Elimination disorders and associated factors among children and adolescents age 5-14 year-old attending paediatric outpatient clinic at Wolaita Sodo University comprehensive specialized hospital, South Ethiopia.

BACKGROUND: Elimination disorder occurs in children over the age of normal toileting who continue to have an inability to control urination or feces, either during the day, at night, or both. Paediatric elimination disorders are not well understood by parents, teachers, medical professionals, mental health practitioners, and researchers. Hence, this study aimed to assess the magnitude of elimination disorder and associated factors among children and Adolescents aged 5-14 years old at Wolaita Sodo University Comprehensive Specialized Hospital, South Ethiopia, in 2022. METHOD: A hospital-based cross-sectional study was conducted from September 22 to November 22, 2022, at Wolaita Sodo University Comprehensive Specialized Hospital. A systematic random sampling technique was employed to select 423 study subjects. The data were gathered using a structured, face-to-face interviewer-administered questionnaire. The development of the symptom score for dysfunctional elimination syndrome of Vancouver questionnaires was used to screen for elimination disorders. Logistic regression model was used to determine the association between the outcome and independent variables. A 95% CI and Odds ratio with corresponding p-value < 0.05 were used to determine the predictors of the outcome variable. RESULT: The overall magnitude of elimination disorder among children and Adolescents age 5-14 in this study was (n 70, 16.8%); in boys (n 47, 17.3%) and girls (n 23, 15.75%). The prevalence of enuresis was (n 64, 15.3%), encopresis (n 15, 3.6%), both enuresis and encopresis, or combined elimination disorder (n 9, 2.2%). Age 9-11 years (AOR = 3.2, 95%CI:1.09, 9.43), family size four and above (AOR = 3.4, 95%CI:1.78, 6.56), family history of elimination disorder (AOR = 3.9, 95%CI:2.12, 7.45), emotional problem (AOR = 2.2, 95%CI:1.18, 4.05), hyperactive problem (AOR = 3.8, 95%CI:1.83, 7.83), low toilet training skills (AOR = 5.9, 95%CI:2.61, 13.33), bad parenting practices, were poor supervision (AOR = 4.4, 95%CI 1.29, 14.69) were significantly associated with elimination disorder. CONCLUSION AND RECOMMENDATION: In this study, approximately one in five children and adolescents had an elimination disorder. Younger age, family size four and above, positive family history of elimination disorder, presence of emotional and hyperactive problems, bad parenting practices, and low toilet training skills were factors associated with elimination disorders. Therefore, preventative, etiological, and therapeutic measure, early toilet training, supportive parenting practices, screening for children's and adolescents' behavioral problems, and elimination disorders need attention to reduce the effect of the problem.

Prevalence of Cognitive Impairment and Associated Factors Among Diabetes Mellitus Patients Attending Follow-up Treatment at Fiche General Hospital, North Ethiopia.

Introduction: Cognitive impairment is having trouble remembering, learning new things, concentrating, or making decisions that affect the daily life of diabetic patients. The worldwide prevalence of diabetes mellitus (DM) was 2.8% in 2000 and is estimated to be 4.4% by 2030. Objective: To assess the prevalence of cognitive impairment and associated factors among DM patients attending follow-up treatment at Fiche General Hospital, North Ethiopia, 2022. Methods: A hospital-based cross-sectional study was conducted from July 15 to September 15, 2022. The total sample size was 421 and a systematic random sampling technique was used. Data were collected through a face-to-face interview. Data were entered using EpiData Version 3.1 and exported to SPSS Version 24 for analysis. Statistically significant was declared at a P-value of less than .05 with an adjusted odds ratio (AOR) and 95% confidence interval (CI). Result: The prevalence of cognitive impairment in the current study was 56.3% with (95% CI: 51.5-60.8). Primary educational status (AOR 6.73, 95% CI: 2.92-15.51), having Type II DM (AOR 4.93, 95% CI: 2.84-8.56), uncontrolled blood sugar (AOR 6.24, 95% CI: 3.84-10.17), and current alcohol use (AOR 1.94, 95% CI: 1.11-3.36) were significantly associated. Conclusion: About three in 5 DM patients attending follow-up treatment at Fiche General Hospital were suffering from cognitive impairment. Educational status, type of DM, status of fasting blood sugar, and current alcohol use were associated with cognitive impairment among DM patients. Therefore, improving educational status, controlling blood sugar, and avoiding alcohol use may reduce the risk of cognitive impairment in DM patients.

Mental health problems during the COVID-19 pandemic among residents of Jimma town: a cross-sectional study.

