HIV/AIDS Preventive Practice and Associated Factors among Female Sex Workers in Afar Region, Ethiopia: A Community Based Study

BACKGROUND: Female Sex Workers (FSWs) are a high-risk population for Human Immune Virus (HIV) infection. However, HIV related services for sex workers are given little attention in developing nations like Ethiopia. Thus, this study attempted to assess HIV preventive practice and associated factors among FSWs in the Afar region.METHODS: Community-based cross-sectional study was conducted on 419 FSWs from April 1st to May 2nd in 2018 in four hotspot towns (i.e. Logia, Mille, Gedamayitu and Awash) found in Afar region. The study participants were selected using snowball sampling technique. The sociodemographic and behavioral data were collected using face-toface interview. Logistic regression analyses were done to determine factors associated with HIV prevention practices. The statistically significant level was declared at a P-value < 0.05.RESULTS: The HIV/AIDS preventive practice among FSWs was 61.1% [95% CI 56.2% - 65.9%]. The multivariable logistic regression analysis showed that being single [AOR=2.57: 95% CI 1.06, 6.21:P<0.05] and urban residence before being FSWs [AOR= 3.26: 95% CI 1.25, 8.54: P<0.05] were found to be enhancing factors of the preventive practice of HIV/AIDS. However, being illiterate [AOR=0.133: 95% CI 0.032, 0.557: P<0.01], young age [AOR=0.065: 95% CI 0.021, 0.196:P<0.001], being alcohol drinker [AOR= 0.104: 95% CI 0.026, 0.417: P<0.01], being cigarette smoker [AOR= 0.096: 95% CI 0.022, 0.414:P<0.01] and lack of aware of HIV transmission [AOR= 0.08: 95% CI0.03, 0.22: P<0.001] were the hindering factors of the preventive practice of HIV among FSWs.CONCLUSION: The HIV/AIDS preventive practice among FSWs in Afar region hotspot towns (61.1%) is still very low compared to the country progress report on HIV response for FSWs (98%). The regional health bureau should design inclusive strategies to improve the HIV preventive practice among FSWs. These includes regular HIV testing campaigns, sustainable condom distribution in the hotspot towns. The region should encourage NGOs to work on inclusive HIV prevention upon FSWs. Female sex workers should be aware of the risky behaviors that lead to HIV. Additional qualitative methods are also recommended

Intimate partner violence during pregnancy and preterm birth among mothers who gave birth in public hospitals, Amhara Region, Ethiopia: A case-control study

Background: Preterm birth (PTB) is an important and under-reported public health problem in developing nations such as Ethiopia. Limited research has been conducted to date to address the effect of intimate partner violence (IPV) during pregnancy on PTB. This study was conducted to assess the association between IPV during pregnancy and PTB. Methods: A case control study was conducted on 138 cases and 276 controls in four randomly selected public hospitals from February to April 2018. Mothers who gave birth before 37 completed weeks of gestation were included as cases, and mothers who gave birth at 37 and above completed weeks of gestation were deemed as controls. A simple random sampling technique was employed to select the two consecutive controls. Bivariate and multivariate logistic regression analyses were done. Results: In this study, the prevalence of any IPV during pregnancy was 44.8% among cases and 25% among controls. Any IPV during pregnancy was significantly associated with PTB [AOR = 2.85; 95% CI: 1.42-6.22]. In addition, women who were exposed to emotional violence during the recent pregnancy were three times more likely to have a PTB compared to those who were not violated [AOR = 3.05; 95% CI: 1.35-6.91]. Similarly, women who experienced physical IPV during pregnancy were 2.6 times [AOR = 2.56; 95% CI: 1.27-6.78] more at risk of PTB compared to those who had no physical IPV. Conclusion: This study found that IPV during pregnancy is significantly associated with PTB. Hence, IPV screening needs to be integrated into routine antenatal care (ANC) services. [Ethiop. J. Health Dev. 2020; 34(1):44-53] Key words: Intimate partner violence, pregnancy, preterm birth, Ethiopi

