Predictors of compliance with community-directed treatment with ivermectin for onchocerciasis control in Kabo area, southwestern Ethiopia

BACKGROUND: Compliance with annual ivermectin treatment is a major challenge in community-directed treatment with ivermectin (CDTI) implementation. There are individuals who do not comply with the annual mass treatment, which contributes to the continuity for disease transmission. Hence, ensuring high treatment coverage and sustained compliance should be given due emphasis in the control of onchocerciasis. The aim of this study was to determine CDTI compliance rate and predictors of compliance where the CDTI was in its 9(th) round in Kabo area, southwestern Ethiopia. METHODS: Community-based cross-sectional study was conducted in Kabo area, three weeks after the 9th round of annual ivermectin distribution. Systematic random sampling was used to select head of households and structured, pre-tested questionnaire was used to interview the study participants. Data was analyzed using SPSS version 16. Descriptive statistics was used to compute mean and standard deviation of continuous variables and frequency for categorical variables, while bivariate and multivariate logistic regressions were used to assess the effects of independent variables on the outcome variable. Variables which showed association in multivariate analysis were considered as final predictors of compliance and strength of association was measured through adjusted odds ratio (AOR). RESULTS: A total of 308 respondents (age range 18-70, mean age ± SD, 32.21 ± 9.64) participated in the study. Of these, 249 (80.8%) reported that they took ivermectin during the 9(th) round annual treatment. Significantly higher rate of treatment compliance was reported by participants age ≥35 years (AOR = 5.48, 95% CI; 1.97 - 15.23), participants who stayed in the area for more than ten years (AOR = 3.86, 95% CI; 1.83- 8.11), participants who perceive that they are at risk of contracting the disease(AOR = 7.05, 2.70- 18.43), participants who perceive community drug distributors (CDDs) are doing their work well (AOR = 2.35 95% CI; 1.15- 4.83) and participants who know at least one CDD in their village (AOR = 2.83, 95% CI; 1.26- 6.40). CONCLUSION: The majority of the study participants in the present study area complied with ivermectin treatment. Nevertheless, intervention packages should consider factors such as age, residence duration and community’s perception of the disease to improve compliance and make drug distribution sustainable

Adherence to diabetic self-care management and associated factors among type 2 diabetic patients in North Shewa Zone public hospitals in Amhara Region, Ethiopia

IntroductionAdherence to diabetes self-care management is a lifestyle modification for people with diabetes.ObjectiveTo assess adherence to diabetic self-care management and associated factors among type 2 diabetic patients in North Shewa Zone public hospitals, Ethiopia, 2023.MethodsThe study employed a concurrent mixed-methods approach among 600 type 2 diabetic patients in North Shewa Zone public hospitals in Amhara, Ethiopia. The study was conducted from May 5 to May 20, 2023. The quantitative data were collected by using a semi-structured interview-administered questionnaire and chart review. Logistic regression was employed, and a p-value < 0.05 was considered statistically significant. Qualitative data were collected by in-depth interviews, and audio recordings were first transcribed verbatim and then translated to the English language by the first author and analyzed manually using a thematic approach.ResultOut of the total 600 type 2 diabetic patients, 262 (43.7%) with 95% CI: 40–47.8% of the study participants had good adherence to diabetes self-care practices. The multivariable analysis indicated that type 2 diabetic patients who lived in urban areas [AOR: 5.4, 95% CI: (1.05-8.7)] were 5.4 times more likely to have good diabetic self-care practice than those rural residents. Those who had a high school level of education [AOR: 2.9, 95% CI: (1.3-6.6)] were 2.9 times more likely to have good self-care practice, and those with college and above [AOR: 5, 95% CI (2–12):] were five times more likely to have good self-care practice. Regarding occupation, unemployed people were 66% less likely to have good self-care practices than employed people. Those who had no availability of healthcare services [AOR: 0.19, 95% CI: (0.09-0.37)] were less likely by 81% to have good self-care practice than those who had availability of healthcare services. These are significantly associated with diabetic self-care practice. The qualitative component clarified six themes: lack of education and awareness, financial affordability, accessibility, lack of family support, and having diabetic-related complications were identified as barriers.ConclusionThis study indicated that adherence of patients with type 2 diabetes to the recommended self-care practices was considerably poor. Different factors included the respondents who had a high school level or higher level of education and those who lived in urban areas. This was supported by the results from the qualitative part and thus the endorsement to strengthen diabetes health education to patients and their families. So, diabetic patients require an integrated approach through treatment as well as health education, which will increase the health and well-being of the patient

