Are Shopkeepers Suffering from Pulmonary Tuberculosis in Bahir Dar City, Northwest Ethiopia: A Cross-Sectional Survey

Background. Despite several interventions, tuberculosis (TB) continues to be a major public health concern in developing countries. Objective. To determine pulmonary TB prevalence and associated factors among shopkeepers in Bahir Dar City, Ethiopia. Methods. A cross-sectional study was conducted in 2016 among 520 shopkeepers who had TB signs and symptoms using questionnaire interview and sputum samples processing. Shopkeepers were considered TB positive if two sputum slides became positive. Data were edited and analyzed using SPSS version 23. Multivariable logistic regression analysis was used to identify factors. Results. A total of 520 shopkeepers were interviewed and gave sputum samples. About 256 (49.2%) of them were under the ≤30 years’ age category, 22.0% can read and write, 65.0% were Muslims, and 32.0% originated from rural areas. Pulmonary TB prevalence was 7.0% (37/520), and positivity proportion was 57.0% (21/37) in males and 70.0% (26/37) in urban residents. Smaller (44.0%) shopkeepers got health education on TB. Illiteracy, no health education, contact history, cigarette smoking, nonventilated shops, and comorbidities were factors to TB infection (p value < 0.05). Conclusions. Significant numbers of shopkeepers were infected by TB. Factors to TB infection were either personal or related to comorbidities or the environment. Therefore, TB officials need to specially emphasize awareness creation, occupational health, and early screening to prevent TB

Magnitude of stroke and associated factors among patients who attended the medical ward of Felege Hiwot Referral Hospital, Bahir Dar town, Northwest Ethiopia

Background: Stroke is the abrupt onset of a neurologic deficit and attributable to a focal vascular cause. It is an alarming issue and the third leading cause of deaths globally. Stroke was considered as a disease of developed nations, but now it becomes a top priority public health problem to developing countries as a result of globalization, which results in life style change, and less attention to prevent non-communicable diseases. This study was aimed to assess the magnitude of stroke and associated factors among patients attended the medical department of Felege Hiwot Referral Hospital between September 2014 and September 2015.Methods: An institution based cross sectional study was conducted among 427 adult (≥30 years old) stroke patient records in June 2016. Data were extracted from the Internal Medicine Department patient registration logbook using data extraction guideline. SPSS version 20 was used to edit and analyze data. Descriptive statistics and logistic regression analysis were computed to describe study objectives and identify factors associated with stroke, respectively.Results: Nearly one-third (36.8%) of reviewed records went to female patients. Nearly two third (60%) patients were aged above 50 years old. About 48(11.2%), 120(28%), 73(17.1%) and 77(18%) patients had diabetes mellitus, hypertension, cardiac and unknown diagnosis, respectively. Only 32(7.5%) were stroke patients (56.7% ischemic and 43.3% haemorrhagic). The majority (63.6%) were male stroke patients and 56.7% were urban residents. Older age, being (hypertensive, diabetes and cardiac), alcohol intake and cigarette smoking were significant factors to stroke.Conclusions: The magnitude of stroke among Internal Medicine Department attendees in Felege Hiwot Referral Hospital was lower compared with previous studies. Age, co morbidity (cardiac, diabetes and hypertensive), alcohol intake and cigarette smoking were identified factors to stroke. Thus, improving personal behaviour/ life style/ and early screening are important to prevent stroke in the study area. [Ethiop. J. Health Dev. 2016;30(3):129-134]Keywords: Stroke, factor, Felege Hiwot Hospital, Bahir Dar, Ethiopi

Are Shopkeepers Suffering from Pulmonary Tuberculosis in Bahir Dar City, Northwest Ethiopia: A Cross-Sectional Survey

Background. Despite several interventions, tuberculosis (TB) continues to be a major public health concern in developing countries. Objective. To determine pulmonary TB prevalence and associated factors among shopkeepers in Bahir Dar City, Ethiopia. Methods. A cross-sectional study was conducted in 2016 among 520 shopkeepers who had TB signs and symptoms using questionnaire interview and sputum samples processing. Shopkeepers were considered TB positive if two sputum slides became positive. Data were edited and analyzed using SPSS version 23. Multivariable logistic regression analysis was used to identify factors. Results. A total of 520 shopkeepers were interviewed and gave sputum samples. About 256 (49.2%) of them were under the ≤30 years’ age category, 22.0% can read and write, 65.0% were Muslims, and 32.0% originated from rural areas. Pulmonary TB prevalence was 7.0% (37/520), and positivity proportion was 57.0% (21/37) in males and 70.0% (26/37) in urban residents. Smaller (44.0%) shopkeepers got health education on TB. Illiteracy, no health education, contact history, cigarette smoking, nonventilated shops, and comorbidities were factors to TB infection (p value < 0.05). Conclusions. Significant numbers of shopkeepers were infected by TB. Factors to TB infection were either personal or related to comorbidities or the environment. Therefore, TB officials need to specially emphasize awareness creation, occupational health, and early screening to prevent TB

