Determinants of default to fully completion of immunization among children aged 12 to 23 months in south Ethiopia: unmatched case-control study

Introduction: Immunization is a cost effective interventions of vaccine preventable disease. There is still, 2.5 million children die by vaccine preventable disease every year in developing countries. In Ethiopia, default to fully completion of child immunization is high and determinants of default to completions are not explored well in the study setting. The aim of the study was to identify determinants of default to fully completion of immunization among children between ages 12 to 23 months in Sodo Zurea District, Southern Ethiopia. Methods: Community based unmatched case-control study was conducted. Census was done to identify cases and controls before the actual data collection. A total of 344 samples (172 cases and 172 controls) were selected by simple random sampling technique. Cases were children in the age group of 12 to 23 months old who missed at least one dose from the recommended schedule. Bivariable and multivariable binary logistic regression was used to identify the determinant factors. Odds ratio, 95%CI and p - value less than 0.05 was used to measure the presence and strength of the association. Results: Mothers of infants who are unable to read and write (AOR=8.9; 95%CI: 2.4, 33.9) and attended primary school (AOR=4.1; 95% CI:1.4-15.8), mothers who had no postnatal care follow up (AOR=0.4; 95%CI: 0.3, 0.7), good maternal knowledge towards immunization (AOR= 0.5; 95% CI: 0.3, 0.8) and maternal favorable perception towards uses of health institution for maternal and child care (AOR= 0.2; 95% CI: 0.1, 0.6) were significant determinant factors to default to fully completion of immunization. Conclusion: Working on maternal education, postnatal care follow up, promoting maternal knowledge and perception about child immunization are recommended measures to mitigate defaults to complete immunization.Pan African Medical Journal 2016; 2

Determinants of blood pressure control amongst hypertensive patients in Northwest Ethiopia

<div><p>Background</p><p>Controlling blood pressure (BP) leads to significant reduction in cardiovascular risks and associated deaths. In Ethiopia, data is scarce about the level and determinants of optimal BP control among hypertensive patients. This study aimed to assess the prevalence and associated factors of optimal BP control among hypertensive patients attending at a district hospital.</p><p>Methods</p><p>A hospital-based, cross-sectional study was conducted among 392 hypertensive patients who were on treatment and follow-up at a district hospital. A structured questionnaire adopted from WHO approach was prepared to collect the data. Medication adherence was measured by the four-item Morisky Green Levine Scale, with a score ≥3 defined as “good adherence”. Blood pressure was measured, and optimal BP control was 0DEFined as systolic BP < 140 mmHg and diastolic BP<90 mmHg. Both binary and multivariable logistic regressions models were fitted to identify correlates of optimal BP control. All statistical tests were two-sided and a p values <0.05 was considered for statistical significance.</p><p>Results</p><p>The mean age of the participants was 58 years (SD±13 years). Over half (53.8%) were females. Three quarters (77.3%) of the participants were adherent to their medications. The overall proportion of participants with optimally controlled BP was 42.9%.Female sex (Adjusted Odd Ratio(AOR) = 1.94, 95% CI: 1.15, 3.26), age older than 60 years (AOR = 2.95, 95% CI: 1.18, 7.40), consumption of vegetables on most days of the week (AOR = 2.16, 95% CI: 1.25, 3.73), physical activity (AOR = 4.85, 95% CI: 2.39, 9.83), and taking less than three drugs per day (AOR = 3.04, 95% CI: 1.51, 6.14) were positively associated with optimally controlled BP. Poor adherence to medications (AOR = 0.18, 95% CI: 0.09, 0.35), having asthma comorbidity (AOR = 0.33, 95% CI:0.12, 0.88) and use of top added salt on a plate (AOR = 0.20, 95% CI:0.11, 0.36) were negatively associated with optimal BP control.</p><p>Conclusion</p><p>A higher proportion of hypertensive patients remain with un-controlled BP. Modifiable risk factors including poor adherence to medications, lack of physical exercise, adding salt into meals, being on multiple medications and comorbidities were significantly and independently associated with poor BP control. Evidence-based, adherence-enhancing and healthy life style interventions should be implemented.</p></div

Sociodemographic characteristics of participants (n = 392).

<p>Sociodemographic characteristics of participants (n = 392).</p

Bivariate and multivariable logistic regression analysis of factors associated with optimal blood pressure control of hypertensive patients in Debre Tabor Hospital, ANRS, Northwest Ethiopia, May 2015 (n = 392).

<p>Bivariate and multivariable logistic regression analysis of factors associated with optimal blood pressure control of hypertensive patients in Debre Tabor Hospital, ANRS, Northwest Ethiopia, May 2015 (n = 392).</p

Anti-hypertensive drugs and level of adherence for medications (n = 392).

<p>Anti-hypertensive drugs and level of adherence for medications (n = 392).</p

Reproductive health service utilization and associated factors among adolescents (15–19 years old) in Gondar town, Northwest Ethiopia

BACKGROUND: The utilization of reproductive health services is an important component in preventing adolescents from different sexual and reproductive health problems. It plays a vital role in safeguarding youth in Sub-Saharan African countries including Ethiopia, which accounts for a high proportion of the region’s new HIV infections as well as maternal and infant mortality ratios. Due to this, assessing adolescent reproductive health service utilization and associated factors has its own contribution in achieving the national Millennium Development Goals (MDG), especially goals 4 to 6. METHODS: A community based cross-sectional study was conducted from April 5–19, 2012, in 4 randomly selected administrative areas of Gondar town. A total of 1290 adolescents aged 15–19 were interviewed using a pre-tested and structured questionnaire. Data were entered in to the EPI INFO version 3.5.3 statistical software and analyzed using an adapted SPSS version 20 software package. Logistic regression was done to identify possible factors associated with family planning (FP), and voluntary counseling and testing (VCT) service utilization. RESULTS: Out of the total participants, 79.5% and 72.2% utilized FP and VCT services, respectively. In addition, among sexually experienced adolescents, 68.1% and 88.4% utilized contraceptive methods and VCT service during their first sexual encounter, respectively. Educational status, discussion with family/relatives, peer groups, sexual partners and teachers were significantly associated with FP service utilization. Also, adolescents who had a romantic sexual relationship, and those whose last sexual relationship was long-term, were about 6.5 times (Adjusted Odds Ratio [AOR] = 6.5, 95% CI: 1.23, 34.59), and about 3 times (AOR = 3, 95% CI: 1.02, 8.24) more likely to utilize FP services than adolescents who had no romantic relationship or long-term sexual relationship, respectively. In addition, the variables significantly associated with VCT service utilization were: participants who had secondary education and above, schooling attendance, co- residence with both parents, parental communication, discussion of services with peer groups, health workers, and perception of a risk of HIV/AIDS. CONCLUSIONS: The majority of the adolescents were utilizing FP and VCT service in Northwest Ethiopia. But among the sexually experienced adolescents, utilization of FP at first sexual intercourse and VCT service were found to be low. Educational status, schooling attendance, discussion of services, type of sexual relationship and perception of risk were important factors affecting the utilization of FP and VCT services. Building life skill, facilitating parent to child communication, establishing and strengthening of youth centers and school reproductive health clubs are important steps to improve adolescents’ reproductive health (RH) service utilization