Self-care practice and associated factors among epileptic patients: a cross-sectional study, Ethiopia.

Introduction: epilepsy results in multidimensional and long term effect on the patients and society. Self-care practice is critical for epileptic patient. So far, the issue of self-care practice still considered as the most important cause of poorly controlled epilepsy. Yet comprehensive epilepsy self-care practice is not recognized, which is not addressed with medical treatment alone has not been studied particular in Ethiopia. The objective was to assess self-care practice and associated factors among epileptic patients on follow up at Jimma Town public hospitals, 2020. Methods: institution based cross-sectional study was conducted from April 08 - May 20/2020. Data was collected using structured interviewer administered questionnaire and data extraction checklist. Simple random sampling technique was used to select a total of 297 study participants. Data was entered to EPI data version 3.5.3 and exported to SPSS version 23.0 for analysis. Variables with p-value < 0.25 on bivariate analysis were candidated for multivariate analyses. Factors with p value < 0.05 on multivariate analyses were considered as statistically significant. Results: a total of 297 study participants were included in the study giving a response rate of 99.0%. Of study participants 146(49.2%) of them were had good self-care practice. Residence (AOR= 1.712, 95%CI: 1.034-2.836, P- 0.037), Seizure frequency (AOR = 0.288, 95% CI: 0.091-0.907, P-0.034), felt stigma (AOR=0.565, 95%CI: 0.342-0.935, P- 0.026) and medication adherence (AOR=0.391, 95%CI: 0.240-0.638, P-0.000) were significantly associated with self-management practice. Conclusion: this study found that half of the study participants were had poor self-care practice. Residence, felt stigma, increased seizure frequency and not adherence to medication were factors contributed for poor self-care practice. Therefore, intervention strategies focused on contributing factor for poor self-care practice should be considered.

Immediate postpartum intrauterine contraceptive device use among pregnant women attending antenatal clinics in Jimma town public healthcare facilities, Ethiopia: Intentions and barriers.

Objective: This study aimed to assess the intention and barriers to the use of immediate postpartum intrauterine contraceptive devices among pregnant women attending antenatal clinics in Jimma town public healthcare facilities, southwest Ethiopia. Methods: A facility-based cross-sectional study design was conducted from 1 September to 30 October 2020 by using a systematic sampling technique. Data were entered into Epi-data 3.1 version and exported to Statistical Package for Social Sciences 23 for analysis. A binary logistic regression analysis was done to sort candidate variables for multiple logistic regression, and multivariable logistic regressions were done to identify factors associated with the intention to postpartum intrauterine contraceptive devices. Factors associated with intention to use immediate postpartum intrauterine contraceptive device declared at 95% confidence interval. Results: This study finding showed that 37.6% (95% confidence interval (31.5, 43.7)) of pregnant women intended to use the immediate postpartum intrauterine contraceptive device after their delivery. The main reason women refused to use immediate postpartum intrauterine contraceptive devices was being satisfied with other methods to use after they gave birth (27.5 %), the concern of health harm (22.2%), and the fear of impaired future fertility (16.4%). The identified factors that were statically significant with the intention to use immediate postpartum intrauterine contraceptive devices among pregnant women were included: attended secondary education (adjusted odd ratio = 2.36; p = 0.03; 95% confidence interval (1.089, 5.128)), attended college and above (adjusted odd ratio = 2.99; p = 0.020; 95% confidence interval (1.189, 7.541)), have high knowledge on immediate postpartum intrauterine contraceptive devices ((adjusted odd ratio = 2.10; p = 0.006; 95% confidence interval (1.236, 3.564)), the previous history of LACM used (adjusted odd ratio = 6.85; p = 0.0001; 95% confidence interval (3.560, 10.021)), parity >4 (adjusted odd ratio = 1.86; p = 0.043; 95% confidence interval (3.99, 8.703)). Conclusion: The intention of pregnant women to use after they gave birth in the study area was low. Maternal educational level, high knowledge, history of previous long-acting contraceptive methods use, and parity were significantly associated with pregnant women's intention to use immediate postpartum intrauterine contraceptive devices. Healthcare providers should focus on delivering crucial information about immediate postpartum intrauterine contraceptive device benefits for postpartum women, particularly concerning reducing barriers during antenatal care follow-up as they plan to use it after their delivery.