Preventive Practice and Associated Factors towards COVID-19 among College Students in Amhara Region, Ethiopia: A Cross- Sectional Study

BACKGROUND: Ethiopia has taken unprecedented preventive measures like closure of higher education institutions to halt the spread of COVID-19. However, still, there is scarce information regarding the knowledge, attitude, and practice (KAP) of students towards COVID-19 pandemic. Thus, this study aimed to assess the KAP and associated factors of preventive measures against COVID- 19 among students.METHODS: A cross-sectional study was conducted on 422 students. The sample was proportionally allocated into the randomly selected four colleges, and the students were recruited using a systematic random sampling technique.Variables with pvalue < 0.25 in the bivariate logistic regression analysis were entered into the multivariable logistic regression model.RESULTS: This study involved 408 students with response rate of 96.6%. The levels of good knowledge, positive attitude and good practice towards COVID-19 were 69.6%, 56.6% and 65% respectively. After adjusting for covariates, being in the late adolescent age group (16-20), living with > 5 family size, and being single were predictors of knowledge level. Besides, being single, attending diploma (TVET) level trainings, and being year-two students were predictors of attitude levels. Similarly, urban residence, being regular students, and being year-one students were the independent predictors of practice level of students.CONCLUSION: In this study, only two-third of the students had good preventive practice level towards COVID-19, which is below the Organization’s recommendation. Thus, the national, regional and local governments should develop effective and inclusive prevention strategies to address students who are at home due to COVID-19 pandemic

Determinants of Neural Tube Defects among Newborns in Amhara Region, Ethiopia: A Case-Control Study

Background. Worldwide, an estimated 300,000 neonates are born with neural tube defects (NTDs) each year. However, NTDs are underreported in Ethiopia though it causes substantial mortality, morbidity, disability, and psychological and economic cost in the country. Moreover, the factors attributed to NTDs were not addressed. Hence, this study intended to identify the determinants of neural tube defects in Amhara Region, Ethiopia. Methods. A case-control study design was conducted among 400 newborns (133 cases and 267 controls) who were born at randomly selected public hospitals. Cases were identified using the physician diagnosis of confirmed NTDs, and the two consecutive controls were selected using a simple random sampling technique. The data analysis was done using Stata 14.0. Variables with p value < 0.25 in the bivariate analysis were entered into the multivariable logistic regression model, and a corresponding 95% confidence interval was used to identify the predictors of NTDs. Results. In this study, fifty percent (48%) of the cases were contributed by anencephaly. After controlling the covariates, living in rural areas (AOR=1.78: 95% CI 1.02, 3.11), being illiterate (AOR=1.81: 95% CI 1.07, 4.61), being female newborn (AOR=1.95: 95% CI 1.09, 3.50), having no ANC follow-up (AOR=1.93: 95% CI 1.17, 5.04), and having a previous history of NTDs (AOR=4.39: 95% CI 2.42, 7.96) were the risk factors for NTDs. However, being supplemented with folic acid or multivitamins before or during pregnancy (AOR=0.37: 95% CI 0.21, 0.65), never having taken any substance during pregnancy (AOR=0.42: 95% CI 0.21, 0.88), and being free from medical illnesses during pregnancy (AOR=0.27: 95% CI 0.11, 0.69) were the protective factors of NTDs. Conclusion. The study revealed different factors associated with NTDs among newborns in the region. Therefore, comprehensive preventive strategies focused on identified risk factors are needed at regional and national levels

A systematic review and meta-analysis protocol on stunting and its determinants among school-age children (6-14years) in Ethiopia.

