Injury severity levels and associated factors among road traffic collision victims referred to emergency departments of selected public hospitals in Addis Ababa, Ethiopia: the study based on the Haddon matrix

Abstract Background Globally, about 1.25 million people die annually from road trafficcollisions. Evidence from global safety report shows a decreasing trend of road traffic injury indeveloped countries while there is an increasing trend in many developing countriesincluding Ethiopia. This study is aimed at assessing factors affecting injury severity levels of road traffic collision victims referred to selected public hospitals in Addis Ababa based on the Haddon Matrix. Methods Ahospital-based cross-sectional study designwas implemented to randomly select a total of 363 road traffic collision victims. The collected data was cleaned andentered into Epidata version 3.1 and exported to SPSS Version 21 for analysis. Bivariate and multivariate logisticregression models were used to examine the association between explanatory and outcome variables. Results A total of 363 individual sustained road traffic injuries were included to the study. Theprevalence of severe injury among road traffic accident victims was 36.4%. The following variables were significantly associated with increased injury severity: motorbike rider or motorbike passenger without helmet, adjusted odds ratio (AOR) 4.7(95% CI: 1.04–21.09); driving under the influence of alcohol, crude odds ratio (COR) 2.64(95% CI;1.23–5.64); victim with multiple injuries, AOR 3.88(95% CI: 2.26–6.65); vehicle size, AOR 2.14(95% CI: 1.01–4.52); collision in dark lighting condition, AOR 1.93(95% CI: 1.01–3.65); collision in cross city/rural, AOR 1.95(95% CI: 1.18–3.24) and vehicle occupant travelling unrestrained on the back of a truck, AOR3.9 (95% CI: 1.18–12.080). On the other hand, victims extricated at the scene by health care professional, AOR 0.33(95% CI: 0.13–0.83); victims extricated at the scene by police AOR 0.47(95% CI: 0.24–0.94); strict traffic police control at the scene of the collision, AOR 0.49(95% CI: 0.27–0.88) were significantly associated with less severe injuries. Conclusions Findings reported in this paper suggest the need forimmediate and pragmatic steps to be taken to curb the unnecessary loss of livesoccurring on the roads. In particular, there is urgent need to introduce road safety interventions

The status of prehospital care delivery for COVID-19 patients in Addis Ababa, Ethiopia: The study emphasizing adverse events occurring in prehospital transport and associated factors.

BackgroundCOVID-19 patients may require emergency medical services for emergent treatment and/or transport to a hospital for further treatment. However, it is common for the patients to experience adverse events during transport, even the shortest transport may cause life-threatening conditions. Most of the studies that have been done on prehospital care of COVID-19 patients were conducted in developed countries. Differences in population demographics and economy may limit the generalizability of available studies. So, this study was aimed at investigating the status of prehospital care delivery for COVID-19 patients in Addis Ababa focusing on adverse events that occurred during transport and associated factors.MethodsA total of 233 patients consecutively transported to Saint Paul's Hospital Millennium Medical College from November 6 to December 31, 2020, were included in the study. A team of physicians and nurses collected the data using a structured questionnaire. Descriptive statistics were used to summarize data, and ordinal logistic regression was carried out to assess the association between explanatory variables and the outcome variable. Results are presented using frequency, percentage, chi-square, crude and adjusted odds ratios (OR) with 95% confidence intervals.ResultsThe overall level of adverse events in prehospital setting was 44.2%. Having history of at least one chronic medical illness, [AOR3.2 (95%; CI; 1.11-9.53)]; distance traveled to reach destination facility, [AOR 0.11(95%; CI; 0.02-0.54)]; failure to recognize and administer oxygen to the patient in need of oxygen, [AOR 15.0(95%; CI; 4.0-55.7)]; absent or malfunctioned suctioning device, [AOR 4.0(95%; CI; 1.2-13.0)]; patients handling mishaps, [AOR 12.7(95%; CI; 2.9-56.8)] were the factors associated with adverse events in prehospital transport of COVID-19 patients.ConclusionsThere were a significant proportion of adverse events in prehospital care among COVID-19 patients. Most of the adverse events were preventable. There is an urgent need to strengthen prehospital emergency care in Ethiopia by equipping the ambulances with essential and properly functioning equipment and trained manpower. Awareness creation and training of transport staff in identifying potential hazards, at-risk patients, adequate documentation, and patient handling during transport could help to prevent or minimize adverse events in prehospital care

"I was raped by the broker on the first day of my arrival in the town." Exploring reasons for risky sexual behavior among sexually-active unmarried young female internal migrants in Ethiopia: A qualitative study.

