Prevalence and associated factors of birth trauma in Ethiopia: A systematic review and meta-analysis.

Birth trauma is described as organ or tissue damage caused by physical pressure during birth. Birth trauma ranges from minor problems that go away on their own to significant wounds that might result in infant morbidity and mortality over the long term. It is one of the critical issues that have received the least attention globally. In Ethiopia, evidence regarding the pooled prevalence of birth trauma among neonates is scarce. Therefore, this study estimated the pooled prevalence of birth trauma and associated factors in Ethiopia over the last decade. The Preferred Items for Systematic Reviews and Meta-analysis (PRISMA-2009) guidelines were followed. The PubMed, Scopus, Web of Science, Google Scholar and Google databases were searched. Articles published in the English language in the last decade were included. Data were extracted by a pre-prepared Excel sheet, and analysis was conducted using STATA version 14. Subgroup analysis was also undertaken to evaluate how the prevalence of birth trauma differs across regions of Ethiopia. The pooled prevalence of birth trauma in Ethiopia was 10.57% (95% CI: 3.08, 18.07), with a heterogeneity index (I2) of 92.6% (p < 0.001). Presentation other than vertex AOR 11.94 (95% CI: 6.25-17.62), P = 0.001 and I2 = 53%, labor assisted by forceps AOR 6.25 (95% CI: 2.95-10.10), P = 0.002 with I2 = 51.8% and labor assisted with vacuum AOR 17.47 (95% CI: 4.25-39.46), P = 0.0001 with I2 = 92.9% were factors associated with the pooled prevalence of birth trauma in Ethiopia. The pooled prevalence of birth trauma in Ethiopia is considerable. Non-vertex presentation, use of instrumental delivery and prolonged labor were factors significantly associated with birth trauma. Strengthening neonatal improvement activities (thermal protection, hygienic umbilical cord and skin care, early and exclusive breastfeeding, assessment for signs of serious health problems or need for additional care and preventive treatment), is need.

Alcohol consumption and associated factors among undergraduate regular students in Wolaita Sodo University, Southern Ethiopia, 2021: a cross-sectional study.

INTRODUCTION: alcohol consumption is a major of public health problem in the worldwide. It has been linked to risk of nutritional related chronic diseases and one of the most common risks taking behaviors among young population in University students. OBJECTIVES: aimed to assess the prevalence of alcohol consumption and associated factors among undergraduate graduating regular students in Wolaita Sodo University. METHODS: a cross-sectional study design was conducted at Woliata Sodo University among undergraduate graduating regular students. Structured, self- administered questioner used to collect data by multistage sampling technique. Data were entered, cleaned and analyzed by using SPSS version 24. Multivariate logistic regression analysis used to decide variables with p<0.05) as statistically significant. RESULTS: four hundred and forty-six (446 (60.7%) of respondents consumes alcohol out of 735 respondents. The associated factors for of alcohol consumption were being female respondents AOR 0.34 95% CI: (0.21-.54), family history members consumes alcohol 4.8 times (AOR= 4.83, 95% CI: (2.68-8.70), who don´t know well about the effect of consuming alcohol were around 2.7 times (AOR= 2.71, 95% CI:( 1.67-4.50) being drunker friend were (AOR=0.03, 95% CI: 0.02-0.06), being chew "chat" use (AOR=0.45, 95% CI: (0.32-0.63), being smoking cigarettes use (AOR= 0.49, 95% CI: 0.29-0.88) were found to be significantly associated. CONCLUSION: the prevalence of alcohol consumption was relatively high compared to previous study. Attention should be given to counseling and peer education training and Anti-psychoactive substance club and sensitization therapy that are designed to change students´ perceptions on alcohol consumption.

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.

Prevalence of HIV seropositive status and associated factors among family members of index cases of antiretroviral clinical attendants in Sodo Town, Southern Ethiopia.

