Health-related quality of life and its predictors among hypertensive patients on follow up at public hospitals in Addis Ababa, Ethiopia: application of Tobit regression model.

BACKGROUND: Health-related quality of life and its associated factors among hypertensive patients living in Ethiopia are not well studied. Therefore, this study aims to assess the level of health-related quality of life and its associated factors in hypertensive patients on follow-up in Public Hospitals in Addis Ababa, Ethiopia. METHODS: A facility-based cross-sectional study was conducted among 339 hypertensive patients on follow-up at Yekatit 12 &Zewditu Hospitals. Data were collected through face-to-face interviews using Euro Quality of Life Groups 5 Dimensions 5 Levels (EQ-5D-5L) in combination with Euro Quality of Life Groups Visual Analog Scale (EQ-VAS). A multivariable Tobit regression model was employed to assess the association between EQ-5D-5L index, EQ-VAS, and potential predicting factors. RESULTS: The median index value and EQ-VAS Scales score was 0.86 (IQR = 0.74, 0.94) and 69 (IQR = 55, 80) respectively. The proportion of participants reporting anxiety/depression and pain/discomfort problems was highest, while the fewest patients reported problems in the self-care dimension. Older, rural residents, low income, higher stages of hypertension, increased use of antihypertensive medications, and patients with an increased hospitalization rate scored lower on health-related quality of life than others. CONCLUSION: Health-related quality of life among hypertensive patients attending public health hospitals in Addis Ababa is unacceptably poor. Emphasis should be given to patients with higher stages of hypertension, increased use of antihypertensive medications, and an increased hospitalization rate giving due focus to older, rural residents, and low-income patients to promote their health-related quality of life.

Compliance to a Five-Year Biannual Ivermectin Treatment for Onchocerciasis Elimination and Its Determinants among Adults in the Bench Maji Zone, Southwest Ethiopia: A Community-Based Cross-Sectional Study.

BACKGROUND: Community-directed treatment with ivermectin twice a year is a major action to control onchocerciasis in endemic countries. Even though the community-directed treatment with ivermectin was proven effective in treating the disease, the level of compliance to the treatment and its contributing factors was not well addressed in our study area. Therefore, the current study was aimed at determining the magnitude of compliance with the five-year (2013-2017 years) biannual ivermectin treatment and its associated factors among adults living in the Bench Maji Zone, Ethiopia. METHODS: A community-based cross-sectional study was done on 572 randomly selected people aged greater than or equal to 15 years. Data were collected by a face-to-face interview. Descriptive statistics were used to summarize descriptive data. Binary logistic regression was done to assess statistical associations. Adjusted odds ratio and its 95% CI were, respectively, used to measure the strength of statistical association and its significance. RESULT: Five hundred fifty-three (553) people had participated in the study making the response rate 96.7%. The overall magnitude of compliance to the five-year biannual ivermectin treatment was 361 (65.3%). The results of the multivariable logistic regression showed that age, positive attitude towards community drug distributers' performance, positive attitude towards height measurement for the treatment dose determination, and involvement in community-directed treatment with ivermectin were independently associated with compliance to ivermectin treatment at P value < 0.05. CONCLUSIONS: Even though the Ethiopian government has set a goal to eliminate onchocerciasis through community-directed treatment with the ivermectin, which is proven effective in treating the disease, the magnitude of compliance with the treatment among adults aged ≥15 years in the Semen Bench District is still unacceptably low. The Bench Maji Zonal Health Department and other stakeholders working on onchocerciasis prevention, control, and elimination should give due emphasis to behavioral change communication through community-based education and other social media to promote community's awareness on community-directed treatment with ivermectin giving due focus to adults aged 45 years and above.

HIV voluntary counseling and testing uptake and associated factors among Ethiopian youths: evidence from the 2016 EDHS using multilevel modeling.

