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Enyew Getaneh Mekonen,1 Belayneh Shetie Workneh,2 Mohammed Seid Ali,3 Niguse Yigzaw Muluneh4 1Department of Surgical 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 Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia; 4Department of Psychiatry, College of Medicine and Health Sciences, University of Gondar, Gondar, EthiopiaCorrespondence: Enyew Getaneh Mekonen Tel +251946607528Email enyewgetaneh12@gmail.comIntroduction: A poorly known contagious disease outbreak, like COVID-19, leads to unavoidable stress, fear, and anxiety. During the pandemic, University students suffer from adverse mental health outcomes resulted from the continuous spread of the disease, sensational media reporting, and implementation of social lockdown. Graduating class students are more affected due to cancellation and postponing of anticipated events such as exchange studies and graduation ceremonies. This study aimed to assess the prevalence and associated factors of anxiety, depression, and stress among graduating class students.Methods: Institution-based cross-sectional study was conducted from November 10 to 30, 2020 at the University of Gondar. A simple random sampling technique was employed to select 350 students. Data were collected using a structured self-administered questionnaire, entered in EