Facility-based Cross-sectional Study Research Articles

Delay in receiving emergency obstetric care and associated factors among mothers who gave birth in public hospitals of Bale and East Bale zones, Oromia region, South East Ethiopia: Facility based cross-sectional study

IntroductionDelays in timely seeking care, failure to reach health institutions and receiving ineffective health care cause maternal mortality in developing countries. The three maternal delay was used to identify contributing factors to maternal death. There was limited data on the maternal delay in receiving emergency obstetric care services in the study area. Therefore, the aim of this study was to assess the magnitude of delay in receiving emergency obstetric care and associated factors among postnatal mothers in the Bale and east Bale zones. MethodsA facility-based cross-sectional study was conducted among 407 postnatal women from April 6 to May 6, 2022. A systematic random sampling technique was used to select study participants. The data were collected electronically using an Open Data Kit and exported to SPSS window version 25 for cleaning and analysis. Both bivariate and multivariable analyses were done by using a binary logistic regression model to identify factors associated with delay in receiving emergency obstetric care services. Statistical significance was declared at P-value < 0.05. ResultsIn this study, the magnitude of delay in receiving institutional delivery service utilization was 34.6% with [95% CI (30.0_39.5)]. Delay one was found to be statistically associated with maternal delay in receiving institutional delivery services (AOR = 2.07; 95% CI: 1.21, 3.53). Mothers with low monthly income had shown higher odds of delay (AOR = 1.79; 95% CI: 1.03, 3.10). Moreover, the delay in receiving emergency obstetric care was 89% less likely among mothers who had not been referred multiple times than among those who had been referred many times (AOR = 0.10; 95% CI: 0.06, 0.18). ConclusionThis study showed that the magnitude of the delay in receiving the utilization of emergency obstetric care services in the study area was high. Factors such as delay one, average monthly income and multiple referrals of mothers were found significant factors for delay in receiving care. Therefore, it is important to reduce delay in receiving institutional delivery by working on promoting road accessibility, transport mechanisms and building health education on key danger signs.

Beyond blood sugar: Unraveling the complexities of liver and kidney health in type 2 diabetes mellitus

ABSTRACT Background: Diabetes mellitus (DM) poses a formidable global health challenge, particularly with the alarming rise of type 2 diabetes. Projections indicate that by 2030, around 440 million individuals will grapple with type 2 diabetes, attributing this surge to urbanization, sedentary lifestyles, and obesity. The intricate relationship between diabetes, liver, and renal functions plays a crucial role in the disease’s progression and complications. Aims and Objectives: This study aims to explore the complex interplay between type 2 diabetes mellitus (T2DM), liver function, and renal health. Specific objectives include assessing abnormal liver function, evaluating kidney profile parameters, and examining the prevalence of anemia in T2DM patients. The study seeks to contribute insights that inform proactive management strategies for diabetes-related complications. Material and Methods: Conducted as a facility-based cross-sectional study from March to June 2022, 120 individuals with T2DM participated. The study focused on patients attending routine follow-ups at the Outpatient Department of general medicine in Santosh Hospital, SMCH, SDTU Ghaziabad. Rigorous assessments and statistical analyses were employed to examine gender distribution, liver and kidney profile parameters, and other relevant factors. Results: Among the notable findings, Table 1 reveals a significant gender distribution, with 51.8% males in the diabetes group. Liver profile parameters, including alkaline phosphates and albumin, exhibited statistically significant differences between diabetes and control groups. Kidney profile parameters also showed significant variations, emphasizing the intricate relationship between diabetes and renal complications. The study further explored differences between male and female patients in the control group, revealing significant variations in hemoglobin levels. Conclusion: This study sheds light on the prevalence of abnormal liver function in T2DM individuals, emphasizing the significance of early detection and tailored interventions. Kidney disorders and the often-overlooked complication of anemia further contribute to the complexity of health challenges faced by those with diabetes. The findings underscore the need for vigilant monitoring and comprehensive management strategies to enhance patient care in the face of this multifaceted health challenge.

Factors associated with first antenatal care (ANC) attendance within 12 weeks of pregnancy among women in Lira City, Northern Uganda: a facility-based cross-sectional study

ObjectiveThis study aimed at assessing factors associated with first antenatal care (ANC) attendance within 12 weeks of pregnancy among women in Lira City.DesignA cross-sectional study.SettingsThe study was conducted in health...

Uptake of the COVID-19 Vaccination and Associated Factors Among Health Care Providers in Addis Ababa, Ethiopia.

