Ethiopian Journal of Health Development

The Effect of Cox’s Interaction Model-based Nutrition Education Program on Health Perception, Dietary SelfEfficacy, Dietary Pattern, and Diet Behaviors of Children

Fadime Hatice İnci — 2023-09-20

Background: Healthy lifestyle behaviors gained in childhood have a great impact on health in adulthood.
Nutrition is one of the most important healthy lifestyle behaviors. Children's nutritional behaviors should be
improved through nutrition programs.
Objective: To determine the effects of Cox’s Interaction Model-based Nutrition Education Program on health
perception, dietary self-efficacy, dietary pattern, and diet behaviors of children.
Methods: The research employed a quasi-experimental design. This research was conducted with 5th
-7
th grade
students of similar socioeconomic status attending two different secondary schools (n=516). The lottery method
was used to randomly assign the two schools to the intervention and control groups. Data were collected using a
demographic data form, Children’s Dietary Self-Efficacy Scale, Dietary Pattern Index, and Diet Behavior Scale.
Cox’s Interaction Model-based Nutrition Education Program was applied to students in the intervention group for
five weeks. This program consists of two sections: interactive education and educational activities. Paired samples
t-test was used for intra-group comparisons and Student's t-test was used for inter-group comparisons.
Results: There was no significant difference between the two groups in terms of diet self-efficacy, dietary pattern,
and diet behaviors in the pre-intervention. After the post-intervention, diet self-efficacy, health perception, and diet
behavior scores of the experimental group increased, while the diet pattern scores decreased. However, there was
no change in the control group.
Conclusions: It was found that Nutrition Education Program given to students positively affected their dietary
self-efficacy, health perception, dietary pattern, and diet behaviors. [Ethiop. J. Health Dev. 2023; 37(1):00-00]

Analysis of risk factors in patients with acute myocardial infarction based on coronary imaging analysis

Ting Zhuang — 2023-09-20

Objective: This paper uses coronary imaging to explore the risk factors of patients with acute myocardial infarction, and to analyse the effect of coronary imaging on the analysis of risk factors for patients with acute myocardial infarction.

Methods: This paper uses coronary imaging analysis to analyse the risk factors of patients with acute myocardial infarction.

Results: Single vessel disease is a leading disease in young AMI patients (34 cases, accounting for 54.0%), this mostly affects the left anterior descending artery (51 cases, accounting for 81.0%), followed by the right coronary artery (30 cases, accounting for 47.6%), in elderly patients with AMI the disease presents in three-vessels (77 cases, accounting for 55.8%), and the left main trunk is mostly affected in the elderly.

Conclusion: The risk factor analysis method of patients with acute myocardial infarction based on coronary imaging analysis has a good effect.

Angina Self-Management Plan and Quality of Life, Anxiety and Depression in Post Coronary Angioplasty Patients

Zhang Mei — 2023-09-20

Background: Patients suffering from coronary artery diseases have some depression and anxiety, as these are the frequent causes of mortality. The self-management programmes showed noteworthy effects on the chronic illnesses.

Aim: The current study was carried out to evaluate the impacts of the angina plan on depression, anxiety, and QoL in individuals after angioplasty.

Methods: This study was done in various specific hospitals and divided the patients into groups such as experimental and control. Height, weight, and blood pressure were also measured. The history of vascular coronary involvement, hypertension, hypercholesterolemia, diabetes, and smoking were also obtained. Then a twelve-week intervention plan for angina was also performed.

Results: The results regarding depression and anxiety were also analysed by t-test independently using SPSS. The difference between the two groups was not statistically significant, indicating that the angina self-management plan was effective in reducing anxiety and improving QoL ‘s perception.

Conclusion: According to study findings and the favourable features of the angina approach to decreasing anxiety as an essential component in the prognosis of coronary artery disease (CAD), it is envisaged that the use of these programmes will play a key role in monitoring the CAD process and preventing coronary events.

