Maternal satisfaction with delivery service and associated factors among women who gave birth at public hospitals in Guji Zone, Southern Ethiopia.

BACKGROUND: Maternal satisfaction during delivery services is considered an important indicator of the quality of healthcare in a hospital setting and determines the uptake of services during subsequent pregnancies. However, there is limited information on the magnitude of women's satisfaction during delivery services in the study area. Thus, this study aimed to assess factors associated with maternal satisfaction with delivery services among women who gave birth at public hospitals in Guji Zone, Southern Ethiopia. METHOD: A facility-based cross-sectional study was conducted at public hospitals in Guji Zone from December 1, 2020, to January 30, 2021. Two hundred forty-nine women who gave birth at public hospitals were recruited by a systematic random sampling technique. The collected data were entered into the Epi Info 7 software and then exported to SPSS Version 26 for analysis. A logistic regression model was employed to identify the association between independent variables and maternal satisfaction during delivery services. A P-value less than 0.05 and an Adjusted Odds Ratio with 95% CI was computed to determine the strength of the association between these variables. RESULT: In this study, 138(55.4%), 95% CI (49.1-61.7) women were satisfied with delivery. Mothers who delivered through cesarean section (AOR = 2.92, 95% CI: 1.34-6.33), privacy assured (AOR = 3.14, 95% CI: 1.76-5.59), shorter duration of labor (AOR = 2.82, 95% CI: 1.64-4.62), waiting time ≤ 30 min (AOR = 5.15,95% CI:1.99-13.32) and normal fetal outcome (AOR = 2.63, 95% CI:1.42-4.85) were associated with mothers satisfaction with delivery care services. CONCLUSION: The overall magnitude of women's satisfaction with delivery services is low, which is below the national client satisfaction target of ≥ 85%. Factors such as mode of delivery, assured privacy, short duration of labor, waiting time ≤ 30 min, and good fetal outcome were significantly associated with women's satisfaction with delivery services. Therefore, healthcare providers should provide better management during intrapartum childbirth or emergency obstetric care to improve fetal outcomes during delivery services. In addition, health facility managers should avail infrastructure that helps to maintain the privacy of women who give birth in the facility.

Assessment of Violence during COVID-19 among Reproductive Age Women in Arsi Zone, South East Ethiopia.

Background: Preventive measures, like staying at home during lockdown, are mandatory during the COVID-19 pandemic. Particularly as a result of staying at home, violence against women is beginning to increase in correlation with these measures. Therefore, the purpose of this study was to assess the prevalence of violence against women of reproductive age during the COVID-19 pandemic in the Arsi Zone. Methods: A community-based cross-sectional study design was employed from February 15 to March 30, 2021. A multistage sampling technique was used to recruit 1458 women aged 15-49 years old. Data entry was performed using Epi info-7 and exported to SPSS version 25 for analysis. A logistic regression analysis was employed to identify factors associated with violence against women at p value <0.05 and AOR values with 95% CI. Results: The prevalence of violence against women during COVID-19 was 51.1% (95% CI 48.5-53.7%). Psychological violence (31.8%) and controlling behavior violence (29.3%) were the leading types of violence followed by economic (20.2%) and sexual violence (15.6%). Respondents who had monthly income of <1000 birr (AOR = 1.72; 95% CI, 1.18, 2.51), 1001-2000 birr (AOR = 2.22; 95% CI, 1.51, 3.27), 2001-3000 birr (AOR = 1.91; 95% CI, 1.26, 2.91), and 3001-4000 birr (AOR = 2.03; 95% CI, 1.31, 3.14), quarreled with their partner's family (AOR = 3.36; 95% CI: 2.14-5.30), witnessed chilhood family violence (AOR = 2.34; 95% CI: 1.81-3.02), and decisions made on the household issue by husband only (AOR = 2.62; 95% CI: 2.01-3.41) or wife only (AOR = 1.99; 95% CI: 1.33-2.98) were significantly associated with violence against women. In addition, we found that participants whose partners cannot read and write (AOR = 2.63; 95% CI: 1.19- 5.81), drink alcohol (AOR = 2.78; 95% CI: 2.10-3.76), chew chat (AOR = 3.27; 95% CI: 2.21-4.85), ever fighting or aggressive with other men (AOR = 2.73; 95% CI: 1.51-4.95), and partners' families taking part in the decision making (AOR = 2.32; 95% CI: 1.49-3.62) were also associated with violence against women. Conclusions: One in every two women was the victim of any form of violence in the study area. Hence, empowering women's economic status and enhancing community-based health education for males on behavioral lifestyle modification were required to prevent violence against women.

Willingness to pay for Social Health Insurance and associated factors among Public Civil Servants in Ethiopia: A systematic review and meta-analysis.

