East African Journal of Health and Biomedical Sciences

Corona virus disease (COVID-19) and Mental Health in the Community

Mandaras Tariku — 2020-08-15

Introduction

Coronavirus disease (COVID-19), SARS-CoV-2, or novel coronavirus is a new infectious virus causing a deadly outbreak of respiratory disease. This viral disease was declared as a global health emergency and a pandemic by the World Health Organization (WHO) on March 11, 2020. It has resulted in more than 766,332 deaths globally since the first case report (WHO, 2020). According to the most recent data from the department of labor, more than 22 million people have lost their jobs due to the lockdown in the United State of America. Many have lost their beloved ones whom they were not allowed to be present in their funeral, which in turn can cause mental disorders including acute stress disorder, anxiety, depression, and/or suicide on the bereaved (Starace and Ferrara, 2020; USA,2020).

World health organization had announced that the COVID-19 outbreak has posted an emerging serious challenge for the mental health services around the globe. Confirmed and suspected cases of the COVID-19 may experience fear of severe disease consequences and the contagion. COVID-19 also affects both the management of mental health patients' follow up and of new cases who need psychiatry services. A population survey from India in March 2020 indicated that more than 80% of the Indian population needs mental health care during the outbreak of COVID-19 (Gao et al., 2020).

Patients with a mental disorder also need strong psychosocial and family support, in addition to biological intervention. Thus, improper management of mental disorders and inability to identify it, early when combined with a lack of social and community support, can be despair and affects the overall quality of life (Wang et al., 2020; WHO, 2020; Xiang et al., 2020).

The different measures which have been taken to control the transmission of COVID-19 in the community, such as the closing of school, refraining gathering, social distancing, and being in quarantine have resulted in the emergence of mental health problems in the population as reported in previously published study (Brooks et al., 2020). This may be due to idleness, excess fear of having COVID-19, and lack of strong family support during the quarantine. Persons may experience loneliness, anxiety, depression, sleep disturbances, and stress-related disorders, which may lower treatment adherence (Shevlin et al., 2020; WHO, 2020).

Psychosocial problems related to a coronavirus pandemic can cause mental and behavioral disorders. A preliminary public survey conducted in Wuhan China in 2020 on mental health problems during the COVID-19 outbreak reported that the magnitude of depression, anxiety disorder, and both depressions and anxiety disorder was 48.3%, 22.6%, and 19.4%, respectively (Gao et al., 2020; Roy et al., 2020).

Combination of mental disorder and COVID-19 can also increase the risk of the pandemic transmission in societies, hampering hormonal regulation in the body, increasing the burden on hospital and complicating the treatment option of COVID-19 (Rajkumar, 2020; Xiang et al., 2020; Yao and Xu, 2020).

In Ethiopia, the transmission of COVID-19 is rapidly increasing all over the country, with the highest report from the capital city, Addis Ababa. The strong values of the society that includes living and sharing together are challenged due to the pandemic. These measures may limit their interaction with each other, which could lead to increased feelings of anxiety, loneliness, hopelessness, and suicide. A satisfying social relationship is essential for the mental and emotional health of society (Asefa, 2020; Tekle et al., 2020).

Copying strategies during coronavirus (COVID-19) pandemic

It is normal to feel anxious and express an emotional reaction toward this pandemic. However, the pervasive experience and long-lasting emotional reaction may need special attention. Generally, the following tips may be important to maintain and prevent the further impact of coronavirus on mental health, according to WHO, 2020 (WHO, 2020).

Working on a healthy lifestyle: practicing adequate and regular sleep pattern is important for a restorative, homeostatic function and appears to be crucial for normal thermoregulation and energy conservation. Eat healthy food; avoid any substance and regular physical exercises (WHO, 2020).

Give attention to your body, feelings, and spirit: Expression of emotional symptoms is common during this pandemic and it should be only for a short period and not pervasive. Talking about your emotion to the outbreak, sharing appropriate health information, and praying are important measures during an infectious disease outbreak (WHO, 2020).

Decreasing the frequency of hearing about the pandemics from different sources: minimize watching, reading, and listening to news about COVID-19, which causes you to feel anxious or distressed. It is better to seek information only from trusted sources, which can help to take practical steps to prepare your plans and protect yourself and your loved ones (WHO, 2020).

Maintain healthy lifestyles in quarantine: engage in healthy activities that you enjoy and find relaxing, exercise regularly, keep regular sleep routines, and eat healthy food. Stay connected through telephone, e-mail, social media, or video conference with a loved one and your children (WHO, 2020).

In addition to the recommendation of World Health Organization, one study suggested that practical considerations for the current pandemic need to focus on the individual mental health status in the context of the larger social environment at the household level, with an emphasis on increasing awareness of the range of possible psychosocial responses during COVID-19 global pandemics such as anxiety and depression, providing access to psychological help, self- care and sustained engagement are pivotal to address mental and psychosocial aspects of COVID-19 (Chew et al., 2020).

