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Background Repeat induced abortion refers to a condition in which a woman has at least one previous history of induced pregnancy termination. It bound in a vicious cycle with repeat unintended or unplanned pregnancy and remains rising concern, particularly for developing countries. Objectives This study was aimed to explore reasons and lived experiences of women, who undergone repeat induced abortion; in Wolaita Sodo town, Southern Ethiopia. Methods and Materials: A phenomenological qualitative study approach was conducted from February 15-March 22, 2021 among women in Wolaita Sodo town. Twelve women between 17 and 35 years old, who had at least one previous abortion were selected using purposive sampling. In-depth interview (IDI) using semi-structured interview guide was conducted. Data were audio recorded, transcribed verbatim and translated in to English and imported to ATLAS.ti8 software for coding. Code book development, peer debriefing, multiple coders and audit trials applied to maintain rigor of the data and analysis was done deductively. Result The study found reasons of repeat induced abortion among women at maternal, partner and family, healthcare and educational institution, community and policy level. It also looked into the effects of induced abortion from the standpoint of women. Economic issues, fears about contraceptive side effects, and a desire to limit the number of children were stated as reasons. Conclusion Study revealed multiple reasons for repeat induced abortion in holistic manner; and presented key emotional and physical effects of abortion and unintended pregnancy. Based on the findings, multiple interventions at individual, community and organizational levels; and strong law enforcement on criminals of rape are needed in order to avoid or minimize the reasons and negative consequences of repeat induced abortion.

Introduction Traumatic brain injury (TBI) is a significant health issue among deployed and non-deployed U.S. military service members (SMs). Since 2000, an estimated 413,858 SMs have been diagnosed with at least one TBI. Due to the difficulty in distinguishing new incident TBIs from follow-up TBI-related medical encounters in the Military Health System (MHS), the official TBI case definition also includes an incidence rule considering an individual an incident case only once per lifetime. We sought to examine patterns in medical records of SMs with at least one TBI encounter, in an effort to identify repeat TBIs in individual SMs and to estimate the incidence of repeat TBIs within the study cohort as a whole. Materials and Methods Using the official DoD TBI case definition, we obtained a list of SMs who sustained their first active duty TBI between October 1, 2015, and September 30, 2017. We identified the SM’s diagnosing encounter (index TBI). Subsequently, we identified patterns associated with diagnosing medical encounters, as opposed to encounters associated with follow-up TBI care. We flagged external cause of injury records and the presence of TBI-related symptom codes at the diagnosing encounter. Traumatic brain injury–related symptoms included memory issues, alteration of cognition, hearing loss, vertigo, headache, anxiety, depression, emotional lability, weakness, insomnia, and vision disturbance. Data discovery results were shared with a group of clinicians at the Defense and Veterans Brain Injury Center, and the list of variables was further refined based on clinical expertise. Subsequently, we conducted stepwise logistic regression, and best fitting model was used to create a probability score to be applied to all TBI-related medical encounters. To validate the accuracy of the model-derived probability score, a stratified random sample of medical records was reviewed by trained clinician. At the 0.5 probability cutoff point, the model had an area under the curve of 0.69. We applied the final model portability scores to all identified TBI encounters to estimate the incidence of repeat TBI within the cohort. Results Between October 1, 2015, and September 30, 2017, we identified 36,440 SMs and their first lifetime TBI encounter. Study follow-up period was 2 years. Predictors of repeat TBI (rTBI) encounters included the presence of TBI diagnosis extender codes “A” (odds ratio [OR] = 4.67, 95% CI 2.15-10.12); W and V series codes (OR = 4.05, 95% CI 2.05-7.95 and OR = 2.86, 95% CI 1.40-5.83, respectively); patient’s disposition at home/quarters; and admission or immediate referral (OR = 3.67, 95% CI 1.79-7.51). Number of diagnosis codes in patient’s medical record was inversely associated with a repeat TBI encounter (OR = 0.84, 95% CI 0.76-0.96). Applying model-derived probability score onto identified medical records, we estimate that 804 unique SMs sustained an rTBI during the follow-up period, yielding a rate of 260 rTBIs per 10,000 person-years or approximately 2.32% of SMs annually. Conclusion Probability scores based on statistical modeling can provide reasonable estimates of repeat incidences of TBI using medical billing data when formerly only the first TBI was thought to be measurable. With 100% sensitivity and 69% specificity, application of these models can inform estimates of repeat TBI across the MHS. This effort shows initial success if estimating repeat TBI, and further modeling work is encouraged to increase the predictive characteristics of the models as these efforts show promise in estimating repeat TBI across the MHS.

