Northwest Ethiopia Research Articles

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.

Prevalence and associated factors of atrial fibrillation among patients with rheumatic heart disease attending public referral hospitals in Bahir Dar city, Northwest Ethiopia, 2023

BackgroundAtrial fibrillation (AF) is a supraventricular arrhythmia associated with uncoordinated atrial activation. Atrial fibrillation is complication of rheumatic heart disease and is associated with substantial morbidity and mortality. It is a growing public health problem and economic and social burden. Studies investigating the prevalence and factors associated with atrial fibrillation among chronic rheumatic heart disease patients in Ethiopia are scarce. Therefore, this study aimed to determine the prevalence and factors associated with atrial fibrillation in patients with chronic rheumatic heart disease.Methods and materialsA hospital-based cross-sectional study was conducted. A total of 410 patients were selected using a systematic random sampling method. The data were entered into Epi-Data version 4.6 and subsequently exported to SPSS version 26 software for analysis. A binary logistic regression model was applied to identify significant variables related to AF.ResultsIn this study, 410 patient charts were reviewed. The prevalence of atrial fibrillation was 43% (95% CI of 38% up to 48%). Male (AOR = 3.81, 95% CI 2.00-7.26), age greater than 30 years (AOR = 7.26, 95% CI 3.93–13.41), heart failure (AOR = 4.65, 95% CI 2.39–9.04), mitral valve stenosis (AOR = 6.36, 95% CI 2.92–13.87), and left atrial diameter enlargement (AOR = 3.41, 95% CI 1.64–7.09) were associated with atrial fibrillation.Conclusions and recommendationsAtrial fibrillation leads patients to frequent hospital admission and increases hospital mortality. As a result, health care professionals need to pay more attention to and apply more clinical treatment for older patients, those with heart failure, those with mitral valve stenosis, and those with left atrial diameter enlargement-associated causes of atrial fibrillation.

Under five children diarrhea prevalence and associated factors in slum areas of Gondar City Northwest Ethiopia: a community based cross-sectional study

Slum areas in Ethiopia have high poverty status. In addition, they possess poor water and sanitation accesses such as unsafe drinking water, a lower number of sanitation facilities and poor hygienic conditions. These scenarios are important in the occurrence of diarrhea among under five children’s. However, there are many studies conducted on diarrhea among under five children in Ethiopia, unfortunately, the majority usually didn’t give enough coverage for the burden of diarrhea among under five children in slum areas. This study aimed to determine the prevalence of diarrhea and associated factors among under five children in slum areas of Gondar City. This community-based cross-sectional study was conducted in slum areas of Gondar City among under five children from March 28 to April 28, 2023. A multi-stage sampling technique was used to collect a sample of 836 through interview-administered methods using a structured data collection tool. The collected data was manually checked for completeness, coded, and entered into EPI Info version 7.1.5.2 software. It was then exported to Stata version 14.1 software for descriptive analysis, as well as bivariable and multivariable binary logistic regression analyses, to identify factors associated with diarrhea among under five children. The prevalence of diarrhea among under five children at 95% confidence interval was 24.64% (CI 21.71–27.56). Mothers/caretakers age < 25 years (AOR = 1.88, 95% CI 1.16–3.06), mothers/caretakers age between 28 and 31 years (AOR = 1.82, 95% CI 1.08–3.05), mothers/caretakers who had no formal education (AOR = 3.18, 95% CI 1.86–5.41), mothers/caretakers who had primary education (AOR = 1.67, 95% CI 1.09–2.57), income level between 4877 and 5643 Ethiopian Birr (AOR = 1.81, 95% CI 1.04–3.15), family size greater than five (AOR = 1.54, 95% CI 1.00–2.36), flies around the house (AOR = 2.27, 95% CI 1.38–3.73), playground not clean (AOR = 2.70, 95% CI 1.62–4.50), breastfed for ≥ 1 year (AOR = 0.63, 95% CI 0.41–0.97), mothers/caretakers who did not wash their hands before food preparation and eating (AOR = 2.31, 95% CI 1.39–3.58), mothers/caretakers who did not wash their hands after visiting latrine (AOR = 1.60, 95% CI 1.07–2.38) were significantly associated factors with diarrhea among under five children in slum areas of Gondar City. The study indicates that the prevalence of diarrhea was higher among under five children in slum areas of Gondar City. The Gondar City Administration Education Bureau should give great emphasis on improving mother’s and caretaker’s education. In addition, the Gondar City Administration Health Bureau should educate mothers and caretakers about breastfeeding, sanitation, and hygiene in the slum areas of Gondar City.

