Factors contributing to the high prevalence of intimate partner violence among south Sudanese refugee women in Ethiopia.

BACKGROUND: Intimate partner violence is a universally occurring form of violence against women which is perpetrated by a husband or other intimate partner. It is a common public health problem during humanitarian crisis. Despite this, little is known about the problem among South Sudanese refugee women in Ethiopia. OBJECTIVE: This study aimed to determine the prevalence of intimate partner violence and identify its contributing factors among married refugee women in Pinyudo refugee camp, Gambella, Ethiopia in 2021. METHODS: A community-based cross-sectional study was conducted from March to June 2021. A random sample of 406 refugee women was included in the study. A structured, pretested, and interviewer-administered questionnaire was used to collect the data. Data were entered into epi-data version 3.1 and exported to SPSS version 22 for analysis. Multivariable logistic regression was run to identify factors associated with intimate partner violence. Statistical significance was affirmed using Adjusted Odds Ratio with its 95% Confidence Interval at a p-value ≤ 0.05. RESULTS: A total of 406 married refugee women participated in the study making a response rate of 96.2%. The overall prevalence of intimate partner violence in the past 12 months was 48.3% 95% CI= (43.6-53.2). Low-income contribution [AOR = 2.4, 95% CI: 1.2-5.5], and attitudinal acceptance [AOR = 2.1, 95%CI: 1.2-3.8] were significantly associated with the problem. CONCLUSION: The prevalence of intimate partner violence is alarmingly high as half of participating women reported facing the problem in the year preceding the study. Low-income contribution and attitudinal acceptance were associated with a higher probability of experiencing violence. The government, humanitarian organizations, and other stakeholders should enable refugee women to generate income. There should be continuous women empowerment and behavioral interventions to improve refugee women's attitudes towards intimate partner violence.

Non-adherence to the World Health Organization's physical activity recommendations and associated factors among healthy adults in urban centers of Southwest Ethiopia.

Physical inactivity is a major risk-factor of non-communicable diseases. The World Health Organization has set physical activity recommendations for adults to reduce physical inactivity and its consequences. However, 1.4 billion adults are non-adherent to the recommendation worldwide. The prevalence of non-adherence to this recommendation and its predictors has not been assessed in urban Ethiopia. This study aimed to determine the prevalence of non-adherence to physical activity recommendations and identify its associated factors among healthy adults in urban centers of Southwest Ethiopia. A community-based cross-sectional study was employed from May to June 2021, involving 1191 adults in urban centers of Southwest Ethiopia. Data was collected using Global Physical Activity Questionnaire. Multivariable logistic regression was used to identify factors associated with non-adherence to physical activity recommendations using 95% confidence interval of adjusted odds ratio at P-value of < 0.05.Overall, 61.2% of participants were non-adherent to physical activity recommendations. Older age (AOR = 6.6; 95%CI (2.3-19)), female sex (AOR = 6.1; 95%CI (3.5-10.5)), lower educational status (AOR = 0.5; 95%CI (.28-0.93)), less community engagement (AOR = 2.7;95% CI (1.3-5.5)), lower level of happiness (AOR = 4.7; 95%CI (1.3-16.8)) and physical inactivity of family members (AOR = 2.5; 95%CI (1.4-4.3)) were associated with non-adherence. The prevalence of non-adherence to physical activity recommendations in the study area is high. Age, sex, educational status, community engagement, level of happiness and physical inactivity of family members were predictors of non-adherence to the recommendations. Interventions have to target females and older adults. Community participation and family based physical activity have to be advocated to avert the consequences of physical inactivity.

Achievement of adequate weight gain among infants and children with complicated severe acute malnutrition receiving treatment in therapeutic feeding centers of South Sudanese refugee camps in Ethiopia.

