Magnitude and Pattern of Injury in Jimma University Specialized Hospital, South West Ethiopia

BACKGROUND: Injury statistics in Ethiopia provides little knowledge about its magnitude and related information needed for prevention. This study, therefore, aims to determine the magnitude and pattern of injury in Jimma University Specialized Hospital (JUSH).METHODS: A retrospective review of records of all injured patients seen at surgical outpatient department from April 09, 2010 to January 07, 2011; was conducted in January 2011. Data were collected using a structured checklist that was developed by adapting the World Health Organization instrument. Five degree holder nurses collected the data while investigators closely supervised. Socio demographic characteristics of the patients and injury related information were collected. Data were analyzed using SPSS for windows version 16.0. RESULTS: Of 13500 patients who visited surgical outpatient department of JUSH during the study period, 1102(8.2%) were injury cases. The commonest mechanism of injury was blunt assault, 341(30.9%), followed by road traffic accident, 334(30.3). Fracture was the leading outcome of injury, 454(41.2%), followed by bruise or skin laceration, 404(36.7%). Significantly more males had cut, (AOR=2.0; 95% CI=1.2, 3.3) and stab, (AOR=3.0; 95% CI=1.6, 5.7), injuries compared to females. Conversely, significantly fewer males had burn, (AOR=0.4, 95% CI=0.2, 0.8) and road traffic accident, (AOR=0.7, 95% CI=0.5, 0.9), than females. Most, 715(95.8%), patients were presented to the hospital within one week. The commonest functional limitations were; difficulty to use hands, 312(28.3%) and difficulty to use legs, 217(19.7%). Eighty three, (7.5%) of the patients died and road traffic accident alone accounted for almost half, 179 (49.7%), of the severe injuries.CONCLUSION: The magnitude of injury in the hospital was considerably high. Age and sex were predictors of injury. Appropriate prevention strategies should be designed and implemented against assault, road traffic accident and cut by sharp tool. KEYWORDS: Injury, Magnitude, Pattern, Case records, Jimma University Specialized HospitalEthiop J Health Sci. Vol. 21, No. 3 November 201

Patterns of Diabetic Complications at Jimma University Specialized Hospital, Southwest Ethiopia

Background: Diabetes Mellitus is common metabolic disease worldwide. Its complications in the Ethiopian care setup has not been well documented. The objective of this study was to assess the pattern and distribution of dia-betic complications among patients having follow-up at Jimma University specialized Hospital diabetic clinic. Methods: A cross sectional study based on record review of 305 patients, selected using systematic sampling with replacement was carried out in October 2008. The data were analyzed using SPSS for Windows version 13.0. Results: Larger proportion, 189 (62.0%), of patients had type II diabetes and 163 (53.4%) of them were diabetic for less than 5 years. Seventy three of the 76 (96.1%) patients with type II diabetes mellitus had hypertension. Acute complications were observed in 93 (30.5%) of the patients of which Diabetic Ketoacidosis was documented in 66(71.0%). Forty eight (45.7%) of patients had proteinuria, 90 (29.5%) had peripheral neuropathy, 13(6.8%) had impotence. Diabetic foot ulcer, skin and/or subcutaneous tissue infection, dental problems and tuberculosis were documented in 14(4.5%), 31(10.0%), 31(10.0%), and 17(5.6%) patients, respectively. Any of the chronic complications were not different by sex of the patient but age had statistically significant association with hypertension, visual distur-bance and neuropathy (p< 0.05). Type of diabetes had statistically significant association with all the tested com-plications except infection (

Knowledge, experiences and training needs of health professionals about disaster preparedness and response in southwest Ethiopia: a cross sectional study

