Occupational exposure to sharps injury among healthcare providers in Ethiopia regional hospitals

BACKGROUND: Sharps injury is a penetrating stab wound from a needle, scalpel, or another sharp object that may result in exposure to blood or other body fluids. According to World Health Organization pooled estimate, the annual incidence of sharps injury in Africa was ranged from 2.10 to 4.68 per person per year, but research data in Ethiopia is limited. The aim of the study was to investigate sharps injury prevalence and associated risk factors. METHODS: Institution based cross-sectional study was conducted with 200 healthcare providers (HCP) in Northeast Ethiopia. Proportionate stratified sampling was used to select HCP. Sharps injury during the last 12 months was an outcome variable whereas demographic characteristics, behavioral attributes, and job environment characteristics were independent variables. Data was collected from April to May 2016 using self-administered questionnaire; which was adapted from World Health Organization best practices for injections and related procedures toolkit. Bivariate and multivariate logistic regression analysis was carried out to identify sharps injury associated risk factors. Epi Info version 3.5.1 software package was used for data coding and entry whereas Statistical Package for Social Sciences (SPSS) version 20 software package was used for analysis. RESULTS: In total, 195 HCP participated with a response rate of 97.5%. The prevalence of sharps injury was 32.8%. Following adjustment for covariates, lack of in-service job training and previous exposure to sharps injury were statistically significant risk factors for sharps injury. HCP who had no in-service job training were 4.7 times more likely sustained sharps injury compared with those who had in-service job training (p < 0.001, OR = 4.7, 95% CI = 2.05-10.56). HCP who had previous exposure to sharps injury were 3.7 times more likely sustained sharps injury compared with those who were not exposed (p-value = 0.002, OR = 3.7, 95% CI = 1.62-8.27). CONCLUSIONS: This study revealed 32.8% or at least three out of ten HCP exposed to sharps injury. This was found statistically significant among HCP who had no in-service job training and who had previous exposure to sharps injury. Thus, training HCP perhaps increase their skill and curiosity to reduce exposure to sharps injury

Perceived stress and its associated factors among people living in post-war Districts of Northern Ethiopia:A cross-sectional study

BACKGROUND: War and conflict environments result in long-term physical and psychological consequences. Sexual violence, displacement, malnutrition, death, illness, injury, torture, and disability are some of the physical effects, whereas stress, depression, aggressive behaviors, and anxiety are some of the emotional complications of war. Hence, evidence-based interventions are required particularly to monitor mental health disorders. Thus, we aimed to investigate the prevalence of perceived stress and its associated factors among people living in post-war situations, Northern Ethiopia. METHOD: A community-based cross-sectional study design was employed among 812 samples from April 1 to May 15, 2022. The study participants were selected using a multistage sampling technique. The data was collected through face-to-face interviews using a structured and pre-tested tool. Data were cleaned and entered into Epi-Data version 4.6 and transferred to SPSS version 25 for analysis. Binary logistic regression analysis was performed to identify determinants of perceived stress. The Hosmer-Lemeshow goodness-of-fit was applied to test for model fitness and a p-value of <0.05 was considered statistically significant. RESULT: The prevalence of perceived stress was 76.1%, 95% CI (72.9–78.8). Age above 45 years (AOR (CI) = 2.45 (1.07–5.62), poor educational level (AOR (CI) = 5.92 (2.36–14.8), large family size (AOR (CI) = 0.48 (0.31–0.74), alcohol consumption (AOR (CI) = 0.63 (0.42–0.94), smoking (AOR (CI) = 0.17 (0.06–0.56), and exposure to multiple traumatic events (AOR (CI) = 2.38 (1.23–4.62) have shown a statistically significant association with perceived stress. CONCLUSION: This study revealed that more than three-fourths of participants living in post-war settings were found to have perceived stress. Older age, poor level of education, large family size, alcohol consumption, smoking, and the number of traumatic events were significant associates of perceived stress. Psychotherapy that can effectively address the medical, social, and psychological well-being of the community is important to reduce the burden of perceived stress

Time to death and its predictors among neonates who were admitted to the neonatal intensive care unit at tertiary hospital, Addis Ababa, Ethiopia:Retrospective follow up study

