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Bewuketu Terefe,1 Mahlet Moges Jembere,2 Engidaw Fentahun Enyew,3,4 Bogale Chekole5 1Department of Community Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia; 2Department of Emergency and Critical Care Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia; 3Department of Anatomy, School of Medicine, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia; 4Department of Reproductive Health, Institute of Public Health, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia; 5Department of Comprehensive Nursing, College of Medicine and Health Sciences, Wolkite University, Wolkite, Southern Ethiopia, EthiopiaCorrespondence: Bewuketu Terefe, Department of Community Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Post Office Box: 196, Gondar, Amhara Region, Ethiopia, Tel +251918099504, Email woldeabwoamriam@gmail.comBackground: The international development agenda emphasizes universal access to family planning, as seen in Sustainable Development Goal 3.7. However, the use of modern contraceptive methods remains low in developing countries, specifically in West Africa. This study aimed to assess the current status of contraceptive use in the region, focusing on different methods.Methods: We analyzed Demographic and Health Survey data from 13 West African nations (2012– 2022) involving 117,165 married women. Using binary and multiple multinomial logistic regression, we identified key factors associated with contraceptive use. Adjusted odds ratios with 95% confidence intervals were utilized, and significance was determined at p ≤ 0.2 for binary regression and p < 0.05 for multiple multinomial regression.Results: About 80.86% of women did not use any method, while 16.56% of women used modern methods. Maternal age of 35– 49 years (RRR=0.77, 95% CI, 0.72,0.82), had given first birth after 20 years (RRR=0.80,95% CI, 0.77,0.83), cohabitation after 20 years old (RRR=1.24,95% CI, 1.18,1.29), being employed (RRR=1.38,95% CI, 1.33,1.43), women who have from 3– 5, and more than five living children (RRR=2.06,95% CI,1.97,2.16, and (RRR=2.57, 95% CI, 2.42,2.74), primary(RRR=1.59, 95% CI, 1.52,1.66), secondary/higher education (RRR=2.08, 95% CI, 1.99,2.18), antenatal visit (RRR= 1.38, 95% CI 1.28,1.49), institutional delivery(AOR=1.42, 95% CI, 1.35,1.49), husband working status (RRR=1.39, 95% CI, 1.28,1.51), media exposure(RRR=1.23, 95% CI, 1.19,1.28), visited health facility more than once (RRR=1.09, 95% CI, 1.05,1.13), rural women (RRR=0.89,95% CI,0.85,0.93), female households (RRR=0.79, 95% CI,0.76,0.83), richer (RRR=1.42, 95% CI,1.33,1.51), and richest wealth indexes (RRR=1.69,95% CI,1.58,1.82) were associated.Conclusion: This study revealed a low level of contraceptive use among women in West Africa. Strengthening maternal reproductive health services, such as antenatal care, institutional delivery, and health visits, while also targeting mass media and disadvantaged women, has the potential to significantly increase the adoption of modern contraception techniques.Keywords: contraceptive utilization, family planning, married women, West Africa, multinomial logistic regression

Background: Antiretroviral treatment failure is a global issue, particularly in developing countries such as Sub-Saharan Africa. Prior research findings were highly variable and inconsistent across areas. As a result, the goal of this systematic review and meta-analysis was to determine the pooled prevalence of treatment failure among children receiving antiretroviral medication in Sub-Saharan Africa., Methods: To find qualifying papers, we searched databases (such as PubMed, Google Scholar, African Journals Online, Scopus, and the Cochrane Library). The data were retrieved using Microsoft Excel and exported to STATA Version 14 for analysis. To check for publication bias, we employed Egger and Begg's regression tests. A random-effects model was used to assess the pooled prevalence of treatment failure due to high levels of variability., Results: Following the removal of duplicated articles and quality screening, a total of 33 primary articles were determined to be appropriate for inclusion in the final analysis for this study. Overall, the pooled prevalence of treatment failure among HIV-infected children was 25.86% (95% CI: 21.46, 30.26). There is great variety across the included studies, with the majority of them being conducted in Ethiopia. Cameroon had the greatest pooled prevalence of treatment failure among HIV-infected children, at 39.41% (95% CI: 21.54, 57.28), while Ethiopia had the lowest, at 13.77% (95% CI: 10.08, 17.47)., Conclusions: The pooled estimate prevalence of treatment failure among HIV-infected children in Sub-Saharan Africa was high. The implementation of national and international policies and strategies on ART clinic care services should be given special focus in order to reduce treatment failure in children living with HIV/AIDS., Trial Registration: The protocol has been registered in the PROSPERO database under the registration number CRD-429011., (© 2024. The Author(s).)

Introduction: Globally, about 45 million under-five children have suffered from wasting where Asian and African countries have the major share of these wasted children. Despite wasting is affected all types of populations, the long and short term effect is more severe and sensitive in under-two aged children. Hence, this review was intended to assess pooled prevalence and associated factors of wasting among under-two children in Ethiopia., Methods: The search was done using electronic data bases (Hinari, PubMed, Google scholar, Scopus) and research repositories from June 19-22/2023. The review included articles published between January 2013 and December 2023.The study included Cross-sectional/case control studies which report the prevalence and associated factors of wasting in under-two aged children. The quality of included studies was assessed using the Joanna Briggs Institute (JBI) quality assessment checklists for observational studies. The presence of heterogeneity between included studies was evaluated using Cochrane Q-test and the I 2 statistics. Publication bias was checked through graphical and statistical test. Associated factors were estimated by random effect model using DerSimonian-Laird model weight., Results: The pooled prevalence of wasting among under-two children was 10.91% (95% CI: 8.97-12.85; I 2  = 86.36%). Absence of maternal antenatal follow up (OR; 3.23: 95%CI: 1.20-5.26), no exclusive breast feeding until six months (OR; 5.30; 95%CI: 1.17-9.43), current illness of the child (OR; 2.58: 95%CI: 1.78-3.37), large family size (OR; 12.38; 95%CI: 1.37-26.13) and low wealth status of the households (OR; 3.91; 95%CI: 1. 54-8.36) were significant factors of wasting among under-two children., Conclusions: This study disclosed that the pooled prevalence of wasting among under- two children were high in Ethiopia. Absence of maternal antenatal follow up, no exclusive breast feeding, low wealth status of the households, large family size and current illness of the child were significant factors of wasting. Strictly adherence of maternal antenatal follow up, counsel the parents to feed only breast milk until six months, limit the number of family size to the level of the household income and early treatment of the sick child were recommended. Furthermore, scale up the wealth status and living standard of the family can address the agenda of reducing and eradicating all forms of malnutrition. This review registered at PROSPERO with registration number CRD42023414914 ( https://www.crd.york.ac.uk/prospero/#myprospero )., (© 2024. The Author(s).)

