Hospitals Of Amhara Regional State Research Articles

Balance impairment and associated factors among stroke survivors in public hospitals of Amhara regional state: a multicenter cross-sectional study

IntroductionBalance impairment is one of the common impairments in patients after stroke. It can lead to depression reduced speed of mobility, dependent on assistive device and reduce quality of life. However, evidence on balance impairment and its risk factors among stroke survivors in Ethiopia was lacking particularly in the study area. Therefore, this study aimed to investigate prevalence and associated factors of balance impairment among stroke survivor’s attendee at an outpatient clinic in Amara regional state comprehensive specialized hospital.MethodsAn institutional based cross-sectional study was conducted from April1-June 30, 2022. A total of 400 participants were selected using the systematic random sampling technique. Standard Berg balance scale tool and semi-structure questionnaire was used. Multicollinearity and model fitness were checked. Variables with a p-value of less than 0.25 in the Bivariable regression were entered into a multivariable logistic regression and p value < 0.05 was used as cutoff point for significant variables.ResultThe prevalence of balance impairment was 51.5% (95% CI (46.58, 56.39). Being depressed (AOR = 12.25:95% CI (4.727, 31.779), using walking aids (AOR = 8.76:95%CI3.469, 22.117)), abnormal speed (AOR = 6.73:95%CI (2.671, 16.977)), did not have physiotherapy treatment (AOR = 3.96:95%CI (1.483, 10.586), and unmarried (AOR = 2.71, 95% CI = 1.061, 6.903) were significantly associated with balance impairment.Conclusion and recommendationThe prevalence of balance impairment in the study was high. Being depressed, use walking aids, did not have physiotherapy treatment, abnormal speed of mobility, and unmarried were significantly associated factors. Therefore; it is better to give greater emphasis for those factors.

Expression of concern: “Practice of non-pharmacological post-operative pain management and associated factors among nurses working in public referral hospitals of Amhara regional state, Ethiopia, 2019” [Int. J. Africa Nurs. Sci. 20 (2024) 100642]

Expression of concern: “Practice of non-pharmacological post-operative pain management and associated factors among nurses working in public referral hospitals of Amhara regional state, Ethiopia, 2019” [Int. J. Africa Nurs. Sci. 20 (2024) 100642]

Level of medication adherence and its determinants of cardiovascular disease patients attending at specialized teaching hospitals of Amhara regional state, Ethiopia: a multicenter cross-sectional study.

Non-adherence to medication in patients with cardiovascular disease continues to be a main cause of suboptimal management, increased morbidity and mortality, and increased healthcare expenses. The present study assessed the level of medication adherence and its determinants of cardiovascular disease patients. An institutional-based multicenter cross-sectional study was conducted with patients with cardiovascular disease in Northwest Ethiopian teaching hospitals. The level of medication adherence was evaluated using a standardized questionnaire of the Adherence in Chronic Disease Scale (ACDS). To find determinants of the level of medication adherence, an ordinal logistic regression model was employed. Statistics were significant when P ≤ 0.05 at a 95% confidence interval (CI). In the end, 336 participants were included in the research. According to this study, one-third of patients had low medication adherence, half had medium adherence, and one-fifth had high medication adherence. Elderly patients [adjusted odds ratio (AOR) = 2.691; 95% confidence interval (CI), 1.704-4.251; P < 0.000], marital status (AOR = 1.921; 95% CI, 1.214-3.039; P = 0.005), alcoholic patients (AOR = 2.782; 95% CI, 1.745-4.435; P < 0.000), Patients without physical activity (AOR = 1.987; 95% CI 1.251-3.156; P = 0.004), non health insurances (AOR = 1.593; 95% CI 1.003-2.529; P = 0.049), sever Charles comorbidity index (AOR = 2.486; 95% CI 1.103-5.604; P = 0.028), patients with polypharmacy (AOR = 2.998 (1.817-4.947) P < 0.000) and, manypolypharmacy (AOR = 3.031 (1.331-6.898) P = 0.008) were more likely to have low medication adherence. The current study concluded that one-third of study participants had low medication adherence. Older age, marital status, drinker, physical inactivity, drug source, comorbidity, and polypharmacy all contributed to the low level of medication adherence. To improve patients with cardiovascular disease's adherence to their medications, intervention is necessary.

