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1.
BMC Infect Dis ; 20(1): 814, 2020 Nov 10.
Artigo em Inglês | MEDLINE | ID: mdl-33167885

RESUMO

BACKGROUND: Anthrax is the second most highly prioritized zoonotic disease in Ethiopia due to its negative impact at the household level, causing disease and production losses in livestock and severe disease in humans. This study seeks to assess the knowledge of, attitudes towards, and practices addressing (KAPs) anthrax in the communities of Eastern Tigray, Northern Ethiopia. METHODS: A cross-sectional survey was conducted concurrently with focus group discussions (FGDs) and key informant interviews (KIIs) between May 2019 and April 2020. A total of 862 respondents participated in the questionnaire survey. Of these, 800 were local community members while 62 were professionals working at health service institutions. In addition, qualitative data were collected using six FGDs and 11 KIIs. RESULTS: Sixty-two percent (496/800) of the community respondents said that they were aware of anthrax while 38% (304/800) of them did not. Only 9.3% (74/800) of the respondents reported that the causative agent of anthrax is germs/microbial. About 56.5% (35/62) of professional respondents said that it is bacterial. More than 60% (64.1%, 513/800) of the respondents did not know that whether the disease was zoonotic or not. Regarding clinical signs, 26.3 (210/800) and 36.8% (294/800) of the respondents could identify at least one in animals and humans, respectively, while 21.3 (170/800) and 20.1% (161/800) knew one or more transmission routes in animals and humans, respectively. Moreover, 43.4% (347/800) and 45.6% (365/800) of the respondents mentioned one or more control/prevention method(s) in animals and humans, respectively. Regarding qualitative results, some of the participants knew the disease (in animals) by their local names: Lalish and Tafia (splenomegaly), and Gulbus (abdominal cramps and shivering). Some reported that anthrax was exclusively a human disease while others recognized its zoonotic potential after the clinical signs in both animals and humans were listed. CONCLUSION: The KAP of the participants regarding anthrax was low. There was no consistent understanding of the disease among the participants. The study also revealed that the participants did not receive consistent, adequate, and continuous education regarding the disease.


Assuntos
Antraz/psicologia , Conscientização , Bacillus anthracis , Conhecimentos, Atitudes e Prática em Saúde , Zoonoses/psicologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Animais , Antraz/epidemiologia , Antraz/microbiologia , Estudos Transversais , Etiópia/epidemiologia , Características da Família , Feminino , Grupos Focais , Pessoal de Saúde , Humanos , Gado , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Adulto Jovem , Zoonoses/epidemiologia
2.
J Pregnancy ; 2020: 8878037, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33194231

RESUMO

Introduction: Uterine rupture is a leading cause of maternal death in Ethiopia. Despite strengthening the health care system and providing basic and comprehensive emergency obstetric care closer to the communities, uterine rupture continues to produce devastating maternal and fetal outcomes. Although risk factors of uterine rupture are context specific, there is lack of clarity in our context towards the contributing factors and untoward outcomes of uterine rupture. This study was conducted to identify the risk factors of uterine rupture and its impacts in public hospitals of Tigrai. Objective: This study would identify determinant factors of uterine rupture and its management outcomes among mothers who gave birth in public hospitals in Tigrai region, North Ethiopia. Method: A retrospective hospital-based unmatched case control study design was implemented with 135 cases of women with uterine rupture and 270 controls of women without uterine rupture. Cases were enrolled consecutively from case notes of women who gave birth from 1/9/2015 to 30/6/2019, while charts (case note) of women without uterine rupture found following the cases were selected randomly and enrolled. Bivariate and multivariate logistic regression with 95% confidence interval was used to identify the determinants of uterine rupture. Result: Mothers referred from remote health institutions (AOR 7.29 (95% CI: 2.7, 19.68)), mothers who visited once for antenatal care (AOR 2.85 (95% CI: 1.02, 7.94)), those experiencing obstructed labor (AOR 13.33 (95% CI: 4.23, 42.05)), and birth weight of a newborn greater than four kilograms (AOR 5.68 (95% CI: 1.39, 23.2)) were significantly associated with uterine rupture. From 135 mothers who develop uterine rupture, 13 (9.6%) mothers died and 101 (74.8%) fetuses were stillborn. Obstetrical complications like abdominal hysterectomy in 75 (55.6%) of mothers and excessive blood loss in 84 (57.8%) were additional untoward outcomes of uterine rupture. Conclusion: Referrals from remote health institutions, once-visited antenatal care, obstructed labor, and birth weight of newborns greater than four kilograms were significant determinants of uterine rupture. Maternal death, stillbirth, hysterectomy, and hemorrhage were adverse outcomes. The findings of this study suggest early identification of factors that expose to uterine rupture during antenatal care, labor, and delivery must be attended to and further prospective studies are needed to explore predictors of untoward outcomes. Knowing the determinants of uterine rupture helps prevent the occurrence of a problem in pregnant women, which reduces maternal morbidity and mortality, and would have a tremendous help in identifying the best optional strategies in our current practices. This assertion was added to the abstract concluding session.


