Determinants of uterine rupture among mothers who gave birth in Jinka and Arba Minch General Hospitals, institution-based case-control study, Southern Ethiopia, Ethiopia, 2019.

BACKGROUND: Uterine rupture is a major public health problem in low-income countries including Ethiopia. In Ethiopia, its prevalence is low, but it results in devastative health problems of the mother and her baby. Even though the Ethiopian government and nongovernmental organizations tried to strengthen the health care system, significant adverse maternal and fetal outcome is still associated with uterine rupture. The aim of this study was to identify determinants of uterine rupture in Jinka and Arba Minch General Hospitals. METHODS: The study was conducted in Jinka and Arba Minch General Hospitals, and the data collection period was 15 to 30 November 2018. A case-control study design was used with simple random sampling of 1:4. Data were collected using data extraction sheets. Variables with p < 0.25 in bivariate logistic regression were entered into multivariable logistic regression. Variables with p < 0.05 in multivariable logistic regression were used to determine significant association between dependent and independent variables. RESULT: Uterine rupture occurred in 112 cases with 448 controls. Women referred from health facilities (adjusted odds ratio = 8.0, 95% confidence interval: 3.5-17.8), multiparous women (adjusted odds ratio = 12.7, 95% confidence interval: 4.2-39.0), duration of labor more than 18 h (adjusted odds ratio = 11.5, 95% confidence interval: 5.5-24.1), malpresentation (adjusted odds ratio = 3.5, 95% confidence interval: 1.0-8.0) and gestational age of ⩾37 weeks (adjusted odds ratio = 5.2, 95% confidence interval: 1.4-19.3) were independent factors associated with uterine rupture. CONCLUSION: Mothers referred from health facilities, multiparous women, duration of labor more than 18 h, gestational age of ⩾37 weeks and malpresentation were significantly associated with uterine rupture. Early referral, encouraging family planning, proper use of partograph, early identification and appropriate intervention for malpresentation are recommended.

Determinants of long acting contraceptive utilization among HIV positive reproductive age women attending care at art clinics of public health facilities in Arba Minch town, Southern Ethiopia, 2019: a case control study.

BACKGROUND: Long acting and permanent contraceptive methods by far are the most effective, very safe and convenient methods than short acting contraceptive methods. But in less developed countries, use of long acting reversible contraceptive or permanent methods (LARCs/PMs) is very low. Therefore the aim of this study was to identify determinants of long acting contraceptive method utilization among HIV positive reproductive age women. METHODS: An institutional based case control study was conducted among random sample of 354 HIV positive reproductive age women (total of 97.8% response rate) at Anti-Retroviral Therapy clinics from February 20 to March 20, 2019. Case to control ratio was 1:2. A structured questionnaire and information recorded from ART card review were used to collect the data. Each variable was entered in Bivariate analysis with dependent variables and those variables with P-value of ≤ 0.25 were included in the Multivariate analysis. Significance was determined at the level of P-value < 0.05 with 95% CI of AOR. RESULTS: A total of 354 (33.3% cases and 66.7% controls) HIV positive reproductive age women were interviewed with response rate of 97.8%. The study revealed being in age group of 39 and above [AOR = 0.17, 95% CI (0.06, 0.48)], being divorced/separated and widowed [AOR = 0.05, 95% CI (0.003, 0.61)], having supportive opinion and strongly supportive opinion regarding family planning service availability in ART clinic [AOR = 5.01, 95% CI (1.79, 14.07)], [AOR = 7.81, 95% CI (2.54, 24.01)] and having no future fertility intention [AOR = 7.03, 95% CI (2.73, 18.06)] were statistically significant determinants for long acting contraceptive method utilization. CONCLUSION: Woman in age group of 39 and above, having no future fertility intention and being divorced/separated and widowed was found to be determinants of long acting contraceptive method utilization among HIV positive reproductive age women. In addition our study support the WHO Strategic Considerations for Strengthening the Linkages between Family Planning and HIV/AIDS Policies, Programs, and Services.

The Prevalence and Associated Factors of Hypertension among Adults in Southern Ethiopia.

