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Zewdu Bishaw Aynalem,1 Melsew Dagne Abate,1 Fentahun Meseret,2 Ahmed Nuru Muhamed,3 Gebremeskel Kibret Abebe,4 Abebaw Bires Adal,1 Adam Wondmieneh,1 Atsedemariam Andualem,1 Sewunet Ademe,1 Haile Workye,1 Bekalu Bewket,1 Getachew Amare Beyene,5 Tamiru Alene,6 Tilahun Degu Tsega7 1Department of Nursing, College of Medicine and Health Sciences, Injibara University, Injibara, Ethiopia; 2Department of Pediatrics and Child Health Nursing, School of Nursing and Midwifery, College of Health and Medical Science, Haramaya University, Harar, Ethiopia; 3Department of Nursing, College of Medicine and Health Science, Wolkite University, Wolkite, Ethiopia; 4Department of Emergency and Critical Care Nursing, School of Nursing, College of Health Sciences, Woldia University, Woldia, Ethiopia; 5Department of Midwifery, College of Medicine and Health Sciences, Injibara University, Injibara, Ethiopia; 6Department of Pediatrics and Child Health Nursing, College of Medicine and Health Sciences, Injibara University, Injibara, Ethiopia; 7Department of Public Health, College of Medicine and Health Sciences, Injibara University, Injibara, EthiopiaCorrespondence: Zewdu Bishaw Aynalem, Department of Nursing, College of Medicine and Health Sciences, Injibara University, Injibara, Ethiopia, Tel +251918375722, Email Zewdu.bishaw@inu.edu.et; zest7@yahoo.comBackground: Fighting health threats, especially the rise of new infectious diseases, is one of the main responsibilities of healthcare workers. However, their knowledge and attitudes toward monkeypox have not yet been assessed. Therefore, this study aimed to assess the knowledge, attitude, and factors associated with monkeypox infection among healthcare workers at Injibara General Hospital, Northwest Ethiopia.Methods: Institution-based cross-sectional study was conducted from December 1– 30, 2022. Data were collected using a structured self-administered questionnaire. A simple random sampling technique was used to select study participants. Descriptive statistics and multivariable logistic regression analyses were computed. The degree of association was interpreted using an odds ratio with a 95% confidence interval and a p-value < 0.05.Results: Among the 200 healthcare workers who participated, 38.5% (95% CI: 32.5%– 45%) and 62% (95% CI: 55– 68.5%) had good knowledge and positive attitudes regarding monkeypox respectively. Having a master’s degree or above (AOR = 11.25: 95% CI: 2.03– 62.33), being vaccinated against COVID-19 (AOR = 2.60: 95% CI: 1.37– 4.94), and having access to information about monkeypox (AOR = 3.37: 95% CI: 1.33– 8.50) were the factors associated with good knowledge. Furthermore, a positive attitude was significantly associated with being 30 years of age or older (AOR = 2.95: 95% CI: 1.55– 5.60) and having access to information about monkeypox (AOR = 4.14: 95% CI: 2.06, 8.30).Conclusion: Both good knowledge and positive attitudes were relatively low among healthcare workers. Factors such as age, education level, COVID-19 vaccination status, and access to information about monkeypox were significantly associated with the knowledge and attitude of healthcare workers. To enhance the knowledge and attitude of healthcare workers, hospitals should consider offering educational upgrades, hosting educational events like seminars, conferences, webinars, and campaigns, and ensuring comprehensive coverage of the topic in medical curricula.Keywords: monkeypox, mpox, knowledge, attitude, associated factors, healthcare worker, Ethiopia, Injibara

Background: Pain management is a crucial component of patient care that promotes relaxation, lowers complications, improves quality of life, and shortens hospital stays. Several studies assessed the nurses' pain management practices in Ethiopia. However, the findings of these studies are highly variable and inconsistent. Therefore, the study aims to determine the overall prevalence of pain management practice and associated factors among nurses working in Ethiopia., Method: The study included all observational quantitative research articles conducted among nurses in Ethiopia. We used Google Scholar, PubMed, Cochrane Library, and Scopus searching databases. The Newcastle-Ottawa Scale was used to check the study quality. Then I2 statistics and Cochran's Q test were used to evaluate heterogeneity. The Funnel, Egger's test, and non-parametric trim and fill effect tests were used to check publication bias by using a random effect model. Finally, we conducted subgroup analysis and sensitivity tests to evaluate statistical heterogeneity and the presence or absence of any influential study., Result: In the final analysis, we included eighteen studies, and 4,213 nurses participated. The overall pooled prevalence of nurses with good pain management practice was 43.79% (95% CI: 38.52, 49.06%). In-service training AOR; 95% CI 3.21 (1.87, 4.54), good knowledge AOR; 95% CI 2.44 (1.78, 3.09), positive attitudes AOR; 95% CI 2.84 (1.24, 4.44), and pain management guidelines in health facilities AOR; 95% CI 3.46 (1.48, 5.44) were the significant associated factors with pain management practice among nurses in Ethiopia., Conclusion: This study found that over half of Ethiopian nurses had poor pain management practices. Knowledge, attitude, training, and pain management guidelines in health facilities were significant factors. Therefore, health managers and stakeholders should prioritize pain management awareness, attitudes, availability of guidelines, and in-service training to improve patient care and outcomes., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2025 Munie et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Introduction: Evidence suggested a link between early adversity and mental health problems. However, it is unclear how much adverse childhood experiences (ACEs) contribute to mental health problems because researchers have produced inconsistent findings. Therefore, the objective of this umbrella review was to combine the contradictory data regarding the effect of ACEs on the development of mental health problems later in life in the global context., Methods: PubMed, Embase, Scopus, Web of Sciences, Cochrane Database of Systematic Reviews, Scopus, and Google Scholar which reported the effect of ACEs on the development of mental health problems was searched. The quality of the included studies was assessed using the Assessment of Multiple Systematic Reviews (AMSTAR). A weighted inverse variance random-effects model was applied to find the pooled estimates. The subgroup analysis, heterogeneity, publication bias, and sensitivity analysis were also assessed., Results: Forty-three SRM with 14,707,614 study participants were included. The pooled effect of ACEs on the development of mental health problems later in life in the global context is found to be (AOR = 1.66 [1.46, 1.87]). Subgroup analysis based on country revealed (AOR = 1.67 [1.23, 2.11]) in UK, (AOR = 0.61 [0.41, 0.81]) in Canada, (AOR = 1.55 [1.40, 1.69]) in Brazil, (AOR = 5.65 [4.12, 7.18]) in Ethiopia, (AOR = 1.92 [1.45, 2.38]) in USA, (AOR = 2.30 [1.89, 2.72]) in Australia, and (AOR = 1.66 [1.46, 1.87]) in Ireland. While subgroup analysis based on types of adverse childhood adverse experience: domestic violence (AOR = 4.13 [1.96, 6.30]), maltreatment (AOR = 1.5 [0.79, 2.21]), physical abuse (AOR = 1.56 [1.43, 1.63]), sexual abuse (AOR = 2.07 [1.63, 2.51]), child abuse (AOR = 5.66 [4.12, 7.18]), parental mental health problem (AOR = 1.73 [1.39, 2.08]), bullying (AOR = 1.99 [1.69, 2.29], neglect (AOR = 2.11 [1.53, 2.69]), and parental divorce (AOR = 1.66 [1.46, 1.87]). Based on the type of mental health problem, the pooled effect size is 1.87 (1.45, 2.30) for depression and 1.67 (1.22, 2.13) for anxiety., Conclusion: This umbrella review revealed that ACE is significantly associated (with 66% increased risk) with anxiety and depression later in life in a global context. This association is most noticeable when one is subjected to domestic violence, maltreatment, physical abuse, sexual abuse, child abuse, parental mental health problems, bullying, neglect, and parental divorce. Childhood periods are a critical window of opportunity for reducing the risk of developing mental illness in the future and for implementing intervention measures. Preventing childhood maltreatment and addressing psychiatric risk factors can prevent psychopathology. Longitudinal studies are needed to optimize healthcare responses to ACEs. Increased awareness and public health interventions are needed to prevent childhood adversity and prevent mental problems among these victims. To optimize healthcare responses to unfavorable outcomes of childhood adversities, longitudinal and intervention research findings, more public health initiatives, and awareness are required., (© 2024 S. Karger AG, Basel.)

