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BackgroundThe Beach Center Family Quality of Life Scale was developed and validated in different languages in different countries. However, this scale is not yet validated in the Ethiopian Amharic language context. Therefore, this study aimed to investigate the cross-cultural validity of the Beach Center Family Quality of Life Scale, among Ethiopian families of persons affected by leprosy and podoconiosis.MethodologyWe explored the semantic equivalence, internal consistency, reproducibility, floor and ceiling effects, and interpretability of the Beach Centre Family Quality of Life Scale in Amharic. After translating, and back-translating the instrument, a cross-sectional study was conducted. A total of 302 adult persons affected by leprosy and podoconiosis, who have a view of their family life were asked about their level of satisfaction using the Beach Center Family Quality of Life Scale. In addition, 50 participants were interviewed again two weeks after the first assessment to check the reproducibility of the scale. Participants were recruited in the East Gojjam zone in Northwest Ethiopia.ResultsThe findings of this study showed that the Beach Center Family Quality of Life Scale had high internal consistency (Cronbach’s alpha of 0.913) and reproducibility (intra-class correlation coefficient of 0.857). The standard error of measurement was 3.01, which is 2.4% of the total score range. The smallest detectable change was 8.34. Confirmatory factor analysis showed adequate factor loadings and model fit indices like the original scale. The composite reliability and average variance extracted from the scale were acceptable. No floor and ceiling effects were found.ConclusionsOur findings indicate that the Amharic version of the Beach Center Family Quality of Life scale has adequate cultural validity to assess the family quality of life in Ethiopian families of persons affected by leprosy and podoconiosis.Author SummaryThe presence of persons with disabilities in the family can affect a family’s quality of life. Neglected tropical diseases such as leprosy and podoconiosis can lead to disabilities and have been found to influence Family Quality of Life. To adequately assess the family quality of life of persons affected by leprosy and podoconiosis, we have selected the Beach Center Family Quality of Life scale. However, this scale has not been validated in the Ethiopian context previously. In this study, the authors aimed to investigate the cross-cultural validity of the Beach Center Family Quality of Life scale in families with one or more persons affected by leprosy and podoconiosis in Ethiopia.A total of 302 participants were included in this study. The results show the scale to be adequately reliable and valid in the target country’s culture and language. Based on the findings, the authors recommend using this scale among families of persons affected by leprosy and podoconiosis.

Adugnaw Alemu,1 Moges Wubie Aycheh,2 Tebelay Dilnessa3 1School of Medicine, Debre Markos University, Debre Markos, Ethiopia; 2Department of Public Health, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia; 3Department of Medical Laboratory Sciences, College of Health Sciences, Debre Markos University, Debre Markos, EthiopiaCorrespondence: Tebelay DilnessaDepartment of Medical Laboratory Sciences, College of Health Sciences, Debre Markos University, PO Box 269, Debre Markos, EthiopiaTel +251 912198715Email tebelay@gmail.comBackground: Human immunodeficiency virus (HIV) and tuberculosis (TB) are the principal global causes of death among patients with communicable diseases. Because of shared immune defense mechanisms, they are the primary cause of morbidity worldwide. However, little information was found regarding the magnitude of TB/HIV co-infection in the study area, in Northwest Ethiopia.Objective: The main aim of this study was to assess the prevalence of TB and HIV co-infection and associated factors among TB patients.Methods: All TB patients at Debre Markos Comprehensive Specialized Hospital were included from September 11, 2012 to September 10, 2016. Data were analyzed using SPSS version 22. Logistic regression was used to determine the associations between independent and outcome variables.Results: A total of 180 TB patients were enrolled. Pulmonary tuberculosis (PTB) accounted for 97/180 (53.9%), followed by extrapulmonary tuberculosis (EPTB) in 83/180 (46.1%). There were 164/180 (91.1%) new TB cases and 16/180 (8.9%) treatment failures, but no relapsing or defaulting