BACKGROUND: Existing evidence showed that Human Immunodeficiency Virus counselling and testing uptake among Ethiopian youths is low, and factors contributing to it are not well studied. Therefore, this study aims to assess the status of uptake and identify its determinants using the 2016 Ethiopia Demographic and Health Survey data. METHOD: Data of 10,903 Ethiopian youths were extracted from the 2016 Ethiopian Demographic and Health Survey. The association between the response variable and the predictors was modeled by multilevel binary logistic regression, whereas adjusted odds ratio and confidence intervals were used to measure associations and their statistical significance. The variation in the uptake of counselling and testing of HIV across regions of Ethiopia was quantified by intra-class correlation. RESULT: The current study revealed that, overall, 34.9% (95% CI: 33.5, 36.2%) Ethiopian youths were ever tested for human immunodeficiency virus. Results show that about 9% of the variation in the probability of being tested for the disease was due to the regional variations. Moreover, having moderate and comprehensive HIV knowledge, being rich, having risky sexual behaviour, having a better educational level, having professional work, being married, owning of mobile, and having access to media were positively associated with human immunodeficiency virus voluntary counselling and testing uptake. On the other hand, being male, following protestant religion, following Muslim religion, and following other religions than orthodox religion were negatively associated with the uptake of human immunodeficiency virus counselling and testing. CONCLUSION: Voluntary human immunodeficiency virus counselling and testing uptake among Ethiopian youths is very low and varies across the regions which might hamper the ambitious plan of Ethiopia to end the disease as a public health threat by 2030. Emphasis should be given to promoting the youths' HIV-related knowledge through community-based education, encouraging and empowering the youths to participate in professional works by giving due focus to poor youths, and promoting mass media utilization to better achieve the plan.

Determinants of Six-Month Appointment Spacing Model Utilization Among ART Clients in the Public Health Facilities of Jimma Town, Southwest Ethiopia: Case-Control Study.

BACKGROUND: Ethiopia is currently implementing an Appointment Spacing Model (ASM) for ART. A study conducted in 6 hospitals that piloted ASM showed that 51% of eligible clients declined ASM. Studies conducted on ASM have focused on its benefits, not factors determining its utilization. This study aimed to identify determinants of ASM non-utilization. OBJECTIVE: To identify determinants of ASM non-utilization among stable ART clients. METHODS: An unmatched case-control study was conducted among 194 cases and 194 controls: consecutively selected stable clients on anti-retroviral therapy (ART) at four public health facilities in Jimma town. Data were collected through face-to-face interviews and observation techniques using semi-structured questionnaire and observation checklist. EpiData version 3.1 and SPSS version 23 were respectively used for data entry and analysis. Descriptive statistics, logistic regression, adjusted odds ratio and 95% CI were used to summarize descriptive data, identify determinants of ASM non-utilization, measure the strength of statistical association, and declare the statistical significance respectively. RESULTS: With 100% response rate, predictors of ASM non-utilization were residing in urban areas (AOR=2.61, 95% CI: 1.10-6.18), fear regarding drug safety (AOR=3.19, 95% CI: 1.56-6.54), duration of ART (<5 years) (AOR=2.45, 95% CI: 1.17-5.16), need for frequent checkups (AOR=2.70, 95% CI: 1.29-5.61), poor understanding of ASM (AOR=3.15, 95% CI: 1.54-6.43), high perceived difficulties of engagement in ASM (AOR=10.13, 95% CI: 4.31-23.84), perceived presence of high opportunistic cost (AOR=3.34, 95% CI: 1.64-6.83), low self-efficacy (AOR=7.44, 95% CI: 3.16-17.46), recent history of opportunistic infection (AOR=3.34, 95% CI: 1.64-6.83), absence of competing family activities (AOR=4.39, 95% CI: 2.05-9.44) and stigma (AOR=2.85, 95% CI: 1.39-5.81). CONCLUSION: The majority of factors affecting ASM non-utilization were behavioral and community related, which can be addressed by health education both at client and community level and additionally, by training service providers to address factors connected with the provision of service. Qualitative study and impact assessment on client retention are recommended for further research.

