The practice of key messages for optimal breastfeeding and associated factors among lactating mothers in the Boset District, Oromia, Ethiopia.

Background: Inadequate breastfeeding can lead to significant morbidity, mortality, and long-term adverse health outcomes. Key messages promoting optimal breastfeeding are integral to Essential Nutritional Action, aimed at improving children's nutritional status, especially those under the age of two. However, there is a dearth of data regarding the extent to which lactating mothers adhere to these key messages and the associated factors. Therefore, this study aimed to assess the level of practice of key messages for optimal breastfeeding and identify associated factors among lactating mothers living in the Boset District, Oromia, Ethiopia. Methods: A community-based cross-sectional study was conducted among 418 lactating mothers from January 1st to February 28th, 2022. The participants were selected using a systematic random sampling technique, and data were collected through interviewer-administered questionnaires. The collected data were entered into Epi Info version 7 and exported to SPSS version 25 for analysis. Binary logistic regressions were performed to examine the association between independent and dependent variables. Adjusted Odds Ratios with a 95% confidence interval were used to estimate the strength of the associations and statistical significance was declared at a p-value < 0.05. Result: The overall level of practice of key messages for optimal breastfeeding was 63.9% (95% CI: 59.1-68.2). The odds of practicing key messages for optimal breastfeeding were higher for mothers who attended antenatal care four times or more (AOR = 2.7, 95% CI: 1.4-5.3), received counseling on breastfeeding during postnatal care (AOR = 3.7, 95% CI: 2.2-6.4), had a good knowledge of breastfeeding (AOR = 6.2, 95% CI: 3.6-10.7), and had a favorable attitude toward breastfeeding (AOR = 6.1, 95% CI: 3.5-10.6). Conclusion: Breastfeeding key message practices among lactating mothers in the study area fell below the recommended universal coverage of 90%. Factors identified included the number of antenatal care visits, counseling on breastfeeding, level of knowledge, and attitude toward breastfeeding. Promoting regular antenatal visits, providing thorough postnatal counseling, and enhancing knowledge and attitudes are crucial for improving optimal breastfeeding practices.

Poor self-care practices and contributing factors among adults with type 2 diabetes in Adama, Ethiopia.

Diabetes mellitus (DM) is a prominent global health challenge, characterized by a rising prevalence and substantial morbidity and mortality, especially evident in developing nations. Although DM can be managed with self-care practices despite its complexity and chronic nature, the persistence of poor self-care exacerbates the disease burden. There is a dearth of evidence on the level of poor self-care practices and contributing factors among patients with DM in the study area. Thus, this study assessed the proportion of poor self-care practices and contributing factors among adults with type 2 DM in Adama, Ethiopia. An institution-based cross-sectional study was conducted among 404 patients. Self-care practice was assessed by the summary of diabetes self-care activities questionnaires. Binary logistic regression was used to identify factors associated with poor self-care practices. An adjusted odds ratio with a 95% confidence interval was used to assess the strength of associations. The statistical significance was declared for a p-value < 0.05. The proportion of poor self-care practices was 54% [95% CI 49.1, 58.6]. Being divorced (AOR = 3.5; 95% CI 1.0, 12.2), having a lower level of knowledge (AOR = 1.70; 95% CI 1.0, 2.8), being on insulin (AOR = 6.3; 95% CI 1.9, 20.6), taking oral medication (AOR = 8.6; 95% CI 3.0, 24.5), being unaware of fasting blood sugar (AOR = 2.9; 95% CI 1.6, 5.2), not a member of a diabetic association (AOR = 3.6; 95% CI 1.7, 7.5), a lack of social support (AOR = 2.9; 95% CI 1.7, 4.9), and having a poor perceived benefit of self-care practices (AOR = 1.84; 95% CI 1.0, 3.2) were associated with poor self-care practices. Overall, this finding demonstrated that a significant percentage of participants (54%) had poor self-care practices. Being divorced, having a low level of knowledge about diabetes and fasting blood sugar, lacking social support, relying on oral medication, perceiving limited benefits from self-care practices, and not being a member of diabetic associations were identified as independent factors of poor self-care.

Magnitude of central obesity and associated factors among adult patients attending public health facilities in Adama town, Oromia region, Ethiopia, 2022.