Background: Over the past decade, the magnitude and intensity of disasters have been vividly rising globally due to the forces of nature or man. This study aimed at assessing the perceived knowledge, experiences and training needs of health professionals regarding disasters, their prevention and management in Jimma Zone, Southwest Ethiopia. Methods: An institution based cross-sectional survey was conducted on 377 health professionals taken from 9 randomly selected districts out of 18. All health professionals working at health offices, hospitals and health centers were included. Data were collected using a structured questionnaire which was developed by the investigators after reviewing the relevant literature in the field. Data were coded and entered into SPSS 20 software for cleaning and analysis. Descriptive and logistic regression analyses were done.Results: The majority (85.1%) of the participants were able to define the concept of disaster from various perspectives; 9.7% did not know about it at all and 5.2% could describe the concept partially or misconceived it. The majority (84.3%) agreed that disaster has direct public health consequences on humans. The main public health consequence of disaster the participants mentioned was environmental pollution (65.8%). Malaria, measles and diarrhoeal diseases accounted for 35.5%, 33.1% and 10.5% of the epidemics, respectively. Only 20.6% of the respondents were trained on disaster related topics in the last two years.The majority felt that they had poor knowledge on early warning indicators of drought (48.0%) and flood (48.0%). Simialry, 50.8%, 47.7%, 51.1% and 42.6% of the participants had poor knowledge on preparedness to drought, preparedness to flood, response to drought, response to flood. On composite scale, they generally perceived to have adequate (29.4%), moderate (32.4%) and poor (38.2%) knowledge about early warning information bout, preparedness for and response to common disasters. A vast majority (92.8%) reported that they need training on disaster preparedness, management and response.Conclusion: A considerable number of professionals had limited understanding about the concept of disaster and response to certain specific disasters. They also had limited opportunities for training,despite their felt needs. Therefore, training should be provided focusing on the specific gaps identified.Keywords: training needs, disaster, knowledge, experience, health professionals, Jimma, Ethiopi

HIV Care continuum Outcomes: Can Ethiopia Meet the UNAIDS 90- 90-90 Targets?

BACKGROUND: Ethiopia has pledged to the UNAIDS 90-90-90 framework. However, the achievements of these UNAIDS targets are not assessed in Southwest Ethiopia. Using HIV care and treatment outcomes as surrogate markers, we assessed all targets.METHODS: Complex surrogate makers were used to assess the HIV care continuum outcomes using antiretroviral therapy data in Jimma University Teaching Hospital. Early HIV diagnosis was a surrogate marker to measure the first 90. Numbers of people on HIV treatment and who have good adherence were used to measure the second 90. To measure the third 90, we used immunological success that was measured using numbers of CD4 counts, clinical success using WHO clinical stages and treatment success using immunological and clinical successes.RESULTS: In total, 8172 patients were enrolled for HIV care from June 2003 to March 2015. For the diagnosis target, the prevalence of early HIV diagnosis among patients on ART was 35% (43% among children and 33.3% among adults). For the treatment target, 5299(65%) received ART of which 1154(22%) patients lost to follow-up or defaulted from ART treatment, and 1015(19%) patients on treatment transferred out to other sites. In addition, 17% had fair or good adherence. Finally, 81% had immunological success, 80% had clinical success and 66% treatment success.CONCLUSIONS: The study revealed that Southwest Ethiopia achieved 35%, 65% and 66% of the first, second and third UNAIDS targets, a very far performance from achieving the target. These highlight further rigorous interventions to improve outcome of HIV continuum of care

Prevalence and factors associated with trachoma among children aged 1–9 years in Zala district, Gamo Gofa Zone, Southern Ethiopia

