Diarrhea remains a major cause of mortality in children under 5 years of age in Sub-Saharan countries in Africa. Risk factors for diarrhea vary by context and have important implications for developing appropriate strategies to reduce the burden of the disease. The objective of this study was to assess the prevalence of diarrhea and associated risk factors among children under 5 years of age in Kersa district, located in Eastern Ethiopia. A community-based crosssectional study was conducted among 1456 randomly selected households with at least one child under 5 years of age. A questionnaire and an observational check list were used for collecting information on socio-economic characteristics, environmental hygiene and behavioral practices, and occurrence of diarrhea among children under 5 years of age. Logistic regression was used to calculate the adjusted odds ratio of 95% confidence interval. The two-week prevalence of diarrhea among children under 5 years of age was 22.5% (95% CI: 20.3 -24.6). Improper refuse disposal practices (OR = 2.22, 95% CI: 1.20 -4.03), lack of hand washing facilities (OR = 1.92, 95%CI: 1.29 -2.86), living in rural area (OR = 1.81, 95% CI: 1.12 -3.31), the presence of two or more siblings in a household (OR = 1.74, 95% CI: 1.33 -2.28), and age of the child (OR= 2.25, 95% CI; 1.5-3.36) were the major risk factors for diarrhea. This study demonstrated that diarrhea morbidity was relatively high among children under 5 years of age residing in Eastern Ethiopia. Efforts to reduce childhood diarrhea should focus on improving household sanitation, personal hygiene, and child birth spacing.

BackgroundViolence against women is now widely recognized as a serious human right abuse, and an important public health problem with substantial consequences physical, mental, sexual, and reproductive health. Data on systematic review of domestic violence are needed to support policy and program recommendations. Therefore, the overall purpose of this systematic review was to assess magnitude of domestic violence against women and associated factors in Ethiopia.MethodsStudies systematically reviewed in Federal Democratic Republic of Ethiopia from 2000 to 2014. Systematic review was employed on published research works from databases such as Pubmed, popline, Hinari, and Google using key words. We also consulted public health experts. Community based studies with a study population (15–49 years) were included for review. Thirteen peer reviewed papers and two consecutive Ethiopian demographic and health surveys (2005 and 2011) were included to the systematic review. Twenty seven available in open access journals were retrieved and assessed based on the criteria’s such as community based study, cross sectional study design, clearly report prevalence and associated factors were included in the systematic review work. Finally, 15 papers were included in this review.ResultsLifetime prevalence of domestic violence against women by husband or intimate partner among 10 studies ranged from 20 to 78 %. The lifetime domestic physical violence by husband or intimate partner against women ranged from 31 to 76.5 %. The life time domestic sexual violence against women by husband or intimate partner ranged from 19.2 to 59 %. The mean life time prevalence of domestic emotional violence was 51.7 %. Significant number of women experienced violence during their pregnancy period. Domestic violence against women significantly associated with alcohol consumption, chat chewing, family history of violence, occupation, religion, educational status, residence and decision making power.ConclusionDomestic violence against women was relatively high in different parts of Ethiopia. Domestic violence has direct relationship with sociodemographic characteristics of the victim as well as perpetrator. Therefore, appropriate health promotion information activities needed to tackle associated factors of domestic violence against women or to prevent and control the problem to save women from being victim.

BackgroundOccupational exposure to blood and body fluids is a serious concern for health care workers, and presents a major risk for the transmission of infections such as HIV and hepatitis viruses. The objective of this study was to investigate occupational exposures and behavior of health care workers (HCWs) in eastern Ethiopia.MethodsWe surveyed 475 HCWs working in 10 hospitals and 20 health centers in eastern Ethiopia using a structured questionnaire with a response rate of 84.4%. Descriptive statistics and multivariate analysis using logistic regression were performed.ResultsLife time risks of needle stick (30.5%; 95% CI 26.4–34.6%) and sharps injuries (25.7%; 95% CI 21.8–29.6%) were high. The one year prevalence of needle stick and sharps injury were 17.5% (95% CI 14.1–20.9%) and 13.5% (95% CI 10.4–16.6%) respectively. There was a high prevalence of life time (28.8%; 95% CI = 24.7–32.9%) and one year (20.2%; 95% CI = 16.6–23.8%) exposures to blood and body fluids. Two hundred thirteen (44.8%) HCWs reported that they were dissatisfied by the supply of infection prevention materials. HCWs had sub-optimal practices and unfavorable attitudes related to standard precautions such as needle recapping (46.9%) and discriminatory attitudes (30.5%) toward HIV/AIDS patients.ConclusionThere was a high level of exposure to blood and body fluids among HCWs. We detected suboptimal practices and behavior that put both patients and HCWs at significant risk of acquiring occupational infections. Health authorities in the study area need to improve the training of HCWs and provision of infection prevention equipment. In addition, regular reporting and assessment of occupational exposures need to be implemented.

