Home drug utilization, storage practice and associated factors among people living in Bahir Dar city, Ethiopia.

Background: Medicines are maintained at home for several reasons. However, irrational household storage of medicines is a universal public health problem, causing significant harm to health and the healthcare system. Objective: This study aimed to assess home drug use and storage practices among the residents of Bahir Dar. Town, Ethiopia. Method: A cross-sectional household study was conducted in three sub-cities of the town of Bahir Dar from July to October 2022. Multistage stratified sampling was used to select the households included in the study. Data on the prevalence of home drug storage, storage place, and self-medication practice, among others, were collected using a semi-structured questionnaire and analyzed using Statistical Package for Social Science version 20. Results: More than half (57.9%) of the respondents stored medicines at home, mostly in drawers (35%). In this study, the widespread use of self-medication (44.6%) and drug-sharing practices (25%) were observed. Most of the leftover medicines (67.3%) were disposed of in the trash. Education status (AOR=3.8, 95% CI: 1.6-9.1), occupation (AOR=2.9, 95% CI: 1.2-7.2), income (AOR=1.73, 95% CI: 1.01-3.0), and the presence of chronic disease (AOR=3.2, 95% CI: 1.7-5.9) showed a significant association with home drug storage. Conclusion: Many study participants stored medications at home and bought them from pharmacies without consulting physicians. Disposing of medications into waste and practice of medication sharing were found to be high in the current study, suggesting that there is a lack of home drug utilization and storage practices by the general public.

Spatial distribution and determinants of tetanus toxoid immunization among pregnant women in Ethiopia using data from Ethiopian demographic and health survey 2016.

INTRODUCTION: Tetanus is a major public health problem caused by clostridium tetani. Although it is vaccine-preventable, the case fatality rate among neonates in areas with poor immunization coverage and limited access to clean deliveries reaches 80-100%. Vaccination of pregnant mothers with the tetanus toxoid (TT) vaccine is the most effective way to protect against neonatal tetanus. This study aimed to examine the spatial distribution and determinants of tetanus toxoid immunization among pregnant mothers using the 2016 EDHS data. METHOD: Secondary analysis of the Ethiopia Demographic and Health Survey 2016 was done to assess the spatial distribution and determinants of tetanus toxoid vaccine among pregnant women in Ethiopia. Spatial autocorrelation analysis and hot spot analysis were used to detect spatial dependency and spatial clustering of the tetanus toxoid vaccine in Ethiopia. Spatial interpolation was used to predict the tetanus toxoid vaccine coverage in unsampled areas. The multilevel binary logistic regression model was fitted to identify factors associated with tetanus toxoid vaccination. An adjusted odds ratio with 95% CI was calculated and used as the measure of association and a p-value less than 0.05 were considered statistically significant. RESULT: From the total of 7043 pregnant women, 42.4% of them have taken at least two doses of tetanus toxoid immunization. Spatial clustering of TT immunization was observed in the Northern, Southwestern and Southwestern parts of Ethiopia. Whereas, low TT coverage was observed in the Eastern and Western parts of the country. Increased ANC visits and the richest economic status favored TT immunization, whereas living in Addis Ababa and Dire Dewa cities decreased the TT immunization coverage. CONCLUSION: The finding of this study reveals that TT immunization had spatial dependency, with the highest immunization coverage observed in the Northern, Southwestern and Southeastern parts of the Country. Thus, geographically targeted interventions should be implemented particularly in the eastern and western parts of the country.

Major maternal related determinants of non-breastfeeding among mothers in Ethiopia: A multilevel analysis from DHS Ethiopia 2016.

INTRODUCTION: In Ethiopia, the burden of non-breastfeeding is still high despite substantial improvements in breastfeeding. However, the determinants of non-breastfeeding were poorly understood. Therefore, the aim of this study was to identify the maternal -related factors associated with non-breastfeeding. METHODS: An in-depth analysis of data from the Ethiopian Demographic and Health Survey 2016 (EDHS 2016) was used. A total weighted sample of 11,007 children was included in the analysis. Multilevel logistic regression models were fitted to identify factors associated with non-breastfeeding. A p-value < of 0.05 was used to identify factors significantly associated with non-breastfeeding. RESULTS: The prevalence of non-breastfeeding in Ethiopia was 5.28%. The odds of not breastfeeding were 1.5 times higher among women aged 35to 49 years (AOR = 1.5 CI: 1.034, 2.267) than among women aged 15to 24 years. The odds of not breastfeeding were higher among children whose mothers had BMIs of 18.5-24.9 (AOR = 1.6 CI: 1.097, 2.368) and 25-29.9 (AOR = 2.445 CI: 1.36, 4.394) than among women with BMIs of < 18.5. In addition, not breastfeeding was also significantly associated with ANC follow-up, where mothers who had 1-3 ANC follow-up had a 54% decreased odds (AOR = 0.651 CI: 0.46,0.921) compared to mothers who had no ANC follow-up. Demographically, mothers from Somalia region were five times (AOR = 5.485 CI: 1.654, 18.183) and mothers from SNNP region were almost four times (AOR = 3.997 CI: 1.352, 11.809) more likely to not breastfeed than mothers residing in Addis Ababa. CONCLUSIONS: Although breastfeeding practices are gradually improving in Ethiopia, the number of children not breastfed remains high. Individual-level characteristics (women's age, body mass index, and ANC follow-up) and community-level characteristics (geographic region) were statistically significant determinants of non-breastfeeding. Therefore, it is good for the federal minister of Health, planners, policy and decision- makers, and other concerned child health programmers to prioritize both individual and community factors.