The COVID-19 pandemic presents an unprecedented challenge to community wellbeing and mental health. However, quantifiable information on the extent of mental health problems and associated factors due to the pandemic is still lacking in low-income countries. Thus, this study aimed to investigate the levels of depression, anxiety, and stress and their association with risk and resilience factors among residents of Jimma town in Southwestern Ethiopia. A community-based cross-sectional study was conducted between October 2021 and November 2021. Data were collected from 1196 adult Jimma town residents selected through multi-stage sampling. The following scales were used for the cross-sectional assessment of depressions, anxiety and stress and their associations: depression, anxiety, and stress-21(DASS-21), World Health Organization (WHO) wellbeing, University of California, Los Angeles Loneliness Scale (UCLA), Childhood trauma questionnaire, and brief resilience scales. A pre-tested, interviewer-completed questionnaire was used for data collection. Bivariate and multivariate logistic regression analyses were conducted to identify factors associated with depression, anxiety, and stress. Odds ratios consistent with 95% CI were used to report the presence of an association between risk and resilience factors and the outcome variable at a P-value < 0.05. Overall, 963 (80.53%) respondents had divergent DASS-21 score findings. Specifically, 27.68%, 31.52% and 21.32% experienced depression, anxiety, and stress respectively. Higher DASS-21 scores were associated with the presence of one or more COVID-19 risk factors for anyone close to the participants (AOR = 1.53, 95% CI 1.03-2.27), feelings of stress/burden (ß = 1.09, 95% CI 1.07-1.12), positive coping (ß = 1.044, 95% CI 1.01-1.07), loneliness (ß = 1.063, 95% CI 1.04-1.08), and childhood trauma (ß = 1.03, 95% CI 1.01-1.04). In contrast, lower DASS-21 scores were associated with beliefs about the necessity of solidarity-based behavior (ß = 0.94, 95% CI 0.90-0.98), resilience (ß = 0.92, 95% CI 0.87-0.97) and wellbeing (ß = 0.90, 95% CI 0.87-0.94). In the course of the COVID-19 pandemic in 2021, symptoms of depression, anxiety, and stress in the study community were prevalent, and associated with numerous risk and resilience factors. Although causality cannot be inferred, these findings underscore the importance of strengthening mental health services and may guide COVID-19 prevention and treatment strategies.

COVID-19-Related Anxiety and Its Association with Dietary Diversity Score Among Health Care Professionals in Ethiopia: A Web-Based Survey.

BACKGROUND: The outbreak of coronavirus disease 2019 (COVID-19) is a stressful and overwhelming situation for health care professionals (HCP), especially, who are caring for patients in the resource-limited health care settings of low-income countries. Due to the increasing number of COVID-19 cases in Ethiopia, HCPs are at risk for COVID-19-related anxiety and associated inadequate nutrition. However, the magnitude of COVID-19-related anxiety and its association with dietary diversity among HCPs is not well studied. OBJECTIVE: To assess the magnitude of COVID-19-related anxiety and its association with dietary diversity score among health care professionals in Ethiopia. METHODS: A web-based cross-sectional survey was conducted among HCPs working in university hospitals, primary hospitals, and health centers in south and southwest Ethiopia. A structured online survey questionnaire was designed on Google forms and carried out from May 15 to June 14, 2020. COVID-19-related anxiety was assessed using the coronavirus anxiety scale. Dietary diversity was measured using 9 items individual dietary diversity score. Data analysis was done using the Statistical Package for Social Sciences version 24. Multiple logistic regression was computed to identify independent factors associated with COVID-19-related anxiety. Statistical significance was set at p<0.05. RESULTS: The prevalence of COVID-19-related anxiety among health care professionals was found to be 20.2%. COVID-19-related anxiety is significantly associated with a low dietary diversity score [AOR=5.93 (1.67, 21.07)]. The other factors which are independently associated with COVID-19-related anxiety are the presence of depression [AOR=6.98 (2.91-16.73)] and diploma educational status [AOR=0.16 (0.04-0.55)]. CONCLUSION: One-fifth of the study participants were found to have probable COVID-19-related anxiety. Designing a screening and intervention strategy for COVID-19-related anxiety among HCPs, particularly to those with low dietary diversity scores and depression, is recommended.

Depression and its determinants among adolescents in Jimma town, Southwest Ethiopia.

OBJECTIVES: To determine the prevalence and socio-demographic and parental-related factors of depression among school adolescents in Jimma town, southwest Ethiopia. METHODS: Using a cross-sectional survey, 546 school adolescents were screened for depression using the patient health questionnaire (PHQ-9) from five randomly selected public and private schools. Oslo social support scale, adverse childhood experience tool, and socio-demographic questionnaire were used to gather data on risk factors. Linear regression analysis was used, and unstandardized beta (ß) coefficients with 95% confidence intervals (CI) were reported to declare statistical significance. RESULTS: A total of 546 adolescents participated in the study, with a response rate of 97.3%. The mean (±SD) age of participants was 16.8 ± 1.3 years. The majority (81%) of the adolescents were attending day classes at public schools. The prevalence of depression was found to be 28% using the patient health questionnaire. Based on the PHQ-9 depression severity scale, 18.5% and 8.2% of the adolescent had moderate and moderate to severe depression while 1.3% had severe depression. In the final multivariate linear regression analysis, it was found that sex, rural residence, low social support, being in higher grade level, and adverse childhood experience were found to be independently associated with a higher score of depression. CONCLUSION: One in three adolescents was found to have a depressive syndrome. We recommend schools to integrate school mental health service that contains routine screening and intervention services. Moreover, efforts are needed to sensitize and educate the communities on child protection, social support, and safeguarding to effectively tackle the magnitude of adolescent depression.

