Impact of disrespectful maternity care on childbirth complications: a multicentre cross-sectional study in Ethiopia

BACKGROUND

Globally, disrespectful, and abusive childbirth practices negatively impact women's health, create barriers to accessing health facilities, and contribute to poor birth experiences and adverse outcomes for both mothers and newborns. However, the degree to which disrespectful maternity care is associated with complications during childbirth is poorly understood, particularly in Ethiopia.

AIM

To determine the extent to which disrespectful maternity care is associated with maternal and neonatal-related complications in central Ethiopia.

METHODS

A multicentre cross-sectional study was conducted in the West Shewa Zone of Oromia, Ethiopia. The sample size was determined using the single population proportion formula. Participants (n = 440) were selected with a simple random sampling technique using computer-generated random numbers. Data were collected through face-to-face interviews with a pretested questionnaire and were entered into Epidata and subsequently exported to STATA version 17 for the final analysis. Analyses included descriptive statistics and binary logistic regression, with a 95% confidence interval (CI) and an odds ratio (OR) of 0.05. Co-founders were controlled by adjusting for maternal sociodemographic characteristics. The primary exposure was disrespectful maternity care; the main outcomes were maternal and neonatal-related complications.

RESULTS

Disrespectful maternity care was reported by 344 women (78.2%) [95% CI: 74-82]. Complications were recorded in one-third of mothers (33.4%) and neonates (30%). Disrespectful maternity care was significantly associated with maternal (AOR = 2.22, 95% CI: 1.29, 3.8) and neonatal-related complications (AOR = 2.78, 95% CI: 1.54, 5.04).

CONCLUSION

The World Health Organization advocates respectful maternal care during facility-based childbirth to improve the quality of care and outcomes. However, the findings of this study indicated high mistreatment and abuse during childbirth in central Ethiopia and a significant association between such mistreatment and the occurrence of both maternal and neonatal complications during childbirth. Therefore, healthcare professionals ought to prioritise respectful maternity care to achieve improved birth outcomes and alleviate mistreatment and abuse within the healthcare sector.

Clinical characteristics, treatment patterns, and outcomes of hospitalized patients with acute heart failure in central Ethiopia: a retrospective observational study

BACKGROUND

Acute heart failure is the rapid onset of new or worsening symptoms and signs of heart failure. Despite the increasing burden of heart failure in developing countries like Ethiopia, there is a paucity of comprehensive data regarding the clinical characteristics, treatment patterns, and outcomes of acute heart failure, especially in the selected study area. Therefore, this study aimed to assess the clinical characteristics, treatment patterns, and outcomes of hospitalized patients with acute heart failure at Yekatit 12 Hospital Medical College, Addis Ababa, Ethiopia.

METHODS

This is a retrospective cross-sectional study of 303 acute heart failure patients who were admitted to the medical wards and intensive care unit of Yekatit 12 Hospital Medical College, Addis Ababa, central Ethiopia, from July 1, 2022, to July 1, 2023. A pretested data abstraction format was used for data extraction from electronic medical records, and SPSS version 26 was used for data analysis. Descriptive analysis was used to summarize sociodemographic data, clinical characteristics, treatment patterns, and outcomes of acute heart failure. Bivariate and multivariate logistic regression models were fitted to identify factors associated with in-hospital mortality. The odds ratio (OR) with the corresponding 95% confidence interval (CI) was calculated to show the strength of the association.

RESULTS

Of the 303 patients, 51.5% were females, and the mean age was 56.7 years. The most frequent symptom and sign were dyspnea (98.7%) and peripheral edema (79%), respectively. The commonest underlying cause and precipitating factor of acute heart failure were cor pulmonale (22.8%) and pneumonia (35.3%), respectively. The commonest anti-remodeling medications prescribed on discharge were beta-blockers (47.9%), followed by mineralocorticoid receptor antagonists (42.8%) and angiotensin-converting enzyme inhibitors/angiotensin receptor blockers (38.6%), and the least prescribed were sodium-glucose cotransporter 2 inhibitors (8.3%). The in-hospital mortality rate was 8.6%, and the median length of hospital stay was 9 days. Based on the multivariate logistic regression analysis, the most important predictors of in-hospital mortality were systolic blood pressure (SBP) < 115 mmHg (adjusted odds ratio [AOR] = 6.28; 95% CI: 1.99, 19.78), chloride level < 96 mg/dL (AOR = 4.88; 95% CI: 1.30, 18.33), blood urea nitrogen (BUN) > 20 mg/dl (AOR = 5.48; 95% CI: 1.47, 20.49), and presence of dyslipidemia (AOR = 3.73, 95% CI: 1.15, 12.07).

CONCLUSIONS

This study has shown that systolic blood pressure (SBP) < 115 mmHg, blood urea nitrogen (BUN) > 20 mg/dL, chloride (Cl) level < 96 mg/dL, and the presence of dyslipidemia were statistically significant factors associated with in-hospital mortality among patients with acute heart failure. Hence, healthcare providers should stratify patients with acute heart failure upon admission based on their risk of in-hospital mortality and address those potential negative prognostic indicators accordingly.

