Utilization of emergency medical service and its associated factors among patients visited public hospitals at Hawassa City, Sidama Region, Ethiopia, 2023.

Background: The burden of emergency medical conditions is borne mostly by poorer nations, with a 6 % increase in deaths of adults and children due to emergency conditions between 1990 and 2015. Emergency medical service is crucial to improve outcomes of those injuries and other time-sensitive illnesses. However, access to emergency medical services in Hawassa City is still limited and its' utilization is influenced by different factors. Methods: A facility-based cross-sectional study was conducted among 422 randomly selected clients who visited the emergency service in public hospitals of Hawassa City. A structured interviewer-administered questionnaire adapted by reviewing previous literature was used. The collected data by using the Kobo toolbox was exported into a statical package for social science software for analysis. Descriptive statistics such as frequency, percentage, mean, and standard deviation were used. A binary logistic regression model at a 95 % confidence interval was used to declare an association between dependent and independent variables using the odds ratio. Results: All 422 participants completed the interview with a response rate of 100 %. The mean age of the study participants was 33.73 years with a 14.67 standard deviation. One quarter (24.9 % (95 % CI: 21.1-29.4)) of the study participants have utilized emergency medical services. Urban residence (AOR = 3.48, 95 % CI: 1.69-7.16), ever utilized ambulance service (AOR = 2.37, 95%CI: 1.21-4.67), having Red Cross Association ambulance number (AOR = 2.64, 95%CI: 1.20-5.83) and awareness on presence of free government ambulance (AOR = 3.74, 95%CI: 1.46-9.59) were the predictors of the outcome variable. Conclusion: utilization of emergency medical services in the study area was relatively low when compared with other studies. urban residence, ever utilization of ambulance service, awareness of the presence of free government ambulances, and having a Red Cross Association ambulance number were predictors of utilization of emergency medical service.

Determinants of premenstrual dysphoric disorder and associated factors among regular undergraduate students at Hawassa University Southern, Ethiopia, 2023: institution-based cross-sectional study.

BACKGROUND: Premenstrual dysphoric disorder (PMDD) is a condition causing severe emotional, physical, and behavioral symptoms before menstruation. It greatly hinders daily activities, affecting academic and interpersonal relationships. Attention is not given to premenstrual disorders among female students in higher education. As a result, students are susceptible to stress, and their academic success is influenced by various factors, including their menstrual cycle, and the long-term outcomes and consequences are poorly researched. Even though PMDD has a significant negative impact on student's academic achievement and success limited research has been conducted in low- and middle-income countries including Ethiopia, especially in the study setting. Therefore, a study is needed to assess premenstrual dysphoric disorder and associated factors among regular undergraduate students at Hawassa University. METHODS: An institutional-based cross-sectional study was conducted among 374 regular undergraduate female students at Hawassa University, College of Medicine and Health Sciences. A self-administered structured premenstrual symptoms screening tool for adolescents was used to assess premenstrual dysphoric disorder. The collected data were loaded into a statistical package for the social science version 25 and analyzed using it. Both bivariate and multivariate logistic regression were used to identify factors associated with premenstrual dysphoric disorder. Each independent variable was entered separately into bivariate analysis, and a variable with a p-value less than 0.25 were included in the multivariate analysis to adjust the possible confounders. Statistically significant was declared at a 95% confidence interval when variable with a p-value less than 0.05 in the multivariate analysis with premenstrual dysphoric disorder. RESULTS: The magnitude of premenstrual dysphoric disorder in this study was 62.6% (95% CI 57.4-67.5). Having severe premenstrual pain (AOR = 6.44;95%CI 1.02-40.73), having irregular menstrual cycle (AOR = 2.21; 95% CI 1.32-3.70), students who had poor social support (AOR = 5.10;95%CI, (2.76-12.92) and moderate social support (AOR = 4.93;95%CI (2.18-11.18), and students who used contraception (AOR = 3.76;95%CI, 2.21-6,40) were statistically significant factors with the outcome variable. CONCLUSION: The prevalence of premenstrual dysphoric disorder was high as compared to other studies. There was a strong link between irregular menstrual cycle, severe menstrual pain (severe dysmenorrhea), poor social support, and contraception use with premenstrual dysphoric disorder. This needs early screening and intervention to prevent the complications and worsening of the symptoms that affect students' academic performance by the institution.

Knowledge, attitude, and practice toward COVID-19 transmission, prevention, and self-quarantine management among public servants in selected locations of the Sidama region, Southern Ethiopia: a multicenter cross-sectional study.

