Disorders In Ethiopia Research Articles

Mobile mental health application use, and app feature preferences among individuals with mental disorders in Ethiopia: A cross-sectional survey

BackgroundMobile health applications have been shown to assist in the treatment of mental illnesses, yet their potential remains underutilized. As supportive care, mental health applications use may be useful tools in improving mental health literacy and treatment outcomes, but patients’ use of and interest in using these apps have not been studied in low-income countries like Ethiopia. This study explores the determinants of patients’ mental health app use interests and app feature preferences. MethodsA cross-sectional study was conducted with 419 outpatient individuals with mental health disorders at Amanuel Mental Specialized Hospital, Ethiopia, between October and November 2023, using a convenience sampling method. Patients’ self-reported mental health app use, interests, attitudes, and app feature preferences were collected. A multivariate logistic regression model was used to identify the associated factors. ResultsOverall prevalence of not interested, somewhat interested, interested, and extremely interested in mental health app use was 5.3 %, 16.9 %, 27.7 %, and 50.1 % respectively. The proportion of current mental health apps use was low (21.2 %). Current mental health app use is associated with living in an urban area (AOR = 6.69, CI: 3.19–14) and having a higher education level (4.12 (2.02–8.04). Furthermore, app features such as psychoeducation, symptom tracking, and self-management techniques ranked as the most preferred app features. ConclusionsMost study participants were interested in using mental health apps, but only about one in four were using mental health apps. This suggests promise for their utility in the Ethiopian context. App developers and policymakers should consider rural residents’, lower educational levels, and patient app preferences when developing these applications.

The cumulative impact of trauma, chronic illness, and COVID-19 stress on mental health in a case-control study of adults with psychotic disorders in Ethiopia

BackgroundThe COVID-19 pandemic has profoundly impacted the economic, psychological, and social well-being of people in Ethiopia. Pandemic-related fears can exacerbate anxiety and depression symptoms among those with pre-existing physical and mental health conditions as well as those with prior exposure to traumatic events. MethodsWe used data from the Ethiopia NeuroGAP-Psychosis study (898 cases and 941 controls with and without a diagnosis of psychosis respectively, 66% male, mean age = 37 years). Data was collected between November 2021 and June 2022 during the COVID-19 pandemic from four hospitals in Ethiopia (three in Addis Ababa and one in Jimma city). Structural equation modeling analysis was conducted to examine the associations between trauma exposure, physical health conditions (like arthristis, neurological disorders, diabetes), COVID-19 stress, and psychological distress (depression and anxiety symptoms). We assessed direct and indirect effects for mediation, and conducted multigroup analysis to examine moderation by case control status. ResultsWe found evidence that the impact of greater trauma exposure and physical health conditions on higher psychological distress was mediated through higher COVID-19 stress. Sociodemographic characteristics (older age and being maried) were associated with higher psychological distress, with these associations mediated through greater trauma, physical health conditions, and COVID-19 stress. Case-control status also moderated the associations between these variables, with the mediation effects being stronger in cases and weaker in controls. Further, cases reported greater trauma and psychological distress, while controls reported more physical health conditions and COVID-19 stress. ImplicationsOur findings uniquely assess the interaction of health and emergency related factors in understudied settings like Ethiopia. They underscore the importance of including daily hardships and environmental stressors, along with prior trauma exposure, as risk factors for the assessment of mental health symptoms. This study has key implications for mental health screening and intervention research in response to complex emergency contexts like Ethiopia with a history of armed conflict in addition to the COVID-19 pandemic. Our findings can aid the development of targeted services that address the mental health of at-risk groups with pre-existing mental and physical health conditions.

Characteristics and outcome of pregnancy-related acute kidney injury in a teaching hospital in a low-resource setting: a five-year retrospective review.

