Level of immediate postpartum family planning utilization and the associated factors among postpartum mothers, Bole Sub-city, Addis Ababa, Ethiopia: institution based cross-sectional study

BACKGROUND

The occurrence of pregnancy in the postpartum period poses a risk to women and their infants, and it also has increased risks of adverse health outcomes if a pregnancy happens less than two years after the preceding birth. Utilization of immediate postpartum family planning is a possible and simple way to reduce these unfavourable outcomes. However, only a small proportion of mothers use the service; but the reasons appear unclear. Thus, this study aimed to determine the level and factors associated with the utilization of immediate postpartum family planning in Bole sub-city, Addis Ababa, Ethiopia.

METHODS

A facility-based cross-sectional study was carried out from August 15 to September 15, 2022, among mothers who gave birth one year before the data collection period. A total of 425 mothers were selected with a systematic random sampling technique. A pretested and structured questionnaire was administered to collect data. Data entry and analysis were done by Statistical Package for Social Sciences 25. Chi-square, multicollinearity and Hosmer-Lemshaw model fitness tests were tested. The level of utilization was determined by descriptive statistics and the associated factors were determined by a binary logistic regression model, and presented with the adjusted odds ratios (AOR) with their respective 95% confidence intervals (95%CI). All statistical tests were conducted at a 5% level of significance.

RESULTS

Utilization of family planning method immediately after birth was 12.9% (95% CI = 11.3-14.5%), and it was statistically significantly associated with ages between 25 and 34 years (AOR = 5; 95% CI [1.38-18.41]) and 35 years and above (AOR = 6[1.47-25.70]), unfavourable attitude (AOR = 0.2[0.11-0.31]) and no counselling about immediate postpartum family planning during antenatal care visit (AOR = 0.43[0.20-0.89]).

CONCLUSION AND RECOMMENDATIONS

The level of utilization of immediate postpartum family planning is low in the study area. To improve it, dealing with younger women, working to achieve a positive attitude amongst women towards immediate postpartum family planning, and incorporating counselling about postpartum family planning methods during antenatal care visits are all recommended.

Grid-based climate variability analysis of Addis Ababa, Ethiopia

Climate change is an intricate global environmental concern. However, its impact is more pervasive in developing nations such as Ethiopia. Hence, this manuscript examines temperature variability and the magnitude of change over 38 years in the specific case of Addis Ababa, Ethiopia. Gridded meteorological data consisting of minimum and maximum temperatures on a monthly time scale ranging from 1981 to 2018 was obtained from the National Meteorological Agency of Ethiopia. The coefficient of variation (CV) and standardized anomaly index (SAI) were used to examine the rate and extent of temperature anomalies. Geostatistical models, particularly ordinary kriging, are presented as a means of spatially interpolating temperature data. Modified Mann-Kendall test (MMK), Sen's Slope (SS) estimator, principal component analysis (PCA), and T-test were employed to determine the monthly, annual, and seasonal trends using Geospatial technologies, "R" programming, and statistical software. The findings revealed substantial spatial and temporal variation in Addis Ababa's annual and seasonal maximum and minimum temperatures. The long-term mean annual maximum and minimum temperatures were 25.8 °C and 12.6 °C, respectively. The monthly, annual, and seasonal temperatures accrued significantly except in the months of January and September. It is noteworthy that the decadal maximum temperature has risen by 2.7 °C, while minimum temperatures have displayed comparatively minor fluctuations. Moreover, the findings also exhibited that the average maximum and minimum temperatures increased by 1.88 °C and 1.72 °C, correspondingly and the highest temperature occurred during the spring (Belg) season. The first two PCAs (Annual and Kiremt Tmax) account for 90% of the temperature variation. In conclusion, the findings underscore the pressing need for the implementation of climate adaptation strategies and policy measures, which can strengthen the city's resilience to imminent climate change-induced hazards. The mounting temperature presents substantial challenges across various sectors within the city, emphasizing the urgency of preemptive actions to mitigate potential repercussions.

Validation study of the Amharic version Safety Attitudes Questionnaire (SAQ) in public hospitals of Addis Ababa, Ethiopia: a cross-sectional study

BACKGROUND

In Ethiopia, there is a growing concern about improving patients' safety in healthcare facilities. However, the lack of a valid and reliable instrument sensitive to the Ethiopian culture for measuring health professional practice environment leads to difficulty in constructing evaluations of safety climate and further linking organizational research to outcomes research. This research study examined the psychometric properties of the Safety Attitude Questionnaire (SAQ) in the Amharic language within an Ethiopian healthcare context.

METHOD

A hospital-based cross-sectional study design was conducted. The SAQ was meticulously translated into Amharic using forward and backward translation methods. Content validity was evaluated with input from seven patient safety and healthcare quality experts. Face validity was established through feedback from healthcare professionals. Then, the Amharic SAQ (SAQ-A) was distributed to 648 participants working in 11 public hospitals, and a total of 611 valid questionnaires were completed and returned (95.2% response rate). Cronbach's alpha, McDonald's omega, composite reliability, correlation analysis, and average variance estimation were calculated, and confirmatory factor analysis was performed. Descriptive analyses were performed to describe socio-demographic characteristics. A P-value of ≤0.05 was considered statistically significant. Tables, figures, charts, and texts are used for data presentation.

RESULT

The overall internal consistency (Cronbach's alpha) for the 31-item SAQ-A was 0.903, indicating excellent reliability. Confirmatory factor analyses demonstrated a good model fit for each dimension and the entire construct (χ2=1086.675, df=412, p<0.001, comparative fit index (CFI)=0.923, Tucker Lewis index (TLI)=0.913, and root mean square error of approximation (RMSEA)=0.052). The positive response rate of healthcare workers in hospitals was 32.1%. The positive response rates of the six dimensions were teamwork climate (59.7%), safety climate (41.9%), job satisfaction (57.1%), working conditions (37.5%), perception of management (37.6%), and stress recognition (46.2%).

CONCLUSION

The Amharic translation of the SAQ showed good psychometric properties, making it a valuable tool for assessing safety attitudes among Amharic-speaking Ethiopian healthcare practitioners.

Prevalence of Hypertension and Its Associated Factors Among Adults Living with HIV on Antiretroviral Treatment in Selected Public Hospitals in Addis Ababa, Ethiopia

Introduction

Hypertension significantly increases the risk of heart, brain, and renal diseases and is one of the leading causes of death and disease worldwide. It is a major comorbidity among HIV-positive people. There have been limited attempts to detect hypertension and its related variables in patients receiving antiretroviral treatment, notably in Addis Ababa, Ethiopia. The current study intended to examine the incidence of hypertension and related variables among adults aged 18 and over living with HIV on ART at selected public referral hospitals in Addis Ababa, Ethiopia.

Methods

A hospital-based cross-sectional study was conducted on 411 HIV-positive individuals aged 18 on ART at Alert and St. Peter's Specialized Hospitals. The research was conducted between December 15, 2021, and January 20, 2022, using an interviewer administered standardized questionnaire. Epi-Info version 7.0 was used to enter and code the collected data, which was subsequently exported to SPSS version 23.0. Bivariate and multivariate logistic regression models were used to identify associated variables.

Results

The prevalence of hypertension among people with HIV on ART was 37.5% (95% CI: 32.8-42.5). Age groups 35-50 years (AOR: 2.18; 95% CI: 1.13-4.21), alcohol consumption (AOR: 5.58; 95% CI: 2.92-10.65), no physical exercise (AOR: 2.35; 95% CI: 1.06-5.21), family history of hypertension (AOR: 4.39, 95% CI: 2.48-7.76), duration of ART (AOR: 3.13; 95% CI: 1.20-8.12), low CD4 count (AOR: 1.87; 95% CI: 1.04-3.37), and body mass index greater than or equal to 25 kg/m2 (AOR: 2.38; 95% CI: 1.33-4.25) were factors associated with hypertension among HIV patients on ART.

Conclusion and Recommendation

According to this study, hypertension is prevalent in HIV-positive people. Factors related with hypertension in PLHIV include alcohol intake, lack of physical activity, age 35-50 years, family history of hypertension, ART duration, low CD4 count, and BMI ≥25kg/m2. As a result, health education on the significance of keeping a healthy lifestyle can be effective in preventing and treating hypertension in HIV patients.

Isolation, and Identification of Escherichia coli O157:H7 Recovered from Chicken Meat at Addis Ababa Slaughterhouses

Introduction

It is a growing concern that pathogenic bacteria can be found in poultry meat, and an additional problem is the ongoing rise in food-derived bacteria's resistance to antibiotics.

Methods

A cross-sectional study was conducted from February 2021 to March 2023. This study aimed to isolate, identify and analyze E. coli in poultry meat collected from slaughterhouses in Addis Ababa. A total of 499 samples were collected from fecal content, carcass, hand and knife swab samples by using purposive and systematic random sampling methods.

Results

An overall 5.2% Escherichia coli (E. coli O157:H7) prevalence was found in this study. On average, antimicrobial susceptibility tests revealed that the sensitivities of (Escherichia coli) E. coli O157:H7 isolates from carcass swabs, fecal content, manuals, knife swabs and water samples were 62.3%, 52.5%, 53%, 60% and 60%, respectively.

Discussion

However, few (Escherichia coli) E. coli O157:H7 isolates have developed multidrug resistance to some antibiotics, for an overall rate of 13.8%. Knowledge and attitude assessment of the slaughterhouse workers showed that 44.2% had no wash their hands at all and that 125.6% had washed their hands before slaughter commencement.

Conclusion

The detection of (Escherichia coli) E. coli O157:H7 isolates from all sample types had a slight prevalence of serious public health concerns. It is important to monitor antibiotic use for both human and animal health in order to make sure that it is safe and effective.

Access to advanced healthcare services and its associated factors among patients with cervical cancer in Addis Ababa, Ethiopia

Objective

This study aimed to assess the extent of access to healthcare services, perception and associated factors among patients with cervical cancer in Addis Ababa, Ethiopia.

Methods

A facility-based cross-sectional study was conducted from 01 July through 30 August 2023 at two tertiary hospitals. Cases with histopathologic and clinical confirmation of cervical cancer were enrolled using a consecutive sampling technique. Data was collected through a validated questionnaire administered by interviewers using the KoboCollect application. Subsequently, the collected data underwent analysis using Statistical Sciences for Social Sciences (SPSS) version 26.0. Bivariable and multivariable regression models were performed at p ≤ 0.2 and p<0.05 statistical significance, respectively.

Results

A total of 391 patients were enrolled in the study. Health facilities were accessible for obtaining general medical services (56.5%), drugs (57.3%), laboratory diagnosis services (57.0%), imaging diagnosis services (56.8%), and radiotherapy services (55.8%) of the patients. Cost of services was affordable only in 11.5% of the cases. Essential anticancer medicines were out of stock for 229 (58.6%) of the patients during the past three months. About two-thirds of the patients have a good perception of access to healthcare services. In multivariable binary logistic regression, admission to the inpatient (AOR: 0.20, 95% CI: 0.06-0.67), joblessness (AOR: 0.19, 95% CI: 0.08-0.46), lower level of income to the extreme poverty line (3567ETB)(64.9 USD) (AOR: 0.19, 95% CI: 0.10-0.35), no CBHI coverage (AOR: 4.16, 95% CI: 1.76-9.85), having social support (AOR: 3.80; 95% CI: 1.96-7.41), and poor dietary practice (AOR: 2.36, 95% CI: 1.28-4.35) were found to have a statistically significant association with perceived good access to healthcare services.

