Antiepileptic Drug Adherence and Its Associated Factors among Epilepsy Patients on Follow-ups at Amanuel Mental Specialized Hospital, Ethiopia

Background: Medication adherence is a fundamental determinant of effective treatment. However, people with epilepsy have poor compliance with  their treatment because of the chronic nature of the disease. Limited studies have been conducted to address antiepileptic medication  adherence in Africa, including Ethiopia. Thus, the aim of this study was to assess antiepileptic drug adherence and its asociated factors among  patients with epilepsy attending outpatient department of Amanuel Mental Specialized Hospital. Methods: A cross-sectional study design was conducted on 439 patients with epilepsy in Amanuel Mental Specialized Hospital. Medication  adherence reporting scale-5 (MARS-5) was used to assess adherence to antiepileptic drugs. The Oslo social support, Jacob perceived stigma scale,  and hospital anxiety and depression scale (HADS) were the instruments used to assess associated factors. Simple and multiple linear regression  analysis models were fitted. Then, the adjusted unstandardized beta (β) coefficient at a 95% confidence level was used. Results: The mean(SD) score of antiepileptic medication adherence was 16.38(±3.76) with 95%CI:(16.03, 16.72). Depressive symptoms (β= -1.35, 95%  CI: (-2.04, -0.65)), anxiety symptoms (β=- 1.12,95%CI:(-1,79,-0.44), perceived stigma (β= -1.64, 95% CI:- 2.16,-1.12), being single (β=-0.67, 95%CI:-1.20,-  0.14), presence of seizure per month(β=-2.11,95% CI: (-2.81,-1.41) and antiepileptic drug adverse effect(β=-0.07,95%CI:-0.11,-0.03) were factors  associated with anti-epileptic medication adherence. Conclusion: The results suggest that the mean score of adherence to antiepileptic drugs was poor as compared to other settings. Antiepileptic  medication adherence screening tool should be included in the patient’s treatment protocol

Prevalence and determinants of antenatal depression in Ethiopia: A systematic review and meta-analysis.

BackgroundMaternal depression is the most prevalent psychiatric disorder during pregnancy, can alter fetal development and have a lasting impact on the offspring's neurological and behavioral development. However, no review has been conducted to report the consolidated magnitude of antenatal depression (AND) in Ethiopia. Therefore, this review aimed to systematically summarize the existing evidence on the epidemiology of AND in Ethiopia.MethodsUsing PRISMA guideline, we systematically reviewed and meta-analyzed studies that examined the prevalence and associated factors of AND from three electronic databases (PubMed, EMBASE, and SCOPUS). We used predefined inclusion criteria to screen identified studies. A qualitative and quantitative analysis was employed. Heterogeneity across the studies was evaluated using Q and the I² test. Publication bias was assessed by funnel plot and Egger's regression test.ResultsIn this review, a total of 193 studies were initially identified and evaluated. Of these, five eligible articles were included in the final analysis. In our meta-analysis, the pooled prevalence of AND in Ethiopia was 21.28% (95% CI; 15.96-27.78). The prevalence of AND was highest in the third trimester of pregnancy at 32.10% and it was 19.13% in the first trimester and 18.86% in the second trimester of pregnancy. The prevalence of AND was 26.48% and 18.28% as measured by Beck depression inventory (BDI) and the Edinburgh Postnatal Depression Scale (EPDS), respectively. Moreover, the prevalence of AND was 15.50% for the studies conducted in the community setting and it was 25.77% for the studies conducted in the institution-based setting. In our qualitative synthesis, we found that those pregnant women who had a history of stillbirth, complications during pregnancy, previous history of depression, no ANC follow-up, irregular ANC follow-up, not satisfied by ANC follow-up, and monthly income Conclusion and recommendationsOur meta-analysis found that the pooled prevalence of AND in Ethiopia was 21.28%. The prevalence of AND was high in the third trimester of pregnancy as compared to the first and second trimesters of pregnancy. The prevalence of AND was high in studies conducted using BDI than EPDS. Studies on the magnitude of AND as well as the possible determinants in each trimester of pregnancy with representative sample size are recommended. Screening of depression in a pregnant woman in perinatal setting might be considered backed by integration of family planning and mental health services. The use of validated and a standard instrument to assess AND is warranted.Systematic review registrationThe protocol for this systematic review and meta-analysis was registered at PROSPERO (record ID=CRD42017076521, 06 December 2017)

Prevalence and Associated Factors of Depression among PLHIV in Ethiopia: Systematic Review and Meta-Analysis, 2017