Determinants of routine health information utilization at primary healthcare facilities in Western Amhara, Ethiopia

Background: Evidence based practice is a key tool to increase effectiveness and efficiency of healthcare providers worldwide. Even if using health facility data at all levels is vital, it is poorly practiced in developing countries. This study was aimed at assessing routine health information utilization and its determinants among health centres in East Gojjam Zone, Northwest Ethiopia. Methods: An institution based cross-sectional study was conducted from May to June 2016 among 250 health centre and department/unit heads. Data collected using a pretested self-administered questionnaire and an observation checklist were analysed by SPSS version 20. A multivariable logistic regression analysis was used to identify determinant factors. Results: The majority (80%) of the respondents were males, and 54% of them were in the ≤30 years age group. Of all 250 study participants, only 96 (38.4%) routinely used facility health information for two or more purposes in addition to reporting duties; 50 (52%) to develop plan, 23 (24%) for feedback, 17 (18%) for patient management, and 6 (6%) to conduct research. Residence, data management knowledge, work load, computer skill, computer access, supportive supervision, HMIS training, and availability of HMIS guideline and formats were important factors affecting health information utilization. Conclusions: In this study, the overall health information utilization of health centres was low compared to previous studies. Personal factors (skills, knowledge, workload, residence), and organizational (access to raining, computer, HMIS formats, guidelines, supervision) were determinants of health information utilization. Improving computer access, data management inputs, training and supportive supervision are crucial to solve the problem

The functionality status and challenges of electronic health management information system: The case of public health centres in Amhara Region, Ethiopia

Background: Although electronic health management information systems (eHMIS) have been applied in the Ethiopian healthcare system since 2006, the functionality status and challenges are not assessed yet. Methods: A facility based cross sectional study was conducted in April 2017 to assess the eHMIS adoption rate, functionality status, and challenges in public health centres from Amhara Region, Ethiopia. Data were collected through phone interviewing of HMIS focal persons and data extraction from eHMIS databases. Data were analysed using SPSS version 23 software. Different descriptive statistics were computed to describe study objectives. Multivariable logistic regression analysis was used to identify factors affecting eHMIS functionality and variables showing p-value of less than 0.05 were considered as statistically significant. Results: The eHMIS adoption rate in the study area was 87.3% (733 from 839 health centres). Two third (66.6%) of the respondents were health information technicians (HIT). The majority, 653 (89.0) of the respondents took training on eHMIS. About 213 (29.0%) of the eHMIS focal persons were non health information technician staffs. More than half, 430 (58.7%) of health centres have functional eHMIS. Being HIT eHMIS focal person, absence of training, system failure, skill gaps, computer problems, and electric power interruption were variables showing statistical significant on the eHMIS functionality. Conclusions: This study revealed relatively high eHMIS adoption rate, but lower functionality status for various reasons. Improving training access, maintenance service, electric power, and recruiting adequately trained staffs is needed to improve eHMIS adoption and functionality

Epidemiology of hepatitis B and C virus infections among patients who booked for surgical procedures at Felegehiwot referral hospital, Northwest Ethiopia.

BackgroundHepatitis B virus(HBV) and hepatitis C virus(HCV) are the main causes of cirrhosis, liver cancer, and death. This study aimed to determine the seroprevalence and associated factors of HBV surface antigen(HBsAg) and anti-HCV among patients screened for surgery at Felegehiwot referral hospital, Northwest Ethiopia.MethodsA hospital-based cross-sectional study was conducted among 433 patients in 2018. Data on socio-demographic and risk factors were collected by an exit interview using a pretested structured questionnaire. A venous blood sample of 5ml was collected from each participant, and serum was tested for HBsAg and anti-HCV using one-step rapid test kits and enzyme-linked immunosorbent assay. Multivariable logistic regression analysis was computed to identify factors associated with HBV and HCV infections. The odds ratio with 95%CI was used to describe the strength of association and statistical significance.ResultsA total of 422 patients gave data and included in the analysis. The mean age of patients was 36±5 years. About two-thirds, 269(64%) and 274(65%) patients were males, and from rural areas, respectively. The seroprevalence of HBsAg was 34(8%) followed by 18(4.3%) anti-HCV and 4(0.9%) co-infections. Being single(AOR = 1.96, 95%CI = 1.12-3.10), rural residence (AOR = 2.68, 95%CI = 1.28-5.61), ever heard about HBV (AOR = 2.41, 95%CI = 1.18-5.20), having multiple sexual partners(AOR = 2.85, 95%CI = 1.30-5.58), HIV positive(AOR = 3.14, 95%CI = 1.31-7.61), history of tooth extraction(AOR = 3.0, 95%CI = 1.40-6.56), hospitalization history(AOR = 2.95, 95%CI = 1.26-5.81), sharing of sharp instruments (AOR = 3.86, 95%CI = 1.82-8.79), and had blood contact(AOR = 2.64, 95%CI = 1.14-5.42) were statistically significant factors to HBV infection. Similarly, sharing of sharp instruments(AOR = 4.65, 95%CI = 1.32-15.1), tooth extraction practice(AOR = 2.81, 95%CI = 1.12-6.56), surgical history (AOR = 3.68, 95%CI = 1.64-9.82), hospitalization history(AOR = 4.51, 95%CI = 1.62-8.35) and had blood contact(AOR = 3.2, 95%CI = 1.56-8.51) were significant factors to HCV infection.ConclusionThe seroprevalence of HBsAg and ant-HCV was high compared to WHO and previous study findings. Giving special attention to awareness creation, rural settings, improving personal behaviors, infection prevention activities of health facilities, quality of healthcare procedures is crucial to prevent viral hepatitis infection

