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Background: Stunting is a major public health concern, particularly in low and middle-income countries. Globally, nearly 149 million under-five children are suffering from stunting. Despite it can occur in all age groups, the impact is more severe among children age less than 24 months as this period is critical time of very rapid growth and development. Therefore, this review aimed to determine the pooled prevalence and determinants of stunting among children during this critical period in Ethiopia. Methods: The literature search was conducted using international electronic data bases (pumed, Google scholar, CINHAL, Hinari, open Google) and the hand search of reference lists of eligible articles. The presence of heterogeneity between studies was evaluated using Cochrane Q-test and I2 test statistics and sensitivity analysis was also checked. Small study effect was checked through graphical and statistical test. Sub-group analysis was performed to handle heterogeneity. Results: This study included 14 studies with a total sample size of 8,056 children. The overall pooled estimate of stunting was 35.01(95% CI: 24.73–45.28, I2 = 98.98%) in the country with the highest prevalence in Amhara region. Increased Child's age (OR = 3.83; 95% CI: 2.47–5.18, I2 = 97.76%), no maternal education (OR = 2.90; 95%CI: 1.59–4.20, I2 = 89.73%), no maternal postnatal follow up (OR = 1.81; 95% CI:1.51–2.10) less than four food diversity of the child (OR = 2.24;95%CI; 1.94–2.55,I2 = 21.55%), low maternal body mass index, failure to colostrum and exclusive breast feeding, two and more under five children in the household and poor wealth index of the family were significant factors of stunting. Conclusion and recommendations: The pooled prevalence of stunting among children during their critical time is high. Increased Child's age, no maternal education and no maternal postnatal follow up, less than four food diversity of the child, low maternal body mass index, failure to colostrum and exclusive breast feeding, two and more under five children in the household and poor wealth index of the family were determinants of stunting. Therefore, providing continuous maternal postnatal follow up, increase awareness of mothers on importance of colostrum and exclusive breast feeding, feeding of children the recommended variety of foods and at large to improve the wealth status of the households are crucial interventions to meet national and international targets of zero stunting in children less than 2 years. [ABSTRACT FROM AUTHOR]

Background: As part of a strategy to reduce maternal and perinatal mortality, Ethiopia's government has made a significant effort to expand the number of Maternity Waiting Homes (MWHs). However, worldwide there is a substantial regional variation in pregnant women's intention to use MWHs. Therefore, the aim of this study is to assess pregnant women's intention to use maternity waiting home and its associated factors in the rural district of Hadiya Zone, Southern Ethiopia. Methods: This was a cross-sectional study carried out on 385 pregnant women from March 1–28, 2020. A systematic random sampling technique was used to recruit the study participants. SPSS software (version 24.0) was used to enter and analyze the data. Bivariate and multivariate logistic regression analyses were used to determine an association between each independent and dependent variables. Odds ratio with their 95% confidence intervals was computed to ascertain the existence and strength of an association, and statistical significance was affirmed at a p-value of < 0.05. Results: The prevalence of pregnant women's intension to use MWHs was observed to be 55.6%. A poor wealth status (AOR = 2.52; 95% CI:1.05–6.05), having a previous history of institutional delivery (AOR = 4.78; 95% CI:1.16–9.64), attending four or more antenatal care visits (AOR = 3.34; 95%CI:1.35–8.29), having obstetric complications during previous pregnancy (AOR = 3.76; 95% CI:1.45–9.77), and having favourable attitude towards MWHs (AOR = 13.51; 95% CI: 5.85–9.54) had a significant association with an intention to use MWHs. Conclusions: According to the findings of this study, more than half of pregnant women have been intended to use MWHs. Therefore, boosting the uptake of the antenatal care visit, raising awareness about the risk and consequences of obstetric complications, and strengthening behavioral modification strategies is very crucial to increase pregnant women's intention to use MWHs. [ABSTRACT FROM AUTHOR]