Background: The Joint Monitoring Program (JMP) for water supply and sanitation developed by the WHO and UNICEF defines safe child feces disposal practices as either burial or defecation into a toilet. Children become exposed to fecal-oral illnesses when their stools are not disposed of appropriately, and this vulnerability persists until all children's stools are properly disposed of. Data on the elements influencing child feces disposal in East Africa is scarce. Hence, this study aimed to assess the prevalence and associated factors of safe child feces disposal in East Africa., Methods: Data from the Demographic and Health Surveys, which were collected between 2015 and 2022 in 10 East African nations, were used in this analysis. For a weighted 44,821 children under the age of two, we examined additional features as well as how child feces were disposed of. Both bivariable and multivariable multilevel logistic regression were carried out to choose potential components and identify important explanatory variables connected to the outcome variable. With 95% confidence intervals, adjusted odd ratios (AORs) were used to present the results. P values of ≤ 0.2 and < 0.05 were used to investigate significant factors in the binary and multivariable multilevel logistic regression models respectively., Results: Approximately 65.54% (95% CI: 65.10, 65.98) of children's waste was disposed of properly. Women age from 35 to 49 years (AOR = 1.12, 95% CI: 1.05-1.19) 15-24 years old, primary (AOR = 1.62, 95% CI, 1.53,1.72), and secondary/higher education (AOR = 1.22, 95% CI, 1.14,1.31), women from highly educated community (AOR = 1.33, 95% CI, 1.22,1.46), employed (AOR = 1.29, 95% CI, 1.24,1.35), poorer(AOR = 1.51,95% CI, 1.42,1.61), middle(AOR = 1.67, 95% CI, 1.56,1.78), richer(AOR = 1.96,95% CI, 1.82,2.11), and richest(AOR = 2.08, 95% CI, 1.91,2.27), mass media exposure (AOR = 1.37,95% CI,1.31,1.44), community level mass media exposure (AOR = 1.23, 95% CI, 1.34,1.34), had ANC visit(AOR = 1.71, 95% CI, 1.55,1.88), modern contraceptive(AOR = 1.17, 95% CI, 1.12,1.23), health institution delivery (AOR = 2.22, 95% CI, 2.09,2.34), had an improved toilet facility (AOR = 1.12, 95% CI, 1.07,1.17), children who's their age group from 6 to 11 months old, (AOR = 2.12, 95% CI, 2.01,2.25) and 12-23 months old (AOR = 3.10,95% CI, 2.94,3.27) were the factors associated with higher odds of safe child feces disposal as compared to less than six months old children respectively. Finally, women from high community poverty level (AOR = 0.87, 95% CI, 0.79,0.95), and rural women were the factors associated with lower odds of safe child feces disposal (AOR = 0.91, 95% CI 0.85-0.98) compared to their counterparts respectively., Conclusions: East Africa has a Slightly lower proportion of properly disposing of child feces. There was a strong correlation between characteristics such as residence, mother's age, education level, work status, place of delivery, ANC visit, child's age, wealth index, media exposure, and poverty. Acting on these factors and strengthening and using links between mother and child health care is, thus, strongly advocated., (© 2024. The Author(s).)

