HIV/AIDS risk perception and behavior of college students of the Metekel Zone,Benishangul Gumuz regional state,Ethiopia

Sexual and reproductive health problems are the main causes of death, disability and disease among young people in the world, particularly in Africa. The objective of this study was to assess human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) risk perception and behavior, and factors associated with risk perception, among college students of the Metekel Zone, Ethiopia. An institutional-based cross-sectional study design was used. The data were collected using a pretested and self-administered questionnaire, were entered into EPI INFO version 6 and exported into Statistical Package of Social Sciences (SPSS) version 16 for analysis. Variables with p < 0.02 in the bivariate logistic regression were entered to multivariate logistic regression and variables with p < 0.05 were considered as statistically significant. Three hundred and eighty-eight students were participated. Total 43% of respondents (50.70% males and 34.10% females) had had sex. About 48.81% of the sexually active respondents reported that they had had sexual intercourse with two or more partners. About 16.49% of study participants perceived themselves at risk of getting HIV/AIDS and the most frequently, cited reasons for perceiving oneself at risk were having sex without a condom, having multiple sexual partners and having sex with commercial sex workers (CSW). Chewing khat (adjusted OR = 3.54, 95% CI: 1.45?8.63); being willing to undergo voluntary counseling and testing (VCT) (adjusted OR = 4. 30, 95% CI: 1.09?16.88); having seen a person infected/dead of HIV (adjusted OR = 4.23, 95% CI: 1.36?13.13) and having multiple sexual partners (adjusted OR = 6.10, 95% CI: 2.40?15.44) were significantly associated with HIV risk perception. The risk perception of HIV/AIDS among the college students was low despite their involvement in different risky sexual behaviors. The government should use mass media techniques, such as television, radio, mobile services and posters to spread information on HIV transmission prevention among college students, especially information on the importance of condom use, minimizing the number of sexual partners and VCT. College administrations need to disseminate information through special lectures, and group discussions about khat chewing, HIV/AIDS and VCT.     

Disease burden due to pre-eclampsia/eclampsia and the Ethiopian health system's response

Objective

To assess the maternal disease burden due to pre-eclampsia/eclampsia in Ethiopia and the national health system's readiness to respond to the needs of women with pre-eclampsia/eclampsia.

Methods

The national emergency obstetric and newborn care (EmONC) assessment entailed collecting information from 112 hospitals and 685 health centers in Ethiopia, focusing on their infrastructure, the services they provided, human resources, equipment and supplies, case load, and mortality due to pre-eclampsia/eclampsia.

Results

Pre-eclampsia/eclampsia complicated 1.2% of all institutional deliveries. Given the low institutional delivery rate and an expected incidence of 2%-8% of all deliveries, this implies that only a small fraction (3.8%) of all women with pre-eclampsia/eclampsia received care at health facilities. 11% of all maternal deaths and 16% of direct maternal deaths were due to this obstetric complication. The cause-specific case fatality rate was high (3.6%). Availability of urine test strips, anticonvulsants, antihypertensives, and actual service provision to treat these diseases was limited, especially at health centers.

Conclusion

The salutary effects of the national EmONC assessment were immediate, as evidenced by how quickly the release of the Ethiopian report led to important national efforts to improve maternal and newborn health. Expansion of health services should be augmented with periodic assessments of logistics and quality-related issues to assure functioning facilities for women accessing obstetric services.     

Surveillance of Bacterial Meningitis,Ethiopia, 2012–2013

Among 139 patients with suspected bacterial meningitis in Ethiopia, 2012–2013, meningococci (19.4%) and pneumococci (12.9%) were the major disease-causing organisms. Meningococcal serogroups detected were A (n = 11), W (n = 7), C (n = 1), and X (n = 1). Affordable, multivalent meningitis vaccines for the African meningitis belt are urgently needed.     

Assessment of community pharmacy professionals’ knowledge and counseling skills achievement towards headache management: a cross-sectional and simulated-client based mixed study

Background

Headache is one of the most common disabling medical condition affecting over 40% of adults globally. Many patients with headache prefer to alleviate their symptom with a range of over-the-counter analgesics that are available in community medicine retail outlets (CMROs). However, data regarding how community pharmacists respond to headache presentation and their analgesic dispensing behaviors in Ethiopia is scarce. The present study aimed to assess the self-reported and actual practice of community pharmacists toward management of a headache in Gondar town, Ethiopia.

