Publications by authors named "Diriba Mulisa"

13 Publications

  • Page 1 of 1

Knowledge, Attitude and Practice Toward Corona virus Infection Among Pregnant Women Attending Antenatal Care at Public Hospitals in Three Wollega Zones, Ethiopia.

Int J Gen Med 2021 15;14:3563-3573. Epub 2021 Jul 15.

Departments of Pediatrics and Neonatology Nursing, School of Nursing and Midwifery, Wollega University, Nekemte, Ethiopia.

Background: Pregnancy is an immune-suppressed state which makes pregnant women generally more susceptible to COVID-19 infection and severe illness. Extensive precautions have been recommended to avoid exposure to the virus. Knowledge and attitude toward the disease play an integral role in readiness to accept public health measures. This study aimed to assess the knowledge, attitude and practice towards COVID-19 among pregnant women attending antenatal clinics in three Wollega zones, Ethiopia.

Methods: Institution-based cross-sectional study was employed among 415 pregnant women attending antenatal care at public hospitals in three Wollega zones, Ethiopia from July to August 2020. The data were collected using an interviewer-administered structured questionnaire. The level of knowledge was assessed using 12 multiple choice questions; the score of above or equal to mean was considered as adequate knowledge. Binary logistic regression was performed and the adjusted odds ratio with P-value ≤0.05 at 95% CI was taken as statistically significant.

Results: This study indicates that more than two-thirds (75.4%; 95% CI: 71.1-79.3%) and 43.6% of the pregnant women had adequate knowledge and good practice about the coronavirus pandemic, respectively. The pregnant women who attended secondary school and above and were urban residents were more likely to have good knowledge, AOR = 2.99 (1.7-5.0) and 1.6 (1.2-2.7), respectively. Maternal age ≤ 25 yearsand being an urban resident were the two predictors of good practice of preventive measures, AOR = 1.7 (1.2-2.6) and 2.3 (1.3-4.0), respectively.

Conclusions And Recommendations: The target population demonstrated acceptable knowledge and poor practice toward COVID-19. Health-care providers should give more attention to educating pregnant women at any point of contact; legal enforcement should be implemented to improve practice of preventive measures. Special consideration should be given to those who are from rural areas, and to less-educated pregnant women.
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http://dx.doi.org/10.2147/IJGM.S295490DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8289464PMC
July 2021

Neonatal Mortality and Its Associated Factors among Neonates Admitted to Wollega University Referral Hospital Neonatal Intensive Care Unit, East Wollega, Ethiopia.

Glob Pediatr Health 2021 7;8:2333794X211030157. Epub 2021 Jul 7.

Mizan-Tepi University, Mizan Teferi, Ethiopia.

Ethiopia has a high neonatal mortality rate in spite of dearth of study. Therefore we aimed to assess magnitude and associated factors of neonatal mortality among neonates admitted to neonatal intensive care units of Wollega University Referral Hospital. Accordingly, a facility based cross-sectional study was conducted on 289 by reviewing medical records of neonates admitted to neonatal intensive care unit. The collected data were entered in to Epi data version 3.1 and Stata version 14 used for analysis. Variables with -value  0.25 at with 95% confidence interval in binary logistic regression analysis were taken to the multiple logistic regression analysis. Finally, variables with Likewise, variable with -value < 0.05 at 95% confidence interval in multiple logistic regression analysis were considered as statistically significant. Among 289 neonates admitted to neonatal intensive care unit, 53 (18.34 %) were died. Majority 42(79.25%) of those deaths occurred at ≤ 7 days of birth. Preterm [AOR 4.15, 95% CI (1.67-10.33)], neonates faced birth asphyxia [AOR 3.26, 95% CI (1.33-7.98)], neonates who developed sepsis [AOR 2.29 95% CI (1.01-5.20)] and neonates encountered with jaundice [(AOR 11.08, 95% CI (1.03-119.59)] were more at risk to die. In general, the magnitude of neonatal mortality among neonates admitted to neonatal intensive care unit was high. Gestational age (maturity of new born), birth asphyxia, neonatal sepsis and neonatal jaundice were predictors of neonatal mortality. Neonates admitted to neonatal intensive care unit with sepsis, jaundice, and birth asphyxia demand special attention to reduce neonatal mortality.
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http://dx.doi.org/10.1177/2333794X211030157DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8267021PMC
July 2021

High Perceived Stigma Among People Living with HIV/AIDS in a Resource Limited Setting in Western Ethiopia: The Effect of Depression and Low Social Support.