Background: Children living with HIV/AIDS are particularly vulnerable to under-nutrition. Under-nutrition associated with HIV/AIDS infection increases the rate of morbidity and mortality in children. To reaffirm a future objective, there needs to be evidence regarding the current national burden of under-nutrition and related factors among children infected with HIV. Hence, the objective of this systematic review and meta-analysis was to estimate the pooled prevalence of under-nutrition, and the pooled effect sizes of associated factors among HIV-infected children in Ethiopia., Methods: We searched Ethiopian universities' online libraries, Google, Google Scholar, PubMed, CINAHL, Cochrane Library, and Scopus to find the primary studies for this review. Publication bias was checked through Egger's regression test. Heterogeneity among the included studies was assessed using the I2 test. The data were extracted using Microsoft Excel and exported to STATA Version 14 statistical software. A random effect meta-analysis model was performed to estimate the pooled prevalence of Under-nutrition., Results: After reviewing 1449 primary studies, 16 articles met the inclusion criteria and were included in the final meta-analysis. The estimated pooled prevalence of stunting, underweight, and wasting among children living with HIV/AIDS was 32.98% (95% CI: 22.47, 43.50), 29.76% (95% CI: 21.87, 37.66), and 21.16% (95% CI: 14.96, 27.35) respectively., Conclusions: This study showed that under-nutrition among HIV-infected children in Ethiopia was significantly high. Under-nutrition is more common among HIV-infected children with opportunistic infections, child feeding problems, do not adhere to dietary recommendations, and have diarrhea. The national policies and strategies for ART service- provider centers should maximize their emphasis on reducing under-nutrition among HIV-infected children. Based on this finding, we recommend HIV intervention programs to address nutritional assessment and interventions for HIV-infected children., Protocol Registration: The protocol has been registered in the PROSPERO database with a registration number of CRD-394170., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Gelaw Walle 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: To address iron deficiency anemia, Multiple Micronutrient Powders (MMNPs) can be sprinkled onto any semisolid diet and given to young children. There is currently no data on actual MMNPs uptake by children; hence, the study's goal was to investigate MMNPs and determinants among children aged 6-23 months in East Africa., Methods: Data from the 2016-2022 East Africa demographic and health survey extracted from Kids Records (KR) files were used in this study. A total of 33,324 weighted 6- to 23-month-old child samples were included. For assessing model fitness and contrast, the intra-class correlation coefficient, median odds ratio, proportional change in variance, and deviance were used. A multilevel logistic regression model was applied to identify variables that may influence MMNPs intake. In the multivariable multilevel logistic regression analyses, variables were judged to be significantly linked with MMNPs intake if their p-values were < 0.05., Results: In East Africa, the prevalence of MMNPs intake among infants aged 6-23 months was 6.45% (95% CI, 6.19%, 6.22%). Several factors were found to be significantly associated with MMNPs consumption. These factors include older maternal age (AOR = 1.23, 95% CI, 1.09, 1.39) and (AOR = 1.46, 95% CI, 1.23, 1.73), poorer (AOR = 0.73, 95% CI, 0.64, 0.84), middle (AOR = 0.75, 95% CI, 0.66, 0.86), richer (AOR = 0.61, 95% CI, 0.52, 0.71), and richest (AOR = 0.49, 95% CI, 0.41, 0.59) as compared to poorest, having employment status (AOR = 0.65, 95% CI, 0.59, 0.71), mass media exposure (AOR = 1.61, 95% CI, 1.35, 1.78), longer birth interval (AOR = 1.19, 95% CI, 1.28, 1.36), place of delivery (AOR = 1.46, 95% CI, 1.28,1.66), and mothers from rural areas (AOR = 0.71, 95% CI, 0.62,0.80)., Conclusions: Overall, MMNPs intake was lower than the national and international recommendations. Only seven out of every hundred children received MMNPs. Improving maternal preventive health care and supporting marginalized women will have a positive impact., (© 2024. The Author(s).)

Background: Despite breastfeeding recommendations, the prevalence and length of breast milk feeding in developing nations is rapidly decreasing, with bottle feeding taking its place. This reduces the effectiveness of breastfeeding and is associated with diarrheal disease mortality and morbidity. The purpose of this study was to determine the prevalence, distribution, and determinants of bottle feeding among under-two-year-old children in the region., Methods: The ten East African countries' Demographic and Health Surveys (DHS) recent data from 2015 to 2022 was used. The data were weighted using sample weights for probability sampling and nonresponse. The study used 43,150 weighted children. A multi-level logistic regression model was used, and P - values of ≤ 0.2 and < 0.05 were used to declare candidate variables in the binary, and multivariable to declare significant variables, respectively., Results: The prevalence of bottle feeding among children under-two-years-old in East Africa was 10.08% (95% CI 9.79, 10.36), ranging from 4.04% (95% CI 3.56, 4.53) in Tanzania to 33.40% (95% CI 32.72, 34.08) in Kenya. High antenatal care communities (AOR 1.22; 95% CI 1.11, 1.35), mothers aged 25-34 years (AOR 1.17; 95% CI 1.06, 1.28), high wealth index communities (AOR 1.12; 95% CI 1.02,1.25), women who had at least one types mass media exposure (AOR 1.64; 95% CI 1.53, 1.77), women from communities with high level mass media exposure (AOR 1.36; 95% CI 1.23, 1.52), given first birth after teenage years (AOR 1.17; 95% CI 1.09, 1.26), having more than one health visit in the year (AOR 1.37; 95% CI 1.27,1.47), multiple children (AOR 1.46; 95% CI 1.22, 1.75) were associated with higher rates of bottle feeding. Whereas a primary education (AOR 0.51; 95% CI 0.47, 0.54), having 3-5 living children (AOR 0.86; 95% CI 0.79, 0.95), a rural setting (AOR 0.53; 95% CI 0.49, 0.58), and a long distance from health facilities (AOR 0.84; 95% CI, 0.78, 0.91) were associated with lower rates of bottle feeding., Conclusions: The overall prevalence of bottle feeding was moderate in East African countries. Improving the availability and accessibility of health facilities to mothers, utilizing maternal healthcare, and media exposure will contribute to a significant decrease in the inappropriate bottle feeding of children in East Africa., (© 2024. The Author(s).)

Background: Undernutrition is the leading cause of mortality among children infected with HIV particularly in resource-deprived settings. Despite several studies were disclosed the effect of undernutrition on mortality of children living with HIV in Ethiopia, the findings were fragmented and inconclusive. Therefore, this review aimed to determine the pooled effects of undernutrition on mortality of children infected with HIV in Ethiopia., Methods: The search were performed using international online electronic data bases (MEDLINE/though PubMed, Google scholar, Hinari, Scopus and open Google). The review included only retrospective/prospective cohort studies reporting the effects of undernutrition on mortality of children infected with HIV. Heterogeneity between included studies was assessed using Cochrane Q-test and the I 2 statistics. Sub-group analysis was done by study regions, sample size and publication year., Results: A total of 1345 articles were identified from databases. Among these, 14 studies met the inclusion criteria and included in the study. Meta-analysis of 4 studies revealed that stunting has a significant effect on mortality of children infected with HIV (AHR: 3.36; 95 % CI: 2.95-3.77). Of 14 included studies, 6 articles indicated that wasting has a significant effect on mortality in children infected with HIV (AHR: 3.93; 95 % CI: 2.56-5.30) as compared to their counterparts. Furthermore, the pooled effect of 8 studies showed that underweight has 3.4 times hazard of death among children who lived with HIV as compared to well-nourished children., Conclusion: This review revealed that undernutrition has deleterious effect on mortality of children infected with HIV/AIDS by disease progression and prone the children to serious opportunistic infections. From the study, the authors recommended that nutritional status of children on antiretroviral therapy need to be evaluated regularly., 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 Published by Elsevier Ltd.)

