Journal of Environmental and Public Health
Vesi 2019, Nkhani ID 4852130, masamba 8
https://doi.org/10.1155/2019/4852130
Tadele Amare
, 1 Tebikew Yeneabat, 2 ndi Yohannes Amare3
1Dee ya Psychiatry, Kalaleji ya Zamankhwala ndi Sayansi ya Zaumoyo, Yunivesite ya Gondar, Gondar, Ethiopia
2De of Midwifery, College of Sciences Sciences, University Debre Markos, Debre Markos, Ethiopia
3De of Internal Medicine, Kalaleji ya Zamankhwala ndi Sayansi ya Zaumoyo, Yunivesite ya Gondar, Gondar, Ethiopia
Kudalirika
Chiyambi. Kuopsa kwa chiwerewere kumachitika pakuyamba kugonana kosagwiritsidwa ntchito, makamaka pakati pa achinyamata, ndikupitirirabe ngati ntchito zowonongeka zikuchitika. Padziko lonse, komanso ku Africa, kufa kwa achinyamata omwe ali ndi kachilombo ka HIV pakati pa achinyamata akukula. Choncho, ndondomeko yowonongeka komanso kuwonetseratu za matenda okhudzana ndi kugonana kwa ophunzira ku koleji ndi yunivesite ku Ethiopia ndilololedwa.
Njira. Tinayesetsa kufufuza kwambiri nkhani monga momwe tawonetsera mu chitsogozo cha kafukufuku wamakono komanso kafukufuku wamakono (PRISMA). Zosungidwa monga PubMed, Global Health, Africa-wides, kufufuza kwa Google patsogolo, Scopus, ndi EMBASE anapeza zofufuzira mabuku. Zomwe zinagwiritsidwa ntchito poyerekeza ndi matenda a chiopsezo chogonana ndi zinthu zogwirizana zinaganiziridwa pogwiritsira ntchito njira zosawerengeka zogwiritsa ntchito meta komanso 95% CI. PROSPERO nambala yolembera ndi CRD42018109277.
Zotsatira. Phunziro lonse la 18 ndi otsogolera a 10,218 linaphatikizidwa mu kuyesa metayi. Chiwerengero cha kuchuluka kwa makhalidwe okhudzana ndi kugonana pakati pa ophunzira a koleji ndi yunivesite ndi 41.62%. Kukhala wamwamuna [OR: 2.35, ndi 95% (CI; 1.20, 4.59)], kumwa mowa [OR: 2.68, ndi 95% CI; (1.67, 4.33)] ndi kuonera zolaula [OR: 4.74, ndi 95% CI; (3.21, 7.00)] anali ogwirizana kwambiri ndi khalidwe loopsa la kugonana.
Kutsiliza ndi ndondomeko. Kuchita zachiwerewere pakati pa ophunzira kunali koopsa. Maphunziro a maphunziro ayenera kusamala kwambiri amuna, ogwiritsira ntchito mowa, komanso ophunzira omwe amaonera zolaula.
1. Introduction
Mchitidwe wokhudzana ndi chiwerewere umatetezedwa ngati chiwerewere chosatetezeka, pakamwa, kapena kugonana [1]. Kuopsa kwa chiwerewere kumachitika pakuyamba kugonana kosaopsa, makamaka pakati pa achinyamata, ndipo amapitirizabe ngati ntchito zowonongeka zikuchitika. Padziko lonse, 14,000 tsiku ndi tsiku atsatira kachilombo ka HIV, kuposa 95% anali mayiko omwe akutukuka chifukwa cha khalidwe loopsa la kugonana [2].
Padziko lonse, komanso ku Africa, achinyamata omwe ali ndi kachilombo ka HIV pakati pa achinyamata akuwonjezeka [3].
