Early Postnatal Care Utilization and Associated Factors Among Women Who Give Birth in the Last Six Weeks in Hosanna Town, Southern Ethiopia, 2022.

Background: The early postnatal period is defined as the first 48 h to 7 days after delivery. The early postnatal visit is especially the most critical time for the survival of mothers and newborns, particularly through early detection and management of postpartum complications. Despite the benefits, most mothers and newborns do not receive early postnatal care services from healthcare providers during the critical first few days after delivery. Objectives: This study is aimed at assessing the prevalence of early postnatal care utilization and associated factors among mothers who gave birth within the last 6 weeks in Hosanna town, Southern Ethiopia, from April 20 to May 30, 2022. Method: A community-based cross-sectional study was conducted in Hadiya Zone, Hosanna town, Southern Ethiopia. A simple random sample technique was used to recruit 403 mothers who had given birth in the previous 6 weeks from a family folder. Data was collected through face-to-face interviews using a standardized questionnaire. Binary logistic regression was used to assess the association between outcomes and explanatory variables, and the strength of the association was interpreted using an odds ratio with a 95% confidence interval. In our study, p values of 0.05 were considered statistically significant. Results: The prevalence of early postnatal care utilization among mothers who gave birth within 1 week of the study area was 25.8% (95% CI: 21.7-30.0). No formal and primary educational level of husband (AOR = 0.05, 95% CI: [0.02, 0.16]), antenatal care follow-up (AOR = 2.13, 95% CI: [1.11, 4.1]), length of hospital stay before discharge (≥24 h) (AOR = 0.3, 95% CI: [0.16, 0.55]), and information about early postnatal care utilization (AOR = 3.08, 95% CI: [1.72, 5.52]) were factors significantly associated with early postnatal care utilization. Conclusion: In comparison to World Health Organization standards, the study's overall prevalence of early postnatal care utilization was low. Early postnatal care use was significantly associated with antenatal care follow-up, the husband's educational level, knowledge of early postnatal care use, and length of stay at the health institution following birth. As a result, the strength of health facilities is to improve service provision, information education, and communication.

Suicidal ideation and associated factors among pregnant women attending antenatal care at public hospitals of Harari regional state, eastern Ethiopia: A cross-sectional study.

BACKGROUND: Suicide is a global issue. It is the third responsible for death among the reproductive age group. Pregnancy is a complicated event and crucial in the life of a woman with considerable physiological, hormonal changes, social, and mental changes. However, third-world countries like Ethiopia have not been investigated well. Therefore, the study planned to assess the magnitude and factors associated with suicidal ideation. Furthermore, it will identify the role of hyperemesis gravidarum on suicidal ideation. METHOD: A Cross-sectional study was employed for 543 pregnant participants attending antenatal care at Hiwot Fana Specialized University Hospital and Jugal General Hospital, Harari regional state, eastern Ethiopia from June 1 to August 1, 2022. The recruited participants were selected by systematic random sampling method. Suicide was assessed using Composite International Diagnostic by interview methods data collection. Epi data and STATA version 14.1 were used for data entry and analysis respectively. Candidate variables were entered into a multivariate logistic regression then those variables that have p-value < 0.05 were considered as significantly associated. RESULTS: The magnitude of suicidal ideation in this study was found to be 11.15% at (95% CI: 8.75-14.11). Regarding the associated factor, unwanted pregnancy (AOR = 3.39: at 95% CI = 1.58-7.27), Hyperemesis gravidarum (AOR = 3.65: at 95% CI = 1.81-7.34), having depressive symptoms (AOR = 2.79: at 95% CI = 1.49-5.23), having anxiety symptoms (AOR = 3.37; at 95% CI = 1.69-6.68), experiencing intimate partner violence (AOR = 2.88: at 95% CI = 1.11-7.46), and having stress (AOR = 3.46; at 95% CI = 1.75-6.86) were significantly associated variable with suicidal ideation among pregnant women. CONCLUSION AND RECOMMENDATION: This study revealed that suicidal ideation is common among pregnant women. Regarding the associated factors unwanted pregnancy, hyperemesis gravidarum, having depressive and anxiety symptoms, experiencing intimate partner violence, and stress were significantly associated with suicidal ideation. Thus, giving awareness and early screening and interferences for antenatal suicide should be warranted.

Depressive disorder, bipolar disorder, and associated factors among adults, in the Eastern part of Ethiopia.

