Prevalence of Trachoma in Benishangul Gumuz Region,Ethiopia: Results of Seven Population-Based Surveys from the Global Trachoma Mapping Project

ABSTRACT

Purpose: Trachoma is a major cause of blindness in Ethiopia, and targeted for elimination as a public health problem by the year 2020. Prevalence data are needed to plan interventions. We set out to estimate the prevalence of trachoma in each evaluation unit of grouped districts (“woredas”) in Benishangul Gumuz region, Ethiopia.

Methods: We conducted seven cross-sectional community-based surveys, covering 20 woredas, between December 2013 and January 2014, as part of the Global Trachoma Mapping Project (GTMP). The standardized GTMP training package and methodologies were used.

Results: A total of 5828 households and 21,919 individuals were enumerated in the surveys. 19,583 people (89.3%) were present when survey teams visited. A total of 19,530 (99.7%) consented to examination, 11,063 (56.6%) of whom were female. The region-wide age- and sex-adjusted trichiasis prevalence in adults aged ≥15 years was 1.3%. Two evaluation units covering four woredas (Pawe, Mandura, Bulen and Dibate) with a combined rural population of 166,959 require implementation of the A, F and E components of the SAFE strategy (surgery, antibiotics, facial cleanliness and environmental improvement) for at least three years before re-survey, and intervention planning should begin for these woredas as soon as possible.

Conclusion: Both active trachoma and trichiasis are public health problems in Benishangul Gumuz, which needs implementation of the full SAFE strategy.     

The Global Trachoma Mapping Project: Methodology of a 34-Country Population-Based Study

ABSTRACT

Purpose: To complete the baseline trachoma map worldwide by conducting population-based surveys in an estimated 1238 suspected endemic districts of 34 countries.

Methods: A series of national and sub-national projects owned, managed and staffed by ministries of health, conduct house-to-house cluster random sample surveys in evaluation units, which generally correspond to “health district” size: populations of 100,000–250,000 people. In each evaluation unit, we invite all residents aged 1 year and older from h households in each of c clusters to be examined for clinical signs of trachoma, where h is the number of households that can be seen by 1 team in 1 day, and the product h?×?c is calculated to facilitate recruitment of 1019 children aged 1–9 years. In addition to individual-level demographic and clinical data, household-level water, sanitation and hygiene data are entered into the purpose-built LINKS application on Android smartphones, transmitted to the Cloud, and cleaned, analyzed and ministry-of-health-approved via a secure web-based portal. The main outcome measures are the evaluation unit-level prevalence of follicular trachoma in children aged 1–9 years, prevalence of trachomatous trichiasis in adults aged 15?+?years, percentage of households using safe methods for disposal of human feces, and percentage of households with proximate access to water for personal hygiene purposes.

Results: In the first year of fieldwork, 347 field teams commenced work in 21 projects in 7 countries.

Conclusion: With an approach that is innovative in design and scale, we aim to complete baseline mapping of trachoma throughout the world in 2015.     

Adherence to antihypertensive medications among adult hypertensive patients attending chronic follow-up units of Dessie Referral Hospital,Northeastern Ethiopia: A cross-sectional study

Hypertension is the leading cause of increased morbidity and mortality rates worldwide. Despite adherence to therapies is the important determinant of treatment success to reduce apparent resistant hypertension, maintaining good adherence to antihypertensive medications remained the most serious challenge. Thus, this study aimed to assess adherence to antihypertensive medications among adult hypertensive patients in Dessie Referral Hospital.A cross-sectional study design was conducted among hypertensive patients during May and June 2020. The study participants were selected using a systematic random sampling technique. The collected data were entered into EpiData version 4.4 and exported to SPSS version 25.0 software for data cleaning and analysis. Data were analyzed using bivariable and multivariable logistic regression at a 95% confidence interval (CI). A variable that has a P-value < .05 was declared as statistically significant. Hosmer–Lemeshow test was used to test goodness-of-fit and multicollinearity was tested.The overall good adherence to antihypertensive medications was 51.9%; 95% CI: (46.8–58.3%) and poor adherence was 48.1%. Factors associated with good adherence were: sex—female adjusted odd ratio (AOR) = 1.31; 95% CI (1.06–2.52), occupational status-employed AOR = 2.24; 95% CI (1.33–3.72), good knowledge of the disease AOR = 2.20; 95% CI (1.34–3.72) and good self-efficacy AOR = 1.38; 95% CI (1.20–2.13).This study revealed that almost half of the hypertensive patients in Dessie Referral Hospital had good antihypertensive medication adherence. Sex, occupational status, knowledge, and self-efficacy were factors associated with good adherence. Therefore, health education should be given to patients on the importance of complying with medication and patients should be monitored by health extension workers.     

