Willingness to pay for medical care and its determinants in private health care facilities among Gondar city residents, Northwest Ethiopia: Cross sectional study.

Medical care is a type of health service that mainly consists of investigation and diagnosis, treatment, rehabilitative care, and nursing care for the purpose of maintaining the structure or function of the body. A medical care payment is a sort of payment made for the diagnosis, cure, mitigation, treatment, or prevention of disease, sickness, or damage, which includes checkups and periodic exams. In low-income nations, out-of-pocket expenditures account for 60 % of overall health spending, compared to 20 % in high-income ones. Willingness to pay is perhaps the highest money that a person is willing to provide to ensure that a particular wellbeing care action is undertaken. Previous research works focused mainly on the patients' willingness to pay but not the amount they can afford. The focus of this study is to determine the level of willingness to pay, the mean amount of willingness to pay for medical care, and its major determinants. A community-based cross-section study was carried out among Gondar city residents from February 2022 to March 2022. The study participants were recruited by systematic random sampling. Four data collectors conducted interviews using a questionnaire. For analysis, the dataset was entered into Epi Info version 7 and transferred to STATA version 14. The descriptive part was summarized using summary statistics like mean, median, and standard deviation. Determinants of willingness to pay were identified using a Tobit regression model with a significance of p-value ≤ 0.05 and confidence interval (CI ≠ 0). Finally, the analyzed data was presented using tables and figures accordingly. The study involved 414 participants, with a response rate of 95.8 %. About 53.62 % of the participants were willing to pay for medical care and the average willingness to pay was 24.17 USD per year. They were more willing to pay if they were still working (ß = 19.66), currently married (ß = 14.49), had a family history of medical care (ß = 25.74), had good knowledge (ß = 36.16), had a history of medical illness (ß = 16.64), lived a long distance from the health facility (ß = 1.98), and had a high wealth index (ß = 29.51). The willingness to pay for medical care is below the actual cost. Designing a cost-recovery strategy with multi-tiered programs assigned to the most vulnerable individuals, such as the elderly, less educated, or seriously sick, is a strategic approach of the raising demand for service uptake and accessibility.

Self-Reported Fall-Related Injury and Its Associated Factors among Adults with Visual Impairment Attending St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia.

Background: Falls account for vast majority of fractures and are a significant reason for trauma related hospital admissions. The main aim of this study is to determine the prevalence of self-reported fall, related injuries, and associated factors among adult patients with visual impairment. Methods: Hospital-based cross-sectional study was conducted from July to August 2021. Systematic random sampling technique was used. The data were entered into Epi-data version 3.1 and exported to SPPS version 26 for analysis. Frequency, mean, and percentage, were used to summarize the descriptive data. The association between the outcome variable and explanatory variables was assessed using binary and multivariate logistic regressions. The adjusted odds ratio was calculated, and variables with a p-value below 0.05 at the 95% confidence interval (CI) were considered statistically significant. Result: A total of 487 study participants were involved in this study with a response rate of 93.83%. The mean age of the study participants was 52 ± 16.26 years. The overall prevalence of self-reported fall was 36.1 %. Being female, being older than 64 years of age, rural residence, fear of falling, and blind stage of visual impairment were significantly associated with falling. Conclusion: The prevalence of self-reported fall was high among visually impaired individuals. Female sex, age more than 64 years, rural residence, fear of falling, and blind stage of visual impairment were significantly associated with falling. Reducing patients' chances of suffering from falling-related injuries and consequences requires raising awareness about the burden, danger, and effects of falling on persons who are visually impaired.

Magnitude of Maladaptive Coping Strategy and Its Associated Factors Among Adult Glaucoma Patients Attending Tertiary Eye Care Center in Ethiopia.

