Growth monitoring service utilization and its associated factors among mothers of children less than 2 years in Muhir Aklil district, Gurage zone, Southern Ethiopia, 2020.

Introduction: United Nations International Children's Emergency Fund recommends a 100% growth monitoring and promotion coverage, but the prevalence of growth monitoring and promotion service utilization rate in Ethiopia is only 16.9%. Even though Ethiopia is attempting different strategies to cope up with this low rate, the problem is still unresolved. Objective: The aim of this study is to assess the prevalence of growth monitoring service utilization and its associated factors among mothers of children less than 2 years in Muhir Aklil district. Methods: A community-based cross-sectional study was conducted on 443 study participants from 10 February to 8 March 2020. The study participants in the study were selected using simple random sampling technique. The collected data were entered in to EpiData3.1 and exported to SPSS version 23. Bivariate and multi-variable logistic regression analysis was used to identify factors associated with growth monitoring service utilization. Statistically significance was declared at p value < 0.05% and 95% confidence interval. Results: In this study, the overall growth monitoring and service utilization was 32.9%. Fully empowered mothers adjusted odds ratio: 2.7, 95% confidence interval: 1.5-4.3), receiving counseling (adjusted odds ratio: 2.8; 95% confidence interval: 2.0-4.7) and regularly participating on community conversation (adjusted odds ratio: 2.8, 95% confidence interval: 1.8-7.6) were significantly associated with growth monitoring service utilization. Conclusion: Growth monitoring services utilization was 32.9%. Maternal empowerment on decision-making, engaging women on financial control, knowledge of mothers receiving counseling and regularly participating on community conversation were the independent factors for growth monitoring service utilization. The health extension workers should strengthen maternal empowerment and community conversation through increasing maternal awareness.

Optimal strategies for COVID-19 prevention from global evidence achieved through social distancing, stay at home, travel restriction and lockdown: a systematic review.

BACKGROUND: Coronavirus disease (COVID-19) is a global public health agenda with high level of pandemicity. There is no effective treatment, but prevention strategies can alter the pandemic. However, the effectiveness of existing preventive measures and strategies is inconclusive. Therefore, this study aimed to review evidence related to COVID-19 prevention achieved through social distancing, stay at home, travel ban and lockdown in order to determine best practices. METHODS/DESIGN: This review has been conducted in accordance with the PRISMA and Cochrane guideline. A systematic literature search of articles archived from major medical databases (MEDLINE, SCOPUS, CINAHL, PsycINFO, and Web of Science) and Google scholar was done. Observational and modeling researches published to date with information on COVID-19 prevention like social distancing, stay at home, travel ban and lockdown were included. The articles were screened by two experts. Risk of bias of included studies was assessed through ROBINS-I tool and the certainty of evidence was graded using the GRADE approach for the main outcomes. The findings were presented by narration and in tabular form. RESULTS: A total of 25 studies was included in the review. The studies consistently reported the benefit of social distancing, stay at home, travel restriction and lockdown measures. Mandatory social distancing reduced the daily growth rate by 9.1%, contacts by 7-9 folds, median number of infections by 92% and epidemic resolved in day 90. Travel restriction and lockdown averted 70.5% of exported cases in china and doubling time was increased from 2 to 4 days. It reduced contacts by 80% and decreased the initial R0, and the number of infected individuals decreased by 91.14%. Stay at home was associated with a 48.6 and 59.8% reduction in weekly morbidity and fatality. Obligatory, long term and early initiated programs were more effective. CONCLUSION: Social distancing, stay at home, travel restriction and lockdown are effective to COVID-19 prevention. The strategies need to be obligatory, initiated early, implemented in large scale, and for a longer period of time. Combinations of the programs are more effective. However, the income of individuals should be guaranteed and supported.

Global strategies and effectiveness for COVID-19 prevention through contact tracing, screening, quarantine, and isolation: a systematic review.

