Prolonged delays in leprosy case detection in a leprosy hot spot setting in Eastern Ethiopia

BACKGROUND: Leprosy or Hansen’s disease is known to cause disability and disfigurement. A delay in case detection of leprosy patients can lead to severe outcomes. In Ethiopia, the disability rates caused by leprosy among new cases are relatively high compared to other endemic countries. This suggests the existence of hidden leprosy cases in the community and a delay in timely detection. To reduce disability rates, it is crucial to identify the factors associated with this delay. This study aimed to determine the extent of delay in case detection among leprosy cases in Eastern Ethiopia. METHODS: This cross-sectional explorative study was conducted in January and February 2019 among 100 leprosy patients diagnosed ≤6 months prior to inclusion. A structured questionnaire was used to collect data, including the initial onset of symptoms, and the reasons for delayed diagnosis. Descriptive statistics, including percentages and medians, were used to describe the case detection delay. Logistic regression analysis was carried out to evaluate the predictors of delay in case detection of >12 months. FINDINGS: The median age of patients was 35 years, with a range of 7 to 72 years. The majority were male (80%) and rural residents (90%). The median delay in case detection was 12 months (interquartile range 10–36 months) among the included patients. The mean delay in case detection was 22 months, with a maximum delay of 96 months. The overall prevalence of disability among the study population was 42% (12% grade I and 30% grade II). Fear of stigma (p = 0.018) and experiencing painless symptoms (p = 0.018) were highly associated with a delay in case detection of >12 months. CONCLUSIONS: Being afraid of stigma and having painless symptoms, which are often misinterpreted as non-alarming at the onset of the disease, were associated with a delay in case detection. This study showed the need to increase knowledge on early symptoms of leprosy among affected communities. Furthermore, it is important to support initiatives that reduce leprosy related stigma and promote health worker training in leprosy control activities

Depression and Associated Factors among Adult Inpatients at Public Hospitals of Harari Regional State, Eastern Ethiopia

Introduction. Globally, depression is one of the three leading causes of disease and it will be the second leading cause of world disability by 2030. The prevalence of depression in Sub-Saharan Africa ranges from 15 to 30%. In Ethiopia, depression was found to be the seventh leading cause of disease burden and its prevalence has been increased in hospital compared to community setting because hospital environment itself is stressful. Yet, no study was done in Eastern Ethiopia, where substance use like Khat is very rampant. Objective. To assess depression and associated factors among adult inpatients at public hospitals of Harari Regional State, Eastern Ethiopia, from February 01 to 28, 2017. Methodology. Hospital based cross-sectional study design was employed on 492 admitted adult patients in Harari region hospitals. Consecutive sampling method was used to include study population. The data were collected by interviewee and analyzed by SPSS version 20.0. Bivariate and multivariate logistic regression analyses were employed. p value of 0.05 or less was considered to be statistically significant. Result. A total of 489 patients were interviewed with response rate of 99.4%. Having duration of 1-2 weeks in the hospital [AOR = 2.02, 95% CI: (1.28, 3.19)], being diagnosed with chronic morbidity [AOR = 4.06, 95% CI: (2.23, 7.40)], being users of psychoactive drugs [AOR = 2.24, 95% CI: (1.18, 4.24)], and having been admitted to surgical ward [AOR = 0.50, 95% CI: (0.31, 0.81)] were significantly associated with depression. Conclusion and Recommendation. Prevalence of depression among admitted inpatients was high. Therefore, increasing the awareness of benefits of early diagnosis of patients to prevent major form of depression and strengthening the clinical set-up and establishing good referral linkage with mental health institutions was considered to be cost-effective method to reduce its prevalence

In Rural Eastern Ethiopia Hearing Loss Is the Most Frequent Disability during Childhood: A Community Based Survey.

BACKGROUND:The type and extent of childhood disability in Ethiopia is unknown due to lack of accurate and reliable data. This study tried to assess the magnitude and types of disabilities among children 0-14 years of age in eastern Ethiopia. METHODS:We conducted a cross-sectional community-based study among households that are under demographic and health surveillance in eastern Ethiopia. The study population consisted of all children aged 0-14 year. A structured questionnaire was used to assess the type and severity of the disability. RESULTS:A total of 21,572 children in the age group 0-14 were screened for disability. Of which 586 (2.7%; 95% CI = 2.5%, 2.9%) had at least one kind of disability at the time of the survey. The proportion of disability increased as children were older; measured by the extended Mantel-Haenszel (M-H) chi square for linear trend (M-H = 48.74; P<0.001). Hearing impairment was the most common reported disability; 417 (71.2%; 95% CI = 67.5%, 74.9%). Among children with a disability, 179 (31.0%; 95% CI = 27.3%, 34.7%) had a combination of multiple disabilities and about a third, 200 (34.1%; 95% CI = 30.3%, 37.9%) had developed the disability during infancy. Magnitude of disability was higher among boys 335 (2.98%; 95% CIs = 2.66%, 3.30%) compared to girls 251 (2.44%; 95% CIs = 2.14%, 2.74%). CONCLUSION:Childhood disability is a health challenge in the study area and is already common at an early age. Permanent disability among children may be prevented by an early screening program in the routine child health services and adequate care, especially for hearing impairment