Pregnancy-related kidney injury contributes to a high burden of acute kidney injury in low-resource settings and causes maternal and perinatal morbidity and mortality. Few studies have examined the impact of acute kidney injury in resource-limited countries, with very limited research on pregnancy-specific disorders in Ethiopia. This study aimed to determine the characteristics of pregnancy-related acute kidney injury, outcomes and associated factors. A retrospective study was conducted to evaluate the clinical profile and maternal-fetal outcome of pregnancy-related acute kidney injury at Ayder Comprehensive Specialized Hospital in Tigray, Ethiopia, from January 1, 2017, to December 31, 2021. Maternal and fetal outcomes were analyzed using descriptive statistics. Multivariate logistic regression was used to determine the association between the dependent and independent variables. Of 27,350 mothers who delivered at Ayder Comprehensive Specialized Hospital between January 1, 2017, and December 31, 2021, a total of 187 women developed pregnancy-related acute kidney injury, a prevalence rate of 68 per 100,000 births. Preeclampsia, sepsis and pre-renal causes due to dehydration and hemorrhage were the most common causes of pregnancy-related acute kidney injury in this study. Hemodialysis was needed in 8.6% (n = 16) of patients. Of the 187 pregnancy-related acute kidney injuries, 143 (76.5%) recovered completely and 30 (16%) partially. The mortality rate was 7.5%. Preexisting chronic kidney disease (AOR = 30.13; 95% CI: 2.92, 310.84), use of vasoactive agents (AOR = 5.77; 95% CI: 1.47, 22.67), increase in creatinine per unit (AOR = 1.65; 95% CI: 1.11, 2.45) and complications related to acute kidney injury (AOR = 5.26; 95% CI: 1.73, 16.00) were determinants of the composite endpoints (partial renal recovery and death). This study emphasizes acute kidney injury in resource-limited settings is a significant cause of maternal and fetal morbidity and mortality. The vast majority of patients with pregnancy-related acute kidney injury recovered completely from kidney injury. The main causes of pregnancy-related acute kidney injury were preeclampsia, sepsis and pre-renal associated with hemorrhage and dehydration. Preexisting renal disease, use of vasopressors, increase in creatinine per unit and complications associated with acute kidney injury were determining factors for concomitant fetomaternal mortality. Appropriate preventive strategies during prenatal care and prompt treatment are needed for pregnancy-related acute kidney injury.

Post-traumatic stress disorder and associated factors among adults exposed to stress in Ethiopia: A meta-analysis and systematic review.

Post-traumatic stress disorder is a complex psychiatric disorder that develops after exposure to traumatic events, such as violent physical assaults, accidents, rape, natural disasters, and conflicts, stranger than usual human experiences. The typical presentation of intrusive thoughts, the persistence of the trauma, the avoidance of pertinent stimuli, emotional numbness, and physiological hyperarousal are the characteristics of this anxiety symptom. Despite the presence of a study conducted on this problem, the pooled effect, particularly in Ethiopia, is not known; therefore, this study assessed the allover burden of post-traumatic stress disorder. The available study was extracted and conducted on post-traumatic stress disorder and its associated factors in Ethiopia by three independent authors. The data were analyzed by using STATA version 11 after extraction was done on a Microsoft Excel spreadsheet. The random-effect model was used to estimate the pooled effect size of post-traumatic stress disorder and its effect in the previous studies with 95% confidence intervals. Funnel plots analysis and Egger regression tests were conducted to detect the presence of publication bias. A subgroup analysis and a sensitivity analysis were done. Thirteen (13) studies were included with a total of 5874 study participants in this meta-analysis and systematic reviews. The pooled prevalence of post-traumatic stress disorder in Ethiopia was 39.28% with a 95% confidence interval (26.54, 52.01). Poor social support (adjusted odds ratio = 2.86; 95% confidence interval (1.81, 4.53)), being female (adjusted odds ratio = 1.89; 95% confidence interval (1.53, 2.34)), presence of previous mental illness (adjusted odds ratio = 4.72; 95% confidence interval (2.62, 8.36)), and witness (adjusted odds ratio = 2.01; 95% confidence interval (1.30, 3.11)) were associated with post-traumatic stress disorder. The burden of post-traumatic stress disorder in this meta-analysis and systematic review is high; therefore, immediate intervention is needed for those specific traumatized individuals.

Ethiopian Medicinal Plants Used for Respiratory Tract Disorders: Ethnomedicinal Review.

Respiratory tract infections (RTIs) refer to infections in any part of the respiratory tract, which are common, with most of the world's population contracting at least one infection annually. These infections are becoming important causes of death and morbidity due to the rapid development of antimicrobial resistance that has resulted in reduced efficacy of existing drugs. Different local societies residing in Ethiopia have been reported to use traditional medicinal plants to treat RTIs. Nevertheless, up-to-date summarized data on the diversity of plants used in the traditional medicine system to treat RTIs in Ethiopia are lacking. The purpose of this review was to assess plant species used in traditional medicine to treat respiratory tract infections in Ethiopia. It attempts to compile available data required for undertaking further scientific investigations. The data were collected by searching for published scientific articles and other grey literature. Following this, medicinal plant (MP) diversity, growth forms, plant parts used, modes of remedy preparation and application, sources and distributions, and frequently treated respiratory disorders were examined. An Excel spreadsheet and SigmaPlot software were used to summarize and present the data. Two hundred twenty-nine (229) plant species that have been used to treat respiratory disorders in Ethiopia were documented. Lamiaceae was the most cited family (27 species), followed by Asteraceae (23 species), and Fabaceae (18 species), whereas cough was primarily cited as being treated by MPs and scored the highest frequency of citation (FOC = 243), followed by the common cold (FOC = 151) and asthma (FOC = 63). The top-cited plant species used in the treatment of RTIs were Eucalyptus globulus (6.8%), Allium sativum (5.5%), Zingiber officinale (4.2%), Ruta chalepensis (3.8%), and Ocimum lamiifolium (2.8%). Herbs were the dominant plant growth form (46%) used to treat respiratory diseases, and the most commonly used MP parts were leaves (37%). The leading traditional method used for preparation was decoction (25.5%), and the remedies were usually administered orally (64.6%). The MP origin reported was mainly from the wild (59%). High diversity of medicinal plants was reported as being used to treat various RTIs in Ethiopia. Information obtained from this review could be used as a reference for the selection of plants for further pharmacological, phytochemical, and toxicological investigations for their possible therapeutic applications and the development of new plant-based drugs.

