Search

Habtamu Sewunet Mekonnen,1 Helena Lindgren,2 Biftu Geda,3 Telake Azale,4 Kerstin Erlandsson5 1Department of Medical Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia; 2Department of Women’s and Children’s Health, Karolinska Institutet, Solna, Sweden; 3Department of Nursing, College of Health Science, Madda Walabu University, Shashemene Campus, Shashemene, Ethiopia; 4Department of Health Education and Behavioral Sciences, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia; 5Department of Women’s and Children’s Health, Karolinska Institutet, Solna, Sweden and School of Education, Health and Social Studies, Dalarna University, Falun, SwedenCorrespondence: Habtamu Sewunet Mekonnen, Email habtsew@ymail.comBackground: As people grow old, they pass through various life courses. Thus, it is important to realize aging in the context of each of these stages, as aging is not only physiological and psychological processes. To understand the lifeworld experiences of the phenomenon “being an elderly person” from the individual perspective was important, in this study, within day-to-day life in Metropolitan cities of northwestern Ethiopia.Objective: The aim of this study was to describe the lifeworld of elderly persons living in Bahir Dar and Gondar Cities, Northwest Ethiopia.Methods: A community based qualitative study conducted from October 29, 2021 to November 6, 2021. A purposive sampling technique and in-depth interviews were used for sampling and data collection, respectively. To explore the life experience /life-world/ of the elderly, a descriptive phenomenological study was conducted among 15 elderly persons. The audio records were transcribed and the field notes incorporated. Transcribed texts were translated into the English language, and a descriptive phenomenological analysis was done.Results: In this study, the essence of the phenomenon, being an elderly person, means, in an ebb and flow motion, balancing a life change characterized by changing perspective, ambiguity to body functions, and preparing for being released. The elderly experienced physical, mental, and psychosocial changes. They had encountered positive and negative situations throughout their life span. They also expressed that their time was over and wished to prepare for God’s Kingdom.Conclusion: The use of phenomenology for this research provided an opportunity for a deeper understanding of the experiences of elderly persons. With knowledge from this study, nurses and other health professionals can understand and support the elderly from an individual point of view.Keywords: elderly person, Ethiopia, lifeworld, phenomenology

Workie Zemene Worku,1 Telake Azale,2 Tadesse Awoke Ayele,3 Dawit Kassahun Mekonnen4 1Department of Community Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia; 2Department of Health Education and Behavioural Sciences, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia; 3Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia; 4Department of Gynaecology and Obstetrics, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, EthiopiaCorrespondence: Workie Zemene Worku, University of Gondar, P.O. Box 196, Gondar, Ethiopia, Tel +251 9187713 63, Email workiezemene@gmail.comBackground: Human immunodeficiency virus (HIV) has remained to be a significant public health problem worldwide mainly affecting women. Despite a 2 to 3 times higher risk of adverse pregnancy outcomes, around 2 million HIV positive women give birth each year globally. However, there is a dearth of evidences in Ethiopia about the effect of maternal HIV infection on pregnancy outcomes where adverse birth outcomes are still a significant health problem. This study is, therefore, aimed to examine the effect of HIV on the risk of adverse pregnancy outcomes in Amhara Regional State, Ethiopia.Methods: A prospective cohort study was conducted among 704 pregnant women (352 women with HIV and 352 women without HIV infection). Systematic random sampling technique was employed to select the study participants. Data on socio-demographic, obstetric, clinical, as well as behavioral and psychosocial characteristics were collected using a validated tool. Data on the outcome variables were also collected following delivery. Modified Poisson regression was employed to estimate the relative risk (RR) of HIV on low birth weight (LBW), preterm birth, and still birth at 95% confidence level. Attributable fraction (AF) was used to report the impact of HIV infection on pregnancy outcomes.Results: Of the total 704 pregnant women enrolled for the study, 96.3% (678) completed the study. The mean age of the study participants was 30.8 (SD ± 5.4) for HIV positive and 27 (SD ± 5.4) for HIV negative women. The cumulative incidence of low birth weight, preterm birth, and stillbirth were 21.4%, 9.4%, and 4.1%, respectively. The incidence of LBW was 24.7% among HIV positive and 17.8% among HIV negative women. The incidence of preterm birth was 10.7% among HIV positive and 7.9% among HIV negative women. And the incidence of stillbirth was 3.7% and 4.6% among HIV positive and those HIV negative women. New-borns from women with HIV infection had a higher risk of low birth weight and preterm birth than those HIV negative women (Adjusted Relative Risk (ARR) = 1.47; 95% CI: 1.06– 2.03) and (ARR = 1.74; 95% CI: 1.08– 2.79), respectively. The attributable risk of HIV on low birth weight was 32% (Attributable Fraction (AF) = 32%, 95% CI: 23– 46%), and 43% (AF = 43%, 95% CI: 23– 46%) for preterm birth.Conclusion: Maternal HIV infection increased the risk of low birth weight and preterm birth. This implies due attention is required while providing maternal health services primarily antenatal care and delivery services. These services should be aimed at reducing adverse pregnancy outcomes with more attention given to women with HIV infection. Moreover, reinforcement of HIV prevention intervention strategies should be considered at all levels.Keywords: HIV infection, low birth weight, preterm birth, stillbirth, Ethiopia

Mohamed Aden,1 Telake Azale,2 Chalie Tadie3 1Ministry of Plan and National Development, Hargeisa, Somaliland; 2Department of Health Education and Behavioral Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia; 3Department of Health Systems and Policy, College of Medicine and Health Sciences, University of Gondar, Gondar, EthiopiaCorrespondence: Telake Azale, Email atelake07@gmail.comBackground: Maternity waiting homes (MWHs) can help women receive the necessary obstetric care and referral if needed. However, there is a lack of evidence on whether women have the desire to stay away from their homes and the sociocultural predictors of their decision in Somaliland.Objective: The purpose of this study was to measure predictors of the intention of women to stay in MWHs using the theory of planned behavior in Hargeisa city, Somaliland.Methods: A facility-based cross-sectional study was conducted from in April 2021 in Hargeisa health facilities among 422 randomly selected participants using an interviewer-administered and structured questionnaire. Data were transferred to Epi Data 4.6 and exported to SPSS 20 for further analysis. Descriptive, bivariate, and multivariate binary logistic regression analyses were used. ORs with 95% CIs were used to assess associations, and statistical significance was set at P< 0.05.Results: A total of 245 (58%, 95% CI 53.1%– 62.8%) pregnant women intended to use an MWH. Multivariate analysis revealed that education (AOR 5.40, 95% CI 3.01– 9.69), experience of using an MWH (AOR 3.80, 95% CI 2.32– 6.27), multigravidity (AOR 2.2, 95% CI 1.16– 4.29), subjective norms (AOR 1.8, 95% CI 1.05– 3.11), indirect attitudes toward use of MWHs (AOR 1.9, 95% CI 1.01– 3.92), and indirect subjective norms (AOR 2.0, 95% CI 1.16– 3.60) were significantly associated with intention to use an MWH.Conclusion: Using an MWH is not the preference of many women. Personal characteristics, such as education, multigravidity, and perceived social pressure are important predictors of intention to use MWHs. It is important to raise the awareness of women and the community about the benefits of using MWHs in the early management of obstetric complications.Keywords: maternity waiting home, intention, Somaliland, pregnant women, theory

Dawed Ali,1 Telake Azale,2 Melese Wondie,1 Jinenus Tadesse1 1University of Gondar, College of Medicine and Health Sciences, Department of Psychiatry, Gondar, Ethiopia; 2University of Gondar, College of Medicine and Health Sciences, Department Health Education and Behavioral Sciences, Gondar, EthiopiaCorrespondence: Telake AzaleUniversity of Gondar, College of Medicine and Health Sciences, Department of Health Education and Behavioral Sciences, PO Box 196, Gondar, Ethiopia, Tel +251 918771951, Email atelake07@gmail.comBackground: Post-traumatic stress disorder (PTSD) is characterized by recurrent, involuntary, and intrusive distressing memories of a traumatic event and dissociative reactions. Little is known about post-traumatic stress disorder in low and middle income countries such as Ethiopia where armed conflict, human rights violations, and ethnic-based violence are becoming everyday occurrences.Objective: This study aimed to assess the prevalence of post-traumatic stress disorder and associated factors among residents of Maikadra, North West Ethiopia.Methods: A community-based cross-sectional study was employed in April 2021. A multi-stage cluster sampling technique was employed to select the study participants. A post-traumatic stress disorder checklist (PCL-5) was used to assess post-traumatic stress disorder through a face-to-face interview. Bivariate and multi-variable binary logistic regression analyses were carried out to examine the association between posttraumatic stress disorder and several demographic and psychosocial variables. Statistical significance was declared at a P-value < 0.05.Results: A total of 610 participants were interviewed with a response rate of 98.8%. The prevalence of PTSD in this study was 59.8% with a 95% CI of 55.7– 63.9. Female sex (AOR=1.93, 95% CI=1.64– 3.24), having a close family member killed or seriously injured (AOR=1.96, 95% CI=1.1– 3.48), having moderate (AOR=3.35, 95% CI=1.98– 5.68) and high perceived threat to life (AOR=3.66, 95% CI=1.85– 6.95), having depression (AOR=1.67, 95% CI=1.13– 2.47) and anxiety disorder (AOR=1.85, 95% CI=1.21– 2.83), and being directly exposed to the event (AOR=3.27, 95% CI=1.09– 9.83) were significantly associated with post-traumatic stress disorder.Conclusion: The majority of the residents of Maikadra town where the November 2020 massacre took place experienced posttraumatic stress disorder. Female sex, having a family member or a friend murdered or seriously injured, having depression and anxiety disorders and being directly exposed to the trauma were found to be significant predictors of post-traumatic stress disorder. People who have been exposed to such an intense traumatic event need psychosocial support to help them recover from the horrible experiences.Keywords: PTSD, prevalence, Maikadra, survivors, Ethiopia

Samuel Mobae Berhe,1 Telake Azale,2 Tolesa Fanta,1 Wubit Demeke,1 Amare Minyihun3 1Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia; 2Department of Health Education and Behavioral Sciences, University of Gondar, Gondar, Ethiopia; 3Department of Health Systems and Policy, University of Gondar, Gondar, EthiopiaCorrespondence: Telake AzaleDepartment of Health Education and Behavioral Sciences, University of Gondar, Gondar, EthiopiaEmail atelake07@gmail.comcBackground: Depressive disorders place an enormous burden on society and ranked fourth in the global disease burden accounting for 4.4% of the total disability-adjusted life years and 11.9% of total years lived with disability. Depression is associated with high level of morbidity and it is the most common contributor to suicide. Refugees have higher rates of mental disorders, in particular depression than those usually found in the non-war affected general population. There is a dearth of evidence in Ethiopia regarding the mental health of refugees.Objective: This study aimed to assess the prevalence of depression and associated factors among Eritrean refugees in Tigray North Ethiopia.Methods: A cross-sectional study was conducted at Maiayni refugee camp. A total of 800 participants were interviewed using systematic random sampling method. Pretested, structured and interviewer administered questionnaire that included socio demographic, clinical, behavioral, Harvard trauma questionnaire, and the patient health questionnaire (PHQ-9) was used. Descriptive statistics and binary logistic regression analyses were carried out.Results: With 786 (98.3%) of response rate, the prevalence of depression was found to be 37.8%, 95% confidence interval (34.2, 41.2). The odds of depression was higher in females [(AOR=8.92 95% CI (5.21, 15.25)], older age [(AOR=2.72 95% CI (1.03– 7.16)], those who never attended school [(AOR=3.09 95% CI (1.16– 8.24)], among the unemployed [(AOR=2.36 95% CI (1.16– 4.83)], those with poor social support [(AOR=8.67 95% CI (4.24– 17.77)], past psychiatric history [(AOR=4.76 95% CI (1.94– 11.67)], family history of a psychiatric disorder [(AOR=3.96 95% CI (1.93– 8.13)], those who were using substances [(AOR=4.08 95% CI (2.51– 6.65)], and among those who stayed for longer than a year at the camp [(AOR=4.18 95% CI (2.47– 7.08))].Conclusion: The study revealed that depression is a major mental health and public health problem among Eritrean refugees in Ethiopia. Several socio-demographic, psychosocial, behavioral and clinical factors were significant predictors of depression among the study participants. Mental health service provision for the refugees needs to be part of the support.Keywords: Eritrean refugee, depression, PHQ-9, trauma, internally displaced, Ethiopia

Ali D, Azale T, Wondie M, Tadesse J. Psychol Res Behav Manag. 2022;15:251–260. The authors have advised there is an error in the author list on page 251. The author name “Melese Wondie” should read “Mesele Wondie.

