BackgroundAlthough community based treatment of severe acute malnutrition has been advocated for in recent years, facility based treatment of severe acute malnutrition is still required. Therefore, information on the treatment outcomes of malnutrition and potential predictors of mortality among severely malnourished children admitted to hospitals is critical for the improvement of quality care. Thus, the aim of this study was to assess survival status and predictors of mortality in severely malnourished children admitted to Jimma University Specialized Hospital from September 11, 2010 to September 10, 2012.MethodsRetrospective longitudinal study was conducted at Jimma University Specialized Hospital. From September 11, 2010 to September 10, 2012 available data from severely malnourished children admitted to the hospital were reviewed. Data were analyzed using SPSS version 20 for windows. Bivariate and multivariable analyses were performed by Kaplan-Meier and Cox regression to identify clinical characteristics associated with mortality.ResultA total of 947 children were enrolled into the study. An improvement, death and abscond rate were 77.8, 9.3 and 12.9 % respectively. The median duration from admission to death was 7 days. The average length of stay in the hospital and average weight gain were 17.4 days and 10.4 g/kg/day respectively. The main predictors of earlier hospital deaths were age less than 24 months (AHR = 1.9, 95 % CI [1.2–2.9]), hypothermia (AHR = 3.0, 95 % CI [1.4–6.6]), impaired consciousness level (AHR = 2.6, 95 % CI [1.5–4.5]), dehydration (AHR = 2.3, 95 % CI [1.3–4.0]), palmar pallor (AHR = 2.1, 95 % CI [1.3–3.3]) and co-morbidity/complication at admission (AHR = 3.7, 95 % CI [1.9–7.2]).ConclusionThe treatment outcomes (improvement rate, death rate, average length of stay in the hospital and average weight gain) were better than most reports in the literatures and in agreement with minimum international standard set for management of severe acute malnutrition. Intervention to further reduce earlier deaths should focus on young children with hypothermia, altered mental status, dehydration, anemia and comorbidities.

Background In countries where the proportion of births attended by skilled providers is low, maternal mortality is high. According to the 2016 EDHS report, the proportion of births attended by skilled providers was only 26% and the maternal mortality ratio was 412 per 100,000 live-births. Disrespectful and abusive behavior of health workers and other facility staff experienced by women during facility-based childbirth is important, but the little-understood barrier of institutional delivery. Objective This study assessed the prevalence of disrespect and abuse experienced by mothers during facility-based childbirth and associated factors. Methods A facility based cross-sectional study was undertaken from October to December 2016. Data were collected by face-to-face interview using a structured questionnaire from 290 mothers consecutively included in the study immediately prior to discharge from the hospital. Reports of disrespect and abuse during childbirth were measured using 23 performance indicators. Data were entered into EpiData and analyzed by SPSS; bivariate and multivariable binary logistic regression analyses were performed to identify factors associated with disrespect and abuse. Result Three-fourths ( 217,[74.8%]) of participants were Muslim. Nearly half (142,[49%]) had a primary level of education. Most (232,[80%]) were housewives and 175(60.3%) were from outside Jimma town. The prevalence of disrespect and abuse during childbirth was 91.7% (266/290; 95%CI:0.879,0.946). The most common types of disrespect and abuse reported were culturally inappropriate care (218,[75.2%]), failure to encourage the client to ask questions (220,[75.9%]), the provider not introducing him/herself (232,[80.0%]), failure to obtain consent/permission prior to any procedure (185,[63.8%]) and not using curtains/visual barriers to protect client (237,[81.7%]). Being non-married [95%CI:(0.009,0.222), ≥para-II [95%CI:(0.093,0.862)] and being attended by female care provider [95%CI:(0.026,0.224)] were associated with the reduced chance of reporting disrespect and abuse. However, achieving ≥secondary education [95%CI:(1.028,10.272)] was associated with a higher chance of reporting disrespect and abuse. Conclusion The very high prevalence of abuse or disrespect during facility-based delivery shows a health system in crisis. A key implication of this finding is that efforts to increase facility-based delivery must address disrespect and abuse to ensure higher utilization by women. Making facility-based deliveries attended by female providers may reduce the problem.

