Spatial variations and determinants of timely completion of vaccination in Ethiopia using further analysis of EDHS 2019 data: Spatial and multilevel analysis.

BACKGROUND: Timely vaccination is the practice of administering the vaccine within the first birthday of the child. Not vaccinating the child at the appropriate age is the cause of improper protection of diseases and can be a possible factor in death. The problem of not completing the vaccine in the scheduled period is a globally distributed problem, but especially in sub-Saharan African countries, it is a bottleneck to child health. Even if timely vaccination is crucial for reducing the impact of VPDs, there are no current national-level studies to generate conclusive and tangible evidence in Ethiopia. OBJECTIVE: To assess spatial variations and determinants of timely completion of vaccination in Ethiopia using further analysis of EDHS 2019 data. METHOD: The secondary data analysis of a community-based cross-sectional study design was employed among 3094 participants. Stata-14 software was used for data cleaning, recording, and analysis. Arc GIS version 10.3 and Kuldorff SAT scan version 9.6 software are used for spatial and SAT scan statistics. A multilevel mixed-effect binary logistic regression analysis was used to identify the predictors of timely vaccination. The clustering effect was also evaluated by Moran's I statistics and intra class correlation. RESULTS: The timely completion of vaccination among Ethiopian women who had a child aged 12-35 months was 19.5% (95%CI: 18.2-20.8), and the spatial distribution of timely completion of vaccinations in Ethiopia was non-randomly distributed. A statistically significant high proportion of timely completion areas were clustered in the eastern part of Amhara, the south part of Afar, Addis Ababa, and Oromia. The primary cluster was located at a 13.11 km radius in Diredawa, which was 3.68 times higher than outside the window (RR = 3.68, LLR = 68.76, p-value < 0.001). History of antenatal care follow-up (AOR = 1.63, 95% CI: 1.3-2.04), giving birth at health facilities (AOR = 1.63, 95% CI: 1.25-2.13), age ≥ 35 years (AOR = 186, 95% CI: 1.35-2.63), age 25-34 years (AOR = 1.72, 95% CI: 1.33-2.21), and being richest (AOR = 2.71, 95% CI: 1.86-3.94) were the factors contributing to the timely completion of vaccination. CONCLUSION: The prevalence of timely completion of vaccination was low in Ethiopia, and the spatial distribution of timely completion of vaccination in Ethiopia was non-randomly distributed across the regions. The factors associated with the timely completion of vaccinations were ANC follow-up, place of delivery, age of the participant, and wealth index. We recommend expanding facility delivery, antenatal care services, and empowering women to scale up timely vaccination in Ethiopia.

Prevalence of physical inactivity and associated factors among older adults in Gondar town, Northwest Ethiopia: a community-based cross-sectional study.

INTRODUCTION: Older adults are increasing in number in both developed and developing countries. However, as the world's aging population grows, the burden of diseases among older people also increases. Despite this, co-occurring health problems due to physical inactivity in older adults have become a concern, and physical inactivity can be caused by different conditions. As a result, for older adults to have better health outcomes, early diagnosis of physical activity status and prevention of non-communicable diseases are crucial. There is a lack of data on the prevalence and associated factors of physical inactivity among older adults that is scarce in sub-Saharan Africa, particularly in the study area, Ethiopia. Therefore, this study aimed to assess the prevalence and associated factors of physical inactivity among older adults in Gondar town, Northwest Ethiopia, in 2022. METHODS: A community-based cross-sectional study was conducted from April 1st to June 30th, 2022, in Gondar town, Northwest Ethiopia. The data was collected by the Global Physical Activity Questionnaire, Volume 2 through face-to-face interviews among 838 participants. Data were entered into Epinfo version 7.1, then exported and analysed using the Statistical Package of Social Science version 25. A binary logistic regression model was performed to identify factors associated with physical inactivity. The result was considered statistically significant based on an adjusted odds ratio of 95% and a p-value less than 0.05. RESULT: The prevalence of physical inactivity was 65.6% (95% CI: 62.1-68.9). Being female (AOR: 3.053, 95% CI:1.487-6.267), age group > = 80 (AOR: 4.082, 95% CI:1.234-13.497), primary school level (AOR: 3.020, 95% CI:1.433-6.367), no formal education (AOR: 8.573, 95% CI:2.843-25.847), unemployed (AOR: 10.273, 95% CI:5.628-18.753), and symptoms of depression (AOR: 7.152, 95% CI: 4.786-17.965) were significantly associated with physical inactivity. CONCLUSION: Physical inactivity was relatively high among older adults in Gondar town. Being female, older age, having low levels of education, being unemployed, and having depression symptoms were associated with physical inactivity. We suggest promoting the health benefits of physical activity among females by reducing their burden, older age groups, and unemployed older adults, and avoiding depression among individuals.

Level of episiotomy practice and its disparity among primiparous and multiparous women in Ethiopia: a systematic review and meta-analysis.