The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.Background: Trachoma is the leading cause of preventable blindness worldwide. It is common in areas where people are socioeconomically deprived. Globally, approximately 1.2 billion people live in trachoma-endemic areas, in which, 40.6 million individuals have active trachoma and 8.2 million have trichiasis. According to the World Health Organization’s 2007 report, globally close to 1.3 million people are blind due to trachoma, while approximately 84 million suffer from active trachoma. The National Survey (2007) of Ethiopia showed a prevalence of 40.1% active trachoma among children aged 1–9 years. Trachoma is still endemic in most parts of Ethiopia. Objective: To assess prevalence of trachoma and factors associated with it among children aged 1–9 years in Zala district, Gamo Gofa Zone, Southern Nations, Nationalities, and Peoples’ Region. Methods: A community-based cross-sectional study was conducted in Zala district from February 28 to March 26, 2014. A total of 611 children were examined for trachoma based on the simplified World Health Organization 1983 classification. A multistage stratified sampling technique with a systematic random sampling technique was used to select study participants. Data were collected by using a semistructured pretested questionnaire and clinical eye examination. The data were entered using EpiData version 3.1 and analyzed using SPSS version 16. Multivariable logistic regression analysis was used to identify independently associated factors. Results: The overall prevalence of active trachoma cases was 224 (36.7%) consisting of 207 (92.4%) trachomatous follicles, eight (3.6%) trachomatous intense, and nine (4.0%) combination of trachomatous follicle and trachomatous intense. Inadequate knowledge of family head about trachoma (adjusted odds ratio [AOR] =2.8 [95% CI: 1.9, 4.2]); #10 m latrine distance (AOR =1.6 [95% confidence interval {CI}: 1.09, 2.4]); presence of above two preschool children (AOR =2.2 [95% CI: 1.3, 3.7]), flies on the face (AOR =6.3 [95% CI: 2.7, 14.7]), and unclean face (AOR =2.4 [95% CI: 1.5, 3.9]) were found to be independently associated with trachoma. Conclusion: Trachoma among children in Zala district is a disease of public health importance. Factors like inadequate knowledge about trachoma by the head of the family, #10 m latrine distance, presence of above two preschool children, flies on the face, and an unclean face were independently associated with trachoma among children. So strengthening of antibiotic use, face washing, and environmental improvement strategy implementation is mandatory

KNOWLEDGE AND BELIEF ABOUT CAUSE AND PREVENTION OF ONCHOCERCIASIS IN BEBEKA, SOUTHWEST ETHIOPIA

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Knowledge and belief about cause and prevention of onchocerciasis in Bebeka, southwest Ethiopia

BACKGROUND: Ignorance and incorrect beliefs can lead to negligence in prevention, control measures and in seeking appropriate treatment. Involvement of individuals and communities is an important component of Onchocerciasis control activities. To attain community participation and design socially acceptable control strategies, researchers must be familiar with people’s knowledge, beliefs and behavior in relation to Onchocerciasis. Such information is scanty as very few studies have been carried out to understand these issues. The objective of this study was to investigate people’s knowledge and beliefs in relation to the cause and prevention of onchocerciasis in rural areas of Southwest Ethiopia. METHODS: A cross-sectional study was conducted in February 2008 among 450 study participants selected by multistage probability sampling. Data were collected using a pre-tested interviewer administered structured questionnaire which then were analyzed using SPSS for windows version 11.5. RESULTS: All the 450 respondents had heard about onchocerciasis. A range of causes for onchocerciasis were identified. Overall, 248 (55.3%) of respondents had at least one misconception about the cause of onchocerciasis. There is a range of misconceptions about modes of transmission including contact with infected person, airborne, sharing cloths and sexual. Only 10% knew that black fly breeding in fast flowing rivers and streams as a cause for the transmission. Overall 397(88.2%) said that onchocerciasis is preventable, out of which 376 (94.7%) indicated use of drug as the means of preventing onchocerciasis. Nearly three-forth of respondents 334 (74.3%) rated the severity of onchocerciasis as high. Nearly half (48%) rated the magnitude of onchocerciasis in their village as high, and 195 (43.3%) of them stated that they are highly at risk. CONCLUSIONS: While Onchocerciasis is endemic in the study area, large proportion of the community held misconceptions about its causation, transmission, prevention and risk. Therefore, community interventions for onchocerciasis need to include behaviour change communications aimed at dispelling misconceptions and increasing risk perception

Factors associated with compliance with community directed treatment with ivermectin for onchocerciasis control in Southwestern Ethiopia

