Eye care utilization among older subjects with visual impairment in Northwest Ethiopia

Purpose: To find out the level of eye care service utilization and its determinants among the elderly visually impaired populations while visiting ophthalmic outreach locations in North Western Ethiopia, 2021. Methods: An ophthalmic outreach-based cross-sectional study was conducted on 852 visually impaired older people. Participants were selected by using a systematic random sampling method from January to July 2021. Data were collected by using an interviewer-administered questionnaire and an ocular examination. The collected data were entered into the Epi Info 7, and analyzed using SPSS 20. A binary logistic regression was fitted. Results: A total of 821 participants, with a response rate of 96.5%, were included in the study. The utilization of eye care services within the past two years prior to the study was 21.1% (95 % CI: 18.2­23.9). Having systemic disease (AOR = 3.2, 95% CI: 1.5­7.0), being a spectacle wearer (AOR = 4.5, 95% CI: 2.0­9.4), having visual impairment at distance (AOR = 2.9; 95% CI: 1.5­5.6), being blind (AOR = 2.9; 95% CI: 1.5­5.6), duration of visual impairment ≤1 year (AOR = 2.5; 95% CI: 1.3­4.9) were all significantly associated. Conclusion: In this study, utilization of eye care services was low. Being visually impaired at distance, being blind, recent onset of visual impairment, being a spectacle wearer, and having systemic disease were all related to the use of eye care services. The commonest barriers to utilization of eye care services were financial scarcity and long distances between eye care facilities.

Psychotic symptoms and its association with substance use disorders among adult prisoners in correctional institution: a facility based cross-sectional study in Southwest Ethiopia

Introduction: The prevalence of psychotic symptoms among prisoners is increasing rapidly throughout the world. It imposes considerable personal and public health burden. In recent years psychotic symptoms among prisoners has been widely emphasized and the current study aimed to assess psychotic symptoms and its association with substance use disorders among adult prisoners in correctional institution in Southwest Ethiopia. Method: Facility based cross-sectional study design was conducted in Jimma Correctional Institution among 336 prisoners selected by systematic random sampling method in June 2017. Data was collected by face-to-face interview using structured questionnaire. Data was analyzed using SPSS version 21.0. Multivariable logistic regression was computed to identify independent associated factors. Results: The prevalence of psychotic symptoms among prisoners was found to be 43%. Poor social support (AOR: 4.12, 95%CI: 1.39-12.66), alcohol use disorder (AOR: 4.03, 95%CI: 1.58-10.27), stressful life events (AOR: 2.19, 95%CI: 1.14-4.21), and common mental disorders (AOR: 5.53, 95%CI: 2.56-11.91) were independently associated with single psychotic symptom. Conclusion: This study showed high prevalence of psychotic symptoms. Psychotic symptoms were significantly associated with poor social support, alcohol use disorder, stressful life events and common mental disorders. It is essential to have screening mechanism and management practice for psychotic symptoms.

Sero-prevalence of Hepatitis B virus surface antigen and associated factors among women of reproductive age in Bench Maji Zone, Southwest Ethiopia: Community based cross-sectional study

Background: Hepatitis B virus infection is one of the leading causes of liver diseases which occurs worldwide particularly in developing countries. It is often caused by prenatal transmission from mother to child or household transmission from a close contact during early childhood. It causes different complications like; jaundice, induces premature labor, and prematurity. Objective: The aim of this study was to estimate the Sero-prevalence of hepatitis B virus surface antigen and associated factors among women of reproductive age in Bench Maji Zone, South West Ethiopia. Methods: A community-based cross-sectional study was conducted from December 15th, 2016, to February 15th, 2017. Multistage sampling technique was applied to select study participants. Logistic regression analysis was applied and p-values < 0.05 was used to see the significant association between dependent and independent variables. Results: A total of 330 participants were included in this study yielding 98.8% response rate. The Sero-prevalence of hbsag among women of reproductive age was 28(8.5%). Having multiple sexual partners (AOR = 18.73, 95% CI = [3.65, 96.21) history of unprotected sex (AOR = 9.39, 95% CI = [1.64, 53.77) were found to be significantly associated with Sero-prevalence of HBV. Conclusions: The Sero-prevalence of HBV infection among women of reproductive age was highly endemic. Hence, behavioral education and communication programs focusing on reduction of risky sexual behaviors should be designed to reduce HBV infection

