Prevalence of premarital sexual practice and associated factors among undergraduate health science students of Madawalabu University, Bale Goba, South East Ethiopia: institution based cross sectional study

Introduction: Several studies in Sub- Saharan Africa have documented high and increasing premarital sexual activities among adolescents.  Younger people face social, peer and cultural pressure to engage in  premarital sex. As a result, significant numbers of adolescents are involved in sexual activities at an early age which exposes them to the risk of unintended pregnancy, early marriage, abortion and STIs/HIV/AIDS. This study was conducted to determine Prevalence of premarital sexual practice and associated factors among Health science students of Madawalabu University, Ethiopia. Methods: A Descriptive cross sectional survey was employed and three hundred twenty four students were randomly selected after proportional allocation according to their level of education. Data were collected by a self –administered questionnaire and analyzed using SPSS Version 16. A stepwise logistic regression with forward method was used to identify  independent predictors of premarital sexual practices at 95% CI and P value less than 0.05.Results: Of respondents 181 (59.9%) who had a boy or girl friends; about 129 (42.7%) have had premarital sexual intercourse. Out of sexually active respondents, 85 (66.4%) had one sexual partner, 44 (33.6%) had two or more sexual partners. The average age of starting sexual intercourses was 18.4 ±2.14years. Sixty three (20.9%) of respondents reported tobacco smoking and 117 (38.7%) reported consumption of alcohol consumption. Conclusion: Alcohol use, boarding, sex, educational level and discussion about sexuality were significantly associated with premarital sexual intercourses. So, there is the need to step up Reproductive health club at the university to bring behavior change among the students in order to detain the usual consequences of premarital sexual practices and risky sexual behavio

Social psychiatry and psychiatric epidemiology functional impairment among people with severe and enduring mental disorder in rural Ethiopia: a cross-sectional study

Purpose: Evidence regarding functional impairment in people with severe mental disorders (SMD) is sparse in low and middle-income countries. The aim of this study was to identify factors associated with functional impairment in people with enduring SMD in a rural African setting. Methods: A cross-sectional study was conducted at the baseline of a health service intervention trial. A total of 324 participants were recruited from an existing communityascertained cohort of people with SMD (n= 218), and attendees at the Butajira General Hospital psychiatric clinic (n= 106). Inclusion criteria defined people with SMD who had ongoing need for care: those who were on psychotropic medication, currently symptomatic or had a relapse in the preceding two years. The World Health Organization Disability Assessment schedule (WHODAS-2.0) and the Butajira Functioning Scale (BFS), were used to assess functional impairment. Multivariable negative binomial regression models were fitted to investigate the association between demographic, socio-economic and clinical characteristics, and functional impairment. Results: Increasing age, being unmarried, rural residence, poorer socio-economic status, symptom severity, continuous course of illness, medication side effects and internalized stigma were associated with functional impairment across self reported and caregiver responses for both the WHODAS and the BFS. Diagnosis per se was not associated consistently with functional impairment. Conclusion: To optimize functioning in people with chronic SMD in this setting, services need to target residual symptoms, poverty, medication side effects and internalized stigma. Testing the impact of community interventions to promote recovery will be useful. Advocacy for more tolerable treatment options is warranted

Improving data quality and supervision of antiretroviral therapy sites in Malawi: an application of Lot Quality Assurance Sampling

<p>Abstract</p> <p>Background</p> <p>High quality program data is critical for managing, monitoring, and evaluating national HIV treatment programs. By 2009, the Malawi Ministry of Health had initiated more than 270,000 patients on HIV treatment at 377 sites. Quarterly supervision of these antiretroviral therapy (ART) sites ensures high quality care, but the time currently dedicated to exhaustive record review and data cleaning detracts from other critical components. The exhaustive record review is unlikely to be sustainable long term because of the resources required and increasing number of patients on ART. This study quantifies the current levels of data quality and evaluates Lot Quality Assurance Sampling (LQAS) as a tool to prioritize sites with low data quality, thus lowering costs while maintaining sufficient quality for program monitoring and patient care.</p> <p>Methods</p> <p>In January 2010, a study team joined supervision teams at 19 sites purposely selected to reflect the variety of ART sites. During the exhaustive data review, the time allocated to data cleaning and data discrepancies were documented. The team then randomly sampled 76 records from each site, recording secondary outcomes and the time required for sampling.</p> <p>Results</p> <p>At the 19 sites, only 1.2% of records had discrepancies in patient outcomes and 0.4% in treatment regimen. However, data cleaning took 28.5 hours in total, suggesting that data cleaning for all 377 ART sites would require over 350 supervision-hours quarterly. The LQAS tool accurately identified the sites with the low data quality, reduced the time for data cleaning by 70%, and allowed for reporting on secondary outcomes.</p> <p>Conclusions</p> <p>Most sites maintained high quality records. In spite of this, data cleaning required significant amounts of time with little effect on program estimates of patient outcomes. LQAS conserves resources while maintaining sufficient data quality for program assessment and management to allow for quality patient care.</p