Determinants of virological failure among patients on first line highly active antiretroviral therapy (HAART) in Southwest Ethiopia: A case-control study.

Background: Virological failure remains a public health concern among patients with human immunodeficiency virus (HIV) after treatment initiation. Ethiopia is one of the countries that aims to achieve the global target of 90-90-90 that aims to achieve 90% virological suppression, but there is a paucity of evidence on the determinants of virological failure. Therefore, the study is intended to assess determinants of virological treatment failure among patients on first-line highly active antiretroviral therapy (HAART) at Mizan Tepi University Teaching Hospital (MTUTH), Southwest Ethiopia. Method: A hospital-based unmatched case-control study was conducted from 11 November to 23 December 2020, among 146 cases and 146 controls. All cases and controls were selected randomly using computer-generated random numbers based on their medical record numbers. During the document review, data were collected using checklists, entered into Epi-data version 4.0.2, and analyzed by SPSS version 25. A multivariable logistic regression analysis was done to identify the independent determinants of virological treatment failure. Results: In this study, being male (adjusted odds ratio (AOR) = 1.89, 95% CI: 1.04, 3.47), substance use (AOR = 2.67, 95% CI: 1.40, 4.95), baseline hemoglobin (Hgb) < 12 mg/dl (AOR = 3.22, 95% CI: 1.82, 5.99), poor drug adherence (AOR = 3.84, 95% CI: 1.77, 5.95), restart ART medication (AOR = 2.45, 95% CI: 1.69, 7.35), and opportunistic infection (OI) while on HAART (AOR = 4.73, 95% CI: 1.76, 12.11) were determinants of virological treatment failure. Conclusion: The study revealed that the sex of the patient, history of substance use, baseline Hgb < 12 mg/dl, poor drug adherence, restart after an interruption, and having OI through the follow-up period were determinants of virological failure. Therefore, program implementation should consider gender disparity while men are more prone to virological failure. It is also imperative to implement targeted interventions to improve drug adherence and interruption problems in follow-up care. Moreover, patients with opportunistic infections and restart HAART need special care and attention.

Does the perception of HIV risk among Female sex workers affect HIV prevention behavior? application of the Health Belief Model (HBM).

BACKGROUND: High prevalence of Human Immune virus/Acquired immunodeficiency syndrome (HIV/AIDS) in Female Sex Workers (FSWs) is identified as a bottleneck in fighting against HIV/AIDS. To this end, the international community planned a strategy of 'Ending inequality' and 'Ending the AIDS epidemic' by 2030. This could not be achieved without due attention to FSWs. Thus, this study attempted to assess HIV prevention behavior and associated factors among FSWs in Dima district of Gambella region, Ethiopia by using the Health Belief Model. METHODS: A community-based cross-sectional study was conducted from March to May 2019 among 449 FSWs selected using the snowball sampling technique. Socio-demographic features, knowledge about HIV, attitude toward HIV prevention methods, and Health Belief Model (HBM) constructs (perceived susceptibility to and severity of HIV, perceived barriers, and benefits of performing the recommended HIV prevention methods, self-efficacy, and cues to practice HIV prevention methods) were collected using face to face interview. Data were entered into Epi-data 3.1 and analyzed using SPSS version 23. Bivariable and multivariable binary logistic regression analysis was done to identify the association between dependent and independent variables. P-value < 5% with 95 CI was used as a cutoff point to decide statistical significance of independent variables. RESULTS: In this study, 449 FSWs participated making a response rate of 98.90%. Of these, 64.8% had high HIV prevention behavior. Age (AOR = 1.911, 95% CI: 1.100, 3.320), knowledge of HIV (AOR = 1.632, 95% CI: 1.083, 2.458), attitude towards HIV prevention methods (AOR = 2.335, 95% CI: 1.547, 3.523), perceived barriers (AOR = .627, 95% CI: .423, .930), and self-efficacy (AOR = 1.667, 95% CI: 1.107, 2.511) were significantly associated with high HIV prevention behavior. CONCLUSION: The study identified that about two third of FSWs practiced the recommended HIV prevention methods. Age of respondents, knowledge of HIV, favorable attitude towards the recommended HIV prevention methods, high self-efficacy, and low perceived barrier were associated with high HIV prevention behavior. Therefore, focusing on these factors would be instrumental for improving effectiveness of the ongoing HIV prevention efforts and attaining the 'Sustainable Development Goals of 'Ending inequality' and 'Ending the AIDS epidemic' by 2030.

