Personal risk perception, HIV knowledge and risk avoidance behavior, and their relationships to actual HIV serostatus in an urban African obstetric population

One quarter of pregnant women in Zambia are infected with HIV. Understanding how knowledge of HIV relates to personal risk perception and avoidance of risky behaviors is critical to devising effective HIV prevention strategies. In conjunction with a large clinical trial in Lusaka, Zambia, we surveyed postpartum women who had been tested for HIV but did not know their status before undergoing the questionnaire. Of 858 women for whom complete data were available, 248 (29%) were HIV infected. Women 22 years of age or older (adjusted odds ratio [AOR], 1.7; 95% confidence interval [CI], 1.1-2.5), women reporting > or =2 sexual partners in their lifetime (AOR, 1.8; 95% CI, 1.3-2.5), and women reporting a history of a sexually transmitted infection (AOR, 2.7; 95% CI, 1.7-4.3) were more likely to be HIV infected. Having had > or =2 lifetime sexual partners was a marker for perception of high personnel risk for HIV infection (AOR, 1.5; 95% CI, 1.1-2.1). However, there was no relationship between perceived risk of HIV infection and actual HIV status. In fact, 127 (52%) of 245 women who stated that they were at no or low risk for HIV infection were HIV infected. Living in an area of high HIV seroprevalence like Zambia seems to be the greatest risk factor for infection in unselected pregnant women. Before significant inroads can be made in decreasing the incidence of HIV infection among pregnant women, population-based strategies that involve men must be implemented.     

Visual impairment and associated factors among primary school children in Gurage Zone,Southern Ethiopia

BackgroundVisual impairment is one of the major public health problems worldwide, especially in developing countries.ObjectiveTo determine the prevalence of visual impairment and its associated factors among school children in Gurage Zone, Southern EthiopiaMethodsA cross sectional study was conducted in eight primary schools of Gurage Zone. A total of 1064 pupils, of whom589 boys and 475 girls were selected using multistage sampling technique. Socio-demographic characteristics of the participants were collected using structured questionnaires and visual acuity was measured using Snellen''s chart. Logistic regression analysis was used to determine the associated factors of visual impairment.ResultsThe prevalence of visual impairment was 5.2%. Factors significantly associated with visual impairment were age group of 13–18 years (AOR = 9.44, 95% CI = 3.83 – 23.25), school grade level of 5- 8 (AOR = 2.97, 95% CI = 1.23 – 7.17), rural residents (AOR = 2.59, 95% CI = 1.22 – 5.54), family''s monthly income of less than 2000 Ethiopian Birr (AOR = 2.87, 95% CI = 1.08 – 7.61) and visually impaired parents (AOR = 2.16, 95% CI = 1.06 – 4.39).ConclusionThis study found that the prevalence of visual impairment was 5.2%.     

Maternal and neonatal outcomes of grand multiparity in Khartoum,Sudan

ObjectivesGrand multiparity is a major health problem that leads to adverse maternal and perinatal outcomes. We aimed to assess the maternal and perinatal outcomes of grand multiparity.MethodsA case-control study was conducted in Saad Abualila Hospital, Khartoum, Sudan from February to December 2019. The cases were grand multiparous (≥ 5 deliveries) women. The controls were women with low parity (multiparous women who delivered two to four times). Maternal and perinatal characteristics were compared between the two groups. Logistic regression analysis was performed.ResultsThere was a significant association between grand multiparity and higher maternal age (adjusted odds ratio [AOR]=1.19, 95% confidence interval [CI]=1.16–1.23), lower education level (AOR=3.38, 95% CI=2.49–5.58) and lower antenatal care attendance (AOR=1.73, 95% CI=1.02–2.92). Grand multiparous women were at increased risk for Anemia (AOR=1.48, 95% CI=1.08–2.03), diabetes mellitus (AOR=10.61, 95% CI=4.89–23.00), caesarean delivery (AOR=1.87, 95% CI=1.40–2.48), preterm birth (AOR=1.90, 95% CI=1.37–2.62) and admission to the neonatal intensive care unit (AOR=3.8, 95% CI=1.95–7.75).ConclusionsGrand multiparity was associated with poor maternal and neonatal outcomes. Development of a national health program addressing family planning, health education and improvement of antenatal, intrapartum and neonatal care are needed.     