BACKGROUND: The provision of equitable and accessible healthcare is one of the goals of universal health coverage. However, due to high out-of-pocket payments, people in the world lack sufficient health services, especially in developing countries. Thus, many low and middle-income countries introduced different prepayment mechanisms to reduce large out-of-pocket payments and overcome financial barriers to accessing health care. Though many studies were conducted on willingness to pay for social health insurance in Ethiopia, there is no aggregated data at the national level. Therefore, this systematic review and meta-analysis aimed to estimate the pooled magnitude of willingness to pay for social health insurance and its associated factors among public servants in Ethiopia. METHOD: Studies conducted before June 1, 2022, were retrieved from electronic databases (PubMed/Medline, Science Direct, African Journals Online, Google Scholar, and Web of Science) as well as from Universities' digital repositories. Data were extracted using a data extraction format prepared in Microsoft Excel and the analysis was performed using STATA 16 statistical software. The quality of the included studies was assessed using the Newcastle-Ottawa Scale for cross-sectional studies. To evaluate publication bias, a funnel plot, and Egger's regression test were utilized. The study's heterogeneity was determined using Cochrane Q test statistics and the I2 test. To determine the pooled effect size, odds ratio, and 95% confidence intervals across studies, the DerSimonian and Laird random-effects model was used. Subgroup analysis was conducted by region, sample size, and publication year. The influence of a single study on the whole estimate was determined via sensitivity analysis. RESULT: To estimate the pooled magnitude of willingness to pay for the Social Health insurance scheme in Ethiopia, twenty articles with a total of 8744 participants were included in the review. The pooled magnitude of willingness to pay for Social Health Insurance in Ethiopia was 49.62% (95% CI: 36.41-62.82). Monthly salary (OR = 6.52; 95% CI:3.67,11.58), having the degree and above educational status (OR = 5.52; 95%CI:4.42,7.17), large family size(OR = 3.69; 95% CI:1.10,12.36), having the difficulty of paying the bill(OR = 3.24; 95%CI: 1.51, 6.96), good quality of services(OR = 4.20; 95%CI:1.97, 8.95), having favourable attitude (OR = 5.28; 95%CI:1.45, 19.18) and awareness of social health insurance scheme (OR = 3.09;95% CI:2.12,4.48) were statistically associated with willingness to pay for Social health insurance scheme. CONCLUSIONS: In this review, the magnitude of willingness to pay for Social Health insurance was low among public Civil servants in Ethiopia. Willingness to pay for Social Health Insurance was significantly associated with monthly salary, educational status, family size, the difficulty of paying medical bills, quality of healthcare services, awareness, and attitude towards the Social Health Insurance program. Hence, it's recommended to conduct awareness creation through on-the-job training about Social Health Insurance benefit packages and principles to improve the willingness to pay among public servants.

Assessment of hospitalisation costs and their determinants among Covid-19 patients in South Central Ethiopia.

BACKGROUND: The coronavirus disease 2019 (Covid-19) pandemic is a global public health problem. The Covid-19 pandemic has had a substantial impact on the economy of developing countries, including Ethiopia.This study aimed to determine the hospitalisation costs of Covid-19 and the factors associated with the high cost of hospitalisation in South Central Ethiopia. METHODS: A retrospective cost analysis of Covid-19 patients hospitalised between July 2020 and July 2021 at Bokoji Hospital Covid-19 Treatment Centre was conducted using both the micro-costing and top-down approaches from the health system perspective. This analysis used cost data obtained from administrative reports, the financial reports of the treatment centre, procurement invoices and the Covid-19 standard treatment guidelines. The Student's t-test, Mann-Whitney U test or Kruskal-Wallis test was employed to test the difference between sociodemographic and clinical factors when appropriate.To identify the determinants of cost drivers in the study population, a generalised linear model with gamma distribution and log link with a stepwise algorithm were used. RESULTS: A total of 692 Covid-19 patients were included in the costing analysis. In this study, the mean cost of Covid-19-infected patients with no symptoms was US$1,073.86, with mild symptoms US$1,100.74, with moderate symptoms US$1,394.74 and in severe-critically ill condition US$1,708.05.The overall mean cost was US$1,382.50(95% CI: 1,360.60-1,404.40) per treated episode.The highest mean cost was observed for personnel, accounting for 64.0% of the overall cost. Older age, pre-existing diseases, advanced disease severity at admission, admission to the intensive care unit, prolonged stay on treatment and intranasal oxygen support were strongly associated with higher costs. CONCLUSIONS: This study found that the clinical management of Covid-19 patients incurred significant expenses to the health system. Factors such as older age, disease severity, presence of comorbidities, use of inhalation oxygen therapy and prolonged hospital stay were associated with higher hospitalisation costs.Therefore, the government should give priority to the elderly and those with comorbidities in the provision of vaccination to reduce the financial burden on health facilities and health systems in terms of resource utilisation.

Cervical cancer screening utilization and associated factors among women attending antenatal care at Asella Referral and Teaching Hospital, Arsi zone, South Central Ethiopia.