BACKGROUND: Depressive disorder is one of the severe and common mental illnesses in the general population. Bipolar disorder is a severe, persistent mental illness associated with significant morbidity and mortality. However, there is a paucity of data on the prevalence of depressive disorder, and bipolar disorder in our study area. OBJECTIVE: This study aimed to assess the prevalence of depressive and bipolar disorders among adults in Kersa, Haramaya, and Harar Health and Demographic Surveillance Sites in Eastern Ethiopia. METHODS: A community-based cross-sectional study was conducted among 1,416 participants. A multi-stage sampling was employed to select the participants. DSM-5 diagnostic criteria was used to assess depressive disorder and bipolar disorder. Data was collected using a standard questionnaire. Data were entered into Epi-Data 3.1 and analyzed using SPSS version 26. Both binary and multivariate logistic regression analyses were done. Those with a p-value < 0.05 in the final model were considered statistically significant. RESULTS: The overall prevalence of depressive and bipolar disorders among our study participants was 6.7% (95% CI: 5.40, 8.20) and 2.1% (95% CI: (1.40, 3.00), respectively. The independent predictors of depressive disorder included a family history of mental illness, chronic medical illnesses, unemployment, low educational status, divorced or widowed, poor social support, and current alcohol use or khat chewing. Single, males, divorced or widowed, and current consumers of alcohol were independent predictors for bipolar disorder. CONCLUSIONS AND RECOMMENDATION: The results of our investigation showed that bipolar illness and depression were significant public health issues. It was shown that although bipolar disorder is highly prevalent in the society, depression is a widespread concern. As a result, it is imperative that the relevant body grow and enhance the provision of mental health services. Furthermore, research on the effects and burdens of bipolar disorder in the community is required.

Preoperative anxiety and associated factors among adult surgical patients in public hospitals, eastern Ethiopia.

Objective: This study aimed to assess the prevalence of preoperative anxiety and associated factors among adult surgical patients in public hospitals of eastern Ethiopia from 25 April to 26 May 2022. Methods: An institutional-based cross-sectional study was undertaken using a systematic sampling technique among 423 participants from patients eligible for elective surgery. The prevalence of preoperative anxiety was assessed using the state and trait anxiety inventory measurement scale. Data were analyzed using SPSS version 26. Descriptive and summary statistics were computed. Binary and multivariable logistic regression were computed. The strength of the association was presented using an adjusted odds ratio with a 95% confidence interval and statistical significance was declared at a p-value < 0.05. Results: The prevalence of preoperative anxiety among patients scheduled for elective surgery was 51.2%. Being 31-45 aged adult (AOR = 0.36; 95% CI = 0.17, 0.78), having moderate (AOR = 0.46; 95% CI = 0.22, 0.96) and strong social support (AOR = 0.04; 95% CI = 0.02, 0.08), being single (AOR = 0.19; 95% CI = 0.04, 0.89), listening to music (AOR = 0.37; 95% CI = 0.18, 0.74) and finding social and religious support (AOR = 0.15; 95% CI = 0.07, 0.33), and orthopedic surgery (AOR = 0.21; 95% CI = 0.10, 0.43) were significantly associated with lower odds of preoperative anxiety, whereas having fear of death (AOR = 1.16; 95% CI = 0.64, 2.09) was significantly associated with increased odds of preoperative anxiety. Conclusion: In the current study, the magnitude of preoperative anxiety was high. Being an older adult and having social and treatment support was associated with lower odds of preoperative anxiety. In contrast, lower psychological readiness (fear of death) was associated with increased odds of preoperative anxiety. Patients should be routinely assessed for anxiety during the preoperative appointment, and the proper coping mechanisms and anxiety-reduction approaches should be used. It is also advisable that appropriate policies and procedures for reducing preoperative anxiety should be devised.

Suicidal and aggressive behavior among populations within institutional quarantine and isolation centers of COVID-19 in eastern Ethiopia: A cross-sectional study.

INTRODUCTION: The coronavirus disease is still not under the control globally and has caused various mental health problems such as depression, anxiety, suicide, and aggressive behavior in different populations. The pandemic-related issues which are applied to control the pandemic such as protection measures against COVID-19, social distancing, isolation, and quarantine can also trigger mental health problems. OBJECTIVE: This study aimed to assess suicidal behavior and aggression, and its correlates during COVID-19 among populations within institutional quarantine and isolation centers in Ethiopia. METHOD: A cross-sectional study was conducted among a sample of 392 participants. The convenience sampling method was used to select the study participants. Suicide Behavioral Questionnaire-Revised (SBQ-R) and the Modified Overt Aggression Scale (MOAS)were applied to determine the suicide and aggressive behavior of study participants respectively. Epi-data 3.1 and SPSS 20.0were used to enter and analyze the data respectively. Logistic and linear regressions were fitted to explore correlates associated with suicidal behavior and aggression respectively. RESULTS: The prevalence of suicidal behavior was 8.7% (95% CI: 6.1, 11.5) whereas the mean total score of behavioral aggression was 2.45±5.90 (95% CI: 1.84, 3.08). Being female (AOR = 2.63, 95% CI: 1.09, 6.32), having common mental disorders (AOR = 6.08, 95% CI: 2.32, 15.93), manifesting the symptoms of COVID-19 (AOR = 2.17, 95% CI: 1.48, 2.86), and poor social support (AOR = 7.30, 95% CI: 1.44, 37.10) were significantly associated with suicidal behavior, whereas male gender (ß coefficient = 3.0, 95% CI: 1.35, 4.70), low level of knowledge about COVID-19 (ß coefficient = 1.87, 95% CI: 1.09, 3.41), and substance use (ß coefficient = 1.7, 95% CI: 1.23, 6.47) were positively associated with mean overt aggression score. CONCLUSION: The present study revealed that suicidal and aggressive behaviors were prevalent with significant correlates. Therefore, it is important and required to provide focused mental health and psycho-social services for the selected and high-risk populations such as those in quarantine and isolation centers for being suspected.