Background. Depression is a substantial contributor to the global burden of disease and affects people in all communities across the globe. Depression is the most common psychiatric problem associated with HIV/AIDS and half of all PLWHIV with depression go underdiagnosed and untreated. Psychiatric complications of HIVAIDS delay mental health services in less affluent countries. However, there is lack of study with regard to the pooled estimation prevalence of depression in PLWHIV in Ethiopia. Objectives. The aim of this systematic review and meta-analysis is to summarize the most current available evidence from 2010 to March 2017 among adult PLWHIV in Ethiopia. Methods. The team explored multiple databases searching methods including MEDLINE/PubMed, PsycINFO, Google Advance Scholar, and Google Scholar to find studies published with the data on the prevalence of depression among PLWHIV. We searched 150 research articles; of these 143 articles were excluded. Subsequently, thirteen articles were used for synthesis prevalence and four studies were included in the synthesis effect of sex on depression among PLWHIV. Results. The total of pooled estimated prevalence of depression in PLWHIV was 36.65. Estimated prevalence of depression in three studies by using CES-D was 31.19% and in six studies by using PHQ-9 was 37.91%. The remaining four studies used a single tool: Kessler-6 Scale (15.5%), HADS (41.2%), HDSQ (43.9%), and BDI (55.8%). Factors such as age, marital status, living alone, poor medication adherence, poor social support, clinical stages II and III of HIV, stigma, income, and occupation were significantly associated with depression. Conclusions and Recommendation. The pooled estimate prevalence of depression among PLWHIV was higher than that in the general population. It is better to offer special attention to these populations

Prevalence of Depressive Symptoms and Associated Factors among HIV-Positive Youth Attending ART Follow-Up in Addis Ababa, Ethiopia

Depression is most frequently and highly occurring common mental disorder in HIV/AIDS patients especially youth living with HIV/AIDS. This study aimed to assess the prevalence and associated factors of depressive symptoms among youth living with Human Immunodeficiency Virus (HIV) attending Antiretroviral Therapy (ART) follow-up at public hospitals in Addis Ababa, Ethiopia. Objective. To assess the prevalence and associated factors of depressive symptoms among youth living with Human Immunodeficiency Virus (HIV) attending Antiretroviral Therapy (ART) follow-up at public hospitals Addis Ababa, Ethiopia, 2016. Method. In a cross sectional study, 507 HIV-positive young people from public health hospitals were recruited by systematic random sampling technique. Beck Depression Inventory-II was used to assess depressive symptoms. Morisky medication adherence rating scale, social support rating scale, and HIV stigma scale were the instruments used to assess the associated factors. Results. Prevalence of depressive symptoms among HIV-positive youth was 35.5% (95% CI:31.3, 39.6). In multivariate analysis, age range between 20 and 24 years with (AOR=2.22, 95% CI: 1.33,3.62), history of opportunistic infection (AOR=1.94, 95% CI:1.15,3.27), poor medication adherence (AOR=1.73, 95%CI:1.13,2.64, low social support (AOR=2.74, 95%CI:1.13,2.64), moderate social support (AOR=1.75 95% CI: 1.03,2.98), and stigma (AOR=2.06, 95% CI: 1.35,3.14) were associated with depressive symptoms. The results suggest that prevalence of depressive symptoms among HIV-positive youth was high. Prevention of opportunistic infection, stigma, and counseling for good medication adherence are necessary among HIV-positive youth

A study on suicidal ideation and associated factors in prisoners of addis ababa correctional center

Background: Suicide is the act of intentionally causing one's own death. Global, estimation of suicide and suicidal behavior is leading cause of death and burden of diseases which is also the third leading cause of death in prison. It is a common mental health problem, and the magnitude is high especially in countries where mental health service is poor. Suicide ideation is the leading cause to commit suicide. However, there is lack of study regarding suicide in prison in African countries including Ethiopia. Objectives: The aim of this study was to assess the prevalence of suicidal ideation and associated factors among prisoners in Addis-Ababa correctional center Addis Ababa, Ethiopia, 2015. Methods: An institution-based cross-sectional study was conducted from April to June 2015. Systematic random sampling technique was used to get a total of 423 samples of prisoners. After obtaining ethical clearance from the University of Gondar and Amanuel Mental Specialized Hospital and verbal consent from the respondents, data were collected. The collected data were coded, entered, and cleaned by Epi Info version 7 and exported to SPSS version 20 for analysis. The strength of association was presented by odds ratio with 95% confidence interval (CI). The independent variables that fulfill P < 0.2 in the bivariate logistic regression analysis were entered to multivariable logistic regression analysis by enter method. Variables with P < 0.05 in multivariable logistic regression analysis were considered as have statistically significant association with dependent variables. Result: A total of 423 prisoners participated with 100% response rate. The magnitude of suicidal ideation in the last 1 month was 35 (8.04%); 95% CI (5.6–11.1). Being male (AOR = 2.962, 95% CI [1.307, 6.712]), perceived stigma (AOR = 2.666, 95% CI [1.161, 6.122]), and family history of suicide (AOR = 2.291, 95% CI [1.736, 7.129]) was associated with suicide ideation. Conclusions and Recommendations: The magnitude of suicide ideation in prisoners was higher than the general population. Hence, special attention pertaining to suicide prevention; should be given for prisoners

The magnitude of suicidal ideation, attempts and associated factors of HIV positive youth attending ART follow ups at St. Paul's hospital Millennium Medical College and St. Peter's specialized hospital, Addis Ababa, Ethiopia, 2018.

