Complication experience during pregnancy and place of delivery among pregnant women: a cross-sectional study.

BACKGROUND: Unlike other causes such as abortion, obstetric complications like hemorrhage, and hypertensive disorders of pregnancy, which are difficult to resolve for women who give birth out of health facilities are persisted or increased to be the cause of maternal mortality in Ethiopia. Direct obstetric complications resulted in the crude direct obstetric case fatality rate in this country. This study aimed to assess the relationship between Complication Experience during Pregnancy and Place of Delivery among Pregnant Women. METHOD: A community-based cross-sectional study was conducted to assess the baseline information as a part of a randomized control trial study. The sample size that was calculated for the cohort study with the assumptions to detect an increase in a minimum acceptable diet from 11 to 31%, with 95% CIs and 80% power, an intra-cluster correlation coefficient of 0·2 for a cluster size of 10 was used for this study. Statistical analysis was done using SPSS version 22. RESULT: The prevalence of self-reported pregnancy-related complications and home delivery were 79(15.9%, CI; 12.7-19.1) and 46.90% (95%CI; 42.5-51.1) respectively. Women who did not face vaginal bleeding were five times AOR 5.28(95% CI: 1.79-15.56) more like to give birth at home than those who faced this problem. Women who did not face severe headache were nearly three AOR 2.45(95%CI:1.01-5.97) times more like to give birth at home. CONCLUSION: This study concluded that home delivery was high among the study participants whereas pregnancy-related complications such as vaginal bleeding and severe headache were identified as protective factors for facility delivery. Hence, the researchers recommended the incorporation of "storytelling" into the existing health extension program packages to improve facility delivery which shall be applied after the approval of its effectiveness by further research.

Dietary self-care and associated factors among diabetic patients in Jimma University Medical Centre, South West Ethiopia; A path analysis.

BACKGROUND: Diabetes Mellitus (DM), a chronic metabolic disorder that caused about 4.2 million deaths and at least 760 billion dollars' expenditure in 2019, has been targeted for action by leaders of WHO member countries. In Ethiopia deaths, due to DM reached 34,262 in 2013. Studies show effective lifestyle interventions; particularly medical nutrition therapy reduces HbA1c by 0.5 to 2%. However, practicing recommended diet is reported to be difficult. Not only Knowledge and practice but also perception studies are therefore necessary to design future health programs. OBJECTIVE: To assess diabetic self-care, dietary practice and associated factors among diabetes patients. METHOD: Institution-basedbased cross-sectional study design was employed from february15-May15, 2020 in Jimma university medical Centre (JUMC). Systematic sampling of every other patient (K = 2.7) was employed to interview 371 participants. A previously validated tool was used to collect data through a face-to-face interview. A path analysis was used to fit the structural model and tests the hypothesized Health Belief Model (HBM) relationships. RESULT: Response rate was 95.4% (354). Around 52% of the participants were male and 76.8% follow diabetic education at least some times. 42.4% and 48% of respondents have good dietary and general self-care practices respectively. With unstandardized coefficient (standard error) self-efficacy0.10 (0.01) being the strongest cues to action0.10 (0.02), perceived threat0.02 (0.01), and perceived barrier-0.08(0.01) constructs of HBM have a significant effect on dietary practice. Knowledge, social support and diabetes distress exert a significant indirect effect on dietary practice through health belief constructs with unstandardized path coefficient (standard error) of 0.22(0.03), 0.02(0.01), and -0.03(0.004) respectively. CONCLUSION: In this study, the proportion of good practice is found to be lower for both dietary as well as general self-care. HBM can best fit to explain variability in dietary self-care practice; therefore, future interventions should be designed to address the vast perception and psychosocial factors influencing dietary self-care practices.

Central obesity and its predictors among adults in Nekemte town, West Ethiopia.

BACKGROUND: Abdominal obesity is emerging as a major contributor to the worsening of non-communicable diseases. There is a dearth of data on central obesity among adults in Ethiopia in general and in the study area in particular. The aim of this research was to determine the prevalence of central obesity and its predictors among adults in Nekemte, Ethiopia. METHODS: Community-based cross-sectional study was conducted in Nekemte town from March to April 2020. Multistage sampling technique was used to select 466 study participants. Interviewer-administered structured questionnaire was used for data collection. The data were entered into Epi Data 3.1 and analyzed by SPSS Version 25. Bivariate logistic regression analysis was used to identify candidate variables at p < 0.25. Finally, multivariable logistic regression analysis was used to identify the independent predictors of central obesity at p < 0.05 with 95% confidence intervals. RESULTS: Prevalence of central obesity in this study was found to be 28.4% (95% CI 24.5-32.6). Where, the prevalence was higher among females (37%) than males (18%). Being a female (AOR = 5.59, 95% CI 2.95-10.57), age range of 40-49 years (AOR = 4.91, 95% CI 2.17-11.13), ⩾ 50 years (AOR = 8.16, 95% CI 3.21-20.72), being in marriage (AOR = 9.306, 95% CI 4.23-20.44), highest wealth status (AOR = 7.94, 95% CI 3.76-16.76), consumption of fast foods (AOR = 3.022, 95% CI 1.375-6.64), and lack of knowledge about obesity (AOR = 3.39, 95% CI 1.93-5.95) were factors associated with central obesity. CONCLUSION: The study revealed a moderate prevalence of central obesity in the study area. Being a female, older age, being in marriage, richest household wealth status, consumption of fast foods, and lack of knowledge on obesity were identified as factors associated with central obesity. Comprehensive health education and promotion on healthy diet should be encouraged focusing on females, married individuals, and older ages.

