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Abstract Background Climate change is making the existing health problems worse and also introducing new health problem and therefore calls for a wider evaluation of climate sensitive global diseases. The review sought to assess and collate quantitative and qualitative evidence on the effects of climate change on global health, more specifically, infectious and respiratory diseases, the impacts of extreme weather events as well as the implications for mental health with the view of establishing appropriate sustainable and resilience public health measures and policies. Methodology A scoping review of observational studies carried out between the years 2000 and 2024, synthesized information on climate-sensitive health outcomes: infectious diseases, severe weather events, and mental illnesses. This analysis was based on data from PubMed, Scopus, Web of Science and Cochrane Library, where appropriate, utilizing meta-extraction and Meta-analysis techniques. Results A total of 3077 studies were screened, and 96 articles were included for quantitative and qualitative analysis, highlighting the significant health risks posed by climate change. Key areas of concern identified include climate-sensitive infectious diseases, respiratory and cardiovascular conditions, food- and water-borne illnesses, and mental health effects. Rising temperatures and variable rainfall patterns increase the incidence of diseases like malaria (up to 50%) and dengue (8–10% per 1 °C rise). Extreme weather events, such as heatwaves and floods, contribute to a 30% rise in respiratory diseases and a 25% increase in cardiovascular conditions. Food- and water-borne illnesses are more prevalent in regions like Africa (30–40%) due to climate change. Additionally, climate change exacerbates mental health issues, leading to conditions like post-traumatic stress disorder (PTSD), anxiety, and depression. Conclusion and recommendations Climate change amplifies global public health risks, worsening diseases and creating new challenges. To address this, enhance machine learning climate sensitive disease surveillance, strengthen climate resilience health infrastructure, and integrate health into climate adaptation and mitigation strategies, promote sustainable agriculture, improve WASH infrastructure, and foster global collaboration.

Abstract Background Metabolic syndrome is a cluster of metabolic risk factors, including glucose intolerance, dyslipidemia, central obesity, high triglyceride levels, and low levels of high-density lipoprotein. It is the commonest type of co-morbidity among people with psychiatric conditions particularly in low and middle-income countries due to poor health care systems and financial burden. Metabolic syndrome among people with psychiatric conditions may be due to prolonged use of psychiatric medications, diminished quality of life, and personal and behavioral-related factors. Except for single studies with fluctuating reports, there is no nationwide study conducted on the prevalence of metabolic syndrome among people with psychiatric conditions in Ethiopia. Thus, this review aims to estimate the pooled prevalence of metabolic syndrome and its association with selected factors among people with psychiatric conditions in Ethiopia. Methods We conducted a thorough search of PubMed, Scopus, Wiley online library, African journals online, and Google Scholar. For analysis, STATA version 14 software was used. A funnel plot and Egger's regression test statistic were used to find the potential reporting bias. A fixed effect model was used to contrast summary effects, odds ratios, and 95% confidence intervals all over research findings. The Newcastle–Ottawa Scale (NOS) was used to evaluate the quality of each included study. Results Eight articles were included in the final review after retrieving 9,714 articles through electronic database searching. By using the national cholesterol education adult treatment panel criteria, the pooled prevalence of metabolic syndrome among people with psychiatric conditions in Ethiopia was found to be 37.33% (95%CI: 24.52–50.14). Being female AOR = 2.66; 95% CI: 0.89, 7.92), urban residency (AOR = 2.84; 95% CI: 0.56, 14.45), physical inactivity (AOR = 3.80; 95% CI: 1.61, 8.98), alcohol consumption (AOR = 4.53; 95% CI: 1.62, 12.71) and body mass index higher than the normal range (AOR = 4.66; 95% CI: 1.22, 17.85) were the factors significantly associated with metabolic syndrome among people with psychiatric conditions. According to the review, schizophrenic-form disorder, delusional disorder, major depressive disorder, schizophrenia, bipolar disorder, and schizoaffective disorder were the frequently reported psychiatric conditions. Conclusion This systematic review and meta-analysis revealed that the magnitude of metabolic syndrome among people with psychiatric conditions in Ethiopia was high and female gender, physical inactivity, alcohol consumption, and body mass index higher than the normal range were the factors that determined the occurrence of metabolic syndrome. Thus, policymakers, clinicians, and other concerned stakeholders must reinforce effective strategies in the control, timely screening, prevention, and management of metabolic syndrome among people with psychiatric conditions. Protocol registration PROSPERO CRD42023405293.