Conclusion

Only close to a half of the patients with cervical cancer, in Addis Ababa, have adequate access to healthcare services. Nearly two-thirds of the patients reported perceived good access to the services. Many factors were found to show a statistically significant association with patients' perceived access to healthcare services.

Retrospective cross sectional study

BACKGROUND

Globally, an estimated 36.9 million (31.1-43.9 million) people were living with HIV in 2017, of whom 17.8 million were women and 1.8 million (1.3-2.4 million) children under 15 years of age. Ethiopia has developed an HIV/AIDS prevention, care, and treatment strategic plan in an investment case approach that has been implemented from 2015 to 2020. The study aim was to assess the outcome and risk factors for HIV-exposed infants receiving Prevention of Mother to Child Transmission (PMTCT) follow-up.

METHOD

A cross-sectional retrospective study was done. All HIV-exposed infants who were on follow-up in the ART and (PMTCT) clinics of St Paul's Hospital Millennium Medical College, Yekatit 12 Hospital Medical College, and Selam Health Center beginning from September 2016 to January 2019 were included. Data collection was done using a well-designed questionnaire and a review of mothers' and infants' medical record charts and HMIS log book. Descriptive and logistic regression analysis was performed to assess the association between dependent and independent variables. Differences are considered statistically significant at p < 0.05, and their strength is presented using an odds ratio and 95% confidence interval.

RESULT

Among the 302 enrolled HIV-exposed infants, 27 (8.9%) were diagnosed as HIV positive. Maternal ART initiation during labor and delivery (AOR = 3.468, 95% CI: 1.22, 13.34, p = 0.04), frequent hospital admission of the infant (AOR = 17.49, 95% CI: 5.41, 56.2, p = 0.001), and mixed feeding option (AOR = 8.25, 95% CI: 2.212, 30.77, p = 0.02) were the major factors associated with positive HIV serostatus among HIV-exposed infants.

CONCLUSION

and Recommendation: The level of HIV infection among infants born to HIV-positive mothers is high as compared to the national and WHO goals. Exclusive breastfeeding should be advocated for all HIV-exposed infants, especially in resource-limited settings like Ethiopia due to the increased prevalence of diarrheal illness.

Venous Thromboembolism and Associated Factors in Hospitalized Patients with COVID-19 at Addis Ababa COVID-19 Field Hospital, Ethiopia

Background

The association of COVID-19 with venous thromboembolism is of particular interest as there are reports that have associated thrombotic events with the pandemic. COVID-19 may predispose to venous thromboembolism. There is initial evidence suggesting that individuals with COVID-19 may be more prone to developing venous thromboembolism (VTE). This study aims to assess venous thromboembolism and associated factors in 19 patients admitted to Addis Ababa's field hospital for COVID-19.

Objective

To identify associated factors that affect the development of thromboembolism in patients admitted with the diagnosis of COVID-19.

Methods

To determine the risks of VTE patients, an institution-based case control research was conducted using SPSS version 26, multivariable binary logistic regression analysis was used.

Results

Significant factors associated with the development of VTE in COVID-19 patients included having a severe case (AOR = 0.38, 95% CI = 0.149-0.961), risk factors for VTE (AOR = 2.57, 95% CI = 1.18-5.33), diabetes (AOR = 3.745, 95% CI = 1.715-8.176), chest pain (AOR = 4.13, 95% CI = 1.89-9), stage 1 hypertension levels (AOR = 3.67, 95% CI = 1.37-9.836), and hospital anticoagulation (AOR = 11.78, 95% CI = 5.25-26.4).

Conclusion

The results of VTE in individuals with COVID-19 imply a direct association between severe COVID-19 and diabetes, having risk factors, hypertension, and hospital anticoagulation.

Incidence and pattern of childhood cancer in Addis Ababa, Ethiopia (2012-2017)

BACKGROUND

Cancer is becoming a major public health problem globally and a leading cause of death in children in developed countries. However, little is known about the epidemiology of childhood cancer in Ethiopia. This study, therefore, assessed childhood cancer incidence patterns in Addis Ababa using the Addis Ababa city population-based cancer registry data from 2012 to 2017.

METHODS

Invasive cancer cases diagnosed in ages 0-14 years from 2012 to 2017 were obtained from the Addis Ababa City population-based Cancer Registry. Cases were grouped according to the International Classification of Childhood Cancer, 3rd edition (ICCC-3) based on morphology and primary anatomic site. Age-standardized incidence rates (ASR) were calculated by the direct method using the world standard population.

RESULTS

The overall average annual incidence rate during 2012-2017 in children was 84.6 cases per million, with rates higher in boys (98.97 per million) than in girls (69.7 per million). By age, incidence rates per million increased from 70.8 cases in ages 0-4 years to 88.4 cases in ages 5-9 years to 110.0 cases 10-14 years. Leukaemia was the most common childhood cancer in both boys (29.1%) and girls (26.8%), followed by lymphoma in boys (24.7%) and renal tumours (13.1%) in girls. The overall cancer incidence rate decreased from 87.02 per million in 2012 to 51.07 per million in 2017.

CONCLUSION

The burden of childhood cancer is considerably high in Addis Ababa. The observed distribution of childhood cancer in Addis Ababa differs from other African countries. This study highlights the need for further research and understanding of the variations in cancer patterns and risk factors across the region.

Adolescent's and youth's adherence to antiretroviral therapy for better treatment outcome and its determinants: multi-center study in public health facilities

BACKGROUND

Low-adherence to Anti-retroviral therapy (ART) negatively affects the clinical, immunological, and virologic outcomes of patients. Adherence is the most important factor in determining Antiretroviral Therapy (ART) treatment success and long-term viral suppression which ultimately reduces morbidity and mortality. Thus, this study aimed to identify factors affecting adherence to antiretroviral therapy among adolescents and youth living with HIV.

METHODS

Facility-based cross-sectional study was conducted from March 21 to April 30, 2020 among 316 respondents in selected five high-loaded hospitals with adolescent and youth clients using systematic random sampling technique. Patients' adherence was assessed when they had reportedly taken 95% or higher of their prescribed antiretroviral drugs in the five days before the interview. Data were collected, entered into EPI Data and exported to SPSS for analysis. Binary logistic regression was used to see the association between dependent and independent variables.

RESULTS

In this study, 316 respondents participated in the study, with a 99.7% response rate. The mean age of respondents were 17.94 years and majority of them (58.5%) were females. The overall ART adherence among adolescents and youths was found to be 70.6%. Being female (AOR = 0.323, 95% CI, 0.164-0.637), presence of opportunistic infection (AOR = 0.483, 95% CI, 0.249-0.936), taking additional medication beside ART (AOR = 0.436, 95% CI, 0.206-0.922) and availability of youth friendly services within the facility (AOR = 2.206, 95% CI, 1.031-4.721) were found to be predictors.

CONCLUSION

The adherence rate in this study was low which is below the recommended adherence level. Being female, taking additional medication beside ART and presence of opportunistic infection were determinants of adherence. As a result, significant work must be done on opportunistic infection prevention through health education and promotion for screening and risk reduction. Similarly, adolescents and youths service integration with the ART Clinic is strongly advised.

Compassionate, respectful care and associated factors among radiology clients at public hospitals in Addis Ababa, Ethiopia

BACKGROUND

Compassionate and Respectful Care (CRC) is the basic radiology professional practice. Even though it is an essential component for all health practitioners, limited evidence was available in the study area, especially focusing on radiology services. Identifying levels of compassionate and respectful care and associated factors help in recommendations for improvement for radiology professionals to deliver service with a good habit of compassion and respect to their clients. Therefore, this study aimed to assess the level of compassionate and respectful care and associated factors among radiology clients.

METHODS

Facility-based cross-sectional study design was conducted from July 6 -27, 2022 in public hospitals in Addis Ababa, Ethiopia. Those hospitals were Tikur Anbessa Specialized Hospital, Armed Force Comprehensive Specialized Hospital, and St. Paulos Hospital. A systematic random sampling technique was used to select patients visited radiology departments and radiographers. Epi-Data version 6 and SPSS version 26 were used for data entry and analysis, respectively. Bi-variable and multivariable logistic regression analysis models are used to identify associated factors. Statistical significance was determined using a P-value of less than 0.05 and an adjusted odds ratio with a 95% confidence level.

RESULTS

A total of 333 respondents were involved in the study with a response rate of 99.1%. Overall, compassionate and respectful care of radiology service providers were 66.7% and 70.9% respectively. Mode of transport (AOR (Adjusted Odd Ratio) =2.2, 95% CI (Confidence Interval): 1.00-4.81), waiting time (AOR= 4.10, 95% CI; 1.92-8.76), CRC training (AOR= 2.35, 95% CI; 1.34-4.12) and workload (AOR= 4.02, 95% CI; 1.9-8.51,) were significantly associated with compassionate care. Distance (AOR=2.98, 95% CI: 1.34-6.61), mode of transport (AOR=4.9, 95% CI; 2.09-11.5), number of service providers (AOR=0.52, 95% CI; 0.27-0.98), CRC training (AOR=2.15, 95% CI; 1.18-3.93) and workload (AOR=7.04, 95% CI; 3.13-15.8) were significantly associated with respectful care provision among radiology clients.

CONCLUSION

Compassionate and respectful care radiology service provision in Addis Ababa public hospitals was similar as compared with other studies. Waiting time, transportation, the number of service providers, Compassionate and respectful care training, and workload were significantly associated with compassionate and respectful care service provision. Providing adequate compassionate and respectful care training for service providers, reducing waiting time, and balancing the service provider-to-client ratio should enhance compassionate and respectful care service provision.

Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia

Background

The COVID-19 epidemic is a rapidly shifting situation that has resulted in significant regulatory reforms and widespread initiatives to deal with the initial crisis and its effects. The COVID-19 pandemic has had a significant impact on transplantation activities. The COVID-19 pandemic has caused various important challenges in the kidney transplant industry.

Objective

To identify the factors influencing COVID-19 severity in kidney transplant and non-kidney transplant patients at St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia.

Methods

A comparative cross-sectional study was conducted. This study included 364 patients (182 kidney transplants and 182 non-kidney transplants). A systematic random sampling was used to select the respondents. Professional nurses collected data for this study using a data extraction tools. Data were analyzed by using SPSS version 25 software. A multivariable logistic regression analysis was performed to identify the association between independent variables and COVID-19 severity with adjusted odds ratio (AOR), and 95% CI for AOR and P-value for testing significance.

