Determinants of hyperemesis gravidarum among pregnant women attending health care service in public hospitals of Southern Ethiopia.

BACKGROUND: Hyperemesis gravidarum is severe nausea and excessive vomiting, starting between 4 and 6 gestational weeks, peak at between 8 and 12 weeks and usually improve and subside by 20 weeks of pregnancy. Identifying the determinants of hyperemesis gravidarum has a particular importance for early detection and intervention to reduce the health, psychosocial and economic impact. In Ethiopia there is low information on determinants of hyperemesis gravidarum. METHODS: Institution based unmatched case-control study design was conducted from April 12- June 12, 2021. A structured face-to-face interviewer administered questionnaire and checklist for document review were used to collect the data from 360 study participants (120 cases and 240 controls). The data were collected by KoBocollect 1.3, and then exported to statistical package for social science version 25 for further analysis. Both bi-variable and multivariable logistic regression analysis were done to identify the determinants and a p-value < 0.05 with a 95% confidence level was used to declare statistical significance. RESULT: Being an urban dweller (AOR = 2.1, 95% CI: 1.01, 4.34), having polygamous husband (AOR = 2.92, 95% CI: 1.27, 6.68), having history asthma/ other respiratory tract infections (AOR = 3.56, 95% CI: 1.43, 8.82), saturated fat intake (AOR = 4.06 95% CI: 1.98, 8.3), no intake of ginger (AOR = 3.04 95% CI: 1.14, 8.09), and inadequate intake of vitamin B rich foods (2.2, 95% CI: 1.14-4.2) were the determinants of hyperemesis gravidarum. CONCLUSION: This study revealed that, urban residence, having polygamous husband, history of asthma/other respiratory tract infections, intake of saturated fat, no intake of ginger, inadequate intake of vitamin B reach foods were found to be independent determinants of hyperemesis gravidarum. It is better if healthcare providers and government authorities exert continual effort to give health education and counselling service concerning to dietary practice and asthma attacks. It is advisable if pregnant women adhere to healthy diets and limit intake of saturated fats and also husband and nearby relatives give care and support for pregnant women.

Risk Perception and Behavioral Response of Teachers to COVID-19 in Southern Ethiopia, 2021.

Introduction: Coronavirus disease 2019 (COVID-19) is an infectious illness which was first identified in Wuhan China. The mode of transmission of COVID-19 is mainly from person-to-person by respiratory transmission and from contact with contaminated surfaces. Teachers may have a significant higher number of social interactions than other professions, putting them at greater risk of contracting the virus. Objective: The aim of this study was to assess the risk perception and behavioral response of teachers to COVID-19 in Gamo zone, Southern Ethiopia. Methods: The study was conducted in Gamo zone from February to march, 2021. An Institution-based-cross sectional study design was employed and multi stage sampling technique was utilized to select 634 study participants. The data were collected using Kobo collect survey tool through interviewer administered questionnaire. The data were analyzed by SPSS version 25. Both bivariable and multivariable logistic regression models were fitted to identify factor associated with risk perception and behavioral response. Odds ratio with 95% confidence interval was computed to determine the level of significance; in multivariable analysis, variables with a P value less than 0.05 with 95% confidence interval were considered as statistically significant. Results: About 79.1% and 75.1% of the teachers had high risk perception and good protective behavior, respectively. Having children ((AOR=1.84, 95% CI: 1.15-2.94), COVID-19 update (AOR=3.7, 95% CI: 1.66-8.59) and good protective behavior (AOR= 1.98, 95% CI: 1.18-3.34) were associated with high risk perception. On the other hand, educational status (AOR=9.42, 95% CI: 4.94-17.96) and availability of personal protective equipment (AOR=5.85, 95CI:2.27-15.02) were associated with good protective behavior. Conclusion: Although majority of the teachers had good protective behavior, some protective measures were not frequently adopted. There were few individuals who had low risk perception; this could be a potential cause for the occurrence of school outbreak. Therefore, the stakeholder should provide adequate resource and training on COVID-19 to enhance their risk perception and to promote adoption of protective methods.

Assessment of Knowledge and Attitude of Cataract and Their Associated Factors Among Adults in Arba Minch Zuria Woreda, Southern Ethiopia.