Background: Episiotomy at the time of vaginal birth is a common lifesaving surgical procedure. In Ethiopia, several studies have been conducted concerning the proportion of episiotomy. However, its prevalence varies across these series of studies. Thus, this systematic review and meta-analysis aimed to estimate the level of episiotomy practice and its disparity among primiparous and multiparous women in Ethiopia. Methods: This systematic review was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guideline. We systematically searched the PubMed/MEDLINE, EMBASE, Google Scholar, and Science Direct databases for studies conducted in Ethiopia focusing on episiotomy. We included all cross-sectional studies published until October 5,2022. Data were analyzed using R version 4.2.1 software. The pooled estimates with 95% confidence intervals (CIs) were presented using forest plots. A random-effects meta-analysis was conducted on extracted crude rates to calculate the national and regional pooled estimates for the country. The I-squared test and Egger's regression test were used to assess heterogeneity and publication bias, respectively. Results: Our search yielded 390 articles. A total of 13 studies covering five administrative regions and 6,404 women who delivered vaginally were involved. The mean age of the study participants ranged from 22 to 27.7 years. The estimated overall pooled prevalence rate of episiotomy in Ethiopian women was 42.75% (95% CI: 34.97%-50.54%). In the subgroup analysis, the pooled prevalence rate of episiotomy was 61.45% (95% CI: 51.11%-71.80%) among primiparous women. Meanwhile, the pooled estimate appears to be approximately 30.47% (95% CI: 22.08%-38.85%) among multiparous women. Conclusion: Our findings concluded that the pooled prevalence rate of episiotomy was higher than the evidence-based WHO recommendations for optimal patient care. Parallel to this, nulliparous women had a higher episiotomy rate than multiparous women. These findings highlight the importance of continued training for labor ward staff, particularly healthcare providers who often perform the majority of deliveries.

Self-reported musculoskeletal disorders and associated factors among HIV/AIDS patients following ART at University of Gondar Comprehensive Specialized Hospital, Gondar, Ethiopia, 2021: Aa cross-sectional study design.

BACKGROUND: Musculoskeletal disorders is an inflammatory, degenerative diseases and disorders that cause pain and functional impairments. Musculoskeletal disorders are common and the major global health concern among people with human immunodeficiency virus/acquired immunodeficiency syndrome which causes physical disability. Despite, it is a recognized health problem among human immunodeficiency virus-positive patients, there is a lack of data on musculoskeletal disorders among patients following anti-retroviral therapy in sub-Saharan Africa, particularly Ethiopia. Therefore, the main aim of the study was to assess the prevalence and associated factors of musculoskeletal disorders among adult human immunodeficiency virus-positive patients following anti-retroviral therapy. METHOD: An institutional-based cross-sectional study was conducted from September 1st to October 1st, 2021 at University of Gondar Comprehensive Specialized Hospital, Gondar, Ethiopia. The data was collected through an interview-administered questionnaire and patient medical record review of 324 participants. Binary logistic regression was used to identify associated risk factors of musculoskeletal disorders. The strength of the association was detected by the adjusted odds ratio and P-value. RESULT: The annual prevalence of musculoskeletal disorders among participants was 158 (48.5%) with [95% CI: 43%, 54%], opportunistic infection [AOR, 10.43; 95% CI = 2.76-42.25], type of ART medication used, CD4-count [AOR, 0.13; 95% CI 0.03-0.85], and change in anti-retroviral therapy regimen change [AOR, 8.14; 95%CI 2.06-32.09] were significantly associated with musculoskeletal disorders. CONCLUSION: The prevalence of musculoskeletal disorders was moderate. Recent CD4 count, opportunistic infection, antiretroviral therapy regime at initiation, and anti-retroviral therapy regime change were significantly associated with musculoskeletal disorder. A multidisciplinary approach is required for preventing and treating musculoskeletal disorders among human immunodeficiency virus-positive patients following anti-retroviral therapy.

Magnitude of depression and associated risk factors among patients with musculoskeletal disorder treated in physiotherapy outpatient department in Amhara region comprehensive specialized hospital in Ethiopia: a prospective cross-sectional study.

BACKGROUND: The state of depression that can lead to substance and drug abuse, as well as an increased risk of suicide. Without a doubt, the link between musculoskeletal pain and depression compromises a person's health and drastically lowers their quality of life, resulting in increased incapacity. Depression and musculoskeletal discomfort are two well-known risk factors for long-term sickness absence, which is defined as a period of sickness lasting more than a week, which means chronic musculoskeletal pains, particularly multiple pains, are linked to depression. And early diagnosis and care of depression in musculoskeletal disorder are critical to patients' physical, functional, and occupational results. This study aimed to assess the magnitude of depression and associated risk factors among patients with musculoskeletal disorder. METHOD: Multi-institution cross-sectional study conducted in Amhara region Comprehensive specialized Hospitals from April 1st to May 30th, 2021. The data was collected from 217 participants through interview administrative questioner and patient medical record review. Binary logistic regression was used to identify associated risk factors of depression. The strength of the association was detected by the adjusted odds ratio. RESULT: A total of 217 participate in this study with the age range of 18-80 years. Among the study participants, 57.1% (n = 124) (AOR: 95% CI: 50.7-63.6) were had depression. Treatment duration, and social support were significantly association with depression among patient with musculoskeletal disorder with P < 0.05. CONCLUSION: The magnitude of depression was relatively high among musculoskeletal disorder patients treated in physiotherapy out-patient department. The length of treatment duration (hospital stay) and the status of social support from families and friends were significantly associated with depression among patients with musculoskeletal disorders. A multidisciplinary strategy is required for diagnosing and treating depression in patients with musculoskeletal disorder.

Individual and community-level determinants and spatial distribution of prenatal HIV test uptake in Ethiopia: Spatial and multilevel analysis.

