Effects of community-led total sanitation and hygiene implementation on diarrheal diseases prevention in children less than five years of age in South Western Ethiopia: A quasi- experimental study.

BackgroundLack of improved sanitation is the most important contributing factor to diarrheal disease among under-five children in low and middle-income countries. There was no study to identify the effect of Community-Led Total Sanitation and Hygiene intervention on diarrheal diseases in the study area. Hence, this study was designed with the aim of finding the effects of Community-led Total Sanitation and Hygiene implementation for preventing diarrhea among under-five children.MethodsA community-based Quasi-Experimental study was conducted among a sample of 846 households selected from intervention (kersa) and comparison (mana) districts using the four-stage random cluster-sampling method. A Semi-structured questionnaire was used to collect data. The collected data was cleaned, coded, and entered into EpiData version 3.1 and exported to SPSS version 20 for analysis. Difference-in Difference method with McNemar's tests was used to compare the prevalence of diarrhea between the intervention and comparison districts, and the significance of change between the pre-test and post-test was declared at p-value less than 0.05 with 95% confidence interval.ResultsThe intervention led to decreased diarrhea prevalence [pp = -8.2, 95% CI: -15.9, -0.5], increased latrine ownership [pp = 5.6, 95% CI: 0.5, 10.8], and increased latrine utilization [pp = 10.7, 95% CI: 4.7, 16.6] in intervention district at post-test compared to the baseline; while the presence of handwashing facility near the latrine, home-based water treatment, and proper water storage and handling practice were decreased at post-test compared to the baseline.ConclusionImplementation of Community-Led Total Sanitation improved sanitation and hygiene status of community that resulted in the reduction of diarrhea diseases in under-five children. Further implementation, evaluation, and scale-up of the interventions are needed to reduce diarrheal disease in under-five children

Community based cross sectional study of podoconiosis and associated factors in Dano district, Central Ethiopia.

BACKGROUND:Podoconiosis, affects lower limb, is an entirely preventable non-communicable tropical disease common in low income countries. Globally it is estimated that there are 4 million peoples with podoconiosis and nationally it is estimated that there are 1.56 million cases of podoconiosis. Even though nationwide mapping has been conducted including the current district under investigation, there are no studies conducted to identify factors associated with podoconiosis in the district. Hence, this study was aimed to determine the prevalence of podoconiosis and associated factors in the west Shewa of Dano district community. METHOD:A community based cross sectional study was conducted from March 1 to 26, 2018. Seven kebeles out of the total of twenty-three kebeles found in the district were selected randomly. The total sample size was allocated by probability proportional to size to each kebele based on the number of households they had. Then, systematic random sampling was employed to select 652 study participants from the seven kebeles. Data was collected using interviewer administered structured questionnaire and observation. In addition, a blood sample was collected from the study subjects who had leg swelling for ruling out lymphedema due to lymphatic filarasis by using Immunochromatographic test card. Podoconiosis case was defined as bilateral but asymmetric swelling which develop first in the foot often confined to the lower leg and negative result for immune-chromatographic test (ICT card). The prevalence of podoconiosis was determined and multiple logistic regression model was fitted using SPSS version 23 to identify factors associated with podoconiosis. RESULT:The prevalence of podoconiosis in Dano district was found to be 6.3% (95%CI: 5.8, 6.8). Age at first shoe wearing (AOR = 1.08,95% CI = 1.06-1.11), washing practice of feet by water only (AOR = 3.68, 95% CI = 1.47-9.24) and not wearing shoe daily (AOR = 9.32, 95% CI = 4.27-20.4) were found to be significantly associated with increased odds of podoconiosis. CONCLUSION:This study revealed that there was significant burden of podoconiosis in the study area. Age at first shoe wearing, washing practice and frequency of shoe wearing were associated with the development of podoconiosis disease. Modalities to enhance the shoe wearing behaviour of the communities should be planned by high level decision makers working in the area of Health. Moreover, collaboration between local government and non-government stakeholders, and integration with existing programs addressing foot hygiene which involves washing feet with soap and water needs to be addressed

Knowledge, attitude, and practice towards mental illness service provision and associated factors among health extension professionals in Addis Ababa, Ethiopia

