The burden and its determinants of mental health distress among adolescents dwelling in Africa: a systematic review and meta-analysis.

BACKGROUND: Adolescent mental health issues are emerging as a significant public health concern across many low- and middle-income countries, particularly in Africa. This study aims to evaluate the aggregated prevalence and contributing risk factors of mental health distress among adolescents in Africa. METHODOLOGY: A comprehensive search of PubMed, PsycINFO, Web of Science, Google Scholar, and HINARI databases was conducted to identify relevant articles on the prevalence and risk factors associated with mental health distress among African adolescents, published up to December 2023. The quality of the selected studies was assessed using the Newcastle-Ottawa Quality Assessment Scale. Heterogeneity among the studies was evaluated using the I² statistical test. Potential publication bias was assessed through a funnel plot and Egger's statistical test. This systematic review was registered with PROSPERO under reference number CRD42023494665. RESULTS: Eighteen studies encompassing data from 37,016 adolescents were included in the analysis. The overall prevalence of mental health distress among adolescents in Africa was found to be 27.34% (95% CI: 23.18-31.50). The occurrence of mental health distress is observed in older adolescents at a prevalence of 29.44% (95% CI: 23.26-35.66) and in younger adolescents at 24.73% (95% CI: 11.96-37.51). Significant risk factors identified included bullying victimization, with an odds ratio (POR) of 1.30 (95% CI: 1.16, 1.46), and experiencing hunger, with an odds ratio (POR) of 2.10 (95% CI: 1.13, 3.91). CONCLUSION: The findings indicate a high prevalence of mental health distress among adolescents in Africa, highlighting the widespread impact on this demographic. These results underscore the urgent need for targeted interventions to prevent and address mental health distress among adolescents. Further research on a global scale is essential to develop effective prevention and treatment strategies tailored to this age group.

Post-traumatic stress disorder in the Ethiopian population dwelling in war-affected communities: a systematic review and meta-analysis.

Background: Post-traumatic stress disorder (PTSD) is a significant mental health concern globally, particularly prevalent in populations exposed to war and conflict. This systematic review and meta-analysis aim to examine the prevalence and factors associated with PTSD among the Ethiopian population residing in war-affected communities. Methods: The review was reported according to the PRISMA guidelines. Related eligible published articles were searched in electronic online databases such as PubMed, Scopus, Web of Science, MEDLINE/PubMed, Scopus, Embase, Science Direct, Web of Science, Google Scholar, and Google, which reported the prevalence and risk factors of PTSD among people dwelling in the war-affected area until January 2024. The relevant data was extracted using a Microsoft Excel spreadsheet. The meta-analysis was conducted using STATA version 11. The estimated pooled prevalence and risk factors were estimated using a random effect model. The potential risk of publication bias was checked using a funnel plot and Egger's statistical test. Results: A total of nine published studies with 6107 participants were analyzed in this meta-analysis. The estimated pooled prevalence of PTSD among people living in war-affected areas was 48.4%, with a 95% CI (37.1, 59.8). This study found a higher prevalence of PTSD among women than men. Being female (OR= 2.2, 95% CI: 1.2, 4.3), witnessing a murder of a loved one (OR= 3.0, 95% CI: 1.2, 7.5), depression symptoms (OR= 2.8, 95% CI: 1.4, 5.6), and anxiety symptoms (OR= 3.4, 95% CI: 1.4, 8.0), a close family member killed or seriously injured (OR= 3.1, 95% CI: 1.2, 7.7), a moderate and high perceived threat to life (OR= 3.4, 95% CI: 1.3, 9.1), and poor social support (OR= 4.4, 95% CI: 1.1, 18.7) were associated with post-traumatic stress disorder. Conclusion: The result of this study shows the high prevalence rate of PTSD in people living in war-affected areas. disparities in PTSD prevalence, with women being at higher risk, and identified risk factors were witnessing the murder of a loved one, experiencing depression and anxiety, and perceived threat to life. Addressing PTSD in war-affected communities requires comprehensive interventions that consider both individual and contextual factors. Systematic review registration: www.crd.york.ac.uk/PROSPERO/, identifier CRD42024501384.

Perceived and self-stigma in people with epilepsy in East Africa: Systematic review and meta-analysis.

