Search

Background: Breast cancer poses a significant health burden in Ghana and globally, being the primary cause of cancer-related illness and death among women. The World Health Organization has identified clinical breast examination as the gold standard for women in low and middle-income countries. However, the uptake of clinical breast examination remains low in these settings, including Ghana, where the nationwide prevalence and associated factors of this practice have not been determined. Therefore, this study aimed to assess the prevalence and factors associated with clinical breast examination among women of reproductive age in Ghana, using data from 2022 Ghanaian Demographic and Health Survey. Methods: In this study, data from the most recent Ghanaian Demographic Health Survey conducted in 2022 were utilized. The survey used a two-stage stratified sampling technique, and a weighted sample of 15,013 participants was included in the analysis. Descriptive statistics, such as frequencies, percentages, and graphical representations, were utilized to present the study's findings. Multilevel mixed-effects logistic regression analysis was employed to identify factors associated with clinical breast examination. Results: The study found that the prevalence of clinical breast examination was 18.39% (95% CI: 17.8-19.0%). Age group of 45 to 49 (AOR=2.84, 95% CI: 2.13, 3.78), having completed secondary education (AOR=1.70, 95% CI: 1.41, 2.06), having diploma or above education (AOR=3.63, 95% CI: 2.86, 4.61), using modern contraception (AOR=1.12, 95% CI: 1.00, 1.25), having health insurance coverage (AOR=1.53, 95% CI: 1.24, 1.89), listening to the radio at least once per week (AOR=1.35, 95% CI: 1.20, 1.53), reading a newspaper at least once per week (AOR=1.75, 95% CI: 1.39, 2.21), being tested for HIV (AOR=1.92, 95% CI: 1.68, 2.19), undergoing screening for cervical cancer (AOR=6.64, 95% CI: 5.51, 7.99), being currently employed (AOR=1.17, 95% CI: 1.02, 1.34), visiting a health facility within the past 12 months (AOR=1.36, 95% CI: 1.23, 1.51), belonging to the wealthiest wealth categories (AOR=1.70, 95% CI: 1.27, 2.28), being from the North East region (AOR=1.96, 95% CI: 1.19, 3.22) or Oti region (AOR=0.54, 95% CI: 0.34, 0.92), having a greater distance to a health facility (AOR=0.86, 95% CI: 0.75, 0.98), and being from a community with a higher proportion of educated individuals (AOR=1.31, 95% CI: 1.07, 1.61) were significant associated factors of clinical breast examination. Conclusions and recommendations: The study revealed that the magnitude of clinical breast examination among Ghanaian women was low. Age, educational status, modern contraceptives utilization, health insurance coverage, media exposure, HIV testing, cervical cancer screening, occupation, health facility visits, wealth index, and region were significantly associated with clinical breast examination. These findings suggest that public health interventions should prioritize addressing these factors to increase clinical breast examination uptake and promote early detection of breast cancer to improve the survival of women with breast cancer. [ABSTRACT FROM AUTHOR]

Introduction: Growth monitoring and promotion services are strategies to promote child health and reduce child mortality. Even though Ethiopia is attempting different strategies to cope with the low rate of GMP utilization, the problem is still unresolved. Objective: Determine the pooled proportion of GMP utilization and its contributing factors among children less than two years in Ethiopia. Method: The review protocol was registered with PROSPERO, number CRD42023472746. The PRISMA-2020 statement guided the conduct of this review. Electronic databases and grey literature were used. Heterogeneity was evaluated using I2. Subgroup analysis was conducted. The random effect model was used to summarize the pooled effect sizes with their respective 95% CI with STATA version 17. To test the small study effect, the funnel plot and Egger's test were applied. Result: A total of seven (7) studies with 4027 participants were considered in this meta-analysis. The pooled proportion of GMP utilization reported by seven studies was 25.71% (95%CI: 24.39, 27.04). ANC follow-up (AOR = 2.11; 95% CI: 1.47, 2.76), PNC follow-up (AOR = 1.96; 95% CI: 1.44, 2.49), counseling (AOR = 2.88; 95% CI: 2.09, 3.68), maternal education (AOR = 2.89; 95% CI: 1.66, 4.13), paternal education (AOR = 3.78; 95% CI: 2.25, 5.32), family health card (AOR = 2.31; 95% CI: 1.67, 2.96), and mothers good knowledge towards GMP (AOR = 2.90; 95% CI: 1.72, 4.07) variables were positively associated with GMP service utilization. Conclusion and recommendation: The pooled proportion of GMP remains low in Ethiopia. ANC and PNC follow-up, counseling, maternal and paternal education, family health cards, maternal knowledge towards GMP were significantly associated. Findings are essential for evidence-based policy making, intervention, and input for ongoing research. [ABSTRACT FROM AUTHOR]

