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Predictors of time-to-recovery from severe acute malnutrition treated in an outpatient treatment program in health posts of Arba Minch Zuria Woreda, Gamo zone, Southern Ethiopia: A retrospective cohort study.

ABSTRACT: BACKGROUND:Access to outpatient therapeutic feeding programs for all children who had uncomplicated severe acute malnutrition (SAM) in need is a global health priority. In Ethiopia SAM is treated in hospitals, health centers and health posts. Health extension workers (HEWs) manage SAM that is uncomplicated at the health posts through the outpatient therapeutic feeding programs (OTP). Identifying predictors that predict time-to-recovery of children on OTP is thus vital to optimizing therapeutic success. However, the factors affecting children's' recovery time at this peripheral health institutions were not well documented. Therefore, this study aimed to identify predictors of time-to-recovery from SAM among children treated at an OTP in health posts of Arba Minch Zuria woreda, Gamo Zone, Southern Ethiopia. METHODS:A retrospective cohort study was conducted on 402 children enrolled in an OTP in the health posts of Arba Minch Zuria woreda based on data abstracted from their medical records. The study children were selected using systematic random sampling method using a list of their medical record numbers. Both descriptive and analytic analyses were performed. Median time of recovery was estimated by using the Kaplan-Meier survival curve. Furthermore, bivariate and multivariable Cox proportional hazard regression analyses were used to identify factors significantly associated with outcome variable. RESULT:The median time-to-recovery from severe acute malnutrition among children was 49 days (Interquartile range [IQR]: 42-56). Among the participants, 70.40% with 95% CI: (74.2-85.0%) recovered from severe acute malnutrition. The Cox-proportional hazard analysis showed that children's age at admission (Adjusted hazards ratio [AHR] = 3.15; 95% confidence interval [CI]: 1.85, 5.03), diagnosis with edema (AHR = 1.75, 95%CI: (1.27, 2.43), co-morbidity of diarrhea (AHR = 0.22, 95% CI(0.13, 0.39), and anemia (AHR = 0.64, 95% CI:(0.42, 0.98) were found to be predictors of time to recovery from SAM. CONCLUSIONS:The median time-to-recovery at the health posts in this study was in the accepted time period for the maximum Ethiopian standard protocol set for the management of SAM. However, the nutritional recovery rate was lower than the minimum acceptable threshold for the Sphere International Standards. Therefore, early screening of co-morbidity like diarrhea, anemia and edemaand timely intervention would increase the chance of recovery of children.

SUBMITTER: Gebremedhin K

PROVIDER: S-EPMC7326160 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Predictors of time-to-recovery from severe acute malnutrition treated in an outpatient treatment program in health posts of Arba Minch Zuria Woreda, Gamo zone, Southern Ethiopia: A retrospective cohort study.

Gebremedhin Kidane K Ayele Gistane G Boti Negussie N Andarge Eshetu E Fikadu Teshale T

PloS one 20200630 6

<h4>Background</h4>Access to outpatient therapeutic feeding programs for all children who had uncomplicated severe acute malnutrition (SAM) in need is a global health priority. In Ethiopia SAM is treated in hospitals, health centers and health posts. Health extension workers (HEWs) manage SAM that is uncomplicated at the health posts through the outpatient therapeutic feeding programs (OTP). Identifying predictors that predict time-to-recovery of children on OTP is thus vital to optimizing thera ...[more]

PMID: 32603366

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Project description:BACKGROUND:Completion along continuum of care for maternal and newborn health (MNH) services like antenatal care, skilled birth attendance and postnatal care services is advantageous over each segment of services. It is one of the currently recommended strategies to reduce both maternal and neonatal mortality and achieve the global target of ending preventable maternal and under-five children's mortality. Although studies on factors affecting each segment of MNH services have been well documented in Ethiopia, there is a dearth of evidence about the level of continuum of care and factors associated with it. This study was intended to fill this gap in evidence in the study area so that interventions could be taken to improve maternal and newborn health. METHODS:A community-basedcross-sectional study was conducted among 432 postnatal women who gave birth in the previous year in Arba Minch Health and Demographic Surveillance System (HDSS) site. Women were selected by computer generated random numbers from a list of women who stayed at least 6 weeks after birth. A pre-tested, structured, and interviewer-administered questionnaire was used for data collection. Data were entered and coded in Epi-data and analyzed using SPSS software version 23. Binary logistic regression model was fitted to identify factors associated with the dependent variable. Bivariate and multivariable analyses were fitted in steps to select candidate variables for multivariable analysis and to control for potential confounding effect respectively. RESULTS:The overall completion along the continuum of care was 42(9.7%). The factors significantly associated with completion of care along the continuumwere timely initiation of antenatalcare (before16weeks) [AOR: 10.7, CI (5.1, 22.7], birth preparedness and complication readiness [AOR: 2.9, CI (1.4, 6.1), pre-pregnancy contraception utilization [AOR: 3.9, CI: 1.4, 11.0], being employed [AOR: 2.6 CI:(1.3, 5.4)], and having a planned pregnancy [AOR:3.5 CI: (1.1, 11.4)]. CONCLUSION AND RECOMMENDATION:Completion along the continuum of care for MNH services was low in the study area. Thus, efforts to improve the completion of care should focus on interventions that enhance early initiation of antenatal care, planned pregnancy, and birth preparedness and complication readiness.

