Determinants of early initiation of breastfeeding following birth in West Africa: A multilevel analysis using data from multi-country national health surveys.

BACKGROUND: Early initiation of breastfeeding (EIBF), within the first hour of birth, is crucial for promoting exclusive breastfeeding and establishing optimal nursing practices. However, global EIBF rates remain low, with even lower rates observed in Africa. Despite existing research gaps, this study aims to determine the prevalence of EIBF and identify maternal and child-related factors associated with its practice in West Africa. METHODS: This study utilized West African Demographic and Health Survey (DHS) data from 13 countries, including 146,964 children's records. To assess model fit, likelihood test and deviance were used. Similarly, intraclass correlation coefficient, median odds ratio, and proportional change in variance were employed for random effect. A multilevel logistic regression model was used to identify individual- and community-level factors influencing EIBF due to the hierarchical nature of the data. Variables with p-values ≤0.2 in the binary model and <0.05 in the final analysis were considered significantly associated with EIBF. RESULTS: The pooled prevalence of EIBF in West African nations was 50.60% (95% CI; 50.34-50.85%). The highest prevalence rate was observed in Serra Leone (75.33%) and the lowest prevalence was found in Senegal (33.94%). In the multilevel multiple logistic regression model, maternal education (AOR = 1.10, 95% CI, 1.03,1.16), marital status AOR = 1.07, 95% CI, 1.01,1.13), birth weight (AOR = 0.91, CI 0.86,0.96), birth orders (AOR = 1.09, CI 1.03,1.16), and (AOR = 1.11, CI 1.03,1.19), place of residence (AOR = 1.14, CI 1.07,1.21), and mode of delivery type (AOR = 0.26, CI 0.24,0.29) were significantly correlated with EIBF in West Africa. CONCLUSIONS: The incidence of EIBF in West Africa was found to be low. The study emphasizes the need for targeted behavioral change communication programs to address timely breastfeeding initiation, specifically targeting mothers and child characteristics. Factors such as education, delivery mode, marital status, birth weight, birth order, and place of residence were significantly associated with EIBF. Special attention should be given to improving EIBF rates among women undergoing caesarean sections, infants with low birth weight, and primiparous mothers, along with structural improvements in the healthcare sector in West Africa.

Common Mental Disorder and Associated Factors among Women Attending Antenatal Care Follow-Up in North Wollo Public Health Facilities, Amhara Region, Northeast Ethiopia: A Cross-Sectional Study.

Introduction: Common mental health disorders (CMD) during pregnancy are a public health concern because of the implications for the mother and infant's health during pregnancy and after birth. The prevalence and factors related to common mental disorders vary globally. Therefore, this study assessed the magnitude and factors associated with common mental disorder among pregnant women attending ANC follow-up in North Wollo Zone, Northeast Ethiopia. Methods: An institutional-based cross-sectional study was conducted in North Wollo, Amhara Region, Northeast Ethiopia. A multistage sampling technique was used to select 777 study participants. The common mental disorder was assessed by using SRQ-20. Data were analyzed using Statistical Package for the Social Sciences (SPSS) version 23. Logistic regression analysis was done to identify the independent variables associated with common mental disorders. Independent variables with a p value less than 0.05 were considered significantly associated with CMD. Results: The magnitude of CMD was 18.1% (95% CI: 15.5, 21.0). Factors significantly associated with CMD were the educational level of participants (AOR = 0.17, 95% CI: 0.06, 0.48), husband's educational status (AOR = 11.13, 95%: 4.18, 29.66), unplanned pregnancy (AOR = 2.54, 95% CI: 1.26, 5.09), self-reported complication on the current pregnancy (AOR = 0.11, 95% CI: 0.05, 0.21), self-reported complication during the previous delivery (AOR = 3.38, 95% CI: 1.39, 8.18), undernutrition (AOR = 2.19, 95%: 1.26, 3.81), high psychosocial risk (AOR = 20.55, 95% CI: 9.69, 43.59), having a legal issue (AOR = 2.06, 95%: 1.12, 3.79), and relationship problem (AOR = 7.22, 95% CI: 3.59, 14.53). Conclusions and Recommendation. One in five pregnant women has common mental disorder. Educational status of the participants and their spouses, unplanned pregnancy, self-reported complication during current and previous pregnancy, psychosocial risk, and legal and relationship problems were the main determinants of common mental disorders. Therefore, screening pregnant women for mental disorders and provision of necessary mental health services are recommended to minimize the adverse health outcome of CMD during pregnancy.

Post-abortion contraceptive utilization and associated factors among women who attended abortion services: A health facility cross-sectional study.

