Under-Nutrition and Associated Factors Among Lactating Mothers in Ethiopia: A Systematic Review and Meta-analysis.

INTRODUCTION: Under-nutrition (body mass index < 18.5 kg/m2) is a global problem with an increasing trend in recent years. The burden is high in low and middle-income countries, especially in Africa. Lactating mothers are among the most vulnerable groups for under nutrition; particularly in sub-Saharan Africa. In Ethiopia, the prevalence of under-nutrition among this group is inconsistent and inconclusive. Therefore, we aimed to assess the pooled prevalence of under-nutrition and its associated factors among lactating mothers in Ethiopia. METHODS: To write this review and meta-analysis, we followed the preferred reporting items for systematic review and meta-analysis guidelines. Primary articles were searched from PubMed, Hinari, Cochrane Library, science direct databases, Google, and Google scholar. STATA version 16 software and a standardized Microsoft excel format were used for analysis and data extraction, respectively. Heterogeneity between studies was checked. To determine the pooled prevalence of under-nutrition, we used a random-effect model. Begg's and Egger's tests were done to detect publication bias. Subgroup analysis was also steered and association was uttered by a pooled odds ratio with 95% CI. RESULTS: The pooled prevalence of under-nutrition among lactating mothers was 23.84% [95% CI (19.40, 28.27)]. Educational status (no formal education) {Pooled OR 2.30 [95% CI (1.34, 3.96)]} was significantly associated with under-nutrition. CONCLUSION: The pooled prevalence of under-nutrition was high. Maternal educational status was significantly associated with under-nutrition. Therefore, the federal ministry of health and the concerned stakeholders should give attention to these most vulnerable groups and strengthen the implementation of the previously designed strategies.

Iodine concentration level of iodized dietary salt and its associated factors: a systematic review and meta-analysis.

Background: Iodine deficiency disorder (IDD) is a major public health problem in Ethiopia. The availability of adequate iodized dietary salt at the household level is immensely important. Hence, this review aimed to estimate the pooled prevalence of adequate iodine concentration level of iodized dietary salt at the household level and its associated factors in Ethiopia. Methods: We searched the literature using electronic databases (PubMed/Medline, Google Scholar, Science Direct, and Embase) and gray literature from January 9, 2022, to February 25, 2022. The rapid test kit was used to measure the adequacy of iodine level of dietary salt. The quality of studies was assessed using Joanna Briggs Institute critical appraisal tool. Heterogeneity between studies was checked using I2 test statistics and publication bias was checked using funnel plot and Egger's statistical test at a 5% significance level. A random-effects model was employed to estimate the pooled prevalence of the outcome variable and its determinants in Ethiopia. Results: The search identified 149 studies of which 18 studies were included with a total of 10,556 participants. The pooled prevalence of adequate iodine levels of iodized salt in Ethiopia was 44.37% (95% CI: 35.85-52.88). Women who had formal education (adjusted odds ratio (AOR) = 1.99 (95% CI: 1.47-2.48)), good knowledge of women (AOR = 2.14, 95% CI: 1.36-3.36), packed iodized salt (AOR = 3.85 (95% CI: 1.88-7.87)) and storage of iodized salt at home for less than 2 months (AOR = 2.66 (95% CI: 2.11-3.35) were the significant factors. Conclusion: This review suggests that the pooled prevalence of adequate iodine levels was low. Our finding highlights the need for considering the educational status, knowledge, and duration of salt storage to enhance the prevalence of adequate levels of iodized salt at the national level.

Determinants of Premature Rupture of Membrane (PROM) Among Pregnant Women in Southern Ethiopia: A Case-Control Study.

