World Journal of Advance Healthcare Research, Apr 8, 2005
The objective of the study was to assess the magnitude and predictors of firstline antiretroviral... more The objective of the study was to assess the magnitude and predictors of firstline antiretroviral treatment failure among HIV-infected children. A retrospective cohort study was conducted between January 2006 and December 2015. All pediatric patients of <15 years old and who took at least 6 months of ART in Fiche and Kuyu hospitals of Oromia region, Ethiopia were included in the study. Collected data were entered and analyzed using SPSS version 20. Multivariable logistic regression was employed to identify predictors of treatment failure. Data of 269 children were analyzed and majority (53.9%) of the children were males with a mean age of 9.8 AE 3.64 years. Based on the two WHO criteria, overall ART failure was found to be 51 (18.8%), of which 33 (12.26%) had clinical and 18 (6.69%) had immunologic failures. The mean time to the detection of treatment failure was 41 AE 24.96 months. Children's age between 6 and 9 years (AOR = 0.26, 95% CI: 0.09, 0.72) was protective toward treatment failure, while lost to follow-up (AOR = 7.54, 95% CI: 2.35, 24.16), died (AOR = 22.22, 95% CI: 3.75, 131.54), transferred out (AOR = 3.34, 95% CI: 1.41, 7.87), suboptimal adherence to ART (AOR = 4.85, 95% CI: 1.82, 12.93), baseline CD4 count of <50 cells/mm 3 (AOR = 4.28, 95% CI: 3.49, 5.9), and WHO advanced clinical stage (AOR = 2.46, 95% CI: 1.14, 5.31) were found to be predictors of treatment failure. The study revealed that the treatment failure is high and the mean time to develop treatment failure is short. The predictors for treatment failure were suboptimal adherence, lost to follow-up, transferred out, initial CD4 count <50 cells/mm 3 , initial WHO stages 3 and 4. On the other hand, being in the age of 6-9 years is protective from developing treatment failure as compared to the other age category. Abbreviations AIDS, acquired immune deficiency syndrome; ART, antiretroviral treatment; ARV, antiretroviral; CD4, cluster of differentiation 4; CDC, Center for Disease Control and Prevention; DBS, dried blood spot; HIV, human immunodeficiency virus; IPT, isoniazid prophylaxis; OI, opportunistic infection; PMTCT, prevention of mother to child transmission; WHO, World Health Organization.
Background The public health approach to antiretroviral treatment management encourages the publi... more Background The public health approach to antiretroviral treatment management encourages the public private partnership in resource limited countries like Ethiopia. As a result, some private health facilities are accredited to provide antiretroviral treatment free services. Evidence on magnitude and predictors of treatment failure are crucial for timely actions. However, there are few studies in this regard.
Background: Ending preventable maternal mortality remains an unfinished agenda and one of the wor... more Background: Ending preventable maternal mortality remains an unfinished agenda and one of the world's most critical challenges. Skilled care at birth is one of the crucial strategies that help to prevent deaths that occur during delivery. Maternity waiting homes have been endorsed to facilitate access to skilled care during intra-partum and post-partum periods for women living in rural areas. However, the majority of pregnant mothers in Ethiopia do not use this service; hence, this study aimed to assess the predictors of intention to use maternity waiting home. Methods: A community-based cross-sectional study was conducted from March 15 to June 20, 2018 in Bench Maji Zone, Southwest Ethiopia. A multistage sampling technique was used. The data were collected by trained data collectors using a structured pre-tested questionnaire. Data were entered into the epi data manager version 4.0.2.101 and exported to SPSS version 21 for analysis. The correlation among constructs of the theory of planned behavior was estimated. A hierarchical linear regression was used to identify predictors of intention to use maternity waiting home, and α value of less than 5% was used as a level of significance. Results: A total of 829 women were interviewed. The mean age of respondents was 27.1 (±5.2) years. Thirty-nine percent of the respondents used maternity waiting home previously. The attitude (β =0.12, p<0.001), subjective norm (β =0.47, p<0.001), perceived behavioral control (β =0.42, p<0.001), and ANC use during current pregnancy (β =0.07, p=0.030) were predictors of intension to use maternity waiting homes. R square was calculated to be 81%. Conclusion: The intention to use maternity waiting homes was significantly associated with antenatal care use, attitude, subjective norm, and perceived behavioral control. Thus, multidimensional interventions are important to increase the intension to use MWH.