Sexual coercion at sexual debut and associated factors among young females in rural areas of Boset District, Eastern Ethiopia: a mixed method study

Objectives: Assess the prevalence and associated factors of sexual coercion at sexual debut among young females in rural areas of Boset district, Oromia Region, Eastern Ethiopia. Methods: Cross-sectional community-based study design was conducted using both qualitative and quantitative data collection methods. A sample of 632 young females aged 10-24 years was taken from six rural Kebeles by systematic random sampling for quantitative and data were collected using a pre-tested structured questionnaire. The collected data was analyzed using SPSS version 23. Principally Binary Logistic regression model was fitted. Moreover, eight focus group discussions targeting different groups were held and analyzed thematically. Results: The prevalence of sexual coercion at sexual debut was 36.5% (95%CI: 34.6%- 38.4%) among sexually active respondents. Married young female (AOR, 0.71; 95%CI: 0.42, 0.81), living away from their parents (AOR, 5.07; 95%CI: 1.07,24.01), age group of 15- 19 years (AOR, 0.19; 95%CI: 0. 06, 0.54), alcohol consumption (AOR, 2.44; 95%CI: 1.17, 5.08) and Khat chewing (AOR, 8.30; 95%CI: 1.89, 36.38) were factors predicting the likelihood of having sexual coercion at sexual debut. Conclusion: Sexual coercion at sexual debut is a major public health problem among young females in the study community. The emerging program interventions need to take this problem into consideration

HIVAIDS services quality in health centers of East Shoa zone, Oromia, Ethiopia

Background: HIV/AIDS is a major public health, social and economic problem in Ethiopia. However, little has been done on assessment of the quality of the services given to patients in this country. Objective: To assess the quality of HIV/AIDS services in health centers of East Shoa Zone, Oromia region, Ethiopia. Method: Cross sectional survey was undertaken in selected health centers of East Shoa Zone between February and May 2017. Data was collected using researcher administered structured questionnaire, logistics indicators assessment tool and observation check list. SPSS for windows version 20 was utilized in the analysis of the collected data. Results: The study facilities were providing various services to HIV/AIDS patients. All (100%) and 6(75%) facilities respectively had shortage of trained human power required to give ART and TB services. Regarding ARV medicines availability, majority of the study facilities, 5 (62.50%) reported that they had the stockout of AZT300/3TC150/NVP200 in six months prior to study while 4 (66.7%) of the facilities had the stockout of NVP 240ml (50mg/5ml) syrup on day of visit. Among anti-TB medicines, E100 was out of stock in three facilities (37.5%) on day of visit and INH100 had been out of stock in 4 (50%) of the facilities in six months prior to the study. From OIs medicines, Cotrimoxazole 960mg tablet stocked out in 4 (66.70%) on day of visit and in 5 (83.30%) health centers in six months prior to the study. Considerable number of study facilities, 4 (66.70%) had the stockout of tramadol 50mg tablet on day of visit and ibuprofen 400mg tablet in six months prior to the study, 5 (71.40%). Conclusion: The studied facilities were challenged by different factors including, scarcity of human power, stockout of various HIV/AIDS related medicines and inability to make patients adhere to the services given by the facilities. The consequences of these factors can be dangerous to the patients as well as to the wider public and hence making available the appropriate human resource and HIV/AIDS related commodities including medicines should be the priority for the health facilities and the region to improve the quality of HIV/AIDS services in the study area

Impact of COVID-19 on non-communicable disease management services at selected government health centers in Addis Ababa, Ethiopia

Background: The global pandemic of COVID-19 forced the world to divert resources and asked the public to shelter-in-place, so the diagnosis surveillance system and management of non-communicable diseases has become more challenging. Objective: To identify the impact of COVID-19 on non-communicable diseases management services at government health centers in Addis Ababa, Ethiopia. Methods: Health facility based cross-sectional study was conducted from August to September 2020. A total of 30 health centers were included in this study. Bivariate and multiple logistic regression models were used to assess association between the outcome and independent variables Results: The majority, 24 (80%), of the study participants perceived that the COVID-19 pandemic severely disrupted the non-communicable disease management services. There was a statistically significant association between a decrease in outpatient volume at non communicable disease (NCD) management services (25 (83.3%), P-value: 0.006), closure of population level screening programs of NCDs (22 (73.3%), P-value: 0.007), and closure of disease specific NCD clinics and the occurrence of the COVID-19 pandemic (23 (76.7%), P-value: 0.013). Conclusion: The most critical health-care services for non-communicable diseases management were severely disrupted by the COVID-19 pandemic. Therefore, during public health emergencies, policymakers should ensure continuation of critical clinical services and inform the public about proper service utilization