Psychotropic Medications-Induced Tardive Dyskinesia and Associated Factors Among Patients with Mental Illness in Ethiopia.

BACKGROUND: Tardive dyskinesia (TD) remains a significant burden especially among patients taking psychotropic medications, and it is associated with adverse effects that can lead to subjective suffering, stigma, poor compliance to medication, and poor quality of life. However, it is unrecognized and overlooked in clinical settings. So, this study aimed to assess the magnitude of tardive dyskinesia and associated factors among mentally ill patients attending follow-up treatment at Jimma University Medical Center Psychiatry clinic, Jimma, Southwest Ethiopia, 2019. METHODS: Institutional-based cross-sectional study design was conducted in 417 samples. Participants were selected by systematic random sampling techniques. Data were collected by a semi-structured interviewer-administered questionnaire, and the document was reviewed to obtain the patient's profile. Tardive dyskinesia was assessed by using the Extrapyramidal Symptom Rating Scale after informed consent was obtained from respondents. Data entry was done by EpiData version 3.1, and analysis was done by using SPSS 22.0 statistical software. Binary logistic regression and multivariate logistic regression were used to see the association and to identify independent factors at a p-value of <0.05. RESULTS: Prevalence of drug-induced tardive dyskinesia was 15.4% (CI 95%: 12.0, 19.3). Female, age range between 30 and 44 years, having a diagnosis of major depressive disorder with the psychotic feature, taking chlorpromazine equivalent dose ˃600mg, and taking anticholinergic medications were variables positively associated with tardive dyskinesia, whereas cigarette smoking was negatively associated with tardive dyskinesia. CONCLUSION: The prevalence of drug-induced tardive dyskinesia in this study was high. Prescribing medications less than 600mg equivalent dose of chlorpromazine, giving attention for female patients, patients having a diagnosis of major depressive disorder, and reducing giving anticholinergic medications will be important measures for clinicians to reduce the occurrence of tardive dyskinesia.

Risk perception and precautionary health behavior toward COVID-19 among health professionals working in selected public university hospitals in Ethiopia.

OBJECTIVE: This study was designed to determine risk perception and precautionary health behavior toward coronavirus disease (COVID-19) among health professionals working in selected public university hospitals of Ethiopia. METHODS: A web-based cross-sectional survey was used with health professionals working in selected public university hospitals of Ethiopia. A structured survey questionnaire consisted of socio-demographic, risk perception, and behavioral response items were used. The survey questions were designed on Google form. All academic and clinical staff invited to participate in the online survey, which was carried out from May 1-14, 2020. Data analysis was done using the Statistical Package for Social Sciences version 24. Descriptive statistics computed and the result is presented by tables and figures. RESULTS: A total of 273 health professionals participated in this study. The mean (± SD) age of participants was 31.03 ± 5.11. Study participants' overall mean score of perceived risk was 23.59 ± 4.75. The study participants' mean score of perceived vulnerability (4.01 ± 1.17) was higher than the human immunodeficiency virus, common cold, malaria, and tuberculosis. Regarding precautionary health behavior, the lowest mean score is for wearing gloves 1.82 ± 1.15. CONCLUSION: Participants mean score of perceived vulnerability of coronavirus disease was higher than some of the prevalent infectious disease in the area. Almost all participants applied recommended protective measures to the acceptable level, except for wearing mask and gloves. Therefore, there is a need to further intensification of more effective ways to support health professionals' adherence to major precautionary measure is important.

Quality of Life and Associated Factors among Patients with Schizophrenia Attending Follow-Up Treatment at Jimma Medical Center, Southwest Ethiopia: A Cross-Sectional Study.