Background: Premature rupture of membrane (PROM) varies from country to country and complicates 4 to 10% of pregnancies worldwide it has an overwhelming effect on maternal and newborn health. Even though many interventions implemented to tackle it, the problem is persisted. Objective: To identify determinants of premature rupture of membrane among pregnant women who have visited labor wards in four hospitals found in Gedeo zone, Southern Ethiopia. Methods: Hospital-based unmatched case-control study was conducted from February to May 2020. Data were collected among 75 cases and 223 controls using face-to-face interviews. Cases and controls were recruited consecutively from pregnant women who have visited the labor ward. Data were entered into Epi-data version 3.1 and analyzed by using SPSS version 20. Bivariable and Multivariable logistic regression was used to check the association between dependent and independent variables, statistically significant association was declared at p-value < 0.05. Results: A total of 75 cases and 233 controls were enrolled in the study. Hypertension during index pregnancy [AOR = 2.81 (95% CI: 1.09 -7.23)], history of abortion [AOR = 3.7 (95% CI: 1.41-9.73)], history of caesarean section [AOR = 3.46 (95% CI: 1.34-8.9)] and history of PROM [AOR = 4.77 (95% CI: 2.31-9.89)] were associated with premature rupture of membranes. Conclusion: Hypertension during the index pregnancy, history of abortion, history of PROM, and history of cesarean section has an association with premature rupture of membrane. The result of the study suggests early identification and treatment of abortion, hypertension, and cesarean section in pregnant women mitigates the risk of premature rupture of membrane.

Risky sexual practice and associated factors among people living with HIV/AIDS receiving antiretroviral therapy in Ethiopia: Systematic review and meta-analysis.

BACKGROUND: The risky sexual behavior of people living with HIV/AIDS (PLWHA) may impose a risk of transmitting the disease to their partners and increase Human Immunodeficiency Virus (HIV) co-infection. This systematic review and meta-analysis aimed to determine the pooled prevalence of risky sexual behavior and associated factors among PLWHA receiving [Antiretroviral Therapy (ART)] in Ethiopia. METHODS: To identify both published and unpublished research articles, systematic searches were performed in PubMed, HINARI, Medline, Science Direct, and Google Scholar databases. The review was carried out following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guideline. Cross-sectional studies reporting the prevalence of risky sexual practice and its associated factors among PLWHA receiving ART in Ethiopia were included. Two authors independently extracted all necessary data using a standardized data extraction format prepared in Microsoft Excel and exported to STATA version 14 statistical software for further analyses. The Cochrane Q test statistics and I2 test were used to assess the heterogeneity of the studies. Since the included studies exhibited considerable heterogeneity, the random-effects meta-analysis model was computed to estimate the pooled prevalence of risky sexual practice which was determined by dividing the total number of PLWHA with risky sexual practice practices by the total number of PLWHA on ART in the study and multiplied by 100. Furthermore, pooled odds ratio (OR) with 95% confidence interval (CI) was determined for the association between determinant factors and risky sexual practice. RESULT: In this study, 2351 articles were identified from different databases, and fifteen articles were selected for final systematic review and meta-analysis. In Ethiopia, the pooled prevalence of risky sexual practices was 43.56% (95% confidence interval (CI):35.51, 51.62). Discussion about safe sex with sexual partner/s [AOR = 0.26, 95% CI: 0.08, 0.92] and having multiple sexual partners [AOR = 1.90, 95% CI: 0.53, 6.84] were factors significantly associated with risky sexual practice in Ethiopia. CONCLUSION: A significant proportion of respondents engaged in risky sexual practices. Multiple sexual partners and a lack of discussion about safe sex are linked to a higher prevalence of the risky sexual practice in Ethiopia. It is critical to raise awareness about safe sexual practices during health education and counselling services and to encourage clients to freely discuss safer sex practices with their sexual partner/s at their antiretroviral therapy (ART) appointments as part of their follow-up care. PROTOCOL REGISTRATION: The protocol for this systematic review and meta-analysis was registered at PROSPERO (record ID = CRD42021274600, 25 September 2021).

Under-nutrition and associated factors among children infected with human immunodeficiency virus in sub-Saharan Africa: a systematic review and meta-analysis.