Results

This study included 364 patients. Off the total, 34.1% developed severe COVID-19. In Multivariable logistic regression analysis, patients with 60 years and above age groups (AOR = 4.73; 95% CI: 1.86, 12.02), aged 40-59 years (AOR = 2.70; 95% CI: 1.17, 6.22), chest congestion (AOR = 4.49; 95% CI: 2.37, 8.50), history of muscle or body aches (AOR = 0.47; 95% CI: 0.22, 0.99) shortness of breath (AOR = 3.03; 95% CI: 1.36, 6.74), changed or lost sense of taste or smell (AOR = 2.77; 95% CI: 1.34, 5.71), and muscle pain (AOR = 3.05; 95% CI: 1.40, 6.65) were significant variables associated with COVID-19 severity after adjusting for other variables.

Conclusion

The study revealed that 34.1% of patients had severe COVID-19. The majority of these patients underwent non-kidney transplants. Age groups and symptoms, such as chest congestion, shortness of breath, changed or lost sense of taste or smell, and muscle pain, were significant predictors of COVID-19 disease severity.

Bacterial profile and extended spectrum beta lactamase screening of urinary tract infection among asymptomatic and symptomatic pregnant women attending antenatal care in ALERT Hospital, Addis Ababa, Ethiopia

Introduction

The occurrence of extended spectrum beta lactamase-producing uropathogens, especially in pregnant women can result in life-threatening condition and morbidity for both the mother and the newborn due to very limited drug options for treatment of these pathogens. The aim of this study was to determine the bacterial profile, associated factors, and their antimicrobial susceptibility patterns and to identify extended spectrum beta lactamase-producing bacterial uropathogens.

Methods

A hospital-based cross-sectional study was conducted from July to September 2018 on a total of 177 pregnant women with and without symptoms of urinary tract infection at ALERT Hospital, Addis Ababa, Ethiopia. From these study participants, 72 have symptoms, whereas 105 have no symptoms. All urine samples were inoculated onto cysteine lactose electrolyte deficient medium and MacConkey agar. Colonies were counted to check the presence of significant bacteriuria. Pure isolates of bacterial pathogen were characterized and identified at species level by colony morphology, gram stain, and standard biochemical procedures. All Gram-negative isolates were put into Muller-Hinton agar plates for antibiotic susceptibility test by Kirby-Bauer disc diffusion technique. Extended spectrum beta lactamase was detected using double-disk synergy methods on Muller-Hinton agar. The data were double entered into epidemiological Information system and analyzed using Statistical Package for Social Science version 26.

Results

The overall proportion of urinary tract infection among pregnant women was 14.7% (n = 26/177). Klebsiella pneumoniae was the predominant bacterial etiologic agent of urinary tract infection 26.9% (n = 7/26). The proportion of extended spectrum beta lactamase among Gram-negative isolates was 50% (n = 6/12). Among extended spectrum beta lactamase-producing isolates (100%), all are resistance to amikacin and gentamicin while intermediate level resistance rate of 66.7% was observed among trimethoprim-sulphamethoxazole. They were susceptible for some limited drugs, and these were Nitrofurantoin (83.3%) and Chloramphenicol (83.3%).

Conclusions

Majority of extended spectrum beta lactamase-producing isolates exhibited co-resistance to other commonly prescribed antibiotics. This indicates that the option of treatment for these pathogens rapidly decreased from time to time which results serious life-threatening conditions, especially in mother and newborn unless the appropriate measure is taken.

Customers' satisfaction towards Addis Ababa City's minibus taxi service

In Addis Ababa, Shared minibus taxis are contributing significantly more than any other form of public transit to meeting the city's transportation needs. But there were limited research done on taxis in general and customer satisfaction with minibus taxis in particular. Therefore, this study aims to assess the satisfaction of minibus taxi customers through a survey questionnaire distributed and collected at taxi stations. Descriptive analysis was used to measure the satisfaction levels/rates of respondents towards each service quality attribute of the minibus taxis. Then, we compared the means value of satisfaction responses followed by factor/principal component analysis. Once the most important satisfaction variables are identified through the factor analysis, an ordered logit model was used to create a relationship between the selected satisfaction variables and the socio-demographic characteristics of taxi riders. The results of the study showed that minibus taxi overload, safety, and security at stations are attributes in which the respondents show greater dissatisfaction. The result of the ordered logit model revealed that the respondents who showed greater dissatisfaction with the taxi drivers and their assistants' behavior are those who had been stolen at least once on a minibus taxi. Also, riders weigh more on the functionality of the service than their comfort and security. Thus, the service providers, Addis Ababa Road Authority, security personnel, and any relevant body should work together on maximizing the customers' satisfaction in minibus taxis.

Post-COVID-19 pulmonary complications among recovered COVID-19 patients: a cross-sectional study from Addis Ababa, Ethiopia

BACKGROUND

The COVID-19 pandemic has been linked to chronic pulmonary complications all over the world. Respiratory complications such as chronic cough, dyspnea, increased respiratory rate, and oxygen support demand are prevalent in recovered COVID-19 patients. These problems are long-term and have a negative impact on one's quality of life. Patients must be evaluated for potential complications, and risk factors must be found. Some reports around the world explain the factors that contribute to the development of these complications. However, to the best of our understanding, no reports of post-COVID-19 complications have been reported from Ethiopia.

METHODS

Facility based cross-sectional study was done among 405 participants selected by simple random sampling technique. Structured questionnaire which includes participants' demographic, clinical and 3rd month visit characteristics was collected by Open Data Kit and exported to SPSS version 25.0 for analysis. Percentage with frequency and median with Interquartile range was used in descriptive statistics. The association between variables was analyzed with bivariate and multi variable logistic regression. A statistical significance was declared at p-value < 0.05, with 95% confidence interval.

RESULTS

The median (Interquartile range) age of participants was 57.0 (43.0, 65.0) years, 63.2% were males. The prevalence of post-COVID-19 pulmonary complication in recovered COVID-19 patients was 14.1% (95% CI: 10.8%, 17.8%). After adjusting for possible confounders on multivariate analysis, older age [AOR = 0.227, 95% CI (0.08-0.66)] and consolidation [AOR = 0.497, 95% CI (0.258-0.957)] were shown to have significant association with post COVID-19 pulmonary complications.

CONCLUSION

The prevalence of post COVID-19 pulmonary complication was observed to be lower than other reports globally. Older age and the presence of consolidation on lung imaging were associated with those complications. Clinicians are recommended to consider assessing the lasting effects of the pandemic, beyond immediate care, and should also investigate the COVID-19 history in patients presenting with respiratory issues.

Incidence, Bacterial Profile and Predictors of Surgical Site Infection After Cesarean Section in Ethiopia, A Prospective Cohort Study

Background

Surgical site infections (SSI) after cesarean section are common in Ethiopia and result in maternal morbidity, mortality, hospitalization, and medical costs. This study aimed to determine the incidence, bacterial profile, and associated factors of surgical site infection after cesarean section (CS) in public and private referral hospitals.

Methods

A prospective observational cohort study was conducted on 741 pregnant women who underwent CS from July to September 2022. Women who had CS were followed up for at least 30 days. Infected wound specimens from those who had SSIs were collected and bacteriologically analyzed. The data were analyzed with SPSS version 25. The logistic regression model assessed the relationship between the independent variable and the outcome with 95% confidence interval.

Results

The incidence of post-cesarean surgical site infection was 11.6% (95% Cl: 9.4, 13.6). Staphylococcus aureus was the most common bacteria in CS wounds 10 (21.2%). Two to three antenatal care visits (ANC) (AOR: 3.11, 95% CI: 1.69, 5.75), delayed antenatal booking (AOR: 6.99, 95% CI: 2.09, 23.32), membrane rupture (AOR: 2.10, 95% CI: 1.04, 4.24), multiple vaginal examinations (AOR = 4.21, 95% CI: 1.35, 6.92) and public hospitals (AOR: 11.1, 95% CI: 1.48, 45, 14) were associated with increased risk of SSI after CS, in contrary shorter hospital stays (AOR = 0.37, 95% CI: 0.15, 0.91) and transversal incisions (AOR = 0.38, 95% CI: 0.15, 0.91) were associated with lower risk SSI after CS.

Conclusion

The incidence of SSI after CS was high. Delayed antenatal booking, two to three antenatal visits, multiple vaginal exams, membrane rupture, vertical incision, longer postoperative hospital stays, and procedures in public hospitals were associated with increased risk of SSI after CS. Therefore, intervention programs should focus on post-discharge surveillance and identification of risk to reduce and prevent SSI after CS rate.

Adherence to Antiretroviral Medications Among People Living With HIV in the Era of COVID-19 in Central Ethiopia and Perceived Impact of the Pandemic

AIM

This study assessed the level of adherence to antiretroviral drugs and the associated factors among clients who have a follow-up at public health facilities in central Ethiopia.

METHOD

A multi-site cross-sectional study was conducted from August 1-30, 2020 at seven public health institutions. A systematic random sampling method was used to recruit 385 participants. Data was collected using a structured interviewer-administered questionnaire. Analysis was done using descriptive statistics, and binary logistic regression model. The OR with its 95% C.I was employed to present analytic outputs. Statistical significance for the multivariable model was considered at p ≤ 0.05.

RESULTS

Of the 371 participants, the majority were females (233, 62.8%), attended health centers (215, 58.0%), and were married (173, 46.6%). Eighty-nine (89, 24.0%) of the participants have at least one comorbidity. About 72 (19.0%) and 50 (13.5%) of the respondents stated that the COVID-19 has posed challenges on their follow-ups and availability of medications respectively. Nearly a half of the people living with HIV and comorbid T2DM or hypertension (29, 48.0%) reported that they had encountered an increase in the price of medications compared to the pre-COVID-19 times. About half of the respondents in the study setting have perfect adherence to antiretroviral therapy (ART) (200, 54.0%). Basic education (aOR = 3.02: 95% CI: 1.57-5.80), marriage (aOR = 2.27: 95% CI: 1.24-4.15), attendance to a health center (aOR = 0.59: 95% CI: 0.36-0.98) and sleep disturbance (aOR = 0.47: 95% CI: 0.26-0.84) showed a statistically significant association with adherence to ART.

CONCLUSION

About half of the respondents in the study settings have perfect adherence to their ART medications. As multiple factors interplay in the success rate of adherence to ART, stakeholders should place and strengthen practices, such as active follow-up and tracing of cases, ensuring medication affordability (access and low pricing), and psycho-social support to patients.

Identification of determinant factors for crash severity levels occurred in Addis Ababa City, Ethiopia, from 2017 to 2020: using ordinal logistic regression model approach

BACKGROUND

Road traffic Injuries (RTI) are multifaceted occurrences determined by the combination of multiple factors. Also, severity levels of injuries from road traffic accidents are determined by the interaction of the composite factors. Even though most accidents are severe to fatal in developing countries, there is still a lack of extensive researches on crash severity levels and factors associated with these accidents. Hence, this study was intended to identify severity levels of road traffic injuries and determinant factors in Addis Ababa City, Ethiopia.