Shegaye Shumet,1 Telake Azale,2 Dessie Abebaw Angaw,3 Getachew Tesfaw,1 Messele Wondie,1 Wondale Getinet Alemu,1 Tadele Amare,1 Tilahun Kassew,1 Gebremeskel Mesafint4 1Department of Psychiatry, University of Gondar, Gondar, Ethiopia; 2Department of Health Education and Behavioral Science, University of Gondar, Gondar, Ethiopia; 3Department of Epidemiology and Biostatistics, University of Gondar, Gondar, Ethiopia; 4Mizan-Tapi University, College of Health Science, Department of Nursing, Mizan Aman, EthiopiaCorrespondence: Gebremeskel MesafintMizan-Tapi University, College of Health Science, Department of Nursing, Mizan Aman, EthiopiaTel +251918209867Email mulegeta111@gmail.comBackground: Globally, 350 million people are suffering from depression. Many people suffering from depression use different sources of help for their problems. People with different mental health problems seek help from formal and/or informal sources. This gives crucial information on community beliefs and perception regarding their preference for help. This study helps to guide effective planning and provision of mental health services, and health policy of the country to explore the community’s preference to different sources of help.Objective: The aim was to contrast patterns of formal and informal help-seeking preferences for depression among residents of Aykel town, Northwest Ethiopia.Methods: This cross-sectional population-based study included 832 participants. We used a major depressive disorder case vignette and general help-seeking questionnaire (GHSQ) to assess preference to seek help. Study participants were selected by multistage cluster sampling technique. An independent sample t-test and analysis of variance test (ANOVA) was performed.Results: A total of 656 subjects (78.8%) showed high propensity to intimate partner, and 655 (78.7%) of the study subjects had high propensity to mental health professional. The mean score of the residents’ preference to seek help from informal sources was 3.41± 0.60. The mean score of preference to seek help from formal sources was 3.18± 0.75. A total of 276 (33.2%) subjects showed high propensity to both informal and formal sources of help. The results also showed there was a mean score difference in preference for informal help between subjects with strong social support and low and moderate social support (P< 0.001).Conclusion: The result suggests that the majority of the residents had a higher preference to seek help from informal sources than formal sources of care. Providing and strengthening both formal and informal sources of help in conjunction are crucial to get a more qualified and effective care for depressed patients.Keywords: depression, preference to seek help, Ethiopia

Temesgen Yihunie Akalu,1 Kassahun Alemu Gelaye,1 Mulat Addis Bishaw,2 Sewbesew Yitayih Tilahun,3 Yigizie Yeshaw,4 Telake Azale,5 Tewodros Tsegaye,2 Daniel Asmelash,6 Yonas Akalu4 1Department of Epidemiology and Biostatistics, Institute of Public Health, University of Gondar, Gondar, Ethiopia; 2Department of Internal Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia; 3Department of Psychiatry, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia; 4Department of Human Physiology, School of Medicine, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia; 5Department of Health Education and Behavioral Science, Institute of Public Health, University of Gondar, Gondar, Ethiopia; 6Department of Clinical Chemistry, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, EthiopiaCorrespondence: Temesgen Yihunie AkaluDepartment of Epidemiology and Biostatistics, Institute of Public Health, University of Gondar, PO.Box: 196, Gondar, EthiopiaTel +251929390709Email temesgenyihunie@gmail.comPurpose: An acute respiratory disease caused by the novel coronavirus disease (COVID) was identified in late 2019. COVID-19 triggered a wide range of psychological problems, such as anxiety, depression, and stress. However, studies on mental health status in developing countries including Ethiopia related to COVID-19 are very limited. Therefore, this study was aimed at determining the magnitude of depression, anxiety, and stress, and their associated factors among Gondar town population during the early stage of the COVID-19 pandemic.Patients and Methods: A community-based cross-sectional study was conducted among 660 residents of Gondar town in April 2020. A multi-stage sampling technique was employed to select study participants. A 21 item depression, anxiety, and stress scale (DASS-21) was used. Variables with a p-value < 0.05 in the final model were declared as statistically significant. Hosmer and Lemeshow goodness of fit test was used to check the model fitness.Results: In this study, the prevalence of depression was 32.0% (95% CI: 28.4– 35.5), anxiety 25.8% (95% CI: 22.4– 29.1), and stress 14.7% (95% CI: 12.0– 17.4), respectively. The odds of developing depression was higher among female respondents (AOR=2.30, 95% CI: 1.01, 3.83) and ever smokers (AOR=2.8, 95 CI: 1.23, 6.28) as compared to their counterparts. Besides, history of medical illness and ever smoking increase the odds of anxiety by 2.3 (AOR=2.3; 95% CI: 1.42– 3.76), and 2.8 (AOR=2.8; 95% CI: 1.23– 3.83), respectively. Furthermore, being unemployed and family size of < 5 increase the odds of stress by 2.1 (AOR=2.1; 95% CI: 1.17– 3.83) and 1.8 (AOR=1.8; 95% CI: 1.09– 2.81), respectively.Conclusion: In this study, the overall depression, anxiety, and stress were significantly high. There are number of factors associated with depression, anxiety, and stress. Designing and implementing tailored strategies for COVID-19 prevention and control could be supremely important to reduce mental health problems in the community.Keywords: depression, anxiety, stress, COVID-19, Gondar

Hewan Tirukelem,1 Solomon Gedlu Nigatu,2 Dessie Abebaw Angaw,2 Telake Azale1 1Department of Health Education and Behavioral Science, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia; 2Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, EthiopiaCorrespondence: Solomon Gedlu Nigatu Email sol.gondar@gmail.comBackground: Epilepsy, defined as seizure activity that is recurrent, unpredictable, and typically unprovoked. It is one of the most common disorders of the nervous system. Sociocultural attitudes in many African nations continue to have a negative impact on epilepsy management. It has been found that stigma and discrimination against people with epilepsy are more devastating and harmful than the illness itself. This is mainly attributed to misconceptions about the disease with fear and fright of the public on confronting an epileptic seizure. So, the current study assesses the community’s attitude toward epilepsy patients and associated factors towards epilepsy in South Achefer District, Northwest Ethiopia.Methods: Community-based cross-sectional study triangulated with the qualitative method was conducted from March 1 to May 30, 2020 in South Achefer District. A systematic sampling technique was used to select a total of 762 individuals. Data were collected by face-to-face interview using a structured questionnaire and analyzed using SPSS version 23. Logistic regression analysis was performed and P < 0.05 with a 95% confidence interval was considered to measure statistically significant variables. For the qualitative study participants were selected purposively. Focus Group Discussion, key Informant Interview, and Individual Depth Interview were conducted until it reaches the point of saturation. Thematic analysis was done by using an open code software version 4.2.Results: A total of 753 respondents participated which gave a 98.8% response rate. Among those 60.8% (95% CI: 57.2– 64.3) were found to have a favorable attitude towards epilepsy patients. Being informed about epilepsy (AOR=1.47; 95% CI, 1.02– 2.11), witnessing seizure in the past (AOR=1.6; 95% CI, 1.14– 2.27), and having good knowledge about epilepsy (AOR=2.08; CI, 1.49– 2.89) were the variables that showed statistically significant association with a favorable attitude.Conclusion: The favorable attitude of the community towards epilepsy patients was found high in the study area. Information about epilepsy, witnessing seizure, and knowledge about epilepsy showed a significant association with attitude. Therefore, health professional and health extension workers should provide a larger and comprehensive community-based education to enhance people’s knowledge about epilepsy to bring attitude change against a negative attitude towards epilepsy.Keywords: attitude, epilepsy, Ethiopia

Wallelign Alemnew, Getu Debalkie, Telake Azale Department of Health Education & Behavioral Sciences, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, EthiopiaCorrespondence: Wallelign Alemnew Tel +251 942 33 16 08Email wallelignaleminew@gmail.comBackground: Cervical cancer screening is consistently effective in reducing the incidence and mortality rates associated with cervical cancer. However, very few women have received cervical cancer screening in the developing countries including Ethiopia. Therefore, this study aims to assess cervical cancer screening intention and its predictors among child bearing age women in Bahir Dar city, North-West Ethiopia.Methods: A community-based cross-sectional study was conducted among 832 child bearing age women using a multistage sampling technique between March and April, 2018. Data were collected using a structured questionnaire through face-to-face interviews. Data were entered and analyzed using EpiData and SPSS version 20.0, respectively. Simple and multiple linear regression analyses were done to identify predictors of intention, and P< 0.05 was used as a cutoff to determine statistical significance at multiple regressions.Results: Eight hundred and thirty-two (98%) respondents participated in this study. The mean age of the participants was 31±SD 7.23 years, ranging from 18– 49 years. The majority (61.4%) of the participants were married. The mean score of intention to receive cervical cancer screening was 10.5± 2.03, with a minimum and maximum sore of 5 and 15, respectively. Four hundred and fifty-eight (55%) (95% CI=51.7– 58.3) respondents scored above the mean score. Direct perceived behavioral control (β=0.19, P< 0.001), direct subjective norm (β=0.06, P< 0.001), direct attitude (β=0.15, P< 0.001), and past screening experience (β=0.64, P< 0.001) were found to be significant predictors of intention.Conclusion: Perceived behavioral control, attitude towards the behavior, subjective norm, and past screening experience were the predictors of intention, and perceived behavioral control was the strongest predictor. Hence, behavioral change communication interventions are crucial to change their attitude and empower them to evaluate their control and normative beliefs.Keywords: cervical cancer, human papilloma virus, theory of planned behavior, Ethiopia