BACKGROUND: Cervical cancer is a major public health problem affecting women worldwide. It is the second cause of mortality among women in Ethiopia. Early Cervical cancer screening has a tremendous impact on reducing morbidity and mortality related to cervical cancer infection. Therefore, this study aimed to assess cervical cancer screening utilization and associated factors among women attending Antenatal Care at Asella referral and teaching hospital, Arsi Zone, south-central Ethiopia. METHOD: This study employed a facility-based cross-sectional study among 457 Antenatal Care mothers from December 2020 to February 2021. Data collection was performed using interviewer-administered structured questionnaires. Data were entered into EpiInfo Version 7 and transferred to SPSS V.21 for analysis. A logistic regression model was used to determine the factors associated with cervical cancer screening utilization and an adjusted odds ratio with a 95% confidence interval at p-value < 0.05 was computed to determine the level of statistical significance. RESULT: The magnitude of cervical cancer screening utilization was found to be 7.2%(95% CI: 5.2, 10.6). Educational status of secondary and above (AOR = 2.92; 95%CI = 1.078-7.94), getting screened for any reproductive healthcare services(AOR = 4.95; 95%CI = 2.24-10.94), having multiple sexual partners(AOR = 4.55; 95%CI = 1.83-11.35), and satisfactory knowledge of cervical cancer screening(AOR = 3.89; 95%CI = 1.74-8.56) were significantly associated factors with cervical cancer screening utilization. CONCLUSION: Utilization of cervical cancer screening was low among women attending Antenatal care at Asella Referral and Teaching hospital, Southcentral Ethiopia. Educational status, history of multiple sexual partners, getting screened for any reproductive healthcare services, and knowledge of cervical cancer screening were significant factors associated with the utilization of cervical cancer screening. Hence, to improve the utilization of Cervical cancer screening, there should be the implementation of programmed health education and awareness creation on the benefits of screening as well as the promotion of reproductive healthcare services at health facilities.

Health-Related Quality of Life and Associated Factors Among Covid-19 Survivors. Experience from Ethiopian Treatment Centers.

Background: The pandemic of the novel coronavirus (Covid-19), which is extremely stressful and has an adverse effect on people's health-related quality of life (HRQoL), poses a serious threat to global public health. As a result, this study evaluated the health-related quality of life and associated factors among Covid-19 patients who were discharged from Ethiopian treatment centers. Methods: We conducted a multi-center, cross-sectional study among 493 Covid-19 survivors who had been discharged from treatment centers between 1st January 2020, and 20th October 2021. We collected respondents' data using validated Amharic version EuroQol 5-dimensional-5 levels (EQ-5D-5L) questionnaire along with medical records of the patients. Differences in HRQOL scores between patient subgroups were tested by Mann-Whitney U or Kruskal-Wallis test, and the multivariable betaMix regression was used to investigate factors associated with HRQOL scores. Results: The EQ-5D and VAS median score for Covid-19 survivors was 0.940 (IQR: 0.783-0.966) and 87 (IQR: 70-91) respectively. Overall, married individuals, old-aged, individuals who had low educational status, high monthly income, comorbidities, admitted to the Intensive care Unit, received intranasal oxygen care, and prolonged hospitalization had lower utility scores and EQ-VAS scores compared to their counterparts. In multivariate betaMix regression, respondents' health status at admission, old age, chronic obstructive pulmonary disease, asthma, and hospital length of stay were significantly associated with the lower EQ-5D-Index value and EQ-VAS score. Conclusion: We found that Covid-19 infection had a persisting impact on the physical and psychosocial health of Covid-19 survivors. Age, having asthma and chronic obstructive pulmonary disease, having a worsening health state upon admission, and a prolonged hospital length of stay were significantly associated with the lower EQ-5D and EQ-VAS score. Therefore, the cost-effective psychological treatment such as cognitive behaviour therapy should be encouraged after hospitalization to improve the post-Covid-19 depression and fatigue.

Is Ethiopian community-based health insurance affordable? Willingness to pay analysis among households in South Central, Ethiopia.

BACKGROUND: Community-based Health Insurance (CBHI) is a voluntary prepayment mechanism that guarantees the provision of basic healthcare services without financial barriers to underserved segments of the population in developing countries. The Government of Ethiopia launched the CBHI program to protect the community from high out-of-pocket health expenditure and improve health service utilization a decade ago. However, to improve the quality of healthcare services delivery in health facilities and cover the changing costs of healthcare, the government should revise the contribution of the CBHI scheme. Therefore, we determined the willingness to pay for a CBHI scheme and associated factors among rural households of Lemu and Bilbilo district, South Central Ethiopia. METHODS: We conducted a community-based cross-sectional study design to assess willingness to pay for the CBHI scheme and its associated factors among households in Lemu and Bilbilo districts, South Central Ethiopia. We used a double bounded contingent valuation method to elicit households' willingness to pay for the CBHI scheme. Data were coded, cleaned, entered into Statistical Package for Social Science (SPSS) version 25, and exported to STATA 16 for analysis. A logistic regression analysis was conducted to determine the presence of statistically significant associations between the willingness to pay for the CBHI scheme and independent variables at a p-value <0.05 and Adjusted odds ratio (AOR) values with 95% CI. Finally, we checked the fitness of the model using Hosmer and Lemeshow's goodness-of-fit test. RESULTS: Of the 476 study participants, 82.9% (95% CI: 79.2%, 86.01%) were willing to pay for the CBHI scheme and only 62% of them can afford the average amount of 358.32ETB ($7.68) per household per annum. Primary education (AOR = 3.17; 95% CI: 1.74-5.80), secondary and above education (AOR = 4.13; 95% CI: 1.86-9.18), large family size (AOR = 2.75; 95% CI: 1.26-5.97), monthly income of 500-1000ETB (AOR = 3.75; 95% CI: 1.97-7.13) and distance to public health facilities (AOR = 2.14, 95% CI: 1.04-4.39 were significantly associated with willingness to pay for the CBHI scheme. CONCLUSION: In this study, around 83% of respondents were willing to pay for the CBHI and meet the government expectation for 2020. The study also revealed that educational status, family size, monthly income, and distance from the health facilities were significant factors associated with WTP for the CBHI scheme. In addition, we found that a large number of the respondents couldn't afford the average amount of money that the participants were willing to pay for the CBHI scheme. So, the government should consider the economic status of the communities while revising the CBHI scheme premium not to miss those who cannot afford the contribution.

