Search

Abstract Maternal health is a major public health tricky globally. Cesarean section delivery reduces morbidity and mortality when certain complications occur throughout pregnancy and labor. Cesarean section subjected to the availability and use of essential obstetric services in regional factors in Ethiopia. There was a scarcity of studies that assess the spatial distribution and associated factors of cesarean section. Consequently, this study aimed to assess the spatial variation of cesarean section and associated factors using mini EDHS 2019 national representative data. A community based cross-sectional study was conducted in Ethiopia from March to June 2019. A two-stage stratified sampling design was used to select participants. A Global Moran’s I and Getis-Ord Gi* statistic hotspot analysis was used to assess the spatial distribution. Kuldorff’s SaTScan was employed to determine the purely statistically significant spatial clusters. A multilevel binary logistic regression model fitted to identify factors. A total of 5753 mothers were included. More than one-fourth of mothers delivered through cesarean section at private health institutions and 54.74% were not educated. The proportion of cesarean section clustered geographically in Ethiopia and hotspot areas were observed in Addis Ababa, Oromia, Tigray, Derie Dewa, Amhara, and SNNR regions. Mothers’ age (AOR = 1.07, 95% CI 1.02–1.12), mother’s had secondary education (AOR = 2.113, 95% CI 1.414, 3.157), mother’s higher education (2.646, 95% CI 1.724, 4.063), Muslim religion followers (AOR = 0.632, 95% CI 0.469, 0.852), poorer (AOR = 1.719, 95% CI 1.057, 2.795), middle wealth index (AOR = 1.769, 95% CI 1.073, 2.918), richer (AOR = 2.041, 95% CI 1.246, 3.344), richest (AOR = 3.510, 95% CI 2.197, 5.607), parity (AOR = 0.825, 95% CI 0.739, 0.921), and multiple pregnancies (AOR = 4.032, 95% CI 2.418, 6.723) were significant factors. Therefore, geographically targeted interventions are essential to reduce maternal and infant mortality with WHO recommendations for those Muslim, poorest and not educated mothers.

Abstract Intrapartum care is a platform of comprehensive healthcare for pregnant women that is designed to improve birth outcomes for mother and child. However, complications during the intrapartum period continued to be the leading cause of death for women of reproductive age and newborns. Therefore, the aim of this study was to assess the prevalence of quality of intrapartum care and its associated factors among mothers in Ethiopia. A community based cross sectional study was conducted among 4469 mothers who gave birth in the last 2 years. Quality of intrapartum care was analyzed based on the assessment of health facility delivery, skilled birth attendants and early initiations of breast-feeding. Stata version 14 software was used for data cleaning and analysis. A mixed effect multilevel logistic regression was conducted to determine factors associated with quality of intrapartum care. An adjusted odds ratio with 95% confidence interval and a P value of less than or equal to 0.05 was used for the identification of both individual and community level factors. Overall, the prevalence of quality intrapartum care in Ethiopia was 23.8% (95% CI 22.6, 25.13). Primary education (AOR = 1.46, 95% CI = 1.14, 1.88), rich household class (AOR = 1.48, 95% CI = 1.10, 1.98), history of ANC (AOR = 2.91, 95% CI = 2.18, 3.86), perceived distance to the health facility as not a big issue (AOR = 1.63, 95% CI = 1.30, 2.05), urban residence (AOR = 2.97, 95% CI = 1.93, 5.09), Tigray region (AOR = 5.01, 95% CI = 1.25, 20.59), community level poverty (AOR = 0.63, 95% CI = 0.41, 0.97), and having 2–4 children (AOR = 0.74, 95% CI = 0.56, 0.97) were significantly associated with quality of intrapartum care. The finding conclude that less than one in four mothers received good quality intrapartum care. In order to optimize the quality of intrapartum care, the government should empower women through extensive education. It is also recommended for the Ministry of Health to evaluate the health facilities and community health workers to increase coverage of ANC and provide financial assistance to rural residents and the poor household class.