BACKGROUND: Human immunodeficiency virus is primarily transmitted through sexual contact with an infected partner and babies born to mothers infected with the virus. Partners of people living with HIV and children whose parents have HIV are at higher risk of contracting HIV unless they take preventive measures. This study aimed at identifying prevalence and determinants of HIV infection among family members of index cases on antiretroviral treatment (ART). METHODS: A community-based cross-sectional study was conducted among 623 randomly selected family members of HIV index cases in Sodo Town from February to June 2021. A pre-tested structural questionnaire was used to collect data. Binary logistic regression was used to identify variables independently associated with the outcome variable. The adjusted odds ratio (AOR) with 95% confidence interval (CI) was used to show the strength of association, and a P-value 0.05 was used as a cut-off point to determine the level of statistical significance of point estimate. RESULTS: This study revealed that 31.5% (95%CI: 27.6-35.2%) of family members of index cases were HIV seropositive. In subgroup analysis, this study also revealed that 11.1% (95%CI 8.4-14.5%) of biological children and 69.6% (95%CI 63.1-75.6%) of spousal partners of index cases were HIV seropositive. Immediate ART initiation of index cases (AOR = 0.148, 95%CI: 0.067-0.325), being bedridden or ambulatory functional status at enrollment (AOR = 7.71, 95%CI: 3.5-17), and baseline CD4 level of 350 cells/ml (AOR = 8.06, 95%CI: 1.8-36) were statistically significant with the outcome variable among biological children. Among spousal partners, STI history or symptoms (AOR = 5.7, 95%CI: 1.86-17.5), early disclosure (AOR = 0.062, 95%CI: 0.024-0.159), immediate ART initiation (AOR = 0.172, 95%CI: 0.044-0.675), and duration of infection (AOR = 5.09, 95%CI: 1.8-14.4) were statistically associated with the outcome variable. CONCLUSION: As evidenced by our data, the risk of HIV among family members of index cases is high. Interventions like immediate ART initiation, early disclosure, screening, and early treatment of STIs for minimizing HIV transmission might be given.

Perceived HIV Stigma and Associated Factors Among Adult ART Patients in Wolaita Zone, Southern Ethiopia.

Objective: This study aimed to assess perceived HIV stigma and associated factors among adult ART patients in Wolaita Zone, Southern Ethiopia. Methods: A facility-based cross-sectional study was conducted among 638 participants selected using a multistage sampling technique from July 10 to September 2020. A 12-item short version of the HIV stigma scale was used to measure HIV-related stigma. Data were collected by the interview method using a pre-tested questionnaire. Binary and multivariable logistic regression analyses were performed to identify the factors associated with the outcome variable. The strength and direction of the association were measured using the adjusted odds ratio (AOR) with a 95% confidence interval (CI). Statistical significance was declared at P-value <0.05. Results: In this study, 57.8% (95% CI = 54.1%-61.9%) of people under HIV care perceived high stigma and 450 (70.5%) disclosed their HIV status. Widowed marital status (AOR = 2.984; 95% CI = 1.728-5.155), primary education (AOR = 3.36; 95% CI = 2.072-5.42), undisclosed HIV status (AOR = 1.657; 95% CI = 1.121-2.451), poor social support (AOR: 2.05; 95% CI = 1.195-3.433), and being member of an HIV support group (AOR: 0.396; 95% CI = 0.249-0.630) were significantly associated with perceived stigma. Conclusion: The perceived stigma is high among adult ART patients in the study setting. Widowed marital status, primary education, undisclosed HIV status, membership to the social support network NEP+ and poor social support were predictors of perceived HIV stigma. Thus, ART patients should be given more psychosocial support to minimize their perceived public HIV-related stigma.

Experience and Perception of Healthcare Workers on the Challenges of Follow-Up and Treatment of Tuberculosis Patients in Southern Ethiopia: An Exploratory-Descriptive Qualitative Study.

Background: There is a scarcity of research evidence on TB follow-up and treatment challenges from a healthcare worker's perspective in Ethiopia. Therefore, this study aimed to explore and describe the experience and perception of healthcare workers on the challenges of follow-up and treatment of TB patients in Southern Ethiopia. Material and Methods: A qualitative exploratory-descriptive study was employed among 26 purposely selected Healthcare Workers (HCWs) from Wolaita Sodo University-Comprehensive Specialized Hospital and Achura, Boloso Sore, and Tida Health Centers in December 2021 and January 2022. Initially, the maximum variation purposive sampling technique was employed, then based on the data requirement of the study it was enriched by a theoretical sampling method. The required data were collected through one-on-one face-to-face audio-taped in-depth interviews. Data analysis was conducted by using a qualitative data analysis framework for the applied research method. NVivo Software Version 11 was used to ease data organization and analysis. Detailed textual narration of subthemes, and themes was done using direct verbatim quotations in the respective headings and subheadings. Results: In the current study, three major themes and eleven sub-themes emerged from the data. The three major themes include the experience of healthcare workers, perceived challenges, and suggestions for improvement of TB patients' follow-up and treatment. Healthcare worker's experience, compliance with infection prevention protocols, fear of contracting and/or spreading TB, public awareness of TB, socio-economic burdens, providers-related problems, shortage of medical supplies, unconducive physical work environment, provision of holistic support for the patients, provision of in or out of service training, and supportive supervision were the sub-themes. Conclusion: This study explored the multidimensional challenges adjoining follow-up and treatment of TB patients. Regular monitoring and supportive supervision accompanied by appropriate and timely decisions and feedback are vital to ensure effective follow-up and treatment of TB patients in Ethiopia.