The COVID-19 vaccine is intended to provide acquired immunity against severe acute respiratory syndrome coronavirus 2(SARS-CoV-2). As a result, 12 billion doses of the COVID-19 vaccination have been given globally as of August 1, 2022. Due to occupational exposure, health professionals obtained priority for COVID-19 vaccination. However, despite the availability of COVID-19 vaccines in countries, there is a discrepancy in the uptake of vaccine among different populations including Health-Care Providers. Assessments of the factors associated with uptake of COVID-19 vaccination among health-care providers in Addis Ababa, Ethiopia in 2022. From June 10 to July 10, 2022, a facility-based cross-sectional study was carried out in Addis Ababa, Ethiopia, involving 473 health-care professionals, used descriptive statistics to summarize the participant's characteristics, and multivariable logistic regression to analyze factors affecting COVID-19 vaccination uptake. P-value <0.05 was used to determine the level of significance. The response rate of the participants was 94.2%. The uptake rate of COVID-19 vaccine among health-care providers was 359 (75.8%). Vaccine uptake was positively associated with higher perceived concerns regarding COVID-19 [AOR = 7.45, (4.041-13.754)], higher monthly income, [AOR: 2.623 (1.398 -4.923)] compared those who earned lower, being married [AOR: 2.114, (1.068-4.181)] and being advanced age (36-45) years old [AOR =0.486 (0.258-0.916)] compared to 18-26 years old. However, being female professional reduced the odds of vaccine uptake [AOR = 0.486 (CI; 0.258-0.916)] in contrast of their counterpart. The uptake of COVID-19 vaccine among health professionals is relatively higher than in earlier reports. However, this was not yet sufficient for the level required to achieve herd immunity. Hence, the Ministry of health should work in collaboration to address concerns about the safety and effectiveness of COVI D-19 vaccine to increase COVID-19 vaccine uptake. Moreover, Health professionals, social media, regular media outlet should strengthen health education on concerns of covid-19 infection.

Identification of Bacterial Uropathogen and Antimicrobial Resistance Patterns Among Patients with Diabetic and Hypertension Attending Dilla University General Hospital, Dilla, Ethiopia.

Having a urinary tract infection (UTI) is a serious health issue which is caused by microbial colonization and proliferation in the urinary system. Patients with diabetes and blood pressure are more vulnerable to bacterial urinary tract infections because their host defense is compromised and their urine has a high glucose content. A proper and quick investigation of uropathogen and their antibiogram is key to patient treatment and infection control. Aimed to assess the identification of bacterial uropathogen and antimicrobial resistance patterns among diabetic and hypertension patients attending DUGH, Ethiopia. A Facility-based cross-sectional study was conducted from February to December 2022 among 158 diabetic and hypertensive patients using a clean catch mid-stream urine sample. Pretested structured questionnaires were used to collect data from study participants. Urine samples were taken and cultured on Blood agar, MacConkey agar and CLED Agar for the identification of uropathogen. An antimicrobial susceptibility test was done according to CLSI. Binary and multiple logistic regression were used to assess the association. A P-value less than 0.05 was considered statistically significant. The overall prevalence of bacterial uropathogenic among diabetes mellitus and hypertension patients was 15.2%. E. coli (29.2%), coagulase negative Staphylococci (CoNS) (20.8%), K. pneumoniae 3 (12.5%) and S. aureus 2 (12.5%) were the leading isolated uropathogens. In our study, illiterates (AOR =8.1, 95% CI: (5.1-12.4)), participants with high blood glucose levels (AOR=1.81, 95% CI: (1.01-2.21)) and comorbid patients (AOR = 4.2, 95% CI: (4.1-17.2)) were significantly associated with UTI. Both gram-negative and gram-positive isolated bacteria showed higher resistance to most of the commonly used antibiotics. Multidrug resistance was reported in 62.5% of the total isolates. This study revealed a high prevalence of bacterial isolate and multidrug resistance. Therefore, continuous monitoring of microbiological and antimicrobial surveillance of UTI among DM patients is crucial for appropriate treatment and infection control.

Prevalence and Factors Associated With Cryptoccocal Antigenemia Among Patients With Advanced Human Immunodeficiency Virus in Eastern Uganda: A Facility-Based Cross-sectional Study.