Introduction: Human immunodeficiency virus (HIV) testing and counseling services are routine prenatal care services for the prevention of mother-to-child transmission of HIV. Although the prevalence of HIV infection is high among women, evidence suggests that the uptake of HIV testing during prenatal services in Ethiopia is scarce. Therefore, the aim of this study was to investigate individual- and community-level determinants and the spatial distribution of prenatal HIV test uptake in Ethiopia based on the 2016 Ethiopian Demographic and Health Survey. Methods: Data were accessed from the 2016 Ethiopian Demographic and Health Survey. A total weighted sample of 4,152 women aged 15-49 years who gave birth in the 2 years preceding the survey were included in the analysis. The Bernoulli model was fitted using SaTScan V.9.6 to identify cold-spot areas and ArcGIS V.10.7 to explore the spatial distribution of prenatal HIV test uptake. Stata version 14 software was used to extract, clean, and analyze the data. A multilevel logistic regression model was used to identify the individual- and community-level determinants of prenatal HIV test uptake. An adjusted odds ratio (AOR) with a corresponding 95% confidence interval (CI) was used to declare significant determinants of prenatal HIV test uptake. Results: The prevalence of HIV test uptake was 34.66% (95% CI: 33.23, 36.13%). The spatial analysis revealed that the distribution of prenatal HIV test uptake was significantly varied across the country. In the multilevel analysis, the following individual and community-level determinants were significantly associated with prenatal HIV test uptake: women who attained primary education (AOR = 1.47, 95% CI: 1.15, 1.87) and secondary and higher education (AOR = 2.03, 95% CI: 1.32, 3.11); women from middle (AOR = 1.46; 95% CI: 1.11, 1.91) and rich household wealth status (AOR = 1.81; 95% CI: 1.36, 2.41); those who had health facility visits in the last 12 months (AOR = 2.17; 95% CI: 1.77, 2.66); women who had higher (AOR = 2,07; 95% CI: 1.66, 2.59) and comprehensive HIV-related knowledge (AOR = 2.90; 95% CI: 2.09, 4.04); women who had moderate (AOR = 1.61; 95% CI: 1.27, 2.04), lower (AOR = 1.52; 95% CI: 1.15, 1.99), and no stigma attitudes (AOR = 2.67; 95% CI: 1.43, 4.99); those who had awareness of MTCT (AOR = 1.83; 95% CI: 1.50, 2.24); those from rural areas (AOR = 0.31; 95% CI: 0.16, 0.61); high community level of education for women (AOR =1.61; 95% CI: 1.04, 2.52); and those living in large central (AOR = 0.37; 95% CI: 0.15, 0.91) and small peripheral areas (AOR = 0.22; 95% CI: 0.08, 0.60). Conclusion: In Ethiopia, prenatal HIV test uptake had significant spatial variations across the country. Both individual- and community-level determinants were found to be associated with prenatal HIV test uptake in Ethiopia. Hence, the impact of these determinants should be recognized while developing strategies in "cold spot" areas of prenatal HIV test uptake to enhance prenatal HIV test uptake in Ethiopia.

Spatial distribution and determinants of newborn care within 2 days of postpartum period among women with at least one antenatal care visit in Ethiopia: Mixed effect multilevel analysis.

INTRODUCTION: Neonatal mortality is pervasive in developing countries like Ethiopia. Though the risk of neonatal mortality is preventable through consolidating simple, low-cost, and less time-consuming essential care, there is a scarcity of evidence about the spatial distribution of newborn care in Ethiopia. OBJECTIVE: The current study aimed to demonstrate spatial distribution and determinants of newborn care within 2 days of the postpartum period in Ethiopia. METHODS: A cross-sectional study was employed based on Ethiopian demographic and health survey 2016 data and 2796 post-partum period women were included. Arc GIS version 10.7 and SaTScan version 9.6 software were used. Mixed effect analysis was done by STATA version 14 software. Bivariate analysis was done and variables with a p value<0.2 were taken as a candidate for multilevel multivariable logistic regression. Intra Class Correlation Coefficient (ICC), Proportion Change in Variance (PCV), and Median Odds Ratio (MOR) were used for model comparison and an Adjusted Odds Ratio (AOR) with respect to a 95% confidence interval was used for declaring statistical significance. In the multivariable analysis, a p-value≤0.05 was considered as a cut point of statistical significance with the outcome variable. RESULTS: The spatial distribution of newborn care was not random and the overall prevalence was 48.39%. Secondary educational level (Adjusted Odds Ratio (AOR = 1.5;95% CI 1.06,2.62), college and above (AOR = 2.47; 95% CI 1.22,5.01), number of antenatal cares three (AOR = 1.5; 95% CI 1.10, 2.04), antenatal care four and above (AOR = 1.6; 95% CI 1.22; 2.19), place of delivery (AOR = 9.67; 7.44, 12.57) and child is a twin (AOR = 3.33; 95% CI 1.23, 9.00) were variables significantly associated with newborn care. CONCLUSIONS: Newborn care practice in Ethiopia is below half per hundred participants. Even the distribution was not random. There is a need to pay attention to those cold spot areas and factors significantly associated with newborn care. Improving women's educational levels secondary and above, and consolidating the continuation of antenatal care and health facility delivery were the priority areas to improve newborn care in Ethiopia. Maternal and neonatal health program managers and policymakers should pay attention to those cold spots of newborn care to achieve the sustainable development goal.

Cross-cultural translation, adaptation, and validation of the stroke-specific quality of life (SSQOL) scale 2.0 into Amharic language.