Introduction: Peripheral neuropathy is a nerve disorder that causes pain, numbness, and tingling in different parts of the body. It is a major and common clinical problem associated with several chemotherapeutic medications frequently used in cancer treatment, with prevalence rates ranging from 19% to 85%. To the best of the authors' knowledge, there is a lack of data on the magnitude and determinants of chemotherapy-induced peripheral neuropathy in Ethiopia., Objective: This study aimed to assess the magnitude and associated factors of chemotherapy-induced peripheral neuropathy among adult cancer patients undergoing chemotherapy in northwest Ethiopia oncology centers in 2022., Method: An institutional-based cross-sectional study was conducted on 406 eligible adult cancer patients undergoing chemotherapy in northwest Ethiopia oncology centers, between May and July 2022., Results: Out of 406 adult cancer patients included in the study, 54.4% had peripheral neuropathy. The stage of cancer (AOR = 4.36 [95% CI: 1.76; 10.8]), comorbidity (AOR = 2.74 [95% CI: 1.28; 5.83]), drug regimen (AOR = 2.99 [95% CI: 1.36; 6.54]), and cycle of therapy (AOR = 4.00 [CI: 1.67; 9.65]) were significantly associated with the magnitude of chemotherapy-induced peripheral neuropathy., Conclusion: Chemotherapy-induced peripheral neuropathy is a common adverse event among Ethiopian cancer patients treated with various chemotherapeutic drugs. Therefore, it is necessary to establish more effective diagnostic methods and incorporate validated assessment tools, such as the European Organization for Research and Treatment of Cancer tools, either alone or in combination with other clinical instruments, into the routine evaluation of all patients receiving chemotherapeutic drug., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Habtie, Abate, Abebe, Wolie, Alamaw and Mitiku.)

Background: Sub-Saharan Africa faces high neonatal and maternal mortality rates due to limited access to skilled healthcare during delivery. This study aims to improve the classification of health facilities and home deliveries using advanced machine learning techniques and to explore factors influencing women's choices of delivery locations in East Africa., Method: The study focused on 86,009 childbearing women in East Africa. A comparative analysis of 12 advanced machine learning algorithms was conducted, utilizing various data balancing techniques and hyperparameter optimization methods to enhance model performance., Result: The prevalence of health facility delivery in East Africa was found to be 83.71%. The findings showed that the support vector machine (SVM) algorithm and CatBoost performed best in predicting the place of delivery, in which both of those algorithms scored an accuracy of 95% and an AUC of 0.98 after optimized with Bayesian optimization tuning and insignificant difference between them in all comprehensive analysis of metrics performance. Factors associated with facility-based deliveries were identified using association rule mining, including parental education levels, timing of initial antenatal care (ANC) check-ups, wealth status, marital status, mobile phone ownership, religious affiliation, media accessibility, and birth order., Conclusion: This study underscores the vital role of machine learning algorithms in predicting health facility deliveries. A slight decline in facility deliveries from previous reports highlights the urgent need for targeted interventions to meet Sustainable Development Goals (SDGs), particularly in maternal health. The study recommends promoting facility-based deliveries. These include raising awareness about skilled birth attendance, encouraging early ANC check-up, addressing financial barriers through targeted support programs, implementing culturally sensitive interventions, utilizing media campaigns, and mobile health initiatives. Design specific interventions tailored to the birth order of the child, recognizing that mothers may have different informational needs depending on whether it is their first or subsequent delivery. Furthermore, we recommended researchers to explore a variety of techniques and validate findings using more recent data., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Ngusie, Tesfa, Taddese, Enyew, Alene, Abebe, Walle and Zemariam.)