BACKGROUND: Schizophrenia is one of the most severe, chronic, and disabling mental disorders found globally. The chronic nature of the illness significantly interferes with functioning and results in a poor quality of life, but little is known about the quality of life among schizophrenia patients, in particular in low-income countries. Therefore, we assessed the quality of life and associated factors among patients with schizophrenia attending Jimma University Medical Center, Southwest Ethiopia. METHODS: The hospital-based cross-sectional study design was employed to collect data from 352 study participants using a systematic random sampling technique from June to July 2018. Patients' sociodemographic characteristic, quality of life, psychopathology, medication adherence, comorbid physical illness, and substance use disorder were assessed. Data entry and analysis were done using EpiData version 3.1 and Statistical Package for the Social Sciences (SPSS) version 21.0, respectively. Variables with a P value < 0.05 in the final multiple regression models were declared to be associated with the outcome variable. The Results. The response rate of the study was 99.7%. The mean (±standard deviation) score of the World Health Organization Quality of Life Assessment Short Version Scale was 74.34 ± 15.83. Positive symptoms, negative symptoms, general psychopathologies, comorbid physical illness, khat use disorder, tobacco use disorder, and medication nonadherence were negatively associated with patient quality of life. However, monthly income was found to be positively associated with quality of life. Conclusion and Recommendation. The mean and standard deviation of the quality of life of people with schizophrenia is found to be 74.34 ± 15.83 in this study. The social relationship domain was found with the lowest mean score. Therefore, priority interventions need to be implemented to improve the social deficits.

Knowledge and Precautionary Behavioral Practice Toward COVID-19 Among Health Professionals Working in Public University Hospitals in Ethiopia: A Web-Based Survey.

BACKGROUND: The novel coronavirus disease, COVID-19, causes massive death, threatens the life and health of the world population. Thousands of health professionals were died and tested positive. OBJECTIVE: This study was designed to determine knowledge and precautionary behavior practice for coronavirus disease-19 among health professionals working in public university hospitals in Ethiopia. METHODS: A web-based online survey was conducted on health professionals working in Ethiopian public university hospitals. A survey questionnaire consisted of socio-demographic, coronavirus disease knowledge questions and precautionary behavioral practice. The survey questions were designed using Google form. All health professionals working (academic and clinical staff) in university hospitals were invited to participate in the online survey carried out from May 1 to 14, 2020. The data were analyzed using the Statistical Package for Social Sciences version 24.0. Descriptive statistics were computed, and tables and figures were used to present the results. Linear regression analysis was used to identify knowledge-related factors independently associated with precautionary behavior practice. RESULTS: A total of 273 health professionals participated in this study. The mean (± SD) age of participants was 31.03 ± 5.11. Two-third (61.5%) and one-fourth (26%) of participants attended second degree and medical doctors, respectively. More than one-fourth of the study participants (27.5%) reported social media as the source of information. In this study, we found a significant gap between the level of knowledge and practical implementation of the recommended precautionary measures, especially for wearing masks and gloves. The final multiple linear regression analysis indicated a positive association between knowledge of the source of infection, incubation period, and mode of disease transmission with recommended behavioral practice. CONCLUSION AND RECOMMENDATION: There was a significant gap in the implementation of the behavioral practice, especially for wearing masks and gloves. Therefore, there is a need to motivate and monitor health professionals' adherence to recommended precautionary measures.

Sociodemographic and Obstetric Determinants of Antenatal Depression in Jimma Medical Center, Southwest Ethiopia: Facility Based Case-Control Study.

BACKGROUND: Worldwide, 10-20% of women experience depression during pregnancy. In sub-Saharan countries, depression during pregnancy is estimated to be 15-57%. Even though there is a high burden of depression during pregnancy, little attention has been given to identify sociodemographic and obstetric determinants in diverse populations like Ethiopia. OBJECTIVE: To identify sociodemographic and obstetric determinants of antenatal depression among women attending an antenatal clinic at Jimma Medical Center, southwest Ethiopia. PATIENTS AND METHODS: A case-control study was conducted among 246 pregnant mothers (82 cases and 164 controls) attending an antenatal clinic in Jimma Medical Center from June 1 to August 30, 2019. Antenatal depression was assessed using the Beck Depression Inventory-II. Epidata 3.1 and SPSS v24 were used for data entry and analysis, respectively. Adjusted odds ratios (AOR) and 95%CIs were estimated using logistic regression models. Statistical significance was set at P<0.05. RESULTS: Married mothers were 67% (AOR=0.33, 95%CI: 0.15-0.75), housewives were 97% (AOR=0.03, 95%CI: 0.01-0.14), private workers were 87% (AOR=0.13, 95%CI: 0.04-0.44), and government employees were 84% (AOR=0.16, 95%CI: 0.05-0.46), less likely to develop antenatal depression. Multigravida were 88% (AOR=0.12, 95%CI: 0.04-0.37) less likely to develop antenatal depression. Third trimester pregnancy was four times (AOR=4.04, 95%CI: 1.51-10.81) more likely to have depression. Mothers who having wanted pregnancy were 83% (AOR=0.17, 95%CI: 0.04-0.81) less likely to develop antenatal depression compared with mothers having unwanted pregnancy. CONCLUSION AND RECOMMENDATION: Being married, multigravida, having wanted pregnancy and occupation status (housewives, private workers and government employees) can protect mothers from developing antenatal depression. Mothers with third trimester pregnancy were four times more likely to have depression. Designing a screening and intervention strategy for antenatal depression must consider the aforementioned protective and risk factors.