Background: Despite the harmful effects of smoking, there have been few studies to pinpoint the factors of this habit, and little is known about it in the East African region. For this reason, this study sought to determine the frequency and factors of cigarette smoking among men in the region., Methods: Data from recent demographic and health surveys carried out in ten East African countries between 2015 and 2022 were analyzed in this study. Data from 87,022 men was collected. The key factors affecting the smoking rates in the area were investigated using binary and multiple multinomial logistic regression. To ascertain if variables were statistically significant in the final model for binary regression and multiple regression, P values of ≤ 0.2 and < 0.05 were used respectively., Results: Overall, about 14.69% of people currently smoke cigarettes. Of this about 11.03 (95% CI = 10.82, 11.24) was for daily active tobacco use. As compared to < 26-year-old men, men with an age range of 26-35 years (RRR = 2.17, 95% CI: 2.01,2.34), 36-45 years (RRR = 2.82, 95% CI: 2.60, 3.07), and > 45 years old (RRR = 3.68, 95% CI: 3.38, 4.02), were using cigarettes daily rather than no-smoking cigarettes. Men who had begun their first sexual intercourse at the age of 7-19 years (RRR = 6.27,95% CI, 5.35,7.35), 20-25 years (RRR = 4.01, 95% CI, 3.40,4.72), and greater than 25 years old (RRR = 3.08, 95% CI, 2.55,3.71) have shown a higher relative risk ratio to smoke cigarette daily rather than using not smoke cigarette respectively, married (RRR = 0.86, 95% CI, 0.79,0.93), divorced or widowed (RRR = 2.51, 95% CI, 2.27,2.77), middle wealth index (RRR = 2.11, 95% CI 1.98,2.24), and rich (RRR = 1.44, 95% CI, 1.34,1.54), secondary/higher education (RRR = 0.72, 05% CI, 0.66,0.77), rural men (RRR = 0.69, 95% CI, 0.65,0.73), employed men (RRR = 1.26,95% CI, 1.17,1.36), mass media exposure (RRR = 0.76, 95% CI, 0.73,0.81), men who have one sex partner (RRR = 1.23,95% CI,1.13,1.35), and more than one sex partner (RRR = 1.63, 95% CI, 1.47,1.79) more times as compared to those participants who had no sex partner respectively., Conclusions: Men in East African nations were substantially more likely to smoke cigarettes if they were older, had less education, had a higher wealth index, were divorced or widowed, had many sexual relationships, had early sexual activity, resided in an urban area, were employed, or had no media exposure. The identified factors should be considered by policymakers and public health professionals to lower smoking initiation and increase smoking cessation among men., (© 2024. The Author(s).)

Background: Intestinal parasitic infections are the world's largest public health issue, primarily in developing nations. The World Health Organization (WHO) recommends deworming as a preventative or therapeutic measure for all vulnerable people residing in endemic areas. Despite this issue, there is little data on the prevalence and associated factors of deworming drug use among children under five years of age in East Africa., Objective: This study aimed to evaluate the prevalence and contributing factors of deworming coverage among children under the age of five in East Africa using the most available national health survey data., Methods: Data from the Demographic and Health Survey, which included 103,865 weighted children between the ages of 12-59 months, were used in this investigation. Our outcome of interest was taking deworming medicine six months before the interview. A logistic regression model was then fitted. A cutoff P value of 0.2 was used in the binary logistic regression analysis. To identify significant variables, a 95% confidence interval and adjusted odds ratio (AOR) with a value < 0.05 were used., Results: The prevalence of deworming in East Africa was 54.13% (95% CI: 53.83%-54.43%). The maternal age group of 24-34 years, and from 35-49 years (AOR = 1.37, 95% CI, 1.32,1.42), and (AOR = 1.71, 95% CI, 1.62,1.79), employed women (AOR = 1.62, 95% CI, 1.58,1.67), being from rural(AOR = 1.11,95% CI,1.07,1.15), unmarried mothers (AOR = 1.12,95% CI,1.09,1.15), mothers from poorer, middle, richer, and richest households (AOR = 1.16,95% CI, 1.12,1.21), (AOR = 1.23, 95% CI, 1.18,1.28), (AOR = 1.22,95% CI, 1.16,1.27), and (AOR = 1.27, 95% CI, 1.21,1.34) having at least one antenatal care follow up(AOR = 2.90, 95% CI, 2.63,3.16), health facility delivery(AOR = 1.69, 95% CI,1.64,1.75), mass media exposure AOR = 1.32, 955 CI, 1.29,1.36), having of 3-5 children (AOR = 0.89, 95% CI, 0.86,0.93), more than five children (AOR = 0.79, 95% CI, 0.73,0.86), and parity of 2nd or 3rd birth order (AOR = 1.05, 95% CI, 1.01,1.09) as compared to primi mothers were associated with the deworming among under five children in east Africa respectively., Conclusion: The under-five population in East Africa had a lower prevalence of deworming medication per the most recent DHS findings. Promoting mother and child health services (antenatal care, institutional delivery, family planning), as well as women's empowerment, should be prioritized., Competing Interests: The authors have declared that no competing interests exist., (Copyright: This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication.)

