Challenges and coping strategies for providing maternal health care services among health care professionals in rural health facilities in Wolaita Zone, Southern Ethiopia: a qualitative study.

BACKGROUND: Many factors can decrease job productivity and cause physical and psychological complications for health care professionals providing maternal care. Information on challenges and coping strategies among healthcare professionals providing maternal healthcare services in rural communities is crucial. However, there needs to be more studies, especially qualitative research, to explore challenges and coping strategies for providing maternal health care services in Ethiopia among health care professionals, particularly in the Wolaita zone. OBJECTIVE: To explore the challenges and coping strategies of professionals providing maternal health care in rural health facilities in Wolaita Zone, Southern Ethiopia, in 2023. METHOD: A phenomenological qualitative study design was applied from May 20 to June 20, 2023. The study was conducted in rural areas of the Wolaita Zone, southern Ethiopia. Healthcare professionals from rural areas were selected using purposive sampling, and in-depth interviews were conducted. A qualitative thematic analysis was employed to analyze the data. Field notes were read, recordings were listened to, and each participant's interview was written word for word and analyzed using ATLAS.ti 7 software. RESULT: Five main themes emerged from the data analysis. These themes included inadequate funding from the government, societal barriers to health and access to health care, professionals' personal life struggles, infrastructure related challenges and health system responsiveness, and coping strategies. Reporting to responsible bodies, teaching mothers about maternal health care services, and helping poor mothers from their pockets were listed among their coping strategies. CONCLUSION: Healthcare professionals have a crucial role in supporting women in delivering babies safely. This study revealed that they are working under challenging conditions. So, if women's lives matter, then this situation requires a call to action.

GIS-based spatio-temporal analysis of rainfall trends under climate change in different agro-ecological zones of Wolaita zone, south Ethiopia.

Understanding the spatiotemporal dynamics of climatic conditions within a region is paramount for informed rural planning and decision-making processes, particularly in light of the prevailing challenges posed by climate change and variability. This study undertook an assessment of the spatial and temporal patterns of rainfall trends across various agro-ecological zones (AEZs) within Wolaita, utilizing data collected from ten strategically positioned rain gauge stations. The detection of trends and their magnitudes was facilitated through the application of the Mann-Kendall (MKs) test in conjunction with Sen's slope estimator. Spatial variability and temporal trends of rainfall were further analyzed utilizing ArcGIS10.8 environment and XLSTAT with R programming tools. The outcomes derived from ordinary kriging analyses unveiled notable disparities in the coefficient of variability (CV) for mean annual rainfall across distinct AEZs. Specifically, observations indicated that lowland regions exhibit relatively warmer climates and lower precipitation levels compared to their highland counterparts. Within the lowland AEZs, the majority of stations showcased statistically non-significant positive trends (p > 0.05) in annual rainfall, whereas approximately two-thirds of midland AEZ stations depicted statistically non-significant negative trends. Conversely, over half of the stations situated within highland AEZs displayed statistically non-significant positive trends in annual rainfall. During the rainy season, highland AEZs experienced higher precipitation levels, while the south-central midland areas received a moderate amount of rainfall. In contrast, the northeast and southeast lowland AEZs consistently received diminished rainfall across all seasons compared to other regions. This study underscores the necessity for the climate resilient development and implementation of spatiotemporally informed interventions through implementing region-specific adaptation strategies, such as water conservation measures and crop diversification, to mitigate the potential impact of changing rainfall patterns on agricultural productivity in Wolaita.

Client satisfaction on family planning, its myths, and misconceptions among women in Wolaita zone, Southern Ethiopia: A mixed methods design.