Factors associated with depression among prisoners in Mizan prison institute, southwest Ethiopia.

PURPOSE: In spite of the vulnerability of prisoners to depression and their increased number, the issue has not been thoroughly investigated in Ethiopia. In particular, the determining factors of depression have not been exhaustively identified. Thus, the purpose of this study is to assess the prevalence of depression and associated factors among prisoners in Mizan prison institute, southwest Ethiopia. DESIGN/METHODOLOGY/APPROACH: An institution-based cross-sectional study was conducted from April 6-27, 2020. A total of 340 randomly selected prisoners were included. Depression was assessed using the Patient Health Questionnaire-nine and participants were considered to be in a state of depression if they scored five and above. Binary logistic regression was used to assess the association between the outcome variable (depression) and the independent variables (factors). The odds ratio with a 95% confidence interval (CI) was used to measure the strength of association. The final significance was decided using a p-value < 0.05. FINDINGS: The prevalence of depression was 29.9% (95% CI: 25%, 34.8%). Prisoners whowere not participating in the duty work of the prison had 55% (adjusted odds ratio [AOR] = 0.45; 95% CI: 0.22, 0.93) less odds of depression compared to those who were participating in the duty work. Similarly, physically active respondents had 81% (AOR = 0.19; 95% CI: 0.10, 0.35) less odds of depression than physically inactive respondents. Moreover, undernourished participants had two times (AOR = 2.03; 95% CI: 1.08, 3.82) higher odds of depression than normal participants. RESEARCH LIMITATIONS/IMPLICATIONS: Considering their risk of exposure compared to the general population and the limitations of cross-sectional study design, special care should be provided to the prisoners' mental health. Moreover, priority attention should be given to the undernourished, physically inactive and those who are participating in duty work in the prison. ORIGINALITY/VALUE: This study demonstrated important and modifiable factors associated with prisoners' depression. It also evaluated the contribution of new variables (such as participation in the duty work, nutritional status and physical activity) that were not considered in previous local studies.

Undernutrition and associated factors among incarcerated people in Mizan prison institute, southwest Ethiopia.

BACKGROUND: In resource-limited countries like Ethiopia, where malnutrition is a common problem, incarcerated people's sentences might be changed into a death sentence if the problems of undernutrition are not well understood and managed properly. There is limited evidence on nutritional status and associated factors among incarcerated people in low- income countries like Ethiopia, including the study area. OBJECTIVE: To assess the magnitude of undernutrition and associated factors among incarcerated people in Mizan prison institute, southwest Ethiopia. METHODS: An institution based cross-sectional study was conducted among 340 incarcerated people in Mizan prison institute from April 1 to 27, 2020, using a stratified sampling technique. An interviewer-administered structured questionnaire was used to collect data. The outcome variable (undernutrition) was assessed by measuring body mass index (BMI). Binary logistic regression was used to identify factors associated with undernutrition. Adjusted odds ratio (AOR) and 95% confidence intervals (CI) were used to measure the strength of association and a p-value less than 0.05 was used to declare the level of statistical significance. RESULTS: The magnitude of undernutrition was 18.6% (95%CI: 14.4%, 22.8%). Being in the age category of 18-29 years (AOR = 2.60; 95%CI: 1.22,5.52), history of previous incarceration (AOR = 2.31;95%CI: 1.23,4.34), duration of imprisonment (AOR = 1.19; 95%CI: 1.05,1.34), having depression (AOR = 2.1; 95% CI: 1.10,3.97) and sleeping in group (AOR = 2.17; 95% CI: 1.18,4.01) were factors significantly associated with an increased odds of undernutrition. However, the presence of family support significantly decreased (AOR = 0.29; 95%CI: 0.12, 0.69) the odds of undernutrition. CONCLUSION: The magnitude of undernutrition in the prison was found to be comparable to that of the general population in Ethiopia. The efforts on the ground to tackle undernutrition in the general population shall be extended to incarcerated people, especially by focusing on vulnerable groups such as those who had longer durations of incarceration, history of previous imprisonment, depression and no support.

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.

Sexual Assault Profile in Jimma University Medical Center, Southwest Ethiopia.

BACKGROUND: Sexual assault cases are increasingly reported in Ethiopia and worldwide. However, in Ethiopia, sexual assaults' profile was not investigated well, regardless of its social, physical, and psychological impacts on survivors. Hence, this study assessed the survivors' characteristics, circumstances of the victims, and treatment offered with the view of describing the management process, and service responsiveness. METHODS: A descriptive study with 3 years retrospective chart review was conducted in Jimma University Medical Center (JUMC). Samples of 187 charts/medical records were selected using a systematic random sampling technique from the medical unit. The selected survivors' records were reviewed using a structured checklist. Data were analyzed using SPSS Version 21.0. RESULTS: Out of the 187 cases of sexual assaults during the study period, 67.4% were rape cases. Among these, 58.8% were below 14 years, and 85.6% knew their assailants. Above 30% of the victims were assaulted during the daytime, and 51.9% developed perennial laceration. Threat and physical force were mostly used to coerce victims during the violence. All of the survivors were not investigated for vaginal/anal swab (for sperm analysis), and 96.8% of the victims were not tested for HIV screening. Only 8% of the victims received emergency contraception. CONCLUSION AND RECOMMENDATION: Children and adolescents remain the most sexually assaulted group of the population, requiring protection and appropriate medical services to ensure their well-being and reduce their suffering. Appropriate and timely intervention is needed to care for such survivors. The findings have highlighted the need for closer monitoring and better follow-up of the care and support provided in the Medical Center to sexual assault victims.