Depression and Burnout among Health Extension Workers in Ethiopia: A Cross-Sectional Study

BACKGROUND: Depression and burnout are common among healthcare workers (HCWs) and negatively affect their well being and the quality of the service they provide. However, the burden of depression and burnout among health extension workers (HEWs) in Ethiopia and their relationship has not been documented well. The objective of this study was to estimate the prevalence of depression and burnout among HEWs in Ethiopia and to investigate the relationship between these conditions. MATERIALS AND METHODS: We used a cross-sectional study design and collected data from 584 rural and 581 urban HEWs in Ethiopia, as part of the 2019 national health extension program assessment. The Patient Health Questionnaire (PHQ-9) and Burnout Self-Test were used to screen HEWs for depression and burnout, respectively. We used descriptive statistics to estimate the magnitude of depression and burnout, and logistic regression to examine their relationship. RESULT: Based on PHQ-9 cutoff scores of 10, the prevalence of major depression was 16.5% among rural and 8.9% among urban HEWs, whereas burnout risk was 39.8% among rural and 12.6% among urban HEWs. The odds of having depression among HEWs with burnout risk was relatively higher compared to those without burnout risk [For rural HEWs, the adjusted odds ratio (AOR) is 11.88 at a 95% confidence interval (CI; 5.27, 26.80), and for urban HEWs, the AOR is 11.49 at a 95% CI (5.35, 24.63)]. CONCLUSION: The prevalence of depression and burnout is high among HEWs in Ethiopia, with a significant rural­urban difference, and burnout is a significant predictor of depression. Mental health interventions that enable prevention, early detection, and management are needed especially for rural HEWs who are in charge of preventive health service delivery for the disadvantaged rural communities

Community awareness of intestinal parasites and the prevalence of infection among community members of rural Abaye Deneba area, Ethiopia

<p><b>OBJECTIVE</b>To assess the knowledge of Abaye Deneba community members regarding intestinal parasites and prevalence of intestinal parasitic infections.</p><p><b>METHODS</b>Knowledge about intestinal parasites was assessed by administering a questionnaire to 345 randomly selected household heads. Parasitological stool examination of 491 randomly selected individuals was done using the formol ether concentration technique.</p><p><b>RESULTS</b>Knowledge of the Abaye Deneba community about parasitic diseases such as schistosomiasis, amoebiasis, ascariasis and taeniasis was very low. However, 204 (59.3%) members correctly responded that the cause of giardiasis is related to contaminated water and 176 (51.2%) knew how to prevent it. In some cases, respondents did correctly identify causes, symptoms of intestinal parasite infection and ways to prevent it, but they did not accurately link it to the appropriate disease caused by the different intestinal parasite species. Among the 491 stool samples examined, 50.2% of study participants showed infection with at least one intestinal parasite. Schistosoma mansoni was the most prevalent (41.3%) followed by Trichuris trichiura(9.4%), Ascaris lumbricoides (8.4%), Taenia saginata (2.4%), Enterobius vermicularis (2.0%) and hookworm (0.4%). Prevalence of schistosomiasis was highest in men aged 15-24 years.</p><p><b>CONCLUSIONS</b>Intestinal parasitic infection is highly prevalent in communities of the Abaye Deneba area. Nevertheless, the knowledge of the community members about the parasite is less. Implementation of preventive chemotherapy, supplemented with health education, provision and use of sanitary facilities would be recommended to reduce morbidity and control transmission of intestinal parasites in this area.</p>

Community awareness of intestinal parasites and the prevalence of infection among community members of rural Abaye Deneba area, Ethiopia

Objective: To assess the knowledge of Abaye Deneba community members regarding intestinal parasites and prevalence of intestinal parasitic infections.Methods:Knowledge about intestinal parasites was assessed by administering a questionnaire to 345 randomly selected household heads. Parasitological stool examination of 491 randomly selected individuals was done using the formol ether concentration technique.Results:Knowledge of the Abaye Deneba community about parasitic diseases such as schistosomiasis, amoebiasis, ascariasis and taeniasis was very low. However, 204 (59.3%) members correctly responded that the cause of giardiasis is related to contaminated water and 176 (51.2%) knew how to prevent it. In some cases, respondents did correctly identify causes, symptoms of intestinal parasite infection and ways to prevent it, but they did not accurately link it to the appropriate disease caused by the different intestinal parasite species. Among the 491 stool samples examined, 50.2% of study participants showed infection with at least one intestinal parasite. Schistosoma mansoni was the most prevalent (41.3%) followed by Trichuris trichiura(9.4%), Ascaris lumbricoides (8.4%), Taenia saginata (2.4%), Enterobius vermicularis (2.0%) and hookworm (0.4%). Prevalence of schistosomiasis was highest in men aged 15-24 years.Conclusions:Intestinal parasitic infection is highly prevalent in communities of the Abaye Deneba area. Nevertheless, the knowledge of the community members about the parasite is less. Implementation of preventive chemotherapy, supplemented with health education, provision and use of sanitary facilities would be recommended to reduce morbidity and control transmission of intestinal parasites in this area.

Bovine tuberculosis is more prevalent in cattle owned by farmers with active tuberculosis in central Ethiopia.

A case control study was conducted between October 2004 and April 2005 to determine the prevalence of bovine tuberculosis (BTB) in cattle in central Ethiopia relative to the tuberculosis status of their owners. A total of 174 farmers (87 with active tuberculosis and 87 with no active tuberculosis), and 1041 cattle (506 owned by farmers with active tuberculosis and 535 by farmers without active tuberculosis) were included. The comparative intradermal cervical tuberculin test was used in cattle while clinical symptoms, chest X-ray and Ziehl-Neelsen staining were used for the diagnosis of tuberculosis in the farmers. In addition, mycobacterial culture, biochemical tests, and drug susceptibility tests were performed for the identification Mycobacterium spp. from both humans and cattle. The prevalence of BTB was threefold higher (odds ratio [OR]=4.2, 95% confidence interval [CI]=2.79-6.2) in cattle owned by farmers with active tuberculosis (24.3%) than in those owned by farmers who did not have active tuberculosis (8.6%). Cattle owned by farmers with active tuberculosis were four times more likely to have tuberculosis than cattle owned by farmers with no active tuberculosis. Furthermore, cattle owners who consumed raw milk were at greater risk (chi2=14.1, P<0.001, OR=3.34) of having active tuberculosis than those who consumed boiled milk. Of the 42 human isolates, 31 (74%) were Mycobacterium tuberculosis, seven (16%) were Mycobacterium bovis while four (10%) were considered a typical mycobacteria on the basis of biochemical and drug sensitivity tests. Of the 11 cattle isolates, two (18%) were Mycobacterium tuberculosis, five (46%) Mycobacterium bovis, and four (36%) were atypical mycobacteria. The prevalence of tuberculosis was higher in cattle owned by farmers with active tuberculosis than in cattle owned by farmers who did not have active tuberculosis, which could suggest possible transmission of Mycobacterium spp. between cattle and their owners.