Abstract Background Antimicrobial resistance (AMR) in neonatal intensive care units (NICUs) complicates treatment of healthcare-associated infections, causing high morbidity and mortality, especially among low-birth-weight and critically ill infants. This study evaluates AMR prevalence, risk factors, outcomes and infection control measures at Felege Hiwot Hospital, aiming to guide clinical practices, antimicrobial stewardship, and improved neonatal health outcomes. Methods This mixed-methods study (Oct 2022–Jun 2023) assessed AMR in NICU neonates by analyzing 420 blood samples, environmental swabs, and staff insights. Bivariable and multivariable regressions identified significant variables, and content analysis was used for qualitative data. Results Out of 420 samples, 35% tested positive for AMR pathogens, with Coagulase-Negative Staphylococci (16.7%), Klebsiella pneumoniae (12.9%), and Acinetobacter spp. (5.6%) being the most prevalent. Resistance rates for Gentamicin, Cotrimoxazole, and Ciprofloxacin were alarmingly high (98–100%), while Amikacin demonstrated low resistance (3.0-5.56%), indicating potential efficacy. Among the neonates admitted, 91.8% survived, and 8.2% succumbed. Risk factor analysis revealed that improper PPE usage (AOR 3.90, p

Abstract Introduction Previous works of literatures on the viral load suppression rate of third line antiretroviral therapy in Africa has produced inconsistent and inconclusive results, with rates varying between 62% and 95%. This variability poses challenges for policymakers and healthcare providers in making informed decisions. This systematic review and meta-analysis aimed to determine the overall viral load suppression rate of third line antiretroviral therapy in Africa and to clarify the contradictory relationship between gender and viral load suppression, based on existing primary studies. Methods A systematic review and meta-analysis were conducted using PubMed, Medline, Cochrane Library, Henari, African Journals Online (AJOL), Web of science, and Google Scholar to access studies up to December 6, 2024. The PRISMA guideline, JBI, and Newcastle Ottawa quality assessment scale checklists were used. Heterogeneity was evaluated with Cochrane’s Q and I2 statistics. Publication bias was checked using a funnel plot, Begg’s and Egger’s test, followed by the DerSimonian and Laird random effects model. Meta-regression, subgroup and sensitivity analyses were also performed. The odds ratio with a 95% confidence interval was used to assess the association of gender with the viral load suppression rate in patients on third-line antiretroviral therapy. All analyses were conducted using Stata 18. Results A total of 14 primary studies with a total sample size of 1791 were included. The pooled magnitude of the viral load suppression rate was 79.82% (95%CI: 75.75%, 83.90%). Around 75% of the included studies’ heterogeneity were explained by country, study year, study settings and quality level of the study level variables. There was not statistically significant association of gender with viral load suppression rate of third line antiretroviral therapy. Conclusion and recommendation The pooled magnitude of the viral load suppression rate was 79.82%. There was not statistically significant association of gender with viral load suppression rate of third line antiretroviral therapy. Therefore, to maintain and further improve the strong viral load suppression rates of TLARVT in Africa, it is essential to focus on appropriate regimen selection, patient counseling and switching, adherence support, and regular viral load testing. Future studies with larger sample sizes should explore the association between gender and viral load suppression to provide conclusive findings.

Abstract A diversified diet in early childhood that comprises plant and animal source foods contributes to better health outcomes throughout the life course. However, inadequate infant and young child-feeding practices are serious public health problems in Africa. Evidence on the magnitude and determinants of inadequate animal source food consumption (ASF) in sub-Saharan Africa (SSA) is not yet well established. Hence, this study aimed to estimate the pooled magnitude and determinants of ASF consumption in SSA. A total weighted sample of 92,309 children aged 6–23 months from the Demographic and Health Survey dataset of 35 SSA countries was used for this study. A multilevel mixed-effect model was fitted. The intra-class correlation coefficient (ICC) and likelihood ratio (LR) tests were used to assess the presence of the clustering effect. The model comparison was made using deviance information criteria (DIC). A p-value of p

Abstract Background Inadequacy of antenatal care (ANC) utilization is a prominent public health problem, causing poor pregnancy outcomes. In developing countries, including Ethiopia, having ANC coverage, many pregnant women do not achieve the first ANC visits in the first trimester and receive at least four ANC visits. Therefore, this study aimed to examine the magnitude and identify determinants of inadequacy of antenatal care attendance amongst pregnant women in Ethiopia. Methods Inadequate ANC attendance was defined as combining starting ANC visits after the first trimester and having fewer than four visits together. The study used secondary data from the 2019 mini-demographic and health survey. A weighted sample of 3927 pregnant women was included in this study. Data management and further analysis were performed using STATA 14 software. A multivariable generalized estimating equation analysis was used to identify determinants associated with inadequacy of antenatal care attendance. The Adjusted odds ratio with a 95% confidence interval was used to identify significant variables for inadequate antenatal care visits. Result Overall, 78.5% of pregnant women did not attend adequate antenatal care visits during pregnancy. In multivariable generalized estimating equation analysis, women aged 25 to 34 years (AOR = 0.77, 95% CI: 0.61–0.95), being educated (AOR = 0.31; 95% CI: 0.22–0.45), and being wealthier index (AOR = 0.67, 95% CI: 0.51–0.88) were less likely to inadequate antenatal care attendance. Whereas being rural residents (AOR = 1.49; 95% CI:1.08–2.07), no television exposure (AOR = 1.51; 95% CI:1.1–2.06), having more family members in the household (AOR = 1.81; 95% CI: 1.11–2.95), and women from semi-peripheral region (AOR = 1.92; 95% CI: 1.42–2.59) were higher odds of being associated with inadequacy of antenatal care attendance. Conclusions The prevalence of Inadequate antenatal care attendance amongst pregnant women in Ethiopia is still High. The study identifies significant variables that could be positively and negatively associated with inadequate antenatal care visits. Health education interventions should target uneducated, poorer, and rural women to attend early antenatal care and use at least four antenatal care utilization for early detection of complications during pregnancy and delivery.