Recreational Drug Use,Polydrug Use and Sexual Behaviors Among Men Who Have Sex With Men in Southwestern China: A Cross-Sectional Study

Abstract

Although recreational drug use is associated with risky sexual behaviors and HIV infection among men who have sex with men (MSM), it is unclear to what extent these behaviors and outcomes differ between single-drug users and polydrug users in China. This is a cross-sectional study conducted from July to September 2016 among MSM in three cities of Sichuan Province, China. Multinomial logistic regression was performed to examine factors correlated with single-drug and polydrug use. A total of 1,122 participants were included in the study. Overall, 28% of MSM have ever used recreational drugs, of whom 64.0% were single-drug users, and 36.0% were polydrug users. Factors associated with both single-drug and polydrug use included: receptive sexual role (single-drug use: AOR = 1.79, 95% CI: 1.05–3.07; polydrug use: AOR = 6.00, 95% CI: 2.54–14.17), engaging in group sex (AOR = 2.23, 95% CI: 1.28–3.87; AOR = 4.68, 95% CI: 2.41–9.08), frequent alcohol use (AOR = 3.11, 95% CI: 1.75–5.52; AOR = 6.41, 95% CI: 2.50–16.47), seeking partners mainly by Internet (AOR = 4.87, 95% CI: 3.31–7.17; AOR = 4.58, 95% CI: 2.58–8.14), history of STIs (AOR = 1.86, 95% CI: 1.08–3.21; AOR = 3.32, 95% CI: 1.77–6.26) and HIV infection (AOR = 1.76, 95% CI: 1.02–3.02; AOR = 3.19, 95% CI: 1.62–6.26). Our findings suggest the urgent need for HIV and STIs prevention programs among MSM in China to integrate strategies that mitigate recreational drug use.     

A multilevel analysis of the determinants of handwashing behavior among households in Eswatini: a secondary analysis of the 2014 multiple indicator cluster survey

IntroductionHandwashing with soap has received considerable attention due to its importance in the prevention and interruption of the transmission of diseases. Regardless of the positive effects of handwashing with soap, developing countries still have a low rate of handwashing.ObjectiveThe study aimed to determine the individual, household and community-level factors associated with handwashing behavior among households in EswatiniMethodsUsing the Eswatini Multiple Indicator Cluster Survey conducted in 2014, a secondary analysis was done of the households surveyed. A total of 1,520 households nested in communities with complete data on handwashing practices were included in the analysis. Univariate, bivariate analysis and multivariate multilevel logistic regression were used to establish the factors that were associated with handwashing behavior.ResultsThe prevalence of handwashing among households was 56% in 2014. Households whose heads were aged 35–54 and 55 years and older were more likely to practice handwashing (AOR=1.88, 95% CI:1.39, 2.54); and (AOR=1.77, 95% CI: 1.205, 2.62) compared to those aged 15–34 years. Households with a pit latrine or no toilet facility at all, were less likely to practice handwashing (AOR=0.24, 95% CI: 0.17, 0.35); (AOR=0.28, 95% CI: 0.11, 0.71) respectively compared to those with a flush toilet. Region of residence was a community-level variable associated with lower odds of handwashing, with those from the Hhohho (AOR=0.22, 95% CI: 0.14, 0.35) and Manzini region (AOR=0.42, 95% CI: 0.27, 0.67) compared to Lubombo region. Households from communities where access to mass media was high were more likely to practice handwashing (AOR =1.47, 95% CI: 1.05, 2.03) compared to those from communities where access to mass media was lowConclusionHouseholds headed by young adults, with pit latrine or no toilet facility at all and lived in the Hhohho and Manzini regions and with low access to mass media, should be targeted for interventions aimed at improving handwashing practices.     

Predictors of non-adherence to medication and time to default from treatment on HIV infected patients under HAART: a comparison of joint and separate models

