Individual and contextual-level factors associated with iron-folic acid supplement intake during pregnancy in Ethiopia: a multi-level analysis.

BACKGROUND: Anemia is still one of the major public health problems in many developing countries including Ethiopia. Thus, this study aimed to assess individual and contextual-level factors associated with iron-folic acid supplement intake during pregnancy in Ethiopia. METHODS: A secondary analysis was done on the 2019 mini-Ethiopian Demographic and Health Survey (EDHS) dataset. A total of 3,927 pregnant women who gave birth five years before the survey were included in the analysis. Multi-level mixed-effect logistic regression analysis was done by STATA/SE version 14.0 to identify individual and contextual-level factors. Adjusted Odds Ratio (AOR) with 95% Confidence Interval (CI) was used to show the strength and direction of the association. The level of statistical significance was declared at a P value less than 0.05. RESULTS: Those primary educated [AOR = 1.83, 95% CI: (1.24, 2.74)], secondary educated [AOR = 2.75, 95% CI: (1.57, 4.824)], women who had greater than 5 living children [AOR = 2.02, 95% CI: (1.25, 3.27)], women who had ANC visit [AOR = 21.26, 95% CI: (13.56, 33.32)] and women who lived in a cluster with high proportion of women had ANC visit [AOR = 1.72, 95% CI: (1.17, 2.54)] and women who lived in Somali [AOR = 0.44 0.73, 95% CI: (0.22, 0.87)] were significantly associated with iron-folic acid intake during pregnancy. CONCLUSIONS: Both individual and contextual-level factors were significantly associated with iron-folic acid intake during pregnancy. From individual-level factors: education status of women, the total numbers of living children, and ANC follow-up are significant and from contextual-level factors: region and living in a high proportion of women who had ANC follow-up were found to have a statistically significant association. Promoting women's education and maternal health services like ANC and intervention targeting the Somali region would be the recalled area of the government.

Epileptic seizure first aid practices of publics in Northwest Ethiopia 2021: Unsafe practices of nearly three-fourths of the community.

Background: Religious and sociocultural beliefs influence how people with epilepsy (PWE) are treated and cared for. Many communities in Africa and other developing countries, including Ethiopia, believe that epilepsy is caused by evil spirits and should be treated with herbal plants by traditional doctors and religious leaders. The combination of these sociocultural beliefs and the level of community awareness of epilepsy affect first aid practices in the management of epileptic seizures. Objective: This study aimed to assess epileptic seizure first aid practice of public and its associated factors in Northwest Ethiopia, south Gondar zone, Amhara, Ethiopia 2021. Methods: A community-based cross-sectional study was conducted using a previously adapted standard questionnaire. A multistage cluster sampling technique was applied. A total of 756 participants were approached and 741 respondents completed the questionnaire with a response rate of 98.02%. Data were entered into Epi data version 4.4.2 and then exported to Statistical Package for Social Science (SPSS) version 24 for analysis. Descriptive and analytical statistical procedures and bivariable and multivariable binary logistic regressions with odds ratios and 95% confidence interval (CI) were employed. The level of significance of the association was determined at p < 0.05. Results: Overall, 71.7% (95%CI: 68.3, 74.9) of the south Gondar community had unsafe practice measures in managing patients with seizure episodes. Individuals who were illiterate [adjusted odd ratio (AOR) = 1.99, 95%CI: 1.00.3.97] and participants who did not take training related to epilepsy (AOR = 2.07, 95%CI: 1.35, 3.17) and had poor knowledge about (AOR = 1.51, 95%CI: 1.06, 2.14) and a negative attitude toward epilepsy (AOR = 2.20, 95%CI: 1.50, 3.22) had unsafe practices compared to their counterparts. Conversely, participants who reached secondary education had safe practice measures (AOR = 0.4, 95%CI: 0.26, 0.63) in the management of epileptic seizures. Conclusions: In this study, large numbers of the south Gondar community had unsafe practice measures in managing people with epileptic seizure episodes. Greater emphasis should be laid on individuals who were illiterate, in the provision of health education and/or training for the community to help them to acquire good knowledge about epilepsy and develop a positive attitude toward epilepsy.

Magnitude and risk factors of chronic respiratory symptoms among municipal street sweepers in Dessie and Kombolcha City, Northeast, Ethiopia: Cross-sectional study.