BackgroundEarly initiation of breastfeeding (EIBF), within the first hour of birth, is crucial for promoting exclusive breastfeeding and establishing optimal nursing practices. However, global EIBF rates remain low, with even lower rates observed in Africa. Despite existing research gaps, this study aims to determine the prevalence of EIBF and identify maternal and child-related factors associated with its practice in West Africa.MethodsThis study utilized West African Demographic and Health Survey (DHS) data from 13 countries, including 146,964 children's records. To assess model fit, likelihood test and deviance were used. Similarly, intraclass correlation coefficient, median odds ratio, and proportional change in variance were employed for random effect. A multilevel logistic regression model was used to identify individual- and community-level factors influencing EIBF due to the hierarchical nature of the data. Variables with p-values ≤0.2 in the binary model and ResultsThe pooled prevalence of EIBF in West African nations was 50.60% (95% CI; 50.34-50.85%). The highest prevalence rate was observed in Serra Leone (75.33%) and the lowest prevalence was found in Senegal (33.94%). In the multilevel multiple logistic regression model, maternal education (AOR = 1.10, 95% CI, 1.03,1.16), marital status AOR = 1.07, 95% CI, 1.01,1.13), birth weight (AOR = 0.91, CI 0.86,0.96), birth orders (AOR = 1.09, CI 1.03,1.16), and (AOR = 1.11, CI 1.03,1.19), place of residence (AOR = 1.14, CI 1.07,1.21), and mode of delivery type (AOR = 0.26, CI 0.24,0.29) were significantly correlated with EIBF in West Africa.ConclusionsThe incidence of EIBF in West Africa was found to be low. The study emphasizes the need for targeted behavioral change communication programs to address timely breastfeeding initiation, specifically targeting mothers and child characteristics. Factors such as education, delivery mode, marital status, birth weight, birth order, and place of residence were significantly associated with EIBF. Special attention should be given to improving EIBF rates among women undergoing caesarean sections, infants with low birth weight, and primiparous mothers, along with structural improvements in the healthcare sector in West Africa.

Abstract Background Surgical site infection is an infection occurring within 30 days after surgery. It is recently reported that evidence-based information on the specific time when the majority of surgical site infections would develop is a key to early detect the infection as well as to preventing and early intervene against their pressing and fatal complications. Therefore, the current study aimed to determine the incidence, predictors, and time to development of surgical site infection among general surgery patients at specialized hospitals in the Amhara region. Method An institution-based prospective follow-up study was conducted. The two-stage cluster sampling procedure was used. A systematic sampling technique with a K interval of 2 was applied to prospectively recruit 454 surgical patients. Patients were followed up for 30 days. Data were collected using Epicollect5 v 3.0.5 software. Post-discharge follow-up and diagnosis were done by telephone call follow-up. Data were analyzed using STATA™ version 14.0. Kaplan–Meier curve was used to estimate survival time. Cox proportional regression model was used to determine significant predictors. Variables with a P-value less than 0.05 in the multiple Cox regression models were independent predictors. Result The incidence density was 17.59 per 1000 person-day-observation. The incidence of post-discharge Surgical site infection was 70.3%. The majority of surgical site infections were discovered after discharge between postoperative days 9 to 16. Being male (AHR: 1.98, 95% CI: 1.201 – 3.277, diabetes Mellitus (AHR: 1.819, 95% CI: 1.097 – 3.016), surgical history (AHR: 2.078, 95% CI: 1.345, 3.211), early antimicrobial prophylaxis (AHR: 2.60, 95% CI: 1.676, 4.039), American Society of Anesthesiologists score ≥ III AHR: 6.710, 95% CI: 4.108, 10.960), duration of the surgery (AHR: 1.035 95% CI: 1.001, 1.070), Age (AHR: 1.022 95% CI: 1.000, 1.043), and the number of professionals in the Operation Room (AHR: 1.085 95% CI: 1.037, 1.134) were found to be the predictors of time to development of Surgical site infection. Conclusion The incidence of surgical site infection was higher than the acceptable international range. The majority of infections were detected after hospital discharge between 9 to 16 postoperative days. The main predictors of Surgical site infection were Age, Sex, Diabetes Mellitus, previous surgical history, the timing of Antimicrobial prophylaxis, American Society of Anesthesiologists score, pre-operative hospital stay, duration of surgery, and the number of professionals in the operation room. Hence, hospitals should give great emphasis on pre-operative preparation, post-discharge surveillance, modifiable predictors, and high-risk patients, as they found in this study.