Misconceptions About COVID-19 and Associated Factors Among Residents of Dilla Town, Southern Ethiopia.

BACKGROUND: Despite the implementation of various coronavirus disease 2019 (COVID-19) prevention and control strategies, the rate of COVID-19 is alarmingly increasing in Ethiopia as well as worldwide. The success of COVID-19 prevention measures is highly influenced by a lack of knowledge and misconceptions. This study aimed to assess misconceptions about COVID-19 and associated factors among residents of Dilla Town, southern Ethiopia. METHODS: A community-based cross-sectional study was conducted from December 1 to 30, 2020. Data were collected from 415 individuals using structured interviewer-based questionnaires. Logistic regression analyses were used to identify the relationship between the dependent and independent variables. RESULTS: The proportion of respondents who have a high misconception about COVID-19 was 41.1%. Study participants who had poor knowledge were 2.1 (95% confidence interval [CI]: 1.1-3.8) times more likely to have a misconception about COVID-19 than their counterparts. Respondents who had access to information from more than 2 sources were 3.29 (with 95% CI: 1.2-9.2) times less likely to have a misconception about COVID-19 when compared with those who had access to 2 or fewer information sources. CONCLUSIONS: A significant proportion of people have misconceptions about COVID-19 in the study area. To resolve these misconceptions, health sectors and stakeholders need to improve the residents' knowledge by delivering COVID-19-related information from credible sources on a routine basis.

Community-Based Health Insurance Membership Renewal Rate and Associated Factors among Households in Gedeo Zone, Southern Ethiopia.

Background: Community-based health insurance (CBHI) scheme is an emerging strategy to achieve universal health coverage and protect communities in developing countries from catastrophic financial expenditure at the service delivery point. However, high membership discontinuation from the CBHI scheme remained the challenge to progress toward universal financial protection in resource-constrained countries. Therefore, this study assessed the community-based health insurance membership renewal rate and associated factors in the Gedeo zone, Southern Ethiopia. Methods: We conducted a community-based cross-sectional study among households in the Yirga Chafe district, Gedeo zone, Southern Ethiopia, from September 10 to 30, 2021. We used a multistage simple random sampling to recruit 537 respondents. We entered data into Epi-Info 7 and exported it to SPSS version 25 for analysis. We used a logistic regression model to determine factors associated with the CBHI scheme membership renewal. Variables with a P value of <0.05 and a 95% confidence level were considered to be significantly associated with the outcome variable. Results: We found the respondents' CBHI membership renewal rate was 82.68%. Those who enrolled in the CBHI scheme >3years (AOR = 3.12; 95% CI: 1.40-6.97), having illnesses in the last three months (AOR = 2.97; 95% CI: 1.47-5.99), the CBHI premium affordability (AOR = 12.64; 95% CI: 3.25-49.38), good knowledge of the CBHI scheme (AOR = 21.11; 95% CI: 10.63-41.93), perceived quality of health service (AOR = 4.21; 95% CI: 1.52-11.68), and favorable attitude towards the CBHI scheme (AOR = 3.89, 95% CI: 1.67-9.04) were significantly associated with the CBHI program membership renewal rate. Conclusion: In our study, we found the magnitude of CBHI members who discontinued their CBHI scheme membership was high. Besides, we found that the affordability of the CBHI premium, respondents' attitude, and knowledge of the CBHI program were predictor factors for dropout from the CBHI membership. Therefore, the government should consider the economic status of communities during setting the CBHI program contribution. Moreover, awareness creation through health education should be provided to improve participants' knowledge and perception of the CBHI program.

Assessment of Households' Willingness to Join and Pay for Improving Waste Management Practices in Gedeo Zone, Southern Ethiopia.

Background: Waste management has become a serious challenge in urban areas of developing countries. However, managing municipal solid waste generated is the most costly urban service and needs community engagement in management of municipal solid wastes. Therefore, this study determined willingness to join and pay for improving solid waste management services and associated factors among households of Gedeo zone, Southern Ethiopia. Method: We performed a community-based cross-sectional study design to assess willingness to join and pay for improved solid waste management and its predictors among residents in Gedeo zone, Southern Ethiopia. Multivariate logistic regression analysis was computed to identify the factors associated with willingness to join and pay for improved solid waste management services. An adjusted odds ratio (AOR) with a 95% confidence interval (CI) was used to report an association, and a p < 0.05 was used to declare a statistically significant association. Result: Of 552 study participants, 91.5% (95% CI: 89.2, 93.8) were willing to join and 86.3% (95% CI: 83.3, 89.4) of them were willing to pay for improving solid waste management services. Having a large family size, higher educational status, positive attitude, and good knowledge of waste management services, access to waste management services, and amount of waste generated per week were positively associated with willingness to support improved solid waste management services. In addition, we found that respondents with high educational status, monthly income, who had good knowledge of waste management, access to waste management services, and the amount of waste generated per week were significant predictors of willingness to pay for improved solid waste management. Conclusion: This study found that a significant number of the respondents were willing to support and pay for improved solid waste management services. A higher probability of willingness to support and pay for solid waste management services among residents who had access to waste management services and good knowledge of solid waste management was observed. Therefore, wide-range awareness creation through mini media should be used to address poor knowledge. In addition, establishing more temporary waste collection sites in every corner of cities is needed to encourage households to support and pay for improved solid waste management services.

