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Habtamu Esubalew,1 Moges Wubie,2 Yilkal Tafere,2 Wodaje Gietaneh,2 Bekalu Endalew,2 Samuel Derbie Habtegiorgis,2 Tsige Gebre,2 Eyerus Tesfaw,2 Hailemariam Abiy,2 Animut Takele Telayneh2 1Debre Elias Woreda Health Office, Amhara, Ethiopia; 2Department of Public Health, College of Health Science, Debre Markos University, Debre Markos, EthiopiaCorrespondence: Animut Takele Telayneh, Debre Markos University, P.O. Box 269, Debre Markos, Ethiopia, Tel +251918215993, Email animuttakele@gmail.comIntroduction: Podoconiosis is endemic non-filarial elephantiasis of the lower legs swelling caused by barefoot exposure to red clay soil. The burden of disability occurs among the poorest populations. Self-care practice is the most cost-effective prevention strategy practiced at home to improve lymphedema, working functionality, and quality of life. Despite this, there is a scarce of knowledge about self-care practices and associated factors among podoconiosis patients in Ethiopia.Objective: To determine self-care practice and its associated factors among podoconiosis patients in East Gojjam zone North West, Ethiopia.Methods: Community-based cross-sectional study design was used among 633 podoconiosis patients. Computer-generated simple random sampling technique was used to recruit participants. All patients who started podoconiosis treatment were the source population. Data were entered using Epidata version 3.1 and exported to SPSS version 25 for cleaning and analysis. Variables with 95% CI corresponding AOR were used to identify statistically significant factors for self-care practice.Results: In this study, the self-care practice of podoconiosis patient was 64%. Females [AOR: 0.38 (95% CI: 0.22, 0.65)], 55– 65 years age [AOR: 0.41 (95% CI: 0.22, 0.74)], above 65 years age [AOR: 0.22 (95% CI: 0.11, 0.450)], 4– 6 km distance from water source [AOR: 0.06 (95% CI: 0.03, 0.12)], above 6 km distance from water source [AOR: 0.03 (95% CI: 0.01, 0.09)], educational level [AOR: 0.05 (95% CI: 0.01, 0.40)], marital status [AOR: 5.40 (95% CI: 2.30, 12.90)], and distance from health institution [AOR: 0.35 (95% CI: 0.23, 0.54)] were statistically identified associated factors for self-care practice of podoconiosis patient.Conclusion: In this study, the self-care practice of podoconiosis patients was not well practiced. Socio-demographic factors are identified as associated factors for self-care practice. Strengthening health education and behavioral changes are required to improve self-care practice.Keywords: podoconiosis, self-care, practice, adults, Ethiopia

Background. Diarrheal diseases are the major cause of morbidity and mortality among under-five children in low- and middle-income countries including Ethiopia. One of the national initiatives to reduce its burden is an implementation of an open-defecation-free program. However, information related to the comparison of diarrheal diseases among residents in open-defecation-free and non-open-defecation-free. Hence, this study assessed the magnitude of diarrheal diseases among residents in open-defecation-free and non-open-defecation-free areas of Farta District, North Central Ethiopia. Methods. A community-based comparative cross-sectional study was conducted among 758 households (378 in open-defecation-free and 380 in non-open-defecation-free kebeles) who have under-five children using a structured questionnaire. A systematic sampling technique was used to select study participants. Binary logistic regression was used to analyze factors associated with diarrheal diseases in the district. Results. Overall, 29.9% of children had diarrheal diseases in the last two weeks prior to the study. The magnitude of diarrheal diseases among under-five children living in open-defecation-free and non-open-defecation-free residents was 19.3% and 40.5%, respectively. Lack of functional handwashing facilities (AOR: 11, 95% CI (8.1–29.6)), improper excreta disposal (AOR: 3.84, 95% CI (2.15–5.65)), and residing in non-open-defecation-free areas (AOR: 2.4, 95% CI (1.72–3.23)) were factors associated with diarrheal diseases. Conclusions. The prevalence of diarrhea among children residing in open-defecation-free areas was lower than that among children those who resided in non-open-defecation-free areas. Lack of functional handwashing facilities, residing in non-open-defecation-free areas, and improper excreta disposal were significantly associated with diarrheal diseases in the district. Strengthening health promotion on non-open defecation, maintaining functional handwashing facilities, and preparing additional handwashing facilities are necessary. Continuous engagement of the community health extension workers is recommended, sustaining the implementation of open-defecation-free programs in the district.