cases were observed. Forty percent (72/180) of patients were co-infected with TB and HIV. The likelihoods of having TB/HIV co-infection were 3.2 and 2.1 times higher in PTB smear-positive and PTB smear-negative patients (AOR=3.2, 95% CI 1.4– 8.1, p=0.006; and AOR=2.1, 95% CI 1.0– 4.3, respectively, p=0.05), in comparison to EPTB. The rate of TB/HIV co-infection was 28/66 (42.4%) in 2013, 18/38 (47.4%) in 2014, 13/32 (40.6%) in 2015, and 13/44 (29.5%) in 2016.Conclusion: TB/HIV co-infection showed a decreasing trend in the past 2 years in the study area. TB/HIV co-infection is one of the most serious community health concerns in the study area. Therefore, TB/HIV collaborative activities should be implemented to reduce co-infection and its impact on the community.Keywords: TB/HIV co-infection, tuberculosis, HIV, multidrug resistant TB

Moges Getie Workie,1 Moges Wubie Aycheh,2 Molla Yigzaw Birhanu,2 Tesfa Birlew Tsegaye2 1Public Health, Ari Primary Hospital, Gazer, Southern Nations, Nationalities, and Peoples’ Region, Ethiopia; 2Department of Public Health, College of Health Sciences, Debre Markos University, Debre Markos, EthiopiaCorrespondence: Molla Yigzaw Birhanu; Tesfa Brilew Tsegaye Tel +251 910614947; +251 913310476Email mollayigzaw33@gmail.com; tesfabirlew@yahoo.comBackground: Tuberculosis treatment interruption is a failure of attending two scheduled appointments to collect the drugs in either phase of tuberculosis treatment. Even if TB treatment is crucial to achieve a cure and avoid the emergence of drug resistance, treatment interruption is the most testing and deterring factor for successful tuberculosis treatment and one of the problems leading to the development of drug-resistant tuberculosis. TB treatment interruption is the precursor for loss to follow-up and treatment failure, but the magnitude of this problem is unknown in Ethiopia. Thus, this study was intended to identify determinants of treatment interruption among drug-susceptible pulmonary tuberculosis patients in South Ari district, Southern Ethiopia.Methods: An institution-based unmatched case control study was conducted from February through April 2020 using 255 samples with a ratio of 2:1 (controls to cases). Data were entered into Epi data version 4.2 and exported for analysis using STATA 14.0 statistical software. The variables having a p-value of less than 0.25 in the bivariable analysis were subjected to multivariable logistic regression analysis. In multivariable logistic regression analysis, AORs, 95% CIs, and p-values of < 0.05 were used to identify significant variables.Results: The median age was 34 (IQR: 18) years in cases and 29 (IQR: 16) years in control groups. Significant factors that were associated with treatment interruption were alcohol consumption (AOR = 2.99, 95% CI; 1.41– 6.36); smoking habits (AOR = 2.82, 95% CI; 1.14– 6.94); use of traditional medicine (AOR = 2.35, 95% CI 1.05– 5.24); co-infected with HIV (AOR=1.58, 95% CI; 1.85– 4.29), and waiting time at the health facility ≥ 30 minutes (AOR = 2.98, 95% CI; 1.31– 6.80).Conclusion: Alcohol consumption, waiting time at the health facility ≥ 30 minutes, smoking habits, used traditional medicine, and HIV co-infected were potential determinants. Enhancing public health education, designing strategies that emphasize patients with HIV co-infection, and reducing waiting times are recommended.Keywords: treatment interruption, susceptible, pulmonary tuberculosis, directly observed treatment, drug resistant tuberculosis

A key issue for persons with leprosy-, lymphatic filariasis- and podoconiosis-related disabilities is the life-long need to practice self-management routines. This is difficult to sustain without regular encouragement and support of others. Family-based support may be a sustainable and feasible strategy to practice self-management routines. This proof of concept study aimed to develop and pilot a family-based intervention to support prevention and self-management of leprosy, lymphatic filariasis and podoconiosis-related disabilities in Ethiopia. We used a quasi-experimental pre/post intervention study design with a mixed methods approach. The study population included persons affected by leprosy, lymphatic filariasis and podoconiosis and their family members. All persons affected had visible impairments due to their condition. We collected physical impairment outcomes, data on activity limitations, stigma and family quality of life using the SALSA scale (range 0–80), the SARI stigma scale (range 0–63) and the Beach Centre Family Quality of