Background: Client satisfaction has been recognized as an essential component in evaluating healthcare quality. In Wolaita Zone, there was a lack of research on the myths, misconceptions, and elements linked to client satisfaction with family planning. This study aimed to assess the myths and misconceptions of family planning and the factors associated with women's satisfaction with family planning services. Methods: We used a mixed methods study design (cross-sectional study design with a phenomenological design of the qualitative study). For the survey, 777 women were selected using multistage sampling, while purposive sampling was used to recruit in-depth interview participants. We used STATA version 15 and NVIVO version 12 software. Results: Only two-thirds, 534 (68.7 %) [95 % CI = 65.4%-71 %] clients, were satisfied with the family planning service. Clients who attended secondary education and above (AOR = 1.84; 95 % CI: 1.07, 3.23) and (AOR = 3.04; 95 % CI: 1.37, 6.72) did not wait to get the service (AOR = 5.11; 95 % CI: 1.98, 13.20), attended family planning service in a facility with convenient working hours (AOR = 4.43; 95 % CI: 2.25-8.74) and with posters in the waiting room (AOR = 3.48; 95 % CI: 1.22-9.94), comfortable with the cleanliness of clinic (AOR = 2.08; 95 % CI: 1.20, 3.94), whose Privacy was maintained (AOR = 9.56; 95 % CI: 5.02, 18.20), who were given information on the possible side effects of a method (AOR = 2.77; 95 % CI: 1.75-4.39), and on how the method works (AOR = 2.57; 95 % CI: 1.49-4.43) had higher odds of satisfaction. Also, various myths and misconceptions, such as implants moving to other parts of the body, implants causing paralysis, affecting routine activities, "womb of the woman may not hold the baby", etc., were identified in a qualitative study. Conclusions: Client satisfaction in this study is low. An improved provider approach that suits on-site advocacy and the quality of counselling during the family planning service is needed. There is also a need to improve waiting time, working hours, cleanliness, awareness creation for both couples, and maintaining clients' privacy.

The abundance and distribution of sandflies (with emphasis on Phlebotomus pedifer) (Diptera: Psychodidae) along the altitudinal gradient in Kindo Didaye district, Wolaita Zone, South Ethiopia.

Understanding the distribution patterns of medically significant sandflies is crucial for effective vector and disease control planning. This study focused on investigating the abundance and distribution of phlebotomine sandflies, specifically emphasizing Phlebotomus pedifer (Diptera: Psychodidae), the vector of Leishmania aethiopica responsible for cutaneous leishmaniasis in the highlands of southern Ethiopia. The study employed CDC light traps and sticky paper traps in various habitats, including human houses, farm fields, and rock cliffs, with and without the presence of hyraxes. The study was conducted along an altitudinal gradient in Kindo Didaye district, Wolaita Zone. A total of 7,994 sandflies belonging to 2 genera, Phlebotomus (26.1%) and Sergentomyia (73.9%), were collected. In the genus Phlebotomus, P. pedifer (74.1%) was the most abundant, followed by P. alexandri (18.05%) and P. gibiensis (7.85%). Altitude showed a strong positive association with the density and distribution of P. pedifer and a negative association with those of P. alexandri, P. gibiensis, and Sergentomyia spp. Furthermore, the study revealed distinct habitat preferences, with P. pedifer showing the highest mean density in hyrax dwellings, followed by human houses, and the lowest in farm fields. These findings provide valuable insights for planning targeted control measures against P. pedifer in both indoor and outdoor environments, particularly in the highland and midland areas of the study region.

Seroprevalence and molecular detection of foot and mouth disease virus in cattle in selected districts of Wolaita Zone, Southern Ethiopia.

Foot and mouth disease (FMD) is a highly contagious, endemic, and acute viral cattle ailment that causes major economic damage in Ethiopia. Although several serotypes of the FMD virus have been detected in Ethiopia, there is no documented information about the disease's current serostatus and serotypes circulating in the Wolaita zone. Thus, from March to December 2022, a cross-sectional study was conducted to evaluate FMDV seroprevalence, molecular detection, and serotype identification in three Wolaita Zone sites. A multistage sample procedure was used to choose three peasant associations from each study region, namely Wolaita Sodo, Offa district, and Boloso sore district. A systematic random sampling technique was employed to pick 384 cattle from the population for the seroprevalence research, and 10 epithelial tissue samples were purposefully taken from outbreak individuals for molecular detection of FMDV. The sera were examined using 3ABC FMD NSP Competition ELISA to find antibodies against FMDV non-structural proteins, whereas epithelial tissue samples were analyzed for molecular detection using real-time RT-PCR, and sandwich ELISA was used to determine the circulating serotypes. A multivariable logistic regression model was used to evaluate the associated risk variables. The total seroprevalence of FMD in cattle was 46.88% (95% CI 41.86-51.88), with Wolaita Sodo Town having the highest seroprevalence (63.28%). As a consequence, multivariable logistic regression analysis revealed that animal age, herd size, and interaction with wildlife were all substantially related to FMD seroprevalence (p < 0.05). During molecular detection, only SAT-2 serotypes were found in 10 tissue samples. Thus, investigating FMD outbreaks and identifying serotypes and risk factors for seropositivity are critical steps in developing effective control and prevention strategies based on the kind of circulating serotype. Moreover, further research for animal species other than cattle was encouraged.