Prevalence, spatial distribution and determinants of infant mortality in Ethiopia: Findings from the 2019 Ethiopian Demographic and Health Survey.

INTRODUCTION: Infant mortality declined globally in the last three decades. However, it is still a major public health concern in Ethiopia. The burden of infant mortality varies geographically with the highest rate in Sub-Saharan Africa. Although different kinds of literature are available regarding infant mortality in Ethiopia, an up to date information is needed to design strategies against the problem. Thus, this study aimed to determine the prevalence, show the spatial variations and identify determinants of infant mortality in Ethiopia. METHODS: The prevalence, spatial distribution, and predictors of infant mortality among 5,687 weighted live births were investigated using secondary data from the Ethiopian Demographic and Health Survey 2019. Spatial autocorrelation analysis was used to determine the spatial dependency of infant mortality. The spatial clustering of infant mortality was studied using hotspot analyses. In an unsampled area, ordinary interpolation was employed to forecast infant mortality. A mixed multilevel logistic regression model was used to find determinants of infant mortality. Variables with a p-value less than 0.05 were judged statistically significant and adjusted odds ratios with 95 percent confidence intervals were calculated. RESULT: The prevalence of infant mortality in Ethiopia was 44.5 infant deaths per 1000 live births with significant spatial variations across the country. The highest rate of infant mortality was observed in Eastern, Northwestern, and Southwestern parts of Ethiopia. Maternal age between 15&19 (adjusted odds ratio (AOR) = 2.51, 95% Confidence Interval (CI): 1.37, 4.61) and 45&49(AOR = 5.72, 95% CI: 2.81, 11.67), having no antenatal care follow-up (AOR = 1.71, 95% CI: 1.05, 2.79) and Somali region (AOR = 2.78, 95% CI: 1.05, 7.36) were significantly associated with infant mortality in Ethiopia. CONCLUSION: In Ethiopia, infant mortality was higher than the worldwide objective with significant spatial variations. As a result, policy measures and strategies aimed at lowering infant mortality should be devised and strengthened in clustered areas of the country. Special attention should be also given to infants born to mothers in the age groups of 15-19 and 45-49, infants of mothers with no antenatal care checkups, and infants born to mothers living in the Somali region.

COVID-19 vaccine acceptance rate and its predictors in Ethiopia: A systematic review and meta-analysis.

Coronavirus disease (COVID-19) is a global pandemic caused by the SARS-CoV-2 virus. COVID-19 vaccine is the best strategy for prevention. However, it remained the main challenge. Therefore, this systematic review and meta-analysis aimed to determine the overall pooled estimate of COVID-19 vaccine acceptance and its predictors in Ethiopia. Consequently, we have searched articles from PubMed, EMBASE, Web of Science, Google Scholar, reference lists of included studies, and Ethiopian universities' research repository. The weighted inverse variance random effects model was employed. The quality of studies and the overall variation between studies were checked through Joanna Briggs Institute (JBI) quality appraisal criteria and heterogeneity test (I2), respectively. The funnel plot and Egger's regression test were also conducted. Following that, a total of 14 studies with 6,773 participants were considered in the study and the overall pooled proportion of COVID-19 vaccine acceptance was 51.2% (95% CI: 43.9, 58.5). Having good knowledge (Odds ratio: 2.7; 95% CI: 1.1, 7.1; P. VALUE: 0.00), chronic disease (Odds ratio: 2; 95% CI: 1.3, 3.1), older age (Odds ratio: 1.8; 95% CI: 1.1, 3.0; P. VALUE: 0.02), and secondary education and above (Odds ratio: 3.3; 95% CI: 1.7, 6.7; P. VALUE: 0.00) were significantly associated with the acceptance of COVID-19 vaccine. In conclusion, Having good knowledge, chronic disease, older age, and secondary education and above were significantly associated with COVID-19 vaccine acceptance. Therefore, special attention and a strengthened awareness, education, and training about COVID-19 vaccine benefits had to be given to uneducated segments of the population.

Spatial distribution and determinants of newbornsnot receiving postnatal check-up withintwodays after birth in Ethiopia: a spatial and multilevel analysis of EDHS 2016.