Analysis of food security among eucalyptus tree farming smallholder farmers in Gurage Zone, Ethiopia: An application of a composite food security indicator

This study examines the contribution of eucalyptus tree expansion on rural households' food security status, focusing on the specific context of Ethiopia. Eucalyptus trees pose a significant challenge to the rural food system, warranting investigation. A composite food security indicator was used, and data were collected through household surveys, Focus Group Discussions (FGDs), and Key Informant Interviews (KIIs). Descriptive analysis and multinomial logistic regression models were employed for data analysis. The findings reveal that among the sampled households, 31.2% were classified as food secured, 24.8% as intermediate food secured, and 44.0% as food insecured. Econometric estimations highlight the positive influence of variables such as total land holding and livestock on the likelihood of being in the food secured category. Moreover, a unit increase in income earned from the sale of eucalyptus trees leads to an 8.5% higher probability of being in the intermediate category, while decreasing the likelihood of falling into the categories of food insecurity by 8.1% and food security by 0.4%. Importantly, this study uncovers the diverse consequences of eucalyptus trees across different food security categories, suggesting that the planting of eucalyptus trees for improving rural livelihoods and food security must be tailored to specific household conditions. The research outcomes provide valuable insights for guiding future policies, practices, and research endeavors aimed at achieving a sustainable food system in rural Ethiopia.

Access to essential medicines for diabetes care: availability, price, and affordability in central Ethiopia

BACKGROUND

Diabetes is a major global public health burden. Effective diabetes management is highly dependent on the availability of affordable and quality-assured essential medicines (EMs) which is a challenge especially in low-and-middle-income countries such as Ethiopia. This study aimed to assess the accessibility of EMs used for diabetes care in central Ethiopia's public and private medicine outlets with respect to availability and affordability parameters.

METHODS

A cross-sectional study was conducted in 60 selected public and private medicine outlets in central Ethiopia from January to February 2022 using the World Health Organization/Health Action International (WHO/HAI) standard tool to assess access to EMs. We included EMs that lower glucose, blood pressure, and cholesterol as these are all critical for diabetes care. Availability was determined as the percentage of surveyed outlets per sector in which the selected lowest-priced generic (LPG) and originator brand (OB) products were found. The number of days' wages required by the lowest paid government worker (LPGW) to purchase a one month's supply of medicines was used to measure affordability while median price was determined to assess patient price and price markup difference between public procurement and retail prices.

RESULTS

Across all facilities, availability of LPG and OB medicines were 34.6% and 2.5% respectively. Only two glucose-lowering (glibenclamide 5 mg and metformin 500 mg) and two blood pressure-lowering medications (nifedipine 20 mg and hydrochlorothiazide 25 mg) surpassed the WHO's target of 80% availability. The median price based on the least measurable unit of LPG diabetes EMs was 1.6 ETB (0.033 USD) in public and 4.65 ETB (0.095 USD) in private outlets. The cost of one month's supply of diabetes EMs was equivalent to 0.3 to 3.1 days wages in public and 1.0 to 11.0 days wages in private outlets, respectively, for a typical LPGW. Thus, 58.8% and 84.6% of LPG diabetes EMs included in the price analysis were unaffordable in private and public outlets, respectively.

CONCLUSIONS

There are big gaps in availability and affordability of EMs used for diabetes in central Ethiopia. Policy makers should work to improve access to diabetes EMs. It is recommended to increase government attention to availing affordable EMs for diabetes care including at the primary healthcare levels which are more accessible to the majority of the population. Similar studies are also recommended to be conducted in different parts of Ethiopia.

Molecular and Serological Investigation of Infectious Bronchitis Virus in the East Shewa, Central Ethiopia

Background

Infectious bronchitis (IB) is an economically important disease in poultry with worldwide distribution. The occurrence of IB has been reported both in commercial and backyard poultry in Ethiopia, although comprehensive information lacks available prevalence of the disease and the circulating serotypes.

Methods

A cross-sectional study was conducted from November 2021 to June 2022 in seven commercial farms found in East Shewa, Central Ethiopia. Serological assay using indirect ELISA, virus isolation techniques in embryonated eggs, and molecular techniques such as one-step reverse transcriptase polymerase chain reaction (RT-PCR) and nested polymerase chain reaction (PCR) targeting a 466 bp S1 gene were employed.

Results

A total of 196 blood samples, 7 pools (35) of swab samples, and 5 pools of tracheal samples were investigated. The results of serological analysis revealed that 97.96% (192/196; 95% CI: 94.86-99.44) of the sera samples were found to be positive for antibodies against IBV. Out of the 7 pools of swab and 5 pools of tracheal tissue samples analyzed using RT-PCR 33.3% (4/12) of them gave positive results all from swab samples. The RT-PCR-positive samples were subjected to a nested PCR yielding 295bp and 154bp indicating the circulation of Mass and 793/B (4/91) strains of IBV, respectively. The 12 pools of samples inoculated into embryonated egg showed cytopathic changes such as congestion, bleeding, and deformation only after three passages.

Conclusion

Two serotypes of IBV are circulating in Ethiopian chickens, and molecular identification of the Massachusetts serotype is the first report in Ethiopia. Further epidemiological investigation is needed in order to devise effective control measures.

Patient Satisfaction with Antiretroviral Therapy Services in Hadiya Zone, Central Ethiopia Using the Donebidean Model: A Time-Motion Study

Background

A time-motion study is a scientific method for recording time spent on various tasks in a narrow range of specialized work settings, beginning with initial enrollment in ART provision. Therefore, the study aimed to assess the time motion of patient satisfaction with antiretroviral therapy services in Central Ethiopia.

Methods

A facility-based cross-sectional study was conducted on a sample of 422 patients from June 14 to July 30, 2021. We used a simple random sampling technique to select the participants. Structural input-related qualitative data were collected using an in-depth interview and used for concurrent triangulation with quantitative. Quantitative data were collected using a standardized and pre-tested questionnaire and analyzed using SPSS version 24.0. Bivariate and multivariable logistic regressions were used to identify independent predictors of time motion and patient satisfaction. The degree of association between the outcome and independent variables was assessed by using an odds ratio with a 95% CI.