METHODS

The study was conducted in Addis Ababa, the capital city of Ethiopia, using secondary data obtained from the Addis Ababa Police Commission office. The ordinal logistic regression model was used to investigate road traffic injury severity levels and factors worsening injury severity levels using the recorded dataset from October 2017 to July 2020.

RESULTS

A total of 8458 car accidents were considered in the study, of which 15.1% were fatal, 46.7% severe, and 38.3% were slight injuries. The results of the ordinal logistic regression analysis estimation showed that being a commercial truck, college and above level educated driver, rollover crash, motorbike passengers, the crash day on Friday, and darkness were significantly associated factors with crash injury severity levels in the study area. On the contrary, driving experience (> 10 years), passenger of the vehicle, two-lane roads, and afternoon crashes were found to decrease the severity of road traffic injuries.

CONCLUSIONS

Road traffic injury reduction measures should include strict law enforcement in order to maintain road traffic rules especially among commercial truckers, motorcyclists, and government vehicle drivers. Also, it is better to train drivers to be more alert and conscious in their travels, especially on turning and handling their vehicles while driving.

Utilization of preconception care and associated factors among pregnant women attending ANC in private MCH Hospitals in Addis Ababa, Ethiopia

BACKGROUND

Despite its benefit in promoting maternal health and the health of her developing fetus, little is known about preconception care practice and its associated factors in Ethiopia. Moreover, preconception care utilization in private hospitals is not known. The purpose of this study, therefore, is to determine the utilization of preconception health care services and its associated factors among pregnant women following antenatal care in the private Maternal and Child Health hospitals in Addis Ababa.

METHODS

A Hospital based cross-sectional study was conducted from April 1 to April 30,2022 among 385 women attending ANC in private MCH hospitals. Bestegah and Hemen MCH hospitals were selected by convenience method. Data were collected by a pretested self-administered semi-structured questionnaire. To identify the factors associated with the utilization of preconception care, bivariable and multivariable logistic regression analysis were performed. Adjusted odds ratios with 95% confidence interval were estimated to assess the strength of associations, and statistical significance was declared at a p-value < 0.05.

RESULTS

The utilization of preconception care among the pregnant mothers according to our study was 40%. Professional/technical/managerial occupation (AOR = 4.3, 95%CI = 1.13, 16.33, P < 0.032), having good knowledge on preconception care (AOR = 3.5, 95%CI = 1.92, 6.53, P < 0.000), having unintended pregnancy (AOR = 0.1, 95%CI = 0.03, 0.42, P < 0.001), history of family planning use before conception (AOR = 3.9, 95%CI = 1.20, 12.60, P < 0.023), having pre-existing medical disease(s) (AOR = 8.4, 95%CI = 2.83, 24.74, P < 0.002), and having adverse pregnancy outcome(s) in previous pregnancies (AOR = 3.2, 95%CI = 1.55, 6.50, P < 0.000) were significantly associated with preconception care utilization.

CONCLUSIONS

This study found out that the utilization of preconception care in the private MCH hospitals is still low i.e., only 40%. Occupation, level of knowledge, having unintended pregnancy, history of family planning use before conception, having adverse pregnancy outcome(s) in previous pregnancy and having pre-existing medical disease(s) were independently associated with preconception care utilization. Lack of awareness about the availability of the services and having an unintended pregnancy were the main reasons for not utilizing preconception care.

Planning for ecosystem services compensation in the central highlands of Ethiopia

The rapid deterioration of the upper Akaki catchment natural environment has led to an increasing impact not only on the watershed ecosystem but also the livelihood and the general well-being of the local community. As a result, the water supply is becoming a problem for Addis Ababa and its surrounding residents. This may lead to a greater willingness to pay and cooperate in initiatives to protect the watersheds. Therefore, a market-based instrument and participatory arrangements are critical for resolving socioecological problems. This research aimed to demonstrate a need for an incentive-based watershed conservation approach that can be used to support nature conservation through long-term financial investments in the central watersheds and elsewhere. To support the market-based intervention, sealable ecosystem services and cost-benefit analysis, as well as relevant stakeholders, institutions, and legal frameworks, were assessed. The prime factors for designing market-based approaches to halt biodiversity loss and reversing ecological processes are discussed. A domestic water tariff increase of ETB 1 per m3 (US$ 0.08) could raise approximately US$ 3.24 million annually for watershed management, which could compensate smallholder farmers' annual opportunity costs for crop and livestock forage loss. Furthermore, the practice could help to abate biodiversity loss, improve the local economy, and accelerate the implementation of global biodiversity targets. Integr Environ Assess Manag 2023;00:1-10. © 2023 SETAC.

Prevalence and determinants of RH alloimmunization in Rh-negative women in teaching hospitals of Addis Ababa, Ethiopia: a hospital-based cross-sectional study

Background

Despite the implementation of immunization with an anti-D antigen for pregnant women, adverse pregnancy outcomes continue to occur in Ethiopia and most Sub-Saharan African countries. Consequently, the woman's obstetric care is compromised, and there is an increase in perinatal morbidity and mortality. In Ethiopia, the burden of the disease is not well understood, and no research has been conducted in the study area. Therefore, this study aims to determine the prevalence and determinants of Rh alloimmunization in Rh-negative women receiving care at Addis Ababa teaching hospitals.

Methods

An institutional-based cross-sectional study was conducted from 5 October 2020 to 5 May 2021, among 328 Rh-negative pregnant women who received antenatal care and delivery services at Teaching Hospitals under Addis Ababa University. Face-to-face interviews were used to gather data using a pre-tested structured questionnaire, and a chart review was performed using a checklist. The data were entered into Epidata version 3.1 and analyzed using SPSS version 22. Multivariable analysis and logistic regression were used to evaluate the predictors, and the results were presented as an adjusted odds ratio (AOR) with a 95% confidence interval. Statistical significance was declared at a p-value < 0.05.

Results

Among Rh-D negative individuals, 56(17.1%) were alloimunized with 95% CI (15.1%, 19.23%). The prevalence of Rh-D negative was 2.1% with 95% CI (1.56%, 2.76%). Factors such as unemployment [AOR = 2.28, 95% CI: 1.21, 4.28], failure to use anti-D prophylaxis in previous pregnancy [AOR = 2.08, 95% CI: 1.10, 3.92), and the presence of sensitizing events [AOR = 0.52, 95% CI: 0.27, 0.84] were statistically significant with the outcome variables.

Conclusions

This study pointed out that the prevalence of Rh was relatively large and that almost one in every five pregnant women was alloimunized. Factors such as unemployment and failure to use anti-D prophylaxis in a previous pregnancy were found to be associated with outcome variables. Therefore, all stakeholders and concerned entities should prioritize enhancing access and affordability to anti-D prophylaxis to prevent the occurrence of Rh alloimmunization and its associated adverse outcomes.

Nearly one-in-five households utilized inadequate iodized salt in Nifas Silk Sub-City, Addis Ababa, Ethiopia

BACKGROUND

There is no country in the developing world where iodine deficiency is not a public health problem including Ethiopia. Therefore, this study aimed to assess inadequate utilization of iodized salt and associated factors at household level in woreda 11 Nifas Silk Sub-city, Addis Ababa, Ethiopia.

METHODS

A community-based cross-sectional study was conducted with multistage sampling technique on 348 household respondents. The data were collected using interviewer-administered structured questionnaires and an iodine rapid test kit. The data were edited, cleaned, and entered using Epi-data version 4.6.2 and exported to SPSS version 25 for analysis. A multivariable logistic regression model was fitted to identify associated factors for inadequate utilization of iodized salt. The statistical significance was declared at a p-value of less than 0.05 with 95% confidence interval.

RESULTS

A total of 348 household respondents were participated. The amount of iodine content in salt 0 ppm, < 15ppm and > 15ppm were 11.8%, 7.2% and 81.0% respectively. Total inadequate utilization of iodized salt was 19%. Using unpacked salt [AOR; 0.50 (95%CI: 0.27, 0.93)], using a container without a lid [AOR; 0.29 (95%CI: 013, 0.63)], and having insufficient knowledge [AOR; 2.10 (95%CI: 1.14, 3.86)] were all significantly connected with using inadequate iodized salt.

CONCLUSIONS

Iodized salt utilization was inadequate. Using containers without a lid, unpacked salt, and poor knowledge were associated factors. There should be a provision of adequate knowledge about iodized salt, a proper storage and handling.

The role of community-based health insurance on healthcare seeking behavior of households in Addis Ababa, Ethiopia

Community-based health insurance is a new and promising concept for delivering easily accessible, affordable, and efficient healthcare services. More importantly, a significant risk pooling arrangement between the wealthy and poor. So far, little has been done regarding community-based health insurance and healthcare seeking behavior in developing countries. Therefore, the aim of this study was to assess healthcare seeking behavior of households due to the introduction of the scheme and associated factors in Addis Ababa. Community-based cross-sectional study was conducted among 270 male and 207 female respondents. The data was collected using standardized and pretested questionnaire and it was analyzed using SPSS software. A bivariate and multivariable logistic regression analysis was applied to determine the relationship between healthcare seeking behavior and determinant variables. Finally, statistical association was declared with a p-value of less than 0.05 in the multivariable logistic regression analysis. The proportion of people who had appropriate healthcare-seeking behavior was 47.31% (95 %CI: 43.27-51.39%). Furthermore, having more than four children [AOR: 0.171, 95%, CI:(0.403-0.99)], being Muslim [AOR: 1.712, 95 %CI: (1.117 2.625)], owning a government house [AOR: 4.472, 95%, CI: (2.037-9.819)], and having under-five children [AOR: 0.548, 95%, CI: (0.375-0.801)] were factors significantly associated with healthcare-seeking behavior. Even though this study was conducted in an urban area, it showed that the magnitude of appropriate healthcare-seeking behavior was low. Therefore, the government of Ethiopia should work to improve housing conditions and family planning provision for the residents to improve the healthcare seeking behavior of community-based health insurance users.

Socio-cultural factors perceived to influence sexual behaviours of adolescents in Ethiopia

BACKGROUND

Adolescence is a period of transition from childhood to adulthood. It is the age of experimentation. They are vulnerable to the undesirable effect of sexual and reproductive health (SRH) problems such as human immunodeficiency virus, sexually transmitted infections and unsafe abortion and childbirth-related risks.

AIM

To explore and describe perceived organisational, community and societal level factors that influence sexual behaviours among adolescents in Ethiopia.

SETTING

The study was conducted by public health care organisations, youth centres and non-governmental organisations in Addis Ababa, Ethiopia.

METHODS

A qualitative descriptive study design was conducted with purposively selected health professionals and adolescents in Addis Ababa from June 2019 to February 2020. The data were collected using in-depth interviews, key informant interviews and focus group discussions. Transcribed interviews were imported to ATLAS. ti 7 for coding, categorising and creating themes using thematic analysis. Lincoln and Guba's model was used to ensure trustworthiness and ethical standards were applied.

RESULTS

Poor school involvement, social norms on sexual behaviour and lack of condom acceptability by the general population, financial problems and the gap in law enforcement were found perceived factors influencing sexual behaviour of adolescents.