Project description:Background:Mental health disorders have identified as being one of the public health issues throughout the world. Recent evidence reveals that more than 21 million people diagnosed with schizophrenia. However, there is little information about community perception and attitude towards people with Schizophrenia in Ethiopia. Objective:The aim of this study was to assess the community perception and attitude towards people with Schizophrenia among residents of Arba Minch Zuria Districts, Southern Ethiopia. Methods:A community-based cross-sectional study was conducted among 617 randomly selected adults. Interviewer-administered standard tool was used to collect the data. Descriptive statistics like frequency, mean, and median computed. A binary logistic regression model used to identify factors affecting community perception and attitude towards people with schizophrenia. Results:Of the study population, 469 (76%) of respondents had good perception and 390 (63.2%) had positive attitudes towards people with schizophrenia. The study participants identified talkativeness and self-neglect behaviors as the most common manifestations of schizophrenia. Besides, this study identified substance misuse and head injury as the perceived cause and spiritual or traditional methods as a preferred treatment for people with schizophrenia. Moreover, the study participants preferred spiritual or traditional methods for the treatment of schizophrenia. Young age [AOR=2.03, 95% CI: 1.21, 3.40], females [AOR=2.32, 95% CI: 1.58, 3.41], good perception towards people with schizophrenia [AOR=4.95, 95% CI: 3.25, 7.54] and no formal educational status [AOR=2.75, 95% CI: 1.33, 5.70], and primary education [AOR=3.72, 95% CI: 1.87, 7.39] were significantly associated with the attitude towards people with schizophrenia. Conclusion:The findings of this study indicate that approximately one-third of the residents had unfavorable attitudes towards people with schizophrenia. Therefore, giving special attention to male, elders and those who were educated, and individuals who have poor perceptions of people with schizophrenia is crucial.

Project description:BACKGROUND:Intestinal parasitic infection is one of the parasitic infections affecting people living in prison. Helminths and intestinal protozoan infections are the most common parasitic infection that may cause serious life-threatening diseases in inmates living in developing countries. This study was aimed to investigate the prevalence and associated factors of intestinal parasitic infections (IPIs) among inmates living in Arba Minch prison, southern Ethiopia. METHODS:Institutional based cross sectional study was conducted on Arba Minch inmates, southern Ethiopian. Pre-tested semi-structured questionnaire was used to gather the data of socio-demographic characteristics, hygiene status of the prisoners, sanitation condition of the prison, and associated factors for IPIs by face to face interview. Direct wet-mount examination and formol-ether sedimentation techniques were used to examine intestinal parasitic infection from stool specimens. Binary logistic regression analysis was used to see the association between different variables and the IPI. Odds ratio with 95% CI was computed to determine the presence association and strength of the associated factors. RESULT:A total of 320 prisoners were participated in this study. Of these, 154(48.1%) of them were infected with one or more intestinal parasites. Eight different intestinal parasites species were identified and Giardia lamblia was the predominant parasite. Among infected inmates, nearly one out of four of them had multiple parasitic infections dominated by Giardia lamblia and E. histolytica/dispar co-infection. Sleeping in group [AOR = 1.9; 95% CI: (1.0-3.8)], married prisoners [AOR = 1.8; 95% CI: (1.1-2.9)], and hand washing habits after handling soil [AOR = 2.4; 95% CI: (1.0-5.6)] were independently associated with IPI. CONCLUSION:High prevalence of intestinal parasitic infection was detected in Arba Minch inmates, southern Ethiopian. Absence of hand washing, marital status, and way of sleeping were the factors associated with the IPI. Implementation of mass drug administration, education on water, sanitation and hygiene (WASH) and periodic screening of intestinal parasitic infection is very important to reduce the high prevalence IPIs in prison.

Project description:BackgroundDepression is a common mental disorder. The burden of antenatal depression is higher in developing countries which is 20% as compared to developed ones 10% to 15%. In Ethiopia around one-fifth of pregnant mothers are depressed. Despite the severity of the problem, only a few studies have been done in Ethiopia, and there is no study done in Arba Minch on the problem.ObjectiveTo assess the magnitude and associated factors of antenatal depressive symptoms among pregnant women attending Public Health facilities in Arba Minch town Southern Nations and Nationalities Peoples Region, Ethiopia 2018.MethodsHealth Institution based, cross-sectional study design was used to assess the magnitude and associated factors of antenatal depression among 323 pregnant mothers who came for antenatal care follow-up in all public health facilities in Arba Minch town. The systematic random sampling technique was applied. Interviewer administered, pretested structured Questionnaire containing Edinburgh postpartum depression scale was utilized. EPI INFO was used to enter data and then the data were analyzed by logistic regression using SPSS. Variables with P-value less than 0.2 in the bivariate logistic regression were inserted in for multivariable analysis to see their independent effect and those with P-value less than 0.05 were used to determine the significant association between dependent and independent variables.ResultThe magnitude of antenatal depression was 35.4%. Variables that were significantly associated with antenatal depression on multivariate analysis were anxiety (AOR = 5.49, 95%CI: 2.56, 11.77), un-planned pregnancy (AOR = 2.71, 95%CI: 1.21, 6.07), and Primigravida (AOR = 2.96, 95%CI: 1.28, 6.8). Similarly, uneducated mothers and those who attend only elementary school had AOR 4.92, 95% CI 1.36,17.73 and AOR 4.04955CI 1.23, 13.39 respectively.ConclusionThe magnitude of antenatal depression, intimate partner violence, and threatening life event in Arba Minch town was high. Anxiety, unplanned pregnancy, educational status, and Primigravida were significantly associated factors with depression. There should be a mechanism for routine screening and management of antenatal depression and intimate partner violence during antenatal care follow-up.

