SWIPE: a conceptual, multi-perspective model for understanding and informing interventions for weight stigma in preconception, pregnancy, and postpartum.

Weight stigma is salient across the preconception, pregnancy, and postpartum (PPP) periods because of prevailing prescriptive norms and expectations about weight and weight gain during the reproductive period. Weight stigma is associated with negative physical and psychological health outcomes for mother and child. A clearly defined, multi-level conceptual model for interventions, research, and policy is critical to mitigating the adverse effects of weight stigma in PPP populations. Conceptual models of weight stigma towards PPP women have advanced our understanding of this issue and guided evidence accumulation but there remains a gap in informing the translation of evidence into action. Guided by evidence-based paradigms for conceptual model development, this paper has two primary objectives. First, we review and summarise theories, frameworks, and models from the PPP population and general literature to inform our understanding of the development and perpetuation of weight stigma for PPP women. Second, we propose a novel comprehensive intervention-guiding conceptual model that draws from and synthesises across multiple disciplines - the SWIPE (Stigma of Weight In the PPP Experience) model. This conceptual model will help to plan coordinated, multi-layered, and effective strategies to reduce and ultimately eliminate weight stigma for PPP women.

Preventing childhood obesity in general practice: a qualitative study of GPs, practice nurses, and practice managers.

BACKGROUND: General practitioners (GPs) in Australia have an important role to play in preventing childhood obesity. Activities such as growth monitoring and promotion of healthy behaviours can contribute to obesity prevention efforts; however, the practicalities of how this is done are poorly documented. OBJECTIVES: Objectives were to understand current attitudes and practices regarding promoting healthy childhood growth and development and preventing childhood obesity in general practice, and identify practical barriers and enablers to routinely incorporating this into general practice based on the observations and personal experiences of general practice staff. METHODS: A descriptive qualitative study was undertaken with Australian general practice staff. Barriers and enablers underwent thematic analysis and mapped to the ecological model. RESULTS: Interviews were conducted with 9 GPs, 4 nurses, and 2 practice managers. Participants agreed that growth monitoring and healthy behaviour promotion should be done for children with a healthy weight. However, the thematic analysis indicated that obesity prevention in clinics is not supported well by the broader general practice system, there are complexities associated with obesity prevention discussions, and the COVID-19 pandemic has intensified challenges in general practice. Two themes for obesity prevention enablers were identified; these related to bridging the implementation gap and the need for changes outside the clinic to support behaviour within the clinic. Ecological model mapping implicated multiple ecological levels for each theme. CONCLUSION: Childhood obesity prevention through growth monitoring and healthy behaviour promotion is relevant to general practice; however, more support is needed to enable implementation and embed these practices day-to-day.

Drivers and facilitators of weight stigma among preconception, pregnant, and postpartum women: A systematic review.

Women in the preconception, pregnant, or postpartum period are susceptible to weight stigma, particularly due to the risk of excess weight gain during the reproductive life period and the negative effects of stigma on the health of both the mother and the child. Identifying the drivers and facilitators of weight stigma will help guide focused weight stigma prevention interventions. This systematic review aimed to identify the drivers and facilitators of weight stigma among preconception, pregnant, and postpartum women. In May 2022, Medline, Embase, PsycINFO, and the Maternity and Infant Care Database were searched for peer-reviewed articles published since 2010 using search terms weight AND stigma AND preconception, OR pregnant, OR postpartum. Of the 1724 articles identified, 34 fulfilled the inclusion criteria and were included in a narrative synthesis. Women reported facing insensitive language, misconceptions about obesity across all settings, and inappropriate media representation. The unavailability of appropriate equipment at facilities was reported by both women and health professionals. Our findings indicate that a rigorous effort by all stakeholders is necessary to promote regulatory, legal, and educational initiatives designed to reduce weight stigma and discrimination against women in the reproductive period.

Assessment of long-lasting insecticide nets coverage, utilization, and associated factors among households in malaria elimination districts of Arsi Zone, Oromia Region, Ethiopia: A cross-sectional study.