Demographic characteristics and clinical features of patients presenting with different forms of cutaneous leishmaniasis, in Lay Gayint, Northern Ethiopia.

Cutaneous leishmaniasis (CL) is a neglected tropical disease caused by Leishmania parasites, that can cause long-term chronic disabilities. The clinical presentation of CL varies in both type and severity. CL presents as three main clinical forms: localised lesions (localised cutaneous leishmaniasis, LCL); mucocutaneous leishmaniasis (MCL) that affects the mucosa of the nose or the mouth; or as disseminated not ulcerating nodules (diffuse cutaneous leishmaniasis, DCL). Here we recruited a cohort of CL patients in a newly established leishmaniasis treatment centre (LTC) in Lay Gayint, Northwest Ethiopia, and collected detailed demographic and clinical data. The results of our study show that more males than females present to the LTC to seek diagnosis and treatment. 70.2% of CL patients presented with LCL and 20.8% with MCL. A small number of patients presented with DCL, recidivans CL (a rare form of CL where new lesions appear on the edges of CL scars) or with a combination of different clinical presentations. The duration of illness varied from 1 month to 180 months. Over a third of CL patients had additional suspected CL cases in their household. Despite the majority of CL patients having heard about CL, only a minority knew about its transmission or that it could be treated. Most CL patients lived in areas where environmental factors known to be associated with the transmission of CL were present. This work highlights that CL is an important public health problem in Lay Gayint and emphasises the urgent need for more CL awareness campaigns, better health education and better disease management practices.

Effect of a chimney-fitted improved stove on pregnancy outcomes in Northwest Ethiopia: a randomized controlled trial

Effect of a chimney-fitted improved stove on pregnancy outcomes in Northwest Ethiopia: a randomized controlled trial

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.

Prevalence of Entamoeba histolytica/dispar and Giardia lamblia infections and their associated factors among schoolchildren in the Amhara region, Northwest Ethiopia

Globally, intestinal protozoa E. histolytica/dispar and Giardia lamblia are the cause of amoebiasis and giardiasis, respectively. Despite their important medical importance and common occurrence in Ethiopia, they are minimally addressed in terms of their prevalence, sensitive diagnostic methods, and associated risk factors. Infections with E. histolytica/dispar and G. lamblia are often misdiagnosed and underreported in impoverished countries. Thus, the purpose of this study was to ascertain the prevalence of Giardia lamblia and E. histolytica/dispar infections as well as related variables among schoolchildren in the Amhara region. A cross-sectional study was conducted among 844 schoolchildren in the Amhara region from April to December 2019. A stool sample was collected from each study participant and processed via the formol ether concentration technique (FECT) and spontaneous tube sedimentation techniques (STST). Data were entered in EpiData and analysed by SPSS statistical software. The prevalence of E. histolytica and G. lamblia infections using each diagnostic method and composite reference was determined by descriptive statistics. The association of risk factors with E. histolytica/dispar and G. lamblia infections was analysed by logistic regression and variables with p < 0.05 were considered to have statistical significance. From the total, 243 (28.8%) schoolchildren were found to be infected by at least one of E. histolytica/dispar or G. lamblia. The prevalence of E. histolytica/dispar and G. lamblia infections was 201 (23.8%) and 62 (7.3%), respectively. The co-infection prevalence with both E. histolytica/dispar and G. lamblia was 22 (2.6%). The sensitivity (78.6%) and negative predictive value of STST (19.6%) were higher than FECT sensitivity (65.4%) and negative predictive value (13.1%). Children in 10–14 years of age (AOR = 1.66;95%CI: 1.16–2.38), lived in the rural (AOR = 1.97;95%CI: 1.12–3.49), used latrine improperly (AOR = 1.49;95%CI: 1.04–2.13), did not wash hands before meal (AOR = 2.10; 95%CI:1.08–4.10), and after latrine (AOR = 1.51;95%CI: 1.05–2.19), ate unwashed raw vegetables (AOR = 1.85;95%CI:1.26–2.70), and played with soil (AOR = 1.48;95%CI:1.06–2.06) were associated with E. histolytica/dispar and G. lamblia infection. These findings revealed high prevalence of E. histolytica/dispar and G. lamblia infections was high in the Amhara region. Therefore, proper implementation of water, sanitation and hygiene should be advocated at the community and school levels to mitigate the disease burden.