BACKGROUND: The stroke-specific quality of life 2.0 (SSQOL 2.0) scale is a valid, reliable instrument which has been widely used as a patients reported outcome measure among stroke survivors. However, the SSQOL scale has not been validated and used in any Ethiopian language. This study aimed to translate, culturally adapt, and test the psychometric properties of the SSQOL scale 2.0 in Amharic, which is the official and working language with about 34 million (23%) speakers in Ethiopia. METHODS: The adapted English version of the SSQOL 2.0 scale was translated into Amharic and then back-translated to English. An expert committee translated and created a final Amharic version of SSQOL (SSQOL-AM) scale. Pre-field testing (pilot and cognitive debriefing) was conducted with 15 post-stroke subjects. The SSQOL-Am was administered to 245 stroke survivors from four referral hospitals to determine the psychometric properties. Cronbach's alpha and Intra-class correlation coefficient were used to calculate the internal consistency and test-retest reliability, spearman's correlation for the convergent validity of the SSQOL-Am scale. The Standard Error of Measurement (SEM), Minimum Detectable Change (MDC), Bland Altman Limit of Agreement (LOA), Confirmatory Factor Analysis, and Exploratory Factor Analysis were also determined. RESULTS: The SSQOL-Am demonstrated excellent test-retest reliability (ICC = 0.93), internal consistency (Cronbach's alpha = 0.96), SEM 0.857, MDC 1.94, and good LOA. As postulated, the mobility domain of the tool demonstrated a significantly strong correlation with the physical function domain of the SF-36 (rho = 0.70, p < 0.001). CONCLUSIONS: The SSQOL-Am is a valid and reliable outcome measure. The tool can be used in both clinical practice and research purposes with Amharic speaking post-stroke survivors.

Magnitude and associated factors of intimate partner violence among youth women in Ethiopia: multilevel analysis based on 2016 Ethiopian Demographic and Health Survey.

BACKGROUND: The period of youth is important for the foundation of healthy and stable relationships, women's health and well-being. Youth women face a higher risk of experiencing violence than older women. Intimate partner violence (IPV) against youth women is a significant public health concern. Despite paramount negative health consequences of IPV for the survivor, as per our knowledge, research study on IPV and associated factors among youth women in Ethiopia is scarce. Therefore, this study aimed to assess the magnitude and associated factors of IPV among youth women in Ethiopia. METHODS: The data was accessed from 2016 Ethiopia demographic and health survey (EDHS) which was a cross sectional population based household survey. It was also conducted using a multi-stage stratified random cluster sampling approach. The data were cleaned, weighted, and analyzed using STATA Version 14 software. The total weighted sample of 1077 youth women were used in this study. Multilevel logistic regression modeling was used to determine factors associated with IPV among youth women. Adjusted odds ratio (AOR) with 95% confidence interval (CI) and p value < 0.05 were used to declare the significant variables. RESULTS: Among the total participants, 30.27% (95% CI 27.59, 33.09) of youth women experienced IPV. Individual level variables such as: Being widowed/divorced/separated (AOR = 2.28; 95% CI 1.33, 3.91), having a partner who drinks alcohol (AOR = 5.76; 95% CI 3.42, 9.69), witnessing inter-parental violence during childhood (AOR = 3.45; 95% CI 2.21, 5.37), being afraid of partners (AOR = 7.09; 95% CI 4.30, 11.68), and from community level variables, youth women residing in communities with a low proportion of educated youth women (AOR = 0.31; 95% CI 0.13, 0.78) were significantly associated with having experience of IPV. CONCLUSION: The magnitude of intimate partner violence among youth women in Ethiopia was relatively high as compared to the global estimate of IPV. Individual and community level variables such as currently widowed/divorced/separated women, having a partner who drinks alcohol, witnessing inter-parental violence, being afraid of partner, and women from a low proportion of community level youth women's education were significantly associated with intimate partner violence. To decrease this public health problem, it is better to strengthen legislation on the purchase and sale of alcohol, provide legal protection for separated/divorced women, establish effective legal response services for IPV, promote gender equality, and provide psychological support for those who witnessed inter-parental violence during childhood to reduce IPV.

Limited handwashing facility and associated factors in sub-Saharan Africa: pooled prevalence and multilevel analysis of 29 sub-Saharan Africa countries from demographic health survey data.

INTRODUCTION: Handwashing is fundamentally an inexpensive means of reducing the spread of communicable diseases. In developing countries, many people die due to infectious diseases that could be prevented by proper hand hygiene. The recent coronavirus (COVID-19) pandemic is a threat to people who are living in resource-limited countries including sub-Saharan Africa (SSA). Effective hand hygiene requires sufficient water from reliable sources, preferably accessible on premises, and access to handwashing facility (water and or soap) that enable hygiene behaviors. Therefore, this study aims to determine the prevalence of limited handwashing facility and its associated factors in sub-Saharan Africa. METHODS: Data from the Demographic and Health Surveys (DHS) were used, which have been conducted in 29 sub-Saharan African countries since January 1, 2010. A two-stage stratified random cluster sampling strategy was used to collect the data. This study comprised a total of 237,983 weighted samples. The mixed effect logistic regression model with a cluster-level random intercept was fitted. Meta-analysis and sub-group analysis were performed to establish the pooled prevalence. RESULTS: The pooled prevalence of limited handwashing facility was found to be 66.16% (95% CI; 59.67%-72.65%). Based on the final model, household head with age group between 35 and 60 [AOR = 0.89, 95% CI; 0.86-0.91], households with mobile type of hand washing facility [AOR = 1.73, 95% CI; 1.70-1.77], unimproved sanitation facility [AOR = 1.58, 95% CI; 1.55-1.62], water access more than 30 min round trip [AOR = 1.16, 95% CI; 1.13-1.19], urban residential area [AOR = 2.08, 95% CI; 2.04-2.13], low media exposure [AOR = 1.47, 95% CI; 1.31-1.66], low educational level [AOR = 1.30, 95% CI; 1.14-1.48], low income level [AOR = 2.41, 95% CI; 2.33-2.49] as well as lower middle-income level [AOR = 2.10, 95% CI; 2.14-2.17] and households who had more than three children [AOR = 1.25, 95% CI; 1.20-1.31] were associated with having limited handwashing facility. CONCLUSION AND RECOMMENDATION: The pooled coverage of limited handwashing facility was high in sub-Saharan Africa. Raising awareness of the community and promoting access to handwashing materials particularly in poorer and rural areas will reduce its coverage.

