Background Antenatal care (ANC) is special care for pregnant women with the aim of preventing, detecting and treating health problems in both the fetus and mother. Early ANC attendance promotes early detection and treatment of complications which result in proper management during delivery and puerperium. However, the majority of pregnant women in Ethiopia initiate their ANC late. Therefore, this study aimed to assess the prevalence of late initiation of ANC and its associated factors among attendants in Addis Zemen primary hospital. Method An institution-based cross-sectional study was conducted at Addis Zemen primary hospital from February 7 to June 122,018. The systematic random sampling technique was employed to select 369 pregnant women who attended ANC in the hospital. Data cleaning and analysis was done using SPSS version 25 statistical software. Descriptive statics and bi variable and multivariable logistic regression models were employed to assess the magnitude and factors associated with late initiation of ANC defined as making the first visit after 12 weeks of gestation. Result This study indicated that 52.5% of the attendants initiated ANC late. The multivariable logistic regression analysis showed that being housewife (Adjusted odds ratio (AOR) = 2.85, 95% CI: 1.36, 5.96), self-employment (AOR = 2.38, 95% CI: 1.12, 5.04), travel expenses (AOR = 1.72, 95% CI: 1.05, 2.81), poor knowledge about ANC (AOR = 2.98, 95% CI: 1.78, 5.01) and unplanned pregnancy (AOR = 2.31, 95% CI: 1.28, 4.16) were significantly associated with late ANC initiation. Conclusion The prevalence of late ANC initiation remains a major public health issue in Ethiopia. The major factors for being late were found to be poor knowledge, being housewife, and self-employment, travel expenses and unintended pregnancy. District and zonal health offices should work to create awareness about the importance of early initiation of ANC, make the service closer to the community and increase contraceptive utilization.

objective Multidrug-resistant tuberculosis (MDR-TB) is an emerging public health problem in Ethiopia. The aim of this study was to assess MDR-TB treatment outcomes and determine predictors of poor treatment outcomes in north-west Ethiopia.methods A retrospective cohort study was conducted using all MDR-TB patients who were enrolled at Gondar University Hospital since the establishment of the MDR-TB programme in 2010. A Cox proportional hazard model was used to identify the predictors of time to poor treatment outcomes, which were defined as death or treatment failure.results Of the 242 patients who had complete records, 131 (54%) were cured, 23 (9%) completed treatment, 31 (13%) died, four (2%) experienced treatment failure, 27 (11%) were lost to follow-up, six (2%) transferred out, and 20 (8%) were still on treatment at the time of analysis. The overall cumulative probability survival of the patients at the end of treatment (which was 24 months in duration) was 80% (95% CI: 70%, 87%). The proportion of patients with poor treatment outcomes increased over time from 6% per person-year (PY) during 2010-2012, to 12% per PY during 2013-2015. The independent predictors of time to poor treatment outcome were being anaemic [AHR = 4.2; 95% CI: 1.1, 15.9] and being a farmer [AHR = 2.2; 95% CI: 1.0, 4.9].conclusions Overall, in north-west Ethiopia, the MDR-TB treatment success rate was high. However, poor treatment outcomes have gradually increased since 2012. Being a farmer and being anaemic were associated with poor treatment outcomes. It would be beneficial to assess other risk factors that might affect treatment outcomes such as co-infection with malaria, poverty and other socio-economic and biological risk factors.

BackgroundUnintended pregnancies can have adverse physical, mental, social, and economic outcomes. Illegal abortions and associated complications often follow unintended pregnancies and claim the lives of many women in developing countries. To better understand how unintended pregnancy impacts married women, this study aimed to assess the prevalence of unintended pregnancies and associated factors among married pregnant women in West Belessa woreda, Ethiopia.MethodsA community-based cross-sectional study was conducted from August to September 2015.. A multistage stratified sampling technique was used to select nine kebeles, to participate in the study. A total of 619 married pregnant women were selected from these kebeles by the simple random sampling technique and data were collected with a structured questionnaire. Binary logistic regression analysis was used to identify factors associated with the unintended pregnancies. A p-value of < 0.05 in the multi-variable model was used to identify significance.ResultA total of 592 married pregnant women were surveyed regarding their intention to become pregnant. The prevalence of unintended pregnancy was 13.7%. Age at pregnancy (AOR: 15.2, 95% CI (1.9, 125.2)), history of stillbirth (AOR: 3.3, 95% CI (1.4, 7.9)), discussing pregnancy related issues with husbands (AOR: 2.3, 95% CI (1.1, 5.0)), making family planning decisions on their own (AOR: 0.4, (0.2, 0.8)), and making family planning decisions with their husbands (AOR: 95% CI 0.2 (0.1, 0.4)) were significantly associated with unintended pregnancies in this group.ConclusionThe magnitude of unintended pregnancy in the study area was low. Age at pregnancy, history of stillbirth and involvement of partners in making reproductive health choices were associated with unintended pregnancies. Empowering women to make family planning decisions and increasing partner involvement in reproductive health could decrease unintended pregnancies.