BACKGROUND: Malaria is a major global public health problem, with a particular burden of disease in sub-Saharan Africa including Ethiopia. Access to Long Lasting Insecticide Nets (LLINs) for at-risk populations, ensuring its appropriate utilization and identifying the barriers are important for malaria prevention, control and elimination. This study aimed to assess coverage, utilization and associated factors of Long Lasting Insecticide Nets (LLINs) among households in the Arsi Zone of Oromia Region, Ethiopia. METHODS: Community-based cross-sectional study was conducted from October to December 2021. Multi-stage sampling technique was used to recruit 1250 households from five districts out of 21 Malarious districts in the Zone. Proportional allocations of households were done in each sampled kebeles and simple random sampling was used to draw the study participants. Data were collected by trained data collectors using a pre-tested structured questionnaire and observation. The collected data were exported to and analyzed using SPSS version 23. Variables with a p-value below 0.2 at bivariable logistic regression analysis were entered into the multivariable logistic regression model. We presented findings using an adjusted odds ratio with 95%CI at a p-value of less than 0.05. RESULTS: Out of the total of 1250 households 99.5% of surveyed owned LLINs and 27.1% of them had slept under the net the night before the survey. The factors associated with LLIN usage included being in the age range of 40 to 49 years (AOR; 1.82, 95%CI 1.01-3.25), preference for conical-shaped LLINs (AOR = 2.36; 95% CI: 1.33-4.18), not believing LLINs expired within 6 months (AOR 3.75, 95% CI 2.31-6.09), reporting a mosquito bite as a mode of malaria transmission (AOR = 2.46; 95%CI: 1.01-5.98), employed (AOR = 9.0; 95%CI: (4.22-20.02) and type of sleeping bed (AOR =: 17.4; 95% CI, 11.74-26.03). On the other hand, households with two and above sleeping rooms were less likely to use LLINs (AOR = 0.46; (95% CI: 0.23-0.88). CONCLUSION: Even though the ownership of Long Lasting Insecticidal Nets was high, the actual utilization was very low. Promoting the usage of LLINs utilization among those at most risk, through intensified health education activities will be helpful.

Incidence, survival time and associated factors of virological failure among adult HIV/AIDS patients on first line antiretroviral therapy in St. Paul's Hospital Millennium Medical College-A retrospective cohort study.

INTRODUCTION: Human Immune deficiency Virus or Acquired Immune deficiency Syndrome (HIV/AIDS) is a pandemic affecting millions around the world. The 2020 the Joint United Nations Programme on HIV/AIDS report stated that the estimated number of people living with HIV (PLHIV) is 38 million globally by 2019. Ethiopia is among HIV high burden countries in Africa. By 2021, PLHIV in Ethiopia is estimated to be 754, 256. Globally out of 25.4 million PLHIV on ART, 41% reported virally non-suppressed. According to UNAIDS, the estimated viral non-suppression in Ethiopia is about 27%. METHODOLOGY: A hospital based retrospective cohort study was conducted among 323 patients who were enrolled to ART from July 2016 to December 2020. The medical records of study participants were selected using simple random sampling technique & data was collected using data extraction checklist. The collected data was entered and cleaned using SPSS V.25. Kaplan-Meier is used to estimate the cumulative hazard of virological failure at different time points. During bivariate analysis variables with p<0.25 were taken for Multivariate Cox regression analysis to assess predictors of virological failure & statistically significant association was declared at p<0.05 with 95% confidence interval. RESULT: The overall incidence rate of virological failure was 1.75 per 1000 months of observations. The mean survival time of virological failure was 14.80 months. Disclosure of sero-status (AHR = 0.038, 95% CI: 0.008-018), poor adherence (AHR = 4.24, 95% CI: 1.04-16), having OIs (Opportunistic infections) (AHR = 4.59, 95% CI: 1.17-18) and use of cotrimoxazole (CPT) prophylaxis (AHR = 0.13, 95% CI: 0.026-0.68) have shown statistically significant association with virological failure. CONCLUSION: The incidence of virological failure among patients on first line ART in St. Paul's hospital is low. Disclosure of sero-status, poor adherence, having OIs and use of CPT prophylaxis were associated with virological failure. Therefore, a due attention needs to be given to these factors in order to minimize virological failure in patients on ART.

Emergency Decompression of Obstructive Uropathy Using Percutaneous Nephrostomy: Disease Pattern and Treatment Outcome at Two Urology Centers in Ethiopia.

