Burden of intestinal parasitic infections and associated factors among pregnant women in East Africa: a systematic review and meta-analysis.

BACKGROUND: The ultimate goal of preventing intestinal parasites among pregnant women is to reduce maternal and newborn morbidity and mortality. Numerous primary studies were conducted in East Africa presented intestinal parasite infection and associated factors among pregnant women. However, the pooled finding is not known. Therefore, this review aimed to identify the pooled prevalence of intestinal parasite infection and its determinants among pregnant women in East Africa. METHODS: Articles published from 2009 to 2021 were searched in PubMed, Web of Science, EMBASE, and HINARI databases. The search for unpublished studies such as thesis and dissertations was checked in Addis Ababa University and Africa Digital Library. PRISMA checklist was used to report the review. Articles published in the English Language were considered. The data were extracted by two authors using data extraction checklists on Microsoft excel. Heterogeneity among the included studies was checked using I2 statistics on forest plots. Sensitivity and sub-group analyses were conducted to assess the presence of primary studies, and study characteristics responsible for the observed heterogeneity. RESULTS: Of the 43 identified articles, about 23 articles were removed due to duplications. Then, by assessing the abstracts and full texts, four articles were removed because they failed to meet the eligibility criteria. Finally, 16 articles were included in the systematic and meta-analysis.The pooled prevalence of intestinal parasites among pregnant women in East Africa was 38.54 (28.77, 48.32). In this study, variables like residing in rural areas (OR: 3.75; CI: 1.15,12.16), availability of latrine(OR: 2.94; 95% CI: 2.22, 3.91), eating raw fruits/vegetables (OR: 2.44; 95% CI: 1.16, 5.11). and sources of water as unprotected sources (OR: 2.20; 95% CI: 1.11,4.35) show statistically significant association with the increased burden of intestinal parasites among pregnant women. CONCLUSION: The burden of intestinal parasite infection among pregnant women in East Africa was high. Therefore, efforts should be made in deworming pregnant women at the community and institutional level by stakeholders to reduce the burden of intestinal parasite infections and related complications.

Determinants of adverse birth outcomes among women delivered in public hospitals of Ethiopia, 2020.

BACKGROUND: Adverse birth outcome is a common health problem consisting of several health effects involving pregnancy and the newborn infant. Infants with one or more adverse birth outcomes are at greater risk for mortality and a variety of health and developmental problems. Factors such as the age of the mother, antepartum hemorrhage, history of abortion, gestational age, anemia, and maternal undernutrition have predisposed the mother to adverse birth outcome. For appropriate prevention of the adverse birth outcomes, data pertaining to determinants of adverse birth outcomes are important. Therefore, this study was aimed to assess the determinants of adverse birth outcomes among women who give birth in public hospitals of western Ethiopia. METHODS: An institutional-based unmatched prospective case-control study was conducted from February 15 to April 15, 2020, in selected public hospitals of western Ethiopia. From mothers who gave birth in public hospitals of Wollega zones, 165 cases and 330 controls were selected. Mothers with adverse birth outcomes were cases and mothers without adverse birth were controls. Data was collected by structured interviewer-administered questionnaires. In addition to the interview, the data collectors abstracted clinical data by reviewing the mother and the babies' medical records. The collected data were entered into Epi info version 7 and exported to SPSS version 21 for analysis. Finally, multivariable logistic regression was used to identify determinants of adverse birth outcomes at P-value < 0.05. RESULTS: A total of 495 mothers (165 cases and 330 controls) were included in the study with a mean age of 28.48 + 5.908. Low ANC visit (AOR = 3.92: 95% CI; 1.86, 8.2), premature rupture of membrane (AOR = 2.83: 95% CI; 1.72,4.64), being Anemic (AOR = 2: 95% CI; 1.16,3.44), pregnancy induced-hypertension (AOR = 2.3:95% CI; 1.4,3.85), not getting dietary supplementation (AOR = 2.47:95% CI; 1.6,3.82), and physical abuse (AOR = 2.13: 95% CI; 1.05,4.32) were significantly associated with the development of the adverse birth outcome. CONCLUSION: Low antenatal care visit, being anemic, premature rupture of membrane, pregnancy-induced hypertension, not getting dietary supplementation, and physical abuse were determinants of adverse birth outcomes. The clinicians should play a pivotal role to improve antenatal care follow up, counsel, and supplement recommended diets and minimize violence and abuse during pregnancy.

The adverse birth outcome is a common health problem consisting of several health effects involving pregnancy and the newborn infant. Birth outcomes are measures of health at birth and their magnitude is dramatically decreased in the past 40 years. However; there is still a large gap between developing and developed countries. Infants with one or more adverse birth outcomes are at greater risk for mortality and a variety of health and developmental problems. For appropriate prevention of adverse birth outcomes, data pertaining to determinants of adverse birth outcomes are important. An institutional-based unmatched prospective case-control study was conducted from February 15 to April 15, 2020, in selected public hospitals of western Ethiopia. In this study, low Antenatal care (ANC) visits, being anemic, premature rupture of membrane, pregnancy-induced hypertension, not getting dietary supplementation, and physical abuse were determinants of adverse birth outcomes. The clinicians should play a pivotal role to improve ANC follow up, counsel, and supplement recommended diets and minimize violence and abuse during pregnancy.

