8.87, P = 0.023), and being obese (AOR = 4.1, 95% CI: 1.24, 13.49, P = 0.021) were significantly associated with uncontrolled hypertension. Conclusion: Uncontrolled hypertension was found to be high among hypertension comorbid type 2 diabetic patients. Patients' adherence to antihypertensive medication, physical activity, and alcohol abstinence should be maximized. Loss of weight is also crucial, as is the early detection and management of comorbidities.

Determinants of willingness to pay for community-based health insurance scheme among households in rural community of southern Ethiopia.

BACKGROUND: Community-based health insurance programs are being acknowledged as effective strategies to attain universal health coverage and mitigate the financial catastrophic shock of the community. Even though Ethiopia has been focusing on the implementation and expansion of a community-based health insurance (CBHI) program since 2011, only a small number of people are enrolled, which might be attributed to a lack of willingness towards the program. The purpose of this study is to determine the willingness to pay for community-based health insurance and associated factors among households in the rural community of Gombora District, Hadiya Zone, southern Ethiopia. METHODS: Using the multistage systematic random sampling technique, a sample of 421 households was chosen for a community-based cross-sectional study. The desired information was gathered using a pre-tested, structured, interviewer-administered questionnaire. The data was entered using Epi-Data V3.1 and exported to SPSS version 24.0 for statistical analysis. Bivariable and multivariable logistic regression analyses were performed to determine the variables associated with the willingness to pay for community-based health insurance. RESULTS: The study showed that 67.1% of respondents expressed a willingness to pay for community-based health insurance. The mean amount of money they are willing to pay for the scheme is 178.41 (± 57.21) Ethiopian Birr (ETB), or 6.43 (± 2.06) USD per household per annum in 2020. Based on multiple logistic regression analysis, belonging to Rich household compared to poor (AOR: 2.78, 95% CI: 1.54, 5.03), having a household head who can read and write (AOR: 2.90, 95% CI: 1.39, 6.05), family size greater than five (AOR: 1.76, 95% CI: 1.06, 2.92), indigenous community insurance (iddir) participation (AOR: 2.83, 95% CI: 1.61, 4.96), and the presence of chronic illness (AOR: 1.94, 95% CI: 1.21, 3.12), were significantly associated with the willingness to pay for a CBHI scheme. CONCLUSION: Households' willingness to pay for a CBHI scheme was found to be significantly influenced by poor household wealth status, household heads who cannot read and write, households with less than or equal to five family members, households who participate in greater or equal to two indigenous community insurance participations, and the absence of chronic illness within the household. Therefore, factors affecting households' willingness to pay should be considered and massive community mobilization needs to be done to strengthen and increase household membership during the implementation of the CBHI scheme, especially in rural areas.

Menstrual abnormality, maternal illiteracy, and household factors as main predictors of anemia among adolescent girls in Ethiopia: Systematic review and meta-analysis.

BACKGROUND: Adolescent girls are more likely to develop anemia as a result of physical and physiological changes that place a greater strain on their nutritional needs. Primary studies, on the other hand, may not be sufficient to provide a complete picture of anemia in adolescent girls and its major risk factors. OBJECTIVE: The study aimed to describe the pooled prevalence of adolescent girls' anemia and the factors that contribute. METHODS: We conducted a systematic review of observational studies using the databases CINAHL (EBSCO), PubMed, Science Direct, Cochrane Library, and Google Scholar. The Newcastle-Ottawa Scale was used to assess the quality of the articles, and studies of fair to good quality were included. We pooled anemia prevalence among adolescents and odds ratio estimates for risk factors. Subgroup analysis employing sample size and study setup was computed to determine the source of heterogeneity, and the I2 test was used to identify the existence or absence of substantial heterogeneity during subgroup analysis. The pooled prevalence of adolescent girls' anemia was calculated using a random-effects meta-analysis model. RESULTS: The overall pooled prevalence of anemia among adolescent girls in Ethiopia was 23.03% (95% confidence interval: 17.07, 28.98). Low dietary diversity (odds ratio: 1.56; 95% confidence interval: 1.05, 2.32), illiterate mothers (odds ratio: 1.45; 95% confidence interval: 1.13, 1.86), household size greater than five (odds ratio: 1.65; 95% confidence interval: 1.14, 2.38), food-insecure households (odds ratio: 1.48; 95% confidence interval: 1.21, 1.82), and menstrual blood flow more than 5 days (odds ratio: 6.21; 95% confidence interval: 1.67, 23.12) were the identified factors associated with anemia among adolescent girls. CONCLUSION: The pooled prevalence of anemia among adolescent girls in Ethiopia was moderately high. Therefore, to combat the burden of anemia among adolescent girls offering nutritional education is crucial. Iron supplementation is also recommended for adolescent females who have a menstrual cycle that lasts longer than 5 days.