BackgroundEnsuring minimum dietary diversity is crucial for lactating mothers. It allows them to consume a variety of foods from different groups, meeting their nutritional needs and supporting maternal and infant health. Despite the global impact of undernutrition and micronutrient deficiencies, the prevalence and determinants of minimum dietary diversity during lactation remain poorly recognized in developing countries. This research aims to assess minimum dietary diversity and its determinants among lactating mothers in five Sub-Saharan African countries.MethodsData from the most recent Demographic and Health Surveys, which covered five Sub-Saharan African countries between 2021 and 2023, were used to execute secondary data analysis. This study included 19,917 lactating mothers in total. Using a multilevel mixed-effects logistic regression model, the variables associated to the minimum dietary diversity were established. Significant factors associated with the minimum dietary diversity were found at p-values ResultsThe magnitude of minimum dietary diversity among lactating mothers in Burkina Faso, Ghana, Kenya, Mozambique, and Tanzania was 25.66% (95% CI: 24.47, 25.75). Factors such as secondary and above educational level (AOR = 1.38, 95% CI: 1.18, 1.61), employed mothers (AOR = 1.40, 95% CI: 1.26, 1.56), distance which was not a big problem to access health facilities (AOR = 1.35, 95% CI: 1.21, 1.51), health facility delivery (AOR = 1.25, 95% CI: 1.08, 1.45), rich wealth status (AOR = 1.86, 95% CI: 1.60, 2.17), high community ANC utilization (AOR = 1.18, 95% CI: 1.04, 1.35), and reside in Ghana (AOR = 4.21, 95% CI: 3.60, 4.94) had higher odds of minimum dietary diversity.ConclusionsThis study reveals that lactating mothers have low dietary diversity. Both community-level and individual-level factors impact this diversity. Consequently, health ministries in Burkina Faso, Kenya, Ghana, Mozambique, and Tanzania should prioritize women who underutilize antenatal services and those without formal education when designing strategies and policies.

BackgroundAlthough the Surgery, Antibiotic, facial cleanliness, and environmental improvement (SAFE) strategy was adopted in Ethiopia over the last five years, there is still a high incidence of trachoma in areas with poor hygiene. In Ethiopia, a systematic review and meta-analysis were conducted before the implementation of SAFE implying, a need for the update. Therefore, this review gives the updated pooled prevalence and associated factors of active trachoma in Ethiopia after the implementation of SAFE.MethodThe literature search was performed from PubMed, Google Scholar, EMBASE, HINARI, Scopus, and Web of Sciences from January 1-30, 2024. Data were extracted by using a pre-tested and standardized data extraction format and analyzed using STATA 17 statistical software. I2 tests to appraise the heterogeneity across the included studies, a random-effect model to estimate the pooled prevalence, and a sub-group analysis to discern the viable source of heterogeneity were executed. Potential publication bias was also assessed by funnel plot, Egger's weighted correlation, and Begg's regression. The odds ratio with its 95% confidence was used to reckon the association between the prevalence and factors.ResultFrom 504 identified studies, 20 articles were included. After the SAFE intervention, the national pooled prevalence of active trachoma among children was 21.16% (95% CI 17.28, 25.04). Fly-eye contact(Adjusted odds ratio (AOR) = 3.83, 95% CI: 2.25, 6.52), facial uncleanliness(AOR = 5.48, 95% CI: 3.02, 9.96), non-utilization of latrine (AOR = 3.30, 95% CI: 2.10, 5.18), and retrieving water from river(AOR = 2.94; 95%CI: 1.42, 6.05) were significantly associated with active trachoma.ConclusionIn Ethiopia, the pooled prevalence of active trachoma after SAFE intervention was much higher than the World Health Organization (WHO) threshold prevalence. It continues to pose a significant public health concern and is far from the elimination of trachoma as a public health problem. Fly-eye contact, facial cleanliness, latrine utilization, and source of water increase the odds of active trachoma. Therefore, it is imperative to fine-tune the intervention focus on personal hygiene-related activities in removing dirt, fly-eye contact, and a well-structured approach for both constructing and ensuring the functionality of household taps and latrines. Additionally, It is crucial to initiate a reliable SAFE intervention in Ethiopia.