HIV AIDS (Auckl) 2021 1;13:389-397. Epub 2021 Apr 1.

Maternal and Child Wellbeing Unit, African Population and Health Research Centre, Nairobi, Kenya.

Background: Antiretroviral therapy (ART) is only one part of a successful range of care among people living with HIV/AIDS (PLWHA). Stigma and low social support are emerging issues worsening the success of ART for PLWHA. This study thus aimed to investigate the level of perceived stigma among PLWHA.

Methods: An institution-based cross-sectional study was conducted in Nekemte, western Ethiopia. A multivariable logistic regression model was used to identify associations between perceived stigma and low social support, depression, and other potential predictor variables using SPSS version 24.0 and adjusted odds ratios (AORs), considering statistical significance at <0.05.

Results: A total of 418 study participants were included in the study, with a response rate of 100%. About 48.6% of PLWHA had experienced perceived stigma, and more than two-fifths had poor social support. The following factors were associated with perceived stigma among PLWHA: age (18-29 years) (AOR=4.88, 95% CI:1.76-13.5), female sex (AOR=2.10, 95% CI 1.15-3.82), <12 months on ART (AOR=2.63, 95% CI 1.09-6.34), depression (AOR=1.86, 95% CI 1.08-3.19), social support (poor: AOR=3.45, 95% CI 1.65-7.23; medium: AOR=2.22, 95% CI 1.09-4.54), and non-disclosure of HIV status (AOR=2.00, 95% CI 1.11-3.59).

Conclusion And Recommendation: The magnitude of perceived stigma among PLWHA was high, highlighting the importance of integrating social and mental health support within standard ART for PLWHA.
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http://dx.doi.org/10.2147/HIV.S295110DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8021262PMC
April 2021

HIV serostatus disclosure and associated factors among HIV positive pregnant and lactating women at Nekemte public health facilities, western Ethiopia.

PLoS One 2021 19;16(3):e0248278. Epub 2021 Mar 19.

School of Nursing and Midwifery, Institutes of Health Sciences, Wollega University, Nekemte, Ethiopia.

Background: Disclosure of Human Immune Virus (HIV) serostatus by pregnant and lactating women is crucial for the successful prevention of mother to child transmission of HIV/AIDS. However, little has been studied regarding the prevalence and factors associated with HIV status disclosure among HIV positive pregnant and lactating women in Ethiopia.

Methods: An institution-based cross-sectional study was conducted in the Nekemte Public Health facilities among 380 pregnant and lactating women enrolled in universal antiretroviral therapy (ART) treatment from January 2015-December, 2019. The data were collected by using a checklist, developed from Prevention of Mother to Child Transmission (PMTCT) logbook, ART intake forms, and medical cards of the patients. Epidata version 3.2 was used for data entry, and then the data were exported to STATA version 14 for further analysis. The binary logistic regression model was employed to determine factors associated with the disclosure status among HIV positive pregnant and lactating women. Adjusted Odds Ratio (AOR) with 95% confidence intervals was computed and statistical significance was declared when it is significant at a 5% level (p-value < 0.05).

Results: A total of 380 women have participated in the study. Two hundred seventy-six (73.4%) of women had disclosed their HIV status to at least one individual. The study found living in urban (OR = 1.83, 95% CI: 1.04, 3.20), married women (OR = 4.16, 95% CI: 1.87, 9.24), higher educational status (OR = 2.35, 95% CI: 1.31, 5.51), positive HIV status of partner (OR = 2.35, 95%CI: 1.17, 4.70), and being multipara (OR = 4.94, 95% CI: 2.29, 10.66) were independent determinants of HIV status disclosure.