<p>Abstract</p> <p>Background</p> <p>Although ivermectin is distributed free of charge through the African Programme for Onchocerciasis Control (APOC), not all eligible individuals within communities receive the annual treatment. This poses a serious threat to efforts aimed to control onchocerciasis. This study attempts to determine factors associated with compliance to Community Directed Treatment with Ivermectin (CDTI) and provides a basis for trying to understand how best to sustain long-term compliance in order to achieve success in the control of onchocerciasis.</p> <p>Methods</p> <p>An unmatched case-control study was conducted in Bebeka coffee plantation southwest Ethiopia. Cases were, compliant i.e., those individuals who had been registered on the relevant treatment registers and had taken all the five annual doses of Ivermectin. Controls were non-compliant, i.e. those individuals who had been recorded in the relevant treatment registers during the first treatment round(2003), and did not take at least two doses of which one being in the last treatment round (2007). Data were collected using a pre-tested interviewer administered structured questionnaire. Data were edited, cleaned, coded and analyzed using SPSS version 12.0.1 for Microsoft Windows. Multiple logistic regression models was used to identify factors associated with compliance to ivermectin.</p> <p>Results</p> <p>From the total of 456 individuals selected for administration of the survey questionnaire, 450(225 cases and 225 controls) were contacted and completed the study 2 refused and 4 were unavailable. Five factors associated with compliance were identified: high risk perception [Adjusted Odds Ratio(AOR) = 1.98, 95% Confidence Interval (CI), 1.32-2.95], one's family support [AOR = 1.86, 95% CI, 1.22-2.84], perceiving that the Community Drug Distributors (CDDs) are doing their work well [AOR = 2.84, 95% CI, 1.50-5.37] and perceiving measuring height is the best way to determine a person's treatment dose [AOR = 6.37, 95% CI, 2.10-19.29] are positive predictors of compliance to ivermectin.</p> <p>Conclusion</p> <p>Interventions to improve compliance in the area should focus on health education using epidemiological data in order to increase risk perception and dispelling misconceptions. Motivation and continued support to improve CDD's performance including training and incentives are crucial.</p

Anti-retro viral therapy adverse drug reaction and associated factors among human immuno deficiency virus infected adult patients at Nigist Eleni Mohammed Memorial hospital, South Ethiopia

Background: Recent increases in access to HAART have made the management of drug toxicities an increasingly crucial component of HIV care in developing countries. The aim of this study was to determine prevalence of antiretroviral therapy adverse drug reactions and associated factors among HIV-infected adult patients at Nigist Eleni Mohammed memorial hospital. Methods: A cross sectional study was conducted by retrospective review of patients\u2019 medical records. From a total 721 adult patient records, 231 patients record were selected by simple random sampling technique. The study was conducted April15-25, 2015.The association between dependent and independent variables was measured by using OR at 95% CI. P-value &lt;0.05 was considered as statistically significant. Result: About 53(22.9%) patients developed ADRs (adverse drug reactions). Female (AOR=2.72, CI=1.177-6.30), patients with WHO stage III and IV (AOR= 13.06, CI=4.17- 40.90) were found more likely to develop ADRs. Commonly identified ADRs were fatigue (18.1%), diarrhea (7.7%), nausea (6.5%), headache (3.6%) and anemia (2%). Conclusion: Nearly one in five patients develop ADRs. Sex of respondents, WHO stage and functional status were associated with ADRs. The health care providers should give due attention to ambulatory, bedridden, and WHO stage III and IV patients

Gender differences regarding barriers and motivators of HIV status disclosure among HIV-positive service users.

There are inconsistent findings about the relation between gender and HIV status disclosure. We conducted a facility-based crosssectional study, using qualitative and quantitative data collection methods, to explore gender differences in HIV-positive status disclosure among service users in south-west Ethiopia. Among 705 participants, an equal number of men and women (94.6% men v. 94.3%, women) indicated that they had disclosed their result to someone, and the majority (90.9% men v. 90.7% women) to their current main partner. 'It is customary to tell my partner everything' was the most frequently cited reason for disclosing (62.5% men v. 68.5% women). Reasons for non-disclosure varied by gender: men were concerned about their partner's worry and exposure of their own unfaithfulness. Women feared physical violence, and social and economic pressure in raising their children. Factors that influenced disclosure also indicated gender variation. For men, disclosure of HIV results to a sexual partner was positively associated with knowing the partner's HIV status and discussion about HIV testing prior to seeking services, while for women it was associated with knowing the partner's HIV status, advanced disease stage, having no more than primary education, being married, and perceiving the current relationship as long-lasting