Institution-based Cross-sectional Study Research Articles

Peripheral neuropathy and associated factors among type 2 diabetic patients attending referral hospitals in the Amhara region, a multi-center cross-sectional study in Ethiopia

Diabetic peripheral neuropathy is one of the diabetes most common microvascular complications. It is very prevalent in Sub-Saharan Africa due to a combination of causes, including rising diabetes prevalence, limited healthcare resources, and a lack of access to competent medical care. However, just a few studies have been undertaken in the study area. Institution-based cross-sectional study was conducted in the Amhara region referral hospitals, in 2022. By using a systematic random sampling technique, a total of 627 respondents were included. The data was entered into EPI Data version 4.6 and exported to SPSS version 25 for further analysis. A binary logistic regression was used to determine the relationship between the dependent and predictor variables. The association between predictor variables and the dependent variable was determined using multivariate logistic regression [p value < 0.05, 95% confidence interval]. The overall prevalence of diabetic peripheral neuropathy among the study participants was 48.2% (95% CI; 44.2, 52.1). Aged between 40 and 60 years (AOR = 4:27; 95% CI 2.62, 6.94), and 60 years and older (AOR = 4:47; 95% CI 2.40, 8.35), participants who have lived alone (AOR = 2:14; 95% CI 1.21, 3.79), patients with comorbidity (AOR = 1:83; 95% CI 1.22, 2.76), and being physically inactive (AOR = 1:69; 95% CI 1.14, 2.49) were significantly associated with Diabetic peripheral neuropathy. Diabetic peripheral neuropathy was high among diabetic patients. Healthcare providers should prioritize regular screening and early intervention for individuals at higher risk, particularly those aged 40 and above, those living alone, patients with comorbid conditions, and those who are physically inactive. Implementing community-based support programs, encouraging physical activity, and providing comprehensive management plans for diabetes and associated comorbidities can help mitigate the risk and improve the quality of life for these patients.

Prevalence and associated factors of lipodystrophy in type 1 diabetic children and adolescents at Ayder Comprehensive Specialized Hospital, Tigray, Ethiopia

IntroductionLipodystrophy can cause poor glycemic control in addition to cosmetic problems in children and adolescents with type 1 diabetes mellitus. However, data on its prevalence and associated factors is scarce among children and adolescents who live in developing countries like Ethiopia.ObjectiveTo determine the prevalence and identify associated factors of lipodystrophy in children and adolescents with type 1 diabetes mellitus who visited the endocrinology clinic of Ayder Comprehensive Specialized Hospital between May 1 and July 31, 2020.MethodThis was an institution-based cross-sectional study conducted on 57 children and 65 adolescents with type 1 diabetes mellitus who had been taking insulin injections for a year or more. The dependent variable was lipodystrophy. A pretested, structured questionnaire was used to collect data related to lipodystrophy and other characteristics. The principal investigator oversaw the data collection, which was done by pediatric and child health specialty residents with training. Data was subjected to descriptive statistics, and predictors of lipodystrophy were identified by fitting a multivariable logistic regression model. Statistical significance was declared at p < 0.05.ResultsMore than half (53.3%) of patients were in the age range of 13 to 17. The male-to-female ratio was almost 1:1. Educational status for 63.1% of patients was primary school. Four-fifths of patients were residing in urban areas. Of the 122 participants, 60 (49.2%) had lipodystrophy (48.3% lipohypertrophy and 0.8% lipoatrophy), with grade II lipohypertrophy being the most common type at 81.7%. The thigh was the most common site of lipodystrophy. In multivariable regression analysis, the long duration of insulin injection (AOR = 3.6, 95% CI, 1.5 to 9.0, p = 0.005) and inappropriate rotation of the injection site (AOR = 9.0, 95% CI, 2.2 to 37.0, p = 0.002) were significantly associated with lipodystrophy. HbA1c testing was conducted for 70 patients, and poor glycemic control (HbA1c ≥ 7%) was found in 43 (61.4%) of them. Patients with lipodystrophy were more likely to have poor glycemic control (75%) than those without lipodystrophy (47.1%) (p = 0.016).ConclusionThe prevalence of lipodystrophy was comparable with other studies. Long duration of insulin injection and improper rotation of the injection site are associated with an increased risk of lipodystrophy. Patients with lipodystrophy were more likely to have poor glycemic control, defined by higher HgA1c, than those without lipodystrophy. Proper education of patients and their parents must include correct injection techniques, rotating injection sites, and changing injection sites intermittently to lessen the risk of developing lipodystrophy.

