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Background: Seventy percent of epileptic patients may not experience seizures if they receive proper treatment with antiepileptic drugs (AEDs). However, many children and adolescents face poor seizure control (PSC). Therefore, the purpose of this review is to systematically and quantitatively summarize the pooled prevalence of PSC and its predictors among children with epilepsy in Ethiopia., Methods: The following databases were used to conduct a thorough literature search: Africa Journal of the Online Library, Hinari, Google Scholar, PubMed, Science Direct, EMBASE, Cochrane Database, Sci-Hub, and Scopus. To evaluate the quality of the studies, Newcastle‒Ottawa Scale (NOS) checklists were utilized. The data on study characteristics and prevalence estimates were then combined via random effects meta-analysis, followed by subgroup and sensitivity analyses. Both visual and statistical analyses were employed to assess for any potential publication bias., Results: This review analyzed a total of 12 main studies and reported that the overall prevalence of PSC was 42.42% (95% CI: 33.42-51.42). However, there was significant heterogeneity in the results based on the study region, design, and seizure-free period. The subgroup analysis revealed that the highest prevalence of PSC was found in Southern Nations, Nationalities, and Peoples' (SNNPs) studies (61.88%; 95% CI: 35.91-87.85), studies with a cross-sectional design (46.73%; 95% CI: 36.83-56.62), and studies with a seizure-free period < 6 months (44.69%; 95% CI: 34.51-54.86). However, the lowest prevalence was observed in the Amhara region (35.54%; 95% CI: 27.40-43.67), cohort studies (29.53%; 95% CI: 21.26-38.21), and studies with a seizure-free duration of six months or more (41.64%; 95% CI: 29.94-53.35). The results also revealed a significant correlation between PSC and medication nonadherence (4.64, 95% CI: 2.84-7.58), comorbidities (2.08, 95% CI: 1.01-4.26), and seizure type (3.59, 95% CI: 1.18-10.8)., Conclusion: Based on this review, the findings suggest a notable prevalence of poorly controlled seizures (PSC) among children with epilepsy who are receiving antiepileptic drugs (AEDs) in Ethiopian outpatient epilepsy clinics. Seizures of tonic‒clonic status, comorbidities, and medication nonadherence were associated with poor seizure control., (© 2024. The Author(s).)

Background: The life-threatening diseases known as ACS (acute coronary syndrome) continue to produce considerable rates of morbidity and mortality despite breakthroughs in therapy. The study determined clinical outcome and its predictors in patients at the University of Gondar Comprehensive and Specialized Hospital (UOGCSH), North West Ethiopia., Design, Setting, and Participants: A retrospective cohort study design was employed at UOGCSH from January 31, 2018 to February 1, 2023. The hospital used a systematic random sampling procedure to select study participants from the medical records of patients in chronic cardiac follow-up clinics., Main Outcome Measures: Exposures were optimal medical therapy (OMT) versus non-optimal medical therapy collected from May to August 2023. Descriptive and analytical statistics were employed to compare study groups. A binary logistic regression model was employed to identify candidate variables for further analysis. Cox's proportional hazard model and log-rank test were employed, with a P-value < 0.05 used to evaluate statistical significance. A five-year all-cause mortality after discharge estimate was displayed by using Kaplan-Meier curves., Results: Among 422 patients with ACS [mean age, 61.56 (SD = 9.686) years; 54.7% male], of whom only 59.2% (250) received optimal medical therapy at discharge. Age ≥ 65, atrial fibrillation, chronic kidney diseases, and cardiogenic shock were negative independent predictors of optimal medical therapy. On the other hand, male sex was independently associated with the use of optimal medical therapy. All-cause mortality occurred in 16.6% (n = 70) and major adverse cardiac events occurred in 30.8% (n = 130) of patients with a 95% CI of 0.132-0.205 and 0.264-0.355, respectively. Multivariate analyses indicated that OMT was significantly associated with reduced all-cause mortality (aHR: 0.431, 95% CI: 0.222-0.835; P = 0.013)., Conclusion: This study revealed that the use of preventive OMT in patients discharged with acute coronary syndrome was associated with a reduction in all-cause mortality. However, the use of this OMT is suboptimal., (© 2024. The Author(s).)

