Knowledge, attitude, and practice towards hepatitis B and C virus infection and associated factors among adults living at selected woredas in Gamo Zone, Southern Ethiopia: a cross-sectional study.

BACKGROUND: Hepatitis is an inflammation of the liver tissue. It is one of the serious public health problems. Though an individuals' knowledge, attitude, and practice level is very vital in order to ensure the control of its adverse health impacts, little is known regarding these issues in the community level. Therefore, this study was aimed to assess knowledge, attitude, and practice towards hepatitis B and C virus infection and associated factors among adults living at selected woredas in Gamo Zone, Southern Ethiopia. METHODS: Community based cross-sectional study design was conducted among 633 adults living at selected woredas in Gamo Zone, Southern Ethiopia. Data were collected by pretested, well-structured questionnaire. The collected data were checked, coded and entered into Epi-data version 4.6.0.2 and were exported to SPSS version 25 for analyses. Bivariable and multivariable logistic regression were done to identify independent factors associated with knowledge, attitude, and practice towards hepatitis B and C virus infection. RESULTS: According to this study, 366(58.1%), 95% CI: (54.23-61.96) of the participants had good knowledge. 381(60.5%), 95% CI: (56.65-64.30) of the participants had favourable attitude. 317(50.3%), 95% CI: (46.40-54.23) of the participants had good practice. From factor analysis, sex, number of sexual partners, sharing sharp material, and vaccination status were significantly associated with knowledge; residence, occupational status, income level, sharing sharp material, and vaccination status were significantly associated with attitude; and residence, occupational status, and vaccination status were identified to be significantly associated with practice towards Hepatitis B and C virus infection. CONCLUSION: Based on the study findings, it could be observed that good knowledge, favourable attitude, and good practice were indicated nearly above the half, only by half, and nearly above the half of the study participants respectively. Implementing actions that could increase awareness regarding limiting the number of sexual partner, not sharing sharp materials, and urbanization is recommended. Moreover, woreda administrators, and other related authorities should consider knowledge, attitude, and practice as an implementation area, and also it would be better to create an opportunities to promote vaccination practices.

Effectiveness of curriculum-based sexual and reproductive health education on healthy sexual behaviors among year one students at Arba Minch University: A quasi-experimental study.

INTRODUCTION: Curriculum-based sexual and reproductive health education (CBSRHE) is one of the preventive strategies targeting youth in higher institutions to protect them from sexual and reproductive health problems, despite never assessing the effect in Ethiopia. Therefore, this study aimed to assess the effect of CBSRHE on knowledge and attitude about SRH services to have safer sexual behaviors among first-year students of Arba Minch University. METHOD: We conducted a quasi-experimental study among purposively selected campuses. The campuses were allocated to (i) an intervention arm consisting of curriculum-based sexual and reproductive health, or (ii) a control arm for those who were free from intervention. Data was collected, at baseline and immediately after the intervention ended by using a structured self-administered questionnaire. To compare differences in the change from baseline to post-intervention between the two arms we use the chi-square test and independent-samples t-test. To see the effect of the CBSRHE by controlling the effect confounding inverse probability-weighted analysis was conducted. RESULT: A total of 832 and 820 students participated in a baseline and post-test respectively. The proportion of youth who practice receptive penetrative sex decreases from 40.9% to 28.3% in the intervention arm compared to 37.6% to 37.3% in the non-intervention arm between baseline and end line, with statistically significant differences between groups. However, there are statistically significant differences between the intervention and control groups in terms of changes in contraception utilization (X2 = 1.21; P>0.05). Furthermore, there were significant improvements in knowledge and attitude among the intervention arm a comprehensive knowledge of HIV/AIDS (ATE = 0.22,95% CI, 0.14 to 0.29; p < 0.01), an average change of attitude toward HIV/AIDS(ATE = 1.32, 95% CI, 1.18 to 1.47; p < 0.01), comprehensive condom knowledge score (ATE = 0.23, 95% CI, 0.13 to 0.33; p < 0.01) and the average change of attitude toward condom score (ATE = 1.83, 95% CI, 1.19 to 2.77; p < 0.01). CONCLUSION AND RECOMMENDATION: It was found that there was a significant difference in knowledge and attitude toward a disk sexual behaviors among r one student. This implies that the educational authority o the country can gain through the adoption of courses to all universities across the country, besides doing further comparative studies to determine the long-term effect of the course supported with models and/or theories like the theory of change.

Zinc deficiency and associated factors among pregnant women's attending antenatal clinics in public health facilities of Konso Zone, Southern Ethiopia.