Abstract Introduction The COVID-19 pandemic has caused an unprecedented health threat globally, necessitating innovative and efficient diagnostic approaches for timely identification of infected individuals. Despite few emerging reports, the clinical utility of circulating microRNAs (miRNAs) in early and accurate diagnosis of COVID-19 is not well-evidenced. Hence, this meta-analysis aimed to explore the diagnostic potential of circulating miRNAs for COVID-19. The protocol for this study was officially recorded on PROSPERO under registration number CRD42023494959. Methods Electronic databases including Embase, PubMed, Scopus, and other sources were exhaustively searched to recover studies published until 16th January, 2024. Pooled specificity, sensitivity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic ratio (DOR), positive predictive value (PPV), negative predictive value (NPV), and area under the curve (AUC) were computed from the metadata using Stata 14.0 software. Risk of bias appraisal of included articles was carried out using Review Manager (Rev-Man) 5.3 package through the modified QUADAS-2 tool. Subgroup, heterogeneity, meta-regression and sensitivity analyses were undertaken. Publication bias and clinical applicability were also evaluated via Deeks’ funnel plot and Fagan nomogram (scattergram), respectively. Result A total of 43 studies from 13 eligible articles, involving 5175 participants (3281 COVID-19 patients and 1894 healthy controls), were analyzed. Our results depicted that miRNAs exhibit enhanced pooled specificity 0.91 (95% CI: 0.88–0.94), sensitivity 0.94 (95% CI: 0.91–0.96), DOR of 159 (95% CI: 87–288), and AUC values of 0.97 (95% CI: 0.95–0.98) with high pooled PPV 96% (95% CI: 94–97%) and NPV 88% (95% CI: 86–90%) values. Additionally, highest diagnostic capacity was observed in studies involving larger sample size (greater than 100) and those involving the African population, demonstrating consistent diagnostic effectiveness across various specimen types. Notably, a total of 12 distinct miRNAs were identified as suitable for both exclusion and confirmation of COVID-19 cases, denoting their potential clinical applicability. Conclusion Our study depicted that miRNAs show significantly high diagnostic accuracy in differentiating COVID-19 patients from healthy counterparts, suggesting their possible use as viable biomarkers. Nonetheless, thorough and wide-ranging longitudinal researches are necessary to confirm the clinical applicability of miRNAs in diagnosing COVID-19.

BackgroundAdverse birth outcomes are unfavorable outcomes of pregnancy that are particularly common in low- and middle-income countries. At least one ultrasound is recommended to predict adverse birth outcomes in early pregnancy. However, in low-income countries, imaging equipment and trained manpower are scarce. According to our search of the literature, there is no validated risk prediction model for predicting adverse birth outcomes in Ethiopia. Hence, we developed and validated a model and risk score to predict adverse birth outcomes using maternal characteristics during pregnancy for use in resource-limited settings.MethodsA retrospective follow-up study was conducted from 1 January 2016 to 31 May 2021, and a total of 910 pregnant women were included in this study. Participants were selected using a simple random sampling technique. Stepwise, backward multivariable analysis was conducted. The model's accuracy was assessed using density plots, discrimination, and calibration. The developed model was assessed for internal validity using bootstrapping techniques and evaluated for clinical utility using decision curve analysis across various threshold probabilities.ResultsPremature rupture of Membrane, number of fetuses, residence, pregnancy-induced hypertension, antepartum hemorrhage, hemoglobin level, and labor onset remained in the final multivariable prediction model. The area under the curve of the model was 0.77 (95% confidence interval: 0.73–0.812). The developed risk prediction model had a good performance and was well-calibrated and valid. The decision curve analysis indicated the model provides a higher net benefit across the ranges of threshold probabilities.ConclusionIn general, this study showed the possibility of predicting adverse birth outcomes using maternal characteristics during pregnancy. The risk prediction model using a simplified risk score helps identify high-risk pregnant women for specific interventions. A feasible score would reduce neonatal morbidity and mortality and improve maternal and child health in low-resource settings.

BackgroundHuman breast milk, a naturally balanced source of infant nutrition, promotes optimal growth and health when exclusively fed for 6 months. Exclusive breastfeeding reduces common childhood infections, provides protection against some chronic illnesses, and contributes to achieving several Sustainable Development Goals. Despite its benefits, only 58% of Ethiopian women practice it, and the associated education-related inequality is not well documented. Thus, this study aims to quantify and decompose the education-related inequality in exclusive breastfeeding practice among Ethiopian mothers.MethodsA total of 1,504 weighted samples were studied using a Performance Monitoring for Action Ethiopia longitudinal panel survey dataset (2021–2023). Wagstaff normalized concentration index and its concentration curve were used to assess education-related inequality in exclusive breastfeeding practice. Wagstaff decomposition analysis was performed to decompose the concentration index and identify factors contributing to the observed education-related inequality. Significance was declared at p-value

BackgroundCongenital anomalies pose a significant challenge to global health and result in considerable morbidity and mortality in early childhood. With the decline of other causes of death among children under five, the burden of congenital anomalies is rising, emphasizing the need for improved prenatal care, screening, and nutrition for pregnant women. This systematic review and meta-analysis aim to estimate the pooled effect of folic acid intake on congenital anomalies.MethodsTo identify relevant research published up until December 30/2023, we conducted electronic searches of PubMed/Medline, PubMed Central, Hinary, Google, African Journals Online, Web of Science, Science Direct, and Google Scholar databases using predefined eligibility criteria. We used Excel to extract data and evaluated the studies using the JBI appraisal checklist. We computed the pooled effect size with 95% confidence intervals for maternal folic acid intake on congenital anomalies using STATA version 17 and the DerSimonian and Laird random effects meta-analysis model. We assessed statistical heterogeneity using Cochran's Q-test, I2 statistic, and visual examination of the funnel plot.ResultsThe review included 16 case-control, cohort, and cross-sectional studies. According to the results of this systematic review and meta-analysis, maternal folic acid intake significantly lowers the incidence of congenital anomalies (odds ratio (OR), 0.23; confidence interval (CI), 0.16, 0.32). Among the included studies, both the Cochrane Q-test statistic (χ2 = 118.82, p

