Determinants of severity levels of anemia among pregnant women in Sub-Saharan Africa: multilevel analysis

Background

Anemia is a severe public health problem affecting 54% of pregnant women in SSA Yet, only a limited number of studies have provided a partial assessment of the pooled prevalence and related determinants of the severity levels of anemia in pregnant women in SSA. Therefore, this study provides the most recent estimates of anemia severity levels and related determinants.

Methods

The most recent Demographic Health Survey (DHS) dataset of 21 Sub-Saharan African countries which were collected between 2015 and 2022 were used. A total of 14,098 pregnant women were included. Multilevel ordinal logistic regression was used.

Results

The pooled prevalence of anemia was 51.26%. Pregnant women who were in the old age groups, and who have attended secondary and higher education were less likely to be at higher levels of anemia. Those women who have given birth to >1 children in the last 5 years, pregnant women in second and third trimester and living in poorest households had greater odds of being at higher levels of anemia.

Conclusion

In Sub-Saharan Africa, anemia is a severe public health concern for pregnant mothers. When developing and implementing strategies for the prevention and control of anemia, it is imperative to take into account the individual and community circumstances. Programs for the prevention and control of anemia should incorporate the economic and educational empowerment of women.

Non-adherence to anti-tuberculosis treatment and associated factors among TB patients in public health facilities of Hossana town, Southern Ethiopia, 2022

Background

Non-adherence to anti-tuberculosis treatment is one of the crucial challenges to improving TB treatment outcomes and reducing healthcare costs. The prevalence of non-adherence to anti-tuberculosis treatment is not well documented in the study context. Therefore, this study was aimed at estimating the prevalence of non-adherence to anti-tuberculosis treatment and associated factors among TB patients attending TB clinics in Hosanna town, Southern Ethiopia, in 2022.

Methods

An institution-based cross-sectional study was conducted from April to May 2022. A systematic random sampling technique was employed to select a sample of 233 study subjects from all four public health facilities. According to the order of arrival, every second person was interviewed. Data were collected using a structured questionnaire that was created using several works of literature. A multivariable binary logistic regression analysis was used to identify factors associated with non-adherence to anti-TB drugs. The adjusted odds ratio (AOR) with a 95% confidence interval (CI) was estimated.

Results

The study included 233 tuberculosis (TB) patients with a response rate of 100%. The prevalence of non-adherence was 18% (95% CI: 15.39, 21.82). Being in the continuation phase (AOR = 3.09, 95% CI: 1.16, 8.23), not attending formal education (AOR = 2.47, 95% CI: 1.12, 5.42), not disclosing TB status to their family (AOR = 2.36, 95% CI: 0.11, 5.04) and having poor TB knowledge (AOR = 3.09, 95% CI: 1.48, 6.48) were significantly associated with non-adherence to TB treatment.

Conclusion

Among TB patients, there was a significant prevalence of non-adherence to anti-TB medications. Interventions that target patients with low education status, are in the continuation phase, and do not disclose their TB status to their families are required to improve TB treatment adherence. In addition, improving health education is important to enhance TB knowledge, which has an impact on TB treatment adherence. The need for good drug adherence should be emphasized while counseling TB patients.

Prevalence and associated factors of severity levels of anemia among women of reproductive age in sub-Saharan Africa: a multilevel ordinal logistic regression analysis

Background

Sub-Saharan Africa is the most anemia-prone region, with several of the sub-region's countries having a substantial prevalence of the anemia among women of reproductive age. Nonetheless, no adequate study has been conducted to illustrate severity levels and associated factors of anemia among women of reproductive age. Therefore, this study presents the most recent estimates on the prevalence and severity levels of anemia and its associated factors among women of reproductive age in 21 Sub-Saharan Africa countries.

Methods

This study used the most recent Demographic Health Survey (DHS) datasets, which were collected in 21 sub-Saharan African countries between 2015 and 2022. A total of 171,348 women of reproductive age were included in the analysis. Multilevel (three-level) ordinal logistic regression was done to identify factors associated with severity levels of anemia.

Results

The pooled prevalence of anemia was 41.74%. The pooled prevalence of mild, moderate and severe anemia was 23.45, 17.05 and 1.24, respectively. Women who were living at distance to a health facility (AOR = 1.07), women living in the poorest households (AOR = 1.49), women living in the households with unimproved toilet (AOR = 1.12) and in households that were using solid cooking fuel (AOR = 1.10), pregnant women (AOR = 1.72) and those who have given birth to more than one children within 3 years (AOR = 1.43) had greater odds of higher levels of anemia as compared to their counterparts. Women who were in the age groups of 20-24 (AOR = 0.81), 25-29 (AOR = 0.78), 30-34 (AOR = 0.79), 35-39 (AOR = 0.88), and 45-49 (AOR = 0.89), women who have attended primary school (AOR = 0.50), secondary (AOR = 0.57) and higher education (AOR = 0.76) and who were living in rural area (AOR = 1.07) had lower odds of higher levels of anemia as compared to their counterparts.