CONCLUSION

Adolescents are engaging in various risky sexual behaviours because of various organisational, community level and societal level factors, which emphasises the need to introduce social and culturally acceptable age-appropriate comprehensive sexuality education for adolescents and other multilevel interventions.Contribution: Provide an in-depth understanding of the influence of sociocultural issues related to adolescent sexual behaviour for health system stakeholders.

Violence against women and associated factors among female construction workers in Addis Ababa, Ethiopia

BACKGROUND

Violence against Women (VAW) is a global public health problem; almost one in three global women experienced one form of violence. Violence free environment is the one that everyone cherishes. However, millions of women worldwide suffer from violence. In Ethiopia, VAW is very common and considered a private matter though it has serious consequences for girls and women. Studies pointed out that it varies by workplace, and hence important to assess it among female construction workers in Addis Ababa.

OBJECTIVE

To assess the prevalence and factors contributing to gender-based violence on female construction workers in Addis Ababa, Ethiopia, 2021.

METHODS

A cross-sectional study design with a multistage cluster sampling technique was used to select 827 study participants and a face-to-face interview was held from February 24 to April 24, 2021. Data entry was done using Epi info-7 and exported to SPSS version 26 for analysis. Both bivariable and multivariable binary logistics regression analysis were employed.

RESULTS

A total of 827 female workers were interviewed in this study. The mean age of the respondents was 24.97 years with SD of ± 5.6. The magnitude of violence against female in the workplace was 70.9% (95% CI: 67.7, 73.9). This study found that females in the age group 15-19 years (AOR = 2.37, 95%CI: 1.26, 4.45), females who live in Addis Ababa for less than 3 years (AOR = 3.02, 95%CI: 1.59, 5.73) and for 3-7 years (AOR = 2.14, 95% CI: 1.14, 4.00) and females who have no formal education (AOR = 3.16, 95%CI: 1.80, 5.54) had higher odds of violence at their workplace.

CONCLUSION

The magnitude of overall VAW among female construction workers in Addis Ababa was high compared to other workplaces. Age and the number of years lived in Addis Ababa were found to be significant factors of violence among female construction workers. Hence, emphasis shall be given for female construction workers in Addis Ababa.

Fate of antimicrobial resistance genes (ARG) and ARG carriers in struvite production process from human urine

Struvite, a human urine-derived fertilizer types, is characterized by its low water solubility that renders it a slow-releasing eco-friendly fertilizer. Knowing the fate of antibiotic resistance genes in struvite is important since human urine carries microorganisms, viruses and mobilomes. In this study, urine samples were collected and struvite production was done using MgCl2. From the fresh, stored urine and struvite, DNA was extracted and metagenomic sequencing was done using Illumina HiSeqX. Metagenome-derived genome sequence analysis revealed the dominance of phages of Streptococcus, Bacillus and Escherichia, with nearly 50% abundance of streptococcus phage in fresh urine. Increased antibiotic resistance genes were found in the stored urine than in fresh and struvite samples. The top five resistance genes in all the three samples were to aminoglycosides, carbapenem, chloramphenicol, erythromycin and efflux pump, with key carrying pathogens including Acinetobacter, Aeromonas and Enterococcus. The identified families for carbapenem, aminoglycoside resistance and efflux pump were shown persistent in struvite with a shift in gene families. The detection of resistance-gene-laden mobilomes, including the last-resort antibiotics in the struvite sample, requires due attention before the implementation of struvite as fertilizer. Further optimization of the struvite production process with regard to the minimization of mobilomes is recommended.

Medical laboratory accreditation status and associated factors in selected private and government health facilities of Addis Ababa, Ethiopia

Introduction

quality medical laboratory service(s) is a key to patient safety with a great emphasis on medical diagnoses and treatment. ISO 15189 laboratory accreditation is an effective way to demonstrate competency. Despite the benefits, there are considerable exigent efforts towards achieving its target, mainly in sub-Saharan Africa. Hence, determining those factors that hinder laboratory quality services and the process of accreditation is important to address and resolve. Thus, this study aimed to assess medical laboratory accreditation process and in selected private and government health facility laboratories in Addis Ababa, Ethiopia.

Methods

institutional-based cross-sectional study design was conducted in Addis Ababa from July 1 to August 30, 2018. Data was entered into EPI-data version 3.1 and analyzed by SPSS version 23. Data from focus group discussions were categorized and discussed thematically. Additionally, logistic regression analyses were computed to examine the relationship between the explanatory and response variable.

Results

a total of 411 professionals participated in this study, of which 117(28.8%) participants were female, 280 (68.2%) participants with a bachelor´s degree, and 352 (85.6%) participants had information about accreditation. The current laboratory accreditation status in Addis Ababa is 3.6%. The primary identified factors were gaps related to method verification/validation, equipment calibration, and continual program quality improvement.

Conclusion

strengthening laboratory management standards towards accreditation (SLMTA) will significantly improve the accreditation process. However, there are internal and external factors may hinder the current accreditation process. Therefore, all responsible agencies/services should give more attention to solving those identified major barriers to achieving accreditation.

Seroepidemiological study of bovine alphaherpesvirus 1 in the dairy cattle herds of Addis Ababa, Ethiopia

Bovine alphaherpesvirus 1(BoHV-1) causes respiratory disease, abortions, and genital disorders in cattle. Although BoHV-1 has been known to cause severe economic damage to the dairy industries, little is known about its epidemiology in dairy cattle of Addis Ababa, Ethiopia. The present study aimed to determine the seroprevalence and the risk factors associated with the occurrence of BoHV-1. A total of 369 blood samples from 115 dairy herds were collected using a proportional stratified random sampling method and examined antibodies against BoHV-1 using ELISA test. A questionnaire survey was done to gather information related to farm demographics and reproductive disorders. Univariate and multivariate mixed-effect logistic regression analyses were used. The overall seroprevalence of BoHV-1 was detected in 21 % (95%CI: 17-25%) and 32 % (95%CI: 24-42 %) at animal and herd levels, respectively. A multivariable mixed effect logistic regression model revealed that adult cattle had 14 times (OR = 14.32; 95 % CI: 2.53-81.5; P = 0.003) more likely to increase the risk of being BoHV-1 seropositive than young cattle. Purchased cattle had 4 times (OR = 4.15; 95 % CI: 1.36-12.66, P = 0.012) more likely to increase the risk of being BoHV-1 seropositive than homebred cattle. The risk of being BoHV-1 seropositive was 195 times higher in herds using bulls (OR = 195.51; 95 % CI: 3.62-1056.51; P = 0.010) than in herds using artificial insemination only for breeding. BoHV-1 seropositivity was significantly associated with cows that had a history of abortion (OR = 6.89; 95 % CI: 1.97-22.76; P = 0.002), retained placenta (OR = 3.26; 95 % CI: 1.32-8.07; P = 0.010), and repeat breeding (OR = 3.64; 95 % CI: 1.08-12.18; P = 0.036). This study demonstrated the gaps in the selection of BoHV-1 free bulls for breeding as well as limited farm biosecurity practices. Thus, awareness creation for dairy farmers on good farm biosecurity practices including vaccination should be initiated.

Quantifying and analyzing the impact assessment on land use change of urban growth using a timeline

Land use change occurs by altering natural landscape to manmade built environment. Rapid urban growth is the main factor for land use change at global level. Addis Ababa is one of the recent rapidly growing urban areas in Africa. Since 1983, the population has increased by nearly three times. However, the spatial expansion of the urban area has been much greater with urban sprawl, informal settlement, industry, condominium housing, and real estate development. The demand for urban land has been increasing at alarming rate both by city government, investors, and its residents. The city is primate and the population nine times the second largest city in the country. This study focused on quantifying and analyzing impact assessment of urban growth on land use change from 1986 to 2019. The study assessed the major change in extent and determinants of land use change through 33 years (1986-2019) and future growth scenario the next 30 years from 2019 to 2049. This study used Landsat image, base map of 1986, 1998, 2008, and 2019, to analyze built-up growth and land use change. Observation and interview have also taken to explore more on major urban growth and land use change driving factor from concerned bodies. The last, land use efficiency method was applied to measure land consumption rate and population growth rate. The result showed that in 1986, 1998, 2008, and 2019, built-up covered 21.83%, 42.31%, 59.42%, and 81.20% respectively. This shows that the agriculture and open space were rapidly changed to built-up by 32,486.67 hectares for housing, manufacturing, and infrastructure development. The result from concerned bodies has portrayed that the key determinants for urban land use change in the city were population growth at 4.2% per annum. Government led condominium housing, real estate development, and industrial development expansion including informal settlement has been rapidly reducing agriculture and open space through time. Therefore, unconventional planning approach could be exercised based on community interest for affordable high-rise building. Moreover, disseminate or decentralize industries beyond capital city in regional capital to reduce migration rate and rapid change of urban land use by creating employment opportunity and urban-urban linkage in the reginal capital rather than the capital city.

Implications of land use/land cover dynamics on urban water quality: Case of Addis Ababa city, Ethiopia

Water resources are often at the center of urban development but, as the city expands, the environmental pressure on its water resources increases. Therefore, in this study, we looked into how various land uses and changes in land cover affect the water quality in Addis Ababa, Ethiopia. Land use and land cover change maps were generated from 1991 to 2021 at intervals of five years. On the basis of the weighted arithmetic water quality index approach, the water quality for the same years was likewise divided into five classes. The relationship between land use/land cover dynamics and water quality was then evaluated using correlations, multiple linear regressions, and principal component analysis. According to the computed water quality index, the water quality decreased from 65.34 in 1991 to 246.76 in 2021. The built-up area showed an increase of over 338%, whereas the amount of water decreased by over 61%. While barren land exhibited a negative correlation with nitrates, ammonia loadings, total alkalinity, and total hardness of the water, agriculture and built-up areas positively correlated with water quality parameters such as nutrient loading, turbidity, total alkalinity, and total hardness. A principal component analysis revealed that built up areas and changes in vegetated areas have the biggest impact on water quality. These findings suggest that land use and land cover modifications are involved in the deterioration of water quality around the city. This study will offer information that might help reduce the dangers to aquatic life in urbanized environments.

Perceived quality of care for severe acute malnutrition management among caregivers of under-five children with severe acute malnutrition in Addis Ababa, Ethiopia, 2022: a mixed-method study

Introduction

All the factors at the institutional, provider, and client levels have an impact on the quality of care. In low- and middle-income countries, poor quality of severe acute malnutrition (SAM) management at health institutions is a major contributor to child morbidity and mortality. This study aimed to determine the perceived quality of care for SAM management among caregivers of under-five children.

Methods

This study was conducted in public health facilities that provide inpatient SAM management in Addis Ababa, Ethiopia. An institution-based convergent mixed-method study design was implemented. Quantitative data were analyzed by using a logistic regression model, while thematic analysis was used to analyze the qualitative data.