Analysis of heavy metals and minerals in edible vegetable oils produced and marketed in Gondar City, Northwest Ethiopia

IntroductionNowadays, food safety is regarded as one of the most critical global public health issues. Edible oil, a key ingredient in food processing, is widely used and consumed in every Ethiopian household. However, its safety is often overlooked. Currently, edible oil is produced in Ethiopia from small-scale operations to large industrial levels, as well as imported from other countries.ObjectiveThis study aimed to determine the levels of heavy metals and essential minerals in edible vegetable oils produced and marketed in Gondar City, Northwest Ethiopia.MethodsA laboratory-based cross-sectional study was conducted from May to July 2021 in Gondar City. Seventeen edible oil samples were collected using simple random sampling techniques. Heavy metal content was determined using an atomic absorption spectrophotometer with the standard procedures and techniques after microwave digestion. The efficiency and validity of the method used were evaluated by determining the limit of detection (LOD), the limit of quantification (LOQ), accuracy, and precision. The collected data were entered into Microsoft Excel and transported to Stata for analysis.ResultA total of seventeen vegetable oil samples were analyzed. The accuracy of the method was evaluated by recovery studies, which ranged from 81 to 115%, and the relative standard deviations were found to be below 15%. The concentrations of Zn, Cu, Fe, Cd, and Pb were in the range of 0.07 to 0.8 mg/l, 0.002 to 0.06 mg/l, 0.01 to 0.8 mg/l, 0.08 to 0.18 mg/l, and 0.003 to 0.27 mg/l, respectively. In general, the lead and cadmium content was higher than other metals in some of the investigated edible vegetable oils. Most values fell within the permissible quality limits for edibility as prescribed by the World Health Organization (WHO) and the National Agency for Food and Drug Administration and Control (NAFDAC). However, the levels of Pb and Cd exceeded the reference levels in some locally produced vegetable oils.ConclusionTo address the exceeded levels of heavy metals, it is imperative to implement more careful handling, processing of raw materials, and filtering practices. Producers and marketers should take the necessary precautions to prevent contamination. Strict regulatory control from responsible bodies and stakeholders is recommended to ensure the safety and metal contents of vegetable oils originating from the study area.

Nurses’ attitude towards patient advocacy and its associated factor in East Gojjam Zone Public hospitals, Northwest Ethiopia, 2023