Objective: Respiratory diseases are one of the main morbidities worldwide, especially in developing countries due to a lack of occupational safety and health measures. Therefore, this study aims to assess the prevalence and risk factors of chronic respiratory symptoms among street sweepers in Dessie and Kombolcha town, Ethiopia. Methods: A cross-sectional study design was used from 15 February to 16 March 2019 Gregorian calendar, among 392 participants. An interviewer-based questionnaire was used. Bivariable and multivariable logistic regression analyses were used, and variables with p value less than 0.05 in the final model were taken as associated factors. Results: The prevalence of chronic respiratory symptoms among street sweepers was 178 (45.4%) with the prevalence of cough 67 (16.54%), phlegm 60 (15.4%), wheezing 127 (32.3%), breathlessness 83 (21.3%), and chest pain 55 (14.3%). Respiratory symptoms were associated with not using face mask (p < 0.001, adjusted odds ratio = 0.31, 95% confidence interval: 0.17-0.57), monthly income (p = 0.013, adjusted odds ratio = 2.1, 95% confidence interval: 1.1-3.8), work experience (p < 0.001, adjusted odds ratio = 3.6, 95% confidence interval: 2.1-6.2), previous sinusitis (p < 0.001, adjusted odds ratio = 8.0, 95% confidence interval: 2.8-22), and educational status (p < 0.001, adjusted odds ratio = 8.6, 95% confidence interval: 3.0-24.4). Conclusion: Respiratory symptoms were prevalent among street sweepers in Dessie and Kombolcha towns, Northeast Ethiopia. The non-use of respiratory equipment, educational status, working experience, and past sinusitis was identified factors.

Depressive, Anxiety Symptom Frequency and Related Factors Among Prisoners During the COVID-19 Pandemic in Northeastern Ethiopia, a Cross-Sectional Study.

Background: Among the more than 10 million people imprisoned around the world, the rate of mental illness is higher than among the general population for various reasons. Although rates of mental illnesses such as depression and anxiety in this population may have changed as a response to the coronavirus disease (COVID-19) outbreak and other factors, to our knowledge, no related studies have been conducted related to depression and anxiety in this population during the pandemic. Therefore, this study aimed to assess depression, anxiety, and associated factors among Dessie City prisoners during the 2020 COVID-19 outbreak. Methods: An institution-based cross-sectional survey was conducted in October 2020. A total of 420 prisoners were selected via a systematic sampling technique. PHQ-9 depression scale, generalized anxiety disorder-7 questionnaire, Oslo 3-item social support scale, insomnia severity index, and Brief COPE scale were used. Data were entered by using Epi-Data version 3.1 and finally exported to Statistical Package for Social Science Software version 21 for analysis. We fitted a multiple binary logistic regression model. Finally, an adjusted odds ratio with 95% confidence interval was reported and factors with a p-value < 0.05 were considered as significant for depression and anxiety. Results: This study showed that 279 (66.4%) of imprisoned people had major depressive disorder with 95% CI of (61.4, 70.6), while 281 (66.9) had generalized anxiety disorder with 95% CI of (61.9, 71.9). Conclusion: In this study, the overall prevalence of depression and anxiety was significantly high, and was related to a number of factors including COVID-19. Therefore, designing and implementing strategies for COVID-19 prevention and control in prisons is highly recommended to reduce mental health problems among prisoners.

Knowledge, attitude, and associated factors towards mental illness among residents of Dessie town, northeast, Ethiopia, a cross-sectional study.