BACKGROUND: People with stigmatizing conditions associated with epilepsy encounter many difficulties in their daily lives and are more likely to have low self-esteem, low levels of hope, internalize negative attitudes, decrease adherence to treatment, and experience unemployment. The purpose of this study was to quantify the extent of perceived stigma and self-stigma among people with epilepsy. METHODOLOGY: This systematic review and meta-analysis followed the Preferred Reporting Item Review and Meta-analysis (PRISMA) guideline. PubMed, PsycINFO, Web of Science, Cochrane Library, Google Scholar, and HINARI were major search databases. The included literature reports the prevalence of perceived stigma and self-stigma among people with epilepsy in East Africa. The quality of each study was evaluated using the Newcastle-Ottawa Quality Assessment Scale (NOS). Data were extracted using a Microsoft Excel spreadsheet, and data analysis was performed using STATA version 11. The pooled prevalence of perceived stigma and self-stigma was determined using a random effect model. Heterogeneity between studies was checked using the I2 statistical test. Publication bias was checked using Egger's statistical test and funnel plot. RESULTS: The pooled prevalence of perceived stigma and self-stigma in people with epilepsy was 43.9 % with a 95 % CI (29.2, 58.7) and 41.2 % with a 95 % CI (12.1, 70.3), respectively. Based on the country, sub-group analysis revealed that the prevalence of perceived stigma among people with epilepsy shows a notable difference between the countries. In Ethiopia, the prevalence was 51.8 % with a 95 % CI of 29.8 to 73.8; in Uganda, 39.4 % with a 95 % CI of 27.1 to 51.3; in Tanzania, 27.4 % with a 95 % CI of 27.9 to 36.9; and in Kenya, 33.2 % with a 95 % CI of 28.2 to 38.2. CONCLUSION: Roughly 30 % of people with epilepsy experience self-stigma, while approximately 44 % of people with epilepsy experience perceived stigma. As a result, the relevant authorities ought to focus on reducing the prevalence of stigma among people who have epilepsy.

Psychiatric comorbidity in people with epilepsy in Ethiopia: Systematic review and meta-analysis.

BACKGROUND: Psychiatric comorbidity is a double burden among people with epilepsy. Since people with epilepsy are more vulnerable to psychiatric illnesses. So, the implementation of an appropriate intervention to minimize the double burden of comorbidity is very important. Therefore, this systematic review and meta-analysis aimed to assess the prevalence and associated factors of psychiatric comorbidity among people with epilepsy in Ethiopia. METHODS: This systematic review and meta-analysis followed the Preferred Reporting Item Review and Meta-analysis (PRISMA) guideline. Searching databases were PubMed, PsycINFO, Web of Science, Cochrane Library, Google Scholar, and HINARI.The quality of the included articles was assessed using the Newcastle-Ottawa Scale (NOS). The pooled meta-logistic regression was computed to estimate the pooled prevalence and the risk factors with a 95% CI. RESULTS: The pooled prevalence of psychiatric comorbidity in people with epilepsy was 34.69 % (95 % CI: 29.27, 40.10). Frequent seizures (POR = 2.94: 95 % CI: 1.08, 8.00) and a history of divorce (POR = 2.00: 95 % CI: 1.09, 3.81) were associated factors of psychiatric comorbidity in people with epilepsy. CONCLUSIONS: This systematic review and meta-analysis revealed that the pooled prevalence of psychiatric comorbidity among people with epilepsy was found to be higher compared with the general population. Therefore, among people with epilepsy, parallel psychiatric evaluation is very important along with neurological evaluation.

Exposure to stress-full life events and help-seeking behaviors among reproductive-age women in Northwest Ethiopia: Community-based cross-sectional study.

BACKGROUND: Stressful life events are a significant public health issue worldwide. Despite its mental, psychological, and social problems, important questions about the prevalence and risk factors remained unanswered. Therefore, this study aimed to show major life events and help-seeking behaviors among women in the reproductive-age group. METHODS: A community-based cross-sectional study design was conducted using a multistage cluster sampling technique to get a total of 845 study participants from March 20 to April 29, 2021. Exposure to stressful life events and help-seeking behavior was collected using Women's Exposure to the Stressful Life Events Test, and General Help-Seeking Questionnaire (GHQ) respectively. Data were cleaned, coded, and entered into EPI-Info version 3.1 and analyzed using SPSS version 20. RESULTS: The prevalence of stressful life events and help-seeking behaviors was 47.9 % and 38.7 % respectively. Reproductive-age women with poor social support (AOR = 2.392, 95 % CI: 1.422, 4.026), moderate social support (AOR = 1.861, 95 % CI: 1.341, 2.583), husband alcohol users (AOR = 1.496, 95 % CI: 1.027, 2.178), husband chat users (AOR = 2.962, 95 % CI: 1.140, 7.696), and having ever suicidal attempt (AOR = 8.702, CI: 1.719, 44.049), were positively associated with stressful life events. CONCLUSION: Nearly half of reproductive-age women had stressful life events. Thus, it is important to give serious attention to addressing those identified factors to increase public awareness, especially among husbands, their families, and elected authorities.

Coping strategies and associated factors among people with physical disabilities for psychological distress in Ethiopia.