BACKGROUND: Cataract is the major cause of reversible blindness and visual impairment in developing countries. It has been assumed that there is poor access to information related to the cause, prevention, and treatment of cataract in developing countries. There is also a paucity of data on knowledge and attitude towards cataract in Ethiopia. PURPOSE: This study aimed to assess the knowledge and attitude of cataract and their associated factors among adults in Arba Minch Zuria Woreda, Southern Ethiopia. PATIENTS AND METHODS: A community-based cross-sectional study was conducted among 623 adults from February 6 to April 16, 2020. The study participants were selected by the multi-stage sampling technique. Data were collected with a pre-tested structured questionnaire by using face-to-face interviews. The data were entered into Epi info version 7.2 and exported to SPSS version 23 for analysis. The level of statistical significance was set at a p-value less than 0.05 in multivariable logistic regression. RESULTS: Among 623 total participants, 54.9% of them had good knowledge about cataract, while 37.9% of them had favorable attitude about cataract. Inability to read and write (AOR=0.104, 95% CI: 0.042-0.258), primary school educational level (AOR=0.208, 95% CI: 0.091-0.478), secondary school educational level (AOR=0.199, 95% CI: 0.088-0.451), earning average monthly income 350-820 Ethiopian birr (AOR=2.364, 95% CI: 1.277-4.373), not having previous eye examination (AOR=0.605, 95% CI: 0.425-0.861) and unavailability of eye clinic (AOR=0.65, 95% CI: 0.446-0.945) were significantly associated with knowledge of cataract. No history of cataract (AOR=0.257, 95% CI: 0.157-0.418) was significantly associated with attitude towards cataract. CONCLUSION: Significant portion of participants had poor knowledge and an unfavorable attitude towards a cataract. So, it is recommended that stakeholders in different hierarchies need to exert efforts on creating awareness about cataract by considering the education level of the community. Moreover, attention should be given to the availability and accessibility of the primary eye care unit.

Perceived stress and associated factors among health care professionals working in the context of COVID-19 pandemic in public health institutions of southern Ethiopia 2020.

INTRODUCTION: Health care professionals are at higher risk of developing stress-related problems during outbreaks, due to the overwhelming clinical workload, fear of contagion, and inadequate protective gears. So, in order to monitoring mental health issues and to understand the factors evidence-based interventions is important. Therefore, this study was aimed to assess perceived stress and associated factors among health care professionals working in the context of COVID-19, Southern Ethiopia. METHODS: Institution based cross-sectional study was conducted among 798 health care professionals from the 1st May to 1st June 2020. The study participants were selected using simple random sampling technique after allocating a proportion to each health institute based on the size of health care professionals. A pre-tested and structured interviewer-administered questionnaire using KOBO collect survey tool was used to collect data. A total score of >20 points was considered as the cut off for experiencing perceived stress based on perceived stress scale. Both bivariable and multivariable logistic regression analysis were performed to identify associated factors. The level of statistical significance was set at a p-value of less than 0.05 in multivariable logistic regression. RESULT: Nearly two-thirds 61.8% (95% CI: 58.4%, 65.2%) of HCPs had perceived stress. Not having COVID-19 updated information (AOR = 2.41, 95% CI: 1.31, 4.43), not at all confident on coping with stress (AOR = 9.94, 95% CI:3.74, 26.41), somewhat confident in coping with stress (AOR = 4.69, 95% CI:2.81, 7.84), moderately confident on coping with stress (AOR = 2.36, 95% CI: 1.46, 3.82), and not getting along well with people (AOR = 4.88, 95% CI: 1.42, 16.72) were positively association with perceived stress. However, feeling overwhelmed by the demand of everyday life (AOR = 0.52 95% CI: 0.35, 0.77) and worrying about what other people think about them (AOR = 0.48, 95% CI: 0.24, 0.81) were negatively associated with perceived stress. CONCLUSION: COVID-19 update, confidence in coping with stress, getting along with people, worrying about what other people think about them, and feeling overwhelmed by the demand of everyday life were factors significantly associated with perceived stress. The provision of COVID-19 update to HCPs along with wider strategies to support their psychological wellbeing is vital.

