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Belete Kassa Alemu, Desye Misganaw Pharmacology and Toxicology Unit, Department of Pharmacy, College of Medicine and Health Sciences, Wollo University, Dessie, EthiopiaCorrespondence: Belete Kassa AlemuPharmacology and Toxicology Unit, Department of Pharmacy, College of Medicine and Health Sciences, Wollo University, P O Box 1145, Dessie, EthiopiaTel +251 918330307Fax +251 333115052Email belete.kassa@wu.edu.etBackground: A current challenge in malaria control and elimination is the progressive resistance to most antimalarial drugs which necessitates the discovery of new options. Hence, the current study was initiated to investigate the antimalarial activity of the stem bark of Fagaropsis angolensis in mice.Methods: The test material was extracted using 80% methanol in a cold maceration technique and further fractionated in solvents of varied polarity. Acute oral toxicity was assessed following the OECD guideline no. 425 protocol. Then, the antimalarial activities of the crude extract and the fractions were evaluated in a 4-day suppression test. Rane’s test was also used to evaluate the curative potential of the n-butanol fraction that showed the highest effect during the 4-day suppressive test. Parameters such as parasitemia suppression, mean survival time, packed cell volume, rectal temperature, and body weight were determined to establish the activity.Results: The acute oral toxicity test indicated that the plant did not cause any signs of behavioral changes or mortality at 200 mg/kg limit dose. In a 4-day suppression test, a significant dose-dependent reduction in the parasitemia level and prolongation of survival time were observed (p< 0.001) in all three doses of the crude extract compared with the negative control. The crude extract also exhibited a significant (p< 0.001) protective effect in packed cell volume and rectal temperature decline in all three doses in a dose-dependent fashion compared with the negative control. Among all fractions, the n-butanol fraction displayed the highest effects in all parameters in the 4-day suppression test. In addition, the n-butanol fraction also showed a significant percentage of parasitemia suppression effects at all doses in Rane’s test. Furthermore, higher free radical scavenging activity was observed in the n-butanol fraction and the 80% methanol extract.Conclusion: This study established that Fagaropsis angolensis had shown potential antimalarial activity as evidenced by the significant effects in the different parameters, upholding its traditional use for the treatment of malaria and laying the foundation for further investigations.Keywords: antimalarial activity, Plasmodium berghei, Fagaropsis angolensis, parasitemia, antioxidant activity

Belete Kassa Alemu, Desye Misganaw, Getnet Mengistu Pharmacology and Toxicology Unit, Department of Pharmacy, College of Medicine and Health Sciences, Wollo University, Dessie, EthiopiaCorrespondence: Belete Kassa AlemuPharmacology and Toxicology Unit, Department of Pharmacy, College of Medicine and Health Sciences, Wollo University, Dessie, EthiopiaTel +251 918330307Fax +251 333115052Email belete.kassa@wu.edu.etBackground: Acokanthera schimperi is traditionally used for the treatment of wounds and various bacterial infections. Due to the ongoing escalation of antimicrobial resistance, there is an increasing demand for the appropriate wound care and hence, the present study was initiated to investigate the wound healing effects of the leaf extract ointments of A. schimperi in mice and its in-vitro antioxidant activity.Methods: The crude extract was prepared as 5% and 10% w/w ointments for topical use in mice. Wound contraction and epithelialization period were determined in excision and infected models, whereas tensile strength was determined in an incision model. Besides, its antioxidant activity was evaluated using the DPPH method.Results: In this study, the 10% w/w extract ointment did not cause toxicity at the 2000 mg/kg limit dose. In the excision model, the 10% w/w ointment exhibited a significant wound contraction effect starting from day 6 to 14 with a complete epithelization shown on day 13. Besides, the 5%w/w ointment showed a significant wound contraction effect starting from day 6 onwards, and a significant decrease in the epithelization period observed on day 16. Conversely, both the 10% w/w and 5% w/w ointments showed significant wound contraction effects starting from day 4 and onwards in the infected model. However, a complete epithelization period was observed on days 14 and 18 in the 10%w/w and 5% w/w/extract ointment treated groups, respectively. In the incision model, the 10% (w/w) and 5% (w/w) extract ointments showed a significant increase in tensile strength by 36.80 and 32.23%, respectively. Moreover, the antioxidant activity of the extract was concentration-dependent with an IC50 value of 5.49± 0.38 μg/μL.Conclusion: The potential wound healing effects of this plant may provide a candidate source in the discovery of new drugs for the treatment of wounds.Keywords: wound healing, antioxidant activity, extract ointments A. schimperi