Overweight and obesity and associated factors among adult ART patients at Hawassa University Comprehensive Specialized Hospital, Southern Ethiopia.

BACKGROUND: Overweight and obesity complicates the care and treatment of ART patients and predispose them to chronic non-communicable diseases. However, there is a shortage of research evidence on overweight and obesity and its associated factors among adult ART patients in our setting. Therefore, this study aimed to asses overweight and obesity and associated factors among adult ART patients at Hawassa University Comprehensive Specialized Hospital, Southern Ethiopia. METHODS: A facility-based cross-sectional study design was conducted by using systematic sampling technique. Primary and secondary data were collected from 369 adult ART patients from February to May 2017. Structured interviewer-administered questionnaire and laboratory outputs were used as primary data. The patient's baseline medical records were used as secondary data. Ethiopian Ministry of Health ART patient's follow-up tool was used to collect the required information. The standard laboratory and well-calibrated digital Seca Scale and portable Stadio-meter were used to collect medical and anthropometric data. Data were entered into Epi- data version 3.1 and exported to SPSS version 20 for analysis. Descriptive statistics were calculated and presented by tables, graphs and texts. Binary and multivariable logistic regression analyses were computed and the level of statistical significance was declared at p-value < 0.05. RESULTS: The prevalence of overweight and obesity (BMI ≥ 25 kg/m2) was 43.4% (95% CI = 43.35, 43.45). The difference in the overweight and obesity between the study period and initial commencement of ART was 35%. The course of HIV chronic care since the commencement of ART and during the study was 35%. Higher recent CD4 counts (200-499cells/mm3) (AOR = 3.15, 95%CI = 1.04-9.49) and (≥ 500 cells/mm3) (AOR = 7.58, 95%CI = 2.49-23.08), hypertension (AOR = 2.57, 95%CI = 1.24-5.35), higher baseline BMI status (AOR = 5.93, 95%CI = 2.62-13.40) and abdominal obesity (AOR = 1.82, 95%CI = 1.07-3.10) were significantly associated with overweight and obesity. CONCLUSION: In this study, a high prevalence of overweight and obesity among adult ART patients was reported compared to general adult population in Ethiopia. Overweight and obesity were significantly higher among hypertensive, with higher recent CD4 counts and abdominal obese ART patients. Thus, screening of overweight and obesity, incorporating nutritionist/dietician into the routine chronic care, and regular monitoring of the nutritional status of ART patients is recommended.

Why Home Delivery After Full Antenatal Care Follow-Up in Southern Ethiopia? An Exploratory-Descriptive Qualitative Study.

Background: Pregnant women who had full antenatal care follow-up are expected to give birth in health facilities. However, in Ethiopia, after full antenatal care booking, many women still prefer to give birth at home. Thus, the purpose of this study was to explore and describe why women give childbirth at home after full antenatal care follow-up in the study setting. Methods: Exploratory-descriptive qualitative design was conducted in Humbo and Abala Abaya districts, Southern Ethiopia, from June to September 2020. Nine in-depth interviews and four focus group discussions were held with purposively selected participants. Women who gave birth at home after attending equal to or more than four antenatal care appointments in the last year were included. The collected data were majorly analyzed by inductive thematic analysis technique, but deductive analysis was also applied whenever the potential themes needed further enrichment. A thick description of the findings is done in the respective heading and sub-heading using participants' verbatim quotations. Results: A total of 9 in-depth interviews and four focus group discussions comprising 35 participants was conducted. Three major themes and nine sub-themes emerged from the data. Socio-cultural and community influences, socio-economic obstacles, and health system-related barriers are the major themes identified. Traditional practices, personal beliefs, social norms, knowledge, and attitude about institutional delivery, household economic capability, decision-making capacity of the women, delivery service quality, and service providers related barriers are the sub-themes defining the home delivery experience of women after full antenatal care follow-up in the study setting. Conclusion: In this study, socio-economic, cultural, and health system-related barriers are major reasons for home delivery. Improvement of public awareness on the risk of home delivery and elimination of its facilitative social norms, empowerment of women's economic, educational, and decision-making capability and healthcare workers' and health facilities' capacity are recommended.