Pooled prevalence and determinants of informed choice of contraceptive methods among reproductive age women in Sub-Saharan Africa: A multilevel analysis.

Background: Despite the commitments of the government to minimize unintended pregnancy, abortion, and unmet need for contraceptives, as per our search of the literature, there is no study on the pooled prevalence and determinants of informed choice of contraceptive methods in sub-Saharan Africa. Therefore, this study aimed to assess the pooled prevalence and determinants of informed choice of contraceptive methods among reproductive-aged women in sub-Saharan Africa. Methods: This study was based on the 32 Sub-Saharan African countries Demographic and Health Survey data. A total weighted sample of 65,487 women aged 15-49 was included in the study. The data were cleaned, weighted, and analyzed using STATA Version 14 software. Multilevel logistic regression modeling was used to identify determinants of an informed choice of contraceptive methods. Adjusted odds ratio (AOR) with 95% Confidence Interval (CI) and p-value < 0.05 were used to declare the significant determinants. Result: The pooled prevalence of informed choice of contraceptive methods among reproductive age (15-49) women in sub-Saharan Africa was 49.47% (95%CI: 44.33, 54.62%) with I 2 =99.5%, and variations in range of 19.42 to 78.42%. Women aged 25-34 years old (AOR = 1.26 95%CI: 1.21, 1.32) and 35-49 years (AOR = 1.33 95%CI: 1.27, 1.40), attending primary education (AOR = 1.26, 95% CI: 1.20, 1.32), secondary education (AOR = 1.50, 95% CI: 1.43, 1.58) and higher education (AOR = 2.01, 95% CI: 1.84, 2.19), having media exposure (AOR = 1.12, 95%CI: 1.07, 1.16), utilizing IUD (AOR = 1.98, 95%CI: 1.79, 2.19), injectable (AOR = 1.29, 95%CI: 1.23, 1.36) and implants (AOR = 1.70, 95%CI: 1.61, 1.79), survey year 2016-2020 (AOR = 1.38, 95%CI: 1.31, 1.44), women from lower middle (AOR = 1.25, 95%CI: 1.19, 1.31) and upper middle income level countries (AOR = 1.37, 95%CI: 1.23, 1.53) were associated with increased odds of informed choice of contraceptive methods. While, women who accessed contraceptives from private clinics (AOR = 0.64, 95%CI: 0.61, 0.67), pharmacies (AOR = 0.37, 95%CI: 0.35, 0.40), and others (AOR = 0.47, 95%CI: 0.43, 0.52), women in East Africa (AOR = 0.70, 95% CI: 0.67, 0.73), Central Africa (AOR = 0.52, 95% CI: 0.47, 0.57), and South Africa (AOR = 0.36, 95% CI: 0.32, 0.40) were associated with decreased odds of informed choice of contraceptive methods. Conclusion: The pooled prevalence of informed choice of contraceptive methods in Sub-Saharan Africa is low with high disparities among the countries. Enhancing maternal education and media exposure, providing greater concern for the source of contraceptive methods, and strengthening the economic status of the country are recommended to enhance informed choice of contraceptive methods.

Low back pain and its determinants among wait staff in Gondar town, North West Ethiopia: A cross-sectional study.

Background: Low back pain is a common public health issue in the working population and one of the leading causes of disability. It is the leading cause of work-related conditions and the most common reason for filing a workers' compensation claim in low- and middle-income countries. Ethiopia is a developing country; there is a shortage of working materials, skilled labor, and a lack of awareness of ergonomics posture, which lead to lifting heavy objects, long periods of standing, repetitive twisting, and same sustained posture for long periods of time without a shift. As a result, the purpose of this study was to assess the prevalence and associated factors of work-related low back pain among restaurant wait staff in Gondar, Ethiopia, in the year 2019. Methods: Institution-based cross-sectional study, including 420 restaurant wait personnel, was undertaken from 1 March to 30 April 2019. A simple random sampling procedure was used to choose the restaurants and wait staff. A standardized Nordic questionnaire was used to collect data. Data were entered into Epi Info 7 and analyzed in SPSS version 20. The univariate and multivariate logistic regression analyses were calculated. The significance of associations was reported by a P-value of < 0.05 and an adjusted odds ratio (AOR). The model fitness checked by the Hosmer-Lemeshow goodness of fit test was used. Result: In this study, a total of 420 participants (99.53% response rate) ranging in age from 17 to 53 years old participated, with 184 (43.8%) participants reporting low back pain at some point in the past 12 months. Female participants had a higher prevalence of 130 (70.6%). Sex (AOR = 2.98; 95% CI: 1.07-8.30), frequent exercise (AOR 0.47; 95% CI: 0.24, 0.93), extended standing (AOR 8.82; 95% CI: 3.30, 20.32], and repetitive tasks (AOR 7.49; 95% CI: 4.29, 13.19) were all found to be significant predictors in low back pain. Conclusion: More than two-fifth of waitresses and waiters reported low back discomfort at some point in the past 12 months. Predisposing factors for low back discomfort among restaurant wait staff included being female, standing for long periods of time while serving, and performing repetitive tasks. Regular exercise was found to be a protective factor against low back pain in wait staff. Delivering ongoing safety training is among the most potent essential measures required in preventing low back pain.

