Magnitude of psychological distress and associated factors among war survivor women in Northern, Ethiopia, 2022: a community-based cross-sectional survey.

BACKGROUND: Civilian war and internal conflicts increase the incidences of mental health conditions among war survivors. It is crucial to assess war-related psychological consequences in war-affected areas in Ethiopia to intervene in the future. Thus, this study aimed to determine the magnitude of psychological distress and associated factors of psychological distress among war survivor women in Northern, Ethiopia. METHODS: A community-based cross-sectional survey was conducted, and 1596 war survivor women were recruited to participate using a face-to-face interviews with a census sampling technique from May 1-30, 2022. The psychological distress was assessed using a Kessler psychological distress scale (K10). Bi-variable and multi-variable logistic regression analyses were used, and variables with a p-value less than 0.05 in the multivariable analyses were considered statistically significant. RESULT: In this study, the response rate was 100% and the prevalence of psychological distress was 44.90% at a 95% CI: (42.40, 47.40). Psychological distress was significantly associated with the education of ability to read and write (AOR = 2.92; 95% CI: 2.12, 4.01), primary education and above (AOR = 3.08; 95% CI: 2.09, 4.54), housewife (AOR = 5.07; 95%CI: 2.64, 9.74), farmer (AOR = 8.92; 95%CI: 4.03, 19.70), emotional violence (AOR = 1.52; 95%CI: 1.05, 2.18), physical violence (AOR = 3.85; 95%CI: 2.37, 6.26) and sexual violence (AOR = 3.25; 95%CI: 1.98, 5.33) whereas being separate was protective for psychological distress (AOR = 0.38; 95%CI: 0.16, 0.92). CONCLUSION: The prevalence of psychological distress was found to be high. Therefore, women who are housewives, married, farmers, educated, and who have experienced violence must be the focus of governmental and private collaborative interventions to prevent war-related psychological morbidity and mortality.

Determinants of Malnutrition and its associated factors among pregnant and lactating women under armed conflict areas in North Gondar Zone, Northwest Ethiopia: a community-based study.

INTRODUCTION: Maternal malnutrition remains a major public health problem, particularly in low and middle-income countries and war-affected areas like Ethiopia. Malnourished pregnant and lactating women with low nutrient stores have babies with poor mental and physical development, increasing the risk of poor birth outcomes. Despite the fact that the majority of Ethiopian mothers are malnourished, there is little evidence in war-affected areas. Therefore, the objective of this study was to assess the prevalence of undernutrition and associated factors among pregnant and lactating mothers in the war affected area of North Gondar Zone, northwest Ethiopia. METHODS: A community-based cross-sectional study was conducted from April 10 to May 25, 2022. A multistage random sampling technique was used to select 1560 pregnant and lactating mothers. MUAC was to ascertain the outcome variable. Data was entered and analyzed by using EPI INFO version 3.5.3 and SPSS version 24, respectively. A multivariable logistic regression analysis was employed to identify the factors associated with acute malnutrition. An adjusted odds ratio (AOR) with a 95% confidence interval was used to show the strength of the association, while a P-value of 0.05 was used to declare the significance of the association. RESULTS: The prevalence of acute malnutrition among pregnant and lactating women was 34.3% at the 95% CI (31.9-36.8). The age of the mothers (AOR = 0.73; 95% CI: 0.54, 0.99), family size 6-8 (AOR = 1.21; 95% CI: 1.03, 1.82), and greater than or equal to 9 family sizes (AOR = 0.44; 95% CI: 0.19, 0.97), were significantly associated with acute malnutrition. CONCLUSIONS: In the current study, the prevalence of acute malnutrition among pregnant and lactating mothers is high in the study area. Mother's age and family size were factors associated with acute malnutrition in war-affected areas. As a result, mothers with large families will require special assistance to reduce the impact of malnutrition.

Magnitude and possible risk factors of musculoskeletal disorders among street cleaners and solid waste workers: a cross-sectional study.