BackgroundEthiopia is one of the Sub-Saharan Africa with the highest number of people living with HIV. Amhara region is one of the regions in the country in which many people are under medication. The main objective of this research was to identify significant predictors of non-adherence to medication and time to default from treatment for HIV infected patients under HAART.MethodsA retrospective secondary data were obtained from a random sample of 220 HIV patients under HAART. Separate and joint modeling approaches were conducted in data analysis. Joint modeling was conducted for analysis of non-adherence to medication and the time to default from treatment. In the joint model, a GLMM and Cox PH sub-models were fit together for non-adherence to medication and time to default from treatment.ResultsThe significant predictors for the variables of interests in current investigation were length of visiting time(AOR of 95% CI=0.866 (0.752, 0.997), female patients(AOR of 95% CI= 0.219 (0.067, 0.717)), patients disclosed the disease(AOR of 95% CI= 0.353 (0.194,0.641)), patients who got social support(AOR of 95% CI= 0.252 (0.194,0.631)), patients living with parter(AOR of 95% CI=0.188 (0.042,0.844)), patients with owner of cell phone(AOR of 95%CI= 0.272 (0.081,0.916)), urban HIV patients(AOR of 94%CI= 0.238 (0.078,0.722)), patients with working functional status(AOR of 95% CI= 0.234 (0.079,0.692)), patients with normal BMI(AOR of 95% CI=0.921 (0.881, 0.963)), patients with high baseline CD4 cell count(AOR of 95% CI=0.873 (0.552, 0.997)).ConclusionSome groups of HIV patients were non-adherent to medication and defaulted from treatment. Health related education is recommended for non-adherent patients to be adherent for the prescribed medication and live long in the treatment.     

Prevalence,predictors and reasons for home delivery amongst women of childbearing age in Dodoma Municipality in central Tanzania

IntroductionThe objective was to determine the prevalence, predictors and reasons for home delivery amongst women of childbearing age in Dodoma, Tanzania.MethodsA cross-sectional study was conducted amongst women living in Dodoma Municipality. Data were collected using adapted questionnaires and analysed using SPPS version 23. A multivariable logistic regression model was used to assess the independent predictors of home delivery.ResultsA total of 425 women of childbearing age were enrolled in this study. The mean (± SD) age of the participants was 28.7 (±7.1) years. The prevalence of home delivery was 35.5% (n=150, 95% CI 30.9 – 40.2). Women with secondary school and above had 93% less odds of home delivery than women who had no education (AOR=0.0795% CI: 0.03–0.18). Women who lived in rural areas (AOR=3.49, 95% CI: 2.12–5.75), and women living more than 5km from health facilities (AOR=2.67, 95% CI: 1.65–4.37) had higher odds of home delivery. The main reasons for home delivery were transportation cost, and long distance to the nearest health facilities.ConclusionIn this population, the prevalence of home delivery remained to be high. To address this more collaborative multisectoral effort like strengthening health education and strengthening maternity waiting homes are needed.     

Evolution of the prevalence of hepatitis C virus infection and hepatitis C virus genotype distribution in human immunodeficiency virus-infected patients in Italy between 1997 and 2015

ObjectivesTo analyse the variation of hepatitis C virus (HCV) prevalence and genotype distribution and their determinants in people living with human immunodeficiency virus (HIV) who entered care between 1997 and 2015.MethodsHIV-infected patients enrolled in ICONA who were tested for HCV antibodies (HCV-Ab) were included.ResultsOverall 3407 of 12 135 (28.1%) were HCV-Ab+; and 735 of 12 135 (6.1%) were HBsAg+. Among patients whose HCV genotype was known, the most represented were genotypes 1 and 3. The prevalence of HCV infection decreased from 49.2% (2565/5217) during 1997–2002 to 10.2% (556/5466) during 2009–2015. The frequency of genotype 1a increased from 29.0% (264/911) to 43.0% (129/300), whereas genotype 3 decreased from 38.5% (351/911) to 27.0% (81/300). Independent predictors of HCV-Ab+ status were being female (adjusted OR (AOR) 1.23, 95% CI 1.04–1.50, p = 0.01), risk category (versus injecting drug users: men who have sex with men AOR 0.01, 95% CI 0.01–0.01, p <0.001; heterosexuals AOR 0.01, 95% CI 0.01–0.01, p <0.001; other/unknown AOR 0.02, 95% CI 0.01–0.02, p <0.001), being cared for in Central Italy (versus being cared for in Northern Italy: AOR 0.85, 95% CI 0.73–0.98, p <0.001), being Italian-born (AOR 1.44, 95% CI 1.16–1.80, p = 0.001) and being enrolled in less recent calendar years (versus 1997–2002: 2009–2015 AOR 0.23, 95% CI 0.19–0.27, p <0.001; 2003–2008 AOR 0.49, 95% CI 0.41–0.61, p <0.001).ConclusionsThe prevalence of HCV infection in HIV-infected patients entering into care in Italy significantly declined in more recent calendar years. After adjusting for risk factors and calendar years, HCV co-infection was more frequent in females and in those born in Italy.     