Medication adherence and associated factors among chronic heart failure patients on follow-up in north Shewa public hospitals, Oromia region, Ethiopia

BackgroundChronic heart failure affects approximately 26 million people globally. World Health Organization data show that only approximately half of chronically ill patients in developed countries adhere to recommended medication, with even lower rates in developing countries. Medication adherence is critical for managing chronic heart failure symptoms, delaying disease progression, and preventing hospitalizations. However, poor adherence increases rehospitalization, morbidity, mortality, and healthcare costs.ObjectiveTo assess medication adherence and associated factors among chronic heart failure patients on follow-up at North Shewa Public Hospitals, Oromia Region, Ethiopia, in 2023.MethodsThis institutional-based cross-sectional study was conducted from March 1 to April 30, 2023, G.C. A total of 603 individuals were selected consecutively among those who underwent chronic OPD after being proportionally allocated to five hospitals in the zone. The data were collected using an interviewer-administered questionnaire and a medical chart review. The data were entered into Epi-data version 3.1 and then exported to SPSS version 26 for analysis. The multivariable logistic regression model included variables with a P value < 0.25 in the bivariate analysis. The degree of association was expressed using an adjusted odds ratio (AOR) with a 95% confidence interval (CI) at a P value < 0.05.ResultsAmong the 603 patients, 56% had optimal medication adherence, with a 95% CI of 52.1 to 60. Being able to read and write (AOR: 2.20; 95% CI: 1.34, 3.61), having a secondary education (AOR: 1.97; 95% CI: 1.06, 3.67), having community-based health insurance (AOR: 1.82; 95% CI: 1.22, 2.71), not having comorbidities (AOR: 1.82; 95% CI: 1.18, 2.52), taking several drugs < 2 (AOR: 2.11; 95% CI: 1.20, 2.45), not adding salt when cooking (AOR: 1.72; 95% CI: 1.20, 2.45), and asking a doctor or nurse without fear (AOR: 1.87; 95% CI: 1.03, 3.40) were factors associated with medication adherence among CHF patients.ConclusionThis study revealed that 56% of chronic heart failure patients had optimal medication adherence. Factors associated with higher adherence included higher education, community health insurance, lack of comorbidities, fewer medications, avoiding added salt, and comfortable communication with providers. Health professionals should provide education to strengthen medication adherence.

Prevalence and associated factors of cancer-related fatigue among adult patients with cancer attending oncology units: an institution-based cross-sectional study design in the Amhara region, Ethiopia, 2022

IntroductionCancer-related fatigue (CRF) continues to be a common problem among most patients with cancer. It is a subjective feeling of tiredness, weakness or lack of energy. CRF has a significant...

Parent-adolescent communication on sexual and reproductive health issues and associated factors among secondary public-school students in Gondar town, northwest Ethiopia: an institution based cross-sectional study.

Effective communication between adolescents and their parents is crucial for reducing sexual health problems. This open dialogue can help address misconceptions, provide accurate information, and foster a supportive environment where adolescents feel comfortable seeking guidance and discussing sensitive issues related to their sexual health. In Ethiopia, with its diverse ethnic and cultural background, effective communication between parents and adolescents about sexual and reproductive health (SRH) is crucial in reducing the likelihood of adolescents engaging in risky sexual behaviors. Despite the importance of such communications, there were no data showing the level of parent-adolescent communication (PAC) in secondary public schools in Gondar town. Therefore, this study aimed to determine the level of parent-adolescent communication on sexual and reproductive health issues along with its influencing factors, among secondary students in Gondar town, northwest Ethiopia. We employed an institution-based cross-sectional study design. A total of 424 students were recruited using a systematic random sampling technique, with a 100% response rate. We developed a structured questionnaire from the related literature to collect data from the participants of the study. The data were entered using EpiData version 4.6, and analyzed using SPSS version 25. A binary logistic regression model was fitted to identify associated factors. The proportion of adolescents who had communicated with their parents was 37.7% (95% CI: 34.65-44.76). In a multivariable analysis at a 95% confidence interval (CI), variables such as being female (adjusted odds ratio (AOR) = 2.23; 95% CI: 1.09-7.45), belonging to grades 11-12 (AOR = 1.25; 95% CI: 1.19-6.98), living with parents/caregivers (AOR = 1.26; 95% CI: 1.07-5.66), having a positive attitude toward sexual health (AOR = 2.4; 95% CI: 1.34-7.82), having poor knowledge about SRH issues (AOR = 1.23; 95% CI: 1.04-7.81), and having good knowledge about the puberty period (AOR=1.23; 95% CI:1.04-7.89) were statistically associated with parent-adolescent communication. This study found a low level of communication between parents and adolescents regarding sexual and reproductive health (SRH) issues. To address this challenge, it is crucial to implement evidence-based education on SRH topics, such as consent, healthy relationships, communication skills, STDs, contraception, and interpersonal dynamics. Enhancing parent-adolescent dialogue on SRH can be achieved by implementing peer education among senior students and training teachers in effective communication techniques. The study also recommended conducting qualitative research to explore the specific barriers affecting parent-adolescent communication.

