19 research outputs found

    Patterns of help-seeking behavior among people with mental illness in Ethiopia: a systematic review and meta-analysis

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    BackgroundDespite the availability of evidence-based and effective treatments, significant numbers of people living with mental illness do not receive treatment or do not seek help from providers of formal modern treatment. Although numerous primary studies have been conducted on patterns of help-seeking behavior among individuals with mental illness with respect to modern therapy, the evidence has not been aggregated nationwide. Therefore, the aim of this review was to investigate pooled data on patterns of help-seeking behavior among individuals with mental illness in Ethiopia.MethodsAll available primary studies were searched via the Google Scholar, HINARI, and PubMed databases from June 22 to December 20, 2023; 912 articles were identified. Sixteen articles were included in the final review; data from them were extracted to an Excel spreadsheet and exported to Stata version 17 for analysis. The search terms used were: ā€œPattern of help-seeking behaviorā€™ā€™ OR ā€œPattern of treatment-seeking behaviorā€ OR ā€œHealth care-seeking behaviorā€ OR ā€œHelp-seeking intentionā€ OR ā€œHelp-seeking preferencesā€ OR ā€œPerceived needā€ OR ā€œPathways to psychiatric careā€, AND ā€œCommon mental disordersā€ OR ā€œMental illnessā€ OR ā€œMental health problemsā€ OR ā€œDepressionā€, AND ā€œPredictorsā€ OR ā€œDeterminate factorsā€ OR ā€œAssociated factorsā€, AND ā€œEthiopiaā€. The quality of the studies included was critically appraised using the modified The Joanna Briggs Institute (JBI) Joanna Briggs Institute quality assessment tool, adapted for observational studies. During critical appraisal, disagreements between the two authors conducting the assessment were resolved by the involvement of a third author. Effect sizes were pooled using the random effects model, and the presence of publication bias was detected based on asymmetry of the funnel plot and a statistically significant result of Eggerā€™s test (p<0.05).ResultsThe pooled rate of positive help-seeking behavior with respect to modern treatment among people living with mental illness was 42.21% (95% CI: 29.29, 55.12; I2 = 99.37%, P=0.00). Factors significantly associated with a positive pattern of help-seeking behavior were: having a secondary education or above (AOR=5.47, 95% CI: 2.33, 12.86); believing that mental illness requires treatment (AOR=2.76, 95% CI: 2.02, 3.78); having strong social support (AOR=2.00, 95% CI: 1.64, 2.44); having a family history of mental illness (AOR=2.68, 95% CI: 1.38, 3.97); having awareness of the availability of treatment (AOR=2.92, 95% CI: 1.56, 5.46); having previously engaged in positive help-seeking behavior (AOR=3.28, 95% CI: 1.63, 6.60); having comorbid disorders (AOR=4.25, 95% CI: 1.69, 10.66); not using alcohol (AOR=3.29, 95% CI: 1.73, 6.27); and the perceived severity of mental illness (AOR=2.54, 95% CI: 1.490, 4.33).ConclusionsThe majority of people with mental illness in Ethiopia exhibited a poor pattern of help-seeking behavior with respect to modern treatment. Therefore, mobilization of the community should be encouraged via regular public awareness campaigns regarding mental illness and the availability of evidence-based and effective modern treatment in Ethiopia. Moreover, the design of effective community-based mental health interventions is recommended in order to improve public attitudes and rates of help-seeking behavior in relation to mental health problems

    Dyslipidemia and serum cystatin C levels as biomarker of diabetic nephropathy in patients with type 2 diabetes mellitus

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    BackgroundDiabetic nephropathy is a leading cause of end-stage renal disease. The diagnostic markers of nephropathy, including the presence of albuminuria and/or a reduced estimated glomerular filtration rate, are not clinically ideal, and most of them are raised after a significant reduction in renal function. Therefore, it is crucial to seek more sensitive and non-invasive biomarkers for the diagnosis of diabetic nephropathy.Objective of the studyThis study aimed to investigate the serum cystatin C levels and dyslipidemia for the detection of diabetic nephropathy in patients with type 2 diabetes mellitus.MethodologyA hospital-based comparative cross-sectional study was conducted from December 2021 to August 2022 in Tikur, Anbessa specialized teaching hospital with a sample size of 140 patients with type2 diabetes mellitus. Socio-demographic data was collected using a structured questionnaire, and 5 mL of blood was collected from each participant following overnight fasting for biochemical analyses.ResultsIn type 2 diabetes patients with nephropathy, we found significant lipoprotein abnormalities and an increase in serum cystatin C (P < 0.001) compared to those without nephropathy. Serum cystatin C, systolic blood pressure, fasting blood glucose, total cholesterol, triglyceride, low density lipoprotein, very low-density lipoprotein, high density lipoprotein, and duration of diabetes were identified as being significantly associated with diabetic nephropathy (P < 0.05) in multivariable logistic regression analysis. The mean values of total cholesterol levels, triglyceride levels, and high-density lipoprotein cholesterol levels were also found to be significantly higher (P < 0.05) in females as compared to male type-2 diabetic patients. The fasting blood glucose levels and lipid profiles of the participants were found to be significantly associated with serum cystatin C levels.ConclusionThe present study found significant serum cystatin C and lipoprotein abnormalities in T2DM patients with diabetic nephropathy when compared with those without diabetic nephropathy, and these lipoprotein abnormalities were significantly associated with serum cystatin C levels