BACKGROUND: In the developing world, such as the sub-Saharan African region, HIV/AIDS has worsened the impact of under-nutrition in children. HIV infected children are highly vulnerable to under-nutrition. Therefore, the objective of this systematic review and meta-analysis was to estimate the pooled prevalence of under-nutrition, and the pooled effect sizes of associated factors among HIV-infected children in sub-Saharan Africa. METHODS: The primary studies for this review were retrieved from PubMed/ MEDLINE online, Science Direct, Hinari, web of science, CINHAL, EMBASE, WHO databases, Google, and Google Scholar databases. The articles selected for this meta-analysis were published between 2010 and 2020. The last search date was 18 October 2021. The data was extracted in Microsoft Excel format and exported to STATA Version 14.0. A random effect meta-analysis model was used. Heterogeneity was evaluated by the I2 test. The Egger weighted regression test was used to assess publication bias. RESULTS: We retrieved 847 records from these databases. Of which records, 813 were excluded due to different reasons and 34 studies were included in the final analysis. The pooled prevalence of stunting, underweight and wasting in HIV infected children was 46.7% (95% CI; 40.36-53.07, I2 = 98.7%, p < 0.01), 35.9% (95% CI; 30.79-41.02, I2 = 97.4% p < 0.01), and 23.0% (95% CI; 18.67-27.42, I2 = 96.9%, p < 0.01) respectively. The advanced WHO HIV/AIDS clinical staging (III&IV) [OR = 6.74 (95%: 1.747, 26.021), I2 = 94.7%] and household food insecurity were associated with stunting [OR = 5.92 (95% CI 3.9, 8.87), I2 = 55.7%]. Low family economic status [OR = 4.737 (95% CI: 2.605, 8.614), I2 = 31.2%] and increased feeding frequency [OR = 0.323 (95% CI: 0.172, 0.605), I2 = 69.8%] were significantly associated with under-weight. Anemia [OR = 2.860 (95% CI: 1.636, 5.000), I2 = 74.8%] and diarrhea in the previous month [OR = 4.117 (95% CI: 2.876, 5.894), I2 = 0.0%] were also associated with wasting among HIV infected children in sub-Saharan Africa. CONCLUSIONS: The pooled prevalence of under-nutrition among HIV infected children was high. Nutritional assessment and interventions need great attention as a part of HIV care for HIV positive children. The implementation of policies and strategies established by national and international stakeholders in ART care centres should take a maximum emphasis on reducing under-nutrition among HIV infected children.

Minimum dietary diversity and its associated factors among infants and young children in Ethiopia: evidence from Ethiopian Demographic and Health Survey (2016).

BACKGROUND: Adequate infant and young child feeding during the first 1000 days of life is very essential to improve child health, survival, growth, and development through minimum dietary diversity (MDD). Hence, this study aimed to assess MDD and its multi-level factors among infants and young children aged 6-23 months in Ethiopia. METHODS: Ethiopian Demographic and Health Survey (EDHS-2016) data was used to identify both individual and community-level factors of dietary diversity. Weighted samples of 2,962 children were eligible and a multi-level regression model was used for the analysis. Finally, factors with a P-value of <0.05 were considered statistically significant. RESULTS: The prevalence of MDD among children in Ethiopia was 12.09%. According to this study, factors such as having a mother who attended higher education (AOR = 3.09, (95% CI; _1.67-5.71)), being a female household head (AOR = 0.62, (95% CI; _0.40-0.95)), having a mother's agricultural occupation (AOR = 1.89, (95% CI; _1.10-3.23)) and living in the household in the richest wealth index were significantly associated at the individual level. At the community level, children living in rural areas (AOR = 0.62, 95% CI; 0.39-0.98) were significant risk factors for MDD (AOR = 0.62, 95% CI; 0.39-0.98). CONCLUSION: The educational and occupational status of the mother, wealth index, and region were significantly associated with MDD. Hence, strengthening of the existing nutritional intervention is helpful to increase diversified food consumption among children.

Tetanus Toxoid Vaccination Coverage and Associated Factors among Childbearing Women in Ethiopia: A Systematic Review and Meta-Analysis.