Activity and participation experiences of people with disabilities in Ethiopia

Ethiopia, as a State Party to the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD), has committed to upholding the rights of people with disabilities in Ethiopia. There is little evidence, however, reflecting the impact of this commitment on the lived experiences of people with disabilities in Ethiopia. Objectives: This study sought to uncover how the experiences of participation and activity shape the enactment of rights for Ethiopians with disabilities as enshrined in the UNCRPD. Method: Analysis of 25 qualitative interviews with people with disabilities and family members living in Ethiopia used a reflexive thematic analysis approach to arrive at central themes. Results: People with disabilities in Ethiopia experience marginalization, distress and practical challenges in both routine daily activities and participation in broader social roles and opportunities. These experiences affect their ability to claim many of the rights afforded by the UNCRPD. Conclusion: Despite legislative efforts to bring about change in Ethiopia, people with disabilities continue to live on the social margins. A meaningful change will require substantial allocation of needed resources by the Ethiopian government to support national-level programs and policy change. It is critical that people with disabilities and their families are engaged in receiving relevant support and serve as change leaders. Contribution: This study illustrates how marginalization, distress and practical challenges in daily activities and social participation arise and are sustained for people with disabilities in Ethiopia. The findings can help to inform the country's efforts to enact the rights of Ethiopians with disabilities as enshrined in the United Nations Convention on the Rights of Persons with Disabilities

Knowledge and Practice about Glasgow Coma Scale Assessment among Nurses Working in Adult Intensive Care Units of Federal Public Hospitals in Addis Ababa, Ethiopia: A Cross-Sectional Study

The Glasgow Coma Scale is a dependable and objective neurological assessment instrument used for determining and recording a patient's level of consciousness. Therefore, the knowledge, practice, and factors affecting Glasgow coma scale evaluation among nurses working in adult intensive care units of federally administered hospitals in Addis Ababa, Ethiopia, were investigated. METHODS: From April 4 to 24, 2020, 121 Adult Intensive Care Unit nurses at Ethiopian federal hospitals participated in an institutional-based cross-sectional survey with a standardized selfadministered questionnaire. The information was entered into Epidata version 3.1 and then exported to SPSS version 25.0 for analysis. Bivariable and multivariable logistic regressions were used to examine the relationships between independent and dependent variables. RESULT: According to this study, nurses working in the Adult Intensive Care Unit of federal hospitals in Addis Ababa, Ethiopia, had poor knowledge (51.2%) and poor practice (62%) of the Glasgow Coma Scale's basic theoretical notions and competencies. Furthermore, the education and gender of nurses were linked to their level of knowledge and clinical practice. Being a male and having a master's degree were both significantly linked with knowledge (AOR = 4.13, 95% CI: (1.87­9.1)), (AOR=7.4, 95% CI: (1.4-38)) and practice (AOR = 2.7, 95% CI: (1.2­6)), (AOR = 10.4, 95% CI: (2.0­53)) respectively. CONCLUSION: The findings from this study showed that nurses had poor knowledge and application of practice-related clinical scenarios on the Glasgow Coma Scale

Electroencephalographic Findings, Antiepileptic Drugs and Risk Factors of 433 Individuals Referred to a Tertiary Care Hospital in Ethiopia

Little is known about the characteristics of electroencephalogram (EEG) findings in epileptic patients in Ethiopia. The objective of this study was to characterize the EEG patterns, indications, antiepileptic drugs (AEDs), and epilepsy risk factors. METHODS: A retrospective observational review of EEG test records of 433 patients referred to our electrophysiology unit between July 01, 2020, and December 31, 2021. Results: The age distribution in the study participants was right skewed unipolar age distribution for both sexes and the mean age of 33.8 (SD=15.7) years. Male accounted for 51.7%. Generalized tonic clonic seizure was the most common seizure type. The commonest indication for EEG was abnormal body movement with loss of consciousness (35.2%). Abnormal EEG findings were observed in 55.2%; more than half of them were Interictal epileptiform discharges, followed by focal/or generalized slowing. Phenobarbitone was the commonest AEDs. A quarter (20.1%) of the patients were getting a combination of two AEDs and 5.2% were on 3 different AEDs. Individuals taking the older AEDs and those on 2 or more AEDs tended to have abnormal EEG findings. A cerebrovascular disorder (27.4%) is the prevalent risk factor identified followed by brain tumor, HIV infection, and traumatic head injury respectively. CONCLUSION: High burden of abnormal EEG findings among epileptic patients referred to our unit. The proportion of abnormal EEG patterns was higher in patients taking older generation AEDs and in those on 2 or more AEDs. Stroke, brain tumor, HIV infection and traumatic head injury were the commonest identified epilepsy risk factors