Incidence and predictors of treatment failure among children with HIV on first-line antiretroviral therapy in Wolaita zone, Southern Ethiopia: A multicenter retrospective cohort study.

Background: Antiretroviral therapy has improved the life expectancy of HIV-positive children. Treatment failure and drug resistance among children with HIV remain major public health concerns despite the rise in ART use. A dearth of evidence exists regarding treatment failure among Ethiopian children from multicenter settings. Therefore, this study sought to assess the incidence and predictors of treatment failure among children with HIV on first-line antiretroviral therapy at health facilities in Wolaita zone, Southern Ethiopia. Methods: A facility-based retrospective cohort study was conducted from January 1, 2017, to December 30, 2021, at health facilities providing ART in Wolaita zone, Southern Ethiopia. A total of 425 children with HIV on first-line ART were selected using a simple random sampling technique. Data were extracted by reviewing the patient's medical record. The data were entered using epi-data version 4.6 and exported to STATA version 15 for analysis. Both bi-variable and multivariable Cox regression analysis were employed. A p-value of less than 0.05 and a hazard ratio with 95 % CI was used to estimate the association between the predictor factors and treatment failure. Results: The overall incidence density rate of treatment failure was 3.2 per 1000 person-months of observation (95 % CI: 2.4-4.6). The factors significantly associated with antiretroviral treatment failure were caregiver marital status, single (AHR = 4.86, 95 % CI: 1.52, 15.60), and widowed (AHR = 3.75, 95 % CI: 1.16, 12.11), duration of follow-up (AHR = 4.95, 95 % CI: 1.81, 13.54), and baseline CD4 count (AHR = 4.70, 95 % CI: 1.68, 13.14). Conclusion: The incidence rate of ART failure among children with HIV was found to be significant. Low baseline CD4 count, short follow-up duration on ART, and having a single or widowed caregiver were significantly associated with antiretroviral treatment failure. Early identification of children with low CD4 count and subsequent initiation of ART should be emphasized by stakeholders working in HIV care programs. Healthcare professionals should pay special attention to and regularly monitor the treatment progress of children who have single or widowed caregivers, and those with shorter duration of follow-ups.

Documentation practice and associated factors among nurses working in public hospitals in Wolaita Zone, Southern Ethiopia.

BACKGROUND: Nursing documentation documents the everyday activities of nursing care that are planned and implemented on individual patients by nurses of different educational statuses. Documentation of nursing activities is the key source of clinical information to meet professional and legal requirements. Although nursing documentation is an important part of nursing practice, it is commonly undone by nurses working with patients for different reasons. OBJECTIVE: To assess the documentation practice and their associated factors among nurses working in public hospitals in the Wolaita Zone, Southern Ethiopia. METHODS: An institutional-based cross-sectional study was conducted among 402 nurses and a simple random sampling technique was used to select participants. Data were collected using a pretested structured self-administered questionnaire adapted from previous studies. Statistical Package for the Social Science version 26 was used for data entry and analysis. Independent variables with p-value < 0.25 from bivariable logistic regression were entered into the multivariable logistic regression method and significant associations were obtained at an adjusted odds ratio with a 95% confidence interval and p-value < 0.05. RESULTS: In this study, the good documentation practice among nurses was 42% [95% confidence interval (CI), 37.2-46.8]. There was a statistically significant relationship between documentation practice and age [adjusted odds ratio (AOR): 2.590 (95% CI: 1.4-4.79)], educational status [AOR: 2.248 (95% CI: 1.13-4.48)], hospital level [AOR: 4.185 (95% CI: 2.63-6.72)], work experience (2-5 years and > 5 years) [AOR: 4.066 (95% CI: 1.55-10.64)] and [AOR: 5.395 (95% CI: 1.97-14.81)] respectively and in-service training [AOR: 0.582 (95% CI: 0.366-0.923)]. CONCLUSION AND RECOMMENDATIONS: This study demonstrated that the good practice of documentation among nurses was found to be low. Age, educational status, working in comprehensive specialized hospitals, work experience, and having in-service training had significant associations with documentation practice. It is very important to plan and intervene with different strategies, such as providing training for young nurses, nurses with low educational status, nurses working in primary hospitals, and nurses with less than two years of work experience on documentation standards, to create positive attitudes and enhance their knowledge.

Adherence to Iron-Folic Acid Among Pregnant Women Attending Antenatal Care in Southern Ethiopia, 2022.