Abstract Food taboo is any unacceptable food items in the society that arise mainly based on religious, cultural, historical and social principles. Developing countries faced the triple burden of malnutrition of under nutrition, micronutrient deficiencies and overeating. Food taboos have great effect on pregnant women through prohibited essential food and/or drinks. There is a paucity of study conducted in food taboo practice among pregnant women in Ethiopia. This study aimed to assess the prevalence of food taboo practice and associated factors among pregnant women attending antenatal care (ANC) at Bahir Dar city, 2020. Institutional based cross-sectional study design was conducted among 421 pregnant women attending antenatal care clinics. Stratified sampling technique was used to approach the study participants, and interviewer administered questionnaire was used for data collection. Binary logistic regression analysis was conducted to identify predictors. The prevalence of food taboo practices among pregnant women was 27.5% (95% CI 23.2–31.8%) at the Bahir Dar city. Most food items avoided during pregnancy were meat, honey, milk, fruit and cereals. Reasons for avoidance of these food items were plastered on the fetal head, and making fatty baby which is difficult for deliver. Maternal age 20–30 years (AOR = 8.39, 95% CI 3.49–20.14), more than 30 years [AOR = 10.56, 95% CI (2.00, 51.74)], more than 2 parity [AOR = 9.83 95% CI (2.79, 34.70)], no previous experience of the ANC visit [AOR = 2.68, 95% CI (1.26, 5.73)], and no information about nutrition [AOR = 4.55, 95% CI (1.77, 11.70)] were significantly associated with practice of food taboo. This study revealed that prevalence of food taboo is high during pregnancy. The implications of this study that needs strengthening nutrition counseling components of ANC follow-up and health professionals needs to design and implement strategic health communication intended to reorient misconceptions and myths for the pregnant women regarding the food taboo.

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

BackgroundPodoconiosis (endemic non-filarial elephantiasis) is a chronic disease characterized by the development of persistent swelling of plantar foot initially; which progresses to the dorsal foot and lower leg slowly or in a number of acute episodes to reach the knee. About 4 million people are said to be affected by the disease worldwide and it is deemed a serious public health problem in at least 10 African countries including Ethiopia. Therefore this study aimed to identify the determinants of podoconiosis among residence in Machakel district.MethodUnmatched case control study design was conducted at Machakel district from August 30 to September 30, 2022. The sample size calculated using Epi-info software yielded 211 controls and 106 cases (317 study participants). Simple random sampling technique was used to select the cases using registration books of the district. Data were entered to Epi info version 7 and exported to SPSS version 22 for statistical analysis. Binary logistic regression was used to identify explanatory variables.ResultA total of 312 study participants (104 cases and 208 controls) were included giving a response rate of 98.42%. Bare foot (AOR, 5.83 [95% CI: 2.34-14.50]), female sex (AOR, 4.25 [95% CI: 2.22-8.14]), family history of podoconiosis (AOR: 3.01(95% CI: 1.41-6.42) and age group 41-60 (AOR: 5.05(95% CI: 2.35-10.83), and 61-80 AOR 15.74 95% CI: (5.56-44.55) were determinants of Podoconiosis.Conclusion and recommendationBarefoot, sex, family history of podoconiosis and age were determinants of Podoconiosis. District health office should encourage at risk populations especially older people and individuals with family history of podoconiosis about shoe wearing practice all the time and not to expose their skin and feet.