Breastfeeding technique and associated factors among breastfeeding mothers in Harar city, Eastern Ethiopia

Abstract Background Ineffective breastfeeding technique is one of the factors contributing to mothers practicing non-exclusive breastfeeding. Inappropriate breastfeeding technique is the leading cause of nipple pain in Ethiopia, as in other countries. However, no studies have examined breastfeeding technique and associated factors in eastern Ethiopia. Therefore, this study was conducted with the aim of assessing breastfeeding technique and associated factors among breastfeeding mothers. Method We conducted an institution based cross-sectional study in selected governmental health facilities of Harar city, Eastern, Ethiopia, from January to February 2017. Systematic random sampling technique was used to select 422 study participants. Data were collected using pretested observational checklist and interviewer administered questionnaires containing sociodemographic, maternal and infant characteristics. The variables, positioning, attachment and suckling, were used to assess the outcome variable of breastfeeding technique. Descriptive, bivariate and multivariate logistic regression analysis was done to identify independent predictors of BFT after controlling for confounding variables. Result The proportion of mothers practicing an effective breastfeeding technique was 43.4% (179/412). Effective breastfeeding technique was 2.3 times more common among mothers with at least secondary school educational status compared to mothers with no formal education (Adjusted Odds Ratio [AOR] 2.3; 95% Confidence Interval [CI] 1.1, 3.9). The practice of effective breastfeeding technique was significantly associated with mothers who had immediate breastfeeding technique counseling after birth (AOR 1.7, 95% CI 1.1, 2.8) and at least two postnatal visits (AOR 5.9; 95% CI 2.1, 15.9) compared to one visit. Absence of breast problems and having previous breastfeeding experience were also associated with the likelihood of effective breastfeeding technique practice (AOR 4.0; 95% CI 1.4, 10.9) and (AOR 3.3; 95% CI 1.1, 10.7) respectively. Conclusion The practice of effective breastfeeding technique was low. Effective breastfeeding technique practice was associated with higher educational status, previous information about breastfeeding technique, previous breastfeeding experience, absence of breast problems, receiving breastfeeding technique counseling immediately after birth and at least two postnatal visits. Therefore; health services should provide education about effective breastfeeding techniques and ensure postnatal care for all women, particularly primipara

Premature rupture of membrane and associated factors among pregnant women admitted to maternity wards of public hospitals in West Guji Zone, Ethiopia, 2021

Background: Premature rupture of membranes is an important cause of perinatal morbidity, and mortality, and complicates about 8% to 10% of pregnancies. Preterm birth and prematurity are a result of premature rupture of membranes and are often associated with fetal lung hypoplasia, respiratory distress syndrome, intraventricular hemorrhage, neonatal sepsis, and even death. This study aimed to assess the prevalence &amp; factors associated with premature rupture of membranes among pregnant mothers admitted in West Guji zone public hospitals. Methods: A facility-based cross-sectional study design was conducted, from April 9 to June 9, 2021. A systematic random sampling method was employed to select 407 study participants from pregnant mothers admitted to labor and delivery wards in selected public hospitals. The data collection consisted of a structured and interviewer-administered questionnaire, chart review, and measurement of the height, and weight of mothers. Data were entered and coded in Epi data version 3.1 and exported to SPSS 25 version for analysis. In bivariable logistic regression analysis, variables with a p-value < 0.25 were entered into multivariable logistic regression and statistical significance was declared at P < 0.05 with AOR and 95%CI. Result: A total of 407 study participants were included with a 100% response rate. About 12.5% (95%CI, 9.5–16.1) of the study participants had premature rupture of membranes. Gestational age < 37 weeks, (AOR = 2.5: 95%CI, 1.16–5.25), a history of premature rupture of the membranes, (AOR = 6, 95%CI, 1.88,-19.16), a history of abortion, (AOR = 2.5, 95%CI, 1.21–6.52), abnormal vaginal discharge, (AOR = 6.9, 95%CI 2.87–16.6), urinary tract infection, (AOR = 3.3, 95%CI, 1.07–10.12), and lower genital tract infections, (AOR = 4.5, 95%CI, 1.81–11.22) were factors associated with premature rupture of membranes. Conclusion: The prevalence of premature rupture of membranes was high relative to worldwide prevalence. All pregnant women should be screened and treated for urinary tract infection, lower genital tract infection, and vaginal discharge