Conclusions: HIV status disclosure among pregnant and lactating women in the study area was sub-optimal. Empowering women through education, encouraging partners for HIV testing, and enhancing active male involvement in HIV treatment and control programs should get due attention.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0248278PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7978369PMC
March 2021

Postpartum modern contraception utilization and its determinants in Ethiopia: A systematic review and meta-analysis.

PLoS One 2020 14;15(12):e0243776. Epub 2020 Dec 14.

School of Nursing and Midwifery, Institutes of Health Sciences, Wollega University, Nekemte, Ethiopia.

Background: Contraceptive use is the best and most cost-effective strategy to reduce feto-maternal adverse effects of short birth intervals. More than two-thirds of women in developing countries who do not want to conceive are not using contraception methods. Although there were various primary studies in different parts of the country, there is no nationally representative evidence on postpartum modern contraception utilization and its determinants in Ethiopia.

Objective: This review was aimed to determine the best available pieces of evidence to pool the magnitude of postpartum modern contraception utilization and find out its determinants.

Methods: Published studies were extensively searched by using electronic databases and unpublished studies were identified from the digital library. All observational studies conducted on the magnitude of postpartum modern contraception utilization and its determinants in Ethiopia were included. Data were extracted on the Microsoft Excel spreadsheet and analyzed using STATA 14.1 version. A random-effects model was used to estimate the pooled magnitude of postpartum modern contraception utilization with a 95% confidence interval (CI). Inverse variance (I2) was used to identify the presence of heterogeneity and forest plot was used to estimate the pooled magnitude of postpartum contraception utilization. The presence of publication bias was assessed by funnel plots and Egger's statistical tests. Sub-group analysis was computed to minimize underlying heterogeneity.

Findings: In this review, 19 primary studies were included. The pooled magnitude of postpartum modern contraception utilization in Ethiopia was 45.79% (95%CI 36.45%, 55.13%). The review found that having more than four Antenatal care visits(ANC), having postnatal care visit (PNC), having a formal education, history of family planning use, history of counseling on family planning, and having greater than four alive children as significant determinants of postpartum modern contraception utilization.

Conclusion: The magnitude of postpartum modern contraception utilization in Ethiopia was low. ANC visit, PNC visit, maternal educational status, history of previous family planning use, counseling on family planning, and number of alive children were found to be significant determinants of postpartum modern contraception utilization. Therefore, strengthening focused ANC and PNC services to encourage women in utilizing modern contraception during the postnatal period is needed.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0243776PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7735615PMC
February 2021

Fertility desire and associated factors among people living with HIV in Ethiopia: a systematic review and meta-analysis.

Arch Public Health 2020 Nov 23;78(1):123. Epub 2020 Nov 23.

Department of Public health, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia.

Background: Increased Anti-Retroviral Therapy (ART) coverage improves health status and the survival of people living with Human Immunodeficiency Virus (HIV) as a result, reproductive health needs of the clients are increased. As part of continuum HIV care, understanding fertility desire and reproductive health care needs of HIV positive peoples will play paramount role in planning and delivering appropriate health services. The finding of studies conducted on the fertility desire and associated factors among People Living with HIV in Ethiopia presented inconclusive. Therefore, this study aimed to assess the pooled prevalence of fertility desire and associated factors among people living with HIV in Ethiopia.

Methods: A total of 26 studies conducted in Ethiopia were included in this Meta-analysis. Pub Med, HINARI, Google scholar and Google data bases were searched. Data from the included articles were extracted using a standardized data extraction tool. The included studies were analyzed using a random effects meta-analysis model. Analysis was done Using STATA version 14 statistical software. Heterogeneity was assessed statistically using the standard Chi-square, I The association between fertility desire and factors were examined using a random effects model.

Result: In this meta-analysis, the pooled prevalence of fertility desire in Ethiopia is 42.21% (95%CI 39.18, 45.25). Fertility desire is significantly associated with sex: being female (OR = 0.71,95%CI 0.57,0.86), partners desire (OR = 16.8, 95% CI: 9.45, 29.88), not having child (OR = 5.46 95%CI 4.24, 7.040), age < 30(OR = 2.34, 95%CI 2.10, 2.60), formal education (OR = 1.31 95%CI 1.09, 1.59)). However, use of family planning, residence, and Knowledge on Prevention of Mother to Child Transmission and disclosure status didn't show association with fertility desire.