Chronic Kidney Disease and Associated Factors among Diabetic Patients at the Diabetic Clinic in a Police Hospital, Addis Ababa.

Background: Diabetes mellitus remains the leading cause of end-stage renal disease in most countries in the world. In Ethiopia, renal complications of diabetes may remain unrecognized due to limited diagnostic resources. As a result, the prevalence of chronic kidney disease among adult diabetics in Ethiopia has not been well described. Hence, this study was aimed at assessing the prevalence of chronic kidney disease and associated factors among diabetic patients who attended the federal police hospital diabetic clinic in Addis Ababa. Methods: A cross-sectional study was conducted among 362 Diabetes Mellitus. Data were collected using face-to-face interviewing questionnaires and analyzed using SPSS version 21.0. Binary logistic regression analyses were performed to identify predictors. Results: The prevalence of chronic kidney disease diagnosed by Cockcroft-Gault equation and Modification of Diet in Renal Disease equation was 14.6% and 7.7% respectively. This finding shows the prevalence of chronic kidney disease among Diabetic patients was low. Age 50-59 years [(AOR= 4.0; 95% CI:(1.2, 13)] by Cockroft-Gault equation (CG), age 60-69 years [(AOR=5.8 95% CI:(1.5,21.0)] by Modification of Diet in Renal Disease (MDRD) and (AOR;22.9 95%CI:7.1,74.2) by CG, age 70 years and above (AOR=4.7; 95 CI: 1.1, 19.7) by MDRD and (AOR= 22.9; 95%CI:7.1,74.2) by CG, BMI (AOR=0.2; 95% CI:0.1,0.4) by CG, and previous kidney disease (AOR=6.2 95%CI:2.0,8.4) by MDRD and (AOR;4.6 95%CI:1.9,10.8) C-G equation have a significant association with chronic kidney disease after an adjustment done. Conclusion: The prevalence of chronic kidney disease among Diabetic patients in this study was lower. Age, BMI, and previous recurrent kidney disease were associated with chronic kidney disease. Preventive measures like giving health education and screening of patients with risk factors should get more attention.

Unmet Need for Family Planning Service and Associated Factors Among Homeless Women of Reproductive Age Group in Jimma Zone Administrative Towns, Ethiopia.

Background: The majority of homeless women (75%) do not wish to have or delay a pregnancy during this difficult time, yet many do not use contraception in developing countries. In Ethiopia, there is limited evidence of unmet need for family planning in settings where homelessness is on the increase. This study aims to assess the unmet need for family planning services among homeless women and identify associated factors in Jimma Town, southwestern, Ethiopia. Methods: A community-based cross-sectional study was conducted on May 3rd and 4th, 2021. The complete enumeration was done to include 206 homeless women. Epidata version 3.1 data entry and exported to SPSS version 20 were used for analysis. Bivariate and multivariable logistic regressions were used to identify factors associated with the unmet need for family planning. Associated factors were determined by a 95% confidence interval of AOR and P-value <0.05 in the multivariable model. Results: The unmet need for family planning among homeless women was 47.3% [95% CI (38.2, 49.7)]. Being with a disability; [(AOR: 4.10, 95% CI (1.73-9.56), visited by a health care provider in the last 12 months; [(AOR: 0.25, CI (0.09-0.65)], and a number of living children; [(AOR: 0.42, CI (0.18-96)] were significantly associated with an unmet need for family planning. Conclusion: The unmet need for family planning methods among homeless women was high compared to the national standard of unmet need for family planning, being with a physical disability, visited by a health care provider in the last twelve months, and having a number of living children contributed to the unmet need for family planning. Therefore, health care professionals should focus on providing health education on family planning among these women at the grass-root level to reduce the unmet need for family planning among these women.