Belete Kassa Alemu,1 Kefyalew Ayalew Getahun,2 Wubayehu Kahaliw2 1Department of Pharmacy, College of Medicine and Health Sciences, Wollo University, Dessie 1145, Ethiopia; 2Department of Pharmacology, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, EthiopiaCorrespondence: Belete Kassa AlemuDepartment of Pharmacy, College of Medicine and Health Sciences, Wollo University, P O Box; 1145, Dessie, EthiopiaTel +251 918330307Fax +251 333115052Email beletekassa0@gmail.comBackground: Brassica carinata is one of the traditional medicinal plants used in Ethiopia for the treatment of wounds and other diseases. However, the plant has not been scientifically validated, and thus the present study evaluated the in vitro anti-oxidant and the in vivo wound healing activity of the crude extract and solvent fractions of B. carinata seeds in mice.Materials and Methods: The crude extract was prepared by maceration using 80% methanol and formulated as 5% and 10% w/w ointments for topical application. The acute dermal toxicity was performed in female albino rats based on Organization for Economic Cooperation and Development (OECD) guideline number 434. Excision and incision wound healing models were used to evaluate the wound healing activities of crude extract and solvent fractions ointments in mice. Wound healing parameters such as wound area contraction and the period of epithelialization were determined in an excision model, whereas tensile strength was determined in an incision model. Moreover, the crude extract and solvent fractions were evaluated for the free radical scavenging activities in DPPH assay.Results: The acute dermal toxicity test showed that a limit dose of 2,000 mg/kg of 10% w/w crude extract ointment did not cause dermal toxicity in mice. In the excision wound model, the data revealed that 10% w/w ointment exhibited a significant wound contraction (from day 6 to 16, P< 0.001) effect with a significant decrease in epithelization period (at day 14, P< 0.001). In addition, 5% ointment of the crude extract showed a significant effect in wound contraction (from day 8 onwards, P< 0.01) and epithelization period (at day 16, P< 0.01). Despite all fractions being shown to promote wound healing, 10% w/w aqueous and ethyl acetate fractions showed a significant wound contraction (P< 0.001) effect starting from the 4th day onwards. Besides, the maximum antioxidant activity was seen in the aqueous fraction with an IC50 value of 3.45± 0.12 mg/mL.Conclusion: The present study demonstrated that the 80% methanol extract and solvent fractions of the seeds of B.carinata possess potential wound healing and anti-oxidant effects, supporting the traditional use of the plant for wound management.Keywords: wound, epithelialization, tensile strength, incision, excision, B. carinata, antioxidant

Getnet Mengistu,1 Desye Misganaw,1 Tessema Tsehay,2 Belete Kassa Alemu,1 Kassahun Bogale2 1Pharmacology and Toxicology Unit, Department of Pharmacy, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia; 2Clinical Pharmacy Unit, Department of Pharmacy, College of Medicine and Health Sciences, Wollo University, Dessie, EthiopiaCorrespondence: Getnet MengistuPharmacology and Toxicology Unit, Department of Pharmacy, College of Medicine and Health Sciences, Wollo University, P.o. Box 1145, Dessie, EthiopiaTel +251 912 49 26 92Fax +251 333115052Email mgetnet12@gmail.comBackground: Enhancing the standards of medical treatment at all levels of the healthcare delivery system can improve the quality of life in developing countries. One method to promote rational drug use is an assessment of drug use pattern based on drug use indicators.Objective: To evaluate prescription patterns at the outpatient pharmacy of Dessie Referral Hospital and Boru Meda Hospital at Dessie town.Methods: An institution-based retrospective cross-sectional study was conducted to assess the prescribing patterns