Determinants of Delay in Seeking Malaria Treatment for Under-Five Children at Gambella Town, Southwest Ethiopia: A Case-Control Study.

BACKGROUND: Most of the malaria-related complications in children are due to delay in the treatment-seeking of caregivers. The objective of this study was to identify determinants of delay in seeking malaria treatment for under-five children in Gambella town, Ethiopia. METHODS: A case-control study was conducted in March 2017 among caregivers/parents consecutively included in the study. Data were collected by face-to-face interviews using a structured questionnaire. Descriptive statistics and logistic regression were, respectively, used for descriptive and analytical data analyses. Adjusted odds ratios and 95% CI were, respectively, calculated to assess the strength of association and statistical significance. RESULT: A total of 153 cases and 153 control caregivers/parents participated in the study giving a response rate of 100%. The mean age of cases and controls was 29.4 years (SD ± 6.0 years) and 29.63 years (SD ± 7.8 years), respectively. Being housewife (AOR = 2.50; 95% CI: 1.47-4.22), having no history of child mortality (AOR = 3.70; 95% CI: 1.79-7.64), and chewing khat (AOR = 3.50; 95% CI: 1.57-7.68) were significantly associated with delay in seeking malaria treatment for under-five children among the caregivers. Conclusion and Recommendation. Comprehensive community-based malaria prevention and control education should be given for the caregivers in the town giving due emphasis to housewives, khat-chewers, and the caregivers with no story of child death to better promote early malaria treatment-seeking for under-five children.

Risk Factors for Rubella Transmission in Kuyu District, Ethiopia, 2018: A Case-Control Study.

BACKGROUND: Rubella is a vaccine-preventable disease associated with a significant morbidity and adverse pregnancy outcomes, mainly if acquired in the first trimester of pregnancy with serious consequences to the fetus. Despite increased episodes of rubella epidemics (127 outbreaks in 2009-2015), rubella national vaccination is not yet introduced in Ethiopia. In January 2018, an increase of fever and rash cases was reported in Kuyu District of Oromia. We investigated the outbreak to confirm rubella, determine risk factors, and guide interventions. METHODS: We identified rubella cases from health centers and conducted a case-control study (1 case : 2 controls) with 150 participants, from March 12 to 15, 2018. Cases were people who presented with fever and rash or laboratory-confirmed cases. Controls were age matched (<15 yrs) with neighbors selected purposively. We interviewed parents by a structured questionnaire and observed the housing condition. Variables include sex, age, vaccination status, family size, contact history, housing condition, and travel history. Simple logistic regression was used to select the candidate variable at a P value <0.25. We identified risk factors at P < 0.05 with AOR and 95% CI by multivariate logistic regression. RESULTS: We identified 50 cases (with no death), and out of them, seven (14%) were confirmed cases (rubella IgM positive). The mean age of the cases was 6 ± 3 years and of the controls was 8 ± 4 years. Family size >5 (AOR = 2.4; 95% CI: 1.5-4.11), not well-ventilated living room (AOR = 4.7; 95% CI: 3.43-8.12), history of contact with rash people (AOR = 2.2; 95% CI: 1.6 3.5), no history of diarrhea in the last 14 days (AOR = 0.8; 95% CI: 0.6-0.9), and no history of vitamin A supplementation (AOR = 2.9; 95% CI: 1.7-2.6) were significant factors for rubella infection. CONCLUSIONS: We identified rubella outbreak in the rural area. Crowded living condition, large family size, not receiving vitamin A in the last 6 months, and contact with people with symptoms of rubella were factors that drove the outbreak, while not having diarrhea in the last 14 days was the protective factor. We recommended the introduction of rubella immunization national programs and advocated the policy on rubella vaccine and strengthening surveillance for congenital rubella syndrome and rubella.

Is There Association between Risky Sexual Behaviors and Depression Symptoms among Youth? A Case of Jimma University Students, Ethiopia.

BACKGROUND: Risky Sexual Behaviors (RSB) and Depression symptoms expose young people to various reproductive health problems including sexually transmitted infections and HIV/AIDS. To date the link between these two major public health problems lacks empirical evidence in the context of higher education institutions in Ethiopia. OBJECTIVE: The aim of this study was to assess association between risky sexual behavior and depression symptoms among Jimma University main campus students, Jimma, Ethiopia, 2016. METHODS: An institution based quantitative cross sectional study was conducted. A pre-tested questionnaire and modified Beck Depression Inventory II were administered to 700 students, selected by multi-stage stratified sampling, from the main campus of Jimma University. Descriptive statistics, simple and multiple logistic regression models were used to analyze possible confounders. Presence of crude association between the dependent and independent variables was detected by bivariate logistic regression analysis. Variables with p value < 0.25 in bivariate analysis were analyzed by multivariable logistic regression to exclude the confounders. Adjusted odd ratios with 95%CI were computed to examine depression symptoms and other independent variables as predictors of RSB. RESULTS: RSB were reported by 30.2% students. Out of 222 (33.6%) students with depression symptoms 105 (47.3%) reported RSB. Students with moderate depression symptoms are nearly two times more likely to experience risky sexual behavior than students with no depression symptoms (AOR 1.9, 95% CI: 1-3.1). Students with severe depression symptoms are nearly two and half times more likely to experience RSB than students with no depression symptoms counterparts (AOR 2.6, 95%CI: 1.3- 5.1). CONCLUSION: RSB were high among students with depression symptoms in the main campus of Jimma University. To help students overcome the challenges, recommendation was given for concerted action from the University, governmental and NGO, and the surrounding community to establish support services and various reproductive and mental health awareness programs within the campus.