Background: Post-abortion contraceptive utilization prevents unintended pregnancies, reduces the number of abortions, and lowers the morbidity and mortality related to obstetric complications. It plays a central role in improving maternal health and reducing child mortality. However, many women are suffering from unintended pregnancy and its complications after abortion care. Hence, the main objective of this study was to determine the magnitude of post-abortion contraceptive utilization and its associated factors in Bahir Dar City. Methods: Health-facility-based cross-sectional study was conducted in Bahir Dar city health facilities from April 1 to May 30, 2018. A systematic random sampling technique was used to select 354 eligible study participants. A pre-tested semi-structured questionnaire was used to collect the data. Data entry was done using Epi Data version 3.7 software and analyzed by SPSS v23 software. Descriptive statistics were done based on the nature of the data. A simple logistic regression model was used to identify the association and strength of exploratory variables and the outcome variables. Associations were announced at a 95% confidence interval and p-value <0.05 with adjusted odds ratio. Model fitness was checked by the Hosmer-Lemeshow goodness of fit test for logistic regression. Results: In this study, 348 aborted participants were involved with a mean age of 24.37 (±5.73) years. About 40% of the participants were not currently married and 12.9% were unable to read and write. The magnitude of post-abortion contraceptive utilization was 65.8%. The number of alive children (adjusted odds ratio: 7.0, 95% confidence interval: 1.54, 31.95), lower income (adjusted odds ratio: 0.14, 95% confidence interval: 0.03, 0.60), and (adjusted odds ratio: 0.11, 95% confidence interval: 0.02, 0.46), primary school education (adjusted odds ratio: 0.18, 95% confidence interval: 0.03, 0.97), and currently unemployed (adjusted odds ratio: 0.23, 95% confidence interval: 0.06, 0.85) were significantly associated with the post-abortion contraceptive utilization. Conclusion: The level of post-abortion contraceptive utilization is low as per the national plan. The number of alive children, lower income, lower education, and currently unemployed were the identified factors affecting post-abortion contraceptive utilization. Therefore, a collaborative effort is needed among stakeholders to increase the utilization and avoid factors that prevent the utilization of post-abortion contraceptive utilization.

Less than one in four mothers get quality intrapartum health care services in Ethiopia.

Intrapartum care is a platform of comprehensive healthcare for pregnant women that is designed to improve birth outcomes for mother and child. However, complications during the intrapartum period continued to be the leading cause of death for women of reproductive age and newborns. Therefore, the aim of this study was to assess the prevalence of quality of intrapartum care and its associated factors among mothers in Ethiopia. A community based cross sectional study was conducted among 4469 mothers who gave birth in the last 2 years. Quality of intrapartum care was analyzed based on the assessment of health facility delivery, skilled birth attendants and early initiations of breast-feeding. Stata version 14 software was used for data cleaning and analysis. A mixed effect multilevel logistic regression was conducted to determine factors associated with quality of intrapartum care. An adjusted odds ratio with 95% confidence interval and a P value of less than or equal to 0.05 was used for the identification of both individual and community level factors. Overall, the prevalence of quality intrapartum care in Ethiopia was 23.8% (95% CI 22.6, 25.13). Primary education (AOR = 1.46, 95% CI = 1.14, 1.88), rich household class (AOR = 1.48, 95% CI = 1.10, 1.98), history of ANC (AOR = 2.91, 95% CI = 2.18, 3.86), perceived distance to the health facility as not a big issue (AOR = 1.63, 95% CI = 1.30, 2.05), urban residence (AOR = 2.97, 95% CI = 1.93, 5.09), Tigray region (AOR = 5.01, 95% CI = 1.25, 20.59), community level poverty (AOR = 0.63, 95% CI = 0.41, 0.97), and having 2-4 children (AOR = 0.74, 95% CI = 0.56, 0.97) were significantly associated with quality of intrapartum care. The finding conclude that less than one in four mothers received good quality intrapartum care. In order to optimize the quality of intrapartum care, the government should empower women through extensive education. It is also recommended for the Ministry of Health to evaluate the health facilities and community health workers to increase coverage of ANC and provide financial assistance to rural residents and the poor household class.

Food Safety and hygiene practices and the Determinants among street vendors during the Chain of Food Production in Northwest Ethiopia.

Background: There is mounting evidence that Ethiopia is becoming a more street-food-consuming nation. The hygienic and safety procedures, however, are not adequately evaluated. Objectives: This study aimed to determine the magnitude of food safety and hygiene practices and associated factors among street food vendors of Bahir Dar City. Method: A community-based cross-sectional study design was conducted from March 10 to April 10, 2019. The data were collected using an interviewer-administered questionnaire with an observational checklist. The collected data were entered into EPI Data and analyzed by R software. Descriptive statistics were computed. A Binary logistic regression model was fit to identify the association and strength of exploratory variables and food safety and hygiene practices at a 95 % confidence interval and p-value <0.05. Results: A total of 421 participants participated. The level of good food safety and hygiene practices was 36 % (95%CI: 31, 41). Monthly income of >2500 Birr (AOR = 4.99; 95%CI: 2.42, 10.3), work experience of >2 years (AOR = 2.05; 95%CI: 1.15, 3.65), having supervision by health professionals (AOR = 2.45; 95%CI: 1.25, 4.85), having good knowledge about food safety and hygiene (AOR = 3.84; 95%CI: 1.42, 10.36), and having a favorable attitude towards food safety and hygiene (AOR = 2.71; 95%CI: 1.12, 6.57) were determinants of food safety and hygiene practice. Conclusions: The level of good food safety and hygiene practices was low. Monthly income, work experience, supervision by health professionals, knowledge, and attitude toward food safety and hygiene were identified as the determinants of good food safety and hygiene practice.