Objectives: This study aimed to assess achievement of adequate weight gain and identify its associated factors among infants and children with complicated severe acute malnutrition admitted in Kule and Tierkidi refugee camps in Gambella, Southwest Ethiopia. Methods: Records of 332 infants and children with complicated severe acute malnutrition were selected by systematic random sampling. Weight gain was calculated for all participants. Patients who achieved weight gain of >5 g/kg/day were regarded as achieving adequate weight gain. Sociodemographic characteristics, season of admission, patients' anthropometry at admission, source of admission, clinical conditions at admission, types of medications used, length of stay at the centers, and the centers of the treatment were considered as covariates. The adjusted odds ratio and its 95% confidence interval were used to identify factors associated with adequate average weight gain in the multivariable logistic regression. Results: In total, 72% of the treated patients achieved adequate weight gain. Treatment at Tierkidi center Adjusted Odds Ratio = 5.9, 95% Confidence Interval: (2.0,16.9), treatment with amoxicillin-clavulanate Adjusted Odds Ratio = 4.1, 95% Confidence Interval: (1.7, 10.0), WFH z-score < -3 Adjusted Odds Ratio = 4.1, 95% Confidence Interval: (1.9, 9.0) and length of stay of ⩽7 days Adjusted Odds Ratio = 2.5, 95% Confidence Interval: (1.4, 4.4) were significantly associated with achievement of adequate weight gain. Conclusion: Seven in ten of treated patients achieved adequate weight gain. However, significant proportion of patients still failed to achieve recommended weight gain in refugee camps. Anthropometric indices, type of antibiotics used for treatment, short length of stay, and the treatment center were associated with achievement of adequate weight gain. We recommend that the local antibiotic sensitivity pattern be studied in order to recommend an appropriate treatment regimen for infants and children. Children requiring longer duration have to be given due focus. Inter-center variations have to be narrowed by strengthening follow-up and supervisory supports.

Self-Medication and Associated Factors Among Pregnant Women in Rural Ethiopia: The Importance of Husband Education in Ensuring a Safe Pregnancy.

Background: Self-medication is the use of drugs without a medical prescription to treat self-identified illnesses; it is also the continued use of drugs without a physician's order for recurring symptoms, either by sharing or purchasing them from unlicensed vendors. It entails substantial risk to pregnant women and fetuses. Magnitude of the problem and its factors among rural pregnant women is not studied in Ethiopia. Objective: This study aimed to assess the prevalence of self-medication practice and identify its associated factors among pregnant women in rural Southwest Shewa, Ethiopia. Methods: A cross-sectional study was conducted on 585 randomly selected pregnant women in selected rural public health institutions from May to July 2021. Data was collected by using an interviewer-administered pretested structured questionnaire. Multivariable logistic regression was used to identify factors associated with self-medication. Variables with p-value <0.05 for the 95% confidence interval of the adjusted odds ratio were considered statistically significant. Results: A total of 585 pregnant women participated in the study with a response rate of 92.3%. The prevalence of self-medication among pregnant women was 19.8%. Primigravidity (AOR = 2.7, 95% CI: 1.2-6.1), lower educational status of husbands (AOR = 3.6, 95% CI: 1.02-12.9), living close to health facilities (AOR = 0.23, 95% CI: 0.09-0.6) and knowing one's own gestational age (AOR = 0.5,95% CI: 0.30-0.9) were significantly associated with self-medication practice. Conclusion and Recommendation: One in five of the pregnant women practiced self-medication during the current pregnancy. Primigravidity and lower educational status of husbands were associated with a higher probability of self-medication. Knowing gestational age and living close to health facilities were associated with a lower likelihood of practicing self-medication. Rational drug use has to be promoted among pregnant women. Maternal and child health interventions should also target husbands. Health education has to be strengthened to help pregnant women have a safe pregnancy.

Fear of COVID-19 and poor accessibility of comprehensive care has caused delay in initiation of antenatal care among pregnant women in Southwest Ethiopia: the need for disaster resilient and accessible maternal health care.