Sero-prevalence of Hepatitis B virus surface antigen and associated factors among women of reproductive age in Bench Maji Zone,Southwest Ethiopia: Community based cross-sectional study

BackgroundHepatitis B virus infection is one of the leading causes of liver diseases which occurs worldwide particularly in developing countries. It is often caused by prenatal transmission from mother to child or household transmission from a close contact during early childhood. It causes different complications like; jaundice, induces premature labor, and prematurity.ObjectiveThe aim of this study was to estimate the sero-prevalence of hepatitis B virus surface antigen and associated factors among women of reproductive age in Bench Maji Zone, South West Ethiopia.MethodsA community-based cross-sectional study was conducted from December 15th, 2016 to February 15th, 2017. Multistage sampling technique was applied to select study participants. Logistic regression analysis was applied and p-values < 0.05 was used to see the significant association between dependent and independent variables.ResultsA total of 330 participants were included in this study yielding 98.8% response rate. The sero-prevalence of hbsag among women of reproductive age was 28(8.5%). Having multiple sexual partners (AOR = 18.73, 95% CI = [3.65, 96.21) history of unprotected sex (AOR = 9.39, 95% CI = [1.64, 53.77) were found to be significantly associated with sero-prevalence of HBV.ConclusionsThe sero-prevalence of HBV infection among women of reproductive age was highly endemic. Hence, behavioral education and communication programs focusing on reduction of risky sexual behaviors should be designed to reduce HBV infection.     

Prevalence and associated factors of HIV-TB co-infection among HIV patients: a retrospective Study

BackgroundTB/HIV co-infection is a major public health problem in many parts of the world. But the prevalence of co-infection was varies among countries.This study was designed to assess prevalence of TB/HIV co-infection and to determine its factors.MethodsA retrospective study was done among HIV-positive patients at Hiwot Fana hospital from December, 2014 to 2018. The study participants were selected by simple random sampling. Patients with incomplete chart reviews were excluded and demographic, clinical and laboratory information were analyzed using SPSS and STATA. Uni-vitiate and bivariate logistic regressions were applied.ResultsFive hundred fourteen patients were enrolled in this study. Of these, 187(37.4%) had TB. Bivariate logistic analysis showed that HIV patients with regards to marital status[AOR = 2.6; 95%CI = 1.19–2.89], education status [AOR = 3.74; 95%CI = 2.47–5.66], weight less than 50kg [AOR = 2.54; 95% CI = 1.35 – 4.81], CD4 level < 200cells/mm³ [AOR = 4.57; 95%CI = 2.38– 6.86] and patient who were at WHO clinical stage III [AOR = 7.8; 95%CI = 5.15 – 8.55] were significantly associated with TB/HIV co-infection.ConclusionThe prevalence of TB among HIV patients was high and predicted by marital, education status, weight, CD4 cell count and WHO clinical stage III.     

Pattern and risk factors for childhood injuries in Dar es Salaam,Tanzania

BackgroundInjuries contribute to morbidity and mortality in children. This study was carried out to describe the pattern of childhood injuries and associated risk factors in Dar es Salaam, Tanzania.MethodsThis case control study was conducted in six selected health facilities in Dar es Salaam, Tanzania. Data were collected using a structured questionnaire. Cases and controls were children below 18 years who had suffered injuries and those without injury associated condition respectively.ResultsA total of 492 cases and 492 controls were included in the study, falls (32%), burns (26%), Road Traffic Injuries (14%) and cuts (10%) were the major types of injuries identified. Younger parents/guardians {Adjusted odds ratio (AOR)= 1.4; 95% CI: 1.4 -3.6}, more than six people in the same house (AOR= 1.8; 95% CI: 1.3–2.6), more than three children in the house {AOR= 1.4; 95% CI (1.0–2.0)}, absence of parent/guardian at time of injury occurrence (AOR= 1.6; 95% CI: 1.1–2.3), middle socio-economic (AOR=1.6; 95%CI: 1.1–2.4) and low socio-economic status (AOR= 1.5; 95% CI: 1.0–2.1) were independent risk factors for childhood injury.ConclusionFalls, burns and road traffic injuries were the main injury types in this study. Inadequate supervision, overcrowding, lower socio-economic status and low maternal age were significant risk factors for childhood injuries.     