Cryptoccocal infection remains an important cause of morbidity and mortality among people with advanced human immunodeficiency virus disease (AHD). In resource-limited settings, there is a paucity of data on cryptoccocal infections. We described the prevalence and factors associated with cryptoccocal antigenemia among people with AHD in Mbale Regional Referral Hospital in Eastern Uganda. In this cross-sectional study, data on sociodemographic, clinical, and laboratory characteristics of adults with AHD were collected, and factors associated with cryptoccocal antigenemia were determined using multivariate logistic regression models. We enrolled 228 participants with a median CD4 cell count of 194/µL (interquartile range, 129-370/µL). The prevalence of cryptoccocal antigen was 10 in 228 (4.4% [95% confidence interval, 2.4%-80%]). CD4 cell counts <100/µL (adjusted odds ratio, 3.70) and poultry keeping were risk factors. The main predictors were headaches (adjusted odds ratio, 1), neck pains (8.817), confusion (6.323), and neck stiffness (676.217). No notable significant associations were found in the multivariate analysis. The prevalence of cryptoccocal antigen was 4.4%, and antiretroviral therapy was protective.

Household Contact Tuberculosis Screening Adherence and Associated Factors Among Pulmonary Tuberculosis Patients on Follow-Up at Health Facilities in Shashamane Town, Southeast Ethiopia.

The greatest risk of getting tuberculosis (TB) infection is contact with patients who have pulmonary tuberculosis (PTB). The World Health Organization (WHO) strongly recommends tuberculosis screening for all household contacts of PTB patients. However, there is no information on household contact screening adherence among PTB patients in Shashamane town. A facility-based mixed-method cross-sectional study was conducted from July 1 to November 30, 2021 among consecutively selected 392 PTB patients and 23 purposely selected key informants. Data were collected using a pre-tested interviewer administered questionnaire and leading questions. Data analysis was made using SPSS version 25 and in-depth interview information was analyzed based on thematic areas. Bivariable followed by multivariable logistic regression with 95% CI were conducted. P-value<0.05 was considered to identify statistically significant factors. The overall adherence to household contact screening (HHCS) was 44.4% (95% CI: 39.3, 49.1). Having under fifteen years of contact (AOR=2.386, 95% CI: 1.44, 3.96), diploma and above education status (AOR=3.43, 95% CI: 1.286, 9.15), good knowledge (AOR=2.999, 95% CI: 1.79, 5.03), favorable attitude (AOR=2.409, 95% CI: 1.45, 4.02), getting health education (AOR=3.287, 95% CI: 1.92, 5.63) and smear positive type of PTB (AOR=2.156, 95% CI: 1.28, 3.62) were factors significantly associated with HHCS adherence. Workload, facility readiness and care provide commitments were also identified from qualitative data. HHCS adherence in our study was sub-optimal referenced to WHO and national recommendations that all household contact should be screened. Having age less than fifteen years contact, education status, knowledge, attitude, receiving health education and type of pulmonary tuberculosis were factors associated with adherence. We recommend increasing community awareness of TB, providing health education TB patients and their families, strengthening positive attitudes toward HHC screening and strengthening the commitment of health professionals to screen for HHCs.

Herbal medicine use among pregnant women at antenatal clinic in Ethiopia

BackgroundHerbal medicines are raw or processed plant-derived ingredients. Their use during pregnancy may contributed to several adverse effects that could be lethal to the mother and their unborn children. AimsThis study aims to assess the prevalence of herbal medicine use and associated factors among pregnant women at Woldia General Comprehensive Specialized Hospital (WGCSH) in Ethiopia. SamplesThe sample size in this study was 272. MethodsA facility-based cross-sectional study was conducted among 270 pregnant mothers from March 2 to April 2, 2021, at WGCSH in the antenatal care clinic. A standardized, structured questionnaire-based interviewer was used to collect the socio-demographic variables; obstetrics variables; and other related variables for this study. The prevalence of herbal medicine use and associated factors were determined using descriptive and logistic regression analysis, with p < 0.05 considered statistically significant. ResultsThe prevalence of herbal medicine use in this study was 22.6%. Most of the pregnant women used Ocimum lamiifolium and Rutachalepensis. The use of herbal medicines during pregnancy in rural areas was higher than in urban areas (OR 2.51; 95% CI 1.35–3.54). The place of residence (AOR 3.66; 95% CI 1.83–4.74), perception of needing to use herbal medicine (AOR 2.20; 95% CI 4.99–9.86), stage of pregnancy (AOR 2.56; 95% CI 1.16–9.36), distance from the health facility (AOR 2.90; 95% CI 1.52–12.65), and previous use of herbal medicine (AOR 3.23; 95% CI 2.74–7.56) were significantly associated with herbal medicine use. ConclusionsNearly one-fourth of pregnant mothers at WGCSH used herbal products and preparations.