Traditional Herbal Remedies in the Management of Metabolic Disorders in Ethiopia: A Systematic Review of Ethnobotanical Studies and Pharmacological Activities.

MetS are common throughout the world, including Ethiopia. These have traditionally been treated using medicinal plants, particularly in rural areas where they are freely accessible. This systematic review tried to investigate the treatment of MetS with Ethiopian medicinal herbs and made recommendations for more validation research. A careful analysis of the literature was also conducted on the therapeutic effects of these and other Ethiopian medicinal plants with hepatoprotective and antihypertensive activities. The relevant keywords "Ethnomedicinal + hypertension," "Ethnopharmacological + hypertension," "Ethnomedicinal + hepatitis, jaundices, and liver disease," "Ethnopharmacological + hepatic disorder," and "Ethnomedicinal + weight loss" were used to search for relevant articles in the major electronic scientific databases, including PubMed, Science Direct, Web of Science, and Google Scholar. The search strategy included all articles with descriptions that were accessible until April 30, 2022. The study's subjects, methods, or year of publication were no restrictions in the search. The outcomes were compiled using descriptive statistics. Fifty-four (54) studies were examined in the review that satisfied the inclusion and exclusion criteria for the treatment of MetS in Ethiopia. The most often used ethnobotanical plant species for the treatment of hypertension and hepatic disorders were Moringa stenopetala and Croton macrostachyus. Both hepatic and hypertensive disorders were treated more frequently with leaves (52% and 39%, respectively) than with roots (20% and 13%, respectively). Some intriguing studies came from an ethnobotanical investigation into medicinal herbs' hepatoprotective and antihypertensive properties. The most often investigated medicinal plant for its antihypertensive effects is Moringa stenopetala. The study revealed that Ethiopians often use anti-MetS herbal remedies. We advocate the experimental validation of the commonly used medicinal plants with the identification of active compounds and the development of effective alternative drugs for the treatment of MetS.

Patterns of Lymphoproliferative Disorders in Ethiopia, Based on Single-Center Experience

Background: Similar to other resource-poor countries, the patterns of lymphoproliferative disorders (LPD) in Ethiopia and in our setup are not clearly known. Here, we describe our experience based on conventional histopathology diagnosis. Method: This is a retrospective data-based cross-sectional study from August 2018 to December 2021 at St. Paul's Millennium Medical College, Addis Ababa, Ethiopia. Histopathology reports of cases with diagnoses of LPDs were retrieved from the department of pathology electronic report archive. The diagnostic sample included excisional lymph node and or core tissue biopsy. The diagnosis was based on conventional histopathology (hematoxylin and eosin staining) of the sample. Pertinent data were extracted using a data collection sheet. It was reviewed and analyzed using SPSS-24. Result:A total of 168 patients with necessary documented information were identified; 109(64.9%) were males; the mean (range) age was 46 (16-86) years. The majority of the patients, 139 (82.7%) had Non-Hodgkin lymphomas (NHL) with major histological sub-types being Small lymphocytic lymphoma (24.5%) and Diffuse large cell lymphoma (15.8%). Hodgkin Lymphoma (HL) accounted for 17(10.1%) cases. Sub-classification as a Classical HL was possible in 13 (76.5%) cases(fig.1). But it was not able to sub-classify NHLs histologically in 48(34.5%) and HLs in 3(17.6%) of the cases. Specific lymphoma diagnosis was not possible in 12(7.1%) patients with lymphoproliferative disorders on which an atypical LPD diagnosis was rendered. The most common biopsied lymph node area was the cervical lymph node (33.3%) (table 1) while the most common extranodal site was gastrointestinal (11.9%). Conclusion: Our study indicates that accurate diagnosis and classification of lymphoproliferative disorders is limited in our setup. Therefore, Capacity building in ancillary tests as limited panel immunohistochemistry and quality improvement projects may help to alleviate the shortcomings. Figure 1View largeDownload PPTFigure 1View largeDownload PPT Close modal