Results

The time motion of patient satisfaction study found that 53.1% (224/422) of the study participants were satisfied. As independent predictors, time spent (time motion) waiting to be seen by a health professional (AOR = 0.228, 95% CI = 0.079-0.661), patient-provider interaction (AOR = 3.72, 95% CI = 2.111-5.771), perceived privacy (AOR = 2.912, 95% CI = 1.76-2.78), sex (AOR = 2.499, 95% CI = 1.556-4.009), and income class (AOR = 0.228, 95% CI = 0.073-0.707) were associated with outcome variable.

Conclusion

The study found low patient satisfaction with ART services, indicating the need for further improvement to enhance patient-centered services with the given time motion. Therefore, further research is needed to assess the intensity and reach of the information through an analysis of pre- and post-intervention that provides a complete picture of conceptualizations of time motion studies.

Medicinal Plants in Treating Hepatitis B Among Communities of Central Region of Ethiopia

Purpose

In Ethiopia, most people rely heavily on traditional therapeutic plants that have been used for years. The practice of traditional medicines use to treat hepatitis is currently gaining popularity due to the limited availability and affordability of modern drugs. The aim of this study was, therefore, to assess the traditional medicinal plants use to treat viral hepatitis among communities of Central region of Ethiopia.

Methods

Data was collected from November 2018 to December 2021 in Central Ethiopia. An open-ended semi-structured interview was used among purposively selected herbalists, traditional medicine entrepreneurs, village heads, and patients visiting traditional healers for hepatitis treatments. A 5 mL blood sample was collected from patients who visited a traditional healers' clinic for hepatitis treatment and tested for HBsAg and HCV-antibody by using ELISA. Among HBsAg-positives, further nucleic acid test for HBV-DNA load was assessed to measure the effects of prescribed medicinal plants.

Results

Herbalists cited 24 plants that were used for hepatitis treatment; of which Rumex nepalensis, Vangueria apiculata, and Solanum incanum were the most frequently cited plants. Remedies were commonly prepared by crushing or powdering, mixing them with water, and taken orally. Forty-two individuals were diagnosed and treated as hepatitis patients by herbalists, of which eight of them were HBsAg-positive but no positives for anti-HCV ELISA. At the third and sixth months of viral load assessment among HBsAg-positive, serum HBV-DNA suppression was observed in three individuals treated with different combinations of frequently cited plants.

Conclusion

In this study, traditional healers used various plants to treat hepatitis. HBV-DNA suppressive activity was detected in three NAT-positive individuals who were treated by using a mixture of these frequently cited and highest preference-ranked plants. This suggests that these plants have antiviral properties and serve as a basis for more pharmacological research in the quest for new antiviral agents.

Epidemiological study and dairy farmers' knowledge, attitudes, and practices on foot and mouth disease in central Ethiopia

Foot and mouth disease (FMD) is consistently ranked as the most economically significant viral disease and one of the top five livestock diseases in Ethiopia. Although FMD is endemic in Ethiopia, the epidemiology and the farmers' knowledge, attitudes, and practices regarding FMD were poorly quantified. Thus, a cross-sectional study was conducted from November 2021 to April 2022 to estimate the seroprevalence, identify the FMD serotypes, and assess the farmers' knowledge, attitudes, and practices on FMD in Addis Ababa city and Sebeta special zone, central Ethiopia. A total of 384 serum samples were collected from cattle and tested using a 3ABC enzyme-linked immunosorbent assay (ELISA). In this study, an overall 56% seroprevalence was recorded. Two types of FMD serotypes were detected in which serotype O was the dominant serotype (75.5%) followed by serotype A (45.5%). A significantly higher seroprevalence (P = 0.00) was recorded in Addis Ababa (85%) compared to Sebeta (28.7%). Seropositivity in older and semi-intensively managed cattle was 2.9 (95% CI: 1.36-6.50; P = 0.006) and 2.1 (95% CI: 1.34-3.26; P = 0.001) times higher compared to young and intensively managed cattle, respectively. A survey on knowledge, attitude, and practice of 103 farmers revealed that 90.2% knew of FMD and the majority of them can recognize its clinical pictures. However, 12.7% of farmers who knew FMD didn't practice any prevention methods. Additionally, 70% of the farmers responded that their cattle roamed outside of their farms for communal grazing, watering, breeding purposes, and vaccination which might put them more at risk of FMD. The current study demonstrated that the majority of farmers have gaps in biosecurity practices and vaccination of cattle against FMD. Therefore, educating farmers on FMD prevention measures is necessary for successful disease control programs.

Household food insecurity and hunger status in Debre Berhan town, Central Ethiopia: Community-based cross-sectional study

Background

Food security occurs when all people have physical, social, and economic access to sufficient, safe, and nutritious food that fits their dietary needs and food preferences for an active and healthy life at all times. There is limited evidence on this topic and not well studied in Ethiopia.

Objective

This study aimed to investigate food insecurity and hunger status among households (HHs) in Debre Berhan town, Ethiopia.

Methods

A community-based cross-sectional study was undertaken from 1 January 2017 to 30 January 2017. A simple random sampling technique was used to enroll 395 HHs for the study. An interviewer-administered, structured, and pretested questionnaire was used to collect data through a face-to-face interview. The household food security and hunger status were assessed by using the Household Food Insecurity Access Scale and the Household Hunger Scale, respectively. Data were entered and cleaned using Epiata 3.1 and exported to SPSS software version 20 for statistical analysis. Logistic regression was fitted, and an odds ratio with a 95% confidence interval (CI) and a value of p of less than 0.05 were used to identify factors associated with food insecurity.