Background: The pregnant woman, the fetus, and the newborn child are all at risk from malaria infection in sub-Saharan Africa. Employing insecticide-treated mosquito nets (ITNs) is one of the most efficient methods for avoiding malaria among expectant mothers. However, there is no literature that describes ITN use among pregnant women in East Africa or the contributing factors. Therefore, this study sought to identify the factors affecting pregnant women's ITN utilization in East Africa., Methods: The most recent DHS (Demographic and Health Survey) data for the 11 East African countries from 2011 to 2022 was used. 13,729 pregnant women were examined. To identify factors associated with ITN use, a binary and multiple logistic regression model was built. Variables having a p-value of less than or equal to 0.2 in the binary logistic regression analysis were taken into consideration for the multivariable analysis. In the multiple logistic regression analysis, the adjusted Odds Ratio (aOR) with the 95% Confidence Interval (CI) was provided to proclaim the statistical significance and degree of correlation., Results: The survey found that just 47.05% (95% CI 46.21, 47.88) of pregnant mothers reported using ITNs. The highest and lowest values were seen in Uganda (64.13%) and Zimbabwe (6.08%). Women age 25-34y (aOR = 1.19; 95% CI 1.11, 1.29), 35-49y (aOR = 1.26; 95% CI 1.13, 1.41) as compared to 15-24 years, poorer (aOR = 1.15; 95% CI 1.04-1.27), middle (aOR = 1.21; 95% CI 1.09, 1.35), and rich (aOR = 1.18; 95% CI 1.06, 1.31) wealth indexes as compared to poorest, having > 5 family size (AOR = 0.84; 95% CI 0.78, 0.91) primary (aOR = 1.49; 95% CI 1.36, 1.65), and secondary/higher education (aOR = 1.52; 95% CI 1.35, 1.70) as compared to not educated, and married women (aOR = 1.64; 95% CI 1.44, 1.86) have shown a statistically significant association with ITN utilization among pregnant women., Conclusion: With a variety of risk variables, including age, wealth, family size, and education, pregnant women in East Africa rarely use ITNs. There is a need to create and strengthen malaria prevention programmes, especially among pregnant women who do not use ITNs, based on the variables mentioned., (© 2023. The Author(s).)

Background: Assessment of quality of life (QoL) in cancer patients can provide an overall picture of the patient's adaptation to the disease and maintain long-term health and well-being. Determining the QoL in cancer patients could help with better care and could be as prognostic as medical factors and the survival benefit that pharmacological treatment could provide. The main objective of this review was to determine the prevalence of QoL among Ethiopian adult cancer patients., Methods: A systematic review was conducted using the "Preferred Reporting Results of Systematic Reviews and Meta-Analyses" guidelines. Databases such as PubMed/Medline, CINAHL, AMED, Embase, the Cochrane Library, ScienceDirect, World Health Organization's Hinari portal, and African Journals Online databases were searched from January 2022 to June 2022. Google, Google Scholar, and university repositories were used to access unpublished studies. Two reviewers independently screened the data using a standardized data extraction format and appraised their quality using the Newcastle-Ottawa Scale., Results: In this review, 10 studies were included. The prevalence of poor QoL ranged from 52 to 89.6. The physical, role, social, and emotional functioning were the most affected domains of QoL and have been significantly associated with QoL. Financial difficulty was the most important predictor of QoL among Ethiopian cancer patients. Pain, dyspnea, nausea, vomiting, and poor appetite were also reported as predictors of QoL. Low income, lower educational status, unmarried status, underweight, anxiety, and depression, advanced stage of cancer, patients with ≤2 cycles of chemotherapy, and the presence of comorbid diseases were significantly correlated with QoL., Conclusions: The QoL of an Ethiopian cancer patient was low. Quality of life assessments, appropriate symptom management, integration of psycho-oncology care, and providing economic support shall be considered to improve their QoL., Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2023.)

Background: Respiratory distress syndrome (RDS) is the leading cause of respiratory failure and death of a neonate in today's world, especially in developing countries like Ethiopia., Methods: We used an institutional-based cross-sectional study in the selected hospitals of the Gurage zone admitted from June 2019 to June 2021. The data were collected using a structured questionnaire. Data were entered into Epi data 3.1 and exported to SPSS version 25 for analysis., Result: The prevalence of respiratory distress syndrome (RDS) in the study area was 45.1%. The odds of RDS in neonates from mothers with gestational age between 35 &37 were 3.99 times higher compared to term gestation. The odds of RDS among neonates with jaundice and sepsis are 4.33- and 1.92-times higher odds compared to their counterparts. The odds of RDS in neonates born via Caesarean section were 1.7 times higher compared with those delivered via spontaneous and instrumental delivery. RDS was also higher in neonates born to mothers <20 years of age and >=35 years old., Conclusion: the prevalence of RDS in the study area was high. Thus, healthcare providers should act on those factors with appropriate follow-up for early detection of the problem and prevent the risk., Competing Interests: The authors have declared that there is no conflict of interest., (© 2023 Chekole B et al.)

Background: Many countries need to accelerate their progress to achieve the sustainable development goal target of neonatal death. It is still high in Ethiopia. Thus, this study aimed to assess the mortality predictors and length of hospital stay among Neonates admitted to the Neonatal Intensive Care Unit of Gurage zone public Hospitals., Method: In this study, a facility-based retrospective follow-up study was applied among 375 neonates admitted to the NICU of selected public hospitals in the Gurage zone from June 1, 2019 to June 30, 2021. The researchers used Epi-Data entry 3.1 for the data entry and then exported it to STATA version 14 for analysis. The Kaplan-Meier survival curve and log-rank test were used to estimate and compare the survival time of categorical variables, respectively., Result: The researchers observed about 85 (22.7% with 95%CI: 18.7, 27.2) deaths from the 2305 person-days follow-up. The median survival time was 14 days. The overall incidence density rate was 36.9 per 1000 person-days observed (95%CI: 29.8, 45.6). Perinatal asphyxia (AHR: 2.9[CI: 1.8; 4.8]), cesarean section as a mode of delivery (AHR: 1.1[CI; 1.01; 1.15]), maternal age of greater or equal to 35 years (AHR: 1.1[95% CI: 1.01, 1.15]), and twin pregnancy (AHR: 2.3[95% CI: 1.2, 4.3]) were predictors of neonatal mortality., Conclusion: The survival rate of neonates was higher compared to other studies. So, to reduce the burden of neonatal mortality, health care providers should give special attention to twin pregnancies, neonates delivered via cesarean section, and neonates with a problem of perinatal asphyxia., Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2023.)

