ObjectiveTo identify the determinants of term premature rupture of membrane in Southern Ethiopia public hospitals, 2017.ResultsSeventy-five cases and 223 controls women were enrolled for the study. Two hundred eighty-four (95.3%) participants were admitted at the gestational age of above 40, and the rest, 14 (4.7%), were admitted at 37–40 weeks of gestation. The current study identified wealth index and inter-birth interval as preventive predictors, but smoking and hypertension during pregnancy were identified as positive determinants of premature rupture of membrane. This finding is supported by multiple logistic regression analysis result of wealth index (AOR: 0.102, 95% CI [0.033, 0.315]), inter-birth interval (AOR: 0.251, 95% CI [0.129, 0 0.488]), smoking (AOR: 17.053, 95% CI [2.145, 135.6]), and hypertension (AOR: 8.92, 95% CI (1.91, 41.605]). The association between PROM and its determinants indicated that evidence-based interventions should be needed and designed to have very high wealth index, and optimal interbirth interval, and prevent smoking and hypertension during pregnancy to decrease PROM occurrence in the study settings. Hence, we recommended that integration of prevention mechanism of modifiable determinants to the obstetrics health care system will reduce premature ruptures of a membrane.
Background It is generally accepted that pregnancy and childbirth are natural physiological processes. However, these significantly affect the quality of mothers’ lives. Little is known about the level of quality-of-life and associated factors among postpartum women in Ethiopia, particularly in the study area. Methods A community-based cross-sectional study was conducted among 409 randomly selected post-partum women who were living in Arba Minch town. Systematic random sampling was employed to select the study participants. The standard quality-of-life assessment tool which is known as the short-form SF 36 tool was used to assess health-related quality-of-life. The logistic regression model was used to identify associated factors. Statistically significant variables at a p -value<0.25 in the bi-variable analysis were candidate variables for multi-variable analysis and statistical significance which was declared at a p -value<0.05. Results Among the study participants, 255 (62.3%) had lower level health-related quality-of-life (HRQoL). About 46.2% of the study participants had lower physical HRQoL and about 79% of the study participants had lower mental HRQoL. The overall mean score of HRQoL was 45.15 (±8.13). Factors associated with lower overall HRQoL were age group 17–24 years (AOR=2.73, 95% CI=1.22–6.10), no formal education [AOR 2.02, 95% CI (1.05–3.89)], and cesarean delivery (AOR=0.49, 95% CI=0.24–0.97). A factor associated with lower physical HRQoL was cesarean delivery (AOR=0.34, 95% CI=0.13–0.88). Factors associated with lower mental HRQoL were age group 17–24 (AOR=3.37, 95% CI=1.60–7.04), not receiving antenatal care (AOR=3.65, 95% CI=1.45–9.16), and having postpartum depression (AOR=2.27, 95% CI=1.30–3.93). Conclusion The results suggest that the majority of post-partum women had a lower HRQoL, particularly women’s mental health was compromised. In this study, a suggestion is made that the respective bodies need to give particular attention to mothers during the post-partum period to prevent poor quality-of-life.
Background. Perinatal depression is a serious mental health problem that can negatively affect the lives of women and children. The adverse consequences of perinatal depression in high-income countries also occur in low-income countries. Objective. To assess the perinatal depression and associated factors among mothers in Southern Ethiopia. Methods. A community based cross-sectional study was conducted among selected 728 study participants in Arba Minch Zuria HDSS. A pretested questionnaire was used to collect the data. Data were analyzed using STATA version 12 software. Descriptive statistical methods were used to summarize the characteristics of the mothers. Bivariate and multivariable logistic regression was used for analysis. Results. The prevalence of perinatal depression among the study period was 26.7%. In the final multivariable logistic regression, monthly income AOR (95% C.I): 4.2 (1.9, 9.3), parity [AOR (95% C.I): 0.14 (0.03, 0.65)], pregnancy complications AOR (95% C.I): 5 (2.5, 10.4), husband smoking status [AOR (95% C.I): 4.12 (1.6, 10.6)], history of previous depression AOR (95% C.I): 2.7 (1.54, 4.8), and family history of psychiatric disorders were the independent factors associated with perinatal depression. Conclusion. The study showed a high prevalence of perinatal depression among pregnant mothers and mothers who have less than a one-year-old child.