Results

A total of 377 HHs participated in the study with a response rate of 95.4%. The proportion of households with food insecurity was 32.4%, among which mild, moderate, and severe food insecurity accounted for 10.3, 18.8, and 3.2%, respectively. The mean score of the Household Food Insecurity Access Scale was 1.88 ± 3.5. Hunger occurred among 3.2% of households. The mean score of the Household Hunger Scale was 2.17 ± 1.03. Husband or male cohabitant's occupation (AOR = 2.68; 95% CI: 1.31-5.48) and wife or female cohabitant's literacy (AOR = 3.10; 95% CI: 1.01- 9.55) were the only factors associated with HH food insecurity.

Conclusion

HH food insecurity and hunger in Debre Berhan town were unacceptably high, which can hamper achieving national targets for food security, nutrition, and health. Intensified efforts are further needed to accelerate the decline in food insecurity and hunger prevalence. Therefore, interventions need to target self-employed merchants in small businesses and women who are uneducated.

Determinants of maternal satisfaction with focused antenatal care services rendered at public health facilities in the West Shewa Zone, Central Ethiopia: A multicentre cross-sectional study

Background

Every woman has the right to receive quality care during pregnancy. It is proven that antenatal care (ANC) reduces maternal and perinatal morbidity and mortality. The government of Ethiopia is also making intense efforts to increase the coverage of ANC. However, among pregnant women, the levels of satisfaction with the care provided are overlooked, as the percentage of women who complete all ANC visits is below 50. Therefore, this study aims to assess maternal satisfaction with ANC services rendered at public health facilities in the West Shewa Zone, Ethiopia.

Methods

A facility-based cross-sectional study was conducted among women who were receiving ANC in public health facilities in Central Ethiopia between September 1 and October 15, 2021. A total of 411 women were selected using the systematic random sampling method. The questionnaire was pretested and the data were collected electronically using CSEntry. The collected data were exported to SPSS version 26. The characteristics of the study participants were described using frequency and percentage. Bivariate and multivariate logistic regression were used to identify the factors associated with maternal satisfaction with focused ANC service.

Result

This study revealed that 46.7% [95% confidence interval (CI) (41.7%-51.6%)] of women were satisfied with ANC service. Factors such as the quality of the health institution [adjusted odd ratio (AOR) = 5.10, (95% CI: 3.33-7.75)], place of residence [AOR = 2.38, (95% CI: 1.21-4.70)], history of abortion [AOR = 0.19, (95% CI: 0.07-0.49)], and previous mode of delivery [AOR = 0.30, (95% CI: 0.15-0.60)] were significantly associated with women's satisfaction with focused ANC service.

Conclusion

More than half of pregnant women who received ANC were dissatisfied with the service they received. This should be a cause for concern, as the level of satisfaction is lower than that of the findings of previous studies conducted in Ethiopia. Institutional variables, interactions with patients, and previous experiences of pregnant women have an impact on the level of satisfaction. Due attention should be paid to primary health and communication of health professionals with pregnant women to improve the levels of satisfaction with focused ANC service.

Time to initiate postpartum modern contraceptives among pregnant women in Ambo Town, Central Ethiopia; Cox-proportional hazard regression analysis

BACKGROUND

Timing of postpartum family planning is crucial for maternal and child wellbeing by preventing unintended and closely spaced pregnancies. However, studies are limited on the time to use modern contraceptives in Ethiopia. Therefore, this study aimed to fill these gaps by assessing the time to initiate postpartum modern contraceptive and identifying its predictors among pregnant women in Ambo town, central Ethiopia.

METHODS

An institution based cross-sectional study was conducted among 356 pregnant women in Ambo town, Central Ethiopia. The data were analysed using STATA-16 software. Kaplan-Meier estimates were performed to explain time-to- modern contraceptive use. A Cox-proportional hazard regression analysis was conducted to identify predictors. The adjusted hazard ratio (AHR) with a 95% confidence interval was considered to declare a statistically significant association.

RESULTS

This study showed that the median survival time to initiate postpartum modern contraceptives was 6 months. In this study, the risk of modern contraceptive use was 2.13 times higher (AHR = 2.13; 95% CI: 1.02-4.45) among younger women, 1.44 times higher (AHR = 1.44; 95% CI: 1.09-2.66) among women with no desire for more children, and 2.25 times higher (AHR = 2.25; 95% CI: 1.02-4.95) among nulliparous women. However, it is 57% times lower (AHR = 0.57; 95% CI: 0.32-0.94) among pregnant women with current unintended pregnancy.

CONCLUSION AND RECOMMENDATION

The median survival time to initiate postpartum modern contraceptive was 6 months. Age of the women, desire for more children, parity and pregnancy status were found to be the significant predictors of time to initiate postpartum modern contraceptive. Therefore health care providers and concerned stakeholders should consider these factors to increase the uptake of the postpartum contraceptive methods.

Second-dose measles vaccination and associated factors among under-five children in urban areas of North Shoa Zone, Central Ethiopia, 2022

Introduction

Measles remain a leading cause of vaccine-preventable infant mortality. In Africa, about 13 million cases and 6,50,000 deaths occur annually, with Sub-Saharan Africa having the highest morbidity and mortality. Ethiopia launched second-dose measles vaccination into the routine immunization program in the second year of life in 2019. However, little has been known about the coverage of the second-dose measles vaccine. Therefore, the purpose of this study was to assess the level of second-dose measles vaccine uptake and associated factors in North Shoa Zone, Central Ethiopia.

Objective

To assess second-dose measles vaccination and associated factors among under-five children and to identify reasons for not being vaccinated in urban areas of North Shoa Zone, Central Ethiopia, 2022.