Caregiving Challenges and Coping Strategies of Family Caregivers for Relatives Diagnosed With Bipolar Disorder in Ethiopia

In Ethiopia, like any other developing country, family caregivers take on most responsibilities to support those with mental health needs. This study explored the psychosocial and spiritual experience of family caregivers for their relatives diagnosed with bipolar disorder. An exploratory study using qualitative methods was employed. Twenty-four family caregivers of persons diagnosed with bipolar disorder participated in the study. The data collection methods were in-depth interviews and focus group discussions. The findings of the study revealed that the family caregivers faced different psychosocial and spiritual crises and challenges while they used varying coping mechanisms ranging from accepting the phenomenon to performing religious/spiritual practices. While caregivers use their own strategies to deal with challenges, this study highlights implication on how the contribution of governmental and nongovernmental organizations to support those caregivers can be maximized.

A systematic review on traditional medicinal Animal's parts and products used for the treatment of respiratory tract disorders in Ethiopia.

Respiratory diseases affect more than one billion people worldwide. Although medicinal animals have huge importance in primary health care, limited effort applied so far been in Ethiopia to properly identify, document, and conserve these animals and the related knowledge. This systematic review was aimed to identify the medicinal animals and document reports on the use ofmedicinal animals for the management of respiratory disorders. Both published and unpublished articles on the ethnozoological use of medicinal animals were searched using electronic database (Science Direct, Pub Med, Google Scholar, Scopus, hinari, and research gate) and institutional repositories. Different keywords were used separately and in combination using Boolean operators "OR" or "AND" as well as medical subject heading [MeSH] terms. Studies that did not address respiratory disorders were excluded. Data were extracted using Microsoft excel spread sheet. Among 211 articles obtained from database searches, nine articles were eligible and included in the review. Thirty two medicinal animals were reported for treatment of respiratory disorders. Mammals were the mostcommonly (43.8%) used medicinal animals. Meat was reported as the most commonly (22.6%) used medicinal remedy. Most of the medicinal remedies were obtained from mammals and administered orally. As the majority of the medicinal animals were obtained from wild sources, due attention should be given to conserve them. Besides, this traditional medicinal knowledge should be integrated to modern medicine to investigate the acute and chronic toxicity profile and efficacy of these remedies to identify potential lead compounds to modern drugs.

Reliability and validity of using EQ-5D-5L among healthy and adolescents with major mental health disorders in Ethiopia.

The EQ-5D is a validated and widely used generic measure of health-related quality of life (HRQoL) in both healthy individuals and those with various medical conditions. The objective of this study was to test whether EQ-5D-5L is reliable and valid for use among school sample adolescents and those with major mental health disorders in Ethiopia. Participants were recruited fromten sub-districts comprising the Butajira Rural Health Programme (BRHP) and Butajira major mental health disorders center. Data were collected using an Amharic(Ethiopia) EQ-5D-5L self-complete-paper and the questionnaire was administered 10days after the first completion for test-retest procedures. Two-way mixed-effects models absolute intraclass correlation coefficient (ICC) was used to test reliability of the instrument while Kruskal-Wallis rank test with pairwise comparison was used to assess the known group validity of the instrument. There were 501 (201 school sample and 300 adolescents with major mental health disorders) participants recruited and 497 were included in the sample for analysis. The ICC was high (ICC > 0.7, p < 0.001) for all EQ-5D-5L dimensions, EQ-5D-5L utility index and EQ-VAS scores. The findings revealed that the Amharic EQ-5D-5L has significant known group validity as shown by the difference in scores among various disease group (depression, schizophrenia, and bipolar) and experience of chronic illness. The results shows that the Amharic EQ-5D-5L is reliable and valid instrument for the measurement of HRQoL among adolescent populations in Ethiopia.

