Publications by authors named "Yadeta Dessie"

46 Publications

Knowledge and involvement of husbands in the reproductive rights of women in Harar, eastern Ethiopia.

SAGE Open Med 2021 11;9:20503121211038456. Epub 2021 Aug 11.

College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.

Objective: Reproductive rights violations are a serious public health concern worldwide, particularly in Sub-Saharan Africa, where more than 38.83% of victims live. Understanding the status of husbands' knowledge and involvement helps to establish important programs and interventions. However, there are limited data related to husbands' roles in women's reproductive rights in the study setting. Therefore, this study aimed to assess husbands' knowledge and involvement in women's reproductive rights and their associated factors in Harar, eastern Ethiopia.

Methods: A community-based cross-sectional study was conducted among 611 husbands in March 2020. A systematic random sampling technique was used to select the study participants. Data were collected using a structured and pretested interviewer-administered questionnaire. Data were entered using EpiData 3.1 and analyzed with SPSS Version 22. A multivariable logistic regression model was applied to examine the factors associated with the outcome variable using an adjusted odds ratio with a 95% confidence interval, and a -value < 0.05 was considered statistically significant.

Results: The levels of husbands' knowledge and involvement were 48.3% and 40.1%, respectively. Social media utilization (adjusted odds ratio = 4.97, 95% confidence interval = 2.79-8.85), partners' discussion (adjusted odds ratio = 2.33, 95% confidence interval = 1.60-3.39), and type of facility: hospital (adjusted odds ratio = 3.21, 95% confidence interval = 1.23-8.36) and health post (adjusted odds ratio = 2.86, 95% confidence interval = 1.20-6.94) were factors associated with knowledge of husbands. Likewise, the experience of using reproductive services (adjusted odds ratio = 2.15, 95% confidence interval = 1.52-3.03), partner discussion (adjusted odds ratio = 1.95, 95% confidence interval = 1.35-2.82), social media utilization (adjusted odds ratio = 1.74, 95% confidence interval = 1.05-2.89), and age 40-49 years (adjusted odds ratio = 1.99, 95% confidence interval = 1.19-3.32) were factors associated with husbands' involvement.

Conclusion: Less than half of the husbands were knowledgeable and involved in executing partners' reproductive rights. Promoting and creating effective media utilization is important for creating awareness of reproductive rights. Moreover, working on reproductive health service utilization, women empowerment, and making open discussions between partners are crucial to increase the knowledge and involvement of husbands.
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http://dx.doi.org/10.1177/20503121211038456DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8361514PMC
August 2021

Community risk perception and health-seeking behavior in the era of COVID-19 among adult residents of Harari regional state, eastern Ethiopia.

SAGE Open Med 2021 28;9:20503121211036132. Epub 2021 Jul 28.

School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.

Background: COVID-19 brought significant challenges to public health. It changed the view of global health and safety, trust in the healthcare system, and clients' willingness to seek healthcare. To contain the course of the COVID-19 pandemic and its detrimental effects, understanding peoples' health behavior, especially healthcare-seeking, and determining the community risk perception is very important. Thus, this study aimed to determine the health-seeking behavior, community's risk perception to COVID-19 pandemics, and factors influencing the community risk perception in Harari regional state, Ethiopia.

Methods: Community-based cross-sectional study was conducted from 5 to 30 February 2021. A total of 1320 adult (>18 years) participants were selected using systematic random sampling. The data were collected using an online kobo collect toolbox and analyzed using descriptive statistical tests. Chi-square test and multiple binary logistic regression were applied to examine the difference between variables. A -value < 0.05 was considered to be of statistical significance.

Results: The study included 1296 respondents >18 years old. The overall prevalence of willingness to seek healthcare in the study area was 35.6% (95% CI: 33%-38.3.0%). The mean cumulative score of risk perception was 30.5 (SD ± 7.25) with the minimum and maximum score of 13 and 63, respectively. A total of 656 (50.6%) of the participants had low-risk perceptions concerning COVID-19. The study found a statistically significant association between risk perception and sociodemographic characteristics (age, educational status, and income), and knowledge of the respondents.

Conclusion: The overall prevalence of willingness to seek healthcare was 35.6%. Healthcare intervention aimed to contain the COVID-19 pandemic should consider the factors associated with the study area. Similarly, the study found a low-risk perception among the community that needs critical action to manage the COVID-19 pandemic and to protect the community as a whole. Thus, it is necessary to improve community risk perception through health education.
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http://dx.doi.org/10.1177/20503121211036132DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8323417PMC
July 2021

Magnitude and Predictors of Health Care Workers Depression During the COVID-19 Pandemic: Health Facility-Based Study in Eastern Ethiopia.

Front Psychiatry 2021 15;12:654430. Epub 2021 Jul 15.

School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.

Depression of health care workers was related to work absences, resignations, and poor work performance, affecting the quality of patient care and the health care system. The Coronavirus disease pandemic has had an effect on the mental health of health care workers. Health care workers are facing challenges that can be stressful, overwhelming, and cause strong emotions, may put them at higher risk to develop depression. There is limited evidence that assesses health care workers' depression and its associated factors in the study area during the Coronavirus disease pandemic. Therefore this study aimed to assess depression and associated factors among health care workers in eastern Ethiopia. The cross-sectional study design was conducted from October 26th to November 15, 2020. A total of 265 health care workers from 10 health facilities participated. Patient Health Questionnaire was used for the collection of depressive symptoms. The data were analyzed by using STATA version 14 software. To assess the association between depression and the predictors Adjusted Odds Ratio along with a 95% confidence interval was estimated by using logistic regression analysis. A statistical significance was declared at -value ≤ 0.05. Of the total 265 study participant, 176 (66.4%) and 95% CI: 60.4%, 71.8% of them reported depressive symptoms. Of 176 reported symptoms of depression 27.9, 24.1, 9.4, 3.7, and 1.1% were had minimal, mild, moderate, moderate-severe, and severe depressive symptoms respectively. The multivariable logistic regression analysis revealed the odds of depression were 2.34 times higher among female participants compared to male participants (AOR: 2.34, 95%CI: 1.09-5.02). In addition, the odds of depression for participants who perceived susceptibility to COVID-19 was 4.05 times higher among their counterpart (AOR: 4.05, 95%CI: 1.12-14.53). Health care workers who experienced depression in the study was high. Health care workers' mental health needs to be protected during the COVID-19 pandemic. Female health care workers and health care workers perceived susceptibility of COVID-19 need attention.
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http://dx.doi.org/10.3389/fpsyt.2021.654430DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8319716PMC
July 2021

Patterns and predictors of gestational weight gain in Addis Ababa, Central Ethiopia: a prospective cohort study.

Reprod Health 2021 Jul 28;18(1):159. Epub 2021 Jul 28.

School of Public Health, Faculty of Health, University of Technology Sydney, Ultimo, Sydney, NSW, Australia.

Introduction: Gaining excessive or inadequate gestational weight is associated with many adverse maternal and fetal outcomes. Inadequate gestational weight gain (GWG) increases the risk of fetal growth restriction, pre-term birth, and low birth weight. It is a public health concern in sub-Saharan Africa. The aim of this study was to assess the patterns and predictors of GWG in Addis Ababa, Ethiopia.

Methods: We conducted a prospective cohort study among pregnant women who attended antenatal care in health centres in Addis Ababa, from January to September 2019. Data were collected by a structured questionnaire and checklists and analysed using Stata version-14. Weight at or before 16 weeks gestation was used as a proxy for pre-pregnancy weight. Women's height and baseline weight were measured by data collectors, and we obtained weight at the end of the 24th and 36th weeks of gestation from women's medical records. GWG was categorized as inadequate, adequate and excessive based on the United States Institute of Medicine criteria. Predictors of GWG were identified using multinomial logistic regression.