Zomwe zimachititsa achinyamata kukhala pachiopsezo chotenga matenda ndizo umphawi, kusowa mphamvu muukwati, chiwawa, miyambo ya chikhalidwe monga kukwatirana koyambirira komanso zachiwerewere zovulaza, komanso kusiyana kwa amuna ndi akazi. Chotsatira chimodzi ndicho chikhalidwe cha kugonana, kumene amayi kapena atsikana amasinthanitsa kugonana ndi ndalama, sukulu ya sukulu, chakudya, kapena nyumba [2, 4].
Kukula kwa khalidwe labwino la kugonana ku ophunzira a koleji ndi yunivesite kunali 26% ku Uganda [5], 63% ku Nigeria [6], ndi 63.9% ku Botswana [7].
Zifukwa za chiwerewere choopsa ndi zosangalatsa, chidwi, zokhudzana ndi anzako, ndi zopindulitsa zachuma [8, 9]. Pafupifupi matenda opatsirana pogonana a 19 miliyoni amapezeka chaka chilichonse: pafupifupi theka la achinyamata a 15 mpaka 24. Pafupifupi achinyamata a 750,000 amatenga mimba chaka chilichonse [10]. Kukula koyamba kwa kugonana kwawatsogoleredwa ndi makhalidwe ambiri oopsa, omwe ali ndi kuvutika maganizo, kusowa kwa kondomu, ndi kumwa mowa ndi mankhwala osokoneza bongo [11]. Zotsatira za khalidwe loopsa la kugonana ndi mimba yosakonzekera, matenda opatsirana pogonana, matenda a m'maganizo, kudzipha, kuchotsa mimba, komanso kuchotsa maphunziro kapena kuchotsa [12, 13].
Zinthu zomwe zinkakhudzana ndi khalidwe loopsa la kugonana zinali kumwa moŵa [14, 15], kukhala wamwamuna [16], kutengera anzawo [17, 18], ndi umphawi [18].
Ngakhale ophunzira a ku koleji ndi yunivesite ali panthawi yovuta kwambiri chifukwa cha zizoloŵezi za chiopsezo cha kugonana, komabe palibe kupatsidwa kwenikweni. Choncho, kuchulukitsidwa komwe kunalinganizidwa ndi zinthu zowonongeka m'zochitika zoyipa za kugonana ndizofunikira.
2. Njira
Tinkafufuzira kwambiri nkhani monga momwe zikuwonetsedwera mu ndondomeko ya kuwonetsa kayendetsedwe ka kayendedwe kake komanso kafukufuku wamakono (PRISMA) [19]. Zosungidwa monga PubMed, Global Health, Africa-wides, kufufuza kwa Google patsogolo, Scopus, ndi EMBASE anapeza zofufuzira mabuku. Tinayesetsa kufufuza mu PubMed pogwiritsa ntchito mawu awa ndi mawu ofunika: "Kufala kapena matenda oopsa kapena KUGWIRITSIDWA KOYENERA KUGWIRITSANA NDI khalidwe loopsa la chiwerewere KODI khalidwe loopsa kapena ZOYENERA KUGWIRITSA NTCHITO ZOYENERA KUDZIWA ZOYENERA KOYENERA KAPENA KODI ZINTHU ZOYENERA KAPENA KUKHALA KAPENA KUKULU KOPHUNZITSA ORI YAM'Yunivesite KODI wophunzira kapena Ophunzira NDI Etiyopiya KODI Aitiopiya. "Kwa maumboni ena, tinagwiritsa ntchito nkhani zina zomwe zikutsogolera maulendo onse. Kuwonjezera apo, kuti tipeze zilembo zina zofanana, ife tafufuza mndandanda wamndandanda wa zilembo zoyenera (Chithunzi 1).
Chithunzi 1: Tchati chozungulira chikuwonetsa momwe nkhani zofufuzira zafufuzira, 2018.
2.1. Zolinga Zoyenera
Owerenga awiri (TA ndi TY) adasanthula zochitikazo pogwiritsa ntchito mutu wawo ndi zilembo zawo asanabweretse zilembo zonse. Nkhani zowonjezera zomwe zinatulutsidwa zinayang'aniranso kupyolera mu ndondomeko yowonjezera ndi kusungidwa. Pofuna kupewa zisankho, gulu la Joanna Briggs Institute linkagwiritsidwa ntchito pofufuza ndondomeko yowonongeka komanso zofufuza zapamwamba, zomwe zinapangidwa 9 pa khumi ndi mmodzi [20]. Tinathetsa kusagwirizana pokambirana ndi wolemba kachitatu (YA).