BACKGROUND: Knowledge and attitude towards mental illness are poor and neglected as compared to medical illness. However, there is an increasing burden of mental illness in the community. As per the knowledge of the investigators, studies are scarce and not done in the study area about knowledge and attitudes of mental illness. Therefore, this study aimed to assess the knowledge, attitude, and associated factors towards mental illness among, Dessie town residents. METHODS: A community-based cross-sectional study was conducted in Dessie town, Northeast, Ethiopia from October 27 to November 29/2020. A multi-stage sampling technique was employed. The data were collected from 477 study participants using a standard structured questionnaire, which were Mental Health Knowledge Schedule (MAKS) and Community Attitude to Mental Illness Inventory (CAMI) respectively. Data were entered using Epi-data version 3.1 and, then exported to SPSS version 26 for analyses. Bivariable and Multivariable logistic regression analyses was employed. RESULTS: From 477 study participants the prevalence of poor knowledge and unfavorable attitude towards mental illness were 55.3% (95% CI: 50.9, 60.0) and 45.1% (95% CI: 40.7,49.5) respectively. Being female [AOR = 1.62 (95% CI:1.06,2.47)], could not read and write [AOR = 6.28 (95% CI: 2.56, 15.39)], lack of information about mental illness [AOR = 5.82 (95% CI: 3.78,8.94)] and unfavorable attitude [AOR =1.73 (95% CI: 1.12,2.66)] were variables found statistical significant with poor knowledge. Whereas, income < 2166 [AOR = 1.64, (95% CI: 1.12, 2.41)], poor social support [AOR = 2.04, (95% CI: 1.13, 3.68)], moderate social support [AOR = 2.44, (95% CI: 1.45, 3.97)] and poor knowledge [AOR = 1.66, (95% CI: 1.13,2.43)] were variables significantly associated with unfavorable attitude toward mental illness. CONCLUSION: In this study about half of the community have poor knowledge, and less than half of the participants have an unfavorable attitude to wards mental illness. There are many factors associated with poor knowledge and unfavorable attitudes. This having poor knowledge and unfavorable attitude may cause certain problems like a decrease in health care of a person with mental illness. Therefore, we recommend practice-based awareness in the community regarding mental health problems needs to be addressed.

Determinants of migraine headache among regular undergraduate students, of Wollo University, Dessie, Ethiopia: cross-sectional study.

BACKGROUND: The prevalence of migraine headaches varied from 2.4 to 48.5% worldwide among university students. As per the knowledge of the investigators, the study of migraine headaches is not done in this study area. Hence, this study aimed to assess determinates of migraine headaches among regular undergraduate students, of Wollo University, Dessie, Ethiopia, 2020. METHOD: Institution-based cross-sectional study design was conducted from November 15-30 /2020 by using a self-administered questionnaire among 371 regular undergraduate students at Wollo University. A multistage sampling technique was employed to represent our study population. Identity migraine test, Migraine Disability Assessment Questionnaire, perceived stress scale, and Oslo social support scale was used. Descriptive statistics, binary and multiple logistic regression were employed. The adjusted odds ratio at a 95% confidence interval and level of significance (p-value < 0.05) was used to interpret the findings. RESULTS: From 371 participants, the prevalence of migraine headache in this study was 34% (95% CI: 29.2, 38.5). Variables statistically associated with migraine headache, were a family history of headache (AOR = 3.83, CI: 2.313, 6.366), suicidal thoughts in the past 3 months (AOR = 10.76, CI: 2.117, 54.74), and had low perceived stress 62.6% (AOR = 0.374, CI: 0.205, 0.683). CONCLUSION: In this study, the prevalence of migraine headaches was very high. Family history of headache, suicidal thoughts, and low perceived stress were determinates for migraine headache. So special emphasis shall be given to those participants who had high perceived stress, a family history of migraine headache, and suicidal thoughts.

Generalized Anxiety Disorder, Depressive Symptoms, and Sleep Problem During COVID-19 Outbreak in Ethiopia Among Police Officers: A Cross-Sectional Survey.

Background: Coronavirus disease 2019 (COVID-19) is an outbreak that caused serious threats to people worldwide. Police officers are one of those frontline fighters during pandemic. Our study is the first to examine psychological health response among police officers in Ethiopia during the COVID-19 outbreak. Methods: A cross-sectional study design with a self-administered questionnaire was conducted among police officers from Dessie town from June 20 to July 10, 2020. A total of 385 questionnaires were completed correctly accounting for 91% of the total. The data were collected by using demographic information and psychological health assessment tools. The Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder 7-item scale (GAD-7), Insomnia Severity Index (ISI), and Brief Resilient Coping Scale questionnaire were used to assess depression, anxiety, sleep, and coping status of participants. Results: The rate of depression was found to be 28.9%. Of these, 19.7% had mild, 7.3% had moderate, 1.6 had moderate-severe, and 0.3% had severe depression symptoms. The rate of general anxiety symptoms was found to be 30.2%. Of these, 22.1% of the police officers had mild, 2.6% had moderate, and 5.5% had severe anxiety. Moreover, 13.8% of police officers had subthreshold insomnia and 2.1% had clinical (moderate-severe) insomnia. Participants who are men, married, highly resilient, and have high social support were associated with lower depression, anxiety, and insomnia scores than those of women, being single or widowed/divorced, low resilient coping score, and low social support, respectively. Conclusion: A psychological health problem was found to be higher among police officers in Dessie town. Younger age, sex, marital status, having chronic diseases, coping, and social support with depression, general anxiety, and insomnia were found to be significantly associated with psychological health problems. There is a need for mental health services, support, and care of police officers during the pandemic.

