Lemessa Oljira

Pre-marital sexual debut and its associated factors among in-school adolescents in eastern Ethiopia

BackgroundMore adolescents in Ethiopia are in school today than ever, but few studies have assessed the sexual behaviour of these learners. Thus, this study tried to assess pre-marital sexual debut and factors associated with it among in-school adolescents in Eastern Ethiopia.MethodsA cross-sectional school-based study was conducted using a facilitator guided selfadministered questionnaire. Respondents were students attending regular school classes in fourteen high schools. The proportion of adolescents involved in pre-marital sexual debut and the mean age at sexual debut was computed. Factors associated with pre-marital sexual debut were assessed using bivariate and multivariable logistic regression.ResultsAbout one in four, 686 (24.8%) never married in-school adolescent respondents reported pre-marital sexual debut of these 28.8% were males and 14.7% were females (p < 0.001). Pre-marital sexual debut was more common among adolescents who had their parents in urban areas (Adjusted OR and [95% CI] =1.42 [1.17–1.73]), who received higher pocket money per month (Adjusted OR and [95% CI] = 1.56 [1.19–2.04]), who perceived low self-educational rank (Adjusted OR and [95% CI] =1.89 [1.07–3.34]) and who lived in rented houses (Adjusted OR and [95% CI] =1.32 [1.03–1.70]). The females and those who were less influenced by external pressure were more protected against pre-marital sexual debut (Adjusted OR and [95% CI] = 0.44 [0.35–0.56; 0.62 [0.52–0.74, respectively]) than their counterparts.ConclusionA significant proportion of in-school adolescents were engaged in sexual relationship. Thus, public health interventions should consider the broader determinants of premarital sexual debut, including the ecological factors in which the behavior occurs.

Assessment of comprehensive HIV/AIDS knowledge level among in-school adolescents in eastern Ethiopia

In Ethiopia, more adolescents are in school today than ever before; however, there are no studies that have assessed their comprehensive knowledge of HIV/AIDS. Thus, this study tried to assess the level of this knowledge and the factors associated with it among in‐school adolescents in eastern Ethiopia.

Post abortion care quality status in health facilities of Guraghe zone, Ethiopia

BackgroundUnsafe abortion in the developing world accounts for 13% of all maternal deaths. Ethiopia is one of the developing countries with the highest maternal mortality ratio (673 per 100,000 live births) in the world. Unsafe abortion was estimated to account for 32% of all maternal deaths in Ethiopia.ObjectiveTo assess post abortion care quality status in health facilities of Guraghe zone.MethodsA facility based cross-sectional study design with both quantitative and qualitative methods was conducted. Patient interview, direct service observation, provider self administered questionnaire and inventory of equipment and supplies were used for the assessment. Six health centers, two hospitals and 422 post-abortion patients were included in the study.ResultsPatient-provider interaction was generally satisfactory from the patient’s perspective. The majority of the respondents (93.5%) said that they were treated with politeness and respect. More than half 226(56.5%) of the clients have received post abortion family planning. Overall, 83.5% of the patients were satisfied with the services. Those who said waiting time was long were less satisfied and unemployed women were more satisfied than others.ConclusionThe study has revealed several improvements as well as problems in the provision of post-abortion care service in the studied health facilities.

HDSS Profile: The Kersa Health and Demographic Surveillance System

Abstract Kersa HDSS was established in 12 sub-districts of Kersa district, Eastern Hararge, Oromia Region, Ethiopia. The site is principally rural with two small towns (Kersa and Weter). The baseline census was conducted in 2007 and since then has been updated every 6 months, with registration of demographic and health events. Data are entered into the HRS-2 relational database. At baseline a total of 10 085 houses, 10 522 households and 50 830 people were registered. The sex ratio and number of persons per household were 1.0 and 5.1, respectively. At the end of 2013, the population was 60 694. Up to the end of 2013, 12 571 births and 3143 deaths were registered, respectively. Over 85% of births and deaths occurred at home. The annual net population growth ranges from 0.06 to 1.6. The majority of the population in Kersa are not working age group; hence the dependency ratio in most of the years is below 1. The total fertility rate ranges from 4.0 to 5.3. A reduction in neonatal, infant and under-five mortalities was observed. For all deaths, verbal autopsies were done. Tuberculosis is the leading cause of death among adults and malnutrition is the leading cause of death among children aged under 5 years. Kersa HDSS is ready to collaborate with interested researchers on health and demographic issues. For further details please visit: [ http://www.haramaya.edu.et/research/projects/kds-hrc/ ].

