African Journal of Health Sciences and Medicine

Assessment of Substance use among adolescents residing in urban and rural areas of Gedeo Zone, Southern Ethiopia: A Comparative Cross-Sectional Study

Yohannes Addisu, Getachew Nenko — Mon, 30 Jun 2025 00:00:00 +0200

Background: Evidence from various studies indicates that the initiation and early stages of substance use often begin in adolescence. However, less research has focused on the differences in substance use levels and determinants across distinct social contexts, particularly between urban and rural areas. This study aims to comparatively assess substance use and associated factors among adolescents in urban and rural areas of Gedeo Zone, Southern Ethiopia.

Method: A community-based comparative cross-sectional study was conducted among 2,446 adolescents. The characteristics of respondents, including substance use patterns, were compared between urban and rural adolescents. Data were collected using a structured questionnaire and analyzed with SPSS version 24. Multivariate binary logistic regression analysis was employed to identify factors associated with substance use, using a significance level of p < 0.05.

Results: The overall prevalence of substance use among adolescents in this study was 23.3%, with 20.1% among urban adolescents and 26.5% among rural adolescents, indicating a statistically significant difference between the two groups. Parental substance use and having peers who use substances increased the risk of substance use, while an unfavorable attitude toward substance use decreased this risk among both urban and rural adolescents. Additionally, urban adolescents with poor parental control were more likely to engage in substance use.

Conclusion: The level of substance use among adolescents in this study is moderately high. Factors such as peer and parental substance use, attitudes toward substance use, and adolescents’ occupations were significantly associated with substance use.

The magnitude of co-morbid depression with post-traumatic stress disorder symptom in Africa, 2024 Systematic review and meta analysis

Mon, 30 Jun 2025 00:00:00 +0200

Objective: Depression is a significant public health concern arising from a complex interplay of environmental, psychological, biological, and social factors. Traumatic life experiences, such as war, disasters, accidents, and abuse, are prevalent in Africa and often lead to various mental health conditions. This review aims to assess the pooled burden of comorbid depression among individuals experiencing PTSD symptoms in Africa in 2024.

Method: This study conducted a systematic review and meta-analysis, focusing on individuals diagnosed with both depression and post-traumatic stress disor der (PTSD). A comprehensive literature search was conducted across six major databases: PubMed, Scopus, Embase, PsycINFO, AJOL, and Google Scholar. Eligible studies published between 2008 and 2024 were included in the analysis. Statistical assumptions for random-effects models, heterogeneity, and publication bias were tested and met. Data extraction was performed using Microsoft Excel, with subsequent statistical analyses conducted using STATA-18 software.

Result: This systematic review and meta-analysis integrated nineteen cross sectional studies from Africa, encompassing a total of 3,249 participants. The pooled prevalence estimate of comorbid depression among individuals exhibiting PTSD symptoms was 61% (95% CI: 49-72; I2 = 99.2%, P < 0.0001). A subgroup analysis based on study settings and sub-regions of the African continent revealed the highest prevalence of comorbid depression in refugee populations, reaching 75% (95% CI: 70-79, P < 0.0001). Regional subgroup analysis indicated a comorbid depression prevalence of 58% (95% CI: 51-65, P < 0.0001) in East Africa and 74% (95% CI: 52-97, P < 0.0001) in West Africa.

Conclusion: This review indicates that more than half of respondents with PTSD in African populations also have comorbid depression, with the highest prevalence observed in refugee settings and West African countries. Comprehensive psychoso cial intervention guidelines are needed to effectively manage both conditions in clinical and humanitarian settings.

Non-psychiatric help-seeking and associated factors among patients attending mental health services at Dilla University Referral Hospi tal, Gedeo Zone, South Ethiopia Region, Ethiopia, 2023

Mon, 30 Jun 2025 00:00:00 +0200

Background: Mental health disorders are a significant public health concern globally, particularly affecting low- and middle-income countries. Ethiopia, like many developing nations, faces challenges in providing adequate mental healthcare services. Previous studies have highlighted the underutilization of psychiatric care and a preference for non-psychiatric treatment options among individuals with mental health issues in the country. Understanding the factors associated with non-psychiatric help-seeking is crucial for developing effective interventions to improve mental health outcomes.

Objective: This study aimed to assess the prevalence of non-psychiatric help seeking and its associated factors among patients attending mental health services at Dilla University Referral Hospital, Gedeo Zone, South Ethiopia Region, in 2023.

Method: The study was conducted at Dilla University Referral Hospital from July to October 2023, using an institutional-based cross-sectional design. A sys tematic random sampling technique was employed to recruit a sample of 423 participants. Data were collected using various tools, including questionnaires and interviews, to assess non-psychiatric treatment-seeking behaviors, social support, mental health literacy, and perceived stigma. Quantitative data were gathered using the Epi-Collect smartphone application and analyzed using SPSS version 26. Bivariate and multivariate logistic regression analyses were conducted to identify factors associated with routes to psychiatric care. Statistical significance was set at p < 0.05.

Result: A substantial majority (92.7%) of participants initially sought non psychiatric care for mental health issues. Factors associated with non-psychiatric treatment-seeking included younger age (AOR=4.28, 95% CI=2.178-10.635), fe male sex (AOR=2.30, 95% CI=1.767-3.742), lower education (AOR=3.20, 95% CI=1.423-9.164), specific diagnoses (such as schizophrenia and bipolar disorder), poor social support (AOR=4.90, 95% CI=1.562-18.024), low mental health literacy (AOR=3.53, 95% CI=2.723-5.677), low income (AOR=3.01, 95% CI=1.602-6.934), limited awareness of psychiatric services (AOR=2.00, 95% CI=1.239-3.618), high perceived stigma (AOR=3.00, 95% CI=2.223-4.443), and residing more than 5 km from a health facility (AOR=2.16, 95% CI=1.562-3.621).

Conclusion: This study highlights the substantial reliance on non-psychiatric care for mental health issues among individuals seeking treatment. Factors such as age, gender, education, diagnosis, social support, mental health literacy, income, awareness of psychiatric services, perceived stigma, and geographical accessibility significantly influenced help-seeking behaviors. Understanding these determinants is crucial for developing targeted interventions to improve access to and utilization of appropriate mental healthcare services.

Sexually Transmitted Infections Treatment Seeking Behaviour and Associated Factors among Symptomatic Students in Hawassa Teacher’s education Colllege, South Ethiopia:A cross sectional study

Mon, 30 Jun 2025 00:00:00 +0200

Background: Sexually transmitted infections (STIs) pose a significant public health challenge globally, impacting quality of life and leading to severe illness and mortality. While treatment-seeking behavior is critical for disease prevention and management, there is limited data on this behavior and its influencing factors in the study area.

Objective: To evaluate treatment-seeking behavior and associated factors for STIs among symptomatic students at Hawassa Teachers Education College, Southern Ethiopia. Methods: An institution-based cross-sectional study design was employed, in volving 415 students selected through simple random sampling. Data were entered using Epi-data version 3.1 and analyzed with Statistical Package for Social Science version 25. Bivariate and multivariable binary logistic regression analyses were conducted to identify variables significantly associated with the outcome, using Adjusted Odds Ratios (AOR) and 95% Confidence Intervals (CI). A p-value of ≤ 0.05 was considered statistically significant. Results: The prevalence of treatment-seeking behavior was 47.2% (95% CI: 42.3 52.2). Factors significantly associated with treatment-seeking behavior included: female sex (AOR: 0.16, 95% CI: 0.06-0.46), students earning pocket money of 1501-2000 birr (AOR: 3.22, 95% CI: 1.19-8.66), preference for self-treatment (AOR: 0.20, 95% CI: 0.07-0.61), comfort in expressing symptoms to health professionals (AOR: 2.76, 95% CI: 1.01-7.59), and poor knowledge of STIs (AOR: 0.32, 95% CI: 0.11-0.92).

Conclusion: The prevalence of treatment-seeking behavior among students was low. Factors such as sex, financial resources, perception of disease burden, privacy concerns, and STI knowledge were significantly associated with treatment-seeking behavior. It is recommended to discourage self-treatment and embarrassment while enhancing participants’ knowledge about STIs.

Expressed Emotions Among Caregivers of Schizophrenia Patients in Southern Ethiopia: Associations with Caregiver and Patient Characteristics

Yohanes Sime, Mubarek Mohammed, Anteneh Gashaw — Mon, 30 Jun 2025 00:00:00 +0200

Background: Expressed Emotion (EE) measures family caregivers’ attitudes and behaviors toward mentally ill family members. This concept is crucial in mental health research, as it assesses criticism, unfriendliness, or support from immediate family. This study addresses a significant gap by evaluating caregivers of schizophrenia patients in Ethiopia. The findings aim to assist policymakers and healthcare professionals in enhancing mental health support in the region. Objective: To determine the magnitude of Expressed Emotions among caregivers of patients with schizophrenia and its association with caregivers’ and patients’ characteristics in Southern Ethiopia, 2022.

Method and Materials: A cross-sectional study design was employed, involving 202 caregivers providing care to patients with schizophrenia at the psychiatry clinic of Dilla University Referral Hospital. Data collection utilized mobile software Epi.INFO version 7 through interviewer administration, supplemented by relevant chart reviews. Caregivers’ EE levels were evaluated using two domains: Critical Comment (CC) and Emotional Over-Involvement (EOI), using validated tools. A systematic random sampling technique was employed to select participants. Data were analyzed using SPSS version 22, with bivariate analysis conducted for potential EE predictors (P-value < 0.2). Variables meeting this criterion were further analyzed using multivariable logistic regression, with a P-value < 0.05 considered statistically significant.

Results: High expressed emotion was observed in 50.5% (43.1-57.4) of respondents. Factors significantly associated with high expressed emotion included caring for patients with schizophrenia for 6-8 years (AOR=3.5; 95% CI: 2.1-6.3), being a female caregiver (AOR=1.2; 95% CI: 1.15-4.1), experiencing moderate to severe caregiver overload (AOR=2.0; 95% CI: 1.81-5.4), and a total duration of illness of 6-10 years (AOR=1.6; 95% CI: 1.42-3.9).

Conclusion: The present study reported a high level of EE among nearly half of the family members. Factors such as being a female caregiver, caring for a patient for 6-8 years, experiencing moderate to severe overload, and a total illness duration of 6-10 years were significantly associated with elevated EE. This underscores the need for psychosocial nursing care for all family members of schizophrenia patients, which can help them effectively cope with the stress of managing a mentally ill family member at home.