Background Palliative care is nowadays essential in nursing care, due to the increasing number of patients who require attention in the final stages of their life. Lack of knowledge of and negative attitude palliative care among nurses is one of the most common barriers to quality palliative care. This study, therefore, aimed to assess nurses' knowledge about palliative care and attitude toward end-of-life care in public hospitals in Wollega zones, Ethiopia. Methods A multicenter institutional-based cross-sectional study design was employed to collect data from 372 nurses working in public hospitals in Wollega zones from October 02-22, 2019. A self-administered questionnaire with three different parts: Demographic characteristics of nurses, the Palliative Care Quiz for Nursing (PCQN), and the Frommelt Attitudes Towards Care of the Dying (FATCOD). SPSS version 21 was used for analysis used for data analysis. The binary logistic regression test was used for analysis at p < 0.05. Findings Our final sample size was 422 nurses (response rate = 88%). With the mean total PCQN scores (9.34), the majority of them showed an inadequate level of knowledge about palliative care. The mean total FATCOD scores (79.58) displayed a positive attitude toward endof-life care, with 52% of respondents eager to care for a dying person and their family. Nurses who had PC service experience [AOR = 1.94 CI (1.10-3.42), p = 0.02] and had ever attended training/lecture on PC [AOR = 1.87 CI (1.01-3.46), p = 0.04] were independently associated with nurses' knowledge about PC. Similarly, nurses who had no PC service experience [AOR = 0.41, CI (0.21-0.79), p = 0.008], who read articles/brochures about PC
Background: Diabetes and its complications including foot ulcer constitute a global public health challenge attributing to a significant cause of morbidity and mortality. Foot ulcer is one of the long-term complication of diabetes mellitus which lead to infection and amputation of lower extremities. In Ethiopia, findings from few studies were inconsistent and there is a need to systematically pool existing data to determine the magnitude of foot ulcer in diabetics and factors contributing to it. Methods: We identified articles through electronic databases such as Medline, Hinari, Pub Med, Cochrane library, the Web of Science and Google Scholar. Accordingly, we identified 95 published and one unpublished article. Finally, eleven studies which fullfilled eligibility criteria were included in final systematic review and meta-analysis. Data were extracted using a standardized data extraction checklist and the analyses were conducted using STATA version 14. The Cochrane Q test statistic and I 2 tests were used to assess heterogeneity. Results: The overall magnitude of foot ulcer was 12.98% (95%CI: 7.81-18.15) in diabetic patients in Ethiopia. Subgroup analyses revealed highest prevalence in Addis Ababa (19.31% (95%CI: 2.7. 41.37)). Foot ulcer was significantly associated with rural residence (OR = 2.72, 95%, CI: 1.84-4.01)), presence of callus on the feet ((OR = 12.67, 95%, CI: 6.47-24.79)), a body mass index of ≥24.5 ((OR = 2.68, 95%, CI: 1.58-4.56)), poor self-care practice ((OR = 1.47, 95%CI: 1.25-1.73)), type I diabetes mellitus ((OR = 0.42, 95%, CI: 0.22-0.79)), staying with DM for < 10 years ((OR = 0.23, 95%, CI: 0.11-0.50)), and age < 45 years ((OR = 0.44, 95%, CI: 0.21-0.92)). Conclusion: The prevalence of diabetic foot ulcers in Ethiopia is relatively low, although its trend is increasing from time to time. Socio-demographic factors, body weight, and healthcare practice contribute to the development of diabetic foot ulcers. Appropriate interventions towards patient self-care practice, lifestyle modification and follow-up are wanted to prevent diabetic foot ulcers.
