Facility-based Cross-sectional Study Research Articles

Health-related quality of life among adults living with chronic non-communicable diseases in the Ho Municipality of Ghana: a health facility-based cross-sectional study

BackgroundMorbidity and mortality rates from chronic non-communicable diseases (CNCDs) are increasing globally. In Ghana, CNCDs account for 43% of all deaths. We examined the Health-Related Quality of Life (HRQoL) and associated factors among adults living with CNCDs in the Ho Municipality.MethodsThis was a health facility-based descriptive cross-sectional study among 432 adults living with cancer, diabetes, chronic kidney disease (CKD), stroke, and hypertension in the Ho Municipality of Ghana. The study adopted the EQ-5D-5L instrument and the Ugandan value set to compute respondents’ HRQoL index. Quantile regression models were used in analysing the data with STATA v17.0 at 95% Confidence Intervals, and statistical significance set at p < 0.05.Results63.7% of our respondents reported having a problem across the five dimensions of the EQ-5D-5L. The most problems were reported in the dimensions “Anxiety/Depression” (94.4%) and “Pain/Discomfort” (91.4%). Divorced/separated respondents (aOR=-0.52, 95% CI=-0.71, -0.33) and those living with comorbidities (aOR=-0.95, 95% CI=-0.15, -0.04,) were less likely to report high index for HRQoL. However, respondents diagnosed with CKD (aOR = 0.26, 95% CI = 0.10, 0.42), diabetes (aOR = 0.28, 95% CI = 0.11, 0.45), hypertension (aOR = 0.35, 95% CI = 0.19, 0.50) and stroke (aOR = 0.26, 95% CI = 0.11, 0.40) were more likely to report higher index than those diagnosed with cancer.ConclusionOur study revealed elevated proportions of reported problems in the “Anxiety/Depression” and “Pain/Discomfort” dimensions, indicating noteworthy concerns in these areas of HRQoL. The prevalent issues reported across HRQoL dimensions are cause for concern, posing potential exacerbation of health conditions. We advocate for collaborative efforts from the Ministry of Health, Ghana Health Service, and relevant stakeholders to scrutinize and implement interventions targeting social and psychological factors. These efforts should specifically address contributors to diminished health-related quality of life, particularly among less educated, divorced, and comorbid individuals.

Partner notification service utilization and associated factors among clients attending anti-retroviral therapy clinics of public health facilities in Gimbi Town, West Ethiopia, 2023: a facility-based mixed-method cross-sectional study

BackgroundPartner Notification Service is among the strategies used to conduct targeted Human Immunodeficiency Virus Testing Service by obtaining information about sexual contacts of index clients to refer for testing. But most people living with Human Immunodeficiency Virus are still unaware of their status, including Ethiopia. Limited studies are available on the magnitude of partner notification service utilization and associated factors in Ethiopia.ObjectiveThe aim of this study was to assess the magnitude of partner notification service utilization and associated factors among people living with Human Immunodeficiency Virus attending anti-retroviral therapy clinics of public health facilities in Gimbi town, West Ethiopia.MethodsA facility-based mixed-method cross-sectional study design was used. Total of 455 study participants were selected by systematic random sampling for quantitative data and health workers were purposively selected for qualitative data until saturation of ideas was reached. The study was conducted from December 1, 2022 to January 30, 2023. Structured questionnaires and key informant interview guides were used for data collection. Quantitative data were analyzed using Statistical Package for Social Science version 25. Open code 4.02 software was used for qualitative data analysis. Frequencies and proportions were used to summarize descriptive statistics. Bivariable and multivariable logistic regression was used to identify associated factors then variables with a p value < 0.05 were declared to have an association with the dependent variable.ResultExactly 298 (65.5%) of the study participants were notified their HIV status to their sexual partners. Factors associated with Partner Notification Service Utilization were depression AOR: 0.12 (95% CI: 0.07, 0.20), urban settlers AOR: 2.21 (95% CI: 1.2, 3.83), fear of support loss AOR: 0.24 (95% CI: 0.14, 0.40) and intimate partner violence AOR: 0.55 (95% CI: 0.31, 0.97). From qualitative part of this study, factors associated to Partner Notification service utilization were fear of stigma, discrimination and fear of divorce.ConclusionTwo-third of the study participants were utilized partner notification service, and efforts are important to prevent depression and intimate partner violence. Local government bodies and stakeholders should implement economic strengthening and strategies to address the rural community for HIV/AIDS prevention. Promotion of supportive and inclusive environment for PLHIV should also considered as way to increase PNS utilization.

Utilization of iron-folic acid supplementation and related factors in pregnant women in Leka Dulecha District, East Wollega Zone, Western Ethiopia: The case study.

