Health-Related Quality of Life Among Type 2 Diabetes Mellitus Patients Using the 36-Item Short Form Health Survey (SF-36) in Central Ethiopia: A Multicenter Study.

Introduction: Diabetes, one of the major global health emergencies of the 21st century, can affect a patient's quality of life. A compromised quality of life has adverse effects on self-care practices, resulting in inadequate glycemic control and an increased susceptibility to complications. In Ethiopia, there is a paucity of information regarding the quality of life of patients with type 2 diabetes mellitus. Therefore, this study aimed to assess health-related quality of life in type 2 diabetes mellitus patients. Methods: A cross-sectional study was conducted among type 2 diabetes mellitus patients attending diabetes follow-up clinics in selected public hospitals in Addis Ababa using short form- 36 (SF-36) health survey measures. Descriptive statistics were used to summarize the characteristics of the study participants. Simple and multiple linear regressions were done to identify significantly associated factors with health-related quality of life. Result: A total of 309 patients participated in this study. The mean scores of the physical and mental component summaries were 40.15 (SD = 7.27) and 48.11 (SD = 8.87), respectively. Being old, being overweight or obese, living with type 2 diabetes mellitus for more than fifteen years, taking combined medication, having diabetes-related complications, and having comorbidities were factors that reduced the mean score of the physical component summary (p-value<0.05). Being obese and diabetes related complication were factors that negatively affect mental component summary (p-value <0.05). On the other hand, being married was factors that positively affect mental component summary (p-value <0.05). Conclusion: Older age, being married, obesity, overweight, longer duration of diabetes, using combined medications, diabetic-related complications, and co-morbidities were factors associated with health-related quality of life. Healthcare providers should strengthen counseling patients on lifestyle modifications such as diet modifications, and weight reduction.

Married women's decision-making autonomy on modern contraceptive use and its associated factors in high fertile sub-Saharan Africa countries: a multi-level analysis of Demographic and Health Surveys.

BACKGROUND: For better maternal and child health, women's independence on reproductive health issues is crucial; however, couples are restricted from discussing openly with their partner. Regarding this, information about women's decision-making autonomy is low in the world, including Sub-Saharan Africa; therefore, this study was aimed to assess married women's decision-making autonomy on modern contraceptive utilization in high fertility SSA countries. METHODS: Data for this study was obtained from the most recent (2010-2018) Demographic and Health Surveys. A total of weighted sample of 14,575 married reproductive age women was included. A multilevel mixed-effect binary logistic regression model was fitted to identify the significant associated factors of decision-making autonomy on modern contraceptive utilization. Finally, the Adjusted Odds Ratio (AOR) with 95% confidence interval was used to declare as statistical significance. RESULTS: Overall prevalence of married women decision-making autonomy on modern contraceptive utilization in the high fertile SSA countries is 25.28% (95% CI:18.32%, 32.24%). The factors significantly associated with the decision-making autonomy on modern contraceptive utilization were women's age 25-34 years (AOR = 1.88, 95% CI = 1.84-1.93) and 35-49 years (AOR = 1.90, 95% CI = 1.82-1.92), had media exposure (AOR = 1.13, 95% CI = 1.00- 1.28), Number of alive children, 1-2 (AOR = 2.35, 95% CI = 1.38-4.01), 3-4 (AOR = 2.98, 95% CI = 1.74-5.10), [Formula: see text] 5 (AOR = 2. 82, 95% CI = 1.63-4.86), educational status; primary education (AOR = 1.93, 95% CI = 1.77-2.83), Secondary and higher (AOR = 2.11, 95% CI = 1.78-2.89), Community media exposure (AOR = 1.80, 95% CI = 1.38-2.34), Community level poverty, (AOR = 1.43, 95% CI = 1.09-1.86) and resides in rural (AOR = 0.67, 95% CI = 0.64-0.71). CONCLUSION: Women's decision-making autonomy on modern contraception utilization in this study was low. Therefore, the government should promote women's autonomy on contraceptive use as an essential component of SRH rights through mass media, with particular attention for, women living in the poorest communities, and those residing in rural settings of the country. Moreover, health professionals should counsel the women about the benefits of using modern contraceptive to help them managing their number of children.