Abstract Background Mental, neurological and substance use disorders are highly prevalent in Ethiopia which are known to result in substantial disability. Improving the knowledge, attitude and practice of the primary health care workers is important to reduce this problem. Hence, this study aimed at assessing knowledge, attitude, and practice towards mental illness service provision and associated factors among urban health extension professionals (UHEPs) of Addis Ababa City Administration. Methods A cross sectional study design was used. Data was collected from 455 study participants using structured and pre-tested self-administered questionnaire and analyzed using SPSS version 20 software respectively. Multivariate logistic regression analysis was performed to identify variables which have significant association with the outcome variables. The level of significant association was determined by adjusted odds ratio (AOR) with 95% confidence interval. Results This study showed that 44.0% of urban health extension professionals (UHEPs) had adequate knowledge, 93.4% did not have positive attitude and 75.2% had good practice towards mental illness. Age 30 years and above [adjusted odds ratio (AOR): 95% CI 0.55 (0.34, 0.90)], having diploma educational status [AOR 95% CI 0.49 (0.32, 0.78)], and personal history of mental illness [AOR 95% CI 0.10 (0.01, 0.89)] were found to have a negative association with knowledge. Presence of job aid (AOR 95% CI 4.30 (2.59, 7.15)) and having good knowledge (AOR 95% CI 0.52 (0.32, 0.85) were increased the practice of service provision of UHEPs. Conclusion Less than half of UHEPs had adequate knowledge, most had unfavorable attitude and about three-fourth of them had good practice. Presence of job aid and having good knowledge were increased the UHEPs practice of mental health service provision. Hence, providing refresher training to UHEPs and fully implementing the national mental health strategy as well as proper clinical supervision and support to improve behavioral change is vital

Patients’ satisfaction towards radiological service and associated factors in Hawassa University Teaching and referral hospital, Southern Ethiopia

Abstract Background Patient satisfaction, one of the main components of quality of care, is a crucial phenomenon for the overall health care delivery system. Even though a number of studies have been conducted about patient satisfaction in different health services, studies in radiology services are flimsy in Ethiopia. This study aimed at assessing patient satisfaction towards radiological service and associated factors in Hawassa University Teaching and Referral hospital. Methods An institution based cross-sectional study was conducted among 321 adult patients presented for radiological service in the study area using stratified sampling technique. Patient satisfaction was measured using SERVQUAL (Service Quality) tool that consisted of seven items: accessibility, quality of radiological service, courtesy of radiology staff, existence of good communication with service provider and desk worker, physical environment and privacy technique. Exit interviews of patients were conducted using a structured and pretested questionnaire. Data was collected by three grade ten completed trained data collectors from May 12 to May 28, 2016. Multiple logistic regressions were used to identify independent factors associated with patient satisfaction on radiological services using SPSS version 21. Results The overall patient satisfaction towards radiological service was 71.6%. Satisfaction to accessibility of the service was 84.5% while it was 80.6% to courtesy of the staff. Similarly, 81.6% reported satisfied with quality of the service and 59.4% and 71% of reported satisfied with physical environment and radiological service provider respectively. On the other hand, 99.7% of the respondents were dissatisfied with privacy of the service. The study revealed that patients who attended primary school (AOR = 0.317, 95% CI: 0.11–0.88), unemployed patients (AOR = 0.067, 95% CI: 0.007–0.622) and patients who had short waiting time to enter into examination room less than one hour (AOR = 4.12, 95% CI: 1.4–11.62) were factors associated with patients satisfaction. Conclusion This study found that majority of respondents was satisfied with the radiological services. Respondent’s education level, occupation as well as duration of time taken to enter into examination room were important factors influencing the satisfaction condition. Hence, concerted effort is needed to constantly improve on patient satisfaction to better radiology returns arising from improved patient patronage. It is recommended to give great care and attention to clients during radiological examination procedure and also suggested that the department should decrease time taken to enter into examination room. On the other hand, the reasons behind more educated clients were less satisfied with radiologic service than more educated respondents need further investigation

Predictors of virological treatment failure among adult HIV patients on first-line antiretroviral therapy in Woldia and Dessie hospitals, Northeast Ethiopia: a case-control study

Abstract Background Virological treatment failure is a problem that a Human Immune Virus patient faces after starting treatment due to different factors. However, there were few studies done on the predictors of virological treatment failure among adult patients on first-line antiretroviral therapy in Ethiopia in general, and no study was done in the study area in particular. Therefore, the aim of the study was to identify predictors of virological treatment failure among adult patients on first-line antiretroviral therapy in Woldiya and Dessie Hospitals, Northeast Ethiopia. Method Hospital based case–control study was conducted in Woldia and Dessie Hospitals from from 12 August 2016–28 February 2018 on 154 cases and 154 controls among adult patients on first-line antiretroviral treatment. All cases were included and comparable controls were selected using stratified random sampling technique. Data were collected by document review using checklists and entered into Epidata version 3.1 and analyzed by SPSS version 21. Multivariable logistic regression analysis was done to identify the independent predictors of virological treatment failure. Results In this study, statistically higher odds of virological failure was observed among patients who had current CD4 T-cell count of  200 mm3, current body mass index(BMI)  18.5 kg/m2, BMI between 16 and 18.5 kg/m2 (AOR = 3.72, 95% CI: 1.75, 7.92) versus BMI > 18.5 kg/m2, poor adherence to antiretroviral therapy (AOR = 5.4, 95% CI: 2.95, 9.97) compared with good adherence. Conclusion This study showed that low current CD4 T-cell count and body mass index, as well as poor adherence for ART treatment predicts virological failure. Therefore, deliberate efforts are urgently needed in HIV care through improving their nutritional status by enhancing nutritional education and support, and by strengthening enhanced adherence counseling

