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Assessment of Quality of Care Delivered for Infectious Pulmonary Tuberculosis Patients in Jimma Zone, South West Ethiopia
T Geremew, C Jira, F Girma
Ethiopian Journal of Health Sciences , 2012,
Abstract: BACK GROUND: Providing quality of care for infectious pulmonary tuberculosis patients is crucial in prevention and control of the disease. However, little is known about the existing quality of care in such services. The objective of the study was to assess the quality of care delivered for infectious pulmonary tuberculosis patient in Jimma Zone, South West Ethiopia. METHODS: Facility based cross- sectional study was conducted from January- February 2008 in 10 public health facilities in Jimma Zone. Facility audit was carried out to assess structural quality. Twenty providers were interviewed and records of 299 smear positive patients registered for 1 year was reviewed. Data were entered and analyzed using SPSS 11.0 for windows statistical software and findings at 95% CI and p value of 0.05 were reported as statistically significant. RESULTS: The results of the study showed that all the three quality dimensions were graded as poor in all the study health facilities and overall 66.0% of TB patients receive poor quality care. Four variables were identified that significantly predicted treatment success, i.e. conformity to the recommended schedule of sputum smear microscopy, conformity to DOTS drug regimen during both intensive and continuation phase of therapy and quality of registration of patients' medical records. CONCLUSION: This study revealed that most of the problems could be managed at local level, while a few needs further discussion with other management bodies. Success of anti tuberculosis therapy could be ensured through strict adherence to all the elements of DOTS strategy, with special emphasis on the 4 variables that significantly predicted treatment success in the present study. KEYWORDS: Quality, Tuberculosis care, Jimma Zone.
Assessment of Quality of Health Care in Jimma Zone, Southwest Ethiopia
W Beyene, C Jira, M Sudhakar
Ethiopian Journal of Health Sciences , 2012,
Abstract: BACKGROUND: Quality of care is an important aspect of health care delivery system that is given a priority. Quality is a multidimensional concept that has been defined in various ways. Variation in quality of care between different health care facilities is thought to reflect differences in efficiency and other organizational factors. There was no adequate study related to quality of health care in Jimma zone. Therefore, the objective of this study was to assess quality of health care in Jimma zone. METHODS: A cross sectional quantitative study design was employed to assess the quality of care with respect to structure, care process and customer satisfaction involving 640 patients and 96 care providers in Jimma zone, southwest Ethiopia. Data were collected using an interview questionnaire and observation checklist devised by the investigators. RESULTS: The study showed that, on average, the studied institutions fulfilled 153(70.4%) of the health human power need. They also fulfilled 86(62.8%) of major equipment requirement against the national standard. The composite average satisfaction level of patients was 89.1% and that of the care providers was 86.7%. Nevertheless, the respect given to patients by care providers was rated as poor. A significant proportion, 39(48.2%) of the care providers were assessed as low performance. CONCLUSIONS: Majority of study subjects rated the overall quality of care as “good”. However the observation revealed that the human aspect of care was “poor”. In addition, the health institutions were facing shortage of human and material resources. Thus it was recommended that the responsible bodies at the 3 levels should take actions for improving institutional capacity and performance of care providers in order to improve quality of care. KEY WORDS: Quality of care, Jimma Zone, Southwest, Ethiopia
Waste Management Problems in Jimma, Southern Ethiopia.