BackgroundIn Ethiopia, stunting is a common public health problem among school-age children. Even though several studies were conducted in different parts of the country, the national pooled prevalence of stunting and its determinants not estimated. Therefore, this study intends to determine the pooled prevalence and determinants of stunting among school-age children in Ethiopia.MethodsThis review protocol is registered at PROSPERO with Registration number: CRD42020160625. Online databases (Medline, PubMed, Scopus, and Science direct), Google, Google Scholar, and other grey literature will be used to search articles until June 2020. The quality assessment will be performed using the Joanna Briggs Institute checklist. The analysis will be organized and presented according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis. The presence of heterogeneity among studies will be examined using a chi-squared test on Cochran's Q statistic with a 5% level of statistical significance, subgroup analyses, and meta-regression will be performed to investigate sources of heterogeneity. To identify influential studies, sensitivity analysis will be conducted. Presence publication bias will be examined by observing funnel plots. The presence of a statistical association will be declared at a p-value DiscussionStunting is a major public health problem in Ethiopia, which affects the health of children. So, designing and implementing different nutritional strategies and promoting healthcare services is extremely mandatory to overcome stunting problems in the country. To understand this, estimating the prevalence of stunting at the national level and determining the pertinent common determinants using high-level evidence is fairly imperative. Therefore, this study will offer a summarizing finding

A multilevel analysis of short birth interval and its determinants among reproductive age women in developing regions of Ethiopia.

BackgroundShort Birth Interval negatively affects the health of both mothers and children in developing nations, like, Ethiopia. However, studies conducted to date in Ethiopia upon short birth interval were inconclusive and they did not show the extent and determinants of short birth interval in developing (Afar, Somali, Gambella, and Benishangul-Gumuz) regions of the country. Thus, this study was intended to assess the short birth interval and its determinants in the four developing regions of the country.MethodsData were retrieved from the Demographic and Health Survey program official database website (http://dhsprogram.com). A sample of 2683 women of childbearing age group (15-49) who had at least two alive consecutive children in the four developing regions of Ethiopia was included in this study. A multilevel multivariable logistic regression model was fitted to identify the independent predictors of short birth interval and Akaike's Information Criterion (AIC) was used during the model selection procedure.ResultsIn this study, the prevalence of short birth interval was 46% [95% CI; 43.7%, 47.9%]. The multilevel multivariable logistic regression model showed women living in rural area [AOR = 1.52, CI: 1.12, 2.05], women attended secondary education and above level [AOR = 0.27, CI: 0.05, 0.54], have no media exposure [AOR = 1.35, CI: 1.18, 1.56], female sex of the index child [AOR = 1.13, CI:1.07,1.20], breastfeeding duration [AOR = 0.79, CI: 0.77, 0.82], having six and more ideal number of children [AOR = 1.14, CI: 1.09, 1.20] and having preferred waiting time to birth two years and above [AOR = 0.86, CI: 0.78, 0.95] were the predictors of short birth interval.ConclusionsThe prevalence of short birth intervals in the developing regions of Ethiopia is still high. Therefore, the government of Ethiopia should work on the access of family planning and education in rural parts of the developing regions where more than 90% of the population in these regions is pastoral

Knowledge level and factors influencing prevention of COVID-19 pandemic among residents of Dessie and Kombolcha City administrations, North-East Ethiopia: a population-based cross-sectional study

