Depression and its associated factors among adult hypertensive patients attending follow-up in South Gondar zone public hospitals, Ethiopia, 2023.

INTRODUCTION: Depression is the most common public health issue affecting the world's population. Like patients with other chronic medical diseases, hypertensive patients experience many intense emotions which increase their risk for the development of depression. This study aimed to assess the magnitude of depression and its associated factors among hypertensive patients in South Gondar zone governmental hospitals, Northwest Ethiopia, 2023. METHODS: An institutional-based cross-sectional study was used in government hospitals of South Gondar Zone. A total of 311 patients were sampled randomly and included in the study. Statistical Package for Social Sciences (SPSS) version 25 was used for analysis. Data were analyzed mainly by using descriptive statistics and binary logistics regression. RESULTS: A total of 311 patients participated with a 100% response rate. Almost half of the participants were female. The mean age of the respondents was 58.85 years. More than 60% of the respondents had a co-morbid illness. Among participants, 83 (26.7%) of hypertensive patients had depression. Being female, age, uneducated, having poor social support, the presence of co-morbid illness and complications, uncontrolled hypertension, having less than or equal to two dietary regimen and duration of hypertension greater than ten years were significantly associated with depression. CONCLUSION: The magnitude of depression was found to be high. This indicated that depression is a common co-morbid illness among hypertensive patients. Healthcare professionals and other stakeholders should consider and diagnose co-morbid diseases like depression among hypertensive patients. It is also better to give particular emphasis to highly vulnerable groups like females, elders, uneducated and those who have poor social support.

Patterns of help-seeking behavior among people with mental illness in Ethiopia: a systematic review and meta-analysis.

Background: Despite the availability of evidence-based and effective treatments, significant numbers of people living with mental illness do not receive treatment or do not seek help from providers of formal modern treatment. Although numerous primary studies have been conducted on patterns of help-seeking behavior among individuals with mental illness with respect to modern therapy, the evidence has not been aggregated nationwide. Therefore, the aim of this review was to investigate pooled data on patterns of help-seeking behavior among individuals with mental illness in Ethiopia. Methods: All available primary studies were searched via the Google Scholar, HINARI, and PubMed databases from June 22 to December 20, 2023; 912 articles were identified. Sixteen articles were included in the final review; data from them were extracted to an Excel spreadsheet and exported to Stata version 17 for analysis. The search terms used were: "Pattern of help-seeking behavior'' OR "Pattern of treatment-seeking behavior" OR "Health care-seeking behavior" OR "Help-seeking intention" OR "Help-seeking preferences" OR "Perceived need" OR "Pathways to psychiatric care", AND "Common mental disorders" OR "Mental illness" OR "Mental health problems" OR "Depression", AND "Predictors" OR "Determinate factors" OR "Associated factors", AND "Ethiopia". The quality of the studies included was critically appraised using the modified The Joanna Briggs Institute (JBI) Joanna Briggs Institute quality assessment tool, adapted for observational studies. During critical appraisal, disagreements between the two authors conducting the assessment were resolved by the involvement of a third author. Effect sizes were pooled using the random effects model, and the presence of publication bias was detected based on asymmetry of the funnel plot and a statistically significant result of Egger's test (p<0.05). Results: The pooled rate of positive help-seeking behavior with respect to modern treatment among people living with mental illness was 42.21% (95% CI: 29.29, 55.12; I2 = 99.37%, P=0.00). Factors significantly associated with a positive pattern of help-seeking behavior were: having a secondary education or above (AOR=5.47, 95% CI: 2.33, 12.86); believing that mental illness requires treatment (AOR=2.76, 95% CI: 2.02, 3.78); having strong social support (AOR=2.00, 95% CI: 1.64, 2.44); having a family history of mental illness (AOR=2.68, 95% CI: 1.38, 3.97); having awareness of the availability of treatment (AOR=2.92, 95% CI: 1.56, 5.46); having previously engaged in positive help-seeking behavior (AOR=3.28, 95% CI: 1.63, 6.60); having comorbid disorders (AOR=4.25, 95% CI: 1.69, 10.66); not using alcohol (AOR=3.29, 95% CI: 1.73, 6.27); and the perceived severity of mental illness (AOR=2.54, 95% CI: 1.490, 4.33). Conclusions: The majority of people with mental illness in Ethiopia exhibited a poor pattern of help-seeking behavior with respect to modern treatment. Therefore, mobilization of the community should be encouraged via regular public awareness campaigns regarding mental illness and the availability of evidence-based and effective modern treatment in Ethiopia. Moreover, the design of effective community-based mental health interventions is recommended in order to improve public attitudes and rates of help-seeking behavior in relation to mental health problems.

The magnitude of common mental illness and associated factors among adult holy water users in Amhara regional state Orthodox Tewahido churches, Ethiopia, 2021.