BACKGROUND: Coping strategies are frequently used among individuals with physical disabilities when they face adversities. Low- and middle-income countries are not investigated coping styles among psychological distress persons with disabilities despite the high prevalence of psychological distress. The aim of this study was to identify coping strategies among people with physical disabilities for their psychological distress in Ethiopia has a crucial role to improve the health status of persons with physical disabilities. METHODS: An institution-based cross-sectional study was employed among individuals living with physical disabilities at the University of Gondar staff and students from May to June 2021. All staff and students with physical disabilities were screened for psychological distress (n = 269). The census sampling technique was used to select the study participants for psychological distress. The Brief Cope with Problems Experienced (COPE-28) was used to assess coping strategies. Bivariate and multivariate linear regression analyses were used to identify factors associated with coping strategies. An odd ratio (OR) with a 95% confidence interval (CI) at P < 0.05 was computed to assess the strength of the association. RESULTS: The emotional-focused coping strategy was the most frequently used when dealing with psychological distress among participants with physical disabilities. The most commonly used emotional-focused coping strategy was spirituality. In the multivariate analyses; urban residence (ß = 3.05, 95% CI: 0.98, 5.12), and stigma (ß = 3.10, 95% CI: 0.61, 2.83) were factors positively associated with emotion-focused coping strategy, and World Health Organization Quality of Life (WHO QOL) (ß = 0.18, 95% CI: 0.13, 0.22), and stigma (ß = 1.11, 95% CI: 0.61, 2.83) were factors significantly associated with problem-focused coping. Urban residence (ß= -0.96, 95% CI: -1.69, -0.22) was negatively associated with dysfunctional coping strategy, but WHO QOL (ß = 0.35, 95% CI: 0.32, 0.38) was positively correlated with dysfunctional coping. CONCLUSION: In this study revealed that spirituality is the most frequently used coping strategy among the study participants. Urban residents, stigma, and WHO QOL significantly correlated with coping strategies among such patients. The Ministry of Health, Ministry of Education, and other concerned organizations may find the present findings useful to strengthen the coping styles to minimize psychological distress among people with physical disabilities.

Spatial distribution and determinants of alcohol consumption among pregnant women in Ethiopia: Spatial and multilevel analysis.

BACKGROUND: Alcohol consumption during pregnancy is a known contributor to teratogen and causes a range of effects on pregnancy and birth outcomes. This study aimed to investigate the spatial variation and determinants of alcohol consumption among pregnant women in Ethiopia. METHODS: A secondary data analysis was conducted using the 2016 Ethiopian Demographic and Health Survey data. A total of 1,135 pregnant women were included in the analysis. ArcGIS version 10.7 software was used to explore the spatial distribution of alcohol consumption, and SaTScan version 9.6 was employed to identify the significant spatial clusters of alcohol consumption. A mixed multi-level logistic regression analysis was employed to identify the determinant factors of alcohol consumption during pregnancy. RESULTS: The result showed that the prevalence of alcohol consumption during pregnancy was 22.49% (with a 95% CI: 18.18 to 26.17). The spatial analysis showed that the spatial distribution of alcohol consumption significantly varied across the country [Global Moran's I value = 0.30 (P<0.001)]. The SaTScan analysis identified two most likely clusters with high rates of alcohol consumption such as northwest Ethiopia (Log-Likelihood Ratio (LLR) = 155.56, p<0.001) and central Ethiopia (LLR = 19.27, p<0.01). Never in union, divorced and/ widowed [Adjusted odds ratio (AOR) = 2.56; 95% CI: 1.07, 10.14], attended primary school [AOR = 0.45; 95% CI: 0.27, 0.95], having two or more lifetime sexual partners [AOR = 2.59; 95% CI: 1.11, 6.18], living in rural [AOR = 1.52; 95% CI: 1.12, 2.93] and higher community media exposure [AOR = 0.54; 95% CI: 0.28, 0.97] were the factors associated with alcohol consumption. CONCLUSION: Alcohol consumption during pregnancy in Ethiopia was high. The spatial distribution of alcohol consumption was significantly varied across the country. Therefore, public health interventions targeting areas with high alcohol consumption are needed for drinking cessation and to prevent poor pregnancy outcomes related to alcohol use.

Antiepileptic Drug Adherence and Its Associated Factors among Epilepsy Patients on Follow-ups at Amanuel Mental Specialized Hospital, Ethiopia.

Background: Medication adherence is a fundamental determinant of effective treatment. However, people with epilepsy have poor compliance with their treatment because of the chronic nature of the disease. Limited studies have been conducted to address antiepileptic medication adherence in Africa, including Ethiopia. Thus, the aim of this study was to assess antiepileptic drug adherence and its asociated factors among patients with epilepsy attending outpatient department of Amanuel Mental Specialized Hospital. Methods: A cross-sectional study design was conducted on 439 patients with epilepsy in Amanuel Mental Specialized Hospital. Medication adherence reporting scale-5 (MARS-5) was used to assess adherence to antiepileptic drugs. The Oslo social support, Jacob perceived stigma scale, and hospital anxiety and depression scale (HADS) were the instruments used to assess associated factors. Simple and multiple linear regression analysis models were fitted. Then, the adjusted unstandardized beta (ß) coefficient at a 95% confidence level was used. Results: The mean(SD) score of antiepileptic medication adherence was 16.38(±3.76) with 95%CI:(16.03, 16.72). Depressive symptoms (ß= -1.35, 95% CI: (-2.04, -0.65)), anxiety symptoms (ß=-1.12,95%CI:(-1,79,-0.44), perceived stigma (ß= -1.64, 95% CI:-2.16,-1.12), being single (ß=-0.67, 95%CI:-1.20,-0.14), presence of seizure per month(ß=-2.11,95% CI: (-2.81,-1.41) and antiepileptic drug adverse effect(ß=-0.07,95%CI:-0.11,-0.03) were factors associated with anti-epileptic medication adherence. Conclusions: The results suggest that the mean score of adherence to antiepileptic drugs was poor as compared to other settings. Antiepileptic medication adherence screening tool should be included in the patient's treatment protocol.