PURPOSE: Obstructive uropathy (OU) is a potentially life-threatening urologic emergency that requires urgent decompression. Percutaneous nephrostomy (PCN) is a commonly performed procedure to decompress OU. The objective of this study is to assess disease patterns and treatment outcome at two urologic centers in Ethiopia. METHODS: A cross-sectional study was conducted on 110 patients who underwent emergency PCN from October 1, 2019 to September 30, 2020. Data were collected by a retrospective chart review. SPSS 25 was used for analysis. Descriptive statistics and logistic regression were utilized to assess disease pattern and significant predictors. A p-value of <0.05 on multivariate logistic regression was considered statistically significant. RESULTS: Females accounted for 70% of cases and mean age at presentation was 48 ± 12.9 years. Bilateral OU was diagnosed in 60% of patients and 77.3% of obstructions occurred at the level of the ureter. Malignancies were diagnosed in >80% of patients among which cervical cancer was the commonest (37.3%) followed by bladder cancer (17.3%). Acute kidney injury (AKI) accounted for 70% of the presenting indications for PCN. Success rate after emergency PCN was 75.5% and 41.8% of the cases developed post-procedure complications. Factors that predicted successful outcome include male gender [AOR = 5.72 (1.13-28.92), 95% CI; p = 0.035], severe hydronephrosis pre-operatively [AOR = 7.12 (1.32-38.45), 95% CI; p = 0.022], and use of combined imaging (ultrasound and fluoroscope) to guide PCN [AOR = 12.91 (1.13-46.54), 95% CI; p = 0.039]. On the other hand, postoperative complication is a negative predictor [AOR = 0.26 (0.08-0.86), 95% CI; p = 0.027]. CONCLUSION: In this study, overall success of emergency PCN is low. Presence of severe hydronephrosis predicts technical ease and better outcome of PCN. Procedures performed under ultrasound and fluoroscope guidance also improve outcome. Postoperative complication rate is high in this study and mandates strict preventive measures as it predicts unfavorable outcome.

Emerging Nutritional Problem of Adult Population: Overweight/Obesity and Associated Factors in Addis Ababa City Communities, Ethiopia-A Community-Based Cross-Sectional Study.

Background: Obesity is an emerging public health problem in developing countries. There is limited study conducted in Ethiopia to determine the prevalence of obesity and its associated factors among adult population. Therefore, this study aimed at determining the prevalence of overweight/obesity and the associated factors among adults aged 25-64 years in Addis Ababa city community residents, Ethiopia. Methods: A community-based cross-sectional study was conducted from April 10, 2017, to May 20, 2017, in Addis Ababa. A total of 512 adults were recruited. A two-stage cluster followed by a systematic random sampling technique was used for sample selection. Data were collected using questionnaires and anthropometric measurements. The adjusted odds ratio (AOR) with a 95% CI was reported to show the strength of association. A P value < 0.05 was considered statistically significant. Results: A total of 484 adults participated in the study with a response rate of 94.5%. The prevalence of overweight and obesity among study participants was found to be 99 (21.5%) and 14 (2.9%), respectively. Males were 90% less likely to be obese when compared to females (AOR = 0.10 (95% CI: 0.01-0.84)). Illiterate people were 94% less likely to be obese compared to those who were literate people (AOR = 0.06 (95% CI: 0.01-0.44)). Nonhypertensive individuals were 86% less likely to be obese when compared to hypertensive (AOR = 0.14 (95% CI: 0.03-0.69)). Conclusion: The combined prevalence of overweight and obesity was found to be considerably high in Addis Ababa city residents compared to the national figure. Being female, literate, and presence of hypertension are independent predictors of overweight/obesity in the study population. Thus, the concerned bodies should initiate efforts to tackle the newly emerging public health problem of the country and promote healthy lifestyle behaviors in the inhabitants of city settings.

Descriptive Epidemiology of breast and gynecological cancers among patients attending Saint Paul's Hospital Millennium Medical College, Ethiopia.

INTRODUCTION: Cancer is a leading cause of death in both more and less economically developed countries; the burden is expected to grow in less developed countries, such as Ethiopia. Lack of adequate information is one of the major problems preventing the design of cancer control strategies in Ethiopia. OBJECTIVE: To characterize gynecological and breast cancers among clients attending Gynecologic clinic of Saint Paul Hospital Millennium Medical college over 5 year period. METHODS: We retrospectively reviewed characteristics of 2,002 female cancer patients who visited the Oncology unit of Saint Paul's Hospital Millennium Medical College from 2014-2018. We estimated the proportion, pattern and trend of common types of gynecologic cancers as well as breast cancer. The ten years incidence projection was also computed. RESULT: From the 2,002 malignancies, cervical (46.7%) was the most frequent cancer followed by breast (29.3%) and ovarian cancers (13%). The majority of breast cancers were observed among younger patients whereas cervical cancer was predominantly observed among older women. An overall increment in number of breast and gynecologic cancer was observed over the five years period. CONCLUSION: In this descriptive study, we found that breast and gynecologic cancers are important public health problems among women in Addis Ababa, and that the number of patients seeking care for these cancers is increasing. Additional studies are needed to identify risk factors for these cancers, particularly among younger women, to characterize the trends over time and to project the scope of the cancer problem expected in the future to inform cancer control programs. Increasing public awareness on the possible risk factors and screening is mandatory in addition to resource allocation for further studies and targeted intervention.