in governmental hospitals of Dessie town from April 1 to May 30, 2019. Six hundred eligible prescriptions were selected from each hospital through a systematic random sampling technique.Results: The result of this study showed that both hospitals used standard prescriptions (100%). Age (99.0%) and name (94.7%) of patients were the most commonly recorded patient information while weight, address of patients and diagnosis were recorded only in 1.1%, 39.2% and 61.3% of the studied prescription papers, respectively. A total 2409 drugs were prescribed in the 1200 prescription papers and the percentage of encounters with injection(s) and antibacterial(s) was 9.0% and 42.6%, respectively. At each hospital, all drugs were prescribed from the Ethiopian essential drug list.Conclusion: The present study revealed the use of standard presecription papers at both hospitals. None of the patient-related information was completely written in all prescrptions. For drug-related information, only the name of the drug was written in all prescription papers. There is also a significant deviation from the acceptable WHO standard for prescribing antibiotics.Keywords: prescription pattern, completeness, WHO core prescribing indicators, Dessie, Ethiopia

Desalegn Birara Mamo, 1 Belete Kassa Alemu 2 1Medicine Department, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia; 2Department of Pharmacy, Pharmacology and Toxicology Unit, College of Medicine and Health Sciences, Wollo University, Dessie, EthiopiaCorrespondence: Belete Kassa AlemuDepartment of Pharmacy, College of Medicine and Health Sciences, Wollo University Address PO Box 1145, Dessie, EthiopiaTel +251 91 833 0307Fax +251 333115052Email belete.kassa@wu.edu.etBackground: Irrational use of drugs is often observed in health-care systems throughout the world, particularly in developing countries. The World Health Organization estimates that more than half of all medicines are prescribed, dispensed, or sold inappropriately and that half of all patients fail to take them correctly. Therefore, the study was aimed at investigating the practice of rational drug use in a referral and teaching hospital in Northeast Ethiopia.Methods: A hospital-based cross-sectional design was employed to conduct the study from February 2019 to May 2019. Systematic random sampling was used to select prescriptions dispensed in outpatient pharmacies. Convenient sampling was employed to select patient attendants and their prescriptions in outpatient departments during the study period. Data were collected using a structured and technical observational checklist for prescribing, patient care, and health-facility indicators. Face-to-face interviews were also employed to assess patient knowledge of correct dosage among patient-care indicators. Data were analyzed using SPSS version 20. Descriptive statistics are given using frequency, proportions, and summary measures.Results: An average of 2.5 drugs per encounter were prescribed, with 34.64% and 13.80% of prescriptions being antibiotics and injections, respectively. Generics were used in 90.53% of prescription, and nearly 83% of drugs were prescribed from an essential-drug list. Average consultation and dispensing times were 1.57 minutes and 47 seconds, respectively. A total of 362 drugs were prescribed, with 82.6% actually dispensed and only 22.7% adequately labeled. The hospital had its own drug formulary and essential drug list, but no standard treatment guidelines. Moreover, except propyl thiouracil, all key essential drugs included in the study were available.Conclusion: The majority of World Health Organization–stated core drug-use indicators were not met by the referral hospital in this study, which is especially problematic regarding patient-care indicators.Keywords: rational drug use, WHO core drug-use indicators, prescribing indicators, patient-care indicators, health-facility indicators, Dessie Referral Hospital