Background: Among the micronutrient deficiencies, iron and folic acid are the most common and frequently occur in pregnant women. So, the objective of this study was to assess the adherence to iron and folic acid among pregnant women booking antenatal services in the study area. Materials and Methods: A facility-based cross-sectional study design was used from January to April 2022. A structured questionnaire was used to collect data using systematic sampling techniques to approach 339 pregnant women. Data were entered and analyzed using SPSS software version 20. A descriptive analysis was performed. Adjusted odds ratios and corresponding 95% confidence intervals (CIs) were used, and statistical significance was reported at p-values <0.05 with 95% confidence. Results: In this study, 339 (99%) pregnant women participated. The mean age of the respondents was 28.04 years old, with a standard deviation of 5.3 years. The rate of adherence to iron and folic acid supplementation (IFAS) in pregnant women was 62.8%. Mothers under 19 years old (adjusted odds ratio [AOR] = 0.025; 95% CI [0.003-0.218]), daily (AOR = 0.127; 95% CI [0.028-0.568]), and those with a history of miscarriage (AOR = 0.276; 95% CI [0.086-0.891]) were less likely to be using IFAS. However, greater knowledge of IFAS was positively correlated with use of the supplements (AOR = 5.56; 95% CI [1.23-8.34]). Conclusions: In this study, the adherence rate with IFAS of pregnant women in the study area was 62.8%. This indicates that one in four women is not in compliance with IFAS. Appropriate counseling and health education should be provided to pregnant women to improve compliance.

Health-related quality of life and associated factors among adult patients with epilepsy in public hospitals of Wolaita zone, southern Ethiopia. An embedded mixed method study.

BACKGROUND: The socioeconomic and overall quality of life of patients with epilepsy are significantly impacted by the disease, which is one of the most prevalent chronic noncommunicable brain disorders. Less consideration has, however, been given to research in Ethiopia generally and the study setting in particular. Consequently, the purpose of this study was to assess the health-related quality of life and associated factors among adult patients with epilepsy in public hospitals in the Wolaita zone of southern Ethiopia. METHODS: A facility-based embedded mixed method with cross-sectional and phenomenological study designs was carried out on 423 adult patients with epilepsy from August 1 to August 30, 2022. Systematic and criterion-purposive sampling was employed for the cross-sectional and phenomenological designs, respectively, to select study participants. Quantitative data were entered into Kobo Toolbox and then exported to SPSS Version 25 for analysis. The frequency, percentage, and cross-tabulation of the different variables were then determined. Finally, the magnitude and associated factors were first analyzed using binary logistic regression and then multivariate logistic regression. P < 0.05 was chosen as the level of statistical significance. An inductive thematic approach was used for qualitative data analysis. RESULTS: A total of 423 patients with epilepsy were included in the study, making the response rate 100%. The overall prevalence of poor quality of life among patients with epilepsy in the study area was 53 percent (95% CI: 48.24-57.76). Being single (AOR = 4.457, 95% CI: 1.149, 17.282), having poor social support (AOR = 3.741, 95% CI: 2.107, 6.643), having uncontrolled seizures (AOR = 2.154, 95% CI: 1.234, 3.759), and having a high frequency of seizures (AOR = 5.192, 95% CI: 1.574, 17.126) were significantly associated factors with quality of life. Lack of social support, a fear of drug side effects, and worry about their disease were findings from the qualitative perspective added to the perspective of the quantitative findings. CONCLUSION: One in every two patients with epilepsy in this study had a poor quality of life. Being single, the frequency of seizures, and a lack of social support all have a significant association. Public health initiatives should continue to strive to create positive awareness of epilepsy in society in addition to managing the clinical aspect of the disease.

Plasmodium falciparum remains the dominant parasite affecting children despite decades of implementing vector control in two villages of Wolaita Zone, Southwest Ethiopia.

