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BackgroundCervical cancer screening and prevention programs have been given considerable attention in high-income countries, while only receiving minimal effort in many African countries. This meta-analytic review aimed to estimate the pooled uptake of cervical cancer screening uptake and identify its predictors in Sub-Saharan Africa.MethodsPubMed, EMBASE, CINAHL, African Journals Online, Web of Science and SCOPUS electronic databases were searched. All observational studies conducted in Sub-Saharan Africa and published in English language from January 2000 to 2019 were included. The Newcastle-Ottawa Scale was applied to examine methodological quality of the studies. Inverse variance-weighted random-effects model meta-analysis was done to estimate the pooled uptake and odds ratio of predictors with 95% confidence interval. I2 test statistic was used to check between-study heterogeneity, and funnel plot and Egger’s regression statistical test were used to check publication bias. To examine the source of heterogeneity, subgroup analysis based on sample size, publication year and geographic distribution of the studies was carried out.ResultsOf 3,537 studies identified, 29 studies were included with 36,374 women. The uptake of cervical cancer screening in Sub-Saharan Africa was 12.87% (95% CI: 10.20, 15.54; I2= 98.5%). Meta-analysis of seven studies showed that knowledge about cervical cancer increased screening uptake by nearly 5-folds (OR: 4.81; 95% CI: 3.06, 7.54). Other predictors include educational status, age, HIV status, contraceptive use, perceived susceptibility, and awareness about screening locations.ConclusionCervical screening uptake is low in Sub-Saharan Africa and influenced by several factors. Health outreach and promotion targeting identified predictors are needed to increase uptake of screening service in the region.sProtocol registrationCRD42017079375

IntroductionHyperemesis gravidarum (HG) is a pregnancy condition characterised by excessive nausea and vomiting resulting in dehydration, weight loss and serious adverse pregnancy outcomes including termination of pregnancies. Even though evidence in low-income and middle-income countries (LMICs) is limited, the prevalence of HG in pregnancy ranges from 0.3% to 10.8%. With this systematic review and meta-analysis, we aim to determine the prevalence/burden, risk factors, and maternal and perinatal outcomes of HG in LMICs.MethodsPubMed, CINAHL, EMBASE, EBSCO, Ovid maternity and infant care databases, Cochrane Database of Systematic Reviews, Web of Science and SCOPUS databases will be searched. Reference lists of selected articles will be assessed in order to identify other potential studies of interest. Observational studies and (non) randomised controlled trials conducted from January 2000 to September 2018 in LMIC will be included. A weighted inverse-variance meta-analysis using fixed-effects and random-effects model will be done to generate a pooled estimate. Funnel plot and Egger’s regression statistical test will be applied to check publication bias. Heterogeneity among studies will be checked using Τ2 to determine dispersion. Moreover, meta-regression analysis will be performed to investigate the source of heterogeneity. STATA V.14 will be used to analyse the data.Ethics and disseminationFormal ethical approval and patient consent are not required; as primary data collection will not be employed. The result will be published in a peer-reviewed scientific journal and will be presented at scientific conferences and public press.PROSPERO registration numberCRD42018096284.

IntroductionGlobally, there has been a dramatic increment of narrative reviews, systematic reviews and overview publication rates. In Ethiopia, only small number of reviews are published and no overviews conducted in biomedical and public health disciplines. Therefore, we aimed to (1) assess the trend of narrative and systematic reviews in Ethiopia, (2) examine their methodological quality and (3) suggest future directions for improvement.MethodsPubMed, EMBASE, Web of Science, SCOPUS, CINHAL, WHO Global Index Medicus, Cochrane Library and PsycINFO electronic databases were searched and supplemented by hand searching as well. All narrative reviews and systematic reviews with or without a meta-analysis from 1970 to April 2018 were included. The International Narrative Systematic assessment (INSA) for narrative reviews and A MeaSurement Tool to Assess Systematic Reviews (AMSTAR-2) for systematic reviews with or without a meta-analysis were used for quality appraisal. Fisher’s exact test at the p-value threshold of 0.05 was used to compare the differences in methodological quality.ResultsOf the 2,201 initially identified articles, 106 articles published from 1970 to 2018 were eligible for full-text review. Among included reviews, 50.9% were narrative reviews, 16% were systematic reviews and 33.1% were systematic reviews with meta-analyses. Twenty-nine percent were published in Ethiopia and 43.4% were published after 2015. 85.1% of narrative reviews poorly described the characteristics of included studies and 63.8% did not report a conflict of interest. In systematic reviews, 89.6%, 91.7%, and 100% did not register/publish the protocol, justifying the selection of the study designs for inclusion and report sources of funding for the primary studies respectively. Overall, 55.3% of narrative reviews and 75% of systematic reviews with or without meta-analysis had poor methodological quality.ConclusionsAlthough publication rate of narrative and systematic reviews have risen in Ethiopia, half of the narrative reviews and three-quarters of the systematic reviews had poor methodological quality. We recommend authors to strictly follow standardized quality assessment tools during conducting reviews. Moreover, immediate interventions such as providing methodological training and employers, editors and peer-reviewers should carefully evaluate all reviews before submission or publication.What is new?Key findingsThe publication rate of narrative and systematic reviews have risen in Ethiopia.Almost half of narrative reviews and three-fourths of systematic reviews with or without meta-analysis had poor scientific methodological quality.What this adds to what is knownTo our knowledge, this is the first overview of its kind providing insight into the publication trend of narrative and systematic reviews, and their methodological rigor in Ethiopia.What is the implication, what should change nowOur review shows that the methodological quality of reviews in biomedical and public health discipline in Ethiopia is substantially low and urges immediate intervention.We recommended authors to strictly follow standardized quality assessment tools during designing, conducting and reporting (systematic)reviews.

