Awareness of Breast Cancer and Its Early Detection Measures Among Female Students, Northern Ethiopia

Globally breast cancer is the most common of all cancers. Since risk reduction strategies cannot eliminate the majority of breast cancers, early detection remains the cornerstone of breast cancer control. This paper, therefore, attempts to assess the awareness of breast cancer and its early detection measures among female students in Mekelle University, Ethiopia. An institution based cross-sectional study was conducted on randomly selected female students. Multistage sampling technique was employed to select the participants. A pre-tested structured questionnaire was used. Data analysis was carried out using SPSS version 16. In this study, 760 students participated making a response rate of 96 percent. Respondents with good knowledge score for risk factors, early detections measures and warning signs of breast cancer were 1.4 percent, 3.6 percent and 22.1 percent respectively. The majority 477 (62.8 percent) of participants practiced self-breast examination. In conclusion the participants had poor knowledge of risk factors, early detection measures and early warning signs of breast cancer.Therefore, the Ministry of health of Ethiopia together with its stalk holders should strengthen providing IEC targeting women to increase their awareness about breast cancer and its early detection measure

Barriers to Adherence of Optimal Birth Spacing: A Qualitative Study Among Mothers and Their Husbands in Arba Minch Zuria district, Ethiopia

Background: Optimal birth spacing plays a critical role in promoting perinatal health. However, in Ethiopia, many women still have shorter birth intervals than they would prefer and studies done to assess knowledge of couples were scarce. The objective of this study therefore was to assess perceived knowledge of couples about the disadvantage of short birth intervals in Arba Minch Zuria district, Ethiopia.Methods: Qualitative study design was conducted from February to April 2014 among women having at least two consecutive live births. Purposive sampling was employed to select information rich participants. Data were collected through focus group discussions using a semi- structured flexible discussion guide. Sixteen FGDs were conducted involving a total of 128 participants. Data were entered in to open code software and analyzed thematically.Result: Perceived disadvantage of short birth spacing, ultimate decision maker about birth intervals and reasons for experiencing short birth spacing were the major themes emerged from the discussion. Perceived knowledge of focus group discussants about the disadvantages of short birth pacing was very high. Ultimate decision maker about birth spacing were couples in the optimal spacers groups. On the other hand, husbands had the right to say the final word among discussants that had short birth intervals. Index child being female, husband & religious influences, fear of side effects of contraceptive, lack of information about the benefit contraceptives, and inaccessibility of reproductive health services were noted as reasons to experience short birth spacing.Conclusion: Perceived knowledge of discussants was similarly high in both short and optimal birth spacers. The main reasons for  experiencing short birth spacing were, husband influence, fear of side effects of  contraceptives, lack of information about the benefits of contraceptives, and geographical inaccessibility of reproductive health care services. For women to achieve optimal birth spacing, they need the support of their significant family members. Hence, behavioral change communications should target all of those who have a direct or indirect influence on birth spacing decisions. Moreover, the district in collaboration with other stallholders needs to work hard to make reproductive health service accessible in all aspects. Keywords: Perceived advantage, short birth interval, Qualitative study, Ethiopia

IMMUNOGENICITY OF PLASMA DERIVED V ACCINE IN ETHIOPIAN HOSPITAL PERSONNEL

ABSTRACT: To study the immunogenicity of plasma derived hepatitis B vaccine, serological markers (HBsAg, anti HBc and anti HBs) were determined in 432 hospital employees by the Hepanostika microenzyme linked immunoassay method (ELISA) using kits obtained from Organon Technika Laboratories (Holland). Three doses of Pasteur plasma derived vaccine (Hevac B), containing 5 mcg of HBsAg, were administered intramuscularly at one month intervals to 80 of the l02 marker negatives. A booster dose was given at one year. Hepatitis B markers (HBsAg, anti HBc and anti HBs) were determined at 4, 12, 13 and 24 months by the ELISA method. Titration for anti HBs were pertormed at T 4, T 12, and T 13 by the radio-immunoassay method. Of 80 vaccinees, 2 discontinued after the first injection. Sero-conversion to anti HBs occurred at 4 months in 57 of 80 (71.3% ); at 12 months in 64 of 73 tested (87.7%) and at months 13 and 24 in 66 of 69 tested (95.6%). Protective levels of anti HBs were achieved in titrated sera collected from sero-converters in 89%, 88.5% and 100% at months,4, 12 and 13 respectively. No vaccinee developed any evidence of hepatitis B infection during the two years of follow up. A female developed generalized skin rash and a pregnant woman aborted, both following the first injection. We conclude that plasma derive<! hepatitis B vaccine administered to adult Ethiopian hospital personnel is highly immunogenic and protective with minimal side effects

Why Many Women in Arba Minch District Have Short Inter Birth Intervals? Implication to Health Care Workers and District Health Managers in Ethiopia