Introduction: Multi-drug resistant tuberculosis has impeded tuberculosis prevention and control due to its low treatment efficiency and prolonged infectious periods. Early culture conversion status has long been used as a predictor of good treatment outcomes and an important infection control metric, as culture-negative patients are less likely to spread tuberculosis. There is also evidence that suggests that delayed sputum conversion is linked to negative outcomes. Therefore, this study was aimed at developing a nomogram to predict the risk of late culture conversion in patients with multi-drug resistant tuberculosis using readily available predictors. Objective: The objective of this study was to develop and validate a risk prediction nomogram for the prediction of late culture conversion among multi-drug resistant tuberculosis patients in North-West Ethiopia. Methods: Multi-drug resistant tuberculosis data from the University of Gondar and the Debre Markos referral hospitals have been used and a total of 316 patients were involved. The analysis was carried out using STATA version 16 and R version 4.0.5 statistical software. Based on the binomial logistic regression model, a validated simplified risk prediction model (nomogram) was built, and its performance was evaluated by assessing its discriminatory power and calibration. Finally, decision curve analysis (DCA) was used to assess the generated model's clinical and public health impact. Results: Registration group, HIV co-infection, baseline BMI, baseline sputum smear grade, and radiological abnormalities were prognostic determinants used in the construction of the nomogram. The model has a discriminating power of 0.725 (95% CI: 0.669, 0.781) and a P-value of 0.665 in the calibration test. It was internally validated using the bootstrapping method, and it was found to perform similarly to the model developed on the entire dataset. The decision curve analysis revealed that the model has better clinical and public health impact than other strategies specified. Conclusion: The developed nomogram, which has a satisfactory level of accuracy and good calibration, can be utilized to predict late culture conversion in MDR-TB patients. The model has been found to be useful in clinical practice and is clinically interpretable. [ABSTRACT FROM AUTHOR]

Background: Esophageal atresia is an upper gastrointestinal tract developmental abnormality in which the upper and lower esophagus do not connect. Esophageal atresia has a higher incidence of death in sub-Saharan Africa, ranging from 30% to 80%. In Ethiopia, infants with esophageal atresia had a higher mortality rate. The assessment of time to death and predictors of esophageal atresia can help to reduce newborn mortality. Objective: This study was aimed to investigate the time to death and predictors of neonates with esophageal atresia admitted to Tikur Anbessa Specialized Hospital, Ethiopia. Methods: An institutional-based retrospective follow-up study was conducted among 225 neonates diagnosed with esophageal atresia. The median survival time, Kaplan–Meier failure estimation curve, and Log rank test were computed. Bivariable and multivariable Cox regression hazards models were fitted to identify the predictors of time to death. Hazard ratio with a 95% confidence interval was calculated and p-values < 0.05 were considered statistically significant. Results: In the study, the incidence density rate of neonates diagnosed with esophageal atresia was 5.5 (95% CI, 4.7– 6.4) per 100-neonates day. The median time to death was 11 days (95% confidence interval (CI), 8.92– 13.08). Birth weight < 2500 g (adjusted hazard ratio (AHR)=1.49, 95% CI, 1.02 − 2.21), having sepsis (AHR=1.67,95% CI, 1.15– 2.44), being malnourished (AHR = 1.61, 95% CI, 1.03 − 2.58), esophageal atretic neonates without surgery (AHR = 3.72, 95% CI, 1.34– 10.38), diagnosis time at > 48 hours of admission (AHR = 1.48, 95% CI, 1.01– 2.15) and being dehydrated (AHR = 2.38, 95% CI, 1.63– 3.46) were significant predictors of time to death among esophageal atretic neonates. Conclusion: The findings in this study highlighted the necessity of early diagnosis, proper comorbidity treatment, and timely surgical intervention to reduce infant deaths due to esophageal atresia. [ABSTRACT FROM AUTHOR]

Background: In the mid-1990s, the development of combination antiretroviral therapy converted HIV infection into a chronic condition, with newly diagnosed patients now living longer than the general population. HIV affects both the central and peripheral nerve systems, resulting in a variety of clinical problems, including peripheral neuropathy, which is a common neurological consequence. Despite this, there is a scarcity of data on the extent of peripheral sensory neuropathy and its underlying factors in Ethiopia, necessitating this study. Objective: The primary goal of this study is to assess the degree of peripheral sensory neuropathy and its related factors among HIV/AIDS clients on follow up at public health institutions in Northwest Ethiopia. Methodology: Institution based cross-sectional study was conducted from November 1 to 30 December 2020 at selected south Gondar zone public health institutions ART clinic. Multistage sampling technique was used to select the study participants. Standardized Questioner adapted from other study was used to collect the data. Moreover, Brief Peripheral Neuropathy Screening tool (BPNS) was used to assess peripheral sensory neuropathy. The data were entered with epi-data manager version 4.4 and analyzed using STATA version 16. Result: A total of 555 adult PLWHIV agreed to participate in the study, resulting in a response rate of 96.8%. The prevalence of Peripheral sensory neuropathy was 32.25, 95% CI (28.28, 36.26). The participant's age, DM comorbidity, viral load level, and disease clinical stage were all found to have a statistically significant association with peripheral sensory neuropathy. Conclusion: Peripheral sensory neuropathy was incredibly common. Accordingly, peripheral sensory neuropathy was found considerably associated with age, viral load level, stage of the disease, and DM comorbidity. It is vital to integrate routine peripheral sensory neuropathy screening strategies for clients who are on ART follow up for prevention and early identification of the problem. [ABSTRACT FROM AUTHOR]