BACKGROUND: Hypertension is a growing public health problem in many developing countries including Ethiopia. Determining the prevalence of hypertension and identifying the associated factors is crucial. OBJECTIVE: To assess the prevalence of hypertension and associated factors, among adult population of Arba Minch town, Gamo Zone, Southern Nations, Nationalities and Peoples Region, Ethiopia. METHODS: A cross-sectional study design was conducted from December 1 to 30, 2017 among adults. Study participants were selected using a multistage systematic sampling method. Data were collected by face-to-face interview after getting written informed consent by using a structured questionnaire. Additionally, weight, height, and blood pressure of participants were measured following standard procedures. Data were entered into a computer using EPI INFO 7 and exported into SPSS version 20 for analysis. Bivariate and multivariable analyses were performed to explore the association between hypertension and associated factors. Multivariable logistic regressions were fitted to control the effect of confounders. RESULTS: A total of 784 study participants were included in this study. The overall prevalence of hypertension in Arba Minch Town was 35.2%, (95% CI: 32.4%, 38.4%). Nearly 90% of hypertensive patients were screened for the first time. Age ≥55 years [AOR = 7.74; 95% CI: 2.19, 27.23], income level which is greater than 2501 Ethiopian Birr [AOR = 9.5; 95% CI: 4.5, 20.20], working hour less than seven hours per day [AOR = 12.5; 95% CI: 4.3, 36.1], and chewing "khat" [AOR = 11.06: 95% CI: 4.3, 27.7] were the independently associated factors with hypertension. CONCLUSION: The prevalence of hypertension is found to be high. Increasing awareness on control use of "khat," increasing physical activity, and strengthening community-based periodic screening programs of high-risk populations are recommended.

Trend of declining bed net utilization among pregnant women in Ethiopia: new data from the Arba Minch Health and Demographic Surveillance System, 2010-2016.

BACKGROUND: Bed net utilization is one of the important methods of malaria prevention. Malaria during pregnancy is one of the fatal diseases which mostly leads to the death of the mother and the fetus. Some of the complications of malaria during pregnancy are: intrauterine growth restrictions, intrauterine fetal death, and stillbirth. The main challenge of malaria treatment is that most of the anti-malarial drugs are not safe to use during pregnancy. The use of bed net is the most effective method of prevention of malaria during pregnancy. There is a paucity of information on bed net utilization among pregnant women in the study setting. Hence, this study aims to assess the trends of bed net utilization among pregnant women in Arba Minch Health and Demography Surveillance Site (HDSS), Southern Ethiopia. METHODS: The study was conducted in the Arba Minch HDSS. The observation started in 2010 till 2016, using a repeated cross-sectional study design. The data was collected using interviewer administered questionnaire biannually with a total of 14 rounds of data collection from 2010 to 2016. A total of 2657 pregnant women were included in the study. Descriptive statistics such as frequency and proportion were used to present the findings of each variable. RESULTS: Out of 2657 mothers included in the study, more than half, 1521 (63.6%), of the study participants were in the age group between 20 and 29 years. About one-third of the study population 793 (29.8) were having no schooling. The trend of bed net utilization decreased from 83.6% in 2010 to 36.5% in 2016. CONCLUSION: The trends of bed net utilization decreased from 2010 to 2016 in Arba Minch HDSS. Utilization of bed net by pregnant women in the area need to be increased as it is malaria endemic. The government should strengthen the existing bed net distribution strategy. Further research is needed to investigate the cause of decreasing bed net utilization.

Socio-demographic correlates of availability of adequate iodine in household salt: a community-based cross-sectional study.

OBJECTIVE: This study aimed to assess the availability of adequately iodized salt at a household level and associated factors in Arba Minch town, South Ethiopia using the gold standard technique, the iodometric titration. RESULTS: 41.8% (95% CI (confidence interval) 38.6 to 45.1) of households had inadequately iodized salt, and 9.3% (95% CI 7.5 to 11.4) had an iodine content below 10 ppm (parts per million). Compared to households with a monthly income of greater than 2000 ETB (Ethiopian Birr), households with a monthly income between 1000 ETB to 2000 ETB (adjusted odds ratio (AOR) = 0.52, 95% CI 0.390.36 to 00.77) and main food handlers aged 30 years or above compared to those aged less than 20 years of age (aOR = 0.55, 95% CI 0.34 to 0.91) had higher odds of having adequately iodized salt. Food handler's knowledge and practice were not found to be correlated with the availability of adequately iodized salt in household salt.