Predictors of Hand-Washing Practices at Critical Times Among Mothers of Under-5 Years Old Children in Rural Setting of Gedeo Zone, Southern Ethiopia.

Background: Various communicable and infectious diseases could be contained by proper hand washing leading to a reduction in mortality and morbidity of children. Objective: To assess predictors of hand-washing practices at critical times among mothers of under 5 years old children in rural setting of Gedeo zone, Southern Ethiopia. Method: An institutional-based cross-sectional survey was conducted among 422 women with children under the age of 5 attended the Dilla Zuria health facility and were chosen using a systematic sampling method. Data was gathered using pre-tested interview-administered structured questionnaires. Data was entered into EPI info version 17 and analyzed using SPSS version 25. Binary logistic regression was employed to identify the association between dependent and independent variables. Finally, for variables with a P < .05 in multivariable analysis, adjusted odds ratio (AOR) with a 95% confidence interval (CI) was determined and interpreted. Results: The hand washing practice of mothers at critical times was 44.9% [95% CI: 40.1, 49.7%]. The pertinent predictors were favorable attitude [AOR = 7.77, 95% CI: 4.56, 10.37], availability of water source near the household [AOR = 5.31, 95% CI: 3.56, 10.37], and constant availability of soaps at household [AOR = 2.32, 95% CI: 1.33, 6.70]. Conclusion: In our study, hand-washing practices at critical times was low. The pertinent predictors were attitude, the presence of a water source near the household, and the presence of soap. Therefore, it is advised to encourage domestic hygiene education to improve mothers' attitudes and to increase the availability of water and soap close to the household to promote handwashing with soap and water at critical times.

Alcohol use disorder and its associated factors among residents in Southern Ethiopia during the era of COVID-19.

Objectives: To determine the prevalence of alcohol use disorder and associated factors among residents of Dilla town, Gedeo zone, Southern Ethiopia, 2021. Methods: A community-based cross-sectional study was conducted among 666 randomly selected participants. Interview-assisted structured questionnaire was used to collect data, and alcohol use disorder identification test was employed to measure alcohol use disorder. The data were entered in to Epi info version 7 and exported in to SPSS version 25 for analysis. Both bivariate and multivariate binary logistic regression analysis were used to identify significant factors related with alcohol use disorder. In the multivariate model, variables with p value < 0.05 were considered as a statistical significant factor for the outcome variable. Finally, adjusted odds ratio with 95% confidence interval was computed to assess the strength of association. Results: The magnitude of alcohol used disorder during the past year was 30.6% (95% confidence interval: 25.5%-35.7%). Being male (adjusted odds ratio = 8.33, 95% confidence interval: (4.34, 15.98)), age of less than 33 years old (adjusted odds ratio = 1.78, 95% confidence interval: (1.06, 3.00)), current cigarette smoking (adjusted odds ratio = 2.49, 95% confidence interval: (1.42, 4.37)), current khat chewing (adjusted odds ratio = 6.23, 95% confidence interval: (3.8, 9.92)), high level of psychological distress (adjusted odds ratio = 7.69, 95% confidence interval: (4.16, 14.28)) and poor social support (adjusted odds ratio = 2.30, 95% confidence interval: (1.27, 4.18)) were significantly associated with alcohol use disorder. Conclusion: A large percentage of respondents in our sample had an alcohol use disorder. Alcohol use problems were linked to being men, under the age of 33 years old, current khat chewing, current cigarette smoking, a high level of psychological distress, and poor of social support. As a result, early screening, public health intervention programs and establishing appropriate referral linkages with mental health facilities are recommended.

Health related quality of life and its association with social support among people living with HIV/AIDS receiving antiretroviral therapy in Ethiopia: a systematic review and meta-analysis.

BACKGROUND: People living with HIV/AIDS (PLWHA) are frequently confronted with severe social issues such as rejection, abandonment, criticism, and stigma. This would negatively affect their quality of life. Several studies have been conducted so far to assess factors affecting the health-related quality of life among people living with HIV/AIDS who are on antiretroviral therapy (ART) in Ethiopia. However, to our knowledge, there is no previous study that has summarized the results of the studies that investigated health-related quality of life (HRQOL) among PLWHA in Ethiopia. Therefore, the purpose of this review was to estimate the pooled prevalence of HRQOL and its association with social support among people living with HIV/AIDS (PLWHA) on ART in Ethiopia. METHODS: A systematic search was carried out using several electronic databases (PubMed, Science Direct, Web of Science, and Cochrane electronic), Google Scholar, Google, and a manual search of the literature on health-related quality of life among people living with HIV/AIDS who are on ART. A Microsoft Excel data extraction sheet was used to extract pertinent data from an individual study. To assess the heterogeneity of primary articles, the Cochrane Q test statistics and the I2 test were carried out, and a random effects meta-analysis was used to estimate the pooled prevalence of HRQOL. RESULT: Out of the 493 articles reviewed, ten with a total of 3257 study participants were eligible for meta-analysis. The pooled prevalence of HRQOL among people living with HIV/AIDS who are on antiretroviral therapy in Ethiopia was 45.27%. We found that strong perceived social support was significantly associated with higher levels of subjectively perceived HRQOL. PLWHA who were on ART and had good social support were four times more likely to report higher HRQOL when compared to their counterparts [AOR = 4.01, 95% CI 3.07-5.23]. CONCLUSION: A substantial number of PLWHA had poor HRQOL in Ethiopia. Social support was significantly associated with HRQOL among people living with HIV/AIDS. Hence, it's recommended to encourage suitable intervention at every follow-up visit, and psycho-social support is also warranted to improve the quality of life.