Life scale (range 0–125) and conducted in-depth interviews and focus group discussions. Quantitative data were analysed using paired t-tests, unequal variances t-tests, linear regression and binary logistic regression. Qualitative data were coded using open, inductive coding and content analysis. The family-based intervention consisted of self-management of disabilities, awareness raising and socio-economic empowerment. The intervention was delivered over several monthly group meetings over the course of several months. A total of 275 (100%) persons affected attended at least one session with a family member, and 215 (78%) attended at least three sessions. There was no significant improvement in eye and hand problems after the intervention. However, foot and leg impairments, number of acute attacks, lymphedema and shoe wearing all significantly improved at follow-up. In addition, family quality of life significantly improved from 67.4 at baseline to 89.9 at follow-up for family members and from 76.9 to 84.1 for persons affected (p, Author summary A key issue for persons with leprosy-, lymphatic filariasis- and podoconiosis-related disabilities is the life-long need to practice self-management routines. Family-based support may be a sustainable and feasible strategy to practice self-management. This proof of concept study aimed to develop and pilot a family-based intervention to support prevention and self-management of leprosy, lymphatic filariasis and podoconiosis-related disabilities in Ethiopia. We collected data on physical impairments, activity limitations, stigma and family quality of life, and conducted in-depth interviews and focus group discussions. The family-based intervention consisted of self-management of disabilities, awareness raising and socio-economic empowerment. The intervention was delivered over several monthly group meetings. A total of 275 persons affected attended at least one session with a family member. There was no significant improvement in eye and hand problems after the intervention. However, foot and leg impairments, number of acute attacks, lymphedema and shoe wearing all significantly improved. In addition, family quality of life significantly improved, and stigma levels significantly decreased after the intervention. Activity levels improved, but not significantly. This proof of concept study showed that the family-based intervention had a positive effect on impairments and self-management of disabilities, family quality of life and stigma.

Background Leprosy, podoconiosis and lymphatic filariasis (LF) may adversely affect the social, economic and psychological well-being of persons affected and their families. The objectives of this study were to assess and compare family quality of life of persons affected and their family members, explore the relationship between family quality of life and perceived stigma and activity limitations and explore what factors influence family quality of life. Methods A cross-sectional quantitative study was conducted in the Awi zone in Ethiopia. Persons affected and their family members were selected using purposive sampling. Three questionnaires were used: the Beach Center Family Quality of Life (FQOL) scale (range 25–125, with higher scores denoting higher family quality of life), the SARI Stigma Scale (range 0–63, with higher scores denoting higher levels of stigma) and the Screening of Activity Limitation and Safety Awareness (SALSA) scale (range 0–80, with higher scores denoting more activity limitations). Data analysis consisted of simple descriptive analysis and regression analysis. Results A total of 95 persons affected and 117 family members were included. The overall mean of the family quality of life score was 71.7. Persons affected had significantly higher mean family quality of life scores than family members on all domains. Female gender, a smaller family size and occupation were associated with lower family quality of life. We found a mean SARI Stigma score of 22.3 and a mean SALSA score of 37.6. There was no association between the FQOL and SARI scores or between the FQOL and SALSA scores. Conclusions Family quality of life is an important area to address because neglected tropical diseases often affect the whole family. It is therefore important in order to provide appropriate support for persons affected and their family members. Efforts to improve the quality of life of families in which a family member is affected by leprosy, podoconiosis or LF should give priority to women and families with a smaller family size.

