Background: Adverse birth outcome which attributes to most perinatal deaths is an important indicator of child health and survival. Hence, this study aims to identify determinants of adverse birth outcome among mothers who gave birth in public hospitals of Tigrai region, North Ethiopia. Methods: Hospital based case-control study was conducted in Tigrai region, Ethiopia between December 2015 and January 2016 among 405 (135 cases and 270 controls) consecutively selected mothers who gave birth in four randomly selected public Hospitals. Mothers with adverse birth outcome (preterm birth; < 37 gestational weeks at birth, low birth weight; < 2.5 kg at birth, or still birth) were the cases while mothers without adverse birth outcome (live birth, birth weight ≥ 2.5 kg and of ≥37 gestational weeks at birth) were the controls. Data were collected by interview and reviewing medical records using structured questionnaire. The collected data were entered into database using EPI info version 3.5.1 then exported to SPSS version 21 for analysis. Finally, multivariate logistic regression was used to identify determinants of adverse birth outcomes at P value < 0.05. Result: The mean age of cases and controls was 27.3 (SD = 6.6) and 26.14 (SD = 4.9) years, respectively. In a multivariate analysis; less than four antenatal care visits [AOR = 4.35, 95% CI: 1.15-13.50], not receiving dietary counseling [AOR = 11.24, 95% CI: 3.92-36.60], not using family planning methods [AOR = 4.06, 95% CI:1.35-17.34], less than 24 months inter pregnancy interval [AOR = 5.21, 95% CI: 1.89-13.86], and less than 11 g/dl hemoglobin level [AOR = 4.86, 95% CI: 1.83-14.01] were significantly associated with adverse birth outcomes. Conclusion and recommendation: The number of antenatal care visits, ever use of family planning methods, not receiving dietary counseling during antenatal care follow up visits, short inter-pregnancy interval, and low hemoglobin level were identified as independent determinants of adverse birth outcome. A concerted effort should be taken improve family planning use, and antenatal care follow-up with special emphasis to maternal nutrition to prevent adverse birth outcomes.

Background Tuberculosis (TB) is a major public health problem and it is among the top 10 causes of death worldwide. One of the challenges against attaining an effective TB control program is delay in seeking health care to diagnosis and treatment of TB patients. The aim of this study was to assess health care-seeking delay among pulmonary TB patients. Methods An institutional based cross-sectional study was conducted among new pulmonary tuberculosis (PTB) patients > 15 years of age who were enrolled in the intensive phase TB treatment from November 1, 2015 – January 30, 2016. Data were collected by an interviewer administered technique using a structured questionnaire. Health care seeking delay was categorized by using a median cutoff point of > 30 days as a prolonged health care seeking delay. Logistic regression analyses were employed to determine factors independently associated with the delays in health care seeking. Results A total of 422 PTB patients were included in this study. The median age of respondents was 37 years (interquartile range (IQR) =35–44). The median time of health care seeking delay was 30 days (IQR) = 21-60). Respondents occupation, knowledge about pulmonary tuberculosis, health facility visited first, seeking treatment from traditional or religious healers before visiting health facilities, reason for not seeking treatment early from health facilities, and reason for first consultation were found to be significantly associated with health care seeking delay. Conclusion The study showed the magnitude of health care seeking delay among pulmonary tuberculosis patient was very long and the factors associated with health care seeking delay were: occupation, knowledge status, health facility visited first and seeking treatment from religious or traditional healer before health facilities. To overcome delay of health care seeking among tuberculosis patients, efforts should required availing tuberculosis diagnostic and treatment services at the primary health care level.

Objectives Soil-transmitted helminthes are among the most common infections worldwide and affect the poorest and most deprived communities. A health facility based cross-sectional study was conducted among pregnant women attending at Maytsebri primary hospital. Data was entered and analysed using SPSS version 20 software. Multivariate analyses were used to identify determinant factors associated with soil transmitted helminthiasis. A total of 448 pregnant women were examined microscopically with a Katokatz technique for parasitological study to each women. Results Out of the total 448 pregnant women examined in the primary hospital, 229 (51.5%) women were infected by at least one of the soil transmitted helminthiasis. Hookworm was the most prevalent 179 (78.16%) soil transmitted helminthes infection. Women who had a habit of eating soil were 2.6 times more likely to be infected by soil transmitted helminthes compared to who do not eat soil. Participants who wear shoe always were 95% less likely to be infected by soil transmitted helminthes. Efforts should be done to advance the awareness of women how to prevent soil transmitted helminthes.

