Parental knowledge and attitude of postoperative paediatric pain: stepwise linear regression analysis.

Background: Despite the fact that mothers care for their children's pain in most cases, it has been noted that mothers have limited knowledge and attitude about paediatric pain. This study aims to assess parental knowledge and attitude of postoperative paediatric pain (POPP). Method: This is institutional based cross sectional study conducted with 102 parents at Nigist Eleni Mohamed Memorial Comprehensive Specialized Hospital (NEMMCSH). A convenience sampling technique was used to select parents. This study has used a questionnaire (Parental Pain Expression Perception (PPEM), examine parents' attitudes and knowledge about how their children exhibit their pain and Medication Attitude Questioner (MAQs), focuses on how parents feel about giving their child analgesic medication to alleviate post-operative pain). Descriptive statistics were utilized to analyse the parent's response and presented with frequency and percentage. Factor analysis to analyze factor structure and stepwise linear regression analysis to examine the impact of socio-demographic factors in predicting parental knowledge and attitude about POPP were done. The statistical tests were performed at 95% confidence interval and 5% significance level. Result: A total of 102 parents fulfilling the inclusion criteria were included. About 78% of parents agreed that children always express pain by crying or whining. The majority of parents (75.6%) believe children who are playing are not in pain. Regarding parental attitudes about pain medications, majority of parents (61%) believe that children should be given pain medication as little as possible because of its side effects. According to about 26.8% of parents, giving children pain medication for pain might teach them to use drugs for other issues. On the other hand, 63.4% of parents say that giving children pain medication as little as possible is the most effective way to manage their pain. Parents of younger children and parents from rural area are more likely to score higher in attention seeking sub-score of PPEP while parents from urban residence and those parents who are employed are more likely to perceive about the side effects of pain medications (Side effects factors). Conclusion: The overall knowledge and attitude of parents about postoperative pain and pain medications were poor.

Road to maternal death: the pooled estimate of maternal near-miss, its primary causes and determinants in Africa: a systematic review and meta-analysis.

BACKGROUND: Maternal near-miss (MNM) is defined by the World Health Organization (WHO) working group as a woman who nearly died but survived a life-threatening condition during pregnancy, childbirth, or within 42 days of termination of pregnancy due to getting quality of care or by chance. Despite the importance of the near-miss concept in enhancing quality of care and maternal health, evidence regarding the prevalence of MNM, its primary causes and its determinants in Africa is sparse; hence, this study aimed to address these gaps. METHODS: A systematic review and meta-analysis of studies published up to October 31, 2023, was conducted. Electronic databases (PubMed/Medline, Scopus, Web of Science, and Directory of Open Access Journals), Google, and Google Scholar were used to search for relevant studies. Studies from any African country that reported the magnitude and/or determinants of MNM using WHO criteria were included. The data were extracted using a Microsoft Excel 2013 spreadsheet and analysed by STATA version 16. Pooled estimates were performed using a random-effects model with the DerSimonian Laired method. The I2 test was used to analyze the heterogeneity of the included studies. RESULTS: Sixty-five studies with 968,555 participants were included. The weighted pooled prevalence of MNM in Africa was 73.64/1000 live births (95% CI: 69.17, 78.11). A high prevalence was found in the Eastern and Western African regions: 114.81/1000 live births (95% CI: 104.94, 123.59) and 78.34/1000 live births (95% CI: 67.23, 89.46), respectively. Severe postpartum hemorrhage and severe hypertension were the leading causes of MNM, accounting for 36.15% (95% CI: 31.32, 40.99) and 27.2% (95% CI: 23.95, 31.09), respectively. Being a rural resident, having a low monthly income, long distance to a health facility, not attending formal education, not receiving ANC, experiencing delays in health service, having a previous history of caesarean section, and having pre-existing medical conditions were found to increase the risk of MNM. CONCLUSION: The pooled prevalence of MNM was high in Africa, especially in the eastern and western regions. There were significant variations in the prevalence of MNM across regions and study periods. Strengthening universal access to education and maternal health services, working together to tackle all three delays through community education and awareness campaigns, improving access to transportation and road infrastructure, and improving the quality of care provided at service delivery points are key to reducing MNM, ultimately improving and ensuring maternal health equity.

Depression and Associated Factors among People Living with Human Immunodeficiency Virus Attending Antiretroviral Therapy in Public Health Facilities, Hosanna Town, Southern Ethiopia.