Survival analysis of COVID-19 patients in Ethiopia: A hospital-based study.

BACKGROUND: COVID-19 is a global public health problem causing high mortality worldwide. This study aimed to assess time to death and predictors of mortality among patients hospitalized for COVID-19 in the Arsi zone treatment center. METHOD: We performed a retrospective observational cohort study using medical records of laboratory-confirmed COVID-19 cases hospitalized at Bokoji Hospital COVID-19 treatment center from 1st July 2020 to 5th March 2021. We extracted data on the patients' sociodemographic and clinical characteristics from medical records of hospitalized patients retrospectively. We carried out Kaplan Meier and Cox regression analysis to estimate survival probability and investigate predictors of COVID-19 death 5% level of significance. The Adjusted Hazard Ratio (aHR) with 95% Confidence Interval (CI) was estimated and interpreted for predictors of time to death in the final cox model. RESULT: A total of 422 COVID-19 patients treated were analyzed, of these more than one tenth (11.14%) deaths, with a mortality rate of 6.35 cases per 1000 person-days. The majority (87.2%) of deaths occurred within the first 14 days of admission, with a median time-to-death of nine (IQR: 8-12) days. We found patients that age between 31 and 45 years (aHR = 2.55; 95% CI: (1.03, 6.34), older than 46 years (aHR = 2.59 (1.27, 5.30), chronic obstructive pulmonary disease (aHR = 4.60, 95%CI: (2.37, 8.91), Chronic kidney disease (aHR = 5.58, 95%CI: (1.70, 18.37), HIV/AIDS (aHR = 3.66, 95%CI: (1.20, 11.10), admission to the Intensive care unit(aHR = 7.44, 95%CI: (1.82, 30.42), and being on intranasal oxygen care (aHR = 6.27, 95%CI: (2.75, 4.30) were independent risk factors increasing risk of death from COVID-19 disease than their counterparts. CONCLUSION: The risk of dying due to COVID-19 disease was higher among patients with HIV/AIDS, chronic obstructive pulmonary disease, and chronic kidney diseases. We also found that older people, those admitted to ICU, and patients who received intranasal oxygen care had a higher risk of dying due to COVID-19 disease. Therefore, close monitoring hospitalized patients that are old aged and those with comorbidities after hospitalization is crucial within the first ten days of admission.

Assessment of Microbiological Quality of Indoor Air at Different Hospital Sites of Dilla University: A Cross-Sectional Study.

Background: In both residential and hospital indoor environments, humans can be exposed to airborne microorganisms. The hospital's indoor air may contain a large number of disease-causing agents brought in by patients, staff, students, visitors, ventilation, or the outside. Hospitalized patients are at a higher risk of infection due to confined spaces, crowdedness, and poor infection prevention practices, which can accumulate and create favorable conditions for the growth and multiplication of microorganisms. Therefore, the aim of this study was to evaluate the indoor air bacterial load in Dilla University Hospital, Southern Ethiopia. Methods: An institutional-based cross-sectional study design was used to assess the bacterial load in the indoor air at Dilla University Hospital. To determine the bacterial load, a passive air sampling technique was used. The settle plate method was used to collect data, which involved exposing Petri-dishes filled with blood agar media to the indoor air of the sampled rooms for 60 minutes. Result: A total of 72 indoor air samples were collected once a week for 2 weeks at 14-day intervals from 18 rooms in 8 wards, and samples were collected twice a day in the morning and afternoon. The mean bacterial concentrations ranged from 450 to 1585.83 CFU/m3 after 60 minutes of culture media exposure. The mean bacterial concentrations in the obstetrics, surgical, pediatric, gynecology, and medical wards exceeded WHO guidelines. A high indoor air bacterial load was found in 58 (80.6%) of the samples in this study. Gram-positive bacteria in the air were the most common 51 (71%) of the bacterial population measured in all indoor environments. Fungal growth was found in 65 (90.3%) of the samples. Temperatures (26.5°C-28.3°C) and relative humidity (61.1%-67.8%) in the rooms were both above WHO guidelines, creating favorable conditions for bacterial growth and multiplication. Conclusion: The majority of the wards at Dilla University Hospital had bacterial loads in the air that exceeded WHO guidelines. Overcrowding, high temperatures, inadequate ventilation, improper waste management, and a lack of traffic flow control mechanisms could all contribute to a high concentration of bacteria in the indoor air. To control the introduction of microorganisms by patients, students, caregivers, and visitors, it is critical to regularly monitor indoor air bacterial load and implement infection prevention and control measures.