Animut Tagele Tamiru,1 Bayew Kelkay Rade,1 Eden Bishaw Taye,2 Zelalem Nigussie Azene,3 Mehari Woldemariam Merid,4 Atalay Goshu Muluneh,4 Getahun Molla Kassa,4 Melaku Kindie Yenit,4 Asefa Adimasu Taddese,4 Kassahum Alemu Gelaye,4 Demiss Mulatu Geberu,5 Sewbesew Yitayih Tilahun,6 Habtamu Sewunet Mekonnen,7 Abere Woretaw Azagew,7 Chalachew Adugna Webneh,8 Getaneh Mulualem Belay,8 Nega Tezera Assimamaw,8 Chilot Desta Agegnehu,9 Telake Azale,10 Zewudu Andualem,11 Henok Dagne,11 Kiros Terefe Gashaye,12 Gebisa Guyasa Kabito,11 Tesfaye Hambisa Mekonnen,11 Sintayehu Daba,11 Jember Azanaw,11 Tsegaye Adane,11 Mekuriaw Alemayehu11 1Department of General Midwifery, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia; 2Department of Clinical Midwifery, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia; 3Department of Women’s and Family Health, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia; 4Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia; 5Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia; 6Department of Psychiatry, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia; 7Department of Medical Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia; 8Department of Pediatric and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia; 9School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia; 10Department of Health Education and Behavioral Sciences, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia; 11Department of Environmental and Occupational Health and Safety, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia; 12Department of Gynecology and Obstetrics, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, EthiopiaCorrespondence: Bayew Kelkay Rade Email bayekelkay@yahoo.comBackground: Coronavirus disease 2019 (COVID-19) is an emerging respiratory infection, and the crisis has become a worldwide issue, and society has become concerned in various aspects. Good information exposure related to transmission, prevention, and risk factors of COVID-19 can be the best means to reduce the risk of disease exposure and mitigate further spread. The countries that have well practiced this strategy (society information exposure) were controlling disease progression, but there is a low practice in sub-Saharan countries, including Ethiopia. Therefore, this study aimed to evaluate the information exposure level about COVID-19 and influencing factors among northwest community of Ethiopia.Methods and Materials: Community-based cross-sectional study design was employed among the community of Gondar city from April 20 to 27, 2020. A total of 623 study participants were involved in this interview, and a systematic sampling technique was applied to select the households. Data were entered into EpiData version 4.6 and then exported to STATA version 14 for analysis. A multivariable binary logistic regression was employed to identify factors associated with good information exposure about COVID-19. The adjusted odds ratio (AOR) with 95% confidence interval (CI) was estimated to show the strength of association. A p-value < 0.05 was a cut-off point to declare statistical significance.Results: The overall rate of information exposure about COVID-19 was 44.9%. Age 18– 26 years [AOR=0.53; 95% CI (0.28– 0.99)] and 34– 45 years [AOR=0.44; 95% CI (0.24– 0.80)], elementary school [AOR=2.48; 95% CI (1.20– 5.15)], secondary school [AOR=3.98; 95% CI (1.99– 7.99)], college and above [AOR=8.38; 95% CI (4.10– 17.26)], browsed or follow social media [AOR=2.21; 95% CI (1.44– 3.38)] and those having a discussion with their family members [AOR=2.37; 95% CI (1.44– 3.90)] and friends [AOR=2.15; 95% CI (1.38– 3.34)] were the factors significantly associated with good information exposure towards COVID-19.Conclusion: Communities total level of good information exposure from different information platforms about COVID-19 in this study area remains low. Age, high level of education, browsing social media, and those having interpersonal (family and friends) discussion were the factors that significantly influence communities who have good information exposure related to COVID-19. Therefore, efforts on community mobilization through regional/national mass media and other information conveying platforms are recommended.Keywords: COVID-19, information exposure, Northwest Ethiopia

Introduction: Postoperative myalgia in surgical patients is mainly caused by the routinely administered depolarizing muscle relaxant, Succinylcholine. There are many proposed strategies but no one were indicated as ideal preventive mechanisms for Succinylcholine induced post-operative myalgia. Even if data were sparse, Lidocaine pretreatment can reduce postoperative myalgia which requires further supportive evidences urging the initiation of this study., Methods: Prospective longitudinal cohort study was conducted from March to May 2021 at Dessie Comprehensive Specialized Hospital on 208 adult surgical patients. Patients pretreated with Lidocaine preoperatively were grouped as exposed and others as unexposed. Patients meeting the inclusion criteria during the study period were selected sequentially from the daily operation schedule list. Postoperative myalgia level was measured using post-operative myalgia survey repeatedly. The result was analyzed by Cochran's Q test and generalized estimating equation (GEE). Adjusted odds ratio with 95 % confidence interval and p value < 0.05 was used to show the difference, direction and strength of association., Result: Exposure specific incidence rate showed that 22 %, 22 % and 29.8 % of patients exposed to Lidocaine and 40.6 %, 42.7 % and 34 % not exposed to Lidocaine developed myalgia at 12, 24, and 48 h respectively. There is no significant difference in the incidence of myalgia over time between the repeated measurements in Lidocaine exposed patients ( p  = 0.513) but in non-exposed patients ( p  = 0.003). Also, there is no difference in the distribution of other predictors between Lidocaine exposed and non-exposed groups ( p  > 0.05). Exposure to Lidocaine reduces postoperative myalgia significantly [AOR = 0.33, 95 % CI = (0.17,0.66)]. Multimodal analgesia [AOR = 0.32, 95 % CI = (0.18,0.55)], non-steroidal anti-inflammatory drugs alone [AOR = 0.47, 95 % CI = (0.29,0.76)], postoperative immobility [AOR = 0.61, 95 % CI = (0.47,0.8)], and being male [AOR = 0.48, 95 % CI = (0.26,0.87)] were other determinants in reducing Succinylcholine induced postoperative myalgia., Conclusion: Lidocaine pretreatment can significantly reduce the occurrence of Succinylcholine induced postoperative myalgia. Additionally, usage of multimodal analgesia with non-steroidal anti-inflammatory drugs or even only non-steroidal anti-inflammatory drugs in the intraoperative and postoperative period can reduce Succinylcholine induced postoperative myalgia., Competing Interests: None., (© 2024 The Authors.)

Background: Mental illness is one of the most severe, chronic, and disabling public health problems that affects patients' Quality of life (QoL). Improving the QoL for people with mental illness is one of the most critical steps in stopping disease progression and avoiding complications of mental illness. Therefore, we aimed to assess the QoL and its determinants in patients with mental illness in outpatient clinics in Northwest Ethiopia in 2023., Methods: A facility-based cross-sectional study was conducted among people with mental illness in an outpatient clinic in Ethiopia. The sampling interval was decided by dividing the total study participants who had a follow-up appointment during the data collection period (2400), by the total sample size 638, with the starting point selected by lottery method. The interviewer-administered WHOQOL BREF-26 tool was used to measure the quality of life (QoL) of people with mental illness. The domains of QoL were identified, and indirect and direct effects of variables were calculated using structural equation modelling with SPSS-28 and Amos-28 software. A p-value of < 0.05 and a 95% CI were used to evaluate statistical significance., Results: A total of 636 (99.7%) participants agreed to participate and completed the data collection. The mean score of overall QoL of people with mental illness in the outpatient clinic was 49.6 ± 10 Sd. The highest QoL was found in the physical health domain (50.67 ± 9.5 Sd), and the lowest mean QoL was found in the psychological health domain (48.41 ± 10 Sd). Rural residence, drug nonadherence, suicidal ideation, not getting counselling, moderate or severe subjective severity, family does not participate in patient care and a family history of mental illness had an indirect negative effect on QoL. Alcohol use and psychological health domain had direct positive effect on QoL. Furthermore, objective severity of illness, having low self-esteem, and having history of mental illness in the family had both direct and indirect effect on QoL. Furthermore, sociodemographic factors (rural residence, illiterate educational status, not married marital status), social support-related factors (poor self-esteem, family not participating in patient care), substance use factors (alcohol use, tobacco use) and clinical factors (high objective and subjective severity of illness, not getting counselling, suicidal ideation, higher number of episodes, comorbid illness, family history of mental illness, poor drug adherence) directly and indirectly affected QoL., Conclusions: In this study, the QoL of people with mental illness was poor, with the psychological health domain the most affected. Sociodemographic factors, social support-related factors, drug use factors, and clinical factors, directly and indirectly affected QoL through the mediator variables of physical health domains, psychological health domains, social relation health domains, and environmental health domains. In order to improve the QoL of people with mental illnesses, we recommend that emphasis be given to addressing the QoL of those with mental illness, including the development of policy and practice responses that address the above identified factors., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Alemu, Mwanri, Due, Azale and Ziersch.)

Background: Depression is a very common psychiatric disorder in worldwide. Globally, Human Immunodeficiency Virus (HIV) is highly prevalent among women, and are disproportionately affected by depression. Antiretroviral Therapy (ART) adherence which could highly be affected by depression is yet to be explored effectively. Depression affects overall poor HIV clinical outcomes, socioeconomic and social interactions. However, it is not well understood specifically how depression affects ART adherence in women living with HIV (WLWHIV). Investigating the effects of depression on ART adherence is critical in order to develop nuanced new evidence to address non-adherence in WLWHIV., Objective: To conduct a meta-analysis on the correlation between depression and adherence to antiretroviral therapy among women living with HIV in the globe., Method: Using population, exposed and outcome approach, we searched Scopus, PubMed, EMBASE, Cochrane Library, Psych info, Web of science and google scholar for cohort and cross-sectional studies globally. The search strategy was structured comprising terms associated with antiretroviral therapy and adherence, women living with HIV and depression. We evaluated the paper quality, using the Newcastle-Ottawa Scales (NOS). The fixed effect model was used to analysis the effect of depression on ART adherence., Result: A total of 8 articles comprise 6474 participants were included in this study. There were controversial findings related to the effect of depression to ART adherence. Among three cross-sectional study, one article demonstrating, depression was associated with ART adherence. Of the five cohort studies, four cohort studies reported association. The overall pooled estimated effect of depression on ART adherence was 1.02 [RR = 1.015 with 95% CI (1.004, 1.026)] with a p-value of 0.005., Conclusion and Recommendation: Depression was the risk factor for ART adherence among women living with HIV. It is therefore, necessary for clinician to note this and perform screening for ART adherence., Trial Registration: The review protocol was developed with prospero registration: CRD42023415935., Competing Interests: All authors declare that no competing interest., (Copyright: © 2024 Zeleke et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Civilian war and internal conflicts increase the incidences of mental health conditions among war survivors. It is crucial to assess war-related psychological consequences in war-affected areas in Ethiopia to intervene in the future. Thus, this study aimed to determine the magnitude of psychological distress and associated factors of psychological distress among war survivor women in Northern, Ethiopia., Methods: A community-based cross-sectional survey was conducted, and 1596 war survivor women were recruited to participate using a face-to-face interviews with a census sampling technique from May 1-30, 2022. The psychological distress was assessed using a Kessler psychological distress scale (K10). Bi-variable and multi-variable logistic regression analyses were used, and variables with a p-value less than 0.05 in the multivariable analyses were considered statistically significant., Result: In this study, the response rate was 100% and the prevalence of psychological distress was 44.90% at a 95% CI: (42.40, 47.40). Psychological distress was significantly associated with the education of ability to read and write (AOR = 2.92; 95% CI: 2.12, 4.01), primary education and above (AOR = 3.08; 95% CI: 2.09, 4.54), housewife (AOR = 5.07; 95%CI: 2.64, 9.74), farmer (AOR = 8.92; 95%CI: 4.03, 19.70), emotional violence (AOR = 1.52; 95%CI: 1.05, 2.18), physical violence (AOR = 3.85; 95%CI: 2.37, 6.26) and sexual violence (AOR = 3.25; 95%CI: 1.98, 5.33) whereas being separate was protective for psychological distress (AOR = 0.38; 95%CI: 0.16, 0.92)., Conclusion: The prevalence of psychological distress was found to be high. Therefore, women who are housewives, married, farmers, educated, and who have experienced violence must be the focus of governmental and private collaborative interventions to prevent war-related psychological morbidity and mortality., (© 2024. The Author(s).)