Experience and perceptions of healthcare providers on clinical management and care of near-miss infants: a qualitative content analysis

IntroductionNeonatal Near Miss (NNM) refers to neonates with severe complications who almost died but survived immediately after birth. In Ethiopia, the prevalence of NNM has been assessed using a validated Neonatal Near-Miss Assessment Scale. However, understanding the experiences and perceptions of healthcare providers in the clinical management and care of NNM infants remains unexplored. The aim was to investigate the determinants contributing to the survival of neonatal near-miss babies and to identify any barriers encountered, as reported by the experiences of healthcare providers in public hospitals of Amhara Regional State, northwest Ethiopia.MethodsSemi structured interviews were used to collect data from 25 midwives, nurses, and pediatricians with at least six months of prior experience in one of the labor wards or neonatal intensive care units at one of the four public health hospitals in the Amhara Regional state of northwest Ethiopia included in a large intervention study assessing a NNM scale. Purposeful sampling was used, selecting participants based on their experiences related to the aim of this study. The participants had a varying level of education and years of experience to care for NNM infants. The average age of the healthcare providers was 31 years, with 7 years of work experience. The transcripts of the interviews with the healthcare providers were analyzed using qualitative content analysis.ResultsThe experience and perceptions of healthcare providers was described in the main category “A sense of hopelessness when caring for the baby” capturing a broader emotional and professional aspect, while the subcategories “Unclear responsibilities discharging one’s mission”, “Provision of kangaroo mother care” and “Quick action required at birth” are more specific and practical. Healthcare providers perceived a sense of hopelessness when caring for the NNM infant, particularly providing Kangaroo Mother Care (KMC) and quick actions when required at birth to save the life of the infant.ConclusionUnclear responsibilities and a sense of hopelessness could have acted as barriers, hindering the ability of healthcare providers to fulfill their mission of taking swift actions and providing KMC to NNM infants, thus impacting their ability to save the lives of these infants. Healthcare providers’ and parents’ attitudes must be changed towards hope rather than hopelessness when caring for NNM infants.

Practice of non-pharmacological post-operative pain management and associated factors among nurses working in public referral hospitals of Amhara regional state, Ethiopia, 2019

BackgroundPostoperative pain is a combined effect of several unpleasant sensory, emotional and mental experiences. Patient’s previous experiences, nature and duration of surgery, site and size of the incision and the extent of surgical trauma are some of the factors affecting the degree of post-operative pain. ObjectivesTo assess practice of non-pharmacological post-operative pain management and associated factors among nurses working in public referral hospitals of Amhara regional state, Ethiopia. MethodInstitutional based cross-sectional study was conducted among nurses working in public referral hospitals of Amhara regional state, Ethiopia from March to April 2019. Census method was employed to select study participants. Data were entered into Epi info version 7.2.0.1 and exported to SPSS window version 20 for analysis. Binary and multivariable logistic regression was used to see the association between dependent and independent variables. The odds ratio with a 95 % confidence interval was computed. P-value < 0.05 was used to declare association. ResultsThree hundred nurses working in post-operative units of selected referral hospitals of Amhara regional state were involved in the study. The respondents’ ages (Mean ± SD.) were (29.8 ± 7.3) years and their experience (Mean ± SD) post-operative unit was (3.8 ± 3.3) years. Majority (59.7 %) of the respondents were females. This study revealed that about 50.2 % of nurses were not applied non-pharmacological post-operative pain management techniques for their patients. Nurse’s educational status, attendance of training, attitude of nurses, willingness of patients, experience in nursing, marital status and working unit were associated with practice of non-pharmacological post-operative pain management with p-value of < 0.05. ConclusionIn this study, nearly half of nurses didn’t apply non-pharmacologic pain management techniques for patients when they had pain. In-service training and educational development are recommended for nurses about non-pharmacologic pain management.

Pregnant women's knowledge of birth defects and their associated factors among antenatal care attendees in referral hospitals of Amhara regional state, Ethiopia, in 2019.