Assuntos
Parto Obstétrico , Hospitais Públicos/estatística & dados numéricos , Ruptura Uterina/etiologia , Adulto , Peso ao Nascer , Estudos de Casos e Controles , Etiópia/epidemiologia , Feminino , Acesso aos Serviços de Saúde , Humanos , Histerectomia , Gravidez , Cuidado Pré-Natal , Estudos Retrospectivos , Fatores de Risco , Natimorto , Resultado do Tratamento , Ruptura Uterina/epidemiologia , Ruptura Uterina/mortalidade , Ruptura Uterina/prevenção & controle , Adulto Jovem
3.
Vasc Health Risk Manag ; 16: 379-387, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33061399

RESUMO

Background: Currently, cardiovascular diseases (CVDs) are rising in the world and require great concern because the consequences are not only morbidity and mortality, but also a high economic burden. However, the pattern of CVDs in Ethiopia is not well known. Therefore, this study aimed to describe CVD and co-existing morbidities among newly registered cardiac patients in Hawassa University Comprehensive Specialized Hospital. Methods: A retrospective cross-sectional study was conducted from January 1 to December 31, 2016 among newly registered cardiac patients in an adult cardiac referral clinic. Records and cardiac referral clinic logbooks were used to collect relevant information using structured checklists. Results: Of the total 310 records of cardiac patients, 236 were explored and included in the study, while the records of 74 patients were absent in the cards room when tracing and/or incomplete to assess cardiac pattern. Rheumatic heart disease (RHD) was the leading cardiac problem and diagnosed in 70 (29.7%) cases followed by non-ischemic cardiomyopathy (55, 23.3%), ischemic heart disease (41, 17.4%), hypertensive heart disease (29, 12.3%), and cor pulmonale (14, 5.9%). The mean age of RHD patients was 28.7 (±13.1) years. Eighty-two (35%) females and 23 (19.8%) males had RHD, while 69 (29.2%) females and 23 (19.8%) males had non-ischemic cardiomyopathy. The overall rate of mitral stenosis, mitral regurgitation, and aortic regurgitation among patients with RHD were 39 (55.7%), 48 (68.6%), and 26 (37.1%), respectively. Moreover, the overall coexisted morbidity was 81 (34.3%), with a high rate of hypertension alone at 44 (18.6%) followed by hypertension with diabetes at 11 (4.7%). Conclusion: This study indicated that more than one-third of cardiac patients had at least one of the co-existing morbidities like hypertension, diabetes mellitus, asthma and other diseases. Therefore, careful diagnosis and management of cardiac patients plays an important role to minimize comorbidity-linked complications. Moreover, population-based studies are recommended for better representing and generalization.


Assuntos
Cardiopatias/epidemiologia , Hospitais Universitários , Adolescente , Adulto , Idoso , Comorbidade , Estudos Transversais , Etiópia/epidemiologia , Feminino , Cardiopatias/diagnóstico , Cardiopatias/terapia , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Prognóstico , Encaminhamento e Consulta , Estudos Retrospectivos , Adulto Jovem
4.
Vasc Health Risk Manag ; 16: 389-401, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33061400

RESUMO

Background: Globally, stroke appears as a major cause of preventable deaths and disabilities. In Ethiopia, the intra-hospital mortality of stroke is significant; however, epidemiologic data are scarce whether there is a difference in the overall survival time between hypertensive and non-hypertensive adult stroke patients admitted in specialized hospitals. This study was intended to determine the survival of stroke patients according to their hypertension status admitted in Ayder Comprehensive Specialized Hospital, Northern Ethiopia from March 1, 2012, to February 28, 2019. Methods and Findings: A hospital-based retrospective cohort study was conducted among all cohorts of confirmed first-ever stroke patients admitted in Ayder Comprehensive Specialized Hospital, Northern Ethiopia. Kaplan-Meier survival analysis was applied to estimate the survival probability of hypertensive and non-hypertensive first-ever stroke patients. Cox proportional hazards regression model was used to determine the adjusted hazard ratio of death for each main baseline predictor variable with 95% CI, and P-value <0.05 was used to declare statistical significance. The assumptions of the Cox proportional hazards regression model assessed by the global test, Schoenfeld residuals. There were 503 (323 were hypertensive, 180 Non-hypertensive) confirmed first, ever adult stroke patients, the overall median age of the patients was 65 years, IQR (53-75) years. Seventy-five (14.9%) of them were dead, with a median survival time of 48 days and 428 (85.1%) of them were censored. At any particular point in time, the hazard of death among hypertensive patients was two times higher than non-hypertensive patients, but this was not found to be a statistically significant (adjusted HR=2.13: 95% CI 0.66-6.81). Glasgow Coma Scale 3-8 at admission (adjusted HR=10.12; 95% CI 2.58-40.68), presence of stroke complications (adjusted HR=7.23; 95% CI 1.86-28.26) and borderline high total cholesterol level (adjusted HR=3.57; 95% CI 1.15-11.1) were the only independent predictors of intra-hospital patient mortality. Conclusion: The overall survival time difference between hypertensive and non-hypertensive first-ever adult stroke patients was not statistically significant. Early identification and treatment of stroke complications, co-morbidities along strict follow-up of comatose patients may improve the intra-hospital survival of stroke patients, and we also recommend community-based studies using a large sample size.


Assuntos
Hipertensão/epidemiologia , Acidente Vascular Cerebral/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Etiópia/epidemiologia , Feminino , Hospitais de Ensino , Humanos , Hipertensão/diagnóstico , Hipertensão/mortalidade , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/mortalidade , Fatores de Tempo
6.
PLoS One ; 15(10): e0239716, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33035217

RESUMO

BACKGROUND: Volatile organic compounds such as gasoline and other fuels are associated with a wide variety of deleterious health effects including liver and kidney diseases. Gasoline station workers are exposed to a mixture of hydrocarbons during dispensing. However, no published studies investigated the liver and renal function tests of gasoline station workers in Ethiopia. Therefore the aim of this study was to assess liver and renal function tests among gasoline station workers. METHOD: A comparative cross sectional study was conduct from January 2018 to April 2018 at Mekelle city, Tigray region, Northern Ethiopia. Liver and renal function tests were analyzed on gasoline exposed (n = 43) and controls (n = 47) by Pentra C400 automated clinical chemistry analyzer. Student independent t-test and one way-ANOVA statistical methods were employed using SPSS Ver23. P-value < 0.05 was regarded as statistically significant. RESULT: The mean level of ALT, AST, Urea, creatinine, and uric acid was significantly higher among gasoline stations workers when compared to control study participants. There was also a significant increase in ALT, AST, Urea, creatinine and uric acid among gasoline stations with above 6 years exposure when compared with those exposed for ≤2 and3-6years. CONCLUSION: These findings suggest that increasing liver and renal parameters may be associated with exposure to gasoline and it is dependent on time of exposure to gasoline.