Background: Globally, Pneumonia continues to be the leading cause of mortality among under-five children. Ethiopia ranks fourth out of 15 countries worldwide in terms of the highest death rate of under-five children due to severe community-acquired pneumonia (SCAP). However, to date, there is no recent study that shows survival status and predictors of mortality from SCAP. Therefore, this study aimed to determine survival status and predictors of mortality from this dangerous disease among under-five children., Methods: A facility-based prospective cohort study was conducted from 1 November 2021 to 31 October 2022 at Debre Tabor comprehensive specialized hospital. All under-five children with SCAP admitted during the study period were included. Participants were selected using a systematic sampling technique. The collected data were coded, edited, and entered into epi-data version 4.2 and then exported to STATA version 17 for further analysis. The Kaplan Meier failure estimate with log-rank test was employed to determine the survival estimates. A cox-proportional hazard regression model was fitted to identify significant variables., Results: The overall incidence density rate of mortality was 5.7 /1000 children with a median hospital stay of 8.2 days. Heart disease (AHR: 4.37; 95%CI: 1.68-11.32), previous admission of SCAP (AHR: 3.87; 95% CI: 1.31-11.43), WFL < -3Z score (AHR: 3.57; 95% CI: 1.02-12.42), impaired consciousness level at admission 3.41(1.14-10.19), and pleural effusion (AHR: 3.42; 95%CI: 1.18-9.93) were significant predictors of mortality., Conclusion: In this study, the survival probability of children with SCAP was low. Children with heart disease, previous admission of SCAP, WFL < -3Z score, impaired consciousness level at admission, and pleural effusion had low survival. Therefore, much emphasis is needed on children with SCAP, particularly those with identified predictors., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2023 Kassaw, Kerebih, Zeleke, Chanie, Desalegn, Bante, Teshome, Chekole, Gelaw, Bayih, Tesfaw, Feleke, Kefale, Azmeraw, Chanie, Awoke and Moges.)

Objective: The maternal continuum of care is a cost-effective intervention to prevent pregnancy and childbirth-related maternal and neonatal mortality and morbidity. This study aimed to investigate the prevalence of completion of the maternal continuum of care and its association with antenatal care (ANC) attendance during previous pregnancy among women in rural kebeles of Gurage Zone, Southwest Ethiopia., Design: A community-based cross-sectional study., Setting: The study took place in 12 rural kebeles of the Gurage Zone from 1 April 2022 to 12 May 2022., Participants: Randomly selected 497 women who gave birth in the previous 12 months in rural kebeles of the Gurage Zone., Outcome: The outcome of this study was the prevalence of completion of the maternal continuum of care., Results: Overall, the prevalence of completion of the maternal continuum of care was 15.5% (95% CI: 12.55% to 18.9%). After adjusting for potential confounders, having ANC attendance during a previous pregnancy (adjusted OR (AOR): 2.01; 95% CI: 1.07 to 3.76) was positively associated with the completion of the maternal continuum of care. In addition, having access to ambulance service as a means of transportation (AOR: 6.01; 95% CI: 3.16 to 11.39) and exposure to mass media (AOR: 2.43; 95% CI: 1.27 to 4.68) were positively associated with completion of the maternal continuum of care., Conclusion: The prevalence of completion of the maternity continuum of care was unacceptably low in this study. This result indicates that the women did not receive the maximum possible health benefit from existing maternal healthcare services. The completion of the maternal continuum of care was affected by ANC attendance in a previous pregnancy. Therefore, interventions that can strengthen ANC are crucial in the maternal continuum of the care pathway., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Children's HIV-positive status disclosure is an essential component of chronic care & long-term disease management. The modalities of status disclosure are complex and vary across different communities. Although data from various settings are necessary to overcome this problem, evidence is limited, specifically in the in the study areas. Therefore, this study aimed to assess the prevalence of HIV-positive status disclosure and associated factors among children on antiretroviral therapy (ART)., Methods: A mixed-method, facility-based study was conducted: among 203 caregivers with children in Wolaita Zone, Southern Ethiopia. We used in-depth interviews for qualitative data in addition to structured questionnaires. Simple random sampling for quantitative and purposive sampling for qualitative parts was applied. We used Content or Thematic analysis for qualitative and Binary logistic regression for quantitative., Results: All the caregivers were interviewed and majorities (84.7%) of them were female. One hundred twelve children (55.2%) were below 12 years of age. In this study, the overall prevalence of children with HIV-positive status disclosure was 46.8%. Being 12 or more years of age (AOR = 7.5, 95% CI: 2.9-15.6), duration on ART 72 or more months (AOR = 3.8, 95% CI: 1.7-6.7), death of the parent (AOR = 2.0, 95% CI: 1.1- 3.8), and having follow up in the hospital (AOR = 2.1, 95% CI: 1.3-4.7) were associated with disclosure. Being an immature child was the commonest reason cited by caregivers for non-disclosure. Frequent questions by the child about why they are taking drugs, for better self-care, and treatment adherence were the commonest reason of caregivers for disclosing their children's HIV-positive status., Conclusion: In our study, children's HIV-positive status disclosure was significantly low. This study identified different factors (Health facility, children, and caregivers-related factors) as the main reason for disclosing children's HIV-positive status. Hence, health care workers should give special attention to children's HIV-positive status disclosure, which helps to increase the effectiveness of treatment and prevent further HIV transmission., (© 2022. The Author(s).)