BACKGROUND:Suicide which is considered a psychiatric emergency, is a serious cause of mortality worldwide. Youth living with HIV/AIDS (YLWHA) have higher rates of suicidal behavior than the general public. This study aimed to assess the magnitude and associated factors of suicide ideation and attempt among the Human Immune deficiency Virus (HIV) positive youth attending anti-retroviral therapy (ART) follow up at St. Paul`s hospital Millennium Medical College and St. Peter`s specialized hospital, Addis Ababa, Ethiopia. METHODS:In this cross-sectional study, 413 HIV positive youth were recruited for interviews, using the systematic random sampling technique. The Composite International Diagnostic Interview (CIDI) was used to assess suicide. PHQ-9, the Oslo social support and HIV perceived stigma scale instruments were used to assess the factors. We computed bivariate and multivariable binary logistic regressions to assess factors associated with suicidal ideation and attempt. Statistical significance was declared at P-value <0.05. RESULT:The magnitude of suicidal ideation and attempts were found to be 27.1% and 16.9%, respectively. In the multivariate analysis, female sex (adjusted odd ratio(AOR) = 3.1, 95% CI, 1.6-6.0), family death (AOR = 2.1, 95%CI 1.15-3.85), WHO clinical stage III of HIV (AOR = 3.1 95% CI 1.3-7.35), WHO clinical stage IV of HIV (AOR = 4.76, 95%CI, 1.3-7.35), co-morbid depression (AOR = 7.14, 95%CI, 3.9-12.9), and perceived HIV stigma (AOR = 4.2, 95%CI, 2.27-8.2) were significantly associated with suicidal ideation, whereas female sex (AOR = 4.12, 95%CI, 1.82-9.78), opportunistic infections (AOR = 3.1, 95%CI, 1.6-6.04), WHO clinical stage III of HIV (AOR = 3.1 95%CI 1.24-7.81), co-morbid depression (AOR = 5.6 95% CI, 2.8-11.1), and poor social support (AOR = 3.4, 95%CI, 1.2-9.4) were statistically significant with suicidal attempt. The result suggests that the magnitude of suicidal ideation and attempts among HIV positive youth were high. We recommend that clinicians consider youth with comorbid depression, perceived HIV stigma and poor social support

Magnitude of internalised stigma and associated factors among people with bipolar disorder at Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia: a cross-sectional study

Objectives To assess the magnitude of internalised stigma and associated factors among patients with bipolar disorder attending the outpatient department of Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia.Design Institution-based cross-sectional study design.Setting Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia.Participants We recruited about 418 participants using systematic sampling technique for an interview during the study period.Measurement Data were collected by face-to-face interviews. Internalized Stigma of Mental Illness scale was used to measure internalised stigma. The Rosenberg Self-Esteem Scale and the Oslo-3 Social Support were instruments used to assess the associated factors. Bivariate and multivariate logistic regressions were performed to identify factors associated with the outcome variable. ORs with 95% CI were computed to determine the level of significance.Results The magnitude of internalised stigma was 24.9% (95% CI: 21.2% to 28.9%). In the multivariate analysis, unemployed (adjusted OR (AOR)=2.3, 95% CI: 1.0 to 5.0), unable to read and write (AOR=3.3, 95% CI: 1.05 to 10.7), poor social support (AOR=5.3, 95% CI: 1.9 to 15.0), ≥4 previous hospitalisations due to bipolar disorder (AOR=2.6, 95% CI: 1.1 to 6.1) and low self-esteem (AOR=2.4, 95% CI: 1.1 to 5.1) had a significant association with internalised stigma.Conclusions One in four patients with bipolar disorder reported high internalised stigma. Unemployment, low educational status, low self-esteem, poor social support and being hospitalised more than three times before were significantly associated with internalised stigma. Thus, a stigma-reduction programme focusing on self-esteem improvement and psychological health of patients to increase their stigma resistance to counteracting effects of internalised stigma is essential

Intention to seek help for depression and associated factors among residents of Aykel town, Northwest Ethiopia: cross-sectional study