Efficacy and cost-effectiveness of task-shared care for people with severe mental disorders in Ethiopia (TaSCS): a single-blind, randomised, controlled, phase 3 non-inferiority trial

BackgroundThere have been no trials of task-shared care (TSC) using WHO's mental health Gap Action Programme for people with severe mental disorders (psychosis or affective disorder) in low-income or middle-income countries. We aimed to evaluate the efficacy and cost-effectiveness of TSC compared with enhanced specialist mental health care in rural Ethiopia. MethodsIn this single-blind, phase 3, randomised, controlled, non-inferiority trial, participants had a confirmed diagnosis of a severe mental disorder, recruited from either the community or a local outpatient psychiatric clinic. The intervention was TSC, delivered by supervised, non-physician primary health care workers trained in the mental health Gap Action Programme and working with community health workers. The active comparison group was outpatient psychiatric nurse care augmented with community lay workers (PSY). Our primary endpoint was whether TSC would be non-inferior to PSY at 12 months for the primary outcome of clinical symptom severity using the Brief Psychiatric Rating Scale, Expanded version (BPRS-E; non-inferiority margin of 6 points). Randomisation was stratified by health facility using random permuted blocks. Independent clinicians allocated groups using sealed envelopes with concealment and outcome assessors and investigators were masked. We analysed the primary outcome in the modified intention-to-treat group and safety in the per-protocol group. This trial is registered with ClinicalTrials.gov, number NCT02308956. FindingsWe recruited participants between March 13, 2015 and May 21, 2016. We randomly assigned 329 participants (111 female and 218 male) who were aged 25–72 years and were predominantly of Gurage (198 [60%]), Silte (58 [18%]), and Mareko (53 [16%]) ethnicity. Five participants were found to be ineligible after randomisation, giving a modified intention-to-treat sample of 324. Of these, 12-month assessments were completed in 155 (98%) of 158 in the TSC group and in 158 (95%) of 166 in the PSY group. For the primary outcome, there was no evidence of inferiority of TSC compared with PSY. The mean BPRS-E score was 27·7 (SD 4·7) for TSC and 27·8 (SD 4·6) for PSY, with an adjusted mean difference of 0·06 (90% CI –0·80 to 0·89). Per-protocol analyses (n=291) were similar. There were 47 serious adverse events (18 in the TSC group, 29 in the PSY group), affecting 28 participants. These included 17 episodes of perpetrated violence and seven episodes of violent victimisation leading to injury, ten suicide attempts, six hospital admissions for physical health conditions, four psychiatric admissions, and three deaths (one in the TSC group, two in the PSY group). The incremental cost-effectiveness ratio for TSC indicated lower cost of –US$299·82 (95% CI –454·95 to –144·69) per unit increase in BPRS-E scores from a health care sector perspective at 12 months. InterpretationWHO's mental health Gap Action Programme for people with severe mental disorders is as cost-effective as existing specialist models of care and can be implemented effectively and safely by supervised non-specialists in resource-poor settings. FundingUS National Institute of Mental Health.

Magnitude and correlates of alcohol use disorder in south Gondar zone, northwest Ethiopia: A community based cross-sectional study.

Alcohol use disorder is the major public health problem in low- and middle-income countries that account for up to 70% of alcohol related premature mortality in the region. Therefore, the aim of this study was to assess the magnitude of alcohol use disorder and its associated factors among adult residents in south Gondar zone, Northwest Ethiopia. A community-based cross-sectional study was conducted among 848 adult residents of the south Gondar zone from January 13 to February 13, 2020. A multistage sampling technique was used to recruit study participants. We assessed alcohol use disorder (AUD) using the alcohol use disorder identification test (AUDIT). A binary logistic regression model was employed to identify factors associated with AUD. The prevalence of alcohol use disorder over the last 12-months was found to be 23.7% (95% CI: 20.9, 26.7). Being male (AOR = 4.34, 95 CI; 2.800, 6.743), poor social support (AOR = 1.95, 95 CI: 1.098, 3.495), social phobia (AOR = 1.69, 95 CI; 1.117, 2.582), perceived high level of stress (AOR = 2.85, 95 CI; 1.829, 34.469), current cigarette smoking (AOR = 3.06, 95 CI; 1.764, 5.307) and comorbid depression (AOR = 1.81, 95 CI; 1.184, 2.778) were significantly associated with alcohol use disorder. The prevalence of alcohol use disorder is high among adult residents of the south Gondar zone and associated with many factors. So, it needs public health attention to decrease the magnitude of alcohol use disorder in Ethiopia.

Effect of Drying Method and Storage Days on Essential Oil Yield and Quality of Rue (Ruta Chalepensis) leaves

