Intestinal parasites among HIV/AIDS patients attending University of Gondar Hospital, northwest Ethiopia

Background: Opportunistic intestinal parasitic infections are the major public health problem among human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) patients. In the absence of anti-retroviral therapy (ART), HIV/AIDS patients in developing countries such as Ethiopia continue to suffer from the consequences of intestinal parasites. This study aimed to determine the prevalence of opportunistic and other intestinal parasites among on-ART HIV/AIDS patients.Methods: A comparative cross-sectional study was conducted from December 2015 to January2016 among pre-ART and on-ART adult HIV/AIDS patients at University of Gondar Hospital, northwest Ethiopia. A pre-tested structured questionnaire was used to collect data on socio-demographic and associated risk factors. Systematic random sampling was used to select the study participants. Stool samples were collected and processed using a direct, wet-mount, formol-ether concentration technique and modified Ziehl-Neelsen staining technique. The CD4 counts were estimated by using the BD FACS Count system. Data were entered and analyzed using SPSS 20 software.Results: A total of 150 study participants (48ARTnaïve and102 on ART) were included in the study. The overall prevalence of intestinal parasitic infections was 45.3% – 25.3% in pre-ART patients and 20% in on-ART patients. Two thirds (8/12) of opportunistic parasitic infections were found in the ART-naïve patients and significantly associated with CD4 counts <200 cells/mm3. Those who have no toilet [AOR=5.21, 95% CI: 1.82, 16.03], source of water from stream [AOR = 2.8; 95% CI: 1.05, 7.72], who have diarrhea [AOR = 11.38; 95% CI: 4.69, 15.61], WHO stage III [AOR =5.3; 95% CI: 2.47, 11.56] and ART status [AOR = 4.2; 95% CI: 2.02, 8.77] were significantly associated with the prevalence of intestinal parasites.Conclusions: The prevalence of intestinal parasites was found to be higher in ART-naïve than on-ART patients. High proportions of intestinal parasites were associated with lower CD4 counts, ART naïve, diarrhea, WHO stage III, absence of toilet and source of water from stream. Therefore, public health measures and adherence to ART for ART naïve should be strengthened to improve the quality of life of these patients. [Ethiop.J. Health Dev. 2019; 33(2):65-72]Key words: Opportunistic intestinal parasites, CD4 T-cells, Anti-retroviral therapy, diarrhea, Gonda

Women's Independent Household Decision Making Power and its influence on their Autonomy in relation to Child Vaccinations: a mixed-method study among Women of Reproductive Age in Northwest Ethiopia

AbstractBackground: The importance of women’s empowerment in influencing health outcomes has received attention globally, but there is limited information in Ethiopia on the relationship between women's household decision making power and the autonomy of decision making in relation to child vaccinations.Aim: The study aimed to assess the role of women's household decision making power on their autonomy in relation to child vaccinations.Methods: A community based mixed method study design was conducted among women who had 12–23-month-old children in Wogera district, Ethiopia. The sample size was determined using a single population proportion formula for the quantitative aspect of the study and the data collection for the qualitative study continued until saturation. The quantitative data was collected using a piloted questionnaire. SPSS software was used for quantitative data analyses. X2-square test was conducted to explore the association between women's household decision making power and their autonomy in relation to decision making around child vaccinations. Framework analysis was employed to analyse qualitative data using open code software.Results: A total of 584 women participated in the quantitative study and 13 In-depth interviews (IDI) with 13 key informants (KII)were conducted for the qualitative study. Majority, 88.2% (95% CI: 85.7, 90.6) of the respondents have autonomy to vaccinate children. This study showed that nearly two-thirds, 61.6% of the women had household decision making power. Respondents of the qualitative study noted that women had low household decision making power. Women's household decision making power is associated with women's autonomy to vaccinate children (x2=92.775a, df=1, P<0.001).Conclusions: The overall level of women’s household decision making power was relatively low compared to EDHS reports whereas women's autonomy to chid vaccination was high. There was a strong relationship between women’s household decision making power and their autonomy in relation to child vaccinations. It is therefore important to implement activities, for example, provision of behavioural change communication (BCC) in the community, that can improve women’s household decision making power which in turn will influence child vaccination coverage. [Ethiop. J. Health Dev. 2021; 35(SI-3):86-97]Key words: Women, Household decision making power, Women's autonomy, Vaccinatio

Full immunization coverage and its determinants among children aged 12-23 months in Wogera district, Northwest Ethiopia