Background: Antenatal care (ANC) is care provided to pregnant women in order to ensure positive health outcomes for both mother and baby. Late ANC contact lacks the opportunity to provide interventions that are effective early in the pregnancy. A huge proportion of pregnant women present late. The aim of this study was to identify determinants of late enrollment in the ANC among pregnant women in public health centers in Ilu Ababor Zone, South-West Ethiopia. Design and methods: A facility-based case-control study was conducted on 270 randomly selected pregnant women (135 cases and 135 controls). A pretested interviewer-administered questionnaire was used to collect data. Multi-variable logistic regression was run to identify the determinants of late ANC initiation. The adjusted odds ratio (AOR) and its 95% confidence interval (CI) were used to determine statistical significance at a P-value of 0.05. Result: A total of 270 pregnant women were interviewed, making a response rate of 97%. Unplanned pregnancy [AOR: 2.8; 95% CI: (1.3, 6.0)], lack of information on time of ANC initiation [AOR: 2.7; 95% CI:(1.02, 5.0)], older age [AOR: 2.2; 95% CI:(1.01, 4.7)], not attending ANC in the previous pregnancy [AOR: 4.07; 95% CI: (1.8, 9.5)], and fear of COVID-19 were determinants of late initiation of ANC in the study area. Conclusion: Age, pregnancy and care-related factors, and fear of COVID-19 were determinants of late initiation of ANC. Community-based provision of comprehensive information on planned pregnancy and the ANC is important. A resilient system has to be built to deliver essential health services during emergencies like COVID-19.

Magnitude of depression and its associated factors among patients with diabetes mellitus at public hospitals in Southwest Ethiopia, 2021.

Depression is the third-leading cause of disability measured in terms of disability-adjusted life-years. When depression coexists with diabetes mellitus, it is associated with major health consequences and results in poor health outcomes, decreased quality of life, lost productivity and increased risk of death. The current study aimed to assess the magnitude of depression and its associated factors among adult patients with diabetes mellitus attending follow-up at the public hospitals of Buno Bedele zone, Southwest Ethiopia. A multi-centre cross-sectional study was done among people living with diabetes mellitus at an outpatient clinic of Buno Bedele zone hospitals. The study period was from April to May 2021. A systematic random sampling technique was used to select the study participants. Data were collected using a structured questionnaire. Depression was assessed by the Patient Health Questionnaire-9. Patient Health Questionnaire-9 is a validated tool to assess depression with sensitivity 86% and specificity 67%. The collected data were cleaned, edited, and entered into epi-data version 3.1, and analysed using SPSS version 24. Logistic regression analysis was employed to identify factors associated with depression occurrence. A p value of 0.05 was considered statistically significant. A total of 310 study participants were included in this study. Among study participants, 41.6% fulfilled the criteria for depression. Variables significantly associated with depression were female gender [AOR: 2.26, 95% CI (1.30, 3.95)], duration of diabetes greater than 5 years [AOR: 2.68, 95% CI (1.57, 4.56)], poor social support [AOR: 2.46, 95% CI (1.10, 5.49)], moderate social support [AOR: 2.63, 95% CI (1.34, 5.16)], current alcohol consumption [AOR: 3.55, 95% CI (1.20, 10.52)] and previous alcohol consumption [AOR = 2.81, 95% CI (1.40, 5.60)]. According to this study, depression is relatively common among diabetic individuals. Being a female, having diabetes for a long time, having poor social support, using alcohol now and in the past were factors that substantially linked to depression. Healthcare professionals should consider screening for depression using the Patient Health Questionnaire-9 or other validated tools in all diabetic patients, especially in those who are at higher risk.

Time to Nutritional Recovery and Its Predictors Among Undernourished Adult Patients Living with Human Immune Deficiency Virus Attending Anti-Retroviral Therapy at Public Health Facilities in Southwest Ethiopia. A Multicenter Study.