Abstract Rabies is a zoonotic viral disease that can occur in all warm blooded animals including humans. Vaccinating dogs can protect people from contracting rabies. Despite the availability of effective human and animal rabies vaccines, rabies prevention and control efforts are inadequate. The aim of the study was to determine the level of rabies prevention practices and associated factors among household heads in Bure Zuria district, North-west Ethiopia. Community based cross-sectional study was conducted at Bure Zuria from June 1 to 30, 2020. A total of 609 participants were selected using simple random sampling technique. Simple and multiple binary logistic regressions were applied to identify associated factors of rabies prevention practices. Of 609 participants, 413 (67.8%) were male and 289 (47.5%) were 30–45 years old. The level of good prevention practices of rabies at Bure Zuria district was 43.3%. Being males (AOR = 2.69 (1.72–4.22)), age group 18–29 years (AOR = 2.70 (1.20–6.10)), ever bitten by dog, (AOR = 2.40 (1.56–3.68)), got training (AOR = 1.70 (1.08–2.68)), had dog (AOR = 2.92 (1.62–5.26)), with good knowledge AOR (95% CI) = 3.42 (2.19–5.32), with good attitude AOR (95% CI) = 1.78 (1.16–2.73) and have 1001–2000 AOR (95% CI) = 2.29 (1.39–3.79) and > 2000 AOR (95% CI) = 2.02 (1.28–3.18)) monthly income were more likely to have good prevention practices of rabies. In this study, we found that the level of good prevention practices of rabies was low in Bure Zuria district. Therefore; awareness creation trainings and multi-sectoral collaborations to prevent rabies are needed in the district, zone and at large region level.

Abstract Perinatal mortality is the total number of fetal death and early neonatal death. Perinatal mortality is a major public health problem, particularly in developing countries, and is used as an implication of the economic, social, and health status of the country. The analysis of count data with hurdle and zero-inflated count models are the most applicable methods to accommodate with excessive zero counts. Therefore, this study aimed to apply the Poisson logit hurdle model to identify the associated factors of perinatal mortality in Ethiopia. A cross-sectional study design was conducted in Ethiopia using EDHS 2016. The sample was multistage stratified and units selected in a two-stage cluster sampling design. The association between the outcome and the independent variables was determined using the Poisson logit hurdle model. A total of 7230 mothers were obtained from EDHS 2016 survey. Of these mothers, 95.27% of them never, 4.47% of them once, 0.26% twice, and 0.04% three times experienced perinatal mortality preceding 5 years of the survey. The main protective associated factors were 40–49 years age of mother, having long preceding birth interval, and secondary + husband education. Parity is greater than four, rural residence, Caesarean section delivery, multiple pregnancies, institutional delivery, having a history of abortion were increased perinatal mortality per mother. This study implies that intervention is needed on family planning and mode of delivery to minimize perinatal mortality in the country.

Background. Since the end of 2019, the world has been facing a new coronavirus disease 19 (COVID-19), which is considered a global pandemic. COVID-19 is considered a major public health burden due to the uncontrolled morbidity and mortality of the global community. The World Health Organization estimates the recovery time as 2 weeks for patients with mild infection and 3 to 6 weeks for those with serious illnesses. The recovery time and its predictors are not well studied in Ethiopia yet. Therefore, the aim of this study was to estimate time to recovery from COVID-19 and its predictors among COVID-19 patients admitted to Tibebe Ghion Specialized Hospital care and treatment center, North West Ethiopia. Methods. An institution-based retrospective follow-up study was conducted among 452 COVID-19 patients admitted to Tibebe Ghion Specialized Hospital from March 2020 to September 2021. Simple random sampling using a table of random number generators was used to select study units. Data entry and analysis were performed using EpiData 3.1 and Stata version 14, respectively. Bivariable and multivariable Cox proportional hazard analyses were used to identify predictors of recovery time. An AHR at a 5% level of significance was used to identify significant predictors. Results: Among 452 COVID-19 patients, 437 (88%) were recovered, with a median recovery time of 9 days. Recovery time was significantly related to age (AHR = 0.98; 95% CI = 0.97, 0.99), oxygen saturation (AHR = 0.42; 95% CI = 0.31, 0.56), shortness of breath (AHR = 0.65; 95% CI = 0.47, 0.85), disease severity (moderate (AHR = 0.63; 95% CI = 0.47, 0.85) and severe (AHR = 0.32; 95% CI = 0.22, 0.47)), and comorbidities (AHR = 0.67; 95% CI = 0.53, 0.84). Conclusions and recommendations: The overall median recovery time was 9 days. Older age, low oxygen saturation, shortness of breath, disease severity (moderate and severe), history of comorbidities, and high-level of WBC were predictors of delayed recovery time. On the other hand, corticosteroid use significantly shortens the median recovery time of COVID-19 patients. Thus, patients presented with older age, low oxygen saturation, shortness of breath, moderate and severe COVID-19 disease, comorbidities, and increased WBC need to be closely monitoring and followed up by healthcare providers. In addition, there should be special attention during the administration of corticosteroid.

