Attitudes of mothers attending public hospitals in Addis Ababa, Ethiopia, to neonatal sunlight exposure: a cross-sectional study.

BACKGROUND: Sunlight exposure helps the body produce vitamin D, prevents rickets and is used for neonatal jaundice treatment. Good neonatal sunlight exposure is exposing the neonate to sunlight in the morning, 8:00 to 10:00, for 30 to 60 min. However, little is known about the practice of neonatal sunlight exposure among mothers in Ethiopia. This study aimed to assess the practices and factors associated with neonatal sunlight exposure among mothers attending public hospitals in Addis Ababa, Ethiopia. METHODS: An institution-based cross-sectional study was conducted among 420 mothers attending public hospitals in Addis Ababa. Study participants were selected using a systematic random sampling method. The collected data were entered into Epi-data V.4.6 and exported to SPSS V.26 for analysis. Descriptive and logistic regression analyses were conducted. RESULTS: The practice of neonatal sunlight exposure among mothers was 27.1%. Neonatal age of 16-28 days (adjusted OR (aOR) 1.99, 95% CI 1.15 to 3.44), family members of 4-6 (aOR 1.86, 95% CI 1.08 to 3.21) and ≥7 (aOR 4.43, 95% CI 1.54 to 12.78), living in compound/villa houses (aOR 2.59, 95% CI 1.26 to 5.33), complete antenatal care (ANC) follow-up (aOR 2.79, 95% CI 1.49 to 5.22), delivery at term (aOR 2.54, 95% CI 1.06 to 6.07), poor knowledge of sunlight exposure (aOR 0.40, 95% CI 0.23 to 0.71) and no fear of sunlight exposure (aOR 1.83, 95% CI 1.08 to 3.12) were factors associated with the practice of neonatal sunlight exposure. CONCLUSION: This study revealed that 27.1% of mothers had good sunlight exposure. Advanced neonatal age, larger family, living in compound/villa houses, complete ANC visits and term delivery were associated with good practices, whereas poor knowledge and fear of sunlight exposure were associated with poor practices. Therefore, interventions focusing on these findings are required to improve the practice of neonatal sunlight exposure.

Practice of Early Childhood Developmental Milestone Assessment and Its Determinants Among Health Professionals Working at Public Hospitals in Addis Ababa, Ethiopia: A Cross-Sectional Study.

BACKGROUND: Early childhood developmental assessment refers to the continual process of observing, gathering, recording, and interpreting information to make developmental and instructional decisions and measure young children's performance over time. Significant changes in the physical and neuropsychomotor developmental milestones take place in the first 2 years of life. Children younger than 3 years of age (36 months) who are at risk of having developmental delays may be eligible for early intervention treatment services. The study aimed to assess practice in early childhood developmental assessment and its determinants among health professionals working in public hospitals in Addis Ababa, Ethiopia. METHODS: This facility-based descriptive cross-sectional study was conducted from September to April 2018, with a total sample size of 268 health professionals from six public hospitals in Addis Ababa, Ethiopia. The data were entered into EpiData software version 4.2, and analyzed by SPSS version 23 software for bivariate and multivariable logistic regression analysis. Significant associations were taken as p<0.05 and the strength of associations was expressed using odds ratios. RESULTS: The practice of early childhood developmental milestone assessment was found to be 27.8%. Being a general practitioner (AOR=23.826, 95% CI: 6.77-83.9, p=0.000) or health officer (AOR=11.02, 95% CI: 2.1-58.812, p=0.005), and work experience greater than 11 years (AOR=20.897, 95% CI: 1.5-291.49, p=0.024) were significantly associated with good practice of early childhood developmental milestone assessment. CONCLUSION: Practice of early childhood developmental milestone assessment remains poor. Training and sharing experiences among different professions, and assigning professionals with the highest levels of work experience in the service could improve the practice levels.

Incidence and predictors of attrition among children attending antiretroviral follow-up in public hospitals, Southern Ethiopia, 2020: a retrospective study.