There is a pressing need for healthy diets guided by environmental and nutritional targets. Plant-based proteins have emerged as a recent and rapidly growing trend in response to the challenge of sustainable and healthy food systems. While plant-based protein foods are widely promoted as sustainable alternatives, shifting beliefs and attitudes about conventional protein sources present an ongoing challenge. The study examined Canadians' intentions to transition to plant-based protein diets, partially or entirely. A nationally representative survey was conducted among Canadian consumers to achieve our research objective. The survey was administered online using the Qualtrics platform by a market research firm and yielded valid responses from over 1800 participants. The Theory of Planned Behavior (TPB) constructs-attitudes, self-efficacy, and perceived availability-explained only 12% of the variation in intentions toward plant-based protein foods, while sustainability and ethical concerns accounted for 10% of the variation in dietary patterns. Meat attachment negatively impacted changes in dietary patterns, explaining 11% of the intention variation. Additionally, individual past behavior accounted for 7% of intentions toward plant-based proteins. Demographic factors, such as gender and education, strongly and positively predicted purchase intentions, while contextual factors, such as residing in rural neighborhoods and being from Atlantic Canada, showed a strong negative association with intentions toward plant-based protein diets. The findings underscore the multifaceted nature of individuals' intentions toward plant-based protein diets and emphasize the significance of considering cognitive, social, emotional, and past behavioral factors, alongside sustainability values and messaging, to transition to a more plant-based protein diet. This approach should carefully balance individuals' emotional connection and the perception of meat as essential to their meals. Also, targeting interventions based on demographic characteristics, specifically gender, education, and residential neighborhood, can enhance changes in dietary protein sources. The findings contribute to the existing body of knowledge on consumer behavior and sustainable diets, guiding future research and policies informing the design of effective interventions to promote plant-based protein consumption and dietary changes., Competing Interests: The authors confirm that no identifiable competing financial interests or personal relationships that could have influenced the work presented in this study., (© 2024 The Author(s). Food Science & Nutrition published by Wiley Periodicals LLC.)

Background: Oxygen therapy is a life-saving intervention used in various healthcare settings to maintain adequate tissue oxygenation while minimizing cardiopulmonary work. Its effective and safe administration depends largely on the knowledge, attitudes, and practices of health professionals. However, there are no pooled studies that examined these skills in the context of Ethiopia. Therefore, this study aimed to assess the pooled prevalence of health professionals' knowledge, attitude, practice, and determinant factors about oxygen therapy in Ethiopia., Methods: The databases PubMed, Web of Science, Scopus, Hinari, Science Direct, African Journal of Online, and Google Scholar were used to search for published studies; Direct Google searches and institutional repositories were used to search for unpublished studies. Duplicate studies were eliminated with Endnote X8 and reported according to PRISMA guidelines. The quality of the included studies was assessed using the Joanna Briggs Institute critical appraisal checklist. A random-effects model was used to estimate the pooled prevalence of KAP among health professionals. Heterogeneity was assessed using Cochran's Q test and I2 statistics. Publication bias was checked by visual inspection of a funnel plot and Egger's regression test. STATA version 11 software was used for statistical analysis., Results: A total of 14 studies with 2,960 participants for knowledge and practice and 9 studies with 1,991 participants for attitude were used to estimate the pooled prevalence of KAP among health professionals. The pooled prevalence of good knowledge, positive attitude, and good practice regarding oxygen therapy were 52.13% (95% CI: 43.88, 60.39), 55.08% (95% CI: 50.80, 59.35%), and 48.94% (95% CI: 41.14, 56.74) respectively. Both good knowledge and positive attitude were affected by the availability of oxygen therapy guidelines, with adjusted odds ratios (AOR) of 6.11 (95% CI: 2.45, 15.22) and 2.17 (95% CI: 1.39, 3.39) respectively. Additionally, good knowledge (AOR: 4.31, 95% CI: 1.53, 12.11), training (AOR: 4.09, 95% CI: 2.04-8.20), and having an adequate oxygen supply and delivery system (AOR: 3.12, 95% CI: 1.92-5.07) were statistically associated with good practice., Conclusion and Recommendations: The national pooled prevalence of good knowledge, positive attitude, and good practice among health professionals was low. Therefore, thorough monitoring, supervision, and evaluation of their oxygen therapy is highly recommended for all stakeholders. Yet again, we strongly advise that the identified factors be improved by organizing training sessions, making oxygen therapy guidelines available, and maintaining an adequate oxygen supply system., Trial Registration: The review protocol was registered in the international prospective register of systematic reviews with registration number PROSPERO: CRD42023486036., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Aynalem et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Introduction: Attention-deficit hyperactivity disorder (ADHD) is a neuropsychiatric condition that affects children. Its magnitude varies by area, ranging from 0.2% to 26.8%. Even though there is debate, culture and geographical location may have little or no influence on the epidemiology of ADHD worldwide. Despite this variation, debate over the national prevalence and location of ADHD is unknown in Ethiopia. Therefore, this study aimed to assess the pooled prevalence of ADHD and its contributing factors among children., Methods: Electronic databases, including Google Scholar, PubMed, Scopus, EMBASE, Web of Science, ScienceDirect, and institutional repositories, were searched. The studies that covered the prevalence and/or risk factors of ADHD in children were included in the collection. The Joanna Briggs Institute quality rating tool was used to rate the quality of each study. The data were extracted using Microsoft Excel 2019, and the statistical analysis was performed using STATA 17.0. Using a random-effects model, we evaluated the combined prevalence of ADHD and associated factors. The Cochrane Q -test and I 2 test statistics were used to quantify the heterogeneity. Furthermore, publication bias was examined using funnel plot graphs and Egger's tests. A Galbraith plot was employed to illustrate outliers. Sensitivity analysis was also applied., Result: This study included a total of six articles with 4,338 participants. The pooled prevalence estimate of ADHD was 8.81% [95% confidence interval (CI), 4.52-13.11; I 2  = 96.95%; P  = 0.001]. Age 6-12 [adjusted odds ratio (AOR) = 3.51 (95% CI, 1.38-5.64), I 2  = 0%; P  = 0.001], being male [AOR = 1.94 (95% CI, 1.09-2.79), I 2  = 0%; P  = 0.001], and living with a single parent [AOR = 4.92 (95% CI, 1.24-861), I 2  = 0%; P  = 0.001] were significant variables., Conclusion and Recommendation: One out of every 12 children in Ethiopia suffers from ADHD. Living with a single parent, being male, and being between the ages of 6 and 12 were risk factors for ADHD. A nationwide study with a large sample size may be required to ascertain the true impact of ADHD. It may be crucial to improve school health services to identify ADHD early and lessen its long-term effects., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2024 Azmeraw, Temesgen, Kassaw, Zemariam, Kerebeh, Abebe, Alamaw and Abate.)