Unmet need for family planning and associated factors among currently married reproductive age women in Tiro Afeta District, South West Ethiopia, 2017: cross-sectional study.

BACKGROUND: Unmet need for family planning in Oromia region was very high (28.9%) compared to other regions in Ethiopia. To address problems associated with unmet need for family planning locally available evidences are essential, however, there were no clear evidences on unmet need for family planning in Tiro Afeta district. This study aims to assess the magnitude and associated factors of unmet need for family planning among currently married women in Tiro Afeta district, South West Ethiopia, 2017. METHODS: Community based cross sectional study was conducted in April, 2017. A total of 348 currently married women of reproductive age were enrolled from eight villages selected by simple random sampling and using proportional to size allocation. Data were entered using EpiData 3.1 and analyzed by SPSS version 22. Adjusted odds ratios at 95% confidence interval with p-value of < 0.05 were considered as significant variables. RESULTS: Unmet need for family planning among currently married women in Tiro Afeta was 26.1%. Factors significantly associated with unmet need for family planning were: never use of family planning before survey (AOR: 5.09, 95% CI: 2.73-9.50); multiparity (AOR: 3.02, 95% CI: 1.56-5.85); perceived husband's attitude as disapproval (AOR: 2.75, 95% CI: 1.43-5.26); lack of counseling from health workers (AOR: 2.07, 95% CI: 1.11-3.85); and unavailability of Radio and/or Television in the house (AOR: 2.05, 95% CI: 1.15-3.66). CONCLUSION: Unmet need for family planning in Tiro Afeta was higher than national average but lower than Oromia region. Never use of family planning, women's parity, husband's attitude towards contraceptives, women counseling and unavailability of Radio and/or Television in the respondent's home were significantly associated factors with unmet need for family planning. Therefore, the service providers and the district health office should strengthen counseling and partner involvement to reduce unmet need for family planning.

Knowledge, Risk Perception and Practice Regarding Tuberculosis Transmission among Long Distance Bus Drivers in Addis Ababa, Ethiopia: A Cross Sectional Study.

BACKGROUND: Window opening during bus transportation is recommended as a tuberculosis prevention strategy.Yet, drivers are affected by lack knowledge and risk perception of passengers and assistants. Boosting knowledge of and notifying the high risk of tuberculosis transmission for every passenger could be too costly. However, strategies targeting bus drivers as key agents unlike targeting all passengers might be less costly for window opening. METHOD: Data were collected from November 18/2014 to December 21/2014 in inter-region bus stations of Addis Ababa using cross sectional study design. Samples of 306 participants were selected using simple random sampling, and data were collected through face-to-face interview. Data were entered into Epi-data version 3.1 andanalyzed using IBM SPSS version 21. RESULT: From a sample of 306 bus drivers, 303 were interviewed. Nine in ten and nearly half of participants believed in the need for opening all windows and avoiding overcrowding of passengers as TB preventive measures respectively. Few bus drivers (7.3%) believed that bus drivers and their assistants could be at risk of tuberculosis. The majority (85.7%) of bus drivers opened side window the whole day without precondition. Hearing tuberculosis related information from radio was a promoting factor for tuberculosis preventive measures among bus drivers. CONCLUSION: Tuberculosis preventive practices and knowledge of bus drivers seempositive (opportunities), despite their low risk perception (challenge). Using the opportunity, further empowering bus drivers to persuade passengers and assistants to open all the rest of the windows is needed.

Health Care Providers' Knowledge and Practice Gap towards Joint Zoonotic Disease Surveillance System: Challenges and Opportunities, Gomma District, Southwest Ethiopia.

Background. Health care providers play a crucial role for realization of joint zoonotic diseases surveillance by human and animal health sectors, yet there is limited evidence. Hence, this study aimed to determine knowledge and practice gap of health care providers towards the approach for Rabies and Anthrax in Southwest Ethiopia. Methods. A cross-sectional survey was conducted from December 16, 2014, to January 14, 2015. Eligible health care providers were considered for the study. Data were entered in to Epi-data version 3.1 and analyzed using SPSS version 20. Results. A total of 323 (92.02%) health care providers participated in the study. Three hundred sixteen (97.8%) of participants reported that both human and animal health sectors can work together for zoonotic diseases while 96.9% of them replied that both sectors can jointly conduct surveillance. One hundred seventeen (36.2%) of them reported that their respective sectors had conducted joint surveillance for zoonotic diseases. Their involvement was, however, limited to joint outbreak response. Conclusion. There is good opportunity in health care providers' knowledge even though the practice was unacceptably low and did not address all surveillance components. Therefore, formal joint surveillance structure should be in place for optimal implementation of surveillance.