BACKGROUND: Because they are prevalent, persistent, and have substantial negative effects on physical health, psychological well-being, and economic implications, common mental illnesses like depression, anxiety, and somatic complaints are major public health problems. Patients with mental illness are devoted to religious therapy including holy water as a coping mechanism for their illnesses. The aim of this study was to investigate the magnitude and associated factors of common mental illness among adult holy water users. METHODS: Facility-based cross-sectional study design was conducted in Amhara regional state orthodox Tewahido churches. A simple random sampling techinque was used to select participants. Data were collected by using the Brief Psychiatric Rating Scale for mental illnesses symptoms and a structured interviewer administered questionnaire was used. Data were entered into EpiData version 4.6 and exported to SPSS version 25 for analysis. Variables with a p-value of 0.25 in the bivariable logistic regression were entered into multivariable logistic regression. RESULT: Three hundred eighty-two participants were involved in the study. The magnitude of Common mental illnesses among holy water users was 58.9%. Unemployed, using more than one substance, having Poor and moderate social support, current daily alcohol drinker and past history of mental illness were significantly associated with common mental illness. CONCLUSION: The magnitude of common mental illness among adult holy water users was high. Giving special attention to decreasing unemployment, establishing social support services, and decreasing substance utilization are the keys to preventing common mental illnesses.

Epileptic seizure first aid practices of publics in Northwest Ethiopia 2021: Unsafe practices of nearly three-fourths of the community.

Background: Religious and sociocultural beliefs influence how people with epilepsy (PWE) are treated and cared for. Many communities in Africa and other developing countries, including Ethiopia, believe that epilepsy is caused by evil spirits and should be treated with herbal plants by traditional doctors and religious leaders. The combination of these sociocultural beliefs and the level of community awareness of epilepsy affect first aid practices in the management of epileptic seizures. Objective: This study aimed to assess epileptic seizure first aid practice of public and its associated factors in Northwest Ethiopia, south Gondar zone, Amhara, Ethiopia 2021. Methods: A community-based cross-sectional study was conducted using a previously adapted standard questionnaire. A multistage cluster sampling technique was applied. A total of 756 participants were approached and 741 respondents completed the questionnaire with a response rate of 98.02%. Data were entered into Epi data version 4.4.2 and then exported to Statistical Package for Social Science (SPSS) version 24 for analysis. Descriptive and analytical statistical procedures and bivariable and multivariable binary logistic regressions with odds ratios and 95% confidence interval (CI) were employed. The level of significance of the association was determined at p < 0.05. Results: Overall, 71.7% (95%CI: 68.3, 74.9) of the south Gondar community had unsafe practice measures in managing patients with seizure episodes. Individuals who were illiterate [adjusted odd ratio (AOR) = 1.99, 95%CI: 1.00.3.97] and participants who did not take training related to epilepsy (AOR = 2.07, 95%CI: 1.35, 3.17) and had poor knowledge about (AOR = 1.51, 95%CI: 1.06, 2.14) and a negative attitude toward epilepsy (AOR = 2.20, 95%CI: 1.50, 3.22) had unsafe practices compared to their counterparts. Conversely, participants who reached secondary education had safe practice measures (AOR = 0.4, 95%CI: 0.26, 0.63) in the management of epileptic seizures. Conclusions: In this study, large numbers of the south Gondar community had unsafe practice measures in managing people with epileptic seizure episodes. Greater emphasis should be laid on individuals who were illiterate, in the provision of health education and/or training for the community to help them to acquire good knowledge about epilepsy and develop a positive attitude toward epilepsy.

Cognitive adverse effects of epilepsy and its predictors attending outpatient department of South Gondar zone hospitals, Amhara Region, Ethiopia 2020 /2021.

BACKGROUND: Epilepsy is the most common neurologic disorder which is further complicated by neurobehavioral co-morbidities, cognitive impairment, psychiatric disorders, and social problems. However, assessments of cognitive status of epileptic patients are far too low during clinical visits. This calls for early neuropsychological assessment soon after the diagnosis of epilepsy for a better treatment plan and outcome for epileptic patients. OBJECTIVE: This study aimed to assess the cognitive adverse effects of epilepsy and its predictors attending outpatient departments of South Gondar Zone hospitals Amhara region Ethiopia 2020/2021. METHODS: A multi-center institutional-based cross-sectional study was conducted. A total of 509 respondents were included with a response rate of 93.9%. Previously adapted pretested structured questionnaire was used containing, socio-demographic, clinical, and seizure related factors. Mini-Mental State Examination (MMSE) was used to measure cognitive impairment. A systematic random sampling technique was applied. Data were entered into Epi data version 4.4.2 then exported to SPSS version 24 for analysis. Descriptive statistics, bivariable and multivariable binary logistic regressions with odds ratios and 95% confidence interval were employed. The level of significance of association was determined at a p-value < 0.05. RESULTS: Prevalence of cognitive impairment in this study was 69.2% (95%CI; 65.4, 73.1). Rural residents (AOR = 4.16,95%CI, 1.99,8.67), respondents who couldn't read and write (AOR = 2.62, 95%CI; 1.24, 5.5,) longer duration of seizure disorder (AOR = 4.59,95%CI; 2.01,10.52), taking combined Phenobarbital and Phenytoin (AOR = 4.69,95%CI; 1.88,11.69), having history of head injury (AOR = 3.29,95%CI;1.30,8.32), having depression (AOR = 4.76,95%CI;2.83,7.98), and anxiety (AOR = 3.11,95%CI; 1.58,6.12) were significantly associated with cognitive impairment. CONCLUSIONS: Prevalence of cognitive impairment in this study was high. Regular neuropsychiatric assessment of patients with epilepsy should be encouraged especially for those participants with longer durations of illness, who are rural residents, who take combined Phenobarbital and Phenytoin, participants who had a history of head injury, depression, and anxiety.