Prevalence of Depressive Symptoms and Its Associated Factors among People Living with HIV Attending Public Hospitals of Nekemte Town, Western Ethiopia, 2021.

BACKGROUND: Depressive symptoms are the most common mental illness among people living with HIV/AIDS. Depressive symptoms impact negatively on the course of HIV infection and can lead to suicide and increased risk of mortality when it is a severe form. Although depressive symptoms are common among HIV/AIDS patients, only a few studies have been conducted in Ethiopia and no study, particularly at Nekemte town public hospitals. Therefore, this study was aimed at assessing the prevalence and risk factors for depressive symptoms among people living with HIV/AIDS attending Nekemte town public hospitals, Western Ethiopia. Methods. An institution-based cross-sectional study design was conducted on 425 HIV/AIDS patients at Nekemte town public hospitals, from March 30 to May 30, 2019. Data were collected through interviews and patient document reviews. The nine-item Patient Health Questionnaire (PHQ-9) was used to collect information concerning depressive symptoms and was defined by a PHQ-9 score ≥ 5. HIV stigma and discrimination scales were used to measure stigma. Social support was described by a sum score of the Oslo3 social support scale (OSS-3). The collected data was entered into EpiData Windows version 4.1 and then exported to Statistical Package for the Social Sciences (SPSS) Windows version 24.0 for analysis. All variables found to be significant at the bivariable level (p value < 0.25) were entered into a multivariable logistic regression model. p values of <0.05 and 95% confidence level were used to determine statistical significance. RESULTS: Out of the total of 384 study participants who participated in the study, 165 (42.96%) had depressive symptoms. Self-reported sleeping problems (AOR = 7.04, 95% CI: 3.23, 15.33), CD4 level of <200 (AOR = 5.45, 95% CI: 2.06, 14.42), poor social support (AOR = 2.79, 95% CI: 1.17, 6.67), and perceived stigma (AOR = 9.11, 95% CI: 1.17, 17.33) were significantly associated with depressive symptoms among HIV/AIDS patients at Nekemte town public hospitals. CONCLUSION: The level of depressive symptoms among HIV/AIDS patients in this study was high. Self-reported sleeping problems, CD4 level, social support, and perceived stigma were found to be significantly associated with depressive symptoms among HIV patients. Health care professionals should have to strengthen the linkage of mental health with antiretroviral therapy (ART) clinic to early detect and treat depressive symptoms.

Magnitude and predictors of poor glycemic control among patients with diabetes attending public hospitals of Western Ethiopia.

BACKGROUND: Diabetes is one of the most prevalent non-communicable diseases globally, which rapidly is increasing in developing countries. Ethiopia is also facing growing morbidity and mortality related to diabetes complications. Thus, dealing with glycemic control is essential for controlling the development of devastating acute and chronic complications related to diabetes. Therefore, this study aims to assess the magnitude and predictors of poor glycemic control among diabetic patients in western Ethiopia. METHODS: The cross-sectional study design was employed on a sample of 423 diabetic patients. A systematic random sampling method was employed. An interviewer-administered structured questionnaire was used. The data entered into Epi data version 3.1 and exported into Statistical Package for the Social Sciences window version 24 for analysis. All variables significant at p-<0.25 in bivariate were entered into multivariate analysis. The multivariable logistic regressions were used to determine predictors' poor glycemic control by considering the Adjusted Odds Ratio at CI 95% and the significance level was set at p <0.05. RESULTS: The magnitude of poor glycemic control was 64.1%. Being females (AOR = 1.684,95%CI = 1.066,2.662), duration of diabetes >8years (AOR = 2.552,95%CI = 1.397, 4.665), presence of diabetes complication (AOR = 2.806,95%CI = 1.594,4.941), negligence of blood glucose test at home (AOR = 1.720, 95%CI = 1.078, 2.743), poor self-care behavior (AOR = 1.787, 95%CI = 1.083,2.959) and poor self-efficacy (AOR = 1.934, 95%CI = 1.078,3.469) were significant predictors of poor glycemic control. CONCLUSION: The proportion of poor glycemic control was high which was nearly comparable to that reported from many countries. This could be due to factors that were significantly associated with poor glycemic control like lack of home blood glucose test, increased duration of diabetes, presence of diabetes complications, poor self-efficacy, and poor self-care behaviors. Each were significant independent predictors of poor glycemic control. Thus, we recommend patients with diabetes and health care providers enhancing self-monitoring practices, and preventing potential complications should be a priority concern to improve blood glucose levels. Further studies are also recommended to explore important factors which were not identified by the current study.

Determinants of preterm birth among women delivered in public hospitals of Western Ethiopia, 2020: Unmatched case-control study.