The magnitude of mortality and its predictors among adult patients admitted to the Intensive care unit in Amhara Regional State, Northwest Ethiopia.

Despite mortality in intensive care units (ICU) being a global public health problem, it is higher in developing countries, including Ethiopia. However, insufficient evidence is established concerning mortality in the ICU and its predictors. This study aimed to assess the magnitude of ICU mortality and its predictors among patients at Tibebe Ghion specialized hospital, Northwest Ethiopia, 2021. A retrospective cross-sectional study was conducted from February 24th, 2019, to January 24th, 2021. Data were collected from medical records by using pretested structured data retrieval checklist. The collected data was entered into Epi-data version 3.1 and analyzed using R version 4.0 software. Descriptive statistics computed. A simple logistic analysis was run (at 95% CI and p-value < 0.05) to identify the determinants for ICU mortality. A total of 568 study participants' charts were reviewed. The median length of ICU stay was four days. Head trauma and shock were the leading causes of ICU admissions and mortality. The overall mortality rate of the ICU-admitted patients was 29.6% (95% CI: 26%, 33%). Admission in 2020 (AOR = 0.51; 95%CI: 0.31, 0.85), having altered mentation (AOR = 13.44; 95%CI: 5.77, 31.27), mechanical ventilation required at admission (AOR = 4.11; 95%CI: 2.63, 6.43), and stayed < 5 days in the ICU (AOR = 3.74; 95%CI: 2.31, 6.06) were significantly associated with ICU mortality. The magnitude of the ICU mortality rate was moderate. Years of admission, altered mentation, mechanical ventilation required at admission, and days of stay in the ICU were the predictors for ICU mortality. This finding underscores the importance of interventions to reduce ICU mortality.

Geographical disparities and determinants of infant mortality in Ethiopia: mapping and spatial analysis using EDHS data.

BACKGROUND: Infant mortality remains a public health challenge in Ethiopia. Exploring infant mortality will aid in tracking the progress toward achieving sustainable development goals. OBJECTIVE: The study aimed to explore the geographical variations and associated factors of infant mortality in Ethiopia. METHOD: A total of 11,023 infants from the 2016 Ethiopian Demographic and Health Survey (EDHS) data were extracted and included in the analysis. EDHS used a two-stage cluster sampling design with a census enumeration area as the primary sampling unit and households as the secondary sampling unit. Arc GIS software was used for spatial analysis using clusters for exploring geographical variations in infant mortality. A binary logistic regression was employed using R software to identify the significant determinants of infant mortality. RESULTS: The study revealed that the spatial distribution of infant mortality was non-random in the country. Infants whose mothers not receiving ANC (AOR = 1.45; 95%CI: 1.17, 1.79), not breastfed status (AOR = 3.94; 95%CI: 3.19, 4.81), poor wealth index (AOR = 1.36; 95%CI: 1.04, 1.77), male infants (AOR = 1.59; 95%CI: 1.29, 1.95), birth order of six or above (AOR = 3.11; 95%CI: 2.08, 4.62), small birth size (AOR = 1.27; 95%CI: 1.26, 1.60), birth spacing [(≤ 24 months (AOR = 2.29; 95%CI: 1.79, 2.92), 25-36 months (AOR = 1.16; 95%CI: 1.12, 1.49)], multiple births (AOR = 6.82; 95%CI: 4.76, 10.81), rural residence (AOR = 1.63; 95%CI: 1.05, 2.77) and regions [Afar (AOR = 1.54; 95%CI: 1.01, 2.36), Harari (AOR = 1.56; 95%CI: 1.04, 2.56), and Somali (AOR = 1.52; 95%CI: 1.03, 2.39)] were the determinants of infant death in Ethiopia. CONCLUSIONS: There is a great geographical disparity in infant mortality rates across regions. Afar, Harari, and Somali regions were verified as hot spot areas. ANC usage, breastfed status, wealth index, sex of the infant, birth order, birth size, birth spacing, birth type, residence, and region were the determinants of infant death in Ethiopia. Therefore, appropriate interventions need to be implemented in the hot spots to alleviate the risk factors for infant mortality.

Determinants of household dropout from community-based health insurance program in northwest Ethiopia; A community-based case-control study.

