Knee Pain After Retrograde Intramedullary Nailing with Surgical Implant Generation Network of Femur Shaft Fractures at Public Hospitals in Bahir Dar City, Ethiopia: Analysis of 6-Months Follow-Up Results

Tsegalem Birlie,1 Biniam Biresaw,2 Elias Yadeta,3 Tamirat Getachew,3 Adera Debella,3 Addis Eyeberu3 1School of Medicine, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia; 2School of Medicine, College of Health and Medical Sciences, Bahir Dar University, Bahir Dar, Ethiopia; 3School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, EthiopiaCorrespondence: Elias Yadeta, School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, P.O. Box: 138, Dire Dawa, Ethiopia, Tel +251924899107, Email [email protected]: The incidence of femur fractures in young and elderly people has increased, particularly in countries with limited resources like Ethiopia. Intra-medullary nailing (IM) has been an effective and cost-effective method of treating long bone shaft fractures, but it can lead to complications such as knee pain.Purpose: This study aimed to evaluate knee pain and its associated factors following retrograde intramedullary nailing for femur fractures.Patients and Methods: The study followed 110 patients diagnosed with femur fractures and treated with retrograde SIGN Standard Nail or Fin Nail from January 2020 to December 2022 at two hospitals in Ethiopia. The patients were followed up for at least 6 months, and data were collected from medical charts, patient interviews, and phone calls to patients who did not attend the follow-up appointment. Binary logistic regression analysis was used to identify factors associated with knee pain.Results: The study showed that 40 patients reported knee pain at 6-months follow-up, making a prevalence of 36.4%. Factors significantly associated with knee pain were a time of injury to nailing (AOR=4.23, 95% CI: 1.28– 13.92), use of a screw to the medial cortex (AOR=9.30, 95% CI: 2.90– 12.74), and fracture site (AOR= 2.67, 95% CI: 14.01– 7.03). Specifically, the longer the time from injury to nailing, the higher the risk of knee pain. The use of a longer screw to the medial cortex and a fracture site were also positively associated with knee pain.Conclusion: This study concludes that although retrograde intramedullary nail fixation is an effective method for femur fractures, it often results in knee pain. Approximately 4 of 10 patients suffered from knee pain in this study. Avoiding delayed surgical management and minimizing the use of prominent metalwork may reduce knee pain.Keywords: knee pain, intramedullary nailing, Ethiopi

Survival Status and Predictors of Mortality Among Women with Uterine Rupture at Public Hospitals of Eastern Ethiopia. Semi-Parametric Survival Analysis

Addisu Alemu,1 Elias Yadeta,2 Alemayehu Deressa,1 Adera Debella,2 Abdi Birhanu,3 Helina Heluf,2 Ahmed Mohammed,3 Fila Ahmed,1 Andinet Beyene,3 Tamirat Getachew,2 Addis Eyeberu2 1School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia; 2School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia; 3School of Medicine, College of Health and Medical Sciences, Haramaya University, Harar, EthiopiaCorrespondence: Addis Eyeberu, School of Nursing and Midwifery, Haramaya University, 138, Dire Dawa, Harar, Ethiopia, Tel +251910005436, Email [email protected]: Uterine rupture is the most dangerous complication of labor and contributes to high maternal mortality. Despite efforts to improve basic and comprehensive emergency obstetric treatment, women continue to suffer from disastrous maternal outcomes.Purpose: This study aimed to assess the survival status and predictors of mortality among women with uterine rupture at public hospitals in the Harari Region, Eastern Ethiopia.Patients and Methods: We conducted a retrospective cohort study among women with uterine rupture in public hospitals in Eastern Ethiopia. All women with uterine rupture were followed for 11 years retrospectively. Statistical analysis was conducted with STATA version 14.2. Kaplan–Meier curves together with a Log rank test were used to estimate the survival time and show the presence of differences among groups. Cox Proportion Hazard (CPH) model was used to determine the association between independent variables and survival status.Results: There were 57,006 deliveries in the study period. We found that 10.5% (95% CI: 6.8– 15.7) of women with uterine rupture have died. The median recovery and death time for women with uterine rupture were 8 and 3 days with interquartile range (IQR) of 7– 11 days and 2– 5 days, respectively. Antenatal care follow-up (AHR: 4.2, 95% CI: 1.8– 9.79), education status (AHR: 0.11; 95% CI: 0.02– 0.85), visiting health center (AHR: 4.89; 95% CI: 1.05– 22.88), and admission time (AHR: 4.4; 95% CI: 1.89– 10.18) were the predictors of survival status of women with uterine rupture.Conclusion: One out of ten study participants died due to uterine rupture. Factors including not having ANC follow-up, visiting health centers for treatment, and being admitted during the night time were predictors. Thus, a great emphasis has to be given to the prevention of uterine rupture and the linkage within health institutions has to be smooth to improve the survival of patients with uterine rupture with the help of different professionals, health institutions, health bureaus, and policymakers.Keywords: emergency obstetrics, uterine rupture, predictors, mortality, Ethiopi

Demand of and Access to Health Messages Through Mass Media in the Rural Community of Eastern Ethiopia: A Mixed Method Study