Individual and community level predictors of utilization of deworming medications among pregnant women in Ethiopia: A multilevel analysis.

BACKGROUND: Deworming is one strategy for reducing the burden of anaemia in pregnant women caused by intestinal parasites and it is one of the components of prenatal treatment offered to pregnant women in Ethiopia during antenatal care visits. However, there is limited evidence on the levels of deworming utilization and its determinants in Ethiopia. Hence, this study was aimed to assess the levels of deworming utilization and its individual and community level determinants among pregnant women in Ethiopia. METHOD: This study used a total weighted sample of 7590 reproductive-aged women who gave birth in the five years preceding the survey from the 2016 EDHS data. The data were cleaned and weighted using STATA version 16. Results were presented with tables and texts. Individual and community level determinants for deworming use among Ethiopian pregnant women were identified using a multilevel binary logistic regression model. In the multivariable multilevel analysis, those variables with p-value < 0.05 were considered to be significantly associated with utilization of deworming medication and reported with adjusted odd ratio with 95% confidence level. RESULTS: The overall utilization of deworming among pregnant women was 5.69% (95% CI: 5.24%, 6.33) in Ethiopia. Having occupation [AOR = 1.59; 95% CI; 1.27, 1.99], wanted pregnancy [AOR = 1.51; 95% CI; [1.16, 1.95], having ANC visit [AOR = 2.72; 95% CI; 2.03,3.64], media exposure [AOR = 1.67; 95%CI; 1.30,2.15], and high community level poverty [AOR = 0.59; 95% CI; 0.40,0.87] were significantly associated with utilization of deworming among pregnant women's. CONCLUSION: According to the findings of this study, out of twenty pregnant women, only one pregnant woman utilizes deworming medication in Ethiopia. Pregnant woman having an occupation, being exposed for media, having wanted pregnancy, having ANC visits and live with low level community poverty were more likely to use deworming medication. Therefore, intervention efforts to enhance utilization of deworming in Ethiopia requires working on enabling factors like media exposure, ANC visit and pregnancy desirability. In addition, Furthermore, increasing the community's economic capacity could support in increasing deworming medication uptake.

Perception of risk regarding the use of COVID-19 vaccine among pregnant women in Motta town and Hulet Eji Enese district, northwest Ethiopia.

BACKGROUND: COVID-19 vaccination during pregnancy is a common practice in developing countries like Ethiopia. Despite there being a rumor from the community that the use of COVID-19 vaccination during pregnancy is associated with many pregnancy adverse outcomes. However, there is a paucity of empirical evidence on the perception of risk COVID-19 vaccination during pregnancy in Ethiopia. This study assessed the perception of risk COVID-19 vaccination during pregnancy and associated factors in Motta town and Hulet Eji Enese district, northwest Ethiopia. METHODS: A community-based cross-sectional study was conducted from December 12 to February 12, 2021. A total of 851 women' were selected using the stratified cluster sampling technique. Data were collected by face-to-face interview using a semi-structured pretested and interviewer-administered questionnaire. A multivariable logistic regression model was fitted to identify factors associated with the perception of risk COVID-19 vaccination during pregnancy. The adjusted odds ratio (AOR) with a 95% confidence interval at a p-value of ≤ 0.05 was used to declare the level of significance. RESULTS: Perception of risk COVID-19 vaccination during pregnancy was 34.2% (95%CI (Confidence Interval): 31-37). Unplanned pregnancy (AOR = 3.66; 95%CI: 2.31-5.81), long travel time to the nearby health care facility (AOR: 4.57; 95% CI: 2.34-8.91), have no formal education (AOR: 3.15; 95%CI: 1.71-5.79), attending secondary educational level (AOR: 5.18; 95% CI: 2.17-12.4), no ANC (Antenatal Care) service utilization (AOR: 7.07; 95% CI: 4.35-11.5) and negative attitude towards COVID-19 vaccination (AOR: 6.05; 95%CI: 3.88-9.43) were significantly associated with the perception of risk COVID-19 vaccination during pregnancy. CONCLUSIONS: Most of the participants perceive COVID-19 vaccination during pregnancy as a risk for the outcome of pregnancy. Designing strategies to increase women's educational status, promoting the need for maternal and child health services, and awareness creation regarding COVID-19 vaccination will have a great role in changing the perception of pregnant women. Therefore, the government should design public health programs targeting the identified factor, and should minimize the perception of risk acquiring infection from COVID-19 vaccine to improve maternal and neonatal health outcome.

Level of activity limitations and predictors in women with pregnancy-related pelvic girdle pain: Prospective cross-sectional study.

Background: For many pregnant women, pelvic girdle pain caused by pregnancy has an impact on their daily living. Women with lumbo-pelvic pain have moderate to severe discomfort that makes daily activities like getting out of a chair, bending, and walking difficult. The aim of this study was to determine the extent of daily activity restrictions and to discover predictors of pregnancy-related pelvic girdle pain. Study design: Prospective cross-sectional study. Methods: This prospective cross-sectional study was undertaken from January October 2018 to October 29/2019 among 337 gravid mothers with pregnancy-related limbo-pelvic pain. A structured questionnaire adapted from the activity limitation-related pelvic girdle pain questionnaire was used for data collection. Epi-info version 7.1 for data entry and STATA version 14 for statistical analysis were used. Ordinal regression with an odds ratio of 95% confidence interval and p-value < 0.05 were cast-off to assess the association between the outcome and dependent variables. Results: Among 324 pregnant women with pelvic girdle pain 96 (29.6%) had small extent level of activity limitation, 185 (57.1%) had moderate activity limitation, and 43 (13.3%) large extent level of activity limitation. Having previous children (AOR = 0.37, 95% CI:0.14, 0.98), occupation (AOR = 1.77, 95% CI: 1.06, 2.95) and taking alcohol (AOR = 0.43, 95% CI: 0.19, 0.99) were the independent predictors for activity limitation. Conclusion: Nearly one-third of the participants had a modest degree of activity restriction, while more than half of the pregnant women with PPGP had a moderate to high level of restriction. Previous children, occupation, and alcohol consumption were all independent predictors of activity limitation among pregnant women.