BACKGROUND: Community-Based Health Insurance (CBHI) is an evolving program for delivering financial protection against the cost of illness and enhancing access to quality health services for low-income informal households. OBJECTIVE: The study aimed to identify determinants of household dropout from a CBHI program in Mecha district, North West Ethiopia, 2019. METHODS: A community-based case-control study was conducted in the Mecha district from March 10 to June 10, 2018. The final sample was 634 (317 cases and 317 controls) determined by the two-population proportion formula, and these samples were selected using a multi-stage sampling technique. The collected data was entered into Epi-data version 3.1 and analyzed using R version 4.0 software. Descriptive statistics computed. A simple logistic analysis was run (at 95% CI and p-value < 0.05) to identify the determinants for the dropout from CBHI. RESULTS: Poor perceived quality of care (AOR = 3.66; 95%CI: 2.35, 5.69), low knowledge of community-based health insurance (AOR = 6.02; 95%CI: 2.97, 12.26), no active community communication (AOR = 5.41; 95%CI: 3.29, 8.90) no chronic illness (AOR = 10.82; 95%CI: 5.52, 21.21) premium fee is not affordable (AOR = 2.35; 95%CI: 1.47, 3.77), and out of pocket money not reimbursed (AOR = 9.37; 95%CI: 4.44, 19.77) were the determinants for the dropout from CBHI. CONCLUSIONS: Poor perceived quality of care, low knowledge of CBHI, no active community participation, no chronic illness, premium fees are not affordable, and out-of-pocket money not reimbursed were the determinants for the dropout from CBHI.

Magnitude of common mental disorders and associated factors among patients with Epilepsy in Amhara regional state, Northwest Ethiopia.

BACKGROUND: Common mental disorders are severe and frequent co-morbid psychiatric illnesses with epilepsy. Different study findings across the world showed that patients with epilepsy have a higher burden of mental disorders than the general population. However, these issues in patients with epilepsy have been consistently undiagnosed. OBJECTIVES: The study aimed to screen common mental disorders and the determinants among patients with epilepsy attending at Fenote Selam hospital. METHODS: An institutional-based cross-sectional study was conducted among patients with Epilepsy from March 10 to May 15, 2019. Patients were assessed for the risk of common mental disorders using a pretested, structured, self-reporting questionnaire (SRQ-20). The collected data were entered into Epi-data version 3.1 software and analyzed using R version 4.0 software. Descriptive statistics were computed using frequency, percent, mean, and standard deviations. A simple logistic regression model was fit to identify the association and strength of exploratory variables and common mental disorders at a 95% confidence interval and p-value < 0.05. RESULTS: The study included 202 patients diagnosed with epilepsy and yielded a response of 91.4%. About 53% of the patients were males. The magnitude of common mental disorders among patients with epilepsy was 57.9% (95% CI: 44.56, 71.24). Being more than one substance user (AOR = 5.7; 95%CI: 1.6, 20.7) and Not having social support (AOR = 4.3; 95%CI: 1.5, 11.9) were the identified determinants of common mental disorders. CONCLUSION: The magnitude of common mental disorders among patients with epilepsy were high. Not having social support and khat chewing were the identified risk factors significantly associated with common mental disorders. Early screening and treatments are the key interventions to prevent complications and deaths from common mental disorders.

Factors associated with willingness to take COVID-19 vaccine among pregnant women at Gondar town, Northwest Ethiopia: A multicenter institution-based cross-sectional study.

BACKGROUND: Coronavirus disease has spread worldwide since late 2019. Vaccination is critical in controlling this pandemic. However, vaccine acceptance among pregnant women is not well-studied. Therefore, this study aimed to assess the COVID-19 vaccine acceptance and associated factors among pregnant women attending antenatal care clinics in Gondar town, Northwest Ethiopia. METHODS: An institution-based cross-sectional study was conducted among pregnant women attending antenatal care clinics at Gondar town, Northwest Ethiopia, 2021. About 510 study subjects were selected using a systematic random sampling technique from August 25 to September 10/2021. Data collection was done by using an interviewer-administered, structured questionnaire. Epi-info 7.2 was used to enter data and then exported to SPSS version 25 software for analysis. Bivariable and multivariable binary logistic regression models were used to identify factors associated with the outcome variable. Variables with a p-value < 0.2 in the bivariable analysis were entered into the multivariable analysis to control for possible confounders. Statistical significance is determined using an adjusted odds ratio and 95% confidence interval (CI) at a p-value of < 0.05. RESULTS: Of 510 participants, 211 (41.4%) were willing to take COVID-19 vaccines. Maternal age ≥ 35 years (AOR: 5.678, 95% CI: 1.775-18.166), having contact history with COVID-19 diagnosed people (AOR: 7.724, 95% CI: 2.183, 27.329), having a pre-existing chronic disease (AOR: 3.131, 95% CI: 1.700-5.766), good knowledge about COVID-19 vaccine (AOR: 2.391, 95% CI: 1.144, 4.998) and good attitude towards COVID-19 vaccine (AOR: 2.128, 95% CI: 1.348) were significantly associated with the outcome variable. CONCLUSIONS: The willingness to take COVID-19 vaccine among pregnant mothers was low. Age, contact history with COVID-19 diagnosed people, chronic disease, knowledge, and attitude towards COVID-19 vaccine were factors associated with COVID-19 vaccine willingness. To enhance the COVID-19 vaccine acceptance, the government with different stakeholders should strengthen public education about the importance of getting COVID-19 vaccine.