BACKGROUND: Tetanus is a bacterial disease caused by the Clostridium tetani, which is a highly fatal, noncommunicable, and toxin-mediated disease. Globally, maternal and neonatal tetanus is a public health problem due to low maternal tetanus toxoid immunization. Ethiopia has the highest neonatal mortality and morbidity related to tetanus due to low tetanus toxoid immunization and the high number of home deliveries. The main objective of this systematic review and meta-analysis was to estimate the pooled coverage of at least two doses of tetanus toxoid immunization, and the pooled effect sizes of associated factors in Ethiopia. METHODS: Primary studies for this review were searched from the PubMed/MEDLINE online, ScienceDirect, Hinari, Google, and Google Scholar databases. Primary articles published from 2010 up to August 30, 2020, were included in this meta-analysis. Data were extracted in Microsoft Excel format and exported to STATA Version 14.0. A random-effects meta-analysis model was used to estimate the pooled coverage of two or more tetanus toxoid immunizations and its associated factors. Heterogeneity was evaluated by the I 2 test. Egger's weighted regression test was used to assess publication bias. RESULTS: We retrieved 212 records; of these, 199 articles were excluded for reasons. Finally, 14 studies were included in this meta-analysis. The pooled estimate of receiving at least two doses of tetanus toxoid immunization coverage in Ethiopia was 52.2% (95% CI: 42.47-61.93, I 2 = 98.4%). Antenatal care (OR = 7.8 (95% CI: 3.2, 19.2), I 2 = 96.3%), media exposure (OR = 8.3 (95% CI: 2.1, 33.3), I 2 = 98.1%), distance from the health facility (OR = 2.64 (95% CI: 1.1, 6.6), I 2 = 94.1%), educational status of women (OR = 4.7 (95% CI: 2.07, 9.56), I 2 = 94.2%), and educational status of husbands (OR = 2.995 (95% CI: 1.194, 7.512), I 2 = 92.5%) were factors significantly associated with receiving at least two doses of tetanus toxoid immunization coverage in Ethiopia. CONCLUSIONS: The coverage of tetanus toxoid immunization among childbearing women was low in Ethiopia. Strengthening maternal health service utilization (antinatal care and institutional delivery) to the nearest health facility even in health posts and empowering education for both women and their husbands is recommended to increase tetanus toxoid immunization coverage in Ethiopia.

Health professional's job satisfaction and its determinants in Ethiopia: a systematic review and meta-analysis.

BACKGROUND: Health professional's job satisfaction is directly related to patient satisfaction and quality of care. Without satisfied health professionals the health system is not functional, and the national and global health related plans are not achieved. However, little is known on the level of health professional's job satisfaction in sub Saharan African countries including Ethiopia. In addition, in Ethiopia there is no summarized evidence helped us an input to design strategies. Therefore, we aimed to assess the pooled prevalence of health professional's job satisfaction and its determinants in Ethiopia. METHODS: Articles were searched from PubMed, PsycINFO, Hinari, Science Direct, web of science and African journal of online (AJOL) databases, Google and Google scholar. A standardized Microsoft excel spread sheet and STATA software version 16 were used for data extraction and analysis respectively. We followed the Preferred Reporting Items for Systematic reviews and Meta-Analysis to write this report. A random effect meta-analysis model was used to determine the pooled prevalence of job satisfaction. I2 was done to check heterogeneity. Egger's test and funnel plot were conducted to detect publication bias. Subgroup analysis was also conducted. Association was expressed through pooled odd ratio with a 95% CI. RESULT: In this review and meta-analysis, a total of 29 studies were included. The pooled prevalence of health professional's job satisfaction was 46.17% [95% CI (43.08, 49.26)]. The heterogeneity and publication bias test results were I2 = 87.3%, P <  0.001 and Eggers', P = 0.16. Female sex; OR: 2.20 [95% CI (1.63, 2.97)], working environment; OR: 9.50 [95% CI (6.25, 14.44)], opportunity for professional growth and development; OR: 5.53 [95% CI (1.56, 19.56)], staff relationship; OR: 3.89 [95% CI (1.65, 9.17)] and supportive supervision; OR: 5.32 [95% CI (1.77, 15.92)] were associated with health professional's job satisfaction. CONCLUSION: More than half of professionals were dissatisfied with their jobs. Therefore, the ministry of health and stakeholders better to design strategies to increase the level of satisfaction. Furthermore, it is better to strengthen staff relationship and making the working environment more attractive and equipped.

The Magnitude of Wasting and Associated Factors among Children Aged 2-5 Years in Southern Ethiopia: A Cross-Sectional Study.