BACKGROUND: COVID-19 is an emerging disease caused by highly contagious virus called SARS-CoV-2. It caused an extensive health and economic burden around the globe. There is no proven effective treatment yet, except certain preventive mechanisms. Some studies assessing the effects of different preventive strategies have been published. However, there is no conclusive evidence. Therefore, this study aimed to review evidences related to COVID-19 prevention strategies achieved through contact tracing, screening, quarantine, and isolation to determine best practices. METHODS: We conducted a systematic review in accordance with the PRISMA and Cochrane guidelines by searching articles from major medical databases such as PubMed/Medline, Global Health Database, Embase, CINAHL, Google Scholar, and clinical trial registries. Non-randomized and modeling articles published to date in areas of COVID prevention with contact tracing, screening, quarantine, and isolation were included. Two experts screened the articles and assessed risk of bias with ROBINS-I tool and certainty of evidence with GRADE approach. The findings were presented narratively and in tabular form. RESULTS: We included 22 (9 observational and 13 modeling) studies. The studies consistently reported the benefit of quarantine, contact tracing, screening, and isolation in different settings. Model estimates indicated that quarantine of exposed people averted 44 to 81% of incident cases and 31 to 63% of deaths. Quarantine along with others can also halve the reproductive number and reduce the incidence, thus, shortening the epidemic period effectively. Early initiation of quarantine, operating large-scale screenings, strong contact tracing systems, and isolation of cases can effectively reduce the epidemic. However, adhering only to screening and isolation with lower coverage can miss more than 75% of asymptomatic cases; hence, it is not effective. CONCLUSION: Quarantine, contact tracing, screening, and isolation are effective measures of COVID-19 prevention, particularly when integrated together. In order to be more effective, quarantine should be implemented early and should cover a larger community.

Risk factors of induced abortion among preparatory school student in Guraghe zone, Southern region, Ethiopia: a cross-sectional study.

BACKGROUND: Induced abortion is a common undergo in many societies of the world. Every year, around 20 million unsafe abortions are done worldwide. From fragmented studies conducted in Ethiopia, the prevalence of induced abortion and its adverse effects are increasing over time. The aim of this study was to assess factors associated with induced abortion among female preparatory school students in Guraghe zone. METHODS: A cross-sectional study was conducted among female students of preparatory schools in April 2017. Systematic random sampling technique was employed to select 404 students from the total of 3960 female preparatory school students in the study area. Data was collected through self-administered questionnaires. Descriptive summary, binary and multivariate analyses were underwent to identify factors associated with induced abortion. The study was ethically approved by institutional review board of Wolkite University. RESULTS: The response rate of this study was 98.3%. The lifetime prevalence of induced abortion among young preparatory schools students whose age range from 15 to 22 years was 13.6% [95% CI (10.4, 17.1)]. The odds of induced abortion undergo was 2.3 times more likely in rural family residents [AOR = 2.3, 95% CI (1.1, 4.8)] as compared to that of urban family residents. Students without sexual health education were 6.4 times more likely to undergo induced abortion as compared to those who got sexual health education at sc0000hool [AOR = 6.4, 95% CI (3.1, 13.1)]. Furthermore, students who drank alcohol often were 4 times [AOR = 4.0, 95% CI (1.1, 14.2)] more likely to undergo induced abortion and students who consumed alcohol sometimes had 3.3 times [AOR: 3.3, 95%CI (1.4, 8.1)] the risk of induced abortion compared with girls with no history of alcohol consumption. CONCLUSION: A high lifetime prevalence of induced abortion among young adolescent was observed. Being rural residence, not having reproductive health education, and alcohol consumption were found to be independent predictors of induced abortion undergo. Therefore, IEC/BCC programs with special emphasis on youth friendly sexual and reproductive health services should be strengthened to reduce induced abortion.

Gender disparity in epidemiological trend of HIV/AIDS infection and treatment in Ethiopia.