BACKGROUND: Central obesity is excessive accumulation of fat around the abdomen, which is associated with the risk of coronary heart and cerebrovascular diseases. This study determined the magnitude of central obesity among adult patients using the waist-to-hip ratio, which has a superior capacity to measure the risk of developing non-communicable diseases compared to the body mass index used in previous studies in Ethiopia. METHODS: Institutional-based cross-sectional study was conducted among a sample of 480 adults from April 1 to May 30, 2022. A systematic random sampling technique was used to select the study participants. Data were collected by using interviewer-administered structured questionnaires and anthropometric measurements. The data were entered into EPI INFO version 7 and analyzed by Statistical Software for Social Science Version 25. The associations between independent and dependent variables were checked using bivariate and multivariate logistic regression analyses. Adjusted odds ratio and 95% confidence interval were used to measure the strengths of the association. Statistical significance was declared at a P value of less than 0.05. RESULTS: The magnitude of central obesity in this study was 40% (51.2% and 27.4% among females and males, respectively (95% CI 36-44%)). Being a female (AOR = 9.5, 95% CI 5.22-17.9), age range 35-44 (AOR = 7.0, 95% CI 2.9-16.7), 45-64 years (AOR = 10.1, 95% CI4.0-15.2), married (AOR = 2.5, 95% CI 1.3-4.7), high monthly income (AOR = 3.3, 95% CI 1.5-7.3), high consumption of milk and milk products (AOR = 0.3, 95% CI 0.1-0.6), family history of obesity (AOR = 1.8, 95% CI 1.1-3.2) were significantly associated with central obesity among the study participants. CONCLUSION: The magnitude of central obesity was higher in the study area. Sex, age, marital status, monthly income, consumption of milk and milk products, and family history of obesity were independent determinants of central obesity. Therefore, it is important to raise awareness about central obesity through behavior change communication that targets the high-risk population.

Failed induction of labor and associated factors in Adama Hospital Medical College, Oromia Regional State, Ethiopia.

Background: Failed induction of labor continues to be a public health challenge throughout the world. This failed induction of labor is associated with a higher rate of maternal and fetal morbidity because it increases the unwanted effect of emergency cesarean section. It is also associated with an increased risk of numerous adverse maternal and perinatal outcomes such as uterine rupture, nonreassuring fetal heart rate tracing, postpartum hemorrhage, stillbirth, and severe birth asphyxia. Thus, this study was aimed to assess the failed induction of labor and associated factors in the Adama Hospital Medical College, Oromia Regional State, Ethiopia. Methods: A facility-based cross-sectional study was conducted from 1 to 30 December 2020 in Adama Hospital Medical College, Ethiopia. A total of 379 women who underwent labor induction in the Adama Hospital Medical College from December 2019 to November 2020 were enrolled in the study. The participants' charts were selected using a simple random sampling technique. Data were collected using a pretested and validated structured questionnaire. Descriptive statistics were carried out using frequency tables, proportions, and summary measures. Predictors were assessed using a multivariable logistic regression analysis model and reported using adjusted odds ratio with 95% confidence interval. Statistical significance was considered at a p value <0.05. Results: Of 379 induced labor included in the study, the proportion of failed induction was found to be 29.6% (95% confidence interval (25.2, 34.3)). Prelabor rupture of the membrane was found to be the most common indication for induction of labor (46.4%) followed by a hypertensive disorder of pregnancy (21.6%). In the final model of multivariable analysis, predictors such as: nulliparity (adjusted odds ratio = 2.32, 95% confidence interval (1.08, 5.02)), unfavorable cervical status (adjusted odds ratio = 3.46, 95% confidence interval (1.51, 7.94)), prelabor rupture of membrane (adjusted odds ratio = 2.60, 95% confidence interval (1.14, 5.91)), hypertensive disorder of pregnancy (adjusted odds ratio = 3.01;95% confidence interval (1.61, 558)), preinduction membrane status (adjusted odds ratio = 3.63; 95% confidence interval (1.48, 8.86)), and birth weight of greater than 4000 g (adjusted odds ratio = 4.33; 95% confidence interval (1.44, 13.02)) were statistically associated with failed induction of labor. Conclusion: The prevalence of failed induction of labor was relatively high in this study area because more than a quarter of mothers who underwent induction of labor had failed induction. This calls for all stakeholders to adhere to locally available induction protocols and guidelines. In addition, pre-induction conditions must be a top priority to improve the outcome of induction of labor.

Clinico-Pathological Findings and Spatial Distributions of Esophageal Cancer in Arsi Zone, Oromia, Central Ethiopia.