Prevalence of overweight/obesity and its associated factors among a sample of Moroccan type 2 diabetes patients

BackgroundObesity constitutes a major risk factor for the development of diabetes, and has been linked with poor glycaemic control among type 2 diabetic patients.AimsThis study examines the prevalence of overweight/obesity and associated factors in type 2 diabetic patients in the Beni-Mellal Khenifra region in Morocco.MethodsA questionnaire-based cross-sectional study was conducted in 2017 among 975 diabetes patients attending primary health centres. Demographic and clinical data were collected through face-to-face interviews. Anthropometric measurements, including body weight, height and waist circumference, were taken using standardized techniques and calibrated equipment.ResultsThe prevalence of overweight was 40.4%, the general obesity was 28.8% and the abdominal obesity was 73.7%. Using multivariate analysis, we noted that the general obesity was associated with female sex (AOR= 3,004, 95% CI: 1.761–5.104, P<0.001), increased age (AOR=2.192, 95% CI: 1.116–4.307, P<0.023) and good glycaemic control (AOR=1.594, 95% CI: 1.056–2.407, P=0.027), whereas abdominal obesity was associated wih female sex (AOR=2.654, 95% CI: 1.507–4.671, P<0.001) and insulin treatment (AOR=2.927, 95% CI: 1.031–8.757, P=0.048).ConclusionOverweight, general obesity and abdominal obesity were high among participants, especially among women. Taken together, these findings urge the implementation of a roadmap for this diabetic subpopulation to have a new lifestyle.     

Magnitude of post-operative mortality and associated factors among patients who underwent surgery in Wolaita Sodo teaching and referral hospital,SNNPR region,Ethiopia

BackgroundEach year 4.2 million people around the world die within 30 days of surgery and postoperative deaths account for 7.7 % of all deaths. So this study aimed to asses'' magnitude of postoperative mortality and associated factors among patients who underwent surgery in Wolaita Sodo University Teaching referral Hospital.MethodRetrospective cross sectional design was carried out from April 15–30 2019. Card review was done on 384 participants by using Systematic sampling technique. Entered to Epi Data; exported to SPSS for analysis. Variables with p-value < 0.25 in bivariate analysis were entered to multivariate logistic regression. Statistical significance is determined at p-value < 0.05.ResultsThe magnitude of postoperative mortality was 5.7%. Using surgical check list (AOR= 0.18; 95% CI 0.05 to 0.61), having comorbid condition (AOR= 4.45; 95% CI 1.39 to 14.19), and don''t having blood transfusion (AOR= 0.07; 95% CI 0.02 to 0.22) and general anesthesia (AOR= 4.37; 95% CI 1.17 to 16.30) are factors of post-operative mortality.ConclusionThe magnitude of postoperative mortality was high. Surgical check list, comorbidity, blood transfusion and general anesthesia are factors. The hospital should encourage using of surgical check list and work on comorbid patients to decrease the mortality.     

HIV,hepatitis B virus,hepatitis C virus,and syphilis among pregnant women attending antenatal care in Luanda,Angola: Seroprevalence and risk factors

Infectious diseases during pregnancy remain a public health concern, especially in a resource-limited setting. The study aimed to determine the seroprevalence and determinants of HIV and co-infection with hepatitis B virus (HBV), hepatitis C virus (HCV), and syphilis among pregnant women attending antenatal care in Luanda, the capital city of Angola. A cross-sectional study was conducted with 1612 pregnant women screened for HIV during antenatal care. HIV-reactive were also screened for the HBV, HCV, and syphilis using immunoassay kits. A logistic regression model, adjusted odds ratios (AOR) and their 95% confidence interval (CI) were calculated with a level of significance set at 5%. The overall seroprevalence of HIV was 2.6%. About 13% of HIV-positive pregnant women were coinfected. From which, 7.5% were reactive to HBV and 5% to syphilis. There was no reactivity to HCV. Pregnant women younger aged than 25 years were significantly protected from HIV-infection (AOR, 0.43 [95% CI, 0.20-0.91], P = .026). The co-infection was 1.3 times (AOR, 0.04-41.0) in younger aged than 25 years, 7.0 times (AOR, 0.50-99.2) to residents in urbanized areas, and 1.4 times (AOR, 0.10-20.9) in pregnant women with a high educational level. In conclusion, infectious diseases are a public health burden among pregnant women in Luanda. However, include an integrated antenatal screening mainly in urbanized areas is crucial to reduce the spread of infectious diseases in different communities of Angola.     