Common mental disorders amongst frontline healthcare workers during the COVID-19 pandemic in Ethiopia: A cross-sectional study.

Background: A novel coronavirus had a profound physiological and psychological burden with regards to contracting the disease or uncertainties in the care of infected patients. Especially, at risk are frontline healthcare workers who are participating in the care of such patients. Aim: This study investigated the burden of mental health problems amongst the frontline health workers during the coronavirus disease 2019 (COVID-19) pandemic in Ethiopia. Setting: East Hararghe Zone of Oromia Region and Harari Regional State, Ethiopia. Methods: A cross-sectional study was conducted in three selected hospitals of COVID-19 treatment centers. Simple random sampling was used to select a sample of 423 participants from each hospital. The self-Reporting Questionnaire (SRQ-20) was used to assess the presence of common mental disorders. Binary and multivariable logistic regressions were fitted to identify factors associated with common mental disorders. Statistical significance was declared at a p-value less than 0.05. Results: The prevalence of common mental disorders amongst frontline healthcare workers was 22.6%. Being female, married, having had direct contact with COVID-19 patients, working in COVID-19 treatment centers and ICU, having any symptoms of COVID-19, current three-month use of any substances, and poor social support were found to be strong predictors of common mental disorders in frontline health workers during COVID-19 pandemic in Ethiopia. Conclusion: The considerable proportions of frontline health care workers have common mental health problems. Strategies need to address COVID-19 related mental health problems, and integrate psychosocial intervention to support the frontline health workers is paramount.

Anxiety and Associated Factors Among Clients on Highly Active Antiretroviral Therapy (HAART) in Public Hospitals of Southern Ethiopia: A Multi-Center Cross-Sectional Study.

Background: Anxiety is an unpleasant feeling of fear, apprehension, and nervousness without any apparent stimulus. Anxiety is one of the co-morbidities that are often overlooked in treating patients with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS). Anxiety is worse among people with HIV/AIDS than the general population. Few studies have been conducted on prevalence of anxiety in people receiving antiretroviral treatment and limited evidence is available on its associated factors. Therefore, the objective of this study was to investigate the magnitude and associated factors of anxiety among clients on highly active antiretroviral therapy in public hospitals of Southern Ethiopia. Methods: An institution-based cross-sectional study was conducted in public hospitals of Southern Ethiopia. Simple random sampling method was used to recruit study participants. Data collection was done by using a structured questionnaire regarding medical data related to HIV/AIDS. Seven items of the Hospital Anxiety and Depression Scale (HADS) were also used to measure the anxiety level. Oslo social support scale and perceived stigma scale were used to measure social support and stigma respectively. Bivariate and multivariate logistic regression analyses were computed with 95% CI to identify different explanatory variables. Significance was declared at p<0.05. Multi-collinearity was checked by variance inflation factors and Hosmer-Lemeshow test was used to check model fitness. Results: Prevalence of anxiety among clients on HAART in selected public hospitals of Southern Ethiopia was found to be 25.6%. Females (AOR=3.24, 95% CI [1.32, 7.97]), being widowed (AOR=5.47, 95% CI [1.08, 29.72], monthly income 1425-2280 Ethiopian birr (AOR=7.29, 95% CI [2.55, 20.88]), comorbid conditions (AOR=5.47, 95% CI [1.92, 15.62]), perceived stigma (AOR=8.34, 95% CI [3.49, 19.91]) were factors associated with anxiety. Conclusion: Approximately one-fourth of participants living with HIV/AIDS had anxiety. Being female, widowed, medium income, comorbid conditions, and perceived stigma were significantly associated with anxiety. This finding highlights the importance of mental health assessment, early detection and treatment of anxiety as an integral component of HIV/AIDS care.

Magnitude and factors associated with anemia among pregnant women admitted to labor ward of Hiwot Fana Specialized University Hospital, Eastern Ethiopia.

