Health care providers' preparedness and health care protection against the third wave of COVID-19 pandemics in a resource-limited setting in Southwest Ethiopia: a multi-center cross-sectional study

Introduction

the provision of quality health care during the COVID-19 pandemic depends largely on the health of health care providers. Health care providers as frontline caregivers dealing with infected patients play a significant role in limiting the outbreak of the disease by implementing safety and prevention practices. However, low and middle-income countries experience barriers to preparedness due to limited resources.

Methods

an institutional-based cross-sectional study was conducted among 326 health care providers from August 10-25, 2021 in Gurage zonal public hospitals. A simple random sampling technique was used to select the study participants. A pretested self -administered structured questionnaire was used as a data collection tool. The data were entered into the Epi-data 3.1 and exported to Statistical package for the social sciences (SPSS) version 25.0 for analysis. Both descriptive statistics and inferential statistics were presented.

Results

this study showed that 53.1%, of health care providers, had adequate preparation against COVID-19 pandemics. The finding showed that monthly income, occupation, and working experience were found to be significantly associated with health care providers' preparedness. Nearly one-quarter (24.8%), 28.3%, 34.5%, and 39.8% of health care providers had access to facemasks, alcohol sanitizer, glove, and isolation gowns respectively.

Conclusion

the levels of health care providers' preparedness and health care protection against the third wave COVID-19 pandemic were found to be low. Based on our findings, the government and other stakeholders should design interventions to increase health care providers' preparedness to respond to the ongoing pandemic and purchase an adequate supply of personal protective equipment to protect the health care providers.

Escalating the limit of median survival time and predictors of mortality among preterm neonates in Northwest Ethiopia, 2021: a 1-year prospective follow-up study

OBJECTIVES

To examine the survival rate and predictors of mortality among preterm neonates in the neonatal intensive care unit at South Gondar public hospitals, 2021.

DESIGN

Prospective follow-up study.

SETTING

South Gondar public hospitals, Northwest, Ethiopia.

PARTICIPANTS

We recruited 283 preterm neonates who were admitted at neonatal intensive care unit at selected hospitals from 15 February 2020 to 22 January 2021.

OUTCOME MEASURES

The primary outcome measure of this study was the survival rate of preterm neonates in the neonatal intensive care unit. Moreover, the study assessed the predictors for the occurrence of mortality by the Cox-proportional hazard model. Data were entered into Epi data V.4.2 and exported to Stata V.14 statistical software for analysis. The log-rank test determines the survival difference between predictor variables.

RESULTS

A total of 283 preterm neonates, 61 died during the follow-up. Born from antepartum haemorrhage mother (adjusted HR (AHR)=2.2 (95% CI 1.10 to 4.37)), being small weight for gestational age (AHR=4.6 (95% CI 2.22 to 9.53)), not having kangaroo mother care practice initiated (AHR=2.7 (95% CI 1.39 to 7.74)), hypothermia (AHR=4.0 (95% CI 1.96 to 8.30)) and perinatal asphyxia (AHR=3.9 (95% CI 1.97 to 7.94)) were significant predictors of preterm neonate mortality.

CONCLUSION

In this study, the preterm neonates survival rate (78.4%) and the median survival time (21 days) were found to be low. Preventing and managing the predictors, including an antepartum haemorrhagic mother, small weight for gestational age, hypothermia and prenatal asphyxia, is crucial. In addition, more emphasis should be placed on initiating universal kangaroo mother care practice soon after birth to increase the survival of preterm neonates.

Prevalence, intensity of infection and associated risk factors of soil-transmitted helminth infections among school children at Tachgayint woreda, Northcentral Ethiopia

BACKGROUND

Soil-transmitted helminths (STH) are one of the most common infections affecting underprivileged populations in low- and middle-income countries. Ascaris lumbricoides, Trichuris trichiura, and hookworm are the three main species that infect people. School children are the most vulnerable groups for STH infections due to their practice of walking and playing barefoot, poor personal hygiene, and environmental sanitation. However, evidence is limited in the study area. So, this study aimed to assess the current prevalence, infection intensity, and associated risk factors of STHs among school children in Tachgayint woreda, Northcentral Ethiopia.

METHODS

A cross-sectional study was conducted among school children of Tachgayint woreda from February to May 2021. The study participants were chosen via systematic random sampling. Stool samples were collected from 325 children and examined using the Kato-Katz technique. The data was analyzed using SPSS version 23. Binary and multivariable logistic regression analyses were used to identify the potential associated factors for STHs. An adjusted odds ratio (AOR) with a 95% confidence interval (CI) was used to measure the magnitude of the association. A P-value <0.05 was considered statistically significant.