Abstract Introduction Female genital amputation is a harmful traditional practice that has adverse risks on health outcomes. Consequently, it affects girls and women's physical, psychological, and mental health conditions. However, evidence on female genital amputation factors among adolescent girls and young women in Ethiopia was limited. Method Secondary data analysis was conducted from the 2016 Ethiopian Demographic and Health Survey. A weighted sample size included in this study was 2961 adolescent girls and young women. Data management and further analysis were performed using Stata 14 software. An adjusted odds ratio with a 95% confidence interval was used for measuring a significant relationship between factors with the outcome variable. Result This study found that the prevalence of female genital amputation among adolescent girls and young women in Ethiopia was 53.4%. Among individual- and community-level variables included in the multivariable multilevel analysis: maternal age, religious status, marital status, maternal educational level, occupational status, residence areas, community uneducated level, and community mass media were significant factors for female genital amputation. Conclusion The prevalence of female genital amputation among adolescent girls and young women in Ethiopia remains high. Those individual- and community-level factors influence female genital amputation among adolescent girls and young women in Ethiopia. It requires health interventions on female genital amputation to improve behavioral changes and create awareness about harmful practices.

IntroductionSexual behaviour needs to take a central position in the heart of public health policy makers and researchers. This is important in view of its association with Sexually Transmitted Infections (STIs), including HIV. Though the prevalence of HIV/AIDS is declining in Ethiopia, the country is still one of the hardest hit in the continent of Africa. Hence, this study was aimed at identifying hot spot areas and associated factors of risky sexual behavior (RSB). This would be vital for more targeted interventions which can produce a sexually healthy community in Ethiopia.MethodsIn this study, a cross-sectional survey study design was employed. A further analysis of the 2016 Ethiopia Demographic and Health Survey data was done on a total weighted sample of 10,518 women and men age 15-49 years. ArcGIS version 10.7 and Kuldorff's SaTScan version 9.6 software were used for spatial analysis. Global Moran's I statistic was employed to test the spatial autocorrelation, and Getis-Ord Gi* as well as Bernoulli-based purely spatial scan statistics were used to detect significant spatial clusters of RSB. Mixed effect multivariable logistic regression model was fitted to identify predictors and variables with a p-value ≤0.05 were considered as statistically significant.ResultThe study subjects who had RSB were found to account about 10.2% (95% CI: 9.64%, 10.81%) of the population, and spatial clustering of RSB was observed (Moran's I = 0.82, p-value = 0.001). Significant hot spot areas of RSB were observed in Gambela, Addis Ababa and Dire Dawa. The primary and secondary SaTScan clusters were detected in Addis Ababa (RR = 3.26, LLR = 111.59, PConclusionIn this study, spatial clustering of risky sexual behaviour was observed in Ethiopia, and hot spot clusters were detected in Addis Ababa, Dire Dawa and Gambela regions. Therefore, interventions which can mitigate RSB should be designed and implemented in the identified hot spot areas of Ethiopia. Interventions targeting the identified factors could be helpful in controlling the problem.

Abstract Background Undernutrition is defined as not consuming enough nutrients and energy to meet one’s needs for maintaining good health. It is exacerbated by armed conflict. Individuals cannot stick to jobs because of a lack of safety during conflicts, which has an impact on families’ ability to purchase food. However, there is a paucity of evidence on pooled evidence on the impact of armed conflict on childhood undernutrition among children aged 6 to 59 months in Africa. Therefore, this review aimed to examine the effects of armed conflict on the magnitude of undernutrition, particularly stunting, underweight, and wasting among children in Africa. Methods A comprehensive literature search was conducted using electronic databases (PubMed, Hinari, and Google Scholar database) to locate potential studies. Heterogeneity between studies was checked using Cochrane Q test statistics and I 2 test statistics. Small-study effects were checked using Egger’s statistical test at a 5% significance level. A random-effects model was employed to estimate the pooled prevalence and associated factors of undernutrition among children aged 6–59 months in Africa. Results Of a total of 585 articles retrieved from the databases, 12 studies met our inclusion criteria. The pooled prevalence of wasting, stunting, and being underweight among conflict-affected African countries was 20.25% (95%CI = 15.08–25.43), 34.18% (95% CI = 26.34–42.02), and 24.00% (95%CI = 16.35–31.65), respectively. The most consistent factors associated with childhood stunting, wasting, and being underweight in Africa were low mother’s education, prolonged duration of armed conflict, and rural place of residence. Conclusion The severity of malnutrition crises will be assisted by a better understanding of the variables associated with child malnutrition, which will improve the effectiveness of development and humanitarian responses. We urge that health planners, policymakers, and the general public prioritize children with acute malnutrition in Africa’s conflict-affected areas. Systematic review registration PROSPERO CRD42022367487