Birth defects (BDs) are structural, behavioral, functional, and metabolic disorders present at birth. Due to lack of knowledge, families and communities stigmatized pregnant women following the birth of a child with birth defects. In Ethiopia, there was limited evidence to assess the level of knowledge among pregnant women despite increasing magnitude of birth defects. This study aims to assess pregnant women's knowledge of birth defects and its associated factors among antenatal care (ANC) attendees in referral hospitals of Amhara regional state in 2019. Between 1 June and 30 June 2019, 636 pregnant women receiving prenatal care participated in an institution-based cross-sectional study. The approach for sampling was multistage. A semi-structured pretested interviewer-administered questionnaire was used to collect data. Data were entered in EpiData version 4.6 and analyzed using SPSS version 25 software. A bivariable and multivariable logistic regression model was used. Odds ratio with 95% confidence interval and p-value of ≤0.05 declared statistical significance association. A total of 636 pregnant women were included in the analysis. Accordingly, pregnant women's knowledge of birth defects was found to be 49.2% (95% CI: 45.4-53.1). Age group of <25 years (AOR = 0.16, 95% CI: 0.04-0.61), urban residence (AOR = 6.06, 95% CI: 2.17-16.94), ANC booked before 20 weeks of gestational age (AOR = 3.42, 95% CI: 1.37-8.54), and ever heard on birth defects (AOR = 5.00, 95% CI: 1.87-13.43) were significantly associated factors with pregnant women's knowledge of birth defects. Approximately half of the pregnant mothers were aware of birth defects. Addressing pre-pregnancy and pregnancy health information and education particularly on the prevention of birth defects is recommended.

Prevalence of Methicillin-ResistantStaphylococcus aureus and Multidrug-Resistant Strains from Patients Attending the Referral Hospitals of Amhara Regional State, Ethiopia.

Staphylococcus aureus (S. aureus) causes different types of human infections and can develop resistance to many antibiotics. There is a scarcity of data on the mecA gene and multidrug-resistant (MDR) strain distribution of this organism in developing countries, such as Ethiopia. This study investigated the presence of mecA gene and MDR profile of S. aureus among patients attending referral hospitals of Amhara regional state. Of the total of 110 isolates collected from Amhara regional referral hospitals, 70 MDR isolates were further processed for isolation of S. aureus mecA gene. Genomic DNA was isolated using a Sigma-Aldrich genomic DNA isolation kit for Gram-positive bacteria. Amplification of S. aureus mecA gene was performed with the amplicon size of 533 bp. Antimicrobial susceptibility test including methicillin resistance was determined by the Kirby-Bauer disc diffusion method. The majority of the isolates were recovered from patients aged less than 5 years (51; 36.7%) and the least number of isolates was recorded in age group greater than 60 years (6; 4.3%). Most of the isolates were from blood (61; 43.9%), followed by wounds (45; 32.4%). A high resistance rate was observed in penicillin (81; 73.6%), followed by cotrimoxazole (78; 70.9%), ceftriaxone (76; 69%), erythromycin (66; 60%), and tetracycline (65; 59.1%). Phenotypically, considering cefoxitin as a surrogate marker, 38 (34.5%) of the isolates were methicillin-resistant. The overall MDR isolates were 80 (72.7%). The PCR amplification result of the mecA gene was 14 (20%). Conclusions and Recommendations. High rates of MDR and methicillin-resistantS. aureus were reported. PCR amplification indicated that 20% of MRSA isolates were the mecA gene carriers. Large-scale studies for the detection of MDR strains of S. aureus including MRSA using molecular techniques should be encouraged in the Amhara region.

Healthcare professionals' knowledge, attitude and its associated factors toward electronic personal health record system in a resource-limited setting: A cross-sectional study.

Electronic personal health record (e-PHR) system enables individuals to access their health information and manage it themselves. It helps patient engagement management of health information that is accessed and shared with their healthcare providers using the platform. This improves individual healthcare through the exchange of health information between patients and healthcare providers. However, less is known about e-PHRs among healthcare professionals. Therefore, this study aimed to assess Health professionals' Knowledge and attitude and its associated factors toward e-PHR at the teaching hospital in northwest Ethiopia. An institution-based cross-sectional study design was used to determine healthcare professionals' knowledge and attitude and their associated factors toward e-PHR systems in teaching hospitals of Amhara regional state, Ethiopia, from 20 July to 20 August 2022. Pretested structured self-administered questionnaires were used to collect the data. Descriptive statistic was computed based on sociodemographic and other variables presented in the form of table graphs and texts. Bivariable and multivariable logistic analyses were performed with an adjusted odds ratio (AOR) and 95% CI to identify predictor variables. Of the total study participants, 57% were males and nearly half of the respondents had a bachelor's degree. Out of 402 participants, ~65.7% [61-70%] and 55.5% [50-60%] had good knowledge and favorable attitude toward e-PHR systems, respectively. Having a social media account 4.3 [AOR = 4.3, 95% CI (2.3-7.9)], having a smartphone 4.4 [AOR = 4.4, 95% CI (2.2-8.6)], digital literacy 8.8 [(AOR = 8.8, 95% CI (4.6-15.9)], being male 2.7 [AOR = 2.7, 95% CI (1.4-5.0)], and perceived usefulness 4.5 [(AOR = 4.5, 95% CI (2.5-8.5)] were positively associated with knowledge toward e-PHR systems. Similarly, having a personal computer 1.9 [AOR = 1.9, 95% CI (1.1-3.5)], computer training 3.9 [AOR = 3.9, 95% CI (1.8-8.3)], computer skill 19.8 [AOR = 19.8, 95% CI (10.7-36.9)], and Internet access 6.0 [AOR = 6.0, 95% CI (3.0-12.0)] were predictors for attitude toward e-PHR systems. The findings from the study showed that healthcare professionals have good knowledge and a favorable attitude toward e-PHRs. Providing comprehensive basic computer training to improve healthcare professionals' expectation on the usefulness of e-PHR systems has a paramount contribution to the advancement of their knowledge and attitude toward successfully implementing e-PHRs.