Background Human Immunodeficiency Virus (HIV) is infection which mainly attacks immune system of an individual. Its disease progress is rapid in children and if treatment is not initiated nearly half of infected children will die by the second year of infection. In Ethiopia, nearly twenty four percent of HIV related death is happen to under-five children; however studies done in this specific age group are limited are with poor evidence of predictors. Objectives To determine time to death and identify predictors of death in HIV infected under- five children on antiretroviral therapy in Amhara regional state, Oromia ‘liyu’ zone, Northeast Ethiopia, from 2014 to 2019. Methods Institution based retrospective follow up study was conducted in 376 under-five HIV- infected children on antiretroviral therapy from January 2014 to December 2019 in health institutions in Oromia Liyu Zone, Amhara region, Ethiopia. Multivariable Cox-proportional hazard regression model was used to identify independent predictors of mortality in HIV- infected under-five children on antiretroviral therapy. Result At the end of follow up, 304 (80.85%) of HIV-infected children were alive, 39 (10.95%) were lost to follow up, 12 (3.19%) were transferred out and 21 (5.59%) were reported dead due to HIV/AIDS. The cumulative survival probabilities of children after 3, 6, 12, 24 and 36 months were 0.99, 0.98, 0.97, 0.89 and 0.87 respectively. The overall mean time to death was 19.7 months (95%CI = 18.74–20.67) with incidence of 5.9 deaths per 100 child-months (95%CI: 3.89–9.09). Children with severe malnutrition at baseline (AHR = 4.9; 95 CI: 1.04, 23.50), advanced WHO clinical stage at enrolment (AHR = 3.9; CI: 1.37, 10.88), poor adherence to ART (AHR = 6.56; CI: 3.33, 10.14) and with no history of Isoniazide prophylaxis were significantly associated to higher mortality events (AHR = 3.6; CI: 1.24, 10.18). Conclusion Death of HIV-infected under-five children on ART is high within the first one year after enrolment. The risk of death increased if the child was malnourished at beginning of treatment, had poor ART adherence, with advanced WHO clinical stages and lack of Isoniazide prophylaxis during their age of infancy.

Antiretroviral therapy lowers viral load only when people living with HIV maintain their treatment retention. Lost to follow-up is the persistent major challenge to the success of ART program in low-resource settings including Ethiopia. The purpose of this study is to estimate time to lost to follow-up and its predictors in antiretroviral therapies amongst adult patients. Among registered HIV patients, 542 samples were included. Data cleaning and analysis were done using Stata/SE version 14 software. In multivariable Cox regression, a p-value

BACKGROUND፡ Delays in seeking timely proper care pay a large number of deaths from diarrhea in children. Timely and appropriate health care seeking in under-five children with diarrhea reduces life-threatening complications. This study aimed to investigate determinants of delayed treatment-seeking for diarrheal diseases among mothers with under-five children.Method: In Debre Markos public health facilities, a facility-based case-control study was conducted among 412 mothers ((137 cases and 274 controls) from September 1 to October 15, 2020. Consecutive sampling was employed to select cases and controls. Data was collected using a semi-structured intervieweradministered questionnaire. Data were entered into Epi- Data version 4.2.1 and exported to STATA version 14 for analysis. Predictors with P-value