Blood Donation Practice and its associated Factors among Civil Servants in Chiro Town, Western Hararghe, Oromia Region, Ethiopia

Sintayehu Nigussie — 2020-08-16

Background: Although blood transfusion has been evident for the past 200 years, it is challenging to get safe blood and blood product for those in need. In Ethiopia, the need for safe blood and blood product is increasing, but the donation practice is still insignificant. This study aimed to assess blood donation practice and its associated factors among civil servants working in west Hararghe zone offices, Chiro town, Oromia region, Ethiopia.

Methods: A cross-sectional study was conducted among 383 civil servants from March 1 to April 20, 2018. Study participants were selected using a simple random sampling technique. Data were collected using a pre-tested self-administered questionnaire and analysed by Statistical Package for Social Science Version 20. Logistic regression analyses was done to identify factors associated with blood donation practice. The level of statistical significance was declared at p-value < 0.05.

Results: The blood donation practice among the civil servants was 43.6% (95% CI: 38.3, 49.3). Willingness to donate blood (AOR=2.54; 95% CI: 1.39, 4.65), good knowledge about blood donation (AOR=3.32; 95% CI: 2.02, 5.46), and following mass media (AOR=1.83; 95% CI: 1.01, 3.35) were the factors significantly associated with the blood donation practice.

Conclusion: The civil servants’ practice of blood donation was low. Willingness to donate, having good knowledge about blood donation, and following mass media were the factors associated with the blood donation practice. Therefore, it is very important to increase the civil servants’ awareness about blood donation practice using mass media.

Keywords:Blood donation; Chiro town; Civil Servants; Ethiopia; Practice

Birth Preparedness and Complication Readiness among Pregnant Women Attending Antenatal Care Clinics in Public Health Facilities, Harari Region, Eastern Ethiopia

Ferdosa Ibrahim — 2020-08-16

Background: Nearly three million women are dying each year from complications of pregnancy and childbirth. Most of these deaths are occurring in low and lower-middle-income countries. Evidence indicates that promoting birth preparedness and complication readiness has importance in averting maternal morbidity and mortality. Therefore, this study aimed to assess factors associated with birth preparedness and complication readiness practice among pregnant women attending antenatal care clinics in public health facilities, Harari region, Eastern Ethiopia.

Methods: Facility-based cross-sectional study was conducted among pregnant women attending antenatal care from April 01 to May 30, 2018. A systematic random sampling technique was used to select 419 study-participants. A pretested questionnaire was used to collect data. The data were entered into EpiData Version 3.1 and exported to Statistical Package for the Social Sciences Version 21 for analysis. Bivariate and multivariable logistic regressions were done to identify factors associated with the practice of birth preparedness and complication readiness. The adjusted odds ratio at a 95% confidence interval was used for the final interpretation of statistical significance.

Results: Birth preparedness and complication readiness among pregnant women was 52.1% (95% CI: 47.2, 56.9). Participants’ age ≥35 (AOR=3.62; 95% CI: 1.95, 10.96), being an urban resident (AOR=3.61; 95% CI: 1.46, 8.96), having planned pregnancy (AOR=3.64; 95% CI: 2.17, 6.09), ever heard about birth preparedness and complication readiness (AOR=1.77; 95% CI: 1.08, 2.92), having knowledge about obstetric danger signs during pregnancy (AOR=3.27; 95% CI: 1.88, 5.69), and having knowledge about obstetric danger signs during childbirth (AOR=6.10; 95% CI: 2.60, 14.31) were found to be significantly associated with the practice of birth preparedness and complication readiness.

Conclusion: The proportion of pregnant women who were prepared for birth and complication readiness was low. Women’s age ≥35, urban resident, planned pregnancy, prior information about birth preparedness and complication readiness, having knowledge of obstetric danger signs during pregnancy and childbirth were the positively associated factors. Therefore, health information dissemination on birth preparedness and complication readiness; obstetric danger sign during pregnancy, and childbirth should be provided at the community and institutional level.

Keywords: Antenatal care; Birth preparedness; Complication readiness; Ethiopia; Pregnant women

Chrome (VI) Removal from Wastewater Using Water Treatment Plant Sludge as an Adsorbent

Awugchew Teshome Ayele — 2020-08-19

Background: The extensive use of chromium in industries such as electroplating, steel production, wood preservation and leather tanning can result in release of chromium containing effluents. Hexavalent chromium in the environment has been often harmful and it should be treated before releasing into the environment. So far various wastewater treatment techniques have been used to remove heavy metals from industrial wastewater. Due to this, adsorbent with high removal capacity, low cost and easy accessibility will be a choice for industrial wastewater treatment option. This study aimed at removing chromium from wastewater using low cost alum based water treatment plant sludge, as an adsorbent.

Methods: The study was conducted on removal of Cr (VI) by alum based water treatment sludge through batch adsorption experimental study. Response surface methodology was applied in batch wise experiment to evaluate the process viable, Cr (VI) concentration, pH, adsorbent dose, time and temperature.