Abstract Smoking invariably has environmental, social, economic and health consequences in Ethiopia. Reducing and quitting cigarette smoking improves individual health and increases available household funds for education, food and better economic productivity. Therefore, this study aimed to apply the Bayesian negative binomial logit hurdle and zero-inflated model to determine associated factors of the number of cigarette smokers per day using the smoking intensity data of 2016 Ethiopia Demographic and Health Survey. The survey was a community-based cross-sectional study conducted from January 18 to June 27, 2016. The survey used two stage stratified sampling design. Bayesian analysis of Negative Binomial Logit Hurdle and Zero-inflated models which incorporate both overdispersion and excess zeros and carry out estimation using Markov Chain Monte Carlo techniques. About 94.2% of them never cigarettes smoked per day and the data were found to have excess zeros and overdispersion. Therefore, after considering both the zero counts and the enduring overdispersion, according to the AIC and Vuong tests, the Zero-inflated Negative Binomial and Negative Binomial Logit Hurdle model best fit to the data. The finding Bayesian estimation technique is more robust and precisely due to that it is more popular data analysis method. Furthermore; using Bayesian Zero-inflation and Zero hurdle model the variable: age, residence, education level, internet use, wealth index, marital status, chewed chat, occupation, the media were the most statistically significant determinate factors on the smoking intensity.

Abstract Under-five mortality is defined as the likelihood of a child born alive to die between birth and fifth birthday. Mortality of under the age of five has been the most targets of public health policies and may be a common indicator of mortality levels. Thus, this study aimed to assess the under-five child mortality and modeling Bayesian zero-inflated regression model of the determinants of under-five child mortality. A community-based cross-sectional study was conducted using the 2016 Ethiopia Demographic and Health Survey data. The sample was stratified and selected in a two-stage cluster sampling design. The Bayesian analytic approach was applied to model the mixture arrangement inherent in zero-inflated count data by using the negative Binomial–logit hurdle model. About 71.09% of the mothers had not faced any under-five deaths in their lifetime while 28.91% of the women experienced the death of their under-five children and the data were found to have excess zeros. From Bayesian Negative Binomial—logit hurdle model it was found that twin (OR = 1.56; HPD CrI 1.23, 1.94), Primary and Secondary education (OR = 0.68; HPD CrI 0.59, 0.79), mother’s age at the first birth: 16–25 (OR = 0.83; HPD CrI 0.75, 0.92) and ≥ 26 (OR = 0.71; HPD CrI 0.52, 0.95), using contraceptive method (OR = 0.73; HPD CrI 0.64, 0.84) and antenatal visits during pregnancy (OR = 0.83; HPD CrI 0.75, 0.92) were statistically associated with the number of non-zero under-five deaths in Ethiopia. The finding from the Bayesian Negative Binomial–logit hurdle model is getting popular in data analysis than the Negative Binomial–logit hurdle model because the technique is more robust and precise. Furthermore, Using the Bayesian Negative Binomial–logit hurdle model helps in selecting the most significant factor: mother’s education, Mothers age, Birth order, type of birth, mother’s age at the first birth, using a contraceptive method, and antenatal visits during pregnancy were the most important determinants of under-five child mortality.

