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Background: Satisfaction is defined as the perceived fulfillment of patient or client needs and desires through the delivery of healthcare services. In developed countries, more than 60% of women have been screened for cervical cancer. However, only 12% of women in sub-Saharan Africa have been screened for precancerous cervical lesions. There is limited evidence on client satisfaction with cervical cancer screening services (CSCCSS) in Ethiopia, particularly, there is no study conducted by mixed method in the Amhara region. Objective: The study aimed to assess clients' satisfaction with cervical cancer screening services and influencing factors among women screened in Debre Markos town public health facilities in Northwest Ethiopia, 2022/23. Methods: A convergent parallel mixed methods design was conducted in Debre Markos town's public health facilities from October 10th, 2022 to January 10th, 2023. For the quantitative wing, a total of 401 cervical cancer screening service users were selected using a systematic random sampling technique. Data were collected using an interviewer-administered structured questionnaire. Clients were interviewed on exit in a private area far from the screening unit and the data were entered into Epi-data version 4.6.0.2, then exported to STATA version 14 for analysis. A binary logistic regression model was fitted to identify factors associated with client satisfaction with cervical cancer screening services. The qualitative data were collected through in-depth and key informant interviews using a semi-structured topic guide. The data were analyzed using a thematic analysis approach with Open code software (version 4.0.2.3). Result: The quantitative wing revealed that overall, 65% (95% CI: 60–69) of respondents were satisfied with the cervical cancer screening services they received. Gender of the provider (AOR: 6.11, 95% CI: 3.23–11.55, p-value = 0.000), waiting time (AOR: 4.77, 95% CI: 1.32–17.31, p-value = 0.017), clients' knowledge (AOR: 0.26, 95% CI: 0.12–0.59, p-value = 0.001), and clients' attitude (AOR: 6.43, 95% CI: 3.43–12.03, p-value = 0.000) were significantly associated with CSCCSS. Qualitative result: The thematic analysis revealed three themes. Theme 1: facility-related barriers (shortage of skilled manpower, shortage of infrastructure, providers' skill gap, unavailability of full service, leadership problem, long waiting time). Theme 2: client-related barriers (poor knowledge and attitude, gender preference). Theme 3: facility-related facilitators (free service, presence of supportive partners). Conclusion: According to the findings of this study, two-thirds of clients were satisfied with cervical cancer screening services, which was lower than the national target of 80%. Long waiting time, male gender of the service provider, unfavorable attitude, and good knowledge of clients were identified as significant factors negatively affecting client satisfaction with cervical cancer screening. [ABSTRACT FROM AUTHOR]

ABSTRACT Background and Aims Intestinal parasitic infection is a common disease that causes significant morbidity and mortality in developing countries, including Ethiopia. The burden of intestinal parasites is worse in schoolchildren, which leads to absenteeism from school, lower cognitive ability, affects academic performance, and causes malnutrition and anemia. While many studies have been reported, there is a paucity of published data in Debre Markos. Therefore, this study aimed to assess the prevalence of intestinal parasites and associated factors among public primary second‐cycle schoolchildren in Debre Markos Town, Northwest Ethiopia. Methods A school‐based cross‐sectional study was conducted among three selected public primary second‐cycle schools in Debre Markos town from May 1 to 30, 2022. Study participants were selected by using random and systematic sampling techniques with proportional allocation to each grade. Data were collected using semi‐structured questionnaires. A single stool specimen was collected from the study participants and processed using direct wet mount and formol ether concentration technique. Binary logistic regression models were applied to assess the association between independent and outcome variables at a 95% confidence level. Results A total of 343 students were included in the study. The overall prevalence of intestinal parasites was 12% (41/343) with a predominance of hookworms (5.2%, 18/343), followed by Ascaris lumbricoides 2.3% (8/343), Entamoeba histolytica/dispar 1.2% (4/343), Hymenolepis nana 0.9% (3/343), Strongyloides stercoralis 0.9% (3/343), Giardia lamblia 0.9% (3/343), and Trichuris trichiura 0.6% (2/343). The habit of open‐field defecation (AOR, 95% CI; 2.43 [1.16–5.09]), not using soap to wash hands (AOR, 95% CI; 2.93 [1.33–6.42]), and not wearing closed shoes (AOR, 95% CI; 3.12 [1.19–8.23]) were factors significantly associated with the prevalence of intestinal parasitic infection. Conclusion The prevalence of intestinal parasites was comparatively low in the study area. Open‐field defecation, not using soap to wash hands, and not wearing closed shoes were identified as independent predictors.

Background: Satisfaction is defined as the perceived fulfillment of patient or client needs and desires through the delivery of healthcare services. In developed countries, more than 60% of women have been screened for cervical cancer. However, only 12% of women in sub-Saharan Africa have been screened for precancerous cervical lesions. There is limited evidence on client satisfaction with cervical cancer screening services (CSCCSS) in Ethiopia, particularly, there is no study conducted by mixed method in the Amhara region. Objective: The study aimed to assess clients' satisfaction with cervical cancer screening services and influencing factors among women screened in Debre Markos town public health facilities in Northwest Ethiopia, 2022/23. Methods: A convergent parallel mixed methods design was conducted in Debre Markos town's public health facilities from October 10th, 2022 to January 10th, 2023. For the quantitative wing, a total of 401 cervical cancer screening service users were selected using a systematic random sampling technique. Data were collected using an interviewer-administered structured questionnaire. Clients were interviewed on exit in a private area far from the screening unit and the data were entered into Epi-data version 4.6.0.2, then exported to STATA version 14 for analysis. A binary logistic regression model was fitted to identify factors associated with client satisfaction with cervical cancer screening services. The qualitative data were collected through in-depth and key informant interviews using a semi-structured topic guide. The data were analyzed using a thematic analysis approach with Open code software (version 4.0.2.3). Result: The quantitative wing revealed that overall, 65% (95% CI: 60–69) of respondents were satisfied with the cervical cancer screening services they received. Gender of the provider (AOR: 6.11, 95% CI: 3.23–11.55, p-value = 0.000), waiting time (AOR: 4.77, 95% CI: 1.32–17.31, p-value = 0.017), clients' knowledge (AOR: 0.26, 95% CI: 0.12–0.59, p-value = 0.001), and clients' attitude (AOR: 6.43, 95% CI: 3.43–12.03, p-value = 0.000) were significantly associated with CSCCSS. Qualitative result: The thematic analysis revealed three themes. Theme 1: facility-related barriers (shortage of skilled manpower, shortage of infrastructure, providers' skill gap, unavailability of full service, leadership problem, long waiting time). Theme 2: client-related barriers (poor knowledge and attitude, gender preference). Theme 3: facility-related facilitators (free service, presence of supportive partners). Conclusion: According to the findings of this study, two-thirds of clients were satisfied with cervical cancer screening services, which was lower than the national target of 80%. Long waiting time, male gender of the service provider, unfavorable attitude, and good knowledge of clients were identified as significant factors negatively affecting client satisfaction with cervical cancer screening. [ABSTRACT FROM AUTHOR]