Medication non-adherence and associated factors among peoples with schizophrenia: multicenter cross-sectional study in Northwest Ethiopia

BackgroundSchizophrenia is a serious and debilitating psychiatric disorder that is linked to marked social and occupational impairment. Despite the vital relevance of medication, non-adherence with recommended pharmacological treatments has been identified as a worldwide problem and is perhaps the most difficult component of treating schizophrenia. There are limited studies conducted on magnitude and potential factors of medication non-adherence among peoples with schizophrenia in Ethiopia.ObjectivesThis study aimed to assess medication non-adherence and associated factors among peoples with schizophrenia at comprehensive specialized hospitals in Northwest Ethiopia.MethodsAn institutional-based cross-sectional study was conducted among 387 peoples with schizophrenia at selected hospitals in the Northwest of Ethiopia from June to August 2022. Study participants were enrolled using systematic random sampling. Medication non-adherence was measured using Medication Adherence Rating Scale (MARS). Data entry and analysis were done using Epi-data version 4.6.0 and SPSS version 24, respectively. A multivariable logistic regression model was fitted to identify factors associated with medication non-adherence. Variables with a p-value of < 0.05 at a 95% confidence interval were considered statistically significant.ResultsThe prevalence of medication non-adherence was 51.2% (95% CI: 46.3, 56.3). Duration of treatment for more than ten years (AOR = 3.76, 95% CI: 1.43, 9.89), substance use (AOR = 1.92, 95% CI: 1.17, 3.13), antipsychotic polypharmacy, (AOR = 2.01, 95% CI: 1.11, 3.63) and extra-pyramidal side effect (AOR = 2.48, 95% CI: 1.24, 4.94) were significantly associated with medication non-adherence.ConclusionIn this study, half of the participants were found to be medication non-adherent. Respondents with a longer duration of treatment, substance users, those on antipsychotic polypharmacy, and those who develop extra-pyramidal side effect need prompt screening and critical follow-up to improve medication adherence.

The magnitude of neurocognitive disorders and associated factors among people living with HIV AIDS facilities in Bahir Dar City Ethiopia

Neurocognitive disorders are mental health conditions that are caused by medical illnesses and can lead to several acquired cognitive deficits, which represent a decline from a previously attained level of functioning. The principal domains of cognitive functions include complex attention, executive function, learning and memory, language, perceptual–motor function, and social cognition. Studies have shown that people living with human immunodeficiency virus (HIV) are at a heightened risk of experiencing cognitive challenges across multiple domains. Given that, a substantial number of people live in Amhara region, assessing cognitive domains to estimate the current magnitude and factors associated with neurocognitive disorders among HIV/AIDS patients is crucial. An institutional-based cross-sectional study was conducted among 569 participants adults living with HIV attending the city’s selected health facilities from March 20 to April 30, 2023. A multistage sampling technique was used. The International HIV Dementia Scale (IHDS) was used to measure the outcome of interest. The data were collected using a structured questionnaire and document review. The data were analyzed using STATA version 14. Multiple binary logistic regressions were used as the final model. A total of 501 individuals, with a response rate of 88.04% participated in the study. The overall proportion of HIV patients with neurocognitive impairment was 54.7% (95% CI 50.62–58.77). Factors associated with the neurocognitive impairment were: being widowed AOR = 3.05 (95% CI 1.47–6.31), divorced AOR = 1.95 (1.16–3.28), rural residence AOR = 2.28 (95% CI 1.02–5.09), CD4 count below 500 cells/dl AOR = 1.61 (95% CI 1.03–2.50), history of opportunistic infection AOR = 2.21 (95% CI 1.42–3.41), being in first-line drug regimen AOR = 2.92 (95% CI 1.22–7.00), being in a first-line regimen with Efavirenz AOR = 4.36 (95% CI 1.07–17.73), and impairment in daily living AOR = 2.64 (95% CI 1.39–4.99). In this study, the proportion of neurocognitive impairment was greater than that in most previous studies conducted in Ethiopia. The factors associated with the disorder were: being widowed or divorced, living in a rural area, having low CD4, having a history of opportunistic infection, receiving a first-line drug regimen, receiving efavirenz-containing drugs, and having impaired daily living. Hence, routine neuropsychological screenings should be integrated into comprehensive ART care by the regional health bureau and implemented by hospitals and health centers.