Backgrounds: Neonatal death is the major problem in developing world. Burden and predictors of neonatal mortality vary across countries and even among regions of a country, so understanding the problem concerning these factors is essential to overcome the problem. Therefore, this study aimed to determine time to death and its predictors of neonatal mortality among neonates who were admitted to the neonatal intensive care unit of Tertiary Hospital, Addis Ababa, Ethiopia. Methods: A hospital-based retrospective cohort study was employed among 434 neonates admitted in Tertiary hospital, Addis Ababa, Ethiopia. A Kaplan Meier curve and a log-rank test were used to estimate the survival time and compare survival curves between variables. The cox proportional hazard model was also fitted to identify predictors. Results: A total of 434 neonates included in the study, 11.1% of which were died, and the incidence rate was 19.2 per 1000 live births. The time to death of neonates was 17 days. Independent predictors of neonatal mortality were incomplete maternal antenatal follow up[AHR: 3.7 (95% CI:1.86,7.60)], low(Appearance, Pulse, Grimily, Activity, and Respiration(APGAR)score[AHR:5.0 (95%CI:1.51–15.04)], perinatal asphyxia [AHR:5.2 (95%CI:1.92–14.30)], preterm 4.2 (95%CI: 1.32–8.83)]. Moreover, small for gestational age [AHR:4.8 (95%CI:2.33–9.72)], respiratory distress[AHR: 2.5 (95%CI: 1.24–5.09)], sepsis [AHR: 3.4 (95%CI: 1.71–4.01)], low birth weight[AHR: 7.3 (95%CI:2.69,1.91)], and tracheoesophageal fistula [AHR: 2.2 (95%CI: 1.13–4.32)]. Conclusion: The overall incidence rate was 19.2 deaths per 1,000 live births. Emphasis should be given to incomplete Antenatal care follow up, small for gestation, preterm, low birth weight, low 5th min APGAR score, neonatal sepsis, respiratory distress, perinatal asphyxia, and tracheoesophageal fistula

The unfinished agenda of communicable diseases among children and adolescents before the COVID-19 pandemic, 1990-2019: a systematic analysis of the Global Burden of Disease Study 2019

BACKGROUND: Communicable disease control has long been a focus of global health policy. There have been substantial reductions in the burden and mortality of communicable diseases among children younger than 5 years, but we know less about this burden in older children and adolescents, and it is unclear whether current programmes and policies remain aligned with targets for intervention. This knowledge is especially important for policy and programmes in the context of the COVID-19 pandemic. We aimed to use the Global Burden of Disease (GBD) Study 2019 to systematically characterise the burden of communicable diseases across childhood and adolescence. METHODS: In this systematic analysis of the GBD study from 1990 to 2019, all communicable diseases and their manifestations as modelled within GBD 2019 were included, categorised as 16 subgroups of common diseases or presentations. Data were reported for absolute count, prevalence, and incidence across measures of cause-specific mortality (deaths and years of life lost), disability (years lived with disability [YLDs]), and disease burden (disability-adjusted life-years [DALYs]) for children and adolescents aged 0-24 years. Data were reported across the Socio-demographic Index (SDI) and across time (1990-2019), and for 204 countries and territories. For HIV, we reported the mortality-to-incidence ratio (MIR) as a measure of health system performance. FINDINGS: In 2019, there were 3·0 million deaths and 30·0 million years of healthy life lost to disability (as measured by YLDs), corresponding to 288·4 million DALYs from communicable diseases among children and adolescents globally (57·3% of total communicable disease burden across all ages). Over time, there has been a shift in communicable disease burden from young children to older children and adolescents (largely driven by the considerable reductions in children younger than 5 years and slower progress elsewhere), although children younger than 5 years still accounted for most of the communicable disease burden in 2019. Disease burden and mortality were predominantly in low-SDI settings, with high and high-middle SDI settings also having an appreciable burden of communicable disease morbidity (4·0 million YLDs in 2019 alone). Three cause groups (enteric infections, lower-respiratory-tract infections, and malaria) accounted for 59·8% of the global communicable disease burden in children and adolescents, with tuberculosis and HIV both emerging as important causes during adolescence. HIV was the only cause for which disease burden increased over time, particularly in children and adolescents older than 5 years, and especially in females. Excess MIRs for HIV were observed for males aged 15-19 years in low-SDI settings. INTERPRETATION: Our analysis supports continued policy focus on enteric infections and lower-respiratory-tract infections, with orientation to children younger than 5 years in settings of low socioeconomic development. However, efforts should also be targeted to other conditions, particularly HIV, given its increased burden in older children and adolescents. Older children and adolescents also experience a large burden of communicable disease, further highlighting the need for efforts to extend beyond the first 5 years of life. Our analysis also identified substantial morbidity caused by communicable diseases affecting child and adolescent health across the world. FUNDING: The Australian National Health and Medical Research Council Centre for Research Excellence for Driving Investment in Global Adolescent Health and the Bill & Melinda Gates Foundation