Prevalence of mental distress and associated factors among medical students of University of Gondar, Northwest Ethiopia: a cross-sectional study.

BACKGROUND: Mental distress is the most common problem among medical students. This is associated with severe consequences of lack of empathy for their patients, committing medical errors, and suicidal ideations and attempts. However, there is limited data on this aspect where the study was conducted especially in this segment of the population. Considering its seriousness, this study will have pivotal input information to plan possible interventions for the future. So, this study is aimed at assessing the prevalence of mental distress and its associated factors among medical students of the University of Gondar, Northwest Ethiopia, 2021. METHODS: An institutional-based cross-sectional study was conducted using a stratified random sampling technique to get a total of 438 study subjects from April 15-30/2021. Mental distress data were collected using a self-administrated questionnaire of the 10-item Kessler Psychological Distress Scale. Data was entered to Epi-data version 4.6.02 and cleaned, coded, and analyzed using STATA version 14. RESULTS: The prevalence of mental distress among medical students was 193(45.95%) with 95% CI (41.2, 50.7). In multi-variable logistic regression being female sex (AOR = 4.5, 95% CI = 2.66, 8.12), lack of interest towards field of study (AOR = 4.4, 95%, CI = (2.18, 8.78), current alcohol use (AOR = 5.8, 95% CI = 3.03, 11.15), monthly pocket money < 735 Ethiopian birr (AOR = 3.1, 95% CI = 1.53, 6.04), extremely high test anxiety (AOR = 3.9, 95% CI = 1.27, 11.88), family history mental illness (AOR = 2.5 95% CI = 1.12, 5.53) and poor social support (AOR = 4.2, 95% CI = (1.94, 9.16) were significantly associated with mental distress. CONCLUSION AND RECOMMENDATION: Prevalence of mental distress among medical students of University of Gondar was found to be higher when compared to previous studies among this population in Ethiopia. It is recommended that the school of medicine should give undue attention to address those identified factors by establishing counseling centers to minimize mental distress.

University students' help seeking intention for depression from health professionals; a cross sectional study.

OBJECTIVES: To assess University students' intention to seek help for depression from health professional and associated factors among University of Gondar students, Northwest, Ethiopia. METHODS: An institution-based cross-sectional study was conducted among 487 students. Multistage sampling technique was used to select study participants. Self-administered questionnaire was employed to collect the data. General help seeking questionnaire with major depressive disorder case vignette was used to assess students' intention to seek help for depression. The collected data was analyzed using SPSS version 20. Simple and multiple linear regression analysis were performed to identify factors for intention to seek help for depression. Association was described by using adjusted unstandardized ß coefficient along with 95% confidence interval. Finally, P-values < 0.05 in adjusted analysis were taken as a cut off for significant association. RESULTS: The mean score of intention to seek help from health professionals was 3.84 (±0.76)with a range of (1 "very unlikely" to 5 "very likely"). About 67.8% of the study participants would seek help from health professionals if they would have depressive symptoms which was depicted in the case vignette. In the multiple linear regression analyses, student age (unstandardized ß = 0.07, 95% CI: (0.05, 0.10)), good attitude towards seeking professional help (ß = 0.03, 95% CI: (0.02, 0.04)) were factors positively associated with intention to seek help. CONCLUSION: The current study showed that more than three-fifth of the study participants reported they were likely or very likely to seek help for depression from health professionals. Increased age and favorable attitude were factors associated with intention to seek help for depression. Working on awareness creation and attitude change towards depression would be necessary to increase students' intention to seek help for depression from health professional.

Magnitude and predictors of common mental disorders among residents in south Gondar Zone, Northwest Ethiopia: a community-based, cross-sectional study.