Abstract Background Scabies is an infectious disease that affects the skin caused by the mite Sarcoptes scabiei and it transmitted through close personal contact. Even though it is easily treatable disease, its prevalence is high and continuous as neglected tropical disease of resource-poor settings, and particularly affects young age groups. Despite of these facts, studies conducted in Ethiopia regarding to the prevalence and associated factors for scabies infestation have been highly variable and didn’t well compiled. Due to that, the aim of this systematic review and meta-analysis was to estimates the overall prevalence of scabies and associated factors in all age groups in Ethiopia. Methods International databases (PubMed/PMC/Midline, EMBASE, CINAHL, Web of Science, Google Scholar, Google and Science Direct) were systematically searched from December 1, 2019, to January 18, 2020. All observational studies noted the prevalence of human scabies and associated factors in Ethiopia were included. Two authors (AG and G.T) independently extracted all necessary data using a standardized data extraction format. The data which is extracted each study were analyzed using STATA Version 14.1. Heterogeneity among the included studies was assessed through the Cochrane Q test statistics and I2 test. Lastly, a random effects meta-analysis model was computed to fix overall prevalence and associated factors of scabies. Results Twelve studies were included in this meta-analysis after 410 articles retrieved. Of these, eight studies were analyzed for prevalence estimation. The overall prevalence of scabies infestation was 14.5% (95%CI: 1.5, 27.6%) in Ethiopia. Furthermore, the subgroup analysis revealed the highest prevalence was 19.6% in Amhara region. A person from a large family size (OR: 3.1, 95% CI: 1.76, 5.67), and sharing a bed (OR: 3.59, 95%CI: 2.88, 4.47) were significantly associated with scabies. Conclusion This study revealed the prevalence of scabies infestation was 14.5% in Ethiopia which was high. Persons from high family size and any contact with scabies case were factors associated with scabies.

Abstract Objective The aim of this study was to identify socio-demographic and health related factors associated with caesarean section in Ethiopia. Results A total of 256 mothers undergoing to CS among 7193 delivery. Average maternal age of a participant was 29.26 years and 80% of mothers having two and more children. A woman delivered in private institution was 30% (AOR = 1.29; 95% CI 1.25, 1.32) more likely undergoing CS as compared to home delivery. Factors associated with CS were higher education level (AOR = 1.09, 95% CI 1.07, 1.12), preceding birth interval (AOR = 1.01; 95% CI 1.00. 1.03), multiple pregnancy (AOR = 1.11; 95% CI 1.08, 1.15), multiple parity (AOR = 0.98; 95% CI 0.97, 0.99), large size the child (AOR = 1.01; 95% CI 1.001, 1.02), richest households (AOR = 0.98; 95% CI 0.97, 0.99), rural residence (AOR = 0.98 95% CI 0.96, 0.99) and Addis Ababa (AOR = 1.06; 95% CI 1.04,1.09). As a conclusion and recommendation, the prevalence of CS higher in private institutions and Addis Ababa, so professionals should apply CS alone medical indication.

Backgrounds Pregnancy related complications are major causes of maternal morbidity and mortality worldwide. Diversified food consumption is essential to produce hormones during pregnancy and it reduced complications. In Ethiopia, many researchers were investigated about the proportion of pregnant women with dietary diversity and its determinant factors. However, those studies are inconsistent and fragmented. Therefore, the aim of this study was to estimate the pooled proportion of pregnant women with dietary diversity practice and its associated factors in Ethiopia. Methods We conducted a systematic electronic web-based search of PubMed/ /MEDLINE, EMBASE, Web of Science, Google Scholar and Google online databases for identifying studies on proportion of pregnant women with dietary diversity practice and its associated factors in Ethiopia using pre-defined quality and inclusion criteria. STATA version 14 statistical software was used to analyze the data. We extracted relevant data and presented in tabular form. The I2 test was used to assess heterogeneity across studies. Funnel plot asymmetry and Begg’s test were used to check for publication bias. The final effect size was determined by applying a random-effects model. Results Our search identified 170 studies. Of which, 23 were included in the final analysis stage. The pooled proportion of dietary diversity among pregnant women in Ethiopia was 41% (95% CI: 33, 49). Mothers can read and write (OR = 1.82 (95% CI: 1.25, 2.64)), maternal primary school and above educated (OR = 2.11 (95% CI: 1.10, 4.05)), nutritional information (OR = 4.1 (95% CI: 2.1, 7.99), dietary diversity knowledge (OR = 3.4 (95% CI: 2.73, 4.73)) and household had rich wealth index (OR = 3.45 (95% CI: 1.19, 10.1)) were significantly associated with dietary diversity practice during pregnancy. Conclusions In this meta-analysis; we found that low proportion of pregnant women with adequate dietary diversity in Ethiopia (41%). Maternal education, nutritional information, dietary diversity knowledge and wealth index level of household were significantly associated factors of pregnant woman with dietary diversity practice. This finding implies that improving the awareness of woman about dietary diversity during pregnancy and empowering women economically would play a significant role to improve dietary diversity practice.