Results: A total of 395 pregnant women were enrolled in the study. GWG was assessed for 369 (93%) women. The median GWG was 8.7 kg with inter quartile ranges (25th, 75th percentiles) of 7.0 kg and 11.6 kg. More than two-third of the participants, 248 (67.2% [95% CI: 62.2, 72.0%]), gained inadequate weight; 103 (27.9% [95% CI: 23.4, 32.8%]) gained adequate weight; and 18 (4.9% [95% CI: 2.9%, 7.6%]) gained excessive weight. Three quarters (75%) of underweight women gained inadequate gestational weight, whereas 43% of overweight or obese women gained inadequate gestational weight. Being underweight (AOR = 3.30 [95% CI: 1.32, 8.24]) or normal weight (AOR = 2.68 [95% CI: 1.37, 5.24]) before pregnancy increased the odds of gaining inadequate gestational weight compared to overweight or obese women. Not having paid employment was associated with higher odds of gaining inadequate gestational weight compared to women employed outside the home (AOR = 2.17 [95% CI: 1.16, 4.07]).

Conclusions: Most pregnant women in Addis Ababa gain inadequate gestational weight. In particular, three quarters of underweight women gained inadequate gestational weight. Being underweight, normal weight or having no paid employment were associated with higher odds of inadequate GWG. Promoting adequate GWG in Addis Ababa among underweight and normal weight women may be an important public health initiative.
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http://dx.doi.org/10.1186/s12978-021-01202-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8317358PMC
July 2021

Predictors of Service Satisfaction Among Clients Receiving Antiretroviral Therapy Services at Public Hospitals in Eastern Ethiopia.

HIV AIDS (Auckl) 2021 5;13:737-747. Epub 2021 Jul 5.

Department of Public Health, College of Health Sciences, Institute of Medicine and Health Science, Debre Berhan University, Debre Berhan, Ethiopia.

Background: The issue of service satisfaction with antiretroviral therapy services needs more attention as it indicates the outcome of quality health services. Although different studies have been conducted on client satisfaction in different countries, there is limited evidence on the major predictors of client satisfaction with ART services in Ethiopia.

Objective: To assess the predictors of service satisfaction among clients receiving antiretroviral therapy services at a public hospital in Harar Town, Eastern Ethiopia.

Methods: A hospital-based cross-sectional study design was employed among 413 antiretroviral therapy clients from February to March 2018. The data were cleaned and entered into EpiData version 3.1 and exported to SPSS version 21 for analysis. A five-point Likert scale was used to assess client satisfaction with the ART services. Clients who scored ≥75% of the items were categorized as "satisfied" and those who scored <75% of the items were categorized as "dissatisfied". Independent variables with a p-value of ≤0.25 in the binary regression analysis were included in the multivariate logistic regression analysis to control confounding factors. Statistical significance was set at a p-value less than 0.05.

Results: The overall client satisfaction with ART services was 76.9% (95% CI: 72.6, 80.6). Regarding the predictors, clients who were not attending formal education [(AOR=3.7, 95% CI: 1.75,8.12)] and primary education [(AOR=3.9, 95% CI: 1.66,9.32)], low wealth index [(AOR=2.8, 95% CI: 1.27, 6.28)], longer duration of treatment [(AOR=2.7, 95% CI: 1.46, 5.5.20)], shorter waiting time [(AOR=5.4, 95% CI: 2.52, 11.57)], disclosure of serostatus of HIV [(AOR=3.7, 95% CI: 1.59, 8.49)], seen by the same health care providers repeatedly [(AOR=2.0, 95% CI: 1.06, 3.82)], loss of medical records [(AOR=0.26, 95% CI: 0.13,0.50)] and social supports [(AOR=2.3, 95% CI: 1.12,4.63)] were significantly associated with service satisfaction on antiretroviral therapy services.

Conclusion: Overall client satisfaction with ART services was relatively low in the study area. However, not attending formal and primary education, low wealth index, longer duration of treatment, shorter waiting time, disclosure of serostatus, seen by the same health care providers, loss of medical records, and social support were independent predictors of client satisfaction.
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http://dx.doi.org/10.2147/HIV.S315133DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8275116PMC
July 2021

One in Five Street Traditional Coffee Vendors Suffered from Depression During the COVID-19 Pandemic in Harar Town, Ethiopia.

Neuropsychiatr Dis Treat 2021 6;17:2173-2182. Epub 2021 Jul 6.

Department of Public Health and Health Policy, School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.

Background: The COVID-19 crisis has already resulted in an economic and labor market shock and a rise of informal work sectors. Being an informal job, traditional coffee vending can predispose women to a myriad of mental disorders. Therefore, this study was aimed to assess depressive symptoms during the COVID-19 pandemic and associated factors among street traditional coffee vendors in Harar town, Eastern Ethiopia.

Methods: A cross-sectional study was employed on 180 women engaged in street traditional coffee vending business in Harar town. Data were collected through a face-to-face interview using a Public Health Questionnaire and analyzed using SPSS version 20. Binary logistic regression was executed to identify factors associated with depression at a cut-off point of P < 0.05.

Results: The mean age of the study participants was 31.83 (±10) years. The majority of the participants were currently married (n = 77, 42.8%), attended primary education (n = 68, 37.8%), had a family member of four or more (n = 60, 33.3%), and had two years or less work experience (n = 123, 68.3%). Most of the study participants obtained COVID-19-related information from television (n = 125, 69.4%). The prevalence of depression was found to be 18.9%. Attending primary education (AOR: 0.34; 95% CI: 0.12, 0.98), attending secondary education or higher (AOR: 0.23; 95% CI: 0.07, 0.69), and having four or more family members (AOR: 2.81; 95% CI: 1.14, 6.92) were significantly associated with depression.

Conclusion: One in five street traditional coffee vendors suffered from depression during the COVID-19 pandemic. Lower odds of being depressed were observed in those who attended a minimum of primary education. On the contrary, having a greater family size was associated with higher odds of being depressed. This finding will direct the government and other concerned bodies to be involved in the provision of psychological and material support for such informal workers during COVID-19.
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http://dx.doi.org/10.2147/NDT.S315370DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8275094PMC
July 2021

COVID-19 Testing Experience in a Resource-Limited Setting: The Use of Existing Facilities in Public Health Emergency Management.

Front Public Health 2021;9:675553. Epub 2021 Jun 14.

Hararghe Health Research Partnerships, Haramaya University, Harar, Ethiopia.

Coronavirus disease 2019 (COVID-19) is a public health emergency with little testing and treatment experiences at its occurrence. Diagnostic and treatment rapidly changed in the world including Ethiopia. Haramaya University has strived to change its diagnostic capacity using existing facilities in response to the national call to the pandemic. This summary aims to detail experiences of setting up COVID-19 testing in Haramaya University laboratories, Eastern Ethiopia. Desktop exercise was conducted to understand the start-up and implementations of COVID-19 testing in two Haramaya University laboratories, Hararghe Health Research Partnership and Campylobacter Genomics and Environmental Enteric Dysfunction laboratories. Communication, formats, guidelines, and standards were reviewed and summarized. Discussion with those involved in the start-up and implementation of the testing were also held. Ideas were summarized to learn the experiences the COVID-19 testing exercises. This is a huge experience for Haramaya University to participate in the national call to increase the testing platform in the management of COVID19. Close work relationship with the public health authorities at all levels demonstrated the university's commitment to public service. The university has used the opportunity to advance its molecular testing capability by training its staff and students. The University has also contributed to the capacity development for laboratories in the surrounding areas of Harar, Somali, Oromia, and Dire Dawa. The pandemic has been an opportunity in harnessing existing resource for the benefit of the public during such times of dire needs to provide critical public health laboratory interventions.
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http://dx.doi.org/10.3389/fpubh.2021.675553DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8236620PMC
July 2021

Effect of specificity of health expenditure questions in the measurement of out-of-pocket health expenditure: evidence from field experimental study in Ghana.

