Assessment of knowledge on emergency contraceptives and factors associated with utilization among female students in Bonga College of Education, Southwest Region, Ethiopia: cross-sectional study.

BACKGROUND: Unintended pregnancy is a major public health problem in sexually active female students in Ethiopia. In higher education, female students are exposed to unprotected sex and are at risk of pregnancy, abortion, and its associated problems. OBJECTIVE: The objective of this study was to assess knowledge of female students about emergency contraceptives and determine factors associated with utilization among college female students at Bonga College of Education, Southwest Ethiopia. METHODS: The study was conducted from November 10, 2022 to May 30, 2023. All female students of Bonga College of education in all departments were included in this study purposively. Data were collected using Amharic version pretested questionnaire. Data obtained from the survey was entered into Microsoft Excel 2010 and analysed with SPSS version 20.0. Data summary was done with descriptive statistics. Logistic regression was used to measure associations between dependent and independent variables. Odds ratio was used to measure strengths of association between variables. Statistical significance was considered at 95% confidence level (CL). P-value less than 0.05 was considered significant during the analysis. RESULTS: In this study a total of 103 College female students were involved. The mean age of the respondents was 20.6 (SD ± 2.06) years. The finding showed that 31 (31.1%) female students had started sexual intercourse and among them 58.1% faced pregnancy. Among the total sexually experienced respondents, 93.5% use contraceptive methods while others 6.5% do not use. Among the total 31 study participants, 27(87.1%) started using EC. The majority of pregnancy (83.3%) was intended type whereas 16.7% was unwanted pregnancy. Regarding the general knowledge about contraceptive methods, 19(18.4%) had poor knowledge. Among the total 103 female college students, 66(64.1%) heard about emergency contraceptives. Forced sex and unprotected free sex are predicting factors that induces female students to use emergency contraceptives. Fear of discontinuing school was the main inducing factor to commit abortion. Logistic regression analysis showed that college female students whose age category above 25 years were more likely to use emergency contraceptives. Students who came from urban area are more likely to use EC than rural areas. Married female students (AOR = 2.5, 95% CI: 0.76, 8.7) were two times likely to use EC as contraceptive method. CONCLUSIONS: Female students who came from urban area use EC better than who came from rural areas. Majority of sexually active female students had good practice and knowledge of using EC but some had poor knowledge. Forced sex and free sexual practice are key determinant factors that induces to use EC. Abortion was mainly done in private clinic. Fear of discontinuing school was determinant factors identified to commit abortion. Therefore, responsible bodies should develop strategies to improve female students' reproductive health related to emergency contraceptives.

Assessing Potential Intermediate Host Snails of Urogenital Schistosomiasis, Human Water Contact Behavior and Water Physico-chemical Characteristics in Alwero Dam Reservoir, Ethiopia.

Introduction: Urogenital schistosomiasis is one of public health problems in lowland areas of Ethiopia. The disease is caused by Schistosoma haematobium. Freshwater Bulinus snails are intermediate hosts for the parasite transmission. The aim of the study was to assess intermediate host snails of urogenital schistosomiasis, human water contact behavior and physico-chemical characteristics of Alwero Dam reservoir. Methods: Bulinus snails were sampled from 12 sites of Alwero Dam. Bulinus snails were collected, identified and examined for natural schistosome infections. A total of 206 people were interviewed to determine human water contact behavior. The water temperature, pH, dissolved oxygen, total dissolved solid, salinity and conductivity of the water were determined. Results: Of 1125 Bulinus snails collected, 72 (6.4%) were infected with echinostome cercariae but none of them were infected with schistosome cercariae. The abundance of Bulinus species did not show significant variation across seasons (P = .61). Occurrence of Bulinus species was significantly higher in stony substratum than sandy substratum (P = .01). Of the total 206 participants, 119 (57.8%) had water contact activities like washing clothes, bathing or swimming. Majority of respondents (70.0%) reported that they visited the dam reservoir once or twice a week, while 16.5% and 13.6% reported that they visited the dam 3 to 5 times a week and daily, respectively. Moreover, 72.3% of the respondents had reported they had history of urogenital schistosomiasis infection. The mean water temperature, pH, dissolved oxygen, total dissolved solid, electric conductivity, and salinity of the dam water was 28.6°C, 7.07, 5.75 mg/l, 90.0 ppm, 124.8 µS/cm, and 50.0 ppm, respectively. Conclusion: At Alwero Dam, Bulinus snails were highly abundant and the human water contact activities were frequent. Therefore, the community awareness creation should be made to reduce water contact with snail infested water to prevent risk of urogenital schistosomiasis infection.

Urogenital schistosomiasis prevalence and diagnostic performance of urine filtration and urinalysis reagent strip in schoolchildren, Ethiopia.