Background: The COVID-19 epidemic has put an enormous strain on the world's healthcare systems, lifestyles, and quality of life. Ethiopia attempted to meet the myriad needs of its people due to the COVID-19 epidemic and the government has demonstrated a strong commitment in order to lessen the epidemic's impact on the populace. Despite this fact, the population's compliance with measures was not as needed. Objectives: To assess knowledge, attitude, and practice regarding COVID-19 transmission, prevention, and self-quarantine management among public employees in selected locations of the Sidama Region, Southern Ethiopia, in 2020. Methods: An institution-based cross-sectional study was conducted from 01 October to 30 October 2020, among 399 public servants in selected locations of the Sidama Region, Sothern Ethiopia. One-stage cluster sampling was used to randomly select 16 public service sector offices from the total 32 sector offices in the selected locations of the region. Simple random sampling was employed to select respondents following equal distribution of the samples to 16 sector offices. Data were collected using an adapted self-administered questionnaire. Data entered using EpiData version 3.1 and SPSS version 24 were used for statistical analysis. Descriptive statistics was used to compute frequencies, percentages, and means for independent and dependent variables. Result: Overall, 42.36% of respondents had good knowledge of COVID-19, while the remaining 57.64% had poor knowledge. The percentage of favorable attitudes toward COVID-19 prevention and control were 65.2, 54.4% of respondents had a good level of practice of COVID-19 preventive and control measures, and 52.4% of the respondents had a good level of knowledge regarding self-quarantine management. Conclusion: The level of knowledge, attitude, practice, and self-quarantine management in the area is insufficient for preventing and controlling the disease. Evidence-based awareness creation and law enforcement in the study areas and surroundings, with an emphasis on infection prevention and control (IPC) in the public sector and other public gathering areas, is recommended.

Health related quality of life among people with mental illness: The role of socio-clinical characteristics and level of functional disability.

Background: People with mental illness (PWMI) have declining health related quality of life (HRQoL), which is frequently equivalent to or greater than that of medical disorders. Although, HRQoL is rapidly being recognized as an essential treatment outcome indicator in modern psychiatry, research on the identification and significance of factors impacting QoL in PWMI is still in its early stages. Objective: The aim of this study was to identify predictors of HRQoL among people with mental illness who underwent outpatient follow-up in Sidama region, southern Ethiopia. Methods: We conducted a multicenter, cross-sectional study from April-1, to May-30, 2022. A total of 412 participants took part in the study, using an interviewer-administered structured questionnaire. The HRQoL was measured using the 12-item Short-Form Health Survey-Version 2 (SF-12v2) scale. To describe different variables, descriptive statistics were employed. To find independent HRQoL predictors, we used multivariable linear regression analysis. P-value of <0.05 were declared statistically significant at 95% confidence interval (CI). Result: Out of 412 participants, nearly two-third 261 (63.3%) were male and nearly half 203 (49.3%) were diagnosed as schizophrenia. HRQoL was positively associated with social support (ß = 0.321) and being single (ß = 2.680). Conversely, functional disability (ß = -0.545), being a student (ß = -4.645) and jobless (ß = -3.279) by occupation, and being diagnosed with depression (ß = -2.839) were negatively impacted HRQoL among PWMI. Conclusion: HRQoL of people with mental disorders in this study was significantly associated to social support, marital status, occupation, diagnosis and level of functional disability. Therefore, the mental health care system should develop HRQoL promoting measures that enhance PWMI functioning, social support and employment.

Predictors of unrecognised comorbid depression in patients with schizophrenia at Amanuel mental specialized hospital, Ethiopia: a cross-sectional study.

BACKGROUND: The occurrence of depression in patients with schizophrenia (PWS) increases the risk of relapse, frequency and duration of hospitalisation, and decreases social and occupational functioning. OBJECTIVE: This study aimed to assess prevalence of unrecognised comorbid depression and its determinants in PWS. METHOD: A cross-sectional study was conducted from 1 to 30 March 2019 at Amanuel mental specialized hospital among 300 PWS. The 9-item Calgary Depression Scale for Schizophrenia was used to assess comorbid depression. Logistic regression was used to determine the association between outcome and explanatory variables. Statistical significance was declared at p value <0.05 with 95% CI. RESULTS: The prevalence of unrecognised comorbid depression was found to be 30.3%. Living alone (adjusted OR (AOR)=3.49, 95% CI=0.45 to 8.36), having poor (AOR=4.43, 95% CI=1.45 to 13.58) and moderate (AOR=4.45, 95% CI=1.30 to 15.22) social support, non-adherence to medication (AOR=3.82, 95% CI=1.70 to 8.55), presenting with current negative symptoms such as asocialia (AOR=4.33, 95% CI=1.98 to 9.45) and loss of personal motivation (AOR=3.46, 95% CI=1.53 to 7.84), and having suicidal behaviour (AOR=6.83, 95% CI=3.24 to 14.41) were the significant predictors of comorbid depression in PWS. CONCLUSION: This study revealed considerably a high prevalence of unrecognised comorbid depression among PWS. Therefore, clinicians consider timely screening and treating of comorbid depression in PWS.