Background: According to the World Health Organization, viral diseases continue to emerge and represent a serious issue for public health. The elderly and those with underlying chronic diseases are more likely to become severe cases. Our study sets out to present in-depth exploration and analyses of the community's risk perception and barriers to the practice of COVID-19 prevention measures in South Gondar Zone, Northwest Ethiopia. Methods: A qualitative study was done in three districts of South Gondar Zone. Community key informants and health extension workers were selected purposely for in-depth interviews and focus group discussion. The interviews were conducted by maintaining WHO recommendations for social distancing and use of appropriate personal protective equipment. The sample size for the study depended on the theoretical saturation of the data at the time of data collection. The qualitative data generated from in-depth interviews and focus group discussions was transcribed verbatim and translated into English language and thematically analyzed using open code software version 4.02. Results: Three main themes and five categories emerged from the narrations of the participants regarding the perceived barriers for the practice of COVID-19 prevention measures. A total of 9 community key informants (5 women development armies (HDA), 2 health extension workers (HEW), and 2 religious leaders participated in the in-depth interview, while two focus group discussions (7 participants in each round) were conducted among purposely selected community members. The age of the participants ranged from 24 to 70 years with the median age of 48 years. The major identified barriers for practicing COVID-19 prevention measures were the presence of strong cultural and religious practices, perceiving that the disease does not affect the young, misinformation about the disease, and lack of trust in the prevention measures. Conclusions: Socio-cultural, religious, and economic related barriers were identified from the participant's narratives for the practice of COVID-19 prevention measures in south Gondar Zone. Our findings suggest the need to strengthen community awareness and education programs about the prevention measures of COVID-19 and increase diagnostic facilities with strong community-based surveillance to control the transmission of the pandemic. [ABSTRACT FROM AUTHOR]

The Ethiopian great famine was one of the severe forms of global famines ever documented in Africa as well as in the recent history of the world. Earlier famine studies, as natural experiments, had tested the association between prenatal famine exposure and the metabolic syndrome and reported heterogeneous findings. Hence, this study aimed at evaluating the effects of prenatal exposure to the 1983–1985 Ethiopian great famine on the metabolic syndrome in adults. Self-reported birth date and age of the study subjects were used to classify the status of famine exposure. The International Diabetes Federation criterion was used to assess the metabolic syndrome. Multivariable logistic regression models were fitted to examine relationship between prenatal famine exposure and the metabolic syndrome. The findings showed that, adjusted for covariates, adults who had prenatal exposure to famine were 2·94 times more likely to develop the metabolic syndrome compared with non-exposed groups (adjusted OR (AOR) 2·94, 95 % CI 1·66, 5·27). More specifically, famine exposure during prenatal life was associated with increased waist circumference (AOR 2·27 cm, 95 % CI 0·28, 4·26), diastolic blood pressure (AOR 2·47 mmHg, 95 % CI 0·84, 4·11), TAG (AOR 0·20 mmol/l, 95 % CI 0·10, 0·28) and fasting blood glucose (AOR 0·24 mmol/l, 95 % CI 0·04, 0·43) compared with the control groups. Higher proportion of the metabolic syndrome, risky anthropometric and dyslipidaemic parameters were observed among exposed groups. This finding adds further evidence on fetal origin of adult diseases hypothesis. The finding may imply that one potential means of preventing adulthood metabolic syndrome is to optimise maternal nutrition during pregnancy. [ABSTRACT FROM AUTHOR]

Background: Blood donation has remained a challenge in developing countries, like Ethiopia. In Ethiopia there is a high reliance on family surrogate and waged blood donors which carries an attendant increased risk of transfusion transmissible infection. Health workers are expected to practice blood donation so as to create a good image to the public. A study on blood donation behavior may improve successful implementation of the blood donation programs. Methods: An institution based cross-sectional study was deployed from January to June 2015. An aggregate of 427 health workers were included in the study by using simple random sampling technique. Data were collected by using pre tested and structured questionnaire via self-administrated method. Descriptive and summary statistics were employed. Bivariate and multiple logistic regressions were computed. Odds ratios and their 95% confidence intervals were calculated to determine the level of significance. Results: A total of 427 participants were included in the final analysis (response rate = 100%). Among these participants, 33.2% of them practice blood donation. Age above 25 years [AOR = 1.8 (95% CI 1.1, 3.0)], health professionals' knowledge of blood donation [AOR = 1.9 (95% CI 1.1, 3.1)], health professionals' attitude towards blood donation [AOR = 3.0, 95% CI 1. 8, 4.9)], and the presence of family members or relatives who received blood [AOR = 5.4, 95% CI 3.7, 8.7)] were significantly and independently associated with blood donation behavior of health professionals. Conclusions: Blood donation practice of health professionals in this study was found to be low as compared to other studies conducted in developing countries. Health professionals' knowledge, attitude, age and the presence of family members or relatives who received blood before were independently associated with blood donation practice. Thus, awareness has to be created for health professionals to improve blood donation practices. [ABSTRACT FROM AUTHOR]