The World Health Organization (WHO) defines preterm birth as the birth of an infant earlier than 37 weeks (259 days) of gestation. [1] The almost 15 million preterm births recorded globally in 2010 represented more than one in ten live births, [1] with approximately 25% of newborn deaths recorded annually attributed directly to prematurity and 30% to secondary infections. [2,3] In addition, ~90% of preterm births and 99% of preterm deaths occur in developing countries. [4] In many low-income countries, only 30% of infants born between 28 and 32 weeks survive and almost all infants born earlier than 28 weeks die during the first few days of life. In these settings, the majority of deaths occur where primary care is not available. [1-4] In Ethiopia, specifically, preterm births contribute directly to 28% of newborn deaths. [5-7] Preterm birth often leads to lifelong complications, including neurodevelopmental impairment and disabilities such as learning difficulties, hearing impairment and behavioural problems, chronic lung disease, retinopathy of prematurity and lower growth achievement. [6] Preterm birth also affects the infant's family, who may have to spend substantial time and financial resources to care for the newborn. Preterm birth therefore has considerable cost implications not only for families but also for a country's health services. [8] The cause of preterm birth is unknown in almost half the cases. [5,9] Some risk factors have been identified, for example sociodemographic factors, history of obstetric abnormalities, intrauterine infections, pregnancy-related irregularities, and genetic and environmental factors. [1,4,10-16] However, the complexity and overlap of risk factors are not well understood and their mechanisms are unknown in most cases. Low socioeconomic status has been identified as a contributing factor in preterm births. [12-17] This may be attributed to women from low-income settings often experiencing nutritional deficiencies, insufficient healthcare, a low level of education and a stressful life. [13] Studies also show that a previous preterm delivery substantially increases a woman's risk of a subsequent spontaneous preterm delivery. [11,14,15,18,19] Multiple pregnancies and stillbirth have also been identified as risk factors for preterm delivery. [17-19] The aetiology of preterm births is multifactorial and evidence suggests that the prevalence varies depending on geographical and demographic features. To reduce the burden of preterm births, effective maternal care, including specific and comprehensive obstetric care for preterm newborns, is required. [20] Despite it being known that maternal complications and social settings have a substantial role in the underlying risk of preterm delivery, the magnitude and risk factors of premature births are not clearly known in Ethiopia. Methods Study setting and design The study was conducted in the central zone of the Tigray Regional State, which is approximately 1 000 km from Addis Ababa, Ethiopia's capital, and 220 km from the regional cap...

Background. Cervical cancer is the major cause of morbidity and mortality among women worldwide with an estimated 528,000 new cases and 266,000 deaths annually. In Ethiopia, there are 7095 new cases and 4732 deaths of cervical cancer every year. But cervical cancer screening utilization remains limited. Therefore, the aim of the study was to assess cervical cancer screening utilization and associated factors among women in the Shabadino district, Southern Ethiopia. Methods. A community-based cross-sectional study was conducted in the Shabadino district, Southern Ethiopia, using a structured questionnaire. A systematic random sampling method was used to recruit 536 study participants. The collected data were entered and analyzed using SPSS version 22.0. Bivariate and multivariate logistic regressions were used to assess factors associated with cervical cancer screening utilization at a 95% level of significance and a p value of less than 0.05. Results. The study revealed that among 506 women, only 52 (10.3%) have been screened for cervical cancer. Women who are educated (completed primary school and above) (AOR=1.9; 95% CI=1.18-3.05), who have a history of the presence of sexually transmitted diseases (AOR=2.6; 95% CI=1.26-5.23), who have multiple sexual partners (AOR=4.0; 95% CI=1.86-8.66), and who knew methods of cervical cancer prevention (AOR=4.3; 95% CI=1.18-13.05) were significantly associated with high cervical cancer screening utilization. Conclusion. The magnitude of cervical cancer screening utilization among women was very low. Educational status, history of multiple sexual partners, history of sexually transmitted diseases, and knowing methods of prevention were significant factors of high cervical cancer screening utilization. Recommendation. It is very crucial to implement an appropriate awareness creation method. Additionally, the STI clinic should be linked to the cervical cancer screening service to increase the knowledge of cervical cancer prevention and the utilization of cervical cancer screening.