Results

A total of 181 caregivers and 15 healthcare providers were recruited. The overall perceived quality of care for SAM management was 55.80% (CI: 48.5-63.10). Urban residence (AOR = 0.32, 95% CI: 0.16-0.66), college and above level education (AOR = 4.42, 95% CI: 1.41-13.86), working as a government employee (AOR = 2.72, 95% CI: 1.05-7.05), readmitted to the hospital (AOR = 0.47, 95% CI: 0.23-0.94), and length of hospital stays >7 days (AOR = 2.1, 95% CI: 1.01-4.27) were found to be significantly associated factors with perceived low-quality care for SAM management. Additionally, lack of support and attention from higher levels of management, and lack of supplements, separate units, and laboratory facilities were among the factors that impede the provision of quality care.

Discussion

Perceived quality of SAM management services was low against the national goal of quality improvement to meet the expectations of both internal and external clients. Rural residents, those with more educational qualifications, government employees, newly admitted patients, and patients who stayed longer in hospitals were the most unsatisfied groups. Improving support and logistic supply to health facilities, providing client-centered care, and responding to caregivers' demands may help to improve quality and satisfaction.

Occupational stress and associated factors among nurses working at public hospitals of Addis Ababa, Ethiopia, 2022; A hospital based cross-sectional study

Background

By its very nature, the nursing profession involves a lot of stress. Working in this field includes interacting with individuals who are already under a great deal of stress. Workplace stress affects the quality of services provided and also causes staff burnout, departure, and absenteeism.

Objective

This study is to determine occupational stress and associated factors among nurses working at public hospitals, Addis Ababa, Ethiopia, 2022.

Materials and methods

An institutional based cross sectional study was conducted among 422 nurses working at public hospitals from March 1 to April 1/2022. Simple random sampling technique was used to select public hospitals. The calculated sample size was allocated proportionally to each hospital based on the number of nurses. Finally, systematic sampling method was used to approach the study participants. The data was collected by using a self-administered structured questionnaire (Expanded Nursing Stress Scale). The collected data was entered by Epi-data version 3.1 and analyzed by SPSS version 23. Descriptive analysis such as frequency distribution and measure of central tendency and variability (mean and standard deviation) was computed to describe variables of the study. Binary logistic regression was used to assess associations between dependent and independent variables. The degree of associations was interpreted using odds ratio (OR) and 95% confidence interval (CI) and statically significance at value of p < 0.05. The result was presented using text, tables, and graphs.

Result

The study finding showed that 198 (47.8%) of nurses were occupationally stressful. Factors significantly associated with occupational stress among nurses were having children (no: AOR = 0.46, 95% CI: 0.22, 0.96) and work shift (rotating: AOR = 2.89, 95% CI: 1.87, 4.45).

Conclusion

In this study, job stress affected over half of the nurses. The presence of children and respondents' work shifts were personal characteristics that were significantly linked to job stress. Therefore based on this result the government policy makers, different stakeholders and hospitals need to collaborate to reduce nurses job related stress.

Health-related quality of life among patients with end-stage renal disease undergoing hemodialysis in Ethiopia: a cross-sectional survey

BACKGROUND

Measurement of health-related quality of life (HRQOL) enables identification of treatment-related side effects of a disease. Such aspects may negatively impact on patients' lives and should be taken into consideration in medical decision-making. In sub-Saharan Africa, research from the perspective of patients with chronic kidney disease is scarce, and it is almost non-existent in patients undergoing hemodialysis. We aimed to determine HRQOL among end-stage renal disease patients undergoing maintenance hemodialysis in Ethiopia and to identify factors associated with HRQOL.

METHODS

A multi-center cross-sectional study was conducted in Addis Ababa, Ethiopia directed to all patients receiving hemodialysis due to kidney failure at 11 randomly-selected government and private hospitals/dialysis centers in the capital of Ethiopia. Data were collected by trained nurses using the KDQOL-36 instrument with five subscales measuring generic and disease-specific HRQOL. Study-specific items were used to collect socio-demographic and clinical data. Factors associated with HRQOL were examined using multivariable linear regression models.

RESULTS

Four hundred eighty-one patients completed the survey through face-to-face interviews (response rate 96%; mean age 45.34 ± 14.67). The mean scores of the subscales ranged from 25.6 to 66.68 (range 0-100), with higher scores reflecting better health. Factors associated with low HRQOL included older age, female sex, no formal education, poor medication adherence, > 2 hemodialysis sessions/week, lower body mass index (< 18.5), longer duration of hemodialysis treatment (≥ 12 months), and poor social support.

CONCLUSION

Patients with kidney failure undergoing hemodialysis in Addis Ababa, Ethiopia, had low HRQOL across all subscales compared to previous studies. Therefore, the implementation of guidelines is crucial to improve patients' adherence to their prescribed medications. Furthermore, establishing patient support groups and encouraging patients to use the available support resources from family members, neighbors, and friends have the potential to improve patients' HRQOL.

Household satisfaction with a pilot community-based health insurance scheme and associated factors in Addis Ababa

Background

Many countries introduce CBHI as their healthcare financing system to ensure healthcare access. Understanding the level of satisfaction and factors associated with it is essential to ensure the sustainability of the program. Therefore, this study aimed to assess household satisfaction with a CBHI scheme and its associated factors in Addis Ababa.

Design and methods

Institutional-based cross-sectional study was conducted in the 10 health centers found in the 10 sub-cities of Addis Ababa. Both quantitative and qualitative methods were used. Logistic regression analysis was carried out to identify its associated factors and thematic analysis was used for qualitative data. Finally, variables with a p-value of <0.05 have been considered statistically significant.

Results

In this study, the overall satisfaction level of households with CBHI was 46.3%. Satisfaction was associated with valid CBHI management regulations (AOR = 1.96, 95% CI: 1.12, 3.46), participants who received the right drug (AOR = 1.77, 95% CI: 1.08, 2.93), households who got immediate care (AOR = 4.95, 95% CI: 2.72, 8.98), those who agreed with the adequacy of medical equipment (AOR = 1.65, 95% CI: 1.02, 2.69), and households who agreed with qualification of health personnel (AOR = 1.89, 95% CI: 1.12, 3.20) were more satisfied with the scheme than their counterparts. The challenges mentioned by the discussants were the shortage of drugs, poor attitude of health professionals, absence of kenema pharmacy, lack of laboratory services, lack of awareness about the CBHI scheme, and tight payment schedule.

Conclusions

the satisfaction level of households was low. To achieve a better result, the concerned bodies should work to improve the availability of medication, and medical equipment and improve the attitude of healthcare workers.

Food environment around schools and adolescent consumption of unhealthy foods in Addis Ababa, Ethiopia

Adolescent diets may be influenced by the retail food environment around schools. However, international research to examine associations between the proximity of retail food outlets to schools and diet provides equivocal support for an association. This study aims to understand the school food environment and drivers for adolescents' consumption of unhealthy foods in Addis Ababa, Ethiopia. Mixed-methods research was conducted, 1200 adolescents (10-14 years) from randomly selected government schools were surveyed, along with vendors within 5-min' walk of the schools and focus group discussions (FGDs) with adolescent groups. Mixed-effect logistic regression investigated the relationship between the number of vendors around the schools and the consumption of selected unhealthy foods. Thematic analysis was used to summarize findings from the FGDs. Consumption of sweets and sugar-sweetened beverages (S-SSB) and deep-fried foods (DFF) at least once a week was reported by 78.6% and 54.3% of the adolescents, respectively. Although all schools were surrounded by food vendors selling DFF and S-SSB, consumption was not associated with the number of vendors available around the school. However, adolescents' awareness and perception of healthy food, and their concerns about the safety of foods in the market, influenced their dietary choices and behaviours. Lack of financial resources to purchase food as desired also played a role in their selection of food and eating habits. Reported unhealthy food consumption is high among adolescents in Addis Ababa. Thus, further research is warranted to come up with school-based interventions that promote access and healthy food choices among adolescents.

Evaluating self-medication practices in Ethiopia

BACKGROUND

Self-medication with antibiotics has become an important factor driving antibiotic resistance and it masks the signs and symptoms of the underlying disease and hence complicates the problem, increasing drug resistance and delaying diagnosis. This study aimed to assess the extent of self-medication practice with antibiotics and its associated factors among adult patients attending outpatient departments (OPD) at selected public Hospitals, in Addis Ababa, Ethiopia.

METHODS

Facility-based cross-sectional study was employed. A systematic random sampling technique was used to include the study participants. Self-administered with structured questionnaires were applied among patients who visited outpatient departments at selected public Hospitals, in Addis Ababa. Data were entered into Epi-data version 4.6 and analyzed using SPSS version 26. Descriptive statistics such as frequencies and percentages were used for the present categorical data. The data are presented in pie charts, tables, and bar graphs. Furthermore, bivariable and multivariable binary logistic regression analyses were used to identify significant associations. Statistical significance was declared at p value < 0.05.

RESULTS

Out of 421 respondents interviewed, 403 (95.7%) participants completed questionnaires. Among the respondents, 71% had generally practiced self-medication. Among these, 48.3% had self-medication with antibiotics, while 51.7% had used other drugs. The most commonly cited indication for self-medication practice was abdominal pain 44.9%, followed by Sore throat 21% commonly used antibiotics are amoxicillin (57%), ciprofloxacin (13%), amoxicillin/clavulanic (10%), erythromycin (8%), cotrimoxazole (7%), and doxycycline (5%).

CONCLUSIONS

Self-medication with antibiotics was common among the study participants. The prevalence of general self-medication was 71%, whereas that of self-medication with antibiotics was 48.3%. In general, the potentially dangerous effects of SMP seem to be underestimated by patients with OPD patients.

Dietary diversity and associated factors among adolescent girls in Nifas Silk Laphto sub city, Addis Ababa, Ethiopia, 2021

BACKGROUND

Addressing the nutritional problems of adolescent girls is important as their nutritional status has a negative effect on the future generation. However, the evidence revealed the variation and unrelated data on the prevalence of dietary diversity and lack of including all adolescent age and community groups in Ethiopia. Hence, this study assessed dietary diversity and associated factors among adolescent girls in Nifas Silk Laphto Sub-city, Addis Ababa Ethiopia, 2021.

METHODS

A community-based cross-sectional study was conducted among 475 adolescent girls at Nifas Silk Laphto sub-city, Addis Ababa Ethiopia from July 1 to 30, 2021. Multistage cluster sampling was employed to select adolescent girls. Pretested questionnaires were used to collect the data. The data were checked for completeness and entered by Epidata version 3.1 and cleaned and analyzed by SPSS version 21.0. A multivariable binary logistic regression model was fitted to identify factors associated with dietary diversity scores. The degree of association was assessed using an odds ratio with a 95% confidence interval and variables with p-value ≤ 0.05 were considered significant.

RESULT

The mean and the standard deviation of dietary diversity scores were 4.70 and 1.21 respectively. The proportion of low dietary diversity scores among adolescent girls was 77.2%. Adolescent girls' age, meal frequency, wealth index of household, and food insecurity were significant determinants of dietary diversity score.