IntroductionOne of the most important but underappreciated roles of nurses is patient advocacy. To advocate for patients effectively, the nurses should have a favorable attitude towards patient advocacy. Despite this fact, the nurses’ attitude towards patient advocacy was not known in Ethiopia. Thus, this study aimed to assess nurses’ attitude towards patient advocacy and its associated factors in East Gojjam Zone Public Hospitals, Northwest in 2023.MethodsInstitutional-based cross-sectional study design was conducted among 385 nurses in East Gojjam Zone Public Hospitals from March 1 to April 30, 2023. Nurses were selected using simple random sampling techniques from 11 public hospitals. The data were collected in a self-administered way. Binary logistic regression was used for data analysis. All independent variables having a P value of < 0.25 in the bivariable logistic regression were fitted into a multivariable logistic regression. The AOR at a 95% confidence interval was used to identify the strength of the association, and a p value of 0.05 was used to declare it statistically significant at the final model.ResultA total of 385 nurses participated in the study, for a 91% response rate. Among these, 49.9% of nurses had an unfavorable attitude. Being working in a primary hospital [AOR = 2.3; 95% CI: (1.4–3.8)], poor cooperation of nurses [AOR = 1.7; 95% CI: (1.1–2.8)], being unsatisfied with the job [AOR = 1.7; 95% CI: (1.1–2.7)], and poor perceived supervision of work [AOR = 6.2; 95% CI: (3.7–9.8)] were factors associated with nurses’ attitudes towards patient advocacy.ConclusionThe number of nurses who had an unfavorable attitude towards patient advocacy was high. Working in a primary hospital, poor cooperation with others, being dissatisfied with the job, and having an unfavorable perception towards the supervision of work were the factors associated with the unfavorable attitude of nurses towards patient advocacy. It is recommended that all hospitals better support the nurses to increase their job satisfaction and have good supervision of the nurses’ activities.

Post-marketing quality surveillance of selected antibacterial agents marketed in porous borders; the case of Ethiopia-Sudan-Eritrea border.

The presence of poor-quality medicines is becoming a public health threat in many parts of the world, particularly in developing countries. Antibiotics are among the most common anti-infective medicines that are highly prone to this problem. The purpose of this study was to assess the quality of selected antibacterials that are marketed in Setit Humera and West Gondar Zones, North West Ethiopia, which are located on the Ethiopian side of the Ethiopia-Sudan-Eritrea border. Seventy-one samples of the four antibacterial medicines (Ciprofloxacin, Norfloxacin, Amoxycillin, and Amoxycillin clavullanate combination) were collected from six sites in Setit Humera and West Gondar Zones, North West Ethiopia. A mystery shopping system was used for sample collection. Visual inspections and confirmation of the registration status were carried out using the joint WHO/FIP/USP checklist and the Ethiopian Food and Drug Authority's (EFDA's) Electronic Regulatory Information System (eRIS), respectively. Then Pharmacopeial methods (USP, BP) were employed to assess the physicochemical quality parameters. During the period of our data collection, the application status for registration in the eRIS system was checked. From 71 samples, 25.35% (18/71) were not registered, and 15.49% (11/71) were registered, but the license period had expired. Some samples (12.06% (17/71)) did not meet the visual inspection criteria. The physicochemical evaluation showed that all the samples studied met the quality specifications for the identification and hardness tests. However, concerning assay, dissolution, uniformity of dosage units, disintegration, and friability test parameters, 27.49% (23/71), 16.9% (12/71), and 14.08% (10/71), 2.82% (2/71) and 8.57% (3/35) of samples were found to be substandard, respectively. Overall, 56.33% (40/71) of the samples tested were of poor quality, failing to meet any one or more of the assessed parameters in this study. The study indicated that poor-quality antibacterial medicines are circulating in the study sites. Therefore, even if the area was affected by conflict at the time of the study, the regulatory bodies should focus on enforcing the necessary measures by collaborating with the regional and national regulatory medicine agencies to ensure that the antibacterial medicines available meet the required mandatory minimum standards.

Quality of life among people with mental illness attending a psychiatric outpatient clinic in Ethiopia: a structural equation model.