OBJECTIVES: Anemia is a common medical problem among pregnant women that will influence pregnancy and birth outcomes. In Ethiopia, there is a paucity of evidences regarding the problem among pregnant women admitted to labor ward. Therefore, the objective of this study was to assess the magnitude and factors associated with anemia among pregnant women admitted to labor ward for deliveries at Hiwot Fana Specialized University Hospital, Eastern Ethiopia. METHODS: A cross-sectional study was conducted among 314 pregnant women admitted to labor ward at Hiwot Fana Specialized University Hospital in June 2020. Data were collected using an interviewer administered questionnaire and were entered into EpiData and analyzed using SPSS. Descriptive statistics and multiple logistic regression analysis were done to identify predictors of anemia. RESULTS: In this study, the magnitude of anemia was 37.9% (95% confidence interval: 32.4, 43.0). Short birth interval (adjusted odds ratio = 2.5; 95% confidence interval: 1.02, 6.13), history of blood loss during pregnancy (adjusted odds ratio = 4.3; 95% confidence interval: 1.86, 9.9), less consumption of citrus fruit within a week (adjusted odds ratio = 2.9; 95% confidence interval: 1.2, 6.9), and meal frequency less than three times per day during pregnancy (adjusted odds ratio = 2.2; 95% confidence interval: 1.0, 4.6) were significantly associated with anemia, respectively. CONCLUSION: This study pointed out that more than one-third of pregnant women affected by anemia. Thus, interventions that could reduce anemia, such as counseling about increasing of meal frequency during pregnancy, foods rich in iron, and prevention and management of blood loss are recommended.

Antipsychotic-induced extrapyramidal side effects: A systematic review and meta-analysis of observational studies.

BACKGROUND: Antipsychotic agents are the basis for the pharmacological management of acute and chronic schizophrenia, bipolar disorders, mood disorders with psychotic feature, and other psychotic disorders. Antipsychotic medication use is frequently associated with unfavorable adverse effects such as extrapyramidal side effects (EPSEs). Hence, this systematic review and meta-analysis was aimed to determine the magnitude of antipsychotic-induced EPSEs. METHOD: A literature search was conducted using legitimate databases, indexing services, and directories including PubMed/MEDLINE (Ovid®), EMBASE (Ovid®), google scholar and WorldCat to retrieve studies. Following screening and eligibility, the relevant data were extracted from the included studies using an Excel sheet and exported to STATA 15.0 software for analyses. The Random effects pooling model was used to analyze outcome measures at a 95% confidence interval. Besides, publication bias analysis was conducted. The protocol has been registered on PROSPERO with ID: CRD42020175168. RESULT: In total, 15 original articles were included for the systematic review and meta-analysis. The pooled prevalence of antipsychotic-induced EPSEs among patient taking antipsychotic medications was 37% (95% CI: 18-55%, before sensitivity) and 31% (95% CI: 19-44%, after sensitivity). The prevalence of antipsychotic-induced parkinsonism, akathisia, and tardive dyskinesia was 20% (95% CI: 11-28%), 11% (95% CI: 6-17%), and 7% (95% CI: 4-9%), respectively. To confirm a small-study effect, Egger's regression test accompanied by funnel plot asymmetry demonstrated that there was a sort of publication bias in studies reporting akathisia and tardive dyskinesia. CONCLUSION: The prevalence of antipsychotic-induced EPSEs was considerably high. One in five and more than one in ten patients experienced parkinsonism and akathisia, respectively. Appropriate prevention and early management of these effects can enhance the net benefits of antipsychotics.

Perceived stigma and associated factors among adults with problematic substance use in Northwest Ethiopia.

BACKGROUND: Substance use-related problems including cigarette smoking and alcohol use are among leading preventable risk factors for premature death. However, people with these problems did not get the appropriate treatment they need. Stigma against substance use could be the potential barrier for people with problematic substance use to seek professional help. Therefore, the objective of this study was to investigate magnitude and associated factors of perceived stigma towards problematic substance use. METHODS: A total of 2400 participants were screened using the Cut down, Annoyed, Guilty, and Eye-opener (CAGE) Adapted to Include Drugs (CAGE-AID) questionnaire. We found 540 participants screened positive for problematic substance use (alcohol, hashish, tobacco and khat) and interviewed them for perceived stigma using Perceived Stigma of Substance Abuse Scale (PSAS). Logistic regression was used to examine associated factors with perceived stigma. RESULTS: Three hundred forty-five (63.9%) participants reported perceived stigma above the mean value of Perceived Stigma of Substance Abuse Scale (PSAS). Variables positively associated with perceived stigma were lower wealth and joblessness, history of separation from family members before age of 18 years, poly-substance misuse and awareness about economic crisis of substance use. CONCLUSION: Approximately, three in five people with problematic substance use perceived having been stigmatized by others. Health planning for problematic substance use should focus on stigma.

Depression among Patients with Schizophrenia in Ethiopian Mental Health Hospital: Association with Sociodemographic and Clinical Variables: A Cross-Sectional Study.