Background: Malaria is still a significant public health concern, and its prevention and control measures have different impacts in different areas. This study assesses the prevalence of malaria and the effectiveness of routine malaria control programmes such as indoor residual spray (IRS) in two Ethiopian villages. Methods: The Kebeles (villages) were purposefully selected based on their malaria prevalence rates. A parasitology survey was conducted in Fango-Gelchecha pre- and post-IRS implementation, whereas in Shochora-Abela it was only conducted post-IRS implementation. The IRS was implemented as part of the routine malaria control programme in August 2017. Every fourth house from the village registration list was systematically selected, resulting in a sample of 300 households per village. A total of 3,075 individuals were enrolled for malaria testing using microscopy. Results: After three to four months of application of IRS in August 2017, 59 malaria cases were confirmed, resulting in an overall prevalence of 1.9% (95% CI: 1.5-2.5). Of the positive cases, 18 cases (0.59%: 95% CI: 1.3-1.8) were from Shochora-Abela village, and 41 cases (1.33%: 95% CI: 1.1-1.3) were from Fango-Gelchecha. About age categories, the prevalence of malaria was 10.1% (95% CI: 5.9-15.9) among children under five, 4.7% (95% CI: 3.3-6.4) in children aged 5-14, and only 0.32% (95% CI: 0.13-0.67) in the age group 15 and above. Overall, P. falciparum was the dominant malaria parasite, accounting for 69.5% (95% CI: 56.1-80.8), while P. vivax malaria accounted for 30.5% (95% CI: 19.2-43.8). The malaria prevalence in Fango-Gelchecha village was 3.1% (95% CI: 2.3-4.0) before IRS and 2.6% (95% CI: 1.8-3.5) after IRS application. In the village of Shochora-Abela, the prevalence of malaria post-IRS was 1.2% (95% CI: 0.7-1.9), but the prevalence prior to IRS was not evaluated. Conclusions: Plasmodium falciparum is the predominant parasite in the villages, mainly affecting children under five. Therefore, protecting young children should be the top priority for reducing infection burdens.

Cervical cancer screening practice and associated factors among women employees in Wolaita Zone hospitals, Southern Ethiopia, 2017: cross-sectional study.

Introduction: cervical cancer is a global public health problem affecting women worldwide. There is very low participation rate in screening practice for cervical cancer in low-resource countries like Ethiopia. So the aims of this study is to assess cervical cancer screening practice and associated factors among women employees in Wolaita Zone hospitals, Southern Ethiopia. Methods: facility based cross-sectional study design was conducted from March 1-April 30, 2017. Simple random sampling technique was employed to select 401 study participants. Pre-tested self-administered questionnaire was used. Logistic regression was performed to assess association between dependent and independent variables with 95% confidence interval (CI) and p-value less than 0.05 was set to declare association. Results: about 120 (30.5%) participants were screened for cervical cancer. Age, source of information from health professions, being adherence supporter, sex with more than one partner, sexual transmitted infection, increase in attitude and knowledge score were significant predictors of cervical cancer screening practice. Conclusion: magnitude of cervical cancer screening practice among age eligible women is still low. Age, being adherence supporter, source of information from health care professionals, history of multiple sexual p artners, sexually transmitted infection, knowledge and attitude were important predictors of cervical cancer screening practice. Hospitals in collaboration with town administration should put priority on cervical cancer prevention by establishing cervical cancer screening campaign.

Clinicopathological and molecular studies on cattle naturally infected with lumpy skin diseases in selected districts of Wolaita Zone, Southern Ethiopia.

BACKGROUND: Lumpy skin disease is a contagious viral disease of cattle caused by LSDV that results in huge economic losses in the cattle industry. This study characterizes LSDV in cattle through clinicopathological and molecular techniques in selected districts of Wolaita Zone, Southern Ethiopia. METHODS: A crossectional study was conducted from November 2020 to June 2021 using Real-time polymerase chain reaction and Histopathological techniques to confirm LSDV. RESULT: This study revealed that the percentage of positivity of cattle for LSDV was 36.2%. Clinically, cattle infected with LSDV revealed fever (39-41 °C), nodular lesions on the skin and mucous membranes, and lymphadenopathy. Histopathologically, affected tissue revealed ballooning degenerations of the epidermis, infiltration of mononuclear inflammatory cells, vasculitis, and intracytoplasmic eosinophilic inclusion bodies. RT-PCR confirmed that DNA extracts from skin biopsies of virus isolates were positive for LSDV. CONCLUSION: The present study confirms that LSDV is widely circulating in cattle of selected districts of the Wolaita zone. Thus, effective control measures through regular vaccination and further confirmation of circulating strains of LSDV through detailed molecular analysis should be recommended.

Animal care professionals' practice towards zoonotic disease management and infection control practice in selected districts of Wolaita zone, Southern Ethiopia.