Mental illness is one of the most severe, chronic, and disabling public health problems that affects patients' Quality of life (QoL). Improving the QoL for people with mental illness is one of the most critical steps in stopping disease progression and avoiding complications of mental illness. Therefore, we aimed to assess the QoL and its determinants in patients with mental illness in outpatient clinics in Northwest Ethiopia in 2023. A facility-based cross-sectional study was conducted among people with mental illness in an outpatient clinic in Ethiopia. The sampling interval was decided by dividing the total study participants who had a follow-up appointment during the data collection period (2400), by the total sample size 638, with the starting point selected by lottery method. The interviewer-administered WHOQOL BREF-26 tool was used to measure the quality of life (QoL) of people with mental illness. The domains of QoL were identified, and indirect and direct effects of variables were calculated using structural equation modelling with SPSS-28 and Amos-28 software. A p-value of < 0.05 and a 95% CI were used to evaluate statistical significance. A total of 636 (99.7%) participants agreed to participate and completed the data collection. The mean score of overall QoL of people with mental illness in the outpatient clinic was 49.6 ± 10 Sd. The highest QoL was found in the physical health domain (50.67 ± 9.5 Sd), and the lowest mean QoL was found in the psychological health domain (48.41 ± 10 Sd). Rural residence, drug nonadherence, suicidal ideation, not getting counselling, moderate or severe subjective severity, family does not participate in patient care and a family history of mental illness had an indirect negative effect on QoL. Alcohol use and psychological health domain had direct positive effect on QoL. Furthermore, objective severity of illness, having low self-esteem, and having history of mental illness in the family had both direct and indirect effect on QoL. Furthermore, sociodemographic factors (rural residence, illiterate educational status, not married marital status), social support-related factors (poor self-esteem, family not participating in patient care), substance use factors (alcohol use, tobacco use) and clinical factors (high objective and subjective severity of illness, not getting counselling, suicidal ideation, higher number of episodes, comorbid illness, family history of mental illness, poor drug adherence) directly and indirectly affected QoL. In this study, the QoL of people with mental illness was poor, with the psychological health domain the most affected. Sociodemographic factors, social support-related factors, drug use factors, and clinical factors, directly and indirectly affected QoL through the mediator variables of physical health domains, psychological health domains, social relation health domains, and environmental health domains. In order to improve the QoL of people with mental illnesses, we recommend that emphasis be given to addressing the QoL of those with mental illness, including the development of policy and practice responses that address the above identified factors.

Evaluation of the implementation fidelity of comprehensive emergency obstetric and newborn care at University of Gondar comprehensive specialized hospital, Northwest Ethiopia: a mixed-method evaluation

BackgroundApproximately 15% of births worldwide result in life-threatening complications during pregnancy, delivery, or postpartum. Comprehensive Emergency Management of Obstetric and Newborn Care (CEmONC) is intended as one of the measures for maternal healthcare services to reduce the high burden with regard to childbirth complications. However, its state of implementation fidelity has not been well investigated. Therefore, this study aimed to evaluate the implementation fidelity of CEmONC services at University of Gondar Comprehensive Specialized Hospital, Ethiopia.MethodA case-study design with an embedded mixed method was employed. Adherence, quality of delivery, and participant responsiveness dimensions from Carroll’s conceptual framework were used in this evaluation. Four hundred four exit interviews, 423 retrospective document reviews and 10 key informants were conducted. Moreover, a binary logistic regression model was fitted. The qualitative data were transcribed, translated, coded, and analysed using a thematic analysis approach. The overall implementation fidelity of the CEmONC was judged based on the pre-seated judgmental criteria.ResultsOverall the implementation fidelity of the CEmONC service was 75.5%. Quality of delivery, participant responsiveness and adherence were 72.7%, 76.6% and 77.2% respectively.Signal functions like parenteral antibiotics and removal of retained products were insufficiently performed against the recommended protocols which was also evidenced by the key informant interviews. Healthcare providers’ respect for the clients was less. Age ≥ 35 years (AOR = 0.48, 95% CI: 0.24,0.98), educational status of college and above (AOR = 2.61, 95% CI: 1.46,4.66), being government employed (AOR = 1.85, 95% CI: 1.08,3.18), having ANC follow-up (AOR = 5.50, 95% CI: 1.83, 16.47) and grand multigravida (AOR = 2.17, 95% CI: 1.08, 4.38) were factors significantly associated with participant responsiveness towards the services.ConclusionsThe overall implementation fidelity of the CEmONC services was implemented in good fidelity. Moreover, the quality of delivery was judged as implemented in fair fidelity. Parenteral antibiotics and removal of retained products were not found to be sufficiently performed. Respect for the clients was insufficiently delivered. Therefore, it is recommended that parenteral antibiotics drugs be adequately provided and training for healthcare providers regarding compassionate and respectful care shall be facilitated. Moreover, healthcare providers are strongly recommended to adhere to the recommended guidelines.