BACKGROUND: Accessibility and utilization of postnatal newborn check-ups within 2 days after delivery are critical for a child's survival, growth, and development. However, the service delivery is not yet improved and fluctuates across the geographical locations in Ethiopia. Therefore, this study aimed to assess the spatial distribution and determinants of newborns not received postnatal check-ups within 2 days after birth in Ethiopia. METHODS: A secondary data analysis of the Ethiopia Demographic and Health Survey (EDHS) 2016 was done among live births within 2 years preceding the survey. A multilevel binary logistic regression model was fitted to identify the factors associated with the outcome variable. Adjusted Odds Ratio with 95% (Confidence Interval) was calculated and used as a measure of associations and variables with a p-value < 0.05, were declared as statistically significant. RESULTS: A total of 4036 live newborns in Ethiopia were included in the analysis, of whom half (51.21%) were females. The mean age of the mothers was 33+ SD 1.3, and more than 60 % (61.56%) of the mothers were not educated. The national prevalence of newborns not receiving postnatal check-ups within 2 days after birth was 84.29 (95% CI: 83.10-85.41) with significant spatial variations across the study area. Mothers who had no ANC visits were 58% higher than (AOR = 0.42(0.27-0.66) mothers who had > 4 ANC visits. Mothers who gave birth at home and others were 80% (AOR = 0.02(0.01-0.29) and 25% (AOR = 0.76(0.59-0.99), higher than mothers delivered at hospital. Rural mothers were 1.90 times higher (AOR = 1.90(1.29-2.81) than urban mothers, and mothers live in administrative regions of Afar 66% (AOR = 0.34(0.16-0.69), Oromia 47% (AOR = 0.53(0.30-0.91), Somali 60% (AOR = 0.40 (0.22-0.74),Benishangul 50% (AOR = 0.50 (0.27-0.92), SNNPR 67% (AOR = 0.33(0.19-0.57), Gambela 70% (AOR = 0.30 (0.16-0.56), Harari 56% (AOR = 0.44 (0.25-0.78), and Dire Dawa70% (AOR = 0.30 (0.17-0.54) were higher than Addis Abeba for not receiving postnatal checkup of new born within the first 2 days, respectively. CONCLUSIONS: Low postnatal check-up utilization remains a big challenge in Ethiopia, with significant spatial variations across regional and local levels. Spatial clustering of not receiving postanal check-ups within 2 days was observed in Afar, Oromia, Gambela, Benishangul, SNNPR, Harari, and Dire Dawa regions. Residence, ANC visits, place of delivery, and administrative regions were significantly associated with not receiving postnatal check-ups. Geographically targeted interventions to improve ANC follow-up and institutional delivery should be strengthened.

Spatial distribution and associated factors of community based health insurance coverage in Ethiopia: further analysis of Ethiopian demography and health survey, 2019.

BACKGROUND: Community-Based Health Insurance is an emerging concept for providing financial protection against the cost of illness and improving access to quality health services for low-income households excluded from formal insurance and taken as a soft option by many countries. Therefore, exploring the spatial distribution of health insurance is crucial to prioritizing and designing targeted intervention policies in the country. METHODS: A total of 8,663 households aged 15-95 years old were included in this study. The Bernoulli model was used by applying Kulldorff methods using the SaTScan software to analyze the purely spatial clusters of community based health insurance. ArcGIS version 10.3 was used to visualize the distribution of community-based health insurance coverage across the country. Mixed-effect logistic regression analysis was also used to identify predictors of community-based health insurance coverage. RESULTS: Community based health insurance coverage among households had spatial variations across the country by regions (Moran's I: 0.252, p < 0.0001). Community based health insurance in Amhara (p < 0.0001) and Tigray (p < 0.0001) regions clustered spatially. Age from 15-29 and 30-39 years (Adjusted Odds Ratio 0.46(AOR = 0.46, CI: 0.36,0.60) and 0.77(AOR = 0.77, CI: 0.63,0.96), primary education level 1.57(AOR = 1.57, CI: 1.15,2.15), wealth index of middle and richer (1.71(AOR = 1.71, CI: 1.30,2.24) and 1.79(AOR = 1.79, CI: 1.34,2.41), family size > 5, 0.82(AOR = 0.82, CI: 0.69,0.96),respectively and regions Afar, Oromia, Somali, Benishangul Gumuz, SNNPR, Gambella, Harari, Addis Ababa and Dire Dawa was 0.002(AOR = 0.002, CI: 0.006,0.04), 0.11(AOR = 0.11, CI: 0.06,0.21) 0.02(AOR = 0.02, CI: 0.007,0.04), 0.04(AOR = 0.04, CI: 0.02,0.08), 0.09(AOR = 0.09, CI: 0.05,0.18),0.004(AOR = 0.004,CI:0.02,0.08),0.06(AOR = 0.06,CI:0.03,0.14), 0.07(AOR = 0.07, CI: 0.03,0.16) and 0.03(AOR = 0.03, CI: 0.02,0.07) times less likely utilize community based health insurance than the Amhara region respectively in Ethiopia. CONCLUSION: Community based health insurance coverage among households in Ethiopia was found very low still. The government needs to develop consistent financial and technical support and create awareness for regions with lower health insurance coverage.

The Co-Utilization of Oral Rehydration Solution and Zinc for Treating Diarrhea and Its Associated Factors Among Under-Five Children in Ethiopia: Further Analysis of EDHS 2016.

Introduction: Diarrhea causes a loss of body water and salt, which can lead to dehydration and death. The use of oral rehydration salts and zinc together is regarded as an effective treatment for diarrhea in resource-poor settings like Ethiopia. However, studies that examine the co-utilization of oral rehydration solution and zinc in the treatment of diarrhea are limited Ethiopia. Objective: To assess the prevalence and associated factors of oral rehydration solution and zinc co-utilization to treat diarrhea in children under the age of five in Ethiopia, EDHS 2016. Methods: Secondary data from the 2016 Ethiopia Demographic and Health Survey (EDHS) was used to investigate the prevalence and factors associated with the co-utilization of ORS and zinc to treat diarrhea in under-five children. A multilevel binary logistic regression model was fitted to identify factors associated with the co-utilization of ORS and zinc. Adjusted odds ratios (AOR) with 95% CI were calculated and used as a measure of associations, and variables having a p-value of less than 0.05 were declared as statistically significant. Results: The national prevalence of ORS and zinc co-utilization was 16.65% (14.66%, 18.84%). Maternal educational status (AOR = 1.45; 95% CI; (1.01, 2.09)), household size (AOR = 1.53; 95% CI; 1.09, 2.16) and distance to health facilities at the community level (AOR = 1.60, 95% CI = 1.02, 2.58) were variables significantly associated with the co-use of ORS and zinc. Conclusion: The co-utilization of ORS and zinc for the management of diarrhea was low in Ethiopia. Education, household size, and distance to health facilities at the community level were significantly associated with the co-utilization of ORS and zinc in Ethiopia.