Introduction Even though people of the world were eagerly waiting for the hope of vaccine development, vaccine hesitancy is becoming the top concern in both developed and developing countries. However, there is no adequate evidence regarding the attitude and perception of health professionals towards the COVID 19 vaccine in resource-limited settings like Ethiopia. The aim of this study was to assess health professionals’ attitudes and perceptions towards COVID 19 vaccine in Western Ethiopia. Methods An institution-based cross-sectional study was conducted among health care workers found in Nekemte town from April 14–21, 2021. A total of 439 health professionals present on duty during the study period was included in the study. The data were collected by using self-administered questionnaire. Epidata version 3.2 was used for data entry, and STATA version 14 was used for data analysis. The binary logistic regression model was employed to determine factors associated with the attitude towards COVID-19 vaccination. Adjusted Odds Ratio (AOR) with 95% confidence intervals was computed and statistical significance was declared at a 5% level (p-value < 0.05). Result A total of 431 health professionals participated in the study yielding a response rate of 98.1%. The results indicated that 51.28% (95%CI: 45.12%, 57.34%) of health professionals had a favorable attitude towards COVID-19 vaccination. Having good knowledge about the COVID-19 vaccine (AOR = 0.38, 95%CI: 0.22, 0.64, P-value <0.001) was negatively associated with unfavorable attitude towards COVID-19 vaccine, whereas age less than 30 years (AOR = 2.14, 95%CI:1.25,3.67, P-value <0.001), working in a private clinic (AOR = 7.77, 95% CI: 2.19, 27.58, P-value <0.001) and health center (AOR = 2.45, 95%CI: 1.01, 5.92, P-value = 0.045) were positively associated with unfavorable attitude towards COVID-19 vaccine. Conclusion and recommendation In general, the attitude and perception of health care professionals toward the COVID-19 vaccine in the study area were unsatisfactory. Knowledge about the COVID-19 vaccine, age of health care workers, and place of work are the factors which affects attitude towards COVID-19 vaccine. Thus, we recommend the media outlets and concerned bodies to work to develop trust among the public by disseminating accurate and consistent information about the vaccine.
Objective: Although Ethiopia has been implementing Option B+ program, LTFU of women from the Option B+ program is one of the challenges that minimizes its implementation. Thus, this study assessed the incidence and predictors of LTFU among women under Option B+ PMTCT program in western Ethiopia. An institution-based retrospective follow-up study was conducted. A cox proportional hazards regression model was fitted to identify predictors of LTFU. A Hazard ratios with 95% confidence CI was computed and all predictors that were associated with the outcome variable at p-value ≤ 0.05 in the multivariable cox proportional hazards were declared as a significance predictor of the outcome. Results: A total of 330 women were followed for a mean follow up time of 16.9 (± 7.6) months. An overall incidence rate of LTFU was 9/1000 person-months. Women's educational status, residence, HIV-disclosure status, the status of women at enrollment, previous history of HIV and ART adherence were significant predictors of LTFU. The incidence of LTFU from Option B+ PMTCT is lower as compared to evidence from sub-Saharan African and strengthening linkage and referral system between clinics as well as establishing appropriates tracing mechanisms would retain pregnant women in the program.
Background The neonatal period is the most vulnerable time for survival in which children face the highest risk of dying in their lives. Neonatal mortality (NM) remains a global public concern, especially in sub-Saharan African (SSA) countries. Although, better progress has been made in reducing NM before 2016, Ethiopia is currently one of the top ten countries affected by NM. Studies are limited to secondary data extraction in Ethiopia which focus only on survival status during admission, and no study has been conducted in the study area in particular. Objective To assess the survival status and predictors of neonatal mortality among neonates admitted to the NICU of WURH and Nekemte Specialized Hospital, Western Ethiopia. Methods An institution-based prospective cohort study was conducted among a cohort of 412 neonates admitted to the NICU of WURH and Nekemte Specialized Hospital from September 1, 2020 to December 30, 2020. All neonates consecutively admitted to the NICU of the two hospitals during the study period were included in the study. Data entry was performed using Epidata version 3.0 and the analysis was performed using STATA version 14. A Kaplan Meier survival curve was constructed to estimate the cumulative survival probability. A cox proportional hazards regression model was used to identify the predictors of NM. Hazard Ratios with 95% CI were computed and all the predictors associated with the outcome variable at p-value ≤ 0.05 in the multivariable cox proportional hazards analysis were declared as a significant predictor of NM. Results A total of 412 neonates were followed for a median of 27 days with an IQR of 22–28 days. During the follow-up period, a total of 9249 person day observations (PDO) were detected. At the end of follow-up, 15.3% of neonates died with an overall incidence rate of death 6.81/1000 PDO. The median time to death was 10 days, and the highest incidence rate of death was observed during the first week of the neonatal period. The study found that rural residence (AHR = 2.04, 95%CI: 1.14, 3.66), lack of ANC visits (AHR = 7.77, 95%CI: 3.99, 15.11), neonatal hypothermia (AHR = 3.04, 95%CI: 1.36, 6.80), and delayed initiation of breastfeeding (AHR = 2.26, 95% CI: 1.12, 4.56) as independent predictors of NM. However, a decreased number of pregnancies decrease the risk of NM. Conclusions and recommendations The incidence rate of neonatal death was high particularly in the first week of life in the study area. The study found that lack of ANC visit, neonatal hypothermia, increased number of pregnancies, rural residence, and delayed initiation of breastfeeding positively predicted NM. Therefore, there is a need to encourage programs that enhance ANC visits for pregnant mothers and community-based neonatal survival strategies, particularly for countryside mothers.
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