Correlates and trend of HIV prevalence among female sex workers attending sexually transmitted disease clinics in Pune, India (1993-2002)

In India, substantial efforts have been made to increase awareness about HIV/AIDS among female sex workers (FSWs). We assessed the impact of awareness regarding safe sex in a cohort of FSWs by studying trends in HIV prevalence, sexually transmitted diseases (STDs), and risk behaviors measured from 1993 to 2002 in Pune, India. A total of 1359 FSWs attending 3 STD clinics were screened for HIV infection, and data on demographics, sexual behaviors, and past and current STDs were obtained. The overall HIV prevalence among FSWs was 54%. Not being married (adjusted odds ratio [AOR] = 1.74, 95% confidence interval [CI]: 1.17 to 2.59), being widowed (AOR = 2.10, 95% CI: 1.16 to 3.80), inconsistent condom use (AOR = 1.60, 95% CI: 1.02 to 2.50), clinical presence of genital ulcer disease (GUD; AOR = 1.66, 95% CI: 1.07 to 2.56), and genital warts (AOR = 4.70, 95% CI: 1.57 to 14.08) were independently associated with HIV infection among FSWs. The prevalence of HIV remained stable over 10 years (46% in 1993 and 50% in 2002; P = 0.80). The prevalence of GUD decreased over time (P < 0.001), whereas that of observed genital discharge remained stable. Reported consistent condom use as well as the proportion of FSWs who refused sexual contact without condoms increased over time (P < 0.001). These data collectively suggest that safe sex interventions have had a positive impact on FSWs in Pune, India.     

Risk factors for pneumonia in urban-dwelling HIV-infected women: a case-control study in Nairobi,Kenya

In sub-Saharan Africa, respiratory tract infections (RTI) are the leading cause of serious morbidity and mortality in HIV-infected persons. This study sought to investigate demographic, socioeconomic, and environmental risk factors for pneumonia in a cohort of HIV-infected women. The authors performed a nested case-control study in a cohort of HIV-1-infected adults followed in Nairobi, Kenya. Thirty-nine women who developed pneumonia during the follow-up period were selected as cases, and 66 women who did not develop pneumonia were randomly chosen to serve as control subjects. A questionnaire was administered in subjects' homes that assessed demographics, home environment, and socioeconomic status. Women were followed in the cohort for a median of 36.8 months (range, 27.3-39.3). Adjusting for length of follow-up period, factors associated with lower socioeconomic status (lower monthly spending [OR = 3.2; 95% CI, 1.2-8.4 per 10,000 Kenyan shilling decrease], having no savings [OR = 4.1; 95% CI, 1.4-11.9], less sturdy home construction material such as mud or cement walls [OR = 2.6; 95% CI, 1.1-5.9] or dirt floors [OR = 2.8; 95% CI, 1.0-7.6], and lack of a window in the home [OR = 5.5; 95% CI, 0.9-32.2]) and being widowed (OR = 4.3; 95% CI, 1.2-15.1) or single (OR = 3.3; 95% CI, 1.0-11.2) were associated with an increased risk of pneumonia. In multivariate analysis, widowed (AOR = 5.9; 95% CI, 1.3-26.3), single (AOR = 7.7; 95% CI, 1.6-36.4), and divorced (AOR = 4.5; 95% CI, 1.0-20.1) women, those without savings (AOR = 3.7; 95% CI, 1.2-11.7), and those living in more crowded and contagious conditions (AOR = 1.5; 95% CI, 1.1-2.1) remained at increased risk of pneumonia. If confirmed by prospective investigation, these findings could help identify persons and subpopulations of HIV-infected women with the greatest risk of pneumonia.     