BACKGROUND: Worldwide, preterm birth accounts for 1 million deaths of infants each year and 60% of these deaths occur in developing countries. In addition to the significant health consequences on the infant, preterm birth can lead to economic costs. There was a lack of study in western Ethiopia, and most of those studies conducted in other parts of a country were based on card review with a cross-sectional study design. The risk factors of preterm birth may vary from region to region within the same country due to variation in socioeconomic status and health care service coverage. Therefore, this study aimed to identify determinants of preterm birth in western Ethiopia. METHODS: An institutional-based case-control study was conducted from February 15 to April 15, 2020, in western Ethiopia. The eligible 188 cases and 377 controls were randomly selected for this study. Cases were women who gave birth after 28 weeks and before 37 completed weeks of gestation, and controls were women who gave birth at and after 37 weeks of gestation from the first day of the last normal menstrual period. Data were collected by a structured interviewer-administered questionnaire. The collected data were entered into Epi info version 7 and exported to SPSS version 21 for analysis. Multivariable logistic regression was used to identify determinants of preterm birth at P-value <0.05. RESULTS: From a total of 565 eligible participants, 516 (172 cases and 344 controls) participated in this study with a response rate of 91.3%. The result of the multivariable analysis shows that mothers who developed pregnancy-induced hypertension (AOR = 3.13, 95% CI; 1.78, 5.50), only one time ANC visits (AOR = 5.99, 95% CI; 2.65, 13.53), experienced premature rupture of membrane (AOR = 3.57, 95% CI; 1.79, 7.13), birth interval less than two years (AOR = 2.96, 95% CI; 1.76, 4.98), developed anemia during the current pregnancy (AOR = 4.20, 95% CI; 2.13, 8.28) and didn't get dietary supplementation during the current pregnancy (AOR = 2.43, 95% CI; 1.51, 3.91) had statistically significant association with experiencing preterm birth. CONCLUSION: Antenatal care service providers should focus on mothers with pregnancy-induced hypertension, premature rupture of membrane, and anemia during pregnancy, and refer to the senior experts for early management to reduce the risk of preterm delivery. Antenatal care services such as counseling the mother on the benefit of dietary supplementation during pregnancy, antenatal care follow up, and lengthening birth interval should be integrated into the existing health extension packages. New and inclusive strategies such as the establishment of comprehensive mobile clinic services should also be designed to reduce the burden of preterm birth among women living in the rural community. Lastly, we recommend future researchers to conduct longitudinal and community-based studies supplemented with qualitative methods.

Fertility desire and associated factors among people living with HIV in Ethiopia: a systematic review and meta-analysis.

BACKGROUND: Increased Anti-Retroviral Therapy (ART) coverage improves health status and the survival of people living with Human Immunodeficiency Virus (HIV) as a result, reproductive health needs of the clients are increased. As part of continuum HIV care, understanding fertility desire and reproductive health care needs of HIV positive peoples will play paramount role in planning and delivering appropriate health services. The finding of studies conducted on the fertility desire and associated factors among People Living with HIV in Ethiopia presented inconclusive. Therefore, this study aimed to assess the pooled prevalence of fertility desire and associated factors among people living with HIV in Ethiopia. METHODS: A total of 26 studies conducted in Ethiopia were included in this Meta-analysis. Pub Med, HINARI, Google scholar and Google data bases were searched. Data from the included articles were extracted using a standardized data extraction tool. The included studies were analyzed using a random effects meta-analysis model. Analysis was done Using STATA version 14 statistical software. Heterogeneity was assessed statistically using the standard Chi-square, I2. The association between fertility desire and factors were examined using a random effects model. RESULT: In this meta-analysis, the pooled prevalence of fertility desire in Ethiopia is 42.21% (95%CI 39.18, 45.25). Fertility desire is significantly associated with sex: being female (OR = 0.71,95%CI 0.57,0.86), partners desire (OR = 16.8, 95% CI: 9.45, 29.88), not having child (OR = 5.46 95%CI 4.24, 7.040), age < 30(OR = 2.34, 95%CI 2.10, 2.60), formal education (OR = 1.31 95%CI 1.09, 1.59)). However, use of family planning, residence, and Knowledge on Prevention of Mother to Child Transmission and disclosure status didn't show association with fertility desire. CONCLUSION: In this finding, significant people of living with HIV have a desire to have a child. The finding showed the need to strengthen fertility desire and reproductive health care needs of HIV positive peoples. Therefore, strengthening the integration of fertility related issues with HIV continuum care will play a paramount role in averting risky sexual behaviors and Prevention of Mother to Child Transmission among peoples on ART.

Perceived Self-Efficacy and Associated Factors Among Adult Patients with Type 2 Diabetes Mellitus at Public Hospitals of Western Ethiopia, 2020.