2.1.1. Mfundo Zowonjezera
Maphunziro ophunzirira aphunzitsi a ku koleji ndi yunivesite Nkhani yosindikizidwa m'Chingelezi Maphunziro omwe amafotokoza kukula kwa khalidwe labwino la kugonana ku sukulu za koleji ndi yunivesite Maphunziro opangidwa ku Ethiopia Kuphunzira chaka kuchokera mu Januwale, 2009 mpaka August, 2018
2.1.2. Zotsatira Zopatula
Makalata, ndemanga, ndi maphunziro apadziko lonse ndi maphunziro ophatikizapo adatulutsidwa.
2.2. Njira Zowonjezera Deta ndi Kuyesa Makhalidwe
Tinagwiritsa ntchito mawonekedwe oyenerera a deta kuti tipeze deta kuchokera ku maphunziro odziwika. Zotsatira zotsatirazi zinatengedwa kuti aliyense aphunzire: dzina la wolemba woyamba, tsiku lofalitsa, kukonza maphunzilo, zinthu zogwirizanitsa, kukula kwazitsanzo, zopangika zowerenga, zosokoneza zomwe zinasinthidwa kuti ziwonongeke (OR), ndi nthawi yokhulupirira 95%. Kuchokera kwadongosolo kuchokera kumabuku oyambirira kunayendetsedwa popanda odzifufuza atatu. Kusagwirizana kunathetsedwa ndi kugwirizana.
Mtengo wa kuphatikiza maphunziro unayesedwa pogwiritsira ntchito Newcastle-Ottawa Scale (NOS) [21]. Chitsanzo cha kufanana ndi kukula kwake, kufanana pakati pa ophunzira, kuzindikiritsa khalidwe labwino la kugonana, ndi khalidwe la chiwerengero ndi madera a ntchito za NOS kuti azindikire ubwino wa phunziro lililonse. Zolinga zenizeni ndi mgwirizano mopanda mwayi (Kappa wosagwira ntchito) zinagwiritsidwa ntchito poyesa mgwirizano pakati pa olemba atatuwo. Timaganizira kufunika kwa 0 ngati mgwirizano wosavomerezeka, 0.01-0.20 ngati mgwirizano pang'ono, 0.21-0.40 monga mgwirizano wogwirizana, 0.41-0.60 monga mgwirizano wogwirizana, 0.61-0.80 monga mgwirizano waukulu, ndipo 0.81-1.00 monga mgwirizano wangwiro [22]. M'mbuyomuyi, mgwirizano weniweni ndi mgwirizano mwangwiro unali 0.82 umene uli mgwirizano weniweni.
2.3. Data Synthesis and Analysis
Pulogalamu ya STATA version14 inagwiritsidwa ntchito pofufuza meta ndi madera a m'nkhalango omwe amasonyeza kusonkhana pamodzi ndi 95% CI. Chiwerengero chonse chofala chimawerengedwa kuti chiwerengero cha meta [23] chosasintha. Kuyeza kwapadera kunayesedwa pogwiritsa ntchito chiwerengero cha Q ndi ma I2 ziwerengero [23]. Kuwonjezeka kwa chiwerengero pakati pa kafukufuku kunayankhidwa pogwiritsa ntchito ziwerengero za I2 ndi mtengo wa 25%, 50%, ndi 75% ankawonedwa kuti amaimira otsika, apakati, ndi apamwamba kwambiri [24]. Mu deta iyi yowonongeka, mawerengero a I2 amtengo wapatali anali 97.1 nawo
kufunika ≤ 0.001 yomwe inasonyeza kuti panali kutentha kwakukulu. Choncho, njira yosasinthika yogwiritsidwa ntchito mosagwiritsidwa ntchito inagwiritsidwa ntchito panthawi yofufuza. Meta-regression inkapangidwira kufufuza zomwe zingapangidwe zowonongeka. Tinachitanso kafukufuku wina wofufuza kuti tiwone maphunziro ofunikira omwe amachititsa kuti pakhale kugwirizana pakati pa kuphunzira. Kusankhana kwapadera kunayesedwa ndi ndondomeko ya mapulogalamu ndi Egger's regression test. Panalibenso chisangalalo chofalitsa.