Veterinary practices or activities expose professionals to occupational hazards, including infection with zoonotic diseases, during contact with animals. To assess animal care professionals' practice towards zoonotic disease management and infection control practices (ICPs) in selected areas of the Wolaita zone, a cross-sectional survey was conducted using a structured questionnaire survey. A total of 287 animal care professionals were registered by the Wolaita zone livestock and fishery office and working in nine different districts of the Wolaita zone. Of these, 135 animal care professionals working across nine different districts of the Wolaita zone were interviewed in the current study. The survey showed that about 55% (74/135) of respondents were animal health assistants, and about 84% (114/135) of the professionals were males. In terms of utilization of ICP, about 72% of professionals routinely wash their hands before eating and drinking in their workplace. However, approximately 7% of professionals sometimes eat or drink at the workplace. Additionally, almost 32% of the professionals always wash their hands between patient contacts. In the survey, approximately 49% of veterinarians said they sterilized and reused disposable needles. When dealing with an animal suspected of carrying a zoonotic infection, nearly 25% of experts isolate or quarantine diseased animals, and only about 25% of the experts remove their personal protective equipment (PPE) before interacting with other animals. Approximately 62% of responders said they used outwear (PPE) when carrying out surgery and 28% when performing a necropsy. Nearly 39% of veterinarians reported using gloves and gowns when assisting with parturition or handling conception products, and around 36% of practitioners utilized proper PPE when handling blood samples. Our findings show that the veterinary community in the Wolaita Zone's selected sites needs to be educated about ICPs regularly. A better understanding of the risk of zoonotic disease exposure, as well as alternatives for reducing this risk and liability problems, may encourage the use of infection control measures. Successful partnerships across multiple professional sectors should use a One Health approach that includes stakeholders from the human, animal, and environmental categories.

Survival and Predictors of Mortality Among Neonates Admitted to Neonatal Intensive Care Unit at Bombe Primary Hospital, Southern Ethiopia: Institution-Based Retrospective Cohort Study.

BACKGROUND: Neonatal mortality includes all deaths of neonate occurring before the 28th day of life. Neonatal mortality has been declining over two decades in Sub-Saharan Africa, including Ethiopia. The foremost causes of death are preventable and treatable. Regardless, recognizing the predictors may be a crucial step in lowering neonatal mortality. However, evidences on the survival status of neonates and/or neonatal death predictors were limited in Ethiopia, particularly in the study area. Thus, this study aimed to answer these questions. METHODS: An institution-based retrospective cohort study was done among 380 Neonates admitted to the Neonatal Intensive Care Unit at Bombe Primary Hospital from January 1, 2018, to December 31, 2019. Bivariable and multivariable Cox regression analyses were conducted to identify predictors of mortality. Association was summarized using adjusted hazard ratio (AHR), and statistical significances were declared at 95% CI and P-value <0.05. Proportionality assumption was tested by a global test based on Schoenfeld residuals analysis. RESULTS: The overall incidence of neonatal mortality was 20.8 (95% CI: 15.2, 28.5) per 1000 neonatal days. Late initiation of early breastfeeding (EBF) after 1 hr. [AHR: 2.9; 95% CI: 1.32, 6.37], 5th min APGAR score <5 [AHR: 3; 95% CI: 1.32; 6.88], low birth weight [AHR: 2.59; 95% CI: 1.1,6.26], hypothermia [AHR: 2.6; 95% CI: 1.1, 6.22] and mothers' time of rupture of membrane >12 hours before delivery [AHR: 2.49; 95% CI: 1.25, 4.97] were increased the risk of neonatal mortality, while cesarean section delivery 91.6% [AHR= 0.084; 95% CI: 0.10, 0.65] and antenatal care (ANC) utilization 61% [AHR: 0.39; 95% CI: 0.15-0.91] decreased the risk of neonatal mortality. CONCLUSION: The incidence of neonatal mortality rate was high at the Bombe primary hospital. Therefore, to improve neonatal survival, it is recommended that complications and low birth weight be managed, that early exclusive breastfeeding be initiated, that service quality be improved, and that a continuum of care be ensured.

Magnitude of Pre-Existing Diabetes Mellitus Among Pregnant Women in Southern Ethiopia: A Cross-Sectional Study.