BACKGROUND: The HIV/AIDS epidemic has been fuelled by gender inequality and disparity resulted in violation of women reproductive right. The "feminization" of the pandemic is more apparent in Sub-Saharan Africa where the larger numbers of HIV infected people are living. Although they carry the higher proportion of HIV cases; access to care and treatment is lower among women. In Ethiopia where HIV is prevalent and gender violence is common, the disparity may be higher. Therefore, this research aimed to assesses trends in gender disparity in the HIV/AIDS epidemic in Ethiopia to bring evidence for action. METHODS: This study was conducted using aggregates of HIV/AIDS indicator data from 1990 to 2016 of UNAIDS data bases. The data was compiled and analyzed with excel and STATA Version 11. The trend was assessed, gender difference was measured and rate of change was compared between genders and specific age groups. RESULT: Adult females (age 15+) accounted 61.5% of the HIV cases and new infection among adults. While, adolescent females (age 10-19) and young women (age 15-24) accounted 52.3 and 57.5% of prevalent cases and 74 and 68% of new infection in their age category respectively. HIV is 1.62 times more prevalent among adult women than men. Since 1990, HIV cases among adults has risen markedly in the first decade with 24 and 20%, then declined by 41.5% in the second decade and rose again by 5 and 8.7% among women and men respectively. The overall prevalence is declined by 72.4 and 71.5% from the maximum record. Women and men have equal access for ART; 62% of men and 61% of women from all adults living with HIV were on ART. While 61% of deaths were among adult women and the death rate is similar among adolescent women and men. AIDS- related death has been declined by 76% from the maximum record. CONCLUSION: HIV/AIDS prevalence, new infection and AIDS-related death are by far higher among adult women than men. While the coverage of treatment and HIV care is equal among both genders. Vulnerable age groups (adolescent females and young women) take the lion's share of the new infections and prevalent cases. Therefore due attention is needed to avert gender disparity with a particular emphasis for adolescents and young women.

Epidemiology of multidrug-resistant tuberculosis (MDR-TB) in Ethiopia: a systematic review and meta-analysis of the prevalence, determinants and treatment outcome.

INTRODUCTION: The emergence of MDR-TB remained a major public health threat particularly in developing countries. With increased prevalence and complexity of treatment, the burden of MDR-TB challenged the country. It is of an important; the epidemiology of drug resistant TB is not well understood. There are few studies conducted to assess the prevalence, determinants and treatment outcome of MDR-TB with inconclusive finding. Therefore, we aimed to conduct a systematic review and meta-analysis on Epidemiology of MDR-TB in Ethiopia, So that policy makers and other stalk holders could have pooled evidence on the problem to make a decision. METHODS: The review was conducted through a systematic literature search of articles published between 1997 and 2017. Five bibliographic databases and libraries: PubMed/Medline, Global Health Database, Embase, the Cochrane Library, and African Index Medicus were used. After cleaning and sorting, analysis was performed using STATA version 11. The pooled rate of MDR-TB prevalence, determinants and treatment outcome was estimated with a random-effects model. Heterogeneity was assessed by the I2 and publication bias through funnel plot. RESULTS: The 34 studies that were retained for final analysis enrolled a total of 7461 TB or MDR-TB patients. We found that 2.18% (95% CI 1.44-2.92%) of newly diagnosed and 21.07% (95% CI 11.47-30.67%) of previously treated patients have MDR-TB with overall prevalence of 7.24% (95% CI 6.11-8.37). History of previous treatment is the major determinant (pooled OR = 4.78 (95% CI 3.16-6.39)), while contact history and adherence also contributed. In this review the pooled death computed among 5 articles showed that 12.25% (95% CI 9.39-15.11%) of MDR-TB patients were died in the course of treatment. Complication, drug side effects and HIV infection were the main determinants for the death. CONCLUSION AND RECOMMENDATION: The prevalence is by far higher than the previous reports. It is mainly associated with history of previous treatment along with contact history. However, the treatment outcomes are comparable with previous studies, yet it is a concern. Comorbidities, drug side effects and HIV sero-positivity were the determinants. Thus, proper treatment of drug susceptible TB and early detection and treatment of MDR-TB before complication develops along with prevention of drug side effect and contacts with MDR-TB cases are very important.