Impaired glomerular filtration rate, high grade albuminuria and associated factors among adult patients admitted to tertiary Hospital in Ethiopia

Abstract Background Chronic Kidney Disease (CKD), the worldwide Public Health problem, is also one of the rising non-communicable diseases in low and middle-income countries. Its early detection and treatment using readily available, inexpensive therapies can slow or prevent progression to end-stage renal disease. Hence, this study was aimed at assessing impaired estimated glomerular filtration rate (eGFR), high grade albuminuria, and associated factors among adult patients admitted to Jimma University Medical Center in South west Ethiopia. Methods Hospital based cross sectional study was conducted from November 1, 2016 to April 30, 2017. Consecutive sampling method was used to select study participants. Logistic regression analysis was conducted to generate factors associated with impaired estimated GFR and albuminuria. A P-value of < 0.05 was considered statistically significant. Results The study involved 422 patients admitted to Jimma University Medical Center who had at least one test result for urinalysis and serum creatinine level during the study period. Fifty two (12.3%) of the study subjects had high grade albuminuria, 19.2, 19.4, and 32.7% had impaired estimated glomerular filtration rate according to Modification of Diet in Renal Disease (MDRD-4), Chronic Kidney Disease Epidemiology (CKD-EPI), and Cockcroft-Gault (CG) equations respectively. Old age (AOR = 2.4;95%CI:1.4–4.01), male sex (AOR = 2.1;95%CI:1.16–3.7), and hypertension (AOR = 2.23; 95%CI:1.24–4.01) were independently associated with impaired eGFR using one of the two equations while diabetes mellitus (AOR = 2.8; 95%CI:1.33–5.82) and BP measurement above optimal (AOR = 4.7; 95%CI:1.9–11.53) were associated with high grade albuminuria. Conclusions High grade albuminuria and impaired eGFR were found in significant proportion of adults admitted to the hospital for various medical conditions. Old age, hypertension, diabetes mellitus and male gender were independently associated with these alterations. These findings necessitate routine urinalysis and estimation of GFR for all hospitalized adults with known CKD risk factors

Adolescent’s and youth’s adherence to antiretroviral therapy for better treatment outcome and its determinants: multi-center study in public health facilities

Abstract Background Low-adherence to Anti-retroviral therapy (ART) negatively affects the clinical, immunological, and virologic outcomes of patients. Adherence is the most important factor in determining Antiretroviral Therapy (ART) treatment success and long-term viral suppression which ultimately reduces morbidity and mortality. Thus, this study aimed to identify factors affecting adherence to antiretroviral therapy among adolescents and youth living with HIV. Methods Facility-based cross-sectional study was conducted from March 21 to April 30, 2020 among 316 respondents in selected five high-loaded hospitals with adolescent and youth clients using systematic random sampling technique. Patients’ adherence was assessed when they had reportedly taken 95% or higher of their prescribed antiretroviral drugs in the five days before the interview. Data were collected, entered into EPI Data and exported to SPSS for analysis. Binary logistic regression was used to see the association between dependent and independent variables. Results In this study, 316 respondents participated in the study, with a 99.7% response rate. The mean age of respondents were 17.94 years and majority of them (58.5%) were females. The overall ART adherence among adolescents and youths was found to be 70.6%. Being female (AOR = 0.323, 95% CI, 0.164–0.637), presence of opportunistic infection (AOR = 0.483, 95% CI, 0.249–0.936), taking additional medication beside ART (AOR = 0.436, 95% CI, 0.206–0.922) and availability of youth friendly services within the facility (AOR = 2.206, 95% CI, 1.031–4.721) were found to be predictors. Conclusion The adherence rate in this study was low which is below the recommended adherence level. Being female, taking additional medication beside ART and presence of opportunistic infection were determinants of adherence. As a result, significant work must be done on opportunistic infection prevention through health education and promotion for screening and risk reduction. Similarly, adolescents and youths service integration with the ART Clinic is strongly advised

A community-based cross-sectional study of eye care service utilization among the adult population in southern Ethiopia