Method

A community-based cross-sectional study was conducted from 1 February to 15 March 2022. The sample size was 410, and it was allocated proportionally to each kebelle. The study units were selected consecutively. The data were collected using structured interviewer-administered questionnaires. Four nurses were used as data collectors. Data were coded manually and entered into Epi-data Version 4.4.2.1. Frequency and cross-tabs were used for data cleaning. Data were analyzed using SPSS Version 21 software. Multicollinearity and model goodness-of-fit tests were checked. A multivariable logistic regression model at 95% CI was used to identify factors associated with the dependent variable.

Result

The response rate was 90.7%. The level of second-dose measles vaccination among children in urban areas of North Shoa Zone was 42.5% [95% CI (36.8, 47.3)]. Maternal age of ≤ 25 years [AOR = 9.12: 95% CI (1.97, 42.19)], 26-30 years [AOR = 9.49: 95% CI (2.33, 38.63)], 31-35 years [AOR = 7.87: 95% CI (1.78, 34.79)]; average time mothers had been waiting for vaccination at the health facility [AOR = 3.68: 95% CI (1.33, 10.23)]; awareness about vaccine-preventable diseases [AOR = 4.15: 95% CI (1.53, 11.26)]; and awareness on recommended measles doses [AOR = 17.81: 95% CI (3.91, 81.22)] were identified as factors associated with MCV2 vaccination. The major reason (48.1%) reported by mothers for not vaccinating second-dose measles vaccine was being unaware of the need to return for second-dose measles vaccination.

Conclusion and recommendation

The level of second-dose measles vaccination (MCV2) among children in urban areas of the North Shoa Zone was low. Maternal age, average time mothers had been waiting for vaccination at the health facility, awareness about vaccine-preventable diseases, recommended age for the last vaccination, and recommended measles doses were identified as factors associated with MCV2 uptake. The major reason for not vaccinating MCV2 was a lack of information (unaware of the need to return for MCV2, unaware of the need to return for MCV2, and the place and/or time of immunization unknown). Hence, enhancing awareness about vaccine-preventable diseases, shortening the average time for vaccination at the health facility by half an hour, creating an alerting mechanism for MCV2 appointments, and future studies on the effect of healthcare provider-related factors on MCV2 uptake are recommended.

Household food insecurity and physically demanding work during pregnancy are risk factors for low birth weight in north Shewa zone public hospitals, Central Ethiopia, 2021: a multicenter cross-sectional study

BACKGROUND

Despite numerous efforts to improve the quality of maternal and child health medical services, over 20 million babies are born with low birth weights each year globally. However, factors related to low birth weight like physically demanding work during pregnancy, intimate partner violence, and food insecurity have not been explored well in Ethiopia. Thus, this study aimed to assess the prevalence of low birth weight and associated factors among neonates born in public Hospitals in North Shewa Zone, Central Ethiopia.

METHODS

A hospital-based cross-sectional study design was conducted from June 15 -to July 15, 2021, in North Shewa public hospitals. A total of 441 mothers and newborn pairs were selected by systematic random sampling. Data were collected using a pretested and structured interviewer-administered questionnaire with chart reviewing. Data entry and analysis were done using Epi Data version 3.1 and Statistical Package for the Social Sciences version 26 respectively. Binary logistic regression was done to identify factors associated with low birth weight. Adjusted odds ratio with its 95% confidence interval and a p-value less than 0.05 was considered to declare the statistically significant association.

RESULTS

The prevalence of low-birth-weight was 17.7% (95% CI: 14.3, 21.5). Pregnancy-related complication [AOR = 2.16; 95% CI:(1.12,4.18)], grand-multiparty [AOR = 2.57; 95% CI:(1.12,5.88)], physically demanding work during pregnancy [AOR = 2.19; 95% CI:(1.11,4.33)], midd-upper arm circumference less than 23 cm [AOR = 2.54; 95% CI:(1.26,5.10)], partner violence during pregnancy [AOR = 3.77; 95% CI:(1.81,7.88)], and being member of household with food insecure [AOR = 2.31; 95% CI:(1.12,4.75)] were factors significantly associated with low birth weight.

CONCLUSIONS

This study showed that the magnitude of low birth weight was relatively high. Women with pregnancy-related complications, grand multiparty, physically demanding work during pregnancy, intimate partner violence, mid-upper arm circumference less than 23 cm, and food insecurity should be prioritized for mitigating LBW. Health care professionals should focus on Screening pregnant women for intimate partner violence, physically demanding activities, undernutrition and providing appropriate treatment during all maternal continuum of care might be helpful.

Magnitude and associated factors of early Implanon discontinuation among rural women in public health facilities of central Ethiopia: a community-based cross-sectional study

Background

Advocating for and promoting contraception use is critical in reducing mother and child morbidity and mortality. Early Implanon discontinuation may result in unwanted pregnancies and induced abortions. Although there has been research in Ethiopia on long-acting reversible contraceptives, there has been none on early Implanon removal among rural women who have used and removed it. Hence, this study aimed to investigate the magnitude of Implanon discontinuation and related characteristics among women who had the Implanon removed in central Ethiopian public health facilities.

Methods

A community-based cross-sectional study was conducted among all women of the reproductive age group who had removed Implanon after using it. A simple random sampling technique was used to select 373 women after proportional allocation to each health facility. Data were collected using a pretested semi-structured interviewer-administered questionnaire adapted from previous studies. Data were entered using EpiInfo and exported to SPSS version 21 for analysis. A binary logistic regression model was used to determine the association between the outcome variable and independent variables. A p-value less than 0.25 was used as a cutoff point to select candidate variables for the final model. Then, a p value less than 0.05, AOR, and a 95% confidence level were used to declare statistical significance.