Exploring Barriers to Effective Implementation of Public Health Measures for Prevention and Control of COVID-19 Pandemic in Gamo Zone of Southern Ethiopia: Using a Modified Tanahashi Model.

BACKGROUND: Since the occurrence of the COVID-19 pandemic, different public health measures have been implemented to prevent and control the further spread of the disease. However, barriers that influence the effective implementation of public health measures were not explore in Ethiopia especially in study Area. Therefore, this study tried to fill this gap by exploring the barriers to effective implementation of public health measures for prevention and control of the COVID-19 pandemic in the Gamo Zone of southern Ethiopia. METHODS: The study employed a qualitative study with a phenomenology approach among purposely selected 30 individuals in the community and selected institutions. Key informant interview was used to collect the data. The data were transcribed verbatim and translated into the English language. The transcribed data were read several times to clearly understand the content for further analysis. The analysis of the data was conducted based on the modified Tanahashi framework. RESULTS: The study identified different barriers under five main themes: accessibility, acceptability, availability, contact and use, and effective implementation of public health measures related to barriers. The main barriers to effective implementation of public health measures were resistance to change, negligence, lack of community engagement, insufficient training for front line workers, poor supportive supervision, poor law enforcement, and lack of continuous community awareness creation. Beside, acceptability related barriers like cultural and religious norms and availability related barriers like shortage of personal protective equipment and shortage of skilled health professional have also lion share barriers for implementation of the public health measures. CONCLUSION: The study identified different personal, institutional, and societal level barriers for effective implementation of public health measures for the COVID-19 pandemic. Therefore, proper and targeted continuous community awareness creation with further mandatory law enforcement activities should be implemented by the concerned bodies to mitigate individual and societal level barriers. In addition, the government with relevant stakeholders should give due attention to equip and protect the frontline professionals by availing the necessary logistic and provision of continuous capacity-building activities.

Uptake of complete postnatal care services and its determinants among rural women in Southern Ethiopia: Community-based cross-sectional study based on the current WHO recommendation.

BACKGROUND: Postnatal care services are a constellation of preventive care, practices, and assessments designed to identify and manage maternal and newborn complications during the first six weeks after birth. Recognizing the role of the appropriate PNC at this critical time, the World Health Organization recommended four visits as a complete PNC for all post-partum mothers and newborns to ensure their survival. Although there have been numerous studies on the factors affecting the general PNC service in Ethiopia, there is a shortage of evidence on the use of complete postnatal care services and its determinants. Therefore, the objective of this study was to assess the uptake of full postnatal care service and its determinants among women who recently gave birth in the Ezha district of southern Ethiopia. METHODS: A community-based cross-sectional study was conducted in Ezha district. A two-stage sampling technique was applied. A total of 568 mothers who stayed for at least 6 weeks after childbirth from selected Kebeles were included in the study using computer-generated random numbers. Data collected through pre-established, structured, and interviewer-administered questionnaires were entered into EpiData3.1 and exported to SPPS version 23 for analysis. The Principal Components Analysis (PCA) was carried out to assess the wealth status of participants. The Multivariable logistic regression model has been fitted to identify the determinants of complete post-natal care service uptake. RESULTS: The overall uptake of complete postnatal care services in the study area was 23.9% [95% CI: (19.9, 27.5)]. The factors namely; maternal education of secondary and above [AOR: 4.31, 95%CI: 2.15, 8.05], having four and more antenatal visits [AOR: 4.03, 95%CI: 1.83, 8.85], Caesarean delivery [AOR: 3.75, 95%CI: 1.78, 7.92], having good knowledge on PNC [AOR: 4.31, 95%CI: 2.34, 9.04], and being a model household [AOR: 3.61, 95%CI: 1.97, 6.64] were recognized as determinants complete postnatal care uptake. CONCLUSION AND RECOMMENDATION: Complete post-natal care services uptake in the study area was low. Thus, a due emphasis should be given to behavioral change communication activities to improve maternal knowledge on PNC and enhancing adequate ANC uptake by health workers in the district. Besides, health extension workers in the district need to work on creating a model household through continuing education, support, and follow-up.

Disparities in utilization of sexual and reproductive health services among high school adolescents from youth friendly service implemented and non-implemented areas of Southern Ethiopia.