Underweight and its associated factors among pediatrics attending HIV Care in South Gondar Zone public health facilities, Northwest Ethiopia, 2021.

BACKGROUND: Malnutrition associated with HIV infection is a complex condition, with HIV-positive children having a higher mortality rate than HIV-negative children, resulting in significant morbidity and mortality in children. Data from a variety of situations are needed to counter this, but the evidence is limited, especially for the nutritional status of HIV-infected children. Therefore, this study aims to assess the magnitude of underweight and factors associated with it in children receiving antiretroviral therapy. METHODS: An institutional-based cross-sectional study was conducted among HIV-positive children in South Gondar, Northwest Ethiopia. Data were collected using an interviewer-administered questionnaire and anthropometry measurement. Data were coded and entered into Epi-Data Version 3.1 and analyzed using SPSS Version 25. Bivariable and multivariable binary logistic regression models were used to identify factors associated with nutritional status and variables with p-values ˂0.05 in multivariable logistic regression were considered as statistically significant factors. RESULTS: Of 406 participants, 379 participant were included in the study, which corresponds to a response rate of 93.3%. About one-third (36.4%) of the caregivers were not first relatives and 162 (42.7%) were unable to read and write. Of the study participants, 101 (26.6%) had a CD4 count below the normal threshold. Ninety (23.7%) of those questioned did not follow any nutritional advice from health care workers. In this study, the prevalence of underweight was 106 (28%). In the multivariable analysis being younger age, having low CD4 count, having recurrent diarrhea, and having poor adherence to dietary advice was significantly associated with being underweight. CONCLUSION: This study found that the prevalence of underweight among HIV-positive children in south Gondar is significantly high. Therefore, HIV-positive pediatrics who are young, have low CD4 counts, have recurrent diarrhea, and do not adhere to dietary recommendations need to detect and monitor nutritional problems promptly.

Poor sleep quality and associated factors among HIV-positive pregnant women in Northwest, Ethiopia: a facility-based, cross-sectional study.

BACKGROUND: Poor sleep quality during pregnancy might have an impact on adverse birth outcomes like premature rupture of membrane, preterm birth, lifelong neurocognitive impairment, low birth weight, and increased the risk of neonatal morbidity and mortality. In Ethiopia, the magnitude of poor sleep quality among this group of people is extremely limited. So, this study aims to determine the magnitude of poor sleep quality and its associated factors among HIV-positive pregnant women attending public hospitals in Northwest Ethiopia. METHODS: An institution-based cross-sectional study was done using a simple random sampling technique to recruit 411 HIV-positive pregnant women from January to March; 2021. Sleep quality over the last 1 month was measured using the Pittsburgh Sleep Quality Index (PSQI). General anxiety disorder (GAD-7), Sleep Hygiene Index (SHI), and List of Threatening of Experiences (LTE) instruments were used to identify factors associated with poor sleep quality. Bivariate and multivariable logistic regression with odds ratio and 95% CI were employed to identify determinant factors of poor sleep quality. Statistical significance association was declared at P-value < 0.05. RESULTS: A total of 411 out of 423 HIV-positive pregnant women were interviewed, with a response rate of 97.1%. The overall magnitude of poor sleep quality among HIV-positive pregnant was found to be 39.4% with a 95% of confidence interval (CI) (34.3, 44.3). Stressful life events, [AOR = 3.10, 95% CI (1.60, 6.01)], having comorbid general anxiety symptoms [AOR = 2.46, 95% CI (1.58, 3.81)], unplanned pregnancy [AOR = 2.18, 95% CI (1.20, 3.96)], and poor sleep hygiene practice [AOR = 2.23, 95% CI (1.21, 4.10)] were significantly associated with poor quality of sleep. CONCLUSION: The overall magnitude of poor sleep quality among HIV-positive pregnant women was high. Stressful life events, poor sleep hygiene, unplanned pregnancy, and comorbid general anxiety symptoms were the determinant factors of poor sleep quality that should be taken high consideration for early detection and appropriate intervention for poor sleep quality in HIV-positive pregnant women.

Magnitude of birth asphyxia and its associated factors among live birth in north Central Ethiopia 2021: an institutional-based cross-sectional study.

