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Diabetic retinopathy is a complication of diabetes mellitus and a leading cause of blindness and visual impairment globally. Limited information existed on the epidemiology of diabetic retinopathy at the national level in Ethiopia. Thus, the objective of this review was to determine the pooled prevalence of diabetic retinopathy and its associated risk factors in Ethiopia. A systematic review and meta-analysis was conducted using previous primary studies that were found in electronic databases such as Web of Science, Scopus, PubMed, CINHAL, Google Scholar, and online African journals. We evaluated the quality of the included studies using the Newcastle-Ottawa Assessment Scale. The random-effects model was applied because heterogeneity was expected. I-Square and the Cochrane Q statistics were used to evaluate heterogeneity. Publication bias was examined using Egger's test and a funnel plot. A random-effect meta-analysis was applied to pool the odds ratios of risk factors to determine the association between the independent and dependent variables. After 598 articles were found, 22 studies that met the eligibility requirements were included. The pooled prevalence of retinopathy among patients with diabetes in Ethiopia was 24.35% (95% CI: 18.88–29.83), with considerable heterogeneity (I2 = 98.18%, p < 0.001). Ten years and longer with diabetes (AOR = 4.36, 95% CI: 1.71–7.01), hypertension (AOR = 2.54, 95% CI: 1.45–3.63), poor glycemic control (AOR = 3.83, 95% CI: 1.62–6.04), and positive proteinuria (AHR = 1.55, 95% CI: 1.02–2.07) were risk factors for diabetic retinopathy. Retinopathy affects one in four patients with diabetes. Diabetic patients with longer duration, hypertension, poor glycemic control, and positive proteinuria should receive special care. [ABSTRACT FROM AUTHOR]

Despite the indispensable role of self-care behavior in managing heart failure, the practice of self-care behavior remains poor, especially in developing countries. There is a scarcity of research focusing on poor self-care behavior and its determinants within our specific context. Therefore, the objective of this study was to investigate the prevalence and predictors of poor self-care behavior among ambulatory heart failure patients. A facility-based cross-sectional study was conducted at a tertiary care hospital in Ethiopia, involving patients with heart failure. We utilized the European Heart Failure Self-Care Behavior Scale (EHFScBS-9) to evaluate adherence to self-care behaviors. Data were gathered through patient interviews and a review of medical records. A binary logistic regression analysis was performed to identify predictors of poor self-care behavior in heart failure patients. We included a total of 343 participants in the final analysis of this study. The findings revealed that a majority of the patients (73.8%) demonstrated poor overall self-care behavior. Specifically, the majority of patients did not engage in regular exercise (76.1%), failed to consult doctors in case of rapid weight gain (75.6%), did not monitor weight daily (71.5%), did not restrict fluid intake (69.9%), and did not contact doctors in case of experiencing fatigue (68.6%). Additionally, 32.4% of patients did not reach out to doctors when experiencing shortness of breath, 30% did not restrict salt intake, 29% did not adhere to prescribed medication, and only 7% did not consult doctors if edema occurred. Our findings indicated that rural residence (AOR: 5.76, 95% CI: 2.47–13.43), illiteracy (AOR: 2.64, 95% CI: 1.52–6.31), prior hospitalization (AOR: 2.09, 95% CI: 1.21–3.61), and taking five or more medications (AOR: 1.83, 1.01–3.33) were significant predictors of poor self-care behavior. In conclusion, a majority of the participants in our study demonstrated poor self-care behavior. Risk factors for this behavior included rural residence, illiteracy, prior hospitalization, and taking five or more medications. Therefore, it is crucial to prioritize these high-risk patients and implement interventional programs aimed at improving self-care behaviors and overall treatment outcomes in heart failure patients. [ABSTRACT FROM AUTHOR]

For women living with HIV (WLH) in serodiscordant partnerships, decisions about childbearing can challenge condom use and antiretroviral adherence. In a prospective cohort of 148 WLH in serodiscordant partnerships, 58 (39%) wanted more children in the future but were not currently trying to conceive (fertility desire), and 32 (22%) were currently trying to become pregnant (fertility intent). Detection of prostate specific antigen (PSA) in vaginal secretions, a marker for recent condomless sex, was lowest in women with fertility desire and highest in women with fertility intent. Detectable viral load followed a similar pattern. Risk of HIV transmission, when condomless sex and PSA detection occurred concurrently, was three to fourfold higher at visits with fertility intent compared to visits with fertility desire. Qualitative interviews underscored the importance women place on childbearing and suggested that they had limited information about the role of antiretroviral therapy in reducing sexual HIV transmission. [ABSTRACT FROM AUTHOR]