BackgroundSexual and reproductive health communications are most likely promoting healthy sexual development and reduce sexual risks. Communication is the principal means for parents to transmit sexual values, beliefs, expectations and knowledge to their adolescents. However, there is a paucity of evidence about adolescent parent communication in Ethiopia. This study aimed to determine adolescent-parent communication on sexual and reproductive health issues and associated factors among high school students in Dire Dawa, Eastern Ethiopia.MethodsInstitution based cross sectional study was conducted among high school students in Dire Dawa administrative council from February to March 2011. Simple random sampling technique was used to select 695 students from 9–12 grades. Qualitative data were collected through focus group discussion separately for female and male parents. Data were entered in Epi info version 3.5.1 and analyzed by SPSS version 16.1. Logistic regression with OR and 95% confidence interval was used to identify the independent predictors of adolescent parent communication.ResultsThirty seven percent of students had ever discussed on at least two sexual and reproductive health topics with their parents. Of which, majority of student preferred to discuss with their peers than parent. Condom use during first intercourse was associated with having communication about sexual and reproductive health [AOR = 1.9, 95% CI: 1.0, 3.8]. Cultural taboo, shame and lack of communication skill were reasons that hinder communication between parent and adolescent about sexual matters.ConclusionCommunication on sexual and reproductive health issue between adolescent and their parent was low. School based education is important to improve adolescent parent communication about sexual and reproductive health issues.Electronic supplementary materialThe online version of this article (doi:10.1186/1742-4755-11-77) contains supplementary material, which is available to authorized users.

IntroductionStudies have shown high initial mortality in Antiretroviral Therapy (ART) programs from resource-limited settings. However, there is dearth of evidence on treatment outcomes and associated determinant factors in public hospitals. Therefore, the objective of this study is to assess survival and identify predictors of death in adult HIV-infected patients initiating ART at a public hospital in Eastern Ethiopia.MethodsA retrospective cohort study was conducted by reviewing baseline and follow-up records of patients who started ART between December 1, 2007 and December 31, 2011 at Kharamara hospital. Time to death was the main outcome measure. Kaplan-Meier models were used to estimate mortality and Cox proportional hazards models to identify predictors of mortality.ResultsA total of 784 patients (58.4% females) were followed for a median of 60 months. There were 87 (11.1%) deaths yielding an overall mortality rate of 5.15/100 PYO (95% CI: 4.73-6.37). The estimated mortality was 8.4%, 9.8%, 11.3%, 12.7% and 14.1% at 6, 12, 24, 36 and 48 months respectively. The independent predictors of death were single marital status (AHR: 2.31; 95%CI: 1.18-4.50), a bedridden functional status (AHR: 5.91; 95%CI: 2.87-12.16), advanced WHO stage (AHR: 7.36; 95%CI: 3.17-17.12), BMI < 18.5 Kg/m2 (AHR: 2.20; 95%CI: 1.18-4.09), CD4 count < 50 cells/µL (AHR: 2.70; 95%CI: 1.26-5.80), severe anemia (AHR: 4.57; 95%CI: 2.30-9.10), and TB co-infection (AHR: 2.30; 95%CI: 1.28-4.11).ConclusionImproved survival was observed in patients taking ART in Somali region of Ethiopia. The risk for death was higher in patients with advanced WHO stage, low CD4 count, low Hgb, low BMI, and concomitant TB infection. Intensive case management is recommended for patients with the prognostic factors. Optimal immunologic and weight recoveries in the first 6 months suggest increased effort to retain patients in care at this period.