BACKGROUND: Zinc is an essential mineral known to be important for the normal physiological functions of the immune system. It is one of the basic nutrients required during pregnancy for the normal development and growth of the fetus. However, Zinc deficiency during pregnancy causes irreversible effects on the newborn such as growth impairment, spontaneous abortion, congenital malformations and poor birth outcomes. Even though, the effect of Zinc deficiency is devastating during pregnancy, there is scarcity of evidence on Zinc deficiency and related factors among pregnant women in the current study area. OBJECTIVE: To assess Zinc deficiency and associated factors among pregnant women attending antenatal clinics in public health facilities of Konso Zone, Southern Ethiopia. METHODS: Institution based cross-sectional study was conducted among randomly selected 424 pregnant mothers. Data were collected using pre tested questionnaire (for interview part), and 5 blood sample was drawn for serum zinc level determination. Data were entered to Epi-Data version 3.1 software and exported to SPSS version 25 for analysis. Binary logistic regression analysis was computed and independent variables with a p-value ≤ 0.25 were included in multivariable analysis. Serum zinc level was determined using atomic absorption spectroscopy by applying clean and standard procedures in the laboratory. Finally adjusted odds ratio with 95% confidence level, P-value < 0.05 was used to identify significant factors for Zinc deficiency. RESULT: The prevalence of Zinc deficiency was found to be 128 (30.26%) with the mean serum zinc level of 0.56±0.12 g/dl. Age, 25-34 years [AOR 2.14 (1.19,3.82)], and 35-49 years [AOR 2.59 (1.15, 5.85)], type of occupation, farming [AOR 6.17 (1.36, 28.06)], lack of antenatal follow up during pregnancy [AOR 3.57 (1.05,12.14)], lack of freedom to purchase food items from market [AOR 3.61 (1.27, 10.27)], and inadequate knowledge on nutrition [AOR 3.10(1.58, 6.08)] were factors associated with Zinc deficiency. CONCLUSION: Zinc deficiency is a public health problem among pregnant mothers in the current study area. Improving maternal nutritional knowledge, motivating to have frequent antenatal follow up, and empowering to have financial freedom to purchase food items from market were the modifiable factors to reduce Zinc deficiency. Nutritional intervention that focused on improving nutritional knowledge and insuring access to Zinc sources food items should be delivered for pregnant mothers.

Sero-prevalence and risk factors for hepatitis B virus infection among the consumers of the alcoholic beverage, cheka in Konso zone, southwestern Ethiopia.

INTRODUCTION: Hepatitis B virus (HBV) is a hepatotropic and partially double stranded deoxyribonucleic acid (DNA) virus that causes the immune-mediated killing of infected liver cells. It is a public health conundrum due to its considerable morbidity and mortality. Cheka is a cereal and vegetable-based fermented beverage that is consumed as a key dietary component in the southwestern parts of Ethiopia. This study was aimed to assess the seroprevalence of hepatitis B surface antigen (HBsAg) and associated risk factors among cheka consumers in the Konso community, southwest of Ethiopia. METHODS: A community-based cross-sectional study was conducted in a total of 633 cheka consumers between October 01, 2018, and May 31, 2019. The socio-demographic characteristics and associated factors were collected using a pre-tested semi-structured questionnaire. HBV infection was screened using immune-chromatographic strip tests and positive results were further confirmed with ELISA. RESULTS: The prevalence of HBV was found to be 18.2% (95% CI, 15.1-21.5). Gender (male) (AOR = 1.757:95% CI, 1.009-3.059), age (35-44 yrs), (AOR = 4.123:95% CI, 1.718-9.892), nature of the job (daily laborer) (AOR = 4.551:95% CI, 1.115-18.57), awareness about the transmission of the disease (AOR = 2.056:95% CI, 1.074-3.934) and previous history of contacts with patients having liver diseases (AOR = 2.496:95% CI, 1.187-5.248) were identified as factors which are being significantly associated with the HBV infection. CONCLUSIONS: Very high endemic levels of HBV infection are identified in the study. Male participants of age between 35 and 44 years, who are daily laborers and are aware of HBV transmission, with a previous history of contacts with patients having liver diseases were even at higher risk of HBV infection. The need for more research to find the links between cheka consumption and other mechanisms of HBV cross-infection in these communities is indicated.

Effects of comprehensive sexuality education on the comprehensive knowledge and attitude to condom use among first-year students in Arba Minch University: a quasi-experimental study.