Magnitude of Transfusion Transmissible Infections and Associated Factors Among Blood Donors at the Woliso Blood Bank, Oromia, Ethiopia: Across-Sectional Study

&amp;lt;i&amp;gt;Background: &amp;lt;/i&amp;gt;Blood transfusion is an effective treatment for saving millions of lives, even though transfusion-transmissible infections are the major problem. The prevalence of transfusion-transmissible infections varies between different geographical populations. This study aims to assess the prevalence of transfusion-transmissible infections and associated factors among blood donors at Woliso Blood Bank, South West Shewa Zone, Oromia, Ethiopia. &amp;lt;i&amp;gt;Method: &amp;lt;/i&amp;gt;An institutional-based cross-sectional study design was conducted. A structured and pre-tested questionnaire was used to collect data through a face-to-face interview. The data was entered in Epi Data version 3.1, and exported to STATA version 17.0 for data cleaning and analysis. A binary logistic regression analysis was performed to identify factors associated with outcome variables. Odd ratios along with the 95% confidence interval were used to present the finding and statistical significance was reported with a p-value of 0.05. &amp;lt;i&amp;gt;Results: &amp;lt;/i&amp;gt;The overall prevalence of transfusion-transmissible infections was 9.5% (95% CI 6.3-12.9%). Participants without formal education [AOR=4.84; 95% CI= 1.09, 21.46], unprotected sexual intercourse with multiple partners [AOR=4.77; 95% CI= 1.38, 16.44], and participants with a lower frequency of blood donation [AOR=2.85; 95% CI: 1.16, 6.99] were significantly associated with transfusion transmissible infections. &amp;lt;i&amp;gt;Conclusions: &amp;lt;/i&amp;gt;The prevalence of transfusion-transmissible infections was high in this study area. Educational level, unprotected sexual intercourse with more partners, and a number of blood donations were found to be independent predictors of transfusion-transmitted infections. Blood banks and regional health offices should work to mobilize the community and improve health promotion through prevention and control considering the associated factors identified.

Determinants of Early Mortality Among Deaths at Adult Emergency Departments in Southern Ethiopia

BackgroundIn Ethiopia, the first 3 days (72 h) after admission to the emergency department (ED) account for more than half (59.8%) of all deaths. However, little is known about the prevalence of early mortality and its associated factors in southern Ethiopia. ObjectiveThe main objective of this study is to assess the prevalence and associated factors of early mortality among deaths in adult EDs at selected public hospitals in Hawassa, southern Ethiopia. MethodsAn institutional-based retrospective cross-sectional study design was applied. A systematic random sampling technique was used to select 369 charts of patients who died in the adult EDs of selected public hospitals in the past 2 years. The data were collected using a standardized and pretested data abstraction tool using the Kobo Toolbox data collection tool. Logistic regression analyses were carried out to assess the strength of the association. Statistical significance was declared at p-value < 0.05, and an adjusted odds ratio (AOR) with a 95% confidence interval was used to report the strength of the association. ResultAccording to the results of the current study, 288 patients, or 78% of the total, passed away within 72 h of admission to the ED. The following variables were significantly associated with early mortality: delayed initial intervention (AOR 2.338), red triage categories (AOR 3.9), lack of investigation (AOR 3.4), comorbid illness (AOR 3.2), absence of prehospital treatment (AOR 4.2), and road traffic accidents (AOR 4.1). ConclusionThere was an increased early mortality rate seen in this investigation. The following factors were significantly associated with an early death in the ED: comorbidity, delayed intervention, red warning score, road traffic accidents, absence of prehospital treatment, and lack of diagnostic testing. By addressing the variables that are strongly linked to an early mortality, every intervention should be undertaken to reduce the risk of an early death.

Pregnant women's knowledge, attitude, and practice toward physical exercise during pregnancy and its associated factors at Dessie town health institutions, Ethiopia

Physical exercise consists of planned, repetitive, and intentional movements that reduce the risk of pregnancy-related complications. Worldwide, there is a high rate of physical inactivity during pregnancy, including in Ethiopia, which has detrimental effects on both pregnant women and their developing fetus. This study aimed to assess pregnant women's knowledge, attitude, and practice toward physical exercise during pregnancy and its associated factors among antenatal care attendants at health institutions in Dessie, South Wollo Zone, Amhara Region, Ethiopia, in 2023. An institutional-based cross-sectional study was conducted among 614 pregnant women receiving antenatal care between January 18, 2023, and February 25, 2023. The study participants were selected using systematic random sampling technique. Data were collected using a pretested, face-to-face interviewer-administered, and semistructured questionnaire. The data were cleaned, coded, and entered into EpiData (version 4.6; www.epidata.dk) and analyzed using SPSS (version 25; SPSS Inc, Chicago, IL). Bivariate and multivariate binary logistic regression analyses were performed to identify factors associated with knowledge, attitude, and practice toward physical exercise during pregnancy. Variables with a P value of <.2 in the bivariate analysis were transferred to the multivariate analysis. Finally, the adjusted odds ratio and 95% confidence interval with a P value of <.05 in the multivariate analysis were considered statistically significant. The study found that 56.3% of participants had good knowledge, 51.5% of participants had a favorable attitude, and 32.2% of participants practiced physical exercise during pregnancy. Age, educational level, and heard about physical exercise during pregnancy were positively associated with pregnant women's knowledge and attitude. In addition, age, antenatal care follow-up, no history of abortion, ever done physical exercise before becoming pregnant, and good knowledge were positively associated with pregnant women's practice of physical exercise during pregnancy. Our findings indicate that approximately half of the participants had good knowledge and a favorable attitude. However, almost one-third of the participants practiced physical exercise during their pregnancy. It is recommended that antenatal care providers advise pregnant women to strengthen their antenatal care follow-up and offer health education and counseling about the benefits of physical exercise during pregnancy.