Introduction: Ethiopia is one of the countries where persistently high neonatal and maternal mortalities are reported. Preterm prelabor rupture of membrane (PPROM) plays an important contribution to these high mortalities. However, there is a paucity of comprehensive evidence about the epidemiology of PPROM in Ethiopia. Therefore, this systematic review was conducted to assess the pooled prevalence and determinants of PPROM among pregnant women in Ethiopia. Methods: A systematic review and meta-analysis were conducted following the PRISMA guideline. Relevant literatures were searched on African Journals Online (AJOL), PubMed, Scopus, Epistemonikos, CINAHL, Cochrane Library and gray literature. All statistical analyses were performed using STATA 17 software. The random effect meta-analysis model was employed to summarize the pooled estimates. Heterogeneity between included studies was evaluated using I2 statistic. Egger's regression test and Begg's correlation test were employed to assess publication bias, in conjunction with funnel plot. Besides, the non-parametric trim-and-fill analysis, sensitivity analysis, subgroup analysis and meta-regression were also performed. Results: A total of 13 original studies with 24,386 participants were considered in this systematic review. The pooled prevalence of PPROM was 6.58% (95% CI: 5.36, 7.79). Urinary tract infection (OR: 3.44; 95% CI: 1.81, 6.53), abnormal vaginal discharge (OR: 4.78; 95% CI: 2.85, 8.01), vaginal bleeding (OR: 2.04; 95% CI: 1.03, 4.06), history of PROM (OR: 4.64; 95% CI: 2.71, 7.95), history of abortion (OR: 3.06; 95% CI: 1.71, 5.46), malnutrition (OR: 5.24; 95% CI: 2.63, 10.44), anemia (OR: 3.97; 95% CI: 2.01, 7.85) and gestational diabetes (OR: 5.08; 95% CI: 1.93, 13.36) were significantly associated with PPROM. Conclusion: This meta-analysis found a high prevalence of PPROM in Ethiopia. Urinary tract infection, abnormal vaginal discharge, vaginal bleeding, history of PROM, history of abortion, malnutrition, anemia and gestational diabetes were risk factors for PPROM. Prevention and control of antenatal infections and malnutrition are highly recommended to reduce the magnitude of PPROM in Ethiopia. Additionally, healthcare providers should emphasize the identified risk factors. Protocol registration number: CRD42024536647. [ABSTRACT FROM AUTHOR]

Background: While HIV testing and counselling play a crucial role in preventing mother-to-child transmission, numerous pregnant women did not receive these services. Understanding the spatial variation of HIV testing and counselling and its associated factors during antenatal care in Ethiopia remains limited. Thus, this study was aimed at assessing the spatial patterns and factors associated with HIV testing and counselling during antenatal care visits in Ethiopia. Methods: A cross-sectional study design was employed with a two-stage stratified cluster sampling technique. A total of 2,789 women who gave birth in the two years prior to the survey and had at least one antenatal care visit were included in the study. Stata version 16 and ArcGIS version 10.8 software were used for analysis. A multilevel robust Poisson regression model was fitted to identify significantly associated factors since the prevalence of HIV testing and counselling was higher than 10%. A statistically significant association was declared based on multivariable multilevel robust Poisson regression analysis using an adjusted prevalence ratio with its 95% confidence interval at a p-value < 0.05. Spatial regression analysis was conducted, and the local coefficients of statistically significant spatial covariates were visualised. Results: In Ethiopia, the overall prevalence of HIV testing and counselling during antenatal care visits was 29.5% (95% CI: 27.8%, 31.2%). Significant spatial clustering was observed (Global Moran's I = 0.138, p-value <0.001). In the spatial regression analysis, high and comprehensive knowledge related to HIV, and comprehensive knowledge on the prevention of mother-to-child transmission were significant explanatory variables for the spatial variation of HIV testing and counselling. In the multivariable multilevel robust Poisson regression analysis, education, household wealth, media exposure, number of antenatal care visits, comprehensive knowledge on mother-to-child transmission, comprehensive knowledge on prevention of mother-to-child transmission, and region were significantly associated factors. Conclusion: The prevalence of HIV testing and counselling during antenatal care visits was low. Empowering women through education, promoting mass media exposure, increasing numbers of antenatal care visits, and enhancing women's knowledge related to HIV and mother-to-child transmission by targeting cold spot areas could improve HIV testing and counselling service uptake among pregnant women in Ethiopia. [ABSTRACT FROM AUTHOR]

