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BackgroundCoronavirus (COVID-19) disease affected people throughout the globe and has become a severe threat to the health and wellbeing of the global community. Time to death and predictors of mortality vary across settings. So far, no or few related studies have been undertaken in Ethiopia. Studying the time to death from COVID-19 and its predictors is essential to understand the characteristics of the disease and thereby contribute to the identification of indicators for early detection and initiation of treatment. Therefore, this study aimed to estimate time to death and its predictors among adults with COVID-19 in Ethiopia.MethodsA retrospective follow-up study was conducted among 602 adults with COVID-19 attending Eka Kotebe General Hospital, COVID-19 Treatment Center, between 13 March 2020 and 13 November 2020. The data were entered by Epi-data version 4.2 while the analysis was carried out using STATA version 16. A Kaplan–Meier survivor curve was computed to estimate the survival probabilities. A log-rank test was used to compare the difference in survival curves. Cox proportional hazard models were fitted to identify the predictors of time to death.ResultsThe overall median time to death was 21 days. Older adults (aged ≥65 years) [adjusted hazard ratio (AHR) 2.22, 95% confidence interval (CI) 1.02–4.86], being men (AHR 3.04, 95% CI 1.61–5.74), shortness of breathing at admission (AHR 2.29, 95% CI 1.16–4.54), comorbidity (AHR 2.23, 95% CI 1.04–4.80), diabetes mellitus (AHR 2.31, 95% CI 1.30–4.08), altered cardiac function (AHR 2.07, 95% CI 1.21–3.43), and baseline white blood cell count of greater than 10 (103/µl) (AHR 2.62, 95% CI 1.55–4.44) were independent predictors of COVID-19 mortality.ConclusionMale sex, older adults, shortness of breathing at admission, patients with comorbidities, and higher blood cell count were significant predictors of time to death from COVID-19. Therefore, concerned stakeholders should focus on those predictors of mortality and design interventions accordingly to enhance the survival of patients with COVID-19.

Background The clinical learning environment is important to achieve the defined learning outcomes of the program, however nurse students face a multitude of challenges during their clinical placement. Objectives The objective of the study was to explore challenges experienced by nursing students during clinical placement with associated factors among highest institutions of Addis Ababa city, Ethiopia, 2020. Method A mixed method approach composed of cross sectional study and phenomenological method employed from February 15, to April 30, 2020 on 179 third- and fourth-year undergraduate nursing students selected using simple random sampling for the quantitative study and seven purposively selected students for qualitative study. Self-administered questionnaire and recording of telephone interview used to collect quantitative and qualitative data respectively. Logistic regression analysis carried out to identify the independent predictors, whereas the qualitative data analyzed using interpretation of the voice recorded during telephone interview, extracting significant statements, formulating meanings, and coding, categorizing into clusters of themes using the content analysis approach and using ATLAS ti.Version 7.5.16 software. Result the prevalence of challenge among nursing students was found to be 29 (16.9%).Consequently, in bivariate logistic regression, students’ religion, residence, entrance year, learning institution and substance use were found to have association with challenge among nursing student. However, in multivariable analysis only substance use and learning institution found to have significant association. Furthermore statistically significant negative moderate correlation between students total challenge score and their overall competency score were identified [r= -0.672, P value =

Background In Ethiopia, about 80% of the population use traditional medicine (TM) due to the cultural acceptability of healers and local pharmacopeias, the relatively low cost of traditional medicine, and the difficulty of accessing modern health facilities. This study was aimed at assessing traditional medicine utilization and its determinants among parents of the children employing a case study of the Tole District of South West of Oromia, Ethiopia. Methods A community-based cross-sectional data were collected from 267 parents who have children less than 18 years old. The respondents were selected through a systematic random sampling technique. Both descriptive and exploratory techniques were used to analyze the data. The exploratory logistic regression analysis was carried out to identify factors determining the use of traditional medicine (TM). Results We found out that 85.9% of parents used TM for their children. Herbal medicine 73 (34.4%), massage 55 (25.9%), and religious/prayer therapy 25 (11.8%) were the major therapies used by parents for their children. In the study area, the rate of parental TM utuilization for their children was determined by monthly income [OR: 0.25(0.08, 0.78)], cultural belief [OR: 3.01(1.16, 7.83)], religious belief [OR = 3.17(1.26, 7.93)], and duration of illness [OR = 3.11(1.07, 9.02)]. Conclusion Traditional medicine use is highly prevalent that its contribution to the public health is significant as some could not access to and afford modern health services in the area. Therefore, health professionals should advise parents side-by-side procuring modern health services. In light of this, further research will be needed on the safety and efficacy of TM for wider application.