Spatial variation and determinants of underweight among children under 5 y of age in Ethiopia: A multilevel and spatial analysis based on data from the 2019 Ethiopian Demographic and Health Survey.

OBJECTIVES: Childhood underweight is a critical public health problem that needs urgent attention in developing countries like Ethiopia. Despite its variation between localities, the determinant factors and its geospatial variation have not been adequately addressed across the various regions of the country. Therefore, the aim of this study was to investigate the spatial variation and determinant factors of underweight among children under 5 y of age in Ethiopia. METHODS: The total weighted samples of 5753 children aged <5 y were included in this study. The data were taken from the 2019 Ethiopian Demographic and Health Survey (EDHS 2019). Arc GIS software was used to analyze geospatial variations to identify the hot- and cold spot areas of underweight in Ethiopia. A multilevel multivariable logistic regression model was used to identify the determinant factors of underweight. Excel, STATA-16, and ArcGIS software were used for the data management and analysis. In the multivariable multilevel analysis, adjusted odds ratio (aOR) with 95% confidence interval (CI) was used to declare significant determinants of underweight among children aged <5 y. RESULTS: Among 5753 children aged <5 y in Ethiopia, 21.3% were underweight during the 2019 EDHS. The distribution showed that there was a geospatial variation of underweight among children aged <5 y in Ethiopia; the Global Moran's index value was 0.36 with P < 0.001. In multivariable multilevel analysis, the significant factors associated with underweight were the sex of the child (aOR, 1.25; 95% CI, 1.09-1.44); age of the child, with the highest odds of being underweight observed in the age group of 24 to 35 mo (aOR, 3.52; 95% CI, 2.60-4.74); wealth index, with poorer children having higher odds of being underweight (aOR, 2.25; 95% CI, 1.58-3.24); and the regions, with the highest odds of underweight was observed in Tigray (aOR, 5.63; 95% CI, 2.79-11.36) and Afar (aOR, 4.71; 95% CI, 2.33-9.51). CONCLUSIONS: Underweight has significant spatial variation in Ethiopia, with spatial clustering in the northern and eastern parts of the country. It is recommended that in regions like Tigray, Afar, and Somali, as well as some areas in Gambella, priority steps be taken to reduce the burden of underweight in children aged <5 y. Thus, nutritional intervention programs should be strengthened and intervention strategies developed, with special emphasis on families with poor wealth index in the hotspot areas.

The effect of gestational age, low birth weight and parity on birth asphyxia among neonates in sub-Saharan Africa: systematic review and meta-analysis: 2021.

BACKGROUND: Despite simple and proven cost-effective measures were available to prevent birth asphyxia; studies suggested that there has been limited progress in preventing birth asphyxia even in healthy full-term neonates. In Sub-Saharan Africa, Inconsistency of magnitude of birth asphyxia and its association gestational age, Low birth Weight and Parity among different studies has been observed through time. OBJECTIVE: This study aimed to estimate the Pooled magnitude of birth asphyxia and its association with gestational age, Low birth Weight and Parity among Neonates in Sub-Saharan Africa. METHOD: PubMed, Cochrane library and Google scholar databases were searched for relevant literatures. In addition, reference lists of included studies were retrieved to obtain birth asphyxia related articles. Appropriate search term was established and used to retrieve studies from databases. Searching was limited to cohort, cross-sectional, and case-control studies conducted in Sub-Saharan africa and published in English language. Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI) was used for critical appraisal of studies. Heterogeneity across the included studies was evaluated by using the inconsistency index (I2) test. Funnel plot and the Egger's regression test were used to test publication bias. A weighted inverse variance random effects- model was used to estimate the pooled prevalence of birth asphyxia among neonates in Sub-Saharan Africa. STATA™ version 11softwarewasused to conduct the meta-analysis. RESULT: A total of 40 studies with 176,334 study participants were included in this systematic review and meta-analysis. The overall pooled magnitude of birth asphyxia in Sub-Saharan Africa was 17.28% (95% CI; (15.5, 19.04). low birth weight (AOR = 2.58(95% CI: 1.36, 4.88)), primigravida (AOR = 1.15 (95% CI: 0.84, 1.46) andMeconium-stained amniotic fluid (AOR = 6(95% CI: 3.69, 9.74)) werevariables significantly associated with the pooled prevalence of birth asphyxia. CONCLUSION: The pooled magnitude of birth asphyxia was found to be high in Sub-Saharan Africa. Low birthweight and Meconium-stained amniotic fluid were variables significantly associated with birth asphyxia in Sub-Saharan Africa. Hence, it is better to develop early detection and management strategies for the affected neonates with low birth weight and born from mothers intrapartum meconium stained amniotic fluid.