BackgroundChild marriage is a harmful traditional practice, which compromises children of their childhood and threatens their lives and health. In Ethiopia, 58% of women and 9% of men get married before the age of 18 years. Surprisingly, parents in the Amhara region make marriage promises of their children before they are even born, which will hinder the region from attaining the Sustainable Development Goal of ending child marriage. Thus, this study aimed to assess the trends, determinants, and future prospects of child marriage in the Amhara region of Ethiopia.MethodsA repeated cross-sectional study was conducted using four consecutive nationally representative Ethiopian demographic and health surveys (2000–2016). A logit-based multivariate decomposition analysis for a non-linear response model was fitted to identify factors that contributed to the change in child marriage over time. Statistical significance was declared at a p-value of < 0.05. The child marriage practice in the Amhara region by the year 2030 was also predicted using different forecasting features of Excel.ResultsThe trend of child marriage over the study period (2000–2016) decreased from 79.9% (76.7, 82.8) to 42.9% (39.1, 46.9), with an annual average reduction rate of 2.9%. Approximately 35.2% of the decline resulted from an increase in the proportion of women who attained secondary and above-secondary education over the two surveys. A decrease in the proportion of rural women and a change in the behavior of educated and media-exposed women also contributed significantly to the decline in child marriage. The prevalence of child marriage in the Amhara region by the year 2030 was also predicted to be 10.1% or 8.8%.ConclusionThough there has been a significant decline in child marriage in the Amhara region over the past 16 years, the proportion is still high, and the region is not going to eliminate it by 2030. Education, residence, and media exposure were all factors associated with the observed change in child marriage in this study. Therefore, additional efforts will be required if child marriage is to be eliminated by 2030, and investing more in education and media access will hasten the region's progress in this direction.

BackgroundThe Corona virus disease 19 (COVID-19) pandemic is a human tragedy that occurred in this era. It poses an unprecedented psychological, social, economic, and health crisis. The mental health and well-being of entire societies are suffering as a result of this crisis, but the suffering is greater in students at all levels of education and must be addressed immediately. Thus, this study was aimed to estimate the pooled prevalence and associated factors of the psychological impact of COVID-19 among higher education students.MethodsThe potential studies were searched via PubMed, HINARI, the Cochrane Library, and Google Scholar. Studies were appraised using the Joanna Briggs Institute appraisal checklist. Micro Soft Excel was used to extract the data, which was then exported to Stata version 14 for analysis. Heterogeneity between studies was tested using Cochrane statistics and the I2 test, and small-study effects were checked using Egger’s statistical test. A random-effects model was employed to estimate the pooled prevalence of the psychological impact of COVID-19 and its associated factor.ResultsAfter reviewing 227 studies, eight fulfilled the inclusion criteria and were included in the meta-analysis. The pooled prevalence of the psychological impact of Corona virus disease 19 among higher education students in Ethiopia, including depression, anxiety, and stress was 43.49% (95% CI: 29.59, 57.40%), 46.27% (95% CI: 32.77, 59.78%), and 31.43% (95% CI: 22.71, 40.15), respectively. Having a medical illness, being an urban resident, living with parents, having relative death due to pandemics, and having a non-health field of study were identified as significant associated factors for the impact of the pandemic in higher education students.ConclusionThe COVID-19 pandemic had a significant psychological impact on college and university students. Depression, anxiety, and stress were the most commonly reported psychological impacts across studies among higher education students. Hence, applying tele-psychotherapy using, smartphones, and social media platforms has an effect on reducing the impact. Programs for preventing and controlling epidemics should be developed by the government and higher education institutions that incorporate mental health interventions and build resilience.

IntroductionDrug compliance is the act of taking medication on schedule or taking medication as prescribed and obeying other medical instructions. It is the most crucial aspect in the treatment of chronic diseases particularly for patients with multidrug-resistant tuberculosis (MDR-TB). Drug non-compliance is the main reason for causing drug resistance and poor treatment outcomes. Hence, developing a risk prediction model by using early obtainable prognostic determinants of non-compliance is vital in averting the existing, unacceptably high level of poor treatment outcomes and reducing drug resistance among MDR-TB patients.Materials and methodsA retrospective follow-up study was conducted on a total of 517 MDR-TB patients in Northwest Ethiopia. A logistic regression–based machine learning algorithm was used to develop a risk score for the prediction of treatment non-compliance among MDR-TB patients in selected referral hospitals of Northwest Ethiopia. The data were incorporated in EpiData version 3.1 and exported to STATA version 16 and R version 4.0.5 software for analysis. A simplified risk prediction model was developed, and its performance was reported. It was also internally validated by using a bootstrapping method.ResultsEducational status, registration group (previously treated/new), treatment support, model of care, and khat use were significant prognostic features of treatment non-compliance. The model has a discriminatory power of area under curve (AUC) = 0.79 with a 95% CI of 0.74–0.85 and a calibration test of p-value = 0.5. It was internally validated by using a bootstrapping method, and it has a relatively corrected discriminatory performance of AUC = 0.78 with a 95% CI of 0.73–0.86 and an optimism coefficient of 0.013.ConclusionEducational status, registration group, treatment supporter, model of care, and khat use are important features that can predict treatment non-compliance of MDR-TB patients. The risk score developed has a satisfactory level of accuracy and good calibration. In addition, it is clinically interpretable and easy to use in clinical practice, because its features are easily ascertainable even at the initial stage of patient enrolment. Hence, it becomes important to reduce poor treatment outcomes and drug resistance.

