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Background: Patients with type 2 diabetes mellitus (T2D) have an increased risk of vascular complications. Despite the rise in the prevalence of T2D and its complications throughout the globe, there is a paucity of data regarding the prevalence and determinants of vascular complications of T2D in Ethiopia. Hence, this study aimed to assess the prevalence, patterns, and determinants of the microvascular and macrovascular complications of T2D among adult patients attending a teaching hospital in Addis Ababa, Ethiopia. Methods: A retrospective study was done by reviewing the electronic health records of adult patients with T2D attending the general medical and endocrine referral clinics of Yekatit 12 Hospital Medical College, Addis Ababa, Ethiopia, from June 1, 2023, to November 30, 2023. Statistical Package for Social Sciences (SPSS), version 25, was used to analyze the data. Descriptive analysis was used to summarize the sociodemographic, clinical, and laboratory profiles as well as the patterns of vascular complications of T2D. Bivariate and multivariate logistic regression models were fitted, and the crude odds ratio (COR) and adjusted odds ratio (AOR), together with the 95% confidence interval (CI), were computed to identify the determinants of microvascular and macrovascular complications of T2D. Results: A total of 272 patients with T2D were included in this study; 50.5% were females, and the mean (± standard deviation) age was 56.3 ± 12.8 years. The majority of patients (62.5%) had diabetes for ≥ 5 years. More than half (51.5%) had poor glycemic control with glycated haemoglobin (HbA1c) value of ≥ 7%. The overall prevalence of vascular complications was 39%. The prevalence of microvascular complications was 23.5%, the most common being neuropathy (11.8%), and the prevalence of macrovascular complications was 21%, the most common being coronary artery disease (12.1%). The determinants of microvascular complications were age ≥ 60 years (AOR = 2.25, 95% CI: 1.17, 4.33), diabetes duration of ≥ 5 years (5–10 years [AOR = 3.13, 95% CI: 1.37, 7.18], and > 10 years [AOR = 3.88, 95% CI: 1.66, 9.06], and HbA1c value of ≥ 7% (AOR = 2.21, 95% CI: 1.14, 4.28). The odds of developing macrovascular complications were higher with diabetes duration of ≥ 5 to 10 years (AOR = 2.89, 95% CI: 1.37, 6.12) as compared with diabetes duration of < 5 years. Conclusions: This study demonstrated a high prevalence of microvascular and macrovascular complications in adult patients with T2D. Older age, prolonged duration of diabetes, and poor glycemic control were identified as the determinants for the development of microvascular complications of T2D, while prolonged duration of diabetes was the determining factor for the development of macrovascular complications. Hence, targeted initiatives are required to enhance the prevention and early detection of vascular complications of T2D in resource-limited countries like Ethiopia. [ABSTRACT FROM AUTHOR]

Background: Inadequate glycemic management in type 2 diabetes Mellitus patients is a serious public health issue and a key risk factor for progression as well as diabetes-related complications. The main therapeutic goal of preventing organ damage and other problems caused by diabetes is glycemic control. Knowing when to modify glycemic control in type 2 diabetes Mellitus is crucial for avoiding complications and early drug intensifications. Methods: An institutional based retrospective follow-up study was undertaken among 514 eligible adult diabetes patients in Amhara region Comprehensive Specialized Hospitals, Northwest Ethiopia, from January 2017 to January 2022. Simple random sampling technique was used to select study participants. The Kaplan Meier curve was used to assess the survival status of categorical variables, and the log-rank test was used to compare them. The cox proportional hazard model was fitted to identify the predictors of time to first optimal glycemic control. Variables with a p-value < 0.05 were considered to be statistically significance at 95% confidence interval. Results: A total of 514 patient records (227 males and 287 females) were reviewed in this study. The median time to first optimal glycemic control among the study population was 8.4 months IQR (7.6–9.7). The predictors that affect the time to first optimal glycemic control were age group ((AHR = 0.63, 95% CI = 0.463, 0.859 for 50–59 years), (AHR = 0.638, 95% CI = 0.471, 0.865 for 60–69 years), and (AHR = 0.480, 95% CI = 0.298, 0.774 for > = 70 years)), diabetes neuropathy (AHR = 0.629, 95% CI = 0.441,0.900), hypertension (AHR = 0.667, 95% CI = 0.524, 0.848), dyslipidemia (AHR = 0.561, 95% CI = 0.410, 0.768), and cardiovascular disease (AHR = 0.681, 95% CI = 0.494, 0.938). Conclusion: The median time to initial optimal glycemic control in type 2 diabetes Mellitus patients in this study was short. Age between 50 and 59 years and 60–69, diabetes neuropathy, hypertension, dyslipidemia, and cardiovascular disease were predictor's of time to first glycemic control. Therefore, health care providers should pay extra attention for patients who are aged and who have complications or co-morbidities. [ABSTRACT FROM AUTHOR]

Background: The current professional nursing education program adopts various great attention for clinical practice to supply nursing students. Objective: To assess the prevalence and associated factors of stress and coping strategies of nursing students during clinical practice in the school of nursing, Wachemo University, Ethiopia, 2024. Methods: A facility-based cross-sectional design study was conducted between January 1 and 12/2024. The total number of students was 421. Data were collected using the validated tool and entered using Epi-data Version 3.1 and exported to SPSS Version 25 for analysis. Binary logistic regression was done, and variables with a p -value of <.05 were taken into the multivariable analysis. Statistically significant was declared at a p -value of <.05 with AOR and 95% CI. Result: The prevalence of stress and coping strategies was 58.4% with 95% CI [53.6–62.8] and 52.0% with 95% CI [47.3–56.5] respectively. Male gender, private regular, and instructor guide were significantly associated with stress. Age group 19–24 years, having low grades, living in a university dorm, clinical staff guiding, instructor guiding, and asking unclear issues were significantly associated with coping strategies. Conclusion: About six in ten nursing students have stress. Being male gender, being a private, living with families, and instructor guide are significantly associated with stress. Therefore, managing gender-related issues, attending regular programs, living in a university dorm, and guiding the students might reduce the burden of stress during clinical practice. About five in ten nursing students have good coping strategies. Being age group of lower years old, having low grades, living in a university dorm, clinical staff guiding, instructor guiding, and asking the instructor about unclear issues were significantly associated with coping strategies. Therefore, improving grades, living in a university dorm, clinical staff and instructor guidance, and asking about unclear issues might enhance coping strategies. [ABSTRACT FROM AUTHOR]

Background: Pulmonary embolism (PE) and deep venous thrombosis (DVT) are the two most important manifestations of venous thromboembolism (VTE). DVT remains a significant condition since associated morbidity is significant and has elevated healthcare-related costs. Methods: A retrospective cohort study was conducted among DVT patients admitted to Tikur Anbessa Specialized Hospital, Zewditu Memorial Hospital and St. Paul's Hospital Millennium Medical College on follow-up from July 1, 2017, to July 01, 2020. Data on sociodemographic characteristics, types of DVT, laboratory findings, medications, risk factors of DVT, complications and outcomes of DVT were collected. The data were analyzed using SPSS version 25. Multivariate logistic regression analysis was conducted to determine predictors of DVT recurrence and major bleeding. A P value < 0.05 was considered to identify significant predictors. Results: The mean age of the participants was 45.2 years, with SD of 15.36. The major causes of DVT included immobilization (29.9%), previous surgery (27.5%) and cancer (21.1%). The DVT recurrence rate was 22.5%. Nine (2.2%) of the participants died, and 19.9% developed complications. Bilateral DVT (Adjusted odds ratio (AOR) = 2.8, 95% Confidence interval (CI) = 1.14, 6.66), obesity (AOR = 3.3, 95% CI = 1.15, 9.59), hypertension (AOR = 6.5, 95% CI = 2.90, 14.70) and retroviral infection (AOR = 6.3, 95% CI = 2.34, 16.94) were predictors of recurrent DVT. Nineteen (4.7%) patients had major bleeding, and patients with bilateral DVT, active cancer and terminal age had an increased risk of major bleeding. Conclusions: The overall DVT recurrence rate was alarmingly high and further complicated by PE, post thrombotic syndrome and chronic vein insufficiency, resulting in a 2.2% death rate. Major bleeding after DVT and PE remained high. Close monitoring should be performed for patients with advanced age, active cancer, bilateral DVT, retroviral infection, obesity and hypertension to prevent the recurrence of DVT and major bleeding. [ABSTRACT FROM AUTHOR]

Inadequate safe water supply and poor sanitation and hygiene continue to be important risk factors for diarrhoea and stunting globally. We used data from the four rounds of the Ethiopian Demographic and Health Survey and applied the new World Health Organization (WHO)/UNICEF Joint Monitoring Program (JMP) service standards to assess progress in water, sanitation and hygiene (WASH) coverage between 2000 and 2016. We also performed an age‐disaggregated pooled linear probability regression analysis followed by a decomposition analysis to determine whether changes in WASH practices have contributed to the changing prevalence of diarrhoea and stunting in children under 5 years of age. We observed a significant increase in the coverage of safe drinking water and adequate sanitation facilities over the period. At the national level, the use of a basic water source increased from 18% in 2000 to 50% in 2016. Open defecation declined from 82% to 32% over the same period. However, in 2016, only 6% of households had access to a basic sanitation facility, and 40% of households had no handwashing facilities. The reduction in surface water use between 2000 and 2016 explained 6% of the decline in diarrhoea observed among children aged 0–5 months. In children aged 6–59 months, between 7% and 9% of the reduction in stunting were attributable to the reduction in open defecation over this period. Despite progress, improvements are still needed to increase basic WASH coverage in Ethiopia. Our findings showed that improvements in water and sanitation only modestly explained reductions in diarrhoea and stunting. [ABSTRACT FROM AUTHOR]

Age‐appropriate breastfeeding and introduction to complementary foods can shape child feeding practices, ensure adequate energy and nutrient intake and prevent linear growth faltering. This study aimed to assess mothers' and health workers' knowledge of timely introduction to complementary foods and evaluate the relationship between delays in complementary feeding and subsequent linear growth. We conducted two rounds of surveys (March/August 2017) among 249 health workers (n = 249) and caregivers (n = 2635) of children 6–23 months of age. We collected information about socio‐demographic characteristics, knowledge and practice related to timely introduction to complementary foods. The study was conducted in households from the Productive Safety Net Programme (PSNP) districts, in four highland regions of Ethiopia. Delays in the introduction to complementary feeding were widespread with 53% of children 6–8 months of age not consuming solid, semisolid or soft foods in the past 24 h. After controlling for child, caregiver and household characteristics, children not introduced to complementary foods by 6–8 months had a 0.48 SD lower length‐for‐age z‐score at 12–15 months. Caregivers' knowledge was strongly and inversely correlated with untimely introduction of complementary foods in logistic regressions (OR = 0.55, p < 0.01). In turn, local health extension worker's knowledge was strongly correlated with caregiver's knowledge. Consequently, frequent and timely visits by health extension workers emphasising not only on what to feed but also when and how to feed a child are needed. Innovative ways of increasing reach, intensity and frequency of nutrition messaging by using the PSNP interactions as an additional point of contact would need to be explored further. [ABSTRACT FROM AUTHOR]

Acute malnutrition affects not only the growth and development but also the body composition of children. However, its specific effects have not yet been characterized. This study aims to compare the body composition of 5–7‐year‐old children with moderate acute malnutrition (MAM) to that of their well‐nourished (WN) peers and identify associated factors. A school‐based comparative cross‐sectional study was conducted from June to July 2022 in Jimma town, southwest Ethiopia. The study participants were selected from eight kindergartens and eight primary schools using a simple random sampling technique based on the proportional allocation of the sample to the size of the population in the respective school. Descriptive statistics and multivariable linear regression analyses were used to assess the mean differences and associations between variables and isolate independent predictors of body composition, respectively. The statistical significance was determined using ß‐coefficients with 95% confidence intervals and a p value of ≤ 0.05. Data were captured from 388 (194 MAM and 194 WN) children with a response rate of 97.9%. The mean fat‐free mass of WN children was significantly higher compared with those with MAM (p < 0.001). The mean (SD) of fat mass of MAM children was 4.23 ± 0.72 kg, 4.36 ± 0.88 kg and 4.08 ± 0.89 kg for 5, 6 and 7‐year‐olds, respectively. For WN children, the mean (SD) of fat mass was 4.92 ± 0.88 kg for 5 years old, 5.64 ± 1.01 kg for 6 years old and 5.75 ± 1.26 kg for 7 years old (p < 0.001). On the multivariable linear regression analysis after controlling for background variables, WN children exhibited 1.51 times higher fat‐free mass compared with MAM children (β = 1.51, p = 0.003). A unit increase in age of the study participants was associated with a 1.37 increment in fat‐free mass (β = 1.37, p < 0.001). WN children had 1.07 times higher fat mass compared with children with MAM (β = 1.07, p < 0.001). A unit increase in the age of the child resulted in 0.15 times increment in fat mass (β = 0.15, p = 0.020), and being female was associated with a 0.37 increase in fat mass (β = 0.37, p < 0.001). The results showed that the mean fat mass and fat‐free mass were significantly lower among moderately acute malnourished children than in WN children showing the loss of both body compartments due to malnutrition. The body mass index for age, age of the child and sex of the child were significantly linked to both fat‐free mass and fat mass. Key messages: This study demonstrated that children aged 5–7 years suffering from moderate acute malnutrition (MAM) have lower mean body fat mass (FM) and fat‐free mass (FFM) as compared with well‐nourished (WN) children.The substantial difference observed between MAM and WN children in body FM and FFM calls for the integration of MAM treatment into the routine health services to prevent their sliding down to SAM and associated mortality. [ABSTRACT FROM AUTHOR]