Background: Due to the high burden of mortality from acute communicable and non-communicable diseases, emergency department's mortality has become one of the major health indices in Ethiopia that should be evaluated regularly in every health institution. However, there are inconsistencies between studies, and there is no systematic review or meta-analysis study about the prevalence of mortality in the emergency department. Therefore, this study aimed to determine the pooled prevalence of mortality and identify its determinants in the emergency departments of Ethiopian hospitals., Methods: This systematic review was conducted according to the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and has been registered with PROSPERO. A structured search of databases (Medline/PubMed, Google Scholar, CINAHL, EMBASE, HINARI, and Web of Science) was undertaken. All observational studies reporting the prevalence of mortality of patients in emergency departments of Ethiopian hospitals, and published in English up to December 16, 2023, were considered for this review. Two reviewers independently assess the quality of the studies using the Joanna Briggs Institute (JBI) critical appraisal tool. A meta-analysis using a random-effects model was performed to estimate the pooled prevalence. The heterogeneity of studies was assessed using I 2 statistics, and to identify the possible causes of heterogeneity, subgroup analysis and meta-regression were used. Egger's test and funnel plots were used to assess publication bias. STATA version 17.0 software was used for all the statistical analyses. A p-value less than 0.05 was used to declare statistical significance., Results: A total of 1363 articles were retrieved through electronic search databases. Subsequently, eighteen studies comprised 21,582 study participants were included for analysis. The pooled prevalence of mortality among patients in the Emergency Department (ED) was 7.71% (95% CI: 3.62, 11.80). Regional subgroup analysis showed that the pooled prevalence of mortality was 16.7%, 12.89%, 10.28%, and 4.35% in Dire Dawa, Amhara, Oromia, and Addis Ababa, respectively. Moreover, subgroup analysis based on patients' age revealed that the pooled prevalence of mortality among adults and children was 8.23% (95% CI: 3.51, 12.94) and 4.48% (95% CI: 2.88, 6.08), respectively. Being a rural resident (OR; 2.30, 95% CI: 1.48, 3.58), unconsciousness (OR; 3.86, 95% CI: 1.35, 11.04), comorbidity (OR; 2.82, 95% CI: 1.56, 5.09), and time to reach a nearby health facility (OR; 4.73, 95% CI: 2.19, 10.21) were determinants of mortality for patients in the emergency departments., Conclusion and Recommendations: This study found that the overall prevalence of mortality among patients in emergency departments of Ethiopian hospitals was high, which requires collaboration between all stakeholders to improve outcomes. Being a rural resident, unconsciousness, comorbidity, and time elapsed to reach health facilities were determinants of mortality. Improving pre-hospital care, training healthcare providers, early referral, and improving first-line management at referral hospitals will help to reduce the high mortality in our country., (© 2024. The Author(s).)

Cerebral palsy (CP) is the most common motor disability in childhood which causes a child's behavioral, feeding, and sleep difficulties. It remains a poorly studied health problem in Africa. The main aim of this study was assessing the pooled prevalence of Cerebral Palsy (CP) and its clinical characteristics in Africa context. Systematic review and meta-analysis were conducted using Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines to search articles from electronic databases (Cochrane library, Ovid platform) (Medline, Embase, and Emcare), Google Scholar, CINAHL, PubMed, Maternity and Infant Care Database (MIDIRS). The last search date was on 12/05/ 2023 G. C. A weighted inverse variance random-effects model was used to estimate the pooled estimates of cerebral palsy and its types. The subgroup analysis, publication bias and sensitivity analysis were done. Studies on prevalence and clinical characteristics of cerebral palsy were included. The primary and secondary outcomes were prevalence and clinical characteristics of cerebral palsy respectively. A total of 15 articles with (n = 498406 patients) were included for the final analysis. The pooled prevalence of cerebral palsy in Africa was found to be 3·34 (2·70, 3·98). The most common type is spastic cerebral palsy accounting 69·30% (66·76, 71·83) of all cases. The second one is quadriplegic cerebral palsy which was found to be 41·49% (33·16, 49·81). Ataxic cerebral palsy accounted 5·36% (3·22, 7·50). On the other hand, dyskinetic cerebral palsy was found to be 10.88% (6·26, 15·49). About 32·10% (19·25, 44.95) of cases were bilateral while 25·17% (16·84, 33·50) were unilateral. The incidence of cerebral palsy in Africa surpasses the reported rates in developed nations. Spastic and quadriplegic subtypes emerge as the most frequently observed. It is recommended to channel initiatives toward the strategic focus on preventive measures, early detection strategies, and comprehensive management protocols., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Abate et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Abstract: Introduction: The global demand for intensive care has risen, given its effectiveness in lowering mortality rates. Mechanical ventilation (MV) is integral to intensive care but introduces risks such as ventilator-associated complications. Ethiopia experiences a high intensive care unit (ICU) mortality rate. Objective: This systematic review and meta-analysis aim to comprehensively synthesize evidence on the mortality of adults undergoing MV in Ethiopia and identify associated factors. Methods: The study extensively searched databases and gray literature for research on MV outcomes, trends, and associated factors in adult ICUs. Adhering to the 2020 PRISMA checklist, a systematic review and meta-analysis sought to establish the mortality rate and key determinants among adult ICU patients on MV. The search incorporated keywords and MeSH terms, excluding studies with unsound methodologies or missing data. Data extraction, quality assessment, and analysis followed established protocols, including the JBI tool for methodological quality evaluation. STATA version 17.0 facilitated analysis, assessing heterogeneity, publication bias, and performing sensitivity and meta-regression analyses. Results: The pooled mortality rate among adult ICU patients undergoing MV was 48.61% (95% CI: 40.82, 56.40%). Significant mortality-contributing factors included medical diagnosis, Glasgow Coma Scale score, sepsis/septic shock, sedation use, multiple-organ dysfunction syndrome, and cardiovascular disease. Although some pooled odds ratios seemed insignificant, closer examination revealed significant associations in individual studies. Conclusion : The study underscores the urgent need for further research, improved ICU infrastructure, and healthcare personnel training in Ethiopia to enhance outcomes for mechanically ventilated patients. Identified factors offer valuable insights for targeted interventions, guiding tailored treatment strategies to reduce mortality. This study contributes to understanding mortality and associated factors in MV patients, informing initiatives to improve critical care outcomes in Ethiopia., Competing Interests: Author conflict of interest statement: The authors declare that there is no conflict of interest regarding the publication of this article, "Prevalence of Mortality and Associated Factors Among ICU-Admitted Adult Patients with Mechanical Ventilation in Ethiopia: A Systematic Review and Meta-Analysis." The research was conducted objectively, and the authors have no financial or personal relationships that could influence or bias the findings and conclusions presented in this manuscript. This work was carried out with the sole purpose of contributing to the scientific understanding of mortality and associated factors in mechanically ventilated patients in Ethiopian ICUs. The authors report no conflicts of interest., (Copyright © 2024 by the Shock Society.)