AbstractBackground: Immunization is considered one of the most affordable health initiatives for children. Though there is good progress in Ethiopia, the amount of fully vaccinated children, is still below the target. Possible challenges include women having home visits and men’s’ involvement in vaccination uptake. Therefore, this study aimed to determine full immunization coverage and its determinants among children aged 12- 23 months in Wogera districts, Northwest Ethiopia.Aim: This study aimed to determine the full immunization coverage and its determinants among children aged 12-23 months, and to assess the level of immunization coverage and its determinants in Wogera districts, Northwest Ethiopia.Methods: A community-based cross-sectional study was conducted in Wogera district from May 28-June 25/2020. Cluster sampling method was used to recruit 598 study participants. Interviewer administered questionnaire was used to collect data. A bivariable and multivariable logistic regression analysis was done to identify factors associated with full immunization. Odds ratios with 95% Confidence intervals were used to determine significant variables.Results: A total of 584 mothers who had children aged 12-23 months participated in this study. The full immunization coverage was 76.5% (95%CI 73.2-79.8). Mother age >40 years (AOR=7.37, 95% CI: 1.65, 32); mothers who initiate vaccine uptake(woman empowerment) (AOR=1.57, 95% CI: 1.13-2.39); mothers who had 1-3 ANC visit (AOR=2.51, 95% CI:1.14, 5.52), and 4+ ANC follow up (AOR=2.73,95% CI: 1.26, 5.91); r health extension worker's home visit during the first weeks of postpartum period (AOR=1.76,95% CI:1.10, 2.84), and males involved in child immunization (AOR=3.27, 95% CI:1.84, 5.81) was positively associated with being fully vaccinated , however, birth order of 6 and above (AOR=0.35, 95% CI: 0.14, 0.86) was negatively associated with being fully vaccinated.Conclusion: In this study, the full immunization coverage is found to be suboptimal, and it is far from the expected national target coverage. Maternal health care uptake; women empowerment; home visits by HEW during the first week of the postpartum period and male involvement in child immunization were found to be predictors of being fully vaccinated. [Ethiop. J. Health Dev. 2021; 35(SI-3):16-27]Keywords: Full immunization, Children12-23 months, Northwest Ethiopia, Male involvemen

Modern contraceptive use and associated factors among married women in Finote Selam town Northwest Ethiopia: a community based cross-sectional study

Abstract Background A modern contraceptive method is a product or medical procedure that interferes with reproduction following sexual intercourse; however, contraceptive services remain out of reach for many women of reproductive age worldwide, resulting in millions of unwanted pregnancies and unsafe abortions each year. In addition to limiting the number of children, family planning is essential to promoting the well-being and autonomy of women, their families, and their communities. Factors influencing modern contraceptive utilization are multifaceted and challenging, therefore; this study aimed to assess modern contraceptive utilization and associated factors among mid to late reproductive age, married women in Finote Selam town, northwest Ethiopia. Methods A community based cross-sectional study was conducted from June 30 to July 15, 2017 among married women aged 30–49. A cluster sampling technique was used to select 1146 eligible participants from three randomly selected kebeles. A face-to-face interviewer administered a structured and pretested questionnaire. Binary logistic regression models, in bivariate and multivariable analyses, were fitted to identify factors associated with the outcome variable. Adjusted odds ratios (AOR) with 95% confidence intervals (CI) was calculated to determine the presence, direction, and strength of associations. Results A total of 1134 women aged 30–49 participated in this study representing a response rate of 98.9%.The overall modern contraceptive utilization was 37% (95% CI 35.43–40.21). An injectable contraceptive was the most commonly used method, followed by an implant contraceptive method. Factors independently associated with modern contraceptive use were: educational status -secondary school (AOR = 1.5,95%CI 1.01–2.2) and college and above (AOR = 1.5,95%CI 1.02–2) compared to no education, number of previous pregnancy: nulligravid (AOR = 4.6,95%CI 3.2–5.5),1–2 previous pregnancies (AOR = 3.2,95%CI 2.03–5.44), 3–4 previous pregnancies(AOR = 2.3,95% CI1.4–3.7) compared to > 4 pregnancies and postnatal care utilization (AOR = 1.5,95% CI 1.1–2.1)compared to no postnatal service utilized. Conclusion Our findings show that modern contraceptive utilization among women age 30–49 is low in Finote Selam town Northwest Ethiopia. Women’s educational status, low number of previous pregnancies and postnatal care service utilization during the last birth were independently associated with modern contraceptive method used. Providing modern contraceptives targeting grand multiparous women and women having no formal education is important. Improving postnatal care utilization is one potential strategy to enhance modern contraceptive utilization