BACKGROUND: The presence of maternal diabetes mellitus (DM) during pregnancy has complications for both mother and child. Pre-existing DM can result in higher risk of maternal and child mortality and morbidity. In Ethiopia, the magnitude of pre-existing DM among pregnant women is not well studied. The aim of this study was to assess the magnitude of pre-existing DM among pregnant women in Wolaita Zone, Southern Ethiopia. METHODS: A retrospective document review was carried out to determine the magnitude of pre-existing DM in three hospitals and four health centers in Wolaita Zone, Southern Ethiopia. A total of 600 pregnant mothers who attended maternity services at the study health facilities in one year period from January 1, to December 31, 2017 were included in the study. Data were collected from medical records of mothers. Chi-square and logistic regression analysis model were used to check the relationship between pre-existing DM and independent variables. RESULTS: A total of 600 mothers were included in the analysis. The magnitude of pre-existing DM among mothers receiving maternity care within a one year period was 2.8% (95% CI: 1.5, 4.2). The magnitudes among urban and rural residents were 3.4% and 1.4%, respectively. Pre-existing DM is significantly associated with family history of diabetes (Chi square 24.8, P-value, 0.001). Previous history of spontaneous abortion (aOR: 5.3; 95% CI: 1.6-17.4) and fetal macrosomia (aOR: 3.9; 95% CI: 1.2-13.1), was identified to be significantly associated with pre-existing DM. The magnitude of pre-existing DM is comparable with International Diabetes Federation Estimate to Ethiopia in the study area. Family history of DM was found to be associated with pre-existing DM. Pre-existing DM is associated with increased risk of abortion and fetal macrosomia. CONCLUSION: The magnitude of pre-existing DM is comparable with previous estimates to the country. A nationwide, large-scale study is important to estimate the burden of pre-existing DM and associated risk factors among pregnant mothers at national level.

Health-Related Quality of Life and Associated Factors Among Adult Patients with Heart Failure in Wolaita Zone Governmental Hospitals, Southern Ethiopia.

BACKGROUND: Knowing how heart failure affects patients' quality of life and its associated factors are crucial for a better patient-centred approach and management. Therefore, this study aims to assess health-related quality of life and its associated factors among adult heart failure patients in southern Ethiopia hospitals. METHODS: The facility-based cross-sectional study design was conducted in Wolaita zone governmental hospitals from March to April 2018. The population was all adult heart failure patients in the chronic illness follow-up clinic and inpatient department. All adult heart failure patients on follow-up clinic and inpatient departments who have at least a 6-month follow-up were included in the study. In contrast, patients who had chronic comorbidities were excluded from the study. Minnesota Living with Heart Failure Questionnaire (MLHFQ) tool was used to measure the outcome variable health-related quality of life (HRQoL). Interviews and client medical record reviews also collected socio-demographic, clinical and behavioural characteristics of participants. The data were analyzed using STATA version 14, and multiple linear regression analysis with P-value < 0.05 was used to measure the degree of association between HRQoL and independent variables. RESULTS: A total of 372 patients participated in the study. The HRQoL score for the physical, emotional, and total were 22.2, 7.7, and 46.37, respectively. HRQoL was significantly associated with gender, age, family size, occupation, residency, and recent admission within the past six months, New York Heart Association (NYHA) functional class, department of treatment, salt intake, and health perception. CONCLUSION: Generally, the HRQoL for patients with heart failure was found to be low. Besides the variables age and gender of participants, family size, occupation, residency, admission history, salt intake, and NYHA class were significant factors for the HRQoL of patients with heart failure.

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.

Healthcare Worker Experience and the Challenges in Screening for Intimate Partner Violence Among Women Who Use Antiretroviral Therapy and Other Health Services in Wolaita Zone, Ethiopia: A Phenomenological Study.

BACKGROUND: Intimate partner violence is a crime against humanity. This study aimed to explore the experiences and challenges in screening for intimate partner violence among women who use antiretroviral therapy and other health services in Wolaita Zone in Ethiopia. METHODS: A descriptive phenomenological qualitative study design was used, and 16 in-depth interviews were conducted with healthcare workers from 19 health facilities who were providing healthcare services in Wolaita Zone. We selected participants purposively until data saturation was reached. Colaizzi's descriptive phenomenological method was used for the data analysis, and the Open Code software was used to assist with the data coding. We maintained the scientific rigour of credibility, transferability, dependability, and confirmability. RESULTS: Analysis of the study data identified the following five themes: type of IPV identified by HCWs among women, provider-related barriers, healthcare system barriers, patient-level barriers, and providers' recommendations for improvements. Issues that emerged from these findings were a gap in medico-legal report provision, absence of a separate record-keeping for IPV cases, lack of client follow-up, absence of routine assessment of violence for women who have injuries, and lack of specific coordination with an external organisation. Moreover, the absence of staff training, weak referral systems, and a shortage of necessary medical equipment challenged IPV screening. CONCLUSION: This study has shown that there are healthcare provider and health system challenges relating to screening clients for intimate partner violence in Wolaita Zone. Provision of separate record-keeping of intimate partner violence cases in the healthcare facilities, standardising the medico-legal reporting system, improving women's access to education, and executing more gender-equitable policies, are needed. Moreover, the inclusion of intimate partner violence-specific policy frameworks in national legislation is necessary.