Introduction: Blood pressure assessment is an essential strategy for early detection and treatment of hypertension and hypotension. Hypertensive disorders of pregnancy (HDP) are major public health problems resulting in a significant burden of perinatal and maternal morbidity and mortality. In Ethiopia, among pregnancies complicated by HDP, 25% end up with perinatal death. Perinatal and maternal mortality related to HDP were found to be higher in Ethiopia compared to high-income and most of the low- and middle-income countries. Despite its importance, there is limited evidence on blood pressure assessment during pregnancy. Therefore, this study aimed to determine the prevalence of blood pressure assessment during pregnancy and its associated factors in Ethiopia. Methods: This study was based on the 2019 Mini Ethiopian Demographic and Health Survey data. A total weighted sample of 2923 women who had a live birth five years before the survey were included and Stata version 16 software was used for statistical analysis. To identify associated factors, a multilevel robust Poisson regression model was fitted since the prevalence of blood pressure assessment was higher than 10%. Variables with p-value < 0.2 in the bi-variable analysis were exported to the multivariable analysis. In the multivariable analysis, the adjusted prevalence ratio with its 95% confidence interval was used to declare a statistically significant association. Results: In Ethiopia, the prevalence of blood pressure assessment during pregnancy was 88.1% (95% CI: 86.9%, 89.2%). In the multivariable multilevel robust Poisson analysis, primary education and secondary education, grand-multiparity, initiation of antenatal care before three months and 3–6 months, four and above antenatal care visits, being counselled by a health professional, being from richer and richest households, residing in Afar and Amhara regions were significantly associated with BP assessment during pregnancy in Ethiopia. Conclusion and recommendations: To reduce the high burden of mortality related to hypertensive disorders of pregnancy in the country, blood pressure assessment should be improved. Therefore, policymakers should design interventions that empower women in terms of education and economy, promoting early initiation of antenatal care visits and prenatal counselling could improve blood pressure assessment. [ABSTRACT FROM AUTHOR]

Introduction: Breast cancer continues to be the most common malignancy and the leading cause of cancer-related deaths in Ethiopia. The poor prognosis and high mortality rate of breast cancer patients in the country are largely caused by late-stage diagnosis. Hence, understanding the epidemiology of late-stage diagnosis is essential to address this important problem. However, previous reports in Ethiopia indicated inconsistent findings. Therefore, this literature review was conducted to generate dependable evidence by summarizing the prevalence and determinants of late-stage diagnosis among breast cancer patients in Ethiopia. Methods: Pertinent articles were retrieved by systematically searching on major electronic databases and gray literature. Data were extracted into an Excel spreadsheet and analyzed using the STATA 17 statistical software. The pooled estimates were summarized using the random effect meta-analysis model. Heterogeneity and small study effect were evaluated using the I2 statistics and Egger's regression test in conjunction with the funnel plot, respectively. Meta-regression, sub-group analysis, and sensitivity analysis were also employed. Protocol registration number: CRD42024496237. Results: The pooled prevalence of late-stage diagnosis after combining reports of 24 studies with 8,677 participants was 65.85 (95% CI: 58.38, 73.32). Residence (adjusted OR: 1.92; 95% CI: 1.45, 2.53), patient delay at their first presentation (adjusted OR: 2.65; 95% CI: 1.56, 4.49), traditional medicine use (adjusted OR: 2.54; 95% CI: 1.89, 3.41), and breast self-examination practice (adjusted OR: 0.28; 95% CI: 0.09, 0.88) were significant determinants of late-stage diagnosis. Conclusion: Two-thirds of breast cancer patients in Ethiopia were diagnosed at an advanced stage. Residence, delay in the first presentation, traditional medicine use, and breast self-examination practice were significantly associated with late-stage diagnosis. Public education about breast cancer and its early detection techniques is crucial to reduce mortality and improve the survival of patients. Besides, improving access to cancer screening services is useful to tackle the disease at its curable stages. [ABSTRACT FROM AUTHOR]

