Temesgen Lera

Background: Sexual and reproductive health (SRH) services are essential for promoting the wellbeing of individuals and communities. Achieving universal health coverage is unattainable without ensuring equitable access to SRH services and upholding sexual and reproductive rights. Podoconiosis, a neglected tropical disease and non-filarial form of elephantiasis, is caused by prolonged barefoot exposure to irritant volcanic soils. Although SRH services have been increasingly integrated into primary healthcare systems in Ethiopia, people affected by podoconiosis continue to face substantial barriers in accessing these services due to stigma, mobility limitations, and socioeconomic constraints. In this context, the present study aims to assess the utilization of SRH services and the factors associated with their utilization among patients with podoconiosis in Wolaita Zone, South Ethiopia.Methods: A community-based cross-sectional study was conducted among 836 patients with podoconiosis in Wolaita Zone from 12 November to 20 December 2024. Multistage sampling was used to select participants, and data were collected through face-to-face interviews. A multilevel logistic regression analysis was performed to identify the factors associated with SRH service utilization. Statistical significance was set at p < 0.05, and adjusted odds ratios (AOR) with 95% confidence intervals (CI) were reported.Results: The study found that 154 respondents (18.4%; 95% CI: 16%, 21%) utilized SRH services within the past 12 months. The factors significantly associated with SRH service utilization included the following: age groups 18–29 years (AOR = 3.57; 95% CI: 1.55–8.25), 30–34 years (AOR = 2.89; 95% CI: 1.30–6.40), and 35–39 years (AOR = 5.06; 95% CI: 2.45–10.45); prior experience with health services (AOR = 2.39; 95% CI: 1.56–4.93); family awareness of podoconiosis etiology (AOR = 3.60; 95% CI: 2.13–6.21); positive attitude toward SRH services (AOR = 5.80; 95% CI: 3.16–10.70); family support (AOR = 2.47; 95% CI: 1.47–4.14); and autonomy in using household financial resources for healthcare (AOR = 2.05; 95% CI: 1.18–3.57).Conclusion: The utilization of SRH services among patients with podoconiosis was found to be low. The significant factors associated with SRH service utilization included the age of respondents, prior experience with health services, family awareness of podoconiosis etiology, family support, autonomy in using household financial resources for healthcare, and positive attitudes toward SRH services.

Sexual health is a crucial aspect of overall well-being, yet individuals with podoconiosis often face stigma and exclusion from healthcare services which promote sexual health. In Ethiopia, particularly in the study area, the Sexual quality of life (SQOL) of podoconiosis patients remains unexplored. This study aimed to assess the SQOL and associated factors among podoconiosis patients in Wolaita Zone, South Ethiopia. A community-based cross-sectional study was conducted among 639 podoconiosis patients using a multistage sampling technique. SQOL-F and SQOL-M questionnaires (validated tools) were used to collect data via Kobocollect software. Generalized Linear Models (GLM) with a log link and gamma variance were employed to examine associations between SQOL and independent variables. Data analysis was performed using STATA version 14, with statistical significance set at p-value < 0.05. The total of 639 respondents were included in this study. The median SQOL-F and SQOL-M scores were 50 and 22, respectively, with 60.5% of females and 84.2% of males having low SQOL score. Factors positively influencing SQOL-F score included having an educated partner, having family and government support, healthcare accessibility, ability to move from place to place, positive sexual health attitudes, and middle-income status. SQOL-M scorewas negatively affected by having a partner in government or private work, additional chronic illnesses, shorter disease duration, and poor healthcare experiences, while family and government support improved SQOL-M score. Podoconiosis significantly lowers SQOL score for both men and women. Strengthening family and community support, improving healthcare access, and integrating sexual health interventions are essential for improving SQOL score among affected individuals.

Background: Sexual and reproductive health (SRH) encompasses an individual’s overall well-being in relation to sexuality and the reproductive system. It extends beyond specific reproductive health concerns to include broader issues of sexual health. Despite the availability of SRH services in primary health care units, approximately 4.3 billion people globally lack access to essential services such as prenatal, postnatal, contraceptive, and abortion care. Attitudes toward SRH significantly influence service utilization and the effective management of sexual health concerns. This study aimed to assess attitudes and associated factors towards SRH services among podoconiosis patients in Wolaita Zone, South Ethiopia. Methods: A community-based cross-sectional study was conducted among 836 reproductive-aged podoconiosis patients. Bivariable and multivariable logistic regression analyses were performed. A Cronbach’s alpha reliability test was conducted, with a value above 0.7 considered acceptable. Variables with a p-value less than 0.25 in the bivariable analysis were included in the multivariable model. A p-value < 0.05 and 95% confidence interval (CI) were used to determine statistical significance. Results: The study found that 499 participants (59.7%) had a favorable attitude towards SRH services, while 337 (40.3%) had an unfavorable attitude. Factors significantly associated with favorable attitudes included being female (AOR = 1.64, 95% CI: 1.08–2.49), residing in urban areas (AOR = 8.85, 95% CI: 5.54–14.1), living with the disease for 1–5 years (AOR = 0.41, 95% CI: 0.2–0.82), not fearing stigma (AOR = 1.6, 95% CI: 1.1–2.34), family awareness of the disease’s cause (AOR = 2.16, 95% CI: 1.08–4.32), regular use of health services (AOR = 3.32, 95% CI: 2.04–5.44), previous use of SRH services (AOR = 10.0, 95% CI: 5.93–16.98), and being able to move from place to place (AOR = 2.75, 95% CI: 1.37–5.56). Conclusion: A favorable attitude toward SRH services was observed in 59.7% of podoconiosis patients. Significant predictors of favorable attitudes included gender, residence, duration of illness, perceived stigma, family awareness, health service utilization, prior SRH service use, and mobility. Efforts to improve SRH attitudes among podoconiosis patients should focus on expanding health education in rural areas and promoting male involvement in health-seeking behaviors. Key words: Attitude, Reproductive age, Sexual and reproductive health, Sexual and reproductive health services, Wolaita, Ethiopia