To treat neural tube closure abnormalities and maternal anemia during pregnancy, iron and folic acid (FA) supplements are typically necessary. Ethiopian Ministry of Health plan to increase the numbers of pregnant women who take iron and FA supplements from 11% to 50%, and by 2029, to 90% by 2024. Hence, the main objective of this study was to investigate the degree of iron-folic acid supplementation (IFAS) and associated factors among pregnant women receiving antenatal care at Leka Dulecha Woreda public health facilities from May 1 to October 31, 2022. In this study, about 316 pregnant women who visited Leka Dulecha prenatal care services were selected. A facility-based cross-sectional study was conducted. Multivariable logistic regression was utilized to examine parameters associated with the utilization of IFAS. These findings suggest that maternal educational status (adjusted odds ratio, AOR = 2.00, 95% confidence interval, CI [1.5, 3.05]), the timing of the first prenatal consultation (AOR = 1.93, 95% CI [1.47, 2.62]), having a good understanding of anemia (AOR = 1.50, 95% CI [1.00, 2.11]), and a history of anemia during the current pregnancy (AOR = 1.60, 95% CI [1.11, 3.16]) are important factors to consider when promoting adherence to iron-FA supplementation among pregnant women. It is crucial for healthcare providers to address these factors to improve the overall health outcomes for pregnant women attending Leka Delecha Health Facility.

Violence against physicians working in public tertiary care hospital of Bangladesh: a facility-based cross-sectional study

BackgroundViolence against physicians in the workplace is a prevalent global issue, and Bangladesh is no exception. Such violence significantly disrupts healthcare delivery and the attainment of universal health coverage. This...

Determinants of health literacy and its impact on glycemic control among women with gestational diabetes mellitus in a tertiary care hospital, Puducherry - A cross-sectional analytical study.

Health literacy is vital during pregnancy, as maternal health knowledge and behavior have a significant impact on the health of both mother and child. Hence, this study aimed to assess the health literacy status of pregnant women diagnosed with gestational diabetes mellitus (GDM), as well as its associated factors and impact on glycemic control. The facility-based Cross-sectional analytical study was conducted among 200 pregnant women with GDM in a tertiary care hospital. The eligible participants were consecutively selected for the study. The study was conducted from September 2022 to March 2023. A validated semi-structured questionnaire, the Health Literacy Questionnaire (HLQ) for GDM, was used to measure health literacy status. Stata V.17 software was used for data analysis. Out of 200 pregnant women with GDM, the mean (SD) age of the participants is 29.5 (±5.5) years. It was observed that 164 (82%) of the participants had adequate health literacy, whereas 36 (18%) had inadequate health literacy about Gestational Diabetes. Adequate health literacy (HL) was observed among 88.5% of women with controlled blood sugar and 55.1% of women with uncontrolled blood sugar. Results of multivariate logistic regression analysis revealed that pregnant mothers' educational status (PR: 1.8; 95% CI: 1.2-2.5) and glycemic control (PR: 1.4; 95% CI (1.2-1.7) were associated with adequate HL. In conclusion, this study supports the association between adequate HL and glycemic control in pregnant women with GDM. Addressing this gap is essential for healthcare officials and planners to implement programs that promote women's HL during pregnancy, with a focus on low-educated groups.

Adherence to Anti-Retroviral Therapy (ART) and Its Determinants Among People Living with HIV/AIDS at Bonga, Kaffa, South-West Ethiopia.

The scaling-up of antiretroviral therapy (ART) is the greatest accomplishment to reduce the burden of acquired immunodeficiency syndromes (AIDS) to date. However, it requires optimal adherence to be effective. Thus, this study was designed to assess the level of adherence of people living with HIV (PLWH) to ART and its determinants in one of the hardest-hit areas with HIV in Ethiopia. A health facility-based cross-sectional study design was conducted among adult PLWH, age >18 years, and receiving ART in southwest Ethiopia. Data was collected by face-to-face interviews following the Self-Rating Scale Item for drug adherence and from participants' medical cards. The effects of variables related to socio-demographic and socio-economic factors, disease and medication, health facilities, and patients' behavior on ART adherence were analyzed using a binary logistic regression model. The data was analyzed using R software. Self-reported good adherence to ART recorded in this study was 73.1% (n =301/412). The risk of poor adherence was significantly higher among those who were divorced, merchants, used ART for longer durationsand were found in stage IV WHO pathogenesis. Contrarily, those who had a positive perception of the effectiveness of ART had significantly better adherence to ART. Longer duration on ART and frequency of pills taken, ≥3 pills per day, were significantly associated with a low CD4+ cell count (<500 cells/mm3). For each unit increase in medication frequency per day, the likelihood of having a high viral load of >1000 copies/mL was 5.35 times higher. The ART adherence documented in this study was graded as moderately low. Some variables, such as clinical, medical, and behavioral, were found to affect the adherence of people living with HIV to ART. Hence, care providers should be aware of such variables in the process of treatment, follow-up, and monitoring of people living with HIV in the study area.