Abstract Background and Aims Utilizing health facility delivery services is one of the pillars of lowering maternal mortality. However, the coverage of health facility delivery service utilization continues to be uneven around the world. In Ethiopia, particularly among pastoralist regions, health facility delivery service utilization is less common. Therefore, the purpose of this study was to determine the pooled prevalence of health facility delivery service utilization and identify the associated factors among women in the pastoralist regions of Ethiopia. Methods A comprehensive systematic search was carried out in PubMed/MEDLINE, Hinary, Cochrane Library, Google Scholar, Google, and Ethiopian online university repositories. Studies were appraised using the JBI appraisal checklist. The analysis was done using STATA version 16. The pooled analysis was conducted using DerSimonian and Laird random‐effects model. I2 test and Eggers & Begg's tests were used to assess the heterogeneity and publication bias, respectively. p

Objective To develop and validate a clinical risk score for in-hospital stroke mortality.Design The study used a retrospective cohort study design.Setting The study was carried out in a tertiary hospital in the Northwest Ethiopian region.Participants The study included 912 patients who had a stroke admitted to a tertiary hospital between 11 September 2018 and 7 March 2021.Main outcome measures Clinical risk score for in-hospital stroke mortality.Methods We used EpiData V.3.1 and R V.4.0.4 for data entry and analysis, respectively. Predictors of mortality were identified by multivariable logistic regression. A bootstrapping technique was performed to internally validate the model. Simplified risk scores were established from the beta coefficients of predictors of the final reduced model. Model performance was evaluated using the area under the receiver operating characteristic curve and calibration plot.Results From the total stroke cases, 132 (14.5%) patients died during the hospital stay. We developed a risk prediction model from eight prognostic determinants (age, sex, type of stroke, diabetes mellitus, temperature, Glasgow Coma Scale, pneumonia and creatinine). The area under the curve (AUC) of the model was 0.895 (95% CI: 0.859–0.932) for the original model and was the same for the bootstrapped model. The AUC of the simplified risk score model was 0.893 (95% CI: 0.856–0.929) with a calibration test p value of 0.225.Conclusions The prediction model was developed from eight easy-to-collect predictors. The model has excellent discrimination and calibration performance, similar to that of the risk score model. It is simple, easily remembered, and helps clinicians identify the risk of patients and manage it properly. Prospective studies in different healthcare settings are required to externally validate our risk score.

BackgroundSoil-transmitted helminthes (STHs) are the major public health problems that affect the health of pregnant women and their incoming newborns. In Ethiopia, about 33.35% of pregnant women were affected by these infections. Utilization of deworming medication during pregnancy is the main strategy endorsed by the World Health Organization (WHO) to reduce the burden of STH-induced anemia and its related complications. However, information related to the coverage and its individual as well as community-level factors on the utilization of deworming medication among pregnant mothers with at least one antenatal care (ANC) visit is limited in Ethiopia.MethodsA nationwide population-based cross-sectional study was conducted from January 18 to June 27, 2016. The information was obtained from the 2016 Ethiopian Demographic Health Survey (EDHS 2016), which can be accessed at: https://www.dhsprogram.com. A weighted sample of 4690 pregnant women selected using a two-stage stratified cluster sampling technique was included in the final analysis. A Multi-variable multilevel binary logistic regression model was fitted to identify the determinants of the utilization of deworming medication during pregnancy. Log-likelihood ration (LLR), deviance and Akaike's Information Criterion (AIC) were used to select the best fitted model in the multilevel analysis. Statistical significance was declared at p-value ResultFrom a total of 4690 mothers included in the final analysis, only 365 (7.8%) of them utilized deworming medication in pregnancy. After controlling for confounding effects, having four or more Antenatal care (ANC) visits, having functional working status, intake of iron folic acid (IFA) tablets and coming from a community with a low poverty level increases the odds of utilization of deworming medication during pregnancy.Conclusion and recommendationIn this study, less than one in ten pregnant mothers takes deworming medication. Mothers with less than four ANC visits, who did not receive IFA tablets, who came from a community with a high poverty level, and mothers with no good functional status were at the greatest risk of not receiving deworming medication during pregnancy. Sustained efforts need to be undertaken to increase the socioeconomic status of the community and to scale up the health care utilization behaviors of pregnant mothers.