Self-stigma and medication adherence among patients with mental illness treated at Jimma University Medical Center, Southwest Ethiopia.

BACKGROUND: Self-stigma associated with mental illness has remained a global public health issue affecting social interactions, health care, productivity and acceptance among others. It is one of important factors contributing to non-adherence to medication that leads to increased hospitalization and higher healthcare costs. Hence, the study aimed to assess self-stigma and medication adherence among patients with mental illness treated at the psychiatric clinic of Jimma University Medical Center (JUMC). METHODS: A cross-sectional, community-level study was conducted at Jimma town. The patient's data was collected from records between April and June 2017 and the collected data was analyzed using SPSS version 21. The Internalized Stigma of Mental Illness (ISMI) tool was utilized to measure internalized stigma. Linear regression analysis was performed to get the final model. Statistical significance association was considered at p-values less than 0.05 and 95% confidence interval was used. RESULTS: Males comprised more than half (61%) of the total sample of 300 respondents and with a mean age of 34.99 (SD ± 11.51) years. About one-third (32%) of patients had a working diagnosis of schizophrenia followed by major depressive disorder (24.3%). More than half of them, 182 (60.7%) were adherent to their psychotropic medication. The overall mean value of self-stigma was 2.16 (SD = 0.867) and 84 (28%) of the respondents had moderate to high self-stigma. Using ISMI the mean score of alienation was 2.26 (SD = 0.95), stereotype endorsement 2.14 (SD = 0.784), perceived discrimination 2.18 (SD = 0.90), social withdrawal 2.10 (SD = 0.857) and stigma resistance 2.11 (SD = 0.844). Increasing age of the patients (std. ß = - 0.091, p = 0.009) and living with kids and spouse (std. ß = - 0.099, p = 0.038) were negatively associated with self-stigma whereas increased world health organization disability assessment schedule (WHODAS) score (ß = 0.501, p < 0.001), number of relapses (std. ß = 0.183, p < 0.01) and medication non-adherence (std. ß = 0.084, p = 0.021) were positively associated with self-stigma. CONCLUSION: The study revealed that there was high self-stigma among patients with mental illness and a significant association between overall ISMI score and level of medication adherence. These require mental health professionals and policy-makers should give attention to ways to overcome self-stigma and increase medication adherence among patients with mental illness.

Children emotional and behavioural problems and its association with maternal depression in Jimma town, southwest Ethiopia.

BACKGROUND: In sub-Saharan countries, one in five children and one in three women experiences emotional and behavioural problems (EBPs) and depression, respectively. While various factors were reported to affect the mental health of children, little is known about the impact of maternal depression on the offspring. Moreover, the magnitude of children's EBPs is barely known in Ethiopia. AIM: To determine the magnitude of child EBPs and its association with maternal depression in Jimma town, southwest Ethiopia. METHODS: A quantitative cross-sectional study was conducted among 734 mother-child pairs in Jimma town from January to June, 2019. EBP was assessed by using the parent version of Strengths and Difficulties Questionnaire (SDQ) with cut-off score of ≥14. Maternal depression was assessed using Patient Health Questionnaire-9 with a cut-off score of ≥10. Data were entered into Epidata V.3.1 and exported to SPSS V.24 for analysis. Multivariable logistic regression was fitted to identify the strength of association between exposure and outcome variables. RESULTS: Of the 734 participants, 146 (19.9%, 95% CI: 16.9% to 22.9%) met EBP criteria based on parent version of SDQ. Maternal depression had significant association with child EBP (adjusted OR=2.38, 95% CI: 1.55 to 3.66). In addition, children aged 7-10 years, family size categories of ≤3 and 4-6, maternal intimate partner violence and maternal khat use had significant association with child EBP. CONCLUSIONS AND RECOMMENDATIONS: A significant number of children suffer from EBP in Jimma town. Maternal depression is found to be a predictor of children's EBPs. Thus, there is a need to design and implement an integrated maternal and child mental health programme. The maternal and child health section at the national level should integrate and cascade routine maternal and child mental health screening and intervention modalities down to the family healthcare system.

Psychotropic medications induced parkinsonism and akathisia in people attending follow-up treatment at Jimma Medical Center, Psychiatry Clinic.