Background: One of the key strategies to reduce fertility and promote the health status of mothers and their children is adhering to optimal birth spacing. However, women still have shorter birth intervals and studies addressing its determinants were scarce. The objective of this Study, therefore, was to assess determinants of birth interval among women who had at least two consecutive live births.Methods: Case control study was conducted from February to April 2014. Cases were women with short birth intervals (<3years); whereas, controls were women having history of optimal birth intervals (3 to 5 years). A pre-tested and structured questionnaire was used. Multivariable analysis was performed to determine independent predictors. For the qualitative study, data were collected through focus group discussions (FGDs) with mothers and their husbands. Result: Having no formal education (AOR=2.36, 95%CL: [1.23-4.52]), duration of breast feeding for less than 24 months(AOR: 66.03, 95%CI;[34.60-126]), preceding child being female(AOR: 5.73, 95%CI; [3.18-10.310]), modern contraceptive use (AOR: 2.79, 95%CI: [1.58-4.940]) and poor wealth index (AOR: 4.89, 95%CI; [1.81-13.25]) of respondents were independent predictors of short birth interval. In the qualitative study, lack of information about optimal birth spacing, inaccessibility of health care service, reliance on clean lactation, family & religious influence, previous child being female were indicated as reasons of short birth interval. Conclusion: In equalities in education, duration of breast feeding, sex of the preceding child, contraceptive method use and wealth index were markers of the unequal distribution of inter birth intervals. Thus, to optimize birth spacing, strategies of providing information, education and communication targeting predictor variables should be improved. Key words: Determinants, short inter birth interval, between two live births, Case control stud

Evaluation of pre-service training on integrated management of neonatal and childhood illness in Ethiopia

Background: The Integrated Management of Newborn and Childhood Illness strategy equips health workers with essential knowledge and skills to effectively manage sick children with common neonatal and childhood diseases. Since in-service training is very demanding to achieve the desired coverage of training of health workers, pre-service training is taken as a solution. At the time of the survey, most public and some private health professionals’ training institutions were conducting pre-service training. However, several concerns have been expressed on the training. Therefore, this survey was conducted to assess the status of pre-service Integrated Management of New-born and Childhood Illness training. Methods: A cross sectional survey on health professional training institutes/schools to evaluate pre-service Inte-grated Management of Newborn and Childhood Illness training was conducted in November 2007. Data was col-lected using pre-tested questionnaires, focused group interviews with teachers and students, observation of stu-dents while managing sick children using Integrated Management of Newborn and Childhood Illness guidelines, and reviews of pediatric course outlines and other teaching/learning materials. Data was entered in computer and analyzed using SPSS for Windows version 12.0.1. Results: Twenty nine health professionals’ training institutions (34 academic programs) which have started pre-service training were included in the survey. Of the 34 programs 22 were diploma nursing, 6 Bachelor of Sciences nursing, 4 health officer and the remaining two medicine. Thirty (88.2%) programs have integrated it in their cur-riculum. All academic programs had at least one fulltime staff for Integrated Management of Newborn and Child-hood Illness classroom instruction. Twenty nine (85.3%) programs had staff trained in case management skills. All the 34 academic programs taught health workers skills, 28(82.3%) used mixed approach. Integrated Management of Newborn and Childhood Illness was either incorporated for 21 (61.8%) or added to the previous teaching 11 (32.3%). The instructor to student ratio was low for most of the schools. Main challenges encountered in the pre-service teaching were constraints with trained staff and other resources each by 28 (82.3%) programs. Integrated Management of Newborn and Childhood Illness was included in student evaluation by all programs (100%). All students and instructors (100%) rated that Integrated Management of Newborn and Childhood Illness concept is very relevant or extremely relevant but majority said the time given was short. The over all mean score of students clinical practice was 63.5%. Conclusion: This study demonstrated that Integrated Management of Newborn and Childhood Illness was intro-duced into the teaching programs of most health professional training institutions. The most preferred teaching style was the mixed approach. Group discussion and demonstration were commonly used methods and Integrated Management of Newborn and Childhood Illness questions were included in students’ evaluation in almost all pro-grams. Shortage of IMNCI trained staff and teaching materials were major challenges. The use of teaching materi-als prepared for pre-service training like handbook and model chapter was limited. Instructors and students atti-tude towards IMNCI was very good. The students overall performance in managing sick child as per the IMNCI guidelines was above average. We recommend that the respective bodies at every level make every effort to strengthen IMNCI pre-service teaching through revisiting curricula, facilitating staff training, availing teaching materials and allocating adequate time. Exploring for an alternative/innovative and sustainable training approach is an assignment for all

Factors affecting the academic performance of female students at Mekelle University, Ethiopia