Assuntos
Gasolina/análise , Rim/patologia , Fígado/patologia , Adulto , Benzeno/efeitos adversos , Benzeno/análise , Estudos Transversais , Etiópia/epidemiologia , Feminino , Gasolina/efeitos adversos , Humanos , Rim/química , Fígado/química , Masculino , Pessoa de Meia-Idade , Doenças Profissionais , Exposição Ocupacional/análise , Instalações de Transporte
7.
PLoS One ; 15(10): e0239728, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33048941

RESUMO

INTRODUCTION: School-aged children become a highly vulnerable group for malaria, yet they are less likely to use malaria prevention interventions. Previous studies exploring perception on cause of malaria mainly focused on pregnant mothers or parents of children under age five years. Exploring parent's perception on cause of malaria and their experiences on the prevention of malaria and associated challenges among school-aged children is important to develop a malaria prevention education package for school-aged children to reduce malaria and malaria related morbidities among school-aged children. METHODS: A descriptive qualitative study is conducted in Kutcha district by recruiting 19 parents of school-aged children for semi-structured interviews, 6 key informants and 6 focus group discussion which consists of parents, health development army and health extension workers. A semi-structured interview guide is used to guide the interview process. The collected data is analyzed thematically with a focus on the three major areas of concern: perceived cause of malaria, experience of malaria prevention and challenges of bed net use for prevention of malaria. RESULTS: Five causes of malaria were identified, namely hunger, mosquito bite, exposure to hot sunshine, poor sanitation and hygiene and eating some sweet foods and unripe maize. Participants perceived that eating sweet foods and unripe maize lead to enlargement of the spleen that ends in malaria while poor hygiene and sanitation leads to either development of the ova of mosquito and the landing of the housefly to contaminate food for consumption. The experiences of malaria prevention were largely influenced by their perceived cause of malaria. The malaria prevention measures undertaken by parents were vectors control measures, homemade herbal remedies and restricting children from eating sweet foods. The challenges of malaria prevention by using bed nets were related to a negative attitude, sleeping behaviors of children; use of bed nets for unintended purposes, shortage of bed nets and delays in the distribution of bed nets. CONCLUSION: There were misconceptions about the cause of malaria and associated experiences of malaria prevention. Control of malaria among school-aged children need health education targeting the challenges and correcting identified misconceptions by parents in Kutcha district and in other similar settings.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde/etnologia , Malária/prevenção & controle , Pais/psicologia , Adulto , Etiópia/epidemiologia , Feminino , Grupos Focais , Educação em Saúde , Humanos , Mordeduras e Picadas de Insetos , Mosquiteiros Tratados com Inseticida , Malária/etiologia , Masculino , Controle de Mosquitos/métodos , Pais/educação , Pesquisa Qualitativa
8.
PLoS One ; 15(10): e0238987, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33052919

RESUMO

INTRODUCTION: One third of the world population has been exposed to hepatitis B virus and an estimated 257 million people are chronically infected. The main route of hepatitis B virus (HBV) infection is vertical transmission. Post exposure prophylaxis is recommended by world health organization to have free Hepatitis B infection by 2030. OBJECTIVE: The main purpose of this research project was to assess Hepatitis B virus post exposure prophylaxis coverage, rate of vertical transmission and factors among exposed newborns delivered at Arsi zone health institution. METHODS: A cross-sectional study was conducted in Arsi zone health institutions among hepatitis B virus exposed newborns delivered at Arsi zone health institutions from January 2018 to September 2019. Systematic sampling technique was used to select 422 exposed newborns into the study. A pre-tested structured questionnaire and checklist were used to collect relevant data. Data was entered and cleaned using epidata7 & analyzed using SPSS version 25 software package. Both bivariate and multivariate analyses was carried out to identify associations. Odds ratio with 95% CI and P-value <0.05 was considered statistically significant. RESULTS: The study revealed that among 401 exposed newborns only 83(20.7%), have been administered post exposure prophylaxis. But vertical transmission of hepatitis B virus (HBV) was observed in 32.4% (27.9%-36.9%) exposed newborns. Antenatal (ANC) attendance (AOR = .40, 95%CI = .23-.69), Instrumental delivery (AOR = 4.18, 95%CI = 2.05-8.51) HIV coinfection (AOR = 9.7, 95%CI = 4.37-21.34), Post exposure Prophylaxis (AOR = .20, 95%CI = .08-.50) and Knowledge on HBV (AOR = .27, 95%CI = .14-.53) are significant predictors of HBV vertical transmission. CONCLUSION: Magnitude of HBV post exposure prophylaxis coverage is very low while Rate of vertical transmission is high. Antenatal attendance, Instrumental delivery, Post exposure Prophylaxis and Knowledge on hepatitis B virus transmission are significant predictors of HBV vertical transmission.


Assuntos
Hepatite B/prevenção & controle , Hepatite B/transmissão , Transmissão Vertical de Doença Infecciosa/prevenção & controle , Profilaxia Pós-Exposição/métodos , Complicações Infecciosas na Gravidez/epidemiologia , Adolescente , Adulto , Estudos Transversais , Etiópia/epidemiologia , Feminino , Hepatite B/epidemiologia , Antígenos de Superfície da Hepatite B/sangue , Vacinas contra Hepatite B/administração & dosagem , Humanos , Imunoglobulinas/administração & dosagem , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Gravidez , Fatores de Risco , Adulto Jovem
9.
BMC Infect Dis ; 20(1): 751, 2020 Oct 14.
Artigo em Inglês | MEDLINE | ID: mdl-33054788