Introduction: Coping strategy is the mechanism by which patients adjust to the condition they face. It can be adaptive or maladaptive. A maladaptive coping strategy is a harmful and ineffective way of dealing with stress or anxiety. It is common among patients with chronic illnesses. Despite Ethiopia having a greater glaucoma prevalence, there was no evidence of patients with glaucoma using maladaptive coping mechanisms. Objective: The main goal of this study was to evaluate the magnitude of maladaptive coping strategy use and the factors that associate with it among adult glaucoma patients enrolled in the Tertiary Eye Care and Training Center at the University of Gondar in Northwest Ethiopia in 2022. Methods and Materials: At the University of Gondar, Tertiary Eye Care and Training Center, a facility-based cross-sectional study was carried out on a sample of 423 glaucoma patients chosen by a systematic random sampling technique from May 15 to June 30, 2022. Optometrists conducted an interview with the study subject and reviewed the medical record, and administered a pretested, structured questionnaire of the brief cope inventory assessment. In the multivariable logistic regression, binary logistic regression was performed to identify the related factors, and significance was taken into account when the p-value was less than 0.05 at the 95% confidence interval. Results: The study found that among study participants 50.1% (95% CI: 45.1-54.5%) had a maladaptive coping strategy. Female sex (AOR=2.031, 95% CI:1.185-3.480), chronic medical illness (AOR=1.760, 95% CI:1.036-2.989), bilateral glaucoma (AOR=2.321, 95% CI: 1.328-4.055), receiving both drug and surgery treatment (AOR=1.895, 95% CI: 1.002-3.585), severe visual impairment (AOR=2.758, 95% CI:1.110-6.852), absolute glaucoma (AOR=2.543, 95% CI:1.048-6.169), duration of diagnosis >12 months (AOR=3.886, 95% CI: 2.295-6.580) were significantly associated with a maladaptive coping strategy. Conclusion and Recommendation: Half of the participants had a maladaptive coping strategy. It is better to set and plan strategies that enable the integration of coping strategy care into the current treatment of patients with glaucoma to encourage positive coping strategies instead of maladaptive ones.

Prevalence, causes and associated factors of visual impairment and blindness among older population in outreach site, Northwest Ethiopia. A dual center cross-sectional study.

Purpose: The study aimed to determine the prevalence, causes, and associated factors of visual impairment and blindness among the older population in Outreach sites, Northwest Ethiopia. Methods: A community-outreach-based cross-sectional study was conducted on 821 older population which were selected using a systematic random sampling technique. Face-to-face interviews and ocular examinations were performed to collect the data. A binary logistic regression was performed. Result: A total of 821 participants were recruited for the study with a median age of 57 years, with a range of 40-91 years. Out of 821 participants, 41.8% had visual impairment, and 11.7% were blind. Sixty-four and fifty seven percent of visual impairment and blindness were caused by cataract. Age ≥70years (AOR=15.0; 95%CI: 8.4-26.9), rural residency (AOR=2.3; 95%CI: 1.5-3.6), non-formal education (AOR=3.0; 95%CI: 1.6-5.6), unemployed (AOR=1.5;95%CI:1.05-2.4) and history of eye examination (AOR=1.7;95%CI:1.1-2.8) were positively associated with visual impairment. Similarly, blindness was significantly associated with age ≥ 70years (AOR=7.2; 95%CI: 3.1-16.6), rural residency (AOR=2.2;95%CI:1.2-4.2), and history of eye examination (AOR=1.9; 95%CI: 1.1- 3.3). Conclusion: the prevalence of visual impairment and blindness in this study was found to be high. Age, residency, educational status, occupational status, and history of eye examination were significantly associated with visual impairment and blindness.

Visually significant cataract and associated factors among older people attending a community ophthalmic service in central Gondar Zone, Northwest Ethiopia: a cross-sectional study.

OBJECTIVE: In this study, we aimed to determine the prevalence of visually significant cataract and associated factors among older people attending community ophthalmic services in the central Gondar Zone, Northwest Ethiopia. METHODS: We conducted a community outreach-based cross-sectional study among adults aged ≥40 years in the central Gondar Zone from 30 May to 15 June 2021. We used systematic random sampling to select study participants. Interviewer-administered questionnaires and ocular examinations were performed and the data recorded. We applied binary logistic regression to identify factors associated with visually significant cataract. RESULTS: A total of 821 participants were included, with median age 57 years. The prevalence of visually significant cataract was 29.1% (95% CI: 26.1-32.0). Age ≥80 years (adjusted odds ratio [AOR] = 16.9; 95% CI: 7.5-38.4), rural residence (AOR = 1.7; 95% CI: 1.02-2.7), unmarried status (AOR = 1.9; 95% CI: 1.2-3.2), illiteracy (AOR = 2.9; 95% CI: 1.4-6.1), unemployed status (AOR = 1.7; 95% CI: 1.1-2.7), and sunlight exposure ≥5 hours per day (AOR = 1.6; 95% CI: 1.04-2.4) were significantly associated with visually significant cataract. CONCLUSION: In this study, visually significant cataract was found to be high, which requires immediate public health intervention.

Willingness of corneal donation and its associated factors among adult patients attending Gondar University Comprehensive and Specialized Hospital.