BackgroundHygienic umbilical cord care is one of the essential interventions advocated to reduce neonatal mortality. However, traditional cord care measures-applying cow dung and oil-that have harmful health consequences are commonly practiced in Ethiopia. Hence, in this study, it was planned to analyze individual and community-level factors associated with the application of cow dung and oil on the umbilical cord stump in Ethiopia.MethodsData from the 2016 Ethiopian demographic and health survey were used to identify individual and community level factors associated with women's practice of applying cow dung and oil on the umbilical cord stump of their neonate. Taking into account for the hierarchical structure of the data; multilevel binary logistic regression analysis has been employed to a nationally representative weighted sample of 7,168 women.ResultsIn Ethiopia, 780 (10.88%) with 95% CI (10.18–11.62) women apply oil and/or cow dung on the neonate's umbilical cord stump. Age increase by one year [AOR = 0.97; 95% CI (0.94–0.99)] and giving birth in a health facility [AOR = 0.61; 95% CI (0.42–0.89)] were individual-level factors that reduced women's practice of applying cow dung and oil on the umbilical cord stump of their neonate. Whereas, rural residence [AOR = 2.54; 95% CI (1.28–5.06)] was the predictor at the community level that raised the practice of applying cow dung and oil on the neonate's umbilical cord stump.ConclusionThis nationwide study revealed that a significant number of mothers in Ethiopia still apply cow dung and/or oil on the umbilical cord stump of their neonates. Both the individual and community level characteristics: maternal age, place of delivery, and residence were found to have significant influence on the practice of applying cow dung and/or oil on the umbilical cord stump in Ethiopia. Thus, to reduce neonatal mortality due to avoidable umbilical cord infections, clean cord care practice strategies should be designed by considering these factors.

IntroductionVisual impairment is a major public health problem in developing countries where there is no enough health-care service. It has a significant impact on the affected child's psychological, educational and socioeconomic experiences, during childhood and beyond. Therefore, the aim of this review was to estimate the pooled prevalence of visual impairment and its associated factors among children in Ethiopia.MethodThis systematic review and meta-analysis was designed based on the PRISMA guidelines. Relevant published articles in Ethiopia from 2011-2021 were searched in PubMed/Medline, HINARI, Google scholar, and conference paper and thesis or research final reports were accessed from Ethiopian Universities' repositories. Data was extracted in Microsoft excel by using JBI data extraction checklist. The pooled prevalence and odds ratio of associated factors with their 95% CI was computed by using STATA 14/SE software. A fixed effect meta-analysis model was employed for a Cochrane Q test statistic and I2 test showed there was no heterogeneity in the included studies.ResultA total of 7,647 children from nine studies were included in this study. The overall prevalence of visual impairment among children in Ethiopia was 7% (95% CI: 6, 7%). The pooled prevalence of visual impairment by region was almost similar in Ethiopia. However, there was no significant association between the identified factors and visual impairment among children. But the result showed that being males (AOR 0.642, 95% CI: 0.357-1.156), Children in the age of 10-13 years (AOR 0.224, 95% CI: 0.046-1.102) and 14-18 years (AOR 0.508, 95% CI: 0.102-2.534) were found to be less likely to have visual impairment. On the other hand, children of parents with visual impairment (AOR 1.820, 95% CI: 0.381-8.698) more likely to have visual impairment.ConclusionVisual impairment among children in Ethiopia is still a public health problem one year later to VISION 2020, a global initiative aimed to eliminate avoidable blindness. All most one out of fourteen children in Ethiopia had visual impairment. Therefore, the government of Ethiopia should focus on effective, efficient, comprehensive eye health care services by integrating with the national health system to prevent avoidable visual impairment among children.

Background. The average duration of recovery from COVID-19 and influencing factors, which would help inform optimal control strategies, remain unclear. Moreover, studies regarding this issue are limited in Ethiopia, and no region-wise studies were conducted. Hence, this study aimed to investigate the median recovery time from COVID-19, and its predictors among patients admitted to Amhara regional state COVID-19 treatment centers, Ethiopia. Methods. A facility-based retrospective follow-up study was conducted at Amhara regional state COVID-19 treatment centers from 13 March 2020 through 30 March 2021. Data were entered using EpiData version 3.1, and STATA version 14 was used for analysis. A Kaplan–Meier curve was used to estimate survival time, and the Cox regression model was fitted to identify independent predictors. P value with 95% CI for the hazard ratio was used for testing the significance at alpha 0.05. Results. Six hundred twenty-two cases followed, and 540 observations developed an event at the end of the follow-up. The median time to recovery was 11 days with an interquartile range of 9–14 days. Most of the patients were recovered from COVID-19 between days seven and fourteen. In the first six days of admission, only 4.2% of cases had recovered, but by day 14, 73.8% had recovered. Patients without comorbid illness/s were faster to recover than their counterparts (AHR = 1.44 : 95% CI: 1.10, 1.91) and those who have signs and symptoms on admission (AHR = 0.42 : 95% CI: 0.30, 0.60) and old-aged (AHR = 0.988; 95% CI: 0.982, 0.994) took longer to recover. Conclusion. In conclusion, a relatively short median recovery time was found in this study. Significant predictors for delayed recovery from COVID-19 were older age, presence of symptoms at admission, and having at least one comorbid condition. These factors should be placed under consideration while developing a strategy for quarantining and treating COVID-19 patients.