BACKGROUND: Depression is a significant contributor to the global burden of disease and affects all individuals throughout their lifetime. Patients with schizophrenia are frequently attacked by depression during their total illness duration. Presence of comorbid depression in schizophrenia makes the patients more deteriorating and disabling course and poor outcome. Aim of the Study. To determine the prevalence of depression and highlight the associated sociodemographic and clinical factors in patients with schizophrenia in a specialized hospital in Addis Ababa, Ethiopia. Setting. This study was conducted at Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia. METHODS: An institutional based cross-sectional study was conducted from May to June 2018. Depression was measured by Calgary Depression Scale for Schizophrenia on 455 samples of patient with schizophrenia and systematic sampling was used to select the study participants. Oslo Social Support Scale and Alcohol, Smoking, and Substance Involvement Screening Test were used to assess social support and substance use factors, respectively. A bivariable and multivariable logistic regression analysis model was performed to control the confounding factors. Odds ratio (OR) with the corresponding 95% confidence interval (95% CI) was determined to evaluate the strength of association. RESULTS: A total of 445 patients responded to the questionnaire, which yields a response rate of 97.8%. The Magnitude of depression among schizophrenia patients was 24.9%. A multivariable logistic regression analysis model showed that being female [AOR 2.00, 95% CI: 1.25-3.18], divorced/widowed [AOR 2.39, 95% CI: 1.04-5.49], current substance use [AOR 1.95, 95% CI: 1.17-3.25], and poor social support [AOR 2.75, 95% CI: 1.35-5.61] were significantly associated with depression in schizophrenia. CONCLUSION: The magnitude of depression among schizophrenia was 24.9%. Being female, divorced/widowed, current substance use, and poor social support were associated with depression among patients with schizophrenia. Regular screening and prompt management of depressive symptoms among patients with schizophrenia is of particular importance to reduce the burden of the condition.

Psychological Burden and Associated Factors of the COVID-19 Pandemic on People in Quarantine and Isolation Centers in Ethiopia: A Cross-Sectional Study.

Background: Globally, a lot of countries put into practice early quarantine measures as an essential COVID-19 prevention mechanism. Other than physical effects, quarantine has a major result on mental health and well-being at both the individual as well as the community level at large. Therefore, this study aimed to assess the psychological burden of COVID-19 on the people in quarantine and isolation centers and to identify associated factors for early and effective psychosocial intervention during the pandemic and beyond. Method: A cross-sectional study was done among 392 suspected cases of COVID-19 that were in quarantine and isolation centers found in Eastern Ethiopia in 2020. Participants were selected by the convenience sampling method. The common mental disorder was measured by the Self Reporting Questionnaire-20 (SRQ-20). Logistic regression was done to identify predictive factors, and a P < 0.05 was considered statistically significant. Results: The common mental disorder among suspected cases of COVID-19 in Ethiopia was found to be 13.5% (95% CI: 10.2, 17.1%). Female (AOR = 1.52, 95% CI: 1.1, 2.92), known chronic medical illness (AOR = 7.0, 95% CI: 2.2, 21.8), inadequate accessibility of personal protective equipment (AOR = 6.1, 95% CI: 2.8, 13.3), poor awareness about the pandemic (AOR = 2.90, 95% CI: 2.71, 7.54), presence of symptoms of the disease (AOR = 5.3, 95% CI: 2.57, 11.1), and substance use (AOR = 2.7, 95% CI: 1.2, 6.1) were found to be associated with a common mental disorder. Conclusion: The current study revealed that the common mental disorder was relatively high among suspected cases of COVID-19 in quarantine and isolation centers as compared with the general population. The results of the present study demonstrate that some subpopulations are more vulnerable to the pandemic's deleterious effects on mental health. Therefore, providing appropriate psychosocial intervention for the populations at risk is important to decrease the effect of common mental disorders among suspected cases of COVID-19.

Current alcohol consumption and associated factors among school adolescents and youths in Ethiopia: A systematic review and meta-analysis.

BACKGROUND: The use of alcohol is an alarmingly growing public health concern worldwide, and it has an impact on younger generations. There are a few large scale and comprehensive nation-wise surveys conducted on the subject matter and study groups. Hence, the purpose of this study was to render strong evidence for policymakers and researchers on the prevalence of alcohol consumption and its associated factors among school adolescents and youths in Ethiopia. METHODS: Systematic searching was conducted using electronic (Medline, EMBASE, PubMed, CINAHL, Web of Science, Scopus, PsycINFO, and Science direct), and grey literature sources. Cross-sectional studies conducted among adolescents and youths (12-24 years old) were included. Joanna Briggs Institute critical appraisal tool was used to assess the quality of studies. Heterogeneity was examined by using forest plot and I2 heterogeneity tests. Publication bias was also assessed by inspecting the funnel plot and Egger's regression test. Stata/M16.0 for windows was used for the analysis. RESULTS: A total of 26 studies were included in the final analysis with a total of 17,880 participants. The pooled prevalence of current alcohol consumption was 27.0% (95% CI = 22.0-32.0). In the subgroups, the prevalence of current alcohol consumption among high school, college, and university students was 23%, 27%, and 29%, respectively. The pooled data revealed that being a male (odds ratio = 1.93; 95% CI = 1.24-2.99), khat chewing (odds ratio = 6.65; 95% CI = 2.52-17.52), family members alcohol consumption behavior (odds ratio = 3.20; 95% CI = 2.08-5.17), and peer pressure (odds ratio = 3.79; 95% CI = 2.64-5.42) were significantly associated with alcohol consumption. CONCLUSION: The pooled analysis of 26 studies indicate that over a quarter of school adolescents and youths consume alcohol in Ethiopia. Hence, we recommend designing and implementing community and school-based intervention programs to tackle the growing problems of alcohol consumption and its multifaceted impacts.