RESUMO

BACKGROUND: HIV is a major public health issue, especially in developing countries. It is important to track and design successful intervention programs to explore the spatial pattern, distribution, and associated factors of HIV Seropositivity. This study therefore showed the spatial variation of HIV Seropositivity and related factors in Ethiopia. METHODS: A total sample of 25,774 individual data collected from the 2016 EDHS data were primarily HIV biomarkers, IR, MR, and GPS. Spatial heterogeneity analysis was used with methods such as Morans I, Interpolation, and Kulldorff 's scan statistic. Spatial analysis was conducted using open source tools (QGIS, GeoDa, SaTScan). Multilevel logistic regression analysis was performed using Stata14 to identify HIV-associated factors. Finally, the AOR with a 95% confidence interval was used to report the mixed-effect logistic regression result in the full model. RESULT: The prevalence of HIV / AIDS at national level was 0.93%. The highest prevalence regions were Gambela, Addis Abeba, Harari and Diredawa, accounting for 4.79, 3.36, 2.65 and 2.6%, respectively. Higher HIV seropositive spatial clusters have been established in the Gambela and Addis Ababa regions. Multilevel analysis at the individual level being married [AOR = 2.19 95% CI: (1.11-4.31)] and previously married [AOR = 6.45, 95% CI: (3.06-13.59)], female [AOR = 1.8, 95% CI: (1.19-2.72)], first-sex at age ≤15 [AOR = 4.39, 95% CI: (1.70-11.34)], 18-19 [AOR = 2.67 95% CI: (1.05-6.8)], middle age group (25-34) [AOR = 6.53, 95% CI: (3.67-11.75)], older age group (>34) [AOR = 2.67 95% CI: (1.05-6.8)], primary school [AOR = 3.03, 95% CI: (1.92-4.79)], secondary school [AOR = 3.37, 95% CI: (1.92-5.92) were significantly associated with serropositivity. Regarding household level, place of residence [urban: AOR = 6.13 CI: (3.12, 12.06)], female-headed households (AOR = 2.24 95% CI: (1.57-3.73), media exposure [low exposure (AOR = 0.53 95% CI: (0.33-0.86), no exposure AOR = 0.39 95% CI: (0.23-0.65)] and increased household size [AOR = 0.72 95% CI: (0.65-0.8)] were associated with HIV Seropositivity. CONCLUSION: High cluster HIV cases were found in Gambela, Addis Abeba, Harari, and Diredawa. Having a history of married, start sex at a younger age, female-headed household, urban residence, and lower household size is more affected by HIV/AIDS. So any concerned body work around this risk group and area can be effective in the reduction of transmission.


Assuntos
Soropositividade para HIV/epidemiologia , Síndrome de Imunodeficiência Adquirida/epidemiologia , Adolescente , Adulto , Estudos Transversais , Etiópia/epidemiologia , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Análise Multinível , Prevalência , Fatores de Risco , Análise Espacial , Adulto Jovem
10.
BMC Infect Dis ; 20(1): 750, 2020 Oct 13.
Artigo em Inglês | MEDLINE | ID: mdl-33050903

RESUMO

BACKGROUND: Tuberculosis (TB) is caused by Mycobacterium tuberculosis complex (MTBC). Mapping the genetic diversity of MTBC in high TB burden country like Ethiopia is important to understand principles of the disease transmission and to strengthen the regional TB control program. The aim of this study was to investigate the genetic diversity of Mycobacterium tuberculosis complex (MTBC) isolates circulating in the South Omo, southern Ethiopia. METHODS: MTBC isolates (N = 156) were genetically analyzed using spacer oligotyping (spoligotyping) and mycobacterial interspersed repetitive unit-variable number of tandem repeat (MIRU-VNTR) typing. Major lineages and lineages were identified using MTBC databases. Logistic regression was used to correlate patient characteristics with strain clustering. RESULTS: The study identified Euro-American (EA), East-African-Indian (EAI), Indo-Oceanic (IO), Lineage_7/Aethiops vertus, Mycobacterium bovis and Mycobacterium africanum major lineages in proportions of 67.3% (105/156), 22.4% (35/156), 6.4% (10/156), 1.9% (3/156), 1.3% (2/156) and 0.6% (1/156), respectively. Lineages identified were Delhi/CAS 23.9% (37/155), Ethiopia_2 20.6% (32/155), Haarlem 14.2% (22/155), URAL 14.2%(22/155), Ethiopia_3 8.4% (13/155), TUR 6.5% (10/155), Lineage_7/Aethiops vertus 1.9% (3/155), Bovis 1.3% (2/155), LAM 1.3% (2/155), EAI 0.6% (1/155), X 0.6% (1/155) and Ethiopia H37Rv-like strain 0.6% (1/155). Of the genotyped isolates 5.8% (9/155) remained unassigned. The recent transmission index (RTI) was 3.9%. Orphan strains compared to shared types (AOR: 0.09, 95% CI: 0.04-0.25) were associated with reduced odds of clustering. The dominant TB lineage in pastoral areas was EAI and in non-pastoral areas was EA. CONCLUSION: The epidemiological data, highly diverse MTBC strains and a low RTI in South Omo, provide information contributing to the TB Control Program of the country.


Assuntos
Variação Genética , Mycobacterium bovis/genética , Mycobacterium tuberculosis/genética , Tuberculose Pulmonar/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Alelos , Etiópia/epidemiologia , Feminino , Genótipo , Humanos , Masculino , Pessoa de Meia-Idade , Repetições Minissatélites/genética , Epidemiologia Molecular , Reação em Cadeia da Polimerase Multiplex , Mycobacterium bovis/isolamento & purificação , Mycobacterium tuberculosis/isolamento & purificação , Escarro/microbiologia , Tuberculose Pulmonar/microbiologia , Adulto Jovem
11.
Reprod Health ; 17(1): 152, 2020 Oct 07.
Artigo em Inglês | MEDLINE | ID: mdl-33028424