Satisfaction of chronic patients with community-based health insurance schemes and related factors: Explanatory sequential mixed methods study.

Chronic disease poses a serious threat to accessible, high-quality healthcare. Community-based health insurance (CBHI) schemes provide the poor with financial security. However, there is no evidence in Ethiopia on how satisfied chronic patients are with the schemes. The objective of the current study was to evaluate the satisfaction of chronic patients with the schemes and identify contributing factors. A hospital-based explanatory sequential mixed methods study on 632 chronic patients and 12 key informants was carried out between February 28 and May 31, 2022, in the hospitals of East Gojjam, Northwest Ethiopia. Hospitals and study participants were selected using multistage sampling methods. Quantitative data was entered using Epi Data 3.1 and exported to SPSS version 25 for analysis. P value <0.05 was used to consider significant association in multivariable binary logistic regression. Thematic analysis was a method to manually review qualitative data. A narrative approach was used for integrating the two data. The mean age of study participants was 46.1 (46.1± 5.2, range: 25-82). Patients aged 45 to 64 made up the majority of the population (60.6%). Rheumatoid arthritis affected the preponderance of individuals (36.4%). The overall level of satisfaction of chronic patients with the CBHI scheme was 31% (95% CI; 27-35%). Respect and friendliness (AOR = 7.05; CI: 3.71-13.36), knowledge of benefits packages (AOR = 2.02; CI: 1.24-3.27), partial or non-availability of drugs (AOR = 0.24, AOR = 0.21, respectively), waiting times (AOR = 1.84; CI: 1.12-3.0), and availability of laboratory tests (AOR = 1.59; CI: 1.01-2.48) were significantly associated with participants' satisfaction with the schemes. Our study revealed that the overall satisfaction of chronic patients was quite low and affected by the availability of drugs and laboratory tests, caregivers' respect and friendliness, waiting times, and participant knowledge. Therefore, stakeholders must concentrate on reducing waiting times, improving the availability of drugs and laboratory tests at each hospital, opening back up community pharmacies, and promoting awareness about benefits packages primarily through health education. The main focus of researchers needs to be on nationally representative studies that include more important factors.

Change management through strategic leadership: the mediating effect of knowledge management in public organizations, Ethiopia

The purpose of this study is to investigate the effects of strategic leadership on change management within public organizations, mediated by knowledge management. In this study, an explanatory design and a quantitative approach were employed. A structured questionnaire survey was administered to 366 randomly selected respondents from public organizations in northwest Ethiopia. The reliability and validity of the scale items were rigorously assessed, and the data were analyzed using partial least squares structural equation modeling. The findings reveal the direct effects of strategic leadership and knowledge management on change management, with knowledge management partially mediating the relationship between strategic leadership and change management. The study addresses a significant gap in the literature by shedding light on how strategic leadership drives change in public organizations. Its interdisciplinary approach and examination of mediation offer original insights, paving the way for future studies on challenges within public service contexts. Recommendations underscore the importance of considering local context, embracing adaptive leadership, and integrating knowledge processes for effective change management in public organizations.

Clients’ satisfaction with cervical cancer screening services and influencing factors at public health facilities in Debre Markos town, Northwest Ethiopia, 2022/23: a convergent parallel mixed method