Conclusion

Considering individual, household and community contexts is necessary while formulating and implementing anemia prevention and control policies. Adolescent women, and women who did not attend education and at a distance to a health facility should get especial attention while implementing anemia prevention and control programs.

Food Hygiene Practices and Associated Factors Among Street Food Vendors in Urban Areas of Gedeo Zone, Southern Ethiopia

Background

Street food is expanding all around Ethiopia. Street vendors have become commonplace near schools, hospitals and bus stations. Because street vended food is sold in unsanitary surroundings near streets, it can be contaminated with variety of pathogens, exposing consumers to foodborne illnesses. There haven't been enough studies on Ethiopian street food, and little is known about how hygienic these foods are. The local authorities don't even have a regulatory system to ensure food safety for street food vendors. Thus, this study aimed to assess food hygiene practices among street food vendors and associated factors.

Methods

Community-based cross-sectional analytical study design was conducted from June, 2021 to July, 2021 including 402 respondents. Structured questionnaire and observational checklists were used for assessing food hygiene practices. Data were analyzed using SPSS statistics (version 25.0). Binary logistic regression analyses were used to check association of covariates with food hygiene practices. Adjusted odds ratio, and P-value less than 0.05 at 95% confidence interval were used to report significant association.

Results

Out of 402, 390 individuals responded. About 123 (31.5%) (95% CI: 27.2-36.4) of vendors had good food hygiene practices. Being female (AOR = 0.15; 95% CI: 0.09-0.27), age (19-25 years (AOR = 0.29; 95% CI: 0.11-0.81) and 26 to 35 years (AOR = 0.24; 95% CI: 0.08-0.74), marital status (being married (AOR = 0.52; 95% CI: 0.29-0.93), educational status (college and above (AOR = 3.42; 95% CI: 1.35-8.62), monthly income (1001-2000 Ethiopian Birr (AOR = 0.36; 95% CI: 0.19-0.68), being inspected (AOR = 13.15; 95% CI: 2.76-62.66) and lack of water at vending site (AOR = 0.40; 95% CI: 0.17-0.97) were factors significantly associated with food hygiene practices of street vendors.

Conclusion

Few street food vendors who adhered to good food hygiene were present. Significant variables of food hygiene behaviors included gender, age, marital status, education level, monthly income, inspection frequency, and the availability of water at vending sites. The vendors' food hygiene practices needed to be improved, which necessitated continual assistance, frequent inspections, and public awareness campaign.

Assessment of Microbiological Quality of Indoor Air at Different Hospital Sites of Dilla University: A Cross-Sectional Study

BACKGROUND

In both residential and hospital indoor environments, humans can be exposed to airborne microorganisms. The hospital's indoor air may contain a large number of disease-causing agents brought in by patients, staff, students, visitors, ventilation, or the outside. Hospitalized patients are at a higher risk of infection due to confined spaces, crowdedness, and poor infection prevention practices, which can accumulate and create favorable conditions for the growth and multiplication of microorganisms. Therefore, the aim of this study was to evaluate the indoor air bacterial load in Dilla University Hospital, Southern Ethiopia.

METHODS

An institutional-based cross-sectional study design was used to assess the bacterial load in the indoor air at Dilla University Hospital. To determine the bacterial load, a passive air sampling technique was used. The settle plate method was used to collect data, which involved exposing Petri-dishes filled with blood agar media to the indoor air of the sampled rooms for 60 minutes.

RESULT

A total of 72 indoor air samples were collected once a week for 2 weeks at 14-day intervals from 18 rooms in 8 wards, and samples were collected twice a day in the morning and afternoon. The mean bacterial concentrations ranged from 450 to 1585.83 CFU/m³ after 60 minutes of culture media exposure. The mean bacterial concentrations in the obstetrics, surgical, pediatric, gynecology, and medical wards exceeded WHO guidelines. A high indoor air bacterial load was found in 58 (80.6%) of the samples in this study. Gram-positive bacteria in the air were the most common 51 (71%) of the bacterial population measured in all indoor environments. Fungal growth was found in 65 (90.3%) of the samples. Temperatures (26.5°C-28.3°C) and relative humidity (61.1%-67.8%) in the rooms were both above WHO guidelines, creating favorable conditions for bacterial growth and multiplication.