RESUMO

BACKGROUND: As the global pandemic of corona virus (COVID-19) spreads across continents and communities, people are forced to respond with strict preventive measures such as staying at home and keeping social distance. In relation with these measures, particularly with the staying at home, increasing rates of domestic violence are beginning to surface. Hence, this study was aimed at determining the prevalence of intimate partner violence against reproductive age women in northern Ethiopia during the COVID-19 pandemic. METHODS: A community-based cross-sectional study design was employed. The data were collected during the period of April to May, 2020 using interviews and a self-administered standard questionnaire. The data were entered into the Epi-data manager version 4.2 and exported to SPSS 22 for analysis. The descriptive analysis such as frequency distribution, percentage, and measures of central tendency were used. This was followed by binary and multiple logistic regression analysis to infer the association between the outcome and independent variables. RESULTS: A total of 682 participants were included in the study. The prevalence of intimate partner violence against women was found to stood at 24.6% with psychological violence being the most prevalent (13.3%), followed by physical (8.3%) and sexual violence (5.3%). Women were more likely to suffer from violence if they were housewives (AOR, 95% CI (18.062 (10.088, 32.342))), age less than 30 (AOR, 95% CI (23.045 (5.627, 94.377))), women with arrange marriage (AOR, 95% CI (2.535 (1.572, 4.087))) and women with husband's age being "between" 31-40 (AOR, CI 95% (2.212 (1.024, 4.777))). CONCLUSIONS: This study showed the presence of a relatively high prevalence of intimate partner violence against women. Thus, public reporting of any cases or concerns of abuse is critical and vital to mitigate the problem.


Assuntos
Betacoronavirus/isolamento & purificação , Pesquisa Participativa Baseada na Comunidade , Infecções por Coronavirus/epidemiologia , Violência Doméstica/estatística & dados numéricos , Violência por Parceiro Íntimo/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Delitos Sexuais/estatística & dados numéricos , Parceiros Sexuais/psicologia , Adulto , Infecções por Coronavirus/virologia , Estudos Transversais , Etiópia/epidemiologia , Feminino , Humanos , Masculino , Pandemias , Pneumonia Viral/virologia , Prevalência , Reprodução , Fatores de Risco , Adulto Jovem
12.
J Pregnancy ; 2020: 2856502, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33029400

RESUMO

Objectives: This study was aimed at assessing the magnitude of induced abortion and associated factors among students in Hawassa University, southern region, Ethiopia, 2019. Methods: An institutional-based cross-sectional study was conducted among a total of 422 students selected on the bases of a probability simple random sampling method. A pretested structured questionnaire was used to collect data. Analysis was made with SPSS 20. Descriptive summary and inferential statistics (binary logistic regression) were used with a 95% CI and P value of less than 5% as a level of significance. Findings were presented in tables, figure, and texts. Confidentiality of information was also secured. Results: The prevalence of induced abortion in the study setting was 68.7% (95% CI: 64.15%-73.2%). Participants who used emergency contraceptives had 12 times higher odds of undergoing abortion than those who did not use emergency contraceptives at AOR: 11.95, 95% CI: 5.615-25.326, P < 001. Conclusions: A higher prevalence of induced abortion was observed in the study setting. Contraceptive use was the predictor of induced abortion identified. Concerned bodies were recommended to work on the identified determinant of induced abortion in the study setting.


Assuntos
Aborto Induzido/estatística & dados numéricos , Anticoncepcionais/administração & dosagem , Estudantes/estatística & dados numéricos , Adolescente , Adulto , Estudos Transversais , Emergências , Etiópia/epidemiologia , Feminino , Humanos , Masculino , Valor Preditivo dos Testes , Prevalência , Inquéritos e Questionários , Adulto Jovem
13.
J Pregnancy ; 2020: 6859157, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33029401

RESUMO

Despite several efforts globally, the problem of perinatal mortality remained an unsolved agenda. As a result, it continued to be an essential part of the third sustainable development goals to end preventable child deaths by 2030. With a rate of 33 per 1000 births, Ethiopia has the highest level of perinatal mortality in the world. Thus, determining the magnitude and identifying the determinants are very crucial for evidence-based interventions. A community-based longitudinal study was conducted in Southwest Ethiopia among 3474 pregnant women to estimate the magnitude of perinatal mortality. Then, a case-control study among 120 cases and 360 controls was conducted to identify the determinants of perinatal mortality. Data were collected by using an interviewer-administered questionnaire and analyzed by using SPSS version 20. Multivariate logistic regression analysis was used to identify variables having a significant association with perinatal mortality at p < 0.05. The perinatal mortality rate was 34.5 (95% CI: 28.9, 41.1) deaths per 1000 births. Attending ≥4 ANC visits (AOR = 0.46; 95% CI: 0.23, 0.91), having good knowledge on key danger signs (AOR = 0.27; 95% CI: 0.10, 0.75), and having a skilled attendant at birth (AOR = 0.34; 95% CI: 0.19, 0.61) were significantly associated with a reduction of perinatal mortality. Being a primipara (AOR = 3.38; 95% CI: 1.90, 6.00), twin births (AOR = 5.29; 95% CI: 1.46, 19.21), previous history of perinatal mortality (AOR = 3.33; 95% CI: 1.27, 8.72), and obstetric complication during labor (AOR = 4.27; 95% CI: 2.40, 7.59) significantly increased perinatal mortality. In conclusion, the magnitude of perinatal mortality in the study area was high as compared to the national target for 2020. Care during pregnancy and childbirth and conditions of pregnancy and labor were identified as determinants of perinatal mortality. Hence, interventions need to focus on increasing knowledge of danger signs and utilization of skilled maternity care. Special emphasis needs to be given to mothers with a previous history of perinatal mortality, twin pregnancies, and having obstetric complications.