Risky sexual practice and associated factors among people living with HIV/AIDS receiving antiretroviral therapy in Ethiopia: Systematic review and meta-analysis.

BACKGROUND: The risky sexual behavior of people living with HIV/AIDS (PLWHA) may impose a risk of transmitting the disease to their partners and increase Human Immunodeficiency Virus (HIV) co-infection. This systematic review and meta-analysis aimed to determine the pooled prevalence of risky sexual behavior and associated factors among PLWHA receiving [Antiretroviral Therapy (ART)] in Ethiopia. METHODS: To identify both published and unpublished research articles, systematic searches were performed in PubMed, HINARI, Medline, Science Direct, and Google Scholar databases. The review was carried out following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guideline. Cross-sectional studies reporting the prevalence of risky sexual practice and its associated factors among PLWHA receiving ART in Ethiopia were included. Two authors independently extracted all necessary data using a standardized data extraction format prepared in Microsoft Excel and exported to STATA version 14 statistical software for further analyses. The Cochrane Q test statistics and I2 test were used to assess the heterogeneity of the studies. Since the included studies exhibited considerable heterogeneity, the random-effects meta-analysis model was computed to estimate the pooled prevalence of risky sexual practice which was determined by dividing the total number of PLWHA with risky sexual practice practices by the total number of PLWHA on ART in the study and multiplied by 100. Furthermore, pooled odds ratio (OR) with 95% confidence interval (CI) was determined for the association between determinant factors and risky sexual practice. RESULT: In this study, 2351 articles were identified from different databases, and fifteen articles were selected for final systematic review and meta-analysis. In Ethiopia, the pooled prevalence of risky sexual practices was 43.56% (95% confidence interval (CI):35.51, 51.62). Discussion about safe sex with sexual partner/s [AOR = 0.26, 95% CI: 0.08, 0.92] and having multiple sexual partners [AOR = 1.90, 95% CI: 0.53, 6.84] were factors significantly associated with risky sexual practice in Ethiopia. CONCLUSION: A significant proportion of respondents engaged in risky sexual practices. Multiple sexual partners and a lack of discussion about safe sex are linked to a higher prevalence of the risky sexual practice in Ethiopia. It is critical to raise awareness about safe sexual practices during health education and counselling services and to encourage clients to freely discuss safer sex practices with their sexual partner/s at their antiretroviral therapy (ART) appointments as part of their follow-up care. PROTOCOL REGISTRATION: The protocol for this systematic review and meta-analysis was registered at PROSPERO (record ID = CRD42021274600, 25 September 2021).

Factors Associated with Poor Treatment Outcome among Hospitalized COVID-19 Patients in South Central, Ethiopia.

BACKGROUND: Deaths due to COVID-19 are common among the elderly, especially among individuals with underlying illnesses. The pandemic of the COVID-19 impaired the mental, psychological, and physical well-being of people admitted to hospitals. Furthermore, in underdeveloped countries, scarcity of medical equipment was a challenge to manage cases in public health facilities. Thus, understanding the epidemiology and clinical outcomes of COVID-19 patients who are receiving treatment is critical for developing effective treatments and assessing service quality. Therefore, this study is aimed at assessing the treatment outcomes and associated factors among patients affected by the COVID-19 virus. METHOD: We used an institutional-based retrospective cross-sectional analysis of 398 patients discharged in South Central, Ethiopia, between June 1, 2020, and July 5, 2021. Data were extracted using the data abstraction format. Data were entered, coded, and analyzed using the STATA 16 software. Bivariate and multivariate logistic regression analysis was used to assess the factors associated with poor treatment outcomes. A 95% confidence interval with adjusted odds ratio (AOR) and p value less than 0.05 were considered statistically significant. RESULT: In our study, the proportion of poor treatment outcomes was 61 (15.3%). Chronic pulmonary disease (AOR = 5.62; 95% CI: 2.49-12.70), asthma (AOR = 2.8; 95% CI: 1.17-6.67), chronic kidney disease (AOR = 4.81; 95% CI: 1.27-18.22),diabetic mellitus (AOR = 2.27; 95% CI: 1.02-5.09), HIV positive (AOR = 10.44; 95% CI: 3.0-36.35), worsening conditions (AOR = 3.73, 95% CI: 1.17-11.95), and age 55 and above years (AOR = 4.35, 95% CI: 1.30-14.60) were statistically associated with poor treatment outcomes. CONCLUSION: We found a significant number of patients had favourable treatment. Moreover, aging, having complicated situations at admission, and chronic illnesses such as COPD, CKD, asthma, diabetic mellitus, and HIV/AIDS participants were significantly associated with poor treatment outcomes. Therefore, critical follow-up and management of patients with underlying diseases and worsening health conditions during admission is required.

Time to recovery from Covid-19 and its associated factors among patients hospitalized to the treatment center in South Central Ethiopia.