OBJECTIVE: To determine the magnitude and factors associated with psychotropic drug-induced parkinsonism and akathisia among mentally ill patients. METHODS: A hospital-based cross-sectional study was conducted with a total of 410 participants attending a follow-up treatment service at Jimma Medical Center, a psychiatry clinic from April to June 2019. Participants were recruited using a systematic random sampling method. Drug-induced parkinsonism and akathisia were assessed using the Extra-pyramidal Symptom Rating Scale. Substance use was assessed using the World Health Organization Alcohol, Smoking, and Substance Involvement Screening Test. Data entry was done using EpiData version 3.1, and analysis done by the Statistical Package for Social Sciences version 22. Statistically, the significant association was declared by adjusted odds ratio, 95% confidence interval, and p-value less than or equal to 0.05. RESULTS: The mean age of the respondents was 33.3 years (SD ± 8.55). Most of the participants 223 (54.4%) had a diagnosis of schizophrenia. The prevalence of drug-induced parkinsonism was 14.4% (95% CI: 11.0 to 18.0) and it was 12.4% (95% CI: 9.3 to 15.4) for drug-induced akathisia. The result of the final model found out drug-induced parkinsonism was significantly associated with female sex, age, type of antipsychotics, physical illness, and anti-cholinergic medication use. Similarly, female sex, chlorpromazine equivalent doses of 200 to 600 mg, combined treatment of sodium valproate with antipsychotic, and severe khat/Catha edulis use risk level was significantly associated with akathisia. CONCLUSION: One of seven patients developed drug-induced parkinsonism and akathisia. Careful patient assessment for drug-induced movement disorders, selection of drugs with minimal side effects, screening patients for physical illness, and psycho-education on substance use should be given top priority.

Quality of life and its association with current substance use, medication non-adherence and clinical factors of people with schizophrenia in Southwest Ethiopia: a hospital-based cross-sectional study.

BACKGROUND: Schizophrenia was ranked as one of the top ten illnesses contributing to the global burden of disease. But little is known about the quality of life among people with schizophrenia, in particular in low-income countries. This study was aimed to examine the association of quality of life with current substance use, medication non-adherence and clinical factors of people with schizophrenia at Jimma University Medical Center, psychiatry clinic, Southwest Ethiopia. METHODS: Institution based cross-sectional study design was employed. Study participants were recruited using a systematic random sampling method and a sample fraction of two was used after the first person was identified by the lottery method. we used the World Health Organization Quality of Life Scale-Brief version (WHOQoL-BREF) and 4-item Morisky Medication Adherence Scale (MMAS-4) to assess the quality of life and medication non-adherence respectively. Data about current substance use was assessed by yes/no questions. Descriptive statistics, such as frequency, mean and standard deviations were computed to describe the characteristics of the study population. Data entry was done using EpiData version 3.1 then exported to SPSS statistics version 25 for analysis and analyzed using multiple linear regression. The assumption for linear regression analysis including the presence of a linear relationship between the outcome and predictor variable, the test of normality, collinearity statistics, auto-correlation and homoscedasticity were checked. Un-standardized Beta (ß) coefficients with 95% confidence interval (CI) and P-value < 0.05 were computed to assess the level of association and statistical significance in the final multiple linear regression analysis. RESULT: In this study 31.65% of participants were medication non-adherent and total mean scores of quality of life showed a lower level of satisfaction in social relationship domain (10.14 ± 3.12). Our study showed 152(43.3%), 248(70.7%) and 97(27.6%) of respondents had used tobacco, Khat and alcohol atleast once during the past 3 months respectively. Final adjusted multiple regression model showed medication non-adherence has significant negative association with physical domain (beta = - 4.42, p < 0.001), psychological (beta = - 4.49, p < 0.001), social relationships (beta = - 2.29, p < 0.001) and environmental domains (beta = - 4.95, p < 0.001). Treatment duration has significant negative association with psychological domain (beta = - 0.17, p < 0.04), social relationship (beta = - 0.14, p < 0.005), environmental domain (beta = - 0.24, p < 0.02) and overall quality of life (beta = - 0.67, p < 0.02). Having comorbid physical illness has significant negative association with physical domain (beta = - 2.74, p < 0.001), psychological (beta = - 2.13, p < 0.004), social relationships (beta = - 1.25, p < 0.007), environmental domain (beta = - 3.39, p < 0.001) and overall quality of life (beta = - 9.9, p < 0.001). Current tobacco use has significant negative association with physical domain (beta = - 1.16, p < 0.004), psychological (beta = - 1.23, p < 0.001), social relationships (beta = - 0.88, p < 0.001), environmental domains (beta = - 1.98, p < 0.001) and overall quality of life (beta = - 5.73, p < 0.001). Also, current chewing khat has significant negative association with physical domain (beta = - 1.15, p < 0.003), psychological (beta = - 1.58, p < 0.001), environmental domains (beta = - 2.63, p < 0.001) and overall quality of life (beta = - 6.22, p < 0.001). CONCLUSION: The social relationship domain of quality of life has the lowest mean score. Medication non-adherence, treatment duration, having a comorbid physical illness, current tobacco use and current chewing khat were found to have a statistically significant association with the overall quality of life. Therefore, treatments aimed to improve social deficits, medication non-adherence, comorbid physical illness and decrease substance abuse is imperative.

Perceived Patient Satisfaction and Associated Factors among Psychiatric Patients Who Attend Their Treatment at Outpatient Psychiatry Clinic, Jimma University Medical Center, Southwest Ethiopia, Jimma, 2019.