Assuntos
Assistência Perinatal , Mortalidade Perinatal , Estudos de Casos e Controles , Competência Clínica , Etiópia/epidemiologia , Feminino , Humanos , Lactente , Recém-Nascido , Conhecimento , Modelos Logísticos , Estudos Longitudinais , Masculino , Complicações do Trabalho de Parto , Paridade , Gravidez , Gravidez de Gêmeos , Fatores de Risco , Inquéritos e Questionários
14.
PLoS One ; 15(10): e0239665, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33022006

RESUMO

BACKGROUND: Significant numbers of chronic obstructive respiratory disease patients are readmitted for Acute Exacerbation (AE) within 30 days of discharge. And these early readmissions have serious clinical and socioeconomic consequences. The objective of our study was to determine the rate of readmission within 30 days of discharge and it's predictors among patients treated for acute exacerbations of asthma and chronic obstructive pulmonary disease (COPD). METHODS: A prospective cohort study involving 130 patients (asthma = 59, COPD = 71) was conducted from April-September, 2019, in Jimma Medical Center (JMC), South-West Ethiopia. Socio-demographic, clinical, laboratory, and drug-related data were recorded at admission and during hospital stay. Cox regression analysis was performed to identify risk factors for readmissions following an AE of asthma and COPD. RESULTS: During the study period, 130 (male, 78(60%)) patients were admitted with AE of asthma and COPD. The median age was 59(IQR, 50-70) years. Of 130 patients, 21(18.10%) had a new AE of asthma and COPD that required hospitalization in the 30 days after discharge. The overall median survival time to 30-day readmission was 20 days (IQR, 16-29). Multivariate analysis revealed prolonged use of oxygen therapy (AHR = 4.972, 95% CI [1.041-23.736] and frequent hospital admissions (AHR = 11.482 [1.308-100.793]) to be independent risk factors for early readmissions. CONCLUSION: Early hospital readmission rates for AE of asthma and COPD were alarmingly high. Frequent hospital admission and long-term oxygen therapy during hospital stay were independent predictors of 30-day readmission.


Assuntos
Asma/fisiopatologia , Readmissão do Paciente/tendências , Doença Pulmonar Obstrutiva Crônica/fisiopatologia , Idoso , Estudos de Coortes , Progressão da Doença , Etiópia/epidemiologia , Feminino , Previsões , Hospitalização , Hospitais , Humanos , Tempo de Internação , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Alta do Paciente , Readmissão do Paciente/estatística & dados numéricos , Estudos Prospectivos , Estudos Retrospectivos , Fatores de Risco
15.
BMC Health Serv Res ; 20(1): 913, 2020 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-33008384

RESUMO

BACKGROUND: Novel Coronavirus is a global pandemic affecting all walks of life and it significantly changed the health system practices. Pharmacists are at the front line and have long been involved in combating this public health emergency. Therefore, the study was aimed to explore pharmacy preparedness and response to prevent and control coronavirus disease 2019 (COVID-19). METHODS: A qualitative study was conducted in six pharmacies in Aksum, Ethiopia in May, 2020. We conducted six in-depth interviews with purposively selected key informants. Direct observation measures were made to assess the activities made in the medicine retail outlets for the prevention and control of the pandemic. Interview data were audio-recorded, translated and transcribed verbatim. Thematic analysis was employed to analyze the data and OpenCode version 4.02 software was used to facilitate the data analysis. RESULTS: The thematic analysis has resulted in seven major themes. Good preparedness measures were undertaken to control and prevent COVID-19. Study informants had good knowledge about the pandemic disease and reported they had used different resource materials to update themselves. Preparing of alcohol-based hand-rub, availing finished sanitizers and alcohol, and advising clients to maintain physical distancing were the major counseling information being delivered to prevent the disease. Some tendencies of irrational drug use and false claims of COVID-19 were observed at the beginning of the pandemic. Interview informants had reported they were working with relevant stakeholders and appropriate patient education and support were given to combat the pandemic. CONCLUSION: The study revealed necessary pharmacy services has been rendered to all clients. However, availability of drugs and medical supplies were scarce which negatively affected the optimal delivery of pharmacy services. The government and other responsible bodies should work together to solve such problems and contain the pandemic.


Assuntos
Infecções por Coronavirus/prevenção & controle , Pandemias/prevenção & controle , Assistência Farmacêutica/organização & administração , Farmacêuticos/psicologia , Pneumonia Viral/prevenção & controle , Adulto , Infecções por Coronavirus/tratamento farmacológico , Infecções por Coronavirus/epidemiologia , Etiópia/epidemiologia , Feminino , Pesquisa sobre Serviços de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Preparações Farmacêuticas/provisão & distribução , Farmacêuticos/estatística & dados numéricos , Pesquisa Qualitativa
16.
J Pregnancy ; 2020: 6153146, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33062334

RESUMO

Introduction: Obstetric danger signs are those signs that a pregnant woman will see or those symptoms that she will feel which indicate that something is going wrong with her or with the pregnancy. Evidence on the prevalence of obstetric danger signs and contributing factors were crucial in designing programs in the global target of reducing maternal morbidity and mortality. Objective: To assess the prevalence of obstetric danger signs during pregnancy and associated factors among mothers in a Shashemene rural district, South Ethiopia. Methods: A community-based cross-sectional study design was conducted among 395 randomly selected women who gave birth in the last six months. A pretested interviewer-administered questionnaire was utilized. Data were cleaned, coded, and entered into Epi data manager version 4.1 and then exported to SPSS version 20. Bivariable and multivariable logistic regression analyses were employed to assess the association between independent variables with the outcome variable. Statistical significance was declared at p < 0.05. Result: One hundred sixty-three (41.3%) of women had a history of obstetric danger signs during pregnancy. The most prevalent obstetric danger signs were vaginal bleeding (15.4%) followed by swelling of the body 12.7% and severe vomiting 5.3%. Women who have less than four times antenatal care visits were 6.7 times more likely to experience obstetric danger signs (AOR 6.7 (95% CI 3.05, 14.85)) compared to those who had antenatal care visit four times and above. Women who have inadequate knowledge of obstetric danger signs were 2.5 times more likely to experience obstetric danger signs during pregnancy (AOR 2.5 (95% CI 1.34, 4.71)), and primigravida women were 6.3 times more likely to have obstetric danger signs during pregnancy (AOR 6.3 (95% CI 2.61, 15.09)) compared to multiparous women. Conclusion: About half of the pregnant mothers have experienced at least one obstetric danger signs. Public health interventions on maternal health should give priority to the prevalent causes of obstetric danger signs, strengthening completion of four antenatal care visits and health education on obstetric danger signs for pregnant mothers at community level especially for primgravid women.