Assessment of cervical cancer services and cervical cancer related knowledge of health service providers in public health facilities in Addis Ababa, Ethiopia.

OBJECTIVE: To assess cervical cancer services and knowledge of health service providers in public health facilities. RESULT: Two of the three hospitals had cervical cancer screening services. One-third of the hospital had cervical cancer diagnosis service punch biopsy and cervical cancer treatment. Majority, 289 (93.5%) of study participants said cervical cancer was a preventable disease. Having multiple sexual partners 257 (83.2%) and post coital bleeding 251 (81.2%), were the most mentioned risk factor and clinical manifestation of cervical cancer respectively. Majority of the participants were aware of the correct time to start screening 291 (70.5%), and only 95 (25.9%) knew the screening intervals. Overall, 165 (53.4%) of health providers scored below the mean knowledge level score. Females had better knowledge about cervical cancer than males (X2 = 8.4, P = 0.003).

Perinatal Depression and Associated Factors among Mothers in Southern Ethiopia: Evidence from Arba Minch Zuria Health and Demographic Surveillance Site.

Background. Perinatal depression is a serious mental health problem that can negatively affect the lives of women and children. The adverse consequences of perinatal depression in high-income countries also occur in low-income countries. Objective. To assess the perinatal depression and associated factors among mothers in Southern Ethiopia. Methods. A community based cross-sectional study was conducted among selected 728 study participants in Arba Minch Zuria HDSS. A pretested questionnaire was used to collect the data. Data were analyzed using STATA version 12 software. Descriptive statistical methods were used to summarize the characteristics of the mothers. Bivariate and multivariable logistic regression was used for analysis. Results. The prevalence of perinatal depression among the study period was 26.7%. In the final multivariable logistic regression, monthly income AOR (95% C.I): 4.2 (1.9, 9.3), parity [AOR (95% C.I): 0.14 (0.03, 0.65)], pregnancy complications AOR (95% C.I): 5 (2.5, 10.4), husband smoking status [AOR (95% C.I): 4.12 (1.6, 10.6)], history of previous depression AOR (95% C.I): 2.7 (1.54, 4.8), and family history of psychiatric disorders were the independent factors associated with perinatal depression. Conclusion. The study showed a high prevalence of perinatal depression among pregnant mothers and mothers who have less than a one-year-old child.

Water, sanitation and hygiene practice and associated factors among HIV infected people in Arba Minch town, Southern Ethiopia.

Human immunodeficiency virus (HIV) infected people have substantially greater need for water, sanitation and hygiene (WASH). Many opportunistic infections cause high morbidity and mortality in people living with HIV (PLHIV) than in immune competent populations. The objective of the study was to assess WASH practices and associated factors among PLHIV. A cross-sectional study design was conducted. Bivariate and multivariate logistic model was employed. According to this study, 97 (23.5%) of the households have unimproved water status, 221 (53.5%) of the households have unimproved sanitation status and 171 (41.4%) of the households have poor hygiene practice. Diarrhoea [adjusted odds ratio (AOR) = 16; 95% confidence interval (CI): (6, 44)] was associated with water status of the clients. Occupational status [AOR = 8.9; 95% CI: (2, 38)], wealth index [AOR = 0.23; 95% CI: (0.12, 0.4)], frequency of body washing [AOR = 0.23; 95% CI: (0.12, 0.4)] and hand washing device availability [AOR = 4.4; 95% CI: (2.5, 8)] were significantly associated with hygienic practice. It was concluded that the magnitude of the problem regarding WASH practices in HIV infected people in the study area was high. Health education and integrated additional support for the provision of WASH practices is needed.