BackgroundStudies revealed that internal migrants are one of the most vulnerable groups for poor sexual and reproductive health (SRH) information and services. Risky sexual behavior (RSB) is a threat to public health and might lead to serious health problems such as unintended pregnancy, abortion, and sexually transmitted infections (STIs) including HIV/AIDS. The reported prevalence of RSB among young female internal migrants in Ethiopia was as high as 70.3%. This requires in-depth understanding of the underlying cause. So, this study aimed at exploring reasons for RSB among sexually-active unmarried young female migrants in Ethiopia.MethodsA descriptive qualitative study was conducted using focus group discussions among sexually-active young female migrants working Burayu town. The focus group discussions were done in the local languages of participants (Afaan Oromo and Amharic). The recorded data were transcribed verbatim and translated into English for analysis and presentation in the study. The data were coded and Atlas.ti 7.5 software packages were used for data analyses. Then, the findings were thematically organized and analyzed using content analysis.ResultsThis study revealed that poor socio-economic status, social media indulgence, rape, substance use, poor knowledge of condom use, unfavorable attitude toward condom use, misconceptions about emergency pills, and the nature of the new environment and work place were responsible for RSB among internal migrants. The participants described that the migrants' economic conditions and workplace sexual violence are pushing them toward engaging in unprotected sex, being sexually abused, commercial sex, and transactional sex.ConclusionsInternal migrants' sexual behavior is a complex process influenced by multiple interrelating systems. We have explored a set of factors namely poverty, pressure and sexual abuse from brokers, sexual exploitation and abuses against domestic workers by their bosses, indulgence in social media, sexting, inadequate knowledge, and unfavorable attitude toward condom use that led young female internal migrants to risky sexual practices. An intervention to promote safe sex targeted to this population is urgently needed with a focus on an intervention to eliminate misconceptions about condoms, increase proper condom use, and end sexual violence. Moreover, a relevant policy is needed to safeguard internal migrants from sexual exploitation and abuses at their work place

Risky sexual behavior and associated factors among sexually-active unmarried young female internal migrants working in Burayu Town, Ethiopia.

BackgroundYoung female internal migrants are highly vulnerable to risky sexual behaviors (RSB) which may result in serious health problems such as unintended pregnancy, abortion and sexually transmitted infections including HIV. RSB includes early sexual debut (before 18 years), having multiple sexual partners, sex without a condom or inconsistent use of condom and sex under the influence of substance use. This study aimed to assess the magnitude and the factors associated with RSB among sexually-active unmarried young female internal migrants in Burayu Town, Ethiopia.MethodsA cross sectional study design was used for the study. A total of 267 respondents was recruited into the study using a simple random sampling technique. A semi-structured interviews-administered questionnaire was used to obtain information from the study participants. The collected data were cleaned, coded and entered into Epi data version 3.1 and then exported to SPSS Ver.21 for analysis. Multiple logistic regression models were used to indicate the association between dependent and independent variables.The resultsAbout 35% of the young female internal migrants had sexual debut before the age of 18 years; 64.4% had sex without condom or inconsistently used condom; nearly one quarter of the participants had multiple sexual partners, and 29.6% had sex under the influence of substance uses. The magnitude of RSB among the study participants was (79.1%). Sexting [AOR 3.47(95%; CI;1.10-11.94)], frequent engagement in social media [AOR 10.9(95%;CI;2.31-51.89)], feeling of embarrassment to buy condom [AOR 8.28(95%; CI; 2.10-32.62)], unfavorable attitude toward using condom for steady and loving relationship [AOR 5.72(95%; CI; 1.47-22.24)] were related with RSB while self-efficacy [AOR 0.15(95%: CI; 0.04-0.57)] to use condom and perceived risks of getting pregnant [AOR 0.05(95%; CI; 0.01-0.23)] were found to be protective factors.ConclusionThe study found high levels of RSB among sexually-active unmarried young female internal migrants. This finding suggests an urgent need of intervention to promote safe sex among this group. Special attention and prompt interventions are needed to promote the use of condoms

