Predictors of underweight among adult patients receiving antiretroviral therapy in Bishoftu general hospital, central Ethiopia: Case-control study.

BACKGROUND: Underweight affects the overall clinical outcome and quality of life and increases the risk of mortalities in Human immunodeficiency virus and acquired immunodeficiency syndrome (HIV/AIDS) patients. Though studies have examined the various determinants of being underweight in people living with HIV/AIDS (PLHIV), scanty evidence exists about the influence of dietary diversity scores and dietary counseling on underweight HIV patients in Ethiopia. This study aimed to identify the determinants of being underweight among adult patients receiving antiretroviral therapy at Bishoftu General Hospital, central Ethiopia. METHODS: An institution-based unmatched case-control study was conducted among 279 participants (93 cases and 186 controls) from April to May 2022. Cases were selected consecutively as they occur, and then two subsequent controls that visited the antiretroviral therapy(ART) clinic were interviewed until the sample size was attained. Data were collected using a pretested structured questionnaire and involved patient interviews and chart review. Bivariate and Multivariable logistic regression was used to identify determinants of underweight. The presence of statistically significant association was declared with p-value <0.05, and a 95% confidence interval was used to show the precision in the measure of the strength of association. RESULTS: The response rate of participants was 91.2% for each of the cases and controls. Monthly income of patients ≤2000 birr (AOR = 6.63, 95% CI: 2.96-14.85), absence of support giver (AOR = 3.22, 95% CI: 1.38-7.50), being having an eating problem (AOR = 14.48, 95% CI: 5.06-41.40), dietary diversity score of four to five (AOR = 2.36, 95% CI: 1.92, 6.08), not getting dietary counseling support and advice (AOR = 2.53, 95% CI: 1.11, 5.72) and chewing khat (AOR = 3.36, 95% CI: 1.99,11.33) were determinants of underweight in adult HIV patients. CONCLUSIONS: This study revealed that household dietary diversity, counseling and education on nutrition, monthly income, eating problems, support giver, and khat chewing were predictors of being underweight in HIV patients. This inquires an integrated nutritional intervention including income-generating activities, counseling and education on nutrition and bad habits, and regular monitoring of the nutritional status during clinic visits.

Immediate postpartum intrauterine contraceptive device utilization and associated factors among women who gave birth in public health facilities of Adama town, Ethiopia.

Objectives: The evidence on utilization of immediate postpartum intrauterine contraceptive devices (IPPIUCDs) and its associated factors are limited in Ethiopia. Hence, this study intended to assess IPPIUCD utilization and related factors among women who gave birth in Adama town public hospitals, Ethiopia. Method: A facility-based cross-sectional study was done among 493 postpartum mothers at selected government health facilities in Adama town from January 20 to February 20, 2021. All women who gave birth in selected government health facilities and within 48 h of postpartum were included in the study. Data were collected using an interviewer-administered questionnaire. Logistic regression models were used to identify the factors associated with IPPIUCD utilization. Adjusted odds ratios (AORs) with 95% confidence interval (CI) were calculated to measure the strength of association and statistical significance was declared at p < 0.05. Result: In this study, 22.1% (95% CI: 17.3-25.2) of the mothers used IPPIUCDs within 48 h of giving birth. Having three or more children (AOR = 4.18, 95% CI: 1.79-9.79), having no desire to have another child (AOR = 3.9, 95% CI: 1.86-8.17), counseling after delivery (AOR = 3.1 95% CI: 1.52-6.34), and having good knowledge about PPIUCD (AOR = 3.82, 95% CI: 1.94-7.49) were significantly associated with IPPIUCD utilization. Conclusion: The utilization of IPPIUCD in this study was low. Strategies to raise pregnant mothers' awareness of IPPIUCD through mass media, and integrating standard counseling on immediate postpartum intrauterine device (IPPIUD) during antenatal care, and the immediate postpartum period are required to improve IPPIUD utilization.

Willingness of community based health insurance uptake and associated factors among urban residents of Oromia regional state, Oromia, Ethiopia, a cross-sectional study.