One in five women suffer from pelvic floor disorders in Kersa district Eastern Ethiopia: a community-based study

BackgroundHundreds of millions of women suffer from pelvic floor disorders globally, often in silence. Women in developing countries do not disclose their problems due to associated social stigma or lack of access to services. Thus, the extent of the problem remains largely unknown. This study was conducted to assess the magnitude of pelvic floor disorders in Kersa district Eastern Ethiopia.MethodWe conducted a community-based cross-sectional study among ever married women who reside in Kersa district, Eastern Ethiopia. The study subjects were selected through stratified multistage probability sampling. The data were collected using a structured questionnaire through face-to-face interviews. The prevalence of various pelvic floor disorders are presented along with the 95% Confidence Intervals (CI).ResultsA total of 3432 women participated in the study, of which 704 (20.5%; 95% CI; 19.2, 21.8) reported at least one type of pelvic floor disorder and 349 (49.6%; 95% CI: 46.0, 53.0) reported two or more pelvic floor disorders. The most common pelvic floor disorders included an over active bladder (15.5%; 95% CI: 14.4, 16.8), pelvic organ prolapse (9.5%; 95% CI: 8.5,10.4), stress urinary incontinence (8.3%; 95% CI: 7.4, 9.2) and anal incontinence (1.9%; 95% CI: 1.5, 2.4). More than two-thirds of the women with pelvic floor disorders (68.0%; 95% CI:64.4, 71.3) reported having severe distress but had never sought health care.ConclusionsThe magnitude of the health problem and the low level of health seeking behavior indicates the silent suffering of many women in the study area. Extrapolating these figure to national statistics would indicate the staggering number of women suffering from pelvic floor disorders in the country. This calls for urgent action to improve prevention, diagnosis and treatment services to mitigate the suffering of women from pelvic floor disorders.

Small area clustering of under-five children's mortality and associated factors using geo-additive Bayesian discrete-time survival model in Kersa HDSS, Ethiopia

BACKGROUND Child mortality reflects a countrys level of socio-economic development and quality of life. In Ethiopia, limited studies were conducted on under-five mortality and almost none of them tried to identify the spatial effect on mortality. Thus, this study explored the small area clustering of under-five mortality and associated factors in Kersa HDSS, Eastern Ethiopia. METHODS The study population included all children under the age of five years during the time September, 2008-august 31, 2012 which are registered in Kersa Health and Demographic Surveillance System (Kersa HDSS). A flexible Bayesian geo-additive discrete-time survival mixed model was used. RESULTS Some of the factors that are significantly associated with under-five mortality, with posterior odds ratio and 95% credible intervals, are maternal educational status 1.31(1.13,-1.49), place of delivery 1.016(1.013-1.12), no of live birth at a delivery 0.35(0.23,1.83), low household wealth index 1.26(1.10 1.43) middle level household wealth index 0.95 (0.84 1.07) pre-term duration of pregnancy 1.95(1.27,2.91), post-term duration of pregnancy 0.74(0.60,0.93) and antenatal visit 1.19(1.06, 1.35). Variation was noted in the risk of under-five mortality by the selected small administrative regions (kebeles). CONCLUSION This study reveals geographic patterns in rates of under-five mortality in those selected small administrative regions and shows some important determinants of under-five mortality. More importantly, we observed clustering of under-five mortality, which indicates the importance of spatial effects and presentation of this clustering through maps that facilitates visuality and highlights differentials across geographical areas that would, otherwise, be overlooked in traditional data-analytic methods.