BACKGROUND: Malnutrition accounts for almost half of the global under-five child mortality. Worm infections are one of the immediate and commonest causes that affect the nutritional status of children. There is limited data related to the magnitude of wasting and associated factors among children. Therefore, this study was aimed at assessing the magnitude of wasting and associated factors among children aged 2 to 5 years in the Wonago district of Gedeo Zone, southern Ethiopia. METHODS: Community-based cross-sectional study design was conducted. A total of 3324 children aged 2-5 years were included in the study. A pretested semistructured questionnaire was used for data collection, and anthropometric measurements were computed using the World Health Organization Anthro-nutritional software. The multivariate logistic regression analyses with adjusted odds ratio, 95% confidence interval, and P value less than 0.05 were used to identify the factors significantly associated with wasting. RESULTS: A total of 3273 children aged 2-5 years participated with a 98.5% response rate. The magnitude of wasting was 13%. The factors like government-employed fathers [AOR = 1.93; 95% CI (1.08, 3.46)], child's age range between 48 and 59 months [AOR = 1.46; 95% CI (1.01, 2.09)], being a male child [AOR = 1.42; 95% CI (1.07, 1.88)], having diarrheal disease in the past two weeks [AOR = 0.39; 95% CI (0.17, 0.90)], and bathing less than two times per week [AOR = 1.42; 95% CI (1.03, 1.96)] were factors significantly associated with wasting. CONCLUSION: Undernutrition in children is still a problem, and the proportion of wasting was 13%. Government-employed fathers, child's age range between 48 and 59 months, being a male child, having diarrheal disease in the past two weeks, and bathing below two times per week were significantly associated with children's nutritional status warranting close attention by policymakers and stakeholders. For researchers, a further longitudinal study is recommended to get strong evidence.

Occupational stress and associated factors among health care professionals in Ethiopia: a systematic review and meta-analysis.

BACKGROUND: Occupational stress is a global health problem which affects employed personals especially health professionals. The burden of stress is not limited at individual level, but also affects the organizations productivity, the quality of care and country in large. In Ethiopia, little concern is given to this problem and individual studies conducted among health care professionals also showed inconsistent result. Therefore, the aim of this study was to assess the pooled prevalence of occupational stress and its associated factors among health care professionals in Ethiopia. METHODS: Articles were searched from PubMed, Hinari, PsychInfo, Science direct databases, Google and Google scholar. A total of 10 studies were included in this review and meta-analysis. We used a standardized format for data extraction and STATA software version 13 for analysis. A random effect meta-analysis model was used to determine the pooled prevalence of occupational stress and I2 was used to check heterogeneity. Begg's and Egger's tests were conducted to detect publication bias. Furthermore, sensitivity and subgroup analysis was also conducted. Association was expressed by pooled odd ratio with corresponding 95% CI. RESULTS: The pooled prevalence of occupational stress was 52.5 [95% CI: (47.03, 57.96)]. The heterogeneity test was I2 = 89.1% & P < 0.001. The result of the publication bias detection (Begg's and Egger's) tests were p = 0.283 and p = 0.369 respectively. Female sex was identified as a significant predictor for occupational stress with a pooled effect of 3.75 [95% CI: (2.58, 5.45)]. CONCLUSIONS: Above half of health care professionals had occupational stress. Being female was significantly associated factor in this review and meta-analysis. Therefore, introduction of policies supporting health care professionals well-being at work in Ethiopia are advisable.

Knowledge and attitude towards epilepsy among rural residents in southern Ethiopia: a cross-sectional study.