Background: Cord care is the series of steps applied to handle the umbilical cord after delivery of the newborn. Despite increasing the number of primary health facilities, unhygienic cord care remains persist., Objective: To assess umbilical cord care practices and associated factors among mothers who gave birth in the last six months in Hetosa district, Arsi zone, Ethiopia, 2021., Methods: A mixed-type cross-sectional study design was conducted in the Hetosa district of Arsi zone, from April 15 to May 15, 2021, with 550 mothers using a systematic random sampling technique for quantitative study. Quantitative Data were collected using a structured pretested questionnaire, entered into EpiData version 3.1, and then exported to SPSS version 25 for analysis. Factors associated with outcome variables were identified using logistic regression analysis. Qualitative data was collected through twelve in-depth interviews and analyzed thematically., Result: Overall good cord care practice was 53.4 % [95%CI, 49, 58]. Being in age group ≤ 24years (AOR = 4.55, 95 % CI; 2.08, 9.98) and 24-32years (AOR = 3.70, 95 % CI; 1.98, 6.94), among those who attend primary school (AOR = 5.26, 95 % CI: 2.50, 11.04) and secondary and above (AOR = 3.63, 95 % CI: 1.61, 8.18), health facility delivery (AOR = 5.09, 95 % CI; 2.95, 8.78), and having good knowledge about cord care(AOR = 8.58, 95 % CI; 5.09, 14.46) were statically significantly associated with good umbilical cord care practice. Participants believed that applying fresh butter around the stump could protect the baby., Conclusion: and recommendation: The study found that the percentage of mothers practicing good cord care was low. To improve this, policies and strategies should focus on women's education, encouraging institutional delivery and family planning use among aged mothers, and health education during ANC visits and addressing community beliefs through culturally sensitive health promotion strategies particularly focusing on older mothers and traditional birth attendants to improve cord care practices., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors.)

Background: The preconception period is a window of opportunity to influence maternal and pregnancy outcomes. Inappropriate use of antibiotics results in gut dysbiosis and may affect host reproductive health through multiple dimensions. Animal studies demonstrate that antibiotic treatment profoundly affects ovarian functions and the estrous cycle, and it has a direct implication for infertility. Infertility was defined as the inability to conceive after 12 months of unprotected intercourse. However, whether antibiotic exposure in the preconception period influences female fertility, miscarriage, and congenital malformation remains obscure and controversial., Methods: A systematic review and meta-analysis until April 20, 2024, was conducted by searching PubMed, Web of Science, Scopus, and Science Direct without restrictions to designs and language. The risk of bias was assessed by two independent reviewers using the Newcastle Ottawa Scale (NOS) and the Risk of Bias 2 (RoB-2) tools. The report followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Relative risks (RR), odds ratios (OR), and fecundability ratios (FR) with a 95% confidence interval (CI) were effect size measures determined with a random effect model. Heterogeneity across included studies was assessed using I 2 ,  T2, and H 2 . The review protocol is registered in PROSPERO, CRD42024515680., Findings: Fifteen studies with a total of 1,206,583 participants were included. Preconception exposure to macrolides reduced the FR by 35% (FR: 0.65, 95% CI: 0.48, 0.88, P  < 0.001). Sulfonamide users were also at 2.35 times (OR:2.35, 95% CI: 1.86, 2.97; P  < 0.001) more risk of developing infertility. Using beta-lactams other than penicillin G reduced the odds of infertility by 64% (OR: 0.36, 95% CI: 0.26,0.50; P  < 0.001). The possibility of infertility among quinolone users was 13% lower (OR: 0.87, 95% CI: 0.77, 0.99; P  = 0.03) than non-users. Preconception antibiotics exposure increased the risk of spontaneous miscarriage by 34% (RR: 1.34, 95% CI: 1.16, 1.53; P  < 0.001). Moreover, trimethoprim intake also increased the odds of congenital malformations by 85% (OR:1.85, 95% CI: 1.54, 2.23; P  < 0.001)., Interpretation: Preconception antibiotics exposure in females increases the risk of infertility, miscarriage, and congenital anomalies. Macrolides, sulfonamides, and trimethoprim increase the risk of infertility, spontaneous miscarriage, and congenital malformation while beta-lactams and quinolones reduce the risk. Clinicians, pregnancy planners, and health care policymakers should be warranted for pregnancy needs and success. Further clinical and mechanistic studies are required to illustrate their specific functions and cause effects., Funding: Funded by Leading Discipline Development Fund (No. 403947), The Second Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine; and The Hong Kong Obstetrical and Gynaecological Trust Fund., Competing Interests: We declare no competing interests., (© 2024 The Author(s).)

