The role of social determinants on tuberculosis/HIV co-infection mortality in southwest Ethiopia: a retrospective cohort study

© 2016 Gesesew et al. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/ publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.BACKGROUND: The role played by social determinants of health including social, economic, environmental and cultural factors in influencing health outcomes for many health conditions has been widely described. However, the potential impact of these factors on morbidity and mortality of infectious diseases particularly tuberculosis (Tb)/HIV co-infection mortality is scantly addressed. We assessed the role that social determinants play in Tb/HIV co-infection mortality in southwest Ethiopia. METHODS: A retrospective cohort study collated Tb and HIV data from Jimma University Teaching Hospital, Southwest Ethiopia for the period of September 2010 and August 2012. Data analysis was conducted using STATA version 14 for mackintosh. Both descriptive and inferential statistics analyses were performed. Logistic regression was applied to identify factors associated with Tb/HIV co-infection mortality at P value of ≤0.05 in the final model. RESULTS: Fifty-five (20.2 %) patients died during the study period. Compared to their counterparts, more Tb/HIV co-infection death was observed in young age groups between 25 and 34 years (47.3 %), females (58.2 %), daily labors (40 %) and Muslim followers (54.5 %). 43.6 and 41.8 % of study participants respectively had single and double bedrooms, and 25.5 and 23.6 % of deceased study participants did not have water and electricity in the household respectively. Logistic regression analyses demonstrated the following factors significantly associated with Tb/HIV co-infection mortality: being a commercial sex worker (AOR, 5.6; 95 % CI, 1.2-25.8), being of bed ridden functional status (AOR, 3.9; 95 % CI, 1.5-10.3) and being a rural resident (AOR, 3.4; 95 % CI, 1.4-8.4). CONCLUSIONS: One-fifth of Tb/HIV co-infected patients died due to the co-infection. Social determinants including type of occupation, severity of disease and residing in rural areas seemed to have a significant association with the poor disease outcome. Findings of this study inform the role that social determinants play in influencing mortality due to Tb/HIV co-infection. Consistent with principles of primary health care as stated by Alma Ata declaration, and in order to achieve better disease outcomes, intervention frameworks that address Tb/HIV mortality should not only focus on the medical interventions of diseases, but should also integrate and improve social determinants of affected populations

Low Back Pain and Associated Factors among Hairdressers in Northern Ethiopia: A Cross-Sectional Study

Low back pain is one of the major occupational health problems ranked the highest in terms of years lived with disability, and it has an economic burden on individuals and society in general. Hairdressers are high-risk professionals, but they are usually getting less attention in research and policy actions. The objective of this study is to assess the magnitude and associated factors of low back pain among hairdressers working in female beauty salons of Mekelle, Northern Ethiopia. A cross-sectional study was employed from January up to March 2018. A simple random sampling was applied to select 344 participants. Interviewer-administered, pretested, and structured questionnaire was used. Bivariate and multivariate binary logistic regression analyses were performed using SPSS version 23. A p value of <0.05 was used to declare statistical significance. A total of 314 hairdressers participated, with a 91.3% response rate. The study found that the prevalence of low back pain was 47.5% with 95% CI (41.8–53.1). Marital status (AOR: 0.40, 95% CI (0.23–0.71)), awkward posture (AOR: 2.59, 95%CI (1.45–4.63)), working greater than 4 days in a week (AOR: 5.12, 95% CI (1.94–13.70)), the task of washing the client’s hair (AOR: 4.45, 95% CI (1.93–10.26)), having adjustable washing basin (AOR: 0.35, 95% CI (0.18–0.69)), job stress (AOR: 0.45, 95% CI (0.27–0.77)), and job satisfaction (AOR: 0.58, 95% CI (0.34–0.98)) were factors that show a statistically significant association with low back pain. This study found that low back pain is a major health problem among hairdressers. Marital status, awkward postures, working days per week, the task of washing the client’s hair, adjustable washing basin, job stress, and job satisfaction show a strong association with low back pain. The result suggests that effective intervention strategies for low back pain need to include ergonomic improvements and psychosocial and behavioral aspects of the participants

Household Food Insecurity and Its Association with Nutritional Status of Children 6–59 Months of Age in East Badawacho District, South Ethiopia