Background: Stroke is a leading cause of death and disability worldwide. While caregivers play a vital role in recovery, their long-term support can affect their mental well-being. This study aims to estimate the pooled prevalence of depression and associated factors among caregivers of stroke survivors in developing countries., Method: A comprehensive literature search using the preferred reporting items for systematic review and meta-analysis (PRISMA) statement was conducted on Scopus, PsycINFO, EMBASE, Google Scholar, Psychiatry Online, and PubMed/MEDLINE. Data were extracted via a Microsoft Excel spreadsheet and analyzed via STATA version 11.0. Egger regression tests and funnel plot analysis were used to check for publication bias, and the I 2 statistic was used to evaluate statistical heterogeneity. Sensitivity and subgroup analyses were also conducted to identify potential causes of heterogeneity., Results: Seventeen articles from 12 different countries were analyzed. The pooled prevalence of depression among caregivers of stroke survivors was 48.75% (95% confidence interval (CI): 38.64- 58.86). However, the prevalence of depression ranged widely from 17.2%-76%, which may be due to the variation in the depression assessment tools used, types of caregivers, and continent. A long duration of caregiving was the only significant factor associated with depression among caregivers of stroke survivors., Conclusion: The current systematic review and meta-analysis revealed a high prevalence of depression among caregivers of stroke survivors in developing countries. However, there was significant heterogeneity between studies, which could be explained by differences in the depression assessment tools used, types of caregivers, and continents. Factors such as long caregiving times were significantly associated with depression among caregivers of stroke survivors. The study suggests that the depression assessment tool utilized itself could have modified the prevalence of depression among caregivers of stroke survivors. Therefore, a single depression assessment tool needs to be authorized., Competing Interests: Declaration of competing interest The authors declare that they have no competing interests, (Copyright © 2024. Published by Elsevier Inc.)

Background: Sexual dysfunction is the most frequent health problem among psychiatric patients. This could be the result of both the nature of the illness itself and the side effects of prescribed psychotropic medications. It also significantly affects an individual's general well-being, interpersonal relationships, self-esteem, and treatment outcomes. Therefore, the current systematic review and meta-analysis was conducted to determine the combined prevalence of sexual dysfunction and its correlated factors among people with mental illness., Methods: We retrieved eligible primary studies using various search databases like PubMed, EMBASE, Science Direct, African Journal Online, Google Scholar, and Psychiatry Online. The report of this systematic review was reported following the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. We used standardized data extraction checklists and STATA version 14 for data extraction and analysis, respectively. The I-squared statistics test was used to check statistical heterogeneity within the included articles. Publication bias was assessed using a funnel plot and the Egger test. To estimate the overall prevalence and correlated factors of sexual dysfunction, a random effects model meta-analysis was employed., Results: In this meta-analysis, a total of 15 primary studies with 2849 psychiatric patients were included. The overall pooled prevalence of sexual dysfunction among psychiatric patients in Africa was 58.42% (95% CI: 49.55, 67.28). Having older age (OR = 1.92, 95% CI: 1.28, 2.87), longer duration of illness (OR = 2.60, 95% CI: 1.14, 5.93), history of relapse (OR = 3.51, 95% CI: 1.47, 8.43), poor quality of life (OR = 3.89, 95% CI: 2.15, 7.05), and antipsychotic medications (OR = 2.99, 95% CI: 1.84, 4.86) were significantly associated with sexual dysfunction., Conclusion: This meta-analysis revealed that approximately two-thirds of psychiatric patients in Africa are affected by sexual dysfunction. Therefore, the findings of this study recommend that when evaluating psychiatric patients, health professionals should focus more on sexual dysfunction. It is also essential to promote awareness and incorporate sexual health assessment and intervention into mental health services to reduce the overall burden of the problem., Competing Interests: The authors declare that they have no competing interests., (Copyright: © 2024 Fentahun 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.)