Bushra Aliyi,1 Yadeta Dassie,2 Alemayehu Deressa,2 Adera Debella,3 Abdi Birhanu,4 Mulugeta Gamachu,4,5 Addis Eyeberu,3 Gelana Mamo Ayana,2 Hamdi Fekredin,2 Ibsa Mussa2 1Zonal Health Office, Eastern Hararghe, Oromia, Ethiopia; 2School of Public Health, CHMS, Haramaya University, Harar, Ethiopia; 3School of Nursing and Midwifery, CHMS, Haramaya University, Harar, Ethiopia; 4School of Medicine, CHMS, Haramaya University, Harar, Ethiopia; 5Departments of Public Health, Rift Valley University, Harar, EthiopiaCorrespondence: Alemayehu Deressa, School of Public Health, CHMS, Haramaya University, PO Box 235, Harar, Ethiopia, Tel +251917841709, Fax +251256668081, Email [email protected]: The demand for health-related information has increased dramatically in recent years. Media is crucial in reaching health messages to audiences, especially those who are distant and rural. Therefore, the study aimed to assess demands, access, and factors associated with access to health messages through mass media in the rural community of Kersa District of East Hararghe, Eastern Ethiopia.Methods: A mixed-methods study was conducted from October 15 to November 20, 2020. A quantitative cross-sectional and a qualitative phenomenological study design were applied. A total of 578 participants were included by using a systematic sampling technique. Collected data were entered into Epidata version 3.1 and analyzed using SPSS version 22.0. A multivariate logistic regression analysis model was used and reported using an adjusted odds ratio (AOR) with a 95% confidence interval (CI). Statistical significance was set at p < 0.05. For qualitative, six-focused group discussions (FGDs) were used and then analyzed thematically.Results: Overall, the demand of and access to health messages through mass media was 32.5% (95% CI=28.5– 34.2%) and 26.6% (95% CI=24.6– 28.7%), respectively. Factors such as having electric services (AOR=2.36, 95% CI=2.13– 5.41), having a mobile phone (AOR=4.56, 95% CI=4.32– 8.73), exposure to TV (AOR=4.73, 95% CI=1.03– 11.62), and exposure to social media and printed media (AOR=5.24, 95% CI=1.07– 15.63), a preference for programs such as news, current affairs, entertainment, health and educational were 2.37, 9.47, 4.75 and 7.55 times more likely to access health messages (AOR=2.37, 95% CI=1.00– 5.61; AOR=9.47, 95% CI=3.54– 25.34; AOR=4.75, 95% CI=1.23– 18.38; and AOR=7.55, 95% CI=3.12– 8.66, respectively). Qualitative findings, participants demand for health messages from health workers, radio, and the main source for accessing the message was the radio.Conclusion: Approximately one in every three and one in every four rural communities in the study area had demand, and access to health messages through mass media, respectively. As a result, all stakeholders should emphasize and strengthen expanding methods of reaching health messages using mass media.Keywords: health message, media, access, rural community, Eastern Ethiopi

Sexual Coercion is Associated with HIV Risk Behavior Among Female Waiters in Jimma Town, Southwest Ethiopia

Regasa Imana,1 Misra Abdullahi,1 Rahima Ali,1 Addis Eyeberu,2 Tamirat Getachew,2 Jemal Ahmed,3 Ibsa Mussa,3 Eyobel Amentie,4 Girma Wami,4 Betelhem Sime,5 Adera Debella2 1School of Public Health, College of Health and Medical Sciences, Jimma University, Jimma, Ethiopia; 2School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia; 3School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia; 4School of Medicine, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia; 5Department of Monitoring and Evaluation, public health, Harari Regional Health Bureau, Harar, EthiopiaCorrespondence: Addis Eyeberu, 138, Dire Dawa, Harar, Ethiopia, Tel +251910005436, Email [email protected]: Female waiters are at higher risk of workplace violence including sexual coercion. Even though there are numerous studies on the prevalence of sexual coercion among students, nurses, adolescents, and young pregnant women, studies on the prevalence of sexual coercion among female waiters are limited. Furthermore, there is no evidence existed that show a relationship between sexual coercion and HIV risk behavior in Ethiopia.Purpose: The purpose of this study was to examine the relationship between sexual coercion and HIV risk behavior among female waiters in Jimma, southwest Ethiopia.Patients and Methods: We conducted a cross-sectional survey from 1st April to 30, 2018, among 420 female waiters of reproductive age working in the licensed food and drinking establishments in Jimma town. A structured interviewer-administered questionnaire was used to collect data. Statistical analysis was conducted with SPSS version 21 statistical software. A binary logistic regression model was used to determine the association between independent variables and outcome variables.Results: The lifetime prevalence of sexual coercion among female waiters was 71.4% (95% confidence interval: 67.1– 76.8). More than two-thirds (71.6%) of female waiters engaged in HIV-related risk behaviors. Working in the bar (AOR 4.64, 95% CI: 2.15– 10.0), being a substance user (AOR 3.37, 95% CI: 1.7– 6.7), experiencing sexual coercion (AOR 7.6, 95% CI: 3.8– 15.3) were significantly associated with HIV risk behaviors.Conclusion: A significant number of female waiters experienced sexual coercion and engaged in HIV-risk behaviors. Workplace, substance use, and sexual coercion were significantly associated with HIV risk behavior. As a result, establishments, town health offices, and other stakeholders should work together to safeguard female waiters from the burdens of sexual coercion, HIV risk behavior, and sexually transmitted infections.Keywords: HIV-related risk behaviors, sexual violence, sexual coercion, female waiters, southwest Ethiopi