Spatial-temporal clustering of notified pulmonary tuberculosis and its predictors in East Gojjam Zone, Northwest Ethiopia.

BackgroundTuberculosis (TB) remains a key health menace in Ethiopia and its districts. This study aimed to assess the spatial-temporal clustering of notified pulmonary TB (PTB) cases in East Gojjam Zone, Northwest Ethiopia.MethodsA retrospective study was conducted among all PTB cases reported from 2013-2019. Case notification rates (CNRs) of PTB cases at Kebele (the lowest administrative unit), woreda, and zone levels were estimated. The PTB clustering was done using global Moran's I statistics on Arc GIS 10.6. We used Kulldorff SaTScan 9.6 with a discrete Poisson model to identify statistically significant spatial-temporal clustering of PTB cases at Kebele level. Similarly, a negative binomial regression analysis was used to identify factors associated with the incidence of PTB cases at kebele level.ResultsA total of 5340 (52%) smear-positive and 4928 (48%) smear-negative PTB cases were analyzed. The overall mean CNR of PTB cases at zone, woreda and Kebele levels were 58(47-69), 82(56-204), and 69(36-347) per 100,000 population, respectively. The purely spatial cluster analysis identified eight most likely clusters (one for overall and one per year for seven reporting years) and 47 secondary clusters. Similarly, the space-time scan analysis identified one most likely and seven secondary clusters. The purely temporal analysis also detected one most likely cluster from 2013-2015. Rural residence, distance from the nearest health facility, and poor TB service readiness were factors (p-value ConclusionThe distribution of PTB cases was clustered. The PTB CNR was low and showed a decreasing trend during the reporting periods. Rural residence, distance from the health facilities, and poor facility readiness were factors of PTB incidence. Improving accessibility and readiness of health facilities mainly to rural and hotspot areas is vital to increase case detection and reduce TB transmission

A qualitative insight into barriers to tuberculosis case detection in east gojjam zone, Ethiopia

Tuberculosis (TB) remains to be the leading cause of morbidity and mortality in the developing world. Early TB case detection (TCD) and treatment of infectious cases is vital to reduce the TB burden. The objective of this study was to identify possible barriers to TCD in East Gojjam Zone, northwest Ethiopia. The study used a descriptive phenomenological research method. The study participants included 21 TB patients, six TB control officers, and 40 health workers (HWs) selected by a heterogeneous purposive sampling technique. In-depth interviews and focus group discussions were used to collect data. Interviews were audio recorded, transcribed verbatim, translated, and thematically analyzed using NVivo 12 software (developed by QSR International Qualitative Software Developer, Melbourne, Australia). The study participants identified numerous barriers to TCD which were grouped into three major themes and 14 subthemes: 1) patient-related barriers including rural residence, low income, poor health literacy, and health-seeking delay; 2) healthcare system barriers grouped into two subthemes: HWs barriers (shortage of HWs, lack of training access, and low level of knowledge and skills) and health facility barriers (health service delay, using only passive TCD strategy, poor health education provision, and lack of regular supervision and timely feedback); 3) sociocultural and environmental barriers which included stigma and discrimination, lack of health information sources, poor transportation infrastructure, and community resistance. In conclusion, the TCD activity which is one of the pillars of the TB control program has been confronted with several patient-related, environmental, and healthcare system–related barriers. Improving community health literacy, scale-up access, and improving quality of TB diagnostic services, conducting regular supportive supervision and provision of timely feedback, arranging regular refresher training and staff motivation and recruitment schemes, and engaging local health officials and political leaders to address budgetary problems for TB and transportation infrastructure challenges are imperative interventions to enhance the TCD efforts in the study area