Prevalence of food taboo during pregnancy in Ethiopia: A systematic review and meta-analysis

Back Ground: Food taboos influence intake of vital nutrients which required for optimal maternal health and fetal development during pregnancy. Pregnancy is the most delicate stage of human life and targets of food taboos. Even though there are fewer studies conducted on food taboos during pregnancy, there is no pooled estimate among pregnant women in Ethiopia. The smaller studies reported the different prevalence of food taboos which were difficult to help health planning at a national level. Thus, this study was expected to provide a pooled prevalence of pregnancy related food taboos in Ethiopia. Methods: The relevant studies were identified by manual and electronic data base searching method. Important information from the original studies was presented in a table and the quantitative results were presented in the forest plots. The Cochrane Q test and I2 test statistic were used to test heterogeneity across studies. The Pooled estimate of prevalence of food taboo was computed by a random effects model. Results: 175 articles were identified; nine studies meet inclusion criteria. A random effect meta-analysis of the results from these nine studies was carried out to provide pooled prevalence of food taboo during pregnancy. Analysis showed, the pooled prevalence of food taboo among pregnant women in Ethiopia was 38.50 (95% CI = 24.33-52.67); a significant heterogeneity was observed among studies (I2 = 99%, p value &lt;0.001). Subgroup analysis shows the highest prevalence of food taboo found in Somali region 67.38% and the lowest prevalence seen in Tigray 11.45% region. Conclusion: This review found pooled estimate of food taboo during pregnancy in Ethiopia. Variation in the magnitude of pregnancy related food restriction was seen across the regions. Therefore, integrating nutrition education with the basic antenatal care program was recommended in all regions of Ethiopia to prevent nutritional deficiencies associated with food taboo

Pressure ulcer prevention practices and associated factors among nurses in public hospitals of Harari regional state and Dire Dawa city administration, Eastern Ethiopia.

IntroductionPressure ulcer is one of the major challenges in hospitals; which endanger patient safety, prolonging hospital stay and contributed to disability and death. Data regarding to pressure ulcer prevention practice are very important to take action. However in Ethiopia, there are limited researches that have been conducted and there is clearly paucity of information on this regard. Hence, this study aimed to assess pressure ulcer prevention practice and associated factors among nurses in public hospitals of Eastern Ethiopia.MethodsA cross-sectional study was conducted among randomly selected 422 nurses who were working in the public hospitals of Eastern Ethiopia. Data were collected from the 1st February to the 1st March 2018 using pretested structured self-administered questionnaire and observational checklist. The collected data were entered into EpiData version 3.1 and exported to SPSS version 22.0 for analysis. Bivariable and multivariable logistic regression with crude and adjusted odds ratios along with the 95% confidence interval was computed and interpreted accordingly. Pressure ulcer prevention was determined based on mean calculation; a result above the mean value was categorized as good pressure ulcer prevention practice, and a P-value of ResultsIn this study 51.9% (95% CI: 47.1%, 56.4%) of nurses were reported that they have good pressure ulcer prevention practice. On observation 45.2% of nurses were practicing proper pressure ulcer prevention activities. Pressure ulcer prevention practice were statistically associated with nurses with bachelor degree and above qualification level (AOR = 1.7, 95% CI: 1.02, 2.83), availability of pressure-relieving devices (AOR = 2.2, 95% CI: 1.34, 3.63), being satisfied with their job (AOR = 1.65, 95% CI: 1.09, 2.52) and good knowledge (AOR = 2.3, 95% CI: 1.48, 3.55).ConclusionsIn this study the self-reported practice and results from observation was substantially low. Continuing education and training should be considered for nurses to enhance their practice regarding pressure ulcer prevention practice

Nurses Practice of Hand Hygiene in Hiwot Fana Specialized University Hospital, Harari Regional State, Eastern Ethiopia: Observational Study