Pandemic fatigue, behavioral intention and predictors of COVID-19 vaccination among individuals living with HIV in Bench Sheko Zone, in Southern Ethiopia, application of TBP: a facility based cross sectional study.

People living with HIV often face inequalities and negative outcomes, which make them vulnerable. To protect this population and achieve herd immunity, it is crucial for COVID-19 vaccination efforts to prioritize and encourage vaccination among people living with HIV (PLWH). However, in Ethiopia, there is a lack of motivation in this regard. To tackle this issue, a study was conducted in the Bench Sheko Zone of Southwest Ethiopia. The study aimed to assess pandemic fatigue, behavioral intention to get vaccinated, and factors influencing COVID-19 vaccine acceptance among PLWH in that region. A facility-based cross-sectional study was conducted among individuals living with HIV who were over 18 years old in Bench-Sheko Zone, located in Southwest Ethiopia. The study included a total of 590 participants from four ART healthcare facilities within the zone. The researchers utilized the Theory of Planned Behavior to examine the predictors of intention to use preconception care. Multiple linear regression analysis was employed to determine these predictors, with a p-value of less than 0.05 considered as indicative of a significant association. The final analysis of the study involved the use of linear regression analysis, and the measure of association was presented as the standardized B coefficient following a multivariable logistic regression analysis. In the conducted study, the response rate was an impressive 98%. The researchers aimed to investigate the behavioral intention toward the COVID-19 vaccine, which was found to be 55.7%. The average age of the participants in the study was 34.65 ± 6.67. The study was the assessment of pandemic fatigue, which had a mean value of 17.22 ± 5.28. During the multivariate linear regression analysis, four predictor variables were identified. Among these, three variables, namely subjective norm, pandemic fatigue, and age, positively influenced the behavioral intention toward the COVID-19 vaccine. Comprehending these factors can assist healthcare professionals and policymakers in formulating precise interventions and strategies aimed at enhancing the acceptance and adoption of vaccines. The study indicates that individuals living with HIV have shown lower vaccine intention compared to previous research. The study identifies subjective norm, pandemic control measures, income, and age as predictors of individuals' intention to receive the COVID-19 vaccine.

Magnitude of neonatal asphyxia and its predictors among newborns at public hospitals of Wolaita Zone in Southern Ethiopia, 2023.

Neonatalasphyxia is one of preventable causes of neonatal mortality throughout the world. It could be improved by early detection and control of the underlying causes. However, there was lack of evidence on it in the study setting. Thus, the aim of this study was to assess the magnitudeand predictors of neonatal asphyxia among newborns at public hospitals of Wolaita Zone in Southern Ethiopia. A facility-based cross-sectional study was done among 330 mothers with neonates in selected public hospitals. A systematic random sampling technique was used to select the study participants. Data were collected through an interviewer-administered questionnaire and checklist. The collected data were entered into EpiData version 4.6 and exported to SPSS version 26 for analysis. Logistic regression was fitted to examine the association between explanatory variables and outcome variable. In multivariable logistic regression, AOR with 95% CI was reported, and p < 0.05 was used to declare statistically significant variables. The magnitude of neonatal asphyxia was 26.4% with 95% CI: (21.8, 30.9). In multivariable logistic regression analysis primiparity (AOR = 2.63 95%CI 1.47, 4.72), low-birth-weight (AOR = 3.45 95%CI 1.33, 8.91), preterm birth (AOR = 3.58 95%CI 1.29, 9.92), and premature rupture of membranes (AOR = 5.19 95%CI 2.03, 13.26) were factors significantly associated with neonatal asphyxia. In this study, the magnitude of neonatal asphyxia was high. From the factors, premature rapture of the membrane, parity, birth weight of the newborn, and gestational age at birth were significantly associated with neonatal asphyxia. Attention should be given to early detection and prevention of neonatal asphyxia from complicated labor and delivery.

Access to advanced healthcare services and its associated factors among patients with cervical cancer in Addis Ababa, Ethiopia.