BACKGROUND: Although epilepsy is one of the most prevalent neurological problems, it is highly surrounded by stigma and prejudice, which results in negative attitude towards the illness. Due to numerous misconceptions and beliefs attributed towards epilepsy, most people in rural communities have poor understanding and perception about epilepsy. Studying knowledge and attitude of this major neurologic problem among rural residents is crucial to add knowledge and show area of interventions. Therefore, the aim of this study was to assess the knowledge and attitude towards Epilepsy among rural residents in Ethiopia. METHODS: This was a community based cross-sectional study conducted in rural parts of Gedeo zone, Southern Ethiopia. A total of 732 randomly selected adult residents were interviewed using a pre-tested questionnaire. The collected data were entered to Epi-data version 3.1 and analyzed using SPSS version 20. Descriptive statistics and logistic regressions were performed. Multivariable binary logistic regression analysis was conducted to determine the presence of a statistically significant association between explanatory variables and outcome variables at corresponding 95% CI. RESULTS: The magnitude of poor knowledge and unfavorable attitude towards epilepsy were 27.0 and 51.6%, respectively. Participants who can't read and write, having stigma related to epilepsy, participants who did not live with epileptic patients; unfavorable attitude and age were factors associated with poor knowledge towards epilepsy. On the other hand, Stigma related to epilepsy, poor knowledge, age and perceiving epilepsy as a God punishment for sinful activities were variables significantly associated with unfavorable attitude of epilepsy. CONCLUSIONS: There is a gap regarding the knowledge and attitude towards epilepsy among community residents in southern Ethiopia. This demonstrates a need for community educational program regarding epilepsy which can increase community awareness particularly in rural areas to decrease stigma and negative beliefs towards epilepsy.

Determinants of Preterm Birth among Mothers Who Gave Birth in Dilla University Referral Hospital, Southern Ethiopia: A Case-Control Study.

Globally, every year, 1.1 million newborns die due to prematurity. In Ethiopia, 320,000 preterm births occur each year; out of these, 24,400 deaths were due to preterm complications. However, there is little evidence about preterm birth in the study area. Therefore, this study provides an important direction for health professionals, health programmers, and researchers. A facility-based unmatched case-control study design was employed among 244 women (61 cases and 183 controls) who gave birth in Dilla University Referral Hospital and were selected with purposive sampling. The bivariate and multivariable logistic regression model was used to select independent predictors of preterm birth. The multivariate analysis was used, and the results were interpreted using an adjusted odds ratio at 95% confidence interval and statistically significant level at a P value less than 0.05. A total of 240 mothers (60 cases and 180 controls) were included in the study with a 98.3% response rate. Factors like attending secondary educational and above [adjusted odd ratio (aOR) = 0.07 (0.08-0.65)] and attending antenatal care [aOR = 0.41 (0.18-0.93)] were protective whereas having urinary tract infection [aOR = 3.6 (1.1-11)], having human immune virus diseases [aOR = 4.2 (0.9-18)], having a history of abortion [aOR = 2.3 (1.1-5)], having a history of preterm delivery [aOR = 5 (1.6-15)], and having hypertensive disorders of pregnancy [aOR = 5 (1.9-13)] were significantly associated risk factors for preterm birth. The main determinant factors for preterm birth are having antenatal care follow-up, attending secondary education and above, hypertensive disorders of pregnancy, having HIV/AIDS, and history of abortion. This shows a need to strengthen female education; screen mothers for HIV/AIDS, urinary tract infection, and hypertension; and strengthen nutritional counseling, during ANC visits.

How Menstruation Is Perceived by Adolescent School Girls in Gedeo Zone of Ethiopia?

INTRODUCTION: Perception regarding menstruation is insufficiently acknowledged. Lack of adequate perception towards menstruation may make girls vulnerable to mental, emotional, and physical problems. This might also be a reason for the failure of menstrual hygiene practice which in turn can have multiple social and health consequences. OBJECTIVE: To assess the perception and correlation regarding menstruation among adolescent high school girls in Gedeo zone, Southern Ethiopia. METHODS: An institutional-based cross-sectional study was conducted among a randomly selected 791 adolescent high school girls at the Gedeo zone through the multistage sampling technique. Data were collected using an interviewer-administered questionnaire. The data were entered to EPi Info version 3.5 and exported to SPSS version 20.0 for analysis. Frequency tables were used to describe study variables. Odds ratio with 95% confidence interval was computed to determine the level of significance. RESULT: From a total of 806 adolescent girls that were invited to participate in the study, 791 (98.1%) participated. The mean (±SD) age of respondents was 16.3 (±4.7) years. Living alone in dormitories {OR = 1.75 CI = (1.07, 2.85)}, lower maternal educational status {OR = 4.03, CI = (2.41, 6.74)}, and age of menarche before 12 years {OR = 2.07, CI = (1.02, 4.24)} were factors statistically associated with unfavorable perception regarding menstruation. CONCLUSION: Most high school girls had an unfavorable perception regarding menstruation. Living alone, lower maternal educational status, and age of menarche before 12 years were factors with statistically significant association with unfavorable perception regarding menstruation. This demonstrates a need to design and implement advocacy programs.