BACKGROUND: The leading cause of neonatal death worldwide is birth asphyxia. Yearly, in the first month of life, 2.5 million children died around the world. Birth asphyxia is a major problem, particularly in developing nations like Ethiopia. The goal of this study was to determine the magnitude of birth asphyxia and the factors that contributed to it among neonates delivered at the Aykel Primary Hospital in north-central Ethiopia. METHODS: From August 1 to August 31, 2021, a hospital-based cross-sectional study was conducted on 144 live births. An Apgar score less than 7 in the fifth minute of birth authorized the diagnosis of birth asphyxia. Variable contention (P < 0.250) for multivariable analysis was determined after data examination and cleaning. Then, to identify important factors of birth asphyxia, a multivariable logistic regression model with a p-value of 0.05 was developed. Finally, a significant relationship between a dependent variable and independent factors was defined as a p-value less than 0.05 with a 95% confidence interval. RESULTS: The majority of the mothers, 71.53%, received at least one Antenatal care visit, and more than half of the newborns were male (62.50%). The percentage of neonates that had asphyxia at delivery was 11.11% (95% CI: 6.3 -16.9%). Male newborns were 5.02 times more probable than female newborns to asphyxiate [AOR: 5.02, 95% CI (1.11-22.61)]. Mothers who have not had at least one Antenatal Care visit were 3.72 times more likely to have an asphyxiated newborn than those who have at least one Antenatal Care visit [AOR: 3.72, 95%CI (1.11-12.42)]. Similarly, mothers who had an adverse pregnancy outcome were 7.03 times more likely to have an asphyxiated newborn than mothers who had no such history [AOR: 7.03, 95% CI (2.17-22.70)]. CONCLUSION: Birth asphyxia in newborn has come to a standstill as a major public health issue. The sexual identity of the newborn, Antenatal Care visits, and a history of poor pregnancy outcomes were all found to be significant risk factors for birth asphyxia. These findings have great importance for various stakeholders who are responsible for reducing birth asphyxia; in addition, policymakers should establish and revise guidelines associated to newborn activities and workshops.

Prevalence and determinants of aggressive behavior among adults with problematic substance use in Northwest Ethiopia: a cross-sectional survey.

BACKGROUND: The recent WHO data reported that a high treatment gap for behavioral illnesses (70%) in low- and- middle-income countries and the mortality rate of aggressive behavior reaches up to 32.1 per 100,000 populations in the region. However, the magnitude of aggressive behavior is not well stated in resource-limited settings. Therefore, the aim of this study was to assess the prevalence and determinant factors of aggressive behavior among adults with problematic substance use in northwest Ethiopia. METHODS: A community-based cross-sectional study was employed from January to March 2019. A multi-stage cluster sampling method was used to screen a total of 4028 adults for problematic substance use by using the Cutdown, Annoyed, Guilty, and Eye-opener questionnaire (CAGE AID). Finally, 838 participants were positive for problematic substance use and interviewed for aggressive behavior using a modified overt aggression scale. Multiple logistic regression analysis was used to show the adjusted odds ratios (AOR) and p-value < 0.05 considered statistically significant. A multilevel binary logistic regressions model was employed for the hierarchical structure of two-level data for the individual and woreda/district levels. RESULTS: The prevalence of aggressive behavior was found to be 37.9% (301/795, 95% CI: 34.5, 41.3). Stressful life events (AOR = 2.209, 95 CI; 1.423, 3.429), family history of mental illness (AOR = 4.038, 95 CI; 2.046, 7.971), comorbid physical illness (AOR = 2.01, 95 CI; 1.332, 3.032) and depressive symptoms (AOR = 2.342, 95 CI; 1.686, 3.253) were associated with aggressive behavior among individual with problem substance use. CONCLUSION: Aggressive behavior was found to be high among problematic substance uses. An individual with problematic substance use is recommended to be screened by health extension workers for aggressive behavior at the community level.

Magnitude and predictors of common mental disorders among residents in south Gondar Zone, Northwest Ethiopia: a community-based, cross-sectional study.

BACKGROUND: Common mental disorders such as depression, anxiety, and somatic symptoms are a major public health concern because it is prevalent and chronic, and its impact on physical health, psychological and economic consequences is very serious. Evidence on the prevalence and predictors of common mental disorders is very limited in Ethiopia. This study aims to determine the prevalence and associated factors with common mental disorders. METHODS: A community-based cross-sectional study was conducted among 731 south Gondar zone residents recruited with a multistage sampling method. Data were collected by face-to-face interviews on socio-demographic, clinical, and psychosocial factors. Common mental disorders (CMD) were assessed using a self-reporting questionnaire (SRQ-20). A-List of Threatening Experiences and the Oslo social support instruments were used to identify the factors. We used bivariate and multivariable binary logistic regressions to identify factors associated with common mental disorders. Statistical significance was declared at P-value < 0.05. RESULTS: The prevalence of common mental disorders over the last four weeks was found to be 29.7% with 95% of confidence interval (CI) (26.4-33.1). After adjusting possible confounders, female sex, [AOR = 2.47, 95% CI (1.68, 3.62)], poor social support [AOR = 2.34, 95% CI (1.50, 3.64)], family history of mental illness [AOR = 2.15, (1.32-3.51)], rural resident [AOR = 2.01, 95% CI (1.35, 3.01)], current use of khat [AOR = 1.69, 95% CI (1 0.07, 2.64)] current use of tobacco (AOR = 1.71, 95% CI (1.04-2.84) and unemployment [AOR = 1.762, 95% CI; 1.193, 2.602)] were significantly associated with common mental disorders. CONCLUSION: The prevalence of common mental disorders was high, especially in Female sex, current substance use (khat chewing (leaves) and tobacco smoking), unemployment, rural residence, family history mental illness, and poor social support are the main determinants of common mental disorders. Early detection and appropriate intervention for common mental disorders in the community level should be promoted. Governmental strategies should be focused on implementing substance rehabilitation centers to treat Khat and tobacco might be helpful to minimize the burden of CMD in Ethiopia.