Result

A total of 360 participants responded to the questionnaires, making a response rate of 96.5%. In this study, the early discontinuation rate was 42% (95% CI 36.9–47.7). No formal education (AOR = 0.53 [95% CI 0.3–0.94], having medium monthly income (AOR = 3.02 [95% CI 1.38–6.6]), inadequate pre-insertion counseling (AOR = 0.55 [95% CI 0.31–0.98]), lack of appointment for follow up (AOR = 0.16 [95% CI 0.05–0.54]), didn`t satisfy with service provided (AOR = 0.067 [95% CI 0.015–0.29] and developed side effect (AOR) = 4.45 [95% CI 2.37–8.36] were significantly associated with Implanon discontinuation.

Conclusion

The discontinuation rate of Implanon among those who removed it after using it in this study was high. Lack of formal education, having a medium-income, inadequate pre-insertion counseling, lack of appointments for the follow-up, poor satisfaction, and problems with side effects were the factors associated with early discontinuation rate. Hence, quality family planning service provision is essential to reduce the discontinuation rate.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12905-022-01651-y.

Feto-Maternal Outcomes of Obstructed Labor and Associated Factors among Mothers Who Gave Birth in Public Hospitals of West Shoa Zone, Central Ethiopia: Cross-Sectional Study

BACKGROUND

Obstructed labor the major cause of adverse feto-maternal outcomes. Hence, the study assessed adverse fetomaternal outcomes of obstructed labor and associated factors among women who gave birth in public Hospitals of West Shoa Zone.

METHODS

Cross-sectional study design was conducted among 277 respondents. The required data were extracted from the mothers' chart by using a systematic random sampling method. Checklists were used to collect data. Bivariable and multivariable logistic regression was used to identify factors associated with feto-maternal outcomes. The odds ratio with 95%CI and p-value were used to identify the significant variables.

RESULTS

In this study, 145(52.3%) and 157(56.7%) of the respondents had adverse maternal and fetal outcomes respectively. Mothers who were referred from the health center (AOR: 3.96, 95%CI: 1.61-9.8) and who had a trial of labor at the health center and home had a more likelihood of adverse maternal outcomes than those who were referred and had trial of labor at hospital respectively. In addition, mothers who were not followed by partograph and in labor for >24hrs had also a more likelihood of adverse maternal outcomes than their counterparts. Likewise, newborns whom their mothers were not followed by partograph and mothers in labor for >24 hrs had also a more likelihood of adverse fetal outcomes than their counterparts. Hence, health professionals should give special attention to early diagnosis and referral of obstructed labor to higher facilities.

Implementation Status of Health Management Information System in Hospitals of South West Shoa Zone, Oromia, Central Ethiopia

Background

Health Management Information Systems (HMIS) is an information system for health management and planning at district, regional, and national levels. Problems of data collection and processing, poor information use, lack of identifying information required at specific levels, and inadequacy of resources are hindering the implementation of the program.

Objective

To assess the implementation status of Health Management Information System (HMIS) in hospitals of South West Shoa Zone, Oromia, Central Ethiopia.

Methods

The assessment was conducted in South West Shoa Zone hospitals using a cross-sectional study design. Using three dimensions, namely, availability of resources, compliance to guideline, and utilization of information were studied. All hospitals in the zone were included and 210 health workers were included in the study. Quantitative data were entered into Epi-data and analyzed using SPSS.v.23. Descriptive summery was done using the proportion and frequencies and qualitative results were analyzed thematically. The study was conducted from February 20, 2020, to March 20, 2020.

Results

All hospitals have at least one computer specifically assigned for HMIS, while none of the hospitals have an allocated budget for HMIS. Regarding service training, 82% of the respondents had received HMIS training. The overall Implementation status of HMIS was 58%, which showed as a judgment parameter of “poor” implementation. Particularly, availability (58%) and compliance (55%) dimensions are categorized as “poor” implementation, whereas the information utilization dimension is categorized as a judgment parameter of “fair” implementation.

Conclusion

The overall implementation status of HMIS in the study area was poorly implemented according to the preset criteria with stakeholders. Therefore, allocation of budget specifically for HMIS, strengthening capacity building activities such as training and supportive supervision with written feedbacks are recommended for effective implementation of the Health Management Information System.

Veterinary medicinal product usage among food animal producers and its health implications in Central Ethiopia

Background

Antimicrobials and anthelmintics are the most commonly used veterinary drugs to control animal diseases. However, widespread use of these drugs could contribute to the emergence of drug resistance. Information on the practice of antimicrobial usage among food animal raising communities in Central Ethiopia is scarce. We used a standardised questionnaire survey to assess knowledge, awareness, and practices related to drug use and resistance in food animals among the farmers in and around Bishoftu town.

Results

Of the total of 220 livestock owners interviewed, around 80% of the respondents were not able to define what antimicrobials are and for what purposes they are used. Only 14.1% (n = 31) of the respondents had awareness about antimicrobial resistance (AMR) and its consequences; and 35.5% (n = 11/31) and 9.7% (n = 3/31) of them agreed that the irrational use of antimicrobials in animals could lead to AMR in animals and humans. Oxytetracycline was the most commonly available antibiotic in veterinary drug shops/pharmacies and the most widely used drug in the area. However, 43.3% of the respondents did not see clinical improvements after using antibiotics. Similarly, the respondents explained that no response was observed in 73.3, 70.8 and 52.5% of the cases after medication with anthelmintics, antiprotozoal and acaricides, respectively. About 56.7% of the respondents considered traditional medicines equally important to modern medicines. It was also noted that there were illegal drug vendors, dispensing medicines under unfavourable conditions which include a direct exposure to sunlight, which practice violates the drug handling and storage recommendations given by WHO.

