Time to death and predictors of mortality among asphyxiated neonates in southwest Ethiopia, 2022: prospective cohort study.

OBJECTIVE: This study aimed to determine the time to death and predictors of mortality among asphyxiated neonates admitted to public hospitals in the southwest region of Ethiopia. DESIGN: An institution-based prospective cohort study was conducted. SETTING: Public hospitals in southwest Ethiopia. PARTICIPANTS: A total of 144 asphyxiated neonates, who were admitted to the neonatal intensive care unit, and their mothers participated from March 2022 to 30 September 2022. Data were entered into EpiData V.4.4.2.1 and exported to STATA V.16 for analysis. The Cox proportional hazards model using bivariate (p<0.25) and multivariate (p<0.05) analyses was used to identify the predictors of mortality. The median survival time was estimated using Kaplan-Meier survival estimates. PRIMARY OUTCOME: Time to death from asphyxia and its predictors in neonates. RESULTS: The mortality incidence rate of asphyxiated neonates was 9.1 deaths per 1000 person-days of observation (95% CI: 7.11 to 11.52) with a median survival time of 8 days, and 45.83% (95% CI: 37.81% to 54.08%) of asphyxiated neonates died. Being male (adjusted HR (AHR) 0.32 (95% CI: 0.14 to 0.76)), neonatal sepsis (AHR 0.321 (95% CI: 0.13 to 0.77)), not receiving kangaroo mother care (AHR 0.16 (95% CI: 0. 07 to 0.39)) and vaginal delivery (AHR 0.39 (95% CI: 0.16 to 0.95)) were independent predictors of mortality of asphyxiated neonates. CONCLUSIONS: In this study, asphyxiated neonates had a higher incidence of mortality with a median survival time of only 8 days. Being male, vaginal delivery, not receiving kangaroo mother care and comorbidities such as neonatal sepsis were independent predictors of mortality among asphyxiated neonates. Therefore, healthcare providers and other stakeholders should provide timely initiation of advanced diagnosis and appropriate therapeutic interventions for neonates with asphyxia to reduce neonatal mortality.

Knowledge of surgical informed consent and associated factors among patients undergone obstetric and gynecologic surgery at Jimma Medical Center, Jimma, Ethiopia, 2020: an institutional based cross-sectional study.

INTRODUCTION: Informed consent is the process whereby a patient makes a voluntary decision about their medical and surgical care with knowledge of the benefits and potential risks. Poor informed consent processes may increase potential for medical errors and malpractice. Little is known of the knowledge of surgical informed consent with regard to their surgical treatment in Ethiopia. Therefore, this study aimed to assess the knowledge of surgical informed consent and associated factors among patients who underwent obstetric and gynecologic surgery at Jimma Medical Center, Jimma, Ethiopia. METHODS AND MATERIALS: An institution-based cross-sectional study was conducted from April 1 to May 30, 2020, among 404 women undergo obstetric and gynecologic surgery at Jimma Medical Center. Data were collected through a face-to-face interview using a structured questionnaire. The collected data were coded, entered into Epi data version 3.1, and analyzed using SPSS version 25. Bivariate and multivariate regression analyses were performed to determine the association between an outcome variable and an independent variable. Tables, pie-charts, and texts were used to report the result. RESULTS: Of 404 patients sampled, only 372 women were agreed and participated in the study and gave response rate of 92.1%. The respondent satisfaction level (AOR 1.823 (95%CI 1.061-3.134)) and patient to provider relationship (AOR 0.472 (CI 1.217-3.697)) were associated with knowledge of surgical informed consent. CONCLUSION: The overall level of knowledge regarding informed consent for surgerywas significantly lower than that of other national and international figures. Patient satisfaction and patientto provider relationships were associated with knowledge of surgical informed consent. Adequate information should provide before surgery to improve patients' knowledge regarding surgical informed consent and to improve the consent process to make it better suited to fit the needs of all patients.

Adherence to Covid-19 preventive measures among high school students in Jimma town, South-West Ethiopia: Institutional-based cross-sectional study.