Background: The risk of neonatal tetanus infection will be reduced when the pregnant woman takes two doses of the maternal tetanus toxoid vaccine. In Ethiopia, however, low immunization coverage levels, mostly due to missed opportunities, are a concern. The study's main objective of the study was to assess tetanus toxoid immunization utilization coverage and associated factors among postnatal mothers in Debre Markos town, Ethiopia. Materials and Methods: A community-based cross-sectional study was conducted among 505 mothers who had given birth in the last 12 months. A two-stage stratified sampling technique was applied, and the The participants were selected using a systematic random sampling technique. Data were entered into EpiData manager version 4.6.0 and analyzed using Statistical Package for Social Science (SPSS) version 25 software. Bivariable and multivariable logistic regression analysis was performed. Adjusted odds ratios (AORs) at 95% CIs were used to identify factors associated with tetanus toxoid immunization utilization. Results: The total tetanus vaccine intake (TT+2) doses were 71.2% (95% CI: 67.4–76.2). Mothers who attended primary school (AOR: 0.07, 95% CI: (0.01–0.6)), mothers whose husbands had secondary education (AOR: 0.26, 95% CI: (0.08–0.84)), mothers who attended 2–3 times antenatal care (ANC) visit (AOR: 0.05, 95% CI: (0.01–0.3)), good quality service (AOR: 2.8, 95% CI: (1.05–7.5)), appropriate behavior of health workers (AOR: 6.2, 95% CI: (2.2–18.7)), and who visited health extension workers (AOR: 7.6, 95% CI: (2.3–25.3)) were significantly associated with TT vaccine utilization. Conclusion: Only three out of four pregnant women received the current TT vaccine during their previous pregnancy. The most influencing factors in TT vaccine utilization were the mother and her husband's low educational level, 2–3 times ANC visits during pregnancy, the standard of healthcare service, the healthcare provider's behavior, and the mother's visits with health extension staff. Plain language summary: Maternal and neonatal mortality due to lack of tetanus toxoid vaccine Maternal and neonatal mortality is high both in developed and developing countries due to preventable infection. Tetanus is an acute bacterial infection caused by a highly potent neurotoxin that affects the mother and newborn during pregnancy, childbirth, and postnatal. World Health Organization recommended that women of childbearing age benefit from tetanus toxoid immunization. So, assessing tetanus toxoid immunization coverage and their associated factors will help the policy makers for the next planning. The study was employed in the community among 505 childbearing women and found that 71.2% of them were vaccinated with tetanus toxoid dose two (TT++). Even though the women and neonates in the community benefited from the vaccine, only 7.7% of them had cards. Almost 58.8% of the women reported that there was a gap in counseling about the tetanus toxoid vaccine purpose. In this study mother's and husband's educational status, number of Antenatal care visits, perceived quality of service, the behavior of health workers, traveling time to health facilities, and health extension are factors that affected tetanus toxoid vaccine coverage. Finally, the researchers in the area can use this finding as input and conduct further study including qualitative design to explore women's experiences related to the tetanus toxoid vaccine. [ABSTRACT FROM AUTHOR]

Aytenew Atnaf,1 Abtie Abebaw Shiferaw,1 Workineh Tamir,1 Yibeltal Akelew,1 Milkiyas Toru,1 Daniel Tarekegn,2 Bekalu Bewket,3 Alemayehu Reta1 1Department of Medical Laboratory Science, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia; 2Department of Public health, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia; 3Department of Nursing, College of Health Sciences, Debre Markos University, Debre Markos, EthiopiaCorrespondence: Aytenew Atnaf, Department of Medical Laboratory Sciences, College of Health Sciences, Debre Markos University, P.O.Box 269, Debre Markos, Ethiopia, Tel +251 924474452, Email atnafnew5@gmail.comBackground: Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is coronavirus isolated from SARS patients. As far as the researchers’ knowledge, there was paucity of studies conducted in Ethiopia, particularly in the study area. As immune protection is arisen from our blood cells, assessing their level will provide a clue for controlling the disease and monitoring the prognosis. This study will also provide additional information for clinical intervention and patient management.Purpose: This study aimed to investigate the hematological profile and clinical outcome of coronavirus disease-19 (COVID-19) among patients admitted to the Debre Markos Isolation and Treatment Center (DMITC).Material and Methods: A prospective cohort study was conducted among 136 COVID-19 adult patients at DMITC from January 1, 2020 to March 30, 2021. Data related to clinical, hematological profiles and socio-demographic factors were collected, entered into Epi data, and analyzed using STATA 14.2 software. Multivariable logistic regression was applied to determine the predictor variable and a p-value < 0.05 was considered significant.Results: Of 136 COVID-19 patients, 28.68% had died. The mean age of patients was 47.21± 1.29 years. The hematological profile of the patients revealed that 28% had abnormal leukocyte, 23% abnormal lymphocyte, 44.85% abnormal granulocyte, 22.06% abnormal monocyte, 30.15% abnormal RBC and 87% abnormal platelet counts. The prevalence of anemia was 13.24%.Conclusion: Leukocytosis (mainly granulocytosis and monocytosis) and lymphopenia, were the predominant abnormal findings of complete blood cell count (CBC) analysis of the patient’s blood. Most of the patients had abnormally low platelet counts. RBC count and hematocrit determination were the only significant predictors of death. The clinician could manage cases according to the hematological findings of the patients. Further experimental studies should be conducted to determine hematological parameter changes and the clinical outcome of the disease.Keywords: leukocytosis, hematological profile, COVID-19, clinical outcome, Debre Markos

Abstract Background Postpartum hemorrhage is one of the leading causes of maternal deaths worldwide. Early recovery is a performance indicator and better health outcome of patients with postpartum hemorrhage. Therefore, this study aimed to assess time to recovery from postpartum hemorrhage and its predictors in Debre Markos Comprehensive Specialized Hospital, Ethiopia, 2020. Methods A retrospective follow-up study was conducted among 302 women who were diagnosed with postpartum hemorrhage from January 1, 2016 to December 31, 2020 at Debre Markos Comprehensive Specialized Hospital. Consecutive sampling technique was employed. To show the statistical significant difference between each group of variables, log rank test was used. Kaplan Meier analysis to estimate time to recovery and cox proportional-hazard regression analysis to determine independent predictors were carried out cautiously. Adjusted hazard ratio used to determine the strength of association. Result The median recovery time from postpartum hemorrhage was 13 h with range of (10 to 17 h). Blood transfusion (AHR: 1.8, 95% CI (1.39, 2.57)), NASG utilization (AHR: 6.5, 95% CI (4.58, 9.42)) fluid resuscitation (AHR 2.9, 95% CI (1.48, 5.54)), active management of third stage of labor (AHR: 1.7, 95% CI (1.18, 2.45)) and history of antenatal care follow-up (AHR: 2.6, 95% CI (1.91, 3.56)) were the predictors, which shorten the recovery time. Comorbidities like anemia at the time of admission (AHR: 0.62 95% CI (0.44, 0.89)), retroviral infection (AHR: 0.33, 95% CI (0.16, 0.67)) and Hepatitis B-Virus infection (AHR: 0.52, 95% CI (0.32, 0.82)) delay the recovery rate from postpartum hemorrhage. Conclusion Mothers in North-West Ethiopia stays morbid from postpartum hemorrhage for more than half a day. Their recovery time was affected by Non-Pneumatic Anti-Shock Garment utilization, implementation of emergency management components like blood transfusion and fluid resuscitation, history of antenatal care follow up, and being comorbid with viral infections. Non-pneumatic anti-shock garment application to every mother with postpartum hemorrhage and implementation of proper emergency management approach are vital for rapid recovery from postpartum hemorrhage.

BackgroundUnder five children are at risk of diarrhea-associated morbidity and mortality. Salmonella and Shigella are major causes of diarrhea in under-five children, especially in developing countries. This study aimed to assess the prevalence, antimicrobial resistance pattern, and associated factors of Salmonella and Shigella among under-five diarrheic children in Debre Markos town public health facilities.MethodsA cross-sectional study was conducted at public health facilities in Debre Markos town using a consecutive convenient sampling technique. Data on socio-demographic and associated factors were collected using a structured questionnaire. Salmonella serovars and Shigella species were identified using MacConkey, Xylose Lysine Deoxycholate, Salmonella Shigella agar, and biochemical tests. The antimicrobial resistance pattern was determined by using the modified Kirby-Bauer disk diffusion technique.ResultsThe overall prevalence of Salmonella and Shigella was 11.7% (26/222; 95% CI = 7.2–17.5%). Isolated Salmonella serovars showed a higher rate of resistance (85.7%, 6/7) for both Ampicillin and Amoxicillin/Clavulanic acid while Shigella isolates showed a higher resistance rate to Amoxicillin/Clavulanic acid (78.9%, 15/19) and Ampicillin (73.7%, 14/19). The overall multidrug resistance (MDR) rate of Salmonella and Shigella isolates was 88.5% (23/26). Parent/guardian educational status ≤ elementary school (AOR = 3.783; 95% CI = 1.28–11.19; P = 0.016), presence of two or more under-five children in the family (AOR = 8.999; 95% CI = 2.93–27.69; P < 0.001), unimproved source of drinking water (AOR = 5.010; 95% CI = 1.56–16.10; P = 0.007), the habit of storing cooked foods for later use (AOR = 3.199; 95% CI = 1.07–9.54; P = 0.037), attendance of the child at social gatherings (AOR = 5.387; 95% CI = 1.78–16.35; P = 0.003), and infrequent child fingernail trimming (every ≥ 2 weeks; AOR = 4.693; 95% CI = 1.47–14.94; P = 0.009) showed statistically significant association with the prevalence of culture-confirmed Salmonella and Shigella isolates.ConclusionThe prevalence of culture-confirmed Salmonella and Shigella isolates was significantly high in the study area. Salmonella and Shigella isolates exhibited a high rate of MDR pattern. Parent/guardian education level below the elementary school, the presence of two or more under-five children in the family, using unimproved water source, a habit of storing cooked food, and infrequent fingernail trimming were independent predictors of culture-confirmed Salmonella and Shigella. Therefore, besides public health measures, regular surveillance of the prevalence and antimicrobial resistance pattern of Salmonella and Shigella should be routinely practiced in the study setting.

