Determinants of mortality among pediatric patients admitted to Wolaita Sodo University Comprehensive Specialized Hospital with acute bacterial meningitis, Southern Ethiopia: an unmatched case-control study.

BACKGROUND: People of all ages suffer from acute bacterial meningitis, but children are the most vulnerable, accounting for over 50% of all cases and deaths in children under the age of five. It is the leading cause of morbidity, mortality, and long-term suffering worldwide. Children are at great risk of disease and mortality due to a lack of specific immunity associated with their young age. As a result, determinants of death were found among pediatric patients treated with acute bacterial meningitis at Wolaita Sodo University Comprehensive Specialized Hospital in Southern Ethiopia. METHODS: A facility-based unmatched case-control study was conducted on pediatric patients admitted with acute bacterial meningitis at Wolaita Sodo University Comprehensive Specialized Hospital from July 1, 2019, to June 30, 2022. A total of 355 (71 cases and 284 controls) pediatric medical charts were used for data extraction using a preestablished checklist. Data were checked for completeness and consistency, entered into Epi-Data version 4.6 software, and transported to SPSS version 25 for analysis. Multivariable logistic regression analysis was performed to identify the independent determinants of acute bacterial meningitis mortality at a P value of < 0.05 along with a 95% confidence interval (CI). RESULTS: Age between 2 months and 5 years (adjusted odds ratio (AOR) = 3.19, 95% CI = 1.15-8.88), admission in the summer season (AOR = 0.27, 95% CI = 0.15-0.49), and family size greater than or equal to six (AOR = 3.13, 95% CI = 1.76-5.56), initial antibiotic change (AOR = 10.81, 95% CI = 2.10-55.7), clinical features at presentation such as loss of consciousness (AOR = 16.90, 95% CI = 4.70-60.4), abnormal body movements (seizures) (AOR = 6.51, 95% CI = 1.82-23.4), increased intracranial pressure (AOR = 3.63, 95% CI = 1.78-7.4), malnutrition (AOR = 2.98, 95% CI = 1.34-6.59) and presence of more than one comorbidity (AOR = 3.03, 95% CI = 1.03-9.03) were found to be determinants of acute bacterial meningitis mortality. CONCLUSIONS: In summary, children aged 2 months to 5 years from large families ( > = 6) with a history of initial antibiotic change, malnutrition, more than one comorbidity, and worse clinical characteristics were related to greater death due to acute bacterial mortality in this study.

Effect of intravenous tramadol versus pethidine on postspinal shivering control among mothers during cesarean section at Wolaita Sodo University Comprehensive Specialized Hospital, Southern Ethiopia: a prospective observational cohort study.

Postspinal anesthesia shivering is a common complication during spinal anesthesia. It is very unpleasant and physiologically stressful for patients and challenging for healthcare providers. Shivering could be treated with tramadol or pethidine. However, the comparative effectiveness of one drug over the other drug has not been proven with a low-drug setup. Objective: To compare the effect of intravenous tramadol versus pethidine on postspinal shivering control among obstetric mothers who underwent cesarean section. Methods and materials: A prospective cohort study design was conducted on 180 ASA (American Society of Anesthesiology) I and II obstetric mothers. A systematic random sampling method was employed. Data were entered into EpiData version 4.6 and exported into SPSS version 25 for analysis. The independent sample t test was used to compare the difference of means between groups for normally distributed data, and the Mann-Whitney U test was used for non-normally distributed data. Categorical data were analyzed using the chi-squared test. Data were presented by mean±standard deviation for normally distributed data and median and interquartile range for non-normally distributed data. Categorical data were presented as numbers and frequencies. P values less than 0.05 were considered statistically significant. Results: One hundred eighty participants were used for analysis. The mean time of shivering disappearance was 5.5±1.75 min and 6.6±2.08 min in tramadol and pethidine groups, respectively (P<0.001). The hemodynamic changes were all comparable between the two groups. The difference in the recurrence of shivering after treatment was significant between the groups (P<0.001). Sedation was higher in the pethidine group, 9 (10%), than in the tramadol group, 2 (2.2%). Nausea and vomiting were found to be higher in the tramadol group, 10 (11.1%), than in the pethidine group, 5 (5.6%). Conclusions: Tramadol controlled shivering early, and recurrence of shivering and incidence of sedation were also low in the tramadol group. Therefore, tramadol is as effective as pethidine for the treatment of postspinal shivering in obstetric mothers who underwent cesarean delivery. So tramadol can be used as an alternative for postspinal shivering in obstetric mothers.

Lived Experience of Women Who Underwent Early Removal of Long-Acting Family Planning Methods in Bedesa Town, Wolaita Zone, Southern Ethiopia: A Phenomenological Study.