BackgroundSatisfaction is defined as the perceived fulfillment of patient or client needs and desires through the delivery of healthcare services. In developed countries, more than 60% of women have been screened for cervical cancer. However, only 12% of women in sub-Saharan Africa have been screened for precancerous cervical lesions. There is limited evidence on client satisfaction with cervical cancer screening services (CSCCSS) in Ethiopia, particularly, there is no study conducted by mixed method in the Amhara region.ObjectiveThe study aimed to assess clients’ satisfaction with cervical cancer screening services and influencing factors among women screened in Debre Markos town public health facilities in Northwest Ethiopia, 2022/23.MethodsA convergent parallel mixed methods design was conducted in Debre Markos town’s public health facilities from October 10th, 2022 to January 10th, 2023. For the quantitative wing, a total of 401 cervical cancer screening service users were selected using a systematic random sampling technique. Data were collected using an interviewer-administered structured questionnaire. Clients were interviewed on exit in a private area far from the screening unit and the data were entered into Epi-data version 4.6.0.2, then exported to STATA version 14 for analysis. A binary logistic regression model was fitted to identify factors associated with client satisfaction with cervical cancer screening services. The qualitative data were collected through in-depth and key informant interviews using a semi-structured topic guide. The data were analyzed using a thematic analysis approach with Open code software (version 4.0.2.3).ResultThe quantitative wing revealed that overall, 65% (95% CI: 60–69) of respondents were satisfied with the cervical cancer screening services they received. Gender of the provider (AOR: 6.11, 95% CI: 3.23–11.55, p-value = 0.000), waiting time (AOR: 4.77, 95% CI: 1.32–17.31, p-value = 0.017), clients’ knowledge (AOR: 0.26, 95% CI: 0.12–0.59, p-value = 0.001), and clients’ attitude (AOR: 6.43, 95% CI: 3.43–12.03, p-value = 0.000) were significantly associated with CSCCSS.Qualitative resultThe thematic analysis revealed three themes. Theme 1: facility-related barriers (shortage of skilled manpower, shortage of infrastructure, providers’ skill gap, unavailability of full service, leadership problem, long waiting time). Theme 2: client-related barriers (poor knowledge and attitude, gender preference). Theme 3: facility-related facilitators (free service, presence of supportive partners).ConclusionAccording to the findings of this study, two-thirds of clients were satisfied with cervical cancer screening services, which was lower than the national target of 80%. Long waiting time, male gender of the service provider, unfavorable attitude, and good knowledge of clients were identified as significant factors negatively affecting client satisfaction with cervical cancer screening.

Prevalence and factors associated with suicidal ideation and attempts among war-affected internally displaced people in northwest Ethiopia, 2022.

People who are forced to leave home often experience emotional suffering and may be disproportionately subjected to risk factors for suicide. Although it is a grave concern for the global public health community, it has not been understood in Ethiopia. This study aims to assess the prevalence and factors associated with suicidal ideation and attempts among war-affected internally displaced people in northwest Ethiopia, 2022. From 23 May to 22 June 2022, a cross-sectional study design was conducted, and a sample of 765 participants was selected through simple random sampling. A structured interview was employed to collect data. Suicidal ideation and attempts were assessed using the Composite International Diagnostic Interview. Out of 751 interviewed participants with a response rate of 98.2%, the magnitude of suicidal ideation and attempt was 22.4% (95% CI: 19.5%, 25.4%) and 6.7% (95% CI: 5.1%, 8.7%), respectively. People of female gender, having depression, family with a history of mental illness, and poor social support were significantly associated with both suicidal ideation and attempts. Furthermore, post-traumatic stress symptoms and the death of a family member were significantly associated with suicide ideation and attempt, respectively. At least one in five of the displaced people in this population had experienced suicide ideation, and one in fifteen had attempted suicide. Therefore, strengthening early detection and intervention for individuals is recommended, especially for females with depression, post-traumatic stress symptoms, family with a history of mental illness, poor social support and the death of family members.

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.

Measles Outbreak Investigation in Aneded District, Northwest Ethiopia: A Case-Control Study