Trends and Challenges in Access to Essential Medicines in Ethiopia and the Contributions of Local Pharmaceutical Production

Decades ago, the United Nations declared that access to essential medicines was a key element of universal human rights. Accordingly, member states have been striving to address this issue through strategic policies and programs. Strengthening local pharmaceutical production has been a pivotal strategy adopted by many developing countries including Ethiopia. The government of Ethiopia identified local pharmaceutical production as a key industrial sector and has been implementing a ten-years strategic plan to improve capabilities and attract investment. Such support is needed because local production could satisfy only 15 to 20% of the national demand, typically from a limited portfolio of medicines in conventional dosage forms. The increasing prevalence of chronic diseases has accentuated the need for a more sustainable supply to reduce reliance on imports and increase access to essential medicines. A full understanding of the structure, constraints and complexities of the Ethiopian pharmaceutical market structure is vital to direct effective policies, target most impactful investments and exploit opportunities for leapfrogging. Hence, the purpose of this review was to assess the trends and challenges in access to essential medicines and local pharmaceutical production in Ethiopia. Literature search through major databases and review of policy documents and performance reports from relevant sector institutions were made to extract information for the review

Activity and participation experiences of people with disabilities in Ethiopia

Ethiopia, as a State Party to the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD), has committed to upholding the rights of people with disabilities in Ethiopia. There is little evidence, however, reflecting the impact of this commitment on the lived experiences of people with disabilities in Ethiopia. Objectives: This study sought to uncover how the experiences of participation and activity shape the enactment of rights for Ethiopians with disabilities as enshrined in the UNCRPD. Method: Analysis of 25 qualitative interviews with people with disabilities and family members living in Ethiopia used a reflexive thematic analysis approach to arrive at central themes. Results: People with disabilities in Ethiopia experience marginalisation, distress and practical challenges in both routine daily activities and participation in broader social roles and opportunities. These experiences affect their ability to claim many of the rights afforded by the UNCRPD. Conclusion: Despite legislative efforts to bring about change in Ethiopia, people with disabilities continue to live on the social margins. A meaningful change will require substantial allocation of needed resources by the Ethiopian government to support national-level programmes and policy change. It is critical that people with disabilities and their families are engaged in receiving relevant support and serve as change leaders. Contribution: This study illustrates how marginalisation, distress and practical challenges in daily activities and social participation arise and are sustained for people with disabilities in Ethiopia. The findings can help to inform the country's efforts to enact the rights of Ethiopians with disabilities as enshrined in the United Nations Convention on the Rights of Persons with Disabilities

Knowledge and perceptions of COVID-19 among government employees in Ethiopia: A cross-sectional study

Background:Knowledge and perceptions of the public about the 2019 coronavirus disease (COVID-19) play a critical role in the prevention of the disease through adopting effective preventive measures. The aim of this study wasto assess the knowledge and perceptions of COVID-19 as well as the source of information about the disease among government employees.Methods:A cross-sectional survey of 1,573 government employees from 46 public institutions located in Addis Ababawas undertaken from 8thto 19thJune 2020.Systematicrandom sampling or consecutive sampling techniques were used to select the study participants. Paper-based self-administeredquestionnaires were used for data collection.ANOVA test and t-test wereused to assess the difference between the groups. Results:The respondents demonstrated very high knowledge of the cause of COVID-19 (93%), its main clinical symptoms (>90%), modes of transmission (89%), and the main preventive measures (>90%).Almost all respondents reportedthat people with travel history (86.8%) or people with closecontact with COVID-19 patients (93.5%) were at higher risk to coronavirusinfection. About 51% of the participants reported that people without travel history or people who had no contact with confirmed cases werealso at risk of infection. About 84% of the respondents perceived those older adults above 60 years were most at risk to die from COVID-19. Themajority of the respondents reported that adults with other underlying health problems (95.4%), cigarette smokers (88.1%) and substanceusers (87.5%) were more likely to die from the disease.Television (32.2%) and health workers (30.5%) constituted the most trusted sources of information related to COVID-19.Conclusions:This study has found higherlevelsof knowledge and perceptionsamong respondents about COVID-19. Efforts should be focused on improving the knowledge, perceived susceptibility, severity, and benefits of preventive measuresby providing timely and adequate informationthrough trusted sources of information.