Incidence of unplanned intensive care unit admission following surgery and associated factors in Amhara regional state hospitals

Unplanned postoperative critical care admission poses a potential risk to patients and places unanticipated pressure on clinical services and it has become an important parameter to assess patient safety in perioperative services. This study was aimed to determine the incidence of unplanned intensive care unit admission following surgery and the associated factors. A multi-center cross-sectional study was conducted on postoperative patients admitted to the ICU of three hospitals located in the Amhara region. Data were collected via a structured survey tool and analyzed using SPSS version 23 software with binary logistic regression analysis. The statistical significance to identify patient, anesthetic and surgical related factors in the preoperative, intraoperative, and postoperative period was < 0.05 for multivariable regression with a 95% confidence interval. Predominantly patients were admitted to the ICU in an unplanned manner. ASA status, preoperative hemoglobin (Hgb) level, intraoperative estimated blood loss, and adverse events occurring in the operating room were significantly associated with intensive care unit admission following surgery. Patients who had a low preoperative Hgb value were 35.1 times more likely to be admitted to the intensive care unit in an unplanned manner compared with their counterparts [(Adjust odds ratio (AOR) 35.16; CI 12.82, 96.44)]. Patients with ASA II and III were 19.4 and 16.2 times more likely to be admitted to ICU in an unplanned way compared to patients who had ASA I physical status [(AOR 51.79; CI 8.28, 323.94) (AOR 67.8 CI 14.68, 313.53)]. Unplanned ICU admission after surgery was high in this study, suggesting poor perioperative planning, risk stratification, and optimization of patients.

Assessment of perioperative anesthesia record sheet completeness: A multi-center observational study

BackgroundAnesthesia record is an essential part of perioperative patient management and, it is one of the global patient safety challenges. The aim of this study is to assess the completeness of perioperative anesthesia record sheets in Amhara regional state hospitals of Ethiopia. MethodsA retrospective review of anesthetic records was employed for patients who underwent surgery in Amhara Regional State Hospitals of Ethiopia from December 1, 2019, to February 29, 2020. All the intraoperative, preoperative, and postoperative data completeness of anesthesia record sheets was assessed using a structured checklist. ResultsA total of 420 perioperative anesthetic records were included in this study. The basic preoperative history was documented in less than 80% of anesthesia record sheets. A physical examination was done and the results of the basic investigations were recorded in less than 75% of anesthesia record sheets. The name and dose of anesthetic medications were documented in 91% of the anesthesia records sheets. The completeness of parameters related to postoperative plans and orders was less than 70%. ConclusionThe completeness of perioperative anesthesia record was poor in Amhara regional state hospitals of Ethiopia. Anesthesia professionals should document all the necessary perioperative parameters in the anesthesia record sheet.

Low back pain and associated factors among obstetrics care providers in public hospitals of Amhara Regional State, Ethiopia: a cross-sectional study

ObjectivesAlthough the study of low back pain (LBP) among healthcare workers in Ethiopia is becoming common, it mainly focused on nurses leaving obstetrics care providers aside. The objective of this...