BACKGROUND: In the absence of a standardized work environment, insurance system, occupational safety measures and expanding workload an uptrend of musculoskeletal disorders secondary to occupational hazards is observed among a wide range of occupations in developing countries including street sweepers/cleaners. The aim of this study is to determine the burden and potential factors associated with musculoskeletal disorders among street cleaners/solid waste collectors in Gondar town, Ethiopia. METHODS: A cross-sectional study design was used to determine the burden and identify potential risk factors of musculoskeletal disorders among street cleaners. Street cleaners (n = 422) working experience of at least one year were randomly selected from the community at their respective work sites (street). A face-to-face interview recorded the participant's response addressing socio-demographic, occupational, job satisfaction, disability related to basic ADL, physical measurements, and self-reported pain using the Nordic-Musculoskeletal questionnaire. The logistic regression model was created to identify potential factors associated with self-reported MSDs. RESULTS: The sample consists of women street sweepers/cleaners (100%, n = 422, response rate 100%) with at least one-year of work experience with a mean age of 37.03 ± 8.26. About 40% of women sweepers were illiterate and 95% reported no job satisfaction. The overall prevalence of MSDs was 73% (n = 308, 95% CI; 68.5, 77.2), among them nearly 65% reported having experienced disability in performing basic ADL in the past 12 months. Low back pain was the most prevalent region (n = 216, 70.1% case versus MSDs n = 308). In univariate and multivariate logistics analysis, being overweight/obese (AOR of 4.91 (95%, 2.22, 10.87)), age group 35 and above (AOR 2.534 (1.51, 4.26)), not-satisfied with job (AOR 2.66 (1.05, 6.75)), and street cleaning distance of longer than 2 km (AOR 2.82 (1.64, 4.83)) were significantly associated with self-reported musculoskeletal disorder.. CONCLUSION: This study demonstrated higher self-reported MSDs among street sweepers/cleaners. Modifiable predictors like overweight, lack of job satisfaction, and cleaning longer distance were identified to be associated. Hence, there is a need for ergonomic measures and policy to curb these factors to reduce the burden of MSD among women street sweepers.

Environmental determinants for participation among stroke survivors in Africa, a scoping review.

Purpose: In this review, we aimed to determine the environmental factors that are influencing the participation of stroke survivors in Africa. Methods: Four electronic databases were systematically searched from inception to August 2021, and identified articles were screened by the two authors of this review based on predetermined criteria. No date restrictions were imposed, and we included any type of paper, including gray literature. We followed the scoping review framework by Arksey and O'Malley, which was later revised by Levac et al. The whole finding is reported using the preferred reporting items for systematic reviews and meta-analyses extension for scoping reviews (PRISMA-ScR). Results: A total of 584 articles were generated by the systematic search, and one article was added manually. After eliminating the duplicates, the titles and abstracts of 498 articles were screened. From the screening, 51 articles were selected for full article review, of which 13 met the criteria to be included. In total, 13 articles were reviewed and analyzed based on the international classification of functioning, disability, and health (ICF) framework of the environmental determinants. Products and technology; natural environment and human-made changes to environment; and services, systems, and policies were found to be barriers for stroke survivors to participate in their community. Conversely, stroke survivors are getting good support from their immediate family and health professionals. Conclusion: This scoping review sought to identify the environmental barriers and the facilitators that are determining the participation of stroke survivors in Africa. The results of this study can serve as a valuable resource for policymakers, urban planners, health professionals, and other stakeholders involved in disability and rehabilitation. Nonetheless, additional research is necessary to validate the identified facilitators and barriers.

High burden of diabetes and prediabetes among cancer patients at University of Gondar comprehensive specialized hospital, Northwest Ethiopia.

