BackgroundInfection with Human Immunodeficiency Virus is a serious public health problem costing the lives of many people including health workers. Hence, Ethiopia has developed guideline on the prevention of infection in health institutions in July 2004 and also employed the use of post exposure prophylaxis since the implementation of free antiretroviral in January 2005. However in the country, specifically in Jimma zone, published studies showing the clear picture about HIV post exposure prophylaxis in the work place were non-existent. Therefore, this study was conducted to assess the knowledge, practice and factors associated to HIV post-exposure prophylaxis use among health workers of governmental health institutions in the Zone.MethodsA cross-sectional survey employing quantitative and qualitative methods was conducted from October to December 2008. Two hundred fifty four health workers participated in the quantitative study. Health workers for focus group discussion and key informants for in-depth interviews were identified with the help of administrators/ HIV/AIDs coordinators of the two administrative health bureaus and institutions included in the study. The quantitative data were entered and cleaned using Epi Info version 6.4 and analysed using SPSS for windows version 11.0. Descriptive statistics and chi-square test was employed to assess association among variables. P-value less than 0.05 was considered statistically significant.ResultsAmong the total 254 participants, 213 (83.9%) had inadequate knowledge about post exposure prophylaxis of HIV and 174 (68.5%) had ever been exposed to HIV risk conditions. Out of 174 health workers exposed to HIV risk, 105 (60.3%) sustained needle prick/cut by sharps, 77 (44.3%) to blood and 68 (39.1%) exposed to patients' body fluid. Perceived causes of exposure were; high workload 77 (44.3%), lack of protective barriers 58 (33.3%) and lack of knowledge on standard precautions 31 (17.8%). One hundred forty two (81.6%) of those exposed did not use post-exposure prophylaxis. Lack of information about the existence of post-exposure prophylaxis service 48 (33.8%), fear of stigma and discrimination 46 (32.4%), lack of understanding the value of reporting 33 (23.2%) and lack of support and encouragement to report 29 (20.4%) were the reasons for not using. Moreover, formal (separate) HIV post-exposure prophylaxis centre with proper guideline was non-existent in the study areas. Conclusions: In general, findings of the quantitative and qualitative study revealed that the knowledge of health workers about post exposure prophylaxis against HIV is inadequate. Though many of the studied health workers had HIV risk exposure, only few used post-exposure prophylaxis. Therefore, establishing a 24 hours accessible formal post-exposure prophylaxis centre with proper guideline is recommended. Health institutions are also advised to raise awareness of their employees on post exposure prophylaxis.
Background: More than a quarter of children living in Sub-Saharan Africa are underweight. Nutritional deficiency in children increases the risk of infection and affects their mental development. However, there was scarcity of research findings that clearly indicate determinants of academic performance. Therefore, this study was aimed at determining predictors of academic performance with due focus on undernutrition among students attending primary schools. Methods: School based cross sectional study was conducted in February, 2016 among 630 randomly selected students attending primary schools in Hawa Galan woreda. Data were collected through parents/guardians interview, anthropometric measurement of children and school record review. Data were entered into Epidata version 3.1 and analyzed with SPSS Version 20. Anthropometric data were analyzed by WHO Anthro plus software. Pearson's correlation analysis was performed to determine correlation between academic performance and undernutrition. Logistic regression analysis was also performed to assess predictors of academic performance and p < 0.05 was used to declare significant association. Result: Prevalence of stunting, wasting and underweight in this study were 20.6%, 12.7% and 14.3% respectively. This study found a significant correlation between underweight (r = 0.222, P = 0.040), stunting (r = 0.214, P = 0.034) and academic performance. Multiple logistic regression analysis also indicated that being female [AOR 1.48; 95% CI (1.16, 3.82
BackgroundIn individuals infected with HIV, hematological abnormalities are common and are associated with increased risk of disease progression and death. However, the profile of hematological abnormalities in HIV infected adult patients is not known in Ethiopia. Thus, the aim of this study was to assess the hematological manifestations of HIV infection and to identify the factors associated with cytopenias in both HAART and HAART naïve HIV infected adult patients in Ethiopia.MethodWe conducted a cross-sectional quantitative study of HIV-infected adult patients attending the ART follow-up clinic of Jimma University Specialized Hospital in Jimma, Ethiopia, from July 2012 to September 2012. We used a structured questionnaire to collect socio-demographic and clinical information. After interviewing, 4 ml of venous blood was drawn from each study subject for hematologic and immunologic parameters.ResultThe prevalence of anemia, leucopenia, thrombocytopenia and lymphopenia among the study individuals were 51.5%, 13%, 11.1% and 5% respectively. Presence of opportunistic infection (p = 0.001), use of CPT (p = 0.04) and CD4 count < 200 cells/μl (p = 0.002) were associated with an increased risk of anemia.ConclusionHematologic abnormalities were common in HIV infected adult patients. Of the cytopenias anemia was the most common. Use of CPT was independently associated with increased risk of anemia and leucopenia. Therefore, large scale and longitudinal studies, giving emphasis on the association of CPT and cytopenia, are recommended to strengthen and explore the problem in depth.