Depressive, Anxiety Symptom Frequency and Related Factors Among Prisoners During the COVID-19 Pandemic in Northeastern Ethiopia, a Cross-Sectional Study.

Background: Among the more than 10 million people imprisoned around the world, the rate of mental illness is higher than among the general population for various reasons. Although rates of mental illnesses such as depression and anxiety in this population may have changed as a response to the coronavirus disease (COVID-19) outbreak and other factors, to our knowledge, no related studies have been conducted related to depression and anxiety in this population during the pandemic. Therefore, this study aimed to assess depression, anxiety, and associated factors among Dessie City prisoners during the 2020 COVID-19 outbreak. Methods: An institution-based cross-sectional survey was conducted in October 2020. A total of 420 prisoners were selected via a systematic sampling technique. PHQ-9 depression scale, generalized anxiety disorder-7 questionnaire, Oslo 3-item social support scale, insomnia severity index, and Brief COPE scale were used. Data were entered by using Epi-Data version 3.1 and finally exported to Statistical Package for Social Science Software version 21 for analysis. We fitted a multiple binary logistic regression model. Finally, an adjusted odds ratio with 95% confidence interval was reported and factors with a p-value < 0.05 were considered as significant for depression and anxiety. Results: This study showed that 279 (66.4%) of imprisoned people had major depressive disorder with 95% CI of (61.4, 70.6), while 281 (66.9) had generalized anxiety disorder with 95% CI of (61.9, 71.9). Conclusion: In this study, the overall prevalence of depression and anxiety was significantly high, and was related to a number of factors including COVID-19. Therefore, designing and implementing strategies for COVID-19 prevention and control in prisons is highly recommended to reduce mental health problems among prisoners.

Spatial variation and determinates of dietary diversity among children aged 6-23 months in Ethiopia: spatial and multilevel analysis using Ethiopian Demography Health Survey (EDHS) 2019.

BACKGROUND: Minimum dietary diversity is the consumption of five or more food groups from the eight World Health Organization recommended food groups. Adequately diversified diet, in terms of amount and composition, is critical for optimal growth, development, and long-term health outcomes in the first 2 years. Understanding the regional variation of dietary diversity and the underlying factors is crucial for developing and implementing interventions. However, the use of spatial approaches in dietary studies has not been widely established. Therefore, this study aimed to explore the spatial patterns and determinates of minimum dietary diversity practice among 6-23 months children in Ethiopia. METHODS: Secondary data analysis was conducted based on the Demographic and Health Surveys data conducted in Ethiopia. A total weighted sample of 1578 children aged 6-23 months was included for this study. The Global Moran's I was estimated to look into the regional variation of dietary diversity and hotspot and cold spot areas. Further, multivariable multilevel logistic regression was used for factor analyses. Adjusted Odds Ratio with 95% CI was used to declare the strength and significance of the association. RESULTS: Overall, 87.4% (95% CI: 85.7 to 88.9%) of children in 2019 had inadequate Minimum dietary diversity. We identified statistically significant clusters of high inadequate dietary diversity (hotspots) notably observed in Somali, Afar, Eastern and western Amhara, western Tigray, Benishangul, and Northeastern and western parts of the southern nations, nationality and peoples' regions. Inadequate dietary diversity was significantly higher among young children, uneducated mother, married women, younger mother, no postnatal check, community with higher level of poverty and community level uneducated woman. CONCLUSION: According to the findings of this study inadequate Minimum dietary diversity for children as measured by World Health Organization dietary assessment shows high. Children's dietary diversity was distributed non-randomly in different districts across Ethiopia's regions. The findings of the study provided critical evidence about dietary diversity and associated factors. Hence, policy should focused on improve education status of Mother, boosting economic status of the community, increased maternal continuum of care and focused on young children nutrition may advance dietary diversity.

Prevalence and associated factors of double and triple burden of malnutrition among child-mother pairs in Ethiopia: Spatial and survey regression analysis.

BACKGROUND: Evidence on double and triple burdens of malnutrition at household level among child-mother pairs is a key towards addressing the problem of malnutrition. In Ethiopia, studies on double and triple burdens of malnutrition are scarce. Even though there is a study on double burden of malnutrition at national level in Ethiopia, it doesn't assess the triple burdens at all and a few forms of double burden of malnutrition. Therefore, this study aimed to determine the prevalence and associated factors of double and triple burdens of malnutrition among child-mother pairs in Ethiopia. METHODS: A total sample of 7,624 child-mother pairs from Ethiopian Demographic and Health Survey (EDHS) 2016 were included in the study. All analysis were performed considering complex sampling design. Anthropometric measures and hemoglobin levels of children, as well as anthropometric measurements of their mothers, were used to calculate double burden of malnutrition (DBM) and triple burden of malnutrition (TBM). Spatial analysis was applied to detect geographic variation of prevalence of double and triple burdens of malnutrition among EDHS 2016 clusters. Bivariable and multivariable binary survey logistic regression models were used to assess the factors associated with DBM and TBM. RESULTS: The overall weighted prevalence of DBM and TBM respectively were 1.8% (95%CI: 1.38-2.24) and 1.2% (95%CI: 0.83-1.57) among child-mother pairs in Ethiopia. Significant clusters of high prevalence of DBM and TBM were identified. In the adjusted multivariable binary survey logistic regression models, middle household economic status [AOR = 0.23, 95%CI: 0.06, 0.89] as compared to the poor, average birth weight [AOR = 0.26, 95%CI: 0.09, 0.80] as compared to large birth weight and children aged 24-35 months [AOR = 0.19, 95%CI: 0.04,0.95] as compared to 6-12 months were less likely to experience DBM. Average birth weight [AOR = 0.20, 95%CI: 0.05, 0.91] as compared to large birth weight and time to water source <=30 min [AOR = 0.41, 95%CI: 0.19,0.89] as compared to on premise were less likely to experience TBM. CONCLUSION: There is low prevalence of DBM and TBM among child-mother pairs in Ethiopia. Interventions tailored on geographic areas, wealth index, birth weight and child birth could help to control the emerging DBM and TBM at household level among child-mother pairs in Ethiopia.