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Background: Addressing attitudes is central to achieving sexual and reproductive health and rights (SRHR) and Agenda 2030. We aimed to develop a comprehensive index to measure attitudinal support for SRHR, expanding opportunities for global trend analyses and tailored interventions. Methods: We designed a new module capturing attitudes towards different dimensions of SRHR, collected via the nationally representative World Values Survey in Ethiopia, Kenya, and Zimbabwe during 2020–2021 (n = 3,711). We used exploratory factor analysis of 58 items to identify sub-scales and an overall index. Adjusted regression models were used to evaluate the index according to sociodemographic characteristics, stratified by country and sex. Results: A 23-item, five-factor solution was identified and used to construct sub-indices reflecting support for: (1) sexual and reproductive rights, (2) neighborhood sexual safety, (3) gender-equitable relationships, (4) equitable masculinity norms, and (5) SRHR interventions. These five sub-indices performed well across countries and socioeconomic subgroups and were combined into a comprehensive "SRHR Support Index", standardized on a 1–100 scale (mean = 39.19, SD = 15.27, Cronbach's alpha = 0.80) with higher values indicating more support for SRHR. Mean values were highest in Kenya (45.48, SD = 16.78) followed by Ethiopia (40.2, SD = 13.63), and lowest in Zimbabwe (32.65, SD = 13.77), with no differences by sex. Higher education and being single were associated with more support, except in Ethiopia. Younger age and urban residence correlated with more support among males only. Conclusion: The SRHR Support Index has the potential to broaden SRHR attitude research from a comprehensive perspective – addressing the need for a common measure to track progress over time. Plain language summary: Sexual and reproductive health and rights (SRHR) are becoming increasingly polarized worldwide, but researchers have previously not been able to fully measure what people think about SRHR. More research about this topic is needed to address discriminatory norms and advance SRHR for all. In this study, we added new questions to the World Values Survey collected in Ethiopia, Kenya, and Zimbabwe during 2020–2021. We used statistical methods to develop an index capturing to what extent individuals' attitudes were supportive of SRHR. This index, which we call the SRHR Support Index, included 23 survey questions reflecting support for five related dimensions of SRHR. Those dimensions were (1) sexual and reproductive rights, (2) neighborhood sexual safety, (3) gender-equitable relationships, (4) equitable masculinity norms, and (5) SRHR interventions. We found that individuals in Kenya were more supportive of SRHR, followed by Ethiopia and then Zimbabwe. There were no differences in support of SRHR between men and women, but individuals who were single and those with higher education were more supportive of SRHR, except in Ethiopia. Younger men living in urban areas were also more supportive. Our SRHR Support Index enables researchers, policymakers, and others to measure attitudes to SRHR in countries across the world and over time, based on new data from the World Values Survey that are readily available online. If combined with other sources of data, researchers can also investigate how people's support of SRHR is linked to, for example, health and policy. [ABSTRACT FROM AUTHOR]

Background: A negative attitude towards abortion among health care providers providing abortion services could be an obstacle even under a law, which permits abortion on request. Healthcare providers are expected to perform and be change agents of abortion services. However, little information is known about the attitude toward safe abortion among healthcare providers in Ethiopia. Objective: This study aimed to assess health care provider's attitudes towards safe abortion care and its associated factors at the public health facilities of Bahir Dar City, Northwest Ethiopia. Methods: A health facility-based cross-sectional study was employed from March 1 to 30/2021 among 416 health-care providers. The data were collected by computer-based generated simple random sampling technique, entered, coded, and cleaned using Epi data version 4.2 and analyzed using Statistical Package of Social Sciences version 25.0. Bivariate and multivariable logistic regression analyses were employed to estimate the crude and adjusted odds ratio with a confidence interval of 95% and a P-value of less than 0.05 considered statistically significant. Results: The response rate of the study was 99.3%, and 70.2% [95% CI: 65.6–74.6] of health-care providers had a favorable attitude towards safe abortion care. Multivariable analysis indicated that health care providers who are found in the age group of 25–29, 30–34, and ≥ 35 years [AOR = 3.34, 95% CI = 1.03–10.85], [AOR = 4.58, 95% CI = 1.33- 15.83] and [AOR = 5.30, 95% CI = 1.43–19.66] respectively, male health care providers [AOR = 3.20, 95% CI = 1.55–6.60], midwives [AOR = 6.50, 95% CI = 2.40–17.44], working at hospital [AOR = 4.77, 95% CI = 1.53–14.91], ever trained on safe abortion [AOR = 5.09, 95% CI = 2.29–11.32], practicing of an abortion procedure [AOR = 2.52, 95%, CI = 1.13–5.60], knowledge of abortion [AOR = 7.35, 95% CI = 3.23–16.71], awareness on revised abortion law [AOR = 6.44, 95% CI = 3.15–13.17] and need further legalization of abortion law [AOR = 11.78, 95% CI = 5.52–24.26] were associated with a favorable attitude towards safe abortion care. Conclusions: Healthcare providers who had a favorable attitude toward safe abortion care were relatively high compared to the previous studies. Age, sex, profession, workplace, training, knowledge, and practice-related factors were associated with a favorable attitude toward safe abortion. This study indicated that, a need for intervention to help improve the attitude of healthcare providers toward safe abortion care, especially for those working in the maternity care units. [ABSTRACT FROM AUTHOR]

Background: Cervical cancer is one of the most common causes of cancer-related morbidity and mortality globally. In developed countries, effective screening programs reduced its burden. However, in Ethiopia, cervical cancer remains a major public health problem despite the screening service being available free of charge. Objective: The aim of this study was to assess women's willingness for cervical cancer screening services and associated factors among women attending health services in Addis Ababa, Ethiopia. Design: An institutional-based, analytic, cross-sectional study was conducted among sexually active women attending health facilities from August to September 2022. Methods: A pretested interviewer-administered questionnaire was used for data collection. Data were analyzed using SPSS version 25. Logistic regression was used to determine different variables' frequencies and associated factors. A p value of <0.05 was considered statistically significant. Result: Four hundred twenty-two women were approached, and 394 (93.4%) met the study inclusion criteria. Study participants had a minimum of 1 and a maximum of 6 sexual partners in their lives. A total of 256 (64.9%) study participants had heard about cervical cancer. Among those who heard about cervical cancer, only 22 (8.6%) had been tested for cervical cancer. Of those who did not receive cervical cancer screening, only 175 (47.0%) are willing to receive cervical cancer screening. Age, religion, marital status, place of residence, educational level, occupation, and hearing about cervical cancer were found to be statistically significant. Women who heard about cervical cancer were 15.2 times more likely to take the test compared to those who never heard about cervical cancer before the study. Conclusion: Women's willingness to be screened for cervical cancer is low despite many of the study participants having more than one partner in their lives and being at risk for cervical cancer. Only a few participants had been screened for cervical cancer. Women who had heard about cervical cancer were more likely to take the screening service compared to those who had never heard it before. This highlights the need to prioritize raising awareness about the benefits of cervical cancer screening services. [ABSTRACT FROM AUTHOR]

Introduction: Sexual risky behaviors, as defined by the World Health Organization, encompass a spectrum of sexual activities that heighten the likelihood of negative outcomes related to sexual and reproductive health. Despite the implementation of various healthcare programs and interventions, youths continue to encounter challenges in accessing reproductive health services. Consequently, they remain vulnerable to engaging in high-risk sexual behaviors; 50.36% of adolescents in Ethiopia. Therefore, this study was aimed to determine the prevalence of risky sexual behavior and associated factors among out-of-school Youths in Addis Ababa, Ethiopia; 2023. Methods: A community based cross sectional mixed methods study was conducted among 701 youths in Addis Ababa from September 1st to 30th, 2023. The quantitative data were collected through face to face interview using a pre-tested structured questionnaire, while qualitative data were gathered through in depth interviews and focus group discussions. For the quantitative study, the study samples were chosen using systematic sampling. Conversely, purposive sampling was employed for the qualitative study. Variables with P-value ≤ 0.25 in the bivariate analysis were considered as candidates for the multivariable analysis. Statistical significance was declared at a P-value less than 0.05. Results: The prevalence of risky sexual behavior among out of school students in Addis Ababa was 40.6% (95%CI: 36.8, 44.1). Age 15–19 years (AOR: 2.52; 95%CI: 1.61, 3.94), being female (AOR: 2.84; 95%CI: 1.93, 4.18), fathers who were unable to read and write (AOR: 4.13; 95%CI: 2.04, 8.37), alcohol consumption (AOR: 2.07; 95%CI: 1.33, 3.19), peer pressure (AOR: 2.59; 95%CI: 1.81, 3.72), live together with either of biological parent (AOR: 2.32; 95%CI: 1.52, 3.55), watching pornography (AOR: 2.10; 95%CI: 1.11, 3.97) and parental monitoring (AOR: 0.59; 95%CI: 0.39, 0.90) were factors associated with risky sexual behavior. Conclusion and recommendations: A lower prevalence of risky sexual behavior compared to prior research efforts. Age, gender, educational level of the husband, alcohol consumption, peer pressure, living arrangements, exposure to pornography, and family monitoring emerged as significant factors associated with risky sexual behavior. Therefore, government should prioritize strategies to reduce substance use, mitigate the impact of watching pornography, and enhance parent-youth connectedness. [ABSTRACT FROM AUTHOR]

Background: In low-and middle-income countries inadequate neonatal pain management persists as a significant public health issue despite the availability of guidelines. Newborns often experience pain from routine medical and surgical procedures, with limited nurses' knowledge and suboptimal practices posing common obstacles to effective neonatal pain management in hospital settings. Hence, this study aimed to evaluate nurses' knowledge and practices related to neonatal pain management and the factors influencing them in public hospitals in West Oromia, Ethiopia, in 2022. Methods: A multicenter cross-sectional study was conducted among 203 nurses working in public hospitals in West Oromia from 8th May-6th June 2022. Data was gathered using structured, self-administered questionnaire and sampled through simple random sampling. The collected data were coded and entered into a computer using Epi-Data version 4.6 Statistical Software. They were analyzed using the Statistical Package for Social Science (SPSS; IBM Corporation) version 26. Binary logistic regression was used to identify significant independent variables at p < 0.05. Findings: In this study, 127 (62.6%) exhibited adequate knowledge, while 33 (16.3%) nurses demonstrated good practice in neonatal pain management. Attending lectures or receiving training about neonatal pain management was found to be significantly associated with nurses' knowledge of neonatal pain management [AOR, 2.31, 95%CI; 1.29–4.27]. On the other, having adequate knowledge of neonatal pain management [AOR, 3.3, 95%CI; 1.14–9.32]; the presence of a pain management policy in place [AOR, 5.44, 95% CI; 1.92–15.37] and attending lectures on neonatal pain management [AOR, 2.55, 95% CI; 1.09–5.97] were found to be significantly associated to nurses' practices. Conclusion: Given the substandard level of nurses' practice in neonatal pain management. It is suggested to enhance the nurses' knowledge and practice about neonatal pain management by providing refreshment courses, training sessions, or facilitating nurses' opportunity access to reading resources about neonatal pain management. [ABSTRACT FROM AUTHOR]

Background: To enhance patient satisfaction, nurses engaged in preoperative care must possess a comprehensive understanding of the most up-to-date evidence. However, there is a notable dearth of relevant information regarding the current status of preoperative care satisfaction and its impact, despite a significant rise in the number of patients seeking surgical intervention with complex medical requirements. Objective: To assess patient satisfaction with preoperative nursing care and its associated factors in surgical procedures of, 2023. Methods: A cross-sectional study was conducted, and the data was collected from the randomly selected 468 patients who had undergone surgery during the study period. The collected data was entered into Epidata version 3.1 and analyzed using SPSS version 25 software. Results: The complete participation and response of 468 participants resulted in a response rate of 100%. Overall patient satisfaction with preoperative nursing care was 79.5%. Sex (Adjusted odds ratio (AOR): 1.14 (95% confidence interval (CI): 0.21–2.91)), payment status for treatment (AOR: 1.45 (95% CI: 0.66–2.97)), preoperative fear and anxiety (AOR: 1.01, 95% CI: 0.49–2.13)), patient expectations (AOR: 3.39, 95% CI: 2.17–7.11)), and preoperative education (AOR: 1.148, 95% CI: 0.54–2.86)) exhibited significant associations with patient satisfaction with preoperative nursing care. Conclusion: It is important to exercise caution when interpreting the level of preoperative nursing care satisfaction in this study. The significance of preoperative nursing care satisfaction lies in its reflection of healthcare quality, as even minor deficiencies in preoperative care can potentially lead to life-threatening complications, including mortality. Therefore, prioritizing the improvement of healthcare quality is essential to enhance patient satisfaction. [ABSTRACT FROM AUTHOR]