Risky sexual practice and associated factors among HIV positive adults visiting ART clinics in public hospitals in Addis Ababa city, Ethiopia: a cross sectional study

Abstract Background Sexual behavior of HIV positive individuals visiting anti- retroviral clinics is a neglected issue. With access to anti-retroviral treatment, HIV positive individuals experience improved health and are able to reintegrate into their social life and many of them engage in sexual activities. In the context of Ethiopia, safer sex practices among people living with HIV is critical in terms of preventing the acquisition of another strain of HIV and helping address the epidemic. Method An institution-based cross sectional study was conducted at Addis Ababa public hospitals from January to February 2017. A pretested structured questionnaire was used to collect the data. Using the systematic random sampling technique, a total of 562 respondents participated in the study. The data were entered into EPI info version 3.5.3 and transferred to SPSS version 20 for analysis. Descriptive statistics, bi-variate, and multi variable analyses were done. A p-value < 0.05 was considered to determine the statistical significance of the association between factors (independent variables) and risky sexual practice. The Odds ratio was also used to determine the presence and the degree of association between dependent and independent variables. Results A total of 562 respondents participated in the study which revealed that the prevalence of risky sexual practice was 39.1% (95% CI: 35.2, 43.8) three months prior to the data collection. Educational status of participants who were below grade eight (AOR = 2.27, 95% CI:1.01,5.10) and went to grades eight to twelve (AOR = 2.12, 95% CI:1.02,4.41), were married (AOR = 2.07, 95% CI:1.06,4.02), had no concern for safer sexual practice (AOR = 3.74, 95% CI:2.28, 6.13), had CD4 count of ≥500cells/mm3(AOR = 1.66, 95% CI:1.04, 2.64), and used substance (AOR = 3.41, 95% CI:1.83, 6.35) were significantly associated with risky sexual practice. Conclusion The prevalence of risky sexual practice was markedly high in this study due to such contributory factors as low educational status, marriage, lack of concern for safer sexual practices, and substance use

Risky sexual practice and associated factors among HIV positive adults attending anti-retroviral treatment clinic at Gondar University Referral Hospital, Northwest Ethiopia

<div><p>Introduction</p><p>Risky sexual practice among people living with HIV/AIDS is a public health concern because of the risk of transmission of the virus to sero-discordant partner/s. There is also the risk of re-infection with new, drug resistant viral strains between sero-concordant partners. However, there is lack of information on risky sexual practices among HIV positive adults. Therefore, this study aimed to assess risky sexual practice and associated factors among adult HIV positive clients at Gondar University Referral Hospital, Northwest Ethiopia, 2015.</p><p>Methods</p><p>An institution based cross sectional study was conducted at Gondar University Referral Hospital from May to June 2015. A pretested structured questionnaire was used to collect the data. Using systematic random sampling technique, a total of 513 respondents were participated in this study. The data were entered into EPI info version 3.5.3 and transferred to SPSS version 20 for analysis. Descriptive, bivariate and multivariate analyses were done. A P-value <0.05 was considered to determine the statistical significance of the association between factors (independent variables) and risky sexual practice. The Odds ratio was also used to determine the presence and the degree of association between the dependent and independent variables.</p><p>Results</p><p>A total of 513 respondents were participated in this study. The prevalence of risky sexual practices in the past three months was 38% (95% CI: 33.3%, 42.3%). Being in the age range of 18–29 years (AOR = 2.63, 95% CI: 1.55, 4.47) and 30–39 years (AOR = 2.29, 95% CI: 1.48, 3.53), being single (AOR = 6.32, 95%CI: 2.43, 16.44),being married (AOR = 6.06, 95% CI: 2.81, 13.07), having no child (AOR = 2.58, 95% CI: 1.17, 5.72), and a CD4 count of greater than 500/mm³ were factors significantly associated with risky sexual practices.</p><p>Conclusions</p><p>A considerable number of HIV positive clients had risky sexual practices. It is strongly recommended that the Regional Health Bureau and health service providers working at Gondar University Hospital especially in the ART Clinic need to work hard on behavioral change communication.</p></div

Prevalence of risky sexual practice among HIV positive adults attending Anti Retroviral Treatment clinics at Gondar University Referral Hospital, Northwest Ethiopia, 2015.

<p>Prevalence of risky sexual practice among HIV positive adults attending Anti Retroviral Treatment clinics at Gondar University Referral Hospital, Northwest Ethiopia, 2015.</p

Determinants of birth asphyxia among live birth newborns in University of Gondar referral hospital, northwest Ethiopia: A case-control study.