MA Filaba
Ethiopian Journal of Environmental Studies and Management , 2008,
Abstract: The major objective of the project was to design an approach to the problem of indiscriminate and nonclearance of generated wastes in the slums in Jimma town. The project, therefore, aimed to orient Jimma inhabitants to be hygienic, and to encourage the community to participate in setting up mitigating measures against environmental pollution through interface consultations using focused Group Discussions and In-depth Interviews. The scope of the project was limited to the more-slum wards in Jimma town. The findings were conspicuous, that speed of urbanization of Jimma town since ten years back became faster than the previous years, but a subsistence-urbanization. Subsistence urbanization is characterized by increase of the settlement in terms of scale and pace without corresponding increase in sanitation, infrastructures and without mitigating measures to address urban violence. The Wareda has been clearing the wastes where they placed the dustbins. It has also a number of town center cleaners. However, much of the cleaning of the streets and disposing of the wastes are individuals' efforts. The project encouraged more individual and group/community and professional effort in the cleaning of their nearest environments, and to earmark disposal units in the streets/wards. The Wareda was advised to increase distribution of dustbins and to embark on enlightenment. The generated animal and household wastes are good research materials for environmental scientist interested In studying what are generated, the chemical contents of the wastes and their impact on the immediate environment. The key concepts in this study are: Generation of domestic wastes and waste disposal; Urban pollution controls cum Waste Management. Ethiopian Journal of Environmental Studies of Management Vol. 1 (2) 2008: pp. 8-15
The prevalence of thermotolerant Campylobacter species in food animals in Jimma Zone, Southwest Ethiopia
Tesfaye Kassa, Solomon Gebre-selassie, Daniel Asrat
Ethiopian Journal of Health Development , 2005,
Abstract: Background: Thermotolerant Campylobacter spp. is known to occur in the intestinal systems of a wide variety of domestic and wild animals. Although Campylobacter jejuni and Campylobacter coli cause acute diarrhoeal diseases in humans worldwide, they mostly manifest themselves in an apparently healthy carrier state in other mammalian species. However, little is known about the presence of campylobacter bacteria in various food animals as possible sources of infection to humans in Ethiopia. Objective: The aim of this study is to determine the prevalence of thermotolerant Campylobacter spp. in various food animals in Jimma zone, southwest Ethiopia. Methods: A cross-sectional study was conducted in urban and rural farm animal settings in Jimma, southwest Ethiopia in the period between January 2004 to April 2004. Fecal specimens were collected from 485 various food animals (cattle, n=205; poultry, n=191; pigs, n=18; sheep n=71) and cultured using standard methods. Results: Campylobacter spp. were isolated from 192 (39.6%) out of 485 fecal specimens taken from various urban and rural farm animals. The highest isolation rate was recorded among chickens (68.1%), followed by pigs (50.0%), sheep (38.0%) and cattle (12.7%). Among the 192 thermophilic campylobacters isolated, 135 (70.3%) were identified to be C. jejuni, 51 (26.6%) were C. coli and 6 (3.1%) were C. lari. C. jejuni was the most prevalent species in chickens (80.8%), followed by sheep (59.3%) and cattle (53.8%). All isolates found in pigs were identified to be C. coli (100%). Conclusion: The results of this study indicate that thermophilic campylobacters are very frequent among various food animals in Ethiopia, suggesting possible risks of infection to people through the consumption of contaminated animal products or through contact with infected animals. Ethiopian Journal of Health Development Vol. 19(3) 2005: 225-229
Pastoralism and delay in diagnosis of TB in Ethiopia
Abdi A Gele, Gunnar Bjune, Fekadu Abebe
BMC Public Health , 2009, DOI: 10.1186/1471-2458-9-5
Abstract: A cross sectional study of 226 TB patients with pastoralist identity was conducted in SRS of Ethiopia from June to September 2007. Patients were interviewed using questionnaire based interview. Time between onset of TB symptoms and first visit to a professional health care provider (patient delay), and the time between first visits to the professional health care provider to the date of diagnosis (medical provider's delay) were analyzed. Both pulmonary and extrapulmonary TB patients were included in the study.A total of 226 pastoralist TB patients were included in this study; 93 (41.2%) were nomadic pastoralists and 133 (58.8%) were agro-pastoralists. Median patient delay was found to be 60 days with range of 10–1800 days (83 days for nomadic pastoralists and 57 days for agro-pastoralists). Median health care provider's delay was 6 days and median total delay was 70 days in this study. Patient delay constituted 86% of the total delay. In multivariate logistic regression analysis, nomadic pastoralism (aOR. 2.69, CI 1.47–4.91) and having low biomedical knowledge on TB (aOR. 2.02, CI 1.02–3.98) were significantly associated with prolonged patient delay. However, the only observed risk factor for very long patient delay >120 days was distance to health facility (aOR.4.23, CI 1.32–13.54). Extra-pulmonary TB was the only observed predictor for health care providers' delay (aOR. 3.39, CI 1.68–6.83).Patient delay observed among pastoralist TB patients in SRS is one of the highest reported so far from developing countries, exceeding two years in some patients. This long patient delay appears to be associated with patient's inadequate knowledge of the disease and distance to health care facility with nomadic pastoralists being the most affected. Regional TB control programmes need to consider the exceptional circumstances of pastoralists, to maximise their access to TB services.Tuberculosis is one of the major causes of morbidity and mortality in the Horn of Africa with Ethio