BACKGROUND: Diabetes Mellitus is a chronic disease and can be self-managed using five treatment approaches, including education, medical nutrition therapy, physical exercise, pharmacological intervention, and blood sugar monitoring. Improvement of patient compliance and self-efficacy are critical points that impact the self-care behavior in patients with type two diabetes mellitus in order to limit the morbidity and promote glycemic control. Therefore, the present study successfully assesses the effect of perceived self-efficacy and associated factors among patients with diabetes mellitus at public hospitals of western Ethiopia. METHODS: The cross-sectional study design was employed on a sample of 423 diabetic patients. A systematic random sampling method was employed. An interviewer-administered structured questionnaire was used. The data entered into Epi data version 3.1 and exported into Statistical Package for the Social Sciences window version 24 for analysis. All variables significant at p <0.25 in bivariate were entered into multivariate analysis. The multivariable logistic regressions were used to determine factors associated with perceived self-efficacy by considering adjusted odds ratio at CI 95% and the significance level was set at p <0.05. RESULTS: Out of 423 participants sampled, 398 participated in the study giving a response rate of 94.1%. The level of perceived good self-efficacy among diabetes patients was 52.5%. Being married (AOR=1.611, 95% CI = 1.003, 2.587), home blood glucose test (AOR=3.359, 95% CI = 1.912,5.903), doing exercise (AOR=11.412, 95% CI = 2.488,52.346), having good appetite (AOR=2.587, 95% CI = 1.454,4.606), having special diet (AOR=4.902, 95% CI= 1.202, 19.992), and good self-care behavior (AOR=10.320, 95% CI= 5.657, 18.824) were significantly associated with good self-efficacy. CONCLUSION: The level of perceived self-efficacy was high. Home blood glucose tests, good self-care behavior, married, doing exercise, good appetite, having a special diet were significantly associated with high perceived self-efficacy. The national policymaker focused on patients' behavioral change to develop perceived self-efficacy for confidently managing the disease.

Predictors of Adherence to Self-Care Behavior Among Patients with Diabetes at Public Hospitals in West Ethiopia.

BACKGROUND: Diabetes is a typical chronic disease that needs integrated and multifaceted approaches. Self-care practices are fundamental to achieve good blood glucose control and prevent long-term complications. Therefore, the aim of the study was to determine the level and predictors of adherence to self-care behavior among patients with diabetes on follow-up at public hospitals of western Ethiopia. PATIENTS AND METHODS: The cross-sectional study design was employed on a sample of 423 diabetic patients on follow-up at public hospitals of western Ethiopia. A systematic random sampling method was employed. The data were entered into Epi data version 3.1 and exported into Statistical Package for the Social Sciences window version 24 for analysis. All variables significant at p-value <0.05 in the bivariable were entered in multivariate regression analysis. Backward stepwise goodness of fit was used to ascertain the suitable variables in multiple linear regression analysis. Finally, multivariate linear regression analysis with adjusted B, CI at 95%, and the significance level was set at p <0.05. All predictive variables were reported in terms of adjusted R2. RESULTS: The overall mean and standard deviation of adherence to self-care behavior was 23.09 ±6.55. Among the study participants, 42.70% had good self-care behavior. Self-efficacy (B=0.106, p<0.001), home blood glucose test (B=0.075, p<0.001), exercise per week (0.035, P<0.002), meal planning (B=0.039, P<0.001), dietary restriction (B=0.077, P<0.001), duration of diabetes<4 years (B=0.030, P<0.013), non-pharmacological intervention (B=0.055, P<0.011), and good appetite (B=0.039, P<0.045) were significant variables associated with adherence to self-care behaviors. CONCLUSION: The overall level of adherence to self-care behavior was low. Therefore, we recommended that it is better if the national health policymaker focused on dietary management modality that engages patients' behavior change to develop self-care practices and closely monitoring of glucose level. Also, we recommended an additional longitudinal study incorporating a qualitative study that focused on behavioral changes.

Disaster Preparedness in Selected Hospitals of Western Ethiopia and Risk Perceptions of Their Authorities.

PURPOSE: Despite the fact that hospitals are always at a high risk of disasters, the preparedness status in many of the Ethiopian hospitals is not well recognized. It is with this research gap in mind that this study motivated the authors to assess disaster preparedness level in selected hospitals of the western part of Ethiopia and their authorities' risk perceptions. METHODS: This was a facility-based study conducted by using mixed qualitative and quantitative research designs among selected hospitals of western Ethiopia. While disaster and emergency readiness was evaluated using a modified World Health Organization observation check list. The key informant interview method was used to assess the disaster risk perception of the hospitals' authorities in the study area. RESULTS: The overall level of emergency and disaster preparedness in the selected hospitals was weak with an average calculated preparedness score of 45.6%. The score of readiness in terms of disaster response and recovery planning was 33.3%. Moreover, we have not got a documented disaster plan in all of the hospitals and the hazard-specific response sub plans were also not consistently in place. Of prime concerns, this study has revealed that there was no patient evacuation plan in all of the selected hospitals. The human resource preparations of the hospitals were relatively better with an average readiness score of 60%. The study has found that no committee was responsible for emergency readiness at all of the sampled hospitals. The hospital authorities' disaster risk perception was found to vary according to the type of calamities and this was from moderate to high level. CONCLUSION: This study concludes that although their authorities' risk perception of disasters was high, the selected hospitals were ill-prepared for the potential disaster strikes in this study area.

Magnitude of Needlestick and Sharp Injury and Its Associated Factors Among Nurses Working at Health Institutions in Western Ethiopia, 2020.