Background: As the use of antiretroviral therapy (ART) increases, the issue of treatment failure is still a global challenge, particularly in a resource limited settings including Ethiopia. The results of former studies in Ethiopia were highly variable and inconsistent across studies. Thus, this systematic review and meta-analysis intended to provide the pooled estimation of treatment failure and associated factors among children on antiretroviral therapy., Methods: We searched international databases (i.e., PubMed, Google Scholar, Web of Science, Ethiopian Universities' online repository library, Scopus, and the Cochrane Library) during the period of February 30 to April 7, 2021. All identified observational studies reporting the proportion of treatment failure among HIV positive children in Ethiopia were included. Heterogeneity of the studies was checked using I2 test and Cochrane Q test statistics. We run Begg's regression test to assess publication bias. A random-effects meta-analysis model was performed to estimate the pooled prevalence of treatment failure., Results: The estimated pooled prevalence of treatment failure among children in Ethiopia was 12.34 (95%CI: 8.59, 16.10). Subgroup analysis of this review showed that the highest prevalence was observed in Addis Ababa (15.92%), followed by Oromia region (14.47%). Poor ART adherence (AOR = 2.53, CI: 2.03, 4.97), advanced WHO clinical staging (AOR = 1.66, CI: 1.24, 3.21), and opportunistic infections (AOR = 2.64 CI: 2.19, 4.31 were found to be significantly associated factors with childhood treatment failure., Conclusions: This study revealed that treatment failure among children on ART was high in Ethiopia. Poor ART adherence, advanced WHO clinical staging, opportunistic infections, and low level of CD4 cell counts increased the risk of treatment failure., Competing Interests: The authors declared that they have no competing interests.

Background: Although there is a presence of governmental and non-governmental organizations running to provide quality HIV care services to reduce HIV-related mortality, there is rapid disease progression and death among children in developing countries including Ethiopia. Thus, this study was aimed to assess the mortality predictors of children living with HIV at Bahir Dar town public health facilities., Method: A facility-based retrospective follow-up study was conducted among 588 children who were enrolled in the HIV care clinic from 1 September 2010 to 30 August 2019. Data were entered into the Epi-Data entry 3.1 and then exported to STATA version 14 for analysis. Multiple imputation models were employed to handle missing data using the multivariate imputation Chained Equations technique. The Kaplan-Meier survival curve and log-rank test were used to estimate and compare the survival time of categorical variables., Result: About 27 (4.6%) (95% confidence interval: 2.9-6.5) deaths were observed from the 30,062.3 person-months follow-up period, and the overall incidence density rate of 0.9 per 1000 child-months (95% confidence interval: 0.6-1.3). Advanced WHO clinical stage (adjusted hazard ratio = 3.18; 95% confidence interval: 1.07-9.43), hemoglobin level less than 8 g/dL (adjusted hazard ratio = 3.54; 95% confidence interval: 1.27-8.85), children having a weight for age of <-2z (adjusted hazard ratio = 2.81; 95% confidence interval: 1.19-6.6), children with poor adherence (adjusted hazard ratio = 3.91; 95% confidence interval: 1.41-10.8), and starting the treatment beyond 1 week of being eligible (adjusted hazard ratio = 3.22; 95% confidence interval: 1.21-8.53) were predictors of HIV-related mortality among children initiated antiretroviral therapy., Conclusion: The hazard of mortality was higher among HIV-infected children in the early period of initiation. Enhancing antiretroviral therapy drug adherence, monitoring Hgb level, and timely initiation of antiretroviral therapy reduce HIV-related mortality., Competing Interests: Declaration of conflicting interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2022.)

Background: Anemia is a major public health problem worldwide which accounts 24.8% of the population. Subsequently, anemia is a leading killer of people living with human immunodeficiency virus and many of these deaths occur in developing countries including Ethiopia. Cross sectional studies have done on anemia and human immunodeficiency virus. However, there is limited study on incidence of anemia and its predictors among adults on HIV care, especially no survival study has been conducted in the study area., Objective: To assess incidence and predictors of anemia among adults on Human immunodeficiency virus care., Methods: An institution-based retrospective cohort study was conducted among 434 adults on HIV care from January 1st 2015 to December 30th 2019 at Debre Tabor Referral Hospital. A computer-generated simple random sampling technique was employed to select the study participants. Ethical clearance was obtained from the Institutional Review Board of Bahir Dar University, and also, we got implied consent to review charts from the concerned bodies in the hospital. Data were entered using Epi-data version 3.1 and analyzed by using STATA version 14.0. A Kaplan Meier survival curve was utilized to estimate anemia free survival time. Bivariable and Multivariable Cox proportional hazards model were fitted to identify predictors of anemia., Results: The overall incidence density rate of anemia was 6.27 (95% CI: 0.051, 0.077) per 100 person years. Clinical stage III/IV (AHR = 1.04; 95% CI = 1.02, 1.06), Body Mass Index less than 18.5 kg/m2 (AHR = 3.11; 95% CI = 1.56, 6.22), serum creatinine greater than 1.1 IU/L(AHR = 2.07; 95% CI = 1.12, 3.81) and fair/poor level of adherence(AHR = 1.05; 95% CI = 1.03, 1.07) were statistically significant predictors of anemia while increased anti-retroviral treatment duration (AHR = 0.98; 95% CI = 0.97, 0.99) decrease the risk of anemia at 95% confidence level., Conclusion: The overall incidence density rate of anemia was high. Patients with clinical stage III/IV, body mass index < 18.5 kg/m2, serum creatinine greater than 1.1 IU/L and fair/poor level of adherence were significant predictors of anemia while increased antiretroviral treatment duration had decreased the risk of anemia., Recommendation: Even if the overall incidence rate of anemia was lower as compared to previous studies in Ethiopia, still the incidence of anemia was high. So, prevention measures should be taken beside with HIV care especially within 6-months ART initiation., Competing Interests: The authors have declared that no competing interests exist.