Conclusion: In this finding, significant people of living with HIV have a desire to have a child. The finding showed the need to strengthen fertility desire and reproductive health care needs of HIV positive peoples. Therefore, strengthening the integration of fertility related issues with HIV continuum care will play a paramount role in averting risky sexual behaviors and Prevention of Mother to Child Transmission among peoples on ART.
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http://dx.doi.org/10.1186/s13690-020-00504-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7685622PMC
November 2020

Impact of antenatal care on neonatal mortality among neonates in Ethiopia: a systematic review and meta-analysis.

Arch Public Health 2020 Nov 10;78(1):114. Epub 2020 Nov 10.

Department of Statistics, College of Natural Science, Dire Dawa University, Dire Dawa, Ethiopia.

Background: As compared to other regions of the world, Sub Saharan Africa (SSA) is the region with the highest neonatal mortality and is the region showing the least progress in the reduction of newborn death. Despite better progress made in reducing neonatal mortality, Ethiopia contributes the highest rate of neonatal death in Africa. In Ethiopia, findings from few studies were inconsistent and there is a need to systematically pool existing data to determine the impact of antenatal care on neonatal mortality among mother-neonate pairs in Ethiopia.

Methods: Published articles from various electronic databases such as Medline, Hinari, Pub Med, Cochrane library, the Web of Science, and Google Scholar were accessed. Also, unpublished studies from library catalogs were identified. All observational studies that were conducted on the association between antenatal care follow-up and neonatal mortality among neonates in Ethiopia were included. Data were extracted on the Microsoft Excel spreadsheet and analyzed using STATA 14.1 version. A random-effects model was used to estimate the pooled estimate with a 95% confidence interval (CI). Forest plots were used to visualize the presence of heterogeneity and estimate the pooled impact on antenatal care on neonatal mortality. The presence of publication bias was assessed by funnel plots and Egger's statistical tests.

Results: Initially, a total of 345 studies were accessed. Finally, 28 full-text studies were reviewed and fourteen studies fulfilled inclusion criteria and included in the final meta-analysis. The overall pooled estimate indicates the odds of neonatal death among neonates from women with antenatal care were 65% lower than those neonates from women who had no antenatal care follow-up (OR: 0.35, 95% CI: 0.24, 0.51).

Conclusions: In this systematic review and meta-analysis, lack of ANC follow-up increase the probability of neonatal mortality as compared to having ANC follow-up. Thus, we will recommend for more coverages of appropriate antenatal care where risk groups can best be identified and managed.
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http://dx.doi.org/10.1186/s13690-020-00499-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7653817PMC
November 2020

The magnitude of adherence to option B plus program and associated factors among women in eastern African countries: a systematic review and meta-analysis.

BMC Public Health 2020 Nov 27;20(1):1812. Epub 2020 Nov 27.

Department of Public Health, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia.

Background: Despite coverage and benefits associated with the prevention of mothers to child transmission (PMTCT) services, mothers' adherence to option B plus is still a challenge. Though few primary studies are available on the magnitude of adherence to option B plus and factors associated in Eastern African countries, they do not provide strong evidence in helping policymakers to address suboptimal adherence to option B plus. Therefore, this systematic review and meta-analysis was intended to estimate the pooled magnitude of adherence to option B plus program and associated factors among women in Eastern African countries.

Methods: PubMed, Medline, HINARI, Cochrane library, the Web of Science, and Google Scholar were searched for studies reported on the magnitude of adherence to option B plus among women in Eastern African countries. The search terms used were "option B plus", "magnitude", "prevalence", "PMTCT", "ART adherence", "associated factors", "all lists of Eastern African countries" and their combination by Boolean operators. The effect sizes of the meta-analysis were the magnitude of adherence to option B plus and the odds ratio of the associated factors. STATA/SE V14 was used for statistical analysis, and publication bias was assessed using funnel plots and Egger's test.