Background. Cost sharing between beneficiaries and government is critical to attain universal health coverage. The government of Ethiopia introduced social health insurance to improve access to quality health services. Hence, HCP are the ultimate frontline service provider; their WTP for health insurance could influence the implementation of the scheme directly or indirectly. However, there is limited evidence on willingness to pay (WTP) for social health insurance (SHI) among health professionals. Methods. A cross-sectional study was conducted in Addis Ababa, Ethiopia, from May 1st to August 15th, 2019. A total sample of 480 health care providers was selected using a multistage sampling method. The collected data were entered into Epi Info version 7.1 and analyzed with SPSS version 23. Binary and multiple logistic regression analysis was carried out to identify the associated factor outcome variable. The association was presented in odds ratio with 95% confidence interval and significance determined at a P value less than 0.05. Result. A total of 460 health care providers responded to the questionnaire, making a 95.8% response rate. Of the respondents, only 132 (28.7%) were WTP for SHI. Higher educational status [AOR=2.9, 95% CI (1.2-7.3)], higher monthly income [AOR=2.2, 95% CI (1.2-4.3)], recent family illness [AOR=2.4, 95% CI (1.4-4.4)], and a good awareness about SHI [AOR=4.4, 95% CI (2.4-7.8)] showed significant association with WTP for SHI. The main reasons for not WTP were thinking the government should cover the cost, preferring out-pocket payment and the provided SHI scheme does not cover all the health care costs health care providers lost interest in pay for SHI. Conclusion and Recommendation. The majority of health care providers were not willing to pay for the introduced SHI scheme. The provided SHI scheme should be clear and provide special consideration for health care providers as the majority of them receives free health care service from their employer health care institution. Also, the government, health professional associations, and other concerned stakeholders should provide awareness creation programs by targeting low and middle-level health professionals in order to increase WTP for SHI among health care providers.
Background: In resource limited settings, many human immunodeficiency virus (HIV) infected individuals lack access to sufficient quantities of nutritious foods, which poses additional challenges to the success of anti-retroviral therapy. Morbidity and mortality related to human immune deficiency virus infection in the developing world remain unacceptably high, despite major advances in human immune deficiency virus therapy and increased international funding for care. Objective: To determine magnitude of malnutrition and identify factors associated with it among adult people on highly active anti-retroviral therapy (HAART) in health facility of Hosanna town. Methods: Institutional based cross-sectional survey was conducted from March 20 to April30, 2014 on 340 adult people on anti-retroviral therapy at antiretroviral therapy clinics of Hosanna town. Sample clients were selected by simple random sampling technique. Data were collected by face-to-face interview using structured pretested questionnaire, record review using check list and anthropometric measurements. Bi-variate analysis and multivariable logistic regression models were done using SPSS version 16 to identify factors associated with malnutrition. Results: Overall, the prevalence of malnutrition (Body Mass Index (BMI) < 18.5 kg/m 2) in this study was 31.2%. Household food insecurity (AOR = 2.51, 95% CI: 1.31-4.81), inadequate diversified diet (AOR = 0.44, 95% CI: 0.23-0.84), low meal frequency (AOR = 0.29, 95% CI: 0.11-0.76), clinical staging four (AOR = 5.23, 95% CI: 1.42-19.35), clinical staging three (AOR = 3.91, 95% CI: 1.57, 9.73), presence of opportunistic infections (AOR = 2.62, 95% CI: 1.49-4.59) and nutritional support (AOR = 0.45, 95% CI: 0.23-0.89) were independent predictors of malnutrition. Conclusion: Malnutrition (BMI < 18.5 kg/m 2) was high in adult people on anti-retroviral therapy at anti-retroviral therapy clinics of Hossana town. Only Anti-Retroviral Therapy is not enough to improve the health status of people on HAART. Further, interventional initiatives should focus in improving household food security, diversity of diet, meal frequency, clinical staging and prevention and control of opportunistic infections in adult HIV infected individuals receiving highly active anti-retroviral therapy.
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