Background: Visual impairment, which is related to many eye diseases, is a major public health problem. If detected and treated early, it can be prevented; therefore, regular use of vision services is very important. Objective: This study aimed to assess the proportion of utilization of eye care services and associated factors among the rural community population in southern Ethiopia. Methods: A community-based cross-sectional study design with a two-stage cluster random sampling technique was conducted to collect data from adults aged 40 years and above using interviewer-administered questionnaires. Kebeles were randomly selected by the lottery method, and systematic random sampling with proportional distribution was used to select the households. An adult individual was randomly selected from a household when there was more than one adult available. A binary logistic regression model was used to establish the association between eye care service utilization and the variables that might affect it. Results: Of the 551 study population, 510 responded to this study, and the response rate was 92.6%. The mean age of the respondents was 52.2 years. The rate of eye care service utilization was 29% (95% confidence interval (0.25, 0.33)). The study shows that older participants, aged 65 and above (adjusted odds ratio: 4.04; 95% confidence interval (2.20, 7.43)), having previous eye problems (adjusted odds ratio: 10.04; 95% confidence interval (5.81, 17.33)), the presence of systemic illness (adjusted odds ratio: 2.52; 95% confidence interval (1.21, 5.21)), and having awareness about regular checkups (adjusted odds ratio: 11.75; 95% confidence interval (6.62, 20.84)) were found to be the predictors of eye care service utilization. Conclusion: In this study, utilization of eye care services was low. Older age, previous eye problems, systemic illness, and awareness about checkups were found to be predictors of eye care service utilization. Hence, there is a need to increase the absorption of existing ophthalmic services and create awareness of the use of ophthalmology services to reduce preventive blindness

Investigating the Impact of Irrigation on Malaria Vector Larval Habitats and Transmission Using a Hydrology-Based Model.

A combination of accelerated population growth and severe droughts has created pressure on food security and driven the development of irrigation schemes across sub-Saharan Africa. Irrigation has been associated with increased malaria risk, but risk prediction remains difficult due to the heterogeneity of irrigation and the environment. While investigating transmission dynamics is helpful, malaria models cannot be applied directly in irrigated regions as they typically rely only on rainfall as a source of water to quantify larval habitats. By coupling a hydrologic model with an agent-based malaria model for a sugarcane plantation site in Arjo, Ethiopia, we demonstrated how incorporating hydrologic processes to estimate larval habitats can affect malaria transmission. Using the coupled model, we then examined the impact of an existing irrigation scheme on malaria transmission dynamics. The inclusion of hydrologic processes increased the variability of larval habitat area by around two-fold and resulted in reduction in malaria transmission by 60%. In addition, irrigation increased all habitat types in the dry season by up to 7.4 times. It converted temporary and semi-permanent habitats to permanent habitats during the rainy season, which grew by about 24%. Consequently, malaria transmission was sustained all-year round and intensified during the main transmission season, with the peak shifted forward by around 1&nbsp;month. Lastly, we evaluated the spatiotemporal distribution of adult vectors under the effect of irrigation by resolving habitat heterogeneity. These findings could help larval source management by identifying transmission hotspots and prioritizing resources for malaria elimination planning

Investigating the Impact of Irrigation on Malaria Vector Larval Habitats and Transmission Using a Hydrology‐Based Model

Abstract A combination of accelerated population growth and severe droughts has created pressure on food security and driven the development of irrigation schemes across sub‐Saharan Africa. Irrigation has been associated with increased malaria risk, but risk prediction remains difficult due to the heterogeneity of irrigation and the environment. While investigating transmission dynamics is helpful, malaria models cannot be applied directly in irrigated regions as they typically rely only on rainfall as a source of water to quantify larval habitats. By coupling a hydrologic model with an agent‐based malaria model for a sugarcane plantation site in Arjo, Ethiopia, we demonstrated how incorporating hydrologic processes to estimate larval habitats can affect malaria transmission. Using the coupled model, we then examined the impact of an existing irrigation scheme on malaria transmission dynamics. The inclusion of hydrologic processes increased the variability of larval habitat area by around two‐fold and resulted in reduction in malaria transmission by 60%. In addition, irrigation increased all habitat types in the dry season by up to 7.4 times. It converted temporary and semi‐permanent habitats to permanent habitats during the rainy season, which grew by about 24%. Consequently, malaria transmission was sustained all‐year round and intensified during the main transmission season, with the peak shifted forward by around 1 month. Lastly, we evaluated the spatiotemporal distribution of adult vectors under the effect of irrigation by resolving habitat heterogeneity. These findings could help larval source management by identifying transmission hotspots and prioritizing resources for malaria elimination planning