BMJ Open 2021 05 3;11(5):e042562. Epub 2021 May 3.

Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland.

Background: The effect of number of health items on out-of-pockets (OOPs) has been identified as a source of bias in measuring OOPs. Evidence comes mostly from cross-sectional comparison of different survey instruments to collect data on OOPs. Very few studies have attempted to validate these questionnaires, or distinguish bias arising from the comprehensiveness of the OOPs list versus specificity of OOPs questions.

Objectives: This study aims to estimate biases arising from the specificity of OOPs questions by comparing provider and household's information.

Methods: A generic questionnaire to collect data on household's OOPs was developed following the nomenclature proposed in division 6 of the classification of household final consumption 2018. The four categories within such division are used to set the comprehensiveness of the OOPs list, the specificity within each category was tailored to the design of the nationally representative living standard survey in Ghana where a field experiment was conducted to test the validity of different versions. Households were randomised to 11, 44 or 56 health items. Using data from provider records as the gold standard, we compared the mean positive OOPs, and estimated the mean ratio and variability in the ratio of household expenditures to provider data for the individual households using the Bland-Altman method of assessing agreement.

Findings: We found evidence of a difference in the overall mean ratio in the specificity for OOPs in inpatient care and medications. Within each of these two categories, a more detailed disaggregation yielded lower OOPs estimates than less detailed ones. The level of agreement between household and provider OOPs also decreased with increasing specificity of health items.

Conclusion: Our findings suggest that, for inpatient care and medications, systematically decomposing OOPs categories into finer subclasses tend to produce lower OOPs estimates. Less detailed items produced more accurate and reliable OOPs estimates in the context of a rural setting.
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http://dx.doi.org/10.1136/bmjopen-2020-042562DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8098927PMC
May 2021

Prevalence and determinants of concurrent wasting and stunting and other indicators of malnutrition among children 6-59 months old in Kersa, Ethiopia.

Matern Child Nutr 2021 07 16;17(3):e13172. Epub 2021 Mar 16.

Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA.

Malnutrition is the leading cause of poor child health in Ethiopia, and progress to avert it is unacceptably slow. In addition, little is known about the magnitude and factors associated with concurrent wasting and stunting (WaSt). Therefore, this study aimed to assess the prevalence and factors associated with WaSt, wasting, stunting and underweight among children 6-59 months in Kersa Health and Demographic Surveillance System, Ethiopia. Data from a total of 1091 children and their parents' were analysed from a cross-sectional study. Household questionnaires and anthropometric measurements were used for data collection. Height-for-age, weight-for-height and weight-for-age indices are expressed as standard deviation units from the mean for the reference group. Multivariate analyses were conducted to identify factors associated with WaSt, wasting, stunting and underweight. Statistical significance was declared at p < 0.05. The prevalence of indicators of malnutrition was WaSt (5.8%), wasting (16.8%), stunting (53.9%) and underweight (36.9%). Children aged 6-17 months had a higher odds of wasting (adjusted odds ratio [aOR] 1.8, 95% confidence interval [CI] 1.12-2.75) compared with those aged 36-59 months, whereas children aged 18-35 months (aOR 2.4, 95% CI 1.65-3.47) and 36-59 months (aOR 1.6, 95% CI 1.07-2.37) had higher odds of stunting compared with those aged 6-17 months. Similarly, children aged 18-35 months (aOR 1.6, 95% CI 1.07-2.37) and 36-59 months (aOR 2.2, 95% CI 1.52-3.10) had higher odds of underweight compared with children aged 6-17 months. Households that did not treat drinking water at point of use were at higher odds of WaSt (aOR 3.3, 95% CI 1.16-9.27) and stunting (aOR 1.9, 95% CI 1.31-2.85) compared with those who did treat drinking water. Boys were more likely to be WaSt, wasted, stunted and underweight. Cough was associated with WaSt, wasting and underweight. Furthermore, maternal education, maternal occupation and maternal age were significantly associated with wasting. Maternal body mass index (BMI) of less than 18.5 kg/m and maternal BMI between 18.5 and 25 kg/m were associated with child stunting. In Kersa, the prevalence of WaSt, wasting, stunting and underweight is very high and requires urgent public health intervention. This study highlights point-of-use water treatment, maternal education, hygiene and sanitation, child health service utilization and maternal BMI as important areas to improve to target child malnutrition. Furthermore, a community-based programmatic and policy direction for early identification and management of WaSt in addition to other indicators of malnutrition is recommended.
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http://dx.doi.org/10.1111/mcn.13172DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8189198PMC
July 2021

Association of Effective Spousal Family Planning Communication with Couples' Modern Contraceptive Use in Harar, Eastern Ethiopia.

Open Access J Contracept 2021 26;12:45-62. Epub 2021 Feb 26.

School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.

Background: Spousal family planning communication plays an important role in making better reproductive health decisions and in increasing the use of modern contraceptive methods. The objective of the current study is to examine the association of spousal family planning communication in its broader context with current modern contraceptive use among couples.

Methods: A community based cross-sectional survey was conducted in twelve kebeles of Harar Urban Health and Demographic Surveillance System. A total of 2700 currently married couples of whose wives were in the reproductive age participated in the study. The selection of the study participants was made using simple random sampling and data were collected using an interviewer administered structured questionnaire and analyzed using Stata version 12.

Results: The level of current modern contraceptive use was 57.1% (95% CI: 0.53, 3.39). Effective spousal family planning communication was significantly associated with current modern contraceptive use even after controlling for socio-economic and demographic variables. Socio-economic and demographic variables such as religion of couples, number of couples' living children, household monthly income, couples' family planning approval and women's counseling about family planning by health workers were significantly associated with current modern contraceptive use.

Conclusion: Policies and programs aimed at increasing contraceptive prevalence should properly address the importance of spousal communication about family planning and integrate men into family planning programs to facilitate and enhance couples communication skills.
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http://dx.doi.org/10.2147/OAJC.S285358DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7924133PMC
February 2021

Assessment of Male Involvement in Long-Acting and Permanent Contraceptive Use of Their Partner in West Badewacho, Southern Ethiopia.

Open Access J Contracept 2021 26;12:63-72. Epub 2021 Feb 26.

School of Public Health, College of Health and Medical Science, Haramaya University, Harar, Ethiopia.

Background: Male involvement in family planning use particularly in long-acting and permanent contraceptive methods (LAPCM) is a key strategy to reduce fertility, and promote maternal and child health. Despite this, little is known about male involvement in LAPCM use of their partners in Africa, particularly in Ethiopia. This study aimed to assess male involvement in long-acting and permanent contraceptive method use in west Badewacho district, Southern Ethiopia.

Methods: A community-based cross-sectional study was conducted among 564 participants from April 1 to 30/2019. A multi-stage sampling technique was used to select eligible participants. A pre-tested, structured, and interviewer-administered questionnaire was used. Binary and multivariable logistic regression analysis was done to identify associated factors. The adjusted odds ratio with 95% CI was estimated to show the direction and strength of the association. Variables with p<0.05 were considered statistically significant.