Introduction: More than two-third of global child death is occurred due to inappropriate feeding practice that happened during early childhood period. Evidence on meal frequency status among infant and young children at national level can be used to design appropriate interventions to improve the recommended feeding frequency. Therefore, this study was aimed to explore the spatial distribution and identify associated factors of inadequate meal frequency among children aged 6–23 months in Ethiopia. Methods: Secondary data analysis was conducted using the 2019 mini Ethiopian Demographic and Health Survey data. A total weighted sample of 1,532 children aged 6–23 months were included. To identify significant factors associated with of inadequate meal frequency, multilevel binary logistic regression model was fitted. Variables with p-value < 0.25 from the bi-variable model were exported to multivariable analysis. In the multivariable model, variables with p-value < 0.05 were declared as significantly associated factors and adjusted odds ratio (AOR) with its 95% confidence interval were reported. Multilevel models were compared using deviance and log-likelihood. Spatial analysis tools were utilized to visualize the distribution of inadequate meal frequency. Bernoulli model was fitted using SaTScan V.9.6 to identify most likely clusters and ArcGIS V.10.8 was used to map the hotspot areas. Ordinary least square and geographic weighted regression models were used and compared using information criteria and adjusted-R2. Local coefficients of factors associated with hotspots of inadequate meal frequency were mapped. Results: The prevalence of inadequate meal frequency was 47.03% (95% CI: 44.54%, 49.53%) in Ethiopia. Age of the child, sex of the household head, timely initiation of breastfeeding, current breastfeeding status, number of antenatal care visit, maternal education, and region were significantly associated with inadequate meal frequency. The spatial distribution of inadequate meal frequency was showed significant variation across Ethiopia (Global Moran's I = 0.164, p-value <0.001). A total of 38 significant clusters were detected through SaTScan analysis, from these the 22 primary clusters were located in Somali and Harari. Conclusion and recommendation: The prevalence of inadequate meal frequency was high in Ethiopia and had significant clustering patter. Significant hotspot clusters were located in Somali, northern Afar, Harari, Amhara, Gambela, and eastern South nation nationalities and peoples' region. Therefore, public health interventions which enhance breastfeeding practice, optimal number of antenatal care visits, educational empowerments should target hotspot areas to decrease inadequate meal frequency practice. [ABSTRACT FROM AUTHOR]

Background: For young adults and adolescents, excessive internet use has become a serious public health concern due to its negative impact on their health. It has been associated with detrimental effects on both physical and mental health. Negative academic outcomes were observed in the students, including missing classes, lower grades, and academic dismissal. Therefore, the purpose of the current study was to identify factors associated with PIU among undergraduate students at the University of Gondar. Method: A cross-sectional study was conducted at the University of Gondar among 1514 undergraduate students from June 1–20, 2022. The study participants were selected using a stratified simple random selection procedure. Using structural equation modeling, the degree of relationship was ascertained. A p-value of less than 0.05 and an adjusted regression coefficient with a 95% confidence interval (CI) were used to interpret the data. Results: In our study, being from non-health departments [β = 0.11, 95% CI: 0.037, 0.181], current alcohol use [β = 0.12, 95% CI: 0.061, 0.187], depressive symptoms [β = 0.23, 95% CI: 0.175, 0.291], insomnia symptoms [β = 0.12, 95% CI: 0.060, 0.196], and ADHD symptoms [β = 0.11, 95% CI: 0.049, 0.166] had a significant positive effect on PIU, while having a history of head injury had a significant negative effect [β = -0.12, 95% CI: -0.226, -0.021] on PIU. Conclusion and recommendation: Factors such as current alcohol use, non-health department type, depressive symptoms, insomnia, and ADHD symptoms were positively associated with PIU. However, a history of head injuries was negatively associated with PIU. Therefore, strategies aimed at the early identification of PIU may lead to an improvement in the psychosocial health of university students. [ABSTRACT FROM AUTHOR]