ABSTRACT: Background: Coronavirus disease is a major global public health problem. The contagious disease caused by a newly discovered coronavirus, coronavirus disease 2019 (COVID-19), was declared a pandemic following the outbreak of cases of respiratory illness during 2019. Although studies assessed COVID-19 knowledge, attitude, and practice in Ethiopia the findings were highly variable and inconsistent. Objectives: This study assessed the pooled status of knowledge, attitude, and prevention practices regarding COVID-19 in Ethiopia. Methods: International and national electronic databases, including PubMed/MEDLINE, EMBASE, Cumulative Index to Nursing and Allied Health Literature, Google Scholar, Science Direct, and Google, were systematically searched. All observational studies on COVID-19 knowledge, attitude, and prevention practices in Ethiopia were included. We assessed heterogeneity among the included studies using the Cochrane Q test statistics and I2 test. Lastly, a random-effects meta-analysis model was fitted to estimate the pooled proportion of knowledge, attitude, and prevention practices toward COVID-19 in Ethiopia. Results: Our search identified 206 studies, 13 of which were included in the final analysis. Adequate knowledge, good attitude, and good prevention practice toward COVID-19 in Ethiopia were observed in 70.25% (95% CI, 61.82%–78.02%), 69.08% (95% CI, 55.42%–81.24%), and 41.62% (95% CI, 27.77%–56.17%) of total participants across studies, respectively. Conclusions: The results of this study revealed low proportions of adequate knowledge, attitudes, and preventive practices toward COVID-19 in Ethiopia. The lowest pooled proportion was observed in the Amhara region. These findings indicate the need to revise plans and policies to improve the knowledge, attitudes, and prevention practices of people toward COVID-19 in Ethiopia, especially in the Amhara region. (Curr Ther Res Clin Exp. 2021; 82:XXX–XXX) © 2021 Elsevier HS Journals, Inc.

ABSTRACT: Background: Coronavirus disease 2019 (COVID-19) has currently become a major global public health problem. The prevalence of COVID-19 has increased rapidly worldwide. Because there is no effective COVID-19 vaccine available yet, it is increasingly important to understand the average incubation period of severe acute respiratory syndrome novel coronavirus 2 (SARS-CoV-2), the virus that causes COVID-19, to design appropriate preventive and control strategies. Objective: This systematic review and meta-analysis was designed to estimate the pooled average incubation period of SARS-CoV-2, the virus that causes COVID-19. Methods: We conducted a systematic electronic web-based search of online databases, including PubMed, Google Scholar, Embase, and the World Health Organization Hinari portal. We included peer-reviewed research studies written in the English language on the incubation period of SARS-CoV-2 using pre-defined quality and inclusion criteria. STATA version 15 statistical software was used to analyze the data. Joanna Briggs Institute critical appraisal quality assessment tool for observational studies was utilized to evaluate the included studies. We extracted relevant data and presented in a tabular form. The I2 test was used to assess heterogeneity across studies. Funnel plot asymmetry and Egger tests were used to check for publication bias. The final effect size was determined by applying a random-effects model. Results: Our search identified 206 studies, amongst which 18 studies, representing 22,595 participants were included in the final analysis. The pooled average incubation period of SARS-CoV-2 was 5.7 days (95% CI, 5.1–6.4). Subgroup analyses by geographic location showed that the pooled average incubation period of SARS-CoV-2 was 6.1 days (95% CI, 5.34–6.94) in China and 4.54 (95% CI, 3.9–5.2) in other countries (Singapore, South Korea, and globally). Conclusions: The pooled average incubation period of SARS-CoV-2 was about 6 days. The longest incubation period was observed in China. Global health initiatives as well as local health planners should consider this average incubation period when designing optimal prevention and control strategies for SARS-CoV-2. (Curr Ther Res Clin Exp. 2020; 81:XXX–XXX)