Suicide Behavior and Its Predictors in Patients with Schizophrenia in Ethiopia.

BACKGROUND: People with schizophrenia (PWS) are at greater risk of suicide. However, suicide behaviors that occur in PWS are often overlooked, inadequately characterized, and not consistently integrated into treatment. Despite this burden and consequences in Ethiopia, there is a dearth of studies concerning suicide behavior in PWS. Therefore, this study is aimed at assessing the magnitude of suicide behavior and its predictors among PWS in Ethiopia. METHODS: An institution based cross-sectional study was employed. Data were collected using the structured interviewer-administered questionnaire from a sample of 300 PWS at Amanuel Mental Specialized Hospital (AMSH). The revised version of Suicide Behavior Questionnaire (SBQ-R) was used to assess suicide behavior in PWS. The data was collected from March 1 to 30, 2019. Binary logistic regression was performed to identify independent predictors of suicidal behavior at 95% confidence level. Statistical significance was declared at p value <0.05. RESULT: A total of 300 patients with schizophrenia participated in the study. More than two-thirds of 203 (67.7%) of the participants were males, and 116 (38.7%) participants were between the ages of 28 and 37 years. We found that the prevalence of suicide behavior among PWS was 30.3%. Being unemployed (AOR = 3.65, CI = 1.32, 10.05), family history of suicide (AOR = 3.16, CI = 1.38, 7.23), substance use (AOR = 2.51, CI = 1.13, 5.59), current positive psychotic symptoms (hallucination (AOR = 6.39, CI = 2.86, 14.29), and delusion (AOR = 4.15, CI = 1.95, 14.29) and presence of comorbid depression (AOR = 4.81, CI = 1.98, 11.68) were independent significant predictors with suicidal behavior in PWS. CONCLUSION: The prevalence of suicidal behavior among PWS was found to be high. Hence, designing strategies for early screening and intervention is the most critical prevention strategy of suicide in PWS.

Prevalence and determinant factors of mental health problems among healthcare professionals during COVID-19 pandemic in southern Ethiopia: multicentre cross-sectional study.

OBJECTIVE: To assess the prevalence of depression, anxiety and stress and its determinant factors during COVID-19 pandemic among healthcare professionals in southern Ethiopia. DESIGN: Multi-centre cross-sectional study. SETTING AND STUDY PERIOD: Randomly selected public hospitals in Sidama, southern Ethiopia between 25 September 2020 and 25 October 2020. PARTICIPANTS: 387 healthcare professionals were randomly selected. OUTCOME MEASURES: Prevalence and determinant factors of depression, anxiety and stress was assessed. RESULT: Depression, anxiety and stress prevalence were shown to be 50.1% (95% confidence interval (CI) 45.0% to 55.0%), 55.0% (95% CI 51.1% to 59.9%) and 38.5% (95% CI 33.6% to 43.2%), respectively. Being female (adjusted odd ratio (AOR) 3.71, 95% CI 2.31 to 5.97), married (AOR 2.28, 95% CI 1.34 to 3.86), living alone (AOR 1.87, 95% CI 1.09 to 3.20), nurses (AOR 2.94, 95% CI 1.44 to 5.99) and working in inpatients (AOR 0.53, 95% CI 0.29 to 0.93) were significantly associated with depressive symptoms. Moreover, older age groups (AOR 3.15, 95% CI 1.04 to 6.56), females (AOR 3.25, 95% CI 2.01 to 5.25), married (AOR 1.69, 95% CI 1.01 to 2.87) and nurses (AOR 3.32, 95% CI 1.63 to 6.78) were significantly associated with symptoms of anxiety. Stress symptoms were significantly high among females (AOR 2.47, 95% CI 1.53 to 3.97), married (AOR 2.77, 95% CI 1.60 to 4.78), living alone (AOR 2.01, 95% CI 1.15 to 3.52), nurses (AOR 2.34, 95% CI 1.11 to 4.92) and working in units other than emergency (inpatient (AOR 0.32, 95% CI 0.18 to 0.57) and other units (AOR 0.48, 95% CI 0.25 to 0.95)). CONCLUSION: The current study found that healthcare professionals have high levels of depression, anxiety and stress symptoms. Sex, age, marital status, type of profession, living status and working environment were significant factors for mental health problems in healthcare professionals during the pandemic. Healthcare professionals require mental health support at which monitoring and control can be performed during and after the pandemic.