Background In most developing countries the contact time among antenatal care attendees and care providers have effects on quality of antenatal services and health outcomes. Effectiveness of focused antenatal care relies on standard time spent provisions. Hence this study evaluated the time spent and associated factors on provision of antenatal care in public and private health facilities in Axum Town, Northern Ethiopia. Methods Institutional based comparative cross-sectional mixed quantitative and qualitative methods were used. Data were collected through exit interviews from 456 antenatal care attendees. Qualitative data were also collected using an in-depth interview with providers. The collected data were entered using EPI info version 3.5.1 software then exported to SPSS version 21 software for analysis. Multivariate logistic regression model was used to identify determinant factors of time spent on antenatal care provision at p-value < 0.05. Results Majority, 378 (84.8%) of pregnant woman were served below the mean standard time in both public and private health facilities. The mean (± SD) time spent for first antenatal care provision in private was 19.7 (± 8.5) minutes, which is higher than public health facilities with mean time spent (± SD) of 13.2 (± 3.8) minutes. The mean time spent on antenatal care was significantly different in public and private health facilities. Factors that significantly affect time spent on provision of antenatal care were: type of health facilities [AOR = 2.60; 95% CI, 1.07–6.33], frequency of antenatal care visit [AOR = 3.50; 95% CI, 1.92–6.36] and language similarity with provider [AOR = 2.74; 95% CI, 1.23–6.12]. Conclusions The mean time spent for first and revisit of ANC at both health facilities were lower than the WHO standards. Type of health facilities, frequency of antenatal care visit and language similarity with provider were predictors for time spent on ANC provision. Efforts should be targeted on standard provision of antenatal care.

Background Antiretroviral therapy (ART) provision was among the major challenge of treatments. Maintaining the optimal level of adherence among children living with HIV/AIDS is a pivotal step towards achieving treatment success. However, there are limited studies on child’s ART adherence. Therefore, this study aimed to assess the level of adherence to antiretroviral therapy and associated factors among HIV-infected children in health institutions of Adwa, Axum, and Shire towns, Tigray, Northern Ethiopia. Methods An institutional-based cross-sectional study was conducted among human immunodeficiency virus (HIV)-infected children in between February and April, 2016. A total of 255 children who were taking antiretroviral therapy in the randomly selected three health facilities from Adwa, Axum and Shire towns were included. Data were collected using pretested and structured questionnaires using a face-to-face interview. The collected data were entered into Epi Info version 7 and then exported to SPSS version 21 for analysis. Bivariate and multivariate binary logistic regression models were used to determine the factors associated with adherence to antiretroviral therapy among HIV-infected children. Results A total of the 255 study participants were included in the study. The level of ART adherence among HIV-positive children was 212 (84.8%). Knowledge of caregivers about ART treatment (AOR = 2.78, 95% CI: 1.18, 6.53), occupational status (AOR = 4.78, 95% CI: 1.26, 18.91), appointment to ART less than two months (AOR = 3.05, 95% CI: 1.21, 7.70) and use of memory aids (AOR = 4.58, 95% CI: 1.73, 12.13) were independently associated with adherence to ART. Conclusion The level of adherence to antiretroviral therapy was low. Healthcare providers should reinforce adherence intervention and counseling sessions during follow-up and address the proper use of medication reminders to help children take their drugs appropriately.

BackgroundIn most developing countries contact time between antenatal care attendees and providers have effects on health outcomes and quality of antenatal services. Effectiveness of focused antenatal care relies on standard time spent provisions. Hence this study evaluated the time spent & associated factors on provision of antenatal care in public and private health facilities in Axum Town, Northern Ethiopia.MethodsInstitutional based comparative cross-sectional mixed quantitative and qualitative methods were used. Data was collected through exit interviews with 456 antenatal care attendees. Qualitative data were also collected using an in-depth interview with providers. The collected data were entered using EPI info version 3.5.1 software then exported to SPSS version 21 software for analysis. Finally, multivariate logistic regression was employed to identify determinants of time spent on antenatal care provision at p-value < 0.05.ResultsMajority 378 (84.8%) of pregnant woman were served below the mean standard time in both public and private health facilities. The mean (± SD) time spent for first antenatal care provision in private was 19.7 (± 8.5) minutes, which is higher than public health facilities with mean time spent (± SD) of 13.2 (± 3.8) minutes. The mean time spent on antenatal care was significantly different in public and private health facilities. Factors that significantly affect time spent on provision of antenatal care were: type of health facilities [AOR = 2.60; 95% CI, 1.07–6.33], frequency of antenatal care visit [AOR = 3.50; 95% CI, 1.92–6.36] and language similarity with provider [AOR = 2.74; 95% CI, 1.23–6.12].ConclusionThe mean time spent for first and revisit of ANC in both health facilities was lower than the WHO standards. Type of health facilities, frequency of antenatal care visit and language similarity with provider were predictors for time spent on ANC provision. Efforts should be targeted on standard provision of antenatal care.