In developing countries, one-quarter of young women have suffered from anemia. However, the available studies in Ethiopia have been usually used the traditional stastical methods. Therefore, this study aimed to employ multiple machine learning algorithms to identify the most effective model for the prediction of anemia among youth girls in Ethiopia. A total of 5642 weighted samples of young girls from the 2016 Ethiopian Demographic and Health Survey dataset were utilized. The data underwent preprocessing, with 80% of the observations used for training the model and 20% for testing. Eight machine learning algorithms were employed to build and compare models. The model performance was assessed using evaluation metrics in Python software. Various data balancing techniques were applied, and the Boruta algorithm was used to select the most relevant features. Besides, association rule mining was conducted using the Apriori algorithm in R software. The random forest classifier with an AUC value of 82% outperformed in predicting anemia among all the tested classifiers. Region, poor wealth index, no formal education, unimproved toilet facility, rural residence, not used contraceptive method, religion, age, no media exposure, occupation, and having more than 5 family size were the top attributes to predict anemia. Association rule mining was identified the top seven best rules that most frequently associated with anemia. The random forest classifier is the best for predicting anemia. Therefore, making it potentially valuable as decision-support tools for the relevant stakeholders and giving emphasis for the identified predictors could be an important intervention to halt anemia among youth girls., (© 2024. The Author(s).)

Background: Postoperative mortality is one of the six surgical indicators identified by the Lancet Commission on Global Surgery for monitoring access to high-quality surgical care. This study aimed to assess the magnitude and associated factors of postoperative mortality among patients who underwent surgery in Ethiopia., Methods: This systematic review and meta-analysis were conducted based on the Preferred Reporting Items for Systematic Review and Meta-analysis guidelines. Ten studies were included in this Systematic review and meta-analysis. The risk of bias for each study was assessed using the Joanna Briggs Institute quality appraisal scale. Publication bias was checked using a funnel plot and Egger's regression test. Heterogeneity across studies was assessed by I 2 statistics. STATA version 17 software was used for analysis. A random effect model and the DerSimonian-Laird method of estimation was used to estimate the pooled magnitude of postoperative mortality. Odds ratios with 95% CIs were calculated to determine the associations of the identified factors with postoperative mortality., Results: The results revealed that the pooled magnitude of postoperative mortality among patients who underwent surgery in Ethiopia was 4.53% (95% CI :3.70-5.37). An American Society of Anesthesiologists score greater than or equal to III [adjusted odds ratio (AOR): 2.45, 95% CI: 2.02, 2.96], age older than or equal to 65 years (AOR: 3.03, 95% CI: 2.78, 3.31), and comorbidity (AOR: 3.28, 95% CI: 1.91, 5.63) were significantly associated with postoperative mortality., Conclusion and Recommendations: The pooled magnitude of postoperative mortality among patients who underwent surgery in Ethiopia was high. The presence of comorbidities, age older than 65 years, and ASA physical status greater than III were significantly associated with postoperative mortality. Therefore, the Ministry of Health and other concerned bodies should consider quality improvement processes., Competing Interests: The author declares no competing interest.Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article., (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.)