Factors Associated With HIV Preventive Behavior Among Adults in Majang Zone of Gambella Region, Southwest Ethiopia.

Background: HIV-positive people can spread the virus through unprotected sex; however, HIV can be avoided if populations are educated about the risks. In underdeveloped nations, evidence suggests that the ABC method for HIV prevention is quite effective. As a result, the goal of this study was to determine the magnitude of HIV prevention behavior among adults in the Majang zone of Southwest Ethiopia, as well as the factors that influence it. Methods: A community-based cross-sectional study was carried out from March 1st to May 31st, 2019. The data were collected through a face-to-face interview using a modified validated questionnaire among systematically selected study participants. The collected data were coded and entered using Epidata manager version 4.0.2.101 and analyzed using SPSS version 21. A logistic regression analysis was computed to determine the association using crude and adjusted odds ratios at 95% confidence intervals. The level of significance was declared at a p-value less than 0.05. Results: Of the 772 adults interviewed, the proportion of adults who had good HIV preventive behavior was 51.8%, 95% CI [48.3-55.3%]. Two hundred forty (31.9%) were used abstinence as a type of HIV preventive behavior followed by being faithful (16.1%) and consistent condom use (7.3%). The study also found that respondents with the age group ≥27 years old (AOR = 1.56, 95% CI [1.3-3.12]), marital status (being married (AOR = 6.30, 95% CI [4.48-11.4]), and divorced/widowed (AOR = 5.50, 95% CI [2.60-12.4]) and having good knowledge of HIV prevention methods (AOR = 2.18, 95% CI [1.71-4.00]) were the factors associated with good HIV preventive behavior. Conclusion and Recommendation: In the study area, overall HIV prevention behavior was average. The characteristics linked with successful HIV prevention behavior among adults in the Majang community included increasing age, being married or divorced/widowed, and having a solid understanding of HIV prevention approaches. As a result, policy-level and multi-sectorial intervention approaches from all stakeholders are necessary to develop short- and long-term strategies to address the problem and improve the community's quality of life.

Factors Contributing to High HIV Prevalence in Majang Zone, Southwest Ethiopia: What Lies Beneath the Tip of the Iceberg?

BACKGROUND: Despite the tremendous efforts made, HIV epidemic has been continuing to be a public health threat and one of the leading causes of death in sub-Saharan African countries. Gambella region is a high prevalence region persistently exhibiting the highest share of HIV cases in Ethiopia. Thus, the objective of this study was to explore factors contributing to high HIV prevalence in the Majang zone of Gambella region, Southwest Ethiopia. METHODS: A descriptive qualitative study was conducted in the Majang zone of Gambella region, Southwest Ethiopia from March to May 2019. A heterogeneous purposive sampling technique was employed to recruit key informants and focused group discussion participants. Eighteen key informant interviews and 9 focused group discussions were conducted (N = 90) with health professionals, youth, mothers, and community elders. An interview guide developed through an extensive literature review was used to elicit information from the study participants, and data were collected by the investigators themselves with the help of local guides. Data were audio recorded, transcribed, translated, coded, and analyzed thematically, assisted by Atlas.ti 7.5.16 software. Trustworthiness of the data was ensured through data triangulation, prolonged engagement, member checking, and inquiry audit in which findings were audited and verified by qualitative research experts. Ethical clearance was obtained from the Institutional Review Board of Mizan Tepi University, and written signed informed consent was obtained from all the participants prior to conducting the interviews. RESULTS: A total of 90 individuals have participated in this study. Several factors appear to underlie the sustained high prevalence of HIV in the study area and were organized into five major themes: 1) government-related factors, 2) community perception towards HIV, 3) substance use, 4) socio-cultural factors, and 5) movement of people. CONCLUSION: Low government attention towards HIV prevention and control activities, low perceived severity of HIV, substance use, socio-cultural factors, and high movement of people appear to inform the understanding of factors contributing to HIV risk in Majang zone. The sociocultural factors include the use of "Tifo Bet" and social support for polygamy. These findings loudly call for the governmental, non-governmental, and private sectors to reconsider and strengthen strategies for the prevention and control of HIV in the study area.