Changing hygiene behaviours: a cluster-randomized trial, Ethiopia

Objective To investigate vaccine hesitancy leading to underimmunization and a measles outbreak in Rwanda and to develop a conceptual, community-level model of behavioural factors. Methods Local immunization systems in two Rwandan communities (one recently experienced a measles outbreak) were explored using systems thinking, human-centred design and behavioural frameworks. Data were collected between 2018 and 2020 from: discussions with 11 vaccination service providers (i.e. hospital and health centre staff); interviews with 161 children's caregivers at health centres; and nine validation interviews with health centre staff. Factors influencing vaccine hesitancy were categorized using the 3Cs framework: confidence, complacency and convenience. A conceptual model of vaccine hesitancy mechanisms with feedback loops was developed. Findings: A comparison of service providers' and caregivers' perspectives in both rural and peri-urban settings showed that similar factors strengthened vaccine uptake: (i) high trust in vaccines and service providers based on personal relationships with health centre staff; (ii) the connecting role of community health workers; and (iii) a strong sense of community. Factors identified as increasing vaccine hesitancy (e.g. service accessibility and inadequate follow-up) differed between service providers and caregivers and between settings. The conceptual model could be used to explain drivers of the recent measles outbreak and to guide interventions designed to increase vaccine uptake. Conclusion :The application of behavioural frameworks and systems thinking revealed vaccine hesitancy mechanisms in Rwandan communities that demonstrate the interrelationship between immunization services and caregivers' vaccination behaviour. Confidence-building social structures and context-dependent challenges that affect vaccine uptake were also identified.

Objectif Déterminer si une intervention au niveau de l'eau, de l'assainissement et de l'hygiène pourrait avoir une influence sur les comportements en la matière, considérés comme importants dans la lutte contre le trachome. Méthodes Nous avons mené un essai randomisé par grappes dans les régions rurales d'Éthiopie entre le 9 novembre 2015 et le 5 mars 2019. Nous avons réparti aléatoirement 20 échantillons où l'intervention consistait à développer les infrastructures d'assainissement et d'approvisionnement en eau et à promouvoir l'hygiène, et 20 échantillons n'ayant fait l'objet d'aucune intervention. Tous les échantillons du groupe d'intervention ont suivi une formation sur l'hygiène à l'école primaire, disposaient d'un point d'eau communautaire, d'un poste de lavage par ménage, de savon à domicile, et recevaient des visites de la part de travailleurs chargés d'enseigner les bonnes pratiques en matière d'hygiène. Nous avons évalué le niveau d'observance des mesures en effectuant des enquêtes annuelles au sein des foyers. Résultats En l'espace de 3 ans, le nombre de postes de lavage, de savons et de latrines dans les ménages a davantage augmenté dans le groupe d'intervention que dans le groupe de contrôle: la différence de risque s'élevait à 47 points de pourcentage (intervalle de confiance de 95%, IC: 41­53) pour les postes de lavage, à 18 points de pourcentage (IC de 95%: 12­24) pour le savon et à 12 points de pourcentage (IC de 95%: 5­19) pour les latrines. La proportion de gens déclarant se laver le visage au savon était plus grande dans le groupe d'intervention (différence de risque de 21 points de pourcentage; IC de 95%: 15­27 pour les enfants de 0 à 5 ans), tout comme celle mentionnant l'usage de latrines (différence de risque de 9 points de pourcentage; IC de 95%: 2­15 pour les enfants de 6 à 9 ans). Pour de multiples indicateurs, il a fallu attendre minimum un an après l'instauration du programme pour que les variations observées entre les groupes d'intervention et de contrôle deviennent statistiquement significatives; ces variations se sont ensuite maintenues lors des visites ultérieures. Conclusion Intervenir à l'école et au sein de la communauté a permis d'améliorer l'accès à l'hygiène et les comportements en la matière. Néanmoins, cette évolution prend du temps et plusieurs années d'intervention sont nécessaires.