BACKGROUND: Common mental disorders such as depression, anxiety, and somatic symptoms are a major public health concern because it is prevalent and chronic, and its impact on physical health, psychological and economic consequences is very serious. Evidence on the prevalence and predictors of common mental disorders is very limited in Ethiopia. This study aims to determine the prevalence and associated factors with common mental disorders. METHODS: A community-based cross-sectional study was conducted among 731 south Gondar zone residents recruited with a multistage sampling method. Data were collected by face-to-face interviews on socio-demographic, clinical, and psychosocial factors. Common mental disorders (CMD) were assessed using a self-reporting questionnaire (SRQ-20). A-List of Threatening Experiences and the Oslo social support instruments were used to identify the factors. We used bivariate and multivariable binary logistic regressions to identify factors associated with common mental disorders. Statistical significance was declared at P-value < 0.05. RESULTS: The prevalence of common mental disorders over the last four weeks was found to be 29.7% with 95% of confidence interval (CI) (26.4-33.1). After adjusting possible confounders, female sex, [AOR = 2.47, 95% CI (1.68, 3.62)], poor social support [AOR = 2.34, 95% CI (1.50, 3.64)], family history of mental illness [AOR = 2.15, (1.32-3.51)], rural resident [AOR = 2.01, 95% CI (1.35, 3.01)], current use of khat [AOR = 1.69, 95% CI (1 0.07, 2.64)] current use of tobacco (AOR = 1.71, 95% CI (1.04-2.84) and unemployment [AOR = 1.762, 95% CI; 1.193, 2.602)] were significantly associated with common mental disorders. CONCLUSION: The prevalence of common mental disorders was high, especially in Female sex, current substance use (khat chewing (leaves) and tobacco smoking), unemployment, rural residence, family history mental illness, and poor social support are the main determinants of common mental disorders. Early detection and appropriate intervention for common mental disorders in the community level should be promoted. Governmental strategies should be focused on implementing substance rehabilitation centers to treat Khat and tobacco might be helpful to minimize the burden of CMD in Ethiopia.

Intimate partner violence among reproductive-age women in central Gondar zone, Northwest, Ethiopia: a population-based study.

BACKGROUND: Violence against women is the most widespread kind of human rights violation, and it has been linked to a wide range of consequences. The most prominent psychosocial and mental health concern that has serious effects for women's physical and mental well-being. This study assessed the prevalence and associated factors of women's violence by intimate partner among women in the reproductive age group (15-49). METHODS: Multistage community-based cross-sectional study was conducted among reproductive age group women in the central Gondar zone. We recruited 845 participants and interviewed by health extension workers using face-to-face interviews. We used a Women's Abuse Screening test to outcome variable; it has a total score ranges 0-16, a score > 1 indicates positive for the presence of intimate partner violence within a year. Variables were coded and entered to Epi data version 3.1 and exported to SPSS version 21 for analysis. Descriptive statistics and multivariate logistic regression analysis was run for data analysis. Adjusted odds ratios (AOR) with a 95% confidence level (CI) were declared significant. RESULT: Among a total of 845 participants 804 responded to the interviews with a response rate of 95%. The prevalence rate of intimate partner violence is 391(48.6%). From multivariate logistic regression analysis women being married [AOR:3.85; 95% CI (2.38, 6.22)], high school and above educational status [(AOR: 0.43; 95% CI (0.30, 0.61), women's having > 3children [(AOR: 1.82, 95% CI (1.0, 3.1)], having a household food insecurity[(AOR: 2.09, 95% CI (1.51, 2.91)], having life threatening events [(AOR: 2.09; 95% CI (1.51, 2.91)], moderate social support [(AOR: 0.60; 95% CI (0.41, 0.83)], depression [(AOR: 3.12; 95% CI (1.60, 6.07) were significantly associated with violence by intimate partner at 95% CI . CONCLUSION: Intimate partner violence is common among reproductive-age women. Married, women with several children, food insecurity, life-threatening events, and depression were all found to be significant predictors of violence. Measures should be taken to raise community awareness, particularly among intimate partners, their families, and government officials.

Prevalence of common mental disorder and associated factors among mothers of under five year children at Arbaminch Town, South Ethiopia, 2019.

BACKGROUND: Common mental disorders are the major public healthproblem that affects mothers with young children. Although there were a number of studies done on maternal mental health problems, they were largely focused on perinatal period. However, there is scarcity of information on the magnitude and correlates of these mental health problems beyond perinatal period and due concern is not given mainly in LMICs including our country. OBJECTIVE: To assess the prevalence and factors associated with common mental disorderamong mothers of under-five year children at Arbaminch town, South Ethiopia, 2019. METHODS: A community based cross-sectional study was conducted in May and June 2019 at Arbaminch town. A systematic random sampling technique was used to select 776 participants. The Self-Reporting Questionnaire (SRQ-20) was used to assess common mental disorder (CMD). Data was coded and entered in EPIDATA3.1 and analyzed using SPSS version 25. Bivariable and multivariable logistic regression were used to identify factors associated to common mental disorder. P-values less than 0.05 were considered statistically significant and strength of the association was presented by adjusted odds ratio with 95% confidence interval. RESULT: The prevalence of common mental disorder among mothers with children aged below five years was 36.6% with (95% CI, 33.2, 39.9). Being single/divorced/widowed [AOR = 3.64, 95% CI:(1.47, 8.99), chronic medical illness [AOR = 3.25, 95% CI:(2.10, 5.04)], exposure to two/more stressful events [AOR = 1.62, 95% CI:(1.11, 2.36)], poor social support [AOR = 2.59, 95% CI:(1.62, 4.14)], mothers living with cigarette smoker husband [AOR = 2.03, 95% CI:(1.19, 3.47)], and mothers physically abused by their spouse [AOR = 2.36, 95% CI:(1.49, 3.74)] were factors associated with common mental disorder. CONCLUSION AND RECOMMENDATION: The prevalence of common mental disorder was high among mothers with children aged below five years compared to the general population. Being single/divorced/widowed, chronic medicalillness, exposure to two/more stressful events, poor social support, mothers living with cigarette smoker husbandand physically abuse by their spouse were factors associated with common mental disorder. Early detection and management of these maternal mental health problems is vital for mothers' wellbeing as well as growth and development of children.