Pelvic floor disorders associated with higher-level Sexual dysfunction in Kersa district, Ethiopia

Objective: To assess the prevalence of female sexual dysfunction and its association with pelvic floor disorder (PFD) in a large scale, community-based study. Materials and Methods: A total of 2389 women who were married and still in union at the time of the study were drawn from 3432 women who had ever been married who participated in a PFD study. Study participants were selected through a multistage sampling procedure based on Kersa Health and Demographic Surveillance System database. The Female Sexual Function Index questionnaire was employed to collect data. The index score <26.55 was used as a cut-off point for sexual dysfunction. The content of the tool was validated and internal reliability was checked using Cronbach’s alpha. Poisson regression model with robust variance estimation was used to investigate the relationship between PFDs and sexual dysfunction. Results: From the total 2389 participants, 1127 [47.0%; 95% confidence interval (CI): 45.0-49.0] had sexual dysfunction. Sexual desire disorder was the most prevalent disorder (72.0%; 95% CI: 70.0-74.0). After controlling for confounding factors, the prevalence of female sexual dysfunction was found as 56% (adjusted prevalence ratio, 1.56; 95% CI: 1.44-1.69) higher with women with PFD as compared with women without PFD. Conclusion: In the rural community of Kersa, about half of the women have sexual dysfunction and it is significantly associated with PFD. This would call for an urgent intervention against PFD to maximize the women’s sexual and reproductive health.

Factors associated with pelvic floor disorders in Kersa District, eastern Ethiopia: a community-based study

BackgroundPelvic floor disorders, which diminish the quality of life, disproportionally affect women in developing countries. However, there is a knowledge gap in the understanding of the factors associated with the problem in many countries including Ethiopia. Therefore, we aimed to assess the factors associated with pelvic floor disorders in Ethiopia.Materials and methodsA community-based cross-sectional study was conducted among 3432 ever-married women selected through a stratified multistage sampling procedure from the Kersa Health and Demography Surveillance System. Data were collected using structured questionnaires through face-to-face interviews. A Poisson regression model with robust variance estimation was used to investigate the association of the independent variable with pelvic floor disorder. The results are reported in adjusted prevalence ratios with 95% confidence intervals.ResultsOverall, the prevalence of pelvic floor disorders was 20.5% (95% CI: 19%–22%). Women who had no education (APR = 1.47; 95% CI: 1.06, 2.04) or had undergone five or more vaginal deliveries (APR = 1.56; 95% CI: 1.18, 2.05), an abortion (APR = 1.85; 95% CI: 1.43, 2.38) or episiotomy (APR = 1.39; 95% CI: 1.02, 1.90) were independently associated with having pelvic floor disorders.ConclusionObstetric events are strongly associated with pelvic floor disorders. This finding highlights the greater need for policies to focus on prevention, diagnosis and treatment services to mitigate womens suffering from pelvic floor disorders.

Causes of death among children aged 5 to 14 years old from 2008 to 2013 in Kersa Health and Demographic Surveillance System (Kersa HDSS), Ethiopia

Background The global burden of mortality among children is still very huge though its trend has started declining following the improvements in the living standard. It presents serious challenges to the well-being of children in many African countries. Today, Sub-Saharan Africa alone accounts for about 50% of global child mortality. The overall objective of this study was to determine the magnitude and distribution of causes of death among children aged 5 to 14 year olds in the population of Kersa HDSS using verbal autopsy method for the period 2008 to 2013. Methods Kersa Health and Demographic Surveillance System(Kersa HDSS) was established in September 2007. The center consists of 10 rural and 2 urban kebeles which were selected randomly from 38 kebeles in the district. Thus this study was conducted in Kersa HDSS and data was taken from Kersa HDSS database. The study population included all children aged 5 to 14 years registered during the period of 2008 to 2013 in Kersa HDSS using age specific VA questionnaires. Data were extracted from SPSS database and analyzed using STATA. Results A total of 229 deaths were recorded over the period of six years with a crude death rate of 219.6 per 100,000 population of this age group over the study period. This death rate was 217.5 and 221.5 per 100,000 populations for females and males, respectively. 75% of deaths took place at home. The study identified severe malnutrition(33.9%), intestinal infectious diseases(13.8%) and acute lower respiratory infections(9.2%) to be the three most leading causes of death. In broad causes of death classification, injuries have been found to be the second most cause of death next to communicable diseases(56.3%) attributing to 13.1% of the total deaths. Conclusion and Recommendation In specific causes of death classification severe malnutrition, intestinal infectious diseases and acute lower respiratory infections were the three leading causes of death where, in broad causes of death communicable diseases and injuries were among the leading causes of death. Hence, concerned bodies should take measures to avert the situation of mortality from these causes of death and further inferential analysis into the prevention and management of infectious diseases should also be taken.