Results: Fourteen studies having total participants of 4883 were included in the systematic review and meta-analysis. Using the random effect model, the pooled prevalence of adherence to option B plus was 71.88% (95% CI: 58.54-85.23%). The factors associated with good adherence to option B plus PMTCT program were partner support (Adjusted odds ratio (AOR) = 4.13; 95% CI: 2.78-6.15), received counseling services (AOR = 4.12, 95% CI: 2.81-6.02), disclosure of HIV status to partner (AOR = 4.38; 95% CI: 1.79-10.70), and clinical stage of HIV/AIDS I/II (AOR = 2.62; 95% CI: 1.53-4.46).

Conclusion: The level of adherence to option B plus program in Eastern African countries was generally sub-optimal. Thus, a coordinated effort is needed to raise the number of mothers to be tested, and early treatment initiation for HIV positive mothers before the disease advances. Furthermore, counseling services for couples on the importance of early treatment initiation and adherence to medications must be given due attention.
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http://dx.doi.org/10.1186/s12889-020-09903-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7693523PMC
November 2020

Magnitude of first line antiretroviral therapy treatment failure and associated factors among adult patients on ART in South West Shoa, Central Ethiopia.

PLoS One 2020 11;15(11):e0241768. Epub 2020 Nov 11.

Department of Nursing, College of Health Sciences, Diredawa University, Diredawa, Ethiopia.

Background: First-line antiretroviral treatment failure has become a public health concern in high, low and middle-income countries with high mortality and morbidity In Ethiopia, around 710,000 peoples were living with HIV and 420,000 of them were receiving ART in 2017. Little is known about the magnitude of first-line ART treatment failure and its associated factors in Ethiopia, particularly in the study area. Therefore, this study was aimed to find the magnitude of first-line ART treatment failure and its associated factors among adult patients attending ART clinic at Southwest shoa zone public hospitals.

Methods: Institutions based cross-sectional study was employed from February 1 to April 2, 2019. An interviewer administered questionnaire was used to collect data from 350 adult patients on ART using a systematic random sampling technique. The collected data were coded and entered into Epidata version 3 and exported to STATA SE version 14 for analysis. Bivariable and multivariable logistic regression was done to identify factors associated with first-line ART treatment failure. At 95% confidence level strength of association was measured using Odds ratio. Variables with a p-value of ≤ 0.25 in the bivariable analysis were considered as a candidate variable for multivariable analysis. To get the final variables step-wise backward selection procedure was used and those in the final model were selected at a p-value <0.05. Finally, texts, simple frequency tables, and figures were used to present the findings.

Results: In this study the magnitude of first-line ART treatment failure was 33.42%. Absence of baseline opportunistic infection AOR = 0.362 (95%CI0.178, 0.735), Staying on first-line ART for <5 years AOR = 0.47 (95%CI 0.252, 0.878), Nevirapine containing ART regimen AOR = 3.07 (95%CI 1.677, 5.63), Baseline CD4 count ≥100 cells/mm3 AOR = 0.299 (95%CI 0.152 0.591), absence of opportunistic infections after ART initiation AOR = 0.257 (95%CI 0.142, .467), time taking greater than an one-hour to reach health facility AOR 1.85 (95%CI 1.022 3.367) were significantly associated with first-line ART treatment failure.

Conclusion: The magnitude of first-line ART treatment failure was high in the study area. Base-line opportunistic infection, duration on first-line ART, NVP based ART, Baseline CD4 count level, OI after ART initiation, and time it takes to reach health facility were independent determinants of first-line ART treatment failure.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0241768PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7657481PMC
January 2021

Nurses' knowledge about palliative care and attitude towards end- of-life care in public hospitals in Wollega zones: A multicenter cross-sectional study.

PLoS One 2020 7;15(10):e0238357. Epub 2020 Oct 7.

Department of Mathematics, College of Natural and Computational Science, Wollega University, Nekemte, Ethiopia.

Background: Palliative care is nowadays essential in nursing care, due to the increasing number of patients who require attention in the final stages of their life. Lack of knowledge of and negative attitude palliative care among nurses is one of the most common barriers to quality palliative care. This study, therefore, aimed to assess nurses' knowledge about palliative care and attitude toward end-of-life care in public hospitals in Wollega zones, Ethiopia.