Substance use and associated factors among preparatory school students in Kolfe-Keranyo sub-city of Addis Ababa, Ethiopia

BACKGROUND@#Substance abuse is a worldwide problem that primarily affects adolescents, resulting in chronic health complications as well as psychosocial challenges and economic losses. However, the magnitude of the problem and the factors that contribute to it are not well studied in Ethiopia, particularly in the study area. As a result, this study was carried out to determine the prevalence and associated factors of substance use among preparatory school students in the Kolfe-Keraniyo sub-city of Addis Ababa, Ethiopia.@*METHODOLOGY@#An institution-based cross-sectional study of 383 randomly selected preparatory school students in the Kolfe-Keraniyo sub-city was conducted. The data were gathered using a pretested self-administered structured questionnaire. Multivariable binary logistic regression analysis was employed to identify factors associated with substance use based on the adjusted odds ratio (AOR) and 95% confidence interval (CI) with p values less than 0.05.@*RESULT@#This study revealed that the lifetime prevalence of substance use among preparatory students in Kolfe-Keraniyo sub-city, Addis Ababa, Ethiopia, was 26.5% (95% CI, 22.2, 30.7%). Specifically, 16% drunk alcohol, 9.6% smoked cigarette, and 9.4% chewed khat. The 16.3% were current users, of which 8.3% were drinkers, 6.4% were smokers, and 5.9% were khat chewers. Substance use was significantly associated with being male (AOR, 3.3; 95% CI, 1.284, 8.613), having alcohol drinking family member (AOR, 4.0; 95% CI, 1.704, 9.196), having khat chewing family member (AOR, 2.87; 95% CI, 1.161, 7.070), poor school substance use controlling rule (AOR, 6.64; 95% CI, 1.863, 23.687), availability of substance retailing shops in residential areas (AOR, 2.9; CI, 1.303, 6.606), strong relationship with parents (AOR, 0.005; 95% CI, 0.001, 0.026), and being member of school mini-media (AOR, 0.177; 95% CI, 0.048, 0.657).@*CONCLUSION@#According to the findings of this study, one-quarter of the study participants were substance users. Alcohol, khat, and cigarettes were all commonly used substances. Gender, parent-child relationship, family member substance use history, school substance use controlling rules, school mini-media and pro-social involvement, and the availability of substance retailing shops were all strongly associated with substance use. Strengthening school rules on substance use, controlling substance retailing shops near schools and residential areas, and providing students with health education are all strategies for reducing substance use among students.

Respiratory symptoms related to flour dust exposure are significantly high among small and medium scale flour mill workers in Ethiopia: a comparative cross-sectional survey

BACKGROUND@#International Labour Organization (ILO) report indicates more than 2.4 million workers die from work-related diseases and accidents each year. Work-related respiratory ailments related to airborne particulate matter such as flour dust are responsible for about 386,000 deaths and 6.6 million illness-adjusted life years. Even though exposure to flour dust together with the extreme expansions of flour mill sectors is a priority health concern, extent of the problem is little investigated in Ethiopia. The aim of this study was to evaluate the magnitude and risk factors of work-related respiratory symptoms among flour mill workers in Bahir Dar City, Ethiopia.@*METHODS@#This study employed a comparative cross-sectional survey of 560 samples (280 exposed group from flour mill workers and 280 unexposed group from office workers) with a stratified random sampling technique. The study was conducted from March to April 2019 in Bahir Dar City, Northwest Ethiopia. We used the British Medical Research Council (BMRC) questionnaire to assess work-related respiratory symptoms. The questionnaire was pretested and interview administered to collect data. Binary logistic regression analysis was fitted to evaluate significant factors of respiratory symptoms at a < 0.05 p value. Adjusted odds ratio (AOR) with a confidence interval (CI) of 95% was calculated to determine a strength of association.@*RESULTS@#All the sampled participants had fully responded to the interview. The median age of exposed and unexposed groups was 28.5 interquartile range (IQR, 20) and 31 (IQR, 15) years, respectively. The prevalence of work-related respiratory symptoms among flour mill workers was substantially higher than that of among controls, 63.9% and 20.7%, respectively (Χ@*CONCLUSION@#Respiratory symptoms emanating from exposure to various flour dusts were significantly higher among flour mill workers than among the control group. Therefore, we recommend the need to effectively implement health and safety programs that account for the reduction of dust at a source, use of engineering controls (e.g., provision of adequate ventilation systems), use of administrative measures (e.g., training program and health surveillance) and provision of a suitable personal protective equipment (PPE). Furthermore, it is vital to integrate workplace health and safety programs to the wider public health policies and strategies to effectively mitigate the burden of work-related respiratory conditions. We also encourage future studies to evaluate concentration of flour dusts combined with physical examinations to establish plausible associations of respiratory symptoms with dusts of flour mill-related origin.