The Need of Primary Caregivers of Schizophrenia Patients and Its The Effect on Care Giving Burden: A CrossSectional Study

Nesrin Çunkuş Köktaş — 2023-09-20

Background: Patients’ relatives usually care for patients of with schizophrenia. Caregivers can experience some difficulties during the caregiving process. This can increase the burden of caregivers. This study aimed to determine the requirements of primary caregivers of schizophrenia patients and its effect on caregiver burden.

Methods: The sample of the cross-sectional study consisted of 94 caregivers of patients with schizophrenia who were treated at the university hospital in western Turkey and agreed to participate in this study. A questionnaire form and Caregiving Burden Scale were used to collect data. The data were collected from individual interviews between March-December 2015.

Results: The average score of Caregiving Burden Scale of the primary caregivers is was determined as 38.47±15.05. Based on this the primary caregivers had difficulty in giving medication to their patients, the requirement of knowledge about drug treatment and side effects, coping with symptoms of schizophrenia, early warning signs, communication skills, coping with stress, psychosocial treatment methods, planning of the patients' leisure activities, and contribution of the patient to home life affected the caregiving burden having a p value of (p<0.05).

Conclusions: The overall Caregiving Burden Scale mean score of caregivers was considered moderate. It can be conclude that caregivers' requirements affect the burden of care during the caregiving process. It was considered that the feeling of burden care for caregivers will be able to reduce by giving consultancy services related to what they need and with the creation of comprehensive, systematic, continuous education programs including the difficulties faced by caregivers and the requirements being able to cope easily with the difficulties during caregiving.

Guiding the design of behavioral and lifestyle modification interventions for risk reduction, prevention, and treatment of non-communicable diseases in low- and middle-income countries: An overview of relevant literature

Abel Negussie — 2023-09-20

Background: The increasing burden of chronic non-communicable diseases (NCDs) in low- and middle-income countries (LMICs) calls for the development and dissemination of effective and viable interventions. In this respect, behavioral and lifestyle modification interventions (BLMIs) offer the most effective means of addressing the underlying lifestyle behaviors associated with NCDs at multiple disease prevention levels (primordial, primary, and secondary). This review aims to provide an overview of key features and components of BLMIs as well as some practical considerations when implementing them in LMIC settings.

Methods: An exploratory approach was used to provide an overview of salient issues in the design of BLMIs; and the PubMed and Google Scholar databases, as well as gray literature, were searched. Based on the review‘s aim, the most important issues and themes were identified using a narrative thematic synthesis and analysis approach.

Results: Thirty-three publications were included as the most relevant literature to the topic, and eight overarching themes were identified: understanding the target health behavior; using behavioral and psychological theories; applying behavior change techniques/strategies; providing effective support and follow-up; intervention delivery formats and providers; cultural sensitivity; feasibility consideration; and addressing multiple lifestyle behaviors.

Conclusion: Targeting lifestyle and behavioral modification interventions with a proper understanding of their essential design components and practical contextual considerations is crucial for reducing the rising burden of NCDs in LMICs. Future direction on the importance of conducting original research and systematic reviews on the subject was also emphasized

Respiratory Symptoms and Lung function among Female Flower Farm workers in Ethiopia

Meaza Gezu Shentema — 2023-09-20

Background: The workforces in the growing flower farms of Ethiopia are mainly females. Greenhouse workers
are exposed to pesticides, fertilizers and dust, and might be at risk for developing respiratory diseases.
Objectives: This study aimed to assess respiratory symptoms and lung function of greenhouse workers and
compare them to packinghouse flower farm workers.
Methods: A comparative cross-sectional study was conducted comparing female flower farmworkers from
greenhouses, with female workers in packinghouses. Participants were interviewed for chronic respiratory
symptoms using a standardized questionnaire from the British Medical Research Council. A Minispir light
spirometer, with Winspiro software was used for lung function tests to measure Forced vital capacity (FVC) and
Forced expiratory volume at one second (FEV1). Study groups background characteristics were compared using an
independent t-test and chi-square test. Poisson regression analysis and a general linear model were also performed.
Results: Three hundred fourteen workers participated,160 from greenhouses and 159 from pack houses. The
response rate showed that 99.7% was for the interview and 98% was for spirometry. The mean (SD) age of
greenhouse workers was 26(8) years and of packinghouse workers 24(7) years. There was no significant difference
in respiratory symptoms and spirometry indices while comparing workers in greenhouse with workers from
packinghouse. But service month was a significant predictor for the reduction of FEV1, by a reduction of
2ml/month with a p-value of 0.01.
Conclusion: There was no difference in respiratory symptoms and lung function parameters comparing
greenhouse and packinghouse workers from flower farms. Service duration was a significant predictor for the
reduction of FEV1. This may indicate the development of lung obstruction among flower farm workers over a
course of time. Workers respiratory health including lung function change needs to be monitored regularly.