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BACKGROUND The global cancer burden is estimated to have risen to 18.1 million new cases and 9.6 million deaths in 2018. The period of child's diagnosis negatively influences parents socially and psychologically leading to depression. OBJECTIVES The aim of the study was to assess the prevalence of depression, its associated factors and parent's experience towards care of their cancer diagnosed child. METHODS A mixed approach quantitative and qualitative cross-sectional study was employed between 15 March and 1 April 2017. Systematic random sampling involving 275 participants in the quantitative and 20 conveniently selected participants for qualitative study were included in the study. Beck's depression inventory scale was used to collect data. Logistic regression including bivariate and multivariate analysis considering 95% confidence interval (CI) was utilized to examine association between dependent and independent variables. P-value

Objectives:Postpartum Depression (PPD) is a serious public health problem that leads to high maternal morbidity and mortality, enormously affecting the infant, family and society. Thus, the aim of this study was to assess the prevalence and factors associated with postpartum depression among postpartum mothers attending public health centers in Addis Ababa, Ethiopia, 2016.Methods:Facility-based cross-sectional study was conducted from March 2016-April 2016 among 633 postpartum women. Four sub cities were identified through simple random sampling technique among 10 sub cities in Addis Ababa, Ethiopia. Furthermore, the study participants were determined by systematic random sampling after 10 health centers were selected by lottery method and the number of participants in each health center was proportionally allocated. In order to determine postpartum depression, participants were rated using the Edinburgh Postnatal Depression Scale (EPDS) and the findings were analyzed using bivariate and multivariate logistic regression. P-value less than 0.05 with 95% confidence interval was used to state the association.Results:The study revealed prevalence of postpartum depression among mothers was 23.3%. Moreover, women who were unmarried, had unplanned pregnancy, delivered without presence of any relatives in health institutions, had previous history of child health, had history of substance use and had low income were found to more often display postpartum depression.Conclusion:For optimal maternal health care provision in regards to postpartum depression, integration of mental health service in addition to inter sectoral collaboration of women’s affair with health institutions is crucial.

Back Ground: Risky sexual behavior among orphans and vulnerable children and its associated physical, psychological and social consequences is becoming a major public health concern globally. Objectives: To assess the prevalence of risky sexual behavior and its determinants among orphan and vulnerable children in Addis Ababa. Methodology: A community based cross sectional study was conducted on three support and care giving organizations for orphans and vulnerable children in Addis Ababa, Ethiopia from March to June 2014. A total of 422 orphan and vulnerable children were selected using systematic sampling. Data were collected using pre tested self-administered questionnaire. Logistic regression was used to analyze the data. Result: A total of 407 (96.4%) respondents participated in this study. Among them 112 (27.5%) had sexual intercourse in their life time, of these 50 (44.6%) started sex before the age of 15, 94 (83.9%) had forced sex, 84 (75.0%) had multiple sexual partners, only 16 (14.3%) used condom the first time they had sex and 96 (85.7%) participated in transactional sex. Females were about 3.25 (2.67 - 7.3) times more likely to engage in risky sexual behavior than male respondents, double orphans had 4.32 (2.45 - 9.54) odds of risky sexual behavior compared to their counterparts. Those respondents who had knowledge of HIV transmission and prevention were less likely to be involved in risky sexual behavior 0.58 (0.41 - 0.93). Conclusion: Orphan and vulnerable children are at a higher likelihood of risky sexual behavior. Intervention targeted at multilevel such as orphan survival training, assertive communication skills, sexuality education and education about HIV risk perception, physical, psychological and human right protection, social support, and economic access for basic needs need to be given consideration.