BackgroundSexual violence refers to being forced to perform any unwanted sexual act. Due to the negative effects on both the mother and the fetus, sexual assault during pregnancy is a public health concern. Knowing the prevalence of sexual violence during pregnancy helps policymakers understand the extent of the problem and can be considered the first step toward implementing interventions for prevention and treatment. This study was done to determine the prevalence of sexual violence and its associated factors during pregnancy in public hospitals in Debre Markos.MethodsAn institution-based cross-sectional study was conducted among 306 pregnant women in Debre Markos, north west Ethiopia from May 1 to June 30, 2021, 2021. A systematic random sampling procedure was used to select study participants. Data were collected using a structured and interviewer-administered questionnaire, and a pre-test was done. Both bi-variable and multivariable logistic regression analyses were undertaken to identify significantly associated variables with sexual violence. The adjusted odds ratio (AOR) with its 95% confidence interval (CI) at a p-value of ≤ 0.05 was used to claim statistical association.ResultsThere were 304 interviewed respondents with a response rate of 99.3%. In this study, the overall prevalence of sexual violence among pregnant mothers during the current pregnancy was 19.4%. A husband who had no formal education {AOR = 3.48; 95% CI: 1.06, 11.39}, pregnant mothers who had no formal education {AOR = 6.1; 95% CI: 1.50–18.11}, pregnant mothers who had secondary education {AOR = 2.80, 95% CI: 1.15, 6.81}, being a housewife {AOR = 3.87, 95 CI:1.21, 12.37}, and being a governmental employee {AOR = 4.49, 95% CI: 1.22, 16.40} were factors associated with sexual violence at the value of p ≤ 0.05.Conclusions and recommendationsIn this study, approximately one-fifth of the study participants experienced sexual violence during their current pregnancy. To reduce this, interventions should focus on the education of women as well as their partner about violence against women and on initiatives to economically empower women.

BackgroundPuerperal sepsis is one of the leading causes of maternal mortality, particularly in low and middle-income countries where most maternal deaths occur. Women with puerperal sepsis are prone to long-term disabilities, such as chronic pelvic pain, blocked fallopian tubes, and secondary infertility. Besides this, puerperal sepsis has received less attention. For this reason, this study aimed to determine the incidence of puerperal sepsis and its predictors among postpartum women at Debre Markos Comprehensive Specialized Hospital.MethodsA prospective cohort study was conducted among 330 postpartum women from September 2020 to 2021. A pre-tested interviewer-administered questionnaire with a data extraction checklist was used to collect the data. Data were entered into Epi data 4.2 and analyzed using STATA 14.0. The incidence rate of puerperal sepsis was calculated, and a Kaplan-Meier survival curve was used to estimate the survival probability of developing puerperal sepsis. The cox-proportional hazards regression model was fitted to identify predictors of puerperal sepsis.ResultsThe study participants were followed for a total of 1685.3 person-week observations. The incidence rate of puerperal sepsis was 14.24 per 1,000 person-weeks. However, the overall incidence of puerperal sepsis was 7.27%. Not attending formal education [AHR: 3.55, 95% CI: (1.09–11.58)], a cesarean delivery [AHR: 4.50; 95% CI: (1.79–11.30)], premature rupture of the membranes [AHR: 3.25; 95% CI: (1.08–9.79)], complicated pregnancy [AHR: 4.80; 95% CI: (1.85–12.43)], being referred [AHR: 2.90; 95% CI: (1.10–7.65)], and not having birth preparedness and complication readiness plan [AHR: 2.95; 95% CI: (1.08–10.50)] were statistically significant predictors of puerperal sepsis.ConclusionThe incidence of puerperal sepsis was 7.27%. Not attending formal education, cesarean delivery, premature rupture of membranes, complicated pregnancy, referral status, and absence of birth preparedness and complication readiness plan were predictors associated with the incidence of puerperal sepsis.

Abstract Background Anemia, the most common micro-nutrient deficiency disorder, is the world’s second leading cause of morbidity and morbidity, affecting 24.8% of the population, of which 47.4% are under-five children. The prevalence of anemia ranges from 44 to 56% in Ethiopia. Although its magnitude has shown decreases across regions; it continues to be a significant public health problem, particularly in developing countries including Ethiopia. Despite this evidence, the magnitude and associated factors of anemia was not systematically explored and there is a limited information or limited evidences in the study area. Hence, the aim of this study was to assess the magnitude and associated factors of anemia among children aged 6–59 months attending at Debre Markos Referral Hospital, Northwest Ethiopia. Methods A hospital-based cross-sectional study was conducted at Debre Markos referral hospital Northwest Ethiopia from September 30 to December 30, 2019. Data on socio-demographic and socio-economic factors, health and nutritional features of children and their mothers were obtained using pre-tested structured questionnaires in a face-to-face interview with child care providers. Blood samples and stool examination for intestinal parasites were performed. Hemoglobin level was analyzed using the HemoCue device (HemoCueHb 301). The collected data were coded, cleared and entered into Epi-Data version 3.1, and analyzed using Stata version 14 software. To identify candidates and predictor variables, bivariate and multivariate logistic regressions were applied respectively. The significance level was determined at a confidence interval of 95% at p-value

BACKGROUND: Non-adherence to prescribed medications is possibly the most common reason for poor treatment outcomes among people with diabetes although its rate is highly variable. Data on the magnitude of medication non-adherence and associated factors are scarce in the study area. This study aimed to assess the rate of non-adherence and associated factors among diabetic patients at Debre Markos Comprehensive Specialized Hospital. METHODS: A cross-sectional study was conducted from June 17 to July 17, 2021. Study participants were selected using a simple random sampling technique. Data were collected with a pre-tested structured questionnaire and entered into SPSS version 25. Logistic regression was utilized to determine predictors of medication non-adherence at a significance level of = 0.05. RESULTS: A total of 176 study participants were enrolled in the study. About 59% of the study participants had type-2 diabetes mellitus. The prevalence of non-adherence to anti-diabetic medications was found to be 41.5%. Male sex, rural residence, being divorced, being merchant, self- or family-borne medical cost, and presence of comorbidities were significantly associated with increased rate of non-adherence to anti-diabetic medications. CONCLUSION: The prevalence of non-adherence to medications among diabetic patients is significantly high in the study area. Public health measures should be strengthened to decrease nonadherence among diabetic patients. [ABSTRACT FROM AUTHOR]

Haddis Birhanu,1 Atsede Alle,2 Molla Yigzaw Birhanu2 1Debre Markos Referral Hospital, Debre Markos, Ethiopia; 2Department of Public Health, College of Health Sciences, Debre Markos University, Debre Markos, EthiopiaCorrespondence: Molla Yigzaw Birhanu P. O. Box 269 Email mollayigzaw33@gmail.comBackground: Human immunodeficiency virus/Acquired immunodeficiency syndrome is a chronic communicable disease with devastating global socio-economic, and political impacts commonly affecting the young and early adult populations. Ethiopia is doing well in controlling HIV/AIDS epidemic infection among African countries. This study set out to determine the mortality rate and its predictors among adults on antiretroviral therapy at Debre Markos Referral Hospital, northwest Ethiopia.Methods: A hospital-based retrospective follow-up study was conducted from February to March 2018. A computer-generated simple random sample selected 480 cards of patients on antiretroviral therapy who were enrolled between February 2010 to January 2018. Epi-data Version 4.2 software was used for data entry and SPSS Version 25 for management and analysis. An adjusted hazard rate with a 95% confidence interval was used to identify significant predictors of mortality.Results: The mortality rate was about 3.9 per 100 person-years. Cotrimoxazole prophylactic therapy (AHR: 2.99; 95% CI: 1.58, 5.70), being single (AHR: 2.37: 95% CI: 1.15, 4.87), non-disclosed status (AHR: 7.77; 95% CI: 3.76, 16.06), anemia (AHR: 2.16; 95% CI: 1.14, 4.09), bedridden (AHR: 6.11; 95% CI: 2.42, 15.41) or ambulatory (AHR: 2.16; 95%: 1.04, 4.51), presence of opportunistic infections (OIs) (AHR: 5.02; 95% CI: 1.70, 14.83) and tuberculosis (TB) co-infection (AHR: 5.57; 95% CI: 2.23, 13.88) were the significant predictors.Conclusion and Recommendation: This study had a high mortality rate. Being single, bedridden, TB coinfection, anemia, and cotrimoxazole prophylaxis were the predictors of mortality. Therefore, psychological support and close follow-up for single, non-disclosed, non-adherent patients and early detection and treatment of anemia, tuberculosis, and OIs to reduce mortality is recommended.Keywords: HIV, ART, mortality, predictors of mortality, Debre Markos, Ethiopia