Prevalence and patterns of intimate partner violence among antenatal clinic attendees at federal medical center, Abuja.

Intimate partner violence (IPV) has been a source of increasing concern to the government of nations as well as their citizens despite measures taken to reduce it. This is supported by recent data published by the World Health Organization and other development partners. In health care facilities, intimate partner violence in pregnancy has not been screened routinely. Community-based findings have been the source of most data informing policies for decisions. These were to determine the prevalence and patterns of IPV among antenatal clinic attendees at the Federal Medical Center (FMC), Abuja. Following ethical clearance, a health facility-based cross-sectional study was conducted at the FMC, Abuja to determine the prevalence and correlates of IPV during pregnancy among attendees of antenatal clinics. It was conducted between 26th June and 17th September 2021. A total of 450 questionnaires were administered among consecutive consenting clients and 407 were returned filled giving a non-response rate of 9.6%. The questionnaire collected data on respondents' sociodemographics; experience of and types of IPV; and health problems arising from IPV. Results were presented in tables and charts and analysis was done using IBM SPSS (International Business Machines' Statistical product and service solutions) version 25 software. The mean age was 29.37 ± standard deviation 4.43 years and the predominant ethnic group was Igbo (46.5%); 96.56% were married; 68.06% had tertiary education and 49.14% were in their third trimesters. The combined incidence of intimate partner violence among the participants was 17.69% with physical violence contributing 3.19%; the head region (40%) being the most affected body part. While 34% experienced intrauterine foetal death in the past following IPV. In Miller's landmark study, 27 of 1300 sexually active young women, one in five reported partner pregnancy non promoting behaviors, such as intimidation, threats to leave the relationship if the woman did not become pregnant or actual violence. The two most significant factors for IPV were age and marital status both at P values of P = 0.0001. Medical doctors should feel more open discussing issues around IPV with their clients during antenatal visits.

Comparative whole-genome sequence analysis of Mycobacterium tuberculosis isolated from pulmonary tuberculosis and tuberculous lymphadenitis patients in Northwest Ethiopia.

Tuberculosis (TB), caused by the Mycobacterium tuberculosis complex (MTBC), is a chronic infectious disease with both pulmonary and extrapulmonary forms. This study set out to investigate and compare the genomic diversity and transmission dynamics of Mycobacterium tuberculosis (Mtb) isolates obtained from tuberculous lymphadenitis (TBLN) and pulmonary TB (PTB) cases in Northwest Ethiopia. A facility-based cross-sectional study was conducted using two groups of samples collected between February 2021 and June 2022 (Group 1) and between June 2020 and June 2022 (Group 2) in Northwest Ethiopia. Deoxyribonucleic acid (DNA) was extracted from 200 heat-inactivated Mtb isolates. Whole-genome sequencing (WGS) was performed from 161 isolates having ≥1 ng DNA/μl using Illumina NovaSeq 6000 technology. From the total 161 isolates sequenced, 146 Mtb isolates were successfully genotyped into three lineages (L) and 18 sub-lineages. The Euro-American (EA, L4) lineage was the prevailing (n = 100; 68.5%) followed by Central Asian (CAS, L3, n = 43; 25.3%) and then L7 (n = 3; 2.05%). The L4.2.2.ETH sub-lineage accounted for 19.9%, while Haarlem estimated at 13.7%. The phylogenetic tree revealed distinct Mtb clusters between PTB and TBLN isolates even though there was no difference at lineages and sub-lineages levels. The clustering rate (CR) and recent transmission index (RTI) for PTB were 30 and 15%, respectively. Similarly, the CR and RTI for TBLN were 31.1 and 18 %, respectively. PTB and TBLN isolates showed no Mtb lineages and sub-lineages difference. However, at the threshold of five allelic distances, Mtb isolates obtained from PTB and TBLN form distinct complexes in the phylogenetic tree, which indicates the presence of Mtb genomic variation among the two clinical forms. The high rate of clustering and RTI among TBLN implied that TBLN was likely the result of recent transmission and/or reactivation from short latency. Hence, the high incidence rate of TBLN in the Amhara region could be the result of Mtb genomic diversity and rapid clinical progression from primary infection and/or short latency. To validate this conclusion, a similar community-based study with a large sample size and better sampling technique is highly desirable. Additionally, analysis of genomic variants other than phylogenetic informative regions could give insightful information. Combined analysis of the host and the pathogen genome (GXG) together with environmental (GxGxE) factors could give comprehensive co-evolutionary information.