This study aimed to assess the extent of access to healthcare services, perception and associated factors among patients with cervical cancer in Addis Ababa, Ethiopia. A facility-based cross-sectional study was conducted from 01 July through 30 August 2023 at two tertiary hospitals. Cases with histopathologic and clinical confirmation of cervical cancer were enrolled using a consecutive sampling technique. Data was collected through a validated questionnaire administered by interviewers using the KoboCollect application. Subsequently, the collected data underwent analysis using Statistical Sciences for Social Sciences (SPSS) version 26.0. Bivariable and multivariable regression models were performed at p ≤ 0.2 and p<0.05 statistical significance, respectively. A total of 391 patients were enrolled in the study. Health facilities were accessible for obtaining general medical services (56.5%), drugs (57.3%), laboratory diagnosis services (57.0%), imaging diagnosis services (56.8%), and radiotherapy services (55.8%) of the patients. Cost of services was affordable only in 11.5% of the cases. Essential anticancer medicines were out of stock for 229 (58.6%) of the patients during the past three months. About two-thirds of the patients have a good perception of access to healthcare services. In multivariable binary logistic regression, admission to the inpatient (AOR: 0.20, 95% CI: 0.06-0.67), joblessness (AOR: 0.19, 95% CI: 0.08-0.46), lower level of income to the extreme poverty line (3567ETB)(64.9 USD) (AOR: 0.19, 95% CI: 0.10-0.35), no CBHI coverage (AOR: 4.16, 95% CI: 1.76-9.85), having social support (AOR: 3.80; 95% CI: 1.96-7.41), and poor dietary practice (AOR: 2.36, 95% CI: 1.28-4.35) were found to have a statistically significant association with perceived good access to healthcare services. Only close to a half of the patients with cervical cancer, in Addis Ababa, have adequate access to healthcare services. Nearly two-thirds of the patients reported perceived good access to the services. Many factors were found to show a statistically significant association with patients' perceived access to healthcare services.

Dietary diversity and associated factors among pregnant women in the Southern Province of Rwanda: A facility-based cross-sectional study.

The inadequate dietary diversity of pregnant women in low- and middle-income countries, including Rwanda, is rising and leading to macro and micronutrient deficiencies. The extent of dietary diversity and the factors contributing to it are unknown in Rwanda. This cross-sectional study, with 612 women who attended antenatal care services in Rwanda's Southern Province, identified determinants of dietary diversity among pregnant women. A multistage sampling scheme was used in which four districts were sampled, thereafter one urban and one rural health centre was sampled in each district and finally, a systematic sample of pregnant women was selected in each sampled health centre. Dietary diversity was measured using Minimum Dietary Diversity for Women (MDD-W), and multiple logistic regression models were fitted to identify factors associated with dietary diversity. Only 44.1% (95% confidence interval (CI) of [40.1%, 48.0%]) of participants had adequate dietary diversity. Approximately 95.4% of participants consumed grains, white roots, and tubers. The food groups that were the least consumed consisted of eggs (n = 99, 16.4%), as well as those consisting of milk and milk products (n = 112, 18.5%). The factors which were positively associated with dietary diversity were owning a radio (adjusted odds ratio [aOR] = 1.90 [95% CI 1.27, 2.85]), maternal education (aOR = 1.85 [95% CI 1.28, 2.65]), having a kitchen garden (aOR = 1.69 [95% CI 1.11, 2.57]) and nutrition knowledge score (aOR = 1.45 [95% CI 1.21, 1.74]) for a five-point increase in nutrition knowledge score. The factors negatively associated with dietary diversity include food insecurity, which reduced the odds of dietary diversity (aOR = 0.19 [0.07, 0.50]) per five-unit increase in food insecurity. Furthermore, the odds of adequate dietary diversity were lower among urban residents than rural residents (aOR = 0.69 [0.47, 1.03]). The household size was associated with dietary diversity with the odds of dietary diversity decreasing by 12% for a five-unit increase in household size (aOR = 0.88 [0.79; 0.99]). 23% had poor nutritional status, indicated by their mid-upper arm circumference (MUAC; < 23 cm). Enhanced nutritional education is needed to improve the nutritional knowledge of this population with particular emphasis on the consumption of animal-source foods. Sensitisation activities promoting ownership of kitchen gardens and radios could improve dietary diversity among Rwanda's pregnant women.

Factors Associated with Malaria in Pregnancy among Women Attending Fort Portal Regional Referral Hospital in Fort Portal City, Western Uganda