CONCLUSION

The magnitude of low dietary diversity scores was significantly higher in the study area. Adolescent girls', meal frequency, wealth index, and food security status were predictors of dietary diversity score. School-based nutrition education and counseling and designing strategies for improving household food security programs are crucial.

Aflatoxin contamination in red pepper from producers in Addis Ababa

This study was conducted to determine the occurrence and levels of aflatoxins in powder red pepper. Thirty powder red pepper samples commercially available in Addis Ababa market were collected and the level of aflatoxins (AFB1, AFB2, AFG1, and AFG2) was determined. Aflatoxins were detected in almost all of the samples at concentrations ranging from 0.4 to 52.3 µg/kg. AFB1 was detected in all of the red pepper samples, with levels ranging from 1.8 to 33.3 µg/kg. Out of all the AFB1 positive samples, 25 (83%) contained AFB1 above the EU limit of 5 µg/kg, while 29 (97%) of the samples exceeded the maximum limit of 10 µg/kg for total aflatoxins. Further, all the red pepper samples were contaminated by AFG1 with levels ranging from 0.7 to 52.3 µg/kg. Overall, the majority of the red pepper collected in Addis Ababa market was contaminated by aflatoxins above the EU limit.

Psychological distress and associated factors among cancer patients in public hospitals, Addis Ababa, Ethiopia: a cross-sectional study

BACKGROUND

Cancer has great implications for psychological, social, economic, and emotional dimensions. Psychological distress is overwhelming among cancer patients following a confirmed diagnosis. However, little is known about the prevalence of psychological distress and associated factors among cancer patients in Africa Sub-Saharan. Thus, this study aimed to assess the prevalence of psychological distress and associated factors among cancer patients in public hospitals in Addis Ababa, Ethiopia.

METHODS

An institution-based cross-sectional study was conducted among cancer patients from September 15, 2019, to June 30, 2020. A total of 386 cancer patients selected through a simple random sampling technique participated in the study. Data were collected by an interview-administered questionnaire to evaluate psychological distress with a distress thermometer and social support with the Oslo 3-items Social Support Scale. The collected data were entered into Epi-data version 4.2 and exported into SPSS 25 for analysis, and then binary and multivariate logistic regressions were done to identify the association between dependent and independent variables.

RESULTS

A total of 386 study participants were included in the study with a response rate of 91.4%. The prevalence of psychological distress among cancer patients in public hospitals in Addis Ababa, Ethiopia was 64.5%. Age > 45 years [AOR = 0.41; 95% CI (0.22-0.77)], marital status of being divorced [AOR = 3.3; 95%CI (1.23-8.71)] and married [AOR = 3.2; 95%CI (1.03-10.40)], rural residence [AOR = 1.5; 95%CI (1.15-5.18)], cancer stage II [AOR = 3.9; 95%CI (1.90-15.50)], stage III [AOR = 3.5;95%CI (1.45-8.44)] and stage IV [AOR = 3.4; 95%CI (1.90-10.11)], co-morbidity [AOR = 0.07; 95%CI: (0.03-0.17)], and moderate social support [AOR = 0.36; 95%CI (0.14-0.60)] and strong social support [AOR = 0.06; 95%CI (0.03-0.12)] were found to be significantly associated with psychological distress.

CONCLUSION

The prevalence of psychological distress among cancer patients in public hospitals in Addis Ababa, Ethiopia was high, and age, marital status, place of residence, cancer stage, co-morbidity, and social support were associated with psychological distress. Therefore, interventions focusing on these findings require special emphasis during designing interventions aimed at decreasing psychological distress.

Hand-Washing at Critical Times and Associated Factors Among Mothers/Caregivers of Under-Five Year Children in Nefas Silk Lafto Sub-City, Addis Ababa, Ethiopia

Background

Hand washing is the simplest, most affordable, and most effective means of limiting the spread of infections. Despite increasing efforts to improve hand washing at critical times (after defecation, after handling child/adult feces or cleaning child's bottom, after cleaning the environment, before preparing food, and before eating food), mothers/caregivers of under-five children fail to conduct it; but the reason appears unclear. Thus, this study sought to identify hand washing at critical times and associated factors among mothers/caregivers of under-five children in Nefas Silk Lafto Sub-City, Addis Ababa, Ethiopia.

Methods

A facility-based cross-sectional study was conducted on April 1-15, 2019, and 312 mothers/caregivers participated. A pretested questionnaire was used to collect data from participants by interviewer-administered technique and the data were analyzed with the Statistical Package for Social Science version 20. The factors were determined by conducting logistic regression and the crude odds ratio (COR) and adjusted odds ratio (AOR) with their respective 95% confidence intervals. All statistical tests were conducted at a 5% level of significance.

Results

The study revealed that 232 (74.4%; 95% CI [69.6%-79.2%]) mothers/caregivers washed their hands at critical times. The illiterate mothers/caregivers and mothers/caregivers who lacked tap water inside the home or the backyard had 66% (AOR = 0.34; 95%CI [0.17-0.69]) and 62% (AOR = 0.38; 95%CI [0.18-0.80]) reduced odds of washing hands at critical times, respectively. Mothers/caregivers from middle had (AOR = 4.56; 95%CI [1.84-11.33]), richer had (AOR = 5.61; 95%CI [2.11-15.30]), and the richest had (AOR = 6.14; 95%CI [2.24-16.72]) times increased likelihood of washing hands at critical times than the poorest.

Conclusion

The majority of mothers/caregivers practiced hand washing at critical times, and improving maternal literacy, household economy, and availability of water sources in the backyard are needed to maintain and enhance the practice.

Survival status and predictors of mortality among patients admitted to surgical intensive care units of Addis Ababa governmental hospitals, Ethiopia: A multicenter retrospective cohort study

Introduction

Critical care is a serious global healthcare burden. Although a high number of surgical patients are being admitted to the surgical intensive care unit (SICU), the mortality remained high, particularly in low and middle-income countries. However, there is limited data in Ethiopia. Therefore, this study aimed to investigate the survival status and predictors of mortality in surgical patients admitted to the SICUs of Addis Ababa governmental hospitals, Ethiopia.

Methods

A multicenter retrospective cohort study was conducted on 410 surgical patients admitted to the SICUs of three government hospitals in Addis Ababa selected using a simple random sampling from February 2017 to February 2020. The data were entered into Epidata version 4.6 and imported to STATA/MP version 16 for further analysis. Bi-variable and multivariable Cox regression models were fitted in the analysis to determine the predictor variables. A hazard ratio (HR) with a 95% confidence interval (CI) was computed, and variables with a p-value <0.05 were considered statistically significant.

Results

From a sample of 410 patients, 378 were included for final analysis and followed for a median follow-up of 5 days. The overall mortality among surgical patients in the SICU was 44.97% with an incidence rate of 5.9 cases per 100 person-day observation. Trauma (AHR = 1.83, 95% CI: 1.19-2.08), Glasgow coma score (GCS) <9 (AHR = 2.06, 95% CI: 1.28-3.31), readmission to the SICU (AHR = 3.52, 95% CI: 2.18-5.68), mechanical ventilation (AHR = 2.52, 95% CI: 1.23-5.15), and creatinine level (AHR = 1.09, 95% CI: 1.01-1.18) were found to be significantly associated with mortality in the SICU.

Conclusion

The mortality of surgical patients in the SICU was high. Trauma, GCS <9 upon admission, readmission to the SICU, mechanical ventilation, and increased in the creatinine level on admission to the SICU were the identified predictors of mortality in the SICU.

Squatter settlement and informal urbanization: causes and consequences

Squatter settlement and informal urbanization trends in Addis Ababa were a great concern with highest population living in informal settlements. Squatter settlements were illegally built due to urbanization in an open space, farmland, steep slope, and along river buffer which do not have legal title deed particularly at expansion of cities. Formal land value in the city through time has been increasing. This study focused on the causes and consequences of squatter settlement and informal urbanization. In this study, household income, family size, occupation, and the characteristics of the squatter settlements regarding its physical, social, and economic dimensions were studied using physical observation, questionnaires, interviews, and focus group discussion. Systematic sampling technique was employed for questionnaires to investigate the actual causes and consequences. Among 10 districts in Wereda 03, districts 4, 7, 8, and 9 were purposely selected since there were recorded large numbers (964 households) of new squatter and informal settlements by Wereda 03 administration in one year (2018). Out of 964 newly settled squatter households, 49%, 31%, 11%, and 5% were site-related pulling factors, sloppy topography, migration, and urban policy, respectively. Major causes were migration of persons from rural to urban areas, too expensive formal land price, availability of sloppy land, condominium housing shortage, and could not afford 10/90 government-led condominium housing payment. In addition to this, land speculation and establishment of religious institutions have attracted informal settlement. Consequently, unplanned housing construction and squatter settlement in Addis Ababa has required high cost of infrastructure and unintegrated land use plan, and also it has been difficult to provide infrastructure in this settlement. The affordable housing policy was based on pro-poor development assisting the low-income group in minimum of 10/90 housing scheme, but the policy still did not answer the demand of low income rather than the high-income groups because the poor under poverty line are marginalized due to lack of income source to down payment. Hence, investing more on affordable housing targeting the urban poor to minimize informal settlement as home is the human right to live.

Trace Element Levels in Nails of Residents of Addis Ababa Are Shaped by Social Factors and Geography

The Akaki catchment in Ethiopia is home to Addis Ababa and about five million people. Its watercourses receive a variety of wastes released by the residents and industries. River water is being used for irrigation, livestock watering, and other domestic purposes. This study tested the hypothesis that the river pollution would be reflected in higher levels of trace elements in the nails of residents living in Akaki-Kality Sub-City in the downstream, as compared to those living in Gullele Sub-City in the upstream of the Akaki catchment. Samples were taken and subsequently analysed for metals using inductively coupled plasma optical emission spectrometry (ICP-OES). The mean concentrations of Fe, Zn, Cu, Mn, Ni, Cr, Pb, and As in nails from Akaki-Kality were 488 ± 49, 106 ± 10, 5.2 ± 0.3, 13 ± 1.5, 11 ± 8, 2.2 ± 0.3, 0.09 ± 0.01, and 0.16 ± 0.01 μg/g, respectively. Likewise, the concentrations of Fe, Zn, Cu, Mn, Ni, Cr, Pb, and As in nails from Gullele were 1035 ± 135, 251 ± 10, 6.6 ± 0.4, 31 ± 3.7, 7.4 ± 1.7, 2.0 ± 0.3, 0.63 ± 0.01, and 0.25 ± 0.01 μg/g, respectively. Co and Cd were not detected. Contrary to the initial hypothesis, higher metal levels were found in nails of residents living in the upstream rather than the downstream area of the catchment. In particular, the concentrations of Fe (p = 0.000), Zn (p = 0.01), and Mn (p = 0.000) were significantly elevated in nails from Gullele and also high in comparison with internationally reported values. Besides, geography and social factors, especially education level, correlated to trace metals in nails. Most of the elements were significantly lower in the nails of individuals with a university degree compared to those who were illiterate or only completed primary school.