Background: Microbes in the human body are the determinants of life-long health and disease. Microbiome acquisition starts in utero and matures during early childhood through breastfeeding. However, maternal gut dysbiosis affects the maternal-offspring microbiome interplay. Lines of evidence on dysbiosis-targeted interventions and their effect on maternal-offspring health and gut microbiome are inconsistent and inconclusive. Therefore, this study summarised studies to identify the most common microbiota-targeted intervention during pregnancy and lactation and to comprehensively evaluate its effects on maternal and offspring health., Methods: This umbrella review was conducted by systematically searching databases such as PubMed and the Web of Science from inception to 2 September 2023. The quality was assessed using the Assessment of Multiple Systematic Reviews-2 checklist. The Grading of Recommendations Assessment, Development, and Evaluation was used for grading the strength and certainty of the studies. The overlap of primary studies was quantified by the corrected covered area score., Results: A total of 17 systematic reviews and meta-analyses with 219 randomised controlled trials, 39 113 mothers, and 20 915 infants were included in this study. About 88% of studies had moderate and above certainty of evidence. Probiotics were the most common and effective interventions at reducing gestational diabetes risk (fasting blood glucose with the mean difference (MD) = -2.92, -0.05; I 2  = 45, 98.97), fasting serum insulin (MD = -2.3, -2.06; I 2  = 45, 77), glycated haemoglobin (Hb A1c) = -0.16; I 2  = 0.00)), Homeostatic Model Assessment of insulin resistance (HOMA-IR) (MD = -20.55, -0.16; I 2  = 0.00, 72.00), and lipid metabolism (MD = -5.47, 0.98; I 2  = 0.00, 90.65). It was also effective in preventing and treating mastitis (risk ratio (RR) = 0.49; I 2  = 2.00), relieving anxiety symptoms (MD = -0.99, 0.01; I 2  = 0.00, 70.00), depression in lactation (MD = -0.46, -0.22; I 2  = 0.00, 74.00) and reducing recto-vaginal bacterial colonisation (odds ratio (OR) = 0.62; I 2  = 4.80), and with no adverse events. It also effectively remodelled the infant gut microbiome (MD = 0.89; I 2  = 95.01) and prevented infant allergies. However, studies on pregnancy outcomes and preeclampsia incidences are limited., Conclusions: Our findings from high-quality studies identify that probiotics are the most common microbiome interventions during pregnancy and lactation. Probiotics have a strong impact on maternal and offspring health through maintaining gut microbiome homeostasis. However, further studies are needed on the effect of microbiota-targeted interventions on maternal cardiometabolic health, pregnancy, and neonatal outcomes., Registration: This umbrella review was registered with PROSPERO, CRD42023437098., Competing Interests: Disclosure of interest: The authors completed the ICMJE Disclosure of Interest Form (available upon request from the corresponding author) and disclose no relevant interests., (Copyright © 2024 by the Journal of Global Health. All rights reserved.)