Routine Health Information System Utilization and Its Associated Factors among Healthcare Professionals in Debre Berhan Town, Ethiopia

Background. A routine health information system (RHIS) is a system that records, stores, and processes health data in order to enhance healthcare decision-making. However, systematic use of health information is still not used for program decisions in developing nations, particularly in Ethiopia. Objective. Identifying regular utilization of health information systems and related factors among healthcare workers in Debre Berhan Town health facilities, North Shoa, Amhara, Ethiopia, 2022. Methods. A facility-based cross-sectional study was conducted from February 22 to September 22, 2022 in Debre Berhan Town, Ethiopia. Data from participants were gathered using a self-administered, pretested structured questionnaire by employing a systematic random sample technique among healthcare workers at public health facilities. Data were entered into EpiData version 3.1 and analyzed using SPSS. We employed multivariable logistic regression and descriptive statistics. Variables with a p-value &lt; 0.05 were considered statistically significant factors. Hosmer–Lemeshow goodness of fit was used to check the adequacy of the model. Result. A total of 383 workers were study participants with 100% response rate. The mean age was 32 (±5.23). Utilization of routine health information among health professionals was 42.6%. Type of institution (AOR = 0.56), complexity of RHIS) (AOR = 2.19), training on HMIS (AOR = 9.35), and feeling guilty of not accomplishing their performance (AOR = 2.96) were found significantly associated with routine health information utilization (RHIU). Conclusion. Utilization of RHIS among the health professionals was low. Type of institution, complexity of RHIS, data management skills, training on HMIS, and feeling guilty of not accomplishing their target performance were factors related to RHIS utilization. Comprehensive training and improve data management skills are highly recommended for improving RHIU.

Prevalence of Cesarian Delivery and Associated Factors among Mothers who Gave Birth at Public Hospitals, Jigjiga, Somali Regional State, Ethiopia

Background: Caesarean delivery is a procedure used to save a mother’s and fetus’s lives when the labour situation becomes complicated. However, a wrong decision can substantially increase the rates of morbidity and mortality of the woman and the fetus. Purpose: the study aimed to assess the prevalence of cesarean delivery and associated factors. Methods: A health facility-based cross-sectional study has been conducted. A systematic random sampling technique was used. A face-to-face interview was employed to collect data through a pre-tested and structured questionnaire. Descriptive statistics were counted on. A binary logistic regression was employed to assess factors associated with cesarean delivery. The odds ratio and corresponding 95% confidence interval 95% confidence intervals were used. Results: The prevalence of cesarean delivery in this study is 27.4% (95% CI 23.3, 31.8%). monthly income 3,000-6,000 birr [AOR = 3.91 (95% CI: 1.50, 10.17)], previous cesarean delivery [AOR = 15.86 (95% CI: 8.01, 31.40)] and mother not directed counselling [AOR = 2.87 (95% CI: 1.46, 5.68)] are factors significantly associated. The prevalence of cesarean delivery uses is high. The obstetric factors occurring around delivery are the master ground leading cesarean delivery rather than the background characteristics. There is a low rate of pregnant mother counseling. We recommend interventions for the prevention of unnecessary primary cesarean delivery, counselling for pregnant mothers, particular emphasis on training all health care providers, and further investigation

Opportunistic screening of suspected oral precancerous lesions among patients attending outpatient department of primary health centres, Puducherry

Background: Oral cancer ranks among the top three types of cancer in India. Opportunistic screening of the oral cavity at an early stage could potentially offer long-term survival, improve treatment outcomes, and makes health care affordable for oral cancer patients. The objective is to determine the proportion of suspected oral precancerous lesions among the patients attending the outpatient department of the Primary Health Centres of Puducherry (PHC) by opportunistic screening through visual inspection. Methods: This study was a facility-based cross-sectional study, conducted at the outpatient department of one urban and one rural primary health centre of Puducherry. Twelve hundred individuals aged above 18 years were opportunistically screened at the outpatient department using systematic random sampling. The oral examination was done through visual inspection, and socio-demographic characteristics were collected using a semi-structured questionnaire. Results: The prevalence of suspected oral precancerous lesions was 14.3%, of which (18.5%) in rural areas and (10%) in urban areas. The study revealed that 32.1% of the study participants were in 46-60 years with female predominance of 63.3%. A high prevalence of suspected oral precancerous lesions was seen among the age group &gt;60 years (21.8%) and males (19.1%). Smoking, chewing tobacco/betel quid, and alcohol consumption were the risk factors associated with the prevalence of suspected oral precancerous lesions. Conclusions: Further confirmation of those diagnosed positive for suspected precancerous oral lesions, appropriate follow-up, and treatment of the lesions. Opportunistic screening for all individuals above 30 years of age for suspected oral precancerous lesions is recommended and feasible in primary healthcare settings.