Background Spontaneous preterm birth is commencement of labor with intact or pre labor rapture of membrane and birth before 37 weeks of gestation. The aim of this study was to identify common factors associated with spontaneous preterm birth in Addis Ababa public hospitals. Methods After random selection of three hospitals from the six Addis Ababa’s Public hospitals having Neonatal intensive care unit, systematic sampling was employed to select study units from admission log book of the neonates. Data were collected using structured checklist. Finally, data entered to EpiData 3.1 and transported to SPSS 22 for analysis. Bivariate and multivariate logistic regression analysis was done for the variables. Result The mean gestational age of preterm birth was 32.45 (±2.903 SD). Majority (66.1%) of preterm births were spontaneous and 33.9% were induced preterm births. Hypertension during pregnancy [P = 0.001, AOR = 0.182, 95% CI: (0.067, 0.493)] and maternal HIV infection [P = 0.041, AOR = 3.408 95% CI: (1.048, 11.079)] significantly associated with spontaneous preterm birth. Conclusion Those mothers who were diagnosed with hypertension during pregnancy less likely gave spontaneous preterm birth than who had no history of hypertension during pregnancy and HIV positive mothers gave spontaneous preterm more likely than HIV negative mothers. Thus, giving emphasis to these factors with appropriate care during pregnancy is important to reduce spontaneous preterm birth.

Background: Unsafe abortions resulting from unintended pregnancies denote an important public health challenge throughout the world. Although various strategies have been used to address this problem unsafe abortion from unwanted pregnancy remained the cause for a significant number of maternal morbidity and mortality. Objective: To assess the prevalence of unwanted pregnancies and factors associated with unwanted pregnancies. Methodology: A facility based cross-sectional study was conducted to select randomly 349 women of reproductive age from five hospitals providing antenatal care in Addis Ababa. Data were collected using standardized pretested interviewer administered questionnaire. Logistic regression was used to analyze the association between the dependent and independent variables. Result: A total of 333 reproductive age group females participated in the study making the response rate 95.4%. A total of 126 (37.8%) and 50 (39.6%) respondents had unwanted pregnancy and induced abortion at some point in their lives. Marital status and number of sexual partner were significantly associated with unwanted pregnancy with AOR [1.783 (1.036, 3.068), 11.355 (5.106, 25.253)] respectively. Conclusion: The prevalence of unwanted pregnancy and induced abortion were high, and most of the induced abortion was the result of unwanted pregnancy. This study has implication that comprehensive approaches should be emphasized to increase awareness, access and use of family planning methods.

Background: Understanding ecological factors that influence risky sexual behavior of adolescents is vital in designing and implementing sexual risk reduction interventions in specific contexts. Interventions undertaken without understanding the critical factors may not produce the desired results. Objective: The objective of this study was to identify the factors associated with adolescent risky sexual behavior among school adolescents in Addis Ababa, Ethiopia. Methods: This cross-sectional study was done among randomly selected school adolescents in Addis Ababa, Ethiopia. Data were collected by an anonymous self administered questionnaire. Risky sexual behavior was assessed by asking question about sexual activity, consistent condom use and faithfulness to a single partner. Logistic regression analysis was done to identify factors related to sexual behavior using the ecological framework. Result: Overall 377(10.6%) of the 723 sexually active students were involved in risky sexual practices. Risky sexual behavior was significantly and very strongly associated with perception of peers' involvement in sexual intercourse [AOR = 11.68 (95% CI: 8.76 - 15.58)]. Conclusion: This study demonstrated that peer pressure is the most important factor associated with risky sexual behavior among school adolescents in Addis Ababa. Interventions aimed at reducing sexual behavior among school adolescents should target adolescents as a group rather than individually.

Introduction: Success of antiretroviral therapy (ART) requires that individuals maintain nearly one hundred percent adherence to the prescribed regimen. Lack of optimal adherence to ART is associated with a high risk of developing mutant HIV strains, and increased risk of HIV transmission. Psychosocial adaptation is associated with positive health behaviors in HIV. In this study, we determined the correlation between psychosocial adaptation to living with HIV and adherence to ART, and determined the factors associated with psychosocial adaptation. Methods: In this cross sectional study, we interviewed 235 HIV-infected adults that receive ART from the infectious Diseases Institute (IDI) clinic and used the Health Related Hardiness Scale (HRHS) to measure psychosocial adaptation. Adherence to ART was determined by self-report of the number of doses missed in the previous 7 days. Pearson correlation was used to determine the relationship between psychosocial adaptation and adherence to ART. Logistic regression was used to determine the factors associated with psychosocial adaptation. Results: Most (60.4%) were females, married or staying with a partner (46.4%) and had some form of employment (74.4%). Participants had a mean age of 38 ± 9 years, had been registered in the HIV clinic for a median period of 6 years, with a mean duration on ART of 4 ± 3 years. A majority (86%) were adherent to ART. HRHS is found to be reliable (Cronbach’s alpha=0.83) and participants had a percentage mean adaptation of 85.9%. There was a significant correlation (r=0.159, p=0.015) between psychosocial adaptation and adherence to ART. Excellent perception of health status (OR=2.36, 95% CI=1.22-4.53, P=0.01), very good self-rating of ART adherence (OR=3.35, 95% CI=1.74-6.50, P=