Prevalence and associated factors of needle stick and sharps injuries among healthcare workers in northwestern Ethiopia.

BACKGROUND: Needle stick and sharp injuries (NSSIs) are a common problem among healthcare workers (HCWs). Although the factors related to NSSIs for HCWs are well documented by several studies in Ethiopia, no evidence has been reported about the magnitude of and factors related to NSSIs in hospitals in northwestern Ethiopia. METHODS: An institution-based cross-sectional study was carried out from January to March 2019 among 318 HCWs in three randomly-selected hospitals of the eight hospitals found in South Gondar Zone. Sample sizes were proportionally allocated to professional categories. Study participants were selected by systematic random sampling methods using the monthly salary payroll for each profession as the sampling frame. Data were collected using a self-administered questionnaire. The outcome of this study was the presence (injured) or absence of NSSIs during the 12 months prior to data collection. A binary logistic regression model with 95% confidence interval (CI) was used for data analysis. Variables from the bi-variable analysis with a p-value ≤ 0.25 were retained into the multivariable analysis. From the multivariable analysis, variables with a p-value less than 0.05 was declared as factors significantly associated with NSSIs. MAIN FINDINGS: The prevalence of NSSIs was 29.5% (95% CI: 24.2-35.5%) during the 12 months prior to the survey. Of these, 46.0% reported that their injuries were moderate, superficial (33.3%) or severe (20.7%). About 41.4% of the injuries were caused by a suture needle. Factors significantly associated with NSSIs were occupation as a nurse (adjusted odds ratio [AOR] = 2.65, 95% CI: 1.18-4.26), disposal of sharp materials in places other than in safety boxes (AOR = 3.93, 95% CI: 2.10-5.35), recapping of needles (AOR = 2.27, 95% CI: 1.13-4.56), and feeling sleepy at work (AOR = 2.24, 95% CI: 1.14-4.41). CONCLUSION: This study showed that almost one-third of HCWs had sustained NSSIs, a proportion that is high. Factors significantly associated with NSSIs were occupation as a nurse, habit of needle recapping, disposal of sharp materials in places other than in safety boxes and feeling sleepy at work. Observing proper and regular universal precautions for nurses during daily clinical activities and providing safety boxes for the disposal of sharp materials, practicing mechanical needle recapping and preventing sleepiness by reducing work overload among HCWs may reduce the incidence of NSSIs.

Prevalence and associated factors of acute respiratory infection among street sweepers and door-to-door waste collectors in Dessie City, Ethiopia: A comparative cross-sectional study.

BACKGROUND: Acute respiratory infections are rising in developing countries including Ethiopia. Lack of evidence for the prevalence and associated factors of acute respiratory infection among street sweepers and door-to-door waste collectors in Dessie City, Ethiopia is a challenge for the implementation of appropriate measures to control acute respiratory infection. Thus, this study was designed to address the gaps. METHODS: A comparative cross-sectional study was conducted among 84 door-to-door waste collectors and 84 street sweepers from March to May 2018. A simple random sampling technique was used to select study participants. Data were collected by trained data collectors using a pretested structured questionnaire and on-the-spot direct observation checklist. Data were analyzed using three different binary logistic regression models at 95% confidence interval (CI): the first model (Model I) was used to identify factors associated with acute respiratory infection among street sweepers, whereas the second model (Model II) was used to identify factors associated with acute respiratory infection among door-to-door waste collectors, and the third model (Model III) was used for pooled analysis to identify factors associated with acute respiratory infection among both street sweepers and door-to-door waste collectors. From each model multivariable logistic regression, variables with a p-value <0.05 were taken as factors significantly associated with acute respiratory infection. RESULTS: The overall prevalence of acute respiratory infection among studied population was 42.85% with 95% CI (35.1, 50.0%). The prevalence of acute respiratory infection among street sweepers was 48.80% (95% CI: 37.3, 64.8%) and among door-to-door waste collectors was 36.90% (95% CI: 27.4, 46.4%). There was no statistically significant difference between the prevalence of acute respiratory infection among the two groups due to the overlapping of the 95% CI. Among the street sweepers, we found that factors significantly associated with acute respiratory infection were not cleaning personal protective equipment after use (adjusted odds ratio [AOR]: 2.40; 95% CI: 1.15, 5.51) and use of coal/wood for cooking (AOR: 3.95; 95% CI: 1.52, 7.89), whereas among door-to-door waste collectors, were not using a nose/mouth mask while on duty (AOR: 5.57; 95% CI: 1.39, 9.32) and not receiving health and safety training (AOR: 3.82; 95% CI: 1.14-7.03) were factors significantly associated with acute respiratory infection among door-to-door-waste collectors. From the pooled analysis, we found that not using a nose/mouth mask while on duty (AOR: 2.19; 95% CI: 1.16, 4.53) and using coal/wood for cooking (AOR: 2.74; 95% CI: 1.18, 6.95) were factors significantly associated with acute respiratory infection for both street sweepers and door-to-door waste collectors. CONCLUSION: The prevalence of acute respiratory infection among street sweepers and door-to-door waste collectors has no statistically significant difference. For both groups, not using a nose/mouth mask while on duty and using coal/wood for cooking fuel factors associated with acute respiratory infection. The municipality should motivate and monitor workers use of personal protective equipment including masks and gloves. Workers should use a nose/mouth mask while on duty and should choose a clean energy source for cooking at home.