INTRODUCTION: Corneal transplantation is the only treatment option for corneal blindness to restore sight. However, there is a disproportionate imbalance between the demand and supply of corneal tissue in Ethiopia. This is because accessing corneal tissue is reliant on people who are willing to donate corneas after death. OBJECTIVE: This study aimed to assess the proportion of willingness to donate cornea and associated factors among adult patients attending at University of Gondar comprehensive and specialized hospital. METHOD: Institutional based cross-sectional study was conducted from July 13 to July 28, 2020, through a face-to-face interview. A total of 451 samples were selected using systematic random sampling. The data were entered into Epidemiological information version 7 and exported to statistical package for social science version 20 for formal analysis. Variables with a P-value of < 0.20 in a bi-variable logistic regression were entered into the multivariable logistic regression and those variables with a p-value of < 0.05 were taken as statistically significant. The strength of association was shown using the odds ratio with a 95% confidence interval. RESULT: A total of 408 adults participated in this study with a response rate of 90% and the proportion of willingness to donate cornea was 179(43.90%). Participants who had a religious belief in Christianity (AOR = 3.23 (95% CI: 1.09-9.57)) and good knowledge about corneal donation (AOR = 5.45(95%CI: 2.69-11.18)) were positively associated with the willingness of corneal donation. On the other side, the age group above 43 years (AOR = 0.31(95% CI: 0.11-0.89) was negatively associated with the willingness of corneal donation. CONCLUSION: The proportion of willingness to donate cornea 43.9% among participants attending Gondar University Comprehensive and Specialized Hospital. Age group greater than 43 years, religion of Christianity and good knowledge were associated with the willingness of corneal donation.

Protection of the Eye from Ultraviolet Radiation Damage Among Adults in Addis Zemen Town, Northwest Ethiopia.

BACKGROUND: Ultraviolet radiation is electromagnetic radiation or light having a wavelength of less than 400 nm but greater than 100 nm. Ultraviolet radiation, majorly from sunlight, can potentially damage any organ that is exposed to any part of its spectrum. Aside from the skin, the organ most susceptible to sunlight-induced damage is the eye. Ultraviolet radiation is reported to be the cause of multiple ocular problems ranging from benign conditions like pterygium and pinguecula to ocular malignancies such as basal cell carcinoma which finally leads to visual impairment and blindness. Protection practice is mandatory to avoid the burden of diseases caused by ultraviolet exposure and maximizing the protection measures implementation is important. To maximize this, it is essential to know the current practice and the associated factors affecting the usage of protective devices in the study area. METHODS: Community-based cross-sectional study was conducted from April to May 2019 on 453 study participants. The study participants were selected through a systematic random sampling method. Data were collected using a pretested structured questionnaire. The analyzed result was summarized and presented using texts, tables and charts. A Chi-square test was applied to assess the significant association. RESULTS: A total of 430 study subjects were participated and completed the questionnaire with a response rate of 94.92%. The mean age of the study participants was 35.3 (SD±6.68). Two hundred forty-three (56.5%) study participants were males. About 228 (53%) of participants were married, and 356 (82.8%) were Christian in religion. From the total study participants, 173 (40.23%) had good practice in protecting the eye from ultraviolet radiation damages while the remaining 59.77% had poor practice. A significant association was found between sex and protection practice of the eye from ultraviolet radiation damages. CONCLUSION: The majority of the study participants had poor protection practice of the eye from ultraviolet radiation damages. Improving awareness and protection practice are vital to reduce the burden of ocular abnormalities due to excessive exposure to ultraviolet radiation.

Proportion and Associated Factors of Low Vision among Adult Patients Attending at University of Gondar Tertiary Eye Care and Training Center, Gondar Town, Ethiopia.

INTRODUCTION: Low vision is a worldwide health problem in both developing and developed countries. A national survey of low vision and blindness in Ethiopia showed that the prevalence of low vision was 3.7% and that of blindness was 1.6%, whereas there is no evidence in the study area. PURPOSE: The study was aimed to assess the proportion and associated factors of low vision at the University of Gondar tertiary eye care and training center. METHODS: A hospital-based cross-sectional study was conducted on 727 study participants with a systematic random sampling technique from April 18 to May 16, 2019. Data were collected through the use of a structural questionnaire and physical eye examination. Data were entered into Epi Info version 7, and analysis was performed by using statistical package for social science (SPSS) version 20. The binary logistic regression model was fitted to identify factors associated with low vision, and variables with a P value of <0.05 in a multivariable binary logistic regression were considered as statistically significant. RESULTS: A total of 715 study participants have participated in this study with a mean age of 49.39 ± 19.93 years. The prevalence of low vision was 35.7% (95% CI: 32.3, 39.3). Being female (AOR = 1.58; 95% CI: 1.10, 2.28), no formal educational level (AOR = 2.24; 95% CI: 1.25, 4.02), history of cataract surgery (AOR = 2.58; 95% CI: 1.53, 4.36), and age ≥ 70 years (AOR: 3.96; 95% CI: 2.21, 7.10) were significantly associated with low vision. Conclusion and Recommendation. The prevalence of low vision found in this study was high as compared with the national and global magnitude. Older age, being female, previous history of cataract surgery, and no formal education were independently and significantly associated with low vision. Cataract and uncorrected refractive errors were identified as the main causes of low vision. Therefore, it requires a plan to provide an eye care education to the community, increasing the quality of cataract surgery and refractive service for the community in the catchment area.