Background: Among those infected with the human immunodeficiency virus, depression is one of the most prevalent mental health issues. Despite its high incidence, depression goes undiagnosed and untreated in the majority of HIV/AIDS patients, which has a negative impact on how well they adhere to their antiretroviral regimen. Objective: To assess the magnitude of depression and associated factors among people attending antiretroviral therapy in public health facilities of Hosanna town, Hadiya Zone, Southern Ethiopia, 2019. Methods: Institution-based cross-sectional study was conducted at public health facilities of Hosanna town from June 6 to July 6, 2019, among people living with HIV/AIDS aged 18 years and older who were on ART. A systematic sampling technique was used to select 392 participants. Data were collected using a pretested and standardized structured interviewer-administered questionnaire. Variables having a p value less than 0.2 in bivariate analysis were entered into the multiple logistic regression model. Odds ratio with 95% CI was computed, and variables with p value < 0.05 were considered as statistically significantly associated with depression. Result: The prevalence of depression among HIV patients was 37.8%. Being female (AOR = 2.15, 95% CI (1.21, 3.84)), not disclosing their HIV status (AOR = 2.77, 95% CI (1.57, 4.89)), rural dwellers (AOR = 2.69, 95% CI (1.58, 4.57)), poor ART adherence (AOR = 1.89, 95% CI (1.10, 3.24)), having HIV-perceived stigma (AOR = 1.71, 95% CI (1.01, 2.88)), and poor social support (AOR = 1.85, 95% CI (1.11, 3.09)) were significantly associated with depression. Conclusion: The magnitude of depression was high among PLWHIVs. Being female, rural dwellers, not disclosing HIV status, poor ART adherence, HIV-perceived stigma, and poor social support were significantly associated with depression. Enhancing adherence, counseling, and linking those patients who had poor social support to the concerned relatives for care and support is recommended. Providing health education both at the facility level and at the community level may reduce stigma and subsequently depression. Encouraging disclosing HIV status may help to prevent depression.

The prevalence and associated factors of birth asphyxia among neonates delivered in Public Hospitals, Northern Ethiopia.

Introduction: A body of evidences showed that birth asphyxia is a serious public health problem in low income countries including Ethiopia. There are sparse data on the prevalence of birth asphyxia and its associated factors among neonates in low income countries like Ethiopia, as well as the research area. Objective: Therefore, this study determined the prevalence and associated factors of birth asphyxia among newborns administered in public hospitals in Northern Ethiopia, 2019. Methods and materials: A cross-sectional study of health institution was carried out in December 2019. Systematic sampling technique was used. Data was collected through interviews and chart review. Multivariate logistical regression analysis was done to control confounders and identify significantly associated variable. AOR with 95% confidence intervals were computed to identify the factors independently assoiated with birth asphyxia. Results: The finding showed that the prevalence of birth asphyxia was 20.0%. Induction of labor (AOR=3.59, 95% CI: 1.36-9.46), Prolonged labor (AOR=3.59, 95% CI: 1.36-9.46), meconium-stained amniotic fluid (AOR=3.49), referred mothers (AOR=3.68, 95 % CI: 1.46-9.28), instrumental delivery (AOR=2.87, 95% CI: 1.09-7.55)and primiparous mothers (AOR=2.048 95% CI: 1.10-3.80). were significantly associated with birth asphyxia. Conclusion: The Prevalence of birth asphyxia notable high. Therefore; intra-partum care services should be strengthened to prevent birth asphyxia.

Disparities in sexual and reproductive health services utilization among urban and rural adolescents in southern Ethiopia, 2020: a comparative cross-sectional study.

BACKGROUND: Although studies on the uptake of Adolescent sexual and reproductive health (ASRH) services in Ethiopia have been conducted they have failed to show the disparity in service uptake among rural and urban settings. Once the extent and determinants of ASRH service uptake in urban and rural contexts are known, it will be crucial to provide evidence-based information and recommendations for potential interventions to reduce the burden of disease and disability among adolescents. This study aimed at determining the level of SRH service utilization among urban and rural adolescents in the Guraghe zone, Southern Ethiopia. METHODS: A community-based comparative cross-sectional study was undertaken from November 1 -30, 2020. A multi-stage sampling technique was employed and a total of 1083 adolescents (361 from the urban and 722 from the rural areas) were selected randomly to take part in the study. Pre-tested, interviewer-administered, structured questionnaires were used to collect the data. The data were encoded and entered into Epi-Data version 3.1 and then exported to SPSS version 23 for analysis. χ2 test was computed to see a significant difference in SRH service utilization among urban and rural adolescents. In a bivariable logistic regression analysis, a variable with a p-value less than 0.25 has been selected for a multivariable logistic regression model. Variables with p-values less than 0.05 were declared statistically significant in multivariate logistic regression. RESULTS: A total of 1,075 adolescents (358 from urban and 717 from rural) took part in the study, yielding a response rate of 99.3%. The overall SRH service utilization among the whole adolescents was 39.5% (95%CI: 36.5, 42.4). There was a significant difference in SRH service utilization between urban 56.9% (95%CI: 51.8, 62.1) and rural 30.8% (95%CI: 27.4, 34.2) adolescents (χ2 = 68.3, p < 0.001). Residence[AOR = 2.62; 95%CI:1.63,3.41], availability of youth clubs [AOR = 4.73; 95%CI:3.43,6.53], taking part in peer education [AOR = 2.06; 95%CI:1.48,3.88], having parental discussion [AOR = 3.29; 95%CI:1.73,3.33], and being knowledgeable on SRH issues [AOR = 2.01; 95%CI: 1.45,3.03] were identified as a significant determinants of SRH service uptake. Having parental discussion, geographical accessibility, and knowledge on SRH were significant predictors of SRH service uptake among rural adolescents. CONCLUSION: Overall, ASRH service utilization in the study area was low, despite urban adolescent service uptake becoming higher than rural adolescents. Since the majority of adolescents were enrolled in schools, schools should be an area of intervention to improve adolescents' knowledge of SRH services through mass media, community networks, and interpersonal/group communication. Furthermore, promoting parent-adolescent discussions, as well as peer-to-peer discussions at the family and school level, should be emphasized. Stakeholders in the education and health sectors need to strengthen their efforts to establish youth clubs in places where they do not yet exist, especially in rural schools.