BackgroundInformation on health-seeking behavior and utilization of health facilities in slums of Addis Ababa is scarce, impeding the implementation of effective interventions. The purpose of this study is to assess the status of health facilities utilization and predictors for health-seeking behavior of mothers/caregivers of under-five children with acute diarrhea in slums of Addis Ababa, Ethiopia.MethodsA community-based cross-sectional study design was employed in five rounds of surveys in seven kebeles in slums of Addis Ababa among 472 mothers/caregivers of 472 under-five children with acute diarrhea in reference to Andersen’s behavioral model. Data were entered into EpiData Version 3.1 and analyzed using STATA Version 14.0. Descriptive statistics were used to examine patterns of health facilities utilization and multivariable logistic regression analysis was applied to identify predictors associated with health-seeking behavior.ResultsMost mothers/caregivers (70.8%) sought care either at home (14.2%) or health facilities (56.6%), whereas 29.2% reported that they did not seek any care. Of those who consulted health facilities, government health facilities (76.9%) were more utilized than private (18.0%) and informal (5.1%) health facilities. Nearly all (93.9%) of the mothers/caregivers using government health facilities used health centers, and of those who took their children to private health facilities (60.9%) used clinics and 26.1% used pharmacies/drug vendors. Mothers/caregivers visiting health facilities obtained mainly oral rehydration salt (ORS) (39.8%) and home-recommended fluids (HRF) (40.3%), but few of them (11.9%) obtained ORS plus zinc supplementation. Predisposing factors of literacy of mothers/caregivers (adjusted odds ratio (AOR) = 2.4; 95% CI 1.4–4.1) and occupation (AOR = 2.6; 95% CI 1.5–4.6), the enabling factors of households monthly income of 50 United States Dollars (US$) and above (AOR = 2.9; 95% CI 1.5–5.6) and availability of nearest health facilities within 15 min walking distance (AOR = 3.3; 95% CI 1.7–6.6), and the need factors of recognizing danger signs of fever (AOR = 4.3; 95% CI 2.4–7.6) and vomiting (AOR = 3.3; 95% CI 1.8–5.9) were significantly associated with health-seeking behavior.ConclusionsIncreasing the proximity of health facilities in slums and health education and socioeconomic development programs targeting illiterate mothers/caregivers and poor households may promote and increase health-seeking behavior and the accessibility of health facilities for the treatment of acute diarrhea in under-five children in Addis Ababa slums.

BackgroundAdolescents in developing countries face a range of sexual and reproductive health problems. Lack of health care service for reproductive health or difficulty in accessing them are among them. In this study we aimed to examine health care workers' attitudes toward sexual and reproductive health services to unmarried adolescents in Ethiopia.MethodsWe conducted a descriptive cross-sectional survey among 423 health care service providers working in eastern Ethiopia in 2010. A pre-tested structured questionnaire was used to collect data. Descriptive statistics, chi-square tests and logistic regression were performed to drive proportions and associations.ResultsThe majority of health workers had positive attitudes. However, nearly one third (30%) of health care workers had negative attitudes toward providing RH services to unmarried adolescents. Close to half (46.5%) of the respondents had unfavorable responses toward providing family planning to unmarried adolescents. About 13% of health workers agreed to setting up penal rules and regulations against adolescents that practice pre-marital sexual intercourse. The multivariate analysis indicated that being married (OR 2.15; 95% CI 1.44 - 3.06), lower education level (OR 1.45; 95% CI 1.04 - 1.99), being a health extension worker (OR 2.49; 95% CI 1.43 - 4.35), lack of training on reproductive health services (OR 5.27; 95% CI 1.51 - 5.89) to be significantly associated with negative attitudes toward provision of sexual and reproductive services to adolescents.ConclusionsThe majority of the health workers had generally positive attitudes toward sexual and reproductive health to adolescents. However, a minority has displayed negatives attitudes. Such negative attitudes will be barriers to service utilization by adolescents and hampers the efforts to reduce sexually transmitted infections and unwanted pregnancies among unmarried adolescents. We therefore call for a targeted effort toward alleviating negative attitudes toward adolescent-friendly reproductive health service and re-enforcing the positive ones.

Background: Breast feeding will have the intended outcome when it is initiated timely and exclusive for the first six months. Introducing prelacteal feeding and inadequate amount of breast milk contributes to over a million avoidable infant deaths each year in developing countries. The purpose of this study was to assess prelacteal feeding practice and associated factors among mothers attending immunization clinic in Harari region government health institutions. Methods: An institutional based cross-sectional study design was conducted among 634 mothers and infants dyads attending ten public health facilities. Systematic random sampling method was used to select the study participants. An exit interview using pretested structured questionnaire was conducted about their experience on prelacteal feeding and related experience. Logistic regressions with OR and 95% confidence interval were computed. Result: Two hundred seventy eight (45.4%) of mothers gave prelacteal liquids for their infants. The common pre-lacteal food includes sugar or glucose water 121 (43.5%) followed by milk other than breast milk 70 (25.1%). Home delivery, failure to attend ANC, late breastfeeding initiation and influence by friends were significantly associated with prelacteal feeding. Conclusion: The prevalence of prelacteal feeding was relatively high in the area. Failure to attend ANC, giving birth at home, late initiation of breast feeding and influence of friends and relatives to give prelacteal feeds for their new born infants were found to be positively associated with prelacteal feeding.