Prevalence of anxiety, depression, and psychological distress among the general population during the COVID-19 pandemic: A systematic review and meta-analysis.

BACKGROUND: The COVID-19 pandemic is a worldwide epidemic declared by the world health organization as a public health emergency of concern and consequently inducing huge mental health and psychological reactions. AIMS: This study is aimed to summarize the existing data regarding anxiety, depression, and psychological distress during the covid-19 pandemic among the wider population so that effective intervention strategies will be initiated. METHODS: Pieces of literature that assessed anxiety, depression, and psychological distress among the general population during the COVID pandemic period were systematically gathered. Data extraction in Microsoft excel was done by two independent reviewers using predefined criteria. The analysis was done using a stata-11 and random effect model. A sub-group and sensitivity analysis was done. Besides, the funnel plot and eggers publication bias test was tested. RESULTS: Sixteen studies that assessed 78,225 participants were included. Nine studies were included in the meta-analysis for anxiety prevalence. The average prevalence of anxiety was found to be 38.12%. A sub-group analysis showed that anxiety was 33.33% in China and 47.70% in other countries (Italy, Turkey, and India). Anxiety prevalence in studies measured with the DASS-21 scale, GAD-7 scale, and other tools (SAS, HADS, and 5-point Likert scale) was 23.4%, 40.73%, and 44.47% respectively. The prevalence of anxiety in studies that assessed a sample size above 2,000 participants was 40.33%. The average prevalence of depression among included studies was 34.31% and a sub-group analysis showed that depression was higher in China (36.32%) than in other countries (28.3%). Moreover, six studies reported psychological distress and the average prevalence was 37.54%. CONCLUSION: This study revealed that anxiety, depression, and psychological distress are potential public mental health problems of the global community that suggests the need for early recognition and initiation of interventions during the COVID-19 pandemic period.

Prevalence and associated factors of internet addiction among undergraduate university students in Ethiopia: a community university-based cross-sectional study.

BACKGROUND: Internet addiction is a common problem in university students and negatively affects cognitive functioning, leads to poor academic performance and engagement in hazardous activities, and may lead to anxiety and stress. Behavioral addictions operate on a modified principle of the classic addiction model. The problem is not well investigated in Ethiopia. So the present study aimed to assess the prevalence of internet addiction and associated factors among university students in Ethiopia. OBJECTIVES: Main objective of this study was to assess the prevalence and associated factors of internet addiction among University Students in Ethiopia. METHODS: A community-based cross-sectional study was conducted among Wollo University students from April 10 to May 10, 2019. A total of 603 students were participated in the study using a structured questionnaire. A multistage cluster sampling technique was used to recruit study participants. A binary logistic regression method was used to explore associated factors for internet addiction and variables with a p value < 0.25 in the bivariate analysis were fitted to the multi-variable logistic regression analysis. The strength of association between internet addiction and associated factors was assessed with odds ratio, 95% CI and p value < 0.05 in the final model was considered significant. RESULTS: The prevalence of internet addiction (IA) among the current internet users was 85% (n = 466). Spending more time on the internet (adjusted odds ratio (AOR) = 10.13, 95% CI 1.33-77.00)), having mental distress (AOR = 2.69, 95% CI 1.02-7.06), playing online games (AOR = 2.40, 95% CI 1.38-4.18), current khat chewing (AOR = 3.34, 95% CI 1.14-9.83) and current alcohol use (AOR = 2.32, 95% CI 1.09-4.92) were associated with internet addiction. CONCLUSIONS: The current study documents a high prevalence of internet addiction among Wollo University students. Factors associated with internet addiction were spending more time, having mental distress, playing online games, current khat chewing, and current alcohol use. As internet addiction becomes an evident public health problem, carrying out public awareness campaigns may be a fruitful strategy to decrease its prevalence and effect. Besides to this, a collaborative work among stakeholders is important to develop other trendy, adaptive, and sustainable countermeasures.