Perioperative patient satisfaction and its predictors following surgery and anesthesia services in North Shewa, Ethiopia. A multicenter prospective cross-sectional study

IntroductionPatient satisfaction is a relative and complex concept, that mainly depends on the balance between patient's expected and perceived quality of care. Measuring patient satisfaction is important to assess the continuous quality and improvement in anesthesia services, highly affected by anesthetist patient interaction, perioperative anesthetic management and postoperative follow up. The aim of this study was to assess perioperative adult surgical patient satisfaction and its predictors following surgery and anesthesia services in three general Hospitals in a low income country. MethodsMulticenter prospective cross-sectional study was conducted in all general hospitals found in North Shewa Amhara Regional State hospitals from February to April 2021. After obtaining ethical approval from the institutional review board, 411 willing patients have participated in this study. Data was collected by chart review and face-to-face questions after 24 h of the postoperative period. The level of patient satisfaction was measured via a 5-point Likert scale. Descriptive statistics were presented in frequency and percentage. Both bivariate and multivariate logistic regression models were fit to identify the variables, which had an association with the outcome variable. P-values<0.2 for bivariate and <0.05 for multivariate and adjusted odds ratio were used to consider statistically significant. This study is registered with research unique identifying number of “researchregistry7502”. ResultAmong 411 participants with a response rate of 96.9%; 61.8% were females and 54.7% had surgery under spinal anesthesia. The overall patient satisfaction was 64%. History of anesthesia exposure, premedication, spinal anesthesia and postoperative pain were predictive factors for patient satisfaction after perioperative anesthesia service with AOR (95% CI) P value of 2.311(1.244–4.294)0.008, 2.213(1.277–3.835) 0.005, 2.707(1.458–5.029) 0.002 and 2.430(1.452–4.065) <0.001 respectively. ConclusionIn general the overall patient satisfaction towards perioperative anesthesia service was low in contrast to many previous studies. Factors that cause dissatisfaction should be prevented or better treated and every stakeholder should be trained and participated.

Alcohol drinking delays the rate of sputum smear conversion among DR-TB patients in northwest Ethiopia; A retrospective follow-up study.

Sputum smear microscopy is simple and feasible technique to assess the presence of acid-fast bacilli (AFB) in the respiratory tract of patients with Drug Resistance Tuberculosis (DR-TB). Conversion of sputum smear from positive to negative is considered as an interim indicator of efficacy of anti-tubercular treatment and the program effectiveness. Although evidences regarding the factors affecting the sputum smear conversion are available on drug susceptible TB patients, there is dearth of literature about smear conversion and its predictors among DR-TB patients in the study setting. Hence, shortening the time to sputum smear conversion is desirable to reduce the likelihood of mycobacterial transmission. This study has therefore aimed at estimating the median time of sputum smear conversion and to determine its predictors. This was a retrospective follow-up study conducted among DR-TB patients registered for second-line anti-TB treatment in the four hospitals of Amhara regional state, Northwest Ethiopia. Of all patients enrolled to DR-TB treatment in the study setting from 2010 to 2017, 436 patients have been include for this study who fulfilled the eligibility criteria. The cox proportional hazard model was fitted and the adjusted hazard ratio (AHR) with 95% confidence interval (CI) and p <0.05 was used to declare statistical significance of the variables associated with the smear conversion. From the 436 patients with sputum smear positive at baseline, 351 (80.5%) converted sputum smear at a median time of 48 (IQR: 30-78) days. The median time of smear conversion was 59 (95% CI: 42, 74) and 44 (95% CI: 37, 54) days among patients who had and had no history of alcohol drinking, respectively. Similarly, the median time to smear conversion was 61 (95% CI: 36, 73) days among patients with comorbid conditions and 44 (95% CI: 38, 54) days among patients with no comorbid conditions. In the multi-variable analysis, only history of alcohol consumption [AHR = 0.66 (0.50, 0.87)] was found to delay significantly the rate of sputum smear conversion. In our study, the median time of sputum smear conversion was with in the expected time frame of conversion. History of alcohol consumption was found to delay significantly the rate of sputum smear conversion. The DR-TB patients are strongly advised to avoid alcohol consumption.

Knowledge, Attitudes and Practices of Patients on Antibiotic Resistance and Use in Public Hospitals of Amhara Regional State, Northwestern Ethiopia: A Cross-Sectional Study.