Mbali za maphunziro: maphunziro onse anali ku Ethiopia. Mapangidwe apangidwe kafukufuku onse anali ndi magawo khumi ndi asanu ndi atatu (Included Table 1).
Pulogalamu 1: Kukula kwa khalidwe loopsya pakati pa ophunzira okhudzana ndi bungwe, Ethiopia, 2018.
3. Zotsatira
Phunziro lonse la 18 ndi otsogolera a 10,218 linaphatikizapo meta. Malingana ndi mafano osiyanasiyana ku Ethiopia, kuchuluka kwa khalidwe lachiwerewere loopsya linachokera ku 23.3% mpaka 60.9%. Chiwerengero cha kuchuluka kwa makhalidwe okhudza kugonana pakati pa ophunzira a koleji ndi yunivesite ndi 41.62% ndi 95% CI (36.15, 47.10) (Chithunzi 2).
Chithunzi 2: Chiwerengero cha chiwerengero cha chiwerewere choopsya pakati pa ophunzira a koleji ndi yunivesite, ku Ethiopia 2018.
3.1. Gawo lachidule Kukula kwa Kugonana kwa Ophunzira Mwachiopsezo
Kuchokera pa Chithunzi cha 3 kagulu kafukufuku kanali kochitidwa ndi bungwe monga kuthekera koyambitsa kugonana pakati pa koleji ndi yunivesite. Chiwerengero cha kugawidwa kwa chiopsezo chogonana ku ophunzira ku koleji ndi ku yunivesite kunali 40.65% ndi 42.12%, motero.
Chithunzi cha 3: Chiwembu cha nkhalango pofotokoza momwe gululi likugwiritsira ntchito chiwerengero cha kugonana kwa ophunzira ku koleji ndi yunivesite, ku Ethiopia, 2018.
3.2. Kusiyana kwa kusiyana pakati pa amuna ndi akazi ndi zoopsa zogonana
Kuchokera pa Chithunzi 4 chiwerengero cha zinthu zisanu ndi ziwiri mwazigawozi. Panali mgwirizano waukulu pakati pa khalidwe lachiwerewere ndi loopsa la kugonana. Kukhala wamwamuna anali 2.35 [OR: 2.35, ndi 95% (CI; 1.20, 4.59)] nthawi zambiri kuti achite nawo zoopsa zogonana poyerekeza ndi akazi.
Chithunzi cha 4: Chiwembu cha nkhalango chomwe chimapereka njira zochepa zowonjezera (OR) za amuna omwe ali okhudzana ndi akazi omwe ali ndi chiopsezo chogonana pakati pa ophunzira a koleji ndi yunivesite ku Ethiopia, 2018.
3.3. Kugwiritsa Ntchito Mowa ndi Kugonana Kwabwino
Kuchokera pa Chithunzi 5, nkhani zitatu zinakhazikitsidwa-mu ndondomekoyi. Anthu omwe ankanena kuti adayamba kumwa mowa chifukwa cha khalidwe lawo loopsa lachiwerewere anali 2.68 [OR: 2.68, ndi 95% CI; (1.67, 4.33)] nthawi zambiri kuti achite nawo chiopsezo chogonana.
Chithunzi cha 5: Chiwembu cha m'nkhalango chomwe chimapangitsa kuti anthu asagwiritse ntchito mowa mopitirira muyeso (OR) mowa mwauchidakwa wokhudzana ndi kusagwiritsa ntchito mowa mwauchidakwa pakati pa ophunzira a koleji ndi yunivesite ku Ethiopia, 2018.