    Trend, determinants, and future prospect of child marriage in the Amhara region, Ethiopia: a multivariate decomposition analysis

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    BackgroundChild marriage is a harmful traditional practice, which compromises children of their childhood and threatens their lives and health. In Ethiopia, 58% of women and 9% of men get married before the age of 18 years. Surprisingly, parents in the Amhara region make marriage promises of their children before they are even born, which will hinder the region from attaining the Sustainable Development Goal of ending child marriage. Thus, this study aimed to assess the trends, determinants, and future prospects of child marriage in the Amhara region of Ethiopia.MethodsA repeated cross-sectional study was conducted using four consecutive nationally representative Ethiopian demographic and health surveys (2000ā€“2016). A logit-based multivariate decomposition analysis for a non-linear response model was fitted to identify factors that contributed to the change in child marriage over time. Statistical significance was declared at a p-value of < 0.05. The child marriage practice in the Amhara region by the year 2030 was also predicted using different forecasting features of Excel.ResultsThe trend of child marriage over the study period (2000ā€“2016) decreased from 79.9% (76.7, 82.8) to 42.9% (39.1, 46.9), with an annual average reduction rate of 2.9%. Approximately 35.2% of the decline resulted from an increase in the proportion of women who attained secondary and above-secondary education over the two surveys. A decrease in the proportion of rural women and a change in the behavior of educated and media-exposed women also contributed significantly to the decline in child marriage. The prevalence of child marriage in the Amhara region by the year 2030 was also predicted to be 10.1% or 8.8%.ConclusionThough there has been a significant decline in child marriage in the Amhara region over the past 16 years, the proportion is still high, and the region is not going to eliminate it by 2030. Education, residence, and media exposure were all factors associated with the observed change in child marriage in this study. Therefore, additional efforts will be required if child marriage is to be eliminated by 2030, and investing more in education and media access will hasten the region's progress in this direction

    Global disparities in surgeonsā€™ workloads, academic engagement and rest periods: the on-calL shIft fOr geNEral SurgeonS (LIONESS) study

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    : The workload of general surgeons is multifaceted, encompassing not only surgical procedures but also a myriad of other responsibilities. From April to May 2023, we conducted a CHERRIES-compliant internet-based survey analyzing clinical practice, academic engagement, and post-on-call rest. The questionnaire featured six sections with 35 questions. Statistical analysis used Chi-square tests, ANOVA, and logistic regression (SPSSĀ® v. 28). The survey received a total of 1.046 responses (65.4%). Over 78.0% of responders came from Europe, 65.1% came from a general surgery unit; 92.8% of European and 87.5% of North American respondents were involved in research, compared to 71.7% in Africa. Europe led in publishing research studies (6.6 Ā± 8.6 yearly). Teaching involvement was high in North America (100%) and Africa (91.7%). Surgeons reported an average of 6.7 Ā± 4.9 on-call shifts per month, with European and North American surgeons experiencing 6.5 Ā± 4.9 and 7.8 Ā± 4.1 on-calls monthly, respectively. African surgeons had the highest on-call frequency (8.7 Ā± 6.1). Post-on-call, only 35.1% of respondents received a day off. Europeans were most likely (40%) to have a day off, while African surgeons were least likely (6.7%). On the adjusted multivariable analysis HDI (Human Development Index) (aOR 1.993) hospital capacity > 400 beds (aOR 2.423), working in a specialty surgery unit (aOR 2.087), and making the on-call in-house (aOR 5.446), significantly predicted the likelihood of having a day off after an on-call shift. Our study revealed critical insights into the disparities in workload, access to research, and professional opportunities for surgeons across different continents, underscored by the HDI