The study examined factors affecting the academic performance of female students in Mekelle University, Ethiopia. A total of 392 regular undergraduate students were sampled using (i) stratified random sampling-since students stratified into heterogeneous colleges and departments, (ii) proportional sampling method since the number of students differ in all departments, and (iii) simple random sampling to select respondents. Students were ranked from 1-4, whereas: 4= CGPA>=3.75, 3 = CGPA=3.5, 2=CPA<3.5 and CGPA>=3.25, 1 = CGPA<3.25. An ordered logit model was used to analyze data. Results indicated that academic background of students such as National examination results of grade 10 and grade 12, study strategy, choice of department, and involvement in network studying system were significant determinants of academic performance. Socioeconomic characteristics of parents and tutorial class did not have a significant impact on academic performance. Strategies should be developed to allow weak students to learn and take up study and time management strategies employed by high academic performers

THE PREVALENCE OF HIV-1 ANTIBODIES IN 106 TUBERCULOSIS PATIENTS

ABSTRACT: Sera were collected from all 106 tuberculosis (TB) patients consecutively seen over a period of six months at the Armed Forces General Hospital. All were tested for the presence of HIV-I antibodies, using the ELISA (Wellcozyme) and confirmed with the Western Blot (Biorad), out of which 7 reacted positively. Six of the seven HIV-I positive patients had pulmonary tuberculosis and only one had the disseminated form as opposed to 31% of the 106 patients presenting with the latter. Five of the HIV -I positive patients had a history of sexually transmitted diseases (STD) compared to 30 of the 99 HIV-I negative patients (39.4%). The study seems to show a positive association between HIV-I infection and tuberculosis. We therefore believe that further studies should be done in this country in order to a certain the association between the two diseases

The effect of psychosocial factors and patients’ perception of tuberculosis treatment non-adherence in Addis Ababa, Ethiopia

Background: Although there are several studies reported on factors affecting tuberculosis (TB) treatment non-adherence, there is information gap on psychosocial and patients’ perceptions aspects. Therefore, this study was aimed to investigate the effect of psychosocial factors and patients’ perceptions on TB treatment non-adherence in Ethiopia.Methods: A cross sectional study was conducted in Addis Ababa from May to December, 2014. Thirty one health facilities were randomly selected and 698 TB patients, who had been on treatment, were enrolled consecutively using patient registration number. Structured questionnaire was used to collect data on demographics, knowledge, psychological distress, alcohol use, tobacco smoking and six HBM domains. Treatment adherence level was the main outcome variable, and it measured using visual analog scale. Statistical Package for Social Sciences version 20 was used for data analysis.Results: Non-adherence level within last one month prior to the study was 19.5%. After controlling for all potential confounding variables, Antiretroviral Therapy (ART) status (Adjusted Odds Ratio (AOR) = 1.79, 95% Confidence interval (CI) (1.09 -2.95)), alcohol use (AOR = 2.11, 95% CI (1.33-3.37)), economic status (AOR = 0.53, 95% CI (0.33-0.82)), perceived barriers (AOR = 1.21, 95% CI (1.10-1.47)) and psychological distress (AOR = 1.83, 95% CI (1.47-2.29)) were independently associated with TB treatment non-adherence.Conclusion: ART status, economic status, alcohol use, perceived barrier and psychological distress are the major areas that need to be targeted with health promotion intervention to enhance TB treatment adherence.Keywords: Treatment Non-adherence, Determinants of treatment non-adherence, Health Belief Model, Tuberculosi

A Prospective Study of Causes of Illness and Death in Preterm Infants in Ethiopia: The SIP Study Protocol

Background With nearly 15 million annual preterm births globally, preterm birth is the most common cause of neonatal death. Forty to 60 % of neonatal deaths are directly or indirectly associated with preterm mortality. As countries aim to meet the Sustainable Development Goals to reduce neonatal mortality, significant reductions in preterm mortality are needed. This study aims to identify the common causes of preterm illness and their contribution to preterm mortality in low-resource settings. This article will describe the methods used to undertake the study. Methods This is a prospective, multi-centre, descriptive clinical study. Socio-demographic, obstetric, and maternal factors, and clinical and laboratory findings will be documented. The major causes of preterm mortality will be identified using clinical, laboratory, imaging, and autopsy methods and use the national Ethiopian guidelines on management of preterm infants including required investigations to reach final diagnoses. The study will document the clinical and management protocols followed in these settings. The approach consists of clinical examinations and monitoring, laboratory investigations, and determination of primary and contributory causes of mortality through both clinical means and by post-mortem examinations. An independent panel of experts will validate the primary and contributory causes of mortality. To obtain the estimated sample size of 5000 preterm births, the study will be undertaken in five hospitals in three regions of Ethiopia, which are geographically distributed across the country. All preterm infants who are either born or transferred to these hospitals will be eligible for the study. Three methods (last menstrual period, physical examination using the New Ballard Score, and ultrasound) will be used to determine gestational age. All clinical procedures will be conducted per hospital protocol and informed consent will be taken from parents or caretakers prior to their participation in the study as well as for autopsy if the infant dies. Discussion This study will determine the major causes of death and illness among hospitalized preterm infants in a low-resource setting. The result will inform policy makers and implementers of areas that can be prioritized in order to contribute to a significant reduction in neonatal mortality