Background: Endometriosis is one of the most common gynaecological diseases, yet it lacks efficient biomarkers for early detection and unravels disease mechanisms. Proteomic profiling has revealed diverse patterns of protein changes in various clinical samples. Integrating and systematically analysing proteomics data can facilitate the development of biomarkers, expediting diagnosis and providing insights for potential clinical and therapeutic applications. Hence, this systematic review and meta-analysis aimed to explore potential non-invasive diagnostic biomarkers in various biological samples and therapeutic targets for endometriosis., Methods: Online databases, including Scopus, PubMed, Web of Science, MEDLINE, Embase via Ovid, and Google Scholar, were searched using MeSH terms. Two independent authors screened the articles, extracted the data, and assessed the methodological quality of the included studies. GO and KEGG analyses were performed to identify the pathways that were significantly enriched. Protein‑protein interaction and hub gene selection analyses were also conducted to identify biomarker networks for endometriosis., Results: Twenty-six observational studies with a total of 2,486 participants were included. A total of 644 differentially expressed proteins (180 upregulated and 464 downregulated) were identified from 9 studies. Proteins in peripheral blood exhibited a sensitivity and specificity of 38-100% and 59-99%, respectively, for detecting endometriosis, while proteins in urine had a sensitivity of 58-91% and specificity of 76-93%. Alpha-1-antitrypsin, albumin, and vitamin D binding proteins were significantly DEPs in both serum and urine. Complement C3 is commonly expressed in serum, menstrual blood, and cervical mucus. Additionally, S100-A8 is commonly expressed in both menstrual blood and cervical mucus. Haptoglobin is commonly detected in both serum and plasma, whereas cathepsin G is found in urine, serum, and plasma. GO and KEGG enrichment analyses revealed that proteoglycans in cancer pathways, which regulate cell-to-cell interactions, modulate the extracellular matrix, and promote the proliferation and invasion of endometrial cells, are commonly enriched in serum and urine., Conclusion: This comprehensive study revealed potential proteomes that were significantly differentially expressed in women with endometriosis utilizing various non-invasive clinical samples. Exploring common differentially expressed proteins in various biological samples provides insights into the diagnosis and pathophysiology of endometriosis, as well as potential clinical and therapeutic applications., (© 2024. The Author(s).)

Introduction: Neonatal jaundice is a common and life-threatening health problem in neonates due to overaccumulation of circulating unconjugated bilirubin. Gut flora has a potential influence on bilirubin metabolism. The infant gut microbiome is commonly copied from the maternal gut. During pregnancy, due to changes in dietary habits, hormones and body weight, maternal gut dysbiosis is common, which can be stabilised by probiotics supplementation. However, whether probiotic supplements can reach the baby through the mother and reduce the incidence of neonatal jaundice has not been studied yet. Therefore, we aim to evaluate the effect of prenatal maternal probiotic supplementation on the incidence of neonatal jaundice., Methods and Analysis: This is a randomised double-blind placebo-controlled clinical trial among 94 pregnant women (47 in each group) in a tertiary hospital in Hong Kong. Voluntary eligible participants will be recruited between 28 and 35 weeks of gestation. Computer-generated randomisation and allocation to either the intervention or control group will be carried out. Participants will take either one sachet of Vivomixx (450 billion colony-forming units per sachet) or a placebo per day until 1 week post partum. Neither the study participants nor researchers will know the randomisation and allocation. The intervention will be initiated at 36 weeks of gestation. Neonatal bilirubin level will be measured to determine the primary outcome (hyperbilirubinaemia) while the metagenomic microbiome profile of breast milk and maternal and infant stool samples as well as pregnancy outcomes will be secondary outcomes. Binary logistic and linear regressions will be carried out to assess the association of the microbiome data with different clinical outcomes., Ethics and Dissemination: Ethics approval is obtained from the Joint CUHK-NTEC Clinical Research Ethics Committee, Hong Kong (CREC Ref: 2023.100-T). Findings will be published in peer-reviewed journals and presented at international conferences., Trial Registration Number: NCT06087874., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Introduction: Newborn resuscitation is a medical intervention to support the establishment of breathing and circulation in the immediate intrauterine life. It takes the lion's share in reducing neonatal mortality and impairments. Healthcare providers' knowledge and skills are the key determinants of the success of newborn resuscitation. Many primary studies have been conducted in various countries to examine the level of knowledge and skills of newborn resuscitation and associated factors among healthcare providers. However, these studies had great discrepancies and inconsistent results across East Africa. Hence, this review aimed to synthesize the pooled level of knowledge and skills of newborn resuscitation and associated factors among healthcare providers in East Africa., Method: Studies were systematically searched from February 11, 2023, to March 10, 2023, using PubMed, Google Scholar, HINARI, and grey literature. The effect size measurement of knowledge and skill of health care newborn resuscitation was estimated using the Random Effect Model. The data were extracted by Excel and analyzed using Stata 17 software. The Cochran's Q test and I2 statistic were used to assess the heterogeneity of studies. The symmetry of the funnel plot and Egger's test were used to check for publication bias. A subgroup analysis was done on the study years, sample sizes, and geographical location. Percentages and odds ratios (OR) with 95% CI were used to pool the effect measure., Results: In this systematic review and meta-analysis, a total of 1953 articles were retrieved from various databases and registers. Finally, 17 studies with 7655 participants were included. The overall levels of knowledge and skills of healthcare providers on newborn resuscitation were 58.74% (95% CI: 44.34%, 73.14%) and 46.20% (95% CI: 25.16%, 67.24%), respectively. Newborn resuscitation training (OR = 3.95, 95% CI: 2.82, 5.56) and the availability of newborn resuscitation guidelines (OR = 2.71, 95% CI: 1.90, 3.86) were factors significantly associated with knowledge of health care professionals on newborn resuscitation. Work experience (OR = 5.92, 95% CI, 2.10, 16.70), newborn resuscitation training (OR = 2.83, 95% CI, 1.8, 4.45), knowledge (OR = 3.05, 95% CI, 1.78, 5.30), and the availability of newborn resuscitation equipment (OR = 4.92, 95% CI, 2.80, 8.62) were determinant factors of skills of health care professionals on newborn resuscitation., Conclusion: The knowledge and skills of healthcare providers on newborn resuscitation in East Africa were not adequate. Newborn resuscitation training and the availability of resuscitation guidelines were determinant factors of knowledge, whereas work experience, knowledge, and the availability of newborn resuscitation equipment and training were associated with the skills of healthcare providers in newborn resuscitation. Newborn resuscitation training, resuscitation guidelines and equipment availability, and work experience are recommended to improve healthcare providers' knowledge and skills., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Mihretie 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.)

Non-adherence to medications has many deleterious effects including poor treatment outcomes, increased economic burden, increased morbidity, hospitalization rate, health care utilization, productivity loss, and mortality. Therefore, this review aimed to estimate the pooled prevalence of medication adherence among asthmatic adults in 4 African countries. Primary studies were extensively searched from databases such as PubMed, HINARI, Cochrane Library, CINHALand, Google Scholar, and Google search engines. After screening and assessing the quality of studies, data were extracted using a checklist. Heterogeneity was assessed using forest plot, Chocran's Q Test and I 2 . The random effects meta-analysis model was employed to pool the prevalence of medication adherence among adult asthmatic patients in Africa. Sub-group analysis and meta-regression were performed to identify the sources of heterogeneity. Publication bias was assessed using funnel plots with Egger's test. A sensitivity analysis was performed to assess the influence of individual studies on the overall estimate. The review was performed among 16 studies of which 14 were cross-sectional with a total of 4019 participants. The pooled random effects prevalence of adherence to medications among adult patients with asthma in Africa was 39% (95% CI: 32, 47; p < 0.001) with a heterogeneity (I 2  = 94.82, p < 0.001). The pooled prevalence of medication adherence among adult asthmatic patients in Africa is low. Researchers should conduct further multicenter longitudinal studies by using objective methods of adherence measurement., (© 2024 The Authors.)