Work-Related Stress and Associated Factors Among Textile Factory Employees in Northwest Ethiopia: A Cross-Sectional Study.

BACKGROUND: Work-related stress is becoming an alarmingly growing public health concern worldwide. Textile factories are among the most common manufacturing industries that have a higher rate of work-related stress. Investigating the prevalence and factors associated with work-related stress will help planners and decision-makers at every level in planning, managing, and evaluating the health status of the employees. Research evidence is limited for work-related stress in Northwest Ethiopia. Therefore, this study was aimed to assess work-related stress and associated factors among textile factory employees in Northwest Ethiopia. METHODS: A cross-sectional study design was employed among 403 employees in Bahir Dar Textile Factory. Data were collected using an interviewer administered questionnaire, then entered into EpiData version 3.1, and analyzed using SPSS version 22 software. Descriptive statistics, bivariate and multivariate logistic regressions were carried out. In logistic regression analysis, adjusted odds ratio (AOR), along with 95% confidence interval (CI), was used to identify the associated factors of work-related stress. A P-value<0.05 was considered as statistically significant. RESULTS: The prevalence of work-related stress was 45.2%, with 95% CI=40.0-50.1%. Working in rotational shifts (AOR=2.33, 95% CI=1.34-4.03), current substance use (AOR=5.67, 95% CI=3.38-9.52), poor and medium social support (AOR=3.75, 95% CI=1.71-8.21 and AOR=3.26, 95% CI=1.39-7.64) were significantly associated factors with work-related stress, respectively. CONCLUSION AND RECOMMENDATION: Near to half of the study participants had work-related stress. Work shift, substance use, and social support were among the factors which affect work-related stress. Thus, interventions that could reduce work-related stress such as stress management programs should be considered.

Relapse and Clinical Characteristics of Patients with Bipolar Disorders in Central Ethiopia: A Cross-Sectional Study.

BACKGROUND: Bipolar disorder is a severe mental illness and has huge morbidity and mortality. Relapse is a challenging treatment failure in patients with mental illness, especially in patients with bipolar which causes high economic and social burdens. In the mental health delivery system, relapse is common and can be defined as becoming ill again after apparent recovery and a worsening condition of psychiatric patients. Due to psychiatric patients that may stop medication on their own in contrary to the advice of mental health professionals, relapse of mood episodes, delayed remission, and residual symptoms usually leads to hospitalization, increased suicide risk, and/or impede psychosocial recover. Therefore, understanding the nature of relapse in patients in low-income countries helps to prevent recurrence and related health care expenses. OBJECTIVE: The objective of this study was to assess the prevalence and factors associated with relapse among patients with bipolar disorders in central Ethiopia. METHOD: Facility-based cross-sectional study was conducted from May to June 2015 at Amanuel Mental Specialized Hospital. Relapse was calculated among 400 samples of people with bipolar disorder, and systematic random sampling was used to select the study participants. Oslo's social support scale and ASSIST were used to identify factors with relapse, and a binary and multivariable logistic regression analysis model was performed to control the confounding factors. Odds ratios (OR) with the corresponding 95% confidence interval (95% CI) were determined to evaluate the strength of association. RESULTS: The prevalence of relapse was 71% among patients with bipolar disorder. The longer morbidity (longer than 5 years) had a higher risk of relapse [adjusted odd ratio (AOR) = 3.91, 95% confidence interval (CI): 2.44 to 6.27], while good medication adherence found to be a protective factor for relapse [AOR = 0.39, 95% CI: 0.22 to 0.72]. CONCLUSION: The prevalence of relapse was found pretty high among patients with bipolar disorders (71%). Working on treatment adherence and controlling the psychopathology is important to prevent relapse among bipolar patients.

The relationship between advanced glycation end products and gestational diabetes: A systematic review and meta-analysis.