Survival of HIV/AIDS patients treated under ART follow-up at the University hospital, northwest Ethiopia

INTRODUCTION@#The survival of HIV/AIDS patients on antiretroviral therapy (ART) is determined by a number of factors, including economic, demographic, behavioral, and institutional factors. Understanding the survival time and its trend is crucial to developing policies that will result in changes. The aim of this study was to compare the survival estimates of different subgroups and look into the predictors of HIV/AIDS patient survival.@*METHODS@#A retrospective cohort study of HIV/AIDS patients receiving ART at the University of Gondar teaching hospital was carried out. To compare the survival of various groups, a Kaplan-Meier survival analysis was performed. The Cox proportional hazards model was used to identify factors influencing HIV/AIDS patient survival rates.@*RESULTS@#In the current study, 5.91% of the 354 HIV/AIDS patients under ART follow-up were uncensored or died. Age (HR = 1.051) and lack of formal education (HR = 5.032) were associated with lower survival rate, whereas family size of one to two (HR = 0.167), three to four (HR = 0.120), no alcoholic consumption (HR = 0.294), no smoking and chat use (HR = 0.101), baseline weight (HR = 0.920), current weight (HR = 0.928), baseline CD4 cell count (HR = 0.990), baseline hemoglobin (HR = 0.800), and no TB diseases were associated with longer survival rate.@*CONCLUSIONS@#Fewer deaths were reported in a study area due to high patient adherence, compared to previous similar studies. Age, educational status, family size, alcohol consumption, tobacco and chat usage, baseline and current weight, baseline CD4 cell count, baseline hemoglobin, and tuberculosis (TB) diseases were all significant predictors of survival of HIV/AIDS patients.

Dental caries and associated factors in Ethiopia: systematic review and meta-analysis

BACKGROUND@#Globally, dental caries may be a major public health issue which may be preventable. Many studies have been conducted on dental caries in Ethiopia which present inconsistent results.@*OBJECTIVE@#This meta-analysis was expected to consolidate the findings conducted in various regions of the country and generate country representative information on the burden and its associated factors of dental caries in Ethiopia.@*METHODS@#Our systematic review and meta-analysis was carried out to estimate the pooled prevalence of dental caries and its associated factors in the Federal Democratic Republic of Ethiopia. Medical specialty databases like ScienceDirect, HINARI, Embase, PubMed, Google Scholar, and Cochrane Library were consistently and exhaustively searched. To determine the aggregate prevalence, studies delineating the prevalence of dental caries and associated factors were included. Important data were extracted employing a standardized data extraction tool ready in Microsoft Excel and imported to the STATA version-13 statistical software package for analyses. To assess non-uniformity, the Cochrane Q test statistics and I@*RESULTS@#The result of thirteen studies disclosed that the overall prevalence of dental caries in the Federal Democratic Republic of Ethiopia was found to be 40.98 (31.62, 50.34). Within the subgroup analysis, the uppermost prevalence was determined in Tigray region (46.59% (24.64, 68.54)) whereas the bottom prevalence was determined in Addis Ababa (34.20% (8.42, 59.97)). Dental caries prevalence was considerably high among study subjects who consumed sweet food (OR= 2.4 (95% CI (1.91, 3.01))). But the presence of dental plaque (OR = 5.14 (95% CI (0.67, 39.39))) and habit of tooth- cleaning (OR = 0.71 (95% CI (0.17, 2.96))) were not statistically significant with the outcome of interest.@*CONCLUSION@#Our meta-analysis found that the prevalence of dental caries was comparatively high, and sweet food consumption was the most risk issue for dental caries in Ethiopia. The Ethiopian Federal Ministry of Health ought to offer a lot of attention to strengthen the oral health care system and also the implementation of community-level interference programs.