The prevalence of respectful maternity care during childbirth and its determinants in Ethiopia: a systematic review and meta-analysis

Background: Respectful maternity care is the provision of woman-centered health care during childbirth that is friendly, abuse-free, timely, and discrimination-free. Although several epidemiological studies on the magnitude and determinants of Respectful maternity care in Ethiopia have been conducted, the results have been inconsistent and varied. This makes drawing equivocal conclusions and evidence at the national level harder. Hence, this systematic review and meta-analysis aimed at estimating the pooled prevalence of respectful maternity care and its determinants in Ethiopia. Methods: Studies conducted from 2013 to June 30, 2022, were searched by using PubMed, Google Scholar, Science Direct, Scopus, ProQuest, Web of Science, Cochrane Library, and Direct of Open Access Journals. Searching was carried out from May 15- June 30, 2022. In total, sixteen studies were considered in the final analysis. The data were extracted using Microsoft Excel and analyzed using STATA 16 software. The methodological quality of included studies was assessed by using Joanna Briggs Institute’s critical appraisal checklist for prevalence studies. To estimate the pooled national prevalence of respectful maternity care, a random effect model with a DerSimonian Laird method was used. To assess the heterogeneity of the included studies, the Cochrane Q test statistics and I2 tests were used. To detect the presence of publication bias, a funnel plot and Begg’s and Egger’s tests were used. Results: Sixteen studies were eligible for this systematic review and meta-analysis with a total of 6354 study participants. The overall pooled prevalence of respectful maternity care in Ethiopia was 48.44% (95% CI: 39.02–57.87). Receiving service by CRC-trained health care providers [AOR: 4.09, 95% CI: 1.73, 6.44], having ANC visits [AOR: 2.34, 95% CI: 1.62, 3.06], planning status of the pregnancy [AOR = 4.43, 95% CI: 2.74, 6.12], giving birth during the daytime [AOR: 2.61, 95% CI: 1.92, 3.31], and experiencing an obstetric complication[AOR: 0.46, 95% CI: 0.30, 0.61] were identified as determinants of RMC. Conclusion: As per this meta-analysis, the prevalence of respectful maternity care in Ethiopia was low. Managers in the health sector should give due emphasis to the provision of Compassionate, Respectful, and Care(CRC) training for healthcare providers, who work at maternity service delivery points. Stakeholders need to work to increase the uptake of prenatal care to improve client-provider relationships across a continuum of care. Human resource managers should assign an adequate number of health care providers to the night-shift duties to reduce the workload on obstetric providers

A Qualitative Study of Factors Influencing Unsafe Work Behaviors Among Environmental Service Workers: Perspectives of Workers, and Safety Managers: The Case of Government Hospitals in Addis Ababa, Ethiopia

Background: Environmental Service (EVS) is a term that refers to cleaning in healthcare facilities. EVS personnel are exposed to a variety of hazards, including physical, chemical, ergonomic, cognitive, and biological hazards that contribute to the development of diseases and disabilities. Recognizing the conditions that promote unsafe behavior is the first step in reducing such hazards. The purpose of this study was to (a) investigate the attitudes and perceptions of safety among employees and safety managers in Addis Ababa hospitals, and (b) figure out what factors inhibit healthy work behaviors. Methods: The data for this study was gathered using 2 qualitative data gathering methods: key informant interviews and individual in-depth interviews. About 25 personnel from 3 Coronavirus treatment hospitals were interviewed to understand more about the factors that make safe behavior challenging. The interviews were recorded, transcribed, and then translated into English. Open Code 4.02 was used for thematic analysis. Results: Poor safety management and supervision, a hazardous working environment, and employee perceptions, skills, and training levels were all identified as key factors in the preponderance of unsafe work behaviors among environmental service workers. Conclusions: Different types of personal and environmental factors were reported to affect safe work behavior among environmental service personnel. Individual responsibility is vital in reducing or eliminating these risk factors for unsafe behaviors, but management’s involvement in providing resources for safe work behavior is critical. </jats:sec