INTRODUCTION: Gestational Diabetes Mellitus (GDM) is a condition in which women without history of diabetes experience hyperglycemia during pregnancy, especially at the second and third trimesters. In women who have had GDM, an elevated body mass index (BMI) may have a substantial impact for persistent hyperglycemia in their lives after gestation. Beyond hyperglycemia, increased local oxidative stress directly promotes the formation of Advanced Glycation End-products (AGEs). Hence, this systematic review and meta-analysis was aimed to determine the relationship between the level of AGEs and/or related metabolic biomarkers with GDM. METHODS: Literature search was carried out through visiting electronic databases, indexing services, and directories including PubMed/MEDLINE (Ovid®), EMBASE (Ovid®), google scholar and WorldCat to retrieve studies without time limit. Following screening and eligibility evaluation, relevant data were extracted from included studies and analyzed using Rev-Man 5.3 and STATA 15.0. Inverse variance method with random effects pooling model was used for the analysis of outcome measures at 95% confidence interval. Hedge's adjusted g statistics was applied to calculate the standardized mean difference (SMD) to consider the small sample bias. Besides, meta-regression, meta-influence, and publication bias analyses were conducted. The protocol has been registered on PROSPERO with ID: CRD42020173867. RESULTS: A total of 16 original studies were included for the systematic review and meta-analysis. Compared with women with pregnant controls, the level of AGE was significantly higher in women with GDM (SMD [95% CI] = 2.26 [1.50‒3.02], Z = 5.83, P < 0.00001; I2 = 97%, P< 0.0001). The BMI was also significantly higher in women with GDM (SMD [95% CI] = 0.97 [0.33‒1.62], Z = 2.98, P = 0.003) compared to controls. Regarding specific and related metabolic biomarkers, there was higher level of HOMA-IR (SMD [95% CI] = 0.39 [0.22-0.55], Z = 4.65, P < 0.0001, after sensitivity analysis) and HbA1c (SMD [95% CI] = 0.58 [0.03‒1.12], Z = 2.07, P = 0.04, after sensitivity analysis) in gestational diabetic women. Subgroup analyses indicated that studies conducted in Asia and Europe, at third trimester of pregnancy and blood/plasma AGE samples showed a significant difference in AGE level among women with GDM compared to pregnant controls. What is more, meta-regression with the sample size (regression coefficient (Q) = -0.0092, P = 0.207) and year of publication (Q = 0.0035, P = 0.984) suggested that the covariates had no significant effect on the heterogeneity. CONCLUSION: The study indicated that there was a strong relationship between AGE and GDM. Besides, the BMI and other specific biomarkers showed a significant difference between the two groups indicating the high risk of developing long-standing type 2 diabetes and its complications in gestational diabetic women. Early detection of these biomarkers may play a pivotal role in controlling postpartum diabetic complications.

Childhood hearing impairment and its associated factors in sub-Saharan Africa in the 21st century: A systematic review and meta-analysis.

BACKGROUND: Childhood hearing impairment is still a significant cause of disability in the 21st century in developing countries. Particularly, the burden is more severe in sub-Saharan Africa, where the majority of children with hearing problems is living. Thre are great variations and inconsistencies of available findings conducted in sub-Saharan Africa. Hence, the aim of this review was to determine the pooled prevalence of childhood hearing impairment and its associated factors in sub-Saharan Africa. METHODS: Studies were searched from main databases (PubMed, CINAHL, and African Journals Online), Google Scholar, and other relevant sources using electronic and manual techniques. All observational studies, written in English and conducted among participants (aged less than 18 years) from 2000 to 2018, were eligible. Heterogeneity between included studies was assessed using I2, and publication bias was explored using visual inspection of the funnel plot. Statistical analysis was carried out to determine pooled prevalence using Stata version 14. In addition, subgroup analysis was carried out for the normality criteria of hearing thresholds and characteristics of the study populations. RESULTS: The pooled prevalence of hearing impairment was 10% (95% confidence interval (CI): 9%-11%). The magnitude of hearing impairment varies with the normality criterion used. The most commonly used threshold was 25 and 30 dB hearing level. The prevalence of hearing impairment based on normality criterion (>20 dB, >25 dB, >30 dB, and >35 dB) were 17%, 19%, 2%, and 1%, respectively. While in the questionnaire-based evaluation, the prevalence was 6% (95% CI: 3%-9%). In addition, based on population characteristics, the prevalence of hearing impairment for school or community-based children was 6% (95% CI: 5%-7%) while the prevalence for children with comorbidities was 23% (95% CI: 15%-31%). Chronic suppurative otitis media, impacted cerumen, advanced stage of human immunodeficiency virus, tuberculosis infection, and age of the children were associated with hearing impairment in sub-Saharan Africa. CONCLUSION: Hearing impairment in children and adolescents in sub-Saharan Africa was high, and associated with preventable and treatable risk factors.

Prevalence, associated factors and consequences of substance use among health and medical science students of Haramaya University, eastern Ethiopia, 2018: a cross-sectional study.