Exclusive breastfeeding practice and its associated factors among children aged 6–23 months in Woldia Town,Northwest Ethiopia

BackgroundInappropriate practice of exclusive breastfeeding (EBF) is still a major problem worldwide.ObjectiveTo identify exclusive breastfeeding practice and its associated factors among children aged 6–23 months in Woldia TownMethodsA Community based cross-sectional study was carried out.Interviewer-administered questionnaire was utilized to collect the data. The questionnaire was adapted from the 2016 Ethiopia Demographic and Health Survey. Hosmer-Lemeshow model was fitted at a P-value of 0.91. Finally, Variables having P-Value <0.05 with 95% CI was considered as significant factors.ResultThe prevalence of exclusive breastfeeding practice was 46.2% (95% CI: 42.0, 49.8). Being employed mothers (AOR=0.62,95% CI:0.44,0.87), being head of a household (AOR=0.52,95% CI:0.32,0.83), not g getting husband support (AOR:0.5,95%CI:0.34,0.74), not fed colostrum''s (AOR:0.36,95%CI:0.23,0.57), not affected by traditional belief (AOR:3.59, 95% CI:2.09–6.17) shows significant association with Exclusive breast feeding practice.ConclusionThe prevalence of exclusive breast feeding practice was relatively lower than the National prevalence. Some demographic variable and traditional beliefs were significantly associated with exclusive breast feeding. Designing model policies that empower the role of women and eradicating bad traditional beliefs in the community is fundamental step.     

Self-efficacy and health-related quality of life in chronic obstructive pulmonary disease: A meta-analysis

ObjectiveTo determine the association between self-efficacy and health-related quality of life (HRQoL) in people with Chronic Obstructive Pulmonary Disease (COPD) and the moderating effect of self-efficacy type (exercise task, exercise barrier, COPD symptom, general) and HRQoL type (generic, COPD specific).MethodsDatabases were searched systematically from inception to January 2019. Methodological quality was assessed, and a meta-analysis was conducted following PRISMA guidelines (PROSPERO protocol: CRD42018114846).ResultsAcross 31 coefficients, there was a positive relationship between self-efficacy and HRQoL (r = 0.38, 95 %CI [0.32, 0.45]). Exercise barrier self-efficacy had the strongest relationship to HRQoL (r = 0.42, 95 % CI [0.30, 0.52]), followed by COPD symptoms (r = 0.41, 95 % CI [0.33, 0.49]), exercise tasks (r = 0.40, 95 % CI [0.29, 0.50]), and general self-efficacy (r = 0.21, 95 % CI [0.14, 0.28]). Generic HRQoL had a similar relationship to self-efficacy (r = 0.38, 95 % CI [0.28, 0.47]) as COPD specific HRQoL (r = 0.38, 95 % CI [0.30, 0.46]).ConclusionThere is a moderate positive relationship between self-efficacy and HRQoL in COPD, with the relationship stronger for exercise and COPD symptoms than general self-efficacy.     

Prevalence and risk factors of wheeze and eczema in 1‐year‐old children: the Butajira birth cohort,Ethiopia

Background The rising global prevalence of asthma and other allergic conditions has been linked to potential aetiological factors influencing the developing immune system. Objective To investigate the prevalence and associated risk factors for wheeze and eczema in 1‐year‐old children in a birth cohort from Butajira, Ethiopia. Methods In 2005/6, a population‐based cohort of 1065 pregnant women was established. At 1 year of age, data on wheeze and eczema in the children were collected from the mother via an interview‐administered questionnaire, along with numerous demographic and lifestyle factors. A stool sample was also obtained from the child for geohelminth analysis. Results The prevalence of wheeze was 11.5% (103/899) and eczema 8.6% (77/899). Independent predictors of wheeze were maternal allergic history [adjusted OR (AOR)=3.00, 95% CI 1.23–7.36], paternal allergic history (AOR=2.59, 95% CI 1.08–6.25), increasing household size (P for trend=0.023; AOR=3.54, 95% CI 1.31–9.56 for 7+ vs. 1–3 individuals) and paracetamol use by the child (overall P<0.001; AOR 11.04, 95% CI 4.30–28.31 for 4+ tablets in past month vs. never). Factors independently associated with eczema were maternal allergic history (AOR=3.68, 95% CI 1.54–8.77), household size (overall P=0.035; AOR=0.45, 95% CI 0.23–0.87 for 4–6 individuals relative to 1–3) and place of sleeping (overall P<0.001; AOR=0.29, 95% CI 0.10–0.82 for floor vs. bed/platform). Conclusion These findings support the hypothesis that eczema in early life in these children is a manifestation of allergy, while wheezing is probably due to infection as well as allergy. Cite this as: Y. Belyhun, A. Amberbir, G. Medhin, B. Erko, C. Hanlon, A. Venn, J. Britton and G. Davey, Clinical & Experimental Allergy, 2010 (40) 619–626.