Molla Yigzaw Birhanu,1 Aytenew Atnaf Workineh,2 Yalew Molla,3 Ermias Abebaw,4 Amit Arora,5 Yibelu Bazezew6 1Department of Public Health, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia; 2Department of Medical Laboratory Sciences, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia; 3Department of Pharmacy, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia; 4Department of Pediatrics, School of Medicine, Debre Markos University, Debre Markos, Ethiopia; 5School of Health Sciences, Western Sydney University, Penrith, NSW, 2751, Australia; 6Department of Midwifery, College of Health Sciences, Debre Markos University, Debre Markos, EthiopiaCorrespondence: Molla Yigzaw BirhanuDepartment of Public Health, College of Health Sciences, Debre Markos University, P.O. Box 269, Debre Markos, EthiopiaTel +251910614947Email mollayigzaw33@gmail.comBackground: Neonatal jaundice is one of the most common clinical disorders occurred worldwide. About 1.1 million neonates develop jaundice per year globally and the vast majority of them found in sub-Saharan Africa and South Asia. There is a paucity of evidence on the incidence rate and predictors of neonatal jaundice in Ethiopia. Therefore, this study was aimed at determining the rate and predictors of neonatal jaundice in the northwest, Ethiopia.Methods: A prospective cohort study design was conducted at Debre Markos comprehensive, specialized Hospitals using 334 neonates from October 1, 2019, to June 30, 2020. Using a systematic random sampling technique, the study subjects were drawn. Data were entered into the Epi-DataTM Version 4.2 and analyzed using STATATM Version 14.0. The Kaplan-Meier survival curve was used to estimate the survival time. A generalized Log rank test was used to compare the survival curves of different categorical variables. Finally, both bi-variable and multivariable Cox-proportional hazards regression models were used to identify the predictors of neonatal jaundice.The Results: The overall incidence rate of jaundice among neonates was 4.5 per 100 person-hours. Long duration of labor [ARR = 3.5; 95% confidence interval (CI), (2.8– 8.7)], being male neonates [ARR= 5.2; 95% CI (3.5– 7.3)], “O” blood group mothers [ARR = 4.5; 95% CI (3.4– 10.3)], and having neonatal sepsis 3.4 [ARR=3.4; 95% CI: (2.5– 6.1)] were predictors.Conclusion: The incidence rate of jaundice was higher in this study than the finding of the previous one. Being male, prolonged duration of labor, “O” blood group mothers and sepsis were the significant predictors. Hence, an effort has to be made to decrease the incidence rate of neonatal jaundice through improving newborn care and timely intervention for neonates with sepsis and delivered at a long duration of time as well as the neonates born from “o” blood type mothers are our recommendation.Keywords: neonatal jaundice, incidence, predictor, NICU, Debre Markos, Ethiopia

Background: Postpartum hemorrhage is one of the leading causes of maternal deaths worldwide. Early recovery is a performance indicator and better health outcome of patients with postpartum hemorrhage. Therefore, this study aimed to assess time to recovery from postpartum hemorrhage and its predictors in Debre Markos Comprehensive Specialized Hospital, Ethiopia, 2020.Methods: A retrospective follow-up study was conducted among 302 women who were diagnosed with postpartum hemorrhage from January 1, 2016 to December 31, 2020 at Debre Markos Comprehensive Specialized Hospital. Consecutive sampling technique was employed. To show the statistical significant difference between each group of variables, log rank test was used. Kaplan Meier analysis to estimate time to recovery and cox proportional-hazard regression analysis to determine independent predictors were carried out cautiously. Adjusted hazard ratio used to determine the strength of association.Result: The median recovery time from postpartum hemorrhage was 13 h with range of (10 to 17 h). Blood transfusion (AHR: 1.8, 95% CI (1.39, 2.57)), NASG utilization (AHR: 6.5, 95% CI (4.58, 9.42)) fluid resuscitation (AHR 2.9, 95% CI (1.48, 5.54)), active management of third stage of labor (AHR: 1.7, 95% CI (1.18, 2.45)) and history of antenatal care follow-up (AHR: 2.6, 95% CI (1.91, 3.56)) were the predictors, which shorten the recovery time. Comorbidities like anemia at the time of admission (AHR: 0.62 95% CI (0.44, 0.89)), retroviral infection (AHR: 0.33, 95% CI (0.16, 0.67)) and Hepatitis B-Virus infection (AHR: 0.52, 95% CI (0.32, 0.82)) delay the recovery rate from postpartum hemorrhage.Conclusion: Mothers in North-West Ethiopia stays morbid from postpartum hemorrhage for more than half a day. Their recovery time was affected by Non-Pneumatic Anti-Shock Garment utilization, implementation of emergency management components like blood transfusion and fluid resuscitation, history of antenatal care follow up, and being comorbid with viral infections. Non-pneumatic anti-shock garment application to every mother with postpartum hemorrhage and implementation of proper emergency management approach are vital for rapid recovery from postpartum hemorrhage. [ABSTRACT FROM AUTHOR]

Wound infections are associated with morbidity and mortality in developing countries. Thus, this study aimed to assess bacterial profile, antimicrobial susceptibility pattern and risk factors among wound infection suspected patients. A hospital-based cross-sectional study was conducted on 201 participants at Debre Markos referral hospital from January to May 2019. Sociodemographic data were collected using pre-designed questionnaire and swabs from different types of wounds were collected, and inoculated onto mannitol salt agar, blood and MacConkey agar plate for isolation and identification. Antimicrobial susceptibility tests were done using modified Kirby-Bauer disk diffusion technique. Out of 201 swabs analyzed, 72.6% were culture positive and 10.9% of them had co-infections, and 162 bacterial isolates obtained from 146 swab samples. Staphylococcus aureus was the most frequently isolated which accounted for 32.1% of isolates followed by Pseudomonas aeruginosa, 15.4%. The susceptibility patterns of ciprofloxacin, gentamycin and ceftriaxone were 77.8%, 69.1%, and 68.5%, respectively. The MDR rate of gram positive and gram negative isolates were 69.7% and 82.3%, respectively. Anatomically located wounds near a site of potential contamination, inadequate management of moisture, exudate or edema, mechanism of wound production, presence of predisposing condition and being urban in residence significantly associated with wound infections. S. aureus and P. aeruginosa were the predominant causes of wound infections. Ciprofloxacin, gentamycin and ceftriaxone were the most effective antimicrobials. Periodic surveillance of isolates involved in wound infection and their antimicrobial susceptibility is recommended for effective management of patients. [ABSTRACT FROM AUTHOR]