Background: Immunization estimated to prevent 2 to 3 million children deaths every year from vaccine preventable disease. In Ethiopia, limited and inconclusive studies have been conducted on immunization coverage so far. Therefore, this umbrella review was intended to estimate the pooled national immunization coverage and its associated factors among children age 12-23 months in Ethiopia., Methods: This umbrella review included five systematic reviews and meta-analyses through literature search from PubMed, Science direct, and web of science, CINHALE, and data bases specific to systematic reviews such as the Cochrane Database of Systematic Reviews and Prospero, the International Prospective Register of Systematic Reviews from May 1 to 30/ 2023. Only systematic reviews and meta-analyses published in English from inception to May 1, 2023, were included. The quality of each study was assessed using Assessment of Multiple Systematic Reviews. Data were extracted using Microsoft excel 2016 and analyzed using STATA 17.0 statistical software. Heterogeneity among studies was assessed using the Cochran Q statistics and I2 test. The pooled effect sizes were determined using pooled proportion for the full vaccination coverage and odds ratios for the associated factors with the corresponding 95% confidence interval were used to declare statically significance., Results: Five studies with 77,161 children aged 12-23 months were included. The overall pooled full vaccination coverage was 57.72% (95% CI 50.17, 65.28). Institutional delivery (OR: 2.12, 95% CI: 1.78-2.52), travel to vaccination site for <2 hours (OR: 2.43, 95%CI: 1.97-3.00), received at least one antenatal (ANC) visit (OR: 3.2, 95%CI: 2.46-4.1), good maternal knowledge of immunization (OR: 3.63, 95%CI: 2.82-4.67), being informed on immunization schedule (OR: 2.54, 95%CI: 2.02-3.2), living in urban areas (OR: 2, 95% CI: 1.54-2.6), and a household visit by health-care providers (HCP) during the postnatal period (OR: 2.23, 95%CI: 1.22-4.09) were the independent predictors of immunization coverage., Conclusion: This study showed the full immunization coverage in Ethiopia was lower compared to the WHO-recommended level. Besides, the current umbrella review identifies several factors that contribute to higher immunization coverage. These includes; institutional delivery, near to vaccination site, having ANC visit, being urban residence, household visited by HCP, having good knowledge and informed on immunization schedule. Thus, the government should intensify the growth of immunization services by emphasizing outreach initiatives to reach remote areas and professionals must combine child immunization service with other medical services offered by health institutions., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Zemariam et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Introduction: Diarrhea is particularly prevalent in low-income or marginalized populations because these groups have less access to clean water sources, hygienic conditions, and healthcare. Dehydration due to electrolyte and fluid loss is the main cause of deaths associated with diarrhea. An especially important factor in this death from dehydration is the caregivers' knowledge, attitude, and diarrhea management techniques. While a number of research have been done on managing diarrhea at home, the results tend not to be consistent. This systematic review and meta-analysis aimed to assess the pooled estimate of knowledge, attitude and practice of home-based management of diarrhea in East Africa., Methods: Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines was used to search articles from electronic databases (Cochrane library, Ovid platform (Medline, Embase, and Emcare), Google Scholar, CINAHL, PubMed, and institutional repositories in East Africa countries. The last search date was on 01/06/ 2023 Gregorian Calendar. The authors extracted year of publication, country, study design, knowledge level, attitude level and practice level of home-based management of diarrhea. A weighted inverse variance random-effects model was used to estimate the pooled prevalence of knowledge, attitude and practice of home-based management of diarrhea. Subgroup analysis was done by country, and sample size. Publication bias and sensitivity analysis were also done., Results: A total of 19 articles with (n = 7470 participants) were included for the final analysis. From the random-effects model analysis, the pooled prevalence of good practice, good knowledge and favorable attitude towards home based management of diarrhea in East Africa was found to be 52.62% (95% CI: 45.32%, 59.92%) (95% CI: I2 = 78.3%; p < 0.001), 37.44% (95% CI: 26.99%, 47.89%) (95% CI: I2 = 89.2%; p < 0.001) and 63.05% (95% CI: 35.7%, 90.41%) (95% CI: I2 = 97.8%; p < 0.001) respectively., Conclusion and Recommendations: The level of good knowledge, attitude and practice of home based management of diarrhea in East Africa is found to be low. A collaborative effort from different stakeholders to enhance the knowledge, attitude and practice is needed to tackle the burden of diarrhea and its consequences., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Abate et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Attrition rate is higher in developing nations and it leftovers a major obstacle to enhance the benefits of therapy and achieve the 90-90-90 plan targets. Despite this fact, data on the incidence and its predictors of attrition among human immune deficiency virus infected children on antiretroviral therapy are limited in developing countries including Ethiopia especially after the test and treat strategy implemented. This study aimed to assess the incidence and predictors of attrition among human immune deficiency virus infected children on antiretroviral therapy in Amhara Comprehensive Specialized Hospitals, Northwest Ethiopia. A retrospective follow-up study was conducted among 359 children on ART from June 14, 2014, to June 14, 2022. Study participants were selected using simple random sampling method and the data were collected using Kobo Toolbox software and analysis was done by STATA version 14. Both bi-variable and multivariable Cox regression models were fitted to ascertain predictors. Lastly, an AHR with a 95% CI was computed and variables with a p-value of < 0.05 were took an account statistically key predictors of attrition. The overall incidence of attrition rate was 9.8 (95% CI 7.9, 11.9) per 100 PYO. Children having baseline hemoglobin < 10 mg/dl (AHR 3.94; 95% CI 2.32, 6.7), suboptimal adherence (AHR 1.96; 95% CI 1.23, 3.13), baseline opportunistic infection (AHR 1.8; 95% CI 1.17, 2.96), and children who had experienced drug side effects (AHR 8.3; 95% CI 4.93, 13.84) were established to be a significant predictors of attrition. The attrition rate was relatively high. Decreased hemoglobin, suboptimal adherence, presence of drug side effects and baseline opportunistic infection were predictors of attrition. Therefore, it is crucial to detect and give special emphasis to those identified predictors promptly., (© 2024. The Author(s).)

Background: Neonatal jaundice is a significant contributor to illness and death in newborns, leading to frequent admissions to neonatal intensive care units. To better understand this issue, a study was conducted to identify the factors contributing to neonatal jaundice among newborns admitted to Dessie and Woldia comprehensive specialized hospitals in northeast Ethiopia., Methods: The study took place from April 1 to May 30, 2022, using unmatched case-control design. A total of 320 neonates paired with their mothers were involved, including 64 cases and 256 controls. Data were collected through a structured interviewer-administered questionnaire and a review of medical records. The collected data were analyzed using SPSS Version 23, and a multivariate logistic regression model was employed to understand the relationship between independent factors and the occurrence of neonatal jaundice. Statistical significance was determined at a threshold of P value less than 0.05., Results: The study findings revealed that maternal age over 35 years, residing in urban areas [adjusted odds ratio (AOR) = 2.4, 95% confidence interval (CI): 1.23, 4.82], male gender (AOR = 4.3, 95% CI: 1.90, 9.74), prematurity (AOR = 3.9, 95% CI: 1.88, 8.09), and ABO incompatibility (AOR = 2.6, 95% CI: 1.16, 5.96) were significant determinants of neonatal jaundice. Conversely, the study indicated that cesarean birth was associated with a 76% lower likelihood of infant jaundice compared to vaginal delivery (AOR = 0.24, 95% CI: 0.08, 0.72)., Conclusion: To prevent, diagnose, and treat neonatal jaundice effectively, efforts should primarily focus on managing ABO incompatibility and early detection of prematurity. Additionally, special attention should be given to neonates born through vaginal delivery, those with mothers over 35 years old, and those residing in urban areas, as they are at higher risk of developing newborn jaundice. Close monitoring of high-risk mother-infant pairs during the antenatal and postnatal periods, along with early intervention, is crucial for reducing the severity of neonatal jaundice in this study setting., (© 2024. The Author(s).)