Youth friendly services utilization and associated factors among school youths in North Shewa Zone, Amhara Region, Ethiopia: A mixed-method study.

Objective: To assess youth friendly services utilization and associated factors among school youths in North Shewa zone, Ethiopia, 2020. Methods: Institution-based cross-sectional study complemented with qualitative inquiry was conducted from 25 February to 20 March 2020. Multistage and purposive sampling technique was used. A total of 605 randomly selected students were recruited. Seven in-depth interviews and four focus group discussions were conducted for qualitative study. p-value < 0.05 and adjusted odds ratio with 95% confidence interval were computed to measure the strength of associations between variables. Qualitative data were transcribed verbatim, analyzed manually, and presented in narration. Result: One hundred ninety-five (32.7%, 95% confidence interval: 29.0%, 36.6%) respondents had used youth friendly services during the survey. Educational level of father (can read and write) (adjusted odds ratio = 3.12, 95% confidence interval: (1.47, 6.65)), being knowledgeable about reproductive health issues (adjusted odds ratio = 4.84, 95% confidence interval: (2.77, 8.47)), discussion on reproductive health issues (adjusted odds ratio = 2.50, 95% confidence interval: (1.49, 4.19)), having sexual exposure (adjusted odds ratio = 3.37, 95% confidence interval: (1.54, 7.39)), perceiving oneself as risky for acquiring HIV/AIDS (adjusted odds ratio = 4.49, 95% confidence interval: (2.63,7.65)), history of sexually transmitted infections (adjusted odds ratio = 4.40, 95% confidence interval: (1.61, 12.04)), favorable attitude toward service providers (adjusted odds ratio = 2.20, 95% confidence interval: (1.16, 4.17)), and ever supported to use the services (adjusted odds ratio = 4.18, 95% confidence interval: (2.51, 6.97)) were factors associated with youth friendly services utilization. Conclusion: Compared with previous findings, youth friendly services utilization in the study area was relatively low. Knowledge on reproductive health issues, sexual exposure, perceiving as risky of acquiring HIV, history of sexually transmitted infection, ever supported to use the services, and attitude of youth toward youth friendly service providers were among factors associated with youth friendly services utilization. Health facilities and schools should work coordinately to scale up youth friendly services utilization.

The magnitude of hypertension and associated factors among clients on highly active antiretroviral treatment in Southern Ethiopia, 2020: A hospital-based cross-sectional study.

INTRODUCTION: Following the introduction of Highly Active Anti Retro Viral Treatment (HAART), the survival of people living with HIV/AIDS (PLHIV) has improved. However, hypertension remains a major challenge for people living with HIV. Very little effort has been made to examine the magnitude of hypertension and its contributing factors among clients receiving HAART, particularly in southern Ethiopia. Hence, the current study aimed at determining the frequency of Hypertension and associated factors among clients receiving HAART at Wachemo University Nigist Eleni Mohammed Memorial Referral Hospital, southern Ethiopia, 2020. METHODS: A hospital-based cross-sectional study took place from January 20- March 20, 2020. A systematic sampling technique was employed in the selection of 397 clients. Interviewer administered pretested structured questionnaire was used for data collection. Blood pressure and anthropometric parameters of PLHIV were measured. The data was encoded and entered using Epi Data Version 3.1 and exported to SPSS version 23 for analysis. Then bivariable and multivariable logistic regression analyses were used to identify associated factors. Adjusted Odds Ratio (AOR) with 95% CI was used to present the estimated effect size and declare the presence of statistically significant association respectively. RESULTS: The magnitude of hypertension among clients on HAART was 11.0% 95% CI [7.93, 14.04]. Being on HAART for at least 60 months (AOR: 2.57, 95% CI: 1.24-5.21), being on TDF/3TC/EFV combination (AOR: 4.61, 95% CI: 2.52-8.3), and high alcohol consumption (AOR: 4.31, 95% CI: 1.84-10.02) were identified as significant predictors of hypertension among clients on HAART. CONCLUSION AND RECOMMENDATION: The magnitude of hypertension in the study area was in a considerable state to plan and implement intervention measures. For those clients who have received TDF/3TC/EFV and TDF/3TC/NVP and those who have been on HAART for 60 months, a strong emphasis should be placed on planning a strict follow-up. A concerted effort among health care providers is needed through counseling and education to discourage the habit of high alcohol consumption among clients.