Post-traumatic Stress Disorder Symptoms and Its Predictors Among Healthcare Workers Following COVID-19 Pandemic in Southern Ethiopia: A Cross-Sectional Study.

Background: COVID-19 causes immense psychological pressure on communities in addition to physical misery. There is currently a scarcity of data on the psychological impact of the COVID-19 epidemic on Ethiopian healthcare workers (HCWs). Therefore, this study was aimed to assess the post-traumatic stress disorder (PTSD) symptoms and its predictors following COVID-19 pandemic among healthcare workers (HCWs) in southern Ethiopia. Methods: A hospital based cross-sectional study design was used among 387 randomly selected HCWs between September 25 and October 25, 2020 at four selected public hospitals in Sidama National Regional State, southern Ethiopia. Impact of Event Scale-Revised (IES-R) was used to collect data post-traumatic stress disorder (PTSD) symptoms. Logistic regression analyses with 95% CI were used to examine the relationship between independent and outcome variables. Result: The prevalence of PTSD symptoms was found in 56.8% of participants. Significant factors that increase risk of PTSD symptoms were being female (AOR = 1.91, 95% CI = 1.19, 3.05), married (AOR = 1.87, 95% CI = 1.12, 3.14) and nurses (AOR = 3.31, 95% CI = 1.66, 6.63). On the other hand, HCWs working other than emergency unit such as inpatients/wards (AOR = 0.43, 95% CI = 0.24, 0.75), OPD (AOR = 0.48, 95% CI = 0.24, 0.97) and other units (AOR = 0.49, 95% CI = 0.25, 0.96) less likely to be affected by PTSD symptoms. Conclusion: The current study showed high levels of PTSD symptoms as psychological challenges for HCWs. Sex, age, marital status, type of profession and working environment were significant factors for PTSD symptoms in HCWs during the pandemic. HCWs require mental health support during and after the pandemic.

Social Anxiety Disorder Among Undergraduate Students of Hawassa University, College of Medicine and Health Sciences, Ethiopia.

INTRODUCTION: Social anxiety disorder (SAD), also called social phobia, is an uncontrollable fear of social situations, which involve fear of observation or making contact with strangers. So, helping individuals with social anxiety, which is among the factors affecting mental health, can significantly influence a students' mental health and prevent other problems. OBJECTIVE: The study aimed at assessing the magnitude of SAD and its determinants among undergraduate students of Hawassa University, College of Medicine and Health Sciences. METHODS: An institution based cross-sectional study was conducted from April 1 to May 30, 2018, in Hawassa University, College of Medicine and Health Sciences. We selected participants by a stratified random sampling method, and we collected data independently from each stratum (department) using a 17 item self-rating Social Phobia Inventory (SPIN) scale to assess SAD. We performed multiple logistic regression analysis to find factors associated with SAD. RESULTS: Out of 304 students, 293 completed the questionnaire, with a response rate of 96.3%. The mean age of the participants was 22.13 years with a standard deviation of ± 2.176, and 172 (58.7%) were males. The prevalence of SAD was 32.8%. Family history of mental illness (AOR=4.72, 95% CI (1.25, 17.74)), being a 3rd-year student (AOR=0.178, 95% CI (0.055, 0.57)) and being a 4th year student (AOR=0.15, 95% CI (0.049, 0.49)) were significantly associated with SAD. CONCLUSION: This study showed a high prevalence of SAD among medicine and health science students of Hawassa University. Therefore, the Ethiopian Ministry of Higher Education and university officials need to draw up a plan to reduce social phobia.

Depressive symptoms and its associated factors among prisoners in Debre Berhan prison, Ethiopia.