Cancers preventive practice and the determinants in Amhara regional state, Northwest Ethiopia.

BACKGROUND: Cancer is the leading cause of morbidity and mortality globally. In Ethiopia, 5.8% of deaths are attributed to cancer. Therefore, this study aimed to examine the cancers preventive practice and associated factors in North West Ethiopia, 2019. METHODS: A community-based cross-sectional study was conducted among Bahir Dar city residents. A multistage sampling technique was used to select 845 study participants. Data were collected through a validated interviewer administered questionnaire. The questionnaire was adapted from the American cancer association cancer prevention toolkit. Descriptive statistics were computed and presented in charts and texts. The model fitness was checked using Hosmer and Lemeshow goodness of fit (P > 0.05). Bivariable and multivariable logistic regressions were used to identify factors associated with cancer preventive practice. A p-value < 0.2 at bivariate analysis was candidate variables for multivariable logistic regression analysis. Finally, p-value of < 0.05 was considered as a statistically significant predictor for cancer preventive practice at the 95% confidence interval. RESULT: A total of 845 study participants took part in the study. Nearly 63% of the respondents were females. About 28% (95%CI: 24, 30) of the study participants had good preventive practice. Age ≥ 45 years (AOR = 0.31; 95%CI: 0.15, 0.62), female (AOR = 0.50, 95%CI: 0.35, 0.71) family member with cancer (AOR = 1.68, 95%CI: 1.07, 2.62) and had good knowledge (AOR = 1.66, 95%CI: 1.14, 2.42) were the identified determinants of cancer preventive practices. CONCLUSION: This study revealed that the level of cancer preventive practices was low. Family member with cancer, knowledge about cancer, older age, and being female were significantly associated with cancer preventive practices. This finding underscores the importance of interventions to enhance cancer preventive practices.

Prevalence of stunting and associated factors among public primary school pupils of Bahir Dar city, Ethiopia: School-based cross-sectional study.

BACKGROUND: Stunting is a well-established child-health indicator of chronic malnutrition, which reliably gives a picture of the past nutritional history and the prevailing environmental and socioeconomic circumstances. OBJECTIVE: To investigate the prevalence of stunting and associated factors among public primary school children of the Bahir Dar city. METHOD: A cross-sectional study was carried out from March to June 2019. Data were coded and entered into the Epi-Data and exported to SPSS version 23 software. The pupil was stunted if the height- for-age was ≤ -2 SDs from the median growth standards according to the WHO. A descriptive summary was computed using frequency, percent, mean, median and standard deviation. A simple logistic regression model was fitted to identify associated factors between the independent variables and the dependent variable at a 95% confidence interval (CI) and p-value <0.05. RESULTS: 370 primary school pupils were included in the study with the mean age of 10.15 (± 2.23 SD) years. 51.6% of the pupils were females. The total prevalence of stunting was 15.13% (95%CI; 11%, 19%). The burden of stunting was higher in the age group of 11 years and older. Pupil's age older than 11 years (AOR = 15. 6; 95%CI; 3.31, 73.45; p-value < 0. 001) and male sex (AOR = 7. 07; 95%CI: 2.51, 19.89; p-value < 0. 0002) were significantly associated with stunting. CONCLUSION: The prevalence of stunting was relatively lower than the regional estimated stunting level. Older age and male sex were significantly associated with stunting.

Awareness regarding risk factors and determinants of cancers among Bahir Dar city residents, Northwest Ethiopia.

BACKGROUND: Cancer is the second leading cause of death in the world. Knowing the cancer risk factors could help the policy-makers to design appropriate preventive and control strategies. OBJECTIVE: To investigate the awareness regarding risk factors and determinants of cancers among Bahir Dar city residents, northwest, 2019. METHODS: A community-based cross-sectional study was employed. A systematic random sampling technique was carried out to select 845 study participants from May 1 to June 30, 2019. A validated structured cancer awareness measuring tool was used to collect the data. The data were entered into the Epi-data version 3.1 and analyzed using SPSS version 21 software. A simple logistic regression was run, and AOR (adjusted odds ratio) at a 95% confidence interval was used to identify the determinants of awareness regarding risk factors of cancers. RESULTS: Nearly twenty percent of the respondents had a good awareness regarding risk factors of cancers. An orthodox Christian (AOR = 3. 2; 95%CI: 1.8, 5.6), college graduated (AOR = 2. 3; 95%CI:1.1, 4.9), a family member with cancer (AOR = 2. 0; 95%CI: 1.3, 3.3), and living in a rental house (AOR = 0. 6; 95%CI: 0.4, 0.9) were significantly associated with awareness regarding risk factors of cancers. CONCLUSION: The study revealed that awareness regarding risk factors of cancers was very low in the study area. Being Orthodox Christian, college graduated, a family member with cancer, and living in the rental house were the determinants of awareness regarding risk factors of cancers.