Coronavirus outbreak was a public health emergency. The surge of new confirmed cases and deaths was observed in developing countries due to the occurrence of new variants. However, factors associated with the duration of recovery among admitted patients remained uncertain. Therefore, we assessed factors associated with time to recovery from Covid-19 among hospitalized patients at the treatment center in South Central, Ethiopia. We employed a retrospective cross-sectional study among 422 patients hospitalized at Bokoji Hospital treatment center with Covid-19 from July 1, 2020, through October 30, 2021. Data were entered, coded, and analyzed using SPSS 26 version. We computed the survival probability using the Kaplan Meier method and determined factors associated with time to recovery using Cox regression analysis. Finally, the interpretation of adjusted hazard ratio (AHR) with 95% Confidence Interval (CI) and P-values less than 0.05 were declared as statistically significant. Our study found that the median time to recovery from Covid-19 infection of 13 days, with an IQR of 9-17 days. In multivariate Cox regression, ≥ 60 years old (AHR = 0.66; 95% CI: 0.49, 0.895), chronic pulmonary disease (AHR = 0.67; 95% CI: 0.455, 0.978), Male (AHR = 0.77; 95% CI: 0.611, 0.979), and being on Intranasal oxygen care (AHR = 0.56; 95% CI: 0.427-0.717) were significantly associated with time to recovery. Thus, health providers in treatment centers should give strict follow-up and priority for elders, patients with underlying diseases, and under supportive treatment during case management.

Evaluation of health-related quality of life of Covid-19 patients: a hospital-based study in South Central Ethiopia.

BACKGROUND: Covid-19 causes a wide range of symptoms in patients, ranging from mild manifestations to severe disease and death. This study assessed the health-related quality of life (HRQOL) and associated factors of Covid-19 patients using primary data from confirmed cases in South Central Ethiopia. METHODS: We employed a facility-based, cross-sectional study design and conducted the study at the Bokoji Hospital Covid-19 treatment centre. A structured questionnaire and the EQ-5D-3L scale were used to collect the data for analysis. The HRQOL results measured by the EQ-5D-3L tool were converted to a health state utility (HSU) using the Zimbabwe tariff. The average health utility index and HSU-visual analogue scale across diverse sociodemographic and clinical characteristics were compared using the Mann-Whitney U test or Kruskal-Wallis test. We employed a multiple linear regression to examine factors associated with HSU values simultaneously. The data were analysed using STATA version 15. RESULTS: The overall mean HSU score from the EQ-5D was 0.688 (SD: 0.285), and the median was 0.787 (IQR 0.596, 0.833). The mean HSU from the visual analogue scale score was 0.69 (SD: 0.129), with a median of 0.70 (IQR 0.60, 0.80). Those who received dexamethasone and intranasal oxygen supplement, those with comorbidity, those older than 55 years and those with a hospital stay of more than 15 days had significantly lower HSU scores than their counterparts (p < .001). CONCLUSION: Covid-19 substantially impaired the HRQOL of patients in Ethiopia, especially among elderly patients and those with comorbidity. Therefore, clinical follow-up and psychological treatment should be encouraged for these groups. Moreover, the health utility values from this study can be used to evaluate quality adjusted life years for future cost-effectiveness analyses of prevention and treatment interventions against Covid-19.

Assessment of practice of Covid-19 preventive measures and associated factors among residents in Southern, Ethiopia.

INTRODUCTION: Coronavirus (Covid-19) is a respiratory disease mostly affecting old aged and those with comorbidities. Due to resource constraints in developing countries, control of Covid-19 was based on preventive measures. However, there is variation in adherence to these precautionary measures from place to place among communities. Therefore, this study assessed the practice of Covid-19 preventive measures and associated factors among residents of Southern, Ethiopia. METHODS: A community-based cross-sectional study was employed on residents of Southern, Ethiopia. Interviewer administered questionnaire was used to collect data from households through systematic random sampling methods. Data was entered, coded, and analyzed using STATA version 16. Logistic regression analysis was used to explore the association between outcome variables and predictor variables. Finally, the interpretation of Adjusted Odds ratio (AOR) with 95% Confidence Interval (CI) and p-value was done for statistically significant factors of Covid-19 preventive measures practice. RESULTS: The proportion of residents who had good practice of Covid-19 preventive measures was 31.3% (95% CI: 26.5, 36.1). Out of 364 residents, 264 (72.5%) used facemasks, 218 (59.9%) washed their hands frequently, 167 (45.9%) practiced social distancing, 135 (37.1%) stayed at home, 75 (18.1%) avoided handshaking and 228 (62.6%) used hand sanitizer. Following government directions (AOR = 225; 95% CI: 68.6, 738), good knowledge about Covid-19 (AOR = 3.47; 95% CI: 1.12, 10.73), having access to water supply (AOR = 2.92; 95% CI: 1.05, 8.18), belief towards protectiveness of preventive measure (AOR = 3.53; 95% CI: 1.08, 11.61) and chronic illness (AOR = 5.09; 95% CI: 1.44, 17.96) were significantly associated with practice of Covid-19 preventive measures. CONCLUSION: In this study, the proportion of residents practicing Covid-19 preventive measures was low. Having comorbidity, following government directions, knowledge about Covid-19 and access to water supply were significantly associated with Covid-19 preventive measures practice. Therefore, government and all concerned stakeholders should increase the accessibility of infrastructure and provide continuous awareness creation campaigns regarding Covid-19 mode of transmission, sign and symptom, and protectiveness of Covid-19 preventive measures. Moreover, dissemination of teaching aids using local languages and close monitoring of community compliance to Covid-19 preventive measures is crucial.