Prevalence of post-traumatic stress disorder on health professionals in the era of COVID-19 pandemic, Northwest Ethiopia, 2020: A multi-centered cross-sectional study.

OBJECTIVE: This study aimed to assess the prevalence and associated factors of post-traumatic stress disorder among health professionals working in South Gondar Zone hospitals in the era of the COVID-19 pandemic, Amhara Ethiopia 2020. METHODS: Institutional based cross-sectional study design was conducted. A total of 396 respondents completed the questionnaire and were included in the analysis. A previously adapted self-administered pretested standard questionnaire, Impact of Event Scale-Revised (IES-R-22) was used to measure post-traumatic stress disorder. Data was entered into Epi data version 4.4.2 then exported to SPSS version 24 for analysis. Descriptive and analytical statistical procedures, bivariate, and multivariate binary logistic regressions with odds ratios and 95% confidence interval were employed. The level of significance of association was determined at a p-value < 0.05. RESULTS: The prevalence of post-traumatic stress disorder among health care providers in this study was 55.1% (95% CI: 50.3, 59.6). Lack of standardized PPE supply (AOR = 2.5 7,95CI;1.37,4.85), respondents age > 40 years (AOR = 3.95, 95CI; 1.74, 8.98), having medical illness (AOR = 4.65, 95CI;1.65,13.12), perceived stigma (AOR = 1.97, 95CI;1.01, 3.85), history of mental illness(AOR = 8.08,95IC;2.18,29.98) and having poor social support (AOR = 4.41,95CI;2.65,7.3) were significantly associated with post-traumatic stress disorder at p-value < 0.05. Conversely, being a physician (AOR = 0.15, 95CI; 0.04, 0.56) was less affected by PTSD. CONCLUSIONS: The prevalence of post-traumatic stress disorder among health care providers in this study was high. Adequate and standardized PPE supply, giving especial emphasis to those care providers with medical illness, history of mental illness, and having poor social support, creating awareness in the community to avoid the stigma faced by health care providers who treat COVID patients is recommended.

Quality of life and associated factors among women with obstetric fistula in Ethiopia.

BACKGROUND: Obstetric fistula is an abnormal opening between the vagina and bladder or rectum. Women affected by obstetric fistula are often abandoned by their husbands, stigmatized by the community, physically debilitated and blamed for their conditions. These factors lead the victims to low self esteem, depression and prolonged emotional trauma. The physical, emotional and social suffering associated with continuous leakage of urine has a profound impact on women quality of life. The aim of this study was to assess quality of life and associated factors among obstetric fistula patients in Ethiopia, and it will have a significant role for further intervention. OBJECTIVE: To assess quality of life and associated factors among obstetric fistula patients in Ethiopia, 2017. METHODS: Institution based cross-sectional study design was conducted at fistula centers in Ethiopia. Systematic sampling technique was used to recruit a total of 289 women with obstetric fistula. The World Health Organization Quality of Life-Brief (WHOQOL-BREF) Version was used to assess quality of life. We computed simple and multiple linear regression analysis to assess factors associated with quality of life and P-value < 0.05 was declared statistically significant. Adjusted unstandardized ß coefficient of multiple linear regressions was used to describe associated factors of quality of life. RESULT: Of 289 women studied, only 12.1% felt satisfied with their general state of health and quality of life. In the physical health domain, the mean quality of life score was 40.78 ± .78. In the psychological domain, the mean quality of life score was 39.96 ± .82. In the social and environmental domain, the mean quality of life score was 32.9 ± .95, 36.45 ± .8, respectively. Duration of incontinence (ß = - 3.8,95% CI(- 6.95, - .62), patients coming for surgical procedure (ß = - 4.4, 95% CI(- 7.64, - 1.2), poor social support(ß = - 6.14, 95%CI (- 8.8, - 3.4), co-morbid anxiety (ß = - 4, 95% CI (- 7,-1.1) and depression (ß = - 9.2, 95% CI (- 12, - 6.4) were negatively associated with physical domain of quality of life. Co-morbid anxiety (ß = - 11,95% CI (- 14.8, - 7.3), employment (ß = 9.1,95% CI (.5, 17.6), number of children(ß = 2.1,95%CI(.8, 3.4), and depression(ß = - 6.3,95%CI(- 9.7, - 2.9) were associated with a psychological domain. Duration of incontinence (ß = - 8.1, 95%CI(- 12.82, - 3.4), poor social support (ß = - 7.8(- 12, - 3.6), patients coming for surgical procedure (ß = - 12, 95%CI (- 17.4, - 6.4) and co-morbid anxiety (ß = - 9.2, 95% CI (- 13.8, 4.5) were negatively associated with social domain of quality of life. Number of children present (ß = 2.4, 95%CI (.82, 3.6), and poor social support (ß = - 5.5, 95%CI (- 9.5, - 1.5) were significantly associated with an environmental domain of quality of life. CONCLUSION AND RECOMMENDATION: Co-morbid depression and anxiety, poor social support, duration of urine incontinence, employment, number of children, and duration of hospital stay were factors significantly associated with domains of QOL. Treating co-morbid depression and anxiety, and social support are necessary to increase women's quality of life. In addition, it is better to have a plane of income generation victims, and awareness creation about early treatment of the problem for community by the concerned body to improve women quality of life.