Socio-demographic and economic inequity in the use of insecticide-treated bed nets during pregnancy: a survey-based case study of four sub-Saharan African countries with a high burden of malaria.

Despite global investments in malaria eradication and mitigation efforts, including the dissemination of ITNs to vulnerable communities, the goal of widespread malaria control among pregnant women has yet to be realized in many African countries. One of the explanations forwarded for this is related to the adoption and regular use of ITNs by pregnant women. Based on the available DHS and MIS data from four malaria high burden African countries- according to WHO malaria report 2020- inequality was measured by applying both relative and absolute summary measures for the four dimensions of inequality: economic status, education, place of residence and region. By considering the number of subgroups in each variable, simple and complex summary measures were used.ITN utilization by pregnant women showed an increasing trend over time in all the four countries. There was also significant inequality (variability) in the ITN utilization among population groups. DRC, Mozambique and Uganda showed noticeable inequality that favors the richest population, whereas in Nigeria the inequality was observed among both the rich and the poor during different survey yearsIn conclusion, in all the four countries, there were significant regional variations or differences in ITN use among pregnant mothers across all dimensions of inequality in the survey years. Tailored cost-effective interventions could be considered to improve ITN utilization among pregnant women.

The relationship between postpartum depression and appropriate infant feeding practice in eastern zone of Tigray, Ethiopia: A comparative cross-sectional study.

BACKGROUND: Understanding the relationship between postpartum depression and infant feeding practice may help to reduce the indirect impact of postpartum depression on infant feeding practice. This will further have a positive impact on reducing infant morbidity and mortality attributed to improper feeding practices. Although studies in the country have assessed the prevalence of infant feeding practices, those assessing the association between postpartum depression and infant feeding practices are lacking. Therefore, this study aimed to compare appropriate infant feeding practices and their associated factors among postpartum depressed and non-depressed mothers in Eastern Tigray. METHODS: A comparative cross-sectional study was conducted from March 2019 to April 2019. A multistage random sampling technique was used to select 171 mothers with postpartum depression and 342 mothers without postpartum depression. Data were collected using a structured questionnaire from the Monitoring and Evaluating for Breastfeeding Practices toolkit, then entered into Epi- info and exported into SPSS for further analysis. A binary logistic regression was applied to determine the association between postpartum depression and appropriate infant feeding practice. RESULTS: The overall prevalence of appropriate infant feeding practice was 37.6% (95% CI: 33.5%-41.9%). The prevalence was higher among mothers without postpartum depression 42.7% (95% CI: 42.9%-53.2%) than among postpartum depressed mothers 27.5% (95% CI: 24.7%-32.5%). The odds of appropriate infant feeding practice among mothers with infant birth orders of three or above was 58% (AOR = 0.42; 95% CI: 0.26-0.97) less than those mothers with infant birth orders of three and below. Households with monthly income 1000-1999 ETB (AOR = 2.26; 95% CI: 1.01-5.08), 2000-2999 ETB (AOR = 1.96; 95% CI: 1.21-4.73) and 3000-3999 ETB (AOR = 5.13; 95% CI: 1.97-13.4) were more likely to practice appropriate infant feeding. CONCLUSION: The overall prevalence of appropriate infant feeding practices in the study area was low. A significantly higher proportion of mothers without postpartum depression practice appropriate infant feeding compared to mothers with postpartum depression. In addition, households with higher monthly incomes and mothers with infant birth orders three or above were significant determinants of appropriate infant feeding practice. Therefore, strengthening the provisions of nutritional education, integrating maternal mental health with routine maternal health care services, providing economic support to mothers with low income, and health education for multiparous women is a critical interventions to improve appropriate infant feeding practice.