Background: Despite the World Health Organization's firm recommendation to start breastfeeding during the first hour after delivery, nearly 54% of children in low- and middle-income countries are unable to initiate breastfeeding within the recommended time frame. Understanding the initiation of breastfeeding is essential for optimal child health and maternal well-being. Methods: This study was conducted using the recent Ethiopian Demographic and Health Survey (EDHS) data (2019) on a weighted sample of 1982 Ethiopian mothers of children aged under 24 months. The data extraction was conducted between August 1 and 30, 2023. Delayed' initiation of breastfeeding is defined as failure to initiate breastfeeding within one hour after birth. STATA version 17 was used for non-spatial analysis. ArcGIS Pro and Sat Scan version 9.6 were used to map the visual presentation of delayed breastfeeding initiation. Global Moran's I was computed to determine whether delayed breastfeeding initiation is randomly distributed, clustered, or dispersed. Getis-Ord Gi* Spatial Statistics was done to identify significant spatial clusters of cold and hot spot areas. Multilevel mixed-effect logistic regression analysis was computed to identify determinants of delayed breastfeeding initiation. Results: The prevalence of delayed breastfeeding initiation is 26.4% (95% CI 24.4, 28.3). Significant clustering of delayed initiation of breastfeeding practice was found in the Somali region. Less clustering was identified in Northern Amhara, Addis Ababa and Dire Dawa. Being a young mother (15–24 years) (AOR 1.66; 95% CI 1.06, 2.62), no antenatal care (AOR 1.45; 95% CI 1.04, 2.02), cesarean section (AOR 4.79; 95% CI 3.19, 7.21) and home birth (AOR 1.53; 95% CI 1.14, 2.06) were found to be determinants of delayed initiation of breastfeeding. Conclusions: In Ethiopia, delayed breastfeeding initiation is distributed non-randomly. Significant hotspot areas were identified in the eastern part of Ethiopia. Thus, deploying additional resources in high hotspot regions is recommended. Programs should focus on promoting health facility birth and increasing antenatal care visits. Further emphasis should be considered on supporting young mothers and those giving birth via cesarean section to improve timely breastfeeding initiation. [ABSTRACT FROM AUTHOR]

Background: The provision of respectful and dignified maternal and newborn care is an important component of the quality of childbirth care. Although a growing body of evidence was generated on disrespect and abuse (D&A) of women during childbirth in the past decade there is limited evidence on D&A experienced by newborns. Our study aimed to determine the level of and factors associated with D&A among newborns. Methods: We conducted the study in three public hospitals in Addis Ababa. We directly observed childbirth care starting from the first stage of labor through two hours after the birth of 498 mother–baby dyads. We used frequencies and percentages to describe different forms of D&A among newborns. We used binary and multivariable logistic regression analysis to assess the association between the D&A among newborns and independent variables. Result: All of the newborns 496/496 (100%) experienced at least one form of D&A. Physical abuse was experienced by 41.1% of newborns in the form of unnecessary airway suctioning (23.2%) or slapping or holding upside down (33.5%). Additionally, 42.3% weren't dried immediately after birth, 9.1% weren't placed on the mother's abdomen skin-to-skin, 61.7% had their cord cut before 1 min of birth, 34.9% weren't breastfed within an hour of birth, 24.2% didn't receive vitamin K and 1.8% didn't receive tetracycline. All newborns who developed complications (69/69) received treatments without the consent of parents/caregivers. Moreover, 93.6% of parents/caregivers didn't receive explanations regarding newborn care while the lack of breastfeeding counseling and thermal support during the immediate post-partum period was 87.3%. The likelihood of D&A was higher among newborns who were preterm (AOR = 2.02; 95% CI: 1.11–3.69), female (AOR = 2.01; 95% CI: 1.37–2.95), delivered assisted by instrument (AOR = 2.19; 95%CI: 1.20–3.99), whose mothers reside in rural areas (AOR = 1.97; 95%CI: 1.22–3.20), born from unmarried mothers (AOR = 2.77; 95%CI (1.26–6.06) and whose mothers received fewer than four-time antenatal care (ANC) visits (AOR = 2.37; 95%CI: 1.42–3.96). Conclusion: Our study found a high magnitude D&A among newborns. Gestational age at birth, sex of the newborn, maternal residence, maternal marital status, number of ANC visits, and mode of delivery were statistically significantly associated with D&A among newborns. Plain English Summary: The provision of respectful and dignified care to mothers and newborns during antenatal, childbirth, and postnatal periods is crucial to improve their health outcomes and experiences. Although there is a growing body of knowledge on respectful maternity care, there is limited evidence that systematically assessed newborns' experiences of care. We measured the level of disrespect and abuse among newborns and assessed factors that increase the likelihood of experiencing disrespect and abuse among newborns born in three hospitals in Addis Ababa. We directly observed the care provision to assess whether the newborn was (1) physically abused (suction of the nose or mouth without medical indication; shaken, slapped, or held upside down), (2) stigmatized or discriminated (care compromised because the newborn was considered too sick to save, HIV exposed, or has congenital malformation), (3) didn't receive standard care, and (4) mothers/caregivers didn't receive counseling on breastfeeding and thermal care. We found that all of the newborns have experienced at least one form of disrespect and abuse during childbirth or the postpartum period. 41% experienced physical abuse; 99.6% didn't receive standard care; 87.3% didn't receive counseling on breastfeeding and thermal care; and 13%, 75%, and 67% of the newborns who were identified as too sick to save, HIV exposed, and congenital malformation, respectively, were ignored, denied care or treated differently. In addition, the likelihood of experiencing disrespect and abuse was high among newborns who were preterm, female, from rural areas, of unmarried mothers, whose mothers received fewer than four ANC visits and delivered by instrument. [ABSTRACT FROM AUTHOR]

Background. Typically, the idea of patient satisfaction is employed to evaluate quality. When patients enter hospitals, they have certain demands for treatment. However, patients may become dissatisfied if their requirements or expectations are not met. There is increasing agreement that evaluating hospital services should be based in part on patients' assessments of the quality of treatment they received overall. The aim of this study was to improve patient satisfaction at outpatient department. Objective. To assess improving of patient satisfaction and associated factors at outpatient department in general hospitals of central zone, Northern Ethiopia, 2019. Methods. Pre- and post-intervention study was conducted to assess the patient satisfaction at outpatient department in general hospitals of central zone, between June 2018 and April 2019 using systematic random sampling method. Two hundred seventy-five (275) participants were investigated in the preintervention and postintervention study. Data were entered to SPSS version 20. Binary logistic regression was done to test association of factors with the outcome variable with consideration of p value of less than 0.05. Result. In the preintervention period, the patient satisfaction was 54.2%; after providing intervention, the patient satisfaction was increased to 77% in postinterventional study. Respondents who paid for the medical service were 41% less likely satisfied than those who had gotten free services. Participants whose age of 18-27 years were 22% more likely satisfied than whose age were 58 and greater. Conclusion. The result in this study shows that the patient satisfaction is higher than other studies done in our country. Sex, age, and those who make payment were significantly associated with patient satisfaction. Despite the result, much things are left to be covered to increase satisfaction, so the concerned bodies, including the regional health bureau, woreda health office, and management committee and board, should mobilize the community and give training to the health professionals to make the environment smoother and more comfortable for patients. [ABSTRACT FROM AUTHOR]

Improving diet quality is recognised as a double-duty action that can simultaneously address multiple forms of malnutrition. This study aimed to assess diet quality among non-pregnant non-lactating women of reproductive age (WRA) in Addis Ababa, Ethiopia. A 1-d quantitative 24 h recall was conducted among 653 non-pregnant/non-lactating women. Diet quality, assessed using the women dietary diversity score (WDDS), the Global Diet Quality Score (GDQS) and the Nova 4 classification reflecting consumption of ultra-processed foods (UPF), was compared. The proportion that meets the minimum dietary diversity for women (MDD-W) was estimated. The average MDD-W score was 2·6 (sd 0·9), with only 3 % of women meeting the MDD-W (≥ 5 food groups). Consumption of wholegrain and legumes was high, but UPF were also consumed by 9 % of the women. GDQS was positively associated with WDDS, age and skipping breakfast and was negatively associated with eating out of home and UPF consumption (P < 0·05). The multivariate regression model showed that GDQS (total) was not associated with wealth but was significantly associated with both UPF and WDDS (P < 0·001). Unlike UPF and WDDS alone, GDQS was able to predict both nutrient adequacy and unhealthy dietary practices. The diet quality of WRA in Addis Ababa is low in diversity, possibly exposing them to higher risk of nutrient inadequacy and non-communicable diseases as reflected by the low GDQS. Understanding what drives food and dietary choices in urban settings is urgently needed. [ABSTRACT FROM AUTHOR]

Background: Phlebitis is an inflammation of vein and the common complication of peripheral intravenous cannula. Phlebitis leads patient to sepsis, pulmonary embolism and other serious complications that increase patient morbidity and mortality. Phlebitis-related literature is scarce in Ethiopia. Therefore, the incidence and predictors of phlebitis were the focus of this study.Methods and Materials: An institution-based prospective observational study was carried out at public hospitals of Bahir Dar city. Four hundred sixty-two patients with peripheral intravenous cannulas who were admitted to the medical ward were selected using a systematic random sampling technique. Jackson's Visual Infusion Phlebitis Scoring system was used to determine the presence of phlebitis. We used Cox proportional hazards regression model, to identify significant predictors of phlebitis.Results: In this study, 462 patients included, and 171 (37.01%) of them developed phlebitis. The median survival time of phlebitis was six days. Patients whose age group > 60 years had low probability to develop phlebitis (AHR = 0.49, 95% CI 0.29– 0.82), whereas chronic-diseases (AHR = 1.50, 95% CI 1.09– 2.07), drugs and blood administer in one vein (AHR = 2.03, 95% CI 1.44– 2.86), inappropriate cannula dressing (AHR = 1.81, 95% CI 1.31– 2.51), large cannula size (AHR = 1.52, 95% CI 1.08– 2.15) and longer cannula dwelling time (AHR = 7.39, 95% CI 4.12– 13.32) had high probability to develop phlebitis.Conclusion: The post-peripheral intravenous cannula phlebitis that frequently affects hospitalized cannulated patients requires particular attention and follow-up for cannulated patients with known risk factors. [ABSTRACT FROM AUTHOR]

Purpose: Erectile dysfunction is defined as the inability to achieve and/or maintain an erection of sufficient rigidity and duration to permit satisfactory sexual performance. The purpose of this study is to assess the prevalence of erectile dysfunction and associated factors among adult diabetic men on follow-up at Goba and Robe hospitals, Bale Zone, South East Ethiopia,2022. Methods: Hospital-based cross-sectional study design was used among 420 adult diabetic men from March 1 to April 30 using a systematic random sampling technique. An international index of erectile function questionnaire containing five questions was used to assess the outcome variable. The data were entered, edited, and coded using Epidata version 4.6 and analyzed using SPSS version 26. Bivariable and multivariable binary logistic regression analysis were performed to identify factors associated with erectile dysfunction. Adjusted odds ratios with their corresponding 95% confidence interval were computed to estimate the strength of association. Statistical significance was declared at p-value < 0.05. Results: The prevalence of erectile dysfunction was found to be 354 (84.3%). Multivariable logistic regression revealed that erectile dysfunction is significantly associated with old age (AOR = 12.39, 95% CI:5.10–30.08), inadequate physical activity (AOR = 4.15, 95% CI:1.33–12.97), and being rich (AOR = 2.62, 95% CI = 1.21–5.66). Conclusion: The prevalence of erectile dysfunction in this study population is nearly nine out of ten. Age, inadequate physical activity, and wealth index were independent predictors of erectile dysfunction. Assessment and management of erectile dysfunction in diabetic clinics should be routine medical care. [ABSTRACT FROM AUTHOR]