Molla Yigzaw Birhanu,1 Habtamu Temesgen,2 Gebreselassie Demeke,3 Moges Agazhe Assemie,4 Alehegn Aderaw Alamneh,2 Melaku Desta,5 Milkiyas Toru,3 Daniel Bekele Ketema,4 Cheru Tesema Leshargie1 1Department of Public Health, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia; 2Department of Human Nutrition and Food Sciences, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia; 3Department of Medical Laboratory Sciences, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia; 4Department of Public Health, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia; 5Department of Midwifery, College of Health Sciences, Debre Markos University, Debre Markos, EthiopiaCorrespondence: Molla Yigzaw BirhanuCollege of Health Sciences, Debre Markos University, P.O. Box 269, Debre Markos, EthiopiaEmail mollayigzaw33@gmail.comBackground: Pre-eclampsia is a pregnancy-induced hypertension that occurs after 20 weeks of gestation. It is the leading cause of maternal and perinatal morbidity and mortality globally, but it is higher in developing countries. In Ethiopia, conducting research on the incidence and predictors of pre-eclampsia is crucial due to the paucity of information.Methods: A prospective cohort study was undertaken using 242 pregnant women between November 1, 2018 and March 30, 2019 at Debre Markos Referral Hospital. All eligible women who fulfilled the inclusion criteria were included in this study. Data were entered into the epic-data Version 4.2 and analyzed using the STATA Version 14.0 software. The Cox-proportional hazard regression model was fitted and Cox-Snell residual test was used to assess the goodness of fit. Pre-eclampsia free survival time was estimated using the Kaplan–Meier survival curve. Both bivariable and multivariable Cox-proportional hazard regression models were fitted to identify predictors of pre-eclampsia.Results: The overall incidence rate of pre-eclampsia was 3.35 per 100 person-years. Having a pre-existing history of diabetes mellitus [AHR=2.7 (95% CI=1.43– 8.81)], having a history of multiple pregnancy [AHR=3.4 (95% CI=2.8– 6.9)] and being ≥ 35 years old age [AHR=2.5 (95% CI=1.42– 3.54)] were the significant predictors of pre-eclampsia.Conclusion: The incidence of pre-eclampsia was high in this study. Having (pre-existing diabetes and multiple pregnancy) and being ≥ 35 years old age were the significant predictors of pre-eclampsia. Inspiring pregnant women’s health-seeking behavior should provide a chance to diagnose pre-eclampsia early to prevent the medical complication of pre-eclampsia.Keywords: pre-eclampsia, incidence, predictors, pregnant women, Debre Markos, Ethiopia

Abstract Background Despite the rapid expansion of antiretroviral therapy services, ‘loss to follow-up’ is a significant public health concern globally. Loss to follow-up of individuals from ART has a countless negative impact on the treatment outcomes. There is, however, limited information about the incidence and predictors of loss to follow-up in our study area. Thus, this study aimed to determine the incidence rate and predictors of loss to follow-up among adult HIV patients on ART. Methods A retrospective cohort study was undertaken using 484 HIV patients between January 30, 2008, and January 26, 2018, at Debre Markos Referral Hospital. All eligible HIV patients who fulfilled the inclusion criteria were included in this study. Data were entered into Epi-data Version 4.2 and analyzed using STATATM Version 14.0 software. The Nelson-Aalen cumulative hazard estimator was used to estimate the hazard rate of loss to follow-up, and the log-rank test was used to compare the survival curve between different categorical variables. Both bivariable and multivariable Cox-proportional hazard regression models were fitted to identify predictors of LTFU. Results Among a cohort of 484 HIV patients at Debre Markos Referral Hospital, 84 (17.36%) were loss their ART follow-up. The overall incidence rate of loss to follow-up was 3.7 (95% CI 3.0, 5.0) per 100 adult-years. The total LTFU free time of the participants was 2294.8 person-years. In multivariable Cox-regression analysis, WHO stage IV (AHR 2.8; 95% CI 1.2, 6.2), having no cell phone (AHR 1.9; 95% CI 1.1, 3.4), and rural residence (AHR 0.6; 95% CI 0.37, 0.99) were significant predictors of loss to follow-up. Conclusion The incidence of loss to ART follow-up in this study was low. Having no cell phone and WHO clinical stage IV were causative predictors, and rural residence was the only protective factor of loss to follow-up. Therefore, available intervention modalities should be strengthened to mitigate loss to follow-up by addressing the identified risk factors.

Introduction: coronavirus is a communicable disease that produces severe morbidity and mortality in the globe and more than three million people died due to COVID-19. Pregnant mothers are at higher risk of COVID-19 viral infection, with great morbidity and mortality. Thus, the purpose of this research is to assess the level of COVID-19 vaccine acceptability, determinants, and hesitancy among pregnant mothers attending antenatal care at Debre Markos town, public health institutions, Debre Markos, Northwest Ethiopia. Methods: a mixed study was conducted among 350 pregnant mothers attending antenatal care at Debre Markos town health institutions and the participants were selected by consecutive sampling techniques. The collected data were entered into EPI Info version 7 and then exported to SPSS version 25 for data cleaning and analysis. The level of COVID-19 vaccine acceptability was determined through descriptive statistics, whereas its determinants were identified by binary logistic regression analyses. Variables with p-value < 0.05 in multivariable were considered as significantly associated factors. The qualitative data were collected by an unstructured interviewer guide using in-depth interview data collection methods. Study participants were selected purposively until the required data was saturated. The data was analysed under selected themes based on the guide and summarized manually. Results: sixty-five (18.5%) of the respondents accept the COVID-19 vaccine [95% CI: 13, 23]. Maternal age [AOR: 3.281 (95% CI: 1.184, 9.092)], chronic medical illness [AOR: 0.170 (95% CI: 0.051, .562)], information about COVID-19 vaccine [AOR: 4.063 (95% CI: 1.462, 11.293)], pregnancy-induced medical conditions [AOR: 4.131 (95% CI: 1.055, 16.183) were identified as significant determinants of COVID-19 vaccine acceptability. From the quantitative wing. The qualitative finding implied that misconception, fear of medical complications, lack of trust in its effectiveness, and religious constraints were the common reasons for vaccine hesitancy. Conclusion: COVID-19 vaccine acceptability by pregnant mothers attending ANC at Debre Markos town public health institutions is very low. The health care providers and health extension workers shall create information about the COVID-19 vaccine on its importance and side effects. [ABSTRACT FROM AUTHOR]

Introduction: adolescence is a transition phase from being a child to an adult. Open positive parent-adolescent communication on reproductive health issues has many positive effects on adolescents, families, and society. Methods: a community-based cross-sectional study design was employed, and a multistage sampling technique was used. Data were collected through face-to-face interviews with pre-tested structured questionnaires. After data collection, data were coded and entered using Epi data version 3.1 and analysed using SPSS version 25 statistical software. Binary logistic regression analysis was used to ascertain the association between explanatory variables and the outcome variable. Variables with a P value less than 0.25 in the bivariable analysis and P-value < 0.05 in the multivariable analysis and corresponding 95% CI of odds ratio were considered to declare a result as statistically significant. Results: this study has revealed parent-adolescent discussion on reproductive health issues was 55.2%. Age 45-54 (AOR=2.37, 95% CI: 1.28-4.39) and 55-64 (AOR=2.54, 95% CI: 1.15-5.56) years, male parents (AOR= 0.51, 95% CI: 0.29-0.89) and monthly income above 158 USD (AOR=3.31, 95% CI: 1.796.12) were statistically significant. Conclusion: more than half of the parents discuss reproductive health issues with adolescents. Age 45-54 and 5564 years, male parents, and higher incomes were the factors that allowed parent-adolescent discussion on reproductive health issues. [ABSTRACT FROM AUTHOR]

Abstract Background Tuberculosis is the leading cause of morbidity and mortality among people living with human immunodeficiency virus. Almost one-third of deaths among people living with human immunodeficiency virus are attributed to tuberculosis. Despite this evidence, in Ethiopia, there is a scarcity of information regarding the incidence and predictors of tuberculosis among people living with HIV. Thus, this study assessed the incidence and predictors of tuberculosis among HIV-positive adults on antiretroviral therapy. Methods This study was a retrospective record review including 544 HIV-positive adults on antiretroviral therapy at Debre Markos Referral Hospital between January 1, 2012 and December 31, 2017. The study participants were selected using a simple random sampling technique. The data extraction format was adapted from antiretroviral intake and follow-up forms. Cox-proportional hazards regression model was fitted and Cox-Snell residual test was used to assess the goodness of fit. Tuberculosis free survival time was estimated using the Kaplan-Meier survival curve. Both the bi-variable and multivariable Cox-proportional hazard regression models were used to identify predictors of tuberculosis. Results In the final analysis, a total of 492 HIV-positive adults were included, of whom, 83 (16.9%) developed tuberculosis at the time of follow-up. This study found that the incidence of tuberculosis was 6.5 (95% CI: 5.2, 8.0) per 100-person-years (PY) of observation. Advanced World Health Organization clinical disease stage (III and IV) (AHR: 2.1, 95% CI: 1.2, 3.2), being ambulatory and bedridden (AHR: 1.8, 95% CI: 1.1, 3.1), baseline opportunistic infections (AHR: 2.8, 95% CI: 1.7, 4.4), low hemoglobin level (AHR: 3.5, 95% CI: 2.1, 5.8), and not taking Isonized Preventive Therapy (AHR: 3.9, 95% CI: 1.9, 7.6) were found to be the predictors of tuberculosis. Conclusion The study found that there was a high rate of tuberculosis occurrence as compared to previous studies. Baseline opportunistic infections, being ambulatory and bedridden, advanced disease stage, low hemoglobin level, and not taking Isonized Preventive Therapy were found to be the predictors of tuberculosis. Therefore, early detection and treatment of opportunistic infections like tuberculosis should get a special attention.