Introduction: even though there are many initiatives to improve institutional delivery, there are low service utilization and community readiness for institutional delivery in Ethiopia. This study assessed the role of community readiness on delivery service use., Methods: a pre-and post-test design with a control group was used for the evaluation of the stage-matched educational intervention following the protocol of the community readiness assessment model. Based on the baseline assessment of community readiness among 15 kebeles where the study was conducted, the overall score of nine kebeles was below stage-5 out of the nine stages, which were targeted for the intervention. The intervention group (n= three kebeles) participated in the stage-matched intervention for 15 months, while the control group (n= three kebeles) were not given the intervention. The data were analyzed using the difference in difference (DiD) method., Results: there were significant improvements in a stage of change for the promotion of institutional delivery (p-value <0.001) and institutional delivery use (p-value <0.001) in the intervention group as compared to the control group. The study revealed that the intervention influenced community resource allocation (at marginally significant levels), improved leader-ship quality of prevention, and community climate to supportive prevention efforts. There was evidence that the intervention (health promotion) also increased service use at a significant level., Conclusion: the community readiness-based intervention (health promotion) can be useful to measure the combined attitude and behavior towards institutional delivery services. The village-based mobilizer approach had a positive effect on institutional delivery use and the level of community readiness on the promotion of institutional delivery., Competing Interests: The authors declare no competing interests., (Copyright: Adane Nigusie et al.)

Introduction: Quality of life (QoL) of patients with mental illness has been examined internationally but to a lesser extent in developing countries, including countries in Africa. Improving QoL is vital to reducing disability among people with mental illness. Therefore, this systematic review and meta-analysis aimed to assess the prevalence of QoL and associated factors among people living with mental illness in Africa., Methods: Using the PICOT approach, Scopus, MEDLINE, PsycINFO, CINAHL, Embase, the Web of Science, and Google Scholar were searched. A structured search was undertaken, comprising terms associated with mental health, mental illness, QoL, and a list of all African countries. The Joanna Briggs Institute Quality Appraisal Checklist is used to evaluate research quality. Subgroup analysis with Country, domains of QoL, and diagnosis was tested using a random-effect model, and bias was assessed using a funnel plot and an inspection of Egger's regression test. A p value, OR, and 95% CI were used to demonstrate an association., Results: The pooled prevalence of poor QoL was 45.93% (36.04%, 55.83%), I 2  = 98.6%, p < 0.001). Subgroup analysis showed that Ethiopia (48.09%; 95% CI = 33.73, 62.44), Egypt (43.51%; 95% CI = 21.84, 65.18), and Nigeria (43.49%; 95% CI = 12.25, 74.74) had the highest mean poor QoL prevalence of the countries. The pooled prevalence of poor QoL by diagnosis was as follows: bipolar disorder (69.63%; 95% CI = 47.48, 91.77), Schizophrenia (48.53%; 95% CI = 29.97, 67.11), group of mental illnesses (40.32%; 95% CI = 23.98, 56.66), and depressive disorders (38.90%; 95% CI = 22.98, 54.81). Being illiterate (3.63; 95% CI = 2.35, 4.91), having a comorbid medical illness (4.7; 95% CI = 2.75, 6.66), having a low monthly income (3.62; 95% CI = 1.96, 5.27), having positive symptoms (0.32; 95% CI = 0.19, 0.55), and having negative symptoms (0.26; 95% CI = 0.16, 0.43) were predictors of QoL. Thus, some factors are significantly associated with pooled effect estimates of QoL., Conclusions: The current systematic review and meta-analysis showed that almost half of patients with mental illness had poor QoL. Being illiterate, having a comorbid medical condition, having a low monthly income, having positive symptoms, and having negative symptoms of mental illness were independent predictors of poor QoL. This systematic review and meta-analysis emphasize that poor QoL of people with mental illness in Africa needs attention to reduce its negative consequences., (© 2023. Crown.)

Background: Stressful life events are a significant public health issue worldwide. Despite its mental, psychological, and social problems, important questions about the prevalence and risk factors remained unanswered. Therefore, this study aimed to show major life events and help-seeking behaviors among women in the reproductive-age group., Methods: A community-based cross-sectional study design was conducted using a multistage cluster sampling technique to get a total of 845 study participants from March 20 to April 29, 2021. Exposure to stressful life events and help-seeking behavior was collected using Women's Exposure to the Stressful Life Events Test, and General Help-Seeking Questionnaire (GHQ) respectively. Data were cleaned, coded, and entered into EPI-Info version 3.1 and analyzed using SPSS version 20., Results: The prevalence of stressful life events and help-seeking behaviors was 47.9 % and 38.7 % respectively. Reproductive-age women with poor social support (AOR = 2.392, 95 % CI: 1.422, 4.026), moderate social support (AOR = 1.861, 95 % CI: 1.341, 2.583), husband alcohol users (AOR = 1.496, 95 % CI: 1.027, 2.178), husband chat users (AOR = 2.962, 95 % CI: 1.140, 7.696), and having ever suicidal attempt (AOR = 8.702, CI: 1.719, 44.049), were positively associated with stressful life events., Conclusion: Nearly half of reproductive-age women had stressful life events. Thus, it is important to give serious attention to addressing those identified factors to increase public awareness, especially among husbands, their families, and elected authorities., Competing Interests: Declaration of competing interest The author(s) declared no potential conflicts of interest concerning the research, authorship, and/or publication of this article., (Copyright © 2023. Published by Elsevier B.V.)

Introduction: A change of therapy from one to another antipsychotic medication is currently the main challenge of therapy. This study aimed to assess the prevalence of antipsychotic medication switches and determinants among patients with schizophrenia in Northwest Ethiopia., Methods: Multi-center hospital-based cross-sectional study was conducted at five Comprehensive Specialized Hospitals found in Northwest Ethiopia from April 30, 2021, to August 30, 2021. Data were extracted from both patients' medical charts and interviews. Data were entered into Epi-data software version 3.5.1 and exported to SPSS version 25.0 for analysis. A multivariable logistic regression model was fitted to identify factors associated with medication regimen switch. The level of significance of the study was kept at a p-value of 0.05 with a 95% confidence interval., Result: A total of 414 patients are involved in the study, and 188 (45.5%) of patients switched antipsychotics within one year. The unavailability of the medication is the commonest reason for switching. Being male [AOR = 2.581, 95% CI (1.463, 4.552)], having relapse [AOR = 2.341,95% CI (1.169,4.687)], history of hospitalization in the past year [AOR = 3.00,95% CI (1.478,5.715)] and taking typical antipsychotics [AOR = 3.340, CI (1.76, 6.00)] had a significant association with antipsychotics switching., Conclusions and Recommendations: There is a high prevalence of antipsychotic switches among schizophrenia patients. Prescribers need to be careful while dosing, selecting, and switching antipsychotics, hence may help reduce discontinuation and unnecessary switch and thus achieve optimal clinical management., (© 2023. The Author(s).)

Background: Mental disorders among adolescents represent a high burden and early onset. They compromise their physical health, survival, and future potential. On the other hand, young people have inadequate access to essential health services in sub-Saharan Africa. We aimed to review school-based psychological interventions, contents, delivery, and evidence of effectiveness designed to treat depression, anxiety, or posttraumatic stress symptoms among adolescents and young adults aged 10-24., Method: We searched articles on the following databases: PubMed, Scopus, Embase, and Science Direct from 17/10/2022 to 30/12/2022. Furthermore, relevant studies were searched from advanced google scholar, google and identified reference lists. We used MeSH browser for key words: psychological interventions, depression, anxiety, posttraumatic stress disorder and lists of Sub-Saharan Africa countries. We combined words using standard Boolean operators (OR, AND). The quality of studies was evaluated using the Cochrane Collaboration's risk of bias tool and the results were presented as a narrative synthesis since the interventions were very heterogenous., Results: Fourteen randomized controlled trials were included for systematic review and more than half (57.14%) were from Kenya and Nigeria. Common school-based psychological interventions were cognitive behavioral therapy and Shamiri interventions (an intervention that focuses on youths to cultivate a growth mindset, practice gratitude and take the value). More than half (57.14%) of the interventions were delivered by non-specialists like teachers, lay providers and community health workers. Nearly one-fifth of the interventions were used individual modality. School-based psychological interventions provided by non-specialists also produced a greater reduction in adolescents' depressive, anxiety, and post-traumatic stress symptoms compared to the control groups., Conclusion: Cognitive behavioral therapy and Shamiri interventions were the common treatment delivered in school settings. The range of interventions could be effectively delivered by non- professionals that promote task-shifting of psychological interventions from very scarce mental health specialists in these countries., Trial Registration: Trial Registration: Prospero CRD42022378372. https://www.crd.york.ac.uk/prospero/display&#95;record.php?ID=CRD42022378372., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Tareke et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Protein undernutrition is a prevalent health problem in Ethiopia severely affecting the reproductive outcome of women. This is mainly because of inadequate consumption of protein due to the high cost of animal-origin food and the lack of knowledge about the benefits and the methods of preparation of pulses-based foods. Therefore, this trial was conducted to evaluate the effectiveness of nutrition education in improving the consumption of pulses-based foods among female adolescents., Methods: A two-arm pragmatic cluster randomized controlled trial was conducted among female adolescents in Northwest Ethiopia. Clusters were schools assigned into intervention and control groups by cluster randomization. The trial participants were female adolescents. The intervention was pulses-based nutrition education, and the comparator was the usual dietary practice of adolescent girls. The education was delivered over four weeks on a 45-60 min session per week basis. The primary outcome of the intervention was pulses-based food consumption, and the secondary outcomes were knowledge and attitude about pulses food. Data on the outcome and the confounding variables were collected at baseline and end-line of the intervention. The analysis was based on intention-to-treat analysis, and a log-binomial logistic regression model was fitted to the data to calculate relative risk with the corresponding p value adjusted for baseline characteristics. The intervention was considered effective when the p value was < 0.05., Results: A total of 269 intervention and 278 control participants from the four clusters completed the trial making response rates of 92.1% and 95.2%, respectively. The pulses-based nutrition education enabled participants in the intervention group to maintain their pulses-based food consumption state, while participants in the control group significantly reduced their consumption by about threefold [ARR; 95% CI 2.99 (1.87, 4.79)] from harvesting to non-harvesting season. The consumption of pulses-based food was higher by 16% among the intervention participants as compared to the control participants [ARD; 95% CI 0.16 (0.10, 0.21)]., Conclusion: Pulses-based nutrition education is effective in improving the consumption of pulses-based food among female adolescents. Therefore, policies and strategies are required to integrate this intervention in the school nutrition program., Trial Registration: The trial was registered in the Pan African Clinical Trials Registry (PACTR202111813445259) on 02 November 2021., (© 2023. BioMed Central Ltd., part of Springer Nature.)