Background: Podoconiosis, one of the neglected tropical diseases (NTDs), affects barefoot people in impoverished regions and contributes to poverty by having negative impacts on economic output, education, and disability. Podoconiosis has enormous social, psychological, and economic implications for the affected individuals. Social stigmatization of people with the disease is widespread, and patients are restricted from schools, local meetings, mosques, and churches and not allowed to marry into unaffected families. Therefore, this study aimed to systematically review the stigma related to podoconiosis in Ethiopia.Methods: The Preferred Items for Systematic Reviews and Meta-analysis (PRISMA-2020) guidelines were followed. PubMed/Medline, Scopus, Web of Science, Google Scholar, and Google databases were searched. Articles published in the English language from inception to 2023 were included. Data were extracted by using a pre-prepared Excel sheet, and a narrative synthesis of the findings was done. This review was registered in the PROSPERO International Prospective Register of Systematic Reviews with registration number CRD42024510091.Results: A total of 19 studies were included in this systematic review. This systematic review identified different types of stigmas reported from individuals with podoconiosis. The types of stigmas identified were enacted, felt, and internalized stigma and social stigmas, including exclusion from different social occurrences such as idir, meetings, funerals, and churches/mosques. Stigma also prevented patients with podoconiosis from visiting health institutions for the treatment of the disease and using health services for other cases.Conclusions: Stigma among podoconiosis patients is widely distributed in Ethiopia. Different types of stigmas were identified among the patients. Extensive work needs to be done to prevent the disease and stigma. Strengthening works on community awareness about the disease help to ensure that it does not get transmitted from affected individuals to others.Systematic review registration: PROSPERO, identifier CRD42024510091.

Background: Diabetes poses a significant public health challenge, predominantly affecting low-and middle-income countries (LMICs), including in Sub-Saharan Africa (SSA). The evolving landscape characterized by resource constraints, gaps in availability and functionality of healthcare system, and socio-demographic impediments has compounded these challenges. As an example, self-care interventions have played a crucial role in diabetes care. However, the effectiveness of these interventions in the SSA remains insufficiently explored. Therefore, this systematic review evaluated the effectiveness and implementation approach of diabetes self-care interventions in SSA. Method: A comprehensive search was conducted across electronic databases including PubMed, Scopus, and Google Scholar, to identify studies focusing on diabetes self-care interventions in SSA from 2013 to 2023. The included studies reported interventions targeting dietary adherence, physical activity, medication adherence, blood glucose monitoring, foot care, and educational or support programs. The quality of the studies was assessed using the JBI checklist. Effectiveness was assessed through outcomes including glycemic control, adherence rate, complication reduction, and improvement in patient outcomes. Result: Overall, 38.5% of interventions result showed positive changes in either primary or secondary outcomes. Studies that employed diabetes self-management education showed positive changes in approximately 28.6% of cases. However, SMS text messaging interventions did not demonstrate significant changes in the measured outcomes. Of the 13 studies reviewed, 12 used randomized controlled trial designs, whereas one study employed a quasi-experimental approach. The total of participants across intervention and control groups was 3172 adults with diabetes. The interventions employed various strategies including diabetes self-management education led by nurses and other professionals, SMS text messaging for treatment adherence, and other targeted approaches. The duration of these interventions varied from 2 to 12 months. Specific interventions, such as glucose machine provision with training, family support with culturally tailored educations, and periodontal treatment, exhibited notable improvement in adherences and reductions in HbA1c levels. Conclusion: The review underscores the significance of diabetes self-care interventions in SSA, showing varying effectiveness levels across different strategies. It emphasizes the importance of tailored approaches and highlight interventions that have shown promising outcomes, providing insights for future research, policy, and healthcare strategies in the region.