ObjectiveThis study aimed to assess the incidence and risk factors of treatment failure among HIV/AIDS-infected children who were on antiretroviral therapy (ART) in Amhara National Regional State, Ethiopia.MethodsA retrospective follow-up study was conducted from January 2010 to March 2016. A total of 824 children under the age of 15 who had started ART were included in the study. Data were collected from children’s medical charts and ART registration logbook using a standard checklist. A Weibull regression model was used to identify the risk factors of treatment failure. Adjusted HRs (AHRs) with 95% CIs were used to declare statistical significance.ResultsThe mean (±SD) age of the children was 6.4±3.6 years, with a median (IQR) follow-up of 30.5 (14.6–51.4) months. Sixty-three children (7.7%, 95% CI 5.8 to 9.5) developed treatment failure, 17 (27.0%) of whom were immunological and 46 (73.0%) were clinical failures. The incidence rate of treatment failure was 22.1/10 000 person-months. The cumulative probability of failure was 0.4, with 28 562.5 person-month observations. Lack of disclosure (AHR=4. 4, 95% CI 1.8 to 11.3), opportunistic infections during initiation of ART (AHR=2.3, 95% CI 1.3 to 4.1) and prolonged follow-up (AHR=0.06, 95% CI 0.02 to 0.18) were the main predictors of treatment failure.ConclusionThis study revealed that the incidence of treatment failure remains a significant public health concern in Ethiopia. Undisclosed HIV status to children, the presence of opportunistic infections during initiation of ART and prolonged follow-up were found to be the main predictors of treatment failure. Hence, early detection of treatment failure and further studies on viral monitoring need to be considered.

BackgroundType 2 Diabetes Mellitus is a serious metabolic disease that is often associated with vascular complications. There are 1.9 million people living with Diabetes in Ethiopia; diabetes mellitus is found to be the ninth leading cause of death related to its complications. Although the rate of vascular complications continues to rise, there is limited information about the problem. This study aimed to estimate the incidence and predictors of vascular complications among type 2 diabetes mellitus patients at University of Gondar Referral Hospital.MethodsInstitution based retrospective follow-up study was conducted at University of Gondar Referral Hospital with 341 newly diagnosed type 2 DM patients from September 2005 to March 2017 and the data were collected by reviewing their records. Schoenfeld residuals test and interaction of each covariate with time were used to check proportional hazard assumption. The best model was selected by using Akaike Information Criteria (AIC). Hazards ratio (HR) with its respective 95% confidence interval were reported to show strength of association.ResultThe selected patients were followed retrospectively for a median follow up time of 81.50 months (Inter quartile range (IQR) = 67.2–103.3). The mean age (± Standard deviation (SD)) of patients at baseline was 51.7(SD: ±11.5 years) and 57.48% were females. The incidence rate of vascular complications was 40.6 cases/ 1000 person years of observation. The significant predictors for vascular complications where found to be male sex (Adjusted hazard ratio (AHR) = 0.50, 95% CI: 0.27, 0.94), having hypertension at baseline(AHR = 3.99, 95% CI: 1.87, 8.56), positive protein urea at base line (AHR = 1.69, 95% CI: 1.03, 2.78), high density lipoprotein cholesterol(HDL-C) level ≥ 40 mg per deciliter (mg/dl) (AHR = 0.43, 95% CI: 0.24, 0.77), low density lipoprotein cholesterol(LDL-C) level > 100 mg/dl (AHR = 3.05, 95% CI: 1.47, 6.35) and triglyceride > 150 mg/dl (AHR = 2.74, 95% CI: 1.28, 5.84).ConclusionThe incidence of vascular complications among type 2 diabetes patients remains a significant public health problem. Hypertension at baseline, LDL-C > 100 mg/dl, triglyceride > 150 mg/dl, HDL-C ≥ 40 mg/dl and male sex were significant predictors of vascular complication. In the light of these findings targeted interventions should be given to diabetes patients with hypertension comorbidity and dyslipidemia at follow up clinics.