Background: Thinness and stunting are the most severe public health problems among adolescent girls in Ethiopia. An inadequate intake of protein-source foods is the most critical cause, mainly due to the non-affordability of animal-origin foods. However, research into what extent improving pulses-based food consumption could contribute to decreasing the magnitude of protein-energy undernutrition is limited., Objective: This trial aimed to evaluate the effectiveness of pulses-based nutrition education in reducing the proportion of thinness among adolescent girls., Methods: A two-arm cluster randomized controlled trial was conducted among adolescent girls in Northwest Ethiopia from December 2021 to June 2022. A total of 602 adolescent girls from four schools were enrolled in the trial. Schools were assigned to intervention and control groups using the stratified cluster randomization method. Pulses-based nutrition education was the intervention, whereas the usual dietary practice of adolescent girls was the comparator. The education was delivered over 4 weeks on a 45-60-min session per week basis. Thinness was the primary outcome of the trial, measured by anthropometry. An intention-to-treat analysis method was used. A log-binomial regression model was fitted to the data. Relative risk with the respective confidence interval and value of p was calculated. A value of p < 0.05 was used to declare statistical significance. Stata 16 software was used for the analysis., Results: About 89.37% of the participants in the intervention group and 92.36% in the control group completed the trial. The pulses-based nutrition education intervention did not show a significant difference in reducing the proportion of thinness among the participants in the intervention group compared to the participants in the control group even though a significant difference was observed in terms of the consumption of pulses-based food., Conclusion: The present trial was statistically non-significant in reducing thinness among adolescent girls. Similar studies that utilize objective methods for ascertaining pulses-based food consumption need to be conducted. Clinical trial registration : https://pactr.samrc.ac.za/Search.aspx, the trial was registered in the Pan African Clinical Trials Registry (PACTR202111605102515) on November 12, 2021., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Mekonnen, Biks, Azale and Mengistu.)

Introduction: Maternal malnutrition remains a major public health problem, particularly in low and middle-income countries and war-affected areas like Ethiopia. Malnourished pregnant and lactating women with low nutrient stores have babies with poor mental and physical development, increasing the risk of poor birth outcomes. Despite the fact that the majority of Ethiopian mothers are malnourished, there is little evidence in war-affected areas. Therefore, the objective of this study was to assess the prevalence of undernutrition and associated factors among pregnant and lactating mothers in the war affected area of North Gondar Zone, northwest Ethiopia., Methods: A community-based cross-sectional study was conducted from April 10 to May 25, 2022. A multistage random sampling technique was used to select 1560 pregnant and lactating mothers. MUAC was to ascertain the outcome variable. Data was entered and analyzed by using EPI INFO version 3.5.3 and SPSS version 24, respectively. A multivariable logistic regression analysis was employed to identify the factors associated with acute malnutrition. An adjusted odds ratio (AOR) with a 95% confidence interval was used to show the strength of the association, while a P-value of 0.05 was used to declare the significance of the association., Results: The prevalence of acute malnutrition among pregnant and lactating women was 34.3% at the 95% CI (31.9-36.8). The age of the mothers (AOR = 0.73; 95% CI: 0.54, 0.99), family size 6-8 (AOR = 1.21; 95% CI: 1.03, 1.82), and greater than or equal to 9 family sizes (AOR = 0.44; 95% CI: 0.19, 0.97), were significantly associated with acute malnutrition., Conclusions: In the current study, the prevalence of acute malnutrition among pregnant and lactating mothers is high in the study area. Mother's age and family size were factors associated with acute malnutrition in war-affected areas. As a result, mothers with large families will require special assistance to reduce the impact of malnutrition., (© 2023. BioMed Central Ltd., part of Springer Nature.)

Maternal morbidity and mortality remain high among women who did not attend antenatal care (ANC). Antenatal care is one of the interventions given to pregnant women to detect existed problems or problems that can develop during pregnancy, which harm the health of pregnant women and fetuses. In Ethiopia, however, there is limited evidence that revealed the effect of antenatal depression on ANC service utilization. Hence, this study aimed to see the effect of antenatal depression on ANC visits among women in urban northwest Ethiopia. A population-based, prospective cohort study was done from June 2019 to March 2020. The Edinburgh postnatal depression scale was administered to 970 women in the second and third trimesters of pregnancy to screen for antenatal depression. Additional data were collected on ANC visits, the mother's socio-demographic, obstetric, clinical, psychosocial, and behavioral factors. A logistic regression model was used to adjust confounders and determine associations between antenatal depression and inadequate ANC visits. The cumulative incidence of inadequate ANC visits was 62.58% (95% CI: 59.43, 65.63). The cumulative incidence of inadequate ANC visits among depressed pregnant women was 75% as compared to 56% in non-depressed. The incidence of inadequate ANC visits in the exposed group due to antenatal depression was 25.33%. After multivariable analysis, antenatal depression at the second and third trimesters of pregnancy remained a potential predictor of inadequate ANC visits (AOR = 1.96: (95% CI 1.22, 3.16)). In addition, antenatal depression, long travel time for ANC visits (AOR = 1.83 (95% CI 1.166, 2.870)), and late initiation of ANC visits (AOR = 2.20 (95% CI 1.393, 3.471)) were the predictors of inadequate ANC visits as compared to their counterpart. This study suggested that antenatal depression affects ANC visits in Ethiopian urban settings. Therefore, early detecting and treating depression symptoms during the antenatal period reduced significantly the impacts of depression on the health of the mother and fetus., (© 2023. Springer Nature Limited.)

Background: Pregnancy and the postpartum period are incredibly challenging for women living with the Human Immune Deficiency Virus (HIV) due to the multidimensional influence of HIV infection. These women experience the challenges of navigating pregnancy and motherhood while living with HIV. It is poorly understood how women living with HIV (WLWH) experience pregnancy and postpartum. Therefore, the current study aimed to explore the lived experience of pregnancy and postpartum among women living with HIV., Methods: A phenomenological qualitative study design was employed. A semi-structured, interview guide was used to conduct in-depth interviews with HIV-positive postpartum women from April to May 2022. All interviews were recorded using a voice recorder and note was taken. The collected data were transcribed and translated into English for analysis. Inductive thematic analysis was applied to analyze the data., Results: Six main themes about the lived experience of women living with HIV were identified: (1) Fear and distress related to maternal and child Health, (2) HIV status self-disclosure dilemma, (3) Courage and commitment of HIV-positive women to prevent HIV, (4) Challenges faced and coping mechanisms used by HIV-positive women, (5) Health care providers and HIV-positive women interaction, and (6) Solution from their voices., Conclusion: HIV infection also has a multidimensional impact on women's life during pregnancy and postpartum. The findings of this study improve our understanding of the lived experience of HIV-positive women while pregnant and in the postpartum period. These women's descriptions showed that they have been experiencing various challenges that are not often addressed in antenatal clinics, such as distress and uncertainties related to vertical transmission of HIV. These women need specialized support and all-encompassing care to have a healthy pregnancy and postpartum period. Moreover, it is essential to understand the circumstances of women's lives, their relationships with others, and their decision-making processes. Healthcare professionals and other responsible bodies working with women living with HIV should encourage and support these mothers to appraise and maintain their commitment to protecting their children from acquiring HIV infection and maintaining their Health to the maximum to raise their children., (© 2023. The Author(s).)

Background: Occupational stress (OS) is a psychological state that results from people's perceptions of an imbalance between job demands and their abilities to cope with those demands. The COVID-19 pandemic has disrupted the teaching and learning process and compounded the stress level among teachers due to fear of transmission of the virus and school closures or the difficulty with adherence to the COVOD-19 prevention protocol. This survey study therefore aimed to investigate the prevalence of occupational stress and its associated factors among primary school teachers during the second wave of COVID-19 in western Ethiopia., Method: An institution-based cross-sectional survey was employed from April to May 2021. The survey was conducted in Gimbi town among all 672 primary school teachers in western Ethiopia. The standardized Teacher Occupational Stress Scale was used to measure occupational stress in the past 4 months. The data were collected through a self-administered questionnaire. The collected data were entered into EpiData version 4.6 and analyzed using Stata version 14 software. A multivariable logistic regression analysis was conducted to identify factors associated with occupational stress. The statistical significance was considered at a value of p of < 0.05 and a 95% confidence interval (CI) with an adjusted odds ratio (AOR) to evaluate the strength of associations., Results: The response rate was 96.8% ( N  = 651). The majority, 389 (59.8%) of the study participants were males. The mean (±SD) age was 35.8 (±9.3) years. The prevalence of occupational stress in the second wave of COVID-19 in the past 4 months was 50.1% ( n  = 326) [95% CI (46.1, 53.9)]. Job dissatisfaction [AOR: 2.06, 95% CI (1.43-2.97)] and high-risk perception of COVID-19 infection [AOR: 2.20; 95% CI (1.46-3.31)] were significantly associated with occupational stress., Conclusion: This survey disclosed a high prevalence of occupational stress among primary school teachers during the second wave of COVID-19. Job dissatisfaction and a high-risk perception of COVID-19 infection were significant predictors of the occurrence of occupational stress in school teachers. Enhancing stress management skills and focusing on primary prevention of identified risk factors were advised to curtail the condition., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Tesfaye, Abate, Kabito and Azale.)

Community health workers, also known as health extension workers (HEWs), play an important role in health promotion. This study evaluates HEWs' knowledge, attitude, and self-efficacy for non-communicable diseases (NCD) health promotion. HEWs (n = 203) completed a structured questionnaire on knowledge, attitude, behaviour, self-efficacy and NCD risk perception. Regression analysis was used to determine the association between self-efficacy and NCD risk perception with knowledge (high, medium, low), attitude (favourable/unfavourable) and physical activity (sufficient/insufficient). HEWs with higher self-efficacy were more likely to have high NCD knowledge (AOR: 2.21; 95% CI: 1.21. 4.07), favourable attitude towards NCD health promotion (AOR: 6.27; 95% CI: 3.11. 12.61) and were more physically active (AOR: 2.27; 95% CI: 1.08. 4.74) than those with lower self-efficacy. HEWs with higher NCD susceptibility (AOR: 1.89; 95% CI: 1.04. 3.47) and perceived severity (AOR: 2.69; 95% CI: 1.46, 4.93) had higher odds of NCD knowledge than their counterparts. Moreover, sufficient physical activity was influenced by HEWs' perceived NCD susceptibility and perceived benefits of lifestyle change. Therefore, HEWs need to adopt healthy lifestyle choices to become effective role models for the community. Our findings highlight the need to include a healthy lifestyle when training HEWs, which might increase self-efficacy for NCD health promotion., Competing Interests: The authors declare no conflict of interest.