Level of Maternal Health Literacy (MHL) and Associated Factors among Pregnant Women Attending Antenatal Care Clinics of Public Health Facilities in Southern Ethiopia, 2021: A Facility Based Crossectional Study with Linear Models

Abstract Background: Maternal Health Literacy (MHL) is defined as a woman's cognitive and social abilities and motivation to access, assess, understand and use basic health information and services to make informed decisions that protect and promote their own and their children's health. Pregnant women's HL will enhance the effectiveness and long-term viability of those services by allowing them to get health-related knowledge and behaviours during this critical period. As a result, this study aimed at assessing the level of health literacy and associated factors among pregnant women in Southern Ethiopia, 2021.Methods: A facility-based cross-sectional study was conducted among 635 pregnant women attending ANC units of selected health facilities from January 1 to February 30, 2021, by using pre-tested, interviewer-administered questionnaires. A multistage sampling technique was employed and study participants were selected by using a systematic random sampling technique. Data were entered into EpiData3.1 and exported to SPSS version 23 for analysis. A bivariable statistical analysis was performed through analysis of variance (ANOVA) and independent t-tests and variables with a p-value of &lt; 0.05 were eligible for the multiple linear regression model. To see the weight of each explanatory variable on MHL, multiple linear regression was employed, and the strength and direction of the association were reported by using a regression coefficient (β) with the respected 95% confidence interval.Results: The mean health literacy score of study participants was 23.85±2.87 in which, more than half, 336 (53.5%)( 95%CI: 49.1, 58.1) of the study participants had a good MHL level or above the mean score. The multiple linear regression analysis results revealed a significant relationship between MHL and educational level (β: 1.358; p&lt;0.001), gravidity(β: 1.439; p&lt;0.001), ANC visits (β: 1.418; p &lt;0.001), enrolment in CBHI scheme (β: 2.282; p&lt;0.001) and being a model household(MMH) (β: 1.681; p&lt;0.001).Conclusion and recommendation: The pregnant women in the current study area had a low level of maternal health literacy. Local governments should focus their efforts on establishing adult literacy centers in their respective locations. Pregnant women should be encouraged to attend adequate ANC visits, as per health care providers. Finally, at the community level, administrative bodies and health professionals should work on developing a model household and enrolling unenrolled households in the CBHI scheme.</jats:p

Pattern of Traditional Medicine Utilization among HIV/AIDS Patients on Antiretroviral Therapy at a University Hospital in Northwestern Ethiopia: A Cross-Sectional Study

The objective of this study was to assess traditional, complementary, and alternative medicine (TCAM) utilization pattern among HIV/AIDS patients on antiretroviral therapy at University of Gondar Comprehensive Specialized Hospital. Materials and Methods. Data on sociodemographic profile and clinical and TCAM utilization were collected using a structured, pretested questionnaire from April 01 to May 28, 2014, through interviews with patients. Data on CD4 count, HIV stage, and ART regimen were collected from patient records. Analysis was conducted descriptively using SPSS version 20. Results. Of the 300 participants, 43.7% reported using TCAM, with the largest proportion of them from religious institutions (churches/mosques) (41.22%), followed by home prepared (32.82%) and traditional healers (16.03%). The leading forms of TCAM used were spiritual and herbal therapies constituting 56.49% and 36.64% of the patients, respectively. The most frequently used herbal products included Nigella sativa (22.92%) and Moringa oleifera (20.83%). Most of the patients (73.30%) using TCAM reported improvement in their conditions. Conclusions. TCAM utilization among HIV/AIDS patients on ART was common and different sources and types were used alongside ART, with improvement reported by most. Further research is needed to identify CAM therapies which may be used as adjunct treatments among these patients

Exploring associations between household environmental factors and handwashing with essential agents in sub-Saharan Africa

