Showing papers by "Amanuel Alemu Abajobir published in 2020"

Long-term Cognitive, Psychological, and Health Outcomes Associated With Child Abuse and Neglect

Abstract: Potential long-lasting adverse effects of child maltreatment have been widely reported, although little is known about the distinctive long-term impact of differing types of maltreatment. Our objective for this special article is to integrate findings from the Mater-University of Queensland Study of Pregnancy, a longitudinal prenatal cohort study spanning 2 decades. We compare and contrast the associations of specific types of maltreatment with long-term cognitive, psychological, addiction, sexual health, and physical health outcomes assessed in up to 5200 offspring at 14 and/or 21 years of age. Overall, psychological maltreatment (emotional abuse and/or neglect) was associated with the greatest number of adverse outcomes in almost all areas of assessment. Sexual abuse was associated with early sexual debut and youth pregnancy, attention problems, posttraumatic stress disorder symptoms, and depression, although associations were not specific for sexual abuse. Physical abuse was associated with externalizing behavior problems, delinquency, and drug abuse. Neglect, but not emotional abuse, was associated with having multiple sexual partners, cannabis abuse and/or dependence, and experiencing visual hallucinations. Emotional abuse, but not neglect, revealed increased odds for psychosis, injecting-drug use, experiencing harassment later in life, pregnancy miscarriage, and reporting asthma symptoms. Significant cognitive delays and educational failure were seen for both abuse and neglect during adolescence and adulthood. In conclusion, child maltreatment, particularly emotional abuse and neglect, is associated with a wide range of long-term adverse health and developmental outcomes. A renewed focus on prevention and early intervention strategies, especially related to psychological maltreatment, will be required to address these challenges in the future.

Prevalence and associated factors of foot ulcer among diabetic patients in Ethiopia: a systematic review and meta-analysis

Abstract: Diabetes and its complications including foot ulcer constitute a global public health challenge attributing to a significant cause of morbidity and mortality. Foot ulcer is one of the long-term complication of diabetes mellitus which lead to infection and amputation of lower extremities. In Ethiopia, findings from few studies were inconsistent and there is a need to systematically pool existing data to determine the magnitude of foot ulcer in diabetics and factors contributing to it. We identified articles through electronic databases such as Medline, Hinari, Pub Med, Cochrane library, the Web of Science and Google Scholar. Accordingly, we identified 95 published and one unpublished article. Finally, eleven studies which fullfilled eligibility criteria were included in final systematic review and meta-analysis. Data were extracted using a standardized data extraction checklist and the analyses were conducted using STATA version 14. The Cochrane Q test statistic and I2 tests were used to assess heterogeneity. The overall magnitude of foot ulcer was 12.98% (95%CI: 7.81–18.15) in diabetic patients in Ethiopia. Sub-group analyses revealed highest prevalence in Addis Ababa (19.31% (95%CI: 2.7. 41.37)). Foot ulcer was significantly associated with rural residence (OR = 2.72, 95%, CI: 1.84–4.01)), presence of callus on the feet ((OR = 12.67, 95%, CI: 6.47–24.79)), a body mass index of ≥24.5 ((OR = 2.68, 95%, CI: 1.58–4.56)), poor self- care practice ((OR = 1.47, 95%CI: 1.25–1.73)), type I diabetes mellitus ((OR = 0.42, 95%, CI: 0.22–0.79)), staying with DM for < 10 years ((OR = 0.23, 95%, CI: 0.11–0.50)), and age < 45 years ((OR = 0.44, 95%, CI: 0.21–0.92)). The prevalence of diabetic foot ulcers in Ethiopia is relatively low, although its trend is increasing from time to time. Socio-demographic factors, body weight, and healthcare practice contribute to the development of diabetic foot ulcers. Appropriate interventions towards patient self-care practice, lifestyle modification and follow-up are wanted to prevent diabetic foot ulcers.