Help-Seeking Preferences to Informal and Formal Source of Care for Depression: A Community-Based Study in Northwest Ethiopia.

BACKGROUND: Globally, 350 million people are suffering from depression. Many people suffering from depression use different sources of help for their problems. People with different mental health problems seek help from formal and/or informal sources. This gives crucial information on community beliefs and perception regarding their preference for help. This study helps to guide effective planning and provision of mental health services, and health policy of the country to explore the community's preference to different sources of help. OBJECTIVE: The aim was to contrast patterns of formal and informal help-seeking preferences for depression among residents of Aykel town, Northwest Ethiopia. METHODS: This cross-sectional population-based study included 832 participants. We used a major depressive disorder case vignette and general help-seeking questionnaire (GHSQ) to assess preference to seek help. Study participants were selected by multistage cluster sampling technique. An independent sample t-test and analysis of variance test (ANOVA) was performed. RESULTS: A total of 656 subjects (78.8%) showed high propensity to intimate partner, and 655 (78.7%) of the study subjects had high propensity to mental health professional. The mean score of the residents' preference to seek help from informal sources was 3.41±0.60. The mean score of preference to seek help from formal sources was 3.18±0.75. A total of 276 (33.2%) subjects showed high propensity to both informal and formal sources of help. The results also showed there was a mean score difference in preference for informal help between subjects with strong social support and low and moderate social support (P<0.001). CONCLUSION: The result suggests that the majority of the residents had a higher preference to seek help from informal sources than formal sources of care. Providing and strengthening both formal and informal sources of help in conjunction are crucial to get a more qualified and effective care for depressed patients.

Alcohol use disorder and associated factors among University of Gondar undergraduate students: A cross-sectional study.

BACKGROUND: Alcohol use disorder among health science students is a problem throughout the world. Alcohol is accountable for many diseases, injury-related health conditions, poor academic performance, and dropout; and it is the fifth leading risk factor for premature death in the world. Despite this, we know little about the magnitude of alcohol use disorder among health science students in Ethiopia. Assessing alcohol use disorder and associated factors among this population will be paramount for future interventions. OBJECTIVE: To assess alcohol use disorder and associated factors among University of Gondar undergraduate students. METHODS: The research team conducted an institution-based cross-sectional study from April 18 to June 15, 2019. First, the study screened all students in the health science campus for alcohol use. To further study alcohol use disorder, the research team selected 424 students from alcohol users using a simple random sampling method. The team collected data through self-administered questionnaires. The study used an alcohol use disorders identification test to assess alcohol use disorder. The study team conducted bivariate and multivariate logistic regression analyses and used an adjusted odds ratio (AOR) at a 95% confidence interval (CI) to determine the independently associated factors of alcohol use disorder. RESULTS: The overall prevalence of alcohol use disorder among the students was 61.8%. Chewing khat (AOR = 3.26, CI (1.30, 8.15)), male sex (AOR = 1.65, 95 CI (1.02, 2.67)), and having intimate friends who use alcohol (AOR = 1.603, CI (1.03, 2.50)) were significant factors associated with increased alcohol use disorder. Being a 2nd year student (AOR = 0.39, CI (0.17, 0.94)), 3rd year student (AOR = 0.30 CI (0.14, 0.66)), 4th year student (AOR = 0.39, CI (0.18, 0.85)) were significantly associated with decreased alcohol use disorder. CONCLUSION: The prevalence of alcohol use disorder was high among students. Interventions should be made available to students who use alcohol and khat to reduce use-related problems, and thereby improve their health, and functional and social well-being.

Magnitude of internalised stigma and associated factors among people with bipolar disorder at Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia: a cross-sectional study.