Results: About 108 (19.9%, 95% CI: (16.8, 23.2)) participants were involved in LAPCM use. Being urban dweller [AOR=3.13; 95% CI: (1.58, 6.19)], discussion with wives about LAPCM [AOR=2.81; 95% CI: (1.64, 4.8)], having good knowledge about LAPCM [AOR=2.55; 95% CI: (1.42, 4.57)], and positive attitude towards LAPCM [AOR=2.16; 95% CI: (1.16, 4.02)] were significantly associated factors.

Conclusion: Overall, the male involvement in LAPCM use was low. Enhancing male involvement in family planning use through creating community awareness, encouraging inter-spousal communication to enhance decision making, and increasing positive attitude towards LAPCM in the community is crucial to decrease the problem.
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http://dx.doi.org/10.2147/OAJC.S297267DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7924250PMC
February 2021

Inequality and Inequity in Outpatient Care Utilization in Ethiopia: A Decomposition Analysis of Ethiopian National Health Accounts.

Clinicoecon Outcomes Res 2021 2;13:89-98. Epub 2021 Feb 2.

School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.

Background: Inequity in healthcare use is avoidable inequality, and it exists when there are differences in the use of healthcare after standardization of different needs among the population. In Ethiopia, wide variation and lower achievement exists in outpatient visit per person per year against the target to reach by 2020. Therefore, this study is aimed at measuring inequalities and inequities in outpatient care utilization in Ethiopia.

Methods: The study utilized data from 2015/16 Ethiopian National Health Account survey. The analysis included a weighted sample of 42,460 individuals. Concentration curve and indices were used to measure inequality in outpatient care utilization. Deviations in the degree to which outpatient care was distributed according to need were measured by the horizontal inequity index. All statistical analyses were done using STATA version 14. In all analyses statistical significance was declared at a -value < 0.05 and a 95% confidence interval.

Results: The outpatient care utilizations were found to be concentrated among the rich. The actual (C = 0.0335, 95% CI: 0.0298, 0.0431) and need predicted (C = 0.0157, 95% CI: 0.0117, 0.0413) utilizations were concentrated among the rich. The distributions of outpatient care in Ethiopians were pro-rich (rich-favoring). The decomposition analysis revealed that need factors were the main positive contributors to the inequality (23.6%) and non-need factors were among the negative contributors to the inequality (-48.4%).

Conclusion: This study evidenced the presence of rich-favoring inequality and inequity in outpatient care utilization in Ethiopia. Therefore, there is a need to consider implementation strategies that focus on fairness in healthcare utilization.
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http://dx.doi.org/10.2147/CEOR.S286253DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7866908PMC
February 2021

Modern Family Planning Utilization and Its Associated Factors among Currently Married Women in Rural Eastern Ethiopia: A Community-Based Study.

Biomed Res Int 2020 29;2020:6096280. Epub 2020 Dec 29.

School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, P.O. Box 235, Harar, Ethiopia.

Background: The use of modern family planning methods among women of reproductive age (15-49 years) is of public health importance in Ethiopia. Nationally, modern family planning method use remains as low as 35%. Understanding factors associated with the use of modern family planning methods may help to improve maternal and child health. Hence, this study is aimed at assessing modern family planning method use and its determinants among women of reproductive age in the rural districts of Eastern Hararghe zone, Eastern Ethiopia. . A community-based, cross-sectional survey was conducted among 577 randomly selected, currently married, reproductive-aged women in selected rural districts of Eastern Hararghe, Eastern Ethiopia. Data were collected using a pretested, interviewer-administered questionnaire about women's sociodemographic information, knowledge about contraception, reproductive history, contraceptive use and fertility desire, couple's communication, and decision-making on family planning. Binary and multivariable logistic regression was used to analyze the association between the dependent and independent variables.

Result: A total of 555 study participants participated, yielding a 96.2% response rate. The overall modern family planning utilization among the study participants was 18.4%. Knowledge of modern family planning methods (AOR = 16.958, CI: 4.768, 60.316), husband approval (AOR = 3.590, CI: 2.170, 5.936), couple's discussion (AOR = 2.852, CI: 1.759, 4.623), male involvement in decisions about family planning (AOR = 2.340, CI: 1.531, 3.576), desire for additional child (AOR = 2.295, CI: 1.528, 3.447), and previous use of contraception (AOR = 0.018, CI: 0.005, 0.063) were significantly associated with modern contraceptive utilization.

Conclusion: Even though knowledge of modern family planning methods was very high, the overall modern family planning method use in the study area was low. The government should focus on increasing modern family planning method availability. It must also ensure family planning method security and create awareness on modern family planning methods through community-based education and proper counselling to empower women to make an appropriate choice.
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http://dx.doi.org/10.1155/2020/6096280DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7785364PMC
September 2021

Midwives' and obstetricians' perspectives about pregnancy related weight management in Ethiopia: A qualitative study.

PLoS One 2020 17;15(12):e0244221. Epub 2020 Dec 17.

School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia.

Background: Midwives and obstetricians are key maternity care providers; they are the most trusted source of information regarding nutrition and gestational weight gain. However, their views, practices and perceived barriers to managing pregnancy related weight gain have not been studied in Ethiopia. The aim of this study was to explore midwives' and obstetricians' observations and perspectives about gestational weight gain and postpartum weight management in Ethiopia.

Methods: We conducted face-to-face interviews with 11 midwives and 10 obstetricians, from January 2019 to March 2019. All interview data were transcribed verbatim. We analysed the data using thematic analysis with an inductive approach.

Results: We identified three themes and associated subthemes. Midwives and obstetricians had limited knowledge of the optimal gestational weight gain. Almost all participants were unaware of the presence of the Institute of Medicine recommendations for optimal weight gain in pregnancy. According to the study participants, women in Ethiopia do not want to gain weight during pregnancy, but do want to gain weight after the birth. Counselling about gestational weight gain and postpartum weight management was not routinely provided for pregnant women. This is mostly because gestational weight gain counselling was not considered to be a priority by maternity care providers in Ethiopia.

Conclusions: The limited knowledge of and low attention to pregnancy related weight management by midwives and obstetricians in this setting needs appropriate intervention. Adapting a guideline for pregnancy weight management and integrating it into antenatal care is essential.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0244221PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7746277PMC
March 2021

Willingness to Pay for Community-Based Health Insurance Scheme and Associated Factors Among Rural Communities in Gemmachis District, Eastern Ethiopia.

Clinicoecon Outcomes Res 2020 23;12:609-618. Epub 2020 Oct 23.

Colleges of Health and Medical Sciences, Arsi University, Asella, Ethiopia.

Background: In sub-Saharan Africa, out-of-pocket expenditures constitute approximately 40% of total healthcare expenditures, imposing huge financial burdens on the poor. To tackle the effects of out-of-pocket payment for healthcare services, Ethiopia has been focusing on implementation and expansion of a community-based health insurance (CBHI) program since 2011. This study assessed willingness to pay for CBHI scheme and associated factors among rural communities in Gemmachis district, eastern Ethiopia.

Methods: Community-based cross-sectional study was conducted among 446 randomly selected participants in Gemmachis district from April 1 to April 30, 2019. Data were collected from participants using pretested structured questionnaires through face-to-face interview. Data were entered into EpiData version 3.1 and analyzed using SPSS version 24. Bivariable and multivariable logistic regression analyses were conducted to identify factors associated with willingness to pay for CBHI.