Background: Poor glycemic control increases the risk of acute metabolic derangements and long-term consequences, which are the main causes of morbidity and mortality. Maintaining adequate glycemic control is challenging for children with diabetes, particularly in resource-limited settings. There is a paucity of data on the magnitude of poor glycemic control and its predisposing factors in Ethiopian particularly in this study setting. Hence, we aimed to assess the magnitude of poor glycemic control and its associated factors among children and adolescents with type 1 diabetic mellitus in Jugol and Hiwot Fana Compressive Specialized University Hospitals in Harar, eastern Ethiopia. Methods: A facility-based cross-sectional study was conducted among 231 children and adolescents with type 1 diabetes mellitus in Jugol and Hiwot Fana Compressive Specialized University Hospitals. Participants were included consecutively in the follow-up clinic from November 15, 2022 to January 15, 2023. Data were collected through an interviewer-administered structured questionnaire and a review of medical records. A binary logistic regression model with an adjusted odds ratio (aOR) and a 95% confidence interval (CI) was used to identify the factors associated with poor glycemic control. Statistical significance was set at p < 0.05. Result: A total of 231 children and adolescents with type 1 diabetes mellitus were included. The magnitude of poor glycemic control was 166 (71.9%) with 95% CI 66.0–77.7%). In multivariable analysis, the age of the child (aOR = 0.19, 95% CI: 0.05–0.83), education of the caregiver (aOR = 4.13;95% CI: 1.82–9.46), meal frequency less than three (aOR = 3.28; 95% CI: 1.25–8.62), and consumption of forbidden foods (aOR = 3.17; 95% CI: 1.21–8.29) were factors significantly associated with poor glycemic control. Conclusion: Two-thirds of participants had poor glycemic control. There was a statistically significant association between the age of the child, education of the caregiver, meal frequency, and forbidden foods with poor glycemic control. To improve glycemic control, diabetes education on meal use and selection should be conducted during follow-up along with parent education. [ABSTRACT FROM AUTHOR]

Background: Nursing documentation documents the everyday activities of nursing care that are planned and implemented on individual patients by nurses of different educational statuses. Documentation of nursing activities is the key source of clinical information to meet professional and legal requirements. Although nursing documentation is an important part of nursing practice, it is commonly undone by nurses working with patients for different reasons. Objective: To assess the documentation practice and their associated factors among nurses working in public hospitals in the Wolaita Zone, Southern Ethiopia. Methods: An institutional-based cross-sectional study was conducted among 402 nurses and a simple random sampling technique was used to select participants. Data were collected using a pretested structured self-administered questionnaire adapted from previous studies. Statistical Package for the Social Science version 26 was used for data entry and analysis. Independent variables with p-value < 0.25 from bivariable logistic regression were entered into the multivariable logistic regression method and significant associations were obtained at an adjusted odds ratio with a 95% confidence interval and p-value < 0.05. Results: In this study, the good documentation practice among nurses was 42% [95% confidence interval (CI), 37.2–46.8]. There was a statistically significant relationship between documentation practice and age [adjusted odds ratio (AOR): 2.590 (95% CI: 1.4–4.79)], educational status [AOR: 2.248 (95% CI: 1.13–4.48)], hospital level [AOR: 4.185 (95% CI: 2.63–6.72)], work experience (2–5 years and > 5 years) [AOR: 4.066 (95% CI: 1.55–10.64)] and [AOR: 5.395 (95% CI: 1.97–14.81)] respectively and in-service training [AOR: 0.582 (95% CI: 0.366–0.923)]. Conclusion and recommendations: This study demonstrated that the good practice of documentation among nurses was found to be low. Age, educational status, working in comprehensive specialized hospitals, work experience, and having in-service training had significant associations with documentation practice. It is very important to plan and intervene with different strategies, such as providing training for young nurses, nurses with low educational status, nurses working in primary hospitals, and nurses with less than two years of work experience on documentation standards, to create positive attitudes and enhance their knowledge. [ABSTRACT FROM AUTHOR]

Objective. In Ethiopia, there is no national-level cancer registry except capital Addis Ababa, and little research was performed on ovarian tumors. This study is aimed at assessing different histopathologic patterns of ovarian tumors and their distribution based on age, biological behavior, and gross findings at a tertiary-level hospital in Ethiopia. Methods. In this study, 187 biopsy-confirmed ovarian tumors from September 2017 to August 2021 were included. All data were collected from the pathology department report format, classified according to the latest World Health Organization (WHO) classification system, and analyzed using SPSS 20.0 and Microsoft Excel 2010 at Hawassa University Comprehensive Specialized Hospital, Hawassa, Ethiopia. Results. A total of 187 women with ovarian tumors were included in this study. Of these, 143 (76.5%) were benign, 35 (18.7%) were malignant, and 9 (4.8%) were borderline tumors. Both benign and borderline tumors mostly occur at the age of 20–39 years. Surface epithelial tumors were the most common histopathologic pattern at 57.8% followed by germ cell tumors at 29.4% and sex cord-stromal tumors at 11.7%. Mature cystic teratomas were the most common benign ovarian tumors accounting for 37.8% of them, while serous cystadenocarcinomas were the most common malignant ovarian tumors accounting for 31.4% of malignant neoplasms. Conclusion. In the current study, surface epithelial tumors were the most common ovarian tumors followed by germ cell tumors. Younger age at presentation was observed for malignant ovarian tumors. [ABSTRACT FROM AUTHOR]

Background. Malaria is a serious public health concern in the world, and it causes a major socioeconomic problem in Ethiopia. Malaria data trend analysis of health facilities is useful to understand the prevalence and incidence of malaria cases and implementing evidence-based malaria control strategies. Hence, the main objective of this study was to investigate the malaria trends over the last ten years (2013-2022) at Leka Dulecha Health Center, East Wollega Zone, Western Oromia. Methodology. A retrospective study was conducted at Leka Dulecha Health Center to determine the trends of malaria prevalence by considering the malaria registration laboratory logbook for the last ten years from 2013 to 2022. Hence, to do this, sociodemographic data, years, months, and malaria prevalence were collected using a predesigned data collection sheet recorded from perspective between years. Results. In the last ten years, a total of 30,576.00 suspected malaria cases were examined at Leka Dulecha Health Center, and out of these, 7,413.00 (24.24%) confirmed malaria cases were reported. In this health center, malaria cases were reported among both sexes and all age categories, but male (3,951.00, 54%) and age groups ≥ 15 years (3,994, 54%) were the most affected. The highest peak of malaria cases was reported during the autumn season (September, October, and November) followed by the spring season (March, April, and May) in the years of 2013 and 2007. In this study, the prevalence of malaria species was identified as Plasmodium falciparum, Plasmodium vivax, and mixed cases, with 5,014 (68%), 1,123 (15%), and 1,848 (25%), while Plasmodium falciparum was reported as the highest recorded cases. Conclusion. Males and above 15 years old were more affected than the others. The highest peak malaria prevalence appeared from September to December of 2017 and 2013 years. Therefore, proper planning, implementation, and monitor of malaria prevention and control activities should be strengthened at all levels. [ABSTRACT FROM AUTHOR]

Background: Obstetric fistula is a major public health concerns in Ethiopia. It is the most devastating cause of all maternal morbidities. Method: Data from the 2016 Ethiopian Demographic Health Survey (EDHS) was analyzed. A community-based unmatched case control study was conducted. Seventy cases and 210 non cases were selected using random number table. Data were analyzed by using STATA statistical software version 14. Multivariable logistic regression model was applied to determine the factors associated with fistula. Results: The majority of fistula cases were from rural residences. The multivariable statistical model showed that rural residence (Adjusted OR (AOR) = 5, 95% CI 4.26, 7.52), age at first marriage (AOR = 3.3, 95% CI 2.83, 4.60), poorest wealth index (AOR = 3.3, 95% CI 2.24, 5.01) and decision making for contraceptive use by husband alone (AOR = 1.3, 95% CI 1.124, 1.67) were factors significantly associated with obstetric fistula. Conclusion: Age at first marriage, rural residence, poorest wealth index and decision making for contraceptive use by husband alone were significantly associated factors for obstetric fistula. Intervening on these factors will reduce the magnitude of obstetrics fistula. In this context there is in-need to improve on avoiding early marriage through awareness creation to the community and developing legal framework by the policymakers. Furthermore, information about the joint decision making to use contraceptives should be disseminated though mass-media and interpersonal channels. Plain language summary: Globally, 2–3 million women are affected by obstetric fistula. It is common in developing nations, mainly in sub-Saharan Africa and Southeast Asia where suitable, timely care and treatment are hard to find. This devastating condition adversely affects women's physical and mental health. There is little research conducted in relation to the experiences of women living with leakage of urine and/or feces in Ethiopia. Therefore, this study provides a better understanding on obstetric fistula and its associated factors. The present study used the recent Ethiopia Demographic Health Survey (EDHS) 2016, to determine the associated factors of obstetric fistula among reproductive age group women (15–49 years) in Ethiopia. In this study rural residence, poorest wealth index, age at first marriage less than 18 years, and decision making for contraceptive use by husband alone were the associated factors of obstetric fistula. Intervening on these factors will reduce the magnitude of obstetrics fistula. In this context there is in-need to improve on avoiding early marriage through awareness creation to the community and developing legal framework by the policymakers. Furthermore, information about the joint decision making to use contraceptives should be disseminated though mass-media and interpersonal channels. Comprehensive intervention strategies should be customized at different government hierarchies to combat and reduce obstetric fistula. [ABSTRACT FROM AUTHOR]

World Health Organization stated that traditional medicine is an important part of health care and countries need to consider integrating it into their primary health care system. Traditional bone setting has a long history in Ethiopia and it enjoys enormous acceptance in the community. However, these methods are raw, there is no standardized training and at the same time, complications are common. Therefore, this research aimed to assess the prevalence of traditional bone setting service utilization and associated factors among people with trauma in Mecha district. Methods A Community- based cross-sectional study design was employed from January 15 to February 15, 2021. A total of 836 participants were selected using a simple random sampling technique. Binary and multiple logistic regressions were employed to assess the association between the independent variables with traditional bone setting service utilization. Results The prevalence of traditional bone setting service utilization was 46.05%. Factors significantly associated with TBS utilization were: Age ≥ 60 years (AOR = 0.13, 95% CI: 0.03- 0.43), rural residence (AOR = 3.63, 95% CI: 1.76 -7.50), occupation (merchant (AOR = 0.21, 95% CI: 0.07 -0.61), and housewife (AOR = 4.12, 95% CI: 1.33 -12.70), type of trauma: dislocation (AOR = 6.40, 95% CI: 3.69–11.10), and strain (AOR = 2.09, 95% CI: 1.05- 4.14)), site of trauma: extremity (AOR = 0.20, 95% CI: 0.11, 0.37), trunk (AOR = 0.08, 95% CI: 0.03–0.22), and shoulder (AOR = 0.20, 95% CI: 0.11–0.37), cause of trauma: fall down and natural deformity (AOR = 9.87, 95% CI: 5.93–16.42) and household annual income greater than > 36,500 (AOR = 2.33, 95% CI: 1.29–4.22). Conclusion The prevalence of traditional bone setting practice is high in the study area, despite recent advancements in the practice of orthopedics and trauma in Ethiopia. Since TBS services are more accepted in society, the integration of TBS into the health care delivery system is recommended. [ABSTRACT FROM AUTHOR]

Introduction. The incidence of a pressure ulcer in intensive care units (ICU) is significantly higher than in noncritical care settings. The patients in the ICU are the most vulnerable group to disruption of the skin's integrity. Prior studies in Ethiopia failed to evaluate pressure ulcers in intensive care units and were limited to general wards. The purpose of this study was to identify the incidence and predictors of pressure ulcers in adult patients admitted to intensive care units in Southern Ethiopia. Methods. A single-arm prospective open cohort of 216 patients was used to determine the presence of a pressure ulcer in the intensive care units from June 2021 to April 2022. A consecutive sampling was used until the sample size was reached. The data were collected using a structured questionnaire and analyzed using Stata 14. A cumulative incidence of a pressure ulcer was computed. The life table was used to estimate the cumulative survival. A multivariable Cox proportional hazard regression was used to identify independent predictors of a pressure ulcer. An adjusted hazard ratio with a 95% CI was used to measure the degree of association; a P value ≤ 0.05 was considered significant. Results. Twenty-five patients developed a pressure ulcer (PU), making a cumulative incidence of 11.57%. Out of 25 incident cases of pressure ulcers, four-fifths (80%) of the study patients developed PU within 6 days of their admission to the ICUs. The incidence rate was 32.98 PU per 1000 person-days of ICU stay. Pressure ulcers were most commonly found on the sacrum, followed by the shoulder. Among the incident cases, 52% were stage 2 ulcers. The presence of friction or shearing forces, as well as being 40 years of age or older, was independently associated with pressure ulcers. Conclusion. The overall cumulative incidence of the pressure ulcer was lower than that in other studies but occurred at a faster rate. Age (40 years of age or older) and the presence of friction or shearing forces were the main predictors of pressure ulcers in the intensive care units. Therefore, nurses working in ICUs should continually anticipate the risk of a pressure ulcer. Moreover, special attention should be given to patients of advanced ages. Furthermore, monitoring the installation of a mattress, keeping bed linens unwrinkled, and keeping patients in a proper position on a bed to prevent or reduce friction or shearing forces are very crucial in the prevention of pressure ulcers. [ABSTRACT FROM AUTHOR]