BACKGROUND: Needlestick and sharp injury represent a major occupational hazard in the healthcare environment with nurses experiencing a large proportion of the burden. It is a potential for transmission of bloodborne pathogens including the human immunodeficiency virus, hepatitis B and C virus. Needlestick and sharp injuries are neglected and are often not reported. Few studies have been conducted in Ethiopia, and no study was conducted particularly in the Western part of a country. Therefore, this study aimed to assess needlestick and sharp injuries and associated factors among nurses working at health institutions in western Ethiopia, 2020. METHODS: An institutional based cross-sectional study was conducted on 297 nurses, from January 15 to 30, 2020. The study participants were selected by a simple random sampling method and data were collected using a self-administered questionnaire. Multivariable logistic regression was used to identify associated factors of needlestick and sharp injury. The association between needle stick and sharp injury and associated factors were measured using the odds ratio at a 95% confidence interval. The statistical significance was made at a p-value of less than 0.05. RESULTS: Out of 297 nurses who participated in the study, 100 (33.7%) had encountered needlestick and sharp injury in the past 12 months. Recapping the needle (AOR=3.99 95% CI: 2.20, 7.21), non-utilization of infection prevention guideline (AOR= 2.69, 95% CI: 1.29, 5.60), not taking injection safety training (AOR = 2.25, 95% CI: 1.22, 4.13) and having job-related stress (AOR= 1.93, 95% CI: 1.10, 3.41) were significantly associated with the needlestick and sharp injury. CONCLUSION: In this study, the magnitude of needlestick and the sharp injury was high. The nurse should not recap the needles, should utilize infection prevention guidelines, should minimize stress, and routine injection safety training should be given to minimize needlestick and sharp injuries.

Postpartum depression and associated factors among postpartum women in Ethiopia: a systematic review and meta-analysis, 2020.

INTRODUCTION: The postpartum period is recognized as a high-risk period for the development of various mood disorders like postpartum depression. Globally, postnatal depression is a serious public health problem that has a negative impact on the mother's health and child development, especially in developing countries. In Ethiopia, even though there are different primary studies conducted on postpartum depression, there is no nationally representative evidence. Therefore, the aim of this systematic review and meta-analysis was to estimate the pooled prevalence and associated factors of postpartum depression in Ethiopia. METHODS: Published and unpublished articles from various electronic databases and digital libraries were accessed. This systematic review included studies that were conducted on the magnitude and factors associated with postpartum depression among postnatal women in Ethiopia. A random-effect model was used to estimate the pooled magnitude of postpartum depression with a 95% confidence interval (CI). Inverse variance (I2) was used to visualize the presence of heterogeneity, and forest plot was used to estimate the pooled magnitude of postpartum depression. Publication bias was assessed by funnel plots and Egger's statistical tests. A meta-regression and subgroup analysis were computed to minimize underlying heterogeneity. RESULT: Initially, a total of 764 studies were accessed. Twenty-eight full articles were assessed for eligibility criteria, of which twelve studies fulfilled inclusion criteria were included in the final meta-analysis. The overall pooled magnitude of postpartum depression was 22.89% (95% CI 17.75%, 28.03%) with the lowest (12.20%) and highest (33.82%) in the Southern nations region. Unplanned pregnancy, domestic violence, lack of social support, previous history of depression, infant loss, and dissatisfaction in marriage showed a statistically significant association with postpartum depression. CONCLUSIONS: In the current analysis, the prevalence of postpartum depression was high as compared with other developing countries. Routine screening of mothers in the postpartum period and integrating mental health with maternal health care is highly recommended.

Maternal Satisfaction with Delivery Services of Government Hospitals in Ambo Town, West Shoa Zone, Oromia Region, Ethiopia, 2020.

BACKGROUND: Maternal satisfaction with delivery service is used to measure the ability of services provided to meet consumers' expectations. Satisfying women with the care given during labor and delivery helps to develop a positive childbirth experience and a favorable attitude towards motherhood. There were limited studies that assessed maternal satisfaction in Ethiopia, and this study aimed to assess delivery service satisfaction and its associated factors among mothers who gave birth at public hospitals of Ambo town, West Ethiopia. METHODS: Institutional-based cross-sectional study was conducted on 384 women, from April 20 to May 20, 2019, in public hospitals of Ambo town. The study participants were selected by systematic random sampling method and interviewed using structured questionnaires. The data were checked, coded and entered into Epi info version 7, and then exported to SPSS version 20 for analysis. Multivariable logistic regression analysis was performed to identify predictors of maternal satisfaction. A variable with a P value of less than 0.05 was considered statistically significant. RESULTS: A total of 384 study participants were involved, making a response rate of 100%. Out of 384 mothers who participated in the study, 322 (83.9%) were satisfied with the delivery service, and 62 (16.1%) were unsatisfied with the delivery service. Monthly income less than 650 ETB (AOR=0.46, 95% CI: 0.22, 0.94) was associated with decreased maternal satisfaction. On the other hand, normal birth outcome (AOR=4.409, 95% CI: 1.453, 13.375) and maintenance of mothers' privacy (AOR = 8.405, 95% CI: 1.74,29.59) were associated with increased maternal satisfaction with delivery services. CONCLUSION: The level of maternal satisfaction with the delivery services in this study was moderate. Monthly income, maternal birth outcome and maintenance of privacy were significantly associated with maternal satisfaction.