Clinical Non-Adherence and Its Associated Factors Among HIV-Positive Pediatric Patients Attending HIV Care in South Gondar Zone Public Health Facilities, Northwest Ethiopia, 2021.

BACKGROUND: Poor clinical adherence is the main factor that hinders ART adherence level in children and its ultimate effect on viral load suppression and decreasing morbidity and mortality of children. Although data from different settings are necessary to tackle such types of problems, the pieces of evidence are limited in the case of clinical adherence level. Therefore, this study was intended to assess clinical non-adherence and its associated factors among HIV-infected pediatrics on highly active antiretroviral therapy. METHODS: A multi-center cross-sectional study was conducted from July 1 to August 30, 2021, among HIV-infected children receiving ART in the South Gondar Zone. Data were collected through face-to-face interviews, and reviewing patients' documents using a structured checklist. Data were entered into Epi-data version 4.6 and exported to the Statistical Package for Social Science version 23 for analysis. Binary logistic regression was used to assess the association between the factors and the outcome variable. The significance of variables was declared when a p-value was less than 0.05. RESULTS: From 422 participants, 383 have involved in the study making the response rate of 90.7%. Almost half of the study participants 190 (49.6%) were girls. Two hundred ninety-one (76%) of caretakers were biological mothers, and 203 (53%) did not have adherence supporters. About 179 (46.7%) of caretakers did not disclose the status of the child about the illness. The overall prevalence of non-adherence among children on ART was 31.9% (95% CI: 27.2-36.6). Rural residency, diagnostic status non-disclosure, no adherence supporter, having no biological caretaker and co-morbid illness were significantly associated with clinical non-adherence of HIV positive children. CONCLUSION: Clinical non-adherence among children among HIV-positive children attending care in south Gondar zone health facilities is unacceptably high. Attention shall be given to HIV-positive pediatrics who reside in rural areas, whose status was not disclosed, had no adherence supporter, had a non-biological caretaker, and had comorbidity to have good clinical adherence on ART service.

Time to develop severe acute malnutrition and its predictors among children living with HIV in the era of test and treat strategies at South Gondar hospitals, northwest, Ethiopia, 2021: a multicentre retrospective cohort study.

BACKGROUND: Although severe acute malnutrition is a major public issue among HIV infected children, there is no prior evidence in Ethiopia. Hence, this study aims to assess the time to develop severe acute malnutrition and its predictors among children living with human immunodeficiency virus in Ethiopia, 2012. METHODS: An institution based retrospective cohort study was conducted in South Gondar hospitals among 363 HIV infected children from February 10, 2014, to January 7, 2021. Epi-data version 3.1 was used to enter data, which was then exported to STATA version 14 for analysis. Besides, WHO (World Health Organization) Anthro Plus software was used to assess the nutritional status of the children. A standardized data extraction tool was used to collect the data. The Kaplan Meier survival curve was used to estimate the median survival time. The Cox-proportional hazard model assumption was checked via the Schoenfeld residual ph test and a stph plot. Bivariable and multivariable Cox proportional hazard models were employed at 95% confidence intervals (CI). A variable having a p-value < 0.05 was considered a statistically significant predictor of severe acute malnutrition. RESULTS: A total of 363 children living with HIV, 97 (26.72%) developed severe acute malnutrition during the follow-up period. The overall incidence rate was 5.4 (95% CI: 4.7-5.9) person per year with a total of 21, 492 months or 1791 years of observation. Moreover, the median survival time was 126 months. Treatment failure [AHR =3.4 (95% CI: 2.05-5.75)], CD4 count below threshold [AHR =2.5 (95% CI: 1.64-3.95)], and WHO stage III & IV [AHR =2.9 (95% CI: 1.74-4.73)] were all significant predictors of severe acute malnutrition. CONCLUSION: The time to develop severe acute malnutrition was found to be very low. Treatment failure, CD4 count below threshold, and WHO stage III were all significant predictors of severe acute malnutrition. Hence, emphasizing those predictor variables is essential for preventing and controlling the occurrence of severe acute malnutrition among HIV infected children.

Incidence and predictors of anemia among adults on HIV care at South Gondar Zone Public General Hospital Northwest Ethiopia, 2020; retrospective cohort study.