BACKGROUND: Leprosy, also known as Hansen's disease, is one of the world's oldest diseases, and it is one of the major blinding diseases. Visual impairment in leprosy patients needs special consideration by dermatologists and ophthalmologists, not only preventable but also has a severe burden that affects productivity if not managed early. Nevertheless, little was understood about ocular complications and associated factors among leprosy patients in low-income countries like Ethiopia, including the study locality. MATERIAL AND METHODS: An institution based cross-sectional study was conducted among a total of 423 leprosy patients at the dermatology clinic at Boru Meda Hospital, Dessie, Ethiopia. The collected data were entered into EpiData v3.1 and exported to the statistical package for SPSS v.20 for statistical analysis. The odds ratio (OR) and a 95% confidence interval (CI) were estimated to measure the strength of the association between dependent and independent variables. p = 0.05 was used to determine the level of statistical significance. RESULT: 419 leprosy patients participated in this study, accounting for a response rate of 99%. The proportion of ocular complications was found to be 69.9% (95% CI: 65.09-73.9). Age 40 years and above [adjusted odds ratio (AOR) = 5.2, 95% CI: 3.14-8.83], presence of leprosy reaction (AOR = 1.92, 95% CI: 1.12-3.24), and leprosy disability grading [grade 1 disability (AOR = 2.9, 95% CI: 1.35-6.33), grade 2 disability (AOR = 3.0,95% CI: 1.36-7.08) ]were associated with the presence of ocular complication among leprosy patients. CONCLUSION: Our finding showed that the ocular complication/lesion magnitude was high. Age 40 and above, the presence of leprea reaction and disability were significant factors associated with developing ocular complications among leprosy patients. Our results emphasize the need for solid collaboration efforts and commitment to handling ophthalmologic complications among leprosy patients aged 40 and above with leprosy reactions and disabilities. [ABSTRACT FROM AUTHOR]

Tuberculosis is a communicable mycobacterial disease of humans and animals caused by members of Mycobacterium tuberculosis complex, highly impacting the public health and economy of the country in endemic areas. Retrospective and cross-sectional study was conducted between March and August 2021. For knowledge, attitude, and practices study, five villages were randomly selected using simple random sampling. To quantify the public health burden, one-year data were collected from Jarso Health Center, and unregistered patients were identified using snowball method, and the estimation was based on disability-adjusted life years. Younger age groups (18-40 years) had shown 105.8 times more odds of knowledge towards tuberculosis than the older (>60 years). Moreover, tertiary levels of education had 9395.1 times more odds of knowledge towards tuberculosis compared to illiterates. The estimated economic burden was 7,731.25US$. Of the 51 tuberculosis patients, two died from the disease, resulting in 45.03 disability-adjusted life years. Communities of the study district were heard about tuberculosis, however, unaware of the cause and sources of the infection. Therefore, further strategic and continuous community-based health education and awareness should be given for effective control and prevention of tuberculosis in the study area. [ABSTRACT FROM AUTHOR]

Introduction: Human immunodeficiency virus (HIV) increases epidemiology of tuberculosis (TB) cases worldwide, particularly in sub-Saharan Africa, with a significant increase in TB incidence. In many countries, HIV prevalence in TB patients is a sensitive indicator of the spread of HIV into general population. Therefore, the objective of this study was to determine trends and HIV prevalence among TB patients in two public hospitals in Bale Zone, Southeast Ethiopia. Material and methods: A five-year retrospective data (from July 2013 to June 2018) of TB patients registered in TB clinics of two randomly selected public hospitals in Bale Zone were retrieved. HIV testing and tuberculosis diagnosis were performed according to national HIV/TB co-infection control program guidelines. Data were extracted from a registry of TB patients and analyzed using SPSS version 23. Bivariable and multivariable logistic regression analysis were used to identify factors associated with HIV infection among TB patients. Results: Among 1,281 TB patients, 98.1% (1,257) have been tested for HIV, of whom 246 (19.6%) were HIV co-infected. A slightly declining trend of HIV infection among TB patients was observed during the study period, from 3.1% in 2013 to 2.5% in 2018 (Χ² = 13.4, p = 0.02). Females (AOR = 1.47, 95% CI: 1.09-1.97%), previously treated TB patients, and age between 25 and 44 were found to have a statistically significant association with HIV infection among TB patients. Conclusions: In this study, around one-fifth of TB patients who followed treatment in the past five years was found HIV co-infected. [ABSTRACT FROM AUTHOR]

Introduction: Despite the advances in modern health care, maternal morbidity and mortality remain major problems in Ethiopia. Repeat-induced abortion is an indispensable contributor to this problem. Even though there are adverse effects on health, a significant proportion of Ethiopian women procure more than one abortion during their reproductive lifetime. This study aimed to determine the prevalence and associated factors of repeat-induced abortion in South Ethiopia, in 2020. Methods: An institution-based cross-sectional study design and a systematic random sampling technique were used to collect data from 410 samples of women. Data were collected using pre-tested and semi-structured interviewer-administered questionnaires. The data were coded and entered into EpiData version 4.6.2.0 before being exported to Statistical Package for Social Sciences (SPSS) version 26 for analysis. Variables with a p-value of less than 0.05 in binary logistic regressions were exported into multivariate logistic regression analysis. Finally, variables with a p-value of less than 0.05 in the multivariate logistic regression analysis were used to declare statistical significance. Result: The prevalence of repeat-induced abortion was found to be 35.4% (95% confidence interval = 30.7–40). Not facing a complication in prior abortion care, having more than two partners in the last 12 preceding months, perceiving abortion procedure as non-painful, having a sexual debut before the age of 18 years, and consuming alcohol have higher odds of repeat-induced abortion when compared with their counterparts. Conclusion: The prevalence of repeat-induced abortion in Hawassa city is high compared to studies conducted in other parts of Ethiopia. Not facing complications during previous abortion care, perceiving the abortion procedure as non-painful, alcohol consumption, having multiple sexual partners, and having a sexual debut before the age of 18 years are found to increase the chance of repeat-induced abortion. [ABSTRACT FROM AUTHOR]

Background. The first sexual experience is the most significant event in a woman's life. Early sexual experience has short- and long-term health and behavioral risks. Studying the estimated time for a female to have her first sexual debut is important to reduce its health, demographic, and socioeconomic consequences. Thus, this study is aimed at assessing the time to first sexual experience and its determinants in Ethiopia. Methods. A survival analysis of time to first sexual experience was conducted among 6143 weighted study subjects. The data were extracted from EDHS 2016 using STATA version 16 software. A Kaplan-Meier survival curve was computed to estimate the time of first sexual experience. A log-rank test was used to compare the difference in survival curves. The Cox proportional hazard regression model was used to identify significant predictors. On multivariable analysis, variables having a p value of ≤ 0.05 are considered statically significant. Results. The overall median survival time was 16 years. The significant determinants of time to first sexual experience are educational level (no education (AHR = 2.72 , 95% CI: 2.16, 3.39), primary education (AHR = 2.17 , 95% CI: 1.79, 2.63), and secondary education (AHR = 1.47 , 95% CI: 1.21, 1.77)) and wealth index (poor (AHR = 1.15 , 95% CI: 1.00, 1.32)). Conclusion. About 50% of female youths have a sexual experience for the first time before their 16th birthday. The timing of the first sexual experience in Ethiopia was mainly influenced by educational level and wealth index. Universal access to education and poverty reduction should be the area of concern. [ABSTRACT FROM AUTHOR]

Cutaneous leishmaniasis is a continually spreading health problem in Amhara Region, Ethiopia. Despite this, up- to-date information on referral laboratory facility has been not yet reported. Therefore, this study was aimed at reporting up-to-date information about eight year's cutaneous leishmaniasis trend status. Data on referred cases from 2013 to 2020 were collected at Amhara Public Health Institute Parasitology department by reviewing log book. Of the 243 suspected cases, 114 (46.9%) were positive (confirmed) with microscope and cultured results showed that most of them were negatives. Most of the suspected cases were from 16 to 30 years and males by age and sex, respectively. Trend status by year depicted that largest numbers of suspected and confirmed cases were reported in 2013, 2015, and 2019 years. Finally, the trend status by zone showed that most cases were reported from South Gondar and Awi zones, respectively. [ABSTRACT FROM AUTHOR]

Introduction. Ethiopia has made significant efforts to enhance family planning services despite variations in the community's use of modern contraception in different parts of the country. Various studies have reported the proportion and determinant factors of adolescents' contraceptive uptake in Ethiopia. These studies are not consistent in terms of size, scope, and geographic coverage, and the results need to be systematically collated to inform policies. Therefore, this review was aimed at analyzing the findings of those primary studies to obtain more representative evidence of adolescents' contraceptive uptake in Ethiopia. Methods. Five databases (MEDLINE via PubMed, Google Scholar, Scopus, ScienceDirect, and CINAHL) were searched for papers published from January 2000 up to June 2022 in English. Of thirty eligible studies, eight papers were included in this meta-analysis. Between-study heterogeneity was evaluated by the forest plot and inconsistency index ( I 2 ). A random-effects model was used to calculate the pooled estimates of adolescents' contraceptive uptake. Results. The overall pooled proportion of adolescents' contraceptive uptake was 40% ( I 2 = 99.70 , p ≤ 0.001 ; 95 % CI = 19 , 61). Adolescents' usage of contraception was influenced by a number of factors: individual-, sociocultural-, knowledge- (about contraceptive methods), and healthcare service-related factors. Individual-related factors include the educational status of adolescents, being of young age, and the income status of adolescents' families. Sociocultural-related factors comprise discussion with the family/relatives, parent disapproval and pressure from partners, and being married or having a partner. Healthcare service-related factors include the availability of youth clubs and inconvenient service hours for SRH services. Knowing contraceptive methods and SRH services was also positively associated with adolescents' contraceptive utilization. Conclusions. The proportion of adolescents who used contraception in Ethiopia was 40%. Adolescents' use of contraceptives was influenced by a variety of factors: individual-, sociocultural-, healthcare-, and knowledge-related factors. Hence, integrated interventions targeted at tackling barriers to contraceptive uptake may be helpful to improve adolescents' contraceptive utilization in Ethiopia. [ABSTRACT FROM AUTHOR]

Background. Malaria is endemic in tropical and subtropical regions and causes up to one million deaths each year. It mostly affects sub-Saharan African countries including Ethiopia. In Ethiopia, it was estimated that about 75% of the land and 68% of the population are exposed to malaria. The aim of the current study was to determine malaria cases, its impact on the level of hemoglobin, and parasitemia and predisposing factors among febrile patients who visited Sibu Sire Health Care centers. Methods. Institution-based cross-sectional study was undertaken from May to October, 2020. Febrile patients who visited Sibu Sire Health Care centers were purposefully selected as the target population for the present study. Blood samples were collected and thick and thin smears stained with Giemsa. Hemoglobin level was determined using HemoCue Hb 301. Structured questionnaire and SPSS statistical software were used to collect and analyze data. P value < 0.05 was stated as statistically significant. Results. The overall prevalence of malaria was 168/979 (17.2%) out of which Plasmodium falciparum was 132/168 (78.5%), Plasmodium vivax was 27/168 (16.1%), and mixed infection was 9/168 (5.4%). To assess factors associated with dependent variable and determine the strength of association, binary logistic regression was used at adjusted odds ratios with 95% confidence intervals. The associations between malaria cases, hemoglobin levels, and parasitemia were estimated to evaluate the impacts of malaria on hemoglobin levels and parasitemia level. Out of 979 febrile patients (male 453 and female 526), 168 (male 99 and female 69) individuals were infected with Plasmodium species and Plasmodium falciparum were the predominant parasites. The majority of the study participants 144/168 (85.7%) were from rural residences. Highest malaria-infected patients 74/168 (44%) were aged between 15 and 30 years old. The level of hemoglobin and parasitemia was highly associated with malaria cases; hence, in this study area, intensities of hemoglobin and parasitemia are significantly associated with Plasmodium species. Conclusion. There was a moderate prevalence of malaria parasitemia and hemoglobin level among patients visiting Sibu Sire Health Care center; however, it needs further intervention to prevent and control malaria transmission in this malaria hotspot area. [ABSTRACT FROM AUTHOR]