Impacts of language barriers on healthcare access and quality among Afaan Oromoo-speaking patients in Addis Ababa, Ethiopia

Abstract Background Ethiopia is a multilingual and multinational federation with Addis Ababa serving as both the capital city of Oromia regional state and the seat of the Ethiopian federal government. Nevertheless, only Amharic is considered as the working language of the city and federal offices, including hospitals. As a result, Afaan Oromoo-speaking patients may be facing language barriers in the healthcare settings in Addis Ababa. Language barriers have the capacity to affect patients’ experience of care and treatment outcomes. This study, hence, examined the impacts of language barriers on the healthcare access and quality for the Afaan Oromoo-speaking patients in public hospitals in Addis Ababa. Methods In-depth interviews with patients (N = 27) and key informant interviews with healthcare providers (N = 9) were conducted in six public hospitals found in Addis Ababa. All the interviews were audio-taped and transcribed verbatim. A thematic analysis technique was employed to address the study objectives. Results The study participants indicated the widely existing problem of language discordance between patients and healthcare providers. The impacts of language barriers on the patients include preventable medical errors, low treatment adherence, low health-seeking behavior, additional treatment cost, increased length of hospital stays, weak therapeutic relation, social desirability bias, less confidence, and dissatisfaction with the healthcare. For the healthcare providers, language barriers are affecting their ability to take patient history, perform diagnoses and provide treatment, and have also increased their work burden. The use of ad hoc interpreters sourced from bilingual/multilingual patients, patient attendants, volunteer healthcare providers, and other casual people has been reported to deal with the problem of language barriers. Conclusion A significant number of Afaan Oromoo-speaking patients are facing language barriers in accessing quality healthcare in public hospitals in Addis Ababa, and this constitutes structural violence. As a way out, making Afaan Oromoo an additional working language of the public hospitals in Addis Ababa, the assignment of professional interpreters, and a hiring system that promotes the recruitment of qualified multi-lingual healthcare providers are suggested

Identification of determinant factors for crash severity levels occurred in Addis Ababa City, Ethiopia, from 2017 to 2020: using ordinal logistic regression model approach

Abstract Background Road traffic Injuries (RTI) are multifaceted occurrences determined by the combination of multiple factors. Also, severity levels of injuries from road traffic accidents are determined by the interaction of the composite factors. Even though most accidents are severe to fatal in developing countries, there is still a lack of extensive researches on crash severity levels and factors associated with these accidents. Hence, this study was intended to identify severity levels of road traffic injuries and determinant factors in Addis Ababa City, Ethiopia. Methods The study was conducted in Addis Ababa, the capital city of Ethiopia, using secondary data obtained from the Addis Ababa Police Commission office. The ordinal logistic regression model was used to investigate road traffic injury severity levels and factors worsening injury severity levels using the recorded dataset from October 2017 to July 2020. Results A total of 8458 car accidents were considered in the study, of which 15.1% were fatal, 46.7% severe, and 38.3% were slight injuries. The results of the ordinal logistic regression analysis estimation showed that being a commercial truck, college and above level educated driver, rollover crash, motorbike passengers, the crash day on Friday, and darkness were significantly associated factors with crash injury severity levels in the study area. On the contrary, driving experience (> 10 years), passenger of the vehicle, two-lane roads, and afternoon crashes were found to decrease the severity of road traffic injuries. Conclusions Road traffic injury reduction measures should include strict law enforcement in order to maintain road traffic rules especially among commercial truckers, motorcyclists, and government vehicle drivers. Also, it is better to train drivers to be more alert and conscious in their travels, especially on turning and handling their vehicles while driving

Description of prehospital care utilization by need factors among severe and critical COVID-19 patients who visited treatment centers in Addis Ababa, Ethiopia, from May to July 2021.

Description of prehospital care utilization by need factors among severe and critical COVID-19 patients who visited treatment centers in Addis Ababa, Ethiopia, from May to July 2021.</p

Description of enabling characteristics by ambulance utilization among severe and critical COVID-19 patients who visited treatment centers in Addis Ababa, Ethiopia, from May to July 2021.

Description of enabling characteristics by ambulance utilization among severe and critical COVID-19 patients who visited treatment centers in Addis Ababa, Ethiopia, from May to July 2021.</p