Results: A total of 440 (98.7%) participants were involved in the study. Three in every four (74.8%) participants were willing to pay for CBHI (95% CI: 70.7%, 78.9%). Primary education (AOR=5.1, 95% CI: 2.4, 11.1), being merchant (AOR=0.23, 95% CI: 0.10, 0.51), housewife (AOR=3.8, 95% CI: 1.3, 11.0), poor (AOR=2.5, 95% CI: 1.3, 4.7), illness in the last one year (AOR=3.1, 95% CI, 1.9, 5.2), good knowledge about CBHI (AOR=2.3, 95% CI: 1.5, 3.6) and access to public health facility (AOR=2.0,95% CI: 1.1, 3.7) were all significantly associated with willingness to pay for CBHI.

Conclusion: A significant proportion of participants were willing to pay for CBHI scheme. Education, occupation, wealth status, illness in the last one year, knowledge about CBHI and access to healthcare facility were factors significantly associated with willingness to pay for CBHI. If the scheme is to serve as a means to provide access to health service, the premium for membership should be tailored and customized by individual socioeconomic factors.
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http://dx.doi.org/10.2147/CEOR.S266497DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7591008PMC
October 2020

Anemia among School Adolescents in Haramaya Town, Eastern Ethiopia: Cross-Sectional Study.

Nutr Metab Insights 2020 28;13:1178638820953131. Epub 2020 Aug 28.

Department of Midwifery, Faculty of Health Science, Institute of Health, Jimma University, Jimma, Ethiopia.

Background: Anemia is a condition characterized by reduction in the number of red blood cells and/or hemoglobin concentration. It affects 24.8% of the world population. There is little evidence on burden of anemia among adolescents in low income countries like Ethiopia. Thus, this study aimed to assess the magnitude of anemia and factors associated with anemia among school adolescents in eastern Ethiopia.

Methods: School based cross-sectional study was conducted among 493 school adolescents in Haramaya town during February 1 to 28, 2017. Multi stage cluster sampling technique was used. We collected anthropometric data (weight and height) and hemoglobin level of all study participants. The hemoglobin level was adjusted for altitude. Data were entered into EpiData and exported to SPSS version 20 for analysis. Logistic regression model was fitted to identify factors associated with anemia. Level of statistical significance was declared at  < .05.

Results: In this study, the prevalence of anemia was 29.4% [95% CI: (25.6, 33.5)]. Being female adolescent (AOR = 2.31, 95 % CI: [1.51, 3.54]), adolescents attending grades 9th to 10th (AOR = 1.66, 95% CI: [1.004, 2.77]), adolescents born to illiterate mothers [AOR = 2.23, 95% CI: (1.02, 4.89)], and low dietary diversity score (AOR = 2.33, 95% CI: [1.12, 4.86]) were factors that increased the likelihood of getting anemia.

Conclusion: Anemia among school adolescents was a moderate public health problem in the study area. Being female, lower grade levels (9th to 10th), low dietary diversity score and illiterate maternal educational status increased the likelihood of getting anemia. School based Iron/Folic acid supplementation, nutrition education and promotion of diversified foods consumption should be given attention with particular focus on female adolescents.
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http://dx.doi.org/10.1177/1178638820953131DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7457681PMC
August 2020

Unfavorable outcomes to second-line tuberculosis therapy among HIV-infected versus HIV-uninfected patients in sub-Saharan Africa: A systematic review and meta-analysis.

PLoS One 2020 14;15(8):e0237534. Epub 2020 Aug 14.

School of Public Health, College of Health and Medical Sciences, Haramaya University, Oromia, Ethiopia.

Background: Drug resistance is a key obstacle to the global target set to end tuberculosis by 2030. Clinical complexities in drug-resistant tuberculosis and HIV-infection co-management could worsen outcomes of second-line anti-tuberculosis drugs. A comprehensive estimate for risks of unsuccessful outcomes to second-line tuberculosis therapy in HIV-infected versus HIV-uninfected patients is mandatory to address such aspects in segments of the target set. Therefore, this meta-analysis was aimed to estimate the pooled risk ratios of unfavorable outcomes to second-line tuberculosis therapy between HIV-infected and HIV-uninfected patients in sub-Saharan Africa.

Methods: We conducted a literature search from PubMed/MEDLINE, EMBASE, SCOPUS and Google Scholar. We screened the retrieved records by titles and abstracts. Finally, we assessed eligibility and quality of full-text articles for the records retained by employing appraisal checklist of the Joanna Briggs Institute. We analyzed the data extracted from the included studies by using Review Manager Software, version 5.3 and presented our findings in forest and funnel plots. Protocol for this study was registered on PROSPERO (ID: CRD42020160473).

Results: A total of 19 studies with 1,766 from 4,481 HIV-infected and 1,164 from 3,820 HIV-uninfected patients had unfavorable outcomes. The risk ratios we estimated between HIV-infected and HIV-uninfected drug-resistant tuberculosis patients were 1.18 (95% CI: 1.07-1.30; I2 = 48%; P = 0.01) for the overall unfavorable outcome; 1.50 (95% CI: 1.30-1.74) for death; 0.66 (95% CI: 0.38-1.13) for treatment failure; and 0.82 (95% CI: 0.74-0.92) for loss from treatment. Variable increased risks of unfavorable outcomes estimated for subgroups with significance in mixed-age patients (RR: 1.22; 95% CI: 1.10-1.36) and eastern region of sub-Saharan Africa (RR: 1.47; 95% CI: 1.23-1.75).

Conclusions: We found a higher risk of unfavorable treatment outcome in drug-resistant tuberculosis patients with death highly worsening in HIV-infected than in those HIV-uninfected patients. The risks for the unfavorable outcomes were significantly higher in mixed-age patients and in the eastern region of sub-Saharan Africa. Therefore, special strategies that reduce the risks of death should be discovered and implemented for HIV and drug-resistant tuberculosis co-infected patients on second-line tuberculosis therapy with optimal integration of the two programs in the eastern region of sub-Saharan Africa.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0237534PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7428180PMC
October 2020

Gestational weight gain and its effect on birth outcomes in sub-Saharan Africa: Systematic review and meta-analysis.

PLoS One 2020 23;15(4):e0231889. Epub 2020 Apr 23.

Centre for Midwifery, Child and Family Health, Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia.

Introduction: An increased metabolic demand during pregnancy is fulfilled by gaining sufficient gestational weight. Women who gain inadequate-weight are at a high-risk of premature birth or having a baby with low-birth weight. However, women who gain excessive-weight are at a high-risk of having a baby with macrosomia. The aim of this review was to determine the distribution of gestational weight gain and its association with birth-outcomes in Sub-Saharan Africa.

Methods: For this systematic review and meta-analysis, we performed a literature search using PubMed, Medline, Embase, Scopus, and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases. We searched grey-literature from Google and Google Scholar, and region-specific journals from the African Journals Online (AJOL) database. We critically appraised the included studies using the Effective Public Health Practice Project Quality Assessment Tool for Quantitative Studies. Two independent reviewers evaluated the quality of the studies and extracted the data. We calculated pooled relative-risks (RR) with 95% confidence intervals.