Background Cervical cancer is a leading cause of morbidity and mortality among women in Ethiopia, often due to late disease diagnosis. Early prevention of cancer has been shown to be the most effective measure against the disease. Scientific evidences indicate that lack of awareness towards cervical cancer is a barrier to prevention strategies. Therefore, the aim of the current research was to assess women’s knowledge and attitudes towards cervical cancer preventions in South Gondar zone. Methods A community-based cross-sectional study was carried out in South Gondar zone, Ethiopia. The study sample comprised 844 women ≥ 18 years of age. Participants were selected using systematic sampling technique. Binary and multivariable logistic models were used to assess predictors of women’s knowledge and attitude towards cervical cancer. Results About 66 % of the women had heard about cervical cancer. Regarding the main source of information of respondents, 75.4 % were heard from health professionals. Sixty two point 4 % of women knew at least one preventive measure and 82.6 % of participants knew at least one symptom or sign. Among study participants, 25 and 64 % had good knowledge, and favorable attitude towards cervical cancer prevention measures, respectively. Being reside in rural (AOR = 0.21, 95 %CI; 0.18, 0.34), not attending formal education (AOR = 0.50, 95 % CI: 0.3, 0.75), low income (AOR = 0.57, 95 % CI: 0.43, 0.81) and having Conclusions This study found the majority of the respondents had poor knowledge about cervical cancer prevention measures. The majority of the study participants had favorable attitudes regarding cervical cancer prevention. Living in rural areas, not attending formal education low income and having less than four children was negatively associated with respondents’ knowledge towards cervical cancer prevention measures. There is needed to scale up cervical cancer prevention measures and services .Further studies are needed using strong study design.

Background: Understanding how people perceive the risk of the coronavirus disease outbreak and its impact on undertaking protective behavior can guide the public health policymakers in taking the required measures to limit the magnitude of this outbreak.Objective: This study aimed to assess the knowledge, risk perceptions, and uptake of preventive measures towards COVID-19 in East Gojjam zone.Methods: A mixed method study in order to obtain in-depth behavioral insights related to COVID-19 pandemic prevention measures was conducted in the four randomly selected Woredas of East Gojjam Zone. A flexible data collection tool adapted from World Health Organization (WHO) for quantitative component, and in-depth interview for qualitative component was used. Binary logistic regression analysis was conducted to analyze quantitative data, and while content analysis was used for qualitative component.Results: In this study, a total of 661 study participants were included. Nearly two-third (65.5%) of respondents is residing in the rural area. Only 59.6% of respondents had better understanding of COVID-19 pandemic. Similarly, less-than one-fifth (14.5%) of individuals had favorable attitude towards COVID-19. This study showed that only one-fifth (20.9%) of study participants had good preventive practices. Respondent’s residing in urban area (AOR: 0.1, 95%CI: 0.08, 0.2), who had age between 35 and 45 (AOR: 0.4, 95%CI: 0.2, 0.8), and having secondary and above education level (AOR: 0.2, 95%CI: 0.1, 0.5) had better awareness towards COVID-19 as compared to its counterparts. Similarly, study participants who had better knowledge ((AOR: 3.0, 95%CI: 1.7, 5.5), and residing in urban area had favorable attitude towards COVID-19. Furthermore, respondents with confirmed comorbidity had good preventive practice towards COVID-19.Conclusion and recommendation: In this study, the level of knowledge, attitude and preventive practice towards COVID-19 is low. Residing in rural area, not having formal education, being housewife were factors significantly associated with the poor level of knowledge, attitude, and preventive practice towards COVID-19. Address peoples living in rural area through health professional to create public awareness towards COVID-19 is recommended.