Globally, there was a significant decrease in the number of malaria-risk pregnancies between 2007 and 2020. The risk of Plasmodium falciparum or Plasmodium vivax malaria increased by 25% in Africa compared to 2007. Due to the fast-expanding population and associated rise in pregnancies in malaria-endemic areas, the number of people at risk in Africa has increased despite malaria rates declining in the region. This study determined the prevalence and factors associated with malaria in pregnancy among women attending Fort Portal Regional Referral Hospital. This was a single-center health facility-based cross-sectional study. Data was collected using a face-to-face interview through a structured questionnaire from willing participants. After collecting the data, the principal investigator checked the completed questionnaires for consistency and completeness. Data was coded, cleaned, and entered into the computer using Microsoft Excel, and then analyzed using SPSS version 20. Logistic regression analysis was done to ascertain the relationship between dependent and independent variables. Descriptive statistics were summarized in the form of frequency tables, pie charts, p-values, and odds ratios. A total of 253 pregnant mothers attending ANC were enrolled in this study. The majority (38.3%) of the study participants were aged 30-39 years, attained secondary education (52.2%), earned 100,000–200,000 per month (56.9%), and were housewives (51.0%). In this study, the prevalence of malaria in pregnancy was 10.3%. Age, level of education, income status, and residence, use of an ITN, gravidity, and ANC follow-up were significantly associated with malaria in pregnancy at multivariate logistic regression analysis. Malaria continues to be a major public health issue among pregnant mothers. Age, level of education, income status, and residence, use of an ITN, gravidity, and ANC follow-up were factors significantly associated with malaria in pregnancy. Keywords: Pregnancies, Malaria, Plasmodium, ITN, ANC.

Infant feeding practices and associated factors among HIV-positive mothers of infants aged 0–6 months at public health facilities in Addis Ababa, Ethiopia

BackgroundIn the era of HIV infection, exclusive breast-feeding highly recommended for infants aged less than 6 months. Avoidance of exclusive breast-feeding by HIV-infected mothers recommended when replacement feeding is acceptable, feasible, affordable, sustainable and safe. The prevalence of exclusive breast-feeding has remained very low worldwide. Despite this fact, there is limited information on infant feeding practices of HIV-positive mothers and factors that affect the practice in the current study area.ObjectiveThis study assessed the magnitude of infant feeding practice and associated factors among HIV-positive mothers of infants aged 0–6 months at public health facilities in Addis Ababa, Ethiopia.MethodsA multicenter facility-based cross-sectional study design was employed among a total of 397 study participants. The study participants were selected using a simple random sampling technique. The completeness of the data was checked, coded, cleaned and entered into Epi-data version 4.6 software, and exported to SPSS version 24 for analysis. Descriptive statistics and Binary logistic regression model were employed for the analysis with adjusted odds ratio (AOR) with a 95% CI and a P value ≤ 0.05 to determine the strength of association between infant feeding practice and its independent factors.ResultsThe overall magnitude of appropriate infant feeding practice among HIV-positive mothers was 82.6% (95% CI 80.9–88.2). Good knowledge of mother’s toward infant feeding (AOR: 1.26, 95%, CI 1.11–3.34), better household monthly income, ≥ 6001 Ethiopian birr (AOR: 1.62, 95% CI 1.33–5.14) and favorable attitude of mother’s toward infant feeding (AOR: 1.71, 95% CI 1.01–2.92) were statistically significant associated factors with the recommended way of infant feeding practice.Conclusions and recommendationsHence, the current study area is the capital city of the Ethiopia, where a relatively educated population lived in, there was an opportunity for better income, and appropriate infant feeding practice among HIV-positive mothers was found slightly higher than even the overall national target (70%) that was planned by 2020. Therefore, different stakeholders should develop strategic plan to excel females’ education coverage and thereby their knowledge and attitude toward infant feeding to fully eradicate mother-to-child transmission of diseases.

Self-care practice and its barriers among diabetes patients in North East Ethiopia: A facility-based cross-sectional study.

Diabetes prevention and management through self-care practice is critical to reducing severe complications and death due to diabetes. Data on the prevalence of self-care practices will help us to design and implement prevention and management strategies to foster adherence and compliance with the interventions. This study was intended to assess self-care preparation and its barriers among diabetes patients in Northeast Ethiopia. A facility-based cross-sectional study was conducted among diabetes patients visiting Debre Berhan Town Public Health Institutions from March 10, 2021- April 10, 2021. A systematic random sampling technique was utilized to select 392 samples. Data were collected using a structured questionnaire adapted from Summary of Diabetes Self-Care Activities Measures. Reliability analysis was done using Cronbach's alpha test, and the Hosmer and Lemeshow test also checked for model fitness. Bivariate and multivariable binary logistic regression was done to identify the factors associated with dietary practices. For all statistically significant tests, p- a value < 0.05 was used as a cut-off point. The mean age of the respondents was 47.1 years, with a standard deviation (SD) of ± 13.4 years. The mean adherence to self-care practice was 29.00 ± 10.37 SD. More than half, 218 (61.1%) of the study subjects had poor self-care practices. In the multivariable logistic regression analysis, being a governmental worker (AOR = 7.06 (1.61-30.9) and having social support from partners (AOR = 5.83(3.01-11.3) showed a statistically significant association with good self-care practice. The current study showed that the overall level of self-care practice of study subjects was poor. Therefore, health facilities should provide adequate health education and promotion activities to enhance patients' level of adherence. In addition, families, partners, or friends of diabetes patients should be informed about their essential roles in patients' self-care practice.

