Knowledge, Attitude, Practice, and Associated Factors of Implant Use in Women, Ethiopia.

Background: The world is in a dramatic expansion of population that resulted from the continued high birth rates in developing countries. At present, only a handful of countries have reduced fertility rates. That is enough to make gains as a result of reduced fertility or to ensure that their population will stabilize unforeseeable future. Ethiopia is the second largest country by population in Africa, but contraceptive use in Ethiopia is still low. Objective: The main objective of the study was to assess knowledge, attitude, and practice and associated factors towards implant use among married reproductive age group women. Method: An institutional-based cross-sectional study design was used to collect the data from 272 married reproductive age group women attending the family planning clinic at Ejere Health Center from October 9, 2021 to November 24, 2021. A systematic random sampling technique was used to select and approach the study subjects. The collected data was analyzed using SPSS window version 21, and bi variable, multivariable logistic regression was used to test the association between independent and dependent variables. A P value of less than 0.05 and 95% CI was considered to be statistically significant. Finally, the result was presented using tables and graphs. Result: The finding shows that most of the respondents know implant (87.6%). Concerning the practice of implants, the overall prevalence of implants was 51 (20.6%), and in attitude towards implant utilization among study clients, most of them wrongly believed that using implant can result in irregular uterine bleeding and cause pain during insertion and removal. Mothers who attended primary school 2.580 times (AOR = 2.580, 95% CI: 1.255-5.305, P value =0.01) had more positive attitudes than those who could not read and write. Mothers having positive attitude were 2.066 times (AOR = 2.066, 95% CI: 1.185-3.600, P value =0.01) knowledgeable about implant than those with negative attitudes. Conclusion: Even if most of the respondents were knowledgeable, practice and attitude towards implant utilization were low. To overcome this gap, we recommended adequate early counseling, on possible side effects, and creating awareness on implant contraceptive services and refresher courses for health workers regarding implant contraception should be given regularly regarding reproductive issues.

Institutional delivery knowledge, attitude, and practice among mothers of childbearing age with one or more children, Ethiopia.

Background: Institutional delivery is Giving birth in medical institution under the care and Supervision of trained health care providers which promotes newborn survival and reduces maternal mortality. The objective of the study was to assess Knowledge, Attitude and Practice towards institutional delivery among mothers of child bearing age who have one or more child and visit MCH clinic Adaba health center, West Arsi zone, South East Ethiopia. Methods: Institutional based cross sectional study design was conducted. The study was conducted starting from May 1-30, 2021 at Adaba health center, West Arsi zone, South East Ethiopia. Our study sample size is 250 mothers who have at least one birth and visiting MCH at Adaba health center. Systematic random sampling was used to select mothers, Data was collected by using structured questionnaire. Finally, data was analyzed by SPSS version 21. Results: Out of 250 women during our data collection time 246 (98.4%) were our respondents and 4 (1.6%) were non respondents. Among 246 women 213 (86.6%) had good knowledge and 33 (13.4%) had poor knowledge. While 212 (86.2%) had good attitude and 34(13.8%) had poor attitude and 179 (72.8%) had good practice but 67 (27.2%) had poor practice. Conclusion: Increasing knowledge, attitude and practice of mothers towards institutional delivery plays a key role in reducing maternal mortality and morbidity. However, the prevailing level of KAP towards institutional delivery is not satisfactory. Increasing utilization of institutional delivery by increasing awareness of each community through health information dissemination on importance of institutional delivery is needed.

Genetic Polymorphism of Tumor Necrosis Factor-Alpha, Interferon-Gamma and Interleukin-10 and Association With Risk of Mycobacterium Tuberculosis Infection.

BACKGROUND: Mycobacterium tuberculosis has become the leading cause of morbidity and death in humans worldwide. Thus, genetic variability of the host plays a major role in human susceptibility to the pathogen, among others. Therefore, the objective of this finding was to assess the association of genetic polymorphisms of cytokines with tuberculosis infection. METHOD: A cross-sectional study was conducted between January and May 2018. Five ml of whole blood was collected and extracted the genomic DNA through simple salting out method. The patterns of genetic polymorphism were determined by amplification refractory method PCR using specific primers. Finally, the PCR run on electrophoresis of agarose gel and the band was visualized under UV light. A logistical regression model has been adapted to assess the association of genetic polymorphisms with tubercular infection. In order to determine the association between the explanatory and outcome variable, the odds ratio with 95% CI was calculated. P < 0.05 is a statistically significant value. RESULT: In present study, the frequency of TNF-α -308 G allele and GG genotype OR (95% CI)= 0.20 (0.11-0.37), and OR (95% CI)= 0.29 (0.18-0.46)), respectively) and IFN-γ +874 A allele and AA genotype OR (95% CI)= 3.80 (2.11-6.86) and (OR (95% CI)= 1.61(1.13-2.28), respectively) were significantly associated with tuberculosis incidence. In contrast, there is no significant correlation between IL-10 -1082 A and AA of allele and genotype, respectively in tuberculosis patients (p > 0.05) was evident. CONCLUSION: From our finding, the genetic variability of TNF-α -308 A and IFN-γ +874 alleles are the potent host genetic risk factors associated with tuberculosis infection.

Whole Blood Stimulation Assay as a Treatment Outcome Monitoring Tool for VL Patients in Ethiopia: A Pilot Evaluation.

Visceral leishmaniasis (VL) is a lethal disease if left untreated. Current treatments produce variable rates of treatment failure and toxicity without sterile cure, rendering treatment efficacy monitoring essential. To avoid repeated invasive tissue aspirates as well as empirical treatment, there is a need for new tools that allow a less-invasive and early assessment of treatment efficacy in the field. Cross-sectional studies have suggested levels of cytokines/chemokines after whole blood stimulation as good markers of cure, but longitudinal studies are lacking. In this study, we followed 13 active VL cases in an endemic area in Ethiopia by measuring the production of IFN-γ, TNF-α, IP-10, IL-2, IL-10, MCP-1, and MIG before, during, and at the end of treatment. After 24 hours of stimulation of whole blood with soluble Leishmania antigen, we observed an early, robust, and incremental increase of IFN-γ, TNF-α, and IP-10 levels in all patients during treatment. Moreover, based on the IFN-γ levels that showed an average 13-fold increase from the time of diagnosis until the end of treatment, we could almost perfectly discriminate active from cured status. Similar concentrations and patterns were found in stimulation assays with the two main Leishmania species. The levels of IFN-γ, IP-10, or TNF-α also seemed to be inversely associated with the parasite load at baseline. Despite a 1/10 drop in concentrations, similar patterns were observed in IFN-γ and IP-10 levels when dried plasma spots were stored at 4°C for an average of 225 days. All the above evidence suggests a detectable restoration of cell-mediated immunity in VL and its association with parasite clearance. With a potential application in rural settings by means of dried plasma spots, we recommend to further explore the early diagnostic value of such assays for treatment efficacy monitoring in large cohort studies including treatment failure cases.