Determinants of hypertension among patients with type 2 diabetes mellitus on follow-up at Tikur Anbessa Specialized Hospital, Addis Ababa: A case-control study.

INTRODUCTION: Hypertension (HTN) in patients with diabetes mellitus (DM) is a common problem that increases the risk of mortality and morbidity, and lowers the quality of life. Despite the disproportionately high burden of HTN in DM patients, determinants for the comorbidity have not been sufficiently explored. Therefore, this study aimed to identify the determinants of HTN among patients with type 2 diabetes mellitus on follow-up at Tikur Anbessa Specialized Hospital. METHODS AND MATERIALS: We conducted a hospital-based unmatched case-control study at Tikur Anbessa Specialized Hospital on 386 randomly selected patients with type 2 diabetes on follow-up (200 cases and 186 controls). We collected data by using a structured interviewer-administered questionnaire and data extraction form. To identify determinants of hypertension, a multivariable binary logistic regression was fitted, and the findings are presented using adjusted odds ratio (AOR) with 95% confidence interval (CI). RESULTS: The mean reported age (±SD) of the cases and the controls was 60.3 (±9.9) and 55.3 (±11.3) years, respectively. The eight identified independent determinants of hypertension with AOR [95% CI] were obesity: 2.82 [1.43, 5.57], sedentary activity of ≥4hrs/day: 1.75 [1.10, 2.79], higher stress score: 1.05 [1.01, 1.10], serum creatinine above 1.1 mg/dl: 2.35 [1.13, 4.91], age: 1.05 [1.02, 1.08], being government employee as compared to private workers: 2.18 [1.06, 4.50] and family history of hypertension: 2.11 [1.26, 3.54]. Further, interaction of diabetes duration with insulin use: 1.03 [1.01, 1.07] was also a significant predictor of HTN among DM patients. CONCLUSION: The finding calls for interventions for mitigating these determinants. Further research is needed to examine the interaction between diabetes duration and insulin use.

Prevalence of Early Removal of Long-Acting Contraceptive Methods and Its Associated Factors in Sidama Regional State, Ethiopia.

BACKGROUND: Long-acting reversible contraceptive methods, IUD and sub-dermal implant, offer women the most effective method to control fertility. Yet, reports on high early removal rates were emerged, prompting concern among service providers and highlighting the need to review removal rates and its reasons. Therefore, this study was conducted to assess the prevalence of early removal rates of LARCs and its associated factors in Sidama Regional State, Southern Ethiopia. METHODS:  Community-based cross-sectional study was conducted in Sidama Regional State, Ethiopia from June 1 to June 30, 2019. A multistage sampling technique was used to select 21 administrative units in the first stage. Then, systematic sampling was used to select 475 women who have ever used implants or IUD 3 years preceding the data collection period. Data were entered into Epi Info version 3.4.3 and exported to SPSS version 20 for analysis. Descriptive statistics, bivariate, and multivariate logistic regression were computed. P-value <0.05 was used to declare a significant association. RESULTS: The mean (±SD) of the participant's age was 29.81 (±5.69) years. The prevalence of early removal rate of LARCs was 10.3%, ie, 43 (10.8%) among Implanon/jadelle users and 6 (7.8%) among IUD users. Eleven (22.4%) discontinued within the first six months and 38 (77.6%) utilized for more than six months and discontinued before the 12th month. Women who were not advised about advantage [OR= 2.81 (95% CI: 1.23-6.40)] and effectiveness of contraceptive [OR= 2.70 (95% CI: 1.30-5.60)] and those who were satisfied with the family planning service [OR= 2.24 (95% CI: 1.10-4.57)] were identified as factors. CONCLUSIONS: The prevalence of early removal rate was considerably high among the study subjects. Providing appropriate counseling about the advantage and effectiveness of family planning and improving client satisfaction need to be considered to reduce the early removal rate.

Triage knowledge and skills among nurses in emergency units of Specialized Hospital in Hawassa, Ethiopia: cross sectional study.