BackgroundAlthough inappropriate antibiotic use could contribute to the spread of antimicrobial resistance, data on the knowledge, attitude and practice of antibiotic use and resistance among patients in north-western Ethiopia are scarce. This study assessed patients’ knowledge, attitudes and practices regarding antibiotic use and resistance in selected public hospitals of Amhara regional state, Ethiopia.MethodsA cross-sectional study was conducted in selected public hospitals of Amhara regional state from November to December 2020 to assess the knowledge, attitude, and practice of patients on antibiotic resistance and use. Data were collected from 233 participants using a structured questionnaire and analyzed using SPSS version 23.ResultsAccording to the findings, 60.3% of the participants obtained their antibiotics without a prescription from private pharmacies, and the most commonly used antibiotic to treat human diseases was ampicillin (70.7%). Even though 69.8% of the patients heard about antibiotics and antibiotic resistance from several sources, 68.1–87.9% of them were unaware on the factors that contribute to the transmission of resistant bacteria to humans and the impact of antibiotic resistance on human and animal health. Using the mean score of 3.15 ± 0.08 as the cut-off, 37.5% of patients know about antimicrobial resistance and use. With a mean score of 27.6 ± 0.3, 45.3% of patients had positive attitudes toward prudent antibiotic use and resistance. About 44% of participants had a good practice, with a mean practice score of 4.95 ± 0.17. A higher level of education was associated with better knowledge, positive attitudes, and better practices regarding antibiotic use and resistance. Although 57.3% of respondents viewed poor handwashing practices in hospitals as a major factor contributing to increased antibiotic resistance, 59.9% of respondents viewed implementing hygiene, infection prevention, and control practices as a major strategy contributing to reducing antibiotic use and resistance.ConclusionAccording to the present study, there is a low level of awareness among patients about the proper antibiotics use and resistance. It is essential to raise awareness, develop, and implement interventions to reduce antimicrobial use and antibiotic resistance in the study area.

Prevalence and associated factors of pelvic organ prolapse among women attending gynecologic clinic in referral hospitals of Amhara Regional State, Ethiopia.

While pelvic organ prolapse is common in clinical observation, there is a lack of evidence regarding its actual proportion and associated factors in the study area. Understanding the prevalence and risk factors could potentially help with prevention. Thus, this study aimed to determine the prevalence and associated factors related to pelvic organ prolapse in the Amhara region, northwest Ethiopia. An institutional-based cross-sectional study was conducted among 424 women, recruited by the systematic random sampling technique. Data were collected in a face-to-face interview using a structured and pre-tested questionnaire to assess the symptoms of pelvic organ prolapse and the socio-demographic, obstetric, gynecologic, medical and surgical characteristics. The stage of prolapse was determined by pelvic examination using the Simplified Pelvic Organ Prolapse Quantification staging system. Descriptive statistics and logistic regression analyses were employed. The overall prevalence of pelvic organ prolapse (stage I-IV) was found to be 37.6% when determined by pelvic examination and 9.2% as assessed by prolapse symptoms. Age ≥ 40years [AOR 2.46 (1.320, 5.314)], age at first delivery ≤ 20years [AOR 4.719 (2.44, 9.11)], carrying heavy objects for ≥ 5hours a day [AOR 12.724 (4.89, 33.07)], parity ≥ 4 [AOR 3.739 (1.693, 8.208)], prolonged labor [AOR 3.487 (1.699, 7.159)], constipation [AOR 2.835 (1.273, 6.317)] and anemia [AOR 2.22 (1.049, 4.694)] were significantly associated with pelvic organ prolapse. Prevalence of pelvic organ prolapse is high in the area; thus, developing information and education programs on avoiding risk factors is advisable to reduce the problem.

Health-Related Quality of Life and Its Associated Factors Among Burn Patients at Governmental Referral Hospitals of Amhara Regional State, Northwest Ethiopia, 2020: Institutional-Based Cross-Sectional Study.

IntroductionBurns can have a considerable negative impact on physical and psychosocial functioning that affects the quality of life. The physical and psychological manifestations may compromise the quality of life of burned patients. The aim is to assess health-related quality of life and associated factors among burn patients at Amhara regional state governmental referral hospitals, Northwest Ethiopia, 2020.MethodsInstitution-based cross-sectional study was conducted from June 01 to July 15, 2020, in Amhara National regional state governmental referral hospitals. Systematic random sampling technique was used, and data were collected using structured Burn Specific Health Scale Brief Questionnaire through face-to-face interview and document review from patients time since burn 15 days and above. Data were entered into Epidata, and analysis was done by SPSS version 25. Descriptive statistics were computed, and binary logistic regression analysis was used to determine the association between the dependent and independent variables. Variables with a p-value of ≤0.05 in the multivariable analysis were considered statistically significant.ResultsOf 423 study participants, 95.7% responded completely. Among the respondents, 58.8% (group mean and median of 18.38 and 21) for physical domain and 57% (group mean and median of 44.73 and 53) for generic domains had a poor health-related quality of life. Overall poor health-related quality of life was 57.5% with a mean of 63.12. Third-degree burn, exposed burnt body part, total body surface area burned ≥20%, having an amputation and having a co-morbid illness with (P = 0.001) were associated with poor health-related quality of life.Conclusion and RecommendationThis study revealed that more than half of the burn survivors had poor health-related quality of life. There shall be strengthened long-term physical and psychosocial domains (generic) intervention for burn survivors by giving more concern for those with the identified risk factors.