Food Insecurity among People Living with HIV/AIDS on ART Follower at Public Hospitals of Western Ethiopia.

BACKGROUND: Food insecurity and HIV/AIDS are intertwined in a vicious cycle through nutritional, mental health, and behavioral pathways. Food insecurity is a potentially important barrier to the success of antiretroviral treatment, increased hospitalizations, and higher morbidity among HIV-infected individuals in resource-poor settings particularly in sub-Saharan Africa including Ethiopia. Therefore, the purpose of this study was to assess the prevalence of food insecurity among people living with HIV/AIDS on follow up at public hospitals of western Ethiopia. METHODS: An institutional-based cross-sectional study design was conducted on a sample of 428 among people living with HIV/AIDS on follow up at public hospitals of western Ethiopia. A systematic random sampling technique was used to include all participants. Data was collected using interviewer-administered structured questionnaires. The data were entered into Epi data version 3.1 and then exported into Statistical Package for the Social Sciences window version 21 for analysis. Descriptive and inferential statistics were employed. Bivariable logistic and multivariable logistic analyses were used with AOR at CI 95% and p < 0.05 were used. RESULT: The finding of the study revealed that the majority of the respondents 221(53.1%) were female. The mean age of the respondents was 32.92 ± 7.304 years and 197 (47.4%) of the study participants were between 30 to 39 years' age group. The level of food insecurity among PLWHA receiving ART therapy was 68.8% which was partitioned as mild (23.32%), moderate (29.09%), and severe (16.35%) food in secured. Being single [AOR = 3.507(1.377, 8.934)], illiterate [AOR = 5.234(1.747, 15.686)], cigarette smoking [AOR = 3.577(2.104, 6.081)], presence of anemia (AOR = 2.650(1.563, 4.493)], and inadequate dietary diversity [AOR = 2.870(1.088, 7.569)] were predictors of food insecurity. CONCLUSION: The prevalence of food insecurity was high. Educational status, marital status, cigarette smoking, presence of anemia, opportunistic infection, and inadequate dietary diversity were the major significant factors affecting food insecurity. We recommended a national health policy maker to integrate food and nutrition interventions as part of a package of care, treatment, and support services for people living with HIV and ART follower patients.

Magnitude and Determinants of Uncontrolled Blood Pressure Among Adult Hypertensive Patients on Follow-Up at Nekemte Referral Hospital, Western Ethiopia.

BACKGROUND: Hypertension is the leading cause of morbidity and mortality among non-communicable diseases. The rate of blood pressure (BP) control among hypertensive patients is poor and the reasons for poor control of BP remain poorly understood globally. Therefore, this study aimed to assess the magnitude and determinants of uncontrolled blood pressure among adult hypertensive patients on follow-up at Nekemte referral hospital (NRH). METHODS: A hospital-based cross-sectional study was conducted from February to April 2018 at NRH. BP control status was determined by the average consecutive BP recordings across the 3 months. The data was entered and analyzed using SPSS version 20.0 and p-value <0.05 was considered statistically significant. RESULTS: Out of 297 study participants included, the majority were females, 181 (60.9%), and the mean age of the patients was 59.4 ±10.4 years. About half, 137 (46.12%), of the patients had at least one comorbidity and the most common class of anti-hypertensive medication was angiotensin-converting enzyme inhibitors (88.2%). The mean of systolic blood pressure was 132.41± 15.61mmHg, while the mean of diastolic blood pressure was 84.37± 9.32 mmHg. The proportion of participants with optimally controlled BP was 63.6% and 36% were adherent to their medications. Male sex (Adjusted Odd Ratio [AOR]: 1.89, 95% CI: 1.09-4.84), illiteracy (AOR= 1.56, 95% CI: 1.22-6.78), duration of hypertension diagnosis > 10 years (AOR= 2.01, 95% CI: 1.04-16.11), non-adherence (AOR= 3.14, 95% CI: 1.35-10.76) and lack of physical exercise (AOR= 2.8, 95% CI: 1.16-6.74) were positively associated with uncontrolled BP status. Whereas age older than 55 years (AOR= 0.38, 95% CI: 0.11-0.92) was negatively associated with uncontrolled BP. CONCLUSION: BP control was relatively achieved in about two-third of pharmacologically treated patients. We recommend better health education and care of patients to improve the rate of BP control status.

Adherence to antiretroviral therapy and associated factors among Human immunodeficiency virus positive patients accessing treatment at Nekemte referral hospital, west Ethiopia, 2019.