Microbiological safety of street vended ayib in Jimma town, southwest Ethiopia
T Solomon, T Ketema
Ethiopian Journal of Education and Sciences , 2011,
Abstract: The wide spread habit of street vended cheese consumption is a potential cause for food borne illness, besides the common factors such as over-crowding, inadequate sanitation, and poor hygiene. Therefore, the aim of this study was to assess the microbial quality of street vended Ayib and the associated health risks to consumers of the product in Jimma Town, south west Ethiopia. The microbial quality of different sample of Ayib being sold on the streets of Jimma Town was assessed following the standard microbiological analysis from December, 2010 to June, 2011. Accordingly, a total of 60 samples were collected from three streets Ayib selling market sites of Jimma Town for the analysis of Aerobic Mesophilic Bacteria (AMB) a, Enterobacteriacea, Staphylococcus, Lactic Acid Bacteria, Yeasts and Molds. Preliminary survey was also conducted to get information on the handling practice to trace source of contamination. Moreover, physico-chemical characteristics such as pH and titratable acidity of the Ayib were determined. Data was analyzed using SPSS of windows version 16.0. The mean microbial count of samples was found to be dominated by both AMB and Lactic Acid Bacteria, followed by Enterobacteriacea. The pH and titratable acidity were 4.2±0.02 and 0.21, respectively, indicating the Ayib samples were in acidic range. From among a total of 198 isolates characterized, only 13.1% were found to be Gram negative bacteria with the likelihood that some are potentially pathogenic. Even though the handling practice of Ayib sellers was very poor, the acidic nature of the food somehow provided protection against survival and growth of pathogenic microorganisms. However, bodies concerned and sanitary workers should work on health education in relation to Ayib hygiene before the likely outbreak of Ayib-borne diseases.
Health Services Utilization and Associated Factors in Jimma Zone, South West Ethiopia
F Girma, C Jira, B Girma
Ethiopian Journal of Health Sciences , 2012,
Abstract: BACKGROUND: In Ethiopia, utilization of health services remains low and unevenly distributed. To ensure appropriate health care use, we need to understand factors affecting health care use, and the reasons for low levels of utilization among our community. The objective of the study was to assess utilization of health services and associated factors in Jimma zone, south west Ethiopia. METHODS: A cross sectional data was collected from January 15 to February 08, 2007 in Jimma zone. First, four districts were selected by lottery method. Then 2 ‘kebeles’ from each district were selected randomly and households were selected by systematic sampling. A total of 836 households were studied. The data were cleaned, coded and entered into computer and analyzed using SPSS for windows version 12.0. Bivariate analysis and logistic regression were conducted and a significance level of 5% was considered for interpretation. RESULTS: The health services utilization rate was found to be 45.6%. After controlling confounders using logistic regression; sex (OR=0.23), marital status (OR=8.1), household income (OR=0.70), socioeconomic status (OR=3.5), presence of disabling health problem (OR=3.3), presence of an illness episode (OR=28.3), perceived transport cost (OR=3.6), perceived treatment cost (OR=0.15) and distance to the nearest health center or hospital (OR=2.9) were found to be predictors of utilization of health care. CONCLUSIONS: It has been shown that utilization level was not satisfactory. Thus, we recommend that the level of health service utilization should be improved by improving predictors of health care use like physical accessibility. KEY WORDS: Health services utilization, accessibility, health status
Invasive Bacterial Pathogens and their Antibiotic Susceptibility Patterns in Jimma University Specialized Hospital, Jimma, Southwest Ethiopia
T Zenebe, S Kannan, D Yilma, G Beyene
Ethiopian Journal of Health Sciences , 2011,