    Documentation practice and associated factors among nurses working in public hospitals in Wolaita Zone, Southern Ethiopia

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    Abstract Background Nursing documentation documents the everyday activities of nursing care that are planned and implemented on individual patients by nurses of different educational statuses. Documentation of nursing activities is the key source of clinical information to meet professional and legal requirements. Although nursing documentation is an important part of nursing practice, it is commonly undone by nurses working with patients for different reasons. Objective To assess the documentation practice and their associated factors among nurses working in public hospitals in the Wolaita Zone, Southern Ethiopia. Methods An institutional-based cross-sectional study was conducted among 402 nurses and a simple random sampling technique was used to select participants. Data were collected using a pretested structured self-administered questionnaire adapted from previous studies. Statistical Package for the Social Science version 26 was used for data entry and analysis. Independent variables with p-valueā€‰ā€‰5 years) [AOR: 4.066 (95% CI: 1.55ā€“10.64)] and [AOR: 5.395 (95% CI: 1.97ā€“14.81)] respectively and in-service training [AOR: 0.582 (95% CI: 0.366ā€“0.923)]. Conclusion and recommendations This study demonstrated that the good practice of documentation among nurses was found to be low. Age, educational status, working in comprehensive specialized hospitals, work experience, and having in-service training had significant associations with documentation practice. It is very important to plan and intervene with different strategies, such as providing training for young nurses, nurses with low educational status, nurses working in primary hospitals, and nurses with less than two years of work experience on documentation standards, to create positive attitudes and enhance their knowledge

    Time to recovery and its predictors following traumatic injuries among injured victims in Dessie Comprehensive Specialized Hospital, North East of Ethiopia, 2022: a retrospective follow-up study

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    Abstract Background Injuries are an extremely important public health problem worldwide. Despite being largely preventable and despite government efforts, injuries continue to be a major public health issue. Thus, the study tends to evaluate the time to recovery and its predictors for traumatic injuries. Methods A hospital-based retrospective follow-up study was used. A total of 329 medical charts were actually reviewed. Traumatic injury victims from January 1, 2018ā€“December 31, 2022 were included, and a simple random sampling technique was utilized. The data was gathered by reviewing medical charts. Data was coded and entered into Epi-Data Manager version 4.6.0.4 statistical software and further analyzed using STATA version 17. Descriptive statistics were performed to see the frequency distribution of variables. A Kaplan-Meier survival estimate and log rank test were performed to plot the overall survival curve and compare the difference in recovery among predictor categories, respectively. A model fitness test was done by using the Cox-Snell residual test and Harrellā€™s C concordance statistic. Finally, a Cox proportional hazard model was fitted to determine the effect of predictors on recovery time from traumatic injuries. Results The median time to recovery of traumatic injuries was 5 days (IQR: 3ā€“10Ā days), with an overall incidence density of 8.77 per 100 person-days of observation. In the multivariable cox proportional regression model, variables such as being male (AHR: 0.384, 95%CI: 0.190ā€“0.776, P-value: 0.008), the Glasgow coma scale of 13ā€“15 (AHR: 2.563, 95%CI: 1.070ā€“6.139, P-value: 0.035), intentional injury (AHR: 1.934, 95%CI: 1.03ā€“3.632, P-value: 0.040), mild traumatic brain injury (AHR: 2.708, 95%CI: 1.095ā€“6.698, P-value: 0.031), and moderate traumatic brain injury (AHR: 2.253, 95%CI: (1.033ā€“4.911, P-value: 0.041) were statistically significant variables. Conclusions The median recovery time for traumatically injured respondents was 5 days. Independent predictors such as the Glasgow coma scale, time taken for surgical management, intent of injury, and traumatic brain injury were statistically significant with time to recovery from trauma

    Knowledge, attitude, and practice of personal protective equipment utilization among health care workers

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    Background: Although healthcare personnel often face hazardous working conditions with potential exposures to a variety of toxic and infectious agents, adherence to Personal Protective Equipment (PPE) protocols is quite low. Proper utilization of PPE safeguards health care providers from hazardous working conditions and increases patients' safety. However, there is a shortage of relevant studies yet to address this gap, especially in sub-Saharan regions. Objective: The objective of the study was to determine knowledge, attitude, and practice on personal protective equipment utilization among healthcare workers. Methods: An institutional-based cross-sectional study was conducted among the participants selected using a simple random sampling technique. A logistic regression analysis was carried out to identify the associated factors. Result: The practice of PPE utilization was 78.2%. Multivariate logistic regression analysis revealed educational status, marital status, overcrowding of the working department, and supply of PPE as independent predictors of KAP of PPE utilization. Conclusion: Knowledge about PPE utilization was good; however, the practice of PPE utilization was low. Decreasing the workload of healthcare workers and improving PPE supply are demanded to boost the utilization of PPE