Methods: A multicenter institutional-based cross-sectional study design was employed to collect data from 372 nurses working in public hospitals in Wollega zones from October 02-22, 2019. A self-administered questionnaire with three different parts: Demographic characteristics of nurses, the Palliative Care Quiz for Nursing (PCQN), and the Frommelt Attitudes Towards Care of the Dying (FATCOD). SPSS version 21 was used for analysis used for data analysis. The binary logistic regression test was used for analysis at p < 0.05.

Findings: Our final sample size was 422 nurses (response rate = 88%). With the mean total PCQN scores (9.34), the majority of them showed an inadequate level of knowledge about palliative care. The mean total FATCOD scores (79.58) displayed a positive attitude toward end-of-life care, with 52% of respondents eager to care for a dying person and their family. Nurses who had PC service experience [AOR = 1.94 CI (1.10-3.42), p = 0.02] and had ever attended training/lecture on PC [AOR = 1.87 CI (1.01-3.46), p = 0.04] were independently associated with nurses' knowledge about PC. Similarly, nurses who had no PC service experience [AOR = 0.41, CI (0.21-0.79), p = 0.008], who read articles/brochures about PC [AOR = 1.94, CI (1.11-3.39), p = 0.01] and had provided care for a smaller number of terminally ill patients [AOR = 1.74, CI (1.01-2.97), p = 0.04] were significantly associated with nurses' attitude towards end-of-life care.

Conclusion: The study highlighted that nurses' knowledge about palliative care is inadequate, and showed a less favorable attitude toward end-of-life care. The findings also provide evidence for greater attentions and resources should be directed towards educating and supporting nurses caring for patients with palliative care needs in Wollega Zones.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0238357PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7540839PMC
November 2020

Prevalence and associated factors of foot ulcer among diabetic patients in Ethiopia: a systematic review and meta-analysis.

BMC Public Health 2020 Jan 10;20(1):41. Epub 2020 Jan 10.

African Population and Health Research Centre, Maternal and Child Wellbeing Unit, Nairobi, Kenya.

Background: Diabetes and its complications including foot ulcer constitute a global public health challenge attributing to a significant cause of morbidity and mortality. Foot ulcer is one of the long-term complication of diabetes mellitus which lead to infection and amputation of lower extremities. In Ethiopia, findings from few studies were inconsistent and there is a need to systematically pool existing data to determine the magnitude of foot ulcer in diabetics and factors contributing to it.

Methods: We identified articles through electronic databases such as Medline, Hinari, Pub Med, Cochrane library, the Web of Science and Google Scholar. Accordingly, we identified 95 published and one unpublished article. Finally, eleven studies which fullfilled eligibility criteria were included in final systematic review and meta-analysis. Data were extracted using a standardized data extraction checklist and the analyses were conducted using STATA version 14. The Cochrane Q test statistic and I tests were used to assess heterogeneity.

Results: The overall magnitude of foot ulcer was 12.98% (95%CI: 7.81-18.15) in diabetic patients in Ethiopia. Sub-group analyses revealed highest prevalence in Addis Ababa (19.31% (95%CI: 2.7. 41.37)). Foot ulcer was significantly associated with rural residence (OR = 2.72, 95%, CI: 1.84-4.01)), presence of callus on the feet ((OR = 12.67, 95%, CI: 6.47-24.79)), a body mass index of ≥24.5 ((OR = 2.68, 95%, CI: 1.58-4.56)), poor self- care practice ((OR = 1.47, 95%CI: 1.25-1.73)), type I diabetes mellitus ((OR = 0.42, 95%, CI: 0.22-0.79)), staying with DM for < 10 years ((OR = 0.23, 95%, CI: 0.11-0.50)), and age < 45 years ((OR = 0.44, 95%, CI: 0.21-0.92)).