Water, sanitation, and hygiene conditions and prevalence of intestinal parasitosis among primary school children in Dessie City, Ethiopia.

BACKGROUND: Intestinal parasitosis is a major public health problem that affects the health of primary school children in low- and middle-income countries where water, sanitation, and hygiene (WASH) conditions are deficient. Since there is a paucity of information on the prevalence and associated factors of this problem among primary school children in Dessie City in Ethiopia, this study was designed to address these gaps. METHODS: A school-based cross-sectional study was conducted among 407 stratified-sampled primary school children in five primary schools at Dessie City from April to June 2018. Data were collected using a pretested structured questionnaire, an observation checklist and laboratory analysis of stool samples. Stool specimen from each study participant was collected using clean, properly labeled and leak-proof stool cup. A portion of stool from each study participant collected sample was processed using saline wet mount technique and examined by microscope. The remaining specimens were preserved with 10% formalin and transported to Dessie Comprehensive Specialized Hospital laboratory to be processed by using formol-ether concentration technique. Then, slide smears were prepared from each processed stool specimen and finally, it was microscopically examined with 10x as well as 40x objectives for the presence or absence of intestinal parasites. Factors significantly associated with intestinal parasitosis were determined using binary logistic regression model at 95% CI (confidence interval). Thus, bivariate (COR [crude odds ratio]) and multivariable (AOR [adjusted odds ratio]) logistic regression analyses were carried out. From the multivariable analysis, variables having a p-value of less than 0.05 were declared as factors significantly associated with intestinal parasitosis among primary school children. MAIN FINDINGS: The overall prevalence of intestinal parasitosis was found to be 16.0% (95% CI: 12.5-19.4%), of these, 50.8% were positive for protozoa, 32.2% for helminth infections and 16.9% for double co-infections. Entamoeba histolytica was the most prevalent parasite (29.2%), followed by Giardia lamblia (21.5%), Ascaris lumbricoides (18.5%), Hymenolepis nana (9.2%) and Enterobius vermicularis (4.6%). Prevalence rates were similar among government (16.3%) and private (15.7%) school children. Water consumption was less than 5 liters per capita per day in 4 of the 5 schools. Thirty-eight (9.3%) of primary school students reported that they practiced open defecation. About two-thirds (285, 70.0%) said they always washed their hands after defecation. Mother's education (illiterate) (AOR = 3.3; 95% CI: 1.20-9.37), father's education (illiterate) (AOR = 3.9; 95% CI: 1.40-10.82), fathers who could read and write (AOR = 3.3; 95% CI: 1.25-7.86), handwashing before meal (sometimes) (AOR = 2.2; 95% CI: 1.11-4.17) and poor knowledge of WASH (AOR = 9.3; 95% CI: 2.17-16.70) were statistically associated with presence of intestinal parasitic infections. CONCLUSION: We concluded that the prevalence of intestinal parasitosis in the study area among Grades 4-8 primary school children had public health significance. Factors significantly associated with intestinal parasitosis among primary school children's were illiterate mothers and fathers, irregular handwashing of children before meals, and poor knowledge of WASH. Health education to improve students' WASH knowledge and mass deworming for parasites are recommended as preventive measures; and improvements to the quality of WASH facilities in primary schools are strongly recommended to support these measures.

Blood Pressure Control with Reference to Intensive Blood Pressure Targets Among Hypertension Patients on Chronic Follow-Up at Dessie Referral Hospital, Northeast Ethiopia.

BACKGROUND: Hypertension is a risk factor for heart, brain, kidney, and other diseases. It is also the major cause of premature death. Thus, it is important to prevent, treat, and control hypertension and to reduce the risk of cardiovascular disease. OBJECTIVE: To determine the level of blood pressure control and associated factors based on the new intensive blood pressure goals (<130/80 mmHg). METHODS: A cross-sectional study design was used to assess the level of blood pressure control and associated factors from February 15 to April 15, 2019. Two hundred and sixteen patients were selected through a systematic sampling technique. RESULTS: From 203 hypertension patients incorporated in the study, 102 (50.2%) were females. The mean age of patients documented during the last date of follow-up was 55.2 (SD=±14.47). About 51.2% of patients were less than 5 years from the day of diagnosis of hypertension. The majority of the study participants (111, 54.7%) were using two antihypertensives. The most common anti-hypertensive medication was hydrochlorothiazide (HCT), at 25 (12.3%). The most common combination drug therapy used was the combination of HCT and calcium channel blockers, at 62 (30.5%). Heart failure (22, 20.8%), stroke (18, 16.98%), and dyslipidemia (17, 16.04%) were the top three comorbidities. Based on the new intensive targets of blood pressure control (<130/80 mmHg), the blood pressure was controlled for only 25 (12%) patients. CONCLUSION: The level of blood pressure control for hypertensive patients on chronic follow-up at Dessie Referral Hospital was very poor.