Background: Proper disposal of unwanted medicines, in addition to reducing wastage, has a positive impact on the environment and public health. Improper disposal of medications increases the risk of accidental poisonings, particularly among children. This study aimed to assess the level of knowledge, attitudes, and awareness regarding the proper disposal of unused medicines in Gondar city, northwest Ethiopia., Method: From 30 July to 30 August 2023, a community-based cross-sectional study was conducted among the public in Gondar city. The data were gathered using the Kobo toolbox, exported into an Excel sheet, and then analyzed using SPSS version 27. Multivariate and bivariate binary logistic regressions were performed. A p -value of 0.05 with a 95% confidence interval (CI) was used to determine statistical significance., Result: From 786 study participants, the overall knowledge and attitude of the community toward the proper disposal of unused medicines were 42.6 and 42.9%, respectively. Factors identified in this study included ages between 19 and 25 [AOR = 6.91, 95% CI: (3.45, 13.84); education level: secondary [AOR = 11.82, 95% CI: (1.01, 3.29)] and college and above [AOR = 5.68, 95% CI: (2.25, 14.30)]; prior information [AOR = 6.41; 95% CI: (4.02, 10.22)]; and good attitudes [AOR = 2.11; 95% CI: (1.47, 3.02)]] as factors associated with good knowledge toward proper disposal of unused medicines. In addition, receiving information [AOR = 1.86 95% CI: (1.22, 2.86)], taking medication in the past 6 months [AOR = 1.61, 95% CI: (1.09, 2.38)], and being knowledgeable [AOR = 2.07 95% CI: (1.46, 2.94)] were factors contributing to positive attitudes toward the disposal of unused medicines among the general public. Furthermore, approximately 369 participants (46.9%) in our study lacked awareness about the harmful effects of disposing of unused medicine in regular waste., Conclusion: A relatively low level of knowledge and attitudes about the proper disposal of unused medications is present in the community. In this regard, a well-coordinated and methodical public awareness campaign is recommended to disseminate information and promote the appropriate disposal of unused medications., 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 Tegegne, Genet, Workie Limenh, Yohannes, Mohammed Seid, Alemayehu, Ayenew and Simegn.)

The burden of multidrug-resistant tuberculosis (MDR-TB) related to mortality in resource-poor countries remains high. This study aimed to estimate the incidence and predictors of death among MDR-TB patients in central Ethiopia. A retrospective follow-up study was conducted at three hospitals in the Amhara region on 451 patients receiving treatment for MDR-TB from September 2010 to January 2017. Data were collected from patient registration books, charts and computer databases. Data were fitted to a parametric frailty model and survival was expressed as an adjusted hazard ratio (AHR) with a 95% confidence interval (CI). The median follow-up time of participants was 20 months (interquartile range: 12, 22) and 46 (10.20%) of patients died during this period. The incidence rate of mortality was 7.42 (95% CI 5.56-9.91)/100 person-years. Older age (AHR = 1.04, 95% CI 1.01-1.08), inability to self-care (AHR = 13.71, 95% CI 5.46-34.40), co-morbidity (AHR = 5.74, 95% CI 2.19-15.08), low body mass index (AHR = 4.13, 95% CI 1.02-16.64), acute lung complications (AHR = 4.22, 95% CI 1.66-10.70) and lung consolidation at baseline (AHR = 5.27, 95% CI 1.06-26.18) were independent predictors of mortality. Most of the identified predictor factors of death in this study were considered to be avoidable if the TB programme had provided nutritional support for malnourished patients and ensured a close follow-up of the elderly, and patients with co-morbidities.