Depression, anxiety symptoms, Insomnia, and coping during the COVID-19 pandemic period among individuals living with disabilities in Ethiopia, 2020.

BACKGROUND: People with disabilities face multiple barriers that prevent them from accessing care and essential information related to the COVID-19 pandemic that poses additional stress and psychopathology. Therefore, the investigation of psychopathologies during the COVID-19 outbreak and emergency response is critical. METHODS: A cross-sectional survey was implemented from July 15/2020 to July 30/2020. The PHQ-9, GAD-7 scale, insomnia severity index-7, and brief resilient coping scale were administered to participants. The collected data was then entered into Epi-data version 3.1 and exported to SPSS-20 for analysis. Descriptive statistical procedures were employed to describe the various psychopathologies. A binary logistic regression method was used to identify the related factors for the psychopathologies. Furthermore, an odds ratio with its 95%CI was driven to show association strength, and a P-value <0.05 was declared as statistically significant. RESULTS: A significant proportion of individuals living with disability had psychopathologies; 46.2% for depression symptoms, 48.1% for generalized anxiety disorder symptoms, and 71% for insomnia symptoms. Nearly 45.7% of participants were low resilient copers to their psychopathology. Depression was significantly higher in divorced/widowed/separated (AOR = 3.4, 95% CI: 1.28-8.92, P-value = 0.006), non-educated (AOR = 2.12, 95% CI: 1.12, 5.90, P-value = 0.001), and unemployed (AOR = 2.1, 95% CI: 1.32, 5.11, P-value = 0.005) as well as a daily laborer (AOR = 2.4, 95% CI: 1.20, 4.89, P-value = 0.014) subjects. Generalized anxiety disorder was also significantly higher in young age (<40 years) (AOR = 1.7, 95% CI: 1.32, 2.98, P-value = 0.02), single (AOR = 2.3, 95% CI: 1.24, 5.3, P-value = 0.011), widowed/divorced/separated (AOR = 1.5, 95% CI: 1.12, 2.78, P-value = 0.032), preparatory school completed (AOR = 3.00, 95% CI: 1.59, 5.46, P-value = 0.001), daily laborer (AOR = 2.7, 95% CI: 1.21, 5.23, P-value = 0.003), and unemployed (AOR = 2.5, 95% CI: 1.17, 4.78, P-value = 0.005) participants. Moreover, insomnia was significantly higher in single (AOR = 1.5, 95% CI: 1.12, 3.09, P-value = 0.027), divorced/widowed/separated(AOR = 6.2, 95% CI: 1.08, 11.29, P-value = 0.032), unemployed (AOR = 3.00, 95% CI: 1.22, 7.03, P-value = 0.001), blind (AOR = 2.8, 95% CI: 1.42, 6.35, P-value = 0.001), and deaf (AOR = 10.2, 95% CI: 4.52, 35.33, P-value = 0.002) participants. CONCLUSION: Depression, anxiety, and insomnia were highly prevalent among individuals with a disability during the COVID-19 period. Multiple sociodemographic and disability-related factors were associated with this high psychopathology. Attention has to be given by the government and other stakeholders to intervene in psychopathology and its associated factors.

Suicidal plan, attempt, and associated factors among patients with diabetes in Felegehiwot referral hospital, Bahirdar, Ethiopia: cross-sectional study.

BACKGROUND: Diabetes is a highly prevalent non-communicable disease which is prone to more psychiatric complications like suicide; however, research into this area is limited. Assessing suicidal plan and attempt as well as its determinants are therefore important. METHOD: Institution based cross-sectional study was conducted from May 21 to June 21 at the diabetic outpatient clinic by recruiting 421 participants using systematic sampling. Suicide manual of the composite international diagnostic interview (CIDI) was used to assess suicidal plan and attempt. Chart review was used to obtain data regarding the co-morbidity of medical illness and complications of diabetes mellitus. Binary logistic regression was used to identify factors associated with suicidal attempt. Odds ratio with 95% CI was employed and variables with a p-value of< 0.05 in multivariable logistic regression were declared significant. RESULTS: From 423 participants 421 participated in the study with 99.5% response rate. The mean age (±SD) of the respondents was 38.0((±13.9) years. The lifetime prevalence of Suicidal plan; an attempt was found to be 10.7 and 7.6% respectively. Being female (AOR = 2.14, 95%CI:1.10,5.65), poor social support (AOR = 3.21,95%CI:1.26,8.98), comorbid depression (AOR = 6.40,95%CI:2.56,15.46) and poor glycemic control (AOR = 4.38,95%CI:1.66,9.59) were factors associated with lifetime suicidal attempt. CONCLUSION: The prevalence of suicidal attempt among Diabetes patients is high (7.6%). The suicidal attempt had a statistically significant association with female gender, comorbidity with depression, poor social support and poor glycemic control. Therefore the result of this study helps to do early screening, treatment, and referral of patients with suicidal attempt.