Home-based management practice of diarrhea in under 5 years old children and associated factors among caregivers in Ginchi town, Oromia region, west Ethiopia.

Objective: The study was aimed to assess the home-based management practice of diarrhea and associated factors among caregivers in children under 5 years old at Ginchi town, Oromia region, West Ethiopia. Methods: A community-based cross-sectional study was conducted among 335 caregivers in Ginchi town. Data were collected using face-to-face interviewing questionnaires by using a systematic sampling technique. Data were entered into Epi-data version 3.5.1 and exported to statically software package for social science version 23.0 for analysis. Descriptive analyses were carried out. Bivariable and multivariable logistic regressions were done to identify predictors of home-based management practice of diarrhea in children under 5 years old. Result: The study had a total of 326 participants, with a 97.3% response rate. Accordingly, 193 (59%) have a good home-based management practice of diarrhea in children under the age of 5 years. Attended elementary school (adjusted odds ratio (95% confidence interval), 0.17 (0.06, 0.47)), high school education (adjusted odds ratio (95% confidence interval), 0.04 (0.013, 0.126)), monthly income in second class (adjusted odds ratio (95% confidence interval), 0.19 (0.04, 0.94)), and being mother in child relationship (adjusted odds ratio (95% confidence interval), 1.27 (1.4, 4.20)) were the identified predictors of home-based management practice of diarrhea in children under 5 years old. Conclusion: More than half of the respondents have a good home-based management practice of diarrhea in children under 5 years old. Caregivers' educational status, being mothers of the child, and monthly income were the identified predictors. As a result, health education and awareness programs for caregivers on diarrhea control, proper use of oral rehydration solution, home-based fluid preparation, and diarrhea prevention are critical.

A Quantitative Study on Stigma and Statistically Correlated Factors Among Women Living with Genital Fistula in Oromia Region, Ethiopia. Identification of Urgent Corrective Strategies.

BACKGROUND: Two-to-three million women worldwide live with a genital fistula, with Asian and sub-Saharan African countries including Ethiopia accounting for the greatest percentage. Genital fistula is a devastating health problem due to the stigma associated with constant incontinence and bad-odor. Thus, this study aimed to determine the magnitude of the stigma towards women living with genital fistula in Oromia region, Ethiopia, and to highlight the factors associated with it, identifying potential strategies for corrective interventions. METHODS: This quantitative study was conducted among 422 women living with genital fistula in five fistula treatment centers of Oromia region using a cross-sectional study design from August 30, 2019 to February 28, 2020. Data were collected by face-to-face interview using a structured questionnaire, entered into Epi-data version 4.2, and analyzed by SPSS version 23. Bivariate and multivariable logistic regression analysis was done. P-value <0.05 was used to ascertain statistical significance with an adjusted odds ratio at 95% confidence interval (CI). The results were presented by text and tables. RESULTS: The response rate for this study was 100%. The magnitude of perceived high stigma related to genital fistula was 178 (42.2%). The factors associated with it were the respondents' father's educational level of being able to write and read compared to unknown fathers' educational level (AOR=0.09; 95% CI=0.03-0.34), and duration of living with a genital fistula of less than 2 years compared to living with a genital fistula for 5 years or more (AOR=0.52; 95% CI=0.31-0.86). CONCLUSION: The perceived level of stigma among women living with a genital fistula in Oromia region was significantly high. To reduce the perceived level of stigma and therefore to prevent the severe negative consequences of it, fathers, but also mothers, husbands, family members, and all the persons close to women living with genital fistulas should provide care and psychological support and all the necessary means to strongly encourage them to seek health care quickly, and to make them feel that they are beloved, and that there is hope for a healthy life in their near future.

Extent of Home Delivery among Women Who Gave Birth in the Last One Year in Serbo, Kersa Woreda, Jimma Zone, Oromia Region, Southwest Ethiopia.