BACKGROUND: Globally, Millions of people cannot use health services because of the fear of payment for the service at the time of service delivery. From the agenda of transformation and the current situation of urbanization as well as to ensure universal health coverage implementing this program to the urban resident is mandatory. The aim of this study is to assess the willingness of community-based health insurance (CBHI) uptake and associated factors among urban residents of Oromia regional state, Oromia, Ethiopia, 2018. METHODS: A community-based cross-sectional study was conducted. From the total of eighteen towns; six towns which account for 33% of the total were selected randomly for the study. One population proportion formula was employed to get a total of 845 households. A pre-tested, semi-structured interviewer-administered questionnaire was used to collect the required data. Double-Bounded Dichotomous Choice Variant of the contingent valuation method was used to assess the maximum willingness to pay for the scheme, and a multiple logistic regression model was used to determine the effect of various factors on the willingness to join and willingness to pay for the households. RESULT: About 839 (99.3%) of the respondents participated. The mean ages of the respondents were 40.44(SD ± 11.12) years. 621 (74.1%) ever heard about CBHI with 473 (56.3%) knowing the benefits package. Out of 839, 724 (86.3%) were willing to uptake CBHI of which 704 (83.9%) were willing to pay if CBHI established in their town. CONCLUSION: If CBHI established about 86.3% of the households would enroll in the scheme. Having education, with a family size between 3 & 6, having difficulty in paying for health care and less than 20mins it took to reach the nearest health facility were the independent predictors of the willingness of CBHI uptake. The Oromia and Towns Health Bureau should consider the availability of health facilities near to the community and establishing CBHI in the urban towns.

Acceptability and feasibility of short message service to improve ART medication adherence among people living with HIV/AIDS receiving antiretroviral treatment at Adama hospital medical college, Central Ethiopia.

BACKGROUND: People living with HIV/AIDS are facing sub-optimal adherence to antiretroviral therapy. Short message service innovative strategies have been recommended by the national strategy to support medication adherence among HIV positive people. Thus, this study was conducted to examine the feasibility and acceptability of a short message service to improve medication adherence among people living with HIV/AIDS receiving Antiretroviral Treatment. METHODS: We conducted a cross-sectional survey, from February 5 to 30, 2018, among 422 randomly selected adults living with HIV/AIDS receiving antiretroviral treatment at Adama Hospital. Interviewer administered structured questionnaire was used to collect quantitative data on the feasibility and acceptability of short message services, socio-demographic and clinical characteristics of participants. Qualitative data were also collected from two focus groups to supplement the quantitative findings. Logistic regression analysis was performed to identify factors associated with the feasibility and acceptability of short message services. RESULTS: Of 420 participants responded to our questionnaire, about nine of ten patients (93.8%) possessed had a mobile phone. Most of the patients (90.9%) were willing to accept SMS to improve their medication adherence. Patients who were in young age, early adult, disclosed their HIV status, having cell phone always and believe short message service aid adherence were more likely to accept short messages on adherence. On the other hand, frequent ART Clinic visit and perceived low confidentiality of short message service were negatively associated with acceptability of short message service. CONCLUSION: The acceptability of short message service on adherence to antiretroviral therapy was high among people living with HIV/AIDS central Ethiopia. Authors recommend further studies, piloting or experimenting, that validate the acceptability, feasibility, effectiveness, and scalability of the intervention.

Assessment of Physical Activity Indicators for Children and Youth in Ethiopia: Evidence from the Global Matrix 3.0 Study (2017-2018).

BACKGROUND: Regular physical activity is vital for children's health, well-being, and development. However, evidence is scant about physical activity indicators for children and youth in Ethiopia. This study aimed to assess physical activity indicators among children and youth in Ethiopia. METHODS: This study was conducted as part of the Active Healthy Kids Global Alliance's "Global Matrix 3.0" which included 49 countries. Data were collected from December 2017 to April 2018. The country research team included different disciplines related to physical activity. Data were retrieved from pre-reviewed literature, government policy documents, and an expert interview panel. Data were analyzed using the ten physical activity indicators for children and youth. The grading system was done through a harmonized process and the standard grading rubric of the Global Matrix 3.0 study ((A = ≥ 80%, B = 60%-79%, C = 40%-59%, D = 20%-39%, F = < 20%, INC = incomplete data). RESULTS: For the overall physical activity indicator, 28% of children and youth in Ethiopia met the recommended physical activity of 60 min per day which resulted in a "D" grade. Likewise, the school and government indicator received a "D" grade. Almost 32% of schools in Ethiopia had access to infrastructures and multipurpose spaces for physical activity including outdoor play. The government policy partially existed in the non-communicable diseases agenda but had less focus on children and youth. The active play indicator scored the highest grade of "B." About 71% of children and youth were involved in active play for at least 2 h a day before, during, and after school. About 50% of children and youth were engaging in organized sport participation, and this indicator was graded a "C." Similarly, 48% of children and youth walked to and from school as a means of active transportation resulting in a "C" for this indicator. Three indicators (sedentary behavior, family and peers, and community and environment) were graded as an "F." Approximately 8% of children and youth were living in communities and environments that did not support opportunities for physical activity. Only 13% of children and youth spent less than 2 h per day in sedentary screen time. There was no adequate information to grade the physical fitness indicator. CONCLUSION: This study showed that Ethiopian's children and youth have received low grades for majority of physical activity indicators. Therefore, urgent actions should be taken by the government, policymakers, researchers, and key stakeholders to address the suggested priority areas.