Determinates of depressive disorder among adult patients with cardiovascular disease at outpatient cardiac clinic Jimma University Teaching Hospital, South West Ethiopia: cross-sectional study.

BACKGROUND: Depression and heart disease are an important public-health problem. Depression is one of the most prevalent and disabling psychiatric disorders with more than three times increased risk among patients with cardiovascular disorders. OBJECTIVE: To identify the prevalence and associated factors of depressive disorder among adult patients with cardiovascular disease. METHODS: Institution based cross-sectional study design was used to conduct this study on 293 study participants attending an outpatient cardiac clinic at Jimma University Teaching Hospital. All eligible patients were recruited into the study consecutively. Depression was assessed using patient health questionnaire-9. The patient health questionnaire-9 had a total score of 27, from which 0-4: no/minimal depression, 5-9: mild depression, 10-14: moderately depression, 15-19: moderately severe depression and 20-27 severe depression. The data was feed into Epi-data version 3.1 and lastly exported to SPSS version 21 for analysis. Bivariate analysis was used to analyze the statistical association of covariates of interest with depressive disorder among patients with cardiovascular disease. Then, logistic regression analysis was used as a final model to control confounders. The strength of association was measured by a 95% confidence interval. RESULTS: A total of 293 adult patients diagnosed with the cardiovascular disease were included in the study with 97% (n = 284) of response rate, 47.2% (n = 134) males and 52.8% (n = 150) females, making female to a male ratio around 1.1:1. The prevalence of depression was 52.8% (n = 150/284). Out of the subjects with depression 52.67% (n = 79), 36.0% (n = 54) and 11.33% (n = 17) were mild, moderate and severe depression, respectively. Variables such as employed, unemployed, physical activity, current cigarette user and poor social support were independently associated with depression in the final model. CONCLUSIONS: In this study, depression was found to be highly prevalent psychiatric comorbidity in adult cardiovascular disease patients.

Help-seeking behaviour for depressive disorders among adult cardiovascular outpatient cardiac clinic Jimma University Teaching Hospital, Jimma, South-West Ethiopia: crosssectional study.

BACKGROUND: Depression in healthy person without cardiac disease has been associated with the development of coronary artery disease and cardiovascular disease also risk factor for development of depression. This has devastating effect the patient's quality of live, illness progression, morbidity and mortality. Despite this fact help seeking behavior of cardiovascular patients with depression has not been addressed in Ethiopia. OBJECTIVE: To assess help-seeking behaviors of adult cardiovascular patients with depression for their depressive disorders in Jimma university teaching hospital. METHOD: Institution based cross sectional study conducted October to December in 2014. The study was conducted on 353 cardiovascular patients who attended at cardiac clinic. Depression was assessed using patient health questionnaire version nine (PHQ-9), which is validated in Ethiopia, Help seeking behavior using actual help seeking questionnaire and social support using Oslo social support-3 item scale. RESULT: From the total of 339 participants, 57.5% (n = 195) of them fulfill the case definition of depression and 12.1% (n = 41) of participant reported idea of hurting themselves. Only 33.3% sought help for their depression. Of those participants who sought help, 88.6% sought help from one or more of an informal help source. Occupation (odds of = 4.24, 95% confidence interval (CI) 1. 31, 13.78), education level (AOR 7.6, CI 2. 13, 27.11), the presence of a history of mental illness in the family (AOR 7.33, CI 2. 72, 19.80), ideal of hurting themselves, knowing the availability of the psychiatric service in this hospital and having previous seeking help were significantly associated with help seeking behavior. CONCLUSION AND RECOMMENDATION: The number of patients not seeking help for depression is high. There for scaling up mental health service in tertiary hospitals through multidisciplinary approach should be given high priority.