The genus Rue (Ruta chalepensis) is an aromatic medicinal plant used in the folk as an herbal remedy medicine for the treatment of a variety of disorders in Ethiopia. Information about the effects of drying methods and storage days on essential oil physical properties is limited. The fresh leaf of rue was collected from the Wondo Genet Agriculture research center and was subjected to sun and shade drying methods and four storage days (0,5,10, and 15) days for each day's moisture content and essential oil extraction using hydro distillation. The obtained essential oils were analyzed for physical properties (specific gravity and refractive index). The highest value of moisture content in percent was recorded at 0-day storage days with the value of 73.533 and the lowest one was recorded at 15-day sundry with the value of 8.400. The highest and lowest value of essential oil content in volume by weight in percent was 0.673 and 0.174 at 0 day and 10-day sun, respectively. The highest and lowest value of essential oil content weight by weight in percent was 0.996 and 0.287 at 0 day and 15-day sun, respectively. The results showed that the rue dried under shade had a higher level of moisture content, essential oil content, volume by weight and weight by weight, specific gravity, and refractive index compared to the rue leaf dried under sun-drying methods. In the case of storage days in all parameters except refractive index and specific gravity, the rue fresh leaf (0 days) was higher in moisture content and essential oil contents compared to others storage days. This study provides evidence that drying herbs for different storage days and different drying methods affect the essential oil content and physical properties of essential oil.

Prevalence and correlates of diagnosed and undiagnosed epilepsy and migraine headache among people with severe psychiatric disorders in Ethiopia.

There is a paucity of research on the prevalence of diagnosed as well as undiagnosed neurological disorders with episodic manifestations such as epilepsy and migraine headaches in people with severe psychiatric disorders (SPD). To the best of our knowledge, this is the first study analyzing and comparing the prevalence of diagnosed and undiagnosed chronic neurological disorders with episodic manifestations including epilepsy and migraine headache in people with SPD. This quantitative cross-sectional survey was undertaken among 309 patients with SPD selected by a systematic random sampling technique. The Structured Clinical Interview for DSM-IV Axis I Disorders (SCID) was used to confirm SPD among the participants. The International Classification of Headache Disorders (ICHD-3) and International League Against Epilepsy (ILAE) were used to define migraine headache and epilepsy, respectively]. Risk factors for chronic neurologic disorders were explored by using logistic regression models. In this study, the prevalence of overall neurological disorders, epilepsy, and migraine headache among people with SPD were found to be 5.2% (95%CI 3.2-8.3), 1.6% (95%CI 0.7-3.9), and 3.9% (95%CI 2.2-6.7), respectively. We found that a considerably higher proportion of people with SPD had undiagnosed overall neurological disorder (87.5%; 14/16), epilepsy (60%; 3/5), as well as migraine headaches (100%; 12/12). On the other hand, in this study, 12.5%, 40%, and 0% of patients with overall neurologic disorder, epilepsy, and migraine headaches respectively were diagnosed by the professionals. Higher disability score (WHODAS score) was associated with increased odds of having neurological disorders compared with the lower WHODAS score [OR = 1.30 (95% CI 1.02-1.66)]. Whilst the prevalence estimates of neurological disorders with episodic manifestations including epilepsy and migraine headache was high among people with SPD, the vast majority of them remained undiagnosed. The diagnosis rates of those disorders were significantly low, perhaps surprisingly zero for migraine headache. High WHODAS score was associated with increased odds of having neurological disorders. Routine screening and management of epilepsy and migraine headache are imperative among people with SPD.

Magnitude and predictors of common mental disorder among people with HIV/AIDS in Ethiopia: a systematic review and meta-analysis

BackgroundCommon mental disorders are frequent psychiatric comorbid conditions among people with HIV/AIDS. The presence of such psychiatric disorders negatively affects the treatment adherence, viral load suppression, quality of life, treatment outcomes and functionality of people with HIV/AIDS. However, available studies in Ethiopia have a great variation and inconsistency of reported results have been observed regarding the magnitude and associated factors of common mental disorder. Thus, conducting a systematic review and meta-analysis of existing literatures can have a paramount importance to show its summarized figure.MethodsLiteratures search was performed using databases (PubMed/Medline, Science Direct and PsycINFO. Grey literatures were also searched from Google and Google Scholar. Data were extracted from primary studies using a data extraction format prepared in Microsoft Excel and exported to STATA-version 14 statistical software for analysis. The I2 test was used to assess the heterogeneity of primary articles. The result of the test showed that there was heterogeneity between primary studies. This leads us to execute a random effect meta-analysis to estimate the pooled prevalence of common mental disorder with corresponding 95% confidence interval.ResultsA total of 13 primary studies comply with the inclusion criteria were included in this systematic review. The pooled prevalence of common mental disorder was found to be 28.83% (95% CI: 17.93, 39.73) among people with HIV/AIDS in Ethiopia. The highest prevalence of common mental disorder (35.20%) was observed among studies in which Kessler-10 was used as a screening tool. Single marital status (OR = 1.83; 95%CI: 1.03, 3.27), HIV/AIDS-related stigma (OR = 2.21; 95%CI: 1.68, 2.90) and current job unavailability (OR = 1.38; 95%CI: 1.01, 1.88) had statistically significant association with common mental disorder.ConclusionThe result of this review showed that nearly one among three individuals with HIV/AIDS is suffering from common mental disorder in Ethiopia. This calls a need to integrate the mental health and psycho-social support into the HIV/AIDS care.Trial registrationPROSPERO- CRD42019132402. Registered on 05/08/2019.