RESULTS

The overall prevalence of STHs in this study was 36.0% (95% CI: 30.5-41.2%). Ascaris lumbricoides are the most prevalent species 89 (27.4%) followed by hookworm 14 (4.3%) and Trichuris trichiura 10 (3.1%). All of the infected school children had light-intensity of infections with the mean of eggs per gram (EPG) being 464.53. Lack of shoe wearing habit (AOR = 4.08, 95% CI: 1.29-12.88) and having untrimmed fingernail (AOR = 1.85, 95% CI: 1.06-3.22) were identified as risk factors for STH infections.

CONCLUSIONS

More than one-third of the school children were infected with at least one STH species and this indicates that STHs are still a health problem among school children in the study area. Therefore, periodic deworming, implementation of different prevention strategies, and health education programs should be regularly applied in the area.

Practice of people towards COVID-19 infection prevention strategies in Benishangul Gumuz Region, North–West Ethiopia: Multilevel analysis

Introduction

Coronavirus 2019 (COVID– 19) is an acute respiratory viral infectious disease in human being caused by RNA virus that belonged to the family of corona virus. The incidence of this disease was growing exponentially and affects millions of the world population that leads to expose thousands of peoples for death. Thus, this study was targeted to assess the practice of people on COVID-19 infections prevention strategies in the region.

Methods

A community based cross sectional study design was conducted in Benishangul Gumuz Region from May 25 –June 15, 2020. Multistage sampling technique was carried out to select 21 kebeles/ketena and 422 study participants. Data were collected by face to face interview using semi-structured questionnaires. The collected data were entered, cleaned and analyzed using STATA software version 14.0. Descriptive, bi-variable and multivariable multilevel models were applied. Variables with p value < 0.25 in bi-variable analysis were selected as candidates for multivariable analysis. Finally, the variables with p-value < 0.5 were considered as statistically significant, then variables with odds ratio, 95% CI were used to interpret the effect of association.

Results

The magnitude of good practice on prevention strategies of COVID– 19 infections was 62.1%. The most frequently practiced prevention strategies for COVID-19 infections were hand washing with water and soap (80.7%), alcohol-based hand rub (68.8%), maintaining social/physical distance (74.2%) and avoiding touching eyes. Individual and community level factors that affecting practice of COVID– 19 infection prevention strategies were discovered. Hence, community level factor was place of origin (AOR = 0.1; 95%CI: 0.03, 0.35) whereas individual level factors were able to read and write (AOR = 0.18; 95%CI: 0.04, 0.81) and being merchant (AOR = 2.07; 95%CI: 1.01, 4.28).

Conclusion

The level of practice of community towards COVID-19 infections prevention strategies were low as compared with the expected outcome. Individual and community level factors were identified. This implies that social mobilization and community engagement was not effective. Thus, designing appropriate strategies to improve of practice prevention strategies are strongly recommend.

Determinants of birth asphyxia among newborns in Northwest Ethiopia, 2019: Case Control Study

Introduction

Birth asphyxia is a condition of impaired gas exchange in newborns when the Apgar score is < 7 in the first 5 min. It accounts 31.6% of all neonatal deaths, and the leading causes of neonatal mortality in Ethiopia. Identifying its determinant factors is very important to prevent the problem.

Therefore, this study was aimed at identifying the determinant factors of birth asphyxia among newborns at Benishangul Gumuz region hospital.

Methods and materials

The hospital-based unmatched case-control study was done from March 04 to July 16, 2019 in Benishangul Gumuz Region Hospitals. Total sample size is 275 with 69 cases and 206 controls. Newborns with an Apgar score of less than 7 at 5 min were taken as cases, and those with greater or equal to 7 were taken as controls. All asphyxiated newborns were enrolled as cases, where as in every three-step non-asphyxiated newborns were taken as controls. The data was entered into Epi Info 7 and exported to SPSS for analysis. Bivariable logistic regression analysis was used. Those variables with a p-value <0.05 were identified as significant determinants of birth asphyxia.

Results

In the current study, anemia during pregnancy [AOR = 2.95, 95% CI: (1.02, 8.54)], no ANC visit at all [AOR = 4.26, 95% CI: (1.23,14.7)], prolapsed cord [AOR = 4.52, 95% CI: (1.3, 21)], and low birth weight [AOR = 4.1, 95% CI: (1.11, 15.36] were all determinant factors for birth asphyxia.