Prevalence of Violence Against Women in Ethiopia: A Meta-Analysis

Abstract: Violence against women (VAW) is a major public health problem globally, particularly in developing countries including Ethiopia. Accordingly, sustainable development goal (SDG) 5 (by United Nation) prioritizes VAW and calls for the design and implementation of programs relevant to its elimination by 2030. However, little is known about the epidemiology of VAW as all estimates from few, cross-sectional studies so far are inconsistent and inconclusive. This study, therefore, was conducted to determine the pooled national prevalence of VAW in Ethiopia. Databases including PUBMED, MEDLINE, Cochrane review, CINAHL, African Journals Online, and Google Scholar were reviewed, using relevant search engines. The meta-analysis was conducted using STATA 14 software, and forest plots were used to present the pooled estimates of VAW. The Cochran Q, I2 statistics, and Egger's test were used to test heterogeneity and publication bias of the included studies. A total of 36 published articles, 23,782 participants, were included in the meta-analysis. The overall pooled lifetime and the past 12 months VAW prevalence was 46.93% (95% confidence interval [CI] = [39.96, 54.00]) and 37.02% (95% CI [26.47, 47.56]), respectively. The pooled lifetime physical, sexual, and psychological violence were 38.15%, 39.33%, and 39.51%, respectively. Pooled lifetime prevalence of rape was 13.02%. Overall, nearly half of Ethiopian women experience lifetime VAW, with substantial levels of physical, sexual, or psychological violence. The country should work toward enhancing gender equality, coupled with addressing risk factors at multiple levels, using community- and institution-based approaches to prevent VAW and to specifically achieve SDG5 of eliminating VAW by 2030.

Why Too Soon? Early Initiation of Sexual Intercourse Among Adolescent Females in Ethiopia: Evidence from 2016 Ethiopian Demographic and Health Survey.

Abstract: Background Early sexual initiation - sexual activity that begun earlier than 18 years of age - is among risky sexual behaviors which may be associated with increased risks of adverse outcomes such as sexually transmitted infections (STIs), unwanted pregnancy and unsafe abortions. However, there is no nationally representative evidence on early initiation of sexual intercourse and its determinant factors among adolescent females in Ethiopia. Methods Data were extracted from the 2016 Ethiopian Demographic and Health Survey (EDHS) to assess early initiation of sexual intercourse and factors contributing to it in adolescent females. The analysis included a weighted sample of 3881 adolescent females aged 15-19 years. A multivariable logistic regression analysis was conducted and the results were presented as adjusted odds ratio (AOR) at 95% confidence interval (CI), declaring statistical significance at a p-value <0.05 in all analyses. Results About 1 in 5 (21.9%, 95% CI: 20.5%, 23.33%) adolescent females experienced early sexual debut. Administrative regions (Amhara, AOR = 2.3, 95% CI: 1.30, 4.09 and Gambella, AOR = 4.89, CI 95%: 1.08, 22.07), religion (Muslim, AOR = 1.76, 95% CI: 1.24, 2.49), substance use (e.g., ever chewed khat, AOR = 2.02, 95% CI: 1.47, 2.77, ever drunk alcohol, AOR = 1.83, 95% CI: 1.35, 2.48) and having no knowledge on family planning (AOR = 4.47, 95% CI: 2.22, 8.99) were found to have statistically significant association with early sexual debut in adolescent females. Whereas any levels of formal education decreased the odds of early sexual debut (primary, AOR = 0.44, 95% CI: 0.35, 0.56; secondary, AOR = 0.19, 95% CI: 0.13, 0.28, and higher, AOR= 0.31, 95% CI: 0.15, 0.63). Similarly, all categories of wealth indices as compared to the poorest were protective of early sexual initiation in adolescent females (AOR = 0.40-0.57) as was for education as compared to no education (AOR = 0.19-0.44). Conclusion A significant proportion of adolescent females initiate early sexual intercourse in Ethiopia and multifaceted factors appear to determine their early sexual experiences. Contextualized interventions including strengthening information, education and communication on adverse consequences of early sexual initiation in regions and improving contraceptive knowledge of teenagers will play a paramount role.