Introduction:tobacco is the only legal drug that kills many of its users when used exactly as intended by the manufacturers. It is estimated that of the 1.1 billion smokers worldwide, nearly 80% of them live in low and middle-income countries. This trend increases in college and university students with most smokers starting to smoke during adolescent. The aim of this study is to assess cigarette smoking prevalence and associated factors among a select group of college of teachers´ education students. Methods:a cross-sectional study was conducted. Multistage sampling was used to select 605 study participants from across the eight departments of the Injibara College of Teachers´ Education. Each subject was selected by simple random sampling technique after proportional allocation to each class. EpiData version 4.2 was used for data entry and Stata version 14 was used for data cleaning and analysis. Variables with p-value < 0.2 in bi-variable analysis were selected for multi-variable analysis. Adjusted odds ratio (AOR) with 95% confidence interval (CI) was reported to show the strength of association. Results:the current prevalence of cigarette smoking is 6.8% amongst the Injibara College of Teachers´ Education students. Males [AOR: 2.84 (95% CI: 1.13, 7.14)], divorced marital status [AOR: 7.27 (95% CI: 1.23, 42.85)], food source in hostel [AOR: 11.62 (95% CI 3.23, 41.71)] and exposure to family/other smokers [AOR: 6.17 (95% CI: 2.17, 16.06)] were statistically significant factors for cigarette smoking. Conclusion:the prevalence of cigarette smoking was relatively low. Male, marital status, source of food, and exposure to family/other smokers were identified associated factors. Policy makers and health regulatory body are strongly encouraged to consider this evidence and the associated factors for smoking in their efforts to develop and implement tobacco control laws.

Objective Hand washing with soap and water is the single most weapon against infectious agents. Proper hand washing is not only reduces nosocomial infection, but also prevents the spread of current global concern Novel Corona viruses (COVID-19) and other viral illnesses like cold and flu. Therefore, the aim of this study is to assess hand washing practice among health care workers in Ethiopia. Methods In the current meta-analysis, the target variables search from different databases, like Google Scholar, African Journals OnLine, PubMed, and Scopus. All necessary data extracted by using a standardized data extraction format. Heterogeneity across the studies was evaluated using the I2 index and Cochran's Q test. A random effect model computes to estimate the pooled proportion of hand washing practice among health care workers. Results In this meta-analysis, we included fifteen observational studies summarize the proportional of hand washing practice among health care workers. In the current study, the pooled hand washing practices among Ethiopian was 57.87% (95% CI: 44.14–71.61). Subgroup analysis conduct to identifying the sources of heterogeneity. Conclusion The overall pooled proportion of hand washing practice among health care workers was low. Hand washing with water and soap is recommended at least for 20 s to prevent contagious disease like Corona viruses., Health care workers; Hand washing practice; Meta-analysis; Ethiopia

Background:Meningitis remains a major cause of mortality and morbidity in patients in many countries of the world including Ethiopia. This study aimed to assess clinical outcomes and associated risk factors of meningitis among children who were admitted to Debre Markos Referral Hospital from January 2017 to December 2018.A backward stepwise multivariable logistic regression was applied with 95% confidence interval of odds ratio (OR) andstatistical significance less than 0.05 p-value were taken as cut off value.Methods:A retrospective cross-sectional study was conducted. The study includesAll pediatric meningitis 211 cases from the age of one month to fourteen who were admitted due to meningitis in Debre Markos Referral Hospitalfrom January 2017 to December 2018.Data were entered, cleaned, and analyzed using SPSS for Windows, version 20.Results:The study showed that 18.9% of children with meningitis developed bad outcomes. In this study, children who were a worse clinical condition at admission 6 times more likely to develop bad outcomes [AOR= 6.321(2.121, 18.837)] and having a seizure at admission almost 19 times more likely to develop bad outcomes [AOR=18.953(6.677, 53.799)]. Conclusions:About one in five children with meningitis developed bad outcomes. The health care team should due attention to improving care for patients with severe conditions at admission and seizures were the alarming signs for poor outcomes in children.