Community and individual level determinants and spatial distribution of deworming among preschool age children in Ethiopia: spatial and multi-level analysis.

BACKGROUND: Soil-transmitted helminths caused millions of morbidity of preschool age children in sub-Saharan Africa with low socio-economic status and lack of clean water and sanitation. In Ethiopia, nearly half of children are affected by intestinal parasites. Despite this prevalence, deworming medication utilization among preschool age children is low. Hence, this study aimed to assess the community and individual level determinants and spatial distributions of deworming among preschool age children in Ethiopia. METHODS: Crossectional collected 2016 Ethiopian Demographic and Health Survey datasets with a total weighted 8146 children 12-59 months old were used for this study. The data were cleaned, extracted, and analyzed using STAT Version 16 software and exported to MS excel for spatial analysis. In addition, ArcGIS and SaTScan software were used to detect the geographic distribution of deworming utilization among preschool age children. RESULTS: The magnitude of deworming among preschool age children in Ethiopia was 13.32% (95% CI: 12.60, 14.08) and ranges from the lowest 3.34% (95% CI: 1.01, 10.45) Afar region to the highest 28.66% (95% CI:24.95, 32.69) Tigray region. In multilevel multivariable logistics regression analysis; variables such as secondary and above women education [AOR = 1.89; 95%CI; 1.32, 2.73], women who have occupation [AOR = 1.47; 95%CI; 1.23, 1.76], child with 12-23 months old [AOR = 2.00; 95%CI; 1.62, 2.46], having ANC visit [AOR = 1.68; 95%CI; 1.35, 2.08], households that have media exposure [AOR = 1.50; 95%CI; 1.22, 1.85] were significantly associated with deworming among preschool age children. Afar, Eastern Amhara, Dire Dewa, Harari, Somalia, and Eastern SNNPE regions were cold spot regions with Global Moran's I value 0.268 (p < 0.0001) for deworming of preschool age children. CONCLUSIONS: The prevalence of deworming among preschool age children in Ethiopia is relatively low. Individual-level factors such as; maternal education and occupation, having ANC visit, child age, household media exposure, and community-level variables such as; community media usage had a significant association with deworming among preschool age children in Ethiopia. These findings highlight that, the Ministry of Health (MOH) Ethiopia should prepare a regular campaign for deworming programs for preschool age children. Mass media promotion of deworming should be strengthened. The Ministry of Education should work to strengthen women's education, household and community media exposure. Prior attention should be given to low deworming regions such as Afar, Somalia, Diredewa, and Harari regions.

Household Solid Fuel Use and Associated Factors in Ethiopia: A Multilevel Analysis of Data From 2016 Ethiopian Demographic and Health Survey.

Solid fuels are types of fuel that comprise coal, biomass, charcoal, wood, or straw and are used for cooking, heating, lighting, boiling water, and generating revenue at home. Globally, 3 billion of the world's poorest people continue to rely on inefficient solid fuels, which produce health-damaging contaminants. In Ethiopia, more than 90% of households rely on wood as their primary source of energy. The actual and potential determinants of solid fuel use have not been fully identified, particularly at the national level in Ethiopia. Therefore, this study aimed to determine the magnitude of solid fuel use and its associated factors in Ethiopia. We used the Ethiopian Demographic and Health Survey (EDHS), which was conducted in 2016. The data was conducted using a 2-stage stratified cluster sampling approach. A total of 16 650 weighted samples were taken. Multilevel logistic regression models were fitted to identify factors associated with solid fuel use, and a cluster-level random intercept was introduced in the mixed model. An adjusted odds ratio with a 95% confidence level was reported to show the strength of the association and its significance. The goodness of fit of the model was checked using proportional change deviance (PCV). The magnitude of solid fuel use among households in Ethiopia was 94.03% (95% CI = 93.66, 94.37). Household heads completed in primary school (AOR, 3.09, 95% CI = 2.44, 3.91), outdoor cooking places (AOR, 4.13, 95% CI = 2.96, 5.76), and small peripheral regions (AOR, 14.44, 95% CI = 6.12, 34.04) were all significantly associated with solid fuel use. The intra-cluster correlation coefficient (ICC) showed that about 81% of the variations in the use of solid fuel were attributed to the difference at the 643 cluster level, but the remaining 19% were attributed to individual household factors. The PCV was 90%, which showed that the variation in solid fuel use among study households was explained by factors at both the individual and community levels. The deviation test of the fourth model had the lowest value (3528) and was chosen as the best-fitted model. Due to different influencing factors, the use of solid fuel is still high in Ethiopia. Promoting access to education and raising awareness toward solid fuel impact is very important.

Distal and/or Proximal Joint Stiffness Among Post-Fracture Patients Treated in University of Gondar Comprehensive Specialized Hospital, Gondar, Ethiopia.