Assuntos
Complicações na Gravidez/epidemiologia , Adolescente , Adulto , Estudos Transversais , Edema/epidemiologia , Edema/etiologia , Edema/prevenção & controle , Etiópia/epidemiologia , Feminino , Número de Gestações , Educação em Saúde , Humanos , Conhecimento , Mortalidade Materna , Gravidez , Complicações na Gravidez/etiologia , Complicações na Gravidez/prevenção & controle , Cuidado Pré-Natal/estatística & dados numéricos , Prevalência , Inquéritos e Questionários , Hemorragia Uterina/epidemiologia , Hemorragia Uterina/etiologia , Hemorragia Uterina/prevenção & controle , Vômito/epidemiologia , Vômito/etiologia , Vômito/prevenção & controle , Adulto Jovem
17.
BMC Infect Dis ; 20(1): 797, 2020 Oct 27.
Artigo em Inglês | MEDLINE | ID: mdl-33109110

RESUMO

BACKGROUND: Delay in the diagnosis of Tuberculosis (TB) remains a major challenge against achieving effective TB prevention and control. Though a number of studies with inconsistent findings were conducted in Ethiopia; unavailability of a nationwide study determining the median time of patient delays to TB diagnosis is an important research gap. Therefore, this study aimed to determine the pooled median time of the patient delay to TB diagnosis and its determinants in Ethiopia. METHODS: We followed PRISMA checklist to present this study. We searched from Google Scholar, PubMed, Science Direct, Web of Science, CINAHL, and Cochrane Library databases for studies. The comprehensive search for relevant studies was done by two of the authors (MA and LY) up to the 10th of October 2019. Risk of bias was assessed using the Newcastle-Ottawa scale adapted for observational studies. Data were pooled and a random effect meta-analysis model was fitted to provide the overall median time of patient delay and its determinants in Ethiopia. Furthermore, subgroup analyses were conducted to investigate how the median time of patient delay varies across different groups of studies. RESULTS: Twenty-four studies that satisfied the eligibility criteria were included. Our meta-analysis showed that the median time of the patient delay was 24.6 (95%CI: 20.8-28.4) days. Living in rural area (OR: 2.19, 95%CI: 1.51-3.18), and poor knowledge about TB (OR: 2.85, 95%CI: 1.49-5.47) were more likely to lead to prolonged delay. Patients who consult non-formal health providers (OR: 5.08, 95%CI: 1.56-16.59) had a prolonged delay in the diagnosis of TB. Moreover, the narrative review of this study showed that age, educational level, financial burden and distance travel to reach the nearest health facility were significantly associated with a patient delay in the diagnosis of TB. CONCLUSIONS: In conclusion, patients are delayed more-than three weeks in the diagnosis of TB. Lack of awareness about TB, consulting non-formal health provider, and being in the rural area had increased patient delay to TB diagnosis. Increasing public awareness about TB, particularly in rural and disadvantaged areas could help to early diagnosis of TB.


Assuntos
Diagnóstico Tardio , Mycobacterium tuberculosis , Tuberculose Pulmonar/diagnóstico , Tuberculose Pulmonar/epidemiologia , Fatores Etários , Atitude Frente a Saúde , Conscientização , Etiópia/epidemiologia , Instalações de Saúde , Humanos , Fatores de Risco , População Rural , Fatores de Tempo , Tuberculose Pulmonar/microbiologia
18.
BMC Infect Dis ; 20(1): 803, 2020 Oct 29.
Artigo em Inglês | MEDLINE | ID: mdl-33121458

RESUMO

BACKGROUND: Soil-transmitted helminths are more prevalent in tropics and sub-tropics including Ethiopia. Despite their high prevalence, direct saline microscopy with its low sensitivity has been used as a diagnostic method in almost all health facilities in Ethiopia. Alternative diagnostic methods which have higher sensitivity are not yet implemented. Therefore, this study aimed to compare and evaluate the performance of diagnostic methods for soil transmitted helminths. METHODS: A cross-sectional study among 520 school children was conducted from October to December, 2019 in Amhara National Regional State. The study participants were selected using systematic random sampling technique. Stool samples were processed via formol ether concentration, Kato-Katz, spontaneous tube sedimentation and agar plate culture techniques. Data was entered into Epi-data version 3.1 and analysis was done using SPSS version 20.0. The sensitivity, specificity, and negative predictive value were calculated against the combined result. Strength of agreement of the diagnostic methods was determined by Kappa value. RESULTS: The Overall prevalence of soil transmitted helminths was 40.8% using combination of methods. The prevalence 24.4, 22.5, and 32.4%, respectively was recorded by using formol ether concentration, Kato-Katz and spontaneous tube sedimentation. The highest prevalence of hookworm (29.2%) was detected by the agar plate culture. The sensitivity and negative predictive value of formol ether concentration were 57.9 and 78.4%, for Kato-Katz thick smear 55.2 and 76.4%, for spontaneous tube sedimentation were 79.2 and 87.5% to soil transmitted helminths detection, respectively. The sensitivity and negative predictive value of agar plate culture to hookworm detection were 86.4 and 93.5%, respectively. CONCLUSION: Spontaneous tube sedimentation shows higher sensitivity in the detection of soil transmitted helminth infections. Agar plate culture method also indicated better performance for hookworm detection than other methods. Therefore, the employment of spontaneous tube sedimentation technique for routine laboratory and agar plate culture for research purposes will significantly aid in accurate diagnosis of parasitic infections.


