Master of Public Health

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    DETERMINANTS OF DELAY IN TREATMENT SEEKING FOR DIARRHEAL DISEASES AMONG MOTHERS WITH UNDER-FIVE CHILDREN IN PUBLIC HOSPITALS OF SIDAMA REGION ,SOUTHERN ETHIOPIA: UNMATCHED CASE CONTROL STUDY
    (Hawassa University, 2024-05) MENELIK MATHEWOS
    Background-.A significant majority of pediatric diarrheal deaths are caused by delays in receiving timely, appropriate care. Life-threatening consequences are decreased when under five children with diarrhea obtain medical attention promptly and appropriately. Therefore, this study looked into factors that contributed to mothers of children under five delaying of treatment for diarrheal illnesses. Objective – To assess determinant of delay in treatment seeking for diarrheal disease among mothers with under five children in public hospitals in Sidama region, southern, Ethiopia from April 1 to May 30,2024 Methods - A Facility-based unmatched case control study was conducted on 414(207 Cases and 207 Controls). Cases were under-five children paired with their mothers/caregivers who sought treatment after 24 hours of the onset of signs and symptoms of diarrheal diseases, and controls were under-five children paired with their mothers/caregivers who sought treatment within 24 hours of the onset of signs and symptoms of diarrheal diseases. Data were collected using KOBO collect with smart Phone and analyzed by using SPSS 26. Bivariate and multivariable logistic regressions were computed to identify independent determinants of delay in treatment seeking. Association was described using an adjusted odds ratio along with their 95% confidence interval. Significance was declared at p<0.05 in the multivariable logistic regression. Results- from 418 selected participants, 414 mothers (207 cases and 207 controls) were included. Being rural resident (AOR 3.40(95 % CI 2.03-5.72), Child age < 24 months (AOR 4.43(95 % CI=2.35-8.34), Mothers without formal education (AOR 11.679(95 % CI 3.705 36.81), difficult to pay cost of treatment (AOR 4.345(95 % CI 2.019-9.352), Absence of health insurance AOR 3.182(95 % CI 1.945-5.207), were significant determinants of delayed treatment seeking. Conclusion-Young age of child, rural residence, Educational level of mothers, difficulty to pay Cost of treatment and absence of health insurance were important determinants of delay in treatment seeking. Thus comprehensive strategies that might enhance health facility accessibility crucial to reduce diarrhea related complications.
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    DETERMINANTS OF PODOCONIOSIS IN NORTHERN ZONE OF SIDAMA REGION, ETHIOPIA: AN UNMATCHED CASE- CONTROL STUDY
    (Hawassa University, 2024-06) MELKAMU UGAMO (BSC)
    Background: Podoconiosis is a type of elephantiasis caused by long-term barefoot exposure to red clay soil. It is a debilitating disease that leads to disability and stigma. Despite the widespread prevalence of podoconiosis, the determinants of it remain largely unexplored, especially within the context of the Sidama region. The findings will contribute to a comprehensive understanding of the determinants, facilitate the development of targeted prevention strategies in the specified region, and bridge the existing knowledge gap pertaining to determinants in southern Ethiopia. Objective: To identify the determinants of podoconiosis in the Northern Zone of Sidama Region, Southern Ethiopia, in 2024. Methods: An unmatched case-control study design was employed in selected districts within the northern zone of the Sidama Region. The cases comprised 191 randomly selected individuals with clinically confirmed podoconiosis and a negative filarial test. The controls consisted of 383 randomly selected individuals who exhibited no signs or symptoms of podoconiosis. Data were collected through structured interviews conducted using the KoBo mobile application. Both bivariable and multivariable logistic regression analyses were performed to evaluate the associations between potential determinants of podoconiosis. Statistical significance was declared at a p-value of less than 0.05. The magnitude of the association was presented using the adjusted odds ratio (AOR) with a 95% confidence interval. Results: A total of 574 (191 cases and 383 controls) participants were included in the study. Age ≥50 years (AOR=2.61; 95% CI: 1.22, 5.58), no formal education (AOR=3.04; 95% CI: 1.06, 7.73) , primary education (AOR=3.67; 95% CI: 1.32, 10.20), not wearing shoes (AOR=4.10; 95% CI: 1.72, 9.79), having unclean feet (AOR=4.80; 95% CI: 2.84, 8.11), purchasing no or a pair of shoes in a year (AOR=2.61, 95% CI: 1.48-4.61), poor knowledge (AOR = 3.52; 95% CI: 2.14, 5.78) and negative attitude (AOR = 1.80; 95% CI: 1.11-2.94) were significantly associated with podoconiosis. Conclusions: The study identified older age, lower educational attainment, not wearing shoes, poor foot hygiene, buying no shoes or a pair of shoes in a year, poor knowledge, and poor XIII attitude as significant factors for podoconiosis. Multifaceted interventions on awareness- creation education, consistent shoe use and foot hygiene, and changing attitudes towards podoconiosis are crucial to mitigating this neglected tropical disease in endemic regions.