The impact of community-based health insurance on health-related quality of life and associated factors in Ethiopia: a comparative cross-sectional study.

BACKGROUND: Quality of life can be used to measure the effect of intervention on health related conditions. Health insurance contributes positive effect on availability of medical supplies and empowerment of women and children on financial healthcare. Therefore, the study was aimed to measure the impact of Community-Based Health Insurance on HRQoL and associated socio-demographic factors. METHODS: A comparative community based cross-sectional study was employed. Data was collected by trained enumerators using World Health Organization QoL-BREF tool from a sample of 1964 (982 CBHI insured and 982 un-insured) household heads selected by probability proportional to size. A descriptive summery, simple and multiple linear regression analysis was applied to describe the functional predictors of HRQoL. The study was ethically approved by IRB of Wolkite University. RESULTS: The HRQoL score among CBHI insured family heads was 63.02 and 58.92 for un-insured family heads. The overall variation in HRQoL was explained due to; separated marital condition which reduced the HRQoL by 4.30% than those living together [ß = - 0.044, 95% CI (- 5.67, - 0.10)], daily laborer decreased HRQoL by 7.50% [ß = - 0.078, 95% CI (- 12.91, - 4.10)], but employment increased by 5.65% than farmers [ß = 0.055, 95% CI (2.58, 17.59)]. QoL increased by 6.4 and 6.93% among primary and secondary level educated household heads than those household heads who could not read and write [ß = 0.062, 95% CI (0.75, 4.31)] and [ß = 0.067, 95% CI (1.84, 7.99)], respectively. As family size increased by one households' head, HRQoL decreased by 18.21% [ß = - 0.201, 95% CI (- 2.55, - 1.63)], as wealth index increased by one unit, HRQoL decreased by 32.90% [ß = - 0.306, 95% CI (- 5.15, - 3.86)] and QoL among CBHI insured household heads increased by 12.41% than those un-insured family heads [ß = 0.117, 95% CI (2.98, 6.16)]. CONCLUSIONS: The study revealed that significant difference in quality of life was found among the two groups; health insurance had positive effect on quality of life. Triggered, the government shall expand the scheme into other similar areas' and further efforts should be made on the scheme service satisfaction to ensure its continuity.

Perceived behavioural predictors of late initiation to HIV/AIDS care in Gurage zone public health facilities: a cohort study using health belief model.

OBJECTIVE: The study was aimed to measure incidence density rate and identify perceived behavioural believes of late initiation to HIV/AIDS care in Gurage zone public health facilities from September 2015 to November 2016. RESULTS: The incidence density rates of late initiation to HIV/AIDS care were 2.21 per 100 person-months of observation. HIV positive individuals who did not perceived susceptibility were 8.46 times more likely delay to start HIV/AIDS care than their counter parts [OR = 8.46 (95% CI 3.92, 18.26)]. HIV infected individuals who did not perceived severity of delayed ART initiation were 6.13 time more likely to delay than HIV infected individuals who perceived its severity [OR = 6.13 (95% CI 2.95, 12.73)]. HIV positive individuals who didn't have self-efficacy were 2.35 times more likely delay to start HIV/AIDS care than HIV positive individuals who have self-efficacy [OR = 2.35 (95% CI 1.09, 5.05)]. CONCLUSIONS: The study revealed that high incidence density rates of delayed initiation for HIV care and variations were explained by poor wealth, and perceived threat and benefit. Therefore, interventions should be designed to initiate care at their diagnosis time.