Worsening of medication non-adherence among patients with chronic diseases during times of armed conflict in the war-torn region of Ethiopia

BackgroundArmed conflict is a complex global phenomenon resulting in numerous injuries and significant health risks, particularly for individuals with chronic illness. This study aims to highlight the degree of medication non-adherence during armed conflict in northwest Ethiopia. MethodAn institution-based cross-sectional study was conducted at comprehensive specialized hospitals in northwest Ethiopia. Proportional allocation was used to assign patients in each setting. Proportions and means were compared using the chi-square test and the t-test, respectively. Binary logistic regression was employed to identify significant factors. ResultsThe degree of medication non-adherence was 68.1 %, and 88.3 % of participants reported that the armed conflict had a negative impact on their treatment. Additionally, 69.1 % of participants claimed that they did not use strategies to cope with the challenges they faced. Significant factors associated with medication non-adherence included the absence of health insurance (AOR = 3.43 (95 % CI 2.04–5.76)), the presence of comorbid illness (AOR (95 % CI): 5.19 (2.91–9.24)), medication unavailability (AOR = 1.84 (95 % CI 1.02–3.30)), and routine follow-up disturbances (AOR = 2.03 (95 % CI 1.08–3.79)). ConclusionPatients with chronic diseases exhibited a high rate of medication non-adherence during times of conflict. Particular attention should be given to patients with no social insurance, those with comorbid diseases, those experiencing follow-up disturbances, and those facing medication unavailability. Relevant entities are expected to develop initiatives that minimize constraints on medication adherence during armed conflicts.

Delayed time to pregnancy and associated factors among pregnant women attending antenatal care in bale zone administrative towns health facilities: multi-center cross-sectional study

BackgroundThe desire to conceive and become parents is a fundamental aspect of human life that carries immense personal, emotional, and societal significance. For many couples, achieving pregnancy represents a long-cherished dream, but the journey to parenthood is not always straightforward. The duration it takes to achieve the desired pregnancy can vary significantly among individuals and is influenced by many factors. This study explores the factors that influence the delayed time of pregnancy among women with naturally planned conception.MethodsAn institutional-based cross-sectional study was conducted from May 1 to May 30, 2023, in public health facilities of Bale Zone administrative towns, Southeast Ethiopia. Using systematic random sampling, 388 women participated in the study and a pretested questionnaire was used to collect data. Bivariate logistic regression was done, and variables with p-values < 0.25 were exported to multivariable logistic regression, and a statistically significant association was declared at p-value < 0.05.ResultsThe study revealed delayed time to pregnancy was 18.6% with 95% (CI = 14.67-22.44%). Women’s age ≥ 35, (AOR = 2.61; 95%, CI: 1.17–5.82), menstrual irregularity (AOR = 3.79; 95% CI: 1.98–7.25), and frequency of sexual intercourse/week (AOR = 2.15; 95% CI: 1.05–4.41) and women’s sexual dysfunction before conception (AOR = 3.12, 95% CI: 1.62–6.01) were significantly associated factors with delayed time to pregnancy at p-value < 0.05.ConclusionThe study revealed a substantial proportion of delayed time to pregnancy. This delayed time to pregnancy was associated with older maternal age, irregular menstrual cycles, coital activity per week, and the women’s sexual dysfunction before pregnancy. Consequently, addressing delayed time to pregnancy requires a targeted approach, prioritizing initiatives such as raising awareness, fostering increased frequency of sexual activity per week, exploring interventions for women with irregular menstrual patterns, and challenges related to sexual dysfunction.

Length of hospital stay and associated factors among adult surgical patients admitted to surgical wards in Amhara Regional State Comprehensive Specialized Hospitals, Ethiopia.