BACKGROUND: In recent years, much effort was made to improve access to sexual and reproductive health services (SRH) to adolescents and youths in Ethiopia particularly through establishment of youth friendly service (YFS) corners as part of the existing health care facilities. The existing evidences focused on investigating the utilization of SRH services at YFS established areas alone. There is a dearth of evidence which compares the SRH service use between the YFS implemented and non-implemented areas so that evidences can be drawn to suggest on the successes of the expansion of youth friendly corners. METHODS: A school-based comparative cross-sectional study was conducted by employing a multistage cluster sampling method. A pre-tested self-administered questionnaire was used to collect data and the collected data were entered in to Epidata version 4.4.1 software and then exported to SPSS version 20 for analysis. χ2 test was used to see a significant difference in SRH service utilization among adolescents from YFS implemented and non-implanted areas. The association between the SRH services utilization and the independent variables were examined using binary logistic regression. Finally, variables having p-value less than or equal to 0.05 in the multivariable logistic regression model were considered as statistically significant. RESULTS: There were a significant difference in the rate of SRH service utilization between YFS implemented (33.8%) and YFS non- implemented (9.9%) areas (χ2 = 37.49, p < 0.001). Higher educational status of mothers (AOR = 2.588, 95% CI: 1.220, 5.491), having open discussion with family (AOR = 3.175, 95%CI: 1.624, 6.206), having good knowledge (AOR = 4.511, 95% CI: 2.458, 8.278) and having positive attitude (AOR = 5.084, 95% CI: 2.764, 9.352) were factors positively associated with SRH services utilization. CONCLUSION: Compared with high schools from YFS implemented areas, the SRH service utilization was significantly lower among students from high schools where health facilities did not implement YFS. There is a need for enhancing efforts to establish YFS corners by the stakeholders at different hierarchies at places where the centers were not established so that SRH service uptake would be improved. In addition, it is better to promote open discussion with adolescents at the family level, and emphasis should be given for women education in the broad sense. Furthermore, wide-range awareness creation strategies should be used to address poor knowledge and negative attitude.

Intention and Practice on Personal Preventive Measures Against the COVID-19 Pandemic Among Adults with Chronic Conditions in Southern Ethiopia: A Survey Using the Theory of Planned Behavior.

PURPOSE: With prevention being the only and best available intervention, COVID-19 has recently become a global threat, having had and continuing to have enormous health, economic, and societal impacts. Evidence so far has documented a heightened risk of mortality to people with chronic conditions. There is a dearth of evidence regarding chronic disease patients' intention and practice on the preventive measures. This study tried to fill this gap by assessing the intention to practice and practice on personal preventive measures (PPMs) among adults with chronic conditions. MATERIALS AND METHODS: A facility-based cross-sectional study was conducted in Southern Ethiopia among 806 adults with chronic conditions by employing a multistage sampling technique. Data were collected using a pre-tested and structured questionnaire. Statistical analysis was done using IBM SPSS software version 25. Binary logistic regression analysis was done to identify factors associated with intention and practice. Level of statistical significance was declared at a P-value of less than 0.05. RESULTS: The study showed that 52% (95% CI=47.61-54.80) and 76.3% (95% CI=73.36-79.24) of adults with chronic conditions were intending to practice and had ever practiced the personal preventive measures. Participants' subjective norm (SN) (AOR=4.94; 95% CI=3.49-6.96) and perceived behavioral control (PBC) (AOR=4.13; 95% CI=2.69-6.34) were the factors associated with their intention. Good knowledge and a positive attitude were found to be significant factors associated with the participants' actual practice of the PPMs among other independent factors. CONCLUSION: Around half of the participants were intending to practice PPMs, and three-quarters had good practice on the PPMs against COVID-19. Interventions targeted to improve intention and practice on the PPMs need to take into account improving knowledge and attitude, and build positive subjective norms and heighten the confidence to control the preventive behaviors.

HIV-Positive Status Disclosure and Associated Factors among HIV-Positive Adult Patients Attending Art Clinics at Public Health Facilities of Butajira Town, Southern Ethiopia.