BACKGROUND: Corona (COVID-19) is an infectious disease caused by a newly discovered corona virus. The World Health Organization has recommended several preventive measures for COVID-19 and African countries, including Ethiopia had accepted and engaged in the recommended preventive measures. Adherence to COVID-19 prevention measure is still a big problem; however, the level of adherence to preventive measures had not reported in Ethiopia among students and there is an information gap, therefore, this study conducted to fill the information gap on level of adherence to COVID-19 preventive measures among students. OBJECTIVE: This study aimed to assess the level of adherence to COVID-19 preventive measures and its associated factors among high school students in Jimma Town public High Schools in southwest Ethiopia, 2021. METHODS SAND MATERIALS: An institution-based cross-sectional study was conducted among 404 systematically selected high school students from Jimma town from July 15 to August 2, 2021. The sample size was determined using a single-population proportion formula, and data were collected through face-to-face interviews using a structured and pretested questionnaire. Data were entered into Epi-data manager 4.4.2.1 then exported to Stata 14 for cleaning and analysis. Bivariate and multivariable ordinal logistic regression analyses were declared to identify significant variables. Finally; significant factors were determined at a significance level of <0.05. RESULTS: Of 388 students included in the analysis, approximately 14.7% (95%CI: 11.51-18.60) of students had good level of adherence to COVID-19 preventive measures.Only 6.9%of participants had good knowledge where as approximately half of the respondents had favorable attitude toward COVID-19 preventive measures. Factors such as Female gender (AOR = 1.03(95%CI: 1.01-1.74), access to water and soap (AOR = 2.11(95%CI: 1.06-4.19) andattitude (AOR = 4.36(95%CI: 2.69-7.08)) were found to have a statistically significant association with level of adherence to COVID-19 preventive measures. CONCLUSION: Adherence to COVID-19preventive measures among students wasunexpectedly lower than in other studies. Female gender, lack of access to water and soap, and attitudes were factors associated with adherence to COVID-19 preventive measures. Therefore, to ensure maximal adherence to preventive measures for COVID-19, special messages and efforts targeting males, increasing access to water and soap, trainingto improve attitude toward COVID-19 preventive measures should be implemented at schools.

Survival Status and Predictors of Mortality Among Low Birthweight Neonates Admitted in Amhara Region Referral Hospitals of Ethiopia: Retrospective Follow-Up Study.

Background: Being born with low birthweight is a major determinant of perinatal, neonatal, and infant survival. Even though low birthweight-related neonatal mortality is high, there is an information gap regarding the survival status of low birthweight neonates and their predictors of mortality in Ethiopia. Objective: This study was conducted to assess the survival status and predictors of mortality among low birthweight neonates admitted to Amhara region referral hospitals in Ethiopia. Methods and Materials: A retrospective follow-up study was conducted on randomly selected low birthweight neonates admitted to the Amhara region referral hospital between January 01-2017 and December 30-2018. Data were entered into Epi-data 4.4.2.1 and exported to Stata 14 for cleaning and analysis. A cox regression model was used to analyze the data. Tables, charts, and text were used to report the results. Results: This study revealed that 35.2% of participants died with incidence rates of 37.86 per 1000 person-day observations (95%CI: 31.79-45.10). Sepsis (AHR:1.72(95% CI: 1.05-2.81), respiratory distress (AHR: 2.03 (95% CI:1.36-3.03), necrotizing enterocolitis (AHR: 2.47 (95% CI: 1.17-5.20), congenital anomalies (AHR:2.37 (95% CI: 1.36-4.13), extreme low birth weight (AHR:2.62 (95% CI:1.54-4.44) and prematurity (AHR: 2.55 (95% CI:1.10-5.92) were independent predictors of mortality. Conclusion: Sepsis, respiratory distress, necrotizing enterocolitis, congenital anomalies, extremely low birth weight, and premature birth were the independent predictors of mortality. Therefore, it is better for all stakeholders to focus more on the early diagnosis and management of low birth weight neonates with the factors associated with mortality.

Morbidity and mortality patterns of preterm low birthweight neonates admitted to referral hospitals in the Amhara region of Ethiopia: retrospective follow-up study.