BACKGROUND: Anemia is a major public health problem worldwide which accounts 24.8% of the population. Subsequently, anemia is a leading killer of people living with human immunodeficiency virus and many of these deaths occur in developing countries including Ethiopia. Cross sectional studies have done on anemia and human immunodeficiency virus. However, there is limited study on incidence of anemia and its predictors among adults on HIV care, especially no survival study has been conducted in the study area. OBJECTIVE: To assess incidence and predictors of anemia among adults on Human immunodeficiency virus care. METHODS: An institution-based retrospective cohort study was conducted among 434 adults on HIV care from January 1st 2015 to December 30th 2019 at Debre Tabor Referral Hospital. A computer-generated simple random sampling technique was employed to select the study participants. Ethical clearance was obtained from the Institutional Review Board of Bahir Dar University, and also, we got implied consent to review charts from the concerned bodies in the hospital. Data were entered using Epi-data version 3.1 and analyzed by using STATA version 14.0. A Kaplan Meier survival curve was utilized to estimate anemia free survival time. Bivariable and Multivariable Cox proportional hazards model were fitted to identify predictors of anemia. RESULTS: The overall incidence density rate of anemia was 6.27 (95% CI: 0.051, 0.077) per 100 person years. Clinical stage III/IV (AHR = 1.04; 95% CI = 1.02, 1.06), Body Mass Index less than 18.5 kg/m2 (AHR = 3.11; 95% CI = 1.56, 6.22), serum creatinine greater than 1.1 IU/L(AHR = 2.07; 95% CI = 1.12, 3.81) and fair/poor level of adherence(AHR = 1.05; 95% CI = 1.03, 1.07) were statistically significant predictors of anemia while increased anti-retroviral treatment duration (AHR = 0.98; 95% CI = 0.97, 0.99) decrease the risk of anemia at 95% confidence level. CONCLUSION: The overall incidence density rate of anemia was high. Patients with clinical stage III/IV, body mass index < 18.5 kg/m2, serum creatinine greater than 1.1 IU/L and fair/poor level of adherence were significant predictors of anemia while increased antiretroviral treatment duration had decreased the risk of anemia. RECOMMENDATION: Even if the overall incidence rate of anemia was lower as compared to previous studies in Ethiopia, still the incidence of anemia was high. So, prevention measures should be taken beside with HIV care especially within 6-months ART initiation.

Prevalence of post-traumatic stress disorder on health professionals in the era of COVID-19 pandemic, Northwest Ethiopia, 2020: A multi-centered cross-sectional study.

OBJECTIVE: This study aimed to assess the prevalence and associated factors of post-traumatic stress disorder among health professionals working in South Gondar Zone hospitals in the era of the COVID-19 pandemic, Amhara Ethiopia 2020. METHODS: Institutional based cross-sectional study design was conducted. A total of 396 respondents completed the questionnaire and were included in the analysis. A previously adapted self-administered pretested standard questionnaire, Impact of Event Scale-Revised (IES-R-22) was used to measure post-traumatic stress disorder. Data was entered into Epi data version 4.4.2 then exported to SPSS version 24 for analysis. Descriptive and analytical statistical procedures, bivariate, and multivariate binary logistic regressions with odds ratios and 95% confidence interval were employed. The level of significance of association was determined at a p-value < 0.05. RESULTS: The prevalence of post-traumatic stress disorder among health care providers in this study was 55.1% (95% CI: 50.3, 59.6). Lack of standardized PPE supply (AOR = 2.5 7,95CI;1.37,4.85), respondents age > 40 years (AOR = 3.95, 95CI; 1.74, 8.98), having medical illness (AOR = 4.65, 95CI;1.65,13.12), perceived stigma (AOR = 1.97, 95CI;1.01, 3.85), history of mental illness(AOR = 8.08,95IC;2.18,29.98) and having poor social support (AOR = 4.41,95CI;2.65,7.3) were significantly associated with post-traumatic stress disorder at p-value < 0.05. Conversely, being a physician (AOR = 0.15, 95CI; 0.04, 0.56) was less affected by PTSD. CONCLUSIONS: The prevalence of post-traumatic stress disorder among health care providers in this study was high. Adequate and standardized PPE supply, giving especial emphasis to those care providers with medical illness, history of mental illness, and having poor social support, creating awareness in the community to avoid the stigma faced by health care providers who treat COVID patients is recommended.

Magnitude and correlates of alcohol use disorder in south Gondar zone, northwest Ethiopia: A community based cross-sectional study.