Background: Periodontal disease is the most common oral health problem among individuals living with disabilities. Any physical impairment and/or mental handicap can compromise the capability to perform oral health care. Individuals with poor oral hygiene practice were prone to dental caries, periodontal disease, and upper respiratory tract infections. Despite the high prevalence of disabled people in Ethiopia, data are scarce about their periodontal status. The aim of this study was to determine the prevalence and determinant factors of periodontal disease among students living with disability in the Amhara region. Methods: A school-based cross-sectional study was done on eight special needs schools in Amhara regional state from November 30, 2020, to April 10, 2021. A simple random sampling technique using a computer random generator was employed to recruit the study participants. The participants were interviewed for sociodemographic characteristics, oral hygiene practice, type of disability, and medical condition through a pre-tested semi-structured questionnaire. The periodontal status of the participants was evaluated using the community periodontal index (CPI). Data entry was done using the Epi-data and analyzed using SPSS 26. Binary logistic regression analysis was used to identify the predictors of periodontal disease at a 5% level of significance. Results: A total of 443 study participants were involved with a mean age of 15.84 ± 3.882. Among these, 27.5% (95%CI 23.4–32.0) had a periodontal pocket depth of ≥ 4 mm, and 56.7% had bleeding on probing. The prevalence of periodontal disease was higher in participants with poor oral health status (52.2%), dental caries (34.8%), class-2 malocclusion (46.1%), and low monthly income (30.4%), visually impaired (30%), and mentally disorder (29.9%). Age of above 18 years (AOR = 3.41, 95%CI 1.40, 8.28), low family monthly income (AOR = 2.21; 95%CI 1.22, 4.03), malocclusion (AOR = 1.59, 95%CI 1.01, 2.54), poor oral health status (AOR = 9.41; 95%CI 4.92, 17.98), and dental caries (AOR = 1.85, 95%CI 1.21, 2.82) were independent predictors of periodontal disease. Conclusions: A substantial amount of disabled school students in the study area had periodontal disease. The study found that there was a statistically significant association between age, family monthly income, malocclusion, oral health status, and dental caries with periodontal disease. The implementation of school oral health programs has a great benefit for the oral health status of disabled school students. [ABSTRACT FROM AUTHOR]

Background: Child marriage has powerful implications for a young woman's reproductive health, education, and personal development as well as the development of communities and nations. Child marriage frequently marks the beginning of a young woman's sexual activity and early childbearing. As a country where child marriage is common, Ethiopia has placed additional emphasis on addressing child marriage over the past years. Methods: Using data from Ethiopia Demographic and Health Surveys for 2005, 2011 and 2016, this paper explores trends in child marriage over the last decade in various locations and regions of Ethiopia. Results: Between 2005 and 2016, the percentage of young Ethiopian women married before age 18 declined from 49 to 40%, a reduction of 18% from 2005 levels. The percentage of women married before age 15 experienced even greater reductions, declining by 26% in the same period. The greatest reductions in child marriage took place in the Addis Ababa, Amhara, and Tigray regions. Over the period, estimates for Oromia and Somali suggest that child marriage has increased in these regions. Notwithstanding recent declines, Afar, Beneshangul-Gumuz, Somali, and Oromia are regions where nearly half or more of all girls are married before age 18. Conclusions: Nationally, Ethiopia has experienced impressive declines in child marriage over the last decade. However, progress has also been uneven. Trends in the last decade have resulted in a geographical shift in where child marriage is most prevalent. In particular, locations that are challenging in terms of access, including the most remote and hard to reach, pose persistent challenges to those attempting to eradicate the practice. Intensifying efforts in rural areas and underserved regions can facilitate further declines in child marriage in Ethiopia. Plain Language Summary: Child marriage has powerful implications for young women's reproductive health, education, and welfare. Using data from Ethiopia Demographic and Health Surveys for 2005, 2011, and 2016, this paper analyzes subnational trends in child marriage over the last decade. Between 2005 and 2016, the percentage of Ethiopian women married before age 18 declined from 49 to 40%, a reduction of 18%. The percentage of women married before age 15 experienced even greater reductions, declining by 26% in the same period. The greatest reductions in child marriage took place in Addis Ababa, Amhara, and Tigray regions. Over the same period, estimates for Oromia and Somali regions suggest that child marriage has increased in these regions. Afar, Beneshangul-Gumuz, Somali, and Oromia are regions where more than or nearly half of all girls are married before age 18. Nationally, Ethiopia has experienced impressive declines in child marriage over the last decade. However, progress has also been uneven, resulting in a geographical shift in where child marriage is most prevalent. Remote and hard-to-reach locations pose persistent challenges to eradicating child marriage. Intensifying efforts in rural areas and underserved regions can achieve the elimination of child marriage in Ethiopia. [ABSTRACT FROM AUTHOR]

Background: Cervical cancer is currently the second-leading cause of cancer death among women in Ethiopia. Vaccination against the human papillomavirus (HPV) is an effective primary prevention strategy for HPV-related illnesses. The knowledge and willingness of parents toward the HPV vaccine are crucial to increasing the uptake of the vaccine. The vaccine's acceptance by children and young adolescents is dependent on parental consent. Therefore, this study aimed to assess knowledge, willingness, and associated factors of the human papillomavirus vaccine among parents of girls aged 9–14 years at Debre Tabor Town. Method: A community-based cross-sectional study was conducted among participants from December 10, 2020, to January 15, 2021. A simple random sample technique was used to include 638 participants. A structured face-to-face interviewer-administered questionnaire was used to collect data. The data were entered and analyzed using Epi-Data and SPSS software, respectively. Bivariate and multivariable analyses were used to examine the association. The Odds Ratio (OR), 95% CI, and p-values less than 0.05 were used to determine the statistical association. Results: Thirty-five percent (35.4%, 95% CI = 31.4%, 38.8%) and 44.8% (95% CI = 40.40%, 48.67%) of participants were knowledgeable about HPV vaccination and willing to get it, respectively. Being government employees (AOR = 5.46, 95% CI = 2.42, 9.34), and having a family history of sexually transmitted diseases (STD) (AOR = 1.76, 95% CI = 1.14, 2.72) were significantly associated with knowledge of the human papilloma virus (HPV) vaccine. Participants' age (AOR = 1.43, 95% CI = 1.16, 2.87), secondary education and above (AOR = 1.70, 95% CI = 1.05, 2.74), fear of HPV infection (AOR = 2.29, 95% CI = 1.21, 4.32), and having good knowledge of the HPV vaccine (AOR = 3.30, 95% CI = 2.21, 4.93) were significantly associated with willingness to receive the HPV vaccine. Conclusion and recommendation: The knowledge and willingness of parents toward the HPV vaccine were low. Then, health officials should boost HPV vaccination promotion through public media. In schools, churches, mosques, and health facilities, health extension workers and health professionals provide information about the HPV vaccine for the parents. Mixed quantitative and qualitative studies are preferable for future research to address "why" issues. Plain language summary: Infection with the Human Papillomavirus (HPV) causes nearly 99% of cervical cancer cases and more than 20% of breast, neck, and anogenital cancers. The HPV vaccines protect against high-risk types of HPV (types 16 and 18), which account for approximately 70% of cervical cancers. Global coverage of the HPV vaccine was 39.7%, with high-income countries (68%), middle-income countries (28%), and lower-middle-income countries (2.7%). For different reasons, cervical cancer screening is very poor in Ethiopia (below 2%). Cervical cancer is mostly asymptomatic more than 20 years after infection. Primary prevention (enhancing the HPV vaccine) is the best way to protect women from cervical cancer. Adolescents' uptake and acceptance of the vaccine depend on parental consent. Assessing parental knowledge and willingness at a community level is very crucial. A simple random sample technique was used to include 638 participants. A structured and pre-tested face-to-face interviewer-administered questionnaire was used to collect the data. The data were entered and analyzed using Epi-Data, and SPSS software, respectively. Bivariate and multivariable analyses were used to examine the association. Nearly one-third (35.4%) and less than half (44.8%) of participants were knowledgeable and willing to receive the HPV vaccination. The knowledge and willingness of the parents are significantly lower. Being government employees and having a family history of sexually transmitted diseases (STD) were factors affecting the knowledge of parents about the human papillomavirus vaccine. Participants' age, secondary education and above, fear of HPV infection, and having good knowledge of the HPV vaccine were significantly associated with their willingness to use the HPV vaccine. The knowledge and willingness of the parents are significantly lower. Health officials and stakeholders should scale up HPV vaccine promotion through public media. [ABSTRACT FROM AUTHOR]

Background: The maternal mortality rate in poor nations remains unacceptably high. The purpose of this study was to identify factors associated with institutional delivery usage. Methods: The data came from the Ethiopian mini demographic and health survey, which was conducted in 2019. This study comprised 3978 women of reproductive age who had given birth within the previous 5 years. To uncover significantly linked parameters associated with institutional delivery, we used a multilevel logistic regression model. Statistical significance was declared at p < 0.05, and we assessed the strength of association using adjusted odds ratios with 95% confidence intervals. Results: More than half of the women (53.67%) among 3978 women with last birth had their babies delivered in a health facility. In the multilevel logistic regression analysis, women in age group 45–49 (AOR = 2.43, 95% CI: 1.280, 4.591), primary educational level (AOR = 2.21, 95% CI: 1.864, 2.625, secondary and above education level (AOR = 6.37, 95% CI: 4.600, 8.837), being Muslim (AOR = 2.57, 95% CI: 1.245, 2.166), women who visited ANC service four up to seven times (AOR = 2.75, 95% CI: 2.175, 3.473), women visited ANC service eight times and above (AOR = 3.295% CI: 1.685, 6.050), women who reside in middle wealth index (AOR = 1.57, 95% CI: 1.273, 1.950), and rich wealth index (AOR = 3.43, 95% CI: 2.782, 4.225) were more likely to give birth at health institution compared to their counterparts. Furthermore, women being in rural area (AOR = 0.34, 95% CI:- 0.283, 0.474) and protestant women (AOR = 0.1.57, 95% CI: 0.479, 0.852) were less likely to deliver at health institution. Conclusions: Ethiopia still has a low level of institutionalized delivery. Institutional delivery in Ethiopia should be improved through context-specific and personalized programs, such as educating women and enhancing access to ANC services. [ABSTRACT FROM AUTHOR]

Background: Postpartum hemorrhage or postpartum bleeding (PPH) is often defined as loss of > 500 ml of blood after vaginal delivery or > 1000 ml after cesarean delivery within 24 h. Postpartum hemorrhage is a leading direct cause of maternal morbidity and mortality in Ethiopia. Therefore, the main objective of this systematic review and meta-analysis was to estimate the pooled magnitude of postpartum hemorrhage and the pooled effect size of the associated factors in Ethiopia. Methods: Primary studies were searched from PubMed/MEDLINE online, Science Direct, Hinari, Cochrane Library, CINAHL, African Journals Online, Google and Google Scholars databases. The searching of the primary studies included for this systematic review and meta-analysis was limited by papers published from 2010 to October 10/2021. The data extraction format was prepared in Microsoft Excel and extracted data was exported to Stata Version 16.0 statistical software for analysis. A random effect meta-analysis model was used. Statistical heterogeneity was evaluated by the I2 test and Egger's weighted regression test was used to assess publication bias. Result: A total of 21 studies were included in this meta-analysis. The pooled magnitude of postpartum hemorrhage in Ethiopia was 8.24% [(95% CI 7.07, 9.40]. Older age [OR = 5.038 (95% CI 2.774, 9.151)], prolonged labor [OR = 4.054 (95% CI 1.484, 11.074)], absence of anti-natal care visits (ANC) [OR = 13.84 (95% CI 5.57, 34.346)], grand-multiparty [OR = 6.584 (95% CI 1.902, 22.795)], and history of postpartum hemorrhage [OR = 4.355 (95% CI 2.347, 8.079)] were factors associated with the occurrence of postpartum hemorrhage. Conclusions: The pooled magnitude of postpartum hemorrhage among post-natal mothers in Ethiopia was moderately high. The finding of this study will strongly help different stakeholder working in maternal and child health to focus on the main contributors' factors to reduce post-partum hemorrhage among postnatal mothers. Health professionals attending labor and delivery should give more attention to advanced aged mothers, grand-multipara mothers and mothers who had a history of post-partum hemorrhage due to higher risk for postpartum hemorrhage. Encouraging to continue ANC visit and prevent prolonged labor should also be recommended to decrease postpartum hemorrhage. Plain Language summary: Even though other complications occur during pregnancy, post-partum hemorrhage (PPH) is the most serious complication and most critically important cause during pregnancy and child birth. It can cause severe anemia, acute respiratory distress syndrome (ARDS), acute renal failure (ARF), coma, and cardiac arrest. Uterine atony, retained tissue, genital tract tear, coagulation problem, and uterine rupture are most common causes of post-partum hemorrhage. In developing countries, PPH is one of the leading causes of maternal mortality, accounting for 25–43% of maternal death. It is also a leading cause of maternal morbidity and mortality in Ethiopia. This systematic review and meta-analysis were performed following the preferred reporting items for systematic reviews and Meta-Analyses (PRISMA). Primary studies were searched from different databases and random effect meta-analysis model was used. This systematic review and meta-analysis included 21 primary studies with a total of 93,898 study participants. The pooled magnitude of postpartum hemorrhage in Ethiopia was 8.24%. Advanced maternal age, prolonged labor, absence of antenatal care (ANC) visits, grand multi-parity, previous history of postpartum hemorrhage were significantly associated with postpartum hemorrhage. The finding of this systematic review and meta-analysis will strongly help different stakeholders working in maternal and child health to focus on the main contributor factors to reduce PPH If postpartum hemorrhage is reduced, it is the fact that maternal death will be decreased. [ABSTRACT FROM AUTHOR]