Assessment of Drug Use Pattern Using WHO Core Prescribing Indicators at Outpatient Settings of Governmental Hospitals in Dessie Town.

BACKGROUND: Enhancing the standards of medical treatment at all levels of the healthcare delivery system can improve the quality of life in developing countries. One method to promote rational drug use is an assessment of drug use pattern based on drug use indicators. OBJECTIVE: To evaluate prescription patterns at the outpatient pharmacy of Dessie Referral Hospital and Boru Meda Hospital at Dessie town. METHODS: An institution-based retrospective cross-sectional study was conducted to assess the prescribing patterns in governmental hospitals of Dessie town from April 1 to May 30, 2019. Six hundred eligible prescriptions were selected from each hospital through a systematic random sampling technique. RESULTS: The result of this study showed that both hospitals used standard prescriptions (100%). Age (99.0%) and name (94.7%) of patients were the most commonly recorded patient information while weight, address of patients and diagnosis were recorded only in 1.1%, 39.2% and 61.3% of the studied prescription papers, respectively. A total 2409 drugs were prescribed in the 1200 prescription papers and the percentage of encounters with injection(s) and antibacterial(s) was 9.0% and 42.6%, respectively. At each hospital, all drugs were prescribed from the Ethiopian essential drug list. CONCLUSION: The present study revealed the use of standard presecription papers at both hospitals. None of the patient-related information was completely written in all prescrptions. For drug-related information, only the name of the drug was written in all prescription papers. There is also a significant deviation from the acceptable WHO standard for prescribing antibiotics.

Treatment Outcomes of Patients with Acute Coronary Syndrome Admitted to Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia.

BACKGROUND: Acute coronary syndrome (ACS) refers to a spectrum of conditions compatible with acute myocardial ischemia and/or infarction that are usually due to an abrupt reduction in coronary blood flow. OBJECTIVE: The objective of the study was to assess the treatment outcome and associated factors for ACS. METHODS: A retrospective cross-sectional study was conducted from January 1, 2012 to December 31, 2014. RESULTS: Of 124 ACS patients who were admitted during the 3 years' period, 90 (72.6%) were diagnosed with ST segment elevation myocardial infarction (STEMI). The mean age was 56.3 ± 13.7 years. The average length of hospital stay was 9.77 ± 6.42 days. The average time from onset of ACS symptoms to presentation in the emergency department was 3.8 days (91.7 hours). In about 76 (61.3%) patients, hypertension was the leading risk factor for development of ACS, and 36.4% of ACS patients were either Killip class III or IV. Biomarkers were measured for 118 (95.2%) patients, and 79.2% of patients had ejection fraction of less than 40% and 29.2% had less than 30%. In-hospital medication use includes loading dose of aspirin (79%), anticoagulants (77.4%), beta blockers (88.1%), statins (85.5%), morphine (12.9%), and nitrates (35.5%). The in-hospital mortality was 27.4%. The predictors for in-hospital mortality were age (P = .042), time from symptom onset to presentation (P = .001), previous history of hypertension (P = .025), being Killip class III and IV (P = .001), and STEMI diagnosis (P = .005). CONCLUSIONS: The medical management of ACS patients in Tikur Anbessa Specialized Hospital (TASH) was in line with the recommendations of international guidelines but in-hospital mortality was extremely high (27.4%).

Knowledge, Practice, and Associated Factors of Home-Based Management of Diarrhea among Caregivers of Children Attending Under-Five Clinic in Fagita Lekoma District, Awi Zone, Amhara Regional State, Northwest Ethiopia, 2016.

INTRODUCTION: In Ethiopia, it is the second cause for clinical presentation among under five-year child population. OBJECTIVE: The main aim of this study was to assess knowledge, practice, and associated factors of home-based management of diarrhea among caregivers of children attending the under-five clinic. METHODS: Institution based quantitative cross-sectional study was carried out from March 1, 2016, to April 22, 2016. RESULTS: Two hundred eight (56.2%) of them had good knowledge and one hundred thirty-nine (37.6%) of them had the good practice of home management of diarrhea, specifically, primary education (AOR: 5.384, 95% CI: 2.008, 14.438), secondary and above education (AOR: 11.769, 95% CI: 3.527, 39.275), daily laborer (AOR: 0.208, 95% CI: 0.054, 0.810), and no information about diarrhea (AOR: 0.139, 95% CI: 0.054, 0.354). Moreover, age range of 25-35 (AOR: 4.091, 95% CI: 1.741, 9.616) and 36-45 (AOR: 3.639, 95% CI: 1.155, 11.460), being single (AOR: 0.111, 95% CI: 0.013, 0.938), being divorced (AOR: 0.120, 95% CI: 0.024, 0.598), illiteracy (AOR: 0.052, 95% CI: 0.017, 0.518), primary education (AOR: 0.143, CI: 0.046, 0.440), and no information about diarrhea (AOR: 0.197, 95% CI: 0.057, 0.685) were significantly associated variables with the outcome variables in multivariate regression. CONCLUSION: Caregivers had slightly adequate knowledge but poor practice.