Journal of Resources Development and Management, 2015
Background: The third stage of labour includes the separation and detachment of the placenta from... more Background: The third stage of labour includes the separation and detachment of the placenta from the uterine wall, and ends with complete expulsion of the placenta and membrane. This period is the most hazardous stage for the birthing woman due to the risk of profuse hemorrhage. Severe bleeding is the most important cause of maternal deaths. Active management of third stage of labour effectively reduces the occurrence of hemorrhage. Objective: The objective of this study was to assess factors associated with Knowledge, Attitude, and Practice of Midwifes on active management of third stage of labour at selected health centers of Addis Ababa. Methods: Institution based cross sectional study was conducted among Midwives in health center of Addis Ababa. Convenience sampling was carried out to select 136 Midwives who were working in the 26 health center of Addis Ababa. The questionnaires contained closed ended questions which covered socio demographic information, knowledge, attitude an...
Cervical cancer is the leading cancer-related cause of death among women in Nigeria. An estimated... more Cervical cancer is the leading cancer-related cause of death among women in Nigeria. An estimated 70,700 new cases occur each year, representing one quarter of all female cancers in sub Saharan Africa. The magnitude of the problem has been under recognised and under prioritised compared with the competing health priorities of infectious diseases such as HIV/ AIDS, tuberculosis and malaria. Studies in the United States and Nigeria have indicated that the disease has the highest incidence among the lowest socioeconomic groups especially residing in rural areas. The peak age for the disease has been shown to be within 35-45 years age group. Knowledge of the risk factors of the disease is deemed important in its early detection and prevention. The objective of this study was to assess the knowledge, attitude and practice of rural women with cancer of the cervix. A cross sectional descriptive study was conducted among 1600 rural women aged 15-55 years (randomly selected from 28 villages) who were interviewed using a structured questionnaire between April and June, 2010. The majority (82.2%) were married before the age of 20 years and 19.3% before 15 years, 40% in polygamous union, 22.6% have had 2 or more sexual partners, 71.3% were primi and grand multiparous, 7.5% have had previous treatment for STIs and 10.1% were on various types of contraceptive. 454 (28.4%) have heard of Ca cervix, 358 (22.4%) knew the location of the cervix. 2.3% had Pap smear test of which 72.6% were within 2 years. The majority (89.9%) will avail themselves for screening.
Background: The third stage of labour includes the separation and detachment of the placenta from... more Background: The third stage of labour includes the separation and detachment of the placenta from the uterine wall, and ends with complete expulsion of the placenta and membrane. This period is the most hazardous stage for the birthing woman due to the risk of profuse hemorrhage. Severe bleeding is the most important cause of maternal deaths. Active management of third stage of labour effectively reduces the occurrence of hemorrhage. Objective: The objective of this study was to assess factors associated with Knowledge, Attitude, and Practice of Midwifes on active management of third stage of labour at selected health centers of Addis Ababa. Methods: Institution based cross sectional study was conducted among Midwives in health center of Addis Ababa. Convenience sampling was carried out to select 136 Midwives who were working in the 26 health center of Addis Ababa. The questionnaires contained closed ended questions which covered socio demographic information, knowledge, attitude and practice of midwives on active management of third stage of labour. These were prepared in English. After checking for completeness and consistency, data was coded and entered into Epi-info program and transported to SPSS version 17 for analysis. Logistic regression was used to determine factors associated with knowledge, attitude and practices. Data was presented by tables. Result: In multivariate regression length of service and practice were significantly associated with level of knowledge. Those who have length of service greater than 11 years were 2.5 times more likely to be knowledgeable on Active Management of Third Stage of Labour than their counterparts (AOR= 2.49, 95% CI= 1.04, 5.95). Those who practice Active Management of Third Stage of Labour were almost 4 times more likely to be knowledgeable on Active Management of Third Stage of Labour than their counterparts (AOR = 3.57 (1.73, 7.39). Educational level of the midwives was significantly associated to attitude. Those who have high educational level (degree) were more likely to have positive attitude on Active Management of Third Stage of Labour than diploma holders (AOR= 0.67, 95% CI= 0.005, 0.89). Those who have additional on job training on Active Management of Third Stage of Labour were 3 times more likely to practice Active Management of Third Stage of Labour than their counterparts (AOR = 3.13, 95% CI= 1.0, 9.8). Those who have high educational level (degree) were nine times skillful than diploma holders (AOR= 8.51, 95% CI= 2.02, 35.92). Furthermore those who have good level of knowledge have four times higher odds to have better practice than their counterparts (AOR= 4.64, 95% CI= 1.96, 10.95). Conclusion: Length of service was significantly associated with their knowledge towards AMTSL. Educational level was significantly associated with their attitude towards AMTSL. Educational level, on job training and level of knowledge were significantly associated with their practice on AMTSL. Therefore concerned bodies should give emphasis on education and training of midwives to improve knowledge attitude and practice of AMTSL.