BACKGROUND: Alcohol use disorder is the major public health problem in low- and middle-income countries that account for up to 70% of alcohol related premature mortality in the region. Therefore, the aim of this study was to assess the magnitude of alcohol use disorder and its associated factors among adult residents in south Gondar zone, Northwest Ethiopia. METHODS: A community-based cross-sectional study was conducted among 848 adult residents of the south Gondar zone from January 13 to February 13, 2020. A multistage sampling technique was used to recruit study participants. We assessed alcohol use disorder (AUD) using the alcohol use disorder identification test (AUDIT). A binary logistic regression model was employed to identify factors associated with AUD. RESULTS: The prevalence of alcohol use disorder over the last 12-months was found to be 23.7% (95% CI: 20.9, 26.7). Being male (AOR = 4.34, 95 CI; 2.800, 6.743), poor social support (AOR = 1.95, 95 CI: 1.098, 3.495), social phobia (AOR = 1.69, 95 CI; 1.117, 2.582), perceived high level of stress (AOR = 2.85, 95 CI; 1.829, 34.469), current cigarette smoking (AOR = 3.06, 95 CI; 1.764, 5.307) and comorbid depression (AOR = 1.81, 95 CI; 1.184, 2.778) were significantly associated with alcohol use disorder. CONCLUSION: The prevalence of alcohol use disorder is high among adult residents of the south Gondar zone and associated with many factors. So, it needs public health attention to decrease the magnitude of alcohol use disorder in Ethiopia.

Levels of Adherence and Associated Factors Among Children on ART Over Time in Northwest, Ethiopia: Evidence from a Multicenter Follow-Up Study.

BACKGROUND: Despite the increased availability of antiretroviral therapy (ART), its success depends on a high level of adherence to a life-long antiretroviral therapy. However, the extent and factors associated with adherence to ART are not well known, especially in the current study setup. Therefore, this study aimed to assess the level of adherence and associated factors among children on ART in Northwest, Ethiopia. METHODS: A retrospective follow-up study was conducted on human immunodeficiency virus (HIV)-infected children receiving ART at South Gondar public hospitals. Children receiving ART from January 1, 2015, to November 30, 2020, were included in the study. A computer-generated simple random sampling technique was employed. The data were entered into the EpiData version 3.1 and analyzed by STATA 14 statistical software. Bivariable logistic regression was fitted for each predictor variable. Moreover, those variables having a p-value ≤0.25 in bivariate analysis were fitted into a multivariable logistic regression model. P-value <0.05 was used to declare significance. RESULTS: A total of 363 HIV-infected children were involved in the study. From 363 HIV-infected children, the level of adherence to ART was found to be 78.2%, 95% CI (73.6, 82.2). TB co-infection [adjusted odds ratio (AOR) = 3.8, 95% CI (1.41, 10.1)], short duration on ART (AOR = 3.4, 95% CI (1.60, 7.20)), treatment failure (AOR = 10.2, 95% CI (3.95, 26.2)), and Zidovudine containing ART regimen (AOR = 3.5, 95% CI (1.1, 10.9)) were significant predictors of poor adherence. CONCLUSION: The current study showed that the level of adherence to ART was found to be low TB co-infection, short duration of ART, Zidovudine-containing ART regimen, and treatment failure were found to be significantly associated with poor adherence. Further studies on adherence rate and its determinants with multiple adherence measurements using prospective and multicenter studies were recommended.

Impact of respiratory distress syndrome and birth asphyxia exposure on the survival of preterm neonates in East Africa continent: systematic review and meta-analysis.

INTRODUCTION: Several kinds of researches are available on preterm mortality in the East Africa continent; however, it is inconsistent and inconclusive, which requires the pooled evidence to recognize the burden in general. PURPOSE: To collect and synthesis evidence on preterm mortality and identify factors in the East Africa continent. METHODS: PubMed, Google Scholar, Hinary, Cochrane library, research gate, and institutional repositories were retrieved to identity eligible articles through Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. The articles were selected if the publication period is between 2010-2021 G.C. Data were extracted by a standardized JBI data extraction format for mortality rate and stratified the associated factors. Then exported to STATA 14 for further analysis. I2 and Egger's tests were employed to estimate the heterogeneity and publication bias respectively. Subgroup analysis based on country, study design, year of publication, and the sample size was also examined. RESULT: This meta-analysis included 32 articles with a total of 21,405 study participants. The pooled mortality rate among preterm in the East Africa continent was found to be 19.2% (95% CI (confidence interval (16.0-22.4)). Regarding the study design, the mortality rate was found to be 18.1%, 19.4%, and 19.7% concerning the prospective cohort, retrospective cohort, and cross-sectional studies. The pooled odds of mortality among preterm with respiratory distress syndrome decreased survival by nearly three folds [AOR (Adjusted odds ratio = 3.2; 95% CI: 22, 4.6)] as compared to their counterparts. Similarly, preterm neonates presented with birth asphyxia were nearly three times higher in death as compared with preterm without birth asphyxia [AOR = 2.6; 95% CI: 1.9, 3.4]. CONCLUSION: Preterm mortality was found to be unacceptably high in Eastern Africa continent.Fortunately, the main causes of death were found to be respiratory distress syndrome and birth asphyxia which are preventable and treatable hence early detection and timely management of this problem are highly recommended to improve preterm survival.

The effect of substance use during pregnancy on neonatal outcomes in Ethiopia: A systematic review and meta-analysis.