Typhoid fever continued to be the key cause of morbidity and mortality in developing countries with poor hygienic practices and limited access to safe drinking water. The Widal card agglutination test is the main diagnostic tool in Ethiopia, which is limited in differentiating the overlapping symptoms with other acute febrile illnesses such as malaria and viral enteritis. This eventually leds to unnecessary antibiotic use and eventual drug resistance. Therefore this study wants to assess the burden and associated potential risk factors of typhoid fever among suspected cases using the typhoid rapid stool antigen test in Northeast Ethiopia. A hospital-based cross-sectional study was conducted at Gaint and Meket Shediho primary hospitals from May to July 2021. A total of 255 patients clinically suspected of typhoid fever, and willing to grant informed consent were included systematically. The demographic and hygiene-related variables were collected using a pre-tested structured questionnaire. The rapid stool antigenic test and xylose-lysine-deoxycholate agar (XLD) stool culture were evaluated for the level of agreement. The present study indicated that the prevalence of typhoid fever was 15.3%. This displayed that the human-restricted infectious disease, typhoid fever remained a challenge to Ethiopians. Washing hands with soap, history of typhoid fever, having previous history of hospitalization, and chronic underlying disease was the significant potential factor for typhoid fever. The higher agreement of the rapid stool antigenic test with the stool culture can indicate the factual burden of typhoid fever in the suspected population. This could minimize empiric treatment and the possible emergence of drug resistance. Thus, resource-poor settings may need to look for a rapid and reliable stool antigenic test. [ABSTRACT FROM AUTHOR]

Dairy cheese ball (Rasgulla) is one of the most commercially acclaimed dairy-based sweetmeat products in the Indian subcontinent. The main constrain with rasgulla export is the prediction of its shelf-life period, as there are several factors upon which the perishability of the product is dependent. Twenty-five nodes or concepts were chosen after a thorough consultation with 36 numbers of experts and stakeholders sweetmeat producers, shopkeepers, chhana producers, experts from packaging industries and an experienced tasting panel. The proposed fuzzy cognitive model (FCM) was constructed based on the linguistic variables assigned by the experts. For the defuzzification process centre of gravity, the method was used. There were 137 numbers of interconnections (within the 25 concepts) to build the FCM-based shelf-life model. Steady-state and dynamic-state FCM analysis was done considering the values of each concept to 1 and 0.01 respectively. The two most influential concepts namely freshness of chhana and moisture content were assigned to 0.01 for a better understanding of the rasgulla shelf life with varying values of the concepts. The major challenge related with the application of FCM in food science or food processing is the validation of the proposed model. In this paper, a validation scheme has been proposed to overcome this challenge. [ABSTRACT FROM AUTHOR]

Although motivational interviewing (MI) seems to be promising for enhancing self-care behaviors (i.e., daily disease management and responses to symptoms) in patients with heart failure (HF), no quantitative pooling of effect sizes has been described to summarize and test its efficacy on self-care. Given that self-care behaviors of patients with HF are essential to enhance pharmacological adherence and disease management and optimize clinical outcomes, we sought to perform a systematic review of randomized control trials (RCTs) regarding MI's efficacy on enhancing self-care behaviors among patients with HF, synthesizing MI effects on self-care through meta-analyses. Nine randomized controlled trials were included. MI showed moderate effects on enhancing self-care confidence (Hedge's g = 0.768; 95%CI = 0.326–1.210; P = 0.001) and self-care management (i.e., responses to symptoms) (Hedge's g = 0.744; 95%CI = 0.256–1.232; P = 0.003) and large effects on improving self-care maintenance (i.e., adherence to treatment and symptom monitoring) (Hedge's g = 0.873; 95%CI = 0.430–1.317; P < 0.001). No significant effects were found for enhancing the self-reported physical functioning (Hedge's g = −0.385; 95%CI = −1.063–0.294; P = 0.267) or the directly assessed physical functioning using the 6-min walking test (Hedge's g = −0.131; 95%CI = −0.981–0.720; P = 0.072). Although future research is still required to identify situation-specific indications regarding how MI should be implemented in relation to specific clinical conditions, this study showed that MI is an effective strategy to improve self-care in patients with HF. [ABSTRACT FROM AUTHOR]