Conclusion

The study revealed that there is a general lack of awareness among food animal owners about the correct use of antibiotics and anthelmintics. The widespread misuse and improper drug dispensing and handling practices observed in this study can affect the drug quality and can also contribute to the development of drug resistance in central Ethiopia.

Molecular characterization of Mannheimia haemolytica isolates associated with pneumonic cases of sheep in selected areas of Central Ethiopia

Background

Mannheimia haemolytica has been recognized as the principal cause of pneumonic pasteurellosis in sheep and goats. It is one of the important diseases of small ruminants in Ethiopia. While annual vaccination using a monovalent vaccine (inactivated Pasteurella multocida biotype A) is common, respiratory diseases are still reported in various parts of Ethiopia. This suggests the need for further investigation into the species and strains responsible for the disease, which is vital information for development of a multivalent vaccine. The objective of the current study was to isolate M. heamolytica associated with pneumonic cases of sheep in selected areas of Central Ethiopia, determine its role and the strains/genotypes of the bacterium circulating in the study area.

Results

Bacteriological analysis of nasal swab samples collected from a total of 76 pneumonic cases of sheep showed that M. haemolytica was isolated from 26 of them while B.trehalosi from two cases. Further molecular analyses of the isolates using M. haemolytica species-specific and M.haemolytica serotype-1 antigen specific PCR assays revealed, 26 of the isolates were identified as M. haemolytica of which 21 of them were M. haemolytica serotype-1. Both M. haemolytica and B.trehalosi isolates were not detected in a PCR assay targeting capsular biosynthesis gene (capA) of P.multocida despite the non-specific products observed in M. haemolytica isolates. Phylogenetic analysis of M. haemolytica isolates included in this study in comparison with the reference strains with respect to PHSSA and Rpt2 genes revealed that the Ethiopian M. haemolytica isolates constituted three distinct genotypes consistent with site of origin.

Conclusion

The study indicated that M.haemolytica is commonly associated with cases of pneumonia in sheep in the study areas of central Ethiopia although the remaining other pathogens responsible for majority of the cases are yet to be determined. Molecular characterization revealed the existence of three genotypes of M. haemolytica circulating in the study areas consistent to the site of isolation. The findings suggest further extensive work to determine all pathogens associated with sheep pneumonia and the strain distribution of M. heamolytica to understand its molecular epidemiology at national level and design cost effective prevention and control methods.

Isolation, molecular characterization and sero-prevalence study of foot-and-mouth disease virus circulating in central Ethiopia

BACKGROUND

Ethiopian livestock production and productivity is still very low due to widespread of diseases. Among the diseases, foot-and-mouth disease (FMD) is an extremely contagious and acute viral disease that causes significant economic problems in the country. A cross sectional study design was conducted from September 2015 to May 2016 to isolate and characterize FMD virus from outbreak cases; determine the sero-prevalence of antibodies against FMD virus (FMDV), and assess potential risk factors associated with sero-prevalence of the disease in selected areas of central Ethiopia. A multistage sampling technique was employed to select the study animals. Isolated viruses were characterized by antigen ELISA (IZLER, Brescia, Italy) and by genetic analysis of the sequence of the viral protein 1 (VP1). Sero-prevalence was determined using an ELISA for antibodies against non-structural proteins of FMDV based on the 3ABC proteins (ID Screen® FMD NSP Competition, ID-VET, Grabels, France). Risk factors for sero-prevalence of antibodies against FMD virus was investigated using logistic regression analysis.

RESULT

From outbreak investigation, 28.8% (n = 378) cattle showed signs and lesions suggestive of FMD and 34 samples were subjected to virus isolation. Twenty eight of these cultures exhibited cytopathic effect (CPE) and were serotyped as O, A and SAT 2 FMD viruses. One A and two SAT 2 isolates named A-ETH-19-2015, SAT 2-ETH-18-2015 and SAT 2-ETH-20-2015 were further characterized by phylogenetic analysis. The overall sero-prevalence of antibodies against non-structural proteins of FMDV was 24.2% (n = 574). Cattle herds with crossbreed cattle, with older cattle (> 2 years), and kept together with small ruminants had higher sero-prevalences of antibodies against FMDV (p < 0.05).

CONCLUSION

This study showed that FMD was present in the study areas. Among the associated risk factors, breed, age and herd composition were significantly associated with presence of antibodies against FMD virus. Three different serotypes (A, O and SAT 2) were responsible for the outbreaks of the disease. Genetic analysis indicated that the isolated viruses clustered differently from previous outbreaks. Thus, further molecular analyses coupled with protection potential of the existing vaccines against the isolates should be performed.

Urinary pathogenic bacterial profile, antibiogram of isolates and associated risk factors among pregnant women in Ambo town, Central Ethiopia: a cross-sectional study

Background

Urinary tract infection (UTI) is a well-known bacterial infection posing serious health problem in pregnant women. A study was conducted in pregnant women with the objectives of estimating prevalence of UTI, determining antibiogram of the bacterial isolates and assessment of the potential risk factors associated with UTI.

Methods

A cross-sectional study design was used to collect 300 mid-stream urine samples from pregnant women from March 2016 to December, 2016. Samples were inoculated into Cysteine Lactose Electrolyte Deficient medium (CLED). Colonies from CLED were subcultured onto MacConkey and Blood agar plates. A standard agar disc diffusion method was used to determine antimicrobial susceptibility. Chi-square (X2) test & logistic regression were used to show associations between UTI and explanatory variables & identify the predictors of UTI, respectively.