Dual Contraceptive Utilization and Associated Factors among Women Attending Antiretroviral Therapy Clinics in Central Ethiopia, 2022: The Need for a Better Control of Ever-Increasing New Strain of HIV Infection and its Transmission

Background: Dual contraceptive utilization can reduce the transmission of many sexually transmitted infections and is recommended by the World Health Organization. Even though recent times advise the use of dual contraception as a potent instrument in the control of unintended pregnancy and sexually transmitted infections including HIV/AIDS, there are considerable contraceptive use gaps among women living with HIV globally. Methods: A facility-based cross-sectional study was conducted from March 22 to June 22/2022 among HIV-positive reproductive age women on Antiretroviral Therapy in the North Shewa Zone, central Oromia health facility. A total of 611 women were selected using a multi-stage sampling technique. A pre-tested structured questionnaire was used to collect data. Both bivariable &amp; multivariable logistic regression analysis was used to find predictors for dual contraceptive utilization. Result: The overall magnitude of dual contraceptive method utilization among the respondent was 38.1% (95% CI: 34.80-42.02). After adjusting for other variables; who residing in urban [AOR = 0.23 [95% CI: 0.09-0.56]; respondent who married [AOR = 3.32 [95% CI: 1.03-10.94]; husband with formal education [AOR = 7.38[95% CI: 1.52-35.94], respondents who thoughts one of the advantages to disclose HIV serostatus is protecting sexual partner from HIV [AOR = 3.68[95% CI: 1.42-9.43] were significantly associated with dual contraceptive utilization. Conclusion: The overall magnitude of dual contraceptive utilization among women on ART was found to be low and factors like; place of residence, marital status, educational status of the partner, and participant who utilize due to the reason to protect the sexual partner from acquiring HIV were identified. Efforts have to be made by local governments and other concerned bodies to increase utilization of dual contraceptive method.

Depression and anxiety among persons with type II diabetes mellitus and hypertension; A cross-sectional analytical study in the rural field practice area of a tertiary care center in Puducherry

Objectives: To determine the proportion of depression and anxiety disorders; their association with sociodemographic, NCD-related factors and Quality of Life among persons with type II Diabetes Mellitus or Hypertension at a rural health center in Puducherry. Materials and Methods: This facility-based cross-sectional analytical study recruited 692 participants from May 2020 to September 2021. A structured questionnaire collected sociodemographic and NCD-related history; The Hospital Anxiety and Depression Scale (HADS) and The World Health Organization quality of life (WHOQOL) - BREF questionnaires for depression, anxiety and QOL assessment, respectively. Independent variables were assessed for relationship with depression and anxiety using univariate analysis. Multivariable logistic regression analysis was done to determine the predictors of depression and anxiety. Results: Nearly 17.8% (95% confidence interval [CI] - 13.8%–22.4%) had depression and 12.7% (95% CI - 9.5–16.7%) had anxiety. Age (adjusted odds ratio [aOR] - 0.97; 95% CI - 0.95–0.99), depression/anxiety disorders family history (aOR - 2.58; 95% CI - 1.26–5.26), overall QOL score reduction (aOR - 0.76; 95% CI - 0.60–0.97), and social domain score reduction (aOR - 0.98; 95% CI - 0.97–0.99) were the significant predictors of depression. No formal education (aOR - 10.84; 95% CI - 4.54–25.86), being homemaker (aOR - 3.49; 95% CI - 1.29–9.42), no DM/HTN family history (aOR - 1.51; 95% CI - 0.66–1.54), psychological domain score reduction (aOR - 0.97; 95% CI - 0.95–0.99) and environmental domain score reduction (aOR - 0.96; 95% CI - 0.94–0.98) were significant predictors of anxiety. Conclusion: Nearly one-fifth had depression and more than one-tenth had anxiety among the participants. A fair number of persons with HTN/DM have higher anxiety and depressive scores and most domains had a poor QOL score with depression alone having associated with a depression/anxiety family history.