Determinants of non-Hodgkin's lymphoma at Felegehiwot specialized hospital, North West Ethiopia: A case-control study.

BACKGROUND: The global burden of cancer continues to increase largely because of the aging and growth of the world population alongside an increasing adoption of cancer-causing behaviors. Hence, the purpose of this study was to identify determinants of Non-Hodgkin lymphoma cancer among individuals who diagnosed at the Felegehiwot specialized hospital, North West Ethiopia, 2019. METHODS: An institution-based unmatched case-control study was conducted at the Felegehiwot Specialized hospital from December 2018 up to June 2019. The sample size calculated using the two-population proportion formula. The final sample size was 486, (162 cases and 324 controls). The simple random sampling method was employed to catch up with the estimated samples. The collected data entered into the Epi-data version 3.1 software and analyzed using SPSS version 21 software. Descriptive statistics computed. Simple logistic analysis was run (at 95% CI and p-value < 0.05) to identify the determinants of non-Hodgkin's lymphoma. RESULT: A total of 486 patients participated. Nearly one-third of the cases and controls were in the age group of 46-60 years. About 90% of cases and 91% of controls were orthodox Christian. Monthly income of ≤28 dollars (AOR = 2. 73, 95%CI: 1. 8, 4.2), male sex (AOR = 1. 8, 95%CI: 1.2, 2.8), ever had chemical exposure, (AOR = 11. 9, 95%CI: 7.6, 18.8), no regular physical exercise (AOR = 15. 5, 95%CI: 5.7, 42.3), and having hypertension [AOR = 0. 03; 95%CI:0.005, 0.2), lung disease (AOR = 0. 2; 95%CI: 0.06, 0.7), and chronic kidney and cardiac diseases (AOR = 0. 06; 95%CI: 0.01, 0.2) were the determinants of non-Hodgkin's lymphoma. CONCLUSIONS: The findings in this study suggest that having a low monthly income, being male sex, ever had chemical exposure, not engaged in regular physical exercise, and being diabetic were the determinants of non-Hodgkin's lymphoma.

Community-Based Health Insurance and Associated Factors in North-Western Ethiopia. The Case of Bahir Dar City.

BACKGROUND: Health insurance provides access to health care with financial risk protection. Knowledge and attitude have been found to influence enrolment in community-based health insurance, which avoids catastrophic health-care expenditure. However, knowledge and attitude levels towards health insurance are not well studied. The objective of this study was to determine the knowledge and attitude level of the informal workers of the Bahir Dar city towards community-based health insurance. METHODS: A community-based cross-sectional study was conducted with systematically selected 335 informal workers. We conducted structured face-to-face interviews using a newly developed and validated questionnaire. The collected data were coded and then entered into Epi data and exported to SPSS software for analysis. Logistic regression analysis was used to identify potential associations between the study variables. RESULTS: Out of 325 informal workers, 51% of them had good knowledge of community-based health insurance, while 56% of participants had a favorable attitude towards community-based health insurance. Being single (AOR=3.4, 95% CI; 1.3, 9.0), daily laborer (AOR=2.73, 95% CI; 1.36, 5.48), attending secondary education (AOR=0.29; 95% CI: 0.12, 0.71), and obtaining information from television (AOR=0.31, 95% CI; 0.14, 0.71) were found to be statistically associated with knowledge. While being single (AOR=0.23, 95% CI: 0.08, 0.67), married (AOR=0.29, 95% CI: 0.11, 0.73), daily laborer (AOR=2.84, 95% CI: 1.37. 5.88), getting information from television (AOR= 3.09, 95% CI: 1.37, 6.93) and family (AOR= 2.63, 95% CI: 1.23, 5.61) were found to be statistically associated with the attitude towards community-based health insurance. CONCLUSION: The knowledge and attitude level of the informal workers towards community-based health insurance were low. Therefore, community-based health insurance should be promoted to ensure the accessibility of health care to all.

Healthcare Waste Management Practice and Associated Factors among Private and Public Hospitals of Bahir Dar City Administration.