Objective In Ethiopia, community-level knowledge about the current COVID-19 pandemic has not been well studied. This study is aimed to assess knowledge level and factors influencing the prevention of the COVID-19 pandemic among residents of Dessie and Kombolcha city administrations, Ethiopia.Design Community-based cross-sectional study.Settings Dessie and Kombolcha city administrations.Participants Participants were household heads or members (n=828, &gt;18 years) who have lived in the study area for at least 2 months preceding the survey.Methods Binary logistic regression was used for a single outcome and multiple response variables. In the multivariable regression model, a value of p&lt;0.05 and adjusted OR (AOR) with 95% CI were used to identify factors associated with knowledge level of the community. Epi Info V.7.2 and SPSS V.20 software were used for data entry and analysis, respectively.Outcome Knowledge level.Results A total of 828 participants was involved with a response rate of 98%. Women were 61.7%. Participants’ mean (±SD) age was 39 (±14) years. Of the total participants 54.11% (95% CI 50.6% to 57.6%) had inadequate knowledge about COVID-19 prevention. Significant associations were reported among women (AOR=1.41; 95% CI 1.03 to 1.92); age ≥65 years (AOR=2.72; 95% CI 1.45 to 5.11); rural residence (AOR=2.69; 95% CI 1.78 to 4.07); unable to read and write (AOR=1.60; 95% CI 1.02 to 2.51); information not heard from healthcare workers, mass media and social media (AOR=1.95; 95% CI 1.35 to 2.82), (AOR=2.5; 95% CI 1.58 to 4.19) and (AOR=2.13; 95% CI 1.33 to 3.42), respectively, with inadequate knowledge.Conclusion These findings revealed that more than 50% of participants had inadequate knowledge about COVID-19. It highlights the need for widespread awareness campaigns about COVID-19 through mass media, healthcare professionals and social media as sources of information. House-to-house awareness creation is recommended to address older adults who are more vulnerable to the pandemic

Adolescent transport and unintentional injuries: a systematic analysis using the Global Burden of Disease Study 2019

Background Globally, transport and unintentional injuries persist as leading preventable causes of mortality and morbidity for adolescents. We sought to report comprehensive trends in injury-related mortality and morbidity for adolescents aged 10-24 years during the past three decades. Methods Using the Global Burden of Disease, Injuries, and Risk Factors 2019 Study, we analysed mortality and disability-adjusted life-years (DALYs) attributed to transport and unintentional injuries for adolescents in 204 countries. Burden is reported in absolute numbers and age-standardised rates per 100 000 population by sex, age group (10-14, 15-19, and 20-24 years), and sociodemographic index (SDI) with 95% uncertainty intervals (UIs). We report percentage changes in deaths and DALYs between 1990 and 2019. Findings In 2019, 369 061 deaths (of which 214337 [58%] were transport related) and 31.1 million DALYs (of which 16.2 million [52%] were transport related) among adolescents aged 10-24 years were caused by transport and unintentional injuries combined. If compared with other causes, transport and unintentional injuries combined accounted for 25% of deaths and 14% of DALYs in 2019, and showed little improvement from 1990 when such injuries accounted for 26% of adolescent deaths and 17% of adolescent DALYs. Throughout adolescence, transport and unintentional injury fatality rates increased by age group. The unintentional injury burden was higher among males than females for all injury types, except for injuries related to fire, heat, and hot substances, or to adverse effects of medical treatment. From 1990 to 2019, global mortality rates declined by 34.4% (from 17.5 to 11.5 per 100 000) for transport injuries, and by 47.7% (from 15.9 to 8.3 per 100000) for unintentional injuries. However, in low-SDI nations the absolute number of deaths increased (by 80.5% to 42 774 for transport injuries and by 39.4% to 31 961 for unintentional injuries). In the high-SDI quintile in 2010-19, the rate per 100 000 of transport injury DALYs was reduced by 16.7%, from 838 in 2010 to 699 in 2019. This was a substantially slower pace of reduction compared with the 48.5% reduction between 1990 and 2010, from 1626 per 100 000 in 1990 to 838 per 100 000 in 2010. Between 2010 and 2019, the rate of unintentional injury DALYs per 100 000 also remained largely unchanged in high-SDI countries (555 in 2010 vs 554 in 2019; 0.2% reduction). The number and rate of adolescent deaths and DALYs owing to environmental heat and cold exposure increased for the high-SDI quintile during 2010-19. Interpretation As other causes of mortality are addressed, inadequate progress in reducing transport and unintentional injury mortality as a proportion of adolescent deaths becomes apparent. The relative shift in the burden of injury from high-SDI countries to low and low-middle-SDI countries necessitates focused action, including global donor, government, and industry investment in injury prevention. The persisting burden of DALYs related to transport and unintentional injuries indicates a need to prioritise innovative measures for the primary prevention of adolescent injury