Suicidal behaviors and associated factors among patients attending an emergency department: a facility-based cross-sectional study

BackgroundEmergency departments (ED) are an important site for screening patients with suicidal behaviors. However, there is insufficient data in low-and middle-income countries regarding the magnitude of suicidal attempts among patients attending EDs. Therefore, the present study aimed to screen suicidal behavior and factors associated with suicide in patients attending an ED of Addis Ababa Burn, Emergency and Trauma Hospital, Ethiopia.MethodA facility-based quantitative cross-sectional study was conducted between April and June 2018. A total of 398 participants were recruited using a consecutive sampling technique. The collected data collected includes structured questionnaires containing sociodemographic determinants, chronic medical illness conditions, substance use characteristics, social support level, common mental disorders (CMD) screening, suicidal behaviors assessment and suicidal attempts reason and method.ResultsThe prevalence of suicidal behavior and suicidal attempts were 8% and 6.3%, respectively. Suicide was attempted most frequently in the 18–24 age group. There was no overall difference in sex distribution for suicidal attempts. However, there were sex-based differences when the age group was taken into consideration. The commonest underlying reason for the attempt was social reasons (44%), while the most frequently reported attempt method was hanging (36%). No single factor was found to be significantly associated with the suicidal attempt.ConclusionAlthough suicidal behaviors are more common in patients attending the ED than in the general population, these facts have previously got little attention in patient attending EDs in low and middle income countries. The present findings support the need for a more detailed assessment of suicidal behaviours in patients attending ED and in patients with CMD.

Assessment of health-related quality of life of COVID-19 patients during follow-up

Background: The COVID-19 pandemic has had a significant impact on the quality of life of individuals worldwide. The aim of this study was to assess the health-related quality of life (HRQOL) and its associated factors among COVID-19 patients discharged from hospital. Methods: This facility-based cross-sectional study was conducted among laboratory confirmed COVID-19 patients who were discharged from medicine department of Bangabandhu Sheikh Mujib Medical University and did their first-month follow-up from April to September 2021. A validated Bengali version of International Quality of Life Assessment, Short form – 36 (SF-36) questionnaire was used to assess the HRQOL status. Univariate and multivariate analyses were done for identifying factors associated with low HRQOL. Result: Out of 225 patients, the mean (standard deviation) age was 36.9 (14.2) years and four in every ten patients were women. Out of eight subgroups, almost all scored averagely 79 out of 100. Older age, rural residence and severe to critical disease was reported as factors for low physical and mental component summary of SF-36. Conclusion: COVID-19 patients with older age, rural residence and having severe to critical disease condition need to be addressed critically as they have a higher chance of having low HRQOL status after COVID-19 infection.

Utilization of cervical cancer screening and its associated factors among women of child-bearing age in Mangochi district, Malawi: a facility-based cross-sectional study

BackgroundCervical cancer screening (CCS) uptake remains low in poor countries. Few studies have assessed individual need and health system factors which facilitate/impede use of healthcare services, including CCS utilization. Thus, we examined associations between these factors and CCS utilization among women of child-bearing age (WCBA) in Mangochi, Malawi.MethodsA cross-sectional study, sampling 482 women (18–49 years) using a multi-stage sampling method was conducted in five health facilities (HFs). Data were collected using a structured interview questionnaire from June-July, 2019. Chi-squared or Fisher’s exact tests were used to compare the distribution of CCS utilization according to different independent groups.ResultsOur study found that 13.1% of the study participants had a history of CCS. The proportion of WCBA with a history of CCS was significantly higher among HIV + women than HIV- women and women with unknown HIV status, respectively [27.3% (33/121) vs. 8.5% (30/353) vs. 0% (0/8), χ2 = 29.18, df = 2, p < 0.001]. Significantly higher among those who had ever heard of cervical cancer (CC) than those who had not [23.0% (60/261) vs. 1.4% (3/221), χ2 = 49.28, df = 1, p < 0.001], among those who heard of CC from HFs than those who heard through radios, friends/family and other sources, respectively [31.2% (44/141) vs. 16.7% (7/42) vs. 9.3% (5/54) vs. 16.7% (4/24), χ2 = 12.62, df = 3, p = 0.006], among those with positive beliefs towards CCS than those with negative beliefs [19.2% (53/276) vs. 4.9% (10/206), χ2 = 21.37, df = 1 p < 0.001], among those recommended for CCS by health workers (HWs) than those not recommended [19.6% (53/270) vs. 4.7% (10/212), χ2 = 23.24, df = 1, p < 0.001], among those willing to be screened by male HWs than those unwilling [14.4% (60/418) vs. 4.7% (3/64), χ2 = 4.57, df = 1, p = 0.033]. Fisher’s exact test showed that CCS uptake among WCBA varied significantly by level of knowledge of CC signs/symptoms, with 66.7% (12/18) and 19.8% (48/243) among those with high-level and low-level knowledge screened, respectively (p < 0.001).ConclusionsHIV status, ever heard of CC, sources of information, knowledge of CC signs/symptoms, beliefs, recommendations by HWs for CCS, willingness to be screened by male HWs were associated with CCS utilization. Thus, sensitization campaigns for CCS should be conducted to increase uptake. Further, health facilities should intensify health education on CC, including signs and symptoms to increase knowledge. In addition, CC program implementers should be willing to train both males and females to offer CCS as the clients are open to be attended to by male providers as well.