Married Women's Decision-Making Power in Family Planning Use and its Determinants in Basoliben, Northwest Ethiopia.

Abstract: Background Women's decision-making power influences the use of family planning It is one of the denied fundamental rights of women, particularly in developing countries Objective This study was aimed to assess married women's decision-making power in the use of family planning and its associated factors among married reproductive age women in Basoliben, Amhara, Ethiopia, 2018 Methods A community-based cross-sectional study was conducted among married reproductive age women from March 1 to 30, 2018 A multistage simple random sampling technique was employed in selecting study participants Data were collected using structured questionnaires and analyzed through SPSS 20 software The binary and multiple variable logistic regression models were fitted to identify factors associated with women's decision-making power on family planning use Statistical significance was declared at p-value less than 005 Results A total of 734 married women aged 18-49 years are making a 98% response rate included in this study The level of married women's decision-making power in family planning among married women was 80%; 95% CI (769, 828) Monthly income (AOR=22; 95% CI: 11, 42), husband's desired number of children of <3 (AOR=99; 95% CI: 36), husband's desired time for additional child after 3 years postbirth (AOR=40; 95% CI: 19, 85) and women's information on any contraceptive (AOR=96; 95% CI: 24, 390) were factors significantly associated with married women's decision-making power in family planning Conclusion Married women's decision-making power in family planning use was optimal Household monthly income, husband's desired ideal number of children, husband's desired time when to have another child and information about any contraceptive methods were predictors of their decision-making power on family planning use There should be awareness creation of family planning methods to increase its utilization

Incidence and predictors of lost to follow-up among women under Option B+ PMTCT program in western Ethiopia: a retrospective follow-up study

Abstract: Although Ethiopia has been implementing Option B+ program, LTFU of women from the Option B+ program is one of the challenges that minimizes its implementation. Thus, this study assessed the incidence and predictors of LTFU among women under Option B+ PMTCT program in western Ethiopia. An institution-based retrospective follow-up study was conducted. A cox proportional hazards regression model was fitted to identify predictors of LTFU. A Hazard ratios with 95% confidence CI was computed and all predictors that were associated with the outcome variable at p-value ≤ 0.05 in the multivariable cox proportional hazards were declared as a significance predictor of the outcome. A total of 330 women were followed for a mean follow up time of 16.9 (± 7.6) months. An overall incidence rate of LTFU was 9/1000 person-months. Women’s educational status, residence, HIV-disclosure status, the status of women at enrollment, previous history of HIV and ART adherence were significant predictors of LTFU. The incidence of LTFU from Option B+ PMTCT is lower as compared to evidence from sub-Saharan African and strengthening linkage and referral system between clinics as well as establishing appropriates tracing mechanisms would retain pregnant women in the program.

Early Resumption of Sexual Intercourse and Its Associated Factors Among Postpartum Women in Western Ethiopia: A Cross-Sectional Study.

Abstract: Background Women are often forced to recommence sexual intercourse after childbirth to maintain intimacy and fulfill their partners' desires. Early resumption of postpartum sexual intercourse leads to sexual health problems and unwanted pregnancy if not complemented with appropriate contraceptive use. However, sexual practice during the early postpartum period has received little attention in clinical and research settings. The aim of this study was therefore to assess the early resumption of sexual intercourse and its associated factors among postpartum women attending public health institutions in Nekemte town, Western Ethiopia. Methods An institution-based cross-sectional study was carried out from March to April 2019. A systematic random sampling technique was used to select 528 postpartum women. An interviewer-administered, pretested, and structured questionnaire was used to collect data. Data were coded and entered into Epi Info 7.2.1, and exported to SPSS version 20.0 to run bivariable and multivariable logistic regressions. Results One in five postpartum women (20.2%, 95% CI: 17.1-23.6) practiced an early resumption of sexual intercourse, of whom three-fifths (58%) did not use any contraceptives. Women's secondary education (AOR=0.22, 95% CI: 0.07-0.71), husband's elementary (AOR=0.23, 95% CI: 0.06-0.87) and secondary education (AOR=0.25, 95% CI: 0.07-0.88), as well as women's fertility status (par ity of one) (AOR=3.52, 95% CI: 1.24-10.01), normal vaginal delivery (AOR=5.44, 95% CI: 1.84-16.12), giving birth to a male child (AOR=1.94, 95% CI: 1.05-3.60), desire for another child (AOR=5.71, 95% CI: 1.89-17.25), and pressure from the husband to initiate intercourse (AOR=9.89, 95% CI: 4.99-19.58) were significantly associated with early resumption of sexual intercourse. Conclusion A significant proportion of postpartum women who resume early sexual intercourse do not use any contraceptives. Interventions that focus on strengthening the integration of postpartum sexual health education and service use are warranted.

