Prevalence of unintended pregnancy and associated factors among married women in west Belessa Woreda, Northwest Ethiopia, 2016

Abstract Background Unintended pregnancies can have adverse physical, mental, social, and economic outcomes. Illegal abortions and associated complications often follow unintended pregnancies and claim the lives of many women in developing countries. To better understand how unintended pregnancy impacts married women, this study aimed to assess the prevalence of unintended pregnancies and associated factors among married pregnant women in West Belessa woreda, Ethiopia. Methods A community-based cross-sectional study was conducted from August to September 2015.. A multistage stratified sampling technique was used to select nine kebeles, to participate in the study. A total of 619 married pregnant women were selected from these kebeles by the simple random sampling technique and data were collected with a structured questionnaire. Binary logistic regression analysis was used to identify factors associated with the unintended pregnancies. A p-value of < 0.05 in the multi-variable model was used to identify significance. Result A total of 592 married pregnant women were surveyed regarding their intention to become pregnant. The prevalence of unintended pregnancy was 13.7%. Age at pregnancy (AOR: 15.2, 95% CI (1.9, 125.2)), history of stillbirth (AOR: 3.3, 95% CI (1.4, 7.9)), discussing pregnancy related issues with husbands (AOR: 2.3, 95% CI (1.1, 5.0)), making family planning decisions on their own (AOR: 0.4, (0.2, 0.8)), and making family planning decisions with their husbands (AOR: 95% CI 0.2 (0.1, 0.4)) were significantly associated with unintended pregnancies in this group. Conclusion The magnitude of unintended pregnancy in the study area was low. Age at pregnancy, history of stillbirth and involvement of partners in making reproductive health choices were associated with unintended pregnancies. Empowering women to make family planning decisions and increasing partner involvement in reproductive health could decrease unintended pregnancies

Treatment outcomes in patients with multidrug‐resistant tuberculosis in north‐west Ethiopia

Objective: Multidrug-resistant tuberculosis (MDR-TB) is an emerging public health problem in Ethiopia. The aim of this study was to assess MDR-TB treatment outcomes and determine predictors of poor treatment outcomes in north-west Ethiopia. Mehtods: A retrospective cohort study was conducted using all MDR-TB patients who were enrolled at Gondar University Hospital since the establishment of the MDR-TB programme in 2010. A Cox proportional hazard model was used to identify the predictors of time to poor treatment outcomes, which were defined as death or treatment failure. Results: Of the 242 patients who had complete records, 131 (54%) were cured, 23 (9%) completed treatment, 31 (13%) died, four (2%) experienced treatment failure, 27 (11%) were lost to follow-up, six (2%) transferred out, and 20 (8%) were still on treatment at the time of analysis. The overall cumulative probability survival of the patients at the end of treatment (which was 24 months in duration) was 80% (95% CI: 70%, 87%). The proportion of patients with poor treatment outcomes increased over time from 6% per person-year (PY) during 2010-2012, to 12% per PY during 2013-2015. The independent predictors of time to poor treatment outcome were being anaemic [AHR = 4.2; 95% CI: 1.1, 15.9] and being a farmer [AHR = 2.2; 95% CI: 1.0, 4.9]. Conclusions: Overall, in north-west Ethiopia, the MDR-TB treatment success rate was high. However, poor treatment outcomes have gradually increased since 2012. Being a farmer and being anaemic were associated with poor treatment outcomes. It would be beneficial to assess other risk factors that might affect treatment outcomes such as co-infection with malaria, poverty and other socio-economic and biological risk factors

Client satisfaction with existing labor and delivery care and associated factors among mothers who gave birth in university of Gondar teaching hospital; Northwest Ethiopia: Institution based cross-sectional study

Background There are many reasons for mothers not receiving modern obstetric care, being dissatisfied by health care deliveries is one of the major factors. There are limited studies about maternal satisfaction with labor and delivery care services in Ethiopia and particularly in the study area. Therefore, the aim of this study was to better understand client satisfaction on existing labor and delivery care service and associated factors among mothers who gave birth in the University of Gondar Teaching Hospital, Ethiopia. Methods This institution based cross-sectional study was conducted at the University of Gondar Referral Hospital. 593 mothers who gave birth between July and September 2016 were enrolled. Study participants were selected by systematic random sampling. A standardized, interviewer-administered questionnaire was used to collect data. Descriptive and summary statistics were performed. A linear regression model was fitted and variables having a P value of ≤0.05 in the multivariable model were considered statistically significant. Result Overall, 31.3% of mothers were satisfied by the existing labor and delivery care. Living in rural areas (-2.9%; 95% CI: -5.75,-0.12) and the presence of a co-morbidity (-3.2%; 95%CI:-5.70, -0.72) were the factor which have a negative influence on maternal satisfaction. On the other hand, travel time to reach to the hospital (hours) (0.79%; 95% CI: 0.07, 1.52), birth by episiotomy or assisted vaginal delivery (6.3%; 95%CI: 1.56, 11.04), and receiving cost-free maternal health services (6.66%; 95%CI: 3.31, 10.01) were the factors that had positive influence. Conclusion The level of satisfaction of laboring mothers with the labor and delivery care services was poor. Rural residency and chronic medical co-morbidity were negatively associated with level of satisfaction while travel time, mode of delivery, and payment free delivery service had a statistically significant positive influence on satisfaction.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/151804/1/Gashaye etal_PlosOne_2019.pdfDescription of Gashaye etal_PlosOne_2019.pdf : Main articl

Determinants of long acting reversible contraception utilization in Northwest Ethiopia: An institution-based case control study.

