Knowledge, risk perception, and condom utilization pattern among female sex workers in Dire Dawa, Eastern Ethiopia 2016: a cross-sectional study

Introduction: in 2015, in Dire Dawa administration city, adult HIV prevalence was 3.26 with 9,523 HIV positive population, & 251 annual AIDS deaths. Female sex workers are one of the high-risk groups for contracting HIV. Therefore, this study has assessed the level of HIV/AIDS knowledge, risk perception and condom utilization pattern among female sex workers' in Diredawa city. Methods: a cross-sectional study was conducted from April 15-June 25, 2016, in Dire Dawa among 156 female sex workers using convenient sampling method. Respondents were interviewed face-to-face using a pretested questionnaire. Training was provided to the data collectors and supervisors. Close supervision was done and double data entry was performed. Then the data were checked for completeness, consistency and entered into Epi Info v3.1 and analyzed using SPSS v20. The descriptive statistical analysis was used to compute frequency, mean, mode and proportion of the findings of this study. The results were presented using tables, charts, graphs, and texts. Results: among the 156 female sex workers (FSWs), 99 (63.5%) had been working on commercial sex for more than one year, 92 (59%) were usually street-based, and 80 (51.3%) had partners between 2-3 per night. Only, 17 (10.9%) respondents mentioned three and above ways of HIV/AIDS transmission and prevention methods. Less than two-thirds (64.1%) of FSWs used a condom with all partners. One hundred thirty-eight (88.5%) of participants were engaged in unsafe sexual practice at least once since their engagement in sex work. Majority of FSWs (85.3%)) believed that their occupation is hazardous and 145 (92.9%) reported that they were unhappy being a commercial sex worker. Regarding risk perception, 79 (50.64%) and 37 (23.7%) of respondents perceived their chances of contracting HIV/STIs to be high and moderate respectively. Conclusion: Knowledge about HIV/STIs and magnitude of condom utilization were good. However, a high number of unsafe sex and unsatisfactory risk perception attitudes were observed. Thus, a collaborative effort is needed to create awareness regarding risk perception attitude and increase the level of their practice towards the prevention of unsafe sex

Prevalence and Determinants of Low Birth Weight in Ethiopia: A Systematic Review and Meta-Analysis

Introduction: Low birth weight was defined as weight at birth less than 2500 grams. This had numerous negative outcomes such as fetal and  neonatal mortality and morbidity. It was estimated that between year 2000 to 2018, twenty million (15% to 20%) of all births worldwide had low birth weight yearly. Data analyzed from the Swedish Childhood Diabetes Register (SCDR) indicated that, low birth weight infants. were 24% higher odds of developing type-1 diabetes, hypertension, obesity and dyslipidemia in future compared to normal birth weight infants. In Ethiopia, the proportion of births weighing less than 2.5 kg at birth in the past three DHS surveys was 14% in 2005, 11% in 2011, and 13% in 2016. That differed with WHO 2025 goal of achieving 30% reduction in the number of infants born with weight lower than 2500g. Objectives: This systematic review study was aimed to explicitly assess and determine the contributing factors of low birth weight in Ethiopia for intervention. Methodology: Cross-sectional, case-control and cohort studies were conducted in English language. A search of studies in the main databases; PubMed, EMBASE, CINAHL, Web of Science, Scopus, and other gray literature sources was conducted. In respect to eligibility criteria, the  investigators included observational studies that had been conducted at a facility setting in different parts of Ethiopia on the prevalence and factors associated with low birth weight, published and accessible from 2000 - 2018 then written in English. Articles with irretrievable full text records with unrelated outcome measures with missing or insufficient outcomes, reviews, commentaries, editorial, case series/reports, and patient stories were excluded. Meta-analyses with random effects, subgroup analyses, and meta-regression were performed. Publication bias was measured using the Egger regression test and visual funnel plot inspection. Pooled odds ratio was done by using RevMan 5.3 software. 16 studies fulfilled the eligibility criteria. Result: The underlying causes were multi-factorial. Antenatal Care(ANC) and pregnancy complication increased the risk of low birth weight of  infants in Ethiopia. Maternal harmful substance exposure(pesticide, noise, radiation and alcohol consumption), undernutrition, infections, poor socioeconomic status, history of chronic diseases, hepatitis B carriers, intrauterine growth restrictions (IUGR) were reported. The pooled prevalence of low birth weight was 18% (95% CI: 13.9%, 22.2%). Gestational age less than 37weeks was (AOR,7.8; 95% CI: 4.7, 12.95), no antenatal care (AOR,3.39; 95% CI: 1.65, 6.98), rural residence (AOR,2.44; 95% CI: 1.94, 3.08) and women with medical illness during pregnancy (AOR,4.36; 95% CI: 2.55, 7.44) that was significantly associated with low birth weight in Ethiopia. Conclusion: The pooled prevalence of low birth weight was high in Ethiopia. Most rural mothers were unable to follow antenatal care and maternal medical illnesses during pregnancy were significantly contributing factors. The meta-regression confirmed that the sample size and the  methodological quality could partially explain the statistical heterogeneity. Recommandations: Almost all these factors can be prevented by scaling up Antenatal Care (ANC) with the help of Community Health Workers/ Volunteers(CHW/Vs), quality health facilities and improve on the socioeconomic status of the population. Policy makers to assimilate and take action  to the multiple abnormalities found by formulating a management plan for patients with multiple organ disease in the maternity mortality reports. Keywords: low birth weight; prematurity; Ethiopia; systematic review; meta-analysi