Public Knowledge and Attitude towards Epilepsy and Its Associated Factors: Community-Based Cross-Sectional Study, Ethiopia, 2019

Background. Epilepsy is a disease of the brain defined by any of the following conditions. First, at least two unprovoked (or reflex) seizures occurring greater than 24 hours apart, and secondly, the presence of one unprovoked (or reflex) seizure and a probability of further seizures. Due to persisted misunderstandings and negative attitudes, individuals living with epilepsy live with a poor quality of life. Therefore, this study aimed to assess the community general knowledge about epilepsy and attitude towards person living with epilepsy and its associated factors. Methods. A community-based cross-sectional study conducted from March 10 to June 10, 2019, to assess the community general knowledge and attitude towards epilepsy and its associated factors. Data were entered into Epi data version 3.1 and transported to SPSS version 21 for analysis. Results. 596 study participants participated in a response rate of 98%. Among the study participants, 43.6% (95% CI: 39.6, 47.5) had poor knowledge and 41.3% (95% CI: 37.4, 45.1) had an unfavorable attitude. Lack of modern education, married, never witnessed a seizure, and not hearing the term epilepsy showed statistically significant association with poor knowledge about epilepsy. Lack of modern education, earning less than 1000 Ethiopian birr, not witnessing seizure, not hearing the term epilepsy, and half to one-hour walking time from health facility variables showed statistically significant association with the unfavorable attitude about epilepsy. Conclusions. The current study revealed that nearly half of Debre Berhan dwellers have deficits in terms of general knowledge about epilepsy and attitude towards a person living with epilepsy. Poor knowledge about epilepsy and unfavorable attitude towards a person living with epilepsy are likely to have an important impact on stigmatization and treatment-seeking behavior, and it should be given due attention. It would be better if health educators give special emphasis for the individuals with predictors of poor knowledge and unfavorable attitude

Stigma Resistance and Its Associated Factors among People with Bipolar Disorder at Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia

Background. Stigma resistance is the capacity to cope and remain unaffected by mental illness stigmatization. In bipolar patients, having low stigma resistance may result in a higher internalized stigma, low self-esteem, and poor treatment outcome. In Ethiopia, the prevalence of stigma resistance among bipolar patients is not well known. Therefore, this study is aimed at assessing the prevalence of stigma resistance and its associated factors among bipolar patients at Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia. Method. An institutional-based cross-sectional study was conducted from May 8th to June 14th, 2016, at Amanuel Mental Specialized Hospital. The study participants were selected using a systematic random sampling technique. The stigma resistance subscale of the internalized stigma of mental illness was used to measure stigma resistance. Bivariable and multivariable logistic regression was computed to identify factors associated with stigma resistance. Accordingly, variables with P values of less than 0.05 were considered as statistically significant predictors of stigma resistance with a 95% confidence interval. Results. In this study, 418 participants completed the interview with a response rate of 98.8%. The prevalence of low stigma resistance was 56.9% (95%CI=51.9‐61.6%). Being unemployed (AOR=1.65; 95%CI=1.35‐1.87), high internalized stigma (AOR=3.04; 95%CI=1.83‐5.05) and low self-esteem (AOR=2.13; 95%CI=1.72‐6.76) were significantly associated with low stigma resistance. Conclusions and Recommendation. More than half of the bipolar patients attending the Amanuel Mental Specialized Hospital had low stigma resistance. Therefore, stigma reduction programs have focused on improving self-esteem and reducing internalized stigma to increase their stigma resistance. Mental health information dissemination regarding community support and reengagement of people with bipolar disorder is highly recommended

Implementation of Nursing Process and Its Association with Working Environment and Knowledge in Ethiopia: A Systematic Review and Meta-Analysis

Background. The nursing process is a scientific problem-solving approach, which directs nursing care and potentially improves quality of health care service. The national pooled implementation of the nursing process in Ethiopia remains unknown. Hence, this review and meta-analysis aimed to estimate the overall implementation of the nursing process and its association with the working environment and knowledge in Ethiopia. Methods. PubMed, Scopus, Cochrane Library, Google Scholar, PsycINFO, and CINAHL were searched and complemented by manual searches. The DerSimonian and Laird random effects model was applied to estimate the pooled effect size, odds ratios, and 95% confidence interval across studies. The I2 statistic was used to check heterogeneity between the studies. Sensitivity analysis was deployed to see the effect of a single study on the overall estimation. Publication bias was examined using funnel plot and Egger’s regression test statistic. Analysis was performed using STATA™ Version 14 software. Results. Seven studies comprised of 1,268 study participants were included in this meta-analysis. The estimated pooled implementation of the nursing process in Ethiopia was 42.44% (95% CI: 36.91, 47.97%). Based on subgroup analysis, methods of outcome measurement showed that the highest overall implementation of the nursing process was observed from studies conducted using self-report technique 42.95% (95% CI: 35.76, 50.15). Nurses working in stressful environment were 81% less likely to implement the nursing process (OR 0.19, 95% CI: 0.04, 0.76), and nurses having good knowledge were 8 times more likely to implement nursing process (OR 8.38, 95% CI: 2.82, 24.86). Conclusion. The overall implementation of the nursing process in Ethiopia was relatively low. Good knowledge of nurse had paramount benefits to improve implementation of the nursing process. Therefore, nurse can be educated on the imperative of knowledge in order to enhance the nursing process implementation and to improve the overall quality of healthcare services. Furthermore, policymakers and other concerned bodies should give special attention to improving the implementation of the nursing process