Background. Nurses, who are the majority, can contaminate their hands with different types of microorganism during “clean” activities (e.g., lifting a patient; taking a patient’s pulse, blood pressure, or oral temperature; or touching a patient’s hand, shoulder, or groin). Yet good hand hygiene, the simple task of cleaning hands at the right time and in the right way, can reduce HCAIs that are transmitted by healthcare workers’ hands. Method. Observational study conducted among nurses by observational tool which was adopted from WHO observational tool. And finally compliance was calculated as a percentage (i.e., compliance% = (observed hand hygiene action (HHA) ÷ hand hygiene opportunity (O)) × 100). The data were first coded, entered, and cleaned using EpiData statistical software version 3.1 and then exported into SPSS statistical software version 22 for analysis. Data were presented using descriptive statistics. Result. A total of 110 study participants were observed who gave a response rate of 94.8%. Total of 3902 opportunities and 732 hand hygiene actions were observed with overall compliance of 18.7%. The highest 22.9% hand hygiene practice was observed “before clean∖aseptic procedure.” Highest 19.6% compliance was recorded at night shift and 22.7% in ICU ward of the hospital. Alcohol based hand rub was a major means of method used to clean hands. Conclusion and Recommendation. Observed practice of hand hygiene was poor. Lack of training, conveniently located sink, hand washing agents, and lack of time were major reasons for not practicing hand hygiene. Successful promotion of hand hygiene through instituting system change (e.g., making hand hygiene products available at the point of care) should be considered

Prevalence and correlates of internalizing and externalizing mental health problems among in-school adolescents in eastern Ethiopia: a cross-sectional study

Abstract Adolescent’s mental health issues are a major social burden and a significant public health issue, but they have not received enough attention in Ethiopia. Therefore, this study aimed to determine the prevalence and correlates of internalizing and externalizing mental health problems among in-school adolescents in the Harari region, eastern Ethiopia. A cross-sectional study was conducted among 3227 in-school adolescents. Multistage sampling was used to select schools and eligible students to participate in the study. A guided, self-administered strength and difficulty questionnaire measured mental health problems. Data were double-entered, validated, and cleaned using EpiData 3.1 and analyzed using STATA version 17. Ordinal logistic regression analysis was performed to estimate the adjusted odds ratio between mental health problems and their correlates. Statistical significance was set at p-value < 0.05. The magnitudes of mental health problems among in-school adolescents by subscale was 24.17% (95% CI 22.72; 25.67) for internalizing and 11.93% (95% CI 10.85; 13.09) for externalizing problems. A high internalizing problem score was associated with females, rural residents, alcohol users, attending public schools, those bullied at school, and those in the lowest wealth index. Likewise, the likelihood of a high externalizing problem score was high among alcohol users, adolescents whose fathers are uneducated, rural, and bullied at school. The study suggests that mental health problems are prevalent among in-school adolescents in Ethiopia, especially internalizing problems. The study also identifies several risk factors associated with internalizing and externalizing problems, such as wealth index, school types, alcohol use, bullying, and rural residence. These factors may indicate the need for more mental health awareness and support programs for adolescents in Ethiopia. This highlights that schools and communities should prioritize mental health awareness and support programs for adolescents. These programs should be tailored to address the specific needs of the population, such as rural residents, those in the lowest wealth index, and those who have experienced bullying

Intravenous fluid administration practice among nurses and midwives working in public hospitals of central Ethiopia: A cross-sectional study

Intravenous fluid administration is the most common invasive procedure widely practiced in hospital settings. Globally, approximately 25 million people receive intravenous fluid therapy. Different factors affect nurse's intravenous fluid administration practices; that it may influences on the patient's outcome, increase morbidity and mortality. Previous study indicates that healthcare providers especially in developing countries have skills gap related to intravenous fluid administration. The purpose of this study was aimed to assess the intravenous fluid administration practices and its associated factors among nurses and midwives working in public hospitals of West Shewa zone, Central Ethiopia. Materials and methods: An institution-based cross-sectional study design was employed among 396 nurses and midwives in public hospitals in West Shewa zone, Central Ethiopia, from March 1 to 31, 2019. A Simple random sampling was used to select study participants using structured self-administered questionnaire, and observational checklist. The logistic regression model was used to identify association, and odds ratio was used to test the strength of the associations with outcome variable and predictor variables. Results: In this study, 59.3% (95%CI = 54.7%–64.5%) participants was had inadequate intravenous fluid administration practice. Inadequate knowledge (AOR 2.1; CI 95% = 1.36–3.36), being untrained (AOR 1.7; 95% CI = 1.04–2.86), unavailability of supervision (AOR 1.8; CI 95% = 1.14–2.99), and absence of incentives and promotion for nurses and midwives (AOR 2.1; CI 95% = 1.19–3.62) were significantly associated with outcome variable. Conclusion: Nearly seven in ten participants in the study setting were inadequate intravenous fluid practice. Inadequate knowledge, training, and absence of supervision by senior staffs, and absence of incentives and promotion for nurses and midwives were the main factors affecting intravenous fluid administration practice. Refresher courses, supervision, incentives and promotions were needed to nurses and midwives for an improvement of the intravenous fluid administration practice