Adverse obstetric outcomes in public hospitals of southern Ethiopia: the role of parity.

Abstract: Purpose: Direct obstetric causes have a significant contribution for severe maternal morbidities and mortalities, although the effect of grand multiparity on adverse obstetric outcomes remains controversial across studies. This study aimed to compare obstetric outcomes in grand multiparous and low multiparous women in two hospitals of southern Ethiopia.Materials and methods: A comparative cross-sectional study was conducted in one general and one comprehensive specialized hospitals in 2018. Four hundred and sixty-one mothers were included in the study. Data were collected by structured questionnaire and extraction sheets from clinical documents, and were analyzed using STATA version 14 (StataCorp, College Station, TX, USA).Results: About 39% of the included mothers had at least one adverse obstetric outcome. Hypertensive disorders of pregnancy, antepartum hemorrhage, and premature rupture of membrane and were higher in the grand multiparous mothers. However, obstructed labor and risk of cesarean delivery were higher in low multiparous women. History of medical illnesses, previous cesarean delivery, and high birth weight were independent predictors of adverse maternal outcomes regardless of parity. However, parity did not show statistically significant difference in obstetric outcomes.Conclusion: Parity did not show statistically significant difference in experiencing adverse obstetric outcomes in women. Early identification and treatment of high-risk mothers is recommended regardless of parity.

Burden of intestinal parasitic infections in children and its association with hand washing practice in Ethiopia: a systematic review and meta-analysis

Abstract: Background Intestinal parasitic infections (IPIs) are a major public health challenges in developing countries including Ethiopia, although few studies previously estimated the magnitude of IPIs and associated factors in the country. Reports from these scarce studies were also widely varied and remained inconsistent. This study thus aimed to synthesize the pooled magnitude of IPIs and factors affecting it. Methods Internationally broad based medical database including MEDLINE/PubMed, EMBASE, PsychINFO and Web of Science, and Google Scholar for grey literature were exhaustively searched using a priori set criteria to identify studies estimating the prevalence of IPIs among children from 2000-2018. PRISMA guideline was used to systematically review and meta-analyze these studies. Details of study characteristics including sample size, magnitude of effect sizes (including odds ratios (ORs)) and standard errors were extracted. Random-effects model was used to calculate pooled estimates in Stata/se version-14. I2 and meta-bias statistics assessed heterogeneity and Egger’s test for publication bias. Sub-group analyses were also carried out based on age of children and regions. Results Forty-three studies were included in the final analysis (N = 20,008 children). The overall prevalence of IPIs, with one or more species, was 48.2% (95% CI: 40.1, 56.3) in Ethiopian children. Based on sub-group analyses, the highest prevalence of IPIs was observed among school-age children (52.4% (95% CI, 41.3, 63.5)) and in Amhara regional state (52.1% (95% CI, 37.3-66.8)). The odds of having IPIs was nearly six times higher in children who were not practicing hand washing as compared to their counterparts (pooled OR = 5.6 (95% CI: 3.4,9.3). Funnel plot analysis and Egger’s test detected no publication bias. Conclusion On aggregate, the pooled prevalence of IPIs among Ethiopian children is significantly high. Not hand washing before eating was a risk factor for IPIs. The establishment of applicable sanitation services and health education will help reduce the magnitude of IPIs and promote a healthier childhood.