Background Poor adherence to antiretroviral therapy negatively affects the suppression of viral replication. It increases risks of drug resistance, treatment failure, Acquired Immuno Deficiency Syndrome (AIDS)-related morbidity and mortality among children. This study assessed the level of adherence to antiretroviral therapy and its associated factors among children at hospitals in South Wollo Zone, Northeast Ethiopia. Methods An institution-based cross-sectional study was conducted among Human Immunodeficiency Virus (HIV)-infected children in April 2013. A total of 464 children who were taking Antiretroviral Therapy (ART) in the hospitals were included. Data were collected using pretested and structured questionnaires using a face-to-face interview method. Descriptive and summary statistics were employed. Bivariate and multiple logistic regressions were computed. Odds ratios and their 95% confidence intervals were computed to determine the level of significance. Results Of the 464 study samples, 440 children with their caregivers were included in the final analysis. A total of 78.6% of the caregivers reported that their children were adherent to antiretroviral therapy in the month prior to the interview. Caregivers' knowledge about antiretroviral treatment [AOR = 2.72(95%CI: 1.82, 5.39)], no current substance use of the caregivers [Adjusted Odds Ratio (AOR) = 2.21(95% Confidence Interval (CI): 1.34, 7.13)], proximity to the health care facility [AOR = 2.31(95%CI: 1.94, 4.63)], if the child knows HIV-positive status[AOR = 3.47(95%CI: 2.10, 6.81)] and caregiver's educational status [AOR = 0.59(95%CI: 0.21, 0.82)] were significantly and independently associated with adherence of children to antiretroviral therapy. Conclusion Adherence of antiretroviral therapy in this study was comparable to other studies conducted in developing countries. Caregiver's knowledge about antiretroviral therapy, no current use of substances, close proximity to health facilities, and letting child's know his/her HIV status improves adherence to antiretroviral therapy. Health care providers should educate caregivers about antiretroviral therapy and encourage HIV positive status disclosure to the child. [ABSTRACT FROM AUTHOR]

Objective: Undernutrition contributes to decreased physical and cognitive functional status, higher healthcare consumption, premature institutionalisation and increased mortality. So, the objective of this study was to determine the pooled prevalence and factors associated with undernutrition among older adults in Ethiopia., Design: Systematic review and meta-analysis was used. Articles that presented original data on undernutrition using body mass index (BMI) were included. We made an inclusive literature search from PubMed, Medline and Google Scholar. The I 2 test was used to examine the heterogeneity of the studies considered in this meta-analysis. Stata software V.14 and METANDI command were used., Setting: Studies conducted in Ethiopia were included., Participants: Eight independent studies were eligible and enrolled for final analysis., Outcome: Prevalence and determinants of undernutrition. A selection of publications, data extraction and reported results for the review was designed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines., Results: A total of eight unique studies were enrolled for final analysis. The pooled prevalence of undernutrition was 20.53% (95% CI 17.39% to 23.67%). The study revealed that males had lesser odds of being undernutrition with AOR 0.17 (95% CI 0.15 to 0.20). Older adults in the age range of 65-74 years were less likely to be undernourished as compared with those whose age was above 85 years with Adjusted Odds Ratio (AOR) 022 (95% CI 0.22 to 0.25). Older adults who were depressed had higher odds of undernutrition as compared with their counterparts with AOR 1.27 (95% CI 1.19 to 1.37). However, older adults from households with poor wealth indexes were two times more likely to be undernourished as compared with those who were from rich households., Conclusion: The burden of undernutrition in Ethiopia is significant. The limitation of the current study was that all included studies were observational, mainly cross-sectional., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Iodine deficiency disorder (IDD) is a major public health problem in Ethiopia. The availability of adequate iodized dietary salt at the household level is immensely important. Hence, this review aimed to estimate the pooled prevalence of adequate iodine concentration level of iodized dietary salt at the household level and its associated factors in Ethiopia., Methods: We searched the literature using electronic databases (PubMed/Medline, Google Scholar, Science Direct, and Embase) and gray literature from January 9, 2022, to February 25, 2022. The rapid test kit was used to measure the adequacy of iodine level of dietary salt. The quality of studies was assessed using Joanna Briggs Institute critical appraisal tool. Heterogeneity between studies was checked using I2 test statistics and publication bias was checked using funnel plot and Egger's statistical test at a 5% significance level. A random-effects model was employed to estimate the pooled prevalence of the outcome variable and its determinants in Ethiopia., Results: The search identified 149 studies of which 18 studies were included with a total of 10,556 participants. The pooled prevalence of adequate iodine levels of iodized salt in Ethiopia was 44.37% (95% CI: 35.85-52.88). Women who had formal education (adjusted odds ratio (AOR) = 1.99 (95% CI: 1.47-2.48)), good knowledge of women (AOR = 2.14, 95% CI: 1.36-3.36), packed iodized salt (AOR = 3.85 (95% CI: 1.88-7.87)) and storage of iodized salt at home for less than 2 months (AOR = 2.66 (95% CI: 2.11-3.35) were the significant factors., Conclusion: This review suggests that the pooled prevalence of adequate iodine levels was low. Our finding highlights the need for considering the educational status, knowledge, and duration of salt storage to enhance the prevalence of adequate levels of iodized salt at the national level.