BACKGROUND: In health care, patient satisfaction is an attitudinal response and a pillar for quality assurance, but there is reluctance to measure it among mentally ill patients. Satisfied patients become more compliant. However, no study was done in this study area before. Therefore, this study was conducted to determine the magnitude of perceived patient satisfaction and associated factor at Jimma University Medical Center, outpatient psychiatry clinic. METHODS: Cross-sectional study design was conducted, and systematic random sampling technique was used to get study participants. The 24-item Mental Health Service Satisfaction Scale (a validated tool in Ethiopia) was used to assess patient satisfaction. Data was entered using Epi-data 3.1 and exported to the Statistical Package for the Social Sciences 22.0 for analysis. Linear regression analysis (P < 0.05) was used to identify the association between the outcome and independent variable. RESULT: 414 respondents participated in the study with response rate of 98%. The overall percentage of patient satisfaction was 50.3% (95% CI 48.4%-51.2%). Being male (ß = -0.651, 95% CI (-0.969, -0.332)), having secondary and above educational status (ß = -0.651, 95% CI (-0.969, -0.332)), having secondary and above educational status (ß = -0.651, 95% CI (-0.969, -0.332)), having secondary and above educational status (ß = -0.651, 95% CI (-0.969, -0.332)), having secondary and above educational status (ß = -0.651, 95% CI (-0.969, -0.332)), having secondary and above educational status (ß = -0.651, 95% CI (-0.969, -0.332)), having secondary and above educational status (ß = -0.651, 95% CI (-0.969, -0.332)), having secondary and above educational status (ß = -0.651, 95% CI (-0.969, -0.332)), having secondary and above educational status (ß = -0.651, 95% CI (-0.969, -0.332)), having secondary and above educational status (Conclusion and Recommendation. This study found that half of the study participants are satisfied with the service. Distance from the hospital, current substance use, waiting time, and having good social support were identified as modifiable factors that can be improved through working with stakeholders to increase patient satisfaction.

Quality of life and its association with psychiatric symptoms and socio-demographic characteristics among people with schizophrenia: A hospital-based cross-sectional study.

OBJECTIVES: To identify sociodemographic and illness-related factors associated with quality of life among people with Schizophrenia. METHODS: A hospital-based cross-sectional study design was employed among 351 people with schizophrenia and attending the followup service at Jimma University Medical Center, psychiatric clinic during the study period. Participants were recruited using a systematic random sampling method and a sample fraction of two was used after the first person was identified by a lottery method. Data entry was done using EpiData version 3.1 and then exported to Statistical Package for Social Sciences version 25 for analysis. Multiple regression analysis was used to determine the statistically significant association between quality of life and independent variables. RESULTS: Among the four domains of quality of life, respondents scored the lowest mean in the social relationships domain (10.14 ± 3.12). Final adjusted multiple regression model revealed, being divorced was negatively associated with the physical domain (ß = -0.72, p = 0.02), having no formal education was negatively associated with physical health domain (ß = -0.69, p = 0.001) and age was positively associated with the psychological domain (ß = 0.371, p = 0.071). Being rural resident was negatively associated with physical domain (ß = -0.48, p = 0.01), with environmental domain (ß = -0.64, p = 0.03), with social relationships domain (ß = -0.45, p = 0.04), and with overall quality of life (ß = -1.93, p = 0.006). Positive symptoms (ß = -0.22, p = 0.001), negative symptoms (ß = -0.36, p = 0.001), and general psychopathology (ß = -0.098, p = 0.006) were inversely associated with overall quality of life. CONCLUSION: In this study, the social relationship domain of quality of life among people with schizophrenia has the lowest mean score. Some socio-demographic variables and psychiatric symptoms were found to be key significant associated factors of quality of life. Priority interventions to improve the social deficits and addressing psychiatric symptoms of people with schizophrenia is essential to improve their quality of life.

Factors associated with low birthweight among newborns delivered at public health facilities of Nekemte town, West Ethiopia: a case control study.