BACKGROUND: Antiretroviral therapy has a remarkable clinical effect in reducing the progress of Acquired Immune Deficiency Syndrome. The clinical outcome of Anti-Retroviral therapy depends on strict adherence. Poor adherence reduces the effectiveness of antiretroviral therapy and increases viral replication. With changes in service delivery over time and differences in socio-demographic status from region to region, it is essential to measure adherence. Therefore, this study aimed to assess adherence to antiretroviral therapy and its associated factors among HIV/AIDS patients accessing treatment at Nekemte referral hospital, West Ethiopia. METHODS: Institutional based cross-sectional study was conducted on 311 HIV/AIDS patients from March 01 to March 30, 2019. The study participants were selected by a simple random sampling method and interviewed using structured questionnaires. Bivariable logistic regression was conducted to find an association between each independent variable and adherence to antiretroviral medication. Multivariable logistic regression was used to find the independent variables which best predict adherence. The statistical significance was measured using odds ratio at a 95% confidence interval with a p-value of less than 0.05. RESULTS: Out of a total of 311 patients sampled, 305 were participated in the study, making a response rate of 98.07%. From these 305 study participants,73.1% (95% CI = 68.2, 78.0) were adherent to their medication. Having knowledge about HIV and its treatment (AOR = 8.24, 95% CI: 3.10, 21.92), having strong family/social support (AOR = 6.21, 95% CI: 1.39, 27.62), absence of adverse drug reaction (AOR = 5.33, 95% CI: 1.95, 14.57), absence of comorbidity of other chronic diseases (AOR = 5.72, 95% CI: 1.91, 17.16) and disclosing HIV status to the family (AOR = 5.08, 95% CI: 2.09, 12.34) were significantly associated with an increased likelihood of adherence to antiretroviral medication. CONCLUSION: The level of adherence to antiretroviral therapy was found low compared to WHO recommendation. The clinician should emphasize reducing adverse drug reaction, detecting and treating co-morbidities early, improving knowledge through health education, and encouraging the patients to disclose their HIV status to their families.

Caring behavior and associated factors among nurses working in Jimma University specialized hospital, Oromia, Southwest Ethiopia, 2019.

BACKGROUND: Nursing care behavior and nurse's perception of effective care behavior is an act, conduct, and mannerism enacted by professional nurses that convey concern, safety, and attention to the patient. Behavior associated with caring has a paramount role in linking nursing interaction to the client in experiences but, the concept is ambiguous and elusive toward different scholars to reach on common understanding. Only a few studies have been done on the caring behavior and associated factors globally, and no study was done in this study area. Therefore; the purpose of this study was to assess caring behavior and its associated factors among nurses working in Jimma University specialized hospital, southwest Ethiopia. METHODS: An institutional-based cross-sectional study design was conducted on a sample of 224 nurses working in Jimma university specialized hospital from March 20-April 20, 2019. Data were collected by a self-administered questionnaire. Descriptive statistics including frequency table, mean, standard deviation and percentage were employed. Bivariate and multiple linear regression analysis was used with regression coefficient (ß), coefficient of the determinant (R2), CI 95% and p < 0.05 were used for statistical significance. RESULTS: The overall proportion of nurses caring behavior was 80.3% which was mostly measured in terms of professional -technical (82.9%) and psychosocial (81.3%) dimension. Job satisfaction as personal satisfaction (beta = 1.12, p = 0.00), professional satisfaction, (beta = 1.07, p = 0.00), joint participation in caring process (beta = 0.58, p = 0.00,) satisfaction with nurse management (beta = 0.85, p = 00) were significantly associated with caring behavior. CONCLUSION: The proportion of nurses who had a high perception of caring behavior was found to be lower. Thus, all predictors have their own effect on enhancing job satisfaction, improving and creating conducive management and working environment to increase caring behavior. Further comparative studies involving multidisciplinary and patient point of view were recommended.

Magnitude and associated factors of postpartum depression among women in Nekemte town, East Wollega zone, west Ethiopia, 2019: A community-based study.

BACKGROUND: Postpartum depression is a non-psychotic disorder that happens during the first 1year after childbirth. It affects both the mother's health and child's development and is given significant public health concern in developed countries. However, in developing countries including Ethiopia, postnatal care is mainly concerned with obstetric problems and the baby's health, while the psychological well-being of the mother is given little attention. Therefore, this study was aimed to assess the magnitude and associated factors of postpartum depression among women in Nekemte town, East Wollega zone, West Ethiopia, 2019. METHODS: Community-based cross-sectional study was conducted on 295 postnatal women, from May 15 to June 5, 2019, in Nekemte town. The study participants were selected by a simple random sampling method and interviewed using structured questionnaires. Multivariable logistic regression was used to find the independent variables which are associated with postnatal depression. All associations between dependent and independent variables and statistical significance were measured using odds ratio at 95% confidence interval and p-value less than 0.05. RESULTS: From the total of 295 women sampled, 287 were participated in the study. Out of these 287 women participated, 20.9% had developed postnatal depression. Unplanned pregnancy (AOR = 7.84, 95% CI: 3.19, 19.26), Being first time mother (AOR = 4.99, 95% CI: 1.54, 16.09), History of previous depression (AOR = 3.06, 95% CI: 1.06, 8.82), Domestic violence (AOR = 5.92, 95% CI: 2.44, 14.40), History of substance use (AOR = 3.95, 95% CI: 1.52, 10.30) and poor social support (AOR = 6.59, 95% CI: 2.25, 19.29) were significantly associated with postnatal depression. CONCLUSION: In this study, the magnitude of postnatal depression was found moderate compared to other studies. Perinatal depression screening and intervention need to be integrated with maternal health care services, especially for mothers at risk of postnatal depression.