    Duodenal gastrointestinal stromal tumor presenting with lifeā€threatening upper GI bleeding in a young patient: A case report and literature review

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    Key Clinical Message Duodenal GISTs are rare and challenging tumors. Acute lifeā€threatening upper GI bleeding is a possible presentation of duodenal GISTs. Surgery is the standard treatment for localized duodenal GISTs. Imatinib is an effective adjuvant therapy for duodenal GISTs. Abstract GIST is the most common mesenchymal neoplasm of the gastrointestinal tract, accounting for 1%ā€“2% of gastrointestinal tumors. They originate from the interstitial cells of Cajal and are rare in patients younger than 30ā€‰years. The stomach is the most common site, followed by the small intestine and colon. GISTs are caused by a gainā€ofā€function mutation in the protoā€oncogene receptor tyrosine kinase, with activating mutations in KIT being the most common. Most GISTs are asymptomatic. Even if gastrointestinal bleeding is the most common complication lifeā€threatening hemorrhage is extremely uncommon. We present a case of a 31ā€yearā€old male patient presented with massive active hematemesis and melena with hemorrhagic shock. The patient presented with massive hematemesis and melena of 1ā€‰h duration. Endoscopy showed pulsating active bleeding from the third part of the duodenum which was difficult to manage via endoscopy. Histopathologic evaluation showed spindle cell type GIST. Intraoperatively, there was a nodular mass with active bleeding on the third part of the duodenum. Duodenectomy with endā€toā€end anastomosis was done. Discharged with no postoperative complication and was put on imatinib. There are considerable challenges that arise in the diagnosis and treatment of duodenal gastrointestinal stromal tumors (GISTs) when they present with lifeā€threatening upper gastrointestinal hemorrhage. In order to achieve the best possible outcomes for patients, it is crucial to have a comprehensive understanding of the clinical presentation, diagnostic methods, and treatment approaches

    Prevalence and factors associated with hypertension among peoples living with HIV in East Africa, a systematic review and meta-analysis

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    Abstract Background In recent years, improved access to effective antiretroviral therapy has meant that people living with human immune virus are living longer than before. The burden of non-communicable diseases particularly, hypertension parallels with the increase in age. Although hypertension screening is thought to be an effective indicator of overall health status and paves the way for early interventions in peoples living with human immune virus, the exact prevalence of hypertension in this population remained unknown. We aimed to report the prevalence of hypertension and examine the factors associated with hypertension among people living with human immune virus in East Africa. Methods In this systematic review and meta-analysis, we searched PubMed, Science Direct, Scopus, Cochrane library, and Google Scholar databases for studies published until January 1, 2023. The search period was from January 10/2023, to February 10/ 2023. Random-effect models were used to calculate the pooled prevalence of hypertension. Subgroup analyses were conducted to explore potential heterogeneity. The Funnel plot and Eggerā€™s test were used to assess publication bias. Result A total of 15 studies with 10,916 individuals were included in the present meta-analysis. The pooled prevalence of hypertension among people living with human immune virus was19.75% (95% CI, 16.07%-23.42%)),). The prevalence of hypertension was not differed between studies conducted 2014- 2019 and, studies conducted 2020ā€“2022. The prevalence of hypertension was lowest in Ethiopia (16.13%) and highest in Tanzania (26.76%). Alcohol consumption (Adjusted Odds Ratio (AOR): 3.39, 95% CI: 2.35ā€“4.43), diabetes (AOR: 2.64, 95% CI: 1.89ā€“3.39), longer duration of HIV (AOR: 1.72, 95% CI: 1.15ā€“2.3), male sex (AOR: 1.62, 95% CI: 1.43ā€“1.8), obesity (AOR: 2.89, 95% CI: 1.94ā€“3.84), and older age (AOR: 2.25, 95% CI: 2.0ā€“2.5), were the factors associated with the presence of hypertension in people living with human immune virus. Conclusion Our study shows that one in five peoples living with human immune virus have hypertension causing symptoms and impairment, therefore requiring treatment. Designing effective health screening and hypertension management intervention programs helps to prevent the occurrence of hypertension and promotes peoplesā€™ overall quality of life
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