Conclusion

and Recommendations: The identified determinants of birth asphyxia were anemia during pregnancy, no ANC visit at all, prolapsed cord, cesarean birth, and low birth weight.

Based on our study, most of identified determinant factors of birth asphyxia were preventable so, policy makers, clinicians, and other stakeholders need to invest their maximum effort on prevention of birth asphyxia.

Diabetes mellitus among adults on highly active anti-retroviral therapy and its associated factors in Ethiopia: Systematic review and meta-analysis

BACKGROUND

Diabetes mellitus occurs as a comorbid illness among people living with HIV and, in particular those on Highly Active Anti-retroviral therapies (HAART). Previous studies have documented the prevalence of diabetes mellitus among adults on HAART; however, there is lack of comprehensive estimation. Hence, this study was aimed to estimate the pooled prevalence and associated factors of diabetes mellitus among adults on HAART in Ethiopia.

METHODS

Primary studies were exhaustively searched using Cochrane, PubMed, Google Scholar, Scopus and Web of science databases until February 2021. Eligible studies were selected and critically appraised for quality using the Joanna Briggs Institute (JBI) quality appraisal checklist. The required data were extracted and exported to Stata version 16 for meta-analysis. The overall prevalence of diabetes mellitus among adults on HAART was estimated using a weighted inverse random effect model. Sensitivity and sub-group analysis were conducted for evidence of heterogeneity. Trim and fill analysis was performed after Egger's test and funnel plot were indicating the presence of publication bias.

RESULTS

A total of 17 studies with 6,052 subjects on HAART were included. The pooled prevalence of diabetes mellitus among patients on HAART was 16.04% [95% Confidence Interval (CI); 11.6, 20.92]. Abnormal High Density Lipoprotein Cholesterol (HDL-C) [Adjusted Odd Ratio (AOR) = 4.68, 95% CI; 2.54, 6.82], Body Mass Index (BMI) ≥ 25 kg/m² [AOR = 7.41, 95% CI; 2.75, 12.08], ≥6 years ART [AOR = 8.14, 95% CI; 5.85, 30.43], hypertension [AOR = 3.29, 95% CI; 2.13, 4.45], age 35-44 years [AOR = 6.28; 95% CI; 4.20, 8.37, BMI ≥ 30 kg/m² [AOR = 7.81, 95% CI; 4.97, 10.64], educational status above diploma [AOR = 6.42, 95% CI; 1.28, 11.57] and age 45-55 years [AOR = 4.46, 95% CI; 2.81, 6.10] were positively associated with diabetes mellitus comorbidity among adults on HAART.

CONCLUSION

The higher prevalence of diabetes mellitus was observed for adults on HAART. HDL-C, duration of ART, hypertension, overweight, obesity, age and educational status of participants increases the prevalence of diabetes mellitus. The study highlights the importance of timely screening of HDL-C level, blood pressure and BMI for adults on HAART.

Levels and predictors of anxiety, depression, and stress during COVID-19 pandemic among frontline healthcare providers in Gurage zonal public hospitals, Southwest Ethiopia, 2020: A multicenter cross-sectional study

INTRODUCTION

The provision of quality health care during the COVID-19 pandemic depends largely on the health of health care providers. However, healthcare providers as the frontline caregivers dealing with infected patients, are more vulnerable to mental health problems. Despite this fact, there is scarce information regarding the mental health impact of COVID-19 among frontline health care providers in South-West Ethiopia.

OBJECTIVE

This study aimed to determine the levels and predictors of anxiety, depression, and stress during the COVID-19 pandemic among frontline healthcare providers in Gurage zonal public hospitals, Southwest Ethiopia, 2020.

METHODS

An institutional-based cross-sectional study was conducted among 322 health care providers from November 10-25, 2020 in Gurage zonal health institutions. A simple random sampling technique was used to select the study participants. A pretested self -administered structured questionnaire was used as a data collection technique. The data were entered into the Epi-data version 3.01 and exported to SPSS version 25.0 for analysis. Both descriptive statistics and inferential statistics (chi-square tests) were presented Bivariable and Multivariable logistic regression analyses were made to identify variables having a significant association with the dependent variables.