Background: Africa is the most severely affected area, accounting for more than two-thirds of the people living with HIV. In sub-Saharan Africa, more than 85% of new HIV-infected adolescents and 63% of all new HIV infections are accounted for by women. Ethiopia has achieved a 50% incidence rate reduction. However, mortality rate reduction is slow, as the estimated prevalence in 2021 is 0.8%. In sub-Saharan Africa, heterosexual transmission accounts for the majority of HIV infections, and women account for 58% of people living with HIV. Most of these transmissions took place during marriage. Thus, this study aimed to explore the spatial variation of premarital HIV testing across regions of Ethiopia and identify associated factors. Methods: A cross-sectional study design was employed. A total of 10223 weighted samples were taken from individual datasets of the 2016 Ethiopian Demographic and Health Survey. STATA version 14 and ArcGIS version 10.8 software's were used for analysis. A multilevel mixed-effect generalized linear model was fitted, and an adjusted prevalence Ratio with a 95% CI and p-value < 0.05 was used to declare significantly associated factors. Multilevel models were compared using information criteria and log-likelihood. Descriptive and spatial regression analyses (geographical weighted regression and ordinary least squares analysis) were conducted. Models were compared using AICc and adjusted R-squared. The local coefficients of spatial explanatory variables were mapped. Results: In spatial regression analysis, secondary and above education level, richer and above wealth quintile, household media exposure, big problem of distance to health facility, having high risky sexual behaviour and knowing the place of HIV testing were significant explanatory variables for spatial variation of premarital HIV testing among married women. While in the multilevel analysis, age, education level, religion, household media exposure, wealth index, khat chewing, previous history of HIV testing,age at first sex, HIV related knowledge, HIV related stigma, distance to health facility, and community level media exposure were associated with premarital HIV testing among married women. Conclusions and recommendation: Premarital HIV testing had a significant spatial variation across regions of Ethiopia. A statistically significant clustering of premarital HIV testing was observed at Addis Ababa, Dire Dawa, North Tigray and some parts of Afar and Amhara regions. Therefore area based prevention and interventional strategies are required at cold spot areas to halt the role of heterosexual transmission in HIV burden. Moreover, the considering the spatial explanatory variables effect in implementations of these strategies rather than random provision of service would make regional health care delivery systems more cost-effective. [ABSTRACT FROM AUTHOR]

Introduction: Zero-dose children refer to a child who has not yet received any childhood vaccines. Globally, zero-dose children are the major public health problem. In sub-Saharan African countries, one among five children do not have access to vaccines. But the efforts to identify the factors contributing to the zero-dose children are not well addressed in Ethiopia., Objectives: To assess individual and community-level maternal factors of zero-dose children in Ethiopia using mini-Ethiopian Demographic Health Survey 2019., Methods: A secondary analysis of a cross-sectional study was used among a total of 3208 participants. STATA-14 was used for descriptive and multilevel binary logistic regression (mixed effects model) analysis. Model selection was conducted using Akaike information criteria. To identify significant factors for zero-dose children, a p value of <0.05 with 95% CI was used., Results: The prevalence of zero-dose children among children aged 12-35 months was 523 (16.3%, 95% CI 15% to 17.6%). Women with no antenatal care follow-up (adjusted OR (AOR)=1.55, 95% CI 1.02 to 2.35), uneducated women (AOR=1.47, 95% CI 1.11 to 1.95), women who gave birth at home (AOR=1.39, 95% CI 1.04 to 1.86), women who had poor wealth index (AOR=2.15, 95% CI 1.62 to 2.85) and women from low proportions of community media exposure (AOR=1.39, 95% CI 1.13 to 1.71) were the risk factors for zero-dose children in Ethiopia., Conclusion: Compared with previous studies, the prevalence of zero-dose children was low in Ethiopia. Variables like urban residence, no education, home delivery, poor wealth index, no antenatal care(ANC) visit and women from low proportions of community media exposure were the risk factors for zero-dose children in Ethiopia. Therefore, expanding maternal health services and media access for women is highly recommended to reduce zero-dose children mortality., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2025. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ Group.)