The Lived Experience of Women Using Bilateral Tubal Ligation Service in Rural Southern Ethiopia: A Phenomenological Study.

Background: Bilateral tubal ligation is a highly safe and effective form of permanent contraception for couples who want no more children. However, it is the least known and used form of contraception in Ethiopia. Objective: To explore the lived experience and perception of women using the bilateral tubal ligation method in Southern Ethiopia. Methods: Qualitative phenomenological study design was employed. The study participants were recruited by purposive sampling. The data were collected through in-depth interviews and supportive field notes from March 25 to April 24, 2021. All Interviews with the participants were recorded using a digital audio recorder. Inductive thematic analysis was done using Colaizzi's (1978) seven-step phenomenological analysis framework. Data coding was done using Open code software version 4.03. Results: A total of fifteen participants were included in the study. Women's satisfaction, male partner involvement, perception of women using bilateral tubal ligation, socio-cultural influences, client follow-up, and socio-economic impact of bilateral tubal ligation use are the major themes identified in the study. Findings revealed that most of the participants are satisfied with the method and became more productive and got the freedom to participate income-generating activities. The dominance of socio-cultural influences, male partner's involvement, and client follow-up after the procedure are the common themes that emerged which determine the user's experience. Conclusion: Lack of supportive involvement of partners, community pressure, lack of women's decision-making capacity and inadequate follow-up of women in the post bilateral tubal ligation use by healthcare workers are emergent experiences in the current study. Hence, promoting behavioral change communication for community members regarding bilateral tubal ligation use, empowerment of women's economic, educational, and decision-making capability and healthcare workers' follow-up of women in the post bilateral tubal ligation period are recommended.

The Lived Experience of Primary Family Caregivers of Patients on Hemodialysis Treatment in Southern Ethiopia: A Phenomenological Study.

BACKGROUND: Primary family caregivers of hemodialysis patients are the "hidden patients" who shoulder extraordinary care burdens. However, there is a dearth of studies in Ethiopia. The purpose of this study was to explore the lived experience of primary family caregivers of hemodialysis patients in Southern Ethiopia. METHODS: Qualitative phenomenological study design was employed in February 2021. A homogeneous purposive sampling technique was applied to select study participants. An in-depth interview using an interview guide and field notes were used to collect the required data. All interviews were recorded using a digital audio recorder. Data coding was assisted by Open code software version 4.03. Inductive thematic analysis was used to develop the emerged themes and sub-themes using Colaizzi's 1978 seven-step phenomenological analysis method. The themes and sub-themes are described in detail in the respective heading and sub-headings. RESULTS: A total of twelve participants were involved in the present study. Bio-psychological experience, socio-economic impact, and healthcare provider-primary family caregiver relationships are the major themes that emerged from the data. The emotional responses, coping mechanisms, consequences on the family caregivers' health, care fatigue, lifestyle change, economic burden, impact on social responsibility, social support, the role of the primary family caregiver, and trust and confidence in the service providers are the sub-themes defining primary family caregivers caring experience. CONCLUSION: In this study, emotional instabilities and reactions, care fatigue, distortion of caregiver's health, multiple economic and social damages are the major challenges faced by primary family caregivers.

Exploring Providers' Perception Towards Provision of Sexual and Reproductive Health Services for Unmarried Adolescents in Gamo Zone, Southern Ethiopia: A Phenomenological Study.

BACKGROUND: Healthcare providers play a critical role in the provision of sexual and reproductive health services for adolescents. In Ethiopia, due to different reasons, including healthcare providers associated reasons, most unmarried adolescents are not accessing the services. However, little is known about healthcare providers' perception towards the provision of SRH services for unmarried adolescents. This study aimed to explore healthcare provider perception towards the provision of SRH services to unmarried adolescents in Gamo zone, Southern Ethiopia. METHODS: A qualitative phenomenological research design was used in May 2021. Fifteen healthcare providers (HCPs) working in adolescent and youth sexual and reproductive health centers were involved in this study. A purposive sampling technique was used to select healthcare providers assuming they are "information-rich" regarding the phenomenon of interest. Inclusion of the study participants was continued until data saturation is reached. To analyze the data, we used inductive thematic analysis, method, and main themes, which captured the diverse views and feelings of the participants. To maintain the trustworthiness of the data, we used dependability, transferability, conformability, and credibility. RESULTS: In this study, individual-level attributes such as healthcare provider's personal belief, attitude, and motivation; community-level influences like socio-cultural norms, religious reasons, and lack of parental support; and health system setbacks like shortage of essential medical supplies and lack of training are identified as major obstacles in the provision of sexual and reproductive health services for unmarried adolescents. CONCLUSION: Provision of sexual and reproductive health services for unmarried adolescents is constrained by the interplay of factors acting at an individual level, community level, and health system level. The Ministry of Health (MOH), program planners and policymakers are recommended to give due attention to fulfill the necessary inputs, improving healthcare provider's attitude and skill and engagement of religious and community leaders to create a safe and supportive environment for providing sexual and reproductive health services to unmarried adolescents.