The Role of locally driven Clinical Mentorship and Coaching to improve the advance critical care services in Ethiopia

Menbeu Sultan — 2023-09-20

Introduction: Critical care availability is limited in Ethiopia. Moreover, the available capacity to manage critically ill patients is concentrated in the capital city. Mentoring of smaller ICUs by the experienced provider from the larger ICUS is mentioned as a methods to improve the provision of critical care services but its impact is not well known.

Objectives: This study was aimed to assess the role of locally driven clinical mentorship and coaching and to improve critical care service in Ethiopia.

Methods: Qualitative study methods including in-depth interview and onsite observation was conducted from March 2021 to September 2022 among 24 selected hospitals of Ethiopia. Prior to the study, critical care trained senior professionals from the larger ICUs were deployed to 24 selected smaller ICUS for a two week immersion that included mentorship and coaching for ICU clinicians. Onsite observation was focused on the twelve parameters recommended by the international society intensivisits. In addition, the perceived impact was assessed qualitatively by interviewing 12 key informants from the selected hospitals. Interview was conducted in English and collected data analyzed thematically.

Results: The study included the role of mentorship and coaching for 24 hospitals in Ethiopia. There was consensus that the mentoring program improved their service and or has enabled them to start critical care in their hospitals. An improvement in unit design, human resource capacity and quality improvement projects and academic activities in the mentored hospitals was noted.

Conclusion: Country-specific mentorship and coaching from established ICUs to relatively smaller centers were found to be helpful to improve the clinical service status. Expanding the mentoring program and involving other departments like emergency medicine may help to improve the service.

Methicillin Resistant Staphylococcus aureus contamination of Health care worker gowns and Uniforms: A crosssectional Study from the biggest teaching hospital in Ethiopia

Kassu Desta — 2023-09-20

Introduction: Methicillin-Resistant Staphylococcus aureus (MRSA) is a global public health problem. Personal protective equipment (PPEs), including gowns and uniforms prevents transmission of pathogens including MRSA. Data are limited on the contamination of gowns and uniforms by MRSA in Ethiopia and many other developing nations using molecular markers.

Objective: To determine the rate of MRSA contamination of gowns and uniforms of health care workers (HCWs) at Tikur Anbessa Specialized Hospital (TASH), in Ethiopia.

Methods: A cross-sectional study design was used, and pooled swab samples from 588 HCW’s reusable gowns/uniforms were tested for the presence of S.aureus MRSA and drug-resistant testing using conventional methods and polymerase chain reaction (PCR) based mecA and Panton-Valentine leukocidin (PVL) detection. Socio-demographic data and information on the use of gowns and uniforms were collected using a questionnaire and analysed by SPSS version 20 software. A p value less than 0.05 was considered statistically significant.

Results: Female HCWs are slightly higher in number than males (58.4 % and 41.6 %, respectively). The mean age and standard deviation of HCWs were 29.13 ± 6.6 years. In TASH, 15 % (88/588) and 57.5 % (338/588) of HCWs had single and long sleeve gowns and uniforms, respectively. Forty-seven S.aureus were isolated making MRSA contamination rate of 2.9 % (17/588) (mecA positive and cefoxitin resistant) and a significant difference was seen among HCWs with history of surgical intervention. Ten of 17 MRSA contaminations were seen among HCWs who changed their gown once in a week and 2/3 of S.aureus carried PVL.

Conclusion: Gowns and uniforms of HCWs in TASH harbored MRSA as confirmed by mecA and PVL, which has implications for infection control and prevention. TASH should provide an adequate number of gowns and urgently develop a policy covering gown use to curb MRSA transmission.