Background 3 billion people lack proper home hand hygiene facilities globally. Of these, 1.4 billion (18%) lack soap or water, while 1.6 billion (22%) have neither. This analysis explores the link between living conditions and the use of essential agents in sub-Saharan Africa. This secondary data analysis examines potential associations between the domiciliary environment and the use of essential agents in sub-Saharan Africa. Methods Eighteen demographic and health surveys were used to analyze the association between household environmental factors and handwashing with essential agents. STATA version 16 was used to analyze data from 203,311 households across weighted samples. Using a multivariable multilevel mixed effect logistic regression analysis, it was possible to determine how each independent factor affected the outcome while taking the data clustering into account. The adjusted odds ratio and its associated 95% confidence interval were used to assess the independent factors' statistical significance. Result Only one in three households 34.84%, practiced handwashing with essential agents, with the highest prevalence in Angola (70.2%) and the lowest in Malawi (6.5%). Educational status [aOR = 1.77; 95%(CI = 1.68-1.86)], female headship[aOR = 1.09; 95%(CI = 1.06-1.2)], household wealth[aOR = 4.08; 95%(CI = 3.84-4.33)], not sharing toilets with other homes [aOR = 1.13; 95%(CI = 1.10-1.17)], having a fixed place for hand washing[aOR = 1.49; 95% (CI = 1.45-1.54)], not having regular access to water [aOR = 0.09; 95%(CI = 0.095-0.10)] and being a rural resident [aOR = 0.85; 95%(CI = 0.82-0.88)] were associated with handwashing. Conclusion sub-Saharan nations are failing to demonstrate advancements in handwashing practices. There are still a lot of homes without access to basic infrastructure for handwashing and household water sources. For essential agent adoption programs to be successful in an environment with limited resources, Water, Sanitation, and Hygiene measures must be implemented. Furthermore, it is critical to include contextual factors from the current study as well as socio-cultural and psychological characteristics that dissuade people from using essential agents in intervention strategies.</p

Synthesis, antibacterial and antioxidant activities of Thiazole-based Schiff base derivatives: a combined experimental and computational study

Abstract Background Thiazole-based Schiff base compounds display significant pharmacological potential with an ability to modulate the activity of many enzymes involved in metabolism. They also demonstrated to have antibacterial, antifungal, anti-inflammatory, antioxidant, and antiproliferative activities. In this work, conventional and green approaches using ZnO nanoparticles as catalyst were used to synthesize thiazole-based Schiff base compounds. Results Among the synthesized compounds, 11 showed good activities towards Gram-negative E. coli (14.40 ± 0.04), and Gram-positive S. aureus (15.00 ± 0.01 mm), respectively, at 200 μg/mL compared to amoxicillin (18.00 ± 0.01 mm and 17.00 ± 0.04). Compounds 7 and 9 displayed better DPPH radical scavenging potency with IC50 values of 3.6 and 3.65 μg/mL, respectively, compared to ascorbic acid (3.91 μg/mL). The binding affinity of the synthesized compounds against DNA gyrase B is within − 7.5 to − 6.0 kcal/mol, compared to amoxicillin (− 6.1 kcal/mol). The highest binding affinity was achieved for compounds 9 and 11 (− 6.9, and − 7.5 kcal/mol, respectively). Compounds 7 and 9 displayed the binding affinity values of − 5.3 to − 5.2 kcal/mol, respectively, against human peroxiredoxin 5. These values are higher than that of ascorbic acid (− 4.9 kcal/mol), in good agreement with the experimental findings. In silico cytotoxicity predictions showed that the synthesized compounds Lethal Dose (LD50) value are class three (50 ≤ LD50 ≤ 300), indicating that the compounds could be categorized under toxic class. Density functional theory calculations showed that the synthesized compounds have small band gap energies ranging from 1.795 to 2.242 eV, demonstrating that the compounds have good reactivities. Conclusions The synthesized compounds showed moderate to high antibacterial and antioxidant activities. The in vitro antibacterial activity and molecular docking analysis showed that compound 11 is a promising antibacterial therapeutics agent against E. coli, whereas compounds 7 and 9 were found to be promising antioxidant agents. Moreover, the green synthesis approach using ZnO nanoparticles as catalyst was found to be a very efficient method to synthesize biologically active compounds compared to the conventional method. </jats:sec