Background: Lack of an appropriate management practice of healthcare waste is a potential threat to the healthcare workers, patients, and nearby communities of the health institutions. Objective: The study aimed to assess the healthcare waste management practices (HCWMP) and associated factors among healthcare workers of private and public hospitals of Bahir Dar city administration, Ethiopia. Methods: A facility-based comparative cross-sectional study was conducted from January 2016 to April 2017. The systematic random sampling technique was employed to recruit 460 healthcare workers. The collected data entered into the EpiData software (version 3.1). The analysis was done by using SPSS software (version 20). Descriptive statistics were computed; logistic regression model was run. The model fitness was checked using Hosmer and Lemeshow goodness of fit (p > 0.05). A p value of <0.2 at univariate analysis was included in the multivariable logistic regression analysis. Variables with a p value of <0.05 were statistically associated with healthcare waste management practice at 95% CI (AOR). Results: A total of 418 healthcare workers who participated in the study yielded a response of 90.9%. About 65% (95% CI: 61, 70) of the total respondents had good practice of healthcare waste management. More private hospitals, 79.2% (95% CI: 73, 85), had good healthcare waste management practice compared to public hospitals, 53.5% (95% CI: 47, 60). Male healthcare workers (AOR = 6. 43, 95% CI: 1.82, 22.77) and having a functional healthcare waste management committee (AOR = 6. 47, 95%CI: 1.93, 21.76) were significantly associated with HCWMP at private hospitals. For public hospitals, having a healthcare waste management committee (AOR = 1. 80, 95% CI: 1.03, 3.15) and a manual/guideline on HCWMP (AOR = 2. 43, 95% CI: 1.20, 4.91) was significantly associated with HCWMP. Conclusions: This study revealed there is a great discrepancy in HCWMP between private and public hospitals. Male healthcare workers and having a functional healthcare waste management committee and a manual/guideline were the identified factors of HCWMP.

Incubation Period of Severe Acute Respiratory Syndrome Novel Coronavirus 2 that Causes Coronavirus Disease 2019: A Systematic Review and Meta-Analysis.

BACKGROUND: Coronavirus disease 2019 (COVID-19) has currently become a major global public health problem. The prevalence of COVID-19 has increased rapidly worldwide. Because there is no effective COVID-19 vaccine available yet, it is increasingly important to understand the average incubation period of severe acute respiratory syndrome novel coronavirus 2 (SARS-CoV-2), the virus that causes COVID-19, to design appropriate preventive and control strategies. OBJECTIVE: This systematic review and meta-analysis was designed to estimate the pooled average incubation period of SARS-CoV-2, the virus that causes COVID-19. METHODS: We conducted a systematic electronic web-based search of online databases, including PubMed, Google Scholar, Embase, and the World Health Organization Hinari portal. We included peer-reviewed research studies written in the English language on the incubation period of SARS-CoV-2 using pre-defined quality and inclusion criteria. STATA version 15 statistical software was used to analyze the data. Joanna Briggs Institute critical appraisal quality assessment tool for observational studies was utilized to evaluate the included studies. We extracted relevant data and presented in a tabular form. The I 2 test was used to assess heterogeneity across studies. Funnel plot asymmetry and Egger tests were used to check for publication bias. The final effect size was determined by applying a random-effects model. RESULTS: Our search identified 206 studies, amongst which 18 studies, representing 22,595 participants were included in the final analysis. The pooled average incubation period of SARS-CoV-2 was 5.7 days (95% CI, 5.1-6.4). Subgroup analyses by geographic location showed that the pooled average incubation period of SARS-CoV-2 was 6.1 days (95% CI, 5.34-6.94) in China and 4.54 (95% CI, 3.9-5.2) in other countries (Singapore, South Korea, and globally). CONCLUSIONS: The pooled average incubation period of SARS-CoV-2 was about 6 days. The longest incubation period was observed in China. Global health initiatives as well as local health planners should consider this average incubation period when designing optimal prevention and control strategies for SARS-CoV-2. (Curr Ther Res Clin Exp. 2020; 81:XXX-XXX).

Magnitude of risky sexual practice and associated factors among big construction site daily laborers in Bahir Dar city, Amhara Region, Ethiopia.

BACKGROUND: Young person's susceptibility to sexually transmitted infection has been consistently linked to intractable work places. In Ethiopia, different behavior related interventions had carried out to raise awareness of risky sexual behaviors and their consequences. However, there is still limited information on risky sexual practices. METHODS: A cross-sectional study was conducted among the big construction site daily laborers from April 1, 2019 to May 30, 2019. A pre-tested questionnaire was used for data collection, and data were entered into Epidata and transported to SPSS for analysis. Independent variables with p < 0.05 in the multivariate analysis were considered to have a statistically significant association with risky sexual practice. RESULT: Among 627 sample respondents, the magnitude of risky sexual practice was found to be 24.2%. Labor workers who had a history of an STIs (AOR = 4.29; 95% CI: 2.56, 7.19), those who enjoy in the nightclubs (AOR = 2.33; 95% CI: 1.34, 4.08), those who started sex by peer pressure (AOR = 3.42; 95% CI: 2.06, 5.68), substance users (AOR = 2.03; 95% CI: 1.08, 3.82), those who were unable to read and write (AOR = 3.65; 95% CI: 1.41, 9.67), living independently (AOR = 3.71; 95% CI: 1.78, 7.77) and living with relatives (AOR = 3.12; 95% CI: 1.06, 9.20) were statistically associated with risky sexual practice. CONCLUSION: The magnitude of risky sexual practice among big constriction daily laborers was high in Bahir Dar City likely to increase their vulnerability to HIV. The findings of this study show the need of targeted HIV prevention plan to give due attention for daily laborers who had a history of an STI, enjoy in the night clubs, peer pressure, substance users, educational status and living arrangement. The Amhara Education Bureau and the city education department have to design ways to deliver at least a high school education.