Knowledge about Computer Vision Syndrome among Bank Workers in Gondar City, Northwest Ethiopia.

BACKGROUND: Globally, computer vision syndrome is the most common eye problem which is associated with prolonged exposure to a computer. It has a great socioeconomic impact on the users due to its effect on job performance. Recently, many people in the world, including our country Ethiopia, especially bank workers, are spending most of their time in front of a computer screen to facilitate their work. Since it is assumed that knowledge is pertinent to prevent computer vision syndrome, this study was aimed at assessing the understanding of bank workers towards computer vision syndrome. METHODS: An institution-based cross-sectional study was conducted on 248 bank workers. The study participants were selected by using a simple random sampling technique. A self-administered questionnaire was used to collect the data from the bank workers. The data was entered and analyzed by SPSS version 21 software. RESULTS: A total of 248 bank workers completed the questionnaire fully, which was a response rate of 93.5% (n = 234). Among them, 155 (66.20%) were males and the majority of the respondents were in the age group of 20-39 years (223, 95.3%). The study revealed that from 234 respondents, 211 (90.20%) were aware of computer vision syndrome, while 26.9% of them had a good knowledge about the disorder. Majority of the respondents (40, 17.1%) cited mass media as a source of information. CONCLUSION: Even though the majority of computer-using bank workers heard of computer vision syndrome, it was recognized that only a small portion of the participants had good knowledge.

Xerophthalmia and Its Associated Factors among School-Age Children in Amba Giorgis Town, Northwest Ethiopia, 2018.

INTRODUCTION: Xerophthalmia is a general term applied to all the ocular manifestations from night blindness through complete corneal destruction (keratomalacia) due to vitamin A deficiency. Xerophthalmia is the main contributing factors for childhood blindness in developing countries. However, there is limited evidence that can implicate the current situation. This study aimed to determine the magnitude of xerophthalmia and associated factors among school-age children in Northwest Ethiopia. METHODS: A community-based cross-sectional study was conducted on 490 children, age range of 6 to 12 years. The study participants were selected through systematic random sampling method. Data were collected using a pretested structured questionnaire and ophthalmic examination with different ophthalmic instruments. The analyzed result was summarized and presented using descriptive statistics. Binary logistic regression was used to determine the factors associated with xerophthalmia. Variables with a p value of <0.05 in the multivariable logistic regression analysis were considered as statistically significant. RESULTS: A total of 484 study participants with a response rate of 98.8 were involved in this study, and their median age was 8 years with IQR of 4 years. The prevalence of xerophthalmia was 8.26% (95% CI: 5.8, 10.7). Family income less than 1000 Ethiopian birr (AOR = 4.65, 95% CI: 1.31, 16.4), presence of febrile illness (AOR = 2.8, 95% CI: 1.49, 6.11), poor consumption of fruits and vegetables (AOR = 3.18, 95% CI: 1.30, 7.80), and nonimmunized status (AOR = 3.43, 95% CI: 1.49, 7.89) were significantly associated with xerophthalmia. CONCLUSIONS AND RECOMMENDATIONS: The prevalence of xerophthalmia was high as compared to the World Health Organization criteria for public health significance. Factors identified for xerophthalmia in this study are low income, the poor dietary practice of fruits and vegetables, and the presence of febrile illness and not immunized. Hence, it is a public problem that needs attention.

Knowledge and Attitude toward Eye Donation among Adults, Northwest Ethiopia: A Community-based, Cross-sectional Study.