Bacterial Neonatal Sepsis and Associated Risk Factors among Neonates: The Case of Adama Hospital Medical College

Takele Oli Dinagde — 2023-09-20

Background:Bacterial neonatal sepsis is a systemic inflammatory response to infection and/or isolation of bacteria from the bloodstream in the first 28 days of life.

Objective: the aim of this study is to assess neonatal sepsis and associated factors among neaonates admitted to Adama Hospital Medical College, Ethiopia

Methods: A cross-sectional study was conducted on 333 neonates, consecutive sampling used on neonates admitted at intensive care unit in Adama Hospital Medical College, Adama, Ethiopia. Data were collected using semi-structured questionnaire and 1ml of blood sample was collected following standard aseptic techniques and inoculated into a BACTEC Peds Plus culture vial, and transported to referral laboratory. Gram staining and subculturing were performed for each presumptive positive vial. Bacterial isolation and identification were done by enzymatic and fermentative biochemical tests and analyzed using SPSS v.20. multivariable logistic regression was used to identify factors having significant association with neonatal bacterial sepsis and 95% CI and P-value <0.05 were to state significance level of variable.

Results: Of the 317(95%) collected blood specimen, 147(46.4%)(95% Cl, 41.8 – 52.8%) showed bacterial growth. Gram-negative bacteria were dominants (69.9%); K. pneumoniae 72(48.98%), coagulase negative Staphylococci species 23(14.97%) and E. cloacae 18(12.24%). Factors like Onset of Labor(AOR=2.70, 95% CI: 2.34, 25.41), history of UTI/STI Infection (AOR=3.73,95%CI: 1.35, 10.28), Neonate age 4-7 days and 8-28 day (AOR=4.30, 95% CI: 1.91, 9.65 and AOR=6.07, 95%CI: 2.02, 18.22 respectively) low birth weight (AOR=2.24, 95% CI: 1.1.06, 4.71), Gestation age (AOR=2.53, 95% CI: 1.19, 5.38), intravenous fluids medication (AOR= 5.21, 95% CI: 2.58, 10.51), resuscitation at birth (AOR=7.85, 95% CI: 3.50, 17.58), shows significant association with neonatal sepsis.

Conclusion: The magnitude of bacterial sepsis was considerably high. Factors like onset of labor, history of UTI/STI infection , neonate age 4-7 days and 8-28 day, low birth weight, gestation age, intravenous fluids medication, resuscitation at birth, shows significant association with neonatal sepsis. Therefore, adherence to strict aseptic techniques while providing neonatal resuscitation and intraveinus fluid and medication service is important to reduce neonatal sepsis.

Intention to screen for cervical cancer and factors associated among female healthcare professionals using the trans-theoretical model: Addis Ababa, Ethiopia

Semarya Berhe — 2023-09-20

Background: Healthcare providers can serve as role models to facilitate a supportive environment that encourages women to utilize screening for cervical cancer. Equally important is that being a female healthcare professional does not prevent the risk of cervical cancer. Therefore, this study aims to assess the intention of screening with visual inspection of acetic acid (VIA) and its determinants among female healthcare professionals (HCPs), guided by the trans-theoretical model (TTM) of stages of behavior change.

Method: A cross-sectional study design was used to test readiness for cervical screening among selected female HCPs. A structured, self- administered questionnaire was used to collect data. The analysis included descriptive statistics and logistic regression.

Result: Four hundred sixty female HCPs with a mean age of M=33.8, +5 years participated. The intention to participate in cervical cancer screening was 44.1%. Over (half 52% of the participants) had poor knowledge of cervical cancer and screening. Regarding the TTM stages of change, 46.5% of participants indicated being in the pre-contemplation phase, suggesting they had never a VIA screen and had no intention of being screened within the next six months. In the final logistic regression model, four factors, including age, being screened in the past three years, taking care of patients with cervical cancer, and having good to moderate knowledge of cervical cancer and screening, were statistically significant, with large odds ratios for their association with intention to screen.