Background: Employed women tend to exclusively breastfeed less than non-employed women. Early returning to work has been major reason why employed women stop exclusive breastfeeding. The aim of this study was to investigate exclusive breastfeeding (EBF) cessation and associated factors among employed mothers in Dukem town, Central Ethiopia. Methods: A cross-sectional study was conducted from February to March 2015 using total sample of 313 randomly selected permanently employed women. Information regarding participants' work-related factors, health service and sociodemographic factors were collected by face to face interview using structured questionnaire. Data were checked for completeness, entered and analyzed by SPSS version 20. Binary logistic regression was done to identify factors associated with exclusive breastfeeding cessation. The strength of association was measured using odds ratio with 95% confidence intervals. Results: Prevalence of exclusive breastfeeding cessation was 75.7% (95% CI 71.0, 80.5%). Having a short duration of maternity leave (AOR 9.3; 95% CI 3.8, 23), being a full time employee (AOR 3.5; 95% CI 1.7, 11), being private organization employee (AOR=2.1, 95% CI(1, 4.3)), lack of flexible work time (AOR 3.0; 95% CI 1.2, 7.5), not pumping breast milk (AOR 4.3; 95% CI 1.7, 11), lack of a lactation break (AOR 6.7; 95% CI 3,14.5) and work place far away from her child (AOR 3.1; 95% CI 3.1, 6.3), were significantly associated with cessation of EBF among employed mothers. Conclusion: Prevalence of exclusive breastfeeding cessation was much higher than the international and national expectation. The concerned governmental bodies should consider improving the legislation of the 3 months postpartum maternity leave to reduce employed mother's exclusive breastfeeding cessation.

ObjectiveThe aim of this study was to assess drug-related problems and its determinants in type 2 diabetes patients with hypertension co-morbidity.ResultsA total of 300 type 2 diabetes patients with hypertension co-morbidity were studied. The majority of participants, 194 (64.7%), were males. Mean age of the participants was 54.44 ± 11.68 years. The mean durations of diabetes and hypertension were 5.37 ± 4.79 and 5.15 ± 4.65 years respectively. The most commonly prescribed antidiabetic medications were metformin in 200 (66.7%) and insulin 126 (42%) of the participants. Enalapril was the most commonly prescribed antihypertensive medication; 272 (90.7%). Aspirin was prescribed to 182 (60.7%) participants. Statins were prescribed to one-third (65.67%) of the participants. Eighty-five (28.3%) participants had diabetes related complications other than hypertension. A total of 494 drug related problems were identified. The mean number of drug related problems was 1.65 ± 1.05. The most common drug related problems were need for additional drug therapy (29.35%), ineffective drug (27.94%) and dose too low (15.8%). Independent predictors of drug related problems were age 41–60 years (AOR = 6.87, 95% CI 2.63–17.93), age > 60 years (AOR = 5.85, 95% CI 2.15–15.93) and the presence of comorbidity (AOR = 3.0, 95% CI 1.11–8.16).

Background Virological treatment failure is a problem that a Human Immune Virus patient faces after starting treatment due to different factors. However, there were few studies done on the predictors of virological treatment failure among adult patients on first-line antiretroviral therapy in Ethiopia in general, and no study was done in the study area in particular. Therefore, the aim of the study was to identify predictors of virological treatment failure among adult patients on first-line antiretroviral therapy in Woldiya and Dessie Hospitals, Northeast Ethiopia. Method Hospital based case–control study was conducted in Woldia and Dessie Hospitals from from 12 August 2016–28 February 2018 on 154 cases and 154 controls among adult patients on first-line antiretroviral treatment. All cases were included and comparable controls were selected using stratified random sampling technique. Data were collected by document review using checklists and entered into Epidata version 3.1 and analyzed by SPSS version 21. Multivariable logistic regression analysis was done to identify the independent predictors of virological treatment failure. Results In this study, statistically higher odds of virological failure was observed among patients who had current CD4 T-cell count of < 200 mm 3 (AOR = 2.4, 95% CI: 1.35, 4, 18) compared withCD4 T-cell count of > 200 mm 3 , current body mass index(BMI) < 16 kg/m 2 (AOR = 4.2, 95% CI:1.85, 9.51) compared with BMI > 18.5 kg/m 2 , BMI between 16 and 18.5 kg/m 2 (AOR = 3.72, 95% CI: 1.75, 7.92) versus BMI > 18.5 kg/m 2 , poor adherence to antiretroviral therapy (AOR = 5.4, 95% CI: 2.95, 9.97) compared with good adherence. Conclusion This study showed that low current CD4 T-cell count and body mass index, as well as poor adherence for ART treatment predicts virological failure. Therefore, deliberate efforts are urgently needed in HIV care through improving their nutritional status by enhancing nutritional education and support, and by strengthening enhanced adherence counseling.