Results: Of 1450 retrieved studies, 26 met the inclusion criteria. Sixteen studies classified gestational weight gain according to the United States Institute of Medicine recommendations. The percentage adequate amount of gestational weight ranged from 3% to 62%. The percentage of inadequate weight was >50% among nine studies. Among underweight women, the percentage of women who gained inadequate gestational weight ranged from 67% to 98%. Only two studies were included in the meta-analyses to evaluate the association of gestational weight gain with pre-eclampsia and macrosomia. No difference was observed among women who gained inadequate and adequate gestational weight regarding experiencing pre-eclampsia (RR, 0.71; 95% CI: 0.22, 2.28, P = 0.57). Excessive gestational weight gain was not significantly associated with macrosomia compared to adequate weight gain (RR, 0.68; 95% CI: 0.38, 1.22, P = 0.20).

Conclusion: A substantial proportion of sub-Saharan African women gain inadequate gestational weight particularly high among underweight women. Future interventions would need to design effective pre-pregnancy weight management strategies.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0231889PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7179909PMC
July 2020

Prevalence and predictors of adolescent linear growth and stunting across the urban-rural gradient in eastern Ethiopia.

Trop Med Int Health 2020 01 26;25(1):101-110. Epub 2019 Nov 26.

Department of Global Health and Population, Harvard T.H Chan School of Public Health, Boston, MA, USA.

Objective: To assess the magnitude and factors associated with adolescent linear growth and stunting in two eastern Ethiopian communities.

Methods: This cross-sectional study was conducted in the urban Harar Health Demographic Surveillance Site (HDSS) and rural Kersa Demographic Surveillance and Health Research Center (KDS-HRC). Univariate analysis was used to describe the data. Multiple regression models examined predictors of linear growth. Logistic regression was used to examine factors associated with stunting.

Results: The study included 2010 adolescents. The prevalence of stunting was 26.9% (95% CI 24.9, 28.9), with 8.1% among urban adolescents (95% CI 6.5, 9.9) vs. 47.9% among rural ones (95% CI 44.6, 51.1). There was a significant interaction between residence and sex on the risk of stunting [AOR = 4.17 (95% CI 2.66, 9.9), P < 0.001], and height-for-age z score (HAZ) (β = -0.51, P < 0.001). For urban adolescents, older age (18 to 19 years) was negatively associated with linear growth (β= -0.29; P < 0.001). In the rural setting, handwashing practice after toileting was positively associated with HAZ (0.62; P < 0.001) and with lower risk of stunting [AOR = 0.51 (95% CI 0.34, 0.76)]. Urban females had significantly higher HAZ than urban males [β = 0.52; P < 0.01)], and a significantly lower risk of stunting [AOR = 0.29 (95% CI 0.18, 0.48)].

Conclusions: There are significant disparities in the magnitude of stunting between urban and rural adolescents. The gender gap in stunting and linear growth, along with a high prevalence of stunting in early adolescence, calls for age-appropriate and gender-sensitive interventions. Particular attention and context-specific interventions are warranted for adolescents in these and similar rural eastern Ethiopian communities.
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http://dx.doi.org/10.1111/tmi.13341DOI Listing
January 2020

The age of opportunity: prevalence of key risk factors among adolescents 10-19 years of age in nine communities in sub-Saharan Africa.

Trop Med Int Health 2020 01 28;25(1):15-32. Epub 2019 Nov 28.

Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA.

Objective: To measure health-related behaviours and risk factors among sub-Saharan African adolescents.

Methods: Cross-sectional study in nine communities in Burkina Faso, Ethiopia, Eswatini, Ghana, Nigeria, Tanzania and Uganda between 2015 and 2017. Community-representative samples of males and females 10-19 years of age were selected. All communities used a uniform questionnaire that was adapted from the WHO Global School-based Student Health Survey. Weighted prevalence estimates and 95% confidence intervals were calculated for each indicator and stratified by age and sex using SAS version 9.4. All prevalence estimates were pooled across communities through random-effects meta-analyses in Stata version 14.

Results: A total of 8075 adolescents participated in the study. We observed a high prevalence of inadequate fruit consumption (57-63%) and low physical activity (82-90%); a moderate prevalence of inadequate vegetable consumption (21-31%), unprotected last sex (38-45%), age at first sex <15 years (21-28%) and bullying and physical fighting (12-35%); and a low prevalence of mental health risk factors (1-11%) and alcohol and substance use risk factors (0-6%). We observed a moderate to high prevalence of daily soft drink consumption (21-31%) for all adolescents. Among sexually active adolescents 15-19 years, 37% of females reported ever being pregnant and 8% of males reported to have ever made someone pregnant. Bullying (23%) and physical fighting (35%) were more common among younger male adolescents . The prevalence of low mood was generally higher among older (15-19 years) than younger adolescents (10-14 years). The proportion of adolescents reporting alcohol, drug or cigarette use was very small, with the exception of khat use in Ethiopia.

Conclusion: Overall, diet and physical activity, violence, sexual and reproductive health, and depression are important risk factors for these sub-Saharan African communities. These findings suggest that more evidence is needed including novel efforts for the collection of sensitive information, as well as a need to move towards community-tailored interventions to reach adolescent populations with varying needs.
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http://dx.doi.org/10.1111/tmi.13339DOI Listing
January 2020

The age of opportunity: prevalence of key risk factors among adolescents 10-19 years of age in nine communities in sub-Saharan Africa.

Trop Med Int Health 2020 01 28;25(1):15-32. Epub 2019 Nov 28.

Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA.

Objective: To measure health-related behaviours and risk factors among sub-Saharan African adolescents.

Methods: Cross-sectional study in nine communities in Burkina Faso, Ethiopia, Eswatini, Ghana, Nigeria, Tanzania and Uganda between 2015 and 2017. Community-representative samples of males and females 10-19 years of age were selected. All communities used a uniform questionnaire that was adapted from the WHO Global School-based Student Health Survey. Weighted prevalence estimates and 95% confidence intervals were calculated for each indicator and stratified by age and sex using SAS version 9.4. All prevalence estimates were pooled across communities through random-effects meta-analyses in Stata version 14.

Results: A total of 8075 adolescents participated in the study. We observed a high prevalence of inadequate fruit consumption (57-63%) and low physical activity (82-90%); a moderate prevalence of inadequate vegetable consumption (21-31%), unprotected last sex (38-45%), age at first sex <15 years (21-28%) and bullying and physical fighting (12-35%); and a low prevalence of mental health risk factors (1-11%) and alcohol and substance use risk factors (0-6%). We observed a moderate to high prevalence of daily soft drink consumption (21-31%) for all adolescents. Among sexually active adolescents 15-19 years, 37% of females reported ever being pregnant and 8% of males reported to have ever made someone pregnant. Bullying (23%) and physical fighting (35%) were more common among younger male adolescents . The prevalence of low mood was generally higher among older (15-19 years) than younger adolescents (10-14 years). The proportion of adolescents reporting alcohol, drug or cigarette use was very small, with the exception of khat use in Ethiopia.

Conclusion: Overall, diet and physical activity, violence, sexual and reproductive health, and depression are important risk factors for these sub-Saharan African communities. These findings suggest that more evidence is needed including novel efforts for the collection of sensitive information, as well as a need to move towards community-tailored interventions to reach adolescent populations with varying needs.
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http://dx.doi.org/10.1111/tmi.13339DOI Listing
January 2020

HIV/AIDS awareness and testing practices among adolescents in eastern Ethiopia.

Trop Med Int Health 2020 01 21;25(1):111-118. Epub 2019 Nov 21.

Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA.

Objective: To examine HIV/AIDS awareness, HIV testing practices and associated factors among adolescents in two eastern Ethiopian communities.

Methods: Community-based, cross-sectional study among 2010 adolescents aged 10-19 years. Participants were asked about their awareness of HIV/AIDS and HIV testing practices, and whether they had ever been tested for HIV. Regression models were applied to identify the factors of statistical significance at P-value < 0.05.