BACKGROUND: Depression is a common mental disorder among prisoners characterized by a mood change involving a feeling of sadness, lack of interest, or hopelessness that lasts for weeks, months, or even longer. Besides imprisonment, depression is the primary factor leading to suicidal attempts. However, little is known about the depressive status of prisoners in Ethiopia. Therefore, this study aimed at assessing the magnitude and associated factors of depressive symptoms among prisoners of Debre Berhan prison. METHODS: We conducted an institution-based cross-sectional study. We collected data from 336 randomly selected prisoners using interviewer-administered Patient Health Questionnaire-9 (PHQ-9). We collected the data from May 3 to 28, 2015, and performed binary logistic regression to identify independent predictors of depressive disorder. RESULT: Out of the total of 336 prisoners, 98% (n = 330) were males. Using PHQ-9 at the cut-off point of ≥5, we found the prevalence of depression to be 44% (n = 148). Being widowed (AOR = 6.30; CI: 1.09-36.67), having a college or university level educational status (AOR = 5.34; CI:1.59-17.94), having a history of suicide attempt (AOR = 2.76 CI: 1.04-7.31), having faced severe stressful life events (AOR = 2.57; CI: 1.41-4.67), being sentenced for 5 to 10 years (AOR = 2.51; CI:1.32-4.79), and having a history of chronic medical illness (AOR = 3.32 CI: 1.26-8.75) were found to be independently associated with depressive symptoms. CONCLUSION: There is a high prevalence of depression among prisoners of Debre Berhan prison. Hence, designing strategies for early screening and treatment of depression at prisons is crucial.

Mental Distress and Associated Factors Among Undergraduate Engineering Students of Hawassa University, Ethiopia.

BACKGROUND: Mental distress is a range of symptoms and experiences of a person's internal life that are commonly held to be troubling, confusing or out of the ordinary. Mental distress often interferes with studying, social interaction, and academic outcomes. Therefore, this study aimed at assessing the prevalence of mental distress and factors associated with it among undergraduate engineering students at Hawassa University. METHODS: We conducted an institution-based cross-sectional descriptive study on undergraduate engineering students at Hawassa University. We collected the data from January to April 30, 2018, using interviewer-administered Self-Report Questionnaire 20 (SRQ-20) from 341 participants selected by stratified sampling and we performed multiple logistic regression analysis to find factors associated with mental distress. RESULTS: Out of the total study population, 222 (65.1%) were males, and 172 (50.4%) were age ≥21. We found the prevalence of mental distress using SRQ-20 with a cut-off point ≥8 to be 28.7%. Female students were 2.9 times more likely to have mental distress as compared to male students (AOR= 2.90, 95% CI: 1.52-5.50). Facing financial problem (AOR= 2.20; CI = 1.25-3.85), poor social support (AOR= 2.58, 95% CI: 1.51-4.42), lack of interest in their field of study (AOR=2.57; CI: 1.23-5.38) and unresolved conflict with roommate (AOR= 2.29, 95% CI: 1.08-4.00) were significant predictors of mental distress. CONCLUSION: This study showed a high prevalence of mental distress among engineering students. So, policymakers, university officials, and parents need to give due attention to engineering undergraduate students for proactive measures.

Public Stigma against People with Mental Illness in Jimma Town, Southwest Ethiopia.

BACKGROUND: Stigma towards people with mental illness (PWMI) can result in low self-esteem and isolation and threaten employment. Therefore, this study aimed to assess the magnitude of public stigma against PWMI and factors associated with it among Jimma town residents. METHODS: A community-based, cross-sectional, descriptive study was conducted in adult residents of Jimma town. Data were collected among 820 randomly selected residents with the interviewer-administered Community Attitudes toward the Mentally Ill (CAMI) scale. Linear regression analyses were performed to identify predictors of stigma against PWMI. RESULT: A total of 444 (54%) of the 820 respondents were females, and the mean (SD) age was 35 (8.5) years. The minimum and maximum possible values on each CAMI subscale were 10 and 50, respectively. The respondents had high scores for a stigmatizing attitude towards PWMI across all the subscales, as indicated by the mean (SD) scores: authoritarianism, 27.17 (4.96); social restrictiveness, 32.41 (4.20); benevolence, 35.34 (4.42); and community-based mental health ideology, 33.95 (5.82). Compared to housewives, private organization employees showed more autocratic and socially restrictive views (std. ß = 1.12, P<0.01). Single people had a lower social restrictiveness stigma score than married people (std. ß = -0.20, P<0.001), and participants' academic levels correlated inversely with the stigma score (std. ß = -0.12, P<0.001). A higher benevolence stigma score was observed among participants with no relationship with PWMI than among those with PWMI in their neighborhood (std. ß = 0.08, P< 0.046). CONCLUSION: The study revealed that a negative attitude towards PWMI is widespread. Therefore, there is a need to develop strategies to fight the stigma attached to PWMI at the community level.