Results

The age of pregnant women enrolled in this study ranges from 16 to 46 years (mean ± standard deviation = 25 ± 4.7 years).The overall prevalence of UTI in pregnant women was 18.7% (95% confidence interval [CI]: 14.4-23.54%).The prevalence of symptomatic and asymptomatic UTI was 20.4% (95% CI: 13.09-29.46%) and 17.8% (95% CI: 12.70-23.83%) respectively. The predominant bacteria identified were E. coli (46.4%), S. aureus (14.3%), coagulase negative Staphylococci [CoNS] (14.3%) and Proteus species (10.6%). Majority of Gram-negative bacteria isolates were resistant to ampicillin (70%), ceftriaxon (66%), gentamicin (68%) and nitrofurantoin (64%) while 75-100% of the Gram positive isolates were resistance to ampicillin. Multiple drug resistance was observed in all of the isolates. Multivariable logistic regression revealed that the odds of acquiring UTI was 4.78 times higher in pregnant women earning monthly income of ≤500 Ethiopian Birr (21.18 USD) as compared to those earning monthly income >2001 Ethiopian Birr [84.79 USD] (P = 0.046). Similarly, the risk of UTI was higher in those who eat raw meat (OR = 2.04, 95% CI: 1.09, 3.83, P = 0.026) and had previous UTI history (OR = 2.29, 95% CI = 1.15-4.56, P = 0.019) as compared to those who eat cooked meat and had no previous history of UTI.

Conclusions

The prevalence & antimicrobial resistance of uropathogens was high. Health education, continuous surveillance of UTI and their antimicrobial resistance pattern are essential to reduce the consequence of symptomatic and asymptomatic bacteriuria and multi-drug resistant bacteria in pregnant women.

Molecular typing of Mycobacterium tuberculosis complex isolated from pulmonary tuberculosis patients in central Ethiopia

Background

Identification of the types of strains of Mycobacterium tuberculosis (M. tuberculosis) complex causing tuberculosis (TB) could contribute to TB control program of specific geographic region as well as it could add knowledge onto the existing literature on TB worldwide. The objective of the present study was to identify the species and strains of M. tuberculosis complex causing pulmonary tuberculosis in central Ethiopia.

Methods

A health institution- based cross-sectional study was conducted on 338 smear positive TB cases visiting three hospitals between October 2012 and September 2013. Morning and spot sputum samples were collected before the starting of treatment regimens. Thus, a total of 338 pooled sputum samples collected from these cases. Samples were cultured on Löwenstein Jensen media and the isolates were identified by the region of difference (RD) 9 based polymerase chain reaction (PCR) and spoligotyping.

Result

Of the total isolates 98.6% of the isolates were identified to be M. tuberculosis while the remaining 1.4% were identified as M. africanum. Further, typing of M. tuberculosis using spoligotyping lead to the identification of 90 different strains of M. tuberculosis. Of these strains, 32 were clustered consisting of more than one isolate while the remaining 58 strains were unique consisting of single isolate. Thus, 79.3% (223/281) of the isolates were found in the clustered while only 20.6% (58/281) of the strains were unique. Forty-five of the spolgotyping patterns were registeredin the SITVIT2 or SpolDB4 database in while the remaining 45 were notfound in the database and hence were orphan strains. The dominant strains were SIT53, SIT149, and SIT54, consisting of 43, 37 and 34 isolates, respectively. Classification of the spoligotype patterns using TB-insight RUN TB-Lineage showed that 86.8, 6.4, 5, 1.4% ofthe isolatesbelonged to the Euro-American lineage, East-African-Indian, Indo-oceanic and M. africanum, respectively.

Conclusion

The identification of clustered and new strains using spolygotyping in present study does not give conclusive finding as spoligotyping has low discriminatory power. Thus, further identification of these isolates using mycobacterial interspersed repetitive unit-variable number tandem repeat (MIRU-VENTR) and or whole genome sequencing (WGS) recommended.

Some risk factors for reproductive failures and contribution of Toxoplasma gondii infection in sheep and goats of Central Ethiopia: a cross-sectional study

Reproductive failure has a negative impact on animal production, health and welfare and ultimately rural economies. In Ethiopia, the factors affecting small ruminant reproductive efficiency are inadequately investigated. A cross-sectional survey was done from November, 2010 to May, 2011 to investigate risk factors of reproductive failures including Toxoplasma gondii infection. Analysis of 1372 sera (787 sheep and 585 goats) from 409 flocks using ELISA showed high flock (59.7%) and animal (31.8%) level T. gondii seroprevalence. An overall 24.9% (341/1372) annual abortion rate (19.6% in sheep and 32.0% in goats) was recorded. Animal level T. gondii seroprevalence was significantly associated with abortion in Ambo and Ada'a-Liben districts (Odds ratio [OR] = 2.31, 95% confidence interval [CI]: 1.42, 3.76; P = 0.001). Questionnaire survey on 199 households of Ambo, Ada'a-Liben and Fentale districts revealed high flock level abortion (57.5%), still birth (28.9%) and neonatal losses (47.9%), which are significantly different between study districts (P<0.001). Multivariable logistic regression model showed that species (goat), large flock size, pastoral and agro-pastoral production systems, drinking water from river and stagnant water bodies, grazing/browsing in plain land and extensive management were significant predictors of flock level reproductive failures. In the final Zero inflated Poisson regression model number of abortions was significantly higher in goat than in sheep flocks (Incidence risk ratio [IRR] = 1.42, 95% CI: 1.08, 1.87; P = 0.012). It is also significantly higher in pastoral (IRR = 1.81, 95% CI: 1.16, 2.83; P = 0.008) and agro-pastoral production systems (IRR = 1.94, 95% CI: 1.32, 2.86; P = 0.001) than in sedentary production system. Prevention of toxoplasmosis, improved husbandry practices and further epidemiological studies to identify causes of reproductive failures are recommended.