Determinants of Preeclampsia Among Pregnant Mothers Attending Antenatal Care (ANC) and Delivery Service in Gedeo Zone, Southern Ethiopia: Case Control-Study.

BACKGROUND: The maternal morbidity and mortality related to preeclampsia are increasing in developing countries; figures have been estimated to be between 1.8% and 16.7%, including in Ethiopia. However, there is limited research regarding the determinants of preeclampsia in Gedeo Zone. OBJECTIVE: The aim of the study was to determine the predictors of preeclampsia among pregnant mothers attending ANC and delivery services in southern Ethiopia. METHODS: A facility-based unmatched case-control study was conducted in Gedeo Zone. Pregnant mothers attending ANC and delivery service were selected consecutively until the allotted 243 (162 controls and 81 cases) sample size was fulfilled. The collected data were checked for completeness and entered into Epi-data software version 3.1, and exported to statistical package for social science (SPSS) version 20 for analysis. Multivariable logistic regression was employed and a P-value of less than 0.05 with a 95% confidence interval was used to declare the significant association of the independent variables and the outcome variable. RESULTS: A total of 240 mothers, 80 (33.3%) of cases and 160 (66.70%) of controls, responded, with a response rate of 98.76%. The mean age of the participants among both groups was 27.40 with a standard deviation of ±5.02. Attending education [adjusted odd ratio (AOR) = 0.49; 95% CI (0.006, 0.398)], being a house wife [AOR = 13; 95% CI (1.260, 140.15)], an age range of 20-34 years [AOR = 0.071; 95% CI (0.015, 0.32)], a family history of diabetes mellitus [AOR = 0.28.2; 95% CI (0.081, 0.985)], a family history of hypertension [AOR = 0.124; 95% CI (0.047, 0.325)], did not eat fruit during pregnancy [AOR = 3.355; 95% CI (1.112, 10.126)], and a maternal history of preeclampsia [AOR = 0.162; 95% CI (0.041, 0.640)] were found to be variables significantly associated among mothers with preeclampsia. CONCLUSION: The determinant factors for preeclampsia were being a housewife, having a history of hypertension, diabetes mellitus, and preeclampsia among family members. Strengthening early detection and prevention of predictors, improvement of protective factors, and further follow-up study were recommended.

Treatment-Seeking Behavior Towards Epilepsy Among Rural Residents in Ethiopia: A Cross-Sectional Study.

BACKGROUND: Even though a large number of patients live with epilepsy, few of them receive effective treatment. Most people with epilepsy, particularly those from rural communities, do not seek medical care as they are convinced that solutions lie only with traditional healers (traditional leaders, prophets and community elders). Therefore, studying treatment-seeking behavior regarding this major neurological problem would provide additional knowledge and help to identify a gap which needs to be addressed when tackling related problems. PARTICIPANTS AND METHODS: This rural community-based cross-sectional study was conducted in Gedeo zone, Ethiopia, among 755 participants. Data were collected using face-to-face interview-based questionnaires. Collected data were entered into EpiData version 3.01 and analyzed using SPSS version 20. Bivariate and multivariate logistic regression analysis was conducted to identify associated factors. The strengths of associations were presented as adjusted odds ratios with 95% confidence intervals. RESULTS: The prevalence of poor treatment-seeking behavior was 54.6% (95% CI 51.4, 58.2). Poor knowledge (adjusted odds ratio [AOR]=3.21, 95% CI 2.14, 4.81), poor social support (AOR=2.48, 95% CI 1.12, 5.53), unfavorable attitude (AOR=1.84, 95% CI 1.34, 2.54) and having no history of experiencing others' seizures (AOR=2.17, 95% CI 1.47, 3.2) were variables strongly associated with poor help-seeking behavior towards epilepsy. CONCLUSION: The study showed that more than half of the participants had poor treatment-seeking behavior towards epilepsy. This indicates the need to implement measures to raise community awareness regarding treatment options for epilepsy.