Objectives The aims of this overview are to assess the trend of narrative and systematic reviews in Ethiopia, examine their methodological quality, and suggest future directions for improvement. Study Design and Setting All narrative reviews and systematic reviews with or without a meta-analysis on topics associated with Ethiopia irrespective of the place of publication and authors' affiliation were included. The International Narrative Systematic Assessment for narrative reviews and A MeaSurement Tool to Assess Systematic Reviews for systematic reviews with or without a meta-analysis were used for quality appraisal. Fisher's exact test at the P-value threshold of 0.05 was used to investigate associated factors of methodological quality. Results Of 106 articles reviewed, 54 (50.9%) were narrative reviews, 17 (16%) were systematic reviews, and 35 (33.1%) were systematic reviews with meta-analyses. Among 48 systematic reviews with or without meta-analysis, only five (10.4%) registered their protocol, four (8.3%) justified the selection of the study design for inclusion, and none of them reported sources of funding for the primary studies. Overall, 55.3% of narrative reviews and 75% of systematic reviews with or without meta-analysis had poor methodological quality. Conclusions Although publication rate of narrative and systematic reviews has risen in Ethiopia, half of the narrative reviews and three-quarters of the systematic reviews had poor methodological quality.

INTRODUCTION: Dietary management is considered to be one of the cornerstones of diabetes care. Improvement of dietary practice alone can reduce glycosylated hemoglobin (HbA1c) by an absolute 1 to 2% with the greatest impact at the initial stages of diabetes. METHODS: data from Hospital based cross sectional study were used assess the level of dietary adherence and its determinants among diabetic patients. The morisky 8 item medication adherence scale was used to develop 10 item tool for evaluation of dietary adherence. Multiple logistic regression was conducted to identify factors which affect dietary adherence and variables with P vale < 0.05 were considered statistically significant. RESULTS: more than half of 303 participants (55.7%) were found to be non-adherent to the recommended dietary approach. Gathering with family and friends and eating out were the major reasons for not being compliant with the recommended regimen. Attending diabetic nutrition education (AOR= 2.8 95% C 1.97, 5.61) and having the disease for more than 10 years (AOR 2.9 95% CI 1.32, 5.84) were statistically significant with adherence to dietary recommendation. CONCLUSION: non-adherence to recommended dietary practice was observed in more than fifty percent of the patients; it is therefore a major public health problem. Attending diabetic nutrition education and length of diabetes greater than 10 years were the factors associated with adherence to dietary recommendation. This findings indicate that it is important to design strategies to help patients understand their dietary regimens and improve their adherence.

This study aims to assess diabetic patients’ knowledge of their disease, therapeutic goals, self-management, and its association with goal attainment at a hospital in Ethiopia. A prospective cross-sectional study was conducted from February to March 2012 at the diabetic follow-up clinic of Dessie Referral Hospital. Diabetic patients who came for their diabetic follow-up were included consecutively until a calculated sample size of 303 was obtained. Data were collected by face-to-face interview through a pretested structured questionnaire and by medical record review. Binary logistic regression analysis was used to determine predictors of fasting glycemic control. Ninety-nine patients (32.7%) had poor knowledge about their disease. The average fasting blood glucose was 226.57 ± 85.86 mg/dL, and only 61 patients (20.1%) achieved the recommended fasting glycemic goal (70-130 mg/dL). Diabetic patients who had poor knowledge were 5.53 times (95% confidence interval [CI]: 1.85, 16.49) more likely to not attain fasting glycemic goal compared to those who had good knowledge. Patients who did not practice self-monitoring of blood glucose were 3.09 times (95% CI: 1.33, 7.21) more likely to not attain fasting glycemic goal than those who practiced. Failure to achieve fasting glycemic goal was 2.43 times (95% CI: 1.15, 5.13) more common among patients who did not regularly exercise as compared to those who did. Patients who did not adhere to their medication were 3.72 times (95% CI: 1.69, 8.20) more likely to fail to achieve fasting glycemic goal compared to those who adhered to their medication. Fasting glycemic control was below the recommended standard among the study participants. Glycemic control was poor among patients who had poor knowledge, did not practice self-monitoring of blood glucose, did not participate in regular exercise, and were nonadherent to their medication. This study population had poor knowledge about their disease.