World Journal of Advance Healthcare Research, Apr 8, 2005
The objective of the study was to assess the magnitude and predictors of firstline antiretroviral... more The objective of the study was to assess the magnitude and predictors of firstline antiretroviral treatment failure among HIV-infected children. A retrospective cohort study was conducted between January 2006 and December 2015. All pediatric patients of <15 years old and who took at least 6 months of ART in Fiche and Kuyu hospitals of Oromia region, Ethiopia were included in the study. Collected data were entered and analyzed using SPSS version 20. Multivariable logistic regression was employed to identify predictors of treatment failure. Data of 269 children were analyzed and majority (53.9%) of the children were males with a mean age of 9.8 AE 3.64 years. Based on the two WHO criteria, overall ART failure was found to be 51 (18.8%), of which 33 (12.26%) had clinical and 18 (6.69%) had immunologic failures. The mean time to the detection of treatment failure was 41 AE 24.96 months. Children's age between 6 and 9 years (AOR = 0.26, 95% CI: 0.09, 0.72) was protective toward treatment failure, while lost to follow-up (AOR = 7.54, 95% CI: 2.35, 24.16), died (AOR = 22.22, 95% CI: 3.75, 131.54), transferred out (AOR = 3.34, 95% CI: 1.41, 7.87), suboptimal adherence to ART (AOR = 4.85, 95% CI: 1.82, 12.93), baseline CD4 count of <50 cells/mm 3 (AOR = 4.28, 95% CI: 3.49, 5.9), and WHO advanced clinical stage (AOR = 2.46, 95% CI: 1.14, 5.31) were found to be predictors of treatment failure. The study revealed that the treatment failure is high and the mean time to develop treatment failure is short. The predictors for treatment failure were suboptimal adherence, lost to follow-up, transferred out, initial CD4 count <50 cells/mm 3 , initial WHO stages 3 and 4. On the other hand, being in the age of 6-9 years is protective from developing treatment failure as compared to the other age category. Abbreviations AIDS, acquired immune deficiency syndrome; ART, antiretroviral treatment; ARV, antiretroviral; CD4, cluster of differentiation 4; CDC, Center for Disease Control and Prevention; DBS, dried blood spot; HIV, human immunodeficiency virus; IPT, isoniazid prophylaxis; OI, opportunistic infection; PMTCT, prevention of mother to child transmission; WHO, World Health Organization.
Background The public health approach to antiretroviral treatment management encourages the publi... more Background The public health approach to antiretroviral treatment management encourages the public private partnership in resource limited countries like Ethiopia. As a result, some private health facilities are accredited to provide antiretroviral treatment free services. Evidence on magnitude and predictors of treatment failure are crucial for timely actions. However, there are few studies in this regard.
Background: Ending preventable maternal mortality remains an unfinished agenda and one of the wor... more Background: Ending preventable maternal mortality remains an unfinished agenda and one of the world's most critical challenges. Skilled care at birth is one of the crucial strategies that help to prevent deaths that occur during delivery. Maternity waiting homes have been endorsed to facilitate access to skilled care during intra-partum and post-partum periods for women living in rural areas. However, the majority of pregnant mothers in Ethiopia do not use this service; hence, this study aimed to assess the predictors of intention to use maternity waiting home. Methods: A community-based cross-sectional study was conducted from March 15 to June 20, 2018 in Bench Maji Zone, Southwest Ethiopia. A multistage sampling technique was used. The data were collected by trained data collectors using a structured pre-tested questionnaire. Data were entered into the epi data manager version 4.0.2.101 and exported to SPSS version 21 for analysis. The correlation among constructs of the theory of planned behavior was estimated. A hierarchical linear regression was used to identify predictors of intention to use maternity waiting home, and α value of less than 5% was used as a level of significance. Results: A total of 829 women were interviewed. The mean age of respondents was 27.1 (±5.2) years. Thirty-nine percent of the respondents used maternity waiting home previously. The attitude (β =0.12, p<0.001), subjective norm (β =0.47, p<0.001), perceived behavioral control (β =0.42, p<0.001), and ANC use during current pregnancy (β =0.07, p=0.030) were predictors of intension to use maternity waiting homes. R square was calculated to be 81%. Conclusion: The intention to use maternity waiting homes was significantly associated with antenatal care use, attitude, subjective norm, and perceived behavioral control. Thus, multidimensional interventions are important to increase the intension to use MWH.