Background: Depression is a serious mental health issue and the largest contributor to disability worldwide. Elderly people with depression are significantly more likely to experience negative outcomes such as poor physical health, strained social relationships, and decreased quality of life. Studies on geriatric depression are limited in developing nations like Ethiopia., Objectives: The purpose of this study was to determine the prevalence of depressive symptoms and associated factors among older adults in Yirgalem, Southern Ethiopia, in 2022., Methods: A community-based cross-sectional study was conducted on a sample of 628 older adults in Yirgalem town from May 15 to June 15, 2022. The study subjects were selected using a multi-stage systematic sampling technique. Data were collected using the 15-item Geriatric depression scale through face-to-face interviews. The collected data were edited, cleaned, coded, and entered into Epi data version 4.6 software and analyzed using STATA version 14. Bivariable and multivariate logistic regression analysis was computed to identify factors associated with depression, and statistical significance was declared at a 95% confidence interval with a P -value less than 0.05., Results: A total of 620 older adults were included in the study, with a response rate of 97.8%. The prevalence of depressive symptoms among older adults was 51.77% (95% CI: 47.83-55.69). Being a woman (AOR = 2.3, 95% CI: 1.56-3141); being of more advanced age: 70-79 years old (AOR = 1.92, 95% CI: 1.20-3.07), 80-89 years old (AOR = 2.15, 95% CI: 1.27-3.65), 90 and older (AOR = 3.77, 95% CI: 1.95-7.79); living alone (AOR = 1.99, 95% CI = 1.17-3.41); having a chronic illness (AOR = 3.24, 95% CI: 1.06-4.46); having anxiety (AOR = 3.40; 95% CI: 2.25-5.14); and having poor social support (AOR = 3.56, 95% CI: 2.09-6.04) were statistically associated with depressive symptoms at a P -value of less than 0.05., Conclusion: This study found that depression affects more than half of the elderly residents in the study area. More advanced age, being a woman, living alone, having a chronic illness, having anxiety, and having poor social support were all strongly linked to depression. There is a need to integrate counseling and psychiatric services into the community healthcare system., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Mulugeta, Azale, Mirkena, Koye, Nakie, Kassaye, Dereje, Bedewi, Dechasa and Asfaw.)

Introduction: Suicide is a deliberate attempt to take one's own life. Suicidal behavior among adolescents and young people, a significant global public health issue, is under-researched, particularly in developing nations like Ethiopia. Therefore, this study aimed to assess the prevalence of suicide attempts and their determinants among school-aged and out-of-school youth in the central, north, and west Gondar zones of Ethiopia., Methods: A community-based cross-sectional study was conducted from 15 March to 15 April 2019, among youth in the central, north, and west Gondar zones. The data for this study were extracted from information collected for the assessment of common health problems and risky behaviors among youth. A multistage cluster sampling technique was used to collect the data using face-to-face interviewer-administered questionnaires. Bivariable and multivariable logistic regression analyses were done to identify the independent determinants of suicide attempts. An adjusted odds ratio (AOR) with a 95% confidence interval (CI) was used to identify the presence and direction of the association between the dependent and independent variables., Results: A total of 1,597 youth participated in this study, and the mean age of the participants was 19.1 ± 2.8 standard deviations (SDs). The lifetime prevalence of suicide attempts in the study participants was 5.5% (95% CI: 4.4, 6.8%). Risky sexual practices (AOR = 1.89, 95%CI: 1.19-2.99), the presence of common mental health problems (AOR = 6.31, 95% CI: 3.78-10.88), having a personal income (AOR = 1.68, 95% CI: 1.05-2.71), and a history of violence (AOR = 2.81, 95% CI 1.76-4.49) were significantly associated with a suicide attempt., Conclusion: In this study, the prevalence of lifetime suicide attempts among youth is high. The presence of common mental health problems, having a personal income, risky sexual practices, and a history of violence increase the likelihood of suicide attempts. Working on the reduction of risky sexual practices, ensuring the integration of psychological treatment into medical treatment programs for victims of violence, psychosocial support for young people, and integrating youth-friendly health services to promote mental health would help to reduce suicide attempts among youth., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Geremew, Gelagay, Yeshitila, Azale, Habitu, Abebe, Birru and Fentie.)

Background: Improving Quality of Life (QoL) for patients with chronic diseases is a critical step in controlling disease progression and preventing complications. The COVID-19 pandemic has hampered chronic disease management, lowering patients' quality of life. Thus, we aimed to assess the quality of life and its determinants in patients with common chronic diseases, in Northwest Ethiopia during the COVID-19 pandemic., Methods: A cross-sectional study was conducted among 1815 randomly selected chronic patients with common chronic diseases. A standardized WHOQOL BREF tool was used, and electronic data collection was employed with the kobo toolbox data collection server. Overall QoL and the domains of Health-Related Quality of life (HRQoL) were determined. Structural equation modelling was done to estimate independent variables' direct and indirect effects. Path coefficients with a 95% confidence interval were reported., Results: About one in third, (33.35%) and 11.43% of the study participants had co-morbid conditions and identified complications, respectively. The mean score of QoL was 56.3 ranging from 14.59 and 98.95. The environmental domain was the most affected domain of HRQoL with a mean score of 52.18. Age, psychological, and environmental domains of HRQoL had a direct positive effect on the overall QoL while the physical and social relationships domains had an indirect positive effect. On the other hand, the number of medications taken, the presence of comorbidity, and complications had a direct negative impact on overall QoL. Furthermore, both rural residency and the presence of complications had an indirect negative effect on overall QoL via the mediator variables of environmental and physical health, respectively., Conclusion: The quality of life was compromised in chronic disease patients. During the COVID-19 pandemic, the environmental domain of HRQoL was the most affected. Several socio-demographic and clinical factors had an impact on QoL, either directly or indirectly. These findings highlighted the importance of paying special attention to rural residents, patients with complications, patients taking a higher number of medications, and patients with comorbidity., Competing Interests: the authors have declared that no competing interests exist., (Copyright: © 2022 Ayele et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: The burden of HIV is disproportionately higher among women of reproductive age contributing more than half of the global share. The situation in Ethiopia is not exceptional. The present study was done to determine the proportion of HIV among pregnant women in Amhara Regional State, Ethiopia., Method: Institutions-based cross-sectional study was conducted from October 2020 to December 2020. Systematic random sampling technique was used to select 538 study participants from pregnant women who had ANC follow-up in Referral Hospitals of the Amhara Regional State. Data on socio-demographic, clinical, obstetric, behavioral as well as psychosocial characteristics were gathered using an interviewer administered structured and standardized instruments. The data was entered into Epi-Data Manager V4.6.0.0 and exported to STATA version 14 for data analyses. Descriptive statics were computed to summarize the participant's characteristics. Bi-variable and multivariable logistic regression analyses were conducted to identify the association between dependent and independent variables. Independent variables with a p-value of less than 0.05 were considered to be statistically significant at 95% confidence level (CI)., Results: The proportion of HIV infection among pregnant women was 8.68% (95% CI: 6.5, 11.4). Completing secondary school education (Adjusted Odds Ratio (AOR = 0.15; 95% CI: 0.04-0.53), graduated from college (AOR = 0.03; 95% CI: 0.01-0.22), and family monthly income greater than 8001 ETB (1 USD = 56 ETB) (AOR = 0.19; 95% CI: 0.04-0.87) were protective factors associated with maternal HIV. On the other hand, history of previous abortion (AOR = 7.73; 95% CI: 3.33-17.95) and positive syphilis status (AOR = 10.28; 95% CI: 2.80-37.62) were risk factors associated with maternal HIV status., Conclusion: The proportion of HIV infection among pregnant women was found to be high. Advanced level of education, relatively higher monthly income, history of abortion and previous syphilis status were associated factors with HIV status. Strengthening women's formal education; empowering women in all spheres of life (especially improving their economic standing that prevents women from engaging in risky sexual practices); educating women about HIV transmission methods and HIV prevention and control strategies using behavior change intervention strategy prepared for women to reduce their vulnerability; advocating for the use of family planning to reduce unsafe abortions and syphilis; as well as regular screening and testing for syphilis are recommended., (© 2022. The Author(s).)

Background: Severe mental illnesses affect about 4% of the adult population worldwide. The illness is highly related to the relapse rate and can cause cognitive, social, and functional deterioration in patients. While there are some factors that are known to be protective of the occurrence of relapse in schizophrenia, having good social support is found to be one of the strongest factors. Therefore, the aim of this study was to identify the association between relapse and poor social support in patients with schizophrenia., Methods: With unmatched case-control (case-patients with schizophrenia with poor social support and controls-patients with schizophrenia with good social support), the study included 408 patients with schizophrenia on a follow-up at Amanuel Mental Specialized Hospital from March to May; 2020. The convenience sampling technique was used to draw the participants. Social support was assessed by the Oslo social support scale (Oslo-3), whereas Family Emotional Involvement and Criticism Scale and Medication Adherence Rating Scale-10 (MARS-10) were used to assess the emotion expressed and adherence to medication, respectively. Epidemiological Information (Epi Info) version 7 was used for data coding and entry, which were then exported to the Statistical Package for Social Sciences version 22 for analysis. Unconditioned binary logistic regression analysis and bivariate correlation analysis were carried out., Results: Out of 408 samples, 396 participants, of which 194 were cases and 202 were controls, were included in the study with a response rate of 97.06%. The mean and standard deviation (SD) age of the participants was 36.06 ± 9.842 years. From 194 cases, 61.1% of them were reported to have poor social support. In multiple logistic regression, only social support was found to be statistically significant [ p < 0.001, adjusted odds ratio (AOR) = 3.102, confidence interval (CI) (95%) = (1.985-4.848)]. Hence, the odds of having relapse were 3.102 higher in those who have poor social support when compared to those with good social support. Emotional involvement, financial problems, and stressful life events were found to indirectly affect relapse by having a negative correlation with social support., Conclusion: The present study showed that there was a relationship between relapse and social support, and this indicates that social support can be a good predictor of schizophrenia relapse. The caregivers and clinicians of the patients should increase their support to the patients, while hospitals with mental health services have to encourage formation of better social support for the patients, including psychosocial interventions which will be performed to enhance the social support system., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Samuel, Nigussie, Mirkena and Azale.)

Ethiopia has made improvements in the reduction of maternal mortality; the high burden of preeclampsia remains a concern in the Sidama region. This study aimed to measure the effect of preeclampsia on adverse maternal outcomes and identify risk factors among women with preeclampsia in Sidama region. A prospective open cohort study was conducted from August 8, 2019, to October 1, 2020. We enrolled a total of 1015 the pregnant women who had preeclampsia and normotensive women at ≥ 20 weeks of gestation and followed them until 42 days after delivery. A log-binomial logistic regression model was used to estimate the incidence of adverse maternal outcomes and its risk factors. There were 276 adverse maternal outcomes observed in the preeclampsia group compared to 154 adverse maternal outcomes in the normotensive group (P < 0.001). Women with severe features of preeclampsia had a 43% (aRR = 1.43, 95% CI 1.3-1.58) higher risk for adverse maternal outcomes compared to women without severe features of preeclampsia. Women without severe features of preeclampsia had a 39% (aRR = 1.39, 95% CI 1.2-1.76) higher risk for adverse maternal outcomes compared to women in the normotensive group. More adverse maternal outcomes occurred among women with preeclampsia after controlling for confounders., (© 2022. The Author(s).)