HIV Preventive Behaviors and Associated Factors among Gold Mining Workers in Dima District, Southwest Ethiopia, 2019: Community-Based Cross-Sectional Study.

BACKGROUND: HIV/AIDS is becoming more prevalent over time, resulting in a considerable number of deaths. In 2017, 36.9 million (35.1 million adults) people worldwide were living with HIV, 1.8 million people were newly infected with HIV, and 940 000 people died from AIDS-related illnesses. Mining workers are at a high risk of contracting HIV and infecting others, and effective prevention is a critical. OBJECTIVE: To assess HIV preventive behaviors and associated factors among gold mining workers in Dima district, southwest Ethiopia, 2019. METHODS AND MATERIALS: A community-based cross-sectional study was conducted from November 1st to 30th, 2019. A convenience sampling technique was used to get mining workers for the interview.The data were collected through face-to-face interviews. The collected data were coded and entered into EpiData version 4.2.0.101, cleaned, and analyzed using SPSS version 21 statistical software. A binary logistic regression was conducted to determine the association using odds ratios at 95% confidence intervals. A P value of less than 0.05 considered the level of significance for HIV preventive behaviors. RESULTS: From a total of 455 mining worker, 279 (61.3%) of them have good practices of HIV prevention. Factors associated with good preventive practice were not alcohol drinkers (AOR = 2.86, 95% CI: 1.30-6.29), not chew khat (AOR = 2.09, 95% CI: 1.09-4.02), having good knowledge about HIV (AOR = 1.81, CI: 1.16-2.83), favorable attitude towards HIV prevention (AOR = 4.76, 95% CI: 3.02-7.49), and high perceived susceptibility to HIV (AOR = 2.63, 95% CI: 1.63-4.24). CONCLUSION: Only about 61% of the mining workers in the study area were practiced HIV preventive behaviors. Not alcohol drinkers, having good knowledge about HIV, having a favorable attitude toward HIV prevention, and having high perceived susceptibility to HIV were factors associated with the practice of HIV preventive behaviors. Efforts have to be made by local governments and other concerned bodies to increase preventive behavior.

Prevalence of Hepatitis B Virus Among Pregnant Women on Antenatal Care Follow-Up at Mizan-Tepi University Teaching Hospital and Mizan Health Center, Southwest Ethiopia.

BACKGROUND: Hepatitis B virus(HBV) infection is a global public health problem, even though its prevalence is disproportionately high in low- and middle-income countries. Mother-to-child transmission is a major route of HBV transmission in endemic areas. This study aimed to assess the prevalence of HBV and its determinants among pregnant women attending antenatal care at Mizan-Tepi University Teaching Hospital and Mizan Health Center, Southwest Ethiopia. METHODS: A cross-sectional study was conducted between January 13th 2020 and February 5th 2020 among 370 pregnant women. The sample size was proportionally allocated to each health institution according to the total pregnant women on antenatal care at the respective health institution and a consecutive sampling technique was used to select study participants. Serum hepatitis B surface antigen (HBsAg) was tested using a rapid diagnostic test. Data were analyzed using Statistical Package for Social Sciences (SPSS) software version 22. Multiple logistic regression analysis was done to identify the independent predictors of HBsAg serostatus at p-value <0.05. RESULTS: Three hundred seventy of the total 375 pregnant women participated in the study resulting in a response rate of 98.7%. Twenty-two (5.9%) of the pregnant women screened were found positive for HBsAg (prevalence=5.9%; 95% CI: 3.9-8.80%). History of contact with jaundice patients (AOR=9.87; 95% CI: 2.98-32.65), sharing sharp materials (AOR=3.96; 95% CI: 1.23-11.08) and history of multiple sexual partners (AOR=6.77; 95% CI: 2.44-18.78) were significantly associated with Hepatitis B Virus infection. CONCLUSION: The endemicity of hepatitis B virus seroprevalence is intermediate in the study settings. Factors associated with hepatitis B virus serostatus were behavioral; hence, modification of these factors may help to prevent the infection.