Objectives: The objectives of this study were to assess the prevalence and determinants of undernutrition among older adults aged 65 years in the south Gondar Zone, Ethiopia, in 2020., Design: A community-based cross-sectional study., Setting: The study was conducted from 1 October to 15 December 2020, in the South Gondar Zone, Ethiopia. Study participants were selected by systematic random sampling. A pretested and structured questionnaire adapted from different literature was used to collect data. Anthropometric measurements were taken following the standard procedure., Participants: A total of 290 older adults aged greater than or equal to 65 years of age were included in the study., Data Analysis: Descriptive and summary statistics were employed. Multiple logistic regression was fitted to identify determinants of undernutrition. ORs and their 95% CIs were computed to determine the level of significance., Outcome Measures: Undernutrition was assessed by using Body Mass Index and Mini Nutritional Assessment (MNA) tool., Results: The prevalence of undernutrition was 27.6% (95% CI 22.4 to 32.8), and 2.1% (95% CI 0.7 to 3.8) of the study participants were overweight. Based on the MNA tool, 29.7% (95% CI 24.5 to 35.2) of the study participants were undernourished and 61.7% (95% CI 55.5 to 67.2) were at risk of undernourishment. Rural residence adjusted OR (aOR)=10.3 (95% CI 3.6 to 29.4), inability to read and write aOR=3.5 (95% CI 1.6 to 7.6), decrease in food intake aOR=13.5 (95% CI 6.1 to 29.5) and household monthly income of less than US$35.6 aOR=4.3 (95% CI 1.9 to 9.4) were significantly and independently associated with undernutrition., Conclusion: The level of undernutrition among older adults in the study area was high, making it an important public health burden. The determinants of undernutrition were a place of residence, educational status, food intake and monthly income., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Objectives: To investigate the association between early life famine exposure and cognitive function in adults., Design: Historical cohort study SETTING: North Wollo Zone, Northeast Ethiopia., Participants: We recruited 1047 adult men and women aged 30-38 years who had history of early life exposure to Ethiopian great famine. Based on self-reported age and birth date, participants were categorised into famine exposed in early life (prenatal/postnatal) and non-exposed groups., Outcome Measures: The primary outcome measure of this study was cognitive function in adults after early life exposure to famine. Cognitive function was measured using Montreal Cognitive Assessment-basic. Associations between exposure and outcome variables were examined by linear regression analysis models., Results: Adjusted for covariates, early life exposure to famine showed 1.29 (β=-1.29; 95% CI -2.16 to -0.52) points lower cognitive function score compared with non-exposed. Based on subanalysis for timing of famine exposure, postnatal exposure to famine resulted in 2.26 (β=-2.26; 95% CI -3.12 to -1.36) points lower cognitive function score compared with non-exposed groups. Prenatal famine exposure had 1.26 (β=-1.26; 95% CI -2.35 to 0.94) points lower cognitive function score although not statistically significant., Conclusions: Famine exposure in early life was associated with cognitive functions in adults. While the overall findings highlight the importance of optimal nutrition in early life for brain growth and development, the association observed between postnatal famine exposure and adult cognitive function may indicate the relative importance of learning and experience during early childhood for optimal brain development after birth. Further studies are needed to elucidate the potential mechanism behind this association., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)