Background Timely initiating antenatal care (ANC) is crucial in the countries that have high maternal morbidity and mortality. However, in developing countries including Ethiopia, pregnant mother’s time to initiate antenatal care was not well-studied. Therefore, this study aimed to assess time to first ANC and its predictors among pregnant women in Ethiopia. Methods A community-based cross-sectional study was conducted among 7,543 pregnant women in Ethiopia using the Ethiopian Demographic Health Survey (EDHS), 2016 data. A two-stage stratified cluster sampling was employed. The Kaplan-Meier (KM) method was used to estimate time to first antenatal care visit. Cox-gamma shared frailty model was applied to determine predictors. Adjusted Hazard Ratio (AHR) with 95% confidence interval was reported as the effect size. Model adequacy was assessed by using the Cox-Snell residual plot. Statistical significance was considered at p value <0.05. For data management and analysis Stata 14 was used. Results The median time to first ANC was 5 months with IQR (3,-). The independent predictors of time to first ANC visit were primary education [AHR: 1.24 (95%CI, 1.13–1.35)], secondary education [AHR: 1.28(95% CI, 1.11–1.47)], higher education [AHR: 1.43 (1.19–1.72)] as compared to women with no formal education. Having media exposure [AHR: 1.13 (95% CI, 1.03–1.24)], early initiation of ANC increases by 25% [AHR: 1.25 (95% CI, 1.12–1.40)] in poorer, 32% [AHR: 1.32 (95% CI, 1.17–1.49)] in middle, 37% [AHR: 1.37 (95% CI, 1.20–1.56)] in richer and 41% [AHR: 1.41 (95%CI, 1.1.19–1.67)] in richest households as compared to poorest household wealth index. Living in city administration, media exposure and community women literacy were also enabler factors, while, long distance from health facility and nomadic region residency were hindering factors of early ANC visit. Conclusions The current study revealed that women’s time to first antenatal care visit was by far late in Ethiopia as compared to the world health organization recommendation (WHO). The predictors of time to first ANC visit were education status of women, having media exposure, level of household wealth index, community women literacy ad distance to health facility. It is vital that maternal and child health policies and strategies better to be directed at women development and also designing and applying interventions that intended to increase timely initiation ANC among pregnant-women. Researchers also recommended conducting studies using a stronger design like a cohort to establish temporality and reduce biases.
Background Intestinal parasitosis is a major public health problem that affects the health of primary school children in low- and middle-income countries where water, sanitation, and hygiene (WASH) conditions are deficient. Since there is a paucity of information on the prevalence and associated factors of this problem among primary school children in Dessie City in Ethiopia, this study was designed to address these gaps. Methods A school-based cross-sectional study was conducted among 407 stratified-sampled primary school children in five primary schools at Dessie City from April to June 2018. Data were collected using a pretested structured questionnaire, an observation checklist and laboratory analysis of stool samples. Stool specimen from each study participant was collected using clean, properly labeled and leak-proof stool cup. A portion of stool from each study participant collected sample was processed using saline wet mount technique and examined by microscope. The remaining specimens were preserved with 10% formalin and transported to Dessie Comprehensive Specialized Hospital laboratory to be processed by using formol-ether concentration technique. Then, slide smears were prepared from each processed stool specimen and finally, it was microscopically examined with 10x as well as 40x objectives for the presence or absence of intestinal parasites. Factors significantly associated with intestinal parasitosis were determined using binary logistic regression model at 95% CI (confidence interval). Thus, bivariate (COR [crude odds ratio]) and multivariable (AOR [adjusted odds ratio]) logistic regression analyses were carried out. From the multivariable analysis, variables having a p-value of less than 0.05 were declared as factors significantly associated with intestinal parasitosis among primary school children. Main findings The overall prevalence of intestinal parasitosis was found to be 16.0% (95% CI: 12.5–19.4%), of these, 50.8% were positive for protozoa, 32.2% for helminth infections and 16.9% for double co-infections. Entamoeba histolytica was the most prevalent parasite (29.2%), followed by Giardia lamblia (21.5%), Ascaris lumbricoides (18.5%), Hymenolepis nana (9.2%) and Enterobius vermicularis (4.6%). Prevalence rates were similar among government (16.3%) and private (15.7%) school children. Water consumption was less than 5 liters per capita per day in 4 of the 5 schools. Thirty-eight (9.3%) of primary school students reported that they practiced open defecation. About two-thirds (285, 70.0%) said they always washed their hands after defecation. Mother’s education (illiterate) (AOR = 3.3; 95% CI: 1.20–9.37), father’s education (illiterate) (AOR = 3.9; 95% CI: 1.40–10.82), fathers who could read and write (AOR = 3.3; 95% CI: 1.25–7.86), handwashing before meal (sometimes) (AOR = 2.2; 95% CI: 1.11–4.17) and poor knowledge of WASH (AOR = 9.3; 95% CI: 2.17–16.70) were statistically associated with presence of intestinal parasitic infections. Conclusion We concluded that the prevalence of intestinal parasitosis in the study area among Grades 4–8 primary school children had public health significance. Factors significantly associated with intestinal parasitosis among primary school children’s were illiterate mothers and fathers, irregular handwashing of children before meals, and poor knowledge of WASH. Health education to improve students’ WASH knowledge and mass deworming for parasites are recommended as preventive measures; and improvements to the quality of WASH facilities in primary schools are strongly recommended to support these measures.