Trachoma among adults in Damot Gale District,South Ethiopia

PURPOSE To determine the prevalence of trachoma and its risk factors among adults in the Damot Gale District of south Ethiopia. METHODS A cross-sectional, community based survey was conducted in the Damot Gale District of south Ethiopia. A multi-stage sampling method was used to select subjects. RESULTS Out of 924 eligible subjects, 855 were examined, for a response rate of 92.5%. Active trachoma [follicles (TF), intense inflammation (TI) or TF/TI] was found in 20.6% (95% CI: 17.8–23.4%) of the subjects. The prevalence of trachomatous trichiasis (TT) and corneal opacity (CO) was 6.8% (95% CI: 5.1–8.5%) and 2.1% (95% CI: 1.0–3.1%), respectively. Females were affected by active trachoma twice as often as males [OR 2.13 (95% CI: 1.67–3.50, P &lt; 0.0001)]. The prevalence of blinding trachoma (TT and CO) was also significantly higher among females [OR 3.03 (95% CI: 1.58–5.89, P &lt; 0.001)]. Literacy and face washing were found to be significantly associated with less prevalence of active trachoma. CONCLUSION The prevalence of both active and cicatricial trachoma among adults residing in the Damot Gale District of south Ethiopia is very high. Although children are the main reservoirs of active trachoma, intervention strategies should address the fact that a high prevalence of active trachoma is also found among adults residing in hyperendemic areas.     

Surgical site infection and its associated factors following cesarean section: a cross sectional study from a public hospital in Ethiopia

Background

A cesarean section is a surgical procedure in which incisions are made through a woman's abdomen and uterus to deliver her baby. Surgical site infections are a common surgical complication among patients delivered with cesarean section. Further it caused to increase maternal morbidity, stay of hospital and the cost of treatment.

Methods

Hospital based cross-sectional study was conducted to assess the magnitude of surgical site infection following cesarean Site Infections and its associated factors at Lemlem Karl hospital July 1, 2013 to June 30, 2016. Retrospective card review was done on 384 women who gave birth via cesarean section at Lemlem Karl hospital from July 1, 2013 to June 30, 2016. Systematic sampling technique was used to select patient medical cards. The data were entered by Epi info version 7.2 then analyzed using Statistical Package for Social Sciences windows version 20. Both bivariate and multivariate logistic regression was done to test association between predictors and dependent variables. P value of?<?0.05 was considered to declare the presence of statistically significantly association.

Results

Among 384 women who performed cesarean section, the magnitude of surgical site infection following cesarean section Infection was 6.8%. The identified independent risk factors for surgical site infections were the duration of labor AOR=3.48; 95%CI (1.25, 9.68), rupture of membrane prior to cesarean section AOR=3.678; 95%CI (1.13, 11.96) and the abdominal midline incision (AOR=5.733; 95%CI (2.05, 16.00).

Conclusions

The magnitude of surgical site infection following cesarean section is low compare to other previous studies. The independent associated factors for surgical site infection after cesarean section in this study: Membranes rupture prior to cesarean section, duration of labor and sub umbilical abdominal incision. In addition to ensuring sterile environment and aseptic surgeries, use of WHO surgical safety checklist would appear to be a very important intervention to reduce surgical site infections.

     

Effect of a community intervention with pit latrines in five districts of Amhara,Ethiopia

Objective To evaluate the change in household latrine coverage and investigated predictors of latrine uptake after 3 years of implementation of trachoma control interventions in Dera, Ebinat, Estie, Enebsie Sarmedir and Huleteju Enese districts of Amhara, Ethiopia. Methods Before and after study, baseline surveys were conducted prior to programme implementation and an evaluation after 3 years of interventions. Multi‐stage cluster random sampling was used in both surveys. Results A total of 1096 and 1117 households were sampled and assessed for the presence of household latrines at baseline and evaluation, respectively. The proportion of households with a pit latrine increased by 32.3% overall (95% confidence interval [CI]: 27.9–38.0), ranging from 8.0% (95% CI: 5.1–10.8) in Ebinat to 58.9% (95% CI: 51.9–66.8) in Enebsie Sarmedir. Logistic regression analysis of associations between household latrine ownership and potential factors showed that increasing household size (OR_{per additional person} = 1.2[95% CI: 1.1–1.3]), higher socio‐economic status (tin roof) (OR = 1.8[95% CI: 1.2–2.9]) and participation in health education (OR = 1.6[95% CI: 1.1–2.5]) were independent predictors of latrine ownership. Conclusion Our study documented heterogeneous increase in household latrine coverage after 3 years of latrine promotion; two of five districts had achieved millennium development goal 7.9 and halved the proportion of households without latrine access. We attribute the striking increase in household latrines to increased political commitment of the local government and intensive community mobilisation under the trachoma control programme in Amhara region.