Knowledge of COVID-19 and preventive behaviors among waiters working in food and drinking establishments in Southwest Ethiopia.

BACKGROUND: Waiters working in different food and drinking establishments have a higher risk of contracting COVID-19 and transmitting the infection to others because they interact with many people. Most COVID-19 related studies in Ethiopia mainly focused on the general population, whereas, this study aimed to assess the knowledge of COVID-19 and preventive behaviors among waiters in Southwest Ethiopia. METHODS: A cross-sectional study was conducted from June 1 to June 15, 2020, among waiters working in food and drinking establishments found in Mizan-Aman, Jemu, and Masha towns in Southwest Ethiopia. A total of 422 waiters were selected using a simple random sampling technique, and the data were collected through face-to-face interviews using a structured questionnaire. The data were entered into Epi-data manager version 4.0.2 and analyzed using SPSS version 22. Multivariable binary logistic regression analysis was carried out to identify predictors of good preventive behaviors at a p-value of less than 0.05. RESULTS: Four hundred and sixteen respondents participated in this study, with a response rate of 98.6%. A significant proportion of participants know the cause, route of transmission, symptoms, and prevention methods of COVID-19 virus. However, very few (21.2%) had good preventive behaviors. The study showed that good preventive behavior was positively associated with female sex (AOR = 2.33, 95% CI: 1.38-3.94), higher schooling (AOR = 0.39, 95% CI: 0.17-0.88), high-risk perception (AOR = 2.26, 95% CI: 1.51-4.32), and high perceived self-efficacy (AOR = 1.1.75, 95% CI: 1.05-2.90). CONCLUSIONS: A significant proportion of waiters know common symptoms of COVID 19, route of transmission, and its prevention methods. However, the preventive behavior was very low. Thus, all concerned bodies working on the prevention and control of COVID-19 should give attention to this population group to enhance compliance with recommended preventive behaviors.

Determinants of the Community Knowledge and Attitude Towards HIV Prevention Methods in Majang Zone, Southwest Ethiopia.

BACKGROUND: Although in Ethiopia there is a high burden of HIV/AIDS, the community knowledge and attitude towards HIV/AIDS prevention has not been investigated adequately. Thus, this study assessed the determinants of the community knowledge and attitude towards HIV/AIDS prevention in the Majang zone which is the zone with the highest HIV prevalence in Ethiopia. METHODS: A community-based cross-sectional study was conducted in the Majang zone, southwest Ethiopia from March 1st to May 31st, 2019 by including randomly selected 845 adults. Knowledge and attitude towards HIV prevention methods were dependent variables. The independent variables include socio-demographic characteristics and behavioral factors. A binary logistic regression was employed to determine the association using the odds ratio at 95% confidence intervals. A p-value of less than 5% was considered to declare the final significance. RESULTS: Of 845 respondents recruited, 772 participated yielding a 91.4% response rate. Not sharing contaminated sharp materials (63.4%), consistent condom use (61.2%), and abstinence (57.9%) were the prevention methods mentioned by majority of the respondents. Only two of five respondents (39.6%) had good HIV prevention knowledge. More than half [412 (53.4%)] of the respondents had a positive attitude towards HIV prevention. The independent determinants of HIV prevention knowledge were secondary educational status (AOR=1.84; 95% CI=1.04, 3.24), tertiary and above educational status (AOR=2.01; 95% CI=1.07, 3.75) and positive HIV prevention attitude (AOR=1.89; 95% CI=1.39, 2.57). Similarly, age of greater than 27 years (AOR=2.13; 95% CI=1.55, 2.95) and good HIV prevention knowledge (AOR=1.83; 95% CI=1.35, 2.48) were significantly associated with a positive HIV prevention attitude. CONCLUSION: This study revealed insufficient HIV prevention knowledge and attitude in the community with the highest HIV prevalence. To achieve the goal of ending the HIV epidemic, health education should be considered using different innovative approaches especially by prioritizing young and less educated individuals.

Knowledge Toward Cervical Cancer and Its Determinants Among Women Aged 30-49 in Jimma Town, Southwest Ethiopia.