Background. Infectious bronchitis virus (IBV) is a highly contagious viral disease of chicken typically affecting the reproductive and respiratory tract and results in possible economic causes from its serious infectious and transmission characteristics. Methods. A cross-sectional study was carried on serum samples of chickens selected from six (two commercial and four small holder) farms and two types of production (broiler and layer) to detect seroprevalence of IBV and its associated risk factors in Bishoftu and Holeta areas of central Ethiopia from June 2021 to September 2021. A total of 354 blood samples were collected and subjected to indirect ELISA test by IBV antibody test kit ((ProFLOK IBV), from ProFLOK Laboratories Inc., (USA)) to detect specific antibodies against IBV. Results. Overall, 97.46% seroprevalence was identified. From 230 and 124 samples collected from commercial and smallholder poultry farms, 226 (98.26%) and 119 (95.98%) positive results were obtained, respectively. Among the production types of chickens, high seroprevalence (99.31%) was found in layer poultry, and lower seroprevalence (96.17%) was found in the case of broiler chicken. Significant association was observed among different associated risk factors particularly age, sex, breed, and production types of chickens. From the tested chickens, all age groups, species, and farm types have high seroprevalence of IBV. The prevalence of IBV was highly significant (p ≤ 0.01) in the study site. The risk factors indicated could have increased infection prevalence, pathogens' economic impact, and disease occurrence. Conclusion. IBD is complicating factor affecting poultry production systems in the area. Vaccine and biosecurity measures are recommended for the control of IBV. Furtherly, identification and characterization (by using RT-PCR) of persistent serotype of IBV circulating in the field are recommended. [ABSTRACT FROM AUTHOR]

Background: The frequency of antenatal care utilization enhances the effectiveness of the maternal health programs to maternal and child health. The aim of the study was to determine the number of antenatal care and associated factors in Ethiopia by using 2019 intermediate EDHS. Methods: Secondary data analysis was done on 2019 intermediate EDHS. A total of 3916.6 weighted pregnant women were included in the analysis. Zero-inflated Poisson regression analysis was done by Stata version 14.0. Incident rate ratio and odds ratio with a 95% confidence interval were used to show the strength and direction of the association. Result: About one thousand six hundred eighty eight (43.11%) women were attending four and more antenatal care during current pregnancy. Attending primary education (IRR = 1.115, 95% CI: 1.061, 1.172), secondary education (IRR = 1.211, 95% CI: 1.131, 1.297) and higher education (IRR = 1.274, 95% CI: 1.177, 1.378), reside in poorer household wealth index (IRR = 1.074, 95% CI: 1.01, 1.152), middle household wealth index (IRR = 1.095, 95% CI: 1.018, 1.178), rich household wealth index (IRR = 1.129, 95% CI: 1.05, 1.212) and richer household wealth index (IRR = 1.186, 95% CI: 1.089, 1.29) increases the number of antenatal care utilization. The frequency of antenatal care was less likely become zero among women attending primary (AOR = 0.434, 95% CI: 0.346, 0.545), secondary (AOR = 0.113, 95% CI: 0.053, 0.24), higher educational level (AOR = 0.052, 95% CI: 0.007, 0.367) in the inflated part. Conclusion: The number of antenatal care utilization is low in Ethiopia. Being rural, poorest household index, uneducated and single were factors associated with low number of antenatal care and not attending antenatal care at all. Improving educational coverage and wealth status of women is important to increase the coverage and frequency of antenatal care. Plain language summary: Antenatal care is among the most effective interventions to mitigate maternal mortality and morbidity. It is an entry point for delivery care, postnatal care and child immunization. This study was conducted to determine the frequency and associated factors of antenatal care utilization in Ethiopia by using 2019 intermediate Ethiopian Demography Health Survey. A cross-sectional study design using secondary data from 2019 intermediate Ethiopian demography and health survey was conducted. 3917 weighted women were included in the study. Recoding, variable generation, labeling and analysis were done by using STATA/SE version 14.0. The objective of this study was to identify the determinants of frequency of antenatal care visit in Ethiopia by using zero inflated Poisson regression. In this study 74.38% of women attend antenatal care at least once during their current pregnancy. Only 41.8% of women use WHO recommended number of antenatal care. Conclusion: maternal age, residence, educational status, household wealth index, religion and region show significant association with the frequency of antenatal care utilization. Advocacy and behavioral change communication should be area of concern for different organizations that are working on antenatal care especially for rural, poor and uneducated women through mass campaign, community dialoging and enhance the effectiveness of health extension programs. [ABSTRACT FROM AUTHOR]

Background: Time to age at first marriage of women is the duration of time until the age at which they started living with their first partner. Time to age at first marriage is widely considered a proxy indicator for the age at which women begin to be exposed to the risks inherent in sexual activity. The purpose is to model the determinant of time to age at first marriage among women in Ethiopia using Cox models with mixed effects. Methods: The 2016 Ethiopian Demography and Health survey sample was selected using a two-stage cluster design. The data set in this study were obtained from the Demography and Health survey conducted in Ethiopia in 2016. In this study, we used Cox models with mixed effects. Results: Of all 15,683 women aged 15–49 years, 11,405 (72.72%) were married with the median and mean age at first marriage 17 years and 18 years, respectively. Cox frailty survival model showed that residence, educational level, occupation, work status of women& head education level of households were the most significant factors whereas religion, access to media and wealth index of a household of women were not significant factors at 5% level of significance. The significant clustering effect showed that heterogeneity among the regions on age at first marriage was present. Conclusions: The present study determined the duration of time until the age at first marriage and indicated relevant solutions for marriage-related problems of women aged 15–49 years in Ethiopia. Women residing in rural area of Ethiopia and had lower education level were married earlier. Therefore, programs to reduce the high rate of early marriage in Ethiopia should give attention to women education and women residing in rural area. Plain language summary: Time to age at first marriage of women is the duration of time until the age at which they started living with their first partner. African women are more likely to marry earlier than other continent women, which causes high fertility due to their long period of exposure to the risk of pregnancy. Even though Sub-Sahara Africa accounts for the highest rate of age at first marriage among countries in the Africa continent, comparably the case is very worse in Ethiopia. Furthermore, there is no study about the determinant of time to age at first marriage in Ethiopia using advanced models like Cox Model with Mixed effects. This model allows for the analysis of data with complex patterns of variability, with a focus on nested sources of variability. Very often it makes sense to use such a model to represent the variability within and between groups. For instance, in this study, our interest is not only knowing the significant effect of determinant factors on time to age at first marriage among women in Ethiopia but also the variability of time to age at first marriage within the region of Ethiopia and between regions of Ethiopia. We have used a dataset for this study from Ethiopia Demography and Health Survey which was conducted in 2016. The study helps to indicate relevant solutions for women's marriage-related problems (predominantly, women's reproductive health problems) in Ethiopia and it provides input for further studies in Ethiopia. [ABSTRACT FROM AUTHOR]

Background: Ethiopia is striving to reduce unmet need for family planning (FP) and implementation of the health extension program (HEP) is one of the major actions that the country took to address health issues of rural communities including FP. However, there is limited published evidence demonstrating the role of HEP in reducing the unmet need of married rural women for FP. The aim of this study is to estimate the role of HEP in reducing unmet need for FP in rural Ethiopia. Methods: This paper is based on data extracted from a national rural HEP assessment that covered all regions of Ethiopia. We identified 4991 eligible married women both from agrarian and pastoralist settings. The role of HEP was measured by the exposure of eligible women to FP services through the implementation of HEP packages. We used descriptive statistics to summarize different variables and used logistic regression to model the unmet need for FP. Results: The overall prevalence of unmet need for FP among married rural Ethiopian women was 22.41%, contraceptive prevalence rate (CPR) was 44.60%, and the total demand for FP was 60.86%. Women exposed to HEP had a lower level of unmet need (4.82%), a higher demand for FP (37.78%) and a higher CPR (24.93%) compared to women unexposed to HEP. Having exposure to FP services (adjusted odds ratio (AOR) = 0.46, 95% confidence interval (CI) 0.37–0.59), having level IV Health Extension Workers (HEWs) in the catchment health post (AOR = 0.80, 95% CI 0.67–0.95) and older age are significantly associated with lower levels of unmet need for FP. Having more children (AOR = 2.11, 95% CI 1.67–2.65) and better awareness of the husband about the availability of FP services (AOR = 1.22, 95% CI 1.01–1.48) were associated with a higher likelihood of an unmet need for FP. Conclusion: The unmet need for family planning is high in rural Ethiopia in general and among women who do not have exposure to HEP packages in particular. Assigning a better-qualified health worker at the health post, reaching out to pastoralist women, maximizing opportunities to counsel rural women about FP during any contact with HEWs, and increasing positive attitudes of husbands towards FP use are likely to have positive impacts in reducing the unmet need for FP of rural women. Plain language summary: Family planning is a method that couples can use to limit the number of child or space the gap. Unmet need for family planning is defined as the percentage of reproductive age women who wants to space or limit the number of children but not currently using any family planning method. There is a huge proportion of eligible women have an unmet need for family planning in Ethiopia. The health extension program is one of the strategies to reach rural women to improve the health of the community. Although, family planning service is one of the packages in a health extension program and this study aimed to estimate the role of health extension program in reducing unmet need for family planning. About 4991 married women were asked about the family planning use, need and the place where they get the services. During the assessment the role of health extension program was assessed by different question. Some of the major assessment areas were women exposer to service, service availability, awareness and mode of service delivery. One fourth of the women have unmet need for family planning. The family planning utilization is still low. The contribution of the health extension program in family planning service is significant. Women exposed to HEP through level 4 health extension worker and older age are significantly associated with low level of unmet need FP. The unmet need for family planning is high in rural Ethiopia. This will inform the improvement and sustainability of the program. [ABSTRACT FROM AUTHOR]

Understanding context-specific temporal trends in mortality is essential for setting health policy priorities. To investigate the trends and distribution of deaths due to communicable and non-communicable diseases and external causes in South-Central Ethiopia. All adult deaths captured by the Butajira Health and Demographic Surveillance System between January 2008 and December 2019 were included. A verbal autopsy method of collecting cause of death data was used. Physician review and a computerised algorithm, InterVA, were used to determine the cause of death. Coding was undertaken using the World Health Organization's International Classification of Diseases. Trends in adult mortality rate and proportional mortality were estimated by major cause of death categories. Significant trends were analysed using the Mann–Kendall statistical test with a significance set at P < 0.05. Deaths were also disaggregated by age, sex, and residence. There were 1,612 deaths in 279,681 person-years; 811 (50.3%) were females. The median age at death was 65 years. The proportional adult mortality and adult mortality rates (per 1000 person-years) attributed to communicable diseases, non-communicable diseases, and external causes were 31.1%, 58.9%, and 6.0%, and 1.9, 3.4, and 0.4, respectively. Adult mortality due to communicable diseases showed a declining trend (tau, the measure of the strength and direction of association, = −0.52; P < 0.05), whereas the trend increased for non-communicable diseases (tau = 0.67, P < 0.05) and external causes (tau = 0.29, P > 0.05). Moreover, death rates were pronounced in the 65+ age group and rural areas but comparable among males and females. The trend in deaths due to communicable diseases declined but increased for non-communicable diseases and external causes with significant public health burdens. These findings will provide essential input in formulating health policy reforms to reduce premature mortality. [ABSTRACT FROM AUTHOR]