Aegle marmelos is a sacred fruit with several medicinal properties, though availability is limited in a certain period of the year. It is therefore preserved in the form of leather through dehydration. In total, 16 concepts or nodes were selected after an interview with 27 stakeholders from different segments of food industries (packaging technology, food safety, certified industry auditor, food chemist, experienced sensory evaluation panellists, and food industry stakeholders) and a thorough review of shelf-life determining factors for leather-like products. Linguistic variables were assigned to find the rules governing the proposed model. The centre of gravity method was employed to defuzzify the linguistic variables with triangular membership function. A fuzzy cognitive map (FCM) was constructed with 106 numbers of connections to study the uncertainties in shelf-life modelling. Steady-state FCM analysis was conducted with considering the value of each concept equal to 1. Dynamic-state FCM was conducted considering the moisture content and moisture permeability with 0.1 as a case example. Different dynamic state infers how the shelf life of the leather product be influenced by different concepts/nodes/issues in comparison to steady-state FCM. FCM modelling is feasible for storage study of any type of food, though in this study bael leather is chosen. [ABSTRACT FROM AUTHOR]

This study aimed to assess changes in fasting blood sugar (FBS) levels, time to diabetic retinopathy (DR) and its predictors among type 2 diabetes patients in Ethiopia. An institution-based retrospective follow-up study was conducted at the University of Gondar Comprehensive Specialized Hospital. The linear mixed effect model and Cox proportional hazard models were fitted separately, and later, the two models were fitted jointly using R software. Variables with a p value < 0.05 were considered significant predictors in the adjusted analysis. The incidence rate of DR was 2 per 100-person year of observation with a median follow-up time of 90.8 months (IQR 63.4). The current value and rate of change in FBS level were significant predictors of time to DR (AHR = 1.35; 95% CI 1.12–1.63) and (AHR = 1.70; 95% CI 1.21–2.39), respectively. Hypertension (AHR = 2.49; 95% CI 1.32–4.66), taking > 1 antidiabetic oral agent (AHR = 4.90; 95% CI 1.07–20.0) and more than 10 years duration (AHR = 0.17, 95% CI 0.06–0.46) were predictors of time to DR. This study revealed that the current value of FBS and the rate of FBS change were significantly associated with the time to DR. [ABSTRACT FROM AUTHOR]

Among Sub-Saharan African women living with HIV (WLWH), pregnancy creates unique stressors that may cause depression. We describe the prevalence of depression among WLWH enrolled in the African Cohort Study (AFRICOS) by pregnancy status and describe factors associated with depression. WLWH < 45 years of age underwent six-monthly visits with depression diagnosed using the Center for Epidemiological Studies-Depression scale. Visits were categorized as "pregnant;" "postpartum" (the first visit made after the last pregnancy visit), and "non-pregnant." The prevalence of depression was calculated for each visit type and compared using prevalence odds ratios (POR) with 95% confidence intervals (CI). Logistic regression with generalized estimating equations was used to evaluate sociodemographic factors associated with depression. From January 2013 to March 1, 2020, 1333 WLWH were enrolled, and 214 had pregnancies during follow-up. As compared to the prevalence of depression during "non-pregnant" visits (9.1%), depression was less common at "pregnant" (6.3%; POR = 0.68 [CI: 0.42, 1.09]) and "postpartum" (3.4%; POR = 0.36 [CI: 0.17, 0.76]) visits. When controlling for other factors, the visit category was not independently associated with depression. Visit number, study site, employment status, and food security were independently associated with decreased odds of depression. We observed a lower prevalence of depression during pregnancy and the postpartum period than has been previously described among WLWH during similar time points. We observed protective factors against depression which highlight the impact that holistic and consistent health care at HIV-centered clinics may have on the well-being of WLWH in AFRICOS. [ABSTRACT FROM AUTHOR]

In various settings, heterogeneity in fertility rates among HIV-affected couples highlights the importance of understanding contextual factors to inform program planning and implementation. We interviewed 1016 patients with HIV/AIDS at seven clinics in Vietnam to assess their desire to have a(nother) child and willingness to pay (WTP) for prevention of mother to child transmission (PMTCT) services. One-fifth of participants reported their desire for a(another) child and this was slightly higher among men than women. Factors associated with the desire to have a(nother) child of HIV/AIDS patients included (1) not yet have a child or a son, (2) provincial and district-level service, (3) income per capita, (4) marital status and (5) history of drug injection. The average WTP for PMTCT service was US $179 (95% CI 161-197). The study highlights the need for interventions on social, cultural barriers, improved accessibility and outcomes of counseling, and better care and treatment services for couples and child affected by HIV/AIDS. [ABSTRACT FROM AUTHOR]