BackgroundHepatitis B virus infection (HBV) constitutes major public health problems in sub-Saharan Africa from different infections occuring in HIV positive patients. Ethiopia is a part of sub-Saharan Africa with 1.5% adult HIV prevalence, and also belongs to the intermediate to high HBV prevalence category. Hence, this study aimed to measure the seroprevalence and associated factors of HBV infection among HIV-positive adults attending an antiretroviral treatment (ART) clinic at Wolaita Sodo University Referral Hospital.MethodsAn institution-based cross-sectional study was conducted from October 15 to December 10, 2017 using a systematic random sampling technique. After getting informed written consent, data were collected by a structured and interviewer-administered questionnaire. Venous blood was collected and centrifuged to separate serum. Hepatitis B surface antigen (HBsAg) was detected from serum using an advanced quality one-step rapid test kit. Data were entered into EpiData version 3.01 and exported to SPSS version 20. Summary statistics, bivariate analysis, and multivariate analyses were performed. The variables having significant association of P<0.05 in the multivariate logistic regression were taken as independent factors. OR and 95% CI were used to measure the strength of the association.ResultsA total of 442 study participants, 187 males and 255 females, were included in this study. Overall prevalence of HBsAg was 37 (8.4%). Family history of HBV (adjusted OR=8.83, 95% CI=2.56–30.49), multiple sexual partners (adjusted OR=7.08, 95% CI=2.29–21.9), and CD4 count <200 cells/μL (adjusted OR=15.34, 95% CI=4.77–49.3) were found to be significantly associated with HBsAg positivity.ConclusionThe prevalence of HBsAg in this study was high. Family history of HBV, multiple sexual partners, and CD4 count <200 cells/μL were independently associated with HBsAg positivity. Therefore, screening for HBV is recommended before initiation of ART in HIV patients and providing appropriate treatment for co-infection. Furthermore, accurate information on risk factors for HBV transmission should be provided.
Background Patient preference has preceded the use of health care services, and it has been affected by different hospital attributes. Meanwhile, the number of patients receiving vital health intervention is particularly low in Ethiopia. Therefore, this study aimed to determine the effect of hospital attributes on patient preference for outpatients in the Wolaita area in September 2020. Methods A discrete choice experimental study was applied to determine the effect of hospital attributes on patient preference with a sample size of 1077. The experimental survey was conducted among outpatient attendants selected through a systematic random sampling approach. Six key attributes (competence of healthcare providers; availability of medical equipment and supplies; cost of service; wait time; distance; and hospital reputation) deduced from various hospital attributes were used to elicit the patient preferences. The data was collected from participants through the Open Data Kit application. A random effect probit model with marginal willingness to pay measure and partially log-likelihood analysis was applied to extract important attributes. We used STATA version 15 software for analysis, and the fitness of the model was verified by the calculated p-value for the Wald chi-square with a cut-point value of 0.05. Result One thousand forty-five patients who received outpatient care participated in the study. The random effect probit results have shown that all hospital attributes included in the study were significantly valued by patients while choosing the hospital (p-value < 0.001). Meanwhile, based on marginal willingness to pay and partial log-likelihood analysis, the competence of health care providers was identified as the most important attribute followed by the availability of medical equipment and supplies in hospitals. Conclusion and recommendation The results suggested that the quality of health care providers and availability of medical equipment and supply in hospitals would be primary interventional points for improving the patient preference of hospitals. Assessment, education, and training are recommended for enhancing the quality of health care providers. And stock balance checks, inspections, and accreditation are believed to be valuable for improving the availability of equipment and supply in hospitals.
Background The magnitude of fetal macrosomia is high and associated with adverse maternal and fetal outcomes, especially among women in developing countries like Ethiopia. Despite the observed burden, there is limited evidence on determinants of fetal macrosomia. This study aimed to identify determinants of fetal macrosomia among live births at Wolaita Sodo town Southern Ethiopia. Methods A facility-based matched case-control study design involved 360 singletons deliveries attended at hospitals in Wolaita Sodo town, southern Ethiopia, with 120 cases and 240 controls included. Cases and control were matched by maternal age. Cases were neonates with a birth weight of ≥4000, while controls were neonates with a birthweight between 2500gm and less than 4000gm. Data were collected by interviews, measuring, and reviewing mothers' medical documents. Conditional logistic regression analysis was carried to identify the independent predictor variables. Statistical significance was set using a p-value<0.05 and 95% CI for AOR. Results Male neonates were four times more likely to be macrosomia than female neonates AOR=4.0 [95%CI; 2.25-7.11, p<0.001]. Neonates born at gestational age ≥40 weeks were 4.33 times more likely to be macrosomia with AOR= 4.33 [95%CI; 2.37-7.91, p<0.001]. Neonates born from physically active mothers were 7.76 times more likely to be macrosomia with AOR= 7.76 [95CI; 3.33-18.08, p<0.001]. Neonates born from mothers who consumed fruits and dairy products in their diet frequently were 2 and 4.9 times more likely to be macrosomia AOR=2.03 [95%CI; 1.11-3.69, p=0.021] and AOR= 4.91[95%CI; 2.36-10.23, p<0.001] respectively. Conclusion Mothers' physical exercise and consumption of fruit and dairy products were significant predictor variables for fetal macrosomia. Hence, health care providers may use these factors as a screening tool for the prediction, early diagnosis, and timely intervention of fetal macrosomia and its complications.
Background: Lack of dietary diversity especially for children 6-23 months is critical because they require energy and nutrient-dense foods for both physical, mental growth and development. However, in many low-income countries particularly in rural area, at least meeting the minimum dietary diversity standard has been a major challenge. Therefore, this study aimed to assess minimum dietary diversity and associated factors among 6-23 months children in rural community of Kacha Bira district, Southern Ethiopia.Methods: A community based cross-sectional study was employed on 623 children aged 6-23 months. Two stages cluster sampling method was conducted to select study population. Pre-tested and interviewer administered questionnaire was used for data collection. Data were entered and cleaned by Epi data 3.1, then exported to SPSS (Statistical Package for Social Sciences) version 20 for statistical analysis. Bivariate and multivariable logistic regression was employed using a p-value < 0.25 and < 0.05, respectively. Results: In this study, the day before data collection 46.1% (95% CI: 42.1-50.0) of 6-23 months children were fed on adequately diversified diets. Maternal age 18-24 years [AOR=3.68(95%CI: 1.18, 6.22)], post-natal care follow up [AOR=8.8 (95%CI: 5.17, 14.98)], children 6-11 months age [AOR=2.04(95%CI: 1.24, 3.39)] and being household food secured [AOR=3.64(95%CI: 2.27, 5.84)] were associated with dietary diversity.Conclusions: In the study area less than half of 6-23 months children were fed on adequately diversified diets, which is very low. All mothers should be encouraged to make postnatal care follow up and measures should take to improve food security of the household.
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