The prevalence and risk factors of work-related musculoskeletal disorders among adults in Ethiopia: a study protocol for extending a systematic review with meta-analysis of observational studies

BackgroundWork-related musculoskeletal disorders impose a significant and most often underappreciated burden to the individual, nation, healthcare system, and society as a whole. To the best of our knowledge, there is a lack of reliable estimates on the prevalence of work-related musculoskeletal disorders in Ethiopia. The objective of this study will be to assess the existing literature on the prevalence rates and determinant factors of work-related musculoskeletal disorders in Ethiopia.MethodWe will search PubMed/MEDLINE, Embase, SCOPUS, PsycINFO, PEDro, and Ebsco (from January 2000 onwards). Gray literature will be identified through searching Google Scholar and dissertation databases. Observational studies reporting on the prevalence of work-related musculoskeletal disorders among adult Ethiopians will be included. The primary outcome will be the prevalence of work-related musculoskeletal disorders. Secondary outcomes will be the prevalence of any risk factors in association with work-related musculoskeletal disorders. Two reviewers will independently screen all citations, full-text articles, and abstract data. The study methodological quality (or bias) will be appraised using an appropriate tool. If feasible, we will conduct random effects meta-analysis of observational data. Subgroup analyses will be conducted to explore the potential sources of heterogeneity (e.g., gender, sample size, type of occupation). Publication bias and heterogeneity between the included studies will also be assessed and reported.DiscussionThis systematic review will provide a synthesis of the literature on the prevalence of work-related musculoskeletal disorders and their risk factors in Ethiopia. The results of this review could help the policymakers in occupational health and healthcare sectors in identifying priority areas for interventions in work-related musculoskeletal disorders and will also serve as a baseline for the decision-making processes of musculoskeletal health promotion, work exposure implementations, and prevention programs in workplaces.Systematic review registrationPROSPERO, CRD42020164240

Perceptions and experiences of stigma among parents of children with developmental disorders in Ethiopia: A qualitative study.

Although stigma related to developmental disorders (DD) has been associated with poor mental health among caregivers, an in-depth understanding of factors that influence internalisation of stigma by caregivers is missing. The aim of our study was to explore perceptions and experiences of stigma among parents of children with DD in Ethiopia and examine the contributing and protective factors for internalised stigma based on the perspectives of the parents themselves. We conducted in-depth interviews with eighteen parents (fourteen mothers, four fathers) in Addis Ababa (between December 25, 2017 and January 8, 2018) and the rural town of Butajira (between August 08, 2018 and August 16, 2018). We analysed the data using thematic analysis. Parents perceived and experienced different forms of stigma that were directed towards their child (public stigma) and themselves (courtesy stigma). Some parents also described how they isolated themselves and their child from social life (affiliate stigma). Parents perceived the negative consequence of stigma on the lives of their child with DD, siblings and themselves. Most parents also described examples of positive reactions and support from their own family and the community. Participants’ accounts suggested supportive contributions and positive responses from the general public came primarily from those who had better awareness of DD. Not all parents in our study internalised the stigma that was directed at them. Whilst perceived family support and acceptance and increased awareness about DD appeared to help some parents not to internalise stigma, the perceived lack of social support and acceptance made some parents vulnerable to internalised stigma. These findings can inform anti-stigma intervention priorities. Awareness-raising activities targeting the community as a whole as well as interventions targeting parents themselves are likely to be beneficial. Interventions should consider the wellbeing of the whole family unit rather than focus on individuals alone.

Internalized stigma among patients with mood disorders in Ethiopia: a cross-sectional facility-based study

BackgroundInformation on the degree of internalized stigma experienced by patients with mood disorders in Ethiopia is limited. This study attempted to assess the levels of internalized stigma and factors associated with it in patients with mood disorders who were on follow-up as an outpatient in a Psychiatry clinic at Saint Paul’s Hospital, Addis Ababa, Ethiopia.MethodsA facility-based cross-sectional study employed, and a consecutive sampling technique was used to get study participants (235 cases with mood disorders). Internalized stigma of mental illness scale used to assess stigma of study subjects. The collected data were cleaned, checked for completeness, coded and entered into Epi-data version 3.1 data entry software and exported to SPSS version 20 statistical software for analysis. Univariate linear regression analysis was done to see the association between dependent and independent variables at P-value < 0.25 and multivariate linear regression analysis was done to identify predictor variables at P-value < 0.05.ResultsNearly one-third (31.5%) of the patients had moderate or high levels of internalized stigma, and more than half (54.9%) of the respondents had moderate or high stigma resistance and self-esteem score of (67.2%). About a quarter (27.7%) had moderate to high levels of discrimination experience and a similar proportion (26.4%) had moderate to severe or extreme disability. Females had significantly higher internalized stigma (std. β = .169 with P < 0.01) than men. Adherence to medication was significantly correlated with lower internalized stigma (std. β = − .212 with P < 0.01).ConclusionsThese findings suggested that moderate to high internalized stigma occurred among approximately 1 in 3 people with a mood disorder in the urban city of Ethiopia. So, working on adherence to medication, self-esteem of patients and psycho-education about stigma is crucial to reducing the internalized stigma of people with a mood disorder and special attention should give to female patients.