Birth trauma is described as organ or tissue damage caused by physical pressure during birth. Birth trauma ranges from minor problems that go away on their own to significant wounds that might result in infant morbidity and mortality over the long term. It is one of the critical issues that have received the least attention globally. In Ethiopia, evidence regarding the pooled prevalence of birth trauma among neonates is scarce. Therefore, this study estimated the pooled prevalence of birth trauma and associated factors in Ethiopia over the last decade. The Preferred Items for Systematic Reviews and Meta-analysis (PRISMA-2009) guidelines were followed. The PubMed, Scopus, Web of Science, Google Scholar and Google databases were searched. Articles published in the English language in the last decade were included. Data were extracted by a pre-prepared Excel sheet, and analysis was conducted using STATA version 14. Subgroup analysis was also undertaken to evaluate how the prevalence of birth trauma differs across regions of Ethiopia. The pooled prevalence of birth trauma in Ethiopia was 10.57% (95% CI: 3.08, 18.07), with a heterogeneity index (I²) of 92.6% (p < 0.001). Presentation other than vertex AOR 11.94 (95% CI: 6.25–17.62), P = 0.001 and I² = 53%, labor assisted by forceps AOR 6.25 (95% CI: 2.95–10.10), P = 0.002 with I² = 51.8% and labor assisted with vacuum AOR 17.47 (95% CI: 4.25–39.46), P = 0.0001 with I² = 92.9% were factors associated with the pooled prevalence of birth trauma in Ethiopia. The pooled prevalence of birth trauma in Ethiopia is considerable. Non-vertex presentation, use of instrumental delivery and prolonged labor were factors significantly associated with birth trauma. Strengthening neonatal improvement activities (thermal protection, hygienic umbilical cord and skin care, early and exclusive breastfeeding, assessment for signs of serious health problems or need for additional care and preventive treatment), is need.

Background: Following hospitalization of a preterm infant, mothers experience unexpected and stressful events. In Ethiopia, specifically in the study area, the experiences of mothers with preterm babies, the difficulties they face during their hospital stay, as well as the types of support available to help them deal with the difficulties have not been thoroughly investigated. Objective: To explore the lived experiences of mothers having preterm newborns in a Neonatal Intensive Care Unit at Wolaita Sodo University Comprehensive Specialized Hospital (WSUCSH), Wolaita Sodo, Southern Ethiopia. Methods and materials: A qualitative design with phenomenological approach was used. Twelve mothers were selected purposively to explore their lived experiences. Data were collected using in-depth interviews and field notes from Apr 27-Jun 3, 2022. The interview transcripts were analyzed using inductive thematic analysis following Colaizzi’s 7 steps approach. Data were coded by using Open Code Software Version 4.02. Results: Four themes were identified, namely: mothers’ emotional experience, care and support to cope with the situation, difficulties encountered during NICU stay and sense of difference. Shock, fear, worry, and anxiety were mothers’ major negative emotional experiences. They complained about the lack of medicine and laboratory tests at the hospital and issues with some facilities, such as a lack of space for showering, overcrowded rooms, being in multi-bed rooms, and an inconvenient toilet. Despite difficulties in communication, they appreciated the care and support of health professionals. Conclusion and recommendation: Mothers with preterm babies in the NICU experienced both negative and positive emotions. The unavailability of medicine, inadequate hospital facilities and the negative experience with some HCPs affected mothers’ stay. Hence, HCPs’ effective communication and understanding of mothers situations to better reflect their needs and the hospital’s paying close attention to the difficulties of resource constraints was recommended.

Objective: Podoconiosis, one of the neglected tropical diseases (NTDs), affects barefoot people in impoverished regions and contributes to poverty by having negative impacts on economic output, education, and disability. People who have the disease waste nearly half of all of their productive workdays. There is limited evidence available on prevalence of podoconiosis in sub-Saharan Africa (SSA). Therefore, the aim of this research was to determine the pooled prevalence of podoconiosis in the SSA over the last 10 years. Methods: Studies were retrieved from PubMed, Embase, Web of Science, Scopus, Google Scholar, and Google by using a combination of search terms with Boolean operators. All authors independently assessed each study’s quality using the modified Newcastle–Ottawa Scale for cross-sectional studies. STATA Version 14 was used to conduct the statistical analysis. The random-effect approach of meta-analysis was used. To test for heterogeneity, I-Squared ( I²) statistics were employed and sensitivity analysis with a leave-one-out was done. Result: In this systematic review and meta-analysis, a total of 16 publications with 2,195,722 individuals were included. The pooled prevalence of podoconiosis was 2.66 (95% confidence interval (CI): 2.24, 3.10) with heterogeneity index ( I²) of 99.9%. Walking barefoot adjusted odd ratio (AOR) 5.35 (95% CI: 1.65, 9.05), p = 0.001, not washing feet with soap and water regularly AOR 2.8 (95% CI: 1.16, 4.44, p = 0.001), and an increased age AOR 2.23 (95% CI: 1.25, 5.58) were factors significantly associated with the prevalence of podoconiosis. Conclusion: This study revealed that pooled prevalence of podoconiosis was considerable in SSA. Age, being barefoot, and failing to wash one’s feet with soap and water have been identified to be factors that were significantly associated with the prevalence of podoconiosis. Therefore, creating awareness on shoe wearing and providing shoes in communication with supporting organizations in podoconiosis prevalent areas, and early diagnosis based on family history are needed for the prevention of podoconiosis