Background Dental caries is the most common dental health problem caused by the interaction of bacteria on tooth enamel. Risk factors for dental caries include salivary composition and inadequate fluoride. However, other factors, such as standard of living, behavior, hygiene, eating habits, social status and socio-demographic factors, also contribute to the evolution of caries. Therefore, this study aimed to determine the prevalence of dental caries and associated factors among patients attending the dental clinic in Debre Tabor General Hospital in North West Ethiopia. Method An institution based cross-sectional study was conducted among 280 systematically selected patients attending Debre Tabor General Hospital dental clinic from May 8–20, 2017. The data were collected using pre-tested questionnaire and oral examination by a qualified dental professional. Basic hygienic procedures were observed during an oral examination. The teeth were examined for dental caries by the presence of decay, missing and filled teeth. The data were entered into Epi-Info version 3.5 and cleaned and analyzed using SPSS version 20. Descriptive summary of the data and logistic regression were used to identify possible predictors using odds ratio with 95% confidence interval and P-value of 0.05. Results A total of 280 subjects participated in the study; among whom 129 (46.1%) were female and nearly two-thirds of the respondents 208 (74.3%) attended formal education. The study revealed k8that the overall prevalence of dental caries was 78.2%. Dental caries was lower among respondents who had good oral hygiene status (AOR = 0.05, 95% CI, 0.02, 0.81). Dental caries was higher among participants who earned less than 5000 Eth Birr per month (AOR = 8.43, 95% CI, 2.6, 27.2). Dental caries was lower among respondents who had good knowledge (AOR = 0.51, 95% CI, 0.03, 0.64). Conclusions Prevalence of dental caries was high and found public health problem. Socioeconomic status, educational level, and poor oral hygiene practices were associated factors for dental caries. Health promotion about oral hygiene and integration of services are supremely important for the prevention of the problem of dental caries.

Background: Studies in a number of countries have shown that wherever inappropraite waste disposal morbidity and mortality rates are high. Although latrine coverage is an important indicator for measuring success of the health service program; data on latrine coverage scarce in the study area. Objective: To investigate latrine coverage and associated factors in among households of Debretabor town, Amhara region, Ethiopia. Methods: A community based cross sectional study was conducted in Debretabor town from September 1-30, 2013. A total of 422 households were included in the study using systematic sampling technique. Data were collected using structured questionnaire and analyzed using SPSS version 16.0. Degree of association between independent and dependent variables was assessed with a 95% confidence level and p-value less than 0.05 was used to detect statistical significance. Result: In this study. Ninety three point five percent of households have latrine. Graduated as model family was predictor for availability of latrine (AOR= 3.18,). Income and house ownership were also found to be predictors for availability of latrine (AOR=3.70), (AOR=8.46), respectively. Educational status of respondents was found to be predictors for availability of latrine (AOR= 2.65). Conclusion: latrine coverage was relatively lower from the national target of 100%, still there are households that use open defication. Educational status, house owner shipe, income and graduated as model family were main factors affecting latrine availability. Improving socio economic status of households, provision of continuous advice and technical support at household level on the availability of latrine are recommended.

This study was conducted to determine the knowledge and practice of pregnant women attending specialist antenatal clinics (ANCs) concerning malaria, ITN (insecticide-treated net) utilization and antimalarial treatment. The study recruited 225 women who voluntarily presented at ANCs in Jimma town, Ethiopia. A pre-tested questionnaire was administered. A great majority (98.2%; 221/225) of the respondents were aware of malaria. Among them, 77.4% (174/225) indicated mosquito bites as a mode of malaria transmission. Overall, 94.3% (212/225) and 98.3% (221/225) of pregnant women had knowledge about ITNs and antimalarials, respectively. Overall, 76.8% (173/225) and 57.4% (129/225) of the study participants erroneously indicated mosquito bites and stagnant water as causes of malaria, respectively. In general, the majority of pregnant women were unable to distinguish between malaria transmission and cause. Chi-square analysis revealed a strong association between the educational status of the pregnant women and their daily usage of ITNs (P = 0.001; χ2 = 22.9; df = 8). The results clearly suggest that although the majority of the pregnant women had ample awareness of malaria, ITN usage and antimalarial treatment, a sizable faction still had misconceptions and misunderstandings. Therefore, appropriate communication strategies should be designed and implemented among the marginalized and most vulnerable section of society, especially through health education campaigns, in order to have a constructive outcome in the near future.