In the situation of high maternal morbidity and mortality in Sub-Saharan Africa, less than 80% of pregnant women receive antenatal care services. To date, the overall effect of antenatal care (ANC) follow up on essential newborn practice have not been estimated in East Africa. Therefore, this study aims to identify the effect of ANC follow up on essential newborn care practice in East Africa. We reported this review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). We searched articles using PubMed, Cochrane library, African journal online (AJOL), and HINARI electronic databases as well as Google/Google scholar search engines. Heterogeneity and publication bias between studies were assessed using I2 test statistics and Egger’s significance test. Forest plots were used to present the findings. In this review, 27 studies containing 34,440 study participants were included. The pooled estimate of essential newborn care practice was 38% (95% CI 30.10–45.89) in the study area. Women who had one or more antenatal care follow up were about 3.71 times more likely practiced essential newborn care compared to women who had no ANC follow up [OR 3.71, 95% CI 2.35, 5.88]. Similarly, women who had four or more ANC follow up were 2.11 times more likely practiced essential newborn care compared to women who had less than four ANC follow up (OR 2.11, 95% CI 1.33, 3.35). Our study showed that the practice of ENBC was low in East Africa. Accordingly, those women who had more antenatal follow up were more likely practiced Essential newborn care. Thus, to improve the practice of essential newborn care more emphasis should be given on increasing antenatal care follow up of pregnant women in East Africa.
Objectives: This study is aimed to assess factors associated with knowledge, attitude, and practice of COVID-19 among health care professional’s working in South Wollo Zone Hospitals, Northeast Ethiopia. Methods: Institution-based cross-sectional study was conducted among 422 health care professionals from 10 July to 10 August 2020, at the South Wollo Zone. A pre-tested self-administered structured questionnaire was used to collect the data. Both bi- and multi-variable logistic regressions were fitted to identify variables significantly associated with the outcome variables. Adjusted odds ratios with 95% confidence interval and p-value < 0.05 were used to determine significant factors. Results: About 92.4%, 64%, and 55% of the respondents had good knowledge, favorable attitude, and good practices toward corona virus disease, respectively. Being female (adjusted odds ratio = 0.23, confidence interval: 0.10, 0.56), age ⩾ 35 years (adjusted odds ratio = 0.14, confidence interval: 0.22, 0.84), being unmarried (adjusted odds ratio = 0.20, confidence interval: 0.70, 0.59), getting information from radio and television (adjusted odds ratio = 6.02, confidence interval: 2.09, 17.36), having average monthly income 93.55–163.67 USD (adjusted odds ratio = 8.00, confidence interval: 0.94, 33.10), and average monthly income > 163.70 USD (adjusted odds ratio = 11.41, confidence interval: 1.41, 15.23) were significantly associated with good knowledge about COVID-19. In addition, being unmarried (adjusted odds ratio = 0.70, confidence interval: 0.49, 0.97), having bachelor of science degree and above (adjusted odds ratio = 1.87, confidence interval: 2.24, 2.83), and getting information from seminars and workshops (adjusted odds ratio = 0.59, confidence interval: 0.35, 0.98) had association with good practice toward COVID-19 prevention and control method. Conclusion: More than 90% of the health care workers have good knowledge; nearly half of the respondents had unfavorable attitudes and poor practice toward COVID-19. The findings imply that the government and other stakeholders should implement further strategies for enhancing to change health care professional’s attitude and encourage to practice prevention and control methods.
Background Under-five mortality (U5M) is one of the most important and sensitive indicators of the health status of the community. Despite there having been a substantial reduction in U5M since 1990, its rate is still high in Sub-Saharan African countries. Thus, this study aimed to assess time to under-five mortality and its predictors in rural Ethiopia. Methods This study utilized a secondary analysis of the 2016 Ethiopia Demographic and Health Survey (EDHS). A total of 9,807 weighted under-five children selected at different stages were included in the analysis. The Kaplan-Meier and Cox’s-gamma shared frailty models were used to estimate survival time and to identify predictors of under-five mortality, respectively. An adjusted Hazard Ratio (AHR) along with a 95% Confidence Interval (CI) was used to measure the effect size and direction of the association. Results The study indicated that 6.69% (95% CI: 6.13, 7.30) of children died before celebrating their fifth birthday in rural Ethiopia. Of all the deaths, the median time to death was 27 months. After controlling the effect of cluster and other confounding factors, female sex (AHR = 0.62, 95% CI: 0.52, 0.75), ever born greater than five children (AHR = 1.40, 95% CI: 1.07, 1.83), very large size at birth (AHR = 1.33, 95% CI: 1.03 1.71), very small size at birth (AHR = 1.41, 95% CI: 1.10, 1.82), twin pregnancy (AHR = 3.5, 95% CI: 2.47, 4.88), not ever breastfeeding (AHR = 11.29, 95% CI: 9.03, 14.12), unimproved latrine (AHR = 3.44, 95% CI: 1.91, 6.17), covered by health insurance (AHR = 0.29, 95% CI: 0.12, 0.70) were predictors of under-five mortality. Conclusions Still under-five mortality was high in rural Ethiopia as compared to the global under-five mortality rate. In the final model, sex of a child, the total number of children ever born, children’s size at birth, type of pregnancy, breastfeeding, type of toilet, and being covered by health insurance were significant predictors of under-five mortality. Further emphasis should be given to twin and not breastfeeding children, as well as households’ better encouraging membership of community health insurance and utilization of improved latrines.
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