Data quality assessment and associated factors in the health management information system among health centers of Southern Ethiopia.

BACKGROUND: A well designed Health management information system is necessary for improving health service effectiveness and efficiency. It also helps to produce quality information and conduct evidence based monitoring, adjusting policy implementation and resource use. However, evidences show that data quality is poor and is not utilized for program decisions in Ethiopia especially at lower levels of the health care and it remains as a major challenge. METHOD: Facility based cross sectional study design was employed. A total of 18 health centers and 302 health professionals were selected by simple random sampling using lottery method from each selected health center. Data was collected by health professionals who were experienced and had training on HMIS tasks after the tools were pretested. Data quality was assessed using accuracy, completeness and timeliness dimensions. Seven indicators from national priority area were selected to assess data accuracy and monthly reports were used to assess completeness and timeliness. Statistical software SPSS version 20 for descriptive statistics and binary logistic regression was used for quantitative data analysis to identify candidate variable. RESULT: A total of 291 respondents were participated in the study with response rate of 96%. Overall average data quality was 82.5%. Accuracy, completeness and timeliness dimensions were 76%, 83.3 and 88.4 respectively which was lower than the national target. About 52.2% respondents were trained on HMIS, 62.5% had supervisory visits as per standard and only 55.3% got written feedback. Only 11% of facilities assigned health information technicians. Level of confidence [AOR = 1.75, 95% CI (0.99, 3.11)], filling registration or tally completely [AOR = 3.4, 95% CI (1.3, 8.7)], data quality check, supervision AOR = 1.7 95% CI (0.92, 2.63) and training [AOR = 1.89 95% CI (1.03, 3.45)] were significantly associated with data quality. CONCLUSION: This study found that the overall data quality was lower than the national target. Over reporting of all indicators were observed in all facilities. It needs major improvement on supervision quality, training status to increase confidence of individuals to do HMIS activities.

The magnitude of undernutrition and associated factors among adult chronic kidney disease patients in selected hospitals of Addis Ababa, Ethiopia.

BACKGROUND: Undernutrition is a common comorbidity in chronic kidney disease patients which augments the progression of the disease to an end-stage renal disease, renal dysfunction and related morbidity and mortality. However, in Ethiopia, there is a dearth of research evidence in this regard. Therefore, this study aimed to assess the magnitude of undernutrition and its associated factors among adult chronic kidney disease patients. METHODS: An institution-based cross-sectional study was conducted in selected hospitals of Addis Ababa from May to August 2018. Data were collected by structured and pretested questionnaires. Patients' charts were reviewed from their medical profiles. Body mass index was calculated from anthropometric measurements using calibrated instruments. Serum albumin level was determined by reference laboratory standard procedure. Data were entered into Epi- data version 3.1 and exported to SPSS version 21 for analysis. Descriptive statistics were calculated and presented by tables, graphs and texts. Binary and multivariable logistic regression analyses were computed and the level of statistical significance was declared at p-value <0.05. RESULTS: From the total sample size of 403 participants, 371 were involved in the study. The prevalence of undernutrition (BMI<18.5) among adult chronic kidney disease patients was 43.1% (95% CI: 38%-48%). Undernutrition (BMI<18.5) was significantly higher among patients with diabetic nephropathy [AOR = 2.00, 95% CI, 1.09-2.66], serum albumin value less than 3.8g/dl [AOR = 4.21: CI, 2.07-5.07], recently diagnosed with diabetes mellitus [AOR = 2.36, 95% CI, 1.03-3.14] and stage V chronic kidney disease [AOR = 3.25:95% CI, 1.00-3.87]. CONCLUSION: Undernutrition in chronic kidney disease patients was significantly higher among patients with diabetic nephropathy, patients on stage V chronic kidney disease, recently diagnosed with diabetes mellitus and serum albumin value less than 3.8g/dl.