Results: Of 90% were aware of HIV/AIDS, but only a quarter had ever been tested for HIV. Rural adolescents were less aware of HIV than urban adolescents (AOR = 0.16; 95% CI: 0.05, 0.58), and in-school adolescents had more knowledge about HIV/AIDS than that out-of-school adolescents (AOR = 2.79; 95% CI: 1.88, 4.15). Factors associated with lower uptake of HIV testing were male sex (AOR = 0.74; 95% CI; 0.58, 0.91) and being from a rural area (AOR = 0.16; 95% CI: 0.07, 0.36). Factors associated with higher uptake of HIV testing were being in school (AOR = 1.66; 95% CI: 1.16, 2.38), using the Internet (AOR = 1.52; 95% CI: 1.01, 2.28), and ever visiting a health facility (AOR = 1.54; 95% CI: 1.21, 1.96).

Conclusions: Awareness of HIV/AIDS was high, whereas HIV testing was rare. HIV awareness programs for adolescents should target rural and out-of-school adolescents. Programmes to increase HIV testing implemented in these and similar communities should focus on male and rural adolescents.
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http://dx.doi.org/10.1111/tmi.13337DOI Listing
January 2020

Sexual and reproductive health knowledge among adolescents in eight sites across sub-Saharan Africa.

Trop Med Int Health 2020 01 8;25(1):44-53. Epub 2019 Dec 8.

Department of Community Health and Behavioral Sciences, Makerere University School of Public Health, Kampala, Uganda.

Objective: To examine knowledge of menstruation, HIV and STIs other than HIV across eight sites in SSA to develop effective programmatic interventions enabling adolescents to achieve positive SRH as their transition to adulthood.

Methods: We combine data from eight Health and Demographic Surveillance Sites across sub-Saharan Africa, from an adolescent-specific survey that included 7116 males and females age 10-19 years old. We provide pooled and site-specific estimates from multiple analytic models examining the how year-specific age, school attendance and work correlate with knowledge of menstruation, HIV knowledge and knowledge of sexually transmitted infections (STIs) other than HIV.

Results: Many adolescents lack knowledge of menstruation (37.3%, 95% CI 31.8, 43.1 do not know of menstruation) and STIs other than HIV (55.9%, 95% CI 50.4, 61.3 do not know of other STIs). In multivariate analysis, older age, being in school and wealth are significant positive correlates of STI knowledge. Older adolescent age, female sex and being in school are significant positive correlates of knowledge of menstruation. Knowledge of HIV is high (89.7%, 95% CI 8.3, 12.7 know of HIV) and relatively similar across adolescent age, sex, wealth and school and work attendance.

Conclusion: Knowledge of HIV is widespread across adolescents in these communities in sub-Saharan Africa, but knowledge of other dimensions of sexual and reproductive health - menstruation and other STIs in this study - is lacking especially for early adolescents (10- to 14-year olds). The dissemination of more comprehensive sexual and reproductive health information is needed within these and similar communities in SSA to help adolescents gain insight on how to make their own decisions towards positive adolescent sexual and reproductive health and protect them from risks.
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http://dx.doi.org/10.1111/tmi.13332DOI Listing
January 2020

Intensive phase treatment outcome and associated factors among patients treated for multi drug resistant tuberculosis in Ethiopia: a retrospective cohort study.

BMC Infect Dis 2019 Sep 18;19(1):818. Epub 2019 Sep 18.

College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.

Background: Multi-drug resistant Tuberculosis (MDR-TB) is a strain of Mycobacterium tuberculosis that is resistant to at least Rifampicin and Isoniazid drugs. The treatment success rate for MDR-TB cases is lower than for drug susceptible TB. Globally only 55% of MDR-TB patients were successfully treated. Monitoring the early treatment outcome and better understanding of the specific reasons for early unfavorable and unknown treatment outcome is crucial for preventing the emergence of further drug-resistant tuberculosis. However, this information is scarce in Ethiopia. Therefore, this study aimed to determine the intensive phase treatment outcome and contributing factors among patients treated for MDR-TB in Ethiopia.

Methods: A 6 year retrospective cohort record review was conducted in fourteen TICs all over the country. The records of 751 MDR-TB patients were randomly selected using simple random sampling technique. Data were collected using a pre-tested and structured checklist. Multivariable multinomial logistic regression was undertaken to identify the contributing factors.

Results: At the end of the intensive phase, 17.3% of MDR-TB patients had an unfavorable treatment outcome, while 16.8% had an unknown outcome with the remaining having a favorable outcome. The median duration of the intensive phase was 9.0 months (IQR 8.04-10.54). Having an unfavorable intensive phase treatment outcome was found significantly more common among older age [ARRR = 1.047, 95% CI (1.024, 1.072)] and those with a history of hypokalemia [ARRR = 0.512, 95% CI (0.280, 0.939)]. Having an unknown intensive phase treatment outcome was found to be more common among those treated under the ambulatory care [ARRR = 3.2, 95% CI (1.6, 6.2)], rural dwellers [ARRR = 0.370, 95% CI (0.199, 0.66)], those without a treatment supporter [ARRR = 0.022, 95% CI (0.002, 0.231)], and those with resistance to a limited number of drugs.

Conclusion: We observed a higher rate of unfavorable and unknown treatment outcome in this study. To improve favorable treatment outcome more emphasis should be given to conducting all scheduled laboratory monitoring tests, assignment of treatment supporters for each patient and ensuring complete recording and reporting which could be enhanced by quarterly cohort review. Older aged and rural patients need special attention. Furthermore, the sample referral network should be strengthened.
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http://dx.doi.org/10.1186/s12879-019-4411-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6751790PMC
September 2019

Magnitude, causes and characteristics of trauma victims visiting Emergency and Surgical Units of Dilchora Hospital, Eastern Ethiopia.

Pan Afr Med J 2018 27;30:177. Epub 2018 Jun 27.

Haramaya University College of Health and Medical Sciences, School of Nursing and Midwifery, Harar, Ethiopia.

Introduction: In developing countries, approximately sixteen hundred people die every day from all types of injuries, making injury the third most common cause of all mortalities in the region. The objective of this study was to examine the magnitude, causes and types of traumatic injuries in patients visiting Dilchora Hospital in Dire Dawa Administration of Eastern Ethiopia.

Methods: We conducted a cross-sectional study which was supplemented with qualitative data. Descriptive and thematic analyses were used to characterize the trauma in terms of victims, causes and types.

Results: A total of 382 patients were identified within a two-month period of data collection. The most common causes of traumatic injuries identified were conflict (42.67%), road traffic accidents (35.07%), falls (13.35%) and burn injuries (8.90%). Soft tissue injuries (57.6%), abrasion (29.3%) and fractures (22.3%) were the three most common types of injuries experienced. Most of the victims were males, those people in the productive age bracket and those living in urban areas. Poor road structure, poor adherence to traffic rules and the use of old and poorly maintained vehicles were the main reasons for the road traffic accidents. Substance use behaviors in urban areas and farmland boundary issues in rural areas were the common causes of conflicts, and females were the most common victims of burn injuries.

Conclusion: A high magnitude of injuries was observed such that, on average, six trauma victims visited the hospital each day. Conflict and road traffic accidents were the two most common causes of traumatic injuries. Poor vehicular conditions and poor road design were the main reasons identified for road traffic accident related trauma, which requires multilevel interventions.
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http://dx.doi.org/10.11604/pamj.2018.30.177.10969DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6235504PMC
December 2018

Magnitude, causes and characteristics of trauma victims visiting Emergency and Surgical Units of Dilchora Hospital, Eastern Ethiopia.