BackgroundThough long-acting reversible contraceptives (LARCs) are highly effective, have minimal side effects, require minimal follow-up, and are low cost, only 10% of contraceptives used in Ethiopia are LARCs. The reason for this low uptake is not understood at the country or regional level. Therefore, this study identified determinants of LARC utilization in Northwest Ethiopia.MethodsA facility-based unmatched case control study, using LARC users as cases and short- acting reversible contraception (SARC) users as controls, had been conducted at fourteen public health institutions in Northwest Ethiopia. A systematic random sampling technique was used to select participants with a 1:2 case to control ratio (n = 1167). Binary logistic regression analysis was used to identify determinants of LARC utilization among family planning service users.ResultsWealth status [AOR:1.87, 95%CI (1.08, 3.24)], history of abortion [AOR:2.69, 95%CI (1.41, 5.12)], limiting family size [AOR: 2.38, 95%CI (1.01, 5.62)], good knowledge about LARCs [AOR: 2.52, 95%CI (1.17, 5.41)], method convenience [AOR: 0.23, 95%CI (0.16, 0.34)], good availability of method [AOR:0.10 (0.05, 0.19)], less frequent visits to health facility [AOR:2.95, 95% CI(1.89, 4.62)], health care providers advice [AOR:10.69, 95%CI (3.27, 34.87)], partner approval [AOR:0.66, 95%CI (0.45, 0.97)], and favorable attitude towards LARCs [AOR:13.0, 95%CI (8.60, 19.72)] were significantly associated with LARC utilization.ConclusionProfessional support, favorable attitude towards LARC use, high economic status, history of abortion, advantage of less frequent visits, having good knowledge towards LARC and interest of limiting births were significantly associated with LARC Utilization. On the other hand, perceived method convenience, and contraception availability were inversely associated with it. Family planning education about the benefits of LARC should be done by health providers and media. Male involvement in the counselling and decision making about the advantage of using LARC may improve the negative influence of partners on LARC utilization. It is also recommended that, future qualitative research further explore perceptions of LARC use

Data from: Incidence and risk factors of first-line antiretroviral treatment failure among human immunodeficiency virus-infected children in Amhara regional state, Ethiopia: a retrospective follow-up study

Objective: This study aimed to assess the incidence and risk factors of treatment failure among Human Immunodeficiency Virus (HIV)/Acquired Immunodeficiency Syndrome infected (AIDS) children who were on Antiretroviral Therapy (ART) in Amhara National Regional State, Ethiopia. Methods: A retrospective follow-up study was conducted from January 2010 to March 2016. A total of 824 children under the age of 15 years who had started ART were included in the study. Data were collected from children’s medical chart and ART registration logbook using a standard checklist. A Weibull regression model was used to identify the risk factors for treatment failure. Adjusted Hazard Ratios with 95% confidence intervals were used to declare statistical significance. Results: The mean (±SD) age of the children was 6.4 ± 3.6 years with a median (IQR) follow up of 30.5 (IQR: 14.6, 51.4) months. Sixty-three children (7.7%, 95%CI:5.8, 9.5) developed treatment failure. Seventeen (27.0%) of whom were immunological and 46 (73.0 %) clinical failures. The incidence rate of treatment failure was 22.1/10000 person-months. The cumulative probability of failure was 0.4 with 28562.5 person-month observations. Lack of disclosure [AHR=4. 4, 95%CI (1.8, 11.3)], opportunistic infections during initiation of ART [AHR= 2.3, 95% CI (1.3, 4.1)] and prolonged follow up [AHR = 0.06, 95% CI (0.02, 0.18)] were the main predictors of treatment failure. Conclusion: This study revealed that the incidence of treatment failure remains a significant public health concern in Ethiopia. Undisclosed HIV status to children, the presence of opportunistic infections during initiation of ART and prolonged follow up was found to be the main predictors of treatment failure. Hence, early detection of the treatment failures and further studies on viral monitor need to consider

Data from: Incidence and risk factors of first-line antiretroviral treatment failure among human immunodeficiency virus-infected children in Amhara regional state, Ethiopia: a retrospective follow-up study

Objective: This study aimed to assess the incidence and risk factors of treatment failure among Human Immunodeficiency Virus (HIV)/Acquired Immunodeficiency Syndrome infected (AIDS) children who were on Antiretroviral Therapy (ART) in Amhara National Regional State, Ethiopia. Methods: A retrospective follow-up study was conducted from January 2010 to March 2016. A total of 824 children under the age of 15 years who had started ART were included in the study. Data were collected from children’s medical chart and ART registration logbook using a standard checklist. A Weibull regression model was used to identify the risk factors for treatment failure. Adjusted Hazard Ratios with 95% confidence intervals were used to declare statistical significance. Results: The mean (±SD) age of the children was 6.4 ± 3.6 years with a median (IQR) follow up of 30.5 (IQR: 14.6, 51.4) months. Sixty-three children (7.7%, 95%CI:5.8, 9.5) developed treatment failure. Seventeen (27.0%) of whom were immunological and 46 (73.0 %) clinical failures. The incidence rate of treatment failure was 22.1/10000 person-months. The cumulative probability of failure was 0.4 with 28562.5 person-month observations. Lack of disclosure [AHR=4. 4, 95%CI (1.8, 11.3)], opportunistic infections during initiation of ART [AHR= 2.3, 95% CI (1.3, 4.1)] and prolonged follow up [AHR = 0.06, 95% CI (0.02, 0.18)] were the main predictors of treatment failure. Conclusion: This study revealed that the incidence of treatment failure remains a significant public health concern in Ethiopia. Undisclosed HIV status to children, the presence of opportunistic infections during initiation of ART and prolonged follow up was found to be the main predictors of treatment failure. Hence, early detection of the treatment failures and further studies on viral monitor need to consider