Maternal satisfaction among vaginal and cesarean section delivery care services in Bahir Dar city health facilities, Northwest Ethiopia: a facility-based comparative cross-sectional study.

BACKGROUND: Mothers' delivery care satisfaction is one of the indicators to monitor the quality of health care provision. However, there is only limited information in this regard in Ethiopia, particularly in the study area. Therefore, the study aimed to determine the level of maternal satisfaction and the determinants among vaginal and cesarean section delivery care in Bahir Dar city health facilities. METHODS: Facility-based comparative cross-sectional study was conducted from April to May 2018. Using systematic random sampling, a total of 896 recently delivered mothers were interviewed. The collected data were entered into the Epi-Data soft and then exported to SPSS Version 20.0 for analysis. Descriptive statistics were computed and Logistic regression model was used to identify the association between explanatory and outcome variables. Adjusted Odds Ratio with 95% CI was used to measure the strength of the association between these variables. The model fitness was checked using Hosmer and Lemeshow goodness of fit (P > 0.05). A p-value < 0.2 at bivariate analysis was considered for variables to be candidates for multivariable logistic regression analysis. Variables with a p-value of < 0.05 at multivariate analysis were considered as statistically significant predictors of mothers' satisfaction. RESULTS: A total of 894 recently delivered mothers participated in the study yielded a response of 99.8%. 448 (50.1%) mothers delivered vaginally whereas 446 (25.8%) via cesarean section. The overall mean age of respondents was 26.60 (± 4.88) years. The total maternal delivery care service satisfaction level was 61.4%. More mothers were satisfied with vaginal delivery care, 65.6% (95% CI: 56.97, 74.22%) than cesarean section, 57.2% (95% CI: 48.19, 66.2%). Maternal education, residence, current delivery care planned, maternal HIV status, the gender of health care provider and gave birth in a private health facility were significantly associated with vaginal delivery care satisfaction. Whereas, maternal education, residence, current delivery care planned, antenatal care attended, gender of health care provider was significantly associated with cesarean section delivery care satisfaction. CONCLUSIONS: The overall maternal delivery care service satisfaction level was low as, per the national standard, and there is a great discrepancy in maternal satisfaction level between vaginal and cesarean section delivery care services.

Knowledge and attitude of reproductive age group (15-49) women towards Ethiopian current abortion law and associated factors in Bahir Dar city, Ethiopia.

BACKGROUND: Unsafe abortion accounts for nearly 60% of all gynecologic admissions and almost 30% of all obstetric and gynecologic admissions. Studies on abortion in Ethiopia have given less attention to women's perceptions and experiences of abortion laws. Although the 2005 revised abortion law allows women to access safe abortion services, still unsafe abortion is one of the leading causes of pregnancy-related deaths. Therefore, the current study aimed to assess women's knowledge and attitude towards the Ethiopian current abortion law in Bahir Dar City Administration. METHODS: A community-based cross-sectional study using a systematic random sampling technique was carried out among 403 randomly selected reproductive age women using a pre-tested structured questionnaire in Bahir Dar City Administration from May to June /2017. Data were entered into Epi data version 3.1 and analyzed using SPSS version 21.0 software. Logistic regression was done to identify the possible factors associated with women's knowledge and attitude towards the Ethiopian current abortion law. RESULTS: Three hundred eighty-six respondents partook with a response rate of 95.7%. The study showed that 43% had good knowledge and 38% had a favorable attitude towards the Ethiopian current abortion law. Women's in the age group of 25-29 years (AOR = 2.7, 95% CI: 1.02, 6.9), partner's educational status of primary (AOR = 2.9, 95% CI: 1.19, 7.08), secondary (AOR = 5.5, 95% CI: 2.09, 14.4) and college and above (AOR = 8.2, 95% CI: 2.3, 28.6) were significantly associated with good knowledge of the Ethiopian current abortion law. While partner's educational status; college and above (AOR = 6.15, 95% CI: 1.87, 20.22) was significantly associated with the favorable attitude towards the Ethiopian current abortion law. CONCLUSIONS: 43% of respondents had good knowledge and 38% had a favorable attitude towards the Ethiopian current abortion law. Forty-nine respondents had a history of abortion of which, 8 occurred through induction. Woman's age and partner's education determine the status of knowledge while merely; the partner's educational status of college and above was significantly associated with the attitude towards Ethiopian current abortion law, respectively.