BACKGROUND: Cervical cancer is one of the common causes of premature death and disability in women worldwide. It is preventable through vaccination, and screening for precancerous lesions and early treatment. However, screening service uptake and treatment for cervical cancer face significant challenges in low-income countries due to poor information systems. The aim of this study was to assess knowledge of cervical cancer and its determinants among women aged 30-49 years living in Jimma Town, Southwest Ethiopia. METHODS: A community-based cross-sectional study was undertaken from March 20 to April 15, 2017. The data were collected using a structured interviewer-administered questionnaire and analyzed by SPSS version 21. Multivariable logistic regression anaysis was done and variables with a p-value < 0.05 were considered statistically significant. RESULTS: Of the interviewed women, only 321(43.6%) had adequate knowledge about cervical cancer and screening. Attending secondary school or above (AOR = 2.42, 95% CI: 1.24-4.74), using modern contraceptives (AOR = 6.31, 95% CI: 2.86-13.89), knowing somebody with cervical cancer (AOR = 2.24, 95% CI: 1.35-3.71) and knowing someone screened for cervical cancer (AOR = 2.23, 95% CI: 1.30-3.80) were associated with knowledge of cervical cancer. CONCLUSION: Knowledge of cervical cancer is low in the current study area even if appropriate knowledge regarding the disease is important in decreasing the incidence and prevalence of cervical cancer through screening and human pappiloma virus vaccination. Increasing awereness regarding the disease and prevention strategies are the key issue.

Risk Perception Towards COVID-19 and Its Associated Factors Among Waiters in Selected Towns of Southwest Ethiopia.

BACKGROUND: Waiters working in hotels, pensions, restaurants, and cafeteria are more susceptible to COVID-19 and easily transmit the virus to others because they interact with almost all individuals who enter those establishments. However, information regarding their risk perception is scarce; hence, this study aimed to assess risk perception regarding COVID-19 and its associated factors among waiters working in the selected towns of southwest Ethiopia. METHODS: A cross-sectional study was conducted from June 1 to 15, 2020. The interview-administered structured questionnaire was used to collect data. Data were entered into Epi data manager version 4.0.2 and exported to SPSS version 24 for analysis. Multiple linear regression analysis was done to identify factors associated with risk perception. A p-value of less than 0.05 was used as a level of significance. RESULTS: A total of 416 waiters were interviewed, with a 98.6% response rate. The mean age of respondents was 27.26 (SD=8.35) years. More than half (53.4%) agreed that COVID-19 causes more deaths than other respiratory diseases. Regarding overall risk perception, two hundred twenty-two (53.4%) participants had high-risk perceptions concerning COVID-19. Risk perception was associated with age (ß= 0.10; 95% CI: 0.02, 0.18), knowledge of COVID-19 (ß=0.50, 95% CI: 0.23, 0.76) and preventive behaviors (ß=0.62; 95% CI: 0.33, 0.90). CONCLUSION: A higher level of risk perception was found regarding the COVID-19. Proper risk communication to promote protective behaviors is very essential since waiters are more at risk to be infected with COVID-19 and their infection with the virus has important public health implications.

Perception Toward Quarantine for COVID-19 Among Adult Residents of Selected Towns in Southwest Ethiopia.

BACKGROUND: COVID-19 is a global pandemic caused by a transmissible respiratory virus, SARS-Cov-2. Because it is a novel pathogen, limited information is available to characterize the spectrum of clinical illness, transmission efficiency, and the duration of viral shedding for patients with COVID-19. Quarantine is an important component of a multilayered strategy to prevent sustained spread of COVID-19 everywhere. The aim of this study was to assess public perceptions toward quarantine for COVID-19 and associated factors among adult residents of selected towns in Southwest Ethiopia, 2020. METHODS: The community-based cross-sectional study was conducted from 1 to 15 June 2020 among adult residents of selected towns in south west Ethiopia. Systematic random sampling was used to select 844 participants. A structured and interviewer-administered questionnaire was used to collect data. Descriptive statistics were used to describe different variables. Multiple linear regression was carried out to determine the predictors of outcome variables. In multiple linear regression, variables with p-value <0.05 were taken as statistically significant association with community perception toward quarantine. RESULTS: The total of 816 study participants were interviewed from which 450 (55.1%) were male. The median age of respondents was 30 years. Four hundred and twenty-seven (52.3%) of the respondents have a positive perception toward quarantine. Factors associated with perception toward quarantine were having training on COVID-19 (ß=2.76, p=0.005), educational status of secondary (ß=2.73, p=0.001), educational status to above secondary (ß=2.24, p=0.011), occupational status of merchant (ß=1.73, p=0.020), and knowledge of COVID-19 (ß=0.23, p=0.001). CONCLUSION: Only 52.3% of the respondents have a positive perception toward quarantine. Having training on COVID-19, educational status of secondary and above, being a merchant, knowledge of COVID-19 and knowledge of quarantine were significantly associated with a positive perception toward quarantine. Concerned bodies should work on enhancing the awareness of the community through information education and communication/behavior changing communication materials.