Background: Infection with the human immunodeficiency virus is one of the factors that contribute to malnutrition. Several initiatives have been launched in Ethiopia to improve HIV patients' nutritional status and achieve early recovery when malnourished patients are found. Despite these efforts, adult HIV patients' malnutrition recovery remains poor. Objective: The objective of this study was to assess the time to recovery from undernutrition and associated factors among adult HIV patients on ART at public health facilities in Ilu Aba Bor zone, Southwest Ethiopia, 2021. Methods: An institution-based retrospective cohort study of 374 adult HIV patients with undernutrition receiving ART at public health institutions in Southwest Ethiopia was conducted. Data were extracted from the patient's record and entered into Epi-Data version 3.1 before being exported to STATA version 14. The Kaplan-Meier method was used to estimate the time to recovery, and the difference in survival time between predictor variables was tested using the Log rank test. Weibull regression models, both bivariable and multivariable, were fitted. A p-value of 0.05 was declared statistically significant. Results: The recovery rate was 67.7% and the median recovery time was 65 days (95% CI = 61.6-68.4) and 145 days (95% CI = 130.7-159) for MAM and SAM, respectively. Marital status (Married) (AHR = 0.61; CI = (0.43,0.86)), ART status (pre ART) AHR = 0.492; CI = (0.305,0.793), CD4 (200-350c/m3, AHR = 2.116;CI = (1.447,3.21), type of malnutrition (AHR = 0.22; CI= (0.156,0.307)), ART adherence level (AHR = 3.33, CI = (1.997,5.56)) WHO clinical staging (AHR = 0.685, CI = (0.485,0.948)), sex (male), (AHR = 0.678; CI = (0.509,0.901)) and age (35-54), (AHR = 1.86; CI = (1.408,2.47)) were predictors of recovery time. Conclusion: Compared to previous studies, the recovery rate was high. SAM, advanced clinical stage, sex, and marital status were all negatively associated with nutritional recovery time, whereas ART adherence, CD4 count, and age were predictors. As a result, a therapeutic feeding program should focus on factors that slow recovery time.

Determinants of first-line antiretroviral treatment failure among adult patients on treatment in Mettu Karl Specialized Hospital, South West Ethiopia; a case control study.

BACKGROUND: Antiretroviral therapy has dramatically reduced Human Immunodeficiency Virus related morbidity and mortality. It has also transformed HIV infection into a manageable chronic condition. However, first-line antiretroviral treatment failure continues to grow especially in resource limited settings. Despite this, determinants of first-line antiretroviral treatment failure are not well studied in Ethiopia. OBJECTIVE: To identify determinants of first-line antiretroviral treatment failure among adult patients on antiretroviral therapy in Mettu Karl Specialized Hospital, South West Ethiopia, in 2020. METHODS: A hospital based case-control study was conducted from October to November 2020. Simple random sampling technique was used to select participants. Interviewer administered questionnaire and record review were used for data collection. Data were entered into epi data version 3.1 and exported to SPSS version 20 for analysis. Bivariable and multivariable logistic regression analysis were used. At the end, variables with P-value < 0.05 at 95% confidence intervals for adjusted odds ratio were considered statistically significant determinants of first line treatment failure. RESULT: A total of 113 cases and 339 controls were included in the study with response rate of 98.6%. Sixty-four (56.6%) of cases and 183 (54.0%) of controls were females. Baseline WHO clinical stage III and IV (AOR = 1.909, 95% CI: (1.103, 3.305), baseline body mass index<18.5kg/m2(AOR = 2.208,95% CI:(1.257,3.877),baseline CD4 cell count <100cells/mm3 (AOR = 3.016, 95% CI: (1.734, 5.246), having history of TB co-infection (AOR = 1.855, 95% CI: (1.027, 3.353), having history of lost to follow up (AOR = 3.235, 95% CI: (1.096, 9.551), poor adherence to medication (AOR = 7.597, 95% CI: (4.059, 14.219) and initiation of treatment after two years of diagnosis with HIV (AOR = 4.979, 95% CI: (2.039, 12.158) were determinants of first-line antiretroviral treatment failure. CONCLUSION: In this study several variables were found to be determinants of first-line antiretroviral treatment failure. Concerned bodies should give more attention to early diagnosis of HIV, early enrollment in chronic HIV care and early initiation of ART before patients develop advanced WHO clinical stages. In addition, focus has to be given for patients with low CD4 count. Regular screening for TB, counseling on optimal adherence to medication and enhancing nutritional status of patients with low body mass index are also crucial to prevent first-line antiretroviral treatment failure.