BACKGROUND: Long-acting family planning method (LAFP) is a low-cost yet effective method of reducing maternal mortality, limiting and spacing childbirth. In Ethiopia, the family planning prevalence rate rises from 15% in 2005 to 36% in 2016. However, the discontinuation rate of LAFP is still high in the region. Therefore, the aim of this study was to explore the lived experiences of women who underwent early removal of long-acting family planning methods in Bedesa town, Southern Ethiopia. METHODS: An interpretative phenomenological study design was employed. Women aged 15-49 years who removed LAFP therapy in the past 12 months were our sampled population. Data were collected through in-depth interviews (IDIs) by using open-ended structured interview guide. Purposive sampling technique was used to select 10 participants from the family planning logbook registration of Bedesa health center. The interview continued until information saturation was reached. Open code version 4.03 was used to code and facilitate analysis. Transcripts were read and re-read separately to identify emerging themes. A thematic analysis technique was used. RESULTS: This study revealed that the side effects, seeking more children and the husband's opposition were the main reason for early removal of LAFP. Amongst side effects, heavy and irregular menses were occurred most frequently. Besides, there were various myths and misconceptions about family planning methods. It also noted that the counseling services provided by health professionals were not adequate. CONCLUSION: Side effects, desired to have more children, and the husband's opposition are the most important reason of early removal of LAFP methods. Furthermore, there were misunderstanding, fear and rumors raised by women about each method. Hence, greater public awareness on family planning should be delivered to change community perception on LAFP methods.

Modern Health Service Utilization and Associated Factors among Adults in Southern Ethiopia.

Background: The Ethiopian government is striving to improve the health status of its population through the expansion and strengthening of primary health care services in both rural and urban settings of the country. The study aimed to measure modern health service utilization and associated factors in Wolaita Sodo town, Ethiopia. Method: A cross-sectional study design was implemented from May to June 2019 in Wolaita Sodo town, Ethiopia. All 786 study participants were selected by multistage systematic random sampling. Data were collected by face-to-face interviews using a pretested structured questionnaire. Data were collected by an open data kit. Stata window version 15.0 was also employed for statistical analysis. Multiple logistic regression was conducted, and a 95% confidence interval was considered for interpretation. Result: Health service utilization was 77.2% with (95% CI of 74.1%, 80.0%). In terms of health facilities in which they visit, first 50.6% were at the public health center and 25.5% of them were at Teaching and Referral Hospital. Respondents with marital status married and widowed have higher odds of utilizing health services compared to single marital status (AOR: 2.96; 95% CI: 1.7-5.2 and 9.0; 95% CI: 1.69-48.0), respectively. Respondents with middle and highest wealth status have higher odds of health service utilization than poor wealth status with AOR (1.75 95% CI 1.03-2.97 and 1.58 95% CI; 1.01, 2.77). Similarly, respondents who had chronic disease and perceived poor health status have higher odds of health service utilization. Conclusion: Modern health services utilization was found to be unsatisfactory. Being married, wealth status being middle and high, having chronic health conditions, and having poor perceived health status were found to have a statistically significant association with health service utilization.

Awareness Towards Corona Virus Disease (COVID-19) and Its Prevention Methods in Selected Sites in Wolaita Zone, Southern Ethiopia: A Quick, Exploratory, Operational Assessment.

BACKGROUND: The novel corona virus disease 2019 (COVID-19) presents an important and urgent threat to global health and its effect is expected to get even worse in the middle- and low-income countries where the health system is weak and fragile. Timely access to accurate information and public awareness on prevention methods is one of the feasible interventions in these countries. Identifying level of public awareness on disease prevention is important to mitigate the pandemic. The aim of this study was to explore the level of awareness and prevention methods of COVID-19 among residents in Wolaita Zone, Southern Ethiopia. METHODS: A qualitative study using a qualitative descriptive approach was conducted. Community members engaged in different service sectors were selected purposively. A total of 22 in-depth interviews were done. The transcripts were imported into OpenCode version 4.02 software packages. A qualitative thematic analysis approach was used to analyze the data. RESULTS: The findings revealed that 95.5% of the participants had heard about the disease COVID-19 and realized common modes of transmission. Some participants linked the disease with resentment of God on people or anger of God towards human kind. Importance of consuming hot drinks, ginger or garlic to prevent the disease was reported by participants. Negative attitude towards quarantine and isolation centers and stigmatizing people with a cough were documented in this assessment. Stigma and fear of isolation centers may prevent people from reporting the symptom of the disease and this can create favorable ground for the transmission. Challenges like problem of consistent availability of water supply, affordability of materials used to keep hygiene by rural poor, and keeping physical distancing in different public gathering places were reported. CONCLUSION: Concerned bodies need to address gaps in public awareness by providing health education and continuous awareness creation.