BACKGROUND: Urogenital schistosomiasis has been known to be endemic in several lowland areas of Ethiopia. It is caused by Schistosoma haematobium and causes considerable public health problems to schoolchildren. Ethiopia, after mapping the distribution of the disease (2013 to 2015), launched school-based mass deworming program to treat schoolchildren for schistosomiasis and soil-transmitted helminthiasis (STH) across the country since 2015. However, there is no recent information about the prevalence of the disease among schoolchildren in the current study areas. Diagnostic performance of urine filtration method and urinalysis reagent strip is also lacking. Therefore, this study aimed to determine the prevalence of urogenital schistosomiasis in schoolchildren, and to evaluate diagnostic performance of urine filtration and urinalysis reagent strip in Amibara, Kurmuk and Abobo districts, Ethiopia. METHODS: Across-sectional study was conducted involving 1,171 schoolchildren in Abobo, Amibara and Kurmuk districts from October, 2020 to January, 2021. The study participants were selected using random sampling technique. From each study participant, 10 ml urine samples were collected and examined using urine filtration method and urinalysis reagent strip. Data obtained from the survey were entered into Microsoft Excel 2010 and analysed with SPSS version 20.0. Data was summarized using descriptive statistics. Chi-square, bivariate and multivariable logistic regression and Pearson correlation test were used to measure associations between urogenital schistosomiasis, age, sex and haematuria. Odds ratio was used to measure strengths of association between variables. Agreement between urine filtration method and urinalysis reagent strip was determined using Kappa statistics. P-value < 0.05 at 95% CI was considered as statistically significant. RESULTS: Among the 1,171 urine samples from schoolchildren examined by urine filtration method, 143 (12.2%) were S.haematobium egg positive. Out of 143 positive children 126(88.1%) were lightly infected and 17 (11.9%) were heavily infected. Among the total of 1,171 urine samples tested by dipstick, 264(22.5%) were positive for haematuria. Prevalence of urogenital schistosomiasis by both urine filtration and urinalysis reagent strip method was higher in Abobo than Hassoba (Amibara) and Kurmuk (P< 0.001). The number of egg counts (intensity of infections) were significantly correlated with intensity of haematuria (r = 0.6, P < 0.001). Egg-positive children had significantly higher risk of having haematuria compared to S. haematobium egg negative children (OR; 6.96; 95%CI: 4.98, 8.940). Compared to urine filtration method, the sensitivity, specificity, positive predictive value (PPV) and negative predictive values (NPV) of urinalysis reagent strip were 99.3%, 88.1%, 53.8% and 99.8%, respectively. Furthermore, its positive likelihood ratio (PLR) and negative likelihood ratio (NLR) were 8.34 and 0.008, respectively. The accuracy index and diagnostic odds ratio (DOR) of reagent strip were 0.89 and 1054, respectively. The agreement level between urine filtration methods and urinalysis reagent strip for detecting urogenital schistosomiasis was substantial (Kappa = 0.64). CONCLUSION: This study showed that urogenital schistosomiasis was prevalent in schoolchildren in Abobo, Hassoba and Kurmuk districts. Urogenital schistosomiasis prevalence in Hassoba-bure and Kurmuk falls under low category whereas moderate in Abobo and is almost four times compared to Kurmuk and Hassoba-bure. Chemotherapy is needed in schoolchildren in such endemic areas and other measures like access to safe water, improved sanitation, hygiene, and health education should be implemented to control and prevent schistosomiasis effectively. The sensitivity, specificity, positive and negative predictive values of urinalysis reagent strip were higher and could serve as alternative for mass screening of urogenital schistosomiasis, for surveillance and evaluation of schistosomiasis intervention programs.

Urinary schistosomiasis and malaria associated anemia in Ethiopia.

OBJECTIVE: To assess the prevalence of anemia in children with urinary schistosomiasis, malaria and concurrent infections by the two diseases. METHODS: Urine and blood samples were collected from 387 children (216 males and 171 females) to examine urinary schistosomiasis and malaria and to determine hemoglobin concentration at Hassoba and Hassoba Buri village in Amibara woreda, Afar region, Ethiopia. RESULTS: The overall prevalence of urinary schistosomiasis and Plasmodium falciparum malaria was 24.54% and 6.20% respectively. Only 2.84% of children carried concurrent infections of both parasites. There was high percentage of anemic patients (81.81%) in the coinfected cases than in either malaria (33.3%) or schistosomiasis (38.94%) cases. There was significantly low mean hemoglobin concentration in concurrently infected children than non-infected and single infected (P<0.05). The mean hemoglobin concentration between Plasmodium falciparum and S. haematobium infected children showed no significant difference (P>0.05). The level of hemoglobin was negatively correlated with the number of S. haematobium eggs/10 mL urine (r=-0.6) and malaria parasitemia (r=-0.53). CONCLUSIONS: The study showed that anemia is higher in concurrently infected children than non-infected and single infected. Furthermore, level of hemoglobin was negatively correlated with the number of S. haematobium eggs and malaria parsitemia. Therefore, examination of hemoglobin status in patients co-infected with malaria and schistosomiasis is important to reduce the risk of anemia and to improve health of the community.