Objective: The early-life microbiome is formed during the perinatal period and is critical for infants' lifelong health. This is established by maternal-infant microbiome crosstalk, which is mediated by the breast milk microbiome. The milk microbiome is dependent on the maternal gut microbiome, suggesting that it could potentially be restored through oral probiotic supplements. Therefore, we conducted this systematic review and meta-analysis to summarize the effect of maternal probiotic supplements on breast milk and infant gut microbiome composition and on infant health., Data Sources: The PubMed, EMBASE, Web of Science, Scopus, CINAHL, and Science Direct databases were searched until December 15, 2022., Study Eligibility Criteria: Randomized controlled trials following the population, intervention, comparison, and outcome (population: pregnant or lactating women; intervention: probiotics; control: placebo or follow-up; outcome: breast milk and infant gut microbiome composition and infant health) principles were included., Methods: Using a random effect model, the standard mean difference, risk difference, and risk ratio with 95% confidence interval were used to measure each outcome. All analyses were conducted using the intention-to-treat approach. Heterogeneity was evaluated using I 2 statistics., Results: The final data set included 24 randomized controlled trials with a total of 2761 mothers and 1756 infants. The overall effect of probiotics on the beneficial bacteria detection rate in breast milk had a risk difference of 24% (95% confidence interval, 0.1-0.37; P<.001; I 2 =91.12%). The pooled mean beneficial and pathogenic bacteria abundance in breast milk had a standard mean difference of 1.22 log 10 colony forming units/mL (95% confidence interval, 0.48-1.97; P<.001; I 2 =95.51%) and -1.05 log 10 colony forming unites/mL (95% confidence interval, -1.99 to -0.12; P=.03; I 2 =96.79%), respectively. The overall abundance of beneficial bacteria in the infant gut had a standard mean difference of 0.89 log 10 colony forming units/g (95% confidence interval, 0.22-1.56; P=.01; I 2 =95.01%). It also controlled infant weight gain (standard mean difference, -0.49 kg/equivalent age; 95% confidence interval, -0.82 to -0.17; P<.001; I 2 =0.00%) and decreased the occurrence of infantile colic (risk ratio, 0.30; 95% confidence interval, 0.16-0.57; P<.001; I 2 =0.00%)., Conclusion: Maternal probiotic supplements effectively orchestrate the breast milk and infant gut microbiome with a wide range of clinical benefits and safety. Lactobacillus, Bifidobacterium, Streptococcus thermophilus, and S. boulardii can be used as maternal supplements to promote infant health., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Background: Anemia is still one of the major public health problems in many developing countries including Ethiopia. Thus, this study aimed to assess individual and contextual-level factors associated with iron-folic acid supplement intake during pregnancy in Ethiopia., Methods: A secondary analysis was done on the 2019 mini-Ethiopian Demographic and Health Survey (EDHS) dataset. A total of 3,927 pregnant women who gave birth five years before the survey were included in the analysis. Multi-level mixed-effect logistic regression analysis was done by STATA/SE version 14.0 to identify individual and contextual-level factors. Adjusted Odds Ratio (AOR) with 95% Confidence Interval (CI) was used to show the strength and direction of the association. The level of statistical significance was declared at a P value less than 0.05., Results: Those primary educated [AOR = 1.83, 95% CI: (1.24, 2.74)], secondary educated [AOR = 2.75, 95% CI: (1.57, 4.824)], women who had greater than 5 living children [AOR = 2.02, 95% CI: (1.25, 3.27)], women who had ANC visit [AOR = 21.26, 95% CI: (13.56, 33.32)] and women who lived in a cluster with high proportion of women had ANC visit [AOR = 1.72, 95% CI: (1.17, 2.54)] and women who lived in Somali [AOR = 0.44 0.73, 95% CI: (0.22, 0.87)] were significantly associated with iron-folic acid intake during pregnancy., Conclusions: Both individual and contextual-level factors were significantly associated with iron-folic acid intake during pregnancy. From individual-level factors: education status of women, the total numbers of living children, and ANC follow-up are significant and from contextual-level factors: region and living in a high proportion of women who had ANC follow-up were found to have a statistically significant association. Promoting women's education and maternal health services like ANC and intervention targeting the Somali region would be the recalled area of the government., (© 2023. The Author(s).)

Objective: To investigate medications prescribed for pregnant women and their potential teratogenicity risk in Kemisse General Hospital., Result: A total of 263 medical records of pregnant women were reviewed, of which 234 pregnant women were prescribed with a total of 430 prescription drugs. The average numbers of drugs per pregnant women was found to be 1.84. Most pregnant women 166 (63.2%) were in the third trimester and more than half of them (51.3%) were multigravida. The maximum number of drugs were prescribed in the second trimester 162 (37.67%) followed by third trimester 143 (33.26%). Supplemental drugs were the most widely used medications 297 (69.07%) and followed by 82 (19.1%) drugs from category B; 54 (12.6%) drugs from category C; and the rest 7 (1.6%) drugs from category D. There was no any drug from category X. Moreover, approximately one third of the pregnant women encountered with drugs from category B, C and D. However, there were no FDA category C and D drugs prescribed in first trimester.