Factors Affecting Social Support Status of People Living with HIV/AIDS at Selected Hospitals of North Shewa Zone, Amhara Region, Ethiopia

Background. Globally, millions of people are affected by human immunodeficiency virus (HIV). Acquired immunodeficiency was linked with psychosocial problems, whereby stigma and discrimination are the most common. Therefore, this study was aimed at assessing the level of the social support problem in people living with human immunodeficiency virus (PLHIV) and factors associated with it at selected hospitals of North Shewa Zone, Amhara Region, Ethiopia. Method. An institution-based cross-sectional study design was employed. A total of 422 PLHIV were involved in the study. A multidimensional perceived social support scale (MPSSS) for the measurement of social support problems was implemented. Systematic random sampling was used to recruit the study population after selecting study areas by lottery methods. Multivariate logistic regression analyses were performed via SPSS software. The statistical association was declared at a p value of less than 0.05 in the final model. Result. The prevalence of poor social support among study participants was 12.6%. Poor adherence to their antiretrovirus drugs was highly associated with poor social support (AOR = 2.06, 95% CI: 1.36, 3.13). Moreover, psychological distress (AOR = 4.67, 95% CI: 2.02, 10.81) and perceived stigma (AOR = 1.78, 95% CI: 1.18, 2.70) were positively associated. Conclusion. The burden of poor social support is increasingly affecting the lives of PLHIV. Poor social support in PLHIV is more magnified by poor adherence, having psychological distress, and perceived stigma

Population-level risks of alcohol consumption by amount, geography, age, sex, and year: a systematic analysis for the Global Burden of Disease Study 2020

Background The health risks associated with moderate alcohol consumption continue to be debated. Small amounts of alcohol might lower the risk of some health outcomes but increase the risk of others, suggesting that the overall risk depends, in part, on background disease rates, which vary by region, age, sex, and year. Methods For this analysis, we constructed burden-weighted dose-response relative risk curves across 22 health outcomes to estimate the theoretical minimum risk exposure level (TMREL) and non-drinker equivalence (NDE), the consumption level at which the health risk is equivalent to that of a non-drinker, using disease rates from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2020 for 21 regions, including 204 countries and territories, by 5-year age group, sex, and year for individuals aged 15-95 years and older from 1990 to 2020. Based on the NDE, we quantified the population consuming harmful amounts of alcohol. Findings The burden-weighted relative risk curves for alcohol use varied by region and age. Among individuals aged 15-39 years in 2020, the TMREL varied between 0 (95% uncertainty interval 0-0) and 0.603 (0.400-1.00) standard drinks per day, and the NDE varied between 0.002 (0-0) and 1.75 (0.698-4.30) standard drinks per day. Among individuals aged 40 years and older, the burden-weighted relative risk curve was J-shaped for all regions, with a 2020 TMREL that ranged from 0.114 (0-0.403) to 1.87 (0.500-3.30) standard drinks per day and an NDE that ranged between 0.193 (0-0.900) and 6.94 (3.40-8.30) standard drinks per day. Among individuals consuming harmful amounts of alcohol in 2020, 59.1% (54.3-65.4) were aged 15-39 years and 76.9% (73.0-81.3) were male. Interpretation There is strong evidence to support recommendations on alcohol consumption varying by age and location. Stronger interventions, particularly those tailored towards younger individuals, are needed to reduce the substantial global health loss attributable to alcohol

Population-level risks of alcohol consumption by amount, geography, age, sex, and year: a systematic analysis for the Global Burden of Disease Study 2020

Background: The health risks associated with moderate alcohol consumption continue to be debated. Small amounts of alcohol might lower the risk of some health outcomes but increase the risk of others, suggesting that the overall risk depends, in part, on background disease rates, which vary by region, age, sex, and year. Methods: For this analysis, we constructed burden-weighted dose–response relative risk curves across 22 health outcomes to estimate the theoretical minimum risk exposure level (TMREL) and non-drinker equivalence (NDE), the consumption level at which the health risk is equivalent to that of a non-drinker, using disease rates from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2020 for 21 regions, including 204 countries and territories, by 5-year age group, sex, and year for individuals aged 15–95 years and older from 1990 to 2020. Based on the NDE, we quantified the population consuming harmful amounts of alcohol. Findings: The burden-weighted relative risk curves for alcohol use varied by region and age. Among individuals aged 15–39 years in 2020, the TMREL varied between 0 (95% uncertainty interval 0–0) and 0·603 (0·400–1·00) standard drinks per day, and the NDE varied between 0·002 (0–0) and 1·75 (0·698–4·30) standard drinks per day. Among individuals aged 40 years and older, the burden-weighted relative risk curve was J-shaped for all regions, with a 2020 TMREL that ranged from 0·114 (0–0·403) to 1·87 (0·500–3·30) standard drinks per day and an NDE that ranged between 0·193 (0–0·900) and 6·94 (3·40–8·30) standard drinks per day. Among individuals consuming harmful amounts of alcohol in 2020, 59·1% (54·3–65·4) were aged 15–39 years and 76·9% (73·0–81·3) were male. Interpretation: There is strong evidence to support recommendations on alcohol consumption varying by age and location. Stronger interventions, particularly those tailored towards younger individuals, are needed to reduce the substantial global health loss attributable to alcohol. Funding: Bill & Melinda Gates Foundation