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Knowledge and attitude of parents towards the human papillomavirus vaccine for their daughters and associated factors in Debre Tabor town, northwest Ethiopia: a community-based cross-sectional study

Por: Aragaw · G. M. · Aynalem · G. L. · Abiy · S. A. · Taye · E. B. · Chernet · S. A. · Haile · T. T. · Tsega · N. T. · Mesele · T. T. · Seyoum · A. T. · Tsega · A. G. · Mengistie · B. A.
Objective

This study aims to assess parents’ knowledge and attitude towards the human papillomavirus (HPV) vaccination of their daughters and the associated factors in Debre Tabor town, northwest Ethiopia.

Design

A community-based cross-sectional study.

Setting

Debre Tabor town, Northwest Ethiopia.

Participants

A total of 702 participants were included in the study, with a response rate of 98.2%. Three out of the six kebeles in the town were randomly selected, and participants within the selected kebeles were recruited through a cluster sampling technique. An interviewer-administered structured questionnaire was used to collect data from 15 December 2021 to 15 February 2022.

Primary and secondary outcome measures

Parents’ level of knowledge and attitude towards the HPV vaccination of their daughters, and the associated factors.

Results

In the study, parents’ knowledge and attitude towards HPV vaccination were found to be 46.4% (95% CI 42.7% to 50.1%) and 61.5% (95% CI 58.0% to 65.2%), respectively. Parents with a higher level of education (adjusted OR (AOR)=2.27; 95% CI 1.39 to 3.69), media exposure (AOR=3.36; 95% CI 1.21 to 9.33) and a good attitude towards the HPV vaccine (AOR=8.81; 95% CI 5.78 to 13.44) were significantly associated factors that affect parents’ level of knowledge. Positive subjective norms (AOR=1.53; 95% CI 1.01 to 2.31) and perceived behavioural control towards the HPV vaccine (AOR=3.48; 95% CI 2.37 to 5.10) had statistically significant associations with parents’ attitude.

Conclusions

In this study, more than half of parents had poor knowledge of the HPV and its vaccination, while the majority of the participants showed a favourable attitude to the vaccine. Educational attainment, media exposure and a positive attitude were significantly associated with parental knowledge, and parents’ attitude was positively influenced by subjective norms and perceived behavioural control. This suggests a need to increase the parents’ level of awareness through educational interventions, particularly via media and community engagement. To improve the acceptance and uptake of the HPV vaccination, it is important to address negative attitudes and common misconceptions among parents on the safety, efficacy and necessity of the vaccine for their daughters.

Social context influences <i>Toxoplasma gondii</i> and <i>Trichinella</i> spp. infection in Alberta free-roaming wild pigs (<i>Sus scrofa</i>)

by Kiera Middel, Hailey Strydhorst, Hannah McKenzie, Chunu Mainali, Darcy R. Visscher

The increasing spread of wild pigs across Canada is concerning due to their potential role as reservoirs for zoonotic diseases, including trichinosis and toxoplasmosis. Trichinosis is caused by the parasitic nematode Trichinella spp. and can manifest clinically in humans. Likewise, the intracellular protozoan parasite Toxoplasma gondii is a significant global foodborne and waterborne parasite responsible for toxoplasmosis. Despite wild pigs being recognized globally as reservoirs for T. gondii and Trichinella spp., the status of wild pigs in Alberta remains undetermined. Wild pig diaphragms were collected as part of provincial control efforts between 2018–2024 from four Alberta counties. Meat juice was analyzed for antibodies against Trichinella spp. and T. gondii using commercial ELISA kits. We found that 27/252 pigs were positive for antibodies against T. gondii and 11/293 positive for antibodies against Trichinella spp., corresponding with the respective true prevalence of 15.3% (95% CrI: 9.6–22.7%) and 3.8% (95% CrI: 1.8–6.5%) based on Bayesian analysis using reported test sensitivity and specificity. We found a difference in true prevalence of antibodies against Trichinella spp. between counties, and the prevalence of antibodies against Trichinella spp. and T. gondii was significantly higher in solitary wild pigs, suggesting social context of the individual is an important determinant of infection risk. These findings suggest that Alberta wild pigs function as Trichinella spp. and T. gondii reservoirs, underscoring the need for a One Health approach for managing Alberta’s invasive wild pigs.

Patient Reported Experiences of Receiving Person‐Centred, Nurse‐Led Follow‐Up After Revascularisation for Intermittent Claudication: Secondary Analysis of a Randomised Controlled Trial

ABSTRACT

Aim

To evaluate the quality of care from the patients' perspective after receiving either person-centred, nurse-led follow-up or standard care after surgical treatment of intermittent claudication.

Design

Secondary analysis of a randomised controlled trial.

Methods

Patients at two centres for vascular surgery in Stockholm, Sweden were randomised to either a person-centred, nurse-led follow-up programme (intervention group) or a standard follow-up programme with surgeons. During their visits at 4 to 8 weeks and 1 year after surgery, they received the questionnaire Quality from patients' perspective with 28 items. The patients responded to each item from two aspects: (1) how they perceived the quality of received care and (2) subjective importance (how important the care was for them).

Results

A total of 104 of 138 patients at 4–8 weeks and 159 of 193 patients at 1 year after surgery completed the questionnaire. At 4–8 weeks, the intervention group scored significantly higher perceived quality of care regarding five items: receiving useful information about “How I should take care of myself” and “Which nurse were responsible for my care”, “Nurses were respectful towards me”, “Nurses showed commitment/cared about me” and “Easy to get in contact with the clinic through telephone”. At 1 year, the intervention group scored higher regarding two items: “Which nurses were responsible for my care” and “Next of kin treated well”.

Conclusion

Person-centred, nurse-led follow-up as implemented in this study has been shown to lead to a higher perception of quality of care regarding information about self-care, the experience of being respected, and knowing the care provider responsible for their care. Thus, it could contribute towards improved patient satisfaction without compromising the perception of quality of care regarding other factors such as receiving the best medical care or timeliness.

Implications for the Profession and/or Patient Care

This study addresses how patients with intermittent claudication, who underwent revascularisation, perceive a follow-up care that is person-centred and nurse-led compared to standard care delivered by surgeons. The results indicate that patients find the person-centred and nurse-led follow-up programme satisfactory, with equal or higher quality of care and that follow-up can be delivered by nurses with retained patient safety. Thus, vascular units may consider transitioning follow-up care from surgeons to nurses while maintaining positive patient's perception of quality of care, patient satisfaction and safety.

Reporting Method

Reporting of the work was made using the Consolidated Standards of Reporting Trials (CONSORT) statement.

Patient or Public Contribution

No patient or public contribution.

Trial Registration

Study Details | Person-centred Follow-up and Health Promotion Programme After Revascularization for Intermittent Claudication | ClinicalTrials.gov: NCT03283358

Spatial patterns and predictors of missing key contents of care during prenatal visits in Ethiopia: Spatial and multilevel analyses

by Aklilu Habte Hailegebireal, Habtamu Mellie Bizuayehu, Yordanos Sisay Asgedom, Jira Wakoya Feyisa

Background

Quality Antenatal Care (ANC) is considered if pregnant women have access to essential services that align with the best evidence-based practice. Although several studies have been conducted on ANC uptake in Ethiopia, they have focused on the timing and number of visits and the level of complete uptake of care contents according to the WHO recommendation remains scarce. Hence, this study aimed to assess the magnitude of missing care content during ANC visits, its spatial variations, and individual- and community-level determinants in Ethiopia.

Methods

The study was conducted using the 2016 Ethiopian Demographic and Health Survey and included a total weighted sample of 4,771 women who gave birth within five years before the survey. Spatial analysis was carried out using Arc-GIS version 10.7 and SaTScan version 9.6 statistical software. Spatial autocorrelation (Moran’s I) was checked to determine the non-randomness of the spatial variation in the missing contents of care. Multilevel multivariable logistic regression analysis was performed using STATA version 16. The adjusted odds ratio (aOR) with its corresponding 95% CI was used as a measure of association.

Results

The prevalence of missing full contents of ANC in Ethiopia was 88.2% (95% CI: 87.2, 89.0), with significant spatial variations observed across regions. Missing essential contents of care was higher among women who live in rural areas (aOR = 1.68, 95% CI: 1.47, 2.71), not completed formal education (aOR = 1.94, 95% CI:1.24, 3.02), late initiation of ANC (aOR = 3.05, 95% CI:1.59, 6.54), attended only one ANC (aOR = 4.13, 95% CI: 1.95, 8.74), and not having a mobile phone (aOR = 1.44, 95% CI: 1.07, 1.95).

Conclusion

The level of missing care content during prenatal visits was high in Ethiopia, with significant spatial variation across regions. Health systems and policymakers should promote early initiation and encourage multiple visits to provide optimal care to pregnant women. In addition, it is vital to focus on enhancing education and healthcare infrastructure in rural parts of the country.

Most individuals with diabetes‐related foot ulceration do not meet dietary consensus guidelines for wound healing

Abstract

The inaugural expert consensus and guidance for Nutrition Interventions in Adults with Diabetic Foot Ulcers (DFU) have been welcomed by clinicians internationally. This short report aimed to determine how the macronutrient and micronutrient status of individuals living with DFU compared to the American Limb Preservation Society Nutrition Interventions in Adults with DFU expert consensus and guidance. Descriptive analysis was conducted as a secondary analysis of an existing dataset. Mean (SD) dietary intake, the proportion meeting the nutrition recommendations and the proportion exceeding the upper limit (UL) for specific vitamins and minerals were reported. Most individuals with DFU do not meet current consensus guidelines for optimal dietary intake for wound healing, with inadequacies evident for fibre, zinc, protein, vitamin E and vitamin A. Future iterations of the consensus guideline should consider using evidence-informed recommendations for clinical practice, with the inclusion of all nutrients that are essential for wound healing in DFU.

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