Diabetic peripheral neuropathy among adult type 2 diabetes patients in Adama, Ethiopia: health facility-based study

Diabetic peripheral neuropathy is the most prominent microvascular complication of diabetes mellitus and the leading cause of ulceration, amputation, and extended hospitalization. Evidence regarding the magnitude and factors associated with diabetic peripheral neuropathy is not well documented in Ethiopia, particularly in the study area. A facility-based cross-sectional study was conducted among 293 adult type 2 diabetic patients who were on treatment and follow-up from May to June 31, 2023. To select participants in the study, a systematic random sampling method was utilized. Data were collected using semi-structured questionnaires and medical record reviews. The Michigan Neuropathy Screening Instrument (MNSI) was employed to assess diabetic peripheral neuropathy. To model the association between diabetic peripheral neuropathy and independent variables, binary logistic regression model was used. An adjusted odds ratio with a 95% confidence interval was used to estimate the association and statistical significance was proclaimed at a p-value < 0.05. The magnitude of diabetic peripheral neuropathy was 14.3% (95% CI 10.4–18.0). It was 13.4% (95% CI 8.4–19.1) among males and 15.4% (95% CI 10.1–22.2) among females. Age above 60 years (AOR = 5.06, 95% CI 1.60–15.96), being rural resident (AOR = 2.41; 95% CI 1.15–5.06), duration of diabetes above 5 years (AOR = 2.48, 95% CI 1.16–5.27) and having comorbid hypertension (AOR = 2.56, 95% CI 1.24–5.28) were independently associated with diabetic peripheral neuropathy. One in seven adult type 2 diabetes patients in the study area had diabetic peripheral neuropathy. Factors such as age, place of residence, duration of diabetes, and comorbid hypertension showed positive associations with diabetic peripheral neuropathy. Thus, it is imperative to give special consideration to diabetic patients who are elderly, living in rural areas, experiencing a prolonged duration of diabetes, or dealing with comorbid hypertension.

Undiagnosed hypertension and associated factors among long-distance bus drivers in Addis Ababa terminals, Ethiopia, 2022: A cross-sectional study.

Hypertension is a major public health problem that is often unrecognized, and its detection and control should be prioritized. The level of undiagnosed hypertension and its associated factors among long-distance bus drivers in Ethiopia is unknown. This study aimed to assess the magnitude of undiagnosed hypertension and its associated factors among long-distance bus drivers in Addis Ababa bus terminals. A facility-based cross-sectional study was conducted on 391 long-distance bus drivers from December 15, 2021, to January 15 2022 at five cross-country bus terminals in Addis Ababa. A standardized and structured questionnaire was adapted based on the WHO stepwise approach to a non-communicable disease study and translated into Amharic. Data were coded, cleaned, and entered using Epi-data version 4.6 and exported to SPSS version 26. Logistic regression analysis was performed. Variables with a P-value < 0.25 in the bivariable analysis were selected for multivariable logistic regression analysis. Independent variables with a P-value < 0.05 were considered statistically significant. The magnitude of association between independent and dependent variables was measured by odds ratio with a 95% confidence interval. In this study, 391 study participants were involved with a response rate of 97.1%. The prevalence of undiagnosed hypertension was 22.5% (CI: 18.7%, 26.6%). Poor level of knowledge (AOR: 2.00, CI: 1.08, 3.70), long duration of driving per day (AOR: 2.50, 95% CI: 1.37-4.56), habit of chewing of chat (AOR: 2.61, 95% CI: 1.44, 4.73), regular alcohol consumption (AOR = 3.46; 95% CI: 1.70, 7.05), overweight (AOR:3.14, 95%CI: 1.54,6.42) obesity (AOR: 3.21, 95% CI 1.35, 7.61) and regular physical exercise (AOR: 0.16, 95% CI: 0.09, 0.29) were statistically significantly associated with undiagnosed hypertension. This study revealed that the prevalence of undiagnosed hypertension among long-distance bus drivers was 22.5%, which was associated with modifiable behavioral factors, lack of regular physical exercise, lack of adequate awareness and high body mass index. Stakeholders must implement the necessary preventive measures. These include increasing the level of awareness of hypertension among long-distance drivers and developing prevention of hypertension strategies and policies focusing on lifestyle and behavioral modifications.