Abstract Objective Antimicrobial resistance (AMR) is one of the most serious global public health threats that exert a significant burden in terms of patient morbidity and mortality and financial crises in many developing countries including Ethiopia. Knowledge on the type of predominantly circulating pathogens with their respective AMR profile in a given area is essential for optimal patient care. This study was aimed at assessing the types of bacterial isolates and their AMR profile identified from a range of clinical samples at Debre Markos Referral Hospital, Northwest Ethiopia, over a period of 5 years (2013 to 2017). Results From the total of 514 different clinical samples processed in the stated time frame, about 240 (46.7%) yield bacterial growth. Majority of the identified bacteria were isolated from stool culture 68 (28.3%) followed by urine 56 (23.3%), ear discharge 54 (22.5%) and wound swabs at 26 (10.8%). Most of the clinical isolates were Gram-negative at 171 (71.25%). The predominant isolate was S. aureus at 41 (17.1%) followed by Salmonella species, 40 (16.7%), Escherichia coli 36 (15%) and Pseudomonas aeruginosa at 26 (11.7%). Generally, the isolates were found resistant at (60–100%) against ampicillin, co-trimoxazole, doxycycline, gentamicin, norfloxacin and tetracycline. Gram-positive isolates were found relatively sensitive to ceftriaxone, erythromycin and vancomycin at (71–84%).

Abstract Background Pneumonia is a significant public health problem globally. The early identification and management of the determinants of pneumonia demands clear evidence. But, there is a limited data on this issue in the current study area. Thus, this study aimed to identify the determinants of pneumonia among 2–59 months old children at Debre Markos Referral Hospital, Northwest Ethiopia. Methods A Hospital based unmatched case-control study was conducted among 334 (167 Cases and 167 Controls) children at Debre Markos Referral Hospital from February 1 to March 30, 2018. Consecutive sampling technique was employed and data were collected with a pre-tested interviewer administered questionnaire. Data were entered into Epi-Data version 4.2, and analyzed using SPSS version 25 software. Bi-variable and multi-variable logistic regression analyses were fitted. Variables having p-value

Abstract Objective To assess the prevalence and associated factors of hypertension among adults in Debre Markos town, Northwest Ethiopia. A community based cross sectional study design was employed. Systematic random sampling was used to select 456 study participants. Analysis was performed using SPSS version 20. Binary logistic regression was fitted to show the association between dependent variable and independent variables. Result A total of 57 (12.5%) individuals had hypertension in Debre Markos town. Being female [AOR 3.78, 95% CI 1.56, 9.147], consuming animal source fat [AOR 6.28, 95% CI 2.63, 14.99], family history of hypertension [AOR 4.88, 95% CI 1.99, 12.015], age greater than 50 years [AOR 3.31, 95% CI 1.00, 10.99], body mass index ≥ 25 kg/m2 [AOR 4.70, 95% CI 1.99, 11.06], excess salt consumption [AOR 6.49, 95% CI 2.83,14.89] and alcohol consumers [AOR 3.19, 95% CI 1.13, 8.99] were found to be statistically significant factors associated with hypertension. The prevalence of hypertension in Debre Markos town is still a public health problem. Being female sex, consuming animal source fat, family history of hypertension, excess salt consumption age greater than 50 years and body mass index > 25 kg/m2 were significant factors of hypertension. Therefore, health sectors should take actions to tackle these modifiable risk factors.

Background: Anemia, the most common micro-nutrient deficiency disorder, is the world's second leading cause of morbidity and morbidity, affecting 24.8% of the population, of which 47.4% are under-five children. The prevalence of anemia ranges from 44 to 56% in Ethiopia. Although its magnitude has shown decreases across regions; it continues to be a significant public health problem, particularly in developing countries including Ethiopia. Despite this evidence, the magnitude and associated factors of anemia was not systematically explored and there is a limited information or limited evidences in the study area. Hence, the aim of this study was to assess the magnitude and associated factors of anemia among children aged 6–59 months attending at Debre Markos Referral Hospital, Northwest Ethiopia. Methods: A hospital-based cross-sectional study was conducted at Debre Markos referral hospital Northwest Ethiopia from September 30 to December 30, 2019. Data on socio-demographic and socio-economic factors, health and nutritional features of children and their mothers were obtained using pre-tested structured questionnaires in a face-to-face interview with child care providers. Blood samples and stool examination for intestinal parasites were performed. Hemoglobin level was analyzed using the HemoCue device (HemoCueHb 301). The collected data were coded, cleared and entered into Epi-Data version 3.1, and analyzed using Stata version 14 software. To identify candidates and predictor variables, bivariate and multivariate logistic regressions were applied respectively. The significance level was determined at a confidence interval of 95% at p-value < 0.05. Results: Of the total of 341 participants planned to be participated, about 310 mother-child pairs participated in the study, giving a response rate of 91%; and data were collected from children as well as their parents or guardians. In this study, the magnitude of anemia was 11.9% (95% CI, 8.5, 16.2%). Poor dietary diversity (AOR = 2.3; 95% CI: 1.12, 5.14), food-insecure households (AOR = 3.24; 95% CI: 1.85, 4.52), complementary feeding initiation time (AOR = 3.20; 95% CI:1.23, 6.61), intestinal parasites infection (AOR = 3.20; 95% CI:1.23, 6.61) and family income (AOR = 2.87; 95% CI:1.57, 5.0) were found to be factors significantly associated with anemia. Conclusion: Overall, anemia is considered a public health problem among children aged 6–59 months attending at Debre Markos referral hospital, based on the cut-off point of the World Health Organization. Poor dietary diversity, complementary feeding initiation time, household food insecurity, intestinal parasite infection and family income were significantly associated with childhood anemia. Thus, it needs for proven interventions in public health such as food diversification, anti-helmintic drug provision and household food security. In addition, educating women about nutrition and diet diversification, as well as involving them in alternative sources of income-generating activity, can be vital in the study area. [ABSTRACT FROM AUTHOR]

Introduction: Treatment satisfaction is patient's evaluation of the process of taking the medication and its use. Currently dolutegravir based regimen is first-line agent for treatment of human immunodeficiency virus. But evidence is scarce regarding treatment satisfaction. Thus, the aim of the current study was to assess treatment satisfaction and associated factors of dolutegravir based regimen among adult human immunodeficiency virus patients attending at Debre Markos referral 2020. Methods: Institutional-based cross-sectional study was conducted. A systematic random sampling technique was used to collect data from June 25 to August 25, 2020 at Debre Markos referral hospital. It was entered into Epi Info and exported to SPSS version 23 for analysis. Bivariable and multivariable logistic regression was used to identify factors. Variables with p< 0.05 were considered as statistically significant. Results: From a total of 359, 349 participants (97.2%) responded to the study. In this study, 70.5% of participants reported higher treatment satisfaction. Monthly average income of ≥ 3500 birr (AOR: 2.88; 95% CI: 1.26, 6.58), 1600– 2500 birr (AOR: 2.47; 95% CI: 1.11, 5.48), 800– 1600 birr (AOR: 3.11; 95% CI: 1.31, 7.37), positive belief about medications (AOR: 3.05; 1.76, 5.28), having a discussion with health care providers (AOR: 3.05, 95% CI: 1.58, 5.88), patients without concurrent medication (AOR: 7.72, 95% CI: 3.29, 18.07), and being male (AOR: 2.10, 95% CI: 1.14, 3.87) were associated with treatment satisfaction. Conclusion: Overall, dolutegravir based regimen showed high treatment satisfaction. Monthly income, positive beliefs about medications, discussing about treatment options, sex and concurrent medications were associated with treatment satisfaction. Thus, it is crucial to improve treatment satisfaction by promoting positive belief towards medication and also by engaging patients in treatment decisions. [ABSTRACT FROM AUTHOR]