Background: World health organization (WHO) defines intimate partner violence (IPV) is physical, sexual, or emotional abuse by an intimate partner or ex-partner or spouse to a woman. From all forms of violence, ~ 1.3 million people worldwide die each year, accounting for 2.5% of global mortality. During the COVID-19 crisis, control and prevention measures have brought women and potential perpetrators together which increase the risk of IPV. Therefore, this study was aimed to assess the magnitude and associated factors of IPV against women during COVID-19 in Ethiopia. Methods: Community based cross-section study was employed among 462 reproductive-age women to assess IPV and associated factors during COVID-19 pandemic. To select study participants one-stage cluster sampling technique was used. The data were entered into Epi data version 4.2 and exported to SPSS for analysis. Bivariate and multivariate analysis was used to check the association of dependent and independent variables and statistical significance was declared at P < 0.05. Result: A total of 448 study subjects were responded making a response rate of 96.97%. Two- third (67.6%) of the respondent's age range was between 20 and 29 years. All of the participants heard about the pandemic of COVID-19 at the time of onset. The lifetime and the last twelve months prevalence of women with IPV was 42.19% and 24.11%, respectively. About 58 (12.9%) had experienced all three types of violence. Participants age ≥ 35 (AOR = 2.02; 95% CI: 1.99–4.29), rural residence (AOR = 3.04; 95% CI: 2.59–6.25), husband's educational status of diploma and above (AOR = 0.35; 95% CI: 0.14–0.83), COVID-19 pandemic (AOR = 4.79; 95% CI: 1.13–6.86), and low social support (AOR = 3.23; 95% CI: 1.99–6.23) were independent predictors. Conclusions: In this study two in five women undergo one type of violence in their lifetime. The occurrence of the COVID-19 pandemic has its impact on violence. Age ≥ 35, rural residence, husband's educational status of diploma and above, history of child death, COVID-19 pandemic, and low social support were independent predictors of violence. This implies insight to concerned bodies like policymakers and stakeholders to design appropriate policies to avert this magnitude and making zero tolerance for violence in society. Plain English summary: Intimate partner violence is physical, sexual, or emotional abuse by an intimate partner or ex-partner or spouse to a woman. Community based cross-section study was employed among 462 reproductive-age women to assess the magnitude and associated factors of IPV against women during COVID-19 in Ethiopia. Bivariate and multivariate analysis was used to check the association of dependent and independent variables and statistical significance was declared at P < 0.05. A total of 448 study subjects were responded making a response rate of 96.97%. In this study two in five women undergo one type of violence in their lifetime. The occurrence of the COVID-19 pandemic has its impact on violence. Age ≥ 35, rural residence, husband's educational status of diploma and above, history of child death, COVID-19 pandemic and low social support were independent predictors of violence. This sparks light to concerned bodies like policymakers and stack holders to design appropriate policies to avert this magnitude and making zero tolerance for violence in society. [ABSTRACT FROM AUTHOR]

Background. Loss to follow-up (LTFU) from antiretroviral therapy (ART) reduces treatment benefits and leads to treatment failure. Hence, this study was aimed at determining the incidence of loss to follow-up and predictors among HIV-infected adults who began first-line antiretroviral therapy at Arba Minch General Hospital. Methods. We carried out an institutional-based retrospective cohort study, and data were collected from the charts of 508 patients who were selected using a simple random sampling technique. All the data management and statistical analyses were conducted using STATA version 14. Cumulative survival probability was estimated and presented in the life table, and the Kaplan-Meir survival curves were compared using the log-rank test. The Cox proportional hazard model was used to identify the independent predictors. Results. We followed 508 patients for 871.9 person-years. A total of 46 (9.1%) experienced loss to follow-up, yielding an overall incidence rate of 5.3 (95% CI: 3.9-7.1) per 100 person-years. The cumulative survival probability was 90%, 88%, 86%, and 86% at the end of one, two, three, and four years, respectively. The predictors identified were age less than 35 years (adjusted hazard ratio (aHR = 1.96 ; 95% CI: 1.92-4.00)), rural residence (aHR = 1.98 ; 95% CI: 1.02-3.83), baseline body weight greater than 60 kilograms (aHR = 2.19 ; 95% CI: 1.11-4.37), a fair level of adherence (aHR = 11.5 ; 95% CI: 2.10-61.10), and a poor level of adherence (aHR = 12.03 ; 95% CI: 5.4-26.7). Conclusions. In this study, the incidence rate of loss to follow-up was low. Younger adults below the age of 35 years, living in rural areas, with a baseline weight greater than 60 kilograms, which had a fair and poor adherence level were more likely to be lost from treatment. Therefore, health professionals working in ART clinics and potential stakeholders in HIV/AIDS care and treatment should consider adult patients with these characteristics to prevent LTFU. [ABSTRACT FROM AUTHOR]

Introduction: The ministry of health (MOH) of Ethiopia recommends 4 or more focused antenatal care (ANC) visits at health centre (HC) or at a higher level of health facility (HF). In Ethiopia, few studies investigated time dimension of maternal health continuum of care but lack data regarding place dimension and its effect on continuum of care. The aim of this study is to estimate effect of place of ANC-1 visit and adherence to MOH's recommendations of MOH for ANC visits on continuum of care rural in Ethiopia. Methods: We used data collected from 1431 eligible women included in the National Health Extension Program (HEP) assessment survey that covered 6324 households from 62 woredas in nine regions. The main outcome variable is continuum of care (CoC), which is the uptake of all recommended ANC visits, institutional delivery and postnatal care services. Following descriptive analysis, Propensity Score Matching was used to estimate the effect of place of ANC-1 visit on completion of CoC. Zero inflated Poisson regression was used to model the effect of adherence to MOH recommendation of ANC visits on intensity of maternal health continuum of care. Result: Only 13.9% of eligible women completed the continuum of care, and place of first antenatal care (ANC) visit was not significantly associated with the completion of continuum of care (β = 0.04, 95% CI = -0.02, 0.09). Adherence of ANC visit to the MOH recommendation (at least 4 ANC visits at higher HFs than health posts (HPs)) increased the likelihood of higher intensity of continuum of care (aIRR = 1.29, 95% CI: 1.26, 1.33). Moreover, the intensity of continuum of care was positively associated with being in agrarian areas (aIRR = 1.17, 95% CI: 1.06, 1.29), exposed to HEP (IRR = 1.22, 95% CI: 1.16, 1.28), being informed about danger signs (aIRR = 1.14, 95% CI: 1.11, 1.18) and delivery of second youngest child at HF (IRR = 1.16, 95% CI: 1.13, 1.20). Increasing age of women was negatively associated with use of services (IRR = 0.90, 95% CI: 0.87, 0.94). Conclusion: Completion of maternal health continuum of care is very low in Ethiopia, however most of the women use at least one of the services. Completion of continuum of care was not affected by place of first ANC visit. Adherence to MOH recommendation of ANC visit increased the intensity of continuum of care. Intensity of continuum of care was positively associated with residing in agrarian areas, HEP exposure, danger sign told, delivery of second youngest child at health facility. To boost the uptake of all maternal health services, it is crucial to work on quality of health facilities, upgrading the infrastructures of HPs and promoting adherence to MOH recommendations of ANC visit. Plain language summary: Maternal health continuum of care is an integrated service delivery of antenatal care, facility delivery and postnatal care on appropriate time and place. Continuum of care averts more maternal mortality than individual service provision. In Ethiopia a small percent of women complete continuum of care. Previous studies in Ethiopia explored the effect of time on CoC, however the effect of place of service delivery on subsequent continuum of care were not addressed. This study, therefore, assessed the effect of place of service delivery on completion of subsequent continuum of care using data from 1431 fixed cohort of women during the National HEP assessment survey. The proportion of women who took all essential maternal health services was very low. Whether first antenatal care is at health post or at health centre did not have a significant effect on the completion of maternal health continuum of care. Adherence to the existing recommendations of Ministry of Health for antenatal care visit increases the uptake of maternal health continuum of care. Better completion of maternal health services was observed in agrarian than pastoralist areas, among those who have exposure to health extension program, who have information about danger signs, and who deliver their previous child at health facility. We can conclude that good implementation of the health extension program, and improving service quality at health facilities increase the uptakes of maternal health service. Moreover, promoting adherence of women to the ministry of health ANC recommendations increase uptakes. [ABSTRACT FROM AUTHOR]

Introduction: The health and growth of children less than two years of age can be affected by the poor quality of complementary foods and poor feeding practices even with optimal breastfeeding. In Ethiopia, empirical evidence on the minimum acceptable diet and its associated factors is limited. Therefore, this study was aimed to assess the level of minimum acceptable diet and its associated factors among children aged 6–23 months in Addis Ababa Ethiopia. Methods: An institution-based Cross-sectional study was conducted among a total of 575 mother-child pairs. A simple random sampling technique was used to recruit participants. For infant and young child feeding practices, the data collection tools were adapted from world health organizations' standardized questionnaire which is developed in 2007. Data entry and analysis were performed using EPI data version 3.1 and SPSS version 20 respectively. Bivariable and multivariable logistic regression analyses were performed to determine predictor variables. Statistical significance was declared at p-value < 0.05. Result: In this study, the level of minimum acceptable diet was found to be 74.6%.. About 90.6 and 80.2% of the children received minimum meal frequency and dietary diversity respectively. Having a husband secondary and above educational level [AOR = 4.789(95%CI:1.917–11.967)], being a housewife [AOR = 0.351(95% CI: 0.150–0.819)], having a history of more than three postnatal follow-ups [AOR = 2.616(95%CI:1.120–6.111], Having mothers age between 25 and 34 years [AOR = 2.051(95%CI:1.267–3.320)], being male child [AOR = 1.585(95%CI:1.052–2.388)] and having children age between 18 and 23 months [AOR = 3.026(95%CI:1.786–5.128)] were some of the factors significantly associated with a minimum acceptable diet. Conclusion: In this study, the minimum acceptable diet among children aged 6–23 months was significantly associated with the educational status of the husband, mother's occupation, history of postnatal follow-up, age of the mother, sex of the child, and age of the child. Thus, attention should be given to educating the father, empowering mothers to have a job, promoting gender equality of feeding, and counseling on the benefit of postnatal care visits. In addition, the ministry of health should work on educating and advocating the benefit of feeding the recommended minimum acceptable diet to break the intergenerational cycle of malnutrition. [ABSTRACT FROM AUTHOR]

Introduction: Unwanted pregnancy and sexually transmitted diseases are the major problems in street women because of the non-utilization of modern contraceptives. To the best of our knowledge, no studies have assessed the utilization of modern contraceptives and associated factors among street women in the study area. Therefore, this study aimed to determine the utilization of modern contraceptives and its associated factors among street women. Methods: A community-based cross-sectional study using mixed methods was conducted from February 16th to April 10, 2021, among all censuses and 615 reproductive-aged street women. Face-to-face and in-depth interviews were employed to generate quantitative and qualitative data, respectively. Binary logistic regression was used to analyze the association between modern contraceptive utilization and independent variables with statistical significance set at p < 0.05. Qualitative data were analyzed using a thematic approach. Results: Approximately half 279 (50.3%) (95% CI: 46.3%, 54.4%) street women currently used modern contraceptives. Factors significantly associated were women aged 25–34 years [AOR = 5.5, 95% CI: 1.2–24], distance from a nearby health facility within 30 min [AOR = 9.2, 95% CI: 1.6–51], getting advice from health professionals [AOR = 14.3; 95% CI = 5.3–38.4], discussed with their sexual partners about the utilization of modern contraceptives [AOR = 6.2, 95% CI: 2.4–16.5], a history of pregnancy [AOR = 2.7, 95% CI: 1.2–6], the desire to have a child after two years [AOR = 2.2, 95% CI: 1.1–4.7], and women who faced rape in street life [AOR = 5.4; 95% CI = 1.9–15.3]. Fear of side effects, misperceptions, and the desire to have a child are the main identified themes for the key barriers to using modern contraceptives. Conclusion: The proportion of street women currently using modern contraceptives was low. Age, distance from the health facility, discussion with health professionals, discussion with sexual partners, history of pregnancy, desire time to have a child in the future, and history of rape were factors significantly associated with the use of modern contraceptives. Most of the participants' reasons for the lack of use of modern contraceptives were fear of its side effects. Plain language summary: Street women are a segment of the population in absolute poverty, which they suffer from the major problems of unwanted pregnancy and sexually transmitted diseases. Besides this issue, its consequences necessitate the use of modern contraceptives. This study aimed to determine the utilization and associated factors, and explore the key barriers to modern contraceptive utilization among street women in Dire Dawa. In this study, a community-based cross-sectional study design was conducted among all censuses and 615 reproductive-aged street women from February 16th to April 10, 2021. Face-to-face and in-depth interviews were employed to generate data for both methods. Data were analyzed using the SPSS software version 25 and a thematic approach for quantitative and qualitative, respectively. The findings of this study showed that the proportion of street women who currently used modern contraceptives was 279 (50.3%). Factors significantly associated were age, distance from the health facility, discussion with health professionals, discussion with sexual partners, history of pregnancy, desire time to have a child, and history of rape. The key barriers to using modern contraceptives are fear of side effects, misperceptions, and the desire to have a child. In conclusion: this study demonstrated that the proportion of street women currently using modern contraceptives was low. Health professionals and health extension workers should give health education that integrates well-organized street women's groups and community health extension workers that may help reduce women's fear of potential side effects. To correct the misperceptions and myths about modern contraceptives too. [ABSTRACT FROM AUTHOR]