OBJECTIVES: To assess the magnitude of internalised stigma and associated factors among patients with bipolar disorder attending the outpatient department of Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia. DESIGN: Institution-based cross-sectional study design. SETTING: Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia. PARTICIPANTS: We recruited about 418 participants using systematic sampling technique for an interview during the study period. MEASUREMENT: Data were collected by face-to-face interviews. Internalized Stigma of Mental Illness scale was used to measure internalised stigma. The Rosenberg Self-Esteem Scale and the Oslo-3 Social Support were instruments used to assess the associated factors. Bivariate and multivariate logistic regressions were performed to identify factors associated with the outcome variable. ORs with 95% CI were computed to determine the level of significance. RESULTS: The magnitude of internalised stigma was 24.9% (95% CI: 21.2% to 28.9%). In the multivariate analysis, unemployed (adjusted OR (AOR)=2.3, 95% CI: 1.0 to 5.0), unable to read and write (AOR=3.3, 95% CI: 1.05 to 10.7), poor social support (AOR=5.3, 95% CI: 1.9 to 15.0), ≥4 previous hospitalisations due to bipolar disorder (AOR=2.6, 95% CI: 1.1 to 6.1) and low self-esteem (AOR=2.4, 95% CI: 1.1 to 5.1) had a significant association with internalised stigma. CONCLUSIONS: One in four patients with bipolar disorder reported high internalised stigma. Unemployment, low educational status, low self-esteem, poor social support and being hospitalised more than three times before were significantly associated with internalised stigma. Thus, a stigma-reduction programme focusing on self-esteem improvement and psychological health of patients to increase their stigma resistance to counteracting effects of internalised stigma is essential.

The prevalence of cardiovascular disease in Ethiopia: a systematic review and meta-analysis of institutional and community-based studies.

BACKGROUND: Worldwide cardiovascular disease is the major cause of disability and premature death. This is due to the ascending trend of consuming an unhealthy diet and obesity which increases the risk of hypertension and type 2 diabetes mellitus. Thus this study aimed to determine the pooled prevalence of the cardiovascular disease in Ethiopia. METHODS: Medline, Scopus, and Google Scholar search engines were accessed using medical subject heading (MeSH) terms for studies based in Ethiopia, from 2000 to 2018. However, studies done among a specific group of the population were excluded from the study. Data were extracted by one reviewer and then checked independently by a second reviewer. Studies were qualitatively synthesis in terms of design, quality, study population, outcomes, and result. Sub-group analysis and sensitivity tests were conducted to identify potential influences on the prevalence estimates. Quantitative results were pooled in a statistical meta-analysis using STATA version 14 software. RESULT: Nine eligible cross-sectional studies were included in the analysis. The prevalence ranges from 1 to 20%. The pooled prevalence of cardiovascular disease (CVD) was 5% (95% CI: 3-8%). The prevalence was higher in the population who visits hospitals, 8% (95% CI: 4-12%) compared to the general population, 2% (95% CI: 1-5%). There was no significant difference in the overall prevalence of CVD between males and females. CONCLUSION: The prevalence of cardiovascular disease was high. A higher prevalence of CVD was found among patients who visited health institutions than the general population and no observed significant sex difference in the prevalence.

Quality of Life and Associated Factors Among Patients with Epilepsy Attending Outpatient Department of Saint Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia, 2019.

BACKGROUND: Epilepsy is strongly associated with an impaired quality of life. Patients suffering from epilepsy have a poorer quality of life than both the general population and many other chronic disease sufferers. However, attention is not given on the quality of life of people with epilepsy other than focusing on symptom reduction. This increases the frequency of seizures, impacts on the ability to perform and increases health-related costs. The aim of this study was to assess quality of life and associated factors among patients with epilepsy attending the outpatient department of Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia. METHODS: An institution-based cross-sectional study design was conducted between May and June 2019 at Amanuel Mental Specialized Hospital. A systematic random sampling technique was used to get a total number of 447 samples. Data on quality of life was assessed through interviews using the World Health Organization Quality of Life-Brief (WHOQOL-BREF) Version. The collected data were coded, entered into EpiData 3.1, and analyzed by using SPSS version 20. Simple and multiple linear regression analysis models were fitted and the unstandardized ß coefficient at 95% confidence interval was employed. The statistical significance was accepted at p-value <0.05. RESULTS: The mean score of quality of life was 61.1±11.6 (95%CI: 59.05, 61.23). Perceived stigma (ß=-2.13, 95%CI:-2.96, -1.30), frequent seizure (ß=-3.16, 95%CI: -4.27, -2.04), AED adherence (ß=1.24, 95%CI: 1.10, 1.30), antiepileptic drug side effect (ß=-0.32, 95%CI: -0.38, -0.26), anxiety (ß-1.91, 95%CI: -2.95, -0.86), depression (ß=-3.59, 95%CI: -4.67, -2.52), poor social support (ß=-2.51, 95%CI: -3.62, -1.40) and moderate social support (ß=-1.60, 95%CI: -2.58, -0.62) were significantly associated factors with quality of life. CONCLUSION: The finding from this study indicated that quality of life of patients with epilepsy were moderate. Perceived stigma, frequent seizure, comorbid depression and anxiety, antiepileptic drug nonadherence, antiepileptic drug side effect and poor social support were the predictors of quality of life.