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

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

Fear-Avoidance Beliefs for Physical Activity Among Chronic Low Back Pain: A Multicenter Cross-Sectional Study.

Background: Among different psychological predictors of outcome in low back pain (LBP) adults, the negative influence of fear-avoidance beliefs in physical activity is an area of research attention. However, there is a lack of evidence on the burden of fear avoidance about physical activity among chronic LBP adults in Ethiopia. Objective: To describe fear-avoidance beliefs about physical activity and explore its association with socio-demographic and clinical factors among low back pain patients attending physiotherapy treatment in 3 Amhara regional comprehensive hospitals. Methods: A multi-center cross-sectional study was conducted and adults with chronic LBP (n = 263) participated. Data were collected by face-to-face interview using the modified Fear-Avoidance Belief Questionnaire about Physical Activity (mFABQ-PA) tool. Multivariable logistic regression at a p-value <0.05 significance level was used to identify predictors of fear-avoidance beliefs about physical activity. Results: Among the 263 participants, 113 subjects (43%, 95% CI (36.9-49.0)) reported a higher cut-off (>15) mFABQ-PA. The logistic regression model demonstrated that LBP adults with a higher mFABQ-PA score were more likely to be urban residents (AOR 2.75, 95% CI (1.32, 5.88)), and ADL-related LBP (AOR 1.97 95% CI (1.18, 3.29)). The clinical-specific factor indicative of a higher cut-off score of mFABQ-PA was using analgesic medications (AOR 2.00, 95% CI (1.19, 3.37)). The model fit was 0.21 and 0.11 (R2 = Nagelkerke's, Cox & snell respectively). Conclusion: High fear avoidance beliefs about physical activity in adults with low back pain were found and associated with residence, work, and medication intake. These findings might urge the researchers to explore further associations and assist clinicians in choosing subgroups to use behavioral therapy and graded exposure to physical activity.

Cross-cultural translation, adaptation, and validation of the stroke-specific quality of life (SSQOL) scale 2.0 into Amharic language.

BACKGROUND: The stroke-specific quality of life 2.0 (SSQOL 2.0) scale is a valid, reliable instrument which has been widely used as a patients reported outcome measure among stroke survivors. However, the SSQOL scale has not been validated and used in any Ethiopian language. This study aimed to translate, culturally adapt, and test the psychometric properties of the SSQOL scale 2.0 in Amharic, which is the official and working language with about 34 million (23%) speakers in Ethiopia. METHODS: The adapted English version of the SSQOL 2.0 scale was translated into Amharic and then back-translated to English. An expert committee translated and created a final Amharic version of SSQOL (SSQOL-AM) scale. Pre-field testing (pilot and cognitive debriefing) was conducted with 15 post-stroke subjects. The SSQOL-Am was administered to 245 stroke survivors from four referral hospitals to determine the psychometric properties. Cronbach's alpha and Intra-class correlation coefficient were used to calculate the internal consistency and test-retest reliability, spearman's correlation for the convergent validity of the SSQOL-Am scale. The Standard Error of Measurement (SEM), Minimum Detectable Change (MDC), Bland Altman Limit of Agreement (LOA), Confirmatory Factor Analysis, and Exploratory Factor Analysis were also determined. RESULTS: The SSQOL-Am demonstrated excellent test-retest reliability (ICC = 0.93), internal consistency (Cronbach's alpha = 0.96), SEM 0.857, MDC 1.94, and good LOA. As postulated, the mobility domain of the tool demonstrated a significantly strong correlation with the physical function domain of the SF-36 (rho = 0.70, p < 0.001). CONCLUSIONS: The SSQOL-Am is a valid and reliable outcome measure. The tool can be used in both clinical practice and research purposes with Amharic speaking post-stroke survivors.

Epidemiology of General, Central Obesity and Associated Cardio-Metabolic Risks Among University Employees, Ethiopia: A Cross-Sectional Study.

BACKGROUND: Evidence suggests that middle and low-income countries such as Ethiopia are facing the growing epidemic of both communicable and non-communicable diseases creating a burden on their economy and healthcare system. The increasing prevalence of non-communicable diseases is attributed to sedentarism, lifestyle changes, nutritional transition, and the presence of other cardiometabolic risk factors. Therefore this study was designed to assess the prevalence and association of overweight, obesity, and cardio-metabolic risks and to explore if there was any agreement among the anthropometric measurements among the academic employees of the University of Gondar, Ethiopia. METHODS: An institutional-based cross-sectional study was conducted using the WHO stepwise approach and recommendations on 381 academic staff of the university. In addition, physical measurements such as weight, height, waist and hip circumferences, and biochemical measures such as blood pressure and fasting blood glucose level (peripheral blood samples by finger puncture) were measured using standardized tools. RESULTS: The mean age of the participants was 33.5 (95% CI: 32.7, 34.2) years. The prevalence of obesity among the study participants calculated by body mass index, waist circumference (WC), waist-height ratio (WHtR), and waist-hip ratio (WHR) was 13.1%, 33.6%, 51.9%, and 58.5% respectively. The prevalence of diabetes was 4.7% among which 1.3% was not diagnosed prior to this study. About 53 (13.9%) of the study sample were found to be hypertensive (HTN) (6.3% known versus 29 7.6% newly diagnosed). Among the participants, 39.4% and 23.4% were found to be pre-hypertensive and pre-diabetic respectively. WC was significantly associated with hypertension (AOR = 5.14; 2.503, 9.72), pre-DM (AOR = 4.03; 2.974, 5.96), DM (AOR = 3.29; 1.099, 6.01). In addition, WHtR was significantly associated with Pre-HTN (AOR = 2.69; 1.49, 4.58), HTN (AOR = 2.066; 1.008, 6.31), and DM (AOR = 1.855; 0.76, 4.32). On the contrary, both WHR and general obesity measured by BMI were not significantly associated with pre-HTN, HTN, pre-DM and DM groups. CONCLUSION: This study results revealed the variable prevalence between general obesity and the anthropometric indices (IDF cutoff) defining central obesity; WC, WHtR, and WHR among the participants. The result of this study suggests that the constructs of central obesity, not BMI has to be used to screen risks of cardio-metabolic risks among Ethiopians.