Purpose: Major adverse drug reactions (ADRs) are the leading causes of poor adherence, switching of drugs, morbidity, and mortality. A limited studies was conducted to investigate major ADR in developing countries including Ethiopia, and the purpose of this study was to assess the incidence and predictors of major ADRs among HIV-infected children receiving antiretroviral therapy (ART) in West Amhara Comprehensive Specialized Hospitals, Northwest Ethiopia., Methods: An institutional-based retrospective follow-up study was conducted among 460 children receiving ART from January 1, 2014 to December 31, 2021. A simple random sampling technique was employed, and data were collected using Kobo Toolbox software and then deployed to STATA 14 for analysis. The Kaplan-Meier survival curve and the log-rank test were used to estimate and compare survival times. Both bivariable and multivariable Weibull regression models were fitted to identify predictors. Finally, an adjusted hazards ratio (AHR) with a 95% CI was computed, and variables with P < 0.05 were considered statistically significant predictors of major ADR., Findings: The overall incidence rate of major ADRs was 5.8 (95% CI, 4.6-7.3) per 1000 child months. Being female (AHR, 2.71; 95% CI, 1.52-4.84), tuberculosis (TB)-HIV co-infection (AHR, 2.49; 95% CI, 1.32-4.68), World Health Organization stage (III and IV) (AHR, 2.52; 95% CI, 1.39-4.56), zidovudine-based (AHR, 2.84; 95% CI, 1.11-7.31), and stavudine-based (AHR, 5.96; 95% CI, 1.63-21.84) regimens were found to be significant predictors of major ADRs., Implications: The major ADR incidence rate was high. Health professionals should employ early screening and close follow-up for children with advanced World Health Organization clinical staging, females, those with TB-HIV co-infection, and those receiving stavudine- and zidovudine-based initial regimens to reduce the incidence of major ADRs., Competing Interests: Declaration of Competing Interest The authors declare that they have no competing of interests., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Objectives: Globally, twenty-three million adolescents aged 15-19 years have an unmet need for sexual and reproductive health services and are at risk of unintended pregnancy. In Sub-Saharan Africa, including Ethiopia, it might be difficult for adolescents to get access to sexual and reproductive health services that are acceptable to use. Privacy, a fear of sharing health concerns, a sociocultural environment, the unfriendliness of current services, and traditional taboos are some of the key reasons. This study aimed to explore the perspectives of service providers and adolescents on the use of sexual and reproductive health services., Methodology: A qualitative phenomenological study was conducted from January to February 2023 in the Tikur Anbessa specialized hospital. Purposive sampling was applied to select the study participants. A total of 17 in-depth interviews (with 7 adolescents and 10 health providers) were held. Instead of relying on the number of participants, data saturation was used. Thematic analysis was employed in analyzing the data., Result: The findings indicate that obstacles to the use of sexual and reproductive health services include challenges related to the availability of resources and accessibility; resistance from religious beliefs, cultural beliefs, and customs; quality and institutional-related challenges; and stigma and discrimination in sexual and reproductive health services, which pose the biggest barrier to health professionals providing standardized sexual and reproductive health services., Conclusion: A multi-pronged approach should be created to overcome these challenges, including community outreach for sexual and reproductive health and increasing awareness of the importance of early access to sexual and reproductive health through appropriate community forums. Existing sexual and reproductive health services are not promoted to adolescents and youth, and a lack of and difficulty getting resources for sexual and reproductive health services should be resolved., Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2024.)

Background: Asthma is a leading cause of emergency hospital visits and a significant factor in lost productive hours. The lack of a synthesized body of knowledge on bronchial asthma has notable public health implications., Objective: This systematic review and meta-analysis aim to investigate the prevalence of asthma and its predictors among patients presenting in Ethiopian public hospitals., Design: Duplicate studies were removed using EndNote version X9. The Newcastle-Ottawa Scale guided the quality assessment, and data extraction followed the Joanna Briggs Institute format., Data Source and Methods: The authors used advanced search methods, including databases such as PubMed, Scopus, Embase, Africa Index Medicus, Science Direct, HINARI, Google Scholar, and manual searches. Data presentation adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. Publication bias was assessed using Egger's regression test and a funnel plot. Sensitivity analysis was also conducted., Results: The search yielded 352 original articles, with 22 meeting the criteria for inclusion. Using the random-effects DerSimonian-Laird model, the prevalence of bronchial asthma was found to be 9.02% (95% CI: 7.50, 10.53). Several factors were associated with the prevalence of bronchial asthma, including the spring season (AOR 3.7; 95% CI: 2.11, 6.49), childhood age (AOR 4.2; 95% CI: 1.84, 9.55), and urban residence (AOR 1.7; 95% CI: 1.29, 2.31). Other significant factors include family history of asthma (AOR 2.89; 95% CI: 2.22, 3.75), insecticide exposure (AOR 3.3; 95% CI: 2.23, 4.91), and the presence of household insects like cockroaches (AOR 3.33; 95% CI: 2.15, 5.15). Smoking (AOR 3.64; 95% CI: 2.66, 4.98), obstructive sleep apnea (AOR 4.29; 95% CI: 2.37, 7.76), and recurrent upper respiratory tract infections (AOR 4.31; 95% CI: 2.24, 8.32) were also significant., Conclusion: The pooled prevalence of bronchial asthma is notably high in Ethiopia. Key predictors include childhood age, spring season, urban living, family history of asthma, exposure to insecticides, presence of cockroaches, smoking, obstructive sleep apnea, and recurrent upper respiratory infections. Targeted interventions are crucial and should focus on lifestyle improvements, allergen identification, cockroach control, smoking cessation, reducing insecticide exposure, and promoting a safe environment., Trial Registration: This review's protocol was pre-registered with the International Prospective Register of Systematic Reviews (PROSPERO registration number CRD42023491222).