OBJECTIVE: This study was aimed to assess knowledge and skills of triage and associated factors among nurses in emergency department of Hawassa University Comprehensive Specialized Hospital, South Ethiopia. Institutional based cross-sectional study design was conducted among 101 nurses from March 1-30, 2018. The data was coded and entered to SPSS version 22.0. Descriptive statistics was done and Chi square test was done to show the association between independent variables and dependent variable. RESULTS: Among the study participants, 57.4% were female and 87% were in age group of ≤ 30 years. 51.5% had low triage knowledge scores, with the mean score being 9.54 (SD = 2.317), 76.2% perceived their overall triage skill to be at good level, with mean score 95.75 (SD = 9.562). Working experience of study participants (χ2 = 15.204, p < .01), Educational level of study participant (χ2 = 22.148, p < .01) and triage experience (χ2 = 13.638, p < .01) were factors associated with triage knowledge. Working experience (χ2 = 7.944, p < .05) and triage experience (χ2 = 6.264, p < .05) were factors associated with triage skill.

Incidence and determinants of tuberculosis infection among adult patients with HIV attending HIV care in north-east Ethiopia: a retrospective cohort study.

OBJECTIVE: This study assessed the incidence of tuberculosis (TB) and its predictors among adults living with HIV/AIDS in government health facilities in north-east Ethiopia. SETTING: A 5-year retrospective cohort study was conducted from May to June 2015 on 451 adult HIV/AIDS-infected individuals who enrolled in the HIV care clinics of government health facilities in north-east Ethiopia. PARTICIPANTS: A total of 451 HIV-infected adults who newly enrolled in the adult HIV care clinic from 1 July 2010 with complete information were followed until May 2015. PRIMARY OUTCOME MEASURE: The primary outcome was the proportion of patients diagnosed with TB or the TB incidence rate. SECONDARY OUTCOME MEASURE: The incidence of TB was investigated in relation to years of follow-up. RESULTS: A total of 451 charts with complete information were followed for 1377.41 person-years (PY) of observation. The overall incidence density of TB was 8.6 per 100 PYof observation. Previous TB disease (adjusted HR (AHR) 3.65, 95% CI 1.97 to 6.73), being bedridden (AHR 5.45, 95% CI 1.16 to 25.49), being underweight (body mass index (BMI) <18.5 kg/m2) (AHR 2.53, 95 % CI 1.27 to 5.05), taking isoniazid preventive therapy (IPT) (AHR 0.14, 95% CI 0.05 to 0.39), haemoglobin below 11 g/dL (AHR 2.31, 95% CI 1.35 to 3.93), and being in WHO clinical stages III and IV (AHR 2.84, 95% CI 1.11 to 7.27; AHR 3.07, 95% CI 1.08 to 8.75, respectively) were significant for the incidence of TB. CONCLUSION: The incidence of TB among adults living with HIV/AIDS in the first 3 years of follow-up was higher compared with that of subsequent years. Previous TB disease, no IPT, low BMI and haemoglobin level, advanced WHO clinical stage, and bedridden condition were the determinants of the incidence of TB. Therefore, addressing the significant predictors and improving TB/HIV collaborative activities should be strengthened in the study setting.

Vector Potential of Blattella germanica (L.) (Dictyoptera: Blattidae) for Medically Important Bacteria at Food Handling Establishments in Jimma Town, Southwest Ethiopia.

Cockroaches have been regarded as possible vectors of human enteropathogens. Their presence and crawl particularly in food handling establishments could be risky for human health. Therefore, this study was done to determine the vector potential of cockroach for medically important bacterial pathogens in restaurants and cafeterias. A cross-sectional study was conducted on cockroaches from restaurants and cafeterias in Jimma town from May to September 2014. Standard taxonomic keys and microbiological techniques were applied for species identification and isolation. Data was analyzed in SPSS version 16.0. All cockroaches trapped were the German cockroach, Blattella germanica (L.) (Dictyoptera: Blattidae). Escherichia coli was the most frequently isolated followed by Salmonella species (serogroups B, D, E, C1, and NG), Bacillus cereus, and Shigella flexneri. Wide varieties of bacteria of medical relevance were also identified. Of which, Klebsiella spp. 49(40.8%), Bacillus spp., and Staphylococcus saprophyticus were predominant. Blattella germanica (L.) (Dictyoptera: Blattidae) could serve as a potential vector for the dissemination of foodborne pathogens such as Salmonella spp., Shigella flexneri, E. coli, S. aureus, and B. cereus and these bacteria could be a major threat to public health. Therefore, environmental sanitation and standard hygiene need to be applied in the food handling establishments in that locality.