Introduction: Preterm premature rupture of membrane is the rupture of membrane before 37 weeks of gestational age. It complicates approximately 3 percent of pregnancies and leads to one-third of preterm births. It increases the risk of prematurity and leads to several other perinatal and neonatal complications, including the risk of fetal death. Although the prevalence and associated factors of preterm premature rupture of the membrane were well studied in high-income countries, there is a scarcity of evidence in Ethiopia, particularly in the study area., Method: A hospital-based cross-sectional study design was conducted from 1st June to 30th June 2021 in Wolkite comprehensive specialized hospital. One hundred ninety nine (199) pregnant women were included as study subjects using a systematic random sampling technique. Data were collected using a structured interviewer-administered questionnaire. It carried out descriptive statistical analysis and statistical tests like the odds ratio. Both bivariate and multivariate logistic regression analyses were conducted. Statistically, significant tests were declared at a level of p value < 0.05., Result: The magnitude of preterm premature rupture membrane is 6.6%. Having gestational diabetes mellitus (AOR = 5.99 (95% CI: 1.01, 32.97) and previous history of abortion (AOR = 5.31 (95% CI: 1.06, 26.69) were found to be significantly associated with preterm premature rupture of membrane., Conclusion: Having gestational diabetes mellitus and having a previous history of abortion were significantly associated with preterm premature rupture of membrane., Competing Interests: The authors declare that there is no conflict of interest in this work., (Copyright © 2021 Muche Argaw et al.)

Introduction: Depression is the most common mental health problem in people living with the human immune virus. It ranges from 11% to 63% in low- and middle-income countries. Depression was high in people living with HIV/AIDS in developing countries, especially in the Ethiopian context. Even though depression has negative consequences on HIV-positive patients, the care given for depression in resource-limited countries like Ethiopia is below the standard in their HIV care programs., Method: International databases (Google Scholar, PubMed, Hinari, Embase, and Scopus) and Ethiopian university repository online have been covered in this review. Data were extracted using Microsoft Excel and analyzed by using the Stata version 14 software program. We detected the heterogeneity between studies using the I 2 test. We checked publication bias using a funnel plot test., Results: The overall pooled depression prevalence among adult HIV/AIDS patients attending antiretroviral therapy in Ethiopia was 36.3% (95% CI: 28.4%, 44.2%) based on the random effect analysis. Adult HIV/AIDS patients having CD4count < 200(AOR = 5.1; 95% CI: 2.89, 8.99), widowed marital status (AOR = 3.7; 95% CI: 2.394, 5.789), medication nonadherence (AOR = 2.3; 95% CI: 1.63, 3.15), poor social support (2.986) (95% CI: 2.139, 4.169), perceived social stigma (2.938) (2.305, 3.743), opportunistic infections (3.010) (2.182, 4.151), and adverse drug reactions (4.013) (1.971, 8.167) were significantly associated with depression among adult HIV/AIDS patients on antiretroviral therapy, in Ethiopia. Conclusion and Recommendation . The pooled depression prevalence among adult HIV/AIDS patients attending antiretroviral therapy in Ethiopia was higher than the general population and is alarming for the government to take special consideration for HIV-positive patients. Depression assessment for all HIV-positive patients and integrating with mental health should be incorporated to ensure early detection, prevention, and treatment. Community-based and longitudinal study designs mainly focusing on the incidence and determinants of depression among adult HIV/AIDS patients should be done in the future., Competing Interests: The authors declare that there is no financial and nonfinancial conflict of interest regarding the publication of this paper., (Copyright © 2021 Bitew Tefera Zewudie et al.)

Background: Despite the rapid scale-up of antiretroviral therapy, virologic failure has become global public health concern and challenge, especially in developing countries. Viral load monitoring is an important approach to identify treatment failure and develop public health interventions in children receiving antiretroviral therapy. Thus, this study aims to assess the magnitude and associated factors of virological failure among children on antiretroviral therapy., Methods: A facility-based cross-sectional study was conducted among 399 HIV-positive children on antiretroviral therapy from 2016 to 2019 in Bahir Dar Town public health facilities. Data were extracted from children's charts using a standardized data extraction tool, adapted from ART intake and follow-up forms. Data were entered using Epi-Data Version 3.1, and analyzed using SPSS Version 25. Bivariable and multivariable binary logistic regression models were done to identify factors associated with virological failure. Variables with p-values < 0.25 were fitted into the multivariable analysis. Finally, variables with p-values <0.05 were considered as statistically significant factors., Results: The period prevalence of virological failure was found to be 14.8% (95% CI: 11.5-19.3%). Opportunistic infections (AOR = 2.19, CI: 1.13-4.25), history of treatment interruption and restart (AOR = 2.21, CI: 1.09-4.54), younger age (AOR = 2.42, CI: 1.02-5.74), poor/fair ART adherence (AOR = 2.19, CI: 1.05-4.57), and advanced baseline WHO clinical staging (AOR = 2.32, CI: 1.14-4.74) were found to be factors significantly associated with virological failure., Conclusion: The magnitude of virological failure among HIV-infected children remained high. Children with poor/fair ART adherence, history of treatment interruption, advanced baseline WHO clinical staging, younger age, and opportunistic infections were significantly associated with virologic failure. Thus, special attention should be given to children who had poor/fair ART adherence and presenting with opportunistic infections.