Suicidal ideation, attempt and associated factors among prisoners in Northwest Ethiopia: A cross-sectional study.

BACKGROUND: Suicide is a prominent source of harm and death globally, and it is the leading cause of premature death among prisoners. Therefore, the main aim of this study was to determine the prevalence and factors associated with suicidal ideation and attempt among prisoners in Northwest Ethiopia. METHODS: An institution-based cross-sectional study design was performed from May 23 to June 22, 2022. After proportional allocation to the three correctional institutions, a total of 788 study participants were randomly recruited. The World Health Organization Composite International Diagnostic Interview (CIDI) was used to evaluate suicide ideation and attempt. To determine factors associated with suicidal ideation and attempt, multivariate logistic regression analyses were conducted. At a 95% confidence interval (CI) of P-value <0.05, statistical significance was declared. RESULTS: The prevalence of suicidal ideation and attempt among prisoners was 23.6% and 10.7%, with 95% CI (20.76, 26.70) and (8.68, 13.02), respectively. Female sex (AOR = 2.38, 95% CI: 1.12, 5.05), family history of mental illness (AOR = 3.09, 95% CI: 1.93, 4.88), depression (AOR = 2.04, 95% CI: 1.43, 2.98), poor social support (AOR = 2.76, 95% CI: 1.56, 4.85) and previous incarceration (AOR = 1.84, 95% CI: 1.18, 2.86) were significantly associated with suicidal ideation. However, being single (AOR = 2.58, 95% CI: 1.47, 4.54), family history of suicide (AOR = 2.43, 95% CI: 1.18, 5.01), depression (AOR = 2.62, 95% CI: 1.59, 4.31) and previous imprisonments (AOR = 2.11, 95% CI: 1.20, 3.69) were associated with suicidal attempt. CONCLUSIONS: The prevalence of suicidal ideation and attempt among prisoners were found to be high. Therefore, the findings of this study recommend that early detection and design of prison mental health services should be delivered to develop mental health care, prevention, and intervention programs for incarcerated people to improve suicidal behavior in prison.

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.

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

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. CONCLUSION: The results suggest that the mean score of adherences to antiepileptic drugs was poor as compared to other settings. Antiepileptic medication adherence screening tool should be included in the patient's treatment protocol

Suicide ideation, attempt, and determinants among medical students Northwest Ethiopia: an institution-based cross-sectional study.

BACKGROUND: Suicide ideation and attempt are more highly prevalent among medical students compared to the general population. Suicidal thought negatively impacts the quality of life, physical, and mental well-being of the students. However, research into suicide ideation and attempt among medical students in low- and middle-income countries is limited. Therefore, this study aimed to explore suicide ideation and attempt and their determinants among medical students in Ethiopia have a crucial role for further intervention. METHODS: An institution-based cross-sectional study was conducted on 393 medical students from March to June 2019 at the University of Gondar (UoG) in Ethiopia. Simple random sampling technique was used to select study participants. Suicide ideation and attempt were assessed using the World Health Organization Composite International Diagnostic Interview (CIDI) to assess lifetime suicide ideation and attempts during medical school. Data were collected using a self-administered questionnaire. Binary logistic regression analyses were used to identify factors associated with suicide ideation and attempt. An odds ratio (OR) with a 95% confidence interval (CI) was computed to assess the strength of the association. RESULTS: A total of 393 participants took part with a response rate of 92.9%. The prevalence of suicide ideation and attempt among study participants was found to be 14% and 7.4%, respectively, with 95% CI (10.9-18.1) and (5.1-10.2). Being female (AOR: 5.21, 95% CI 3.42-7.20), co-morbid depression symptoms (AOR: 10.12, 95% CI 6.80-15.52), current khat chewing (AOR: 4.46, 95% CI 3.32-10.02), and poor social support (AOR: 4.46, 95% CI 3.43-9.87) were factors significantly associated with suicide ideation; whereas, female sex (AOR: 8.08, 95% CI 6.04-12.39), depression (AOR: 10.66, 95% CI 8.01-19.01) and history of mental illness (AOR: 5.53, 95% CI 5.20-15.50) were factors significantly associated with suicide attempt. CONCLUSIONS: In the current study, the prevalence of suicide ideation among medical students was low compared to other studies, but the suicide attempt was high. Ministry of Health should develop a guideline on how to screen and manage suicide ideation and attempt among medical students.