Introduction: Oral health is significantly related to oral hygiene behaviors and their knowledge. Poor oral hygiene can have a profound effect on the quality of life. Oral hygiene practices are those measures taken to ensure that the mouth is clean. Oral hygiene practices are essential for the prevention of dental and other associated systemic diseases. The aim of this study is to determine the level of knowledge, attitude, and oral hygiene practices among secondary school students in Debre Tabor town, Amhara region, North Central Ethiopia 2018. Materials and Methods: An institution-based cross-sectional study was conducted among 422 systematically selected students using stratified random sampling technique from January 20 to 30, 2018. Data were collected using a pretested questionnaire on 422 selected students in three secondary schools found in Debre Tabor town. Variables collected included the frequency of brushing teeth and the use of toothpaste, knowledge of plaque, and students' perception of the importance of oral hygiene practices. The data were entered into Epi-Info version 3.5 and cleaned and analyzed using SPSS version 20. Results: A total of 422 patients participated in the study; among whom 216 (51.2%) were female students. The study revealed that 253 (60%) of the respondents had good knowledge with regard to oral hygiene, more than half 281 (66.6%) of the students had positive attitude toward oral hygiene, but their oral hygiene practices were still low that 260 (61.6%) of the students had poor oral hygiene practice. Conclusions: The study showed that more than half of the respondents had good knowledge and positive attitude toward oral hygiene to maintain proper oral health, but their practices toward oral hygiene were remain poor. The majority of students were aware that teachers and parents had not an important role to play in their oral hygiene. Establishment of oral health education programs in the school curriculum that will help a life-long oral hygiene practice in the school environment and at large in the community with the support of teachers and parents are crucial.

Background The estimated HIV prevalence among pregnant women in Ethiopia is 1.2 percent and unfortunately one of every 3 children born to these women gets infected with HIV. Elimination of these mother-to-child transmissions (MTCT) of HIV is possible through HIV testing during pregnancy and taking antiretroviral medications. However, only 24 percent of the pregnant women living with HIV have yet received the medication needed to prevent the transmission of HIV. Hence, there exists a concern that the rate of HIV infection among infants born to HIV positive mothers is increasing. This study assessed the prevalence of HIV infection and associated factors among infants born to women living with HIV, in South Gondar zone, Amhara region, Ethiopia. Methods Facility based document review was conducted upon 434 charts. The study participants were HIV exposed infants enrolled from January to December 2012. The data were reviewed from all the 17 health facilities which were providing PMTCT services in the zone. The study included 434 HIV exposed infants having an HIV Deoxyribonucleic Acid (DNA) Polymerase Chain Reaction (PCR) test result. The data were collected using structured data extraction tool. Binary logistic regression analysis was employed to assess the putative association of independent variables with the outcome variable. Significance was taken at a P value

Back ground: Studies in a number of countries have shown that wherever indiscriminate waste disposal is high, infant and child mortality rates are high. Although utilization of environmental health services is an important indicator for measuring success of the health extension program; data on environmental health services of urban health extension program are scarce in the study area and elsewhere in Ethiopia. Objective: To assess utilization of environmental health services of urban health extension program and associated factors in Debretabor town, Amhara region, Ethiopia. Methods: A community based cross sectional study was conducted in Debretabor town from September 1-30, 2013. A total of 422 households were included in the study using systematic sampling technique. Data were collected using structured questionnaire and analyzed using SPSS version 16.0. Degree of association between independent and dependent variables was assessed with a 95% confidence level and p-value less than 0.05 was used to detect statistical significance. The findings of quantitative data were triangulated with the qualitative one. Result: In this study 69.8% and 65.5% of households practiced proper solid and liquid waste management mechanisms respectively. Income was found to be predictors for liquid waste management (AOR=1.82) Educational status of respondents was found to be predictors for liquid waste management (AOR=1.83). Conclusion: Solid and liquid waste management practices were lower than the minimum 75% expectation of the national health extension program package and, Educational status, house ownership, income and graduated as model family were main factors affecting environmental health services. Improving socio economic status of households, provision of continuous advice and technical support at household level on the utilization of environmental health service are recommended.