Journal of Resources Development and Management, 2015
Background: The third stage of labour includes the separation and detachment of the placenta from... more Background: The third stage of labour includes the separation and detachment of the placenta from the uterine wall, and ends with complete expulsion of the placenta and membrane. This period is the most hazardous stage for the birthing woman due to the risk of profuse hemorrhage. Severe bleeding is the most important cause of maternal deaths. Active management of third stage of labour effectively reduces the occurrence of hemorrhage. Objective: The objective of this study was to assess factors associated with Knowledge, Attitude, and Practice of Midwifes on active management of third stage of labour at selected health centers of Addis Ababa. Methods: Institution based cross sectional study was conducted among Midwives in health center of Addis Ababa. Convenience sampling was carried out to select 136 Midwives who were working in the 26 health center of Addis Ababa. The questionnaires contained closed ended questions which covered socio demographic information, knowledge, attitude an...
Cervical cancer is the leading cancer-related cause of death among women in Nigeria. An estimated... more Cervical cancer is the leading cancer-related cause of death among women in Nigeria. An estimated 70,700 new cases occur each year, representing one quarter of all female cancers in sub Saharan Africa. The magnitude of the problem has been under recognised and under prioritised compared with the competing health priorities of infectious diseases such as HIV/ AIDS, tuberculosis and malaria. Studies in the United States and Nigeria have indicated that the disease has the highest incidence among the lowest socioeconomic groups especially residing in rural areas. The peak age for the disease has been shown to be within 35-45 years age group. Knowledge of the risk factors of the disease is deemed important in its early detection and prevention. The objective of this study was to assess the knowledge, attitude and practice of rural women with cancer of the cervix. A cross sectional descriptive study was conducted among 1600 rural women aged 15-55 years (randomly selected from 28 villages) who were interviewed using a structured questionnaire between April and June, 2010. The majority (82.2%) were married before the age of 20 years and 19.3% before 15 years, 40% in polygamous union, 22.6% have had 2 or more sexual partners, 71.3% were primi and grand multiparous, 7.5% have had previous treatment for STIs and 10.1% were on various types of contraceptive. 454 (28.4%) have heard of Ca cervix, 358 (22.4%) knew the location of the cervix. 2.3% had Pap smear test of which 72.6% were within 2 years. The majority (89.9%) will avail themselves for screening.
Background: The third stage of labour includes the separation and detachment of the placenta from... more Background: The third stage of labour includes the separation and detachment of the placenta from the uterine wall, and ends with complete expulsion of the placenta and membrane. This period is the most hazardous stage for the birthing woman due to the risk of profuse hemorrhage. Severe bleeding is the most important cause of maternal deaths. Active management of third stage of labour effectively reduces the occurrence of hemorrhage. Objective: The objective of this study was to assess factors associated with Knowledge, Attitude, and Practice of Midwifes on active management of third stage of labour at selected health centers of Addis Ababa. Methods: Institution based cross sectional study was conducted among Midwives in health center of Addis Ababa. Convenience sampling was carried out to select 136 Midwives who were working in the 26 health center of Addis Ababa. The questionnaires contained closed ended questions which covered socio demographic information, knowledge, attitude and practice of midwives on active management of third stage of labour. These were prepared in English. After checking for completeness and consistency, data was coded and entered into Epi-info program and transported to SPSS version 17 for analysis. Logistic regression was used to determine factors associated with knowledge, attitude and practices. Data was presented by tables. Result: In multivariate regression length of service and practice were significantly associated with level of knowledge. Those who have length of service greater than 11 years were 2.5 times more likely to be knowledgeable on Active Management of Third Stage of Labour than their counterparts (AOR= 2.49, 95% CI= 1.04, 5.95). Those who practice Active Management of Third Stage of Labour were almost 4 times more likely to be knowledgeable on Active Management of Third Stage of Labour than their counterparts (AOR = 3.57 (1.73, 7.39). Educational level of the midwives was significantly associated to attitude. Those who have high educational level (degree) were more likely to have positive attitude on Active Management of Third Stage of Labour than diploma holders (AOR= 0.67, 95% CI= 0.005, 0.89). Those who have additional on job training on Active Management of Third Stage of Labour were 3 times more likely to practice Active Management of Third Stage of Labour than their counterparts (AOR = 3.13, 95% CI= 1.0, 9.8). Those who have high educational level (degree) were nine times skillful than diploma holders (AOR= 8.51, 95% CI= 2.02, 35.92). Furthermore those who have good level of knowledge have four times higher odds to have better practice than their counterparts (AOR= 4.64, 95% CI= 1.96, 10.95). Conclusion: Length of service was significantly associated with their knowledge towards AMTSL. Educational level was significantly associated with their attitude towards AMTSL. Educational level, on job training and level of knowledge were significantly associated with their practice on AMTSL. Therefore concerned bodies should give emphasis on education and training of midwives to improve knowledge attitude and practice of AMTSL.
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