Biomass-fuelled improved cookstove intervention to prevent household air pollution in Northwest Ethiopia: a cluster randomized controlled trial

BACKGROUND@#Household air pollution from biomass fuels burning in traditional cookstoves currently appeared as one of the most serious threats to public health with a recent burden estimate of 2.6 million premature deaths every year worldwide, ranking highest among environmental risk factors and one of the major risk factors of any type globally. Improved cookstove interventions have been widely practiced as potential solutions. However, studies on the effect of improved cookstove interventions are limited and heterogeneous which suggested the need for further research.@*METHODS@#A cluster randomized controlled trial study was conducted to assess the effect of biomass-fuelled improved cookstove intervention on the concentration of household air pollution compared with the continuation of an open burning traditional cookstove. A total of 36 clusters were randomly allocated to both arms at a 1:1 ratio, and improved cookstove intervention was delivered to all households allocated into the treatment arm. All households in the included clusters were biomass fuel users and relatively homogenous in terms of basic socio-demographic and cooking-related characteristics. Household air pollution was determined by measuring the concentration of indoor fine particulate, and the effect of the intervention was estimated using the Generalized Estimating Equation.@*RESULTS@#A total of 2031 household was enrolled in the study across 36 randomly selected clusters in both arms, among which data were obtained from a total of 1977 households for at least one follow-up visit which establishes the intention-to-treat population dataset for analysis. The improved cookstove intervention significantly reduces the concentration of household air pollution by about 343 μg/m@*CONCLUSIONS@#The biomass-fuelled improved cookstove intervention significantly reduces the concentration of household air pollution compared to the traditional method. This suggests that the implementation of these cookstove technologies may be necessary to achieve household air pollution exposure reductions.@*TRIAL REGISTRATION@#The trial project was retrospectively registered on August 2, 2018, at the clinical trials.gov registry database ( https://clinicaltrials.gov/ ) with the NCT03612362 registration identifier number.

Sítios simbólicos de pertencimento e prevenção e controle da tuberculose: percepções e práticas dos Agentes Comunitários de Saúde no Brasil e na Etiópia / Symbolic sites of belonging and prevention and control of tuberculosis: perceptions and practices of community health workers in Brazil and Ethiopia

Resumo O objetivo do artigo é avaliar a contribuição do DOTS comunitário, do inglês "Directly Observed Treatment Short-Course", nas ações de prevenção e controle da tuberculose na atenção primária no Brasil e na Etiópia, a partir das percepções e práticas dos agentes comunitários de saúde (ACS). Utilizou-se o referencial conceitual e metodológico dos sítios simbólicos de pertencimento, com suas três tipologias: caixas preta, conceitual e operacional. Empregou-se o estudo de dois casos contrastantes, triangulando e complementando informações advindas de entrevistas semiestruturadas com ACS e profissionais de saúde e também observação participante. Os achados destacam o sentido de comprometimento dos ACS como um valor importante nas ações desenvolvidas em ambos contextos. Os principais desafios são a insuficiência de capacitação e supervisão das ações realizadas (caixa conceitual), assim como as dificuldades de acesso (caixa de ferramentas), expressas em distâncias geográficas no caso etíope e em barreiras relacionadas à violência no território, não explicitadas, no contexto brasileiro. Isto implica em um esforço contínuo dos ACS para adaptar suas práticas, respeitando os valores culturais (caixa preta) que dão sentido e direção às suas ações na superação dos desafios.

Abstract This article aims to evaluate the contribution of Community DOTS, Directly Observed Treatment Short-Course, for the prevention and control of Tuberculosis actions in primary care in Brazil and Ethiopia, based on the perceptions and practice of the community health care workers. We employed the Symbolic Sites conceptual-methodological framework, accounting for its three types: Black box, Conceptual box, and Toolbox. The contrasting case study involved triangulating and complementing data collection and analysis from semi-structured interviews with community health workers and health professionals, site observation, and document analysis. The results highlight a sense of commitment as an essential value regarding the activities developed by community health workers in both contexts. The main challenges are the insufficient capacity building and supervision (Conceptual box), and the difficulties related to access (Toolbox), expressed in long geographic distances in the Ethiopian case and barriers related to territory violence, mostly drug trafficking, although not explicit, in the Brazilian context. This implies in a continuous effort for the community health workers to adapt their practices, respecting the cultural values (Black box), in order to direct their actions to overcome these challenges.