Hospitals across the country are facing increases in hospital length of stay ranging from 2% to 14%. This results in patients who stay in hospital for long periods of time being three times more likely to die in hospital. Therefore, identifying factors that contribute to longer hospital stays enhances the ability to improve services and quality of patient care. However, there is limited documented evidence on factors associated with longer hospital stays among surgical inpatients in Ethiopia and the study area. This study aimed to assess the length of hospital stay and associated factors among adult surgical patients admitted to surgical wards in Amhara Regional State Comprehensive Specialized Hospitals, Ethiopia, 2023. An institutional-based cross-sectional study was conducted among 452 adult surgical patients from April 17 to May 22, 2023. Data were collected based on a pretested, structured, interviewer-administered questionnaire, medical record review, and direct measurement of BMI. Study participants were selected using a systematic random sampling technique. The collected data were cleaned, entered into EpiData version 4.6.0 and exported to STATA version 14 for analysis. Binary logistic regression analysis was used. Variables with a p value <0.05 in the multivariable logistic regression analysis were considered statistically significant. In the current study, the prevalence of prolonged hospital stay was 26.5% (95% CI: 22.7, 30.8). Patients referred from another public health facility (AOR = 2.65; 95% CI: 1.14, 6.14), hospital-acquired pneumonia (AOR = 3.64; 95% CI: 1.43, 9.23), duration of surgery ≥110 minutes (AOR = 2.54; 95% CI: 1.25, 5.16), being underweight (AOR = 5.21; 95%CI: 2.63, 10.33) and preoperative anemia (AOR = 3.22; 95% CI: 1.77, 5.86) were factors associated with prolonged hospital stays. This study found a significant proportion of prolonged hospital stays among patients admitted to surgical wards. Patients referred from another public health facility, preoperative anemia, underweight, duration of surgery ≥110 minutes, and hospital-acquired pneumonia were factors associated with prolonged hospital stay. Early screening and treatment of anemia and malnutrition before surgery can shorten the length of stay.

Incidence of acute transfusion reactions and associated factors among adult blood-transfused patients at Jimma University Medical Center, southwest Ethiopia: A cross-sectional study.

Acute transfusion reaction is mainly related to the infusion of blood or blood products resulting at any time within a day of the intervention. It ranges from a non-specific febrile episode to a life-threatening intravascular hemolysis. The severity of the reaction and the degree of morbidity are usually related to the degree of ABO incompatibility and the volume of blood transfused. Therefore, this study aimed to determine the incidence of acute transfusion reactions and its associated factors in Jimma University Medical Center, southwest Ethiopia. Institution-based cross-sectional study was conducted from 1 October to December 30, 2020. A total of 384 transfused patients were followed in this study. Socio-demographic and clinical data were collected through a structured questionnaire. Baseline measurement and 24-hour periodic vital signs monitoring were conducted after each transfusion. Four milliliters of venous blood were drawn after transfusion intervention from each distrusted patient for complete blood count, blood group phenotype, direct antihuman globulin test (DAT), and crossmatching. Data were entered into Epi data version 3.1 and analyzed using Statistical Package for Social Science software (SPSS) version 20. Descriptive statistics, and bivariable and multivariable logistic regression were employed to test the association between independent and dependent variables. A P value ≤ .05 was considered to indicate statistical significance. Acute transfusion reactions were diagnosed in 5.7% of patients, with most of these reactions were febrile nonhemolytic reactions (63.6%) followed by allergic (36.4%) reactions with mild clinical manifestations (27.3%). Transfusion history, transfused blood that was kept for more than 13 days, abortion history, and number of transfused units (≥3 units of blood/blood component) have 3.3, 3.85, 4.2, and 3.9 times greater odds, respectively, besides their significant association with the incidence of acute transfusion reactions. Patients with a history of previous transfusion, abortion, multi-unit transfusion, and patients transfused with blood stored for ≥14 days should be closely monitored. Starting a hemovigilance system of monitoring, collecting, and evaluating data on adverse effects of blood transfusion locally and nationally will decrease the occurrence of acute transfusion reactions.