BACKGROUND: Home delivery is childbirth in a nonclinical setting that takes place in a residence rather than in a health institution. Maternal morbidity and mortality are global health challenges, and developing countries contribute to most of the maternal deaths. OBJECTIVE: This study aimed to assess the extent and associated factors for home delivery in Serbo, Kersa Woreda, Jimma Zone, Southwest Ethiopia. METHOD: A community-based cross-sectional study was employed among the 240 study participants. Data were collected by using systematic sampling technique from July 5 to 26, 2021, via a pretested semistructured questionnaire through face-to-face interview, and analyzed by a statistical package for the social sciences version 23.0. Bivariable and multivariable logistic regression analyses were carried out to identify factors associated with the extent of home delivery, and factors associated with the extent of home delivery were declared at a p value <0.05. RESULT: In this study, the extent of home delivery was 28.7%. Identified factors statically associated with home delivery were low monthly income (AOR = 16.7, 95% CI: (2.028-13,83)), only the husband as the decision-maker (AOR = 5.0, 95% CI: (1.252-20.021)), never had a history of ANC follow-up (AOR = 5.7, 95% CI: (2.358-16.3)), poor knowledge toward delivery service (AOR = 3.0, 95% CI: (1.661-5.393)), negative attitude toward delivery service (AOR = 2.2, 95% CI: (1.054-4.409)), and large family size (AOR = 2.2, 95% CI: (1.187-4,119)). CONCLUSION: When compared to the Ethiopian Demographic and Health Survey 2016, the prevalence of home delivery among women who gave birth in the last one year was low in this study. The study participants' identified factors that were significantly linked with home delivery were low monthly income, only husband as decision maker, no ANC follow-up, poor knowledge of delivery services, negative attitude toward delivery services, and large family size. Health professionals and health extension workers should raise awareness about institutional delivery and birth readiness so that women can give birth at a health facility even if labor begins unexpectedly.

Utilization of non-pneumatic anti-shock garment and associated factors for postpartum hemorrhage management among health care professionals' in public hospitals of Jimma zone, south-West Ethiopia, 2019.

BACKGROUND: Non- pneumatic anti-shock garment is a unique, life -saving first -aid device made of neoprene and velcro, which is used for treatment of women with postpartum hemorrhage. Maternal mortality in the world still very high and postpartum hemorrhage is the leading cause of maternal mortality worldwide. OBJECTIVE: This study was aimed to assess the utilization of non-pneumatic anti-shock garment and associated factors for postpartum hemorrhage management. METHODS: Facility based cross-sectional studies design both quantitative and qualitative data collection methods were employed among 210 health care professionals and 10 key informants respectively. Bivariable and multivariable logistic regression was done to identify factors associated with non-pneumatic anti-shock garment utilization. Qualitative data was transcribed, translated and triangulated with quantitative findings. RESULTS: Seventy six (36.2%) of the respondents used non-pneumatic anti-shock garment in their hospitals for management of post-partum hemorrhage. Having good knowledge [(AOR = 3.96, 95% CI: (1.67, 9.407)], having positive attitude [(AOR = 3.54, 95% CI: (1.37, 9.13)], attending training [AOR = 13.156, 95% CI: (4.81, 36.00], having two and above non-pneumatic anti-shock garment at their hospitals [AOR = 8.7, 95% CI: (2.89, 26.20)] were significantly associated with utilization of non-pneumatic anti-shock garment. … "I didn't use non-pneumatic anti-shock garment for the management of postpartum hemorrhage complication before because I have no training and experience how to use it." CONCLUSION: The utilization of non-pneumatic anti-shock garment for the management of postpartum hemorrhage was low. Having positive attitude, having good knowledge and training on non-pneumatic anti-shock garment were statically associated with its use. The health care professionals that involved in the maternity service should be trained on how to use this important garment in the management of postpartum hemorrhage.