Mapping age- and sex-specific HIV prevalence in adults in sub-Saharan Africa, 2000-2018

BACKGROUND: Human immunodeficiency virus and acquired immune deficiency syndrome (HIV/AIDS) is still among the leading causes of disease burden and mortality in sub-Saharan Africa (SSA), and the world is not on track to meet targets set for ending the epidemic by the Joint United Nations Programme on HIV/AIDS (UNAIDS) and the United Nations Sustainable Development Goals (SDGs). Precise HIV burden information is critical for effective geographic and epidemiological targeting of prevention and treatment interventions. Age- and sex-specific HIV prevalence estimates are widely available at the national level, and region-wide local estimates were recently published for adults overall. We add further dimensionality to previous analyses by estimating HIV prevalence at local scales, stratified into sex-specific 5-year age groups for adults ages 15-59 years across SSA. METHODS: We analyzed data from 91 seroprevalence surveys and sentinel surveillance among antenatal care clinic (ANC) attendees using model-based geostatistical methods to produce estimates of HIV prevalence across 43 countries in SSA, from years 2000 to 2018, at a 5 × 5-km resolution and presented among second administrative level (typically districts or counties) units. RESULTS: We found substantial variation in HIV prevalence across localities, ages, and sexes that have been masked in earlier analyses. Within-country variation in prevalence in 2018 was a median 3.5 times greater across ages and sexes, compared to for all adults combined. We note large within-district prevalence differences between age groups: for men, 50% of districts displayed at least a 14-fold difference between age groups with the highest and lowest prevalence, and at least a 9-fold difference for women. Prevalence trends also varied over time; between 2000 and 2018, 70% of all districts saw a reduction in prevalence greater than five percentage points in at least one sex and age group. Meanwhile, over 30% of all districts saw at least a five percentage point prevalence increase in one or more sex and age group. CONCLUSIONS: As the HIV epidemic persists and evolves in SSA, geographic and demographic shifts in prevention and treatment efforts are necessary. These estimates offer epidemiologically informative detail to better guide more targeted interventions, vital for combating HIV in SSA

Mapping age- and sex-specific HIV prevalence in adults in sub-Saharan Africa, 2000–2018

Background: Human immunodeficiency virus and acquired immune deficiency syndrome (HIV/AIDS) is still among the leading causes of disease burden and mortality in sub-Saharan Africa (SSA), and the world is not on track to meet targets set for ending the epidemic by the Joint United Nations Programme on HIV/AIDS (UNAIDS) and the United Nations Sustainable Development Goals (SDGs). Precise HIV burden information is critical for effective geographic and epidemiological targeting of prevention and treatment interventions. Age- and sex-specific HIV prevalence estimates are widely available at the national level, and region-wide local estimates were recently published for adults overall. We add further dimensionality to previous analyses by estimating HIV prevalence at local scales, stratified into sex-specific 5-year age groups for adults ages 15–59 years across SSA. Methods: We analyzed data from 91 seroprevalence surveys and sentinel surveillance among antenatal care clinic (ANC) attendees using model-based geostatistical methods to produce estimates of HIV prevalence across 43 countries in SSA, from years 2000 to 2018, at a 5 × 5-km resolution and presented among second administrative level (typically districts or counties) units. Results: We found substantial variation in HIV prevalence across localities, ages, and sexes that have been masked in earlier analyses. Within-country variation in prevalence in 2018 was a median 3.5 times greater across ages and sexes, compared to for all adults combined. We note large within-district prevalence differences between age groups: for men, 50% of districts displayed at least a 14-fold difference between age groups with the highest and lowest prevalence, and at least a 9-fold difference for women. Prevalence trends also varied over time; between 2000 and 2018, 70% of all districts saw a reduction in prevalence greater than five percentage points in at least one sex and age group. Meanwhile, over 30% of all districts saw at least a five percentage point prevalence increase in one or more sex and age group. Conclusions: As the HIV epidemic persists and evolves in SSA, geographic and demographic shifts in prevention and treatment efforts are necessary. These estimates offer epidemiologically informative detail to better guide more targeted interventions, vital for combating HIV in SSA

Adverse obstetric outcome and its associated factors in public hospitals of North Ethiopia: does parity make a difference?