Structural equation modeling analysis of health belief model-based determinants of COVID-19 preventive behavior of academic staff: a cross-sectional study

IntroductionDespite COVID-19 being highly contagious and spreading to several countries, the university community has overlooked prevention measures. For more than five decades, the Health Belief Model (HBM) has been a widely used conceptual framework in health behavior. structural equation modeling(SEM) analysis is an advanced statistical method capable of rectifying failures of the basic models and showing complex relations Thus this study aimed to determine the magnitude of COVID-19 prevention behavior and identify its associated factors using HBM and SEM analysis.MethodAn institutional-based cross-sectional study was conducted among academic staff of the University of Gondar in Ethiopia from April 10 to May 10/2021. Daniel Soper’s sample size calculator was used to determine the sample size. Proportional allocation to each campus followed by a simple random sampling technique was employed to select study subjects. A pre-tested, structured questionnaire was used to collect the data. Structural equation modeling analysis was employed to show the relationship between health belief model constructs and their effect on preventive behavior.ResultA total of 602 academic staff participated. The magnitude of good COVID-19 preventive behavior was 24.8%. The HBM explained 55% of the variance in preventive behavior. Perceived barriers (β = -0.37, p < 0.05), self-efficacy (β = 0.32, p < 0.05), perceived susceptibility (β = 0.23, p < 0.05), and perceived benefit (β = 0.16, p < 0.05) were the direct significant predictors of COVID 19 prevention behavior.Conclusiononly a quarter of the academic staff have good COVID-19 preventive behavior. The HBM explained a great amount of variance in preventive behavior and Perceived barriers, benefits, susceptibility, and self-efficacy significantly associated with prevention behavior. Carefully planned intervention that considers those significant perceptions should be designed and implemented to raise COVID-19 prevention behavior.

Acceptance of e-learning and associated factors among postgraduate medical and health science students at first generation universities in Amhara region, 2023: using modified technology acceptance model

BackgroundElectronic learning is the process of remote teaching and learning through the use of electronic media. There is a dearth of research on the factors influencing e-learning acceptance in Ethiopia using the modified technology acceptance model (TAM). Previous research appears to have overlooked the mediating impact of factors on e-learning acceptability Therefore, the present study aimed to assess the acceptance of e-learning and its associated factors among postgraduate medical and health science students by applying TAM at first-generation universities in the Amhara region.MethodsThis institutional-based cross-sectional study was conducted from March 15 to April 20, 2023, at Amhara First Generation University, Ethiopia. A total of 659 students participated in the study. A self-administered questionnaire in the Amharic language was used to collect the data. SEM analysis was employed to test the proposed model and the relationships among factors using SPSS version 25 and AMOS version 26.ResultsThe proportion of postgraduate students who agreed to use e-learning was 60.7%, 95% CI (56.9–64.4). SEM analysis revealed that perceived ease of use (β = 0.210, p < 0.001), attitude (β = 0.377, p < 0.001) and perceived usefulness (β = 0.330, p < 0.001) had positive direct relationships with acceptance of e-learning. Perceived usefulness (β = 0.131, p < 0.001), and perceived ease of use (β = 0.029, p < 0.01) significantly mediate the relationship between self-efficacy, and acceptance of e-learning. Accessibility had a positive indirect effect on acceptance of e-learning through perceived ease of use (β = 0.040, p < 0.01). Facilitating condition had a positive indirect on acceptance of e-learning through perceived ease of use (β = 0.070, p < 0.01), and perceived usefulness (β = 0.084, p < 0.001).Conclusion and recommendationOverall, the proportion of postgraduate students who accepted e-learning is promising. Perceived ease of use perceived usefulness, and attitude had positive direct effects on the acceptance of e-learning. Facilitating conditions and self-efficacy had positive indirect effects on the acceptance of e-learning. Thus, implementers need to prioritize enhancing the provision of devices, students’ skills, and knowledge of e-learning by providing continuous support to improve students’ acceptance of the use of e-learning.

Describing the practice of breast self-examination and associated factors among female healthcare workers in Saint Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia.

Breast cancer is the most frequently occurring cancer in women and is a global health problem. Yet, it can be a manageable disease with early diagnosis and sufficient treatment protocols, such as advanced surgical intervention, chemotherapy, and radiation therapies. Breast self-examination (BSE) is a screening technique that involves examining one's breasts for lumps, distortions, or swelling, and contributes to early diagnosis of the disease. The aim of this study was to assess the practice of BSE and associated factors among female healthcare workers in Saint Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia, 2022. An institution-based cross-sectional study was carried out at St. Paul's Hospital Millennium Medical College. A stratified and systematic random sampling technique was utilized to obtain respondents for the study. The data for this study were collected by professional nurses using a structured questionnaire. Data were analyzed using SPSS (version 20) software. Logistic regression analysis was utilized to assess relevant factors. Predictors with a p-value of < 0.05 were considered as statistically significant. Four hundred respondents participated giving a 100% response rate. The median age of study participants was 28 years, with an inter-quartile range of six years. About two-thirds (63.8%) of the study participants had good knowledge about BSE, 46.3% had a positive attitude toward BSE, and 76.25% reported they practised BSE. Significant associations were observed with the practice of BSE and the factors of age, monthly income, and knowledge about BSE. Compared to participants 40 years and above, participants between 25-29 years [AOR=0.10; 95%CI: 0.01, 0.88] and 35-39 years [AOR=0.09; 95%CI: 0.01, 0.92] were less likely to practise BSE; those with monthly income less than 5250 ETB [AOR=0.19; 95%CI: 0.035, 0.996], and between 5251-7800 [AOR=0.16; 95%CI: 0.032, 0.78], and 7801-10900ETB [AOR=0.18; 95%CI: 0.04, 0.83] were less likely to practise BSE; and those with good knowledge about BSE [AOR=2.08; 95%CI: 1.23, 3.53] were more apt to practise BSE. The study showed that about three-quarters of the health workers practised BSE. Statistically significant associations were observed between BSE and the factors of age in years, monthly income, and knowledge about BSE.