In 2005, Ethiopia liberalized its abortion law and subsequently authorized midwives to offer abortion services. Using a 2013 survey of 188 midwives and 12 interviews with third-year midwifery students, this cross-sectional research examines midwives' attitudes toward abortion to understand their decisions about service provision. Most midwives were willing to provide abortion services. This willingness was positively and significantly related to clinical experience with abortion, but negatively and significantly related to religiosity, belief that providers have the right to refuse to provide services, and care of patients from periurban as opposed to rural areas. No significant relationship was found with perceptions of abortion stigma, years of work as a midwife, or knowledge of the law. Interview data suggest complex dynamics underlying midwives' willingness to offer services, including conflicts between professional norms and religious beliefs. Findings can inform Ethiopia's efforts to reduce maternal mortality through task-shifting to midwives and can aid other countries that are confronting provider shortages and high levels of maternal mortality and morbidity, particularly due to unsafe abortion.

Background: Healthy sexuality is a developmental process which needs investments from parents. Nonetheless, little is known about the effect of parenting practices and styles on the sexual risk behavior of young people. Objectives: to assess the effect of different parenting styles and parenting practices on the sexual behavior of adolescents. Methods: A cross-sectional study was conducted among 3840 randomly selected high school adolescents using three stage sampling in Addis Ababa, Ethiopia. Data were collected by a self-administered anonymous pre tested questionnaire. Logistic regression analysis was done to identify parental factors associated with sexual behavior. Results: From the 3543 students participated in this study 723(20.4%) respondents reported ever having sexual intercourse and nearly three -quarter of those who initiated sex were involved in risky sexual practices. Respondents who live with both parents [AOR= 0.48 (95%CI: 0.21-0.83)] and perceived connected to their parents [AOR= 0.51(95%CI: 0.22-0.96)] were less likely to experience risky sexual behavior. Similarly, students from authoritarian and authoritative parents were more likely to have safe sexual practices [AOR = 0.38(95%CI: 0.23-0.86)] and [AOR = 0.41(95%CI: 0.24-0.93)] respectively compared to children from permissive parenting styles. In addition, parent child communication about sexual issues [AOR =0.56 (95%CI: 0.31-0.94)] and parental monitoring were protective from risky sexual behavior [AOR =0.52(95%CI: 0.32-0.92)]. Conclusion: Appropriate parenting practices have a shielding effect from adolescent sexual risk behavior. Interventions that enable parents to build proper parenting practices, skills and styles have paramount importance.

Background Disclosure of HIV status has become an entry criterion for prevention of mother to child transmission programs in resource-constrained countries. However, little has been explored about the prevalence of, barriers to, outcomes and factors associated with HIV status disclosure among HIV positive pregnant women in Ethiopia. Method Cross- sectional study was conducted among 107 pregnant women who were attending antenatal care in public centers from April to June 2011 in Addis Ababa capital city of Ethiopia. Data was collected using interviewer administered pretested structured questionnaire and entered and was analyzed using SPSS- 15 version. Results presented in tables. Result Seventy three percent of women had disclosed their HIV status to their partner. Discussion about testing and a smooth relationship with the partner were independently associated with their disclosure. Women who disclosed to their partners were almost five times more likely to participate in Prevention of Mother to Child Transmission programs than their counterparts (AOR = 4.74; 95% CI 1.24-18.14). Conclusions Although most participants disclosed their HIV sero-positive status, lack of disclosure by some women might result in a limited ability to participate in PMTCT programs. Thus, assertiveness and improved communication skills training should be offered to HIV positive pregnant mothers and be reinforced during on-going counseling.

This article was migrated. The article was marked as recommended. A 2010 Lancet Commission on global higher education for the health professions called for institutional and instructional reforms worldwide in order to keep pace with pressing global health care needs. Among their many recommendations is an awareness of the value of international collaboration to enhance educational quality. In this article, we reflect on our experience of building such a collaboration in nursing. Using the concept of counterparts as articulated by DeSantis (1993; 1995), we describe the highlights as well as the lessons of our work together in developing the research component of the Masters of Science in Nursing (MScN) at Addis Ababa University in Ethiopia. We extend DeSantis' (1995) emphasis on roles in the relationship for understanding what constitutes success in international collaborations. Beyond identifying roles and responsibilities, our story calls attention to the value of cultivating relationships in which interdependence, mutuality, and issues of reciprocity are at the fore.