Health-related quality of life and associated factors among epileptic patients on treatment follow up at public hospitals of Wollega zones, Ethiopia, 2018.

OBJECTIVE: The aim of this study was to assess health-related quality of life and its associated factors among epileptic patients in public hospitals of Wollega zones, Ethiopia. Institutional based cross-sectional study was conducted on 402 epileptic patients, from March 01 to March 30, 2018. Multiple linear regression with backward elimination was used, and all analyses were conducted at the 0.05 significance level. RESULTS: The overall mean total score on the WHOQOL-BREF scale was 60.47 with ± 23.07 SD. Monthly income ≤ 500 EB (ß = - 12.49, P < 0.001), living alone (ß = - 7.11, P = 0.007), adverse drug reaction (ß = - 10.86, P < 0.001), comorbidity of anxiety (ß = - 12.99, P < 0.001), perceived social stigma (ß = - 9.73, P < 0.001) and frequency of seizure once per week (ß = - 8.41, P = 0.001) were negatively associated with quality of life of epileptic patients. The mean quality of life of patients living with epilepsy in this study was low. The clinician should early recognize and treat drug side effects, detect and manage comorbidity, and control seizure in order to increase quality of life of epileptic patients.

Relationship between nurses' perception of ethical climates and job satisfaction in Jimma University Specialized Hospital, Oromia region, south west Ethiopia.

BACKGROUND: The ethical climate is one aspect of an organization which refers to the shared perceptions of ethically correct behaviors and way of handling ethically deviated behaviors. Increased awareness of the complexity of ethical issues in the health care setting has fueled interest in nursing ethics. However; there is limited information on the relationship between nurses' perception of ethical climate and job satisfaction globally and no study was done on this issue particularly in Ethiopia. Therefore, this study was aimed to assess the relationship between nurses' perception of ethical climates and job satisfaction in Jimma University Specialized Hospital, southwest Ethiopia, 2016. METHODS: Institutional based cross-sectional study was conducted on 266 nurses in Jimma University Specialized Hospital from March to April 2016. The study participants were invited by using simple random sampling method. Data were collected using self-administered questionnaires and were entered into Epidata 3.1 and analyzed using SPSS Version 20.0. Pearson's correlation was used to assess the correlation between each dimension of the hospital ethical climate and job satisfaction of nurses. Variables significant at bivariate analysis (P < 0.25) were considered as a candidate for the multivariable linear regression analysis. All analyses were conducted at the 0.05 significance level. RESULTS: The percentage mean score for ethical climate and job satisfaction were 53.4 and 51.3% respectively. Law and code climate significantly influenced job satisfaction (ß = 1.53, p = 0.000). Caring climate also significantly influenced nurses job satisfaction (ß = 0.99, p = 0.000). The result also showed that an independence climate significantly influenced job satisfaction (ß = 0.62, p = 0.041). On the other hand, rule climate and instrumental climate did not significantly affect job satisfaction (ß = 0.380, p = 0.409 and ß = - 0.208, p = 0.290 respectively). The adjusted R square was 0.601, indicating that 60.1% of the variations in job satisfactions was explained by ethical climate variables. CONCLUSION: The different dimensions of ethical climates have a negative or positive impact on nurses' job satisfaction and maintaining a positive ethical climate is key to increasing nurses' job satisfaction.

Depression and its associated factors among HIV/AIDS patients attending ART clinics at Gimbi General hospital, West Ethiopia, 2018.

OBJECTIVE: The aim of this study was to assess the prevalence and factors associated with depression among people living with HIV/AIDS attending Gimbi General hospital, West Ethiopia. Institutional based cross-sectional study was conducted on 404 HIV/AIDS patients, from March 01 to March 30, 2018. Multivariable logistic regression was used to determine factors associated with depression. Possible association and statistical significance were measured using odds ratio at 95% confidence interval and P-value less than 0.05. RESULTS: A total of 393 HIV/AIDS patients were included in this study. Out of this, 41.7% had depression. Perceived social stigma (AOR = 6.98, 95% CI 3.07, 15.86), opportunistic infection (AOR = 9.38, 95% CI 4.21, 20.89), adverse drug reaction (AOR = 3.73, 95% CI 1.58, 8.81), absence of family/social support (AOR = 9.97, 95% CI 3.57, 27.86), and presence of other chronic diseases (AOR = 6.14, 95% CI 1.66, 22.68) were significantly associated with depression. The level of depression among HIV/AIDS patient in this study was high. The clinician should early recognize and treat drug side effects, early detect and manage opportunistic infection and other chronic diseases, and give health information about the disease for the community to reduce social stigma.