OBJECTIVE: To assess the effect of comprehensive sexuality education on the comprehensive knowledge and attitude to condom use among first-year students at Arba Minch University. RESULTS: A total of 832 students participated at a baseline, and 820 students participated at the posttest. This study found that there was a significant effect on changing students' knowledge and attitude towards a condom. In the education group, the students' average change of comprehensive condom knowledge score was 0.229 higher than the average score of students' in the control group (ATE = 0.229, 95% CI 0.132 to 0.328; p < 0.001). The average change of attitude toward condom score of students' in the education group was 1.834 higher than the average change score of students' in the control group (ATE = 1.834, 95% CI 1.195 to 2.772; p < 0.001).This study provides further evidence on the effectiveness of comprehensive sexuality education in terms of knowledge and attitude towards a condom. Therefore, the implementation of this education should be strengthened in order the prevent youths from STI/HIV and unintended pregnancies.

Knowledge about Neonatal Danger Signs and Associated Factors among Mothers Attending Immunization Clinic at Arba Minch General Hospital, Southern Ethiopia: A Cross-Sectional Study.

BACKGROUND: The first 28 days of life (the neonatal period) constitute the most vulnerable time for a child's survival. Overall 2.7 million neonatal deaths were stated by the 2015 global report of neonatal mortality and they account for 45% of under-five deaths. Sub-Saharan Africa remains the region with the highest risk of death in the first month of life and is among the regions showing the least progress in reducing neonatal mortality in the world. Ethiopia, as part of sub-Saharan Africa, also shares the greatest risk of neonatal death. A recent report in Ethiopia showed that neonatal mortality was 29 deaths per 1,000 live births. Therefore, the signs that suggest the onset of severe illness which leads to death and their contributing factors should be identified. The aim of the study was to assess knowledge about neonatal danger signs and associated factors among mothers attending immunization clinic at Arba Minch General Hospital. METHOD: Institution-based cross-sectional study design was employed from Feb to April 2018. Systematic sampling technique was used to select a total of 345 mother-child pairs. A pretested, structured, and interviewer-administered questionnaire was used to collect data. Data were entered using Epidata version 3.1 and analyzed using SPSS version 20. Bivariate and multivariable analysis were carried out using binary logistic regression to check and test the association between dependent and explanatory variables. Model fitness was checked by Hosmer-Lemeshow goodness of fit test. RESULT: Nearly two-fifths (40.9%) of all mothers had good knowledge about neonatal danger signs (95% CI; 35.7, 46.4). Close to thirty-three percent of mothers identified child's body hotness (fever) as a neonatal danger sign. Maternal educational status (AOR: 5.64; 95% CI: 1.68, 18.95) and attendance of postnatal care (AOR: 2.64; 95% CI: 1.36, 5.15) were significantly associated with maternal knowledge about neonatal danger signs in multivariable analysis. CONCLUSION: Even though considerable improvement has been achieved over the past decades as a result of expanded coverage of maternal and childcare services, still there are a significant number of mothers who have limited knowledge about neonatal danger signs. Therefore, interventional strategies that stress strengthening maternal education and ANC follow-up should be extended.

Assessment of Youth-Friendly Service Quality and Associated Factors at Public Health Facilities in Southern Ethiopia: A Facility-Based Cross-Sectional Study.

BACKGROUND: Evidence shows that services for youths are poorly coordinated and uneven in quality. There is a lack of evidence which informs the level of youth-friendly service quality in the study area. So, this study fills the information gaps and recommends practical solutions. OBJECTIVE: The main aim of the study was to assess youth-friendly service quality and associated factors at public health facilities in Arba Minch town, Southern Ethiopia. METHODS: Facility-based quantitative cross-sectional study supplemented with the qualitative design was conducted from September to December 2017 at two public health centers in Arba Minch town. Sample sizes of 403 young clients were included in the study using a systematic sampling technique. Data was collected by using an interview-administered questionnaire and observation checklist. Quantitative data analysis was made using SPSS version 20.0 to identify the association between the dependent and independent variables. Qualitative findings were coded and analyzed by using content analysis in Microsoft Excel. Finally, results are presented using narrations, tables, and figures. RESULTS: A total of 403 youth-friendly service clients participated in the study. The overall score input, process, and youth clients' satisfaction was 54.41%, 42.0%, and 49.1%, respectively. Age (15-19) [AOR (95% CI) = 3.2 (1.4-7.8)], employment [AOR (95% CI) = 6.4 (2-17)], place of YFS [AOR (95% CI) = 0.35 (0.1-0.8)], frequency of visit [AOR (95% CI) = 0.03 (0.0-0.3)], waiting time [AOR (95% CI) = 0.02 (0.0-0.09)], and comfort with providers' sex [AOR (95% CI) = 0.07 (0.02-0.2)] were factors which are significantly associated with client satisfaction in this study. CONCLUSION AND RECOMMENDATION: The study revealed that the overall quality of youth-friendly health service is below-set criteria (not good quality) in its all components, i.e., structural, process, and output. So, improvement of facility setup, client-provider interaction, and service sensitivity to all young groups and waiting time of services is essential.