BackgroundBetween 2000 and 2018, global measles deaths decreased by 73%, but the disease remains prevalent in many developing countries, especially in Africa and Asia. Although Ethiopia was attempting to eliminate the measles, it still ranks fourth in the world in terms of the number of cases. The aim of the investigation was to describe the outbreak and identify its determinants in the Aneded district.MethodsBetween March 3, 2020, and April 2, 2020, the 89 patients and 178 controls participated in a case-control study. Data were gathered by means of in-person interviews with household leaders. The attack and case fatality rates were determined. In multivariable logistic regression analysis, variables having a p-value of less than 0.05 were considered statistically significant cut-off points.ResultsAn investigation was conducted on a total of 89 measles cases, with 3 deaths and 178 controls. In total, there were 1.65 attacks per 1000 people, or 3.4% of the case fatality rate. There were 155 days of outbreak duration. The disease was significantly associated with being female [adjusted odds ratios (AOR) = 2.66; 95% confidence interval (CI) = 1.38–5.11], under 5 years old [AOR = 7.24; 95% CI = 2.58–20.31], positive in attitude [AOR = 0.22; 95% CI = 0.11–0.42], and having a contact history [AOR = 3.19; 95% CI = 1.67–6.10].ConclusionThe measles outbreak, with its higher attack and case fatality rate, has been influenced by factors like household attitudes, age, sex, contact and travel history and needs to be reduced through early detection, active surveillance, and fostering favorable attitudes towards disease prevention and control.

Awareness of Colorectal Cancer and associated Factors among Adults in Bahir Dar City, Northwest, Ethiopia.

Colorectal cancer (CRC) is characterized by abnormal cancerous division of cells in the colon or rectum. Colorectal cancer (CRC) is the second most prevalent cause of cancer-related deaths worldwide. Therefore, this study aimed to assess awareness of colorectal cancer and its associated factors among adults in Bahir Dar City, Northwest Ethiopia, in 2023. A community-based, cross-sectional study was conducted in Bahir Dar City from April 17 to May 23, 2023. A total of 845 participants were selected using stratified multi-stage sampling. Interviewer administered questionnaire and validated cancer awareness Questionnaire were used to measure awareness of colorectal cancer in adults. In this study, a total of 845 individuals were approached, and 839 participated, with a response rate of 99.2%. Out of 839 respondents, 314 (37.4%) of them had a high awareness of colorectal cancer. Being female (AOR (4.6) 95% CI (3.19-6.63), living in urban areas [AOR = 4.74; 95% CI (3.14-7.15)], educational level secondary school [AOR = 2.1 times; 95% CI (1.02-4.32)] and college and above [AOR =22.9; 95% CI (1.13-6.47)], and heard about colorectal cancer [AOR = 4.29; 95% CI (2.96-6.22)] had high awareness of colorectal cancer. The current study revealed that awareness of colorectal cancer was low. Sex, residency, level of education, and hearing about CRC, were associated factors of the awareness of CRC. Therefore, community-based education should be promoted about awareness of colorectal cancer.

Selection criteria and husbandry practices of indigenous chicken producers in Northwest Ethiopia

This study was conducted to identify the selection criteria and husbandry practices of chicken producers in different agro-ecological zones of Northwest Ethiopia as input for designing a breeding program. The study employed a purposive selection of districts and peasant associations with high indigenous chicken potential. The study areas were stratified based on the major agro-ecologies (highland, midland, and lowland). A total of 360 households were included in the study, and data on chicken breeding practices, selection criteria, and reproductive performance were collected and analyzed using SPSS software. In all agro-ecologies, egg production was prioritized by chicken owners when choosing female chickens. For male chickens, plumage color (index = 0.27), appearance (index = 0.24), and growth rate (index = 0.23) were the main selection factors. Farmers kept chickens primarily to generate cash through the sale of eggs and live animals (male chickens). There was a significant difference (p < 0.01) among agro-ecologies in nutritional management and housing of chickens. Chicken flock composition showed a highly significant difference (p < 0.001) among agro-ecologies, except layers. Most of the farmers had their own cock born in the flock. Chicken owners found in all agro-ecologies were practicing culling unwanted chickens. All the reproductive performance traits have shown a highly significant (p < 0.001) difference among agro-ecologies. A relatively higher inbreeding coefficient (0.18) was obtained in the highland agro-ecology compared to midland (0.16) and lowland (0.12). The study highlighted the importance of designing breeding programs that align with farmers' production objectives and trait preferences based on specific agro-ecologies for sustainable increases in chicken productivity.