Teka Nugusse,1 Semarya Berhe Lemlem,2 Jembere Deressa,2 Sezer Kisa3 1Department of Nursing, Ayder Specialized Referral Hospital, Mekelle, Ethiopia; 2Department of Midwifery, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia; 3Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, NorwayCorrespondence: Jembere DeressaDepartment of Midwifery, College of Health Sciences, Addis Ababa University, P.O. Box 9086, Addis Ababa, EthiopiaTel +251 912782147Email jembere_tesfaye@yahoo.comBackground: Fatigue is a subjective and distressing symptom in cancer patients and has profound effects on daily life. The rates of fatigue during treatment are reported to be 25– 90%. Its causes are secondary to their treatment course, cancer itself and associated factors.Purpose: To assess the prevalence of fatigue and associated factors among cancer patients at Tikur Anbessa Specialized Hospital in Addis Ababa, Ethiopia, 2019.Patients and Methods: A cross-sectional study design was conducted on cancer patients undergoing treatment in Tikur Anbessa Specialized Hospital. A sample of 278 was selected using systematic random sampling technique and Brief Fatigue Inventory questionnaire was used for data collection. The data were entered into EPI data version 3.1 and transferred to SPSS version 24 for analysis. Bivariate and multivariable logistic regression were conducted to summarize the data. The significant statistical test was determined at 95% confidence interval and at p< 0.05.Results: The mean age of the participants was 44.9 ± 14 years. The prevalence of fatigue identified by this study was 208 (74.8%). Age, stage of cancer, presence of infection, type of cancer, and type of treatment had shown a significant association with fatigue [AOR = 3.15, 95% CI: (1.35– 7.34)], [AOR = 0.02, 95% CI: (0.003– 0.172)], [AOR = 4.15, 95% CI: (1.06– 16.07)], [AOR = 5.19, 95% CI: (1.59– 16.90)], [AOR = 0.18, 95% CI: (0.07– 0.462)] respectively.Conclusion: The prevalence of fatigue in cancer patients in this study was high. Risk factors were age of the patients, stage of cancer, presence of infection, cervical cancer and radiation therapy.Keywords: cancer, fatigue, chemotherapy, specialized hospital, Ethiopia

Background. One-third to two-thirds of operated patients in low-income countries acquire surgical site infection, which is nine times higher when compared to high-resource countries. Identifying the incidence and risk factors that contribute to surgical site infection following cesarean delivery is a step ahead for preventing and reducing the problem. Nonetheless, the distribution of the problem in Addis Ababa, where the rate of cesarean delivery is relatively high compared to other parts of the country, is under investigation. Objective. The aim of this study is to assess the incidence of surgical site infection among cesarean deliveries and factors associated with it in selected governmental hospitals found in Addis Ababa, Ethiopia, in 2019. Method. A hospital-based prospective cohort study design was employed to follow 175 women, who gave birth by cesarean delivery in selected government hospitals in Addis Ababa, from March 11 to April 9, 2019. Convenience sampling method was used to select study units from the randomly selected hospitals. Descriptive statistics were run for determining the rate of cesarean delivery surgical site infection. Presence and degree of association between outcome and independent variables were computed through bivariate logistic regression analysis and factors that had p<0.2 significance level in the bivariate logistic regression analysis were considered in the multivariable logistic regression analysis. Result. From 166 participants who completed 30-day follow-up, 25 (15%) of the participants developed surgical site infection. Age, gestational age, duration of operation, and ≥5 vaginal examinations showed a significant association with the outcome variable with AOR (95% CI) of ((AOR = 1.504, 95% CI: (1.170 – 1.933, p=0.001))), ((AOR = 0.019, 95% CI: (0.001 – 0.291, p=0.004))), ((AOR = 1.108, 95% CI: (1.025 – 1.197, p=0.009))), and ((AOR = 13.076, 95% CI: (1.018 – 168.002, p=0.048))), respectively. Conclusion and recommendation. Surgical site infection rate is higher and certain associations lost due to small sample size. Further interventional studies with vast sample size are recommended.