Background: Insufficient knowledge about Sexually Transmitted Infections (STI) and issues around accessing health services are among the major impediments to successfully prevent STIs among adolescent populations in developing countries. Objectives: To assess knowledge of adolescents about STIs and identify the barriers to seeking reproductive health service among high school adolescents. Methods: A cross sectional design complemented with a qualitative inquiry was the method used to collect relevant data among high school students in Addis Ababa, Ethiopia. A multistage sampling procedure was used to randomly select students across the city. The quantitative data were collected using a pre tested self administered questionnaire. Qualitative data were collected by conducting focus group discussions with purposively selected students. The analysis produced the proportion of adolescents who knew at least two symptoms of STI and associated factors. The qualitative information offers contextual understanding of the issues. Results: In total, only 634(17.9%) adolescents had knowledge of at least two symptoms of STIs. The reported knowledge was better among male students [AOR=1.47 (95%CI: 1.13-2.91)] and students who had mothers with formal education [AOR=1.48 (95%CI: 1.09-2.94)] compared to their counterparts. Overall 175(4.9%) of the students reported having symptoms of STIs 12 months prior to the survey, of which 58(33.1%) did not receive treatment. Among those reported treated, 50(42.7%) took self medication. Major barriers for not seeking treatment for STIs were perception of unavailability, unaffordability and inaccessibility of STI services in the existing health institutions. Adolescents prefer obtaining user friendly STIs services in schools. Conclusion: Adolescents are not aware of the symptoms of STI. Proper treatment for STI is not sought by the majority of students that reported STI symptoms. Inclusion of specific information and facts about STI in the school curriculum and providing user friendly STIs services at school can greatly reduce the risk of STIs among school adolescents.

This study was conducted to assess the perceived sufficiency and usefulness of HIV/AIDS information, education and communication (IEC) messages and materials as well as to identify preferences for IEC sources and methods. Data were collected using a self-administered questionnaire and focus group discussions. A total of 901 students in Addis Ababa, Ethiopia, participated in the study. Over three quarters of the respondents believed in the usefulness of IEC. IEC materials were perceived to be useful in increasing knowledge about HIV/AIDS by 456 (51%), to influence attitude by 357 (40%) and to acquire safer sexual practices by 382 (42%) of the respondents. None of the information sources and messages available for high school students highly satisfied the sufficiency indicators. Even though no single information source was highly preferred, radio and television ranked top. Life skills training was the most desired intervention by the students. IEC on HIV/AIDS was able to acquaint students with the disease rather than equipping them with knowledge and skill needed in their daily life. Therefore, appropriate and mutually reinforcing IEC messages with emphasis on life skill training are recommended. RÉSUMÉ Cette étude a été menée pour évaluer la suffisance perçue et l'utilité des messages et des matériels de l'information, l'éducation et la communication (IEC) du VIH/SIDA ainsi que pour identifier les préférences pour les sources et les méthodes d'IEC. Les données ont été recueillies à l'aide d'un questionnaire auto-administré et des discussions à groupe cible. Au total, 901 étudiants à Addis Abeba, Ethiopie, ont participé à l'étude. Plus de trois quarts des repondants avaient confiance en l'utilité de l'IEC. On a perçu les matériels de l'IEC comme étant utiles quant il s'agit d'augmenter de 456(51%) la connaissance sur VIH/SIDA, pour influencer de 357(40%) l'attitude et pour acquérir de 382(42%) des répondents des pratiques sexuelles moins dangereuses. Aucune des sources d'information et des messgaes disponibles pour les étudiants des secondaires n'a bien satisfait les indices de la suffisance. Bien qu'aucune source d'information n'a été bien préférée, la radio et la télévision ont occupé la première place. La formation de technique de vie a été l'intervention la plus désirée par les étudiants sur la maladie plutôt que de les munir de la connaissance et la technique nécessaires dans leur vie quotidience. En conséquence, on préconise les messages de l'IEC appropriés et mutuellement renforçants, qui mettent l'accent sur la formation de technique de vie. Afr J Reprod Health Vol.9 (1) 2005: 66–77