Regional and socio-economic disparity in use of insecticide-treated nets to prevent malaria among pregnant women in Kenya.

BACKGROUND: Insecticide-treated net (ITN) use is among the most recommended strategies to prevent malaria in pregnancy. We analysed the regional and socio-economic patterns of ITN use among pregnant women in Kenya using data from the 2003, 2008 and 2014 Kenyan Demographic and Health Surveys (KDHSs). METHODS: Inequality was assessed using four dimensions: economic status, education, place of residence and region. Both relative and absolute summary measures were applied. In addition, simple and complex summary measures, i.e. difference, population attributable fraction, population attributable risk and ratio were considered based on the number of subgroups in each variable. RESULTS: There was overt inequality in the use of ITNs among pregnant women, with greater use among the better-off group in 2003 and 2014. Greater ITN use was also observed among pregnant women with a higher level of education. Pregnant women from urban settings tended to use ITNs (slept under a net the night before the survey) more than their rural counterparts in the 2003 KDHS. There were significant regional variations across the three surveys in all inequality summary measures, except ratio in the 2014 survey. CONCLUSIONS: Significant inequality in ITN use among pregnant women was observed at a macro scale.

Magnitude and associated factors of depression among people with hypertension in Addis Ababa, Ethiopia: a hospital based cross-sectional study.

BACKGROUND: The burden of depression is higher among people with chronic illnesses like hypertension and this comorbid condition leads to poor adherence to treatment and failure of compliance to lifestyle modifications, which in turn, increases risk of cardiovascular complications and mortalities. Low income countries, Ethiopia included, suffer from paucity of information describing the burden of hypertension comorbid with depression, which demands studies to narrow this knowledge gap, such as this one. METHODS: Institution based cross-sectional study was conducted in three randomly selected public hospitals in Addis Ababa. Through a systematic random sampling method, a total of 416 known hypertensive patients with follow up in hypertension clinics with in the study period enrolled in the study. Data were collected through structured questionnaire administered by trained interviewer, which latter cleaned, edited and entered in to epi-data version 3.1. Descriptive and bi-variable and binary logistic regression analysis were done using the statistical software, SPSS version 25. Depression was assessed through Hospital Anxiety and Depression Scale (HADs). RESULTS: The prevalence of depression among hypertensive patients was found to be 37.8% [95% CI (33.4%-42.5%)]. The binary logistic regression model revealed that, female sex [AOR = 5.37, 95% CI (3.089-9.35)], being married [AOR = 0.25, 95% CI (0.08-0.78)], presence of chronic comorbid illnesses [AOR = 3.03, 95% CI (1.78-5.16)], uncontrolled blood pressure [AOR = 2.80, 95% CI (1.65-4.75)], duration of hypertension of 5-10 years [AOR = 3.17, 95% CI (1.61-6.23)] and more than 10 years [AOR = 5.81, 95% CI (2.90-11.65)], family history of depression [AOR = 4.53, 95% CI (2.37-8.66)] and current alcohol consumption [AOR = 1.77, 95% CI (1.02-3.07)] were significantly associated with depression among hypertensive patients. CONCLUSION: High proportion of depression was observed among hypertensive patients, and socio-demographic, clinical and behavioral characteristics were found to significantly influence the likelihood of occurrence. Health care providers should consider mental health status of hypertensive patients, and counsel for these factors.

Utilization of long-acting and permanent contraceptive methods and associated factors among married women in Adama town, Central Ethiopia: community based cross-sectional study.

BACKGROUND: Long-acting and permanent contraceptive methods have clear advantages over short-acting methods of contraception that benefit both clients and health systems. Despite this importance, studies show that the proportion of women currently using long acting and permanent contraceptive methods are significantly lower than the proportion using short-acting methods. OBJECTIVE: The main aim of the study was to assess the level of utilization of long acting and permanent contraceptive methods and associated factors among married women in Adama town. METHODOLOGY: Community Based Cross-Sectional Study was conducted in four kebeles of Adama town from April 15-30, 2015. Multistage sampling technique was used to select the study participants. The collected data was cleaned and entered using Epi info 3.5.3 and analyzed using statistical package for social science version 20.0. Factors associated with utilization of long acting and permanent contraceptive methods were identified using logistic regression model. RESULT: In this study, the magnitude of long acting and permanent contraceptive methods was 20.9%. Implant, Intra-Uterine devices (IUDs) and tubal ligation accounted for 16.1, 4.6, and 0.2% respectively. Current use of long acting and permanent contraceptive methods was higher among women who had high knowledge (AOR = 5.26, 95% CI = 1.90-14.69), positive attitude (AOR = 3.25, 95% CI = 1.60-6.58) and women who had 3-4 children (AOR [95%CI] =2.3[1.14-4.63]) compared to those who had no child. CONCLUSION: Current use of long acting and permanent contraceptive methods in Adama town was low. Level of knowledge, attitude about the methods, and number of children were factors affecting utilization of long acting and permanent contraceptive methods. Targeted Information Education Communication Intervention should be intensified to improve the utilization of these methods.

Magnitude and Contributing Factors of Low Back Pain among Long Distance Truck Drivers at Modjo Dry Port, Ethiopia: A Cross-Sectional Study.

Background: Low back pain (LBP) is well known as the most common musculoskeletal disorder with the lifetime prevalence of eighty percent. Worldwide, 37% of low back pain was attributable to occupational risk factors. Truck driving is one among the jobs causing occupational LBP. Even though these drivers in Ethiopia run the high risk of occupational injuries and illnesses like drivers elsewhere, the evidence that shows the magnitude and factors that contribute to LBP is a significant shortcoming. Objective: To assess the magnitude and contributing factors of low back pain among long-distance truck drivers at Modjo Dry Port, Ethiopia, 2018. Methods: A cross-sectional study was conducted among systematically selected 422 long-distance truck drivers at Modjo Dry Port, Ethiopia, from February to March 2018. Data were collected through face-to-face individual interview using a structured questionnaire adapted from the standardized Nordic questionnaire for the analysis of musculoskeletal symptoms. The data were entered using EPI-DATA version 4.2.0.0 and cleaned and analyzed using SPSS version 20 statistical software for windows. Binary logistic regression was computed to determine the association using crude and adjusted odds ratios at 95% confidence intervals. Independent variables with a P value less than 0.05 in the multivariable logistic regression model were considered as significant. Results: Of 400 truck drivers interviewed, the prevalence of LBP was found to be 65%. The study also found smoking cigarette (AOR = 2.24, 95% CI (1.25-4.01), and P=0.007), physical inactivity (AOR = 2.12, 95% CI (1.28-3.51), and P=0.003), chronic diseases other than LBP (AOR = 2.18, 95% CI (1.32-3.61), and P=0.002), frequent lifting or carrying heavy objects (AOR = 3.02, 95% CI (1.75-5.22), and P ≤ 0.001), perceived improper sitting posture while driving (AOR = 2.20, 95% CI (1.35-3.60), and P=0.002), and perceived job stress (AOR = 2.07, 95% CI (1.20-3.57), and P=0.009) were contributing factors of low back pain. Conclusion: This finding shows the public health importance of low back pain among long-distance truck drivers in Ethiopia. Individual factors largely accounted for the development of low back pain; hence, orientation on these modifiable risk factors and regular follow-up on safety procedures should be considered to mitigate the problem.

Is health related quality of life influenced by diabetic neuropathic pain among type II diabetes mellitus patients in Ethiopia?

BACKGROUND: Polyneuropathy is one of the commonest complications of long-standing diabetes. Progressive sensory loss can predispose patients to foot ulcer and the neuropathy oftentimes causes pain. The pain can significantly affect the quality of life of patients. OBJECTIVES: To describes the health-related quality of life of patients with type II diabetes mellitus suffering from painful diabetic peripheral neuropathy at two referral hospitals in Addis Ababa, Ethiopia, 2017. METHODS: An institution based cross sectional study with internal comparison was conducted among a sample of 220 type II diabetes mellitus patients in a 1:1 matched ratio of those with and without diabetes associated peripheral neuropathic pain. All were having regular follow up at two hospitals in Addis Ababa, Ethiopia. The Short Form (SF-36) health-related quality of life instrument was used to collect data on quality of life while basic socio-demographic and other disease specific features were collected using a structured questionnaire. Descriptive statistics was used to examine the mean scores of health related quality of life. Cronbach's alpha coefficient and Pearson's correlation coefficient were applied to estimate the internal consistency, and the level of agreement between the different domains of SF-36, respectively. To measure association between health related quality of life domains and explanatory variables, independent T-test and ANOVA were performed followed by multiple linear regression analyses. RESULTS: The health related quality of life of type II diabetes mellitus patients with peripheral neuropathic pain was poorer than those without pain in all the eight domains and the two summary scores by SF-36 (p < 0.001). Higher mean score difference was observed in Mental Component Summary Score (MCS) (14.6) compared to Physical Component Score (PCS) (9.3). Among the eight domains, the largest mean difference was found with the physical one (39.1) followed by mental health (38.2) and physical functioning (30). Pain intensity had a statistically significant negative correlation with all domains as well as the two summary scores. Younger age, a higher level of education, being single, a higher monthly income, normal body mass index, HbA1c less than seven mmo/L, absence of other diabetic complications and taking only oral hypoglycemic agents were found to predict better health related quality of life. CONCLUSION: The presence of diabetic peripheral neuropathic pain was found to negatively influence the health-related quality of life of type II diabetic patients; the greatest impact being on the 'role physical' and 'mental health' domains. Older age, presence of diabetes related complications, longer duration of illness negatively influenced the health-related quality of life.

Determinants of vct uptake among pregnant women attending two ANC clinics in Addis Ababa City: unmatched case control study.

BACKGROUND: With HAART PMTCT interventions can reduce the risk of MTCT below 2%. However, low uptake of VCT is challenging effectiveness of PMTCT programs in sub-Saharan Africa. The aim of this study is to identify factors that determine VCT uptake among pregnant women attending ANC services. METHODS: A case-control study was conducted from August 30, 2005 - November 30, 2005 among pregnant women attending ANC PMTCT services at Teklehaimanot Health Center and Gandhi memorial Hospital in Addis Ababa City. Cases were pregnant mothers who accepted VCT (n=202) and controls were pregnant mothers who refused VCT (n=200). Data was collected by counselor nurses working at the respective services RESULTS: Factors that determine VCT acceptance were women's perceived ability to cope with a positive result (OR = 5.5, 95% CI 3.5-8.5, MHOR = 6.3, 95% CI 3.9-10.2); perceived favorable reaction of husband's after sharing positive test result (OR = 2.7 95% CI 1.4-5.1, MHOR = 2.9, 95% CI 1.4-5.7); perceived positive community response (OR = 2.2 95% CI 1.1-4.2, MHOR = 2.6 95% CI 1.3-5.2); perceived ability to get continuous medical care if found out to be positive (OR = 2.0, 95% CI 1.2-3.5, MHOR = 2.4, 95% CI 1.3-4.5). CONCLUSION: Women's perceived ability to cope with a positive result, accesses to medical care, fear of husband's negative reaction and the stigma and discrimination following a positive test result were key determinants of uptake of VCT. Therefore, increasing uptake of VCT/PMTCT services needs policy makers and service providers' effort to promote couple counseling, intensifying the fight against stigma and discrimination and ensuring continuous HIV/AIDS related medical care.