CONCLUSION

The majority of the wards at Dilla University Hospital had bacterial loads in the air that exceeded WHO guidelines. Overcrowding, high temperatures, inadequate ventilation, improper waste management, and a lack of traffic flow control mechanisms could all contribute to a high concentration of bacteria in the indoor air. To control the introduction of microorganisms by patients, students, caregivers, and visitors, it is critical to regularly monitor indoor air bacterial load and implement infection prevention and control measures.

Sero-Prevalence of Hepatitis B Virus Infection and Associated Factors Among Pregnant Women Attending Antenatal Care Services in Gedeo Zone, Southern Ethiopia

Background:

Hepatitis B virus infection is a major public health problem worldwide and is a major cause of morbidity and mortality. This study aimed to assess the prevalence of hepatitis B virus infection and associated factors among pregnant mothers in the Gedeo Zone, southern Ethiopia.

Methods:

An institution-based cross-sectional study was conducted among 479 pregnant women visiting governmental and private health facilities in the Gedeo zone from January to April 2019. We selected study participants using systematic random sampling techniques. The Eugene strip test was used to determine hepatitis B virus infection among pregnant mothers. We collected the status of HIV of the pregnant women from the records. Other variables were collected from the mothers using interviewer-administered questionnaires. We used binary and multivariable logistic regression for the analysis. An adjusted odds ratios and their 95% confidence intervals (CIs) were calculated to determine the association between HBsAg sero-positivity and various factors. A P-value of less than .05 was considered significant.

Results:

This study revealed that the prevalence of hepatitis B virus infection among pregnant mothers was 9.2% in Gedeo Zone. A previous history of blood transfusion [AOR = 5.2, 95% CI: 2.1, 12.5], a previous history of hospital admission [AOR = 3, 95% CI: 1.4, 6.6], a history of having an abortion [AOR = 4.1, 95 % CI: 1.5, 11.7], the age of the pregnant women [AOR = 5.1, 95 % CI: 1.5, 18.0], and their HIV status [AOR = 8.1, 95 % CI: 1.9, 36.0] had a statistically significant association with HBsAg sero-positivity.

Conclusion:

Hepatitis B virus infection was found to have higher endemicity (9.2%) in Gedeo Zone which is higher than the national pooled prevalence which was 4.75%. The health facilities must implement early initiation of antenatal care services which incorporate the prevention and control of HBV in the Gedeo Zone.

Estimation of rainwater harvesting potential for emergency water demand in the era of COVID-19. The case of Dilla town, Southern, Ethiopia

Safe and adequate quantity of water is crucial for the implementation of infection prevention and control measures during the prevention of COVID-19. Rainwater harvesting could be an optional water source to fulfill or support the emergency water demand in areas where there is abundant rainfall. The study aimed to assess the rainwater harvesting potential and storage requirements for households and selected institutions and to determine its adequacy to satisfy the emergency water demand for the prevention of COVID-19 in Dilla town, Southern Ethiopia. Rainwater harvesting potential for households and selected institutions were quantified using 17 years' worth of rainfall data from the Ethiopian Meteorology Agency. To address the rainfall variability, we computed the confidence limits of monthly harvest-able rainwater potential using confidence intervals about the mean as well as confidence intervals using Coefficient of Variation (COV) of monthly rainfall. The storage requirements were also estimated by considering the driest and west seasons and months. The average annual rainfall in Dilla town was 1464 mm. Households with a roof area of 40 and 100 m2 have the potential to harvest 7.2-39.66 m3 and 19.11-105.35 m3 of rainwater respectively. Similarly, the rainwater harvesting potential for the selected institutions was in the range of 34524.5-190374.5, 4070.8-14964.8 , 1140.4-6288.6, 4561.7-25154.3, 5605.8-14152.8 , and 402.4-2219.1 m3 of rainwater for colleges, vocational schools, secondary schools, primary schools, Dilla University Referral Hospital and health centers respectively. These institutional rainwater harvesting potentials can address, 24-132.2, 222.4 -817.8, 59.4-327.3, 34.6-190.9, 94.5-238.5, and 28.2-155.7 % of the colleges, vocational schools, secondary schools, primary schools, Dilla University referral hospital, and, health centers emergency water demand respectively. Rainwater can be an alternative water source for the town in the prevention and control of COVID-19. Further applied researches must be conducted that can address the rainwater quality and treatment for ease of use.