Adherence to Exclusive Breastfeeding and its Associated Factors among HIV-Positive Mothers in Referral Hospitals of Amhara Regional State, Northwest Ethiopia, 2018

Background: Exclusive breastfeeding is defined as feeding only breast milk without any other liquids or solids, except for medicine. For mothers with positive human immunodeficiency virus (HIV), adherence to exclusive breastfeeding added with antiretroviral therapy extremely reduces the risk of transmitting the virus to their exposed neonates. Therefore, the World Health Organization has recommended exclusive breastfeeding for exposed infants within the first 6 months of life. This study was performed to identify factors associated with adherence to exclusive breastfeeding among HIV-positive mothers. Methods: The required data in this facility based cross-sectional study was collected using a structured questionnaire through a face-to-face interview. Descriptive statistics were used to show the frequency distributions of factors associated with the dependent variable. Logistic regression was applied to identify factors associated with the outcome variable. The odds ratio was used for the measure of association, and statistical tests with p-values of less than 0.05 were considered significant. Results: The proportion of adherence to exclusive breastfeeding among HIV-positive mothers was found to be 80.8 (95 CI: 77.2-84.6). It was revealed that having good knowledge (adjusted odds ratio AOR=7.363, CI=3.37-12.98), receiving exclusive breastfeeding counseling during the postnatal period (AOR=4.88, CI=2.68-8.916), timely initiation of exclusive breastfeeding (AOR=4.429, CI=2.378-8.25), and making 4 or more antenatal care visits (AOR=2.557, CI=1.413-4.629) were identified to be the significant factors. Conclusion: The proportion of adherence to exclusive breastfeeding among HIV-positive mothers was found to be low. Interventions that seek to increase exclusive breastfeeding should focus on ensuring four antepartum care visits and postpartum counseling. Â

Mucosa\u2010associated cultivable aerobic gut bacterial microbiota among colorectal cancer patients attending at the referral hospitals of Amhara Regional State, Ethiopia

BackgroundColorectal cancer (CRC) is one of the top ten causes of cancer deaths in the world. Despite an increased prevalence of colorectal cancer has been documented from developing countries, there is no any report regarding gut microbiota among colorectal cancer patients in Ethiopia. Therefore, the current study evaluated cultivable aerobic gut bacterial distributions among malignant and its adjacent normal biopsies of CRC patients.MethodsCRC patients who were under colorectal cancer resection surgery during April 2017 to February 2018 at Felege Hiwot Referral and University of Gondar Teaching Hospitals enrolled in the study. Biopsy specimens were taken from malignant and its adjacent normal-appearing tissues. Bacterial cultivation, quantification and characterization of saline washed biopsies were performed under aerobic and candle jar conditions. Differences in bacterial microbiota compositions between malignant and normal tissue biopsies were evaluated and analyzed using Microsoft excel 2010 and GraphPad Prism5 statistical software.Results Fifteen CRC patients were participated with a mean age of 53.8 ± 10.8 years old and majorities (73.3 %) of patients were in between the age groups of 40 and 60 years old. The mean ± SD bacterial microbiota of malignant biopsies (3.2 × 105 ± 1.6 × 105 CFU/ml) was significantly fewer than that of adjacent normal tissue biopsies (4.0 × 105 ± 2.2 × 105 CFU/ml). This dysbacteriosis is positively correlated with the occurrence of CRC (p = 0.019). Proteobacteria (55.6 %), Firmicutes (33.3 %) and Fusobacteria (11.1 %) were the most frequently isolated phyla from non-malignant biopsies while only Proteobacteria (58.8 %) and Firmicutes (41.2 %) were from malignant ones. Family level differences were observed among phyla (Firmicutes and Proteobacteria) isolated from the study participants. For instance, the relative abundance of family Bacillaceae from malignant (26 %) was lower than the normal biopsies (39 %). On other hand, family Enterobacteriaceae was twice more abundant in malignant tissues (45 %) than in its matched normal tissues (23 %). Furthermore, the family Enterococcaceae (14 %) of phylum Firmicutes was solely isolated from malignant tissue biopsies.ConclusionsThe overall microbial composition of normal and malignant tissues was considerably different among the study participants. Further culture independent analysis of mucosal microbiota will provide detail pictures of microbial composition differences and pathogenesis of CRC in Ethiopian settings.

