Despite the existence of standard protocol, many stabilization centers (SCs) continue to experience high mortality of children receiving treatment for severe acute malnutrition. Assessing treatment outcomes and identifying predictors may help to overcome this problem. Therefore, a 30-month retrospective cohort study was conducted among 545 randomly selected medical records of children <5 years of age admitted to SCs in Gedeo Zone. Data was entered by Epi Info version 7 and analyzed by STATA version 11. Cox proportional hazards model was built by forward stepwise procedure and compared by the likelihood ratio test and Harrell’s concordance, and fitness was checked by Cox–Snell residual plot. During follow-up, 51 (9.3%) children had died, and 414 (76%) and 26 (4.8%) children had recovered and defaulted (missed follow-up for 2 consecutive days), respectively. The survival rates at the end of the first, second and third weeks were 95.3%, 90% and 85%, respectively, and the overall mean survival time was 79.6 days. Age <24 months (adjusted hazard ratio [AHR] =2.841, 95% confidence interval [CI] =1.101–7.329), altered pulse rate (AHR =3.926, 95% CI =1.579–9.763), altered temperature (AHR =7.173, 95% CI =3.05–16.867), shock (AHR =3.805, 95% CI =1.829–7.919), anemia (AHR =2.618, 95% CI =1.148–5.97), nasogastric tube feeding (AHR =3.181, 95% CI =1.18–8.575), hypoglycemia (AHR =2.74, 95% CI =1.279–5.87) and treatment at hospital stabilization center (AHR =4.772, 95% CI =1.638–13.9) were independent predictors of mortality. The treatment outcomes and incidence of death were in the acceptable ranges of national and international standards. Intervention to further reduce deaths has to focus on young children with comorbidities and altered general conditions.
Background. Cervical cancer is one of the major noncommunicable public health problems among the female population affecting not only the women but also the whole community. Annually, more than half a million new patients are diagnosed with it and over 270,000 deaths occur worldwide. There are very few research efforts conducted on prevalence and associated factors of specific target group in the region. So, this study tries to show the magnitude on all women screened for precervical cancer and serves as a secondary data for other research. Objective. The aim of the study was to assess magnitude of precervical cancer and associated factors among screened women in Arba Minch town and zuria woreda health institutions, southern Ethiopia. Methods. A facility based cross-sectional study was conducted in three health facilities at Arba Minch town and zuria woreda, southern Ethiopia, from June 2015 to June 2017. Data were collected by two nurses that are working in the area of expertise and one health officer as supervisor. Data of 528 screened clients were entered into Epi data version 3.1 using checklist, double data entry verification done and exported to SPSS version 20.0. After cleaning the data, descriptive analysis was done and multivariable logistic regression model was employed to identify predictors of precervical cancer. Finally, statistical significance was declared at P < 0.05. Result. In this study, the magnitude of precervical cancer is 27.7% [95%CI] (24.1-31.4)]. Having primary educational status (AOR [95% CI]) = 0.2 [0.1, 0.96)] and secondary educational status (AOR[95% CI]) = 0.1 [0.02,0.3]), having history of smoking [AOR (95% CI) = 3.7 (1.4-9.9)], having two and more than two life time sexual partners [AOR (95% CI) = 2.2 (1.1-4.7)], having age at first sexual intercourse less than eighteen years [AOR (95% CI) = 6.6 (3.14-13.0)] were significantly associated with precervical cancer. Conclusion and Recommendation. The magnitude of precervical cancer is 27.7% as shown in the result of the present study. Level of education, age at first sexual intercourse, history of smoking, and number of sexual partners were predictors of precervical cancer in this study. Thus, any cervical cancer prevention and control effort at the study area should address those predictors pointed out in the present study and should encourage to screen for precervical cancer.