Abstract Background Depression is the leading cause of disability at a population level and globally 350 million people are suffering from depression. Despite a high prevalence and serious consequences, people with depression are reluctant to seek help and a large proportion remains untreated. The aim of this study was to assess intention to seek help for depression and associated factors among residents of Aykel town, Northwest Ethiopia. Methods This cross-sectional population based study included 832 participants. We used a major depressive disorder case vignette and general help-seeking questionnaire (GHSQ) to assess intention. Study participants selected by multistage cluster sampling technique. Face-to-face interview used to collect data. We performed adjusted multiple linear regression analyses to identify factors for intention to seek help. Results The mean score on intention to seek help from any health professionals was 3.72 (SD = 1.23) with a range of (1 “very unlikely” to 5 “very likely”). Majority of the respondents had an intention to visit health professionals to get a remedy for their illness depicted in the vignette. The proportion of those who had an intention to seek help from any health professionals if they were having depression was 71.2%. Favorable attitude towards seeking professional help for depression positively associated with an intention to seek help with (unstandardized β = 0.03, 95% CI (0.01, 0.05), p-value < 0.001). Other factors positively associated with an intention to seek help for depression were age (β = 0.02, CI (0.01, 0.03) p < 0.001), and perceived need of treatment for depression (β = 0.19, CI (0.01, 0.38), p < 0.05). Poor social support was negatively associated with an intention to seek help for depression (β = − 0.39 CI − 0.68, − 0.10, p < 0.05). Conclusions The results suggest that over two-third of the respondents reported that they were likely or very likely to seek help from health professionals if they were having depression. Increased age, favorable attitude to depression, and perceived need for treatment were factors for intention to seek help. Interventions focusing on awareness creation and attitude change towards depression are necessary

Epidemiology of Depression and Associated Factors among Asthma Patients in Addis Ababa, Ethiopia

Background. Depression in asthma patients can cause worsening of respiratory symptoms. Addressing mental illness in those with asthma improves asthma outcomes. This study aimed to assess the epidemiology of depression and associated factors among asthma patients attending government hospitals in Ethiopia. Methods. Institutional based cross-sectional study was conducted on patients with asthma at three governmental hospitals of Addis Ababa from June to July 2017. Patient health questionnaire (PHQ-9) depression scale was used to assess prevalence of depression among asthmatic patients. The data were entered and analyzed using SPSS version 20 statistical software. Binary logistic regression analysis was conducted to identify associated factors for depression. To indicate the strength of association, odds ratios (OR) and 95% confidence intervals (95% CI) were used. Result. A total of 405 participants were enrolled in the study giving an overall response rate of 96%. The respondents had mean age of 54.46 and standard deviation (SD) of 10.01 years. About 273 (67.4%) were females. The prevalence of depression among asthma patients was 85 (21%). The odds of developing depression among single asthma patients were increased by 1.63 with 95% CI [1. 8, 3.493]. Depression among asthma patients who had comorbid cardiac illness was 6.2 times higher than those who do not have at CI [1.145, 24.109]. The prevalence of depression among uncontrolled asthma patients was 8 times higher than those with well-controlled asthma at CI [1.114, 19.025]. Conclusion. One-fifth of asthmatic patients were experiencing depression. Uncontrolled asthma, comorbid cardiac illness, and single patients were important predictors of depression among asthmatic patients. Proper control of asthmatic attack and cardiac illnesses is very important to reduce the burden of depression

Spatial distribution and determinants of alcohol consumption among pregnant women in Ethiopia: Spatial and multilevel analysis.

BackgroundAlcohol consumption during pregnancy is a known contributor to teratogen and causes a range of effects on pregnancy and birth outcomes. This study aimed to investigate the spatial variation and determinants of alcohol consumption among pregnant women in Ethiopia.MethodsA secondary data analysis was conducted using the 2016 Ethiopian Demographic and Health Survey data. A total of 1,135 pregnant women were included in the analysis. ArcGIS version 10.7 software was used to explore the spatial distribution of alcohol consumption, and SaTScan version 9.6 was employed to identify the significant spatial clusters of alcohol consumption. A mixed multi-level logistic regression analysis was employed to identify the determinant factors of alcohol consumption during pregnancy.ResultsThe result showed that the prevalence of alcohol consumption during pregnancy was 22.49% (with a 95% CI: 18.18 to 26.17). The spatial analysis showed that the spatial distribution of alcohol consumption significantly varied across the country [Global Moran's I value = 0.30 (PConclusionAlcohol consumption during pregnancy in Ethiopia was high. The spatial distribution of alcohol consumption was significantly varied across the country. Therefore, public health interventions targeting areas with high alcohol consumption are needed for drinking cessation and to prevent poor pregnancy outcomes related to alcohol use