ABSTRACT
BACKGROUND: HIV/AIDS is among the most devastating diseases, having multiple effects on the health and well-being of people living with HIV/AIDS (PLWHA). There is a paucity of studies that examined the gender differences in perceived stigma among PLWHA and the different coping strategies that they use in Ethiopia. OBJECTIVE: To assess the gender differences in perceived stigma and coping strategies among PLWHA. METHODS: A comparative cross-sectional study was conducted at Jugal Hospital, Harar, eastern Ethiopia from May 01 to July 30, 2018. A total of 412 (206 females and 206 males) PLWHA were included. Face-to-face interviewer-administered data were collected. Perceived HIV stigma was assessed using the Berger HIV stigma scale. Similarly, the coping strategies were assessed using the Brief Coping Orientation to Problems Experienced (Brief COPE) scale. The data were analyzed using STATA version 13. RESULTS: The mean Berger stigma scale score was 65.3±11.3. The overall perceived stigma mean score was not statistically different between males and females (64.8±10.8 vs 65.8±11.7, p=0.407). Among the four subscales, women reported a higher level of disclosure stigma than men (21.1±5.5 vs 20.3±5.5; p=0.006). Regarding maladaptive coping strategies, men often used substances compared to women (2.8±1.5 vs 2.1±0.4; p<0.001). However, women use behavioral disengagement (4.6±1.1 vs 4.2±1.1; p=0.002) and self-distraction (5.9±1.5 vs 5.5±1.7; p=0.019) more often than men. Females used a higher level of adaptive coping strategies compared to males (42.5±4.9 vs 40.9±6.3, p=0.005). Furthermore, females were found to use more emotional-focused coping than males (27.6±3.2 vs 26.4±4.0; p<0.001). CONCLUSION: Women reported a higher level of disclosure stigma than men and the types of coping strategies used vary between male and female. Thus, interventions to support PLWHA must take into account the gender differences in terms of perceived stigma.
ABSTRACT
Background: Cesarean section (CS) is one of the most recurrently carried out surgical procedures in modern obstetrics. Worldwide, about 18.5 million CSs are conducted annually. Of this, 21-33% are performed in middle-and high-income countries. The effectiveness of the CS in preventing maternal and prenatal mortality and morbidity is medically justifiable. However, cesarean delivery without demanding obstetrical indications, by mere maternal request, may expose the child to several risks over benefits. Therefore, we aim to compare spontaneous vaginal delivery (vaginal delivery other than operative vaginal deliveries) and elective CS (CS before the onset of labor, but not including emergency CS) in decreasing the risk of neonatal respiratory morbidity. Objective: To compare the risk of neonatal respiratory morbidity in ECS and spontaneous vaginal delivery. Methods: A literature search was performed through visiting an electronic database (MEDLINE, PubMed, EMBASE, and CINAHL) and gray literature sources, including Google and Google Scholar, from January 2000 to May 2018. Original observational studies that reported the risk of neonatal respiratory morbidity in relation to mode of delivery conducted in the English language were identified and screened. Joanna Briggs Institute's quality assessment tool for observational studies was used to critically appraise the methodological quality of studies. Synthesis of individual studies was conducted using the Review Manager Software version 5.3 for Windows. Heterogeneity among studies was explored using the Cochran's Q-test and the I 2 statistics. Pooled effect sizes in relative risk ratios with 95% confidence intervals were calculated. The flow of the study was prepared according to the Meta-analysis of Observational Studies in Epidemiology (MOOSE) checklist. Results: Sixteen studies were reviewed. A total of 327,272 neonates born by vaginal delivery and 55,246 born by ECS were included in this study. The risk of neonatal respiratory morbidity was increased by 95% in neonates delivered by ECS (RR = 1.95; 95% CI: 1.40-2.73) as compared with neonates born by spontaneous vaginal delivery. Conclusion: This study investigated the effect of mode of delivery on the respiratory morbidity without considering other risks and found that the ECS has a high risk of developing neonatal respiratory morbidities when compared to spontaneous vaginal delivery. So, we recommend discouraging unnecessary CS. registration: CRD42018104905.
ABSTRACT
In this review, we addressed risk factors for the spread of COVID-19 in the perspective of developing countries, and necessary measures to be undertaken to minimize or control its consequential crisis. Databases such as MEDLINE, PubMed, EMBASE, CINAHL, Web of Science, Scopus and websites of WHO, CDC, and ECDC were searched for relevant information and a narrative analysis approach was followed. As of April 10, 2020, there were a total of 1,674,967 cases and 101,483 deaths from COVID-19 in 210 countries, territories and two international conveyances around the world. During the same period Ethiopia has reported 64 confirmed cases, three deaths and four recoveries. Despite efforts being made to reduce most destinations, international flight especially to and from COVID-19 most hit countries were potential source of virus to the country. Large family size, low prevalence of the soap-based hand-washing practice, poor living conditions and social gatherings are among the main possible risk factors. On the other hand, limited health systems' capacity in terms of trained workforce, medical supplies, diagnostic facilities, and intensive care units are possible challenges to control the pandemic. The current meagre testing capacity in the country that focuses only on suspected symptomatic cases while the virus is reportedly transmits from asymptomatic cases may result in a catastrophe due to its hidden spread in the community. For countries with weak economies, focusing their efforts on preventive measures is the best and yet cost-effective strategy. Some preventive efforts should focus on community health education about physical distancing, hand hygiene, use of personal protective equipment, self-isolation and quarantine in the context of the local situation. It is crucial to enhance self-reporting and community-based family level care to the symptomatic cases and their contacts. Additional care needs to be in place during burial ceremonies of the unavoidably dead bodies to prevent further contamination. The socio-psychological consequences of COVID-19 need to be given appropriate consideration to avoid unnecessary discrimination, stigma and social destructions. Finally, coordinated efforts to increase contact tracing, isolation, testing and treating needs to be strengthened through national and international collaborations