3.4. Kuwonera Zithunzi Zolaula ndi Khalidwe Labwino la Kugonana
Kuchokera pa Chithunzi 6 nkhani zitatu zinazindikiritsidwa. Anthu omwe ankaonera zolaula anali ndi 5 [OR: 4.74, ndi 95% CI; (3.21, 7.00)] nthawi zambiri zowonjezera kuchita chiwerewere chowopsa kusiyana ndi ziwalo zogonana.
Chithunzi cha 6: Chiwembu cha nkhalango chomwe chimapangitsa kuti anthu azionera zolaula zokhudzana ndi zolaula zomwe zimachitika potsata zolaula pakati pa ophunzira ku koleji ndi ku yunivesite ku 2018.
4. Kukambirana
Mu phunziro ili, nkhani khumi ndi zisanu ndi zitatu zinaphatikizidwapo. Pa maphunziro khumi ndi awiriwa anali ophunzira ophunzira ku yunivesite koma asanu ndi mmodzi anali ophunzira a koleji. Ku Ethiopia, kuchuluka kwa khalidwe labwino la kugonana pakati pa ophunzira a koleji ndi yunivesite kuyambira 23.3% mpaka 60.9%. Chiwerengero cha kuchuluka kwa khalidwe lachiwerewere pakati pa koleji ndi yunivesite ku Ethiopia anali 40.65% (28.99, 52.30) ndi 42.41% (35.68, 48.57), motero. Chiwerengerochi chikupezeka kuti chiwerengero cha khalidwe loopsa la kugonana chinali 41.62% (36.45, 47.10). Kupeza kumeneku kunali kochepa kuposa maphunziro omwe anachita ku Nigeria [6] ndi Botswana [7]. Komabe, kupeza izi kunali kwakukulu kusiyana ndi phunziro lomwe lapangidwa ku Uganda [5]. Kusiyana kungakhale kukula kwazitsulo (ku Uganda, chitsanzo cha kukula chinali 261 chomwe chinali chochepa).
Zinthu zomwe zimagwirizanitsa ndi chiopsezo chogonana pakati pa ophunzira a ku Ethiopia ndi ku yunivesiti anali amuna ndi 2.35 [OR: 2.35, ndi 95% (CI; 1.20, 4.59)] nthawi zambiri kuti achite nawo chiopsezo chogonana poyerekeza ndi akazi omwe ankathandizidwa ndi [16]. Anthu omwe ankanena kuti adayamba kumwa mowa chifukwa cha khalidwe lawo loopsa lachiwerewere anali 2.68 [OR: 2.68, ndi 95% CI; (1.67, 4.33)] nthawi zambiri kuti achite nawo chiopsezo chogonana chomwe chinathandizidwa ndi [14, 15]. Kuonerera zolaula kunayambanso kuopsa kwa khalidwe labwino la kugonana. Kuonerera zolaula kumawonjezera chikhumbo cha kugonana.
5. Mapeto ndi Malangizo
Kuchita zachiwerewere pakati pa ophunzira kunali koopsa. Maphunziro a maphunziro ayenera kusamala kwambiri amuna, ogwiritsira ntchito mowa, komanso ophunzira omwe amaonera zolaula.
Mikangano ya Chidwi
Olembawo adanena kuti palibe mikangano ya chidwi.
Mphatso za Olemba
TA ndi TY adasanthula nkhani zomwe zikugwiritsidwa ntchito pogwiritsa ntchito mutu wawo ndi zolemba zawo asanabweretse zilembo zonse. Nkhani zowonjezera zomwe zinatulutsidwa zinayang'aniranso kupyolera mu ndondomeko yowonjezera ndi kusungidwa. Olembawo anathetsa kusagwirizana pokambirana ndi wolemba Wachitatu YA.
Kuvomereza
Olembawo akufuna kuthokoza olemba onse a pepala lofufuzira lomwe likuphatikizidwa mu ndondomeko yowonongekayi ndi meta-analysis.
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