BACKGROUND: In developing countries, the leading cause of childhood blindness is corneal scarring. Although the service of corneal transplantation depends on several factors, availability of potential donors is of paramount importance. Attitude of eligible donors is the main factor that affects corneal supply. However, limited data exist on eye donation. Hence, this study intended to assess the knowledge and attitude toward eye donation and its associated factors. SUBJECTS AND METHODS: A community-based, cross-sectional study was conducted on 760 adults aged ≥18 years selected using multistage systematic random sampling in Gondar town, Northwest Ethiopia. A face-to-face structured questionnaire interview in home-to-home visit was applied to collect the data. Descriptive and analytical tests were performed. A binary logistic regression was fitted. Those variables with P < 0.05 were considered statistically significant. RESULTS: This study comprised 760 adults with a median age of 30 years. The proportion of overall level of good knowledge and favorable attitude toward eye donation was 8.4% and 59.9%, respectively. It has been also recognized that attitude was positively associated with educational level of high school (adjusted odds ratio [AOR] = 2.41, 95% confidence interval [CI]: 1.41-4.14) and college/university (AOR = 2.73, 95% CI: 1.53-4.89) and awareness (AOR = 1.50, 95% CI: 1.05-2.03). CONCLUSIONS: Although the overall level of knowledge about eye donation was poor, the proportion of favorable attitude toward eye donation was fair. Since it was associated with educational level and awareness, it is strategic to follow multidisciplinary approaches to facilitate multi-stakeholder partnerships and to motivate the people to donate their eyes.

Visual outcome of cataract surgery at Gondar University Hospital Tertiary Eye Care and Training Center, North West Ethiopia.

BACKGROUND: Globally, cataract is the leading cause of blindness which accounts for 51% of 39 million blind people. The visual rehabilitation is made through sight-restoring surgery. The patients' postoperative visual satisfaction, vision related quality of life, ability to function in daily activities and their overall productivity mainly depend on the visual outcome. However, there are limited data on the visual outcome and its associated factors in the study area. Therefore, this study intended to evaluate the postoperative level of visual acuity to provide a baseline information regarding visual outcome and design a standardized protocol to maximize it. METHODS AND MATERIALS: A hospital-based cross-sectional study was conducted at the Gondar University Hospital Tertiary Eye Care and Training Center on 223 patients who underwent cataract surgery, selected using simple random technique from April to June 2015. RESULTS: This study consisted of 218 patients or eyes that underwent cataract surgery. The median age of the participants was 65 years with an interquartile range of 20 years. Of 218 cataract-operated visually impaired eyes (<6/60), 26.6% of them achieved good visual acuity (≥6/18), 28.9% of them had borderline acuity (<6/18-6/60), and the remaining of 44.5% were remained as poor visual acuity (<6/60). It has been observed that the postoperative visual acuity had an association with postoperative follow up time duration (P=0.035). CONCLUSION: In this study, the visual outcome of cataract surgery was significantly low as compared to World Health Organization's recommendations, and it has been recognized that there is significant progression of visual acuity in different consecutive weeks.

Prevalence and associated factors of myopia among high school students in Gondar town, northwest Ethiopia, 2016.

INTRODUCTION: Myopia is an important cause of correctable visual impairment and preventable blindness worldwide. Prevalence rates are approximately 20%-35% among the older teenage population globally. It has a medical burden of pathologic complications such as maculopathy and glaucomatous optic neuropathy. High school students experience high-performance and study pressures in the preparation for the final national examination. As a result they are exposed to excessive near work and indoor activities. They are also ignored for regular screening. OBJECTIVE: To determine the prevalence and associated factors of myopia among high school students in Gondar town, Ethiopia. METHODS: An institution-based cross-sectional study was conducted on 498 high school students with systematic random sampling method from April 18 to April 29, 2016, in three full-cycle high schools (9th-12th grades). A standardized structured questionnaire, Snellen acuity chart, pinhole, retinoscope, trial case lenses, pen torch, and direct ophthalmoscope were used to collect data. RESULTS: A total of 495 study participants were included, and they had a mean age of 17.48±1.59 years. The prevalence of myopia was 11.9% (95% confidence interval [CI]: 10.2, 17.9). Family history of myopia (adjusted odds ratio [AOR]=8.08 [95% CI: 4.30, 15.16]), school being private (AOR=2.88 [95% CI: 1.02, 8.11]), longer time spent for near work (AOR=2.89 [95% CI: 1.12, 7.43]), longer time spent partaking in indoor activities (AOR=4.32 [95% CI: 1.69, 10.99]), shorter near working distance (AOR=3.06 [95% CI: 1.33, 7.06]), lack of outdoor sport activities (AOR=2.27 [95% CI: 1.05, 4.90]), use of visual display units (AOR=2.81 [95% CI: 1.30, 6.10]), and abnormal ocular findings (AOR=6.69 [CI: 3.43, 13.03]) were found to be independently associated with myopia. CONCLUSION: The prevalence of myopia was 11.9%. Family history for myopia, school being private, longer time spent partaking in indoor activities, shorter working distance, lack of outdoor sport activities, use of visual display units, and presence of abnormal ocular findings were positively associated with myopia.