Background: Ethiopia has been striving to promote institutional delivery through community wide programs. However, home is still the preferred place of delivery for most women encouraged by the community`s perception that delivery is a normal process and home is the ideal environment. The proportion of women using institutional delivery service is below the expected level. Therefore, we examined the impact of perception on institutional delivery service use by using the health belief model., Methods: A community-based cross-sectional study was conducted among 1,394 women who gave birth during the past 1 year from September to December 2019. A multistage sampling technique was used to select the study participants. Data were collected by using health belief model constructs, and structured and pretested questionnaire. Binary logistic regression was performed to identify factors associated with the outcome variable at 95% confidence level., Results: Institutional delivery service was used by 58.17% (95% CI: 55.57- 60.77%) of women. The study showed that high perceived susceptibility (AOR = 1.87; 95% CI 1.19-2.92), high cues to action (AOR = 1.57; 95% CI: 1.04-2.36), husbands with primary school education (AOR = 1.43; 95% CI 1.06-1.94), multiparty(5 or more) (AOR = 2.96; 95% CI 1.85-4.72), discussion on institutional delivery at home (AOR = 4.25; 95% CI 2.85-6.35), no close follow-up by health workers (AOR = 0.59;95% CI 0.39-0.88), regular antenatal care follow-up (AOR = 1.77;95% CI 1.23,2.58), health professionals lack of respect to clients (AOR = 2.32; 95% CI 1.45-3.79), and lack of health workers (AOR = 0.43;95% CI 0.29-0.61) were significantly associated with the utilization health behavior of institutional delivery service., Conclusion: The prevalence of institutional delivery in the study area was low. The current study revealed that among the health belief model construct perceived susceptibility and cues to action were significantly associated with the utilization behavior of institutional delivery service. On top of that strong follow-up of the community and home based discussion was a significant factor for the utilization behavior of institutional delivery service., (© 2022. The Author(s).)

Aim: We assessed primary care facility preparedness, health workers' knowledge and their classification and treatment of possible serious bacterial infection and local bacterial infection in young infants aged 0-59 days., Method: A cross-sectional survey was conducted in four regions of Ethiopia, including 169 health posts with 276 health extension workers and 155 health centres with 175 staff. Registers of 1058 sick young infants were reviewed., Result: Antibiotics to treat possible serious bacterial infection were available in 71% of the health centres and 38% of the health posts. Nine of ten health extension workers and eight of ten health centre staff mentioned at least one sign of possible serious bacterial infection and local bacterial infection. Among the registered cases with signs of bacterial infections, the health extension workers classified 49% as having a possible serious bacterial infection and 88% as local bacterial infection. The health centre staff classified 25% as possible serious bacterial infections and 86% as local bacterial infections. One-fourth (26%) of possible serious bacterial infection received the recommended treatment at health posts and 35% at health centres., Conclusion: Many health posts lacked antibiotics. The classification and treatment of possible serious bacterial infection did not follow guidelines. The lack of medicines and poor adherence compromise the quality of care., (© 2022 The Authors. Acta Paediatrica published by John Wiley & Sons Ltd on behalf of Foundation Acta Paediatrica.)

Background: Preeclampsia affects the health of the mother and the fetus during pregnancy and childbirth. To date, little is known about the impact of preeclampsia on postpartum health-related to quality of life (HRQoL) in the Sidama region of southern Ethiopia. This study aimed to measure the HRQoL and its contributing factors among postpartum women with preeclampsia in the Sidama region., Methods: A prospective cohort study was conducted by enrolling pregnant women at ≥20 weeks of gestation up until the 37th week of gestation. We then followed them until 12 weeks after delivery. A locally validated, World Health Organization Quality-of-Life-BREF (WHOQOL-BREF) tool was used to assess participants' HRQoL at two time points; the 6th and 12th weeks postpartum. Assessment of HRQoL of participants was based on total scores on the WHOQoL-BREF. Higher scores on the WHOQoL-BREF reflected a higher HRQoL. Multiple linear regression analyses were performed to evaluate the contributing factors to HRQoL. The level of significance was determined at a p-value of < 0.05., Results: The HRQoL of postpartum women with preeclampsia significantly improved over time from 6 (151 ± 17) to 12 weeks (167 ± 18), p < 0.001). However, the overall HRQoL scores were lower (156 ± 16, p < 0.001) among women with preeclampsia compared to normotensive women (181 ± 21). An experience of early neonatal death was found to have a significant negative effect on the HRQoL of women with preeclampsia [β = - 2.1, 95% CI: - 3.43- - 0.85] compared to normotensive women who did not have early neonatal death. At 6 weeks of the postpartum period, the physical domain was found to have a significantly higher contribution to the lower HRQoL [β = 1.04, 95% CI: 0.88-1.12] compared to normotensive women, while other factors were constant., Conclusions: The HRQoL of women with preeclampsia improved over time from 6 to 12 weeks in the postpartum period. Lower HRQoL was observed among postpartum women with preeclampsia, especially among those who experienced preterm birth or early neonatal death. The effects of preeclampsia on the HRQoL of postpartum women should be considered in redesigning postnatal care intervention services., (© 2022. The Author(s).)

Background: Institutional delivery care-seeking behavior is considered a crucial step in preventing maternal and child death. However, the barriers and facilitators related to institutional delivery care-seeking behavior in the study area were not studied very in-depth. Hence, the current study aimed to explore barriers and enablers of institutional delivery care-seeking behavior in Northwest Ethiopia., Methods: A descriptive phenomenological qualitative inquiry was used. The data was collected by using a piloted interview guide. We collected data using in-depth interviews among women and men; and key informant interviews from the Female health development army and health extension workers in November and December 2019. Framework analysis was utilized for the analysis of the data., Results: This study found out the potential factors which hinder and facilitate institutional delivery. The barriers to institutional delivery included the belief that pregnancy and childbirth are normal and business of women's, women's preference of home delivery with traditional attendants, family influence, fear of bad behavior of health care workers, and lack of resources. The facilitators were free maternal services (ambulance services and maternity services), having the experience of safe childbirth at health facilities, and women's health development army linkage with health extension workers., Conclusion: This study provides evidence that low-risk perception of home delivery, socio-cultural influences, service provision modalities, and financial factors were the determinants of institutional delivery service use. Therefore, a stage-matched intervention shall be designed to improve the uptake of institutional delivery service use., (© 2022. The Author(s).)

Background: Despite its effectiveness, the intention, and utilization of long-acting contraceptive methods are very low in many developing countries, and the use of long-acting contraceptive methods has not kept pace with that of short-acting methods such as oral contraceptives and injectables. Therefore, this study aimed to assess the intention of using long-acting contraceptive methods and associated factors among women currently using short-acting contraceptive methods., Methods: Institution-based cross-sectional study was conducted from March 19 to April 19, 2017. The study included 515 short-acting contraceptive users found in Gondar city who were selected from the study population using a systematic random sampling technique. A structured pre-tested questionnaire based on the theory of planned behavior was used to collect data. Both descriptive and analytical statistical procedures were used. Simple and multiple linear regression analyses were carried out. SPSS version 20 was used for the analysis of the data. Multiple linear regression was carried out to see the association between intention and sociodemographic variables, past contraception experience, attitude, subjective norm, and perceived behavioral control, and with 95% CI and a p -value of <0.05 was used to detect statistical significance., Results: The magnitude of intention to use long-acting contraceptive methods was 39.8%. Intention to use long-acting contraceptive methods was higher for women whose husbands were farmers when compared to women whose husbands were government employees (β =0.49, 95% CI: 0.41, 0.72). Number of children wanted (β = -0.19, 95% CI: -0.28, -0.1), attitude (β = 0.34, CI: 0.23, 0.46), subjective norm (β = 19, 95% CI: 0.12, 0.27) and perceived behavioral control (β = 0.18, 95% CI: 0.06, 0.3) were factors significantly associated with intention to use long-acting contraceptive methods., Conclusions: Intention to use long-acting contraceptive methods was low. Interventions that focus on women's attitudes toward long-acting contraceptive methods and support groups, peer education, social mobilization, and persuasive communication could promote the intention to use long-acting contraceptive methods., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Fekadu, Azale, Berhe, Nigusie, Azene and Wolde.)

Objective: This study aimed to determine the level of life satisfaction and identify associated factors among elderly people living in two cities in northwest Ethiopia., Design: Community-based cross-sectional study., Setting: Two cities in northwest Ethiopia (Gondar and Bahir Dar)., Participants: 816 elderly people age 60 years and above living in Gondar and Bahir Dar, northwest Ethiopia. Systematic random sampling was used to select study participants., Main Outcome Measure: Level of life satisfaction. Considering the mean and SD, three levels of satisfaction appeared to suffice as the basis for analysis and discussion: 23.5-34.4 dissatisfied, 34.5-56.5 averagely satisfied and 56.6-67.5 satisfied. Multivariable ordinal regression analysis was done to control the confounders. Since the outcome variable has an ordinal category, ordinal regression analysis is appropriate. A p≤0.05 and AOR (adjusted OR) with a 95% CI were considered to determine the statistically significant variables and strength of the association., Results: The mean age of the respondents was 68.2 years with an SD±7.2. The level of life satisfaction was: dissatisfied 17.2%, moderately satisfied 63.8% and well satisfied 19.0%. Overall, 45.8% (95% CI 42.2% to 49.2%) of the participants had a score equal to or above the mean. Regarding associated factors; retired current occupation (AOR=2.23, 95% CI 1.09 to 4.55), good self-rated health status (AOR=2.54, 95% CI 1.29 to 4.99), having no chronic disease (AOR=1.48, 95% CI 1.03 to 2.11), somewhat-good (AOR=2.15, 95% CI 1.12 to 4.13) and good (AOR=4.51, 95% CI 2.40 to 8.45) self-perception on ageing life, moderate functional impairment on daily living activities (AOR=5.43, 95% CI 1.81 to 16.24), high sense of coherence (AOR=3.80, 95% CI 2.04 to 7.08), house rent as a source of finance (AOR=2.60, 95% CI 1.49 to 4.52) and high perceived social support (AOR=2.13, 95% CI 1.44 to 3.16) had statistically significant association with the life satisfaction., Conclusion: The life satisfaction level in our study group was lower than in some more highly developed countries. To improve the level of life satisfaction in Ethiopia, a holistic programme of nursing care for elderly people, particularly as concerns about their health and psychosocial conditions is crucial in both community and clinical settings., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: In Ethiopia, in 2021, more than 80% of all newborn deaths were caused by preventable and treatable conditions. This study aimed to measure the incidence of adverse perinatal outcomes and risk factors among women with pre-eclampsia in the Sidama region of southern Ethiopia., Methods: A prospective open cohort study was conducted from 8 August 2019 to 1 October 2020. We enrolled 363 women with pre-eclampsia and 367 normotensive women at ≥20 weeks of gestation and followed them until the 37th week. We then followed them until the seventh day after delivery up to the last perinatal outcome status was ascertained. A log-binomial logistic regression model was used to estimate the incidence of adverse perinatal outcomes and its risk factors among women with pre-eclampsia. Relative risk (RR) with a 95% CI was reported. A p<0.05 was considered statistically significant., Results: There were 224 adverse perinatal outcomes observed in the 363 women with pre-eclampsia compared with 136 adverse perinatal outcomes in the 367 normotensive women (p<0.001). There were 23 early neonatal deaths in the pre-eclampsia group compared with six deaths in the normotensive group (p<0.001). There were 35 perinatal deaths in the pre-eclampsia group compared with 16 deaths in the normotensive group (p<0.05). Women with severe features of pre-eclampsia had a 46% (adjusted RR 1.46, 95% CI 1.38 to 2.77) higher risk for adverse perinatal outcomes compared with women without severe features of pre-eclampsia., Conclusions: In this study, more adverse perinatal outcomes occurred among women with pre-eclampsia after controlling for confounders. A higher perinatal outcome observed among women with pre-eclampsia, especially among women with severe features of pre-eclampsia, and those admitted to hospital at <34 weeks. This paper highlights the significantly elevated perinatal risks associated with pre-eclampsia, especially when it has severe features., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Hypertension is a disease that imposes risks of diseases on multi-system. Failure to control hypertension leads patients to end up with unavoidable complications, including death. Noncompliance to treatment is the main factor to develop such devastating complications whereas knowledge of patients about their disease is a key factor for better compliance. Thus, the purpose of this study is to assess the level of knowledge about hypertension and associated factors among hypertensive patients in public health facilities of Gondar city., Methods: Facility-based cross-sectional study was conducted between March and April 2019 in Gondar town. A systematic sampling technique was applied to select a total of 389 patients. A structured interview questionnaire was used to gather the data. The data were analyzed using STATA version 14. Ordinal logistic regression analysis was performed at P < 0.05 with a 95% confidence interval to identify statistically significant variables., Results: A total of 385 respondents participated giving a response rate of 98.9%. The majority (55.3%) of the patients had a low level of, 17.9% had a moderate level of knowledge whereas 26.8% had a high level of knowledge about hypertension. Those working in government organizations had 5.5 times higher odds of having a high level of knowledge than other groups (AOR = 5.5; 95%CI = 1.21, 25). Patients who received longer than four years of treatment showed twice larger odds of knowledge than those with below two years of treatment (AOR = 2; 95%CI = 1.29, 3.22) Moreover, patients residing proximate to the hospital increases the odds of having a higher level of knowledge by 1.64 times versus patients living far away from the hospital (AOR = 1.64, 95% CI = 1.07-2.63)., Conclusions: This finding revealed that knowledge about hypertension and risk factors among patients with hypertension was low. Employment in governmental organizations, longer duration of treatment, and residential proximity to hospitals/ health centers were statistically significant predictors of the participants' knowledge about hypertension. Therefore, it is important to give health education to patients working in non-governmental organizations and self-employed individuals about diseases and risk factors. In addition, emphasis should be given to patients receiving less than two years of treatment and coming from remote areas to improve their knowledge of the disease., Competing Interests: The authors have declared that no competing interests exist.