PURPOSE: Arsi Zone is one of the esophageal cancer endemic areas and is reported to have a high incidence of esophageal cancer in Ethiopia. This study assessed clinicopathological patterns and spatial distributions of esophageal cancer in Arsi Zone, Oromia, Central Ethiopia. METHODS: A cross-sectional study design was carried out by abstracting data of 403 patients treated from January 2015 to January 2019. Data were collected by using a structured data collection form and Geographical Positioning System software. The collected data were summarized in the form of tables, figures, means, and standard deviations. Statistical data analysis was done using SPSS software version 21.0 while geospatial analysis was conducted using the Arc-GIS 10.1 software. RESULTS: The disease was prominent among individuals aged 50 to 59 years. The mean age of females and males was 52.2 (SD±10.41) and 56.94 (SD ±12.27) years respectively. The vast majority (98.3%) of cases had squamous cell carcinoma. Dysphagia with weight loss accounted for 87.6% of the presenting symptoms. A large proportion (42.9%) of patients had a tumor located at the lower thorax. The majority (62%) of patients were from the eastern and north-eastern parts of the Arsi zone. CONCLUSION: Dysphagia with weight loss was the major symptom during the first visit. Squamous cell carcinoma was the predominant histopathological type. Eastern and the northeastern parts of the Zone are the most affected regions. Future studies should focus on the determinants of esophageal cancer and precise areas with high incidences by using the population and/or facility-based cancer registry systems.

Perceived role of hot food in the pathogenesis of oesophageal cancer: a qualitative study in the Arsi Zone, Oromia, Central Ethiopia.

Observational studies in Ethiopia have identified a positive association between hot wheat porridge consumption and oesophageal carcinoma. However, a single dietary intake cannot be a sufficient predictor of cancer among populations that have diverse dietary practices. The present study was carried out to explore the community's perspectives on the role of hot foods in the pathogenesis of oesophageal cancer in Ethiopia. Focus group discussions were conducted from May to August 2019 among purposefully selected 112 participants. Data were collected by using open-ended questions; memo writing, audio recordings and photo pictures. All tape-recorded interviews were transcribed verbatim and inductively coded using Atlas.ti Version 7.0.71 software. Finally, the analysis was performed according to the standard thematic framework analysis techniques. The finding showed that hot foods (porridge, coffee and soup) consumption patterns were perceived as the principal dietary risk of oesophageal cancer. Cooking in unventilated rooms, monotonous cereal-based foods, poor vegetable, and fruit intake, not taking milk with porridge, eating fast, swallowing large bolus of hot porridge and exposure to carcinogens in foods were regarded as predisposing dietary practices to oesophageal carcinoma. Socio-demographic, economic and cultural backgrounds were reported as the underlying risk factors associated with oesophageal cancer. There was a strong perception within the community that oesophageal cancer is linked to several but sequentially interlinked dietary and related practices. Cumulative thermal injuries from the consumptions of hot food could be the immediate dietary risk factors associated with increased risk of oesophageal cancer.

Determinants of Drug-Induced Hepatotoxicity Among Patients with Human Immunodeficiency Virus Taking a High Dose of Rifapentine Plus Isoniazid Drugs at the All Africa Leprosy Tuberculosis Rehabilitation and Training Center in Addis Ababa, Ethiopia.

PURPOSE: The drugs for the treatment of latent Tuberculosis are potentially hepatotoxic and can lead to drug-induced hepatotoxicity. The current study aimed at identifying the determinants of anti-tuberculosis drug-induced hepatotoxicity among patients living with Human Immunodeficiency Virus taking Isoniazid and rifapentine at All Africa Leprosy Tuberculosis Rehabilitation and Training Center in Addis Ababa, Ethiopia. METHODS: An unmatched case-control study was conducted from March, 21, to April 21, 2020, at All Africa Leprosy Tuberculosis Rehabilitation and Training Center. A total of 65 cases and 130 controls were interviewed. Data were collected using a data extraction tool from clinical reporting forms, follow-up charts, and patients' logbooks. Binary and multiple logistic regressions were conducted to check the association between independent and dependent variables. Adjusted odds ratios and the corresponding 95% confidence intervals were estimated to assess the strength of association. P-values <0.05 were used to declare statistical significance. RESULTS: The prevalence of anti-TB drug-induced hepatotoxicity was 8%. Body mass index <18.5 Kg/m2 (AOR = 5.8 [95% CI: 2.2-8.9]), low CD4 count (AOR = 4.9 [95% CI: 1.6-15.8]), and the presence of comorbid illnesses (AOR = 3.9 [95% CI: 1.7-8.9]) were identified as independent predictors of drugs-induced hepatotoxicity among Human Immunodeficiency Virus positive patients taking Isoniazid and rifapentine. CONCLUSION: The prevalence of anti-TB drug-induced hepatotoxicity was higher compared to standard references. BMI<18 kg/m2, low CD4 count, and comorbid illness were positively associated with anti-tuberculosis drug-induced hepatotoxicity among patients with HIV.