BACKGROUND: Substance use during pregnancy mainly khat chewing (20%) and alcohol drinking (18.1%) are commonly practiced in Ethiopia. However, the effect of using these substances has not been studied nationally yet. Thus, this study was aimed to examine national evidence about the effect of substance use during pregnancy on birth outcome in the country, 2020. METHODS: Primary studies were accessed through Google scholar, HINARI, SCOPUS and PubMed databases. The methodological and evidence quality of the included studies were critically appraised by the modified Newcastle-Ottawa quality assessment tool scale adapted for observational studies. From eligible studies, two authors extracted author/year, study region, study design, sample size and reported effect of antenatal substance use on birth outcome on an excel spreadsheet. During critical appraisal and data extraction, disagreements between the two authors were resolved by the involvement of a third author. The extracted data were then exported to stata version 14. Effect sizes were pooled using the fixed-effects model due to homogenous primary studies (I2 = 0.0%). Presence of publication bias was detected from asymmetry of funnel plot and statistically significant Egger's test (p = 0.000). RESULTS: In this systematic review and meta-analysis, a total of 5,343 mother-neonate pairs were included from 15 studies. Alcohol, khat, cigarette and narghile were used during pregnancy, and significant adverse birth outcomes attributable to these substances were reported. From the pooled effect of alcohol use, drinking mothers were twice (95%CI: AOR = 2.16; 1.16, 3.17) likely to have newborns with birth defect; 9 times (95% CI: AOR = 9.39; 2.84, 15.94) more prone to own low birth weight neonates; and 1.9 times more prone to deliver preterm neonates (95% CI: AOR = 1.93; 0.52, 3.33) than the nondrinkers. Khat users were 2.4 times (95%CI: AOR = 2.4; 1.11, 5.19) more likely to have congenitally defected neonates; and 3.1 times (95%CI: AOR = 3.19; 1.01, 5.37) more risked to possess low birth weight neonates. Furthermore, antenatal cigarette smokers (95% CI: AOR = 4.36 (1.75, 6.98)) and narghile users (95% CI: AOR = 20.1; 3.94, 103) were at 4 and 20 times more likelihood of having low birth weight neonates as compared to their counterparts. CONCLUSION: Prematurity, low birth weight and congenital malformation were the investigated adverse effects of antenatal substance use in Ethiopia. Therefore, the existing public health efforts should be encouraged to help women stop using these substances completely before pregnancy. Moreover, increasing public awareness about the potential negative impacts of substance use during pregnancy on birth outcome would be of greatest importance for comprehensive prevention of the problem.

The magnitude of disability in patients with schizophrenia in North West Ethiopia: A multicenter hospital-based cross-sectional study.

OBJECTIVE: To assess the magnitude of disability and its associated factors among patients with schizophrenia in North West Ethiopia in selected hospitals, 2019. DESIGN: Multicenter hospital-based cross-sectional study. SETTING: Gondar, Felege Hiwot, and Debre Tabor hospitals. PARTICIPANTS: We recruit 420 participants for interviews using a systematic random sampling technique. MEASUREMENT: We collect the data by face-to-face interview. Disability was measured using the World Health Organization Disability Assessment Scale 2.0. Coded variables were entered into Epi data V.4.4.2 and exported to SPSS V.24 for analysis. Bivariate and multivariate logistic regressions with OR and 95% CI were employed. RESULT: A total of 423 participants were interviewed, with a response rate of 99.3%. The magnitude of disability in this study was 41.7 % (95 %CI: 36.9, 46.4). Current use of alcohol (AOR = 2.47,n95CI; 1.36,4.48), being jobless (AOR = 3.27, 95CI; 1.80, 5.93), had negative symptoms (AOR = 13.05,95CI, 7.58,22.45), had 5 and more years of illness (AOR = 2.75,95CI; 1.29,5.86), and had 5 and more years of untreated psychosis (AOR = 3.78,95CI, 1.85,7.75) were predictors of disability. CONCLUSION AND RECOMMENDATION: The magnitude of disability in this study was 41.7 %. Avoidance of alcohol usage, early initiation of treatment, creating job opportunities, and giving special emphasis to patients having negative symptoms is recommended.

Knowledge and attitude of the community towards epilepsy in Northwest Ethiopia: A huge gap on knowledge and attitude of the community.

BACKGROUND: Misconception about epilepsy in Ethiopia is higher which in turn affects overall quality of life of the individuals. This research was aimed to assess knowledge and attitude of the community towards epilepsy in Northwest Ethiopia. METHODS: A community-based cross-sectional study was conducted. Data was entered by Epi data version 4.2 and analyzed by SPSS version 24. Descriptive and analytical statistical procedures, with 95% confidence interval were employed and significance level was determined at p-value < 0.05. RESULT: A total of 782 respondents were participated with the response rate of 96.1%. About 66.2% of respondents had poor knowledge and 67.0% had unfavorable attitude, towards epilepsy.In multivariate logistic regression, younger age, rural resident, not knew someone with epilepsy, did not have witness of seizure episode, and did not take prior training were associated with poor knowledge. Male sex, rural resident, did not know someone with epilepsy, did not have witness of seizure episode, did not take prior training, and had poor knowledge were associated with unfavorable attitude towards epilepsy. CONCLUSION: Majority of participants had poor knowledge and unfavorable attitude. Public education about epilepsy is recommended to modify misconceptions and to promote positive attitudes.