Predictors of Intention to Use Maternity Waiting Home Among Pregnant Women in Bench Maji Zone, Southwest Ethiopia Using the Theory of Planned Behavior.

BACKGROUND: Ending preventable maternal mortality remains an unfinished agenda and one of the world's most critical challenges. Skilled care at birth is one of the crucial strategies that help to prevent deaths that occur during delivery. Maternity waiting homes have been endorsed to facilitate access to skilled care during intra-partum and post-partum periods for women living in rural areas. However, the majority of pregnant mothers in Ethiopia do not use this service; hence, this study aimed to assess the predictors of intention to use maternity waiting home. METHODS: A community-based cross-sectional study was conducted from March 15 to June 20, 2018 in Bench Maji Zone, Southwest Ethiopia. A multistage sampling technique was used. The data were collected by trained data collectors using a structured pre-tested questionnaire. Data were entered into the epi data manager version 4.0.2.101 and exported to SPSS version 21 for analysis. The correlation among constructs of the theory of planned behavior was estimated. A hierarchical linear regression was used to identify predictors of intention to use maternity waiting home, and α value of less than 5% was used as a level of significance. RESULTS: A total of 829 women were interviewed. The mean age of respondents was 27.1 (±5.2) years. Thirty-nine percent of the respondents used maternity waiting home previously. The attitude (ß =0.12, p<0.001), subjective norm (ß =0.47, p<0.001), perceived behavioral control (ß =0.42, p<0.001), and ANC use during current pregnancy (ß =0.07, p=0.030) were predictors of intension to use maternity waiting homes. R square was calculated to be 81%. CONCLUSION: The intention to use maternity waiting homes was significantly associated with antenatal care use, attitude, subjective norm, and perceived behavioral control. Thus, multidimensional interventions are important to increase the intension to use MWH.

Determinants of Delayed Treatment-Seeking for Childhood Diarrheal Diseases in Southwest Ethiopia: A Case-Control Study.

BACKGROUND: Although there are low cost and effective interventions to prevent and treat diarrhea, it is one of the leading causes of morbidity and mortality among under-five children in developing countries. Deaths from diarrheal diseases are largely due to lack of prompt seeking of medical care. This study aimed to identify determinants of delayed treatment-seeking for diarrheal diseases among under-five children in Southwest Ethiopia. METHODS: Unmatched case-control study was conducted among 324 under-five children paired with their mothers/caregivers from 1st April to 30th May 2019. Cases were under-five children paired with their mothers/caregivers who sought treatment after 24 hours of the onset of signs and symptoms of diarrheal diseases, and controls were under-five children paired their mothers/caregivers who sought treatment within 24 hours of the onset of signs and symptoms of diarrheal diseases. Consecutive sampling was used, and data were collected through interviews and chart reviews. Multivariable binary logistic regression analysis was performed, and variables with a P-value <0.05 were considered statistically significant. RESULTS: A total of 324 (162 cases and 162 controls) under-five children paired with their mothers/caregivers were included in this study. Being rural residents (AOR=1.93, 95% CI: 1.13,3.31), children from households with more than two children (AOR=2.05, 95% CI: 1.15-3.66), preferring traditional healers for the treatment of diarrhea (AOR= 4.78, 95% CI: 1.74,13.12), not having television or radio for the households (AOR=2.05, 95% CI: 1.11-3.66), living in more than 10 km from the nearest health facility (AOR=4.80, 95% CI: 2.61-4.83), and perceiving diarrhea can cure without treatment (AOR=2.11, 95% CI: 1.15-3.87) were significant determinants of delayed treatment-seeking. CONCLUSION: Being rural residents, larger family size, physical inaccessibility of health facilities, not having access to electronic media (television or radio), preferring traditional healers for the treatment of diarrhea, and having the perception that diarrhea can be cured without treatment were determinants of delayed treatment-seeking for diarrheal diseases among under-five children. Thus, multidimensional approaches that can address accessibility of health facilities and improve caregivers' awareness are necessary to encourage prompt treatment-seeking for diarrheal diseases among under-five children.