Prevalence of Rifampicin resistance tuberculosis among presumptive tuberculosis patients in Egypt-2021: a national health facility-based survey

BackgroundThe magnitude of MDR-TB cases was noticeable in Egypt. However, the last national survey was 11-years ago. The current survey was conducted to determine the prevalence of rifampicin resistance among sputum smear-positive pulmonary tuberculosis patients in Egypt.MethodsA national health facility-based cross-sectional study was conducted in 14 randomly selected governorates in Egypt between August 2020 and September 2021. All presumptive TB cases, either new or previously treated according to WHO definitions, with no gender, age, or nationality limitations, and provided informed consent were included in the study. Each patient completed a case report form (CRF). The CRF included socio-demographic and clinical data. Sputum samples were collected according to standard techniques and cultured on Lowenstein-Jensen (L-J) medium. Gene X-pert test was carried out first on the samples for simultaneous identification of MTB and rifampicin resistance. The prevalence of RR was calculated using crude, cluster, and weighted methods. Factors associated with RR were analyzed by bivariate and multivariate techniques.ResultsAmong the total 849 presumptive TB patients enrolled in the study, 710 (83.6%) patients were subjected to Gene X-pert testing (MTB/RIF). The crude prevalence of RR was 3.32% (95% CI: 1.89–4.76%) among the new cases and 9.46% (95% CI: 2.63–16.29%) among the retreated cases with an overall estimate of 3.99%; (95% CI: 2.51–5.47%). By cluster analysis the overall prevalence of RR was 5.01% (95% CI: 2.90–7.13). Factors associated with the prevalence of RR were co-morbidity with bronchial asthma, drug abuse and history of contact with a family member with TB.ConclusionThe prevalence of RR among either new or retreated cases TB patients was lower than the previous Egyptian rates in 2010–2012. The strongest predictor associated with RR was comorbidity with bronchial asthma.

Electronic medical record systems data use in decision-making and associated factors among health managers at public primary health facilities, Dodoma region: a cross-sectional analytical study.

Tanzania has shown some improvements in the adoption of electronic medical record (EMR) systems in public health facilities; however, the rate of utilization of data generated from EMRs among health managers is not well documented. This study aims to assess the use of electronic medical record systems data in decision-making among health managers at public primary health facilities in Dodoma Region, Central Tanzania. A facility-based quantitative cross-sectional analytical study was conducted among 308 randomly selected health managers. A self-administered questionnaire supplemented with documentary review was used. Descriptive summary statistics and bivariable and multivariable logistic regression analyses (crude and adjusted odds ratios) were used. A P-value of <0.05 was used to declare statistically significant associations. Overall, more than a third (40.6%) of the health managers, that is 174 of the 308 included in the study, reported using data generated by EMR systems in decision-making. One-third (33.4%) of the health managers were adequately using data generated by EMR systems, of which 39.3% used data to support continuous quality improvement initiatives. Among the facilities visited, only nine (30%) had good documented EMR systems data use. Access to computers [adjusted odds ratio (AOR) = 4.72, 95% confidence interval (CI): 1.65, 13.48, p-value (p) = 0.004] and discussions on EMRs during meetings (AOR = 2.77, 95% CI: 1.01, 7.58, p = 0.047) were independent predictors of EMR system data use. Those who reported having EMR systems in all working areas were seven times more likely to use EMR system data (AOR = 7.23, 95% CI: 3.15, 16.59, p = 0.001). The respondents with good perceived EMR system information quality were more likely to use EMR system data (AOR = 2.84, 95% CI: 1.50, 5.39, p = 0.001) than those with poor perception. Furthermore, health managers who had excellent knowledge of computers and data use had higher odds of using EMR system data (AOR = 1.84, 95% CI: 3.38, 10.13, p = 0.001) compared with their counterparts. The findings of this study indicate that utilization of EMR system data in decision-making among health managers was optimal. It was found that training in itself is insufficient to improve use of EMR, which points to more organizational aspects of work routine as a challenge. Hence, a comprehensive approach that addresses these factors is essential for maximizing EMR system data use in decision-making.

Factors associated with utilization of cervical cancer screening services among HIV-positive women aged 18 to 49 years at Lira regional referral hospital, Northern Uganda

BackgroundWomen with HIV have a higher risk of getting cervical cancer due to induced immunosuppression. Though this burden could be avoided through early identification and appropriate management, there is a paucity of information about the utilization of cervical cancer screening (CCS) services in Lira City, Uganda. This study investigated the level and factors associated with the utilization of cervical cancer screening services among HIV-positive women aged 18 to 49 years at Lira Regional Referral Hospital, Lira City, Uganda.MethodsWe conducted a facility-based cross-sectional study employing quantitative techniques. We used consecutive sampling to recruit 297 HIV-positive women at the ART clinic of Lira Regional Referral Hospital. A structured researcher-administered questionnaire was used to collect data. Descriptive statistics were performed to summarize the data. A modified Poisson regression using robust standard errors was performed to ascertain the factors associated with the utilization of cervical cancer screening. Prevalence ratios at 95% confidence intervals were reported.ResultsOut of 297 respondents, 175(58.9%) utilized cervical cancer screening in this study. The factors found to be associated with CCS were; having ever heard of CCS (Adjusted Prevalence Ratio [PR] 1.80, 95% CI 1.31–2.49, p < 0.001), knowing where CCS is done (Adjusted PR 1.99, 95% CI 1.42–2.81, p < 0.001), fear of CCS outcomes (Adjusted PR 0.67, 95% CI 0.54–0.84,p < 0.001), not knowing whether CCS is beneficial or not (Adjusted PR 0.39, 95% CI 0.20–0.75,p = 0.005) and having friends/relatives who screened for cervical cancer (Adjusted PR 1.31, 95% CI 1.09–1.59, p = 0.005).ConclusionThe level of utilization of cervical cancer screening services among HIV-positive women was suboptimal. Implementation of structured interventions aimed at improving cervical cancer screening awareness among HIV-positive women is crucial. Additionally, to increase opportunities for screening and knowledge on cervical cancer prevention, screening programs can target HIV-positive women during their routine clinic visits.