Assuntos
Ancylostomatoidea/isolamento & purificação , Testes Diagnósticos de Rotina/métodos , Infecções por Uncinaria/diagnóstico , Infecções por Uncinaria/transmissão , Solo/parasitologia , Adolescente , Animais , Criança , Estudos Transversais , Etiópia/epidemiologia , Fezes/parasitologia , Feminino , Formaldeído , Infecções por Uncinaria/epidemiologia , Infecções por Uncinaria/parasitologia , Humanos , Masculino , Microscopia/métodos , Prevalência , Sensibilidade e Especificidade
19.
PLoS One ; 15(9): e0238629, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32915835

RESUMO

BACKGROUND: Globally, every year greater than twenty million newborns are born weighing less than 2500grams, of which over 96% of them were in developing countries. It contributes to sixty to eighty percent of all neonatal deaths, annually. These infants weighing less than 2500gram will have a poor immune system and are at risk of morbidity and mortality. This study was aimed to investigate the survival status and predictors of mortality among neonates admitted with low birth weight at public hospitals in Ethiopia. METHOD: A prospective cohort study was conducted among selected 216 newborns admitted with low birth weight who were admitted in neonatal intensive care unit at Arba Minch General hospital, Sawla General Hospital and Chencha district hospital from 1st March 2018 to 28st February 2019. Data were entered into Epi data version 3.02 and exported to STATA V 14 for analysis. The Kaplan Meier survival curve together with log rank test was used to estimate the survival time of the newborns. Variables which had p-value <0.05 in multivariable analysis using the cox proportional hazard model were declared as statistically significant. RESULT: The cumulative proportion of surviving at the end of third days was 99.01% (95%CI: 96.11, 99.75). Similarly it was 97.81% (95%CI: 94.25, 99.18), 96.27% (95%CI: 91.76, 98.33) and 94.33% (95%CI: 88.72, 97.19) at the end of fourth, fifth and sixth day respectively. The overall mean survival time was 17.13 days (95%CI: 12.76, 21.49). The incidence of mortality among neonates admitted with low birth weight was 83 per 1000 live births. Mothers with DM (AHR:4.79; 95%CI:1.15, 19.8), maternal HIV infection(AHR:6.47;95%CI:1.43,29.3), not keeping the newborn under KMC(AHR:13.0;95%CI:3.42, 49.5) and initiating exclusive breast feeding within one hour(AHR:0.19;95%CI:0.04, 0.95) were statistically significant in multivariable cox regression analysis. CONCLUSION: The risk of mortality among neonates admitted with low birth weight was high at the early admission period and the incidence of mortality was high. Maternal history of diabetes mellitus, HIV/AIDS infection, keeping the newborn under kangaroo mother care and exclusive breast feeding initiation were statistically significant predictors of mortality. Special emphasis should be given for neonates with low birth weight at the early follow up periods and Kangaroo mother care practice should be a usual practice.


Assuntos
Infecções por HIV/epidemiologia , Mortalidade Infantil , Recém-Nascido de Baixo Peso , Morte Perinatal , Criança , Etiópia/epidemiologia , Feminino , Infecções por HIV/complicações , Infecções por HIV/virologia , Hospitalização , Hospitais Públicos , Humanos , Lactente , Recém-Nascido , Unidades de Terapia Intensiva Neonatal , Método Canguru , Estimativa de Kaplan-Meier , Masculino , Modelos de Riscos Proporcionais
20.
PLoS One ; 15(9): e0239013, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32931502

RESUMO

BACKGROUND: Although antiretroviral therapy (ART) significantly improves the survival status and quality of life among human immunodeficiency virus (HIV)-infected children, loss to follow-up (LTFU) from HIV-care profoundly affecting the treatment outcomes of this vulnerable population. For better interventions, up-to-date information concerning LTFU among HIV-infected children on ART is vital. However, only a few studies have been conducted in Ethiopia to address this concern. Thus, this study aims to identify the predictors of LTFU among HIV-infected children receiving ART at Debre Markos Referral Hospital. METHODS: An institution-based retrospective follow-up study was done among 408 HIV-infected children receiving ART at Debre Markos Referral Hospital between 2005 and March 15, 2019. Data were abstracted from the medical records of HIV-infected children using a standardized data abstracted checklist. We used Epi-Data Version 3.1 for data entry and Stata Version 14 for statistical analysis. The Kaplan-Meier survival curve was used to estimate the survival time. A generalized log-rank test was used to compare the survival curves of different categorical variables. Finally, both bi-variable and multivariable Cox proportional hazard regression models were used to identify the predictors of LTFU. RESULTS: Of 408 HIV-infected children included in the final analysis, 70 (17.1%) children were LTFU at the end of the study. The overall incidence rate of LTFU among HIV-infected children was found to be 4.5 (95%CI: 3.5-5.7) per 100-child years of observation. HIV-infected children living in rural areas (AHR: 3.2, 95%CI: 2.0-5.3), having fair or poor ART drug adherence (AHR: 2.3, 95%CI: 1.4-3.7), children started ART through test and treat approach (AHR: 2.7, 95%CI: 1.4-5.5), and children started protease inhibiter (PI)-based ART regimens (AHR: 2.2, 95%CI: 1.1-4.4) were at higher risk of LTFU. CONCLUSION: This study found that one in every six HIV-infected children lost form ART follow-up. HIV-infected children living in rural areas, having fair or poor ART drug adherence, started ART based on test and treat approach, and taking PI-based ART regimens were at higher risk of LTFU.


Assuntos
Infecções por HIV/epidemiologia , Perda de Seguimento , Adolescente , Antirretrovirais/uso terapêutico , Criança , Pré-Escolar , Etiópia/epidemiologia , Feminino , Seguimentos , Infecções por HIV/tratamento farmacológico , Humanos , Incidência , Estimativa de Kaplan-Meier , Masculino , Modelos de Riscos Proporcionais , Encaminhamento e Consulta , Estudos Retrospectivos , Fatores de Risco
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