Magnitude and antimicrobial susceptibility profile of bacteria isolated from pediatric sepsis cases at University of Gondar Hospital, Northwest Ethiopia

BackgroundSepsis is one of the major causes of morbidity and mortality among pediatric patients throughout the world. The varying microbiological pattern of sepsis warrants the need for researches on the causative organisms and their antimicrobial susceptibility pattern. The epidemiology of neonatal and pediatric sepsis in Ethiopia is under-research. The objective of this study was to evaluate the burden of bacterial pathogens and their antimicrobial susceptibility patterns among children suspected of sepsis.MethodsAn institutional-based prospective cross-sectional study was conducted on 370 pediatric(age birth-15 years) patients suspected of sepsis at the University of Gondar Comprehensive Specialized hospital from December 2020 to November 2021. Blood samples were collected aseptically and inoculated into Tryptone Soya Broth for culture. The organisms grown were identified by standard microbiological methods and subjected to antibiotic susceptibility testing by modified Kirby-Bauer disk diffusion method recommended by Clinical laboratory and standard institute. Methicillin resistance was confirmed using Cefoxitin disk diffusion method. Data entry and analysis were done using Statistical Package for Social Sciences (SPSS) version 26 software. A p-value less than 0.05 at 95% confidence interval was considered statically significant.ResultsOut of the total 370 study subjects, 21.6% (80/370) of them were culture positive. Of these, 43 (53.8%) and 37 (46.3%) were Gram-positive and Gram-negative bacterial pathogens, respectively. The most prevalent Gram-positive bacterial isolate was Staphylococcus aureus (n = 24; 30%) and coagulase negative staphylococci (n = 7; 8.8%). Among the Gram-negative bacterial isolates, the leading bacteria was Klebsiella pneumoniae (n = 20; 25%) followed by Escherichia coli (n = 7; 8.8%). Clindamycin, Chloramphenicol, Gentamicin and Ciprofloxacin were the most effective antibiotics against Gram-positive bacterial isolates while Amikacin, Meropenem and Chloramphenicol were effective against Gram-negative pathogens. Methicillin resistance was detected in 45.8% of Staphylococcus aureus. Multi-drug resistance (MDR) antimicrobial susceptibility pattern was observed in 76% of the bacterial isolates.ConclusionGram positive bacteria were the predominant isolates among pediatric sepsis cases and most of the bacterial isolates showed MDR. Staphylococcus aureus and Klebsiella pneumoniae were frequently isolated bacteria. The high prevalence of drug resistance warrants rational use of antibiotics and the need for regular antibiotic susceptibility surveillance studies.

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.

Prevalence and pattern of congenital clubfoot among less than 5-year-old children in Ethiopia; cross-sectional based study

BackgroundClubfoot is one of the most common congenital malformations, but it is also one of the most neglected public health problems among less than five-year-old children, mainly in middle- and low-income countries. Approximately 80% of clubfoot cases are found in low- and middle-income countries. In this study setting, no epidemiological studies have been conducted to assess clubfoot deformity. Due to this gap, the study aimed to assess prevalence, and pattern of congenital club foot among less than 5-year-old children.Materials and methodsAn institutional-based cross-sectional study was carried out at Black Lion Specialized Hospital at the pediatric orthopedic clinic. The sample size was 261 to determine the prevalence and pattern of congenital clubfoot. Terms like frequency, percentage, and mean were used for data presentation.ResultA total of 36,303 pediatric patients visited Black Lion Specialized Hospital during the study period, and clubfoot prevalence was 7.2 per 1000. The largest subclassification of congenital clubfoot was idiopathic clubfoot, which accounted for 6.2 per 1000, whereas syndromic clubfoot was 0.3 per 1000, and neuropathic clubfoot was shared at 0.36 per 1000. Most of the cases in this study were bilateral clubfoot, with males having more dominance.ConclusionIn the area under investigation, a significant prevalence of congenital clubfoot was observed, especially among male children. The majority of cases were bilateral, with idiopathic clubfoot being the dominant form.