Maternal sepsis and factors associated with poor maternal outcomes in a tertiary hospital in Tigray, Ethiopia: a retrospective chart review

BackgroundMaternal sepsis is the third leading cause of maternal death in the world. Women in resource-limited countries shoulder most of the burdens related to sepsis. Despite the growing risk associated with maternal sepsis, there are limited studies that have tried to assess the impact of maternal sepsis in resource-limited countries. The current study determined the outcomes of maternal sepsis and factors associated with having poor maternal outcomes.MethodsA facility-based retrospective cross-sectional study design was employed to assess the clinical presentation, maternal outcomes, and factors associated with maternal sepsis. The study was conducted in Ayder Comprehensive Specialized Hospital, Tigray, Ethiopia, from January 1, 2017, to December 31, 2021. Sociodemographic characteristics, clinical characteristics and outcomes of women with maternal sepsis were analyzed using a descriptive statistic. The association between dependent and independent variables was determined using multivariate logistic regression.ResultsAmong 27,350 live births, 298 mothers developed sepsis, giving a rate of 109 maternal sepsis for every 10,000 live births. There were 22 maternal deaths, giving rise to a case fatality rate of 7.4% and a maternal mortality ratio of 75 per 100,000 live births. Admission to the intensive care unit and use of mechanical ventilator were observed in 23.5% and 14.1% of the study participants, respectively. A fourth (24.2%) of the mothers were complicated with septic shock. Overall, 24.2% of women with maternal sepsis had severe maternal outcomes (SMO). Prolonged hospital stay, having parity of two and above, having the lung as the focus of infection, switchof antibiotics, and developing septic shock were significantly associated with SMO.ConclusionsThis study revealed that maternal sepsis continues to cause significant morbidity and mortality in resource-limited settings; with a significant number of women experiencing death, intensive care unit admission, and intubation attributable to sepsis. The unavailability of recommended diagnostic modalities and management options has led to the grave outcomes observed in this study. To ward off the effects of infection during pregnancy, labor and postpartum period and to prevent progression to sepsis and septic shock in low-income countries, we recommend that concerted and meticulous efforts should be applied to build the diagnostic capacity of health facilities, to have effective infection prevention and control practice, and to avail recommended diagnostic and management options.

Factors Associated with Self-Care Practice among Adult Diabetes Patients

Introduction: Diabetes mellitus is a major public health problem worldwide, and the prevalence of diabetes mellites is steadily increasing in developing countries including Ethiopia. Adherence to diabetes self-care activities is a vital strategy for the reduction in diabetes mellitus. This study aimed to assess the level of self-care practice and its associated factors among adult diabetes patients in Tercha Zonal diabetes center: A Southern Nation Nationality of Ethiopia. Methods: An facility-based cross-sectional study was conducted among 213 diabetes mellitus patients follow-up at Tercha Zonal diabetes center selected by systematic random sampling. Data were entered into Epi-Data version 4.6 and exported to SPSS version 25 for analysis. Both descriptive and inferential statistics were used to describe and test the association between selected variables. Statistical significance was declared at p-value &lt;0.05. Results: Out of the 213 study participants, only 84 (39.4%) had good self-care practices. The multivariate logistic regression analysis revealed that attending secondary education (AOR=16.015,(95%CI:1.925-133.251),P=0.01] and college and above [AOR=89.553, (95%CI:9.732–824.021),P&lt;0.001]and having diabetes complications [AOR=0.412, (95%CI:0.204 – 0.832), P=0.013] were significantly associated with good self-care practice. Conclusion: The study revealed that a significant number of the study participant have poor self-care practices in the prevention and control of diabetes mellitus. Educational level, and having diabetes complications were found statistically significantly associated with a good level of self-care practice. Therefore, all frontline healthcare providers should provide basic information and counseling regarding diabetes self-care practice.