Male involvement in birth preparedness and complication readiness for emergency referral at Sodo town of Wolaita zone, South Ethiopia: a cross sectional study.

BACKGROUND: Preventable maternal mortality remains a huge burden more especially in sub-Saharan Africa. The involvement of male partner during pregnancy and its complication helps an expectant mother to make timely decisions to avoid delays that brings about complications that could result in morbidity or mortality. METHODS: Institution based cross sectional study was conducted in 2017, at Sodo Town of Wolaita Zone among mothers who came to hospital and admitted to MCH department due to emergency obstetric referral. Data were collected using pre-tested and structured questionnaire. The collected data entered by Epi data, cleaned and analyzed by using SPSS for windows version 23.0. A descriptive analysis was done using frequency, mean, quartile and standard deviation. Bivariate and multivariable logistic regression was carried out to identify the associated factors. Level of statistical significance was declared at p value < 0.05. Finally the results of Bivariate and multivariable logistic regression analysis were presented in crude and adjusted odds ratio with 95% confidence intervals. RESULT: Data were obtained from 233 women, with a response rate of 100%. The prevalence of male partner's involvement in birth preparedness and complication redness for emergency referral in this study was 30.9%. After adjusting for the effect of confounding variables using multivariable logistic regression, variables like distance of health facility (AOR = 0.29, 95%CI = 0.12, 0.72), having ANC follow-up (AOR = 2.9, 95%CI = 1.52-5.51) and experience of obstetric complication (AOR = 1.79, 95%CI = 1.06-3.04) have statistically significant association with male partner's involvement in birth preparedness and complication readiness for obstetric referral. CONCLUSION: In general, male partner's involvement in birth preparedness and complication readiness for obstetric referral in the study area was low. Antenatal care attending and experiencing of obstetric complication were factors determining male partner's involvement in complication readiness. Health care professionals should involve male partners to attend ANC clinic at each stage and arrange special antenatal care conferences which may increase awareness and practice about complication readiness and plan.

Epidemiology of intestinal helminthiasis among school children with emphasis on Schistosoma mansoni infection in Wolaita zone, Southern Ethiopia.

BACKGROUND: Intestinal helminth infections are major parasitic diseases causing public health problems in Ethiopia. Although the epidemiology of these infections are well documented in Ethiopia, new transmission foci for schistosomiasis are being reported in different parts of the country. The objective of this study was to assess the prevalence of Schistosoma mansoni and other intestinal helminth infections among school children and determine the endemicity of schistosomiasis in Wolaita Zone, southern Ethiopia. METHODS: Cross-sectional parasitological and malacological surveys were conducted by collecting stool samples for microscopic examination and snails for intermediate host identification. Stool samples were collected from 503 children and processed for microscopic examination using Kato-Katz and formalin-ether concentration methods. Snails collected from aquatic environments in the study area were identified to species level and Biomphalaria pfeifferi snails, the intermediate host of S. mansoni,, were individually exposed to artificial light in order to induce cercariae shedding. Cercariae shed from snails were used to infect laboratory-bred Swiss albino mice in order to identify the schistosome to species level. RESULTS: The overall prevalence of intestinal helminth infections was 72.2% among school children. S. mansoni infection prevalence was 58.6%. The prevalence and intensity of S. mansoni infections varied among schools and sex of children. Swimming was the only factor reported to be significantly associated with S. mansoni infection (AOR = 2.954, 95% CI:1.962-4.449). Other intestinal helminth species identified were hookworms (27.6%), Ascaris lumbricoides (8.7%), E. vermicularis (2.8%), Taenia species (2.6%), T. trichiura (1.2%) and H. nana (0.6%). Only B. pfeifferi snails collected from streams shed schistosome cercariae and 792 adult S. mansoni worms were harvested from mice exposed to cercariae shed from B. pfeifferi on the 6th week post-exposure. CONCLUSION: The present study found high level of intestinal helminth infections in the study area. The study also confirmed autochthonous transmission and endemicity of S. mansoni as evidenced by both parasitological and malacological findings as well as by further establishing infections in lab-bred mice. Therefore, there is a need to include the area in the control programs with anti-helminth drugs and also consider other complementary measures including sanitation, provision of clean water supply, and snail control.