Co-occurrence of Behavioral Risk Factors of Non-communicable Diseases and Social Determinants among Adults in Urban Centers of Southwestern Ethiopia in 2020: A Community-Based Cross-Sectional Study.

BACKGROUND: Non-communicable diseases are priority global health problems. Smoking, harmful alcohol consumption, physical inactivity, and an unhealthy diet are four behavioral risk factors of these diseases. Studies in Ethiopia have focused on establishing associations between these factors and incommunicable diseases. OBJECTIVE: To assess the prevalence, co-occurrence, and social determinants of behavioral risk factors of non-communicable diseases among adults in urban centers of southwestern Ethiopia. METHODS: This study employed a cross-sectional design. Multistage sampling and the Kish method were used. The WHO's STEPS instrument was used for data collection. Proportions and other descriptive measures are used to describe the data. Bivariate and multivariate logistic regression was run to assess associations. Associations between dependent and independent variables were determined using AORs, 95% CIs, and significance level of P=0.05. RESULTS: A total of 1,191 adults participated in the study for a 93.3% response rate. In sum, 4.8% of participants were smokers and 15.6% indulge in harmful drinking. Prevalence of physical inactivity was 60.45%, and 94.8% consumed insufficient fruit and vegetables. Regarding co-occurrence of these factors, 65.5% of participants had two or more behavioral risk factors. Female sex (AOR 3.1, 95% CI 1.8-5.5), no formal employment (AOR 1.9, 95% CI 1.02-3.7), greater wealth (AOR 2.44, 95% CI 1.1-5.1), not having a friend who does physical exercise (AOR 2.7, 95% CI 1.5-4.7), having friends who do not drink (AOR 0.20, 95% CI 0.09-0.44), and participating in community activities (AOR 2.95, 95% CI 1.4-6.0) were associated with co-occurrence of behavioral risk factors of non-communicable diseases. CONCLUSION: The prevalence and co-occurrence of behavioral risk factors of non-communicable diseases in the study area are alarming. Several factors were associated with co-occurrence of these factors. Community-based interventions have to be implemented considering family settings. Special focus has to be given to physical inactivity and fruit and vegetable consumption.

Prevalence of intestinal parasitic infections and associated factors among street children in Jimma town; south West Ethiopia in 2019: a cross sectional study.

BACKGROUND: Street child is any child whose age is less than 18 years for whom the street has become his or her habitual abode and/or source of livelihood, is inadequately protected, supervised or directed by responsible adults. In Ethiopia the health problems of street children are given poor attention in research. This problem is pronounced when it comes to intestinal parasitic infections, making it difficult to design appropriate interventions targeting this segment of population. The aim of this study was to assess the prevalence of intestinal parasitic infections and associated factors among street children in Jimma town in the year 2019. METHODS: Community based cross sectional study was employed. Complete enumeration was used to include 312 street children. Pretested questionnaire was used to collect the data. Data was entered to Epidata version 3.1 and exported to SPSS version 20. Stool samples were examined by wet mount and formalin ether concentration techniques. Bivariable and multivariable logistic regression was used to identify factors associated with intestinal parasitic infection. Significance of association was decided by using the 95% confidence interval of AOR and P-value of ≤0.05 in the multivariable model. RESULT: A total of 312 children of the street were involved in the study making the response rate 96.2%. The prevalence of intestinal parasitic infection was 66.7%. Untrimmed finger nails AOR = 2.03;95%CI (1.02-4.06), eating street food AOR = 2.24;95% CI (1.04-5.02), practice of swimming in unprotected water bodies AOR = 2.5; 95% CI (1.24-5.04), not wearing shoes at the time of data collection AOR = 3.8;95% CI (1.8-8.2) and lacking knowledge of way of transmission of intestinal parasites AOR = 2.5; 95% CI (1.25-5.0) were significantly associated with parasitic infections. CONCLUSIONS: The prevalence of intestinal parasitic infections among street children in the study area was high and require integrated interventions to avert the problem. Several factors were also found to be associated with intestinal parasitic infections. Measures has to be taken to curb the problem by including them in mass drug administration and targeted health education towards identified factors.