Background: Stiffness, or more precisely, a restriction in the range of motion, is a potential complication following any intra- or extra-articular injury. The passive or active range of motion of the physiological joint is an important factor in determining the significance of joint stiffness. The goals of this study were to assess the incidence of joint stiffness following a fracture, using a standard goniometer, and to identify potential predictors of joint stiffness among post-fracture patients. Methods: A prospective hospital-based cross-sectional study was conducted from July 1, 2021 to September 13, 2021, at University of Gondar Comprehensive Specialized Hospital. A total of 230 study participants participated in the study, and systematic sampling methods were used to recruit the study participants. Bivariate and multivariable binary logistic regression model analyses were conducted, with SPSS version 23, to identify factors associated with post-fracture joint stiffness. Results: The overall prevalence of post-fracture stiffness was 25.7% (n=59). Having a left-side fracture (AOR=10.83; 95% CI 1.71-17.74), patients having no physiotherapy follow-up (AOR=6.72; 95% CI 1.79-25.13), and patients using assistive devices (AOR=11.95; 95% CI 3.63-39.35) were significantly associated with post-fracture stiffness, with p-values of less than 0.05. Conclusion: The study found that one-quarter of the study participants experienced post-fracture joint stiffness. A fracture on the left side, individuals with no physiotherapy follow-up, and the use of assistive devices were found to be independent predictors of joint stiffness. Early referral of fracture patients to the rehabilitation center is recommended to prevent post-fracture complications and joint stiffness.

Assessment of post-operative nausea and vomiting prophylaxis usage for cesarean section, 2021: A cross sectional study.

Background: Post-operative nausea and vomiting (PONV) are common and distressing to patients. This common anesthetic and surgical side effect has been reported to increase patient dissatisfaction and can be more distressing to patients than post-operative pain. It has multi-factorial causes: patient, anesthesia and surgery related risk factors have been identified. Prevention of PONV is important since it has psychological and physical effects, and it can also cause severe complications. Objective: To determine the level of practice of PONV prophylaxis usage for caesarean section. Methods: This clinical perspective study was conducted at all pregnant mothers scheduled for caesarean section under anesthesia from March 1 to March 30, 2021 consecutively. The standards were directly changed into question forms with two integral checking components, "Yes", and "No". Data were entered and analyzed by statistical package of social sciences (SPSS) version 20. Results: A total of 100 parturients scheduled for caesarean section were included with a response rate of 100%. Based on the standards, Anti-emetic treatment to patients with post-operative nausea and vomiting (PONV), adherence of anesthetists to local evidence based guideline for PONV prevention and more importantly no prophylactic administration to patients at low risk for PONV were implemented with a percentage of 17%,47%, and 14% respectively. Conclusions: and recommendations: There was a significant performance gap in the clinical practice of prevention of post-operative nausea and vomiting. We strongly suggest that adherence to a Protocol to reduce baseline risk and the adoption of a multimodal approach will highly likely ensure success in the management of PONV. The usage of appropriate anti-emetic prophylaxis to the right patient is necessary to have a good outcome after surgery and anesthesia.

Open defecation practice and its determinants among households in sub-Saharan Africa: pooled prevalence and multilevel analysis of 33 sub-Saharan Africa countries demographic and health survey.

BACKGROUND: Open defecation facilitates the transmission of pathogens that cause diarrheal diseases, which is the second leading contributor to the global burden of disease. It also exposed hundreds of millions of girls and women around the world to increased sexual exploitation. Open defecation is more practice in sub-Saharan African (SSA) countries and is considered an indicator of low socioeconomic status. However, there is little evidence on the pooled prevalence and factors contributing to open defecation practice among households in SSA. OBJECTIVES: This study aimed to assess the pooled prevalence, wealth-related inequalities, and other determinants of open defecation practice among households in sub-Saharan Africa. METHODS: Demographic and Health Survey data sets of 33 SSA countries with a total sample of 452,281 households were used for this study. Data were weighted, cleaned, and analyzed using STATA 14 software. Meta analyses were used to determine the pooled prevalence of open defecation practice among households in SSA. Multilevel analysis was employed to identify factors contributing to open defecation practice among households in SSA. Moreover, concentration index and graph were used to assess wealth-related inequalities of open defecation practice. The associations between dependent and independent variables were presented using adjusted odds ratios and 95% confidence intervals with a p value of < 0.05. RESULTS: The pooled prevalence of open defecation practice among households in sub-Saharan African countries was 22.55% (95%CI: 17.49%, 27.61%) with I2 = 99.9% and ranges from 0.81% in Comoros to 72.75% in Niger. Individual level factors, such as age, educational attainment, media exposure, wealth status, and access to drinking water, as well community level factors, such as residence, country income status, and region in SSA, had a significant association with open defecation practice. The concentration index value [C = - 0.55; 95% CI: - 0.54, - 0.56] showed that open defecation practice was significantly disproportionately concentrated on the poor households (pro-poor distribution). CONCLUSIONS: Open defecation practice remains a public health problem in sub-Saharan Africa. Individual level factors, such as age, educational attainment, media exposure, household wealth status, and access to drinking water had an association with open defecation practice. Moreover, community level factors such as residence, country income status and region in SSA have a significant effect on open defecation. There is a significantly disproportional pro-poor distribution of open defecation practice in SSA. Each country should prioritize eliminating open defecation practices that focused poorest communities, rural societies, and limited water access areas. Media exposure and education should be strengthened. Moreover, public health interventions should target to narrow the poor-rich gap in the open defecation practice among households including provisions of subsidies to the poor. Policymakers and program planners better use this evidence as preliminary evidence to plan and decide accordingly.