Project description:BackgroundTrachomatous trichiasis is the leading infectious cause of blindness worldwide. The World Health Organization recommends eyelid surgery to reduce the risk of visual impairment from trichiasis. Unfortunately, the number of cases operated has grown less than expected. An understanding of barriers is fundamental for instituting measures to increase surgical uptake. Therefore, the aim of this study was to explore barriers of TT surgery implementation.MethodsA qualitative study design was employed in December 2019. Purposive sampling technique was used to select three districts from Gamo zone, Southern Ethiopia. We conducted 9 FGDs and 12 in-depth interviews. Data was collected by audio tape recorder in Amharic and Gamogna languages and then transcribed to English language. The recorded interviews and focus group discussions were transcribed to verbatim (written text) and thematic analysis was done manually and reported accordingly.Findingswe explored a number of barriers that hindered implementation of trichiasis surgery. The recurrence of trichiasis after surgery was the main challenges faced by operated individuals. The other barriers reported are negative perception towards trichiasis surgery, lack of logistic and supplies, transportation access problem for remote communities, inadequate trained health professional, less commitment from higher officials, lack of interest of integrated eye care workers due to incentive issues, believes of patients waiting supernatural power for healing service and carelessness of patients to undertake operation.Conclusion and recommendationPost-surgical trichiasis, lack of commitment from government officials and negative perception of patients towards the disease were considered as the reported barriers for implementation of trachomatous trichiasis. Closely supervising the integrated eye care workers would be the first task for district health offices to increase the uptake and improve the quality of service. Logistics and supplies should be made available and adequate to address all affected people in the community.

Project description:BACKGROUND:Ethiopia is one of the species-rich countries in the world and the center of origin with regard to the diversity of many plant species. Ethnobotanical studies are vital to investigate these diverse biological resources for medicinal purposes. The aim of this study was to document the indigenous knowledge of the Sidama people regarding the use of medicinal plants to treat human and livestock diseases in the Hawassa Zuria district of Southern Ethiopia. METHODS:A total of 150 informants (118 men and 32 women) were selected to collect ethnobotanical information from ten kebeles by means of a stratified purposive sampling method. Among the informants, 30 key informants were selected purposefully. Ethnobotanical data were collected through semi-structured interviews and group discussions and were analyzed by descriptive statistics, informant consensus factor (ICF), fidelity level (FL), and ranking methods. RESULTS:A total of 105 medicinal plants distributed across 52 families and 96 genera were collected. Fabaceae (11 species) was represented by the highest number of plant species, followed by Lamiaceae (7 species). Herbs (34%) were the dominant growth habits, followed by trees (33%). Leaves (56%) were the dominant plant part used in the preparation of remedies, followed by fruit (15%). The most common method of remedy preparation was grinding (39%) followed by chewing and boiling (11% each). Oral (74%) was the major routes of administration, followed by dermal (20%). There was a significant knowledge difference (p < 0.05) between social groups regarding the use of traditional medicinal plants. Insects and ectoparasites disease category (0.95) had higher informant consensus factor value followed by fever disease category (0.91). Eucalyptus globulus Labill. (100%) had a higher fidelity level to treat stomachache, followed by Ensete ventricosum (Welw.) Cheesman. (87.27%) to treat placenta delay. Ensete ventricosum (total score = 73) was ranked highest as the most preferable medicinal plant for various purposes by local people, followed by Olea welwitschii (Knobl.) Gilg (total score = 72). CONCLUSION:The present study revealed the existence of indigenous knowledge of medicinal plants to treat human and livestock ailments. However, agricultural expansion, firewood collection, environmental degradation, and deforestation are the main threats to medicinal plants. Therefore, there should be mentoring for the local people in the study area to conserve their indigenous knowledge resources and prevent the extinction of medicinal plants.

Dataset Information

Predictors of time-to-recovery from severe acute malnutrition treated in an outpatient treatment program in health posts of Arba Minch Zuria Woreda, Gamo zone, Southern Ethiopia: A retrospective cohort study.

Publications

Predictors of time-to-recovery from severe acute malnutrition treated in an outpatient treatment program in health posts of Arba Minch Zuria Woreda, Gamo zone, Southern Ethiopia: A retrospective cohort study.

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