RESULTS

The results of this study had shown that the overall prevalence of anxiety, depression and stress among health care providers during the COVID-19 pandemic was 36%, [95% CI = (30.7%- 41.3%)], 25.8% [95% CI = (21.1%- 30.4%)] and 31.4% [95% CI = (26.4%- 36.0%)] respectively. Age, Adjusted Odds Ratio [AOR = 7.9], Educational status, [AOR = 3.2], low monthly income [AOR = 1.87], and presence of infected family members [AOR = 3.3] were statistically associated with anxiety. Besides this, gender, [AOR = 1.9], masters [AOR = 10.8], and degree holder [AOR = 2.2], living with spouse [AOR = 5.8], and family [AOR = 3.9], being pharmacists [AOR = 4.5], and physician [AOR = (0.19)], were found to be statistically significant predictors of depression among health care providers. Our study finding also showed that working at general [AOR = 4.8], and referral hospitals [AOR = 3.2], and low monthly income [AOR = 2.3] were found to be statistically significant predictors of stress among health care providers.

CONCLUSION

Based on our finding significant numbers of healthcare providers were suffered from anxiety, depression, and stress during the COVID-19 outbreak. So, the Government and other stakeholders should be involved and closely work and monitor the mental wellbeing of health care providers.

The effect of timely initiation of complementary feeding and vitamin A supplementation on acute malnutrition among children aged 6-59 months attending Hamusit Health Centre, Northwest Ethiopia, 2021: A cross-sectional study

INTRODUCTION

Acute malnutrition is a nutritional deficiency that results either from inadequate energy or protein intake. It is more prevalent in low- and middle-income countries. Even though efforts have been carried out at the global and national level, the burden is still intolerable and it attracts the attention of the government and researchers. Hence, this study aims to assess the magnitude of acute malnutrition and its associated factors among under-five children who attended Hamusit Health Centre from 1st September to 30th January 2021.

MATERIALS AND METHODS

This institution-based cross-sectional study was conducted from 1st September to 30th January on 404 randomly selected under-five children who visited the health centre. Samples were selected using a simple random sampling technique, and the data were obtained using a pre-tested standardized questionnaire. For data entry and analysis, Epi-info 7 and SPSS 21 applications were used, respectively. Bivariable and multivariable binary logistic regression were used to identify associated factors at a 95% confidence interval. Significance was considered at p-value<0.05.

RESULTS

The present research involved a total of 404 children aged 6-59 months. The magnitude of acute malnutrition in this study was 14.4%. Children aged 6-23 months [AOR: 2.92; 95%CI (1.46, 5.85)], vitamin A supplementation [AOR: 0.49; 95%CI (0.25, 0.95)], not timely initiation of complementary feeding [AOR: 2.02; 95%CI (1.06, 3.82)] and children with diarrhea prior to two weeks of the survey [AOR: 2.47; 95% CI (1.28, 4.87)] were significantly associated with acute malnutrition.

CONCLUSION

A significant number of children aged 6-59 months were affected by acute malnutrition. Younger children, vitamin A supplementation, not timely initiation of complementary feeding, and children with diarrhoea were other factors associated with acute malnutrition.

Full Vaccination Coverage and Associated Factors Among 12-to-23-Month Children at Assosa Town, Western Ethiopia, 2020

Introduction

Vaccination means the injection of a killed microbe to stimulate the immune system against the microbe, which prevents communicable diseases. It’s the most important and cost-effective public health intervention to reduce child mortality and morbidity. Ethiopian national full vaccination coverage is 43%. This research aimed to assess full vaccination coverage and associated factors among 12-to-23-month children at Assosa Town.

Methods

A community-based cross-sectional study was conducted among children aged of 12 to 23 months from November to December 2020. Assosa town has two woredas. Each woreda has five kebeles. By using lottery method, five kebeles were selected from two woredas. Systematic sampling technique was used for sampling. The total sample size was 372. It was calculated by the proportionate allocation method. Questioners were used to collect data by the observation of vaccination caring and mother interviewing. Data were entered into SPSS and analyzed. Multivariance analysis was used by considering a 95% confidence interval. Variables whose p-value less than 0.05 were identified as significant.

Results

The respondent rate of this study was 372 (100%). Of the total respondents, 338 (90.8%) were females and 34 (9.1%) of them were males. The coverage of full, partial, and non-vaccination is 71.77%, 16.67%, and 11.56%, respectively. Based on multivariate logistic regression analysis, child age [AOR=2.7, 95% CI: (1.36, 5.4)], no antenatal care visit [AOR=0.41, 95% CI: (0.24, 0.71)] and fear of covid 19 at health institutions [AOR=3.5, 95% CI: (2, 6)] were identified as significant variables. There are major identified factors for partial and non-vaccination.

Conclusion

Coverage of full, partial, and non-vaccination was 71.77%, 16.67%, and 11.56%, respectively. Child age, no antenatal care visit, and fear of covid 19 at health institutions were significant variables. Fear of covid-19 is the commonest factor for partial and non-vaccination.