Abstract Background Postpartum maternal morbidity is maternal illness that occurs after one hour of expulsion of placenta up to six weeks of childbirth. Though the true burden of this problem is not well known estimates of WHO, UNICEF and UNFPA showed that 1.4 million women experience acute obstetric morbidity annually. Knowledge of magnitude and predicting factors postpartum morbidity is central to understand the extent of the problem and will help as a cornerstone in designing and implementing better preventive strategies. Objectives To assess the magnitude and factors associated with postpartum morbidity in public health institutions in Debre Markos town. Method Institutional based cross sectional study was conducted in Debre Markos town public health institutions by reviewing delivery charts, delivery records and reporting log books. Total deliveries in each health institution in the previous year were identified and number of records to be included from each institution was determined by probability proportion to size. Systematic sampling technique was employed to select 308 charts for review. Data was collected by trained midwifes using structured checklist; entered by epi info and analyzed using SPSS 20. To present findings descriptive statistics using frequencies, charts and figures were used accordingly. Finally binary and multiple logistic regressions were performed to identify predicting factors. Results The magnitude of postpartum morbidity was found to be 101(32.8%). Divorced/widowed women [AOR = 10.920, 95% CI: (2.168, 54.998)], women who didn’t have ANC follow up [AOR = 3.710, 95% CI: (1.749, 7.870)], abnormal labour [AOR =3.496, 95% CI: (1.69, 7.22)], women delivered by doctor [AOR =0.111, 95% CI: (0.027, 0.454)] and women who were not attended postpartum visit [AOR =0.088, 95% CI: (0.040, 0.194)] were the factors associated with postpartum maternal morbidity. Conclusion Maternal morbidity in Debre Markos health institution was found to be major maternal health issue. Being divorced/widowed, absence of ANC visit, intrapartum abnormalities, delivery attended by skilled professionals and no post-partum visit were important predictors of maternal postpartum morbidity.

Background: Toxoplasma gondii is an obligate intracellular protozoan parasite that causes a zoonotic disease called toxoplasmosis. If the infection acquired during pregnancy is not detected and treated early, the parasite can be transmitted transplacentally to the fetus, resulting in congenital toxoplasmosis, which likely leads to serious consequences in the fetus. Toxoplasmosis constitutes a major public health problem particularly in low- and middle-income countries including Ethiopia. This study aimed to determine the seroprevalence and to assess the potential risk factors of toxoplasmosis among pregnant women attending antenatal care at Debre Markos Referral Hospital, Northwest Ethiopia. Methods: In this cross-sectional study, data on the sociodemographic and potential obstetric and behavioral risk factors were gathered through pretested structured questionnaires, and 3 mL of venous blood was also drawn from each of randomly selected 233 study subjects. The serum samples were separated from the blood samples and tested for anti- Toxoplasma antibody using Toxo-latex slide agglutination test. Logistic regression analysis was used to examine the association between risk factors considered and T gondii infection. Results: The overall prevalence of T gondii infection was 67.8%, indicating a high prevalence of toxoplasmosis in the study area. In multivariate analysis, keeping domestic cat at home was found to be the only explanatory variable of toxoplasmosis (adjusted odds ratio = 2.449, 95% confidence interval = 1.183-5.070, P =.016). All sociodemographic variables and most of the potential obstetric and behavioral risk factors were not statistically significant explanatory variables of T gondii infection. Conclusion: The prevalence of toxoplasmosis is high in the study area. Thus, pregnant women should be aware of the potential risk of the disease when keeping cats at home and management of their litter. Inclusion of serologic screening for T gondii infection at antenatal care is warranted for prevention of congenital toxoplasmosis. [ABSTRACT FROM AUTHOR]

Tenaw Gualu, Abebe Dilie, Dessalegn Haile, Abebe Abate Department of Nursing, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia Background: Prelacteal feeding (PLF) is giving liquids or food other than breast milk prior to the establishment of regular breast-feeding (colostrum). The practice of PLF is common in Ethiopia. PLF deprives the child of the valuable nutrients and the protection of colostrum and exposes the newborn to the risk of infection. There are limited studies conducted so far on this topic, and even then, findings are inconsistent. Objective: The objective of this study was to assess determinants of PLF practice and associated factors among postpartum mothers in Debre Markos town, Amhara Regional State, Ethiopia, 2016. Methods: A community-based cross-sectional study was conducted among 262 mothers (postpartum) with infants. Census data was used to include all the postpartum mothers and infant pairs. Structured interviewer-administered questionnaires were used to collect data. The data were cleaned, coded, and entered in Epi data version 3.1 and transferred to SPSS version 20.0 for analysis. Frequency and percentage were used to summarize the sociodemographic characteristics. Variables with a P-value of

Background: Person-centered maternity care is a crucial scheme for a positive childbirth experience. It enhances facility-based delivery, improves patient-provider communication, and increases women's satisfaction. However, there is limited evidence on the magnitude of person-centered care and certain variables were missed in Ethiopia. Therefore, this study assessed the magnitude of person-centered maternity care during childbirth and associated factors at health institutions of Debre Markos town, Ethiopia., Methods: Institution-based cross-sectional study was conducted at public health institutions of Debre Markos town. Participants were enrolled using systematic random sampling technique. Data were collected through face-to-face exit interviews, cleaned, coded, and entered into Epi-Data version 3.1 then exported to SPSS version 25 for analysis. After generating simple linear regression analysis, variables with p -value ⩽ 0.25 were fitted into multivariable linear regression model and p -value < 0.05 was declared statistically significant with 95% CI for β. Finally, study findings were presented using texts, tables, and figures., Results: In this study, 380 women participated, with a response rate of 98.19%. The respondent's mean person-centered maternity care score was 56.83 with 95% CI: (55.83, 57.83). Mean score for sub-scale was 15.08 for dignity and respect, 14.42 for communication and autonomy, and 27.33 for supportive care. Commencing antenatal care during third trimester (β = -4.86, 95% CI: -8.22, -1.49), caesarean delivery (β = -5.78, 95% CI: -7.68, -3.87), college and above educational level of women (β = 3.75, 95% CI: 1.11, 6.39), being multiparous (β = 3.69, 95% CI: 1.85, 5.55), and health center delivery (β = 6.59, 95% CI: 4.17, 9.02) were factors significantly associated with person-centered maternity care., Conclusion: This study showed person-centered maternity care was low compared with World Health Organization standards. This informs local policymakers, district health offices, institutional healthcare administrators, and healthcare professionals of the discrepancies in achieving international standards of quality care., Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2024.)

Objective: To assess the preference of birth attendant gender and associated factors among antenatal care attendants in Debre Markos town public health facilities, northwest Ethiopia, 2021., Method: A facility-based cross-sectional study was conducted from 8 January 2021 to 28 February 2021 at Debre Markos town public health facilities. A total of 662 study participants were selected by systematic random sampling technique. Pretested interviewer-administered structured questionnaires were used for data collection. Data were entered using Epi Data version 3.1 and analyzed using SPSS version 25. Bivariable and multivariable logistic regression were applied to identify factors associated with birth attendant gender preference. Association was described by the "odd ratio" along with a 95% confidence interval. Finally, a P value < 0.05 in the adjusted analysis was used to declare a significant association., Result: In this study, 644 women participated making a response rate of 97.3%. Of the total study participants, 108 (16.8%; 95% confidence interval: 13.8-19.4) preferred male birth attendants, while 232 (36%; 95% confidence interval: 32.5-39.8) preferred female birth attendants. Age (15-24) (adjusted odds ratio = 4.81, 95% confidence interval: 1.79, 12.94), no formal education (adjusted odds ratio = 2.94, 95% confidence interval: 1.32, 6.52), and primary education (adjusted odds ratio = 2.42, 95% confidence interval: 1.07, 5.47) were significantly associated with female birth attendant preference. A lack of formal education (adjusted odds ratio = 0.08; 95% confidence interval: 0.01, 0.68), secondary education (adjusted odds ratio = 0.34; 95% confidence interval: 0.16, 0.71), and history of assisted vaginal delivery (adjusted odds ratio = 3.72; 95% confidence interval: 1.40, 9.87) were significantly associated with a male birth attendant preference., Conclusion: A female birth attendant is preferred by almost one-third of pregnant mothers, while one-sixth preferred a male. The clients who were younger in age and lower in educational status were more likely to prefer female birth attendants, whereas those who had a history of assisted vaginal delivery were more likely to prefer male birth attendants. To have a mother in the continuum of care, it is crucial to take her preferences into account when providing services., Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2022.)