Abstract: BACKGROUND: Presence of microorganisms in the circulating blood whether continuously or intermittently is a threat to every organ in the body. Approximately 200,000 cases of bacteraemia occur annually with mortality rates ranging from 20-50%. Early diagnosis and appropriate treatment of these infections can make the difference between life and death. The aim of the present study was to determine the bacterial flora of the blood stream infections and their antibiotic susceptibility pattern. METHODS: A cross sectional study was conducted on 260 adult febrile patients in Jimma University Specialized Hospital from 27 October 2009 to 26 March 2010. The positive blood cultures were examined and the organisms were identified as per standard procedures. Antimicrobial testing was performed for all isolates by disk diffusion techniques, according to Clinical Laboratory Standards Institute guide lines. The data was analyzed using SPSS for windows version 16 and Microsoft Office Excel. RESULTS: From the total of two hundred sixty blood specimens only 23(8.8%) were positive to seven different types of bacteria. The isolated bacteria were: Coagulase negative staphylococci 6(26.1%), S. aureus 5 (21.7%), S. pyogens 3 (13.0%), E. coli 4(17.4%), K. pneumoniae 3(13.0%), Salmonella spp. 1(4.3%), and Citrobacter spp. 1(4.3%). The isolates showed high rates of resistance to most antibiotics tested. The range of resistance for gram positive bacteria were 0% to 85.7%, and for gram negative from 0% to 100%. None of the isolates were resistance to ciprofloxacin and ceftriaxone. CONCLUSION: Our study result showed the presence of invasive bacterial pathogens with high rate of resistance to most commonly used antibiotics used to treat bacterial infections. Therefore, timely investigation of bacterial flora of the blood stream infections and monitoring of their antibiotic resistance pattern plays an important role in reduction of the incidence of blood stream infections. KEYWORDS: invasive bacteria, antimicrobial resistance, Jimma, Ethiopia
Substance use and sexually transmitted infections among anti-retroviral treatment in Jimma University specialized Hospital, Jimma, Ethiopia
Shimelis Mitiku, Andualem Mossie, Sintayehu Fekadu
Ethiopian Journal of Health Sciences , 2012,
Abstract: BACKGROUND: Substance use increases both the risk of Human Immunodeficiency Virus and other Sexually Transmitted Infections, either directly or indirectly. The association of substance use and Sexually Transmitted Infections has not yet studied in Southwestern Ethiopia. The main aim of this study is to determine the associations between substance use and Sexually Transmitted Infections on clients under follow up in Anti-Retroviral Treatment clinic at Jimma University Specialized Hospital. METHODS: A cross-sectional study was conducted on clients under follow up at Anti-Retroviral Treatment clinic from June 10 to July 10, 2011 at Jimma University Specialized Hospital. Data collection was done using a pre-coded and pre-tested questionnaire. Trained Anti-Retroviral Treatment adherence counselors collected the data. Data were entered and analyzed using SPSS for Windows version 16.0. Chi-square test was used to measure the levels of significance. P-value < 0.05 was considered as significant. RESULTS: Three hundred thirty eight Anti-Retroviral Treatment attendees participated in the study. Two hundred twenty (65.1%) of the study participants were females and their mean (±SD) age was 33.6 ± 8.04 years while 156 (46.2%) of them lied in the age group of 25-34 years. Clients who reported that they had Sexually Transmitted Infections were 120 (35.5%). Those who consumed alcohol were more likely to have contracted in Sexually Transmitted Infections: AOR (95% CI) =0.46 (0.26-0.80). CONCLUSION: Prevalence of Sexually Transmitted Infections was comparable among females and males. Substance use, particularly alcohol consumption, found to be a potential risk factor for Sexually Transmitted Infections.
An assessment of the free health care provision system in Jimma town, Southwest Ethiopia
Mirkuzie Woldie, Chali Jirra, Ayalew Tegegn
Ethiopian Journal of Health Development , 2005,
Abstract: Background: Despite the fact that equity is the underlying principle of all major global health policies, difficulties have emerged in providing proper care for the poor with the introduction of user fees for health services. However, the criteria used to determine eligibility for free health services at public health facilities are either unclear or nonexistent in most sub-Saharan African countries. Objective: To assess the free health care delivery system and the extent to which strict criteria are followed in granting free health care services in Jimma town, southwest Ethiopia. Methods: A cross-sectional, exploratory study, employing both quantitative and qualitative study designs, was conducted from December 22–27, 2003. Results: Fifty-eight percent of the respondents were found to be patients exempted from fees on the day of interview. There exist no clearly stated criteria in the free health care provision system of Jimma town. The presence of leakage and under-coverage were 36.9% and 43.6% respectively. The occupation and income category of the respondents showed a statistically significant association with their service category at the public health facilities (p=0.000). Conclusion: The absence of clearly defined criteria for waiving user fees at public health facilities has made the free health care provision system difficult for both the providers and users. The system is also prone to the possibility of leakage and under-coverage. These findings imply the importance of a strict reconsideration of the exemption policy of the locality and the country with focus on efforts to produce clear criteria and guidelines in granting free health care. Ethiopian Journal of Health Development Vol. 19(3) 2005: 188-194
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