Knowledge of Neonatal Danger Signs and Its Associated Factors among Mothers Attending Child Vaccination Centers at Sheko District in Southwest Ethiopia.

BACKGROUND: Even though a great improvement in the last twenty years, the problem of newborn deaths is still remaining. In 2017 alone, an estimated 2.5 million neonatal deaths occurred worldwide, around 39 percent of all deaths in sub-Saharan Africa. Early detection of neonatal illness is an important step towards improving newborn survival. If mothers know the appropriate manifestations of the causes of death in newborns (neonatal danger signs), it is possible to avert related mortality, because of the health-seeking behavior of mothers highly relies on their knowledge of neonatal danger signs. OBJECTIVE: To assess knowledge of neonatal danger signs and its associated factors among mothers attending child vaccination centers at Sheko District in Southwest Ethiopia. METHODS: A facility-based cross-sectional study was conducted among 351 mothers who attended health centers for child vaccination in Sheko District from March 17 to April 30, 2018. A consecutive sampling method was used to select study participants. Data were collected by using structured questionnaires through face-to-face interviews. Data were entered using EPI-DATA version 3.1 and analysed using SPSS version 21. RESULTS: Of the 351 mothers interviewed, 39% (137) had good knowledge of neonatal danger signs. The study also found that mothers aged 29-40 years (AOR = 2.37, 95% CI [1.35-4.17], P = 0.003), educational status of primary and above (AOR = 2.68, 95% CI [1.48-4.88], P = 0.001), attending ≥ 4 antenatal care visits during pregnancy (AOR = 3.57, 95% CI [2.10-6.06], P < 0.001), and history of postnatal attendance after birth (AOR = 2.33, 95% CI [1.16-4.65], P = 0.017) were significantly associated with good knowledge of neonatal danger signs. CONCLUSION: The proportion of mothers with good knowledge of neonatal danger signs was remarkably low. Since the problem is a public health importance in developing countries, particularly in Ethiopia, which determines future generations. Great efforts are needed to create awareness for mothers on the importance of the early identifying neonatal danger signs plus to avert the high magnitude of neonatal mortality.

Depression and Its Associated Factors among Diabetes Mellitus Patients Attending Selected Hospitals in Southwest Ethiopia: A Cross-Sectional Study.

BACKGROUND: Diabetes mellitus and depression are very common diseases worldwide, and the prevalence rates of both conditions are increasing rapidly. Depression among patients with diabetes mellitus results in poor glycemic control through different mechanisms. Besides, the coexistence of a chronic medical illness with depression reduces the probability of recognizing and treating depression. The study is aimed at assessing the prevalence and factors associated with depression among adults with diabetes mellitus. METHODS: A hospital-based cross-sectional study was conducted among adult diabetes mellitus patients on follow-up in Mizan-Tepi University Teaching Hospital and Tepi General Hospital. A consecutive sampling technique was employed to recruit the study participants, and data were collected through face-to-face interview and medical chart review. Depression was measured using Patient Health Questionnaire-nine (PHQ-9). Binary logistic regression analysis was done and a p value of less than 0.05 was used as a level of significance. RESULTS: The prevalence of depression among study participants was 37.0% (95% CI 32.0%-42.0%). The majority (44.7%) of the patients had mild depression, while only 2% had severe depression. Being male (AOR = 1.92, 95% CI: 1.15-3.22), urban residence (AOR = 3.02, 95% CI: 1.57-5.78), single marital status (AOR = 7.72, 95% CI: 3.6-16.53), duration of diabetes mellitus 5 years and more (AOR = 2.00, 95% CI: 1.21-3.5), and having sexual dysfunction (AOR = 3.55, 95% CI: 2.13-5.91) were associated with increased odds of depression among diabetes mellitus patients. CONCLUSIONS: The prevalence of depression among diabetes mellitus was high. Therefore, the patients should be thoroughly screened for this comorbid condition, and the significant factors should be addressed during routine follow-up.