Background: Access to antiretroviral drugs for all infected persons in need is a global health priority. The viral load and CD4 counts should be monitored regularly. The plasma viral load should be reduced by as much and for as short as possible. Identifying factors that predict time to viral load suppression of patients on antiretroviral therapy regimens is thus vital to optimizing therapeutic success. Therefore, this study aimed to estimate the time to viral load suppression and identify predictors of time to viral load suppression of patients on antiretroviral therapy at Arba Minch general Hospital.Methods: This study was observational study using data abstracted from medical records, patient interviews and laboratory work-up during 6 months of follow up. The data were collected from 152 naive to anti-retro viral drug patients. The univariable and multivariable Cox proportional hazard regression analyses were done to identify predictors.Result: The median survival time of viral load suppression among adult patients living with HIV was 3 months with 95% CI (2.68, 3.32). The Cox-proportional hazard analysis shows baseline CD4 count of <200cells/mm3 (AHR=0.683, CI:0.471, 0.990), baseline viral load of <10,000 copies/ml (AHR=4.135, CI:1.835, 9.317), having baseline Cotrimoxazole preventive therapy (AHR=1.997, CI:1.108, 3.600), having baseline Isoniazid preventive therapy (AHR=3.085, CI:1.721, 5.529) and good adherence level to ART (AHR=2.648 ,CI: 1.202, 5.834) significantly predict the time to viral load suppression.Conclusion: Early improvement and maintenance of CD4 count and viral load to normal level should be attained through streamlining and strengthening monitoring and counseling of patients on adherence to ART, Cotrimoxazole and Isoniazid drugs.
Background Despite the efforts made by the government of Ethiopia, the community-based health insurance (CBHI) enrollment rate failed to reach the potential beneficiaries. Therefore, this study aimed to assess the enrollment status of households for community-based health insurance and associated factors in peripheral areas of Southern Ethiopia. Methods We conducted a community based cross-sectional study design with both quantitative and qualitative methods. Systematic random sampling was employed to select 820 households from 27, April to 12 June 2018. A pretested structured questionnaire, in-depth interview, and focus group discussion guiding tool were used to obtain information. A binary logistic regression model was used to assess the association between independent and outcome variables. A P-Value of less than 0.05 was taken as a cutoff to declare association in multivariable analysis. Qualitative data were analyzed manually using the thematic analysis method. Results Out of 820 households, 273[33.30%; 95% CI: 29.9–36.20] were enrolled in the community based health insurance scheme. Having good knowledge [AOR = 13.97, 95%CI: 8.64, 22.60], having family size of greater than five [AOR = 1.88, 95% CI: 1.15, 3.06], presence of frequently ill individual [AOR = 3.90, 95% CI: 2.03, 7.51] and presence of chronic illness [AOR = 3.64, 95% CI: 1.67, 7.79] were positively associated with CBHI enrollment. In addition, poor quality of care, lack of managerial commitment, lack of trust and transparency, unavailability of basic logistics and supplies were also barriers for CBHI enrollment. Conclusion and recommendation The study found that lower community based health insurance enrollment status. A higher probability of CBHI enrollment among higher health care demanding population groups was observed. Poor perceived quality of health care, poor managerial support and lack of trust were found to be barriers for non-enrollment. Therefore, wide-range awareness creation strategies should be used to address adverse selection and poor knowledge. In addition, trust should be built among communities through transparent management. Furthermore, the quality of care being given in public health facilities should be improved to encourage the community to be enrolled in CBHI.
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