BACKGROUND:Birth asphyxia, which accounts for 31.6% of all neonatal deaths, is one of the leading causes of such mortality in Ethiopia. Early recognition and management of its contributing factors would modify the problem. Thus, this study aimed to identify the determinants of birth asphyxia among live births at the University of Gondar Referral Hospital, northwest Ethiopia. METHODS:A hospital-based unmatched case-control study was conducted from April to July 2017.Cases were newborn babies with an APGAR score of < 7at 5 minutes of birth; controls were newborn babies with an APGAR score of ≥7 at 5 minutes of birth. Every other asphyxiated baby was selected as a case and every 6th non-asphyxiated baby as a control. A pretested structured questionnaire was used to collect data on maternal sociodemographic characteristics. A pretested structured checklist was used to retrieve data on ante-partum, intra-partum, and neonatal factors of both cases and controls. Data were entered using Epi Info 7 and analyzed using SPSS 20. The bivariate logistic regression analysis was used to identify the relation of each independent variable to the outcome variable. Variables with p values of up to 0.2 in the bivariate analysis were considered for the multiple logistic regression analysis. An adjusted odds ratio (AOR) with a 95% CI and p-value of <0.05 was used to identify significant variables associated with birth asphyxia. RESULTS:In this study, prolonged labor (AOR = 2.75, 95% CI: 1.18, 6.94), cesarean section delivery (AOR = 3.58, 95% CI: 1.13, 11.31), meconium stained amniotic fluid (AOR = 7.69, 95% CI: 2.99, 17.70), fetal distress (AOR = 5.74, 95% CI: 1.53, 21.55), and low birth weight (AOR = 7.72, 95% CI: 1.88, 31.68) were factors which significantly increased the odds of birth asphyxia. CONCLUSION:Prolonged labor, cesarean section (CS) delivery, meconium stained amniotic fluid (AF), fetal distress, and low birth weight were the determinants of birth asphyxia. Thus, efforts should be made to improve the quality of intra-partum care services in order to prevent prolonged labor and fetal complications, and to identify and make a strict follow up on mothers with meconium stained amniotic fluid

Partner related characteristics, partner's HIV status and disclosure among HIV positive adults visiting Gondar University Rreferral Hospital, Northwest Ethiopia, 2015.

<p>Partner related characteristics, partner's HIV status and disclosure among HIV positive adults visiting Gondar University Rreferral Hospital, Northwest Ethiopia, 2015.</p

Survival and predictors among preterm neonates admitted at University of Gondar comprehensive specialized hospital neonatal intensive care unit, Northwest Ethiopia

Abstract Background Prematurity accounts about 1 million neonatal deaths worldwide and the second causes of both neonatal and under five-child mortality. Neonatal mortality accounts for 43% of under-five child mortality in Ethiopia. From this preterm is the second leading cause of death and is steadily increased in low-income countries. Therefore, the aim of this study was to assess time to death and predictors among preterm neonates admitted in University of Gondar comprehensive specialized hospital neonatal intensive care unit North West Ethiopia 2018. Methods Institution-based retrospective follow-up study was conducted among 516 preterm neonates from January 2016 to March 2018. Data were extracted retrospectively from patients’ records using a pretested structured checklist. Descriptive summary statistics like median survival time, Kaplan Meier failure estimation curve and Log-rank test were computed. Bivariate and multivariable Gompertz parametric hazards models were fitted to identify the predictors of mortality. Hazard ratio with a 95% confidence interval was calculated and p-values < 0.05 were considered statistically significant. Results The proportion of preterm neonatal death in this study was 28.8% (95%CI (25.1, 32.9)). Home delivery (AHR = 2.25, 95% CI (1.03, 4.88)), hyaline membrane disease (AHR =3.21, 95% CI (1.96, 5.25)), gestational age, (AHR = 0.82, 95% CI (0.74, 0.91)), cry immediately at birth (AHR = 1.74, 95% CI (1.19, 2.53)), kangaroo mother care (AHR = 0.24, 95%CI (0.11, 0.52)), presence of jaundice (AHR = 1.62, 95%CI (1.12, 2.54)) and hypoglycemia at admission (AHR = 1.75, 95%CI (1.21, 2.54)) were found to be significant predictors of time to death for preterm neonates. Conclusion Proportion of preterm neonatal death in this study was high. Home delivery, Jaundice, hypoglycemia, gestational age, cry immediately at birth, kangaroo mother care and hyaline membrane disease were significant predictors of time to death