BACKGROUND: Substance use has a terrible impact on health, behavior and country's economy because the number of people particularly the youngsters being involved in this practice is increasing rapidly. However, the prevalence, determinants and consequence of substance use in the study area has been overlooked. METHODS: A descriptive quantitative cross-sectional study was conducted among 254 health science students of Haramaya University. The respondents were selected randomly after double stratification based on their department and batch respectively. A pre-tested self-administrable anonymous questionnaire was used. The collected data were entered into epidata version 3.1 and exported to SPSS version 23. Descriptive statistical analysis was done to examine findings. Besides, chi-square (X2) test was considered to examine the nonparametric association of factors with ever substance use. RESULTS: Prevalence of ever substance use for at least one substance was found to be 114(45.4%). Ever khat chewers take the highest percentage [107(93.9%)] followed by ever smokers 45(39.5%) and ever drinkers 44(38.6%). Among these ever substance users, 80(70.2%) were found to be current substance users. Being a preparatory student (26.3%) and freshman at university (57.9%) were critical times to initiate substance use. Sex, monthly income, sexual risk behavior and family history of substance use were found to be significantly associated with being ever substance user as witnessed by their respective X2 values of 19.67, 72.28, 28.99 and 139.72 at P-value = 0.05 and degree of freedom (df = 1). From the overall ever substance users, 31.6% had undesirable health consequences. Among these consequences, anorexia [40 (35.1%)] accounted for the highest percentage followed by insomnia [29 (25.4%)], depression [25 (22%)], gastritis [25 (22%)], dental caries [23 (20.2%)] and increased sexual activity [12 (10.5%)]. CONCLUSION: Prevalence of ever substance use in the study area was relatively high. Therefore attention should be given to the major reasons for substance use mainly orientation of freshman students about better stress coping mechanisms and expansion of adequate recreational activities.

Insomnia among Town Residents in Ethiopia: A Community-Based Cross-Sectional Survey.

BACKGROUND: Insomnia is one of the most common sleep problems throughout the world and a major public health concern among adults in the general population. The aim of this study was to assess the prevalence of insomnia and its associated factors among town adult residents in Ethiopia. METHODS: Community-based cross-sectional study was done among 840 randomly selected adult participants by using standardized and pretested Athens insomnia scale (AIS) to assess insomnia. Systematic random sampling technique was used to get samples of the study participants. Data were entered into Epi-Info and analyzed using SPSS version 20. Descriptive, bivariate, and multivariate logistic regression models were used for analysis. Adjusted odds ratio (AOR) with 95% Confidence Interval (CI) was used to show the odds, and P value < 0.05 was considered as statistically significant. RESULTS: The prevalence of insomnia was found to be 42.9%. Sleep problems were associated with female sex [AOR =2.74, 95% CI; (1.77, 4.24)], age above 48 years [AOR=4.67, 95% CI: (2.32, 9.40)], being single [AOR=2.81, 95% CI (1.59, 4.95)] and widowed [AOR=4.20, 95% CI; (1.60, 11.01)], khat chewing [AOR=1.76,95% CI; (1.19, 2.60)], current tobacco smoking [AOR=3.13, 95% CI; (1.64, 5.95)], caffeinated beverage use [AOR=1.67, 95% CI; (1.12, 2.49)], comorbid medical-surgical disorders [AOR=2.03, 95% CI; (1.18, 3.48)], common mental disorders [AOR=8.92, 95% CI; (5.93,13.44)], and noise at bed time [AOR=2.13 95% CI; (1.20, 3.78)]. CONCLUSION: The prevalence of insomnia has to be found high and associated with many area related factors. It is important to pay attention in urban settings and large scale studies recommended.

Magnitude and associated factors of aggressive behaviour among patients with bipolar disorder at Amanual Mental Specialized Hospital, outpatient department, Addis Ababa, Ethiopia: cross-sectional study.

BACKGROUND: Aggressive behavior is a challenging behavior among bipolar patients that causes poor social interaction and hospitalization. But, there is no information regards of the magnitude and contributing factors for aggressive behaviour among bipolar patients in Ethiopia. Therefore, this study was designed to assess the prevalence and associated factors of aggressive behaviour among patients with bipolar disorder. METHOD: An institutional based cross sectional study was conducted at Amanual Mental Specialized Hospital from May 1 to June 1, 2015 among 411 participants who were selected by systematic random sampling technique. Data was collected by interview technique by using Modified Overt Aggression Scale, entered and analyzed by using Epi Data 3.1 and Statistical Package for Social Science version 20, respectively. Adjusted Odd Ratio (AOR) with 95% Confidence Interval (CI) were used to show the odd and P-value <0.05 was considered as statistically significant. RESULTS: A total of 411 bipolar patients were included in the study and the prevalence of aggressive behaviour was 29.4%. Significant associated factors for aggression were, having two or more episode [AOR = 2.35 95% CI (1.18, 4.69)], previous history of aggression, [AOR = 3.72, 95% CI (1.54, 8.98)], depressive symptoms [AOR = 3.63, 95% CI (1.89, 6.96)], psychotic symptoms [AOR = 5.41,95% CI (2.88, 10.1)], manic symptoms [AOR = 3.85,95% CI (2.06, 7.19)], poor medication adherence [AOR = 3.73 95% CI (1.71, 8.13)], poor social support [AOR = 2.99 95% CI (1.30, 6.91)] and current use of substance[AOR = 2.17 95% CI (1.16, 4.06)]. CONCLUSION: Prevalence of aggression is high among bipolar patients and associated with many factors. So it needs public health attention to decrease aggression among bipolar patients.