Background: It is a global challenge to enrol and retain paediatric patients in HIV/AIDS care. Attrition causes preventable transmission, stoppable morbidity and death, undesirable treatment outcomes, increased cost of care and drug resistance. Thus, this study intended to investigate the incidence and predictors of attrition among children receiving antiretroviral treatment (ART). Method: A retrospective follow-up study was conducted among children <15 years who had ART follow-up in Gedeo public hospitals. After collection, data were entered into Epi-data V.4.6, then exported to and analysed using STATA V.14. Data were described using the Kaplan-Meier statistics, life table and general descriptive statistics. The analysis was computed using the Cox proportional hazard regression model. Covariates having <0.25 p values in the univariate analysis (such as developmental stage, nutritional status, haemoglobin level, adherence, etc) were fitted to multivariable analysis. Finally, statistical significance was declared at a p value of <0.05. Results: An overall 254 child charts were analysed. At the end of follow-up, attrition from ART care was 36.2% (92 of 254), of which 70 (76.1%) were lost to follow-up, and 22 (23.9%) children died. About 8145.33 child-months of observations were recorded with an incidence attrition rate of 11.3 per 1000 child-months (95% CI: 9.2 to 13.9), whereas the median survival time was 68.73 months. Decreased haemoglobin level (<10 g/dl) (adjusted HR (AHR)=3.1; 95% CI: 1.4 to 6.9), delayed developmental milestones (AHR=3.6; 95% CI: 1.2 to 10.7), underweight at baseline (AHR=5.9; 95% CI: 1.6 to 21.7), baseline CD4 count ≤200 (AHR=4.4; 95% CI: 1.6 to 12.2), and poor or fair ART adherence (AHR=3.5; 95% CI: 1.5 to 7.9) were significantly associated with attrition. Conclusion and recommendation: Retention to ART care is challenging in the paediatrics population, with such a high attrition rate. Immune suppression, anaemia, underweight, delayed developmental milestones and ART non-adherence were independent predictors of attrition to ART care. Hence, it is crucial to detect and control the identified predictors promptly. Serious adherence support and strengthened nutritional provision with monitoring strategies are also essential.

Risk Factors of Perinatal Asphyxia Among Newborns Delivered at Public Hospitals in Addis Ababa, Ethiopia: Case-Control Study.

BACKGROUND: Perinatal asphyxia determines the newborn's future health status and viability with risk factors yet to be completely understood. It measures the status of the healthcare delivery of an organization including antenatal, intranatal, and postnatal care. In Ethiopia, 31.6% of neonatal mortality was attributed to perinatal asphyxia. This study aimed to assess the risk factors of perinatal asphyxia. METHODS: An unmatched case-control study was conducted on 213 (71 cases selected using lottery method and 142 controls systematically) subjects in Addis Ababa from November 1, 2018 to June 30, 2019. Data were collected using a structured questionnaire through face-to-face interviews, entered to Epi data version 4.4, and exported to SPSS version 25 for analysis. Logistic regression was used for analysis. Variables with p< 0.25 in bivariate analysis were taken to multivariable analysis. Statistical significance was declared at P<0.05 and findings were presented using texts and tables. RESULTS: A total of 210 newborns (70 cases and 140 controls) and their mothers were included with an overall response rate of 98.5%. Antepartum hemorrhage [AOR=7.17; 95% CI 1.73-29.72], low birth weight [AOR=2.87; 95% CI 1.01-8.13], preterm birth [AOR=3.4; 95% CI 1.04-11.16], caesarean section delivery [AOR=2.75; 95% CI 1.01-7.42], instrumental delivery [AOR=4.88; 95% CI 1.35-17.61], fetal distress [AOR=4.77; 95% CI 1.52-14.92] and meconium-stained amniotic fluid [AOR=9.02; 95% CI 2.96-30.24] were significantly associated with perinatal asphyxia. Hence, efforts ought to go to improve the quality of antenatal and intra-natal services.

Medication-related quality of life among Ethiopian elderly patients with polypharmacy: A cross-sectional study in an Ethiopia university hospital.

Polypharmacy among older patients has been associated with a decline in their quality of life. We aimed to assess the medication-related quality of life (MRQOL) among older patients with polypharmacy at Gondar University Hospital, Gondar, Ethiopia. A prospective cross-sectional study was carried out among 150 elder patients who had visited the internal medicine ward and ambulatory ward of Gondar referral hospital from March 25 to May 15, 2017, using a validated scale, Medication-Related Quality of Life Scale version 1.0 (MRQoLS-v1.0). A total of 150 older patients with polypharmacy participated in the study with a mean age of 70.06±5.12, andtwo-thirds of the participants (67.3%) were female. The overall prevalence of poor quality of life due to polypharmacy in the current study was found to be three fourth (75.3%) of the participants. Regarding the severity of impairment in MRQoL, Univariate analysis revealed that frequency of hospital visits (COR = 1.34, 95% CI, 1.02-1.77) and medication number (COR = 1.94, 95% CI, 1.33, 2.8) had a statistically significant positive association with the likelihood of having a severe impairment.The multivariate analysis also showed that one unit increase in the number of hospital visits (AOR = 1.45, 95% CI, 1.040-2.024) and medications greater than 5 (AOR = 1.91, 95% CI, 1.29, 2.84) increases 1.45 and 1.91 times the likely hood of posing severe impairment of MRQoL, respectively. As far as poor MRQoL quality of life is concerned, multivariate analysis did not show any significant association between the poor MRQoL;and Sociodemographic and clinical data of patients. The poor QoL associated with medication was very high in this study. Deprescribing should be sought by the health care providers to optimize drug therapy and minimize the polypharmacy related poor quality of life.