Objective: This study aimed to assess fathers' knowledge of neonatal danger signs and their associated factors in Northwest Ethiopia., Design: Community-based cross-sectional study., Setting: Enarji and Enawga Woreda, Northwest Ethiopia., Participants: The study was conducted on 613 participants in Enarji and Enawga Woreda from 13 May to 13 June 2022. Participants were selected using stratified simple random sampling. Participants with serious illnesses who were unable to respond to the questions were excluded from the study. A total of 602 participants completed the questionnaire. Data were collected through face-to-face interviews conducted by four well-trained data collectors. To assess participants' knowledge, 10 structured and standardised questions were adopted from WHO and the Ethiopian Federal Ministry of Health. The data were analysed using SPSS V.26. A logistic regression model was fitted to identify factors associated with knowledge about neonatal danger signs. An adjusted OR (AOR) with a 95% CI and a p value <0.05 was used to declare factors as significantly associated., Result: Less than a quarter (23.26%) of fathers had good knowledge of neonatal danger signs (95% CI 19.9, 26.8). The study also found that several factors were significant predictors of good knowledge, including: secondary education (AOR 2.98, 95% CI 1.08, 8.24), college education or higher (AOR 3.45, 95% CI 1.09, 10.85), number of children (AOR 3.68, 95% CI 1.62, 8.34), history of sickness in the index baby (AOR 2.18, 95% CI 1.18, 4.01), fathers' attendance on postnatal care visits (AOR 4.32, 95% CI 2.06, 9.08), history of neonatal death (AOR 3.94, 95% CI 1.80, 8.64), receiving information on neonatal danger signs (AOR 2.71, 95% CI 1.30, 5.64) and health professionals as a source of information (AOR 3.27, 95% CI 1.52, 7.04). These factors were all significantly associated with good knowledge of neonatal danger signs., Conclusion: Fathers' knowledge of neonatal danger signs was found to be low. Therefore, substantial efforts are needed to enhance their knowledge. It is essential to develop strategies that actively involve fathers in the continuum of postnatal care for both mothers and newborns. Additionally, providing targeted information on neonatal danger signs through health professionals can significantly improve fathers' knowledge., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Objective: To assess the quality of childbirth care and its determinants along the continuum of care in Gondar town public health facility in Ethiopia., Design: An institution-based, cross-sectional study was employed. Completed data were imported to Stata V.16 for cleaning and analysis. A generalised structural equation model was employed to examine the relationships along the continuum of childbirth care and to determine the factors affecting the quality of childbirth care., Setting and Participants: This study was conducted among a total of 865 women who delivered in the public health facility of Gondar, Ethiopia, from 19 May to 30 June 2022., Results: The study revealed the proportion of good-quality childbirth care during admission, intrapartum and immediate postpartum period was 59% (95% CI 55.7, 62.4), 76.8% (95% CI 73.8, 79.5) and 45% (95% CI 41.7, 48.5), respectively. Postsecondary educational status of mothers (β=0.60, 95% CI 0.16, 1.04) and maternal age of 25-35 (β=0.68, 95% CI 0.33, 1.02) were predictors of quality of care at admission. Referral hospital (β=0.43, 95% CI 0.10, 0.76), presence of guidelines (β=1.36, 95% CI 0.72, 1.99) and provider age of 25-35 (β=0.61, 95% CI 0.12, 1.10) affected the quality of care during the intrapartum period. Urban residence (β=0.52, 95% CI 0.12, 0.93), skilled birth attendant experience (β=0.19, 95% CI 0.11, 0.28) and number of delivery couches (β=-0.29, 95% CI -0.44, -0.13) had significant associations with the quality of childbirth care during the immediate postpartum period., Conclusions: Although our study found improvements in the quality of childbirth care along the continuum compared with previous studies, more workers are needed to alleviate the problem of poor-quality service. Different maternal, provider and facility factors were found to be predictors of the quality of childbirth care., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)