Conclusions: Most of the participants were in the pre-contemplation phase, and the limited knowledge health workers had about cervical cancer screening is worrisome. Intervening in the factors that affect intention for screening is vital to reducing barriers to cervical screening among female healthcare workers as well as the broader female population in Ethiopia. Providing cancer screening guidelines to all HCPs, regardless of their specialty, could be a key factor in lessening the burden of cervical cancer.

Renal Dysfunction Among Stroke Patients, Hospital Based Cross Sectional Study, Addis Ababa, Ethiopia, 2021

Lissane Seifu — 2023-09-20

Background: - Stroke is the leading explanation for neurological disability and the second commonest cause of death in the world. Even though renal dysfunction is among commonly encountered comorbidity in acute stroke patients, there was no data on the prevalence and associated factors of renal dysfunction among acute stroke patients in Ethiopia.

Objective: This study aimed to determine the magnitude of renal dysfunction and factors associated with renal dysfunction among hospitalized acute stroke patients.

Method: Hospital based retrospective cross sectional study wasonducted among all acute stroke patients admitted to Saint Peter’s specialized hospital from January to December 2021. The Data were collected from patient medical charts using a structured checklist. SPSS 23.0 was used to analysis the collected data. In order to evaluate the factors associated with renal dysfunction, statistical logistic regression with a level of α set at 0.05 was employeed. For variables with a p<0.05, statistical significance was considered.

Result: The study included 118 acute stroke patients, with a mean and standard deviation age of 60.1±14.9 years, and 63(53.4%) were males. 22 (18.6%) of the study, population had renal dysfunction. Males were more commonly 12(54.5%) affected than females. Diabetes mellitus had statistically significant association with renal dysfunction (p=0.031). Patients who had renal dysfunction had a higher mortality rate (31.8%) as compared with patients with normal renal function (21.9%).

Conclusion: Renal dysfunction is a frequent comorbidity in patients who are admitted with the diagnosis of acute stroke and had a higher mortality rate than stroke patients with normal renal function.

Magnitude and drug resistance profile of Extended Spectrum β-Lactamase (ESBL) producing gram-negative bacteria from different inanimate objects at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia

Asegedech Asmamaw Jemberu — 2023-09-20

Background: Infections caused by gram-negative bacteria are causing morbidity and mortality worldwide. The production of Extended- Spectrum β-Lactamases (ESBLs) is an important mechanism that is responsible for resistance to the third-generation cephalosporin.

Aim: The purpose of this study was to determine the magnitude and drug resistance profile of ESBL producing gram-negative bacteria isolated from various inanimate objects at Tikur Anbessa Specialized Hospital (TASH).

Methods: Laboratory based study was conducted on stored isolates from January to March 2019. The samples were taken from different inanimate objects (Intensive care unit (ICU) tables, ICU sinks, ICU IV stands, ICU beds, Incubators, ICU pediatrics trolley, oxygen regulators, Operation room (OR) tables, OR beds, OR computers, OR doors, lift buttons, x-ray chairs, and some other items) in Tikur Anbessa Specialized Hospital(TASH) and 216 isolates were used for further analysis. Biochemical tests for identification and antimicrobial susceptibility test were done by disc diffusion method. Screening of ESBLs was done using ESBL CHROME agar and confirmed with a combined disk diffusion test. The data were analyzed using SPSS software version -20 and descriptive statistical tests including frequency and percentage were calculated.

Results: In this study out of 216 gram negative bacteria, 15.3% of them were found to be ESBL producers based on the confirmatory test (combined disk method) from the various inanimate objects of TASH. Klebsiella ozaenae, Klebsiella oxytoca, Klebsiella pneumoniae, Klebsiella rhinoscleromatis, Citrobacter spp, Escherichia coli, Serriatia spp and Acinetobacter spp were ESBL producing gram-negative bacteria and found to be 100% resistant to ceftazidime and ceftriaxone.

Conclusion: It is worrisome to detect ESBL producing gram-negative bacteria from the inanimate objects of TASH, calling for systematic screening of inanimate objects for ESBL and other multidrug-resistant bacteria in the hospital. Furthermore, strengthening the infection prevention practice is vital to halt the transmission of these microorganisms.