Results: Chrome (VI) concentration and pH increase was found to decrease chrome removal, while adsorbent dose and shaking time increase, increase chrome removal. Cr (IV) concentration with pH shows that maximum chrome removal 95.62% was obtained at Cr (IV) concentration of 2.4mg/l and pH 2.45, while the interaction of Cr (IV) concentration and adsorbent dose shows, 97.06% chrome removal was obtained at a chrome concentration of 3.3mg/L and adsorbent dose of 6.3g.

Conclusion: Alum based water treatment sludge is a suitable material from which a low-cost adsorbent for removal of Cr (VI) can be developed.

Keywords: Alum Based Water Treatment Sludge; Batch Adsorption; Cr (VI); Response Surface Methodology

Placenta Previa and its associated Factors among Women Admitted with Antepartum Haemorrhage in Hawassa University Comprehensive Specialized Hospital, Southern Ethiopia

Selamu Elias — 2020-08-29

Background: Placenta previa is one of the causes of antepartum hemorrhage. It contributes to maternal death. Hence, this study assessed the magnitude of placenta previa and its associated factors among women admitted with antepartum hemorrhage at Hawassa University comprehensive specialized hospital.

Methods: A facility-based retrospective cross-sectional study was conducted among 300 pregnant women admitted with antepartum hemorrhage at Hawassa University comprehensive specialized hospital. A simple random sample technique was used to select a woman’s charts. Data were collected using a pre-tested checklist. Data were analyzed using statistical software. Bivariable and multivariable logistic regression analyses were done to identify the factors associated with placenta previa. A P-value of less than 0.05 was considered as statistically significant.

Results: The prevalence of placenta previa among mothers with antepartum hemorrhage was 60.3% (95% CI: 57.8, 62.4). The major adverse maternal outcomes identified were cesarean delivery 175 (96.4%), hypovolemic shock 82(45.3%), and blood transfusion 92(50.8%). Those mothers with gravidity of 2-4 (AOR=3.40; 95% CI: 1.39,8.31) and >5 ( AOR=5.67; 95% CI: 2.11,15.20), gestational age of 28-33 weeks (AOR=3.83; 95% CI: 1.77, 4.65), 34-36 weeks (AOR=2.45; 95% CI: 1.30, 4.56), having previous caesarean section scar (AOR=3.27; 95% CI: 1.26, 8.50), and having a male fetus gestation (AOR=3.49; 95% CI: 1.26, 8.50) had a more likelihood of developing placenta previa than their counterparts.

Conclusion: About two-thirds of the cases admitted with the diagnosis of antepartum hemorrhage were caused by placenta previa. Previous cesarean section, gravidity, male sex, and gestational age were the factors identified for placenta previa. Efforts should be made to reduce the rate of pregnancy and cesarean delivery through improving the provision of family planning to decrease the magnitude of placenta previa.

Keywords: Hawassa, placenta previa, Southern Ethiopia

Late Initiation of Antenatal Care and Its Associated Factors among Pregnant Women in Dire Dawa, Eastern Ethiopia

Alekaw Sema — 2020-09-30

Background: The timing of the first antenatal care visit is paramount for optimal health outcomes for women and newborns. The World Health Organization recommends a minimum of four antenatal care visits for any pregnancy to promote the health of the fetus and the mother, and then improve the birth outcome. However, there is a paucity of data on the time of initiation of antenatal care among pregnant women in this study setting. Hence, this study aimed to assess the magnitude and factors associated with late initiation of antenatal care among pregnant women in Dire Dawa City, eastern Ethiopia.

Methods: An institutional-based cross-sectional study was conducted on 406 pregnant women selected using a systematic sampling method in Dire Dawa City from February 1-30, 2017. Data were collected using a pre-tested face-to-face interviewer-administered questionnaire. Data were analyzed using Statistical Package for Social Science Version 22.0. Logistic regression was used to examine the factors associated with late initiation of antenatal care. P-value<0.05 was considered statistically significant.

Results: The magnitude of late initiation of antenatal care was 55.9% (95% CL: 51.1, 60.8%). Women aged 25 years and above (AOR=1.77; 95% CL: 1.12, 2.78), unemployment (AOR=2.07; 95% CL:1.3, 3.27), poor knowledge about antenatal care (AOR=2.47; 95% CL: 1.54, 3.96), advised to start ANC visits (AOR=1.87; 95% CL:1.20,2.91), decision-making power to initiate antenatal care (AOR=0.36;95% CI:0.16, 0.78) and history of stillbirth (AOR=0.37; 95% CI: 0.17,0.78) were factors associated with late initiation of antenatal care.

Conclusion: More than half of the pregnant women initiated antenatal care late. Those factors associated with late initiation of antenatal care visits were maternal age, employment status, decision-making power, knowledge about antenatal care, received counseling on time of antenatal care, and history of stillbirth. Therefore, the concerned body should give due attention to strengthening the promotion of health education, empowering women, and giving appropriate advice on pregnancy. In addition, intervention strategies aimed at reducing the late initiation of antenatal care should target on the identified factors.

Keywords: Antenatal care, late initiation, pregnant women, Dire Dawa, Ethiopia