IntroductionLeprosy, podoconiosis and lymphatic filariasis (LF) are three skin-related neglected tropical diseases. All three conditions can lead to temporary and permanent impairments. These impairments progressively worsen and are major determinants of stigma, discrimination and participation restrictions. Self-care is essential to prevent disabilities and chronic disease complications. Many persons with leprosy-related, LF-related and podoconiosis-related disabilities need to practice self-management routines their entire life. This is difficult without support and encouragement of others. The objective of this study was to assess the effectiveness of a family-based intervention in terms of physical outcomes related to prevention and self-management of disabilities due to leprosy, podoconiosis and LF and family quality of life and well-being compared with usual practice and care.Methods and analysisThe study will use a cluster-randomised controlled trial design with two study arms. The project will be carried out in endemic districts in East and West Gojjam zones in the Amhara region in Ethiopia. Clusters consist of kebeles (lower administrative structures in the district) that have been merged, based on their geographical proximity and the number of cases in each kebele. A total of 630 participants will be included in the study. The intervention group will consist of 105 persons affected by leprosy, 105 persons affected by LF or podoconiosis, and 210 family members. The control group will consist of 105 persons affected by leprosy and 105 persons affected by LF or podoconiosis. The family-based intervention comprises an essential care package that consists of the following three main components: (1) self-management of disabilities, (2) economic empowerment and (3) psychosocial support. Participants in the control areas will receive usual practice and care. Data analysis includes, but is not limited to, calculating the percentage of change and corresponding 95% CI of physical impairment outcomes in each group, before and after the intervention is implemented, effect sizes, intention to treat and difference in difference analysis.Ethics and disseminationEthical approval has been obtained from the Debre Markos University Health Sciences Institutional Research Ethics Review Committee. Results will be disseminated through peer-reviewed publications, conference presentations and workshops.Trial registration numberPACTR202108907851342.

Background In Ethiopia assuring the satisfaction of health care provider with their job is a major challenging problem. Job satisfaction is a worker’s emotional response to different job related factors resulting in finding pleasure, comfort, confidence, rewards, personal growth and various positive opportunities, including upward mobility, recognition, and appraisal done on a merit pattern with monetary value as compensation. Professionals, whose needs and expectations are satisfied, tend to be more productive compared to their colleagues. Thus, study is aimed at assessing job satisfaction and associated factors among health professionals working at Western Amhara region, Ethiopia. Methods An institution-based cross sectional study was conducted on March 2016 at Western Amhara region among 575 health professionals selected using simple random sampling. Logistic regression analysis was used to identify factors related to job satisfaction. Variables which have p-value less than or equal to 0.05 with corresponding AOR at 95 confidence interval was considered to declare the significance association. Results This study revealed that job satisfaction of health professional working at Western Amhara region was 31.7%. The mean age of respondent was 27.13 years. Majority of them, 79.3% and 95.3% were less than 30 years in age and orthodox Christian religion followers respectively. The presence of health professionals’ reference manual/guide, alcohol drinking, workload, experience, educational status and profession types were identified as significant factors associated with health care professionals’ job satisfaction level. Professional being laboratory technicians, pharmacists and Environmental health workers were 4.86 times more likely to satisfy themselves than nurses, midwives and Public health officers. Similarly, in their educational status, degree and above holders were 5.64 times more likely to satisfy themselves than below degree holders. Health professionals whose experience with > 3 years were 2.83 times more likely to satisfy themselves than counterpart. Health professionals who had high workloads were 3.99 times more likely to satisfy than those professionals whose workload was low. Professionals who did not drink alcohol were 3.55 times more likely to satisfy themselves than professionals who drank. Professionals who consult health reference manual/guide were 15.96 more likely to satisfy themselves than those professional who did not. Conclusion Only one third of health professionals working at Eastern Amhara Region were satisfied on their job. The presence of health professionals’ reference manual/guide, alcohol drinking, workload, experience, educational status and profession types were identified as important predictors for job satisfaction.