Cancer and diabetes mellitus (DM) are diagnosed within the same individual more frequently and share common risk factors. Although diabetes among cancer patients may result in more aggressive clinical courses of cancer, there is limited evidence about its burden and associated factors. Hence, this study aimed to assess the burden of diabetes and prediabetes among cancer patients and its associated factors. Institution-based cross-sectional study was conducted at the University of Gondar comprehensive specialized hospital from 10 January to 10 March 2021. A systematic random sampling technique was used to select 423 cancer patients. The data was collected using a structured interviewer-administered questionnaire. Prediabetes and diabetes diagnosis was made based on World Health Organization (WHO) criteria. Bi-variable and multivariable binary logistic regression models were fitted to identify factors associated with the outcome. Adjusted Odds Ratio (AOR) with a 95% confidence interval was estimated to show the direction and strength of associations. Variables with a p-value less than 0.05 in the multivariable model were considered significantly associated with the outcome. The final analysis was based on 384 patients with cancer. The proportion of prediabetes and diabetes was 56.8% (95% CI 51.7, 61.7) and 16.7% (95% CI 13.3, 20.8), respectively. Alcohol consumption was found to increase the odds of elevated blood sugar among cancer patients (AOR: 1.96; 95%CI: 1.11, 3.46). The burden of prediabetes and diabetes is alarmingly high among cancer patients. Besides, alcohol consumption was found to increase the odds of having elevated blood sugar among cancer patients. Hence, it is essential to recognize cancer patients are at high risk of having elevated blood sugar and design strategies to integrate diabetes and cancer care.

Home-based therapy and its determinants for children with cerebral palsy, exploration of parents' and physiotherapists' perspective, a qualitative study, Ethiopia.

OBJECTIVE: This study aimed to explore the perceptions of parents and physiotherapists regarding home-based therapy programs for children with cerebral palsy and to understand the factors affecting adherence to home-based therapy programs. MATERIALS AND METHOD: Thematic analysis method was used to identify, analyse and report findings. Twelve physiotherapists and five caregivers were purposively sampled and interviewed. RESULTS: All transcripts were coded line by line, and the codes were then organized into categories for the development of descriptive themes and the generation of analytical themes. The data analysis followed the steps of the thematic analysis process. Seven themes emerged during the analysis: Why Home-Based Therapy? Ways of Teaching, Types of the therapy, Strategies of assessing adherence, Environmental factors, Attitude and knowledge; and Family participation. Physiotherapists use home-based therapy to prevent complications and improve functioning. They use various ways of teaching, such as explaining, demonstrating, and using pictures and videos. Physiotherapists consider several factors such as severity, age, and availability of resources before they decide the type of home therapy programs. However, parent's participation was low; and strategies to monitor and evaluate adherence were also low. Low family support, limited recourse, lack of knowledge and poor attitude negatively affected adherence to home-based therapy. CONCLUSIONS: Our finding revealed that physiotherapists use quite limited methods of teaching, and do not properly monitor adherence of the home-based therapy. Additionally, family participation to select type of therapy and to set goal were low.

Prevalence and associated factors of cancer pain among adult cancer patients evaluated at an oncology unit in the University of Gondar Comprehensive Specialized Hospital, northwest Ethiopia.

Introduction: Globally, cancer is the second leading cause of death and was responsible for 9.6 million deaths in 2018. Worldwide, 2 million people experience pain every day, and cancer pain is one of the major neglected public health problems, especially in Ethiopia. Despite reporting the burden and risk factors of cancer pain as a principal importance, there are limited studies. Therefore, this study aimed to assess the prevalence of cancer pain and its associated factors among adult patients evaluated at the oncology ward in the University of Gondar Comprehensive Specialized Hospital, northwest Ethiopia. Methods: An institution-based cross-sectional study was conducted from 1 January to 31 March 2021. A systematic random sampling technique was used to select the total sample size of 384 patients. Data were collected using pretested and structured interviewer-administered questionnaire. Bivariate and multivariate logistic regression models were fitted to identify the factors associated with cancer pain among patients with cancer. An adjusted odds ratio (AOR) with a 95% CI was computed to determine the level of significance. Results: A total of 384 study participants were involved, with a response rate of 97.5%. The proportion of cancer pain was found to be 59.9% (95% CI 54.8-64.8). The odds of cancer pain were escalated by anxiety (AOR = 2.52, 95% CI 1.02-6.19), patients with hematological cancer (AOR = 4.68, 95% CI 1.30-16.74), gastrointestinal cancer (AOR = 5.15, 95% CI 1.45-18.2), and stages III and IV (AOR = 14.3, 95% CI 3.20-63.7). Conclusion: The prevalence of cancer pain among adult patients with cancer in northwest Ethiopia is relatively high. Variables such as anxiety, types of cancer, and stage of cancer had a statistically significant association with cancer pain. Hence, to advance the management of pain, it is better to create more awareness regarding cancer-related pain and provide palliative care early on in the diagnosis of the disease.