OBJECTIVE: This study aimed to assess the morbidity and mortality patterns of preterm neonates with low birth weight admitted in the Amhara region referral hospitals in Ethiopia. DESIGN: Hospital-based retrospective follow-up study. SETTING: Amhara region referral hospitals, Ethiopia. PARTICIPANTS: A total of 291 preterm neonates low birth weight that were admitted to referral hospitals in the Amhara region between 1 January 2017 and 30 December 2018 were reviewed. Data were entered into Epi-data V.4.4.2.1 and exported to STATA V.14 for analysis, and variables with a p value of <0.05 at 95% confidence level in multivariable logistic regression model analysis were declared as statistically significant associated factors of mortality. PRIMARY OUTCOME: Morbidity and mortality patterns in preterm low birthweight neonates. RESULTS: This study revealed that 37.8% (95% CI 32.4% to 43.5%) of preterm low birthweight neonates died. The most common morbidities found were 219 (75.26%) hypothermia, followed by 201 (69.07%), 145 (49.83%), 39 (13.4%) and 24 (8.25%) with sepsis, respiratory distress, jaundice and congenital anomalies, respectively. Sepsis (AOR: 2.0; 95% CI 1.03 to 3.89), respiratory distress (AOR: 4.6; 95% CI 2.51 to 8.40), hypoglycaemia (AOR 3.91; 95% CI 1.09 to 10.52), APGAR score at fifth minute <7 (AOR 0.39; 95% CI (0.18 to 0.82) and duration of hospital stay below mean (<9.82 days) (AOR 0.17; 95% CI 0.09 to 0.33) were associated with mortality. CONCLUSION: The mortality rate of preterm low birthweight neonates was high, indicating that this is a public health issue. Hypothermia, sepsis, respiratory distress, jaundice and congenital anomalies were the common morbidities. Sepsis, respiratory distress, hypoglycaemia, Apgar score at fifth minute <7 and duration of hospital stay below the mean were independent factors of mortality. However, these need to be further investigated in future research and appropriately addressed using prospective follow-up.

Time to detection of anaemia and its predictors among women of reproductive-age living with HIV/AIDS initiating ART at public hospitals, Southwest Ethiopia: a multicentre retrospective follow-up study.

OBJECTIVE: To assess the time to development of anaemia and its predictors among women of reproductive-age receiving antiretroviral therapy (ART) in public hospitals, Southwest Ethiopia. DESIGN: Hospital-based retrospective follow-up study SETTING: Mizan-Tepi University Teaching Hospital, and Gebretsadik Shawo General Hospital Southwest Ethiopia. PARTICIPANTS: A total of 389 records of women living with HIV/AIDS at public hospitals were reviewed using a systematic sampling method. The data were entered using Epi-Data Manager V.4.2 and exported to STATA V.14 for data analysis. A Cox-regression model was used and variables with a p-value of <0.05% and 95% confidence level in multivariable analysis were declared as statistically significant predictors for anaemia. PRIMARY OUTCOME: Time to development of anaemia and its predictors among women of reproductive-age on ART in public hospitals. RESULTS: Of 370 records of women of reproductive-age, 203 (54.86%, 95% CI (49.77% to 59.96%)) were anaemic with an incidence rate of 12.07 per 100 person months of observation, and the overall median survival time of 60 months. The total of 2.97%, and 80.26% of women were developed anaemia within the first 6 months and the last 6 months period of follow-up, respectively. Moreover, non-employed women, women with advanced WHO stage, women with baseline opportunistic infections and women who were on ART for long-duration were significantly associated with anaemia among women living with HIV/AIDS. CONCLUSION: In this study, the incidence rate of anaemia was significantly high. The development of anaemia among women on ART was also increased with increased follow-up time. The risk of anaemia is increased in women living with HIV/AIDS due to advanced baseline WHO staging, presence of OIs at baseline, an increased duration on ART and low occupational status. Therefore, early identification and treatment of opportunistic infections and other coinfections are required to decrease the incidence of anaemia among women living with HIV/AIDS.