Hyponatremia and its associated factors in children admitted to the pediatric intensive care unit in eastern Ethiopia: a cross-sectional study

BackgroundHyponatremia is a serious problem that leads to substantial increases morbidity and mortality in critically ill children. The identification of risk factors, implementation of preventive measures, and timely diagnosis and management are crucial to reduce adverse events related to hyponatremia. Despite the higher burden of the problem in Ethiopia, evidence related to the risk factors for hyponatremia among children in Ethiopia is limited; in particular, no study has been identified in eastern Ethiopia. Therefore, we aimed to determine the magnitude of hyponatremia and its associated factors in children admitted to the pediatric intensive care unit at the Hiwot Fana Comprehensive Specialized University Hospital.MethodsA facility-based cross-sectional study was conducted using 422 medical records of pediatric patients admitted to the pediatric intensive care unit at Hiwot Fana Comprehensive Specialized University Hospital from January 2019 to December 2022. Medical records were reviewed to collect data. Data were analyzed using a statistical package for social sciences (SPSS) version 26. A binary logistic regression model with an adjusted odds ratio (aOR) and a 95% confidence interval (CI) was used to identify factors associated with the outcome variable. Statistical significance was set at p < 0.05.ResultsThe magnitude of hyponatremia was 39.1% (95% CL: 34.4–43.8%). The age of the child (aOR = 2.37;95% CL:1.31–4.31), diagnosis of sepsis (aOR = 2.33; 95% CL:1.41–3.84), surgical procedures (aOR = 2.39; 95% CL:1.26–4.56), nutritional status (aOR = 2.60; 95% CL:1.51–4.49), and length of hospital stay (aOR = 3.04; 95% CL: 1.73–5.33) were factors significantly associated with hyponatremia.ConclusionsFour out of ten children admitted to pediatric intensive care units had hyponatremia. Hyponatremia was significantly associated with the age of the child, malnutrition, sepsis, surgical procedures, and length of hospital stay. To reduce the burden of hyponatremia and associated mortality, attention should be focused on improving the care of malnourished children, and those with sepsis, and the quality of postoperative monitoring services. Moreover, intervention strategies aimed at reducing the burden of hyponatremia should target the identified factors.

Predicting nutritional status during pregnancy by women's empowerment in West Shewa Zone, Ethiopia.

Considerable proportions of pregnant women are affected by poor nutrition outcomes in Ethiopia. Women's empowerment, on the other hand, is highly recognized as a means to achieve better maternal nutrition outcomes. However, the role of pregnant women's empowerment in nutritional status during pregnancy has not been empirically examined in Ethiopia. This study aimed to address this gap. To assess the association of individual and composite women's empowerment dimensions with pregnant women's nutrition outcomes in West Shewa Zone, Ethiopia. A health facility-based cross-sectional study was performed on 1,453 pregnant women living in West Shewa Zone, Ethiopia, in 2021. Exploratory and confirmatory factor analyses were conducted on half of the samples to identify and validate dimensions of pregnant women's empowerment. The associations between pregnant women's empowerment dimensions and anemia status and mid upper arm circumference levels were examined by logistic regressions. Composite pregnant women's empowerment was positively associated with both anemia status and mid-upper-arm circumference level. The odds of not being anemic were higher among pregnant women empowered in economic [adjusted odds ratio (AOR) = 1.7, 95% confidence interval (CI): 1.26, 2.22] and assertiveness (AOR = 1.9, 95% CI: 1.46, 2.38) dimensions than those not empowered in these dimensions. Empowered pregnant women in household decision-making (AOR = 1.6, 95% CI: 1.19, 2.22) and psychological (AOR = 1.4, 95% CI: 1.04, 1.85) dimensions had higher odds of having normal mid-upper-arm circumference measures than those not empowered in the respective dimensions. Communication and time dimensions were not significantly associated with any of the nutrition outcomes. This study suggests that empowered pregnant women are nutritionally better off than their less empowered counterparts. This is also important in child health outcomes. Policies and programs that aim to improve maternal and child health in the study area need to consider interventions that promote the decision-making power, economic, psychological, and assertiveness dimensions of pregnant women.