Undiagnosed HIV, hepatitis B, and hepatitis C infections in people with severe psychiatric disorders in Ethiopia

BackgroundWorldwide, there is limited epidemiologic evidence on the seroprevalence of undiagnosed chronic viral infections including HIV, hepatitis B virus (HBV) and hepatitis C virus (HCV) infections among patients with severe psychiatric disorders. To our knowledge, this is the first study to explore and compare undiagnosed seroprevalence rates of HIV, HBV, and HCV infections among patients with severe psychiatric disorders.MethodIn this study, we included a random sample of 309 patients with severe psychiatric disorders selected by systematic sampling technique. We used a structured clinical interview for DSM-IV (SCID) to confirm the diagnosis of severe psychiatric disorders among the participants. Binary and multivariable logistic regression models, adjusting for the potential confounding factors was used to explore the potential determinants of chronic viral infections.ResultThe prevalence estimates of HIV infection among patients with severe psychiatric disorders in this study (3.24%) was roughly 3 times the estimated population prevalence of HIV infection in Ethiopia (1.1%). This study showed that the prevalence rates of HBV and HCV infections among patients with severe psychiatric disorders were 4.85 and 1.29%, respectively. Our results also showed that among patients with chronic viral infections, HIV, HBV and HCV, 76.92, 60, 80, and 75% respectively were undiagnosed. Regarding associated factors, the presence of chronic viral infection was found to be significantly associated with the age of the participants (ranging between 30 and 40 years) after adjusting for the possible confounding factors [AOR = 3.95 (95%CI.18–13.17)].ConclusionEven though the prevalence estimates of HIV (3.24%), HBV (4.85%), and HCV (1.29%) infections were high among patients with severe psychiatric disorders, the majority of them remained undiagnosed. HBV was found to be the commonly undiagnosed infection (4 out of 5) followed by HCV (3 out of 4) and HIV (6 out of 10). The present study provided evidence of a significant association between the age of the participant (between 30 and 40 years) and chronic viral infections in patients with severe psychiatric disorders. Increasing the awareness of psychiatry professionals and early screening, as well as interventions of chronic viral infections among patients with severe psychiatric disorders are imperative.

Risky sexual behavior and associated factors among patients with bipolar disorders in Ethiopia

BackgroundPeople with bipolar disorder are highly vulnerable to risky sexual behaviors (RSBs). The magnitude of RSBs among bipolar disorders was not studied in our population. The present study aimed to explore the prevalence of RSBs and associated factors among patients with bipolar disorder.MethodAn institution based cross-sectional study was conducted from 1 April to 30 May 2017 among people living with bipolar disorder at outpatient departments of Amanuel Mental Health Hospital, Addis Ababa. Systematic random sampling was used to select participants. Risky sexual behavior was defined as having sex with two or more sexual partners, having unprotected sexual intercourse, sex after alcohol consumption, exchanged money for sex in a previous 12 months. Data collection was conducted through face-to-face interview by a structured questionnaire adopted from behavioral surveillance survey. Binary logistic regression was conducted to identify factors associated with RSBs.ResultA total of 424 participants were enrolled in the study, giving overall response rate of 96%. About 223(52.6%) were males. The prevalence of risky sexual behavior was 49.1% among bipolar patients. Male patients (Adjusted Odds Ratio (AOR) =2.23,95% CI = 1.27,3.92), patients in age group of 18–24(AOR = 2.08,95% CI = 1.47,3.81),current manic phase of the illness (AOR = 2.3195% CI,1.24,4.32) and current alcohol drinking (AOR = 3.70,95% CI = 2.01,6.78) had significant association with RSB.ConclusionAlmost half of bipolar patients reported a risky sexual behavior. Current manic episode and the consumption of alcohol were independently associated with RSB. To reduce the burden of RSBs, mental health services which focuses on sexual behaviors of bipolar patients is required.