Background Anemia among pregnant women is one of the most common public health problems in developing country. World health organization (WHO) estimate shows nearly half of pregnant women were affected by anemia. High burden of anemia is observed in Africa particularly in Ethiopia. However, the factors that contribute to the occurrence of anemia were not exhaustively studied. Therefore, the aim of this study was to identify determinant factors of anemia among pregnant women in Durame Town, southern Ethiopia. Method An institutional based unmatched case control study was conducted among 111 cases and 222 controls in Durame Town from 16th February to 8th May 2017 using interviewer administered questionnaires. Controls were pregnant women whose hemoglobin level was 11 g/dl and above at their first antenatal care clinics and cases were pregnant women whose hemoglobin level was less than 11 g/dl. Bivariate and multivariate logistic regression model was used to see the determinants of anemia. Adjusted odds ratio (AOR) with 95% confidence interval (CI) and p-value were used to identify the significant association. Result A total of 333 women (111 cases and 222 controls) participated in the study. The major determinant factors were parasitic infection (AOR: 3.67, 95% CI: 1.72-7.86), not taking additional diet during pregnancy (AOR: 2.49, 95% CI: 1.22-5.08), consuming tea/coffee immediately after food (AOR: 3.58, 95% CI: 1.72-7.42), not eating meat (AOR: 2.07, 95% CI: 1.03-4.15), previous heavy menstrual blood flow (AOR: 2.62, 95% CI: 1.18-5.84), and being housewife (AOR: 2.38, 95% CI: 1.02-5.57). Conclusion Parasitic infection, additional diet during pregnancy, consuming tea/coffee immediately after food, meat consumption, previous heavy menstrual blood flow, and occupational status of women were significant factors associated with anemia among pregnant women. Therefore, anemia prevention strategy should include promotion of counseling on additional diet during pregnancy, preventing parasitic infection, and increasing employment opportunities for women.
Background: Undernutrition constitutes an important threat to the success of HIV programs in sub-Saharan Africa, and failure to effectively address it may jeopardize the benefits gained so far in the fight against HIV. The aim of the study was to assess undernutrition and associated factors among HIV-positive adult patients enrolled in antiretroviral therapy (ART) clinics in Arba Minch area, south Ethiopia. Methods: A facility-based cross-sectional study was conducted in 2017. There were 351 adult individual study participants who were enrolled in ART clinics in Arba Minch area public health facilities. Variables with P -value less than 0.25 on binary logistic regression analysis were entered into a multivariate logistic regression model to outline the independent predictors of undernutrition. CI of 95% was used to assess precision of the study. Results: Out of all the participants, 18.23% (95% CI: 14.52–22.65) were undernourished. The prevalence of undernutrition was significantly lower among those consuming food from five or more food groups per day (AOR: 0.33; 95% CI: 0.16–0.71) and undergoing ART for more than a year (AOR: 0.24; 95% CI: 0.08–0.73). On the contrary, the prevalence was significantly higher among those who were currently smoking tobacco (AOR: 6.67; 95% CI: 1.45–30.76). In addition, those with WHO clinical stage 3 had a significantly higher prevalence of undernutrition compared to those with WHO clinical stage 1 (AOR: 311; 95% CI: 1.47–6.60). Conclusion: The prevalence of undernutrition was high among adults with HIV/AIDS enrolled in ART clinics in the study area. The prevalence of undernutrition was lower among those who consumed diverse food groups and had been receiving ART for longer (more than a year). On the contrary, the prevalence of undernutrition was higher among those who consumed tobacco and with higher WHO clinical stage. Therefore, efforts should be made to enhance the dietary diversity of these individuals.
Background: In Ethiopia, though all kinds of mortality due to external causes are an important component of overall mortality often not counted or documented on an individual basis. Objective: The aim of this study was to describe the patterns of mortality from external causes using verbal autopsy (VA) method at the Ethiopian HDSS Network sites. Methods: All deaths at Ethiopian HDSS sites were routinely registered and followed up with VA interviews. The VA forms comprised deaths up to 28 days, between four weeks and 14 years and 15 years and above. The cause of a death was ascertained based on an interview with next of families or other caregivers using a standardized questionnaire that draws information on signs, symptoms, medical history and circumstances preceding death after 45 days mourning period. Two physician assigned probable causes of death as underlying, immediate and contributing factors independently using information in VA forms based on the WHO ICD-10 and VA code system. Disagreed cases sent to third physician for independent review and diagnosis. The final cause of death considered when two of the three physicians assigned underlying cause of death; otherwise, labeled as undetermined. Results: In the period from 2009 to 2013, a total of 9719 deaths were registered. Of the total deaths, 623 (6.4%) were from external causes. Of these, accidental drowning and submersion, 136 (21.8%), accidental fall, 113 (18.1%) and transport-related accidents, 112 (18.0%) were the topmost three leading external causes of deaths. About 436 (70.0%) of deaths were from the age group above 15 years old. Drowning and submersion and transport-related accidents were high in age group between 5 and 14 years old. Conclusion: In this study, external causes of death are significant public health problems and require attention as one of prior health agenda.
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