Prevalence of sexual dysfunction and related factors among diabetes mellitus patients in Southwest Ethiopia.

BACKGROUND: Diabetes mellitus causes multiple medical, psychological and sexual problems in both men and women. Sexual dysfunction is one of those problems that lead to a strong social and psychological problem which adversely affect marital relation and treatment outcome. The issue has not been well studied in Ethiopia; therefore, this study aimed to evaluate the prevalence and factors related to sexual dysfunction in adult patients with diabetes mellitus. METHODS: Facility-based cross-sectional study was conducted among adults with diabetes mellitus on follow-up at diabetic clinics of Mizan-Tepi University Teaching Hospital and Tepi General Hospital. A consecutive sampling technique was employed to select 423 study participants, and data were collected through interviewer-administered questionnaire and patients' medical chart review. Changes in Sexual Functioning Questionnaire-fourteen items (CSFQ-14) was used to measure sexual dysfunction. Descriptive statistics and binary logistic regression analyses were performed. Two tail tests at α of less 0.05 were used as a level of significance. RESULTS: A total of 398 diabetic patients were interviewed, with a 94% response rate. The prevalence of sexual dysfunction was 53.3%. Age of above 41 years (AOR: 3.98, 95% CI 2.32-6.85), lack of formal education (AOR: 3.20, 95% CI 1.60-6.39), divorced or widowed (AOR: 5.28, 95% CI 2.35-11.86), type 2 DM (AOR: 4.52, 95% CI 2.17-9.42), depression (AOR: 4.05, 95% CI 2.32-7.10), complications or co-morbidity (AOR: 2.05, 95% CI 1.18-3.58), and not doing physical activity (AOR: 1.62, 95% CI; 1.47-1.77) were significantly associated with sexual dysfunction among diabetes patients. CONCLUSIONS: The prevalence of sexual dysfunction was as high as reports from other studies. Therefore, health care providers should include the issue of sexual health in their routine discussions with adult diabetes mellitus patients. Presence of depression, not doing physical activity and having complications or co-morbidity are modifiable factors associated with sexual dysfunction; therefore, they should be attended during care addressing sexual dysfunction.

Predictors of Clinical and Immunological Failure Among Patients on First-Line Antiretroviral Therapy (ART) in Southwest Ethiopia.

BACKGROUND: Global expanded access to antiretroviral therapy has led to a rapid fall in the number of people dying from HIV-related causes. However, the remarkable achievement recorded in reducing morbidity and mortality has been affected due to the occurrence of first-line ART failure. The study was intended to identify predictors of clinical and immunologic failure of first-line ART in southwest Ethiopia. METHODS: A retrospective cohort study was conducted among 737 randomly selected ART patients from 1st January 2010 to 30th June 2016. Trained data collectors collected the data from the patients' follow-up charts and electronic databases. The Kaplan Meier (KM) curve was used to describe the probability of survival time to antiretroviral treatment failure. Variables with a p-value of ≤ 0.05 in a multivariable cox-proportional hazard model were statistically significant predictors of first-line ART failure. RESULTS: Among 737 HIV patients on ART followed retrospectively, 445 (60.4%) were females. During the follow-up period, the incidence rate of treatment failure was 7.3 per 100 person-year observations, and the highest rate was observed during the first 6 to 12 months of ART initiation. Not disclosing HIV status (AHR꞊ 2.04, 95% CI: 1.32-3.16), being bedridden (AHR꞊ 2.01, 95% CI: 1.02-3.98) and low hemoglobin at ART initiation (AHR꞊ 2.02, 95% CI: 1.29-3.13) were associated with an increased hazard rate for first-line ART failure. CONCLUSION: The study showed that predictors of first-line ART treatment failure are modifiable. Therefore, these factors should be addressed during routine care of HIV patients by health care providers to preserve the rapid exhaustion of  first-line medications, improve the quality of life of the patients and reduce HIV/AIDS related deaths.