Background Direct obstetric causes account for nearly 75% of all maternal deaths. Controversy prevails in the effect of grand multiparity on adverse obstetric outcomes. This study thus aimed to determine and compare the obstetric outcomes in low multiparous (LM) and grand multiparous (GM) women in Public Hospitals of North Ethiopia. Method An institution-based comparative cross-sectional study was done among 540 (180 GM and 360 LM) participants from January 1 to March 30, 2021. The data was collected through face-to-face interviews and a review of clinical records and birth registries. Epi-Data version 4.6 was used for data entry and analysis was performed using SPSS version 25.0 statistical software. A p-value o

Perceived stress and its associated factors among people living in post-war Districts of Northern Ethiopia: A cross-sectional study

Background: War and conflict environments result in long-term physical and psychological consequences. Sexual violence, displacement, malnutrition, death, illness, injury, torture, and disability are some of the physical effects, whereas stress, depression, aggressive behaviors, and anxiety are some of the emotional complications of war. Hence, evidence-based interventions are required particularly to monitor mental health disorders. Thus, we aimed to investigate the prevalence of perceived stress and its associated factors among people living in post-war situations, Northern Ethiopia. Method: A community-based cross-sectional study design was employed among 812 samples from April 1 to May 15, 2022. The study participants were selected using a multistage sampling technique. The data was collected through face-to-face interviews using a structured and pre-tested tool. Data were cleaned and entered into Epi-Data version 4.6 and transferred to SPSS version 25 for analysis. Binary logistic regression analysis was performed to identify determinants of perceived stress. The Hosmer-Lemeshow goodness-of-fit was applied to test for model fitness and a p-value of <0.05 was considered statistically significant. Result: The prevalence of perceived stress was 76.1%, 95% CI (72.9–78.8). Age above 45 years (AOR (CI) = 2.45 (1.07–5.62), poor educational level (AOR (CI) = 5.92 (2.36–14.8), large family size (AOR (CI) = 0.48 (0.31–0.74), alcohol consumption (AOR (CI) = 0.63 (0.42–0.94), smoking (AOR (CI) = 0.17 (0.06–0.56), and exposure to multiple traumatic events (AOR (CI) = 2.38 (1.23–4.62) have shown a statistically significant association with perceived stress. Conclusion: This study revealed that more than three-fourths of participants living in post-war settings were found to have perceived stress. Older age, poor level of education, large family size, alcohol consumption, smoking, and the number of traumatic events were significant associates of perceived stress. Psychotherapy that can effectively address the medical, social, and psychological well-being of the community is important to reduce the burden of perceived stress

Perceived stress and its associated factors among people living in post-war Districts of Northern Ethiopia: A cross-sectional study

Background War and conflict environments result in long-term physical and psychological consequences. Sexual violence, displacement, malnutrition, death, illness, injury, torture, and disability are some of the physical effects, whereas stress, depression, aggressive behaviors, and anxiety are some of the emotional complications of war. Hence, evidence-based interventions are required particularly to monitor mental health disorders. Thus, we aimed to investigate the prevalence of perceived stress and its associated factors among people living in post-war situations, Northern Ethiopia. Method A community-based cross-sectional study design was employed among 812 samples from April 1 to May 15, 2022. The study participants were selected using a multistage sampling technique. The data was collected through face-to-face interviews using a structured and pre-tested tool. Data were cleaned and entered into Epi-Data version 4.6 and transferred to SPSS version 25 for analysis. Binary logistic regression analysis was performed to identify determinants of perceived stress. The Hosmer-Lemeshow goodness-of-fit was applied to test for model fitness and a p-value of Result The prevalence of perceived stress was 76.1%, 95% CI (72.9–78.8). Age above 45 years (AOR (CI) = 2.45 (1.07–5.62), poor educational level (AOR (CI) = 5.92 (2.36–14.8), large family size (AOR (CI) = 0.48 (0.31–0.74), alcohol consumption (AOR (CI) = 0.63 (0.42–0.94), smoking (AOR (CI) = 0.17 (0.06–0.56), and exposure to multiple traumatic events (AOR (CI) = 2.38 (1.23–4.62) have shown a statistically significant association with perceived stress. Conclusion This study revealed that more than three-fourths of participants living in post-war settings were found to have perceived stress. Older age, poor level of education, large family size, alcohol consumption, smoking, and the number of traumatic events were significant associates of perceived stress. Psychotherapy that can effectively address the medical, social, and psychological well-being of the community is important to reduce the burden of perceived stress