Background: Diabetes and hypertension have emerged as important clinical and public health problems in Ethiopia. The need to have long-term sustainable healthcare services for patients with diabetes and hypertension is essential to enhance good treatment control among those patients and subsequently delay or prevent complications. A collective shift towards acute care for COVID-19 patients combined with different measures to contain the pandemic had disrupted ambulatory care. Hence, it is expected to have a significant impact on treatment control of hypertensive and diabetic patients. However, there is limited evidence on the effect of the pandemic on treatment control and its determinants. Therefore, this study aimed to assess the effect of COVID-19 pandemic on treatment control of ambulatory Hypertensive and Diabetic patients and identify the factors for poor treatment control in North West Ethiopia., Methods: A retrospective chart review and cross-sectional survey design were conducted between December 2020 and February 2021. Using a stratified systematic random sampling technique, 836 diabetic and/or hypertensive patients were included in the study. Web-based data collection was done using Kobo collect. The changes in the proportion of poor treatment control among ambulatory Hypertensive and/or Diabetic patients during the COVID-19 pandemic period were assessed. A multivariable binary logistic regression mixed model was fitted to identify the determinants of poor treatment control. The odds ratios were reported in both crude and adjusted form, together with their 95% confidence intervals and p-values., Result: Poor treatment control increased significantly from 24.81% (21.95, 27.92) prior to the COVID-19 pandemic to 30.33% (27.01, 33.88), 35.66% (32.26, 39.20), 36.69% (33.40, 40.12), and 34.18% (3102, 37.49) in the first, second, third, and fourth months following the date of the first COVID-19 case detection in Ethiopia, respectively. Marital status (AOR = 0.56, 95%CI; 0.41, 0.74), regimen of medication administration (AOR = 1.30, 95%CI; 1.02, 166), daily (AOR = 0.12, 95%CI; 0.08, 0.20), twice (AOR = 0.42, 95%CI; 0.30. 0.59), and three times (AOR = 0.31, 95%CI; 0.21, 0.47) frequency of medication, number medications taken per day (AOR = 0.79, 95%CI;0.73, 0.87), patients habits like hazardous alcohol use (AOR = 1.29, 95%CI; 1.02, 1.65) and sedentary lifestyle (AOR = 1.72,95%CI;1.46, 2.02), missed appointment during the COVID-19 pandemic (AOR = 2.09, 95%CI; 1.79, 2.45), and presence of disease related complication (AOR = 1.11, 95%CI; 0.93, 1.34) were significantly associated with poor treatment control among Diabetic and/or hypertensive patients during the COVID-19 pandemic., Conclusion: The COVID-19 pandemic had a substantial impact on ambulatory Diabetic and/or Hypertensive patients' treatment control. Being married, as well as the frequency and types of medicines taken per day were all found to be negatively associated with poor treatment control. During the COVID -19 pandemic, patients' habits such as hazardous alcohol use and sedentary lifestyle, longer follow-up time, having disease-related complication (s), patients taking injectable medication, number of medications per day, and missed appointments were positively associated with poor treatment control in ambulatory diabetic and hypertensive patients. Therefore, it is better to consider the risk factors of poor treatment control while designing and implementing policies and strategies for chronic disease control., Competing Interests: The authors have declared that no competing interests exist.

Background: Although most instructors appear to understand visible disability, they appear to have a negative attitude toward children with attention deficit hyperactivity disorder (ADHD), considering them to be lazy or purposefully disruptive. In Ethiopia, there is a scarcity of data on teachers' attitudes toward children with ADHD., Methods: An institution-based cross-sectional study was conducted. A pre-tested questionnaire that contains a case vignette was administered through face-to-face interview with 417 teachers. The data was entered into Epi-data version 4.2 and exported into SPSS version 25.0 for analysis. Multiple linear regression analyses were used to assess the correlates of attitude in the participants and a B coefficient with 95% confidence interval (CI) were used. The statistical significance was accepted at p -value < 0.05., Results: The mean score of the teachers' attitude toward ADHD was 41.6 ± 5.4 (95% CI; 41.12, 42.16) and 46% of the participants had unfavorable attitudes. Low level of educational status, knowledge, teaching experience, familiarity in teaching students with ADHD, and having training were significantly associated with attitude of the teachers., Conclusion: The study revealed that nearly half of the participants had an unfavorable attitude toward students with ADHD. Based on the findings, it was recommended that it is better to strengthen training of teachers to recognize students with ADHD., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Amha and Azale.)

Background: Violence against women is the most widespread kind of human rights violation, and it has been linked to a wide range of consequences. The most prominent psychosocial and mental health concern that has serious effects for women's physical and mental well-being. This study assessed the prevalence and associated factors of women's violence by intimate partner among women in the reproductive age group (15-49)., Methods: Multistage community-based cross-sectional study was conducted among reproductive age group women in the central Gondar zone. We recruited 845 participants and interviewed by health extension workers using face-to-face interviews. We used a Women's Abuse Screening test to outcome variable; it has a total score ranges 0-16, a score > 1 indicates positive for the presence of intimate partner violence within a year. Variables were coded and entered to Epi data version 3.1 and exported to SPSS version 21 for analysis. Descriptive statistics and multivariate logistic regression analysis was run for data analysis. Adjusted odds ratios (AOR) with a 95% confidence level (CI) were declared significant., Result: Among a total of 845 participants 804 responded to the interviews with a response rate of 95%. The prevalence rate of intimate partner violence is 391(48.6%). From multivariate logistic regression analysis women being married [AOR:3.85; 95% CI (2.38, 6.22)], high school and above educational status [(AOR: 0.43; 95% CI (0.30, 0.61), women's having > 3children [(AOR: 1.82, 95% CI (1.0, 3.1)], having a household food insecurity[(AOR: 2.09, 95% CI (1.51, 2.91)], having life threatening events [(AOR: 2.09; 95% CI (1.51, 2.91)], moderate social support [(AOR: 0.60; 95% CI (0.41, 0.83)], depression [(AOR: 3.12; 95% CI (1.60, 6.07) were significantly associated with violence by intimate partner at 95% CI ., Conclusion: Intimate partner violence is common among reproductive-age women. Married, women with several children, food insecurity, life-threatening events, and depression were all found to be significant predictors of violence. Measures should be taken to raise community awareness, particularly among intimate partners, their families, and government officials., (© 2022. The Author(s).)

Objective: Although there has been a massive expansion of hospitals in Ethiopia in the last 2 decades, most are primary-level hospitals. Assessing the capability of the hospitals in managing trauma victims is essential to strengthening the hospitals., Methods: We employed a mixed-method approach using quantitative descriptive design triangulated with qualitative research. We audited 10 hospitals using WHO essential trauma care checklist. We interviewed 37 health care professionals, 9 hospital managers, and 12 decision-makers using a semi-structured interview guide. We used the COREQ checklist to report the qualitative finding., Results: The physical structures of the hospitals were good in all cases. Airway, breathing and circulation management were partially available, with a score ranging from 0 - 3. The extent of injury, lack of radiology service, and scarcity of drugs and supplies were common causes for the referral of trauma victims to Gondar University hospital., Conclusion and Recommendation: Unavailability of drugs and supplies, lack of diagnostic services, inability to recruit specialist professionals, lack of training, and inconvenient working and living environment were stated as the main barriers to providing trauma care. In the study area, the gaps in trauma care in the primary hospitals can be improved by further commitment of the hospitals, the district, zonal administrators, and the regional health bureau.

Objectives: To identify distinct trajectories of health-related quality of life and its predictors among postpartum women in Northwest Ethiopia., Design: Health facility-linked community-based prospective follow-up study., Setting: South Gondar zone, Northwest Ethiopia., Participants: We recruited 775 mothers (252 exposed and 523 non-exposed) after childbirth and before discharge. Exposed and non-exposed mothers were identified based on the criteria published by the WHO Maternal Morbidity Working Group., Outcome Measures: The primary outcome measure of this study was trajectories of health-related quality of life. The Stata Traj package was used to determine the trajectories using a group-based trajectory modelling. Multinomial logistic regression model was used to identify predictors of trajectory membership., Results: Four distinct trajectories for physical and psychological and five trajectories for the social relationships and environmental health-related quality of life were identified. Direct and indirect maternal morbidities, lower educational status, poor social support, being government employed and merchant/student in occupation, vaginal delivery, lower monthly expenditure, stress, fear of childbirth and anxiety were found to be predictors of lower health-related quality of life trajectory group membership., Conclusions: Health professionals should target maternal morbidities and mental health problems when developing health intervention strategies to improve maternal health-related quality of life in the postpartum period. Developing encouraging strategies for social support and providing health education or counselling for women with less or no education are essential to avert the decrease in health-related quality of life trajectories of postpartum women., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)