Factors and outcomes associated with the induction of labor in referral hospitals of Amhara regional state, Ethiopia: a multicenter study

BackgroundInduction of labor is an artificial initiation of uterine contractions after fetal viability with the aim of vaginal delivery prior to the onset of spontaneous labor. Prevalence of induction of labor is increasing worldwide with subsequent increase in failure rate. However, there is limited evidence on labor induction in Ethiopia. Therefore, this study was aimed at assessing the prevalence and associated factors of failed induction of labor among women undergoing induction of labor at referral hospitals of Amhara national regional state, Ethiopia, 2016.MethodA multicenter cross-sectional study was conducted at referral hospitals found in Amhara national regional state from February 01 to September 30, 2016. Multistage sampling technique was employed to select a total of 484 women who underwent labor induction. Pre-tested structured questionnaires and checklists were used to collect the data. Data were entered into EPI info version 7 and analyzed using SPSS version 20 software. Stepwise Binary Logistic regression model was fitted to identify factors associated with failed induction of labor. The level of significance was determined based on the adjusted odds ratio with 95% confidence interval at the p-value of ≤0.05.ResultThe prevalence of failed induction of labor among women undergoing induction of labor was 31.4% (95% CI: 27.0, 36.0). Failed induction of labor was independently predicted by a Bishop score of ≤5 (AOR = 2.1; 95% CI: 1.3, 3.6), prolonged latent first stage of labor (AOR = 2.0; 95% CI: 1.2, 3.5), induction with oxytocin alone (AOR = 4.2; 95% CI: 2.2, 8.1), nulliparity (ARO = 1.9; 95% CI: 1.2, 2.9), post term pregnancy (AOR = 4.1; 95% CI: 1.8, 9.3) and hypertensive disorder of pregnancy (AOR = 2.4; 95% CI: 1.5, 5.1).ConclusionFailed induction of labor was high in the study area compared to the reports of previous studies done in Ethiopia. The majority of the determinants of failed induction of labor were connected with unjustifiable and inconsistent indication of induction of labor. Thus, preparing standardized practical guidelines and preventing unjustifiable case selection may help reduce the current high failure rates.

Contributing Factors to Failed Oxytocin Induction among Women Giving Birth at Referral Hospitals of Amhara Regional State, Ethiopia, in 2018: A Case-control Study

Background & aim: Failed oxytocin induction of labor increases the rate of cesarean section and associated complications. The present study aimed to identify contributing factors to failed oxytocin induction among women who gave birth at the referral hospitals of Amhara regional state, Ethiopia, in 2018. Methods: This unmatched case-control study was conducted on a total of 336 parturient women (112 cases and 224 controls) at the referral hospitals of Amhara regional state, Ethiopia, within March 19 to May 18, 2018. Systematic and consecutive sampling methods were applied for the selection of controls and cases, respectively. Both the interviewer-administered questionnaire and medical chart review were utilized as tools for data collection. The validity of the tools was determined by content validity, and Cronbach’s alpha coefficient as a measure of tool reliability was rendered at 0.82. Data analysis was carried out by SPSS software (version 23) using multivariable logistic regression analysis. Results: According to the obtained results, primiparity (AOR=6.24; 95% CI: 3.32-11.73), intermediate Bishop score (AOR=11.77; 95% CI: 5.19-26.71), emergency oxytocin induction (AOR=2.47; 95% CI: 1.31-4.68), and age of ≤ 30 years (AOR=2.16; 95% CI: 1.13-4.16) were considered the determinants of failed oxytocin induction. Conclusion: Considering the factors of primiparity, intermediate Bishop score (5-8) and the age of ≤ 30 years as determinants of failed oxytocin induction, it is recommended to use oxytocin induction after obtaining a favorable Bishop score.