Background Ethiopia ratified its abortion law in 2005, primarily to reduce the incidence of unsafe abortion and the availability of safe abortion services has increased. However, service availability has not led to a significant reduction in unsafe abortion.Objective The aim of this study was to assess women’s perception about accessibility of safe abortion care services at selected public institutions in Addis Ababa, Ethiopia.Method Institution-based cross-sectional study was conducted among 432 women of reproductive age who work in non-health related public institutions. A structured questionnaire was used to collect the data. Data were entered into Epi-data and cleaned and exported to SPSS version 24.0 for data analysis. Data analysis involved descriptive statistics, independent-sample t-test, one-way analysis of variance (ANOVA), and linear regression. Statistical significance was set at 5%. Multi-categorical independent variables were dummy coded before entering into the models. Results In this study, more than half (60.2%) of the participants reported that they had pregnancy at least once. Seventy eight respondents (18.1%) had history of previous miscarriage, among these the greater number (74.4%) has happened due to spontaneous abortion. Among the respondents studied, 283 (65.5%) of them have heard of abortion care and media was the major source of information. Closely half of (46.2%) the females who had miscarriage history were treated at governmental health institutions; followed by private clinics (35.9%) and traditional methods (6.4%). Whereas, 11.5% of them didn’t get any abortion care service. There was significant difference in mean scores of participants faced post abortion complications and treated at traditional healer, and particularly the respondents attended traditional healer makes the strongest unique contribution to explaining the perception score.Conclusion Over the past two decades, the safe abortion services has advanced and expanded increasingly in Ethiopia. However, this study indicated that significant number of women still unheard about accessibility of the safe abortion care and attending the traditional and risky procedure of care. There is an urgent need for the government and other stakeholders to provide more awareness on the accessibility and advantage of safe abortion services in the community.

Background: Planned vaginal birth after cesarean section is appropriate for and offered to the majority of women with a singleton pregnancy of cephalic presentation at 37 weeks or beyond. The main purpose of the study was to assess factors associated with successful vaginal birth after cesarean section and its outcome in Asella Referral and Teaching Hospital. Methods: An institutional based case-control study conducted to identify factors associated with successful vaginal birth after cesarean section and its outcome in a two years period. The data was collected from patients’ charts after tracing a patient’s number, a double proportion sampling technique was used to determine sample size using EPI info version 7.1.4.0, and multivariate regression analysis of independent variables associated with successful vaginal birth after cesarean section was performed with unmatched case control. Results: Two hundred eighty-eight (288) mothers with history of one previous cesarean delivery attempted vaginal birth after cesarean section. This study found significant successful vaginal birth after cesarean section in mothers with previous vaginal birth, prior successful vaginal delivery after cesarean section, presented with cervical dilatation more than or equal to 4 cm and intact membrane at admission. Meconium>grade I and duration of labour>481minute negatively affected the success rate but weight did not affect vaginal birth after cesarean outcome.Conclusions: Careful selection of mother is the corner stone of successful vaginal birth after cesarean section with special consideration of gestational age, condition of membrane, and develops national evidence-based clinical practice guidelines for potential implication.