BACKGROUND: Human immunodeficiency virus-positive status disclosure is the process of informing one's HIV-positive status to others. It is the base for accessing care and treatment programs, attaining psychosocial support, reducing stigma, adhering to treatment, and promoting safer health. Even though different strategies were done in Ethiopia to increase the magnitude of HIV status disclosure among HIV-positive patients, the magnitude is still low. The magnitude of HIV-positive status disclosure was not assessed yet after initiation of the new strategy (test and treat strategy). The aim of this study is to assess the magnitude and factors associated with HIV-positive status disclosure among HIV-positive adults attending antiretroviral therapy clinic at the public health facilities of Butajira town. METHODS: Institution-based cross-sectional study was conducted at public health facilities of Butajira town. A total of 414 study participants were selected by systematic random sampling technique. Data were collected by using pretested interviewer-administered semistructured questionnaire. The collected data were entered into EpiData3.1 and exported to SPSS version 23. Bivariate and multivariable logistic regression analysis was used to identify factors associated with HIV-positive status disclosure. The strength of association was assessed by crude odds ratio and adjusted odds ratio for bivariate and multivariable logistic regression analysis, respectively. Statistically significance was declared at p value <0.05 and 95% CI. RESULTS: The magnitude of HIV-positive status disclosure was 90%. Discussing about safer sex (AOR: 3.5; 95% CI: 1.3, 9.4), viral load suppression (AOR: 4; 95% CI: 1.5, 10.1), having good ART adherence (AOR: 6; 95% CI: 2.4, 14.0), receiving counseling (AOR: 2.5; 95% CI: 1.01, 6.3), and perceiving stigma (AOR: 0.25; 95% CI: 0.09, 0.60) were the independent factors associated with HIV-positive status disclosure. CONCLUSION: Although the majority of the participants (90%) of them disclosed their HIV-positive status, lack of disclosure by few people can tackle HIV prevention and control programs. Health programs could improve disclosure of HIV-positive status by providing counseling service, strengthening adherence of antiretroviral therapy, suppressing viral load, and avoiding (reducing) stigma on HIV-positive patients by their community.

Generalized Anxiety Disorder and Its Associated Factors Among Health Care Workers Fighting COVID-19 in Southern Ethiopia.

BACKGROUND: Healthcare workers (HCWs) are among the many groups of people who are in the frontline caring for people and facing heavy workloads, life-or-death decisions, risk of infection, and have been facing various psychosocial problems. So, monitoring mental health issues to understand the mediating factors and inform evidence-based interventions in a timely fashion is vital. PURPOSE: This study aimed to assess generalized anxiety disorder and its associated factors among HCWs fighting COVID-19 in Southern Ethiopia. PATIENTS AND METHODS: An institution-based cross-sectional study was conducted among 798 HCWs from 20 May to 20 June 2020. A pre-tested and structured interviewer-administered KOBO collect survey tool was used to collect data. The study participants were selected using a simple random sampling technique by allocating a proportion to each health institute. The association between the level of generalized anxiety disorder and its independent variables was examined by ordinal logistic regression. Assumptions for the proportional odds model were checked using parallel line tests. An adjusted proportional odds ratio with a 95% CI was used to calculate the strength of the statistical association between the independent and dependent variables. RESULTS: The prevalence of mild and moderate anxiety disorder among HCWs was 29.3% and 6.3%, respectively. Contact with confirmed or suspected cases (aPOR =1.97; 95% CI: 1.239, 3.132), no COVID-19 updates (aPOR=4.816, 95% CI=2.957, 7.842), no confidence on coping with stresses (aPOR=2.74, 95% CI=1.633, 4.606), and COVID-19-related worry (aPOR=1.85, 95% CI=1.120, 3.056) were positively associated with higher-order anxiety disorder. However, not feeling overwhelmed by the demands of everyday life (aPOR=0.52, 95% CI=0.370, 0.733) and feeling cannot make it (aPOR=0.44, 95% CI=0.308, 0.626) were negatively associated with a higher order of anxiety. CONCLUSION: The study revealed that the prevalence of anxiety disorder among HCWs was high in the study area. The findings of the current study suggest immediate psychological intervention for health care workers in the study area is vital. Therefore, proactive measures should be taken by the stakeholders at different hierarchies to promote the psychological wellbeing of HCWs in order to control the impact of the pandemic on the HCWs, and containing the pandemic.