Pan Afr Med J 2018 27;30:177. Epub 2018 Jun 27.

Haramaya University College of Health and Medical Sciences, School of Nursing and Midwifery, Harar, Ethiopia.

Introduction: In developing countries, approximately sixteen hundred people die every day from all types of injuries, making injury the third most common cause of all mortalities in the region. The objective of this study was to examine the magnitude, causes and types of traumatic injuries in patients visiting Dilchora Hospital in Dire Dawa Administration of Eastern Ethiopia.

Methods: We conducted a cross-sectional study which was supplemented with qualitative data. Descriptive and thematic analyses were used to characterize the trauma in terms of victims, causes and types.

Results: A total of 382 patients were identified within a two-month period of data collection. The most common causes of traumatic injuries identified were conflict (42.67%), road traffic accidents (35.07%), falls (13.35%) and burn injuries (8.90%). Soft tissue injuries (57.6%), abrasion (29.3%) and fractures (22.3%) were the three most common types of injuries experienced. Most of the victims were males, those people in the productive age bracket and those living in urban areas. Poor road structure, poor adherence to traffic rules and the use of old and poorly maintained vehicles were the main reasons for the road traffic accidents. Substance use behaviors in urban areas and farmland boundary issues in rural areas were the common causes of conflicts, and females were the most common victims of burn injuries.

Conclusion: A high magnitude of injuries was observed such that, on average, six trauma victims visited the hospital each day. Conflict and road traffic accidents were the two most common causes of traumatic injuries. Poor vehicular conditions and poor road design were the main reasons identified for road traffic accident related trauma, which requires multilevel interventions.
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http://dx.doi.org/10.11604/pamj.2018.30.177.10969DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6235504PMC
December 2018

Perinatally acquired HIV-positive status disclosure and associated factors in Dire Dawa and Harar, Eastern Ethiopia: a health facility-based cross-sectional study.

BMJ Open 2018 08 30;8(8):e019554. Epub 2018 Aug 30.

School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.

Objectives: The aim of this study was to assess the level and factors associated with caregivers' disclosure of perinatally HIV-infected (PHIV+) children's seropositive status.

Design: We conducted a cross-sectional study in five public health facilities providing HIV treatment and care in Dire Dawa and Harar, Eastern Ethiopia. The data were collected from 310 caregivers through face-to-face interviews and record reviews. Data analyses were done using STATA V.14.2 and statistical significance was declared at p value <0.05.

Results: The study revealed that the level of PHIV+ diagnosis disclosure was 49.4% (95% CI 43.8 to 54.9). Mean age at disclosure was 11.2 years. Disclosure level was higher among children who frequently asked about their health status (aOR (adjusted OR) 2.04, 95% CI 1.04 to 4.03) and when caregivers knew other people who had a disclosure experience (aOR 2.49, 95% CI 1.17 to 5.32). Disclosure level was less among children of 12 years or below (aOR 0.04, 95% CI 0.02 to 0.09) and among caregivers practising deception about the children's HIV positive status (aOR 0.38, 95% CI 0.19 to 0.74).

Conclusion: Only half of the caregivers disclosed their child's PHIV+ diagnosis. To facilitate disclosure, caregivers should be counselled about the appropriate age of disclosure and related misconceptions that hinder it. It is also apparent that caregivers need to be guided as to how to address children's frequent questions about their health status. These interventions can be made in a one-on-one approach or through patient group counselling when they come to get healthcare services.
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http://dx.doi.org/10.1136/bmjopen-2017-019554DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6119410PMC
August 2018

Long lasting insecticidal net use and its associated factors in Limmu Seka District, South West Ethiopia.

BMC Public Health 2018 01 10;18(1):124. Epub 2018 Jan 10.

Department of Environmental Health Sciences, Haramaya University College of Health and Medical Sciences, P. O. Box 235, Harar, Ethiopia.

Background: Many countries in sub-Saharan Africa, including Ethiopia, are focusing on the distribution of Long Lasting Insecticidal Nets (LLINs) to combat malaria. However, utilization of the LLIN is low when compared with LLIN possession because of various factors. This study was conducted to measure the actual LLIN usage and identify factors associated with its utilization in Limmu Seka District, South West Ethiopia.

Methods: A community based cross-sectional survey was conducted among 830 households from December 25, 2011 to February 29, 2012.

Results: A total of 830 households were selected by stratified systematic sampling and surveyed. Ninety percent of those surveyed owned LLINs and 68.3% reported that someone had slept under the net on the night prior to the survey. The factors associated with LLIN usage were knowledge of the mode of malaria transmission (AOR; 0.086, 95% CI 0.03, 0.24), the preferred conical shapes of the LLIN (AOR; 1.6, 95% CI 1.31, 4.1), receiving information about their use from Health Extension Workers (HEWs) (AOR; 2.4, 95% CI 1.5, 3.9), hearing media campaigns (AOR; 3.2 95% CI 3.5, 9.2), education at a health facility (AOR; 2 95% CI 1.5, 3.9) or having a family size of three or less (AOR; 2.1, 95% CI 1.3, 3.5).

Conclusion: Although ownership of Long Lasting Insecticidal Nets was high at 90%, the actual usage of LLIN was low, and not all family members were protected. Promoting the usage of LLINs utilization by those at most risk, especially the conical shaped ones, through intensified health education using HEWs and mass media campaigns at all health facilities, schools and communities will improve LLIN utilization.
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http://dx.doi.org/10.1186/s12889-018-5022-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5764020PMC
January 2018

Long lasting insecticidal net use and its associated factors in Limmu Seka District, South West Ethiopia.

BMC Public Health 2018 01 10;18(1):124. Epub 2018 Jan 10.

Department of Environmental Health Sciences, Haramaya University College of Health and Medical Sciences, P. O. Box 235, Harar, Ethiopia.

Background: Many countries in sub-Saharan Africa, including Ethiopia, are focusing on the distribution of Long Lasting Insecticidal Nets (LLINs) to combat malaria. However, utilization of the LLIN is low when compared with LLIN possession because of various factors. This study was conducted to measure the actual LLIN usage and identify factors associated with its utilization in Limmu Seka District, South West Ethiopia.

Methods: A community based cross-sectional survey was conducted among 830 households from December 25, 2011 to February 29, 2012.

Results: A total of 830 households were selected by stratified systematic sampling and surveyed. Ninety percent of those surveyed owned LLINs and 68.3% reported that someone had slept under the net on the night prior to the survey. The factors associated with LLIN usage were knowledge of the mode of malaria transmission (AOR; 0.086, 95% CI 0.03, 0.24), the preferred conical shapes of the LLIN (AOR; 1.6, 95% CI 1.31, 4.1), receiving information about their use from Health Extension Workers (HEWs) (AOR; 2.4, 95% CI 1.5, 3.9), hearing media campaigns (AOR; 3.2 95% CI 3.5, 9.2), education at a health facility (AOR; 2 95% CI 1.5, 3.9) or having a family size of three or less (AOR; 2.1, 95% CI 1.3, 3.5).

Conclusion: Although ownership of Long Lasting Insecticidal Nets was high at 90%, the actual usage of LLIN was low, and not all family members were protected. Promoting the usage of LLINs utilization by those at most risk, especially the conical shaped ones, through intensified health education using HEWs and mass media campaigns at all health facilities, schools and communities will improve LLIN utilization.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1186/s12889-018-5022-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5764020PMC
January 2018
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