Conclusion: The prevalence of diabetic foot ulcers in Ethiopia is relatively low, although its trend is increasing from time to time. Socio-demographic factors, body weight, and healthcare practice contribute to the development of diabetic foot ulcers. Appropriate interventions towards patient self-care practice, lifestyle modification and follow-up are wanted to prevent diabetic foot ulcers.
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http://dx.doi.org/10.1186/s12889-019-8133-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6954527PMC
January 2020

Incidence and predictors of lost to follow-up among women under Option B+ PMTCT program in western Ethiopia: a retrospective follow-up study.

BMC Res Notes 2020 Jan 7;13(1):18. Epub 2020 Jan 7.

Department of Nursing, Institute of Health Science, Wollega University, Nekemte, Ethiopia.

Objective: Although Ethiopia has been implementing Option B+ program, LTFU of women from the Option B+ program is one of the challenges that minimizes its implementation. Thus, this study assessed the incidence and predictors of LTFU among women under Option B+ PMTCT program in western Ethiopia. An institution-based retrospective follow-up study was conducted. A cox proportional hazards regression model was fitted to identify predictors of LTFU. A Hazard ratios with 95% confidence CI was computed and all predictors that were associated with the outcome variable at p-value ≤ 0.05 in the multivariable cox proportional hazards were declared as a significance predictor of the outcome.

Results: A total of 330 women were followed for a mean follow up time of 16.9 (± 7.6) months. An overall incidence rate of LTFU was 9/1000 person-months. Women's educational status, residence, HIV-disclosure status, the status of women at enrollment, previous history of HIV and ART adherence were significant predictors of LTFU. The incidence of LTFU from Option B+ PMTCT is lower as compared to evidence from sub-Saharan African and strengthening linkage and referral system between clinics as well as establishing appropriates tracing mechanisms would retain pregnant women in the program.
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http://dx.doi.org/10.1186/s13104-019-4882-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6947837PMC
January 2020

Determinants of first line antiretroviral therapy treatment failure among adult patients on ART at central Ethiopia: un-matched case control study.

BMC Infect Dis 2019 Dec 3;19(1):1024. Epub 2019 Dec 3.

School of Nursing and Midwifery, Wollega University, P.O.BOX: 395, Nekemte, Ethiopia.

Background: In 2018 in Ethiopia, magnitude of human immunodeficiency virus Acquired Immunodeficiency Syndrome treatment failure was 15.9% and currently the number of patient receiving second line antiretroviral therapy (ART) is more increasing than those taking first line ART. Little is known about the predictors of treatment failure in the study area. Therefore; more factors that can be risk for first line ART failure have to identified to make the patients stay on first line ART for long times. Consequently, the aim of this study was to identify determinants of first line ART treatment failure among patients on ART at St. Luke referral hospital and Tulubolo General Hospital, 2019.

Methods: A 1:2 un-matched case-control study was conducted among adult patients on active follow up. One new group variables was formed as group 1 for cases and group 0 for controls and then data was entered in to Epi data version 3 and exported to STATA SE version 14 for analysis. From binary logistic regression variables with p value ≤0.25 were a candidate for multiple logistic regression. At the end variables with a p-value ≤0.05 were considered as statistically significant.

Result: A total of 350 (117 cases and 233 controls) patients were participated in the study. Starting ART after 2 years of being confirmed HIV positive (AOR = 3.82 95% CI 1.37,10.6), nevirapine (NVP) based initial ART (AOR = 2.77,95%CI 1.22,6.28) having history of lost to follow up (AOR 3.66,95%CI 1.44,9.27) and base line opportunistic infection (AOR = 1.97,95%CI 1.06,3.63), staying on first line ART for greater than 5 years (AOR = 3.42,95%CI 1.63,7.19) and CD4 less than100cell/ul (AOR = 2.72,95%CI 1.46,5.07) were independent determinants of first line ART treatment failure.

Conclusion: Lost to follow up, staying on first line ART for greater than 5 years, presence of opportunistic infections, NVP based NNRT, late initiation of ART are determinant factors for first line ART treatment failure. The concerned bodies have to focus and act on those identified factors to maintain the patient on first line ART.
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http://dx.doi.org/10.1186/s12879-019-4651-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6889620PMC
December 2019
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