Background. Ethiopia has one of the highest child malnutrition rates in the world. Food insecurity is one of the determinant factors of malnutrition in developing countries; however its role remains unclear. Objective. To assess household food insecurity and its association with the nutritional status of children 6–59 months of age in East Badawacho District, South Ethiopia. Methods. A community based cross-sectional study was conducted from February 20 to 30, 2014 on a sample of 508 mother/child pairs of 6–59-month-old children. Sample households with eligible children were selected using systematic random sampling technique. Both bivariate and multivariate analysis were used to identify factors associated with nutritional status of children. P value of <0.05 was considered as statistically significant. Result. The prevalence of household food insecurity was 75.8%. The prevalence rates of stunting, underweight, and wasting among children were 45.6%, 26.3%, and 14.6%, respectively. Household food insecurity was significantly associated with underweight (AOR = 3.82; CI = 1.78–8.19) and stunting (AOR = 6.7; CI = 3.71–12.1) but not with wasting. Conclusion and Recommendation. Household food insecurity and the prevalence rates of stunting, underweight, and wasting, among children 6 to 59 months, were high. Intervention programs should focus on improving household food insecurity and nutritional status of children

Farmers Knowledge, Attitudes, Practices and Health Problems Associated with Pesticide Use in Rural Irrigation Villages, Southwest Ethiopia.

BACKGROUND:In Ethiopia, pesticides are widely used for a variety of purposes. The occurrence of contamination and poisoning for farmers is highly reported due to unsafe handling practices and their usage. We assessed knowledge, attitudes and experiences of previous pesticide exposure, and related health problems among farmers who use irrigation in Jimma Zone, Southwest Ethiopia. METHODS:A community based cross-sectional study was conducted among farmers living in the zone. Respondents were 796 irrigation farmers from 20 kebeles (lowest administration unit) in Jimma Zone. Data were collected using a pretested and structured questionnaire via face-to-face interviews. Both descriptive and inferential statistics analysis were performed. A binary logistic regression was used to identify factors associated with attitudes of farmers towards the safe use of pesticides at P value of ≤ 0.05 in the final model. RESULTS:Among the participants, 54.4% (95%CI, 50.7-58%) knew at least one pesticide control method and 53.7% had positive attitudes towards safe use of pesticide. The mean score of attitudes was found to be 3.9(±0.4). Knowledge including each of the following: the names of the pesticides (AOR, 0.41; 95%CI, 0.25-0.67), methods of pest control and the use of gloves during pesticide exposure (AOR, 1.52; 95%CI, 1.07-2.16) was found to be independent predictor of the farmers' attitudes about safe use of pesticides. Past exposure of pesticide was reported by 89.6% of farmers. Participants reported ingestion (88.9%) and inhalation (90.4%) as possible mechanisms of pesticide exposure. Nearly 42% of farmers had never used any personal protective equipment (PPE) to protect themselves against pesticide exposure. Farmers reported several health complications, which were perceived as complications of pesticide exposure, including: headache, nausea and vomiting, skin rash and irritation and abdominal pain. CONCLUSIONS:The study exposed the existence of high probability of pesticide exposure, the low safe use of pesticide and the low use of PPE. However, but farmers had positive attitudes towards safe use of pesticides. These findings appeal for the development of effective public health strategies to improve farmers' awareness and safe use of PPE. In addition, there is a need to inform farmers about integrated pest management to prevent severe health complications, which may occur as a result of unsafe and inappropriate use of pesticides

Pesticides reported as used by farmers in rural irrigation villages.

<p>Pesticides reported as used by farmers in rural irrigation villages.</p

Additional file 2: of Predictors of mortality in a cohort of tuberculosis/HIV co-infected patients in Southwest Ethiopia

Clinical and non-clinical data of Tb/HIV co-infectd patients attending in JUTH, Southwest Ethiopia. (SAV 17 kb

Additional file 1: of The prevalence and associated factors for delayed presentation for HIV care among tuberculosis/HIV co-infected patients in Southwest Ethiopia: a retrospective observational cohort

Multilingual abstracts in the six official working languages of the United Nations. (PDF 763 kb

Additional file 1: of Predictors of mortality in a cohort of tuberculosis/HIV co-infected patients in Southwest Ethiopia

Multilingual abstract in the five official working languages of the United Nation. (PDF 782 kb