Methods

A dual-phase mixed-methods research design, including pseudo-client visits (between April 1 and 30, 2018) followed by a questionnaire-based cross-sectional study (between May 1 and 20, 2018) was conducted among CMROs in Gondar town, Ethiopia.

Results

Among the 60 pseudo-client visits, 95% of them dispensed medications. The overall counseling approach was found to be 42.6% which improved to 58.3% when the pseudo-clients demanded it. Duration (73.3%) and signs/symptoms (45%) of headache were asked before dispensing the medications. Dosing frequency (86.7%), indication (60%) and dosage form (35%) were the most discussed items. Ibuprofen (45%) and diclofenac (41.5%) were primarily added to paracetamol for better headache treatment. Effectiveness (61.7%) and cost (21.7%) were the main criteria to choose drugs. In the cross-sectional survey, 60 participants were requested and 51 of them agreed to participate (response rate of 85%). Of these participants, 64.7% agreed that managing headache symptomatically is challenging. Patient lack of confidence in dispensers (41.2%) and lack of updated medical information (31.4%) were reported as the primary barriers to counsel clients.

Conclusion

This study demonstrated the practical gaps in counseling practices and poor headache management of community pharmacies in Gondar city. National stakeholders in collaboration with academic organizations should be involved in continuous clinical training and education regarding proper counseling practices.

     

A small-molecule Psora-4 acts as a caloric restriction mimetic to promote longevity in C. elegans

GeroScience - In populations around the world, the fraction of humans aged 65 and above is increasing at an unprecedented rate. Aging is the main risk factor for the most important degenerative...     

User fees and maternity services in Ethiopia

Objectives

To examine user fees for maternity services and how they relate to provision, quality, and use of maternity services in Ethiopia.

Methods

The national assessment of emergency obstetric and newborn care (EmONC) examined user fees for maternity services in 751 health facilities that provided childbirth services in 2008.

Results

Overall, only about 6.6% of women gave birth in health facilities. Among facilities that provided delivery care, 68% charged a fee in cash or kind for normal delivery. Health centers should be providing maternity services free of charge (the healthcare financing proclamation), yet 65% still charge for some aspect of care, including drugs and supplies. The average cost for normal and cesarean delivery was US $7.70 and US $51.80, respectively. Nineteen percent of these facilities required payment in advance for treatment of an obstetric emergency. The health facilities that charged user fees had, on average, more delivery beds, deliveries (normal and cesarean), direct obstetric complications treated, and a higher ratio of skilled birth attendants per 1000 deliveries than those that did not charge. The case fatality rate was 3.8% and 7.1% in hospitals that did and did not charge user fees, respectively.

Conclusion

Utilization of maternal health services is extremely low in Ethiopia and, although there is a government decree against charging for maternity service, 65% of health centers do charge for some aspects of maternal care. As health facilities are not reimbursed by the government for the costs of maternity services, this loss of revenue may account for the more and better services offered in facilities that continue to charge user fees. User fees are not the only factor that determines utilization in settings where the coverage of maternity services is extremely low. Additional factors include other out-of-pocket payments such as cost of transport and food and lodging for accompanying relatives. It is important to keep quality of care in mind when user fees are under discussion.     

Indicators for availability, utilization, and quality of emergency obstetric care in Ethiopia, 2008

Objective

To report on the availability and quality of emergency obstetric and newborn care (EmONC) in Ethiopia.

Methods

All licensed hospitals and health centers were visited and standard questionnaires were administered. In addition, a nonrandom systematic sample was taken of recent cesarean deliveries, partographs, and maternal deaths—and these cases were systematically reviewed. Health facilities were geocoded using geographic positioning system devices.

Results

Too few facilities provided EmONC to meet the UN standards of 5 per 500 000 population, both nationally and in all but 2 regions. Only 7% of deliveries took place in institutions of any type, and only 3% in facilities that routinely provided all the signal functions. Only 6% of women with obstetric complications were treated in any health facility, half of whom were treated in fully functional EmONC facilities. Nationwide, 0.6% of expected deliveries were by cesarean. The mortality rate for women with serious obstetric complications (case fatality rate) was 2%. The cause of death was unknown in 10% of cases, and 21% were due to indirect causes (primarily malaria, anemia, and HIV-related).

Conclusion

None of the indicators met UN standards. Ethiopia faces many challenges—not least geography—with regard to improving EmONC. Nevertheless, the government places high priority on improvement and has taken (and will continue to take) action to achieve Millennium Development Goals 4 and 5. This comprehensive survey serves both as a road map for planning strategies for improvement and as a baseline for measuring the impact of interventions.