HIV Voluntary Counseling and Testing Uptake and Associated Factors Among Sexually Active Men in Ethiopia: Analysis of the 2016 Ethiopian Demographic and Health Survey Data.

BACKGROUND: Human immuno-deficiency virus (HIV) counseling affirms that people exercise the right to know their HIV status, which opens the gateway to care, treatment, and support for a person in need. HIV counseling and testing uptake among sexually active males in Ethiopia is too low. Moreover, existing studies were not done at country level and the contributing factors were not well studied. Therefore, the aim of this study is to determine the status of uptake and identify its correlates using the 2016 Ethiopia Demographic and Health Survey. METHODS: Data on 12,688 participants were utilized in this study. Descriptive statistics and multilevel logistic regression were used to summarize the data and investigate the associations between predictors and HIV counseling and testing uptake. RESULTS: The overall HIV voluntary counseling and testing uptake among sexually active men in Ethiopia was 45.69%; 95% CI [43.08%, 48.33%]. About 13% of the variation in the likelihood of being tested for HIV was due to the variation among the regions. On the other hand, age, religion, education, occupation, marital status, HIV knowledge, health insurance coverage, wealth status, risky sexual behavior, family planning discussion with health workers, owning a mobile, frequency of watching television, and listening to the radio were significantly associated with the uptake of HIV voluntary counseling and testing. CONCLUSION: HIV voluntary counseling and testing uptake in Ethiopia is still low and varies across the regions, which might hamper the ambitious plan of Ethiopia to end AIDS as a public health threat by 2030. Therefore, giving due consideration to scale up HIV knowledge to avoid risky sexual behavior, improving access to health insurance and media, and working on the significant modifiable sociodemographic determinants are worthy to boost HIV voluntary counselling and testing uptake, which is an integral component of the strategies to efficiently prevent and control HIV.

Unmet need for family planning and associated factors among currently married reproductive age women in Tiro Afeta District, South West Ethiopia, 2017: cross-sectional study.

BACKGROUND: Unmet need for family planning in Oromia region was very high (28.9%) compared to other regions in Ethiopia. To address problems associated with unmet need for family planning locally available evidences are essential, however, there were no clear evidences on unmet need for family planning in Tiro Afeta district. This study aims to assess the magnitude and associated factors of unmet need for family planning among currently married women in Tiro Afeta district, South West Ethiopia, 2017. METHODS: Community based cross sectional study was conducted in April, 2017. A total of 348 currently married women of reproductive age were enrolled from eight villages selected by simple random sampling and using proportional to size allocation. Data were entered using EpiData 3.1 and analyzed by SPSS version 22. Adjusted odds ratios at 95% confidence interval with p-value of < 0.05 were considered as significant variables. RESULTS: Unmet need for family planning among currently married women in Tiro Afeta was 26.1%. Factors significantly associated with unmet need for family planning were: never use of family planning before survey (AOR: 5.09, 95% CI: 2.73-9.50); multiparity (AOR: 3.02, 95% CI: 1.56-5.85); perceived husband's attitude as disapproval (AOR: 2.75, 95% CI: 1.43-5.26); lack of counseling from health workers (AOR: 2.07, 95% CI: 1.11-3.85); and unavailability of Radio and/or Television in the house (AOR: 2.05, 95% CI: 1.15-3.66). CONCLUSION: Unmet need for family planning in Tiro Afeta was higher than national average but lower than Oromia region. Never use of family planning, women's parity, husband's attitude towards contraceptives, women counseling and unavailability of Radio and/or Television in the respondent's home were significantly associated factors with unmet need for family planning. Therefore, the service providers and the district health office should strengthen counseling and partner involvement to reduce unmet need for family planning.