Background: The first case of COVID-19 virus was reported in Africa on 14 February 2020. The pandemic became more aggressive in the continent during the second wave than the first wave. Promoting vaccination behavior is an unparalleled measure to curb the spread of the pandemic. Regarding this, the health belief model (HBM) is the major model for understanding health behaviors. This study aimed to examine predictors of intended COVID-19 vaccine acceptance in the second wave of the pandemic among university students in Ethiopia using HBM., Methods: A cross-sectional study was conducted among 423 randomly selected medical and health science students at the University of Gondar from 21 August to 15 September 2020. Analysis of data was performed using STATA 14.0. Linear regression analysis was applied and a p value of less than 0.05 was used to declare statistical significance., Results: Among the total participants, 293 [72.2% (95.0%: CI: 67.2-76.8)] of them scored above the mean of COVID-19 vaccine acceptance. HBM explained nearly 46.3% (adjusted R 2  = 0.463) variance in intention to receive the COVID-19 vaccine. Year of study (β = 0.288; 95% CI: 0.144-0.056), using social media (β = 0.58; 95% CI: 1.546-2.804), existing chronic disease (β = 0.12; 95% CI: 0.042-0.433), perceived overall health condition (β = 0.117; 95% CI: 0.307-0.091), perceived susceptibility (β = 0.58; 95% CI: 1.546-2.804), perceived benefit (β = 0.338; 95% CI: 1.578-2.863), and cues to action (β = 0.49; 95% CI: 0.388-0.99) were significantly associated with intended COVID-19 vaccine acceptance at p value < 0.5., Conclusion: Approximately, three-quarters of the participants were above the mean score of COVID-19 vaccine acceptance, which is higher compared to previous reports in resource-limited settings. Interventions in this study setting chould include placing emphasis on the risks of acquiring COVID-19, enhancing perceived benefits of COVID-19 vaccination and improving cues to action by advocating COVID-19 vaccination. Our findings also implied that social media health campaigns are significant factor in COVID-19 vaccination behavioral change in this study setting., Competing Interests: The authors declare that there is no conflict of interest., (© The Author(s), 2023.)

Introduction: Acute coronary syndrome (ACS) is the most common cause of morbidity and mortality in patients with coronary heart disease. Furthermore, the recurrence of this problem has significant adverse outcomes. However, there is insufficient information pertaining to this problem in Ethiopia; hence, this study aims to assess the incidence rate and identify the predictors of ACS recurrence in the West Amhara region., Methods: A retrospective follow-up study was conducted among 469 patients diagnosed with primary ACS. Data from the patient chart were collected using a pre-tested structured data extraction tool. The study employed the Weibull regression analysis model, and the effect size was measured using an adjusted hazard ratio (HR) with a 95% confidence interval (CI). The statistical significance of the findings was established based on a p -value <0.05., Result: A total of 429 patients were included in the final analysis [average age, 60 ± 13.9 years; and 245 (57.1%) men]. A total of 53 patients (12.35%; 95% CI: 9.55%-15.83%) experienced recurrent ACS. The overall risk time was found to be 93,914 days (3,130.47 months), and the recurrence rate was 17/1,000 patients/month. The identified predictors were the typical symptoms of ACS such as syncope (HR: 3.54, p  = 0.013), fatigue (HR: 5.23, p  < 0.001), history of chronic kidney disease (HR: 8.22, p  < 0.001), left ventricular ejection fraction of <40% (HR: 2.34, p  = 0.009), not taking in-hospital treatments [aspirin (HR: 9.22, p  < 0.001), clopidogrel (HR: 4.11, p  = 0.001), statins (HR: 2.74, p  = 0.012)], and medication at discharge [statins (HR: 4.56, p  < 0.001)]., Conclusion: This study found a higher incidence rate of recurrent ACS. Hence, the implementation of guideline-recommended anti-ischemic treatment should be strengthened., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2023 Alamaw, Asefa, Abebe, Zemariam and Liyew.)

Background: Nurses with reduced work ability had a high risk of disability pension, sickness absences, retirement intention, and leave their job and profession early. Nurses frequently suffer from job related stress, occupational fatigue and sleep problems, which can further compromise their work ability., Aims of the Study: The aim of this study was to assess perceived work ability and its associated factors among nurses working in the Northwest of Amhara regional state Referral Hospitals, Northwest Ethiopia, 2022., Methods: A multicenter, an institutional based, cross-sectional study was conducted among 410 nurses working in five selected Referral hospitals, found in the Northwest of Amhara regional state, Northwest Ethiopia, 2022. The data were collected using a structured, self-administered questionnaire and entered using Epi info version 7.2.5 software, analyzed using SPSS version 25. Summary statistics (median or IQR for continuous data and frequency and percentage for categorical variables) were used. The ordinal logistic regression was used to assess' the presence of association between dependent and independent variables., Results: The findings of this study revealed that 59.0% of nurses had poor level of work ability, whereas 34.4% and 6.6% of nurses had sub-optimal and optimal level of work ability respectively. Multivariable ordinal logistic regression revealed that being male [AOR = 2.43; 95% CI (1.52, 3.91)], being BSC nurse [AOR = 0.21; 95% CI (0.08, 0.51)], nurses who had poor sleep quality [AOR = 0.34; 95% CI (0.12, 0.98)] and nurses who had chronic disease [AOR = 0.18; 95% CI (0.08, 0.41)] were significantly associated with nurses' level of work ability, p-value < 0.05., Conclusions: In this study, the prevalence of poor level of work ability among nurses was high. Nurses with a female sex, nurses who had chronic disease, BSC holders and nurses who had poor sleep quality had a poor level of work ability. The federal Minister of health and the study hospitals collaborative with concerned stakeholders to design strategies to enhance work ability among nurses., (© 2023. The Author(s).)