Individual and community level factors associated with anemia among children 6-59 months of age in Ethiopia: A further analysis of 2016 Ethiopia demographic and health survey.

BACKGROUND: Anemia is a global public health problem; but its burden is disproportionately borne among children in the African Regions. The 2016 Ethiopia Demographic and Health Survey report showed that the prevalence of anemia among children 6-59 months of age was 57%; far exceeding the national target of 25% set for 2015. Although studies have been conducted in Ethiopia, multilevel analysis has rarely been used to identify factors associated with anemia among children. Therefore, this study aimed to identify individual and community-level factors associated with anemia among children 6-59 months of age by fitting a multilevel logistic regression model. METHODS: The data was obtained from the 2016 Ethiopia Demographic and Health Survey, conducted from January to June 2016, and downloaded from the website http://www.DHSprogram.com. The sample was taken using two-stage stratified sampling. In stage one, 645 Enumeration Areas and in stage two 28 households per Enumeration Area were selected. A sample of 7790 children 6-59 months of age was included. Data were analyzed using STATA version 14. A multilevel logistic regression model was fitted and an adjusted odds ratio with a 95% confidence interval was obtained. RESULT: From the individual-level factors, anemia was associated most strongly with child age, wealth index, maternal anemia and child stunting followed by child underweight, child fever and birth order whereas from the community-level, the strongest odds of anemia occurred among children from Somali, Harari, Dire Dawa and Afar region followed by Oromia and Addis Ababa. Low community-poverty is a protective factor for anemia. The odds of anemia were 0.81 (95% CI: 0.66, 0.99) times lower for children who were living in communities of lower poverty status than children who were living in communities of higher poverty status. Children from Somali and Dire Dawa had 3.38 (95% CI: 3.25, 5.07) and 2.22 (95% CI: 1.42, 3.48) times higher odds of anemia, respectively than children from the Tigray region. CONCLUSIONS: This study shows that anemia among children 6-59 months of age is affected both by the individual and community level factors. It is better to strengthen the strategies of early detection and management of stunted and underweight children. At the same time, interventions should be strengthened to address maternal anemia, child fever and poverty, specifically targeting regions identified to have a high risk of anemia.

Perceived Stigma and Associated Factors Among HIV Positive Adult Patients Attending Antiretroviral Therapy Clinics at Public Facilities of Butajira Town, Southern Ethiopia, 2020.

BACKGROUND: Stigma refers to attitudes and beliefs that lead people to reject, avoid, or fear those they perceive as being different. It identifies people as criminals, slaves, or traitors to be shunned. Globally 30-80% of people living with HIV experience stigma during their lifetime. There is a paucity of research in identifying determinants of stigma on HIV positive patients in Ethiopia. The aim of this study is to assess magnitude and factors associated with stigma among HIV positive adults attending antiretroviral therapy (ART) clinics at public health facilities of Butajira town. METHODS: Institution-based cross-sectional study was conducted at public health facilities of Butajira town. A total of 403 study participants were selected by systematic random sampling technique. Data were collected by using pre-tested interviewer-administered semi-structured questionnaire. The collected data were entered into EpiData3.1 and exported to SPSS version 23. Bivariate and multivariable logistic regression analysis were used to identify factors associated with stigma. The strength of association was assessed by crude odds ratio and adjusted odds ratio for bivariate and multivariable logistic regression analysis, respectively. Statistical significance was declared at p-value <0.05 and 95% CI. RESULTS: The magnitude of stigma among HIV positive patient was 28.9%. Discussing about safer sex (AOR: 2; 95% CI: (1.14,3.18), disclosing HIV positive status (AOR: 6;95% CI: (2.3,14.9), being a female (AOR: 2.5; 95% CI: (1.41,4.12) and age >34 years (AOR: 4; 95% CI: (1.46,12.9) were the independent factors associated with stigma in HIV positive patients. CONCLUSION: The magnitude of stigma in ART patient is still unresolved problem. Discussing about safer sex, disclosing HIV positive status, being a female and age were the independent factors associated with stigma in HIV positive patients.

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.