Breast Feeding Practice: Positioning and Attachment during Breast Feeding among Lactating Mothers Visiting Health Facility in Areka Town, Southern Ethiopia.

BACKGROUND: Breastfeeding is the act of milk conveyance from the mother to the infant. Adequate nutrition during infancy and early childhood are mandatory to ensure growth, health, and development of children to their maximum potential. The positioning of the baby's body is important for maintaining good attachment and successful breastfeeding. Most difficulties of breastfeeding can be avoided altogether if good attachment and positioning can be achieved at the first and early feeds. Plenty of studies have been conducted to explore factors affecting breastfeeding practice in general; however, there is a meagerness of evidence that assesses factors affecting attachment and positioning during breastfeeding specifically. Therefore, the current study was aimed to assess positioning and attachment during breastfeeding among lactating mothers visiting health facilities of Areka town. METHODS: an institution-based cross-sectional study was conducted by using observational checklist adopted from the World Health Organization breastfeeding observation form. Maternal-related characteristics were collected by using a structured and pretested questionnaire. The study was conducted from April to June 2017. Respondents were selected by using a systematic random sampling technique. Descriptive summaries were done to present pertinent findings and a chi-square test was used to check association between variables. RESULT: There was poorer positioning among primipara mothers (47.1%) than multipara mothers (28.7%). A poor attachment was also more apparent among primipara mothers which were more (31.1%) than the multipara (27.1%) mothers. CONCLUSION: Younger mothers (<20 years old), the primipara, and those who have no formal education deserve more attention, support, and direction to make sure that they can achieve proper positioning and attachment during breastfeeding at the first and early feeds.

Exploring Reasons for Low Attendance of Mothers to Growth Monitoring and Promotion Program at Loka Abaya District, Southern Ethiopia: Exploratory Qualitative Study.

BACKGROUND: Different organizations in Ethiopia are currently working on prevention and promotion activities to fight malnutrition among children through a community-based nutrition program. One of these activities with little success is growth monitoring and promotion (GMP). Exploring the reason and better understanding of low attendance of mothers to the GMP program can help to improve the program by incorporating finding. The aim of the study was to explore reasons for low attendance to the GMP program among mothers of under-two children. METHOD: An exploratory qualitative study design was used to unearth reasons for low attendance of mothers with under-2-year-old child to the GMP program. In-depth interviews were carried out with 13 mothers. The data were analyzed using qualitative content analysis approach. RESULT: Mothers perceived that GMP is (meant) for unhealthy children (only). Again mothers mentioned community dishonor of mothers with wasted children and method of weighing a child as a community-related reason for low attendance to the GMP program. They also indicated that there was no community conversation and weak counseling of the mothers about child feeding and growth. Perception about "evil eye" was also indicated as a reason for lower attendance of the program. CONCLUSION: Mothers showed that there was lack of knowledge about GMP. Limited community conversation and weak counseling about child nutrition as a GMP program were explored reasons for low attendance. Other reasons mentioned by the mothers were consideration of "evil eye" and method of weighing a child. Further research is needed to explore the implementation of GMP by health workers and to evaluate the extent of the identified reasons for low attendance to the GMP program by the mother.

Burden of intestinal helminths and associated factors three years after initiation of mass drug administration in Arbaminch Zuria district, Southern Ethiopia.

BACKGROUND: Epidemiological information on the burden of various parasitic infections and associated factors in different localities is indispensable to develop appropriate control and prevention measures as well as to monitor and evaluate existing programs. Hence the aim of the present study was to assess the prevalence and associated factors of intestinal helminths among school age children in Arbaminch Zuria district, Southern Ethiopia. METHODS: A community based cross-sectional study was conducted by recruiting 391 primary school age children. Participants were selected using simple random sampling technique. Pre-tested structured questionnaire was used to collect data about socio-demographic characteristics and perceived factors associated with intestinal parasitosis. Stool microscopic examination was done following standard protocol. Data were analyzed using Statistical Package for Social Science version 22. RESULTS: Among 391 children participated, 181 (46.3%; 95% CI: 41.9-51.5) were infected with intestinal helminths. The magnitudes of single and double infections were 40.2% and 6.1% respectively. Seven helminths were detected among which Ascaris lumbricoides was with the highest frequency (56, 14.3%) followed by hookworms (55, 14.1%). Not washing fruits and vegetables before consumption (AOR = 2.16; 95%CI: 1.10-4.25, p = 0.026) and habit of swimming (AOR = 1.17; 95%CI: 1.03-1.95, p = 0.045) were significantly associated with helminthic infection. CONCLUSION: High prevalence of intestinal helminthic infections among school age children demands integration of deworming with water, hygiene and sanitation as well as consistent health education.