Objective: This study aimed to assess the prevalence and associated factors of depressive symptoms among adults attending anti-retroviral therapy follow up at Debre Markos Comprehensive Specialized Hospital., Methods: Institution-based cross-sectional study was conducted, and a systematic sampling technique was used to select the 266 participants. Depressive symptoms were assessed by using patient health questionnaire 9. A binary logistic regression analysis with an odds ratio and a 95% confidence interval was used to assess the strength of associations in SPSS version 20 and a p-value < 0.05 was considered as statistically significant., Results: In this study, the prevalence of depressive symptoms among HIV-positive individuals was 39.1% with 95% confidence interval (33.7%-45.3%). Multivariable analysis showed that participants who had age group > 40 (adjusted odds ratio = 5.26, 95% confidence interval (2.24-12.35)), presence of perceived stigma and discrimination (adjusted odds ratio = 7.5, 95% confidence interval = (3.77-14.9)), poor medication adherence (adjusted odds ratio = 6.05, 95% confidence interval = (2.86-12.80)), and poor social support (adjusted odds ratio = 2.53, 95% confidence interval = (1.25-5.12)) were significantly associated with depression., Conclusion: The prevalence of depressive symptoms in this study was found to be significantly high. Age > 40 years old, the presence of perceived stigma and discrimination, poor medication adherence, and a lack of social support were found to be associated factors of depressive symptoms. It would be better for clinicians to give special emphasis to those patients who were stigmatized, who had compliance problems, and poor social support., Competing Interests: Declaration of conflicting interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2022.)

Background: Tuberculosis is the leading cause of morbidity and mortality among people living with human immunodeficiency virus. Almost one-third of deaths among people living with human immunodeficiency virus are attributed to tuberculosis. Despite this evidence, in Ethiopia, there is a scarcity of information regarding the incidence and predictors of tuberculosis among people living with HIV. Thus, this study assessed the incidence and predictors of tuberculosis among HIV-positive adults on antiretroviral therapy.Methods: This study was a retrospective record review including 544 HIV-positive adults on antiretroviral therapy at Debre Markos Referral Hospital between January 1, 2012 and December 31, 2017. The study participants were selected using a simple random sampling technique. The data extraction format was adapted from antiretroviral intake and follow-up forms. Cox-proportional hazards regression model was fitted and Cox-Snell residual test was used to assess the goodness of fit. Tuberculosis free survival time was estimated using the Kaplan-Meier survival curve. Both the bi-variable and multivariable Cox-proportional hazard regression models were used to identify predictors of tuberculosis.Results: In the final analysis, a total of 492 HIV-positive adults were included, of whom, 83 (16.9%) developed tuberculosis at the time of follow-up. This study found that the incidence of tuberculosis was 6.5 (95% CI: 5.2, 8.0) per 100-person-years (PY) of observation. Advanced World Health Organization clinical disease stage (III and IV) (AHR: 2.1, 95% CI: 1.2, 3.2), being ambulatory and bedridden (AHR: 1.8, 95% CI: 1.1, 3.1), baseline opportunistic infections (AHR: 2.8, 95% CI: 1.7, 4.4), low hemoglobin level (AHR: 3.5, 95% CI: 2.1, 5.8), and not taking Isonized Preventive Therapy (AHR: 3.9, 95% CI: 1.9, 7.6) were found to be the predictors of tuberculosis.Conclusion: The study found that there was a high rate of tuberculosis occurrence as compared to previous studies. Baseline opportunistic infections, being ambulatory and bedridden, advanced disease stage, low hemoglobin level, and not taking Isonized Preventive Therapy were found to be the predictors of tuberculosis. Therefore, early detection and treatment of opportunistic infections like tuberculosis should get a special attention. [ABSTRACT FROM AUTHOR]

Background: Pneumonia is a significant public health problem globally. The early identification and management of the determinants of pneumonia demands clear evidence. But, there is a limited data on this issue in the current study area. Thus, this study aimed to identify the determinants of pneumonia among 2-59 months old children at Debre Markos Referral Hospital, Northwest Ethiopia.Methods: A Hospital based unmatched case-control study was conducted among 334 (167 Cases and 167 Controls) children at Debre Markos Referral Hospital from February 1 to March 30, 2018. Consecutive sampling technique was employed and data were collected with a pre-tested interviewer administered questionnaire. Data were entered into Epi-Data version 4.2, and analyzed using SPSS version 25 software. Bi-variable and multi-variable logistic regression analyses were fitted. Variables having p-value < 0.05 were considered as statistically significant.Results: A total of 328(164 cases and 164 controls) 2-59 months old children were included in this study. Not opening windows daily [AOR:6.15(2.55,14.83)], household near to the street [AOR:4.23(1.56,11.44)], child care by the house workers and relatives [AOR:2.97 (1.11,7.93)], using only water for hand washing before child feeding [AOR:3.81 (1.51, 9.66)], mixed feeding practice from birth to six months [AOR: 7.62 (2.97, 19.55)], having upper respiratory tract infection in the last 2 weeks for the child [AOR: 5.33 (2.16, 13.19)] and children with history of co- residence with URTI family [AOR: 6.17 (2.36,16.15)] were found to be determinants of pneumonia.Conclusions: The main contributing factors for pneumonia in this study are preventable with no or minimal cost. Therefore, we recommend appropriate and adequate health education regarding pneumonia prevention and control. [ABSTRACT FROM AUTHOR]

Objective: To assess the prevalence and associated factors of hypertension among adults in Debre Markos town, Northwest Ethiopia. A community based cross sectional study design was employed. Systematic random sampling was used to select 456 study participants. Analysis was performed using SPSS version 20. Binary logistic regression was fitted to show the association between dependent variable and independent variables. Result: A total of 57 (12.5%) individuals had hypertension in Debre Markos town. Being female [AOR 3.78, 95% CI 1.56, 9.147], consuming animal source fat [AOR 6.28, 95% CI 2.63, 14.99], family history of hypertension [AOR 4.88, 95% CI 1.99, 12.015], age greater than 50 years [AOR 3.31, 95% CI 1.00, 10.99], body mass index ≥ 25 kg/m2 [AOR 4.70, 95% CI 1.99, 11.06], excess salt consumption [AOR 6.49, 95% CI 2.83,14.89] and alcohol consumers [AOR 3.19, 95% CI 1.13, 8.99] were found to be statistically significant factors associated with hypertension. The prevalence of hypertension in Debre Markos town is still a public health problem. Being female sex, consuming animal source fat, family history of hypertension, excess salt consumption age greater than 50 years and body mass index > 25 kg/m2 were significant factors of hypertension. Therefore, health sectors should take actions to tackle these modifiable risk factors. [ABSTRACT FROM AUTHOR]

Although the world has been fighting HIV disease in unity and patients are getting antiretroviral therapy treatment, HIV disease continues to be a serious health issue for some parts of the world. A large number of AIDS-related deaths and co-morbidities are registered every year in resource-limited countries like Ethiopia. Most studies that have assessed the progression of the disease have used models that required a continuous response. The main objective of this study was to make use of appropriate statistical models to analyze routinely collected HIV data and identify risk factors associated with the progression of the CD4 + cell count of patients under ART treatment in Debre Markos Referral Hospital, Ethiopia. In this longitudinal retrospective study, routine data of 445 HIV patients registered for ART treatment in the Hospital were used. As overdispersion was detected in the data, and Poisson-Gamma, Poisson-Normal, and Poisson-Gamma-Normal models were applied to account for overdispersion and correlation in the data. The Poisson-Gamma-Normal model with a random intercept was selected as the best model to fit the data. The findings of the study revealed the time on treatment, sex of patients, baseline WHO stage, and baseline CD4 + cell count as significant factors for the progression of the CD4 + cell count., (Copyright © 2020 Andualem and Ayele.)