Dietary and Environmental Determinants of Oesophageal Cancer in Arsi Zone, Oromia, Central Ethiopia: A Case-Control Study.

PURPOSE: Oesophageal cancer is ranked 5th of all types of malignancies in Ethiopia and highly prevalent in the Arsi Zone. However, no study was conducted to elucidate the dietary and environmental determinants of oesophageal cancer in the Arsi Zone. METHODS: A matched case-control study was conducted from June 1, 2019, to June 30, 2020. A total of 104 cases and 208 controls were interviewed. Data were collected using food frequency questionnaires (structured questionnaires). Binary and multiple logistic regression analyses were conducted to check the association between independent and dependent variables. Adjusted odds ratios and the corresponding 95% confidence intervals were estimated for the strength of association. Statistical significance was declared at a P-value of <0.05. RESULTS: In multivariable logistic regression, drinking very hot coffee (AOR=5.1,[95% CI: (1.95, 13.71), drinking large volume of coffee (AOR=4.9, [95% CI: (2.03, 12.17), very hot porridge (AOR= 3.1,[95% CI: (1.38,7.03) and eating porridge fast (AOR=7.0, [95% CI: (2.48, 20.14), low intake of dairy products (AOR=6.0, [95% CI: (2.29, 15.95), cooking food in sleeping room (AOR=3.7, [95% CI: (1.22, 11.39), exposure to x-ray (AOR=9.4,[95% CI: (3.94, 22.82), nonalcohol homemade drinks (AOR=5.4,[95% CI: (1.97, 15.14), use of chemical containers (AOR=3.4, [95% CI: (1.48, 8.23) were determinants of oesophageal cancer. CONCLUSION: Coffee temperature, coffee drinking volume, porridge consumption temperature, porridge consumption speed, dairy products intake patterns, food cooking place, x-ray exposure, nonalcohol homemade drink, and use of chemical containers were independent determinants of the increased risk of oesophageal cancer in the study community.

Determinants of Virological Failure Among Patients on First-line Antiretroviral Therapy in Central Oromia, Ethiopia: A Case-Control Study.

BACKGROUND: Viral suppression among people living with HIV is the main goal of antiretroviral therapy (ART). Despite the treatment, more than four million people and over 55 thousand patients globally and in Ethiopia had virological failure respectively in 2017. The purpose of this study was to identify determinants of virological failure among patients on ART in central Oromia, Ethiopia. METHODS: A facility-based unmatched case-control study was conducted. Sample size was calculated using EpiInfo software, and 504 randomly selected patient's records were analyzed. Case to control ratio was one to one. Separate sampling frames were prepared for cases and controls using medical registration numbers (MRN) from patients' registrations data. Cases and controls were selected from respective sampling frames. Respective patient charts were traced using the MRN, and data were extracted from patient charts using data abstraction format. The data were entered using EpiInfo version seven and analyzed using SPSS version 20.0. Descriptive statistics and binary logistic regression were used for the analysis. Adjusted odds ratio with its 95%CI was used to present strength association. A P-value of <0.05 was used to determine statistical significance of the association. RESULTS: Age <15 years (AOR=3.72, 95%CI: 1.70-8.12), baseline CD4 count <100/mm3 (AOR=2.31, 95%CI: 1.05-5.08), TDF-3TC-NVP regimen (AOR=2.81, 95%CI: 1.28-6.18), nondisclosure of HIV status (AOR=6.78, 95%CI: 3.24-14.15) and history of poor adherence (AOR=11.19, 95%CI: 5.65-22.15) were factors independently associated with virological failure among the study participants. CONCLUSION: Younger age, low baseline CD4 count, TDF/NVP containing regimen, poor adherence, and nondisclosure of HIV status were significant determinants of virological failure. Therefore, adherence counseling and paying due attention to patients having these determinants are required to achieve adequate viral load suppression.