BACKGROUND: Low birthweight (LBW) remains the most important risk factor which attributed to mortality of 15-20% of newborns across the globe. An infant with low birthweight is more likely to have stunting in childhood and develop markers of metabolic risk factors at his later age. Furthermore, LBW is a risk for inter-generational assaults of malnutrition as it is the risk for sub optimal growth until adulthood, affecting women's and male's reproductive capabilities. Thus, there is enough concern to study the determinants of LBW across different settings. Accordingly, this study was conducted to assess the determinants of low birthweight s in public health facilities of Nekemte town, West Ethiopia. METHODS: Facility based unmatched case control study was employed from February to April 2017. The data were collected using structured, pretested interviewer administered questionnaire in all public health facilities of Nekemte town. Consecutive live births of less than 2500 g in each of the hospitals and health centres were selected as cases and succeeding babies with weights of at least 2500 g as controls. Data were entered in to Epi-data software version 3.1 and exported to SPSS Version 21 and analyzed using frequency, cross-tabs and percentage. Factors with p-value < 0.25 in Bivariate analysis were entered in to multivariable logistic regression and statistical significance was considered at p-value < 0.05. RESULT: A total 279 (93 cases &186 controls) were included in the study with a mean birthweight of 2138.3 g ± SD 206.87 for cases and 3145.95 g ± SD 415.98 for controls. No iron-folate supplementation (AOR = 2.84, 95% CI, 1.15-7.03), no nutritional counselling (AOR = 4.05, 95%CI, 1.95-8.38), not taking snacks (AOR =3.25, 95%CI, 1.64-6.44), maternal under nutrition (AOR =5.62, 95%CI, 2.64-11.97), anemia (AOR = 3.54, 95%CI, 1.46-8.61) and inadequate minimum dietary diversity score of women MDDS-W (AOR = 6.65, 95%CI, 2.31-19.16) were factors associated with low birthweight . CONCLUSION: Lacking nutrition counselling during pregnancy, lacking iron/folic acid supplementation during pregnancy, not taking snacks during pregnancy, maternal under-nutrition, maternal anemia and inadequate minimum dietary diversity score of women (MDDS-W) were independently associated with LBW. Thus, public health intervention in the field of maternal and child health should address these determinants.

Maternal Common Mental Disorder as Predictors of Stunting among Children Aged 6-59 Months in Western Ethiopia: A Case-Control Study.

BACKGROUND: Child malnutrition in low- and middle-income countries still continues to be an alarming. Africa and Asia bear the greatest share of all forms of malnutrition. The association between maternal common mental disorder and stunting has not been studied well even in developed countries; much less in developing countries and even the findings are conflicting. Thus, the purpose of the present research was to investigate the relationship of maternal common mental disorder and child stunting. METHODS: Institution based unmatched case-control study design was employed from March to April 2017. Two hundred thirty-four sampled children (78 cases and 156 controls) were randomly selected. Anthropometric measurements (height/length and weight) were taken by calibrated instruments. Maternal common mental disorder (CMD) was measured by using the locally validated Self-Reporting Questionnaire (SRQ-20). Data entry was done by Epi data version 3.1 and analysis was done by SPSS 21.0 statistical software. RESULT: Finding of this study found out about three-fourths of cases (71.8%) and three-fourths of controls (69.9%) were residing in rural and urban areas, respectively. Regarding maternal common mental disorder, more than half of cases mother (53.8%) and more than one-tenth of controls mother (13.5%) were found to have common mental disorder. The study showed that children of mothers who had common mental disorder were found to be three times more likelihood of developing stunting than children whose mothers had not common mental disorder. CONCLUSION AND RECOMMENDATION: The study indicated that maternal common mental disorder was significantly associated with stunting. Therefore, emphasis should be given in preventing, managing, and maintaining maternal mental health in order to prevent stunting.

Posttraumatic Stress Disorder and Associated Factors Among Drivers Surviving Road Traffic Crashes in Southwest Ethiopia.

BACKGROUND: Road traffic crashes (RTCs) can cause serious and long-lasting consequences for drivers, both in terms of physical and mental health outcomes. Posttraumatic stress disorder (PTSD) is the most frequent mental disorder occurring after traumatic exposure. Ethiopian drivers experience RTCs more frequently than other sub-Saharan countries. Despite this prevailing phenomenon, limited attention has been given to PTSD among drivers. OBJECTIVE: To determine the prevalence of PTSD and associated factors among drivers surviving RTCs in southwest Ethiopia. METHODS: A cross-sectional quantitative study was conducted among 402 male drivers who had survived RTCs. The study was conducted in Jimma zone, southwest Ethiopia from March to June, 2019. All drivers who had survived RTCs in the last year were included in the study. The Trauma Screening Questionnaire was used to determine the prevalence of PTSD. Data were entered in EpiData 3.1 and exported to SPSS 24 for analysis. RESULTS: The response rate of the study was 398(99%). Fifty of 398 (12.6%, 95% CI 9.5%-16.1%) met PTSD criteria based on the questionnaire. A history of near-miss RTCs (AOR 3.49, 95% CI 1.89-6.43), depression (AOR 3.32, 95% CI 1.36-5.12), and severe-risk cannabis use (AOR 2.51, 95% CI 1.96-7.52) were significantly associated with PTSD. CONCLUSION AND RECOMMENDATION: The prevalence of PTSD among drivers surviving RTCs was high compared to the general population. A record of near-miss RTCs, depression, and severe-risk cannabis use shown significant associations with PTSD. Strategies and guidelines must be developed to screen and treat PTSD among drivers surviving RTCs. Drivers with experience of near-miss RTCs, depression, and severe-risk cannabis use should be given priority when screening for PTSD.