Level of self-care practices and associated factors among hypertensive patients in Addis Ababa, Ethiopia

OBJECTIVES

The study assessed the level of self-care practice and its predictors among hypertensive patients in the health centers of Bole Sub-city, Addis Ababa, Ethiopia.

METHODS

A multi-Center-based cross-sectional study that employed 370 hypertensive participants at the conveniently selected Health Centers in Bole Sub-City; from August 01-30, 2020. The researchers selected the participants based on a simple random sampling method after applying for a pre-tested interviewer-administered questionnaire and secured for informed consent. All the statistical analyses were SPSS 22.0 software based. The authors used binary logistics regression to identify the presence and strength of association; with its respective 95%CI and p-value less than five percent as a significant level.

RESULTS

The overall level of good self-care practice among hypertensive patients was 53.0% (95% CI: 47.2-58.8%) whereas 61.4%, 63.8%, 92.7%, 82.7%, and 18% of the study participants were adherent to medication, good weight management, non-smokers, alcohol abstainers and physical activity consecutively. Being illiterate had 2.347 and 2.084 times higher odds of having had good self-care practice compared to secondary school and a diploma or above consecutively. Being a merchant, civil, and retired were associated with good self-care practice than being unemployed.

CONCLUSION AND RECOMMENDATION

The study reported a lower level of self-care practice in the study settings. Educational level and occupation were factors identified for self-care practice. The authors recommended policymakers, healthcare workers, and researchers work on the identified factors of self-care practice of hypertensive participants in the study settings.

Determinants of safe food handling practice among food handlers in food establishments, Yeka sub city, Addis Ababa, Ethiopia

Background

Poor food handling practice is a key cause of foodborne diseases notably in developing countries like Ethiopia. This study aimed to assess food safety knowledge, attitude and practice of food handlers, establishments' status and determinants of safe food handling practice.

Methods

The study utilized institution based cross-sectional study among food handlers working in Cafeterias, Restaurants and Hotels in Yeka sub city, Addis Ababa. A total of 284 food handlers: 69 from Cafeterias, 89 from Restaurants and 126 from non-stared Hotels were enrolled using stratified random sampling technique. Data were collected in observational checklist and through structured-questionnaire via face to face interview. A binary and multivariate logistic regression was used and adjusted for cofounders. A P-value of less than 0.05 was considered statistically significant.

Result

The present study has indicated 42.6% of food handlers had good food handling practice. Food handling practice in the establishments were significantly associated with sex, monthly income, availability of functional pipe water supply, availability of soap and/or detergents and presence of insects or rodents.

Conclusion

Food handlers in the study area were executing in a poor food handling practice, as most of them were not knowledgeable as needed. In fact, revising the salary of food handlers based on their work load could be valid, as there is existing worldwide economic inflation. Likewise enhancing pipe water availability in the food premises and dispatching sufficient soaps and detergents coupled with eradicating ubiquitous insects and rodents are key.

Predictors of high school students' mathematics self-efficacy in Addis Ababa: The importance of educational expectations

In Ethiopia studies on high school students' mathematics self-efficacy and associated factors are scarce. The present study examined students' mathematics self-efficacy and associated predictors among high school students in Addis Ababa. Data were collected using adapted questionnaire from 120 students (9th and 10th graders) recruited via multi-stage sampling. Descriptive statistics, independent sample t-test, ANOVA, Chi-square and logistic regressions were utilized to analyze the collected data. In the study it was found that students have more than average mathematics self-efficacy even though significant numbers of students (44.2%) have low mathematics self-efficacy. It was also revealed that differences in grade level [t(118) = 2.545, p < 0.05] and students' expected grade in the upcoming national exam [F(3,116) = 5.553, p < 0.05] were statistically significant. Living arrangements (AOR = 6.704, 95% CI = 1.598-28.118), expected grade in the upcoming national exam (AOR = 5.808, 95% CI = 1.804-18.696) and expected marks in the semester (AOR = 1.126, 95% CI = 1.055-1.202) are significant predictors of students' mathematics self-efficacy. Generally educational expectations are important predictors of students' mathematics self-efficacy. Therefore, researchers and organizations need to gear their attention towards improving students' mathematics self-efficacy.

Change in depression during the COVID-19 pandemic among healthcare providers in Addis Ababa, Ethiopia

Background

The COVID-19 pandemic has increased mental health problems among healthcare workers globally. However, studies from low- and middle-income countries on this matter were minimal. This study assessed the change in depression prevalence during the first year of the COVID-19 pandemic and associated factors among healthcare providers in Addis Ababa, Ethiopia.

Methods

We conducted surveys among healthcare workers in Addis Ababa at two-time points, September 2020 and October 2021. A total of 577 study participants were randomly selected based on registers obtained from professional associations. Computer-assisted telephone interviewing technique was used for data collection. The Patient Health Questionnaire (PHQ-9) was used to screen for depression. Multivariable logistic regression analysis was performed to identify potential factors associated with depression.

Result

The prevalence of depression among healthcare workers was 2.3% (95% CI [1.1-4.8]) in Time 1 and 6.5% (95% CI [4.1-10.1]) in Time 2; nearly a three-fold increase in Time 2 compared to Time 1. The most frequently reported symptoms at both times based on the PHQ-9 item were having poor energy, sleep problem, and anhedonia, while reported suicidal ideation was less than 5%. Depression showed a positive and significant association with a positive COVID-19 test result (AOR 7.25 95% CI [1.32-39.4]) in Time 1, and with being a female healthcare provider (AOR 3.96 95% CI [1.08-14.51]) and lack of COVID-19 related policy or guidelines at the workplace (AOR 3.22 95% CI [1.11-9.35]) in Time 2.

Conclusion

The prevalence of depression among healthcare workers tripled during the first year of the COVID-19 pandemic. Panic reaction to positive COVID-19 test result seems to have a negative effect at the beginning while lack of disease-specific prevention guidelines and comprehensive psychological interventions for healthcare providers had an adverse effect on the mental health of health workers.

Acute Kidney Injury Among Admitted COVID-19 Patients in Addis Ababa, Ethiopia

Background

Although diffuse alveolar damage and respiratory failure are the most common symptoms of coronavirus disease 2019, other organ involvement, such as the kidney, has been reported. The incidence of acute kidney injury in COVID-19 patients has been reported to vary greatly. In this study, we look at the magnitude and risk factors for acute kidney injury in COVID-19 patients in Ethiopia, a developing country.

Methods

A hospital-based retrospective cross-sectional study design was conducted among admitted COVID-19 patients at Eka Kotebe general hospital and Saint Peter COVID-19 treatment center by reviewing data from September 2020 to September 2021. A random sampling technique with proportional size allocation was used to select a total sample of 402 patients (225 from Eka Kotebe and 177 from St. Peter). Secondary data was collected from patient medical records using a standard, pre-tested data collection checklist using the Kobo toolbox, which was then exported to SPSS version 25.0 for analysis. The association between dependent and independent variables was analyzed using binary logistic regression. A statistical significance test was declared at a p value of <=0.05 with a 95% confidence interval.

Results

A total of 402 patient charts were reviewed, and the proportion of patients with acute kidney injury was found to be 18.9%. After adjusting for potential confounders, age<=35 years (AOR = 0.23, 95% CI = 0.07-0.72), female gender (AOR = 0.51, 95% CI = 0.28-0.94), and isolation type ICU (AOR = 5.11, 95% CI = 1.44-18.06) were significantly associated with acute kidney injury.

Conclusion

Acute kidney injury is a common complication in hospitalized COVID-19 patients. The prevalence of acute kidney injury in this study was 18.9%. Age, gender, and type of isolation were the factors that had a significant association with acute kidney injury. Clinicians and other concerned parties should provide more care to ICU patients and COVID-19 patients who are older.

Evaluation of the quality of environmental impact statements in Ethiopia

Environmental impact statement (EIS) is rarely assessed for its quality and thus, poses challenges for rectifying the compromised qualities at earlier time. The objective of the study was to evaluate the quality of the Environmental Impact Statement (EIS) submitted to Addis Ababa Environmental Protection and Green Development Commission (AAEPGDC) in year 2020 and 2021. The article has evaluated the quality of 16 EIS for the year 2020 and 15 for the year 2021 using the modified Lee and Colley review package. The findings revealed that each of the evaluation criteria has shown various degrees of qualities with overall assessment that falls under satisfactory score of 66% (sum of grade A-C). Impact identification & description, monitoring plan and project setting and description were the most described sections of the EIS while baseline assessment and establishment, scoping, alternate consideration were otherwise. Inadequate baseline description was found resulting in compromising impact prediction. Though adverse impact identification and description was the best dealt with section of the EIS, it overlooked describing how impacts affect receptors, undermined occupation health & safety and disregarded project affected people by luring them with job opportunity. In terms of magnitude, positive impacts were presented pretty well than adverse impacts. How long the duration of the impacts last were not dealt by 39%, as to whether the impact were reversible or not were not dealt by 42% and the extent of coverage of the impacts were not discussed by 39% of the reviewed EIS. Energy use was one of the least described EIS section (64.5% score) with gaps of failing to recommend renewable energy for best energy use practices. Comparisons of the EIS quality for 2020 and 2021 using Mann-Whitney U-test had shown that there was no quality difference between them. We thus, generally recommend multi-stage review processes at least every five years to enhance the overall quality of the EIS.

Work-related stress and associated factors among garment workers in Bole Lemi Industrial Park of Addis Ababa, Ethiopia: a multi-center institution-based cross-sectional study

BACKGROUND

Work-related stress (WRS) is a growing problem around the world that affects the health and well-being of employees. However, evidence of work-related stress in Ethiopia, particularly among garment industry employees, is scarce. This study aimed to assess the prevalence and associated factors of work-related stress among garment workers in the Bole Lemi industrial park in Addis Ababa, Ethiopia.

METHODS

A multi-center institutional-based cross-sectional study was conducted from February 01 to March 31, 2021. A total of 605 study participants were selected using a stratified random sampling technique. A pre-tested, interviewer-administered standardized questionnaire was used to collect data. The logistic regression model was employed to identify determinant factors for work-related stress, and statistical significance was declared at a p-value < 0.05.

RESULTS

The magnitude of work-related stress in garment workers was 44.1% (95% CI: 40.0, 48.0). Being within the age group of 25 - 34 years (AOR = 0.57, 95% CI: 0.36, 0.90) and receiving induction training (AOR = 0.35, CI: 0.20, 0.62) were protective factors with stress. Whereas lack of family support (AOR = 2.72, CI: 1.60, 4.64), lack of job satisfaction (AOR = 4.26, CI: 2.77, 6.57), and khat chewing (AOR = 3.14, CI: 1.35, 7.32) were positively associated with work-related stress.

CONCLUSION

Work-related stress is prevalent among garment workers in the study setting. Being between the ages of 25-34 years and receiving induction training were protective factors against stress, while a lack of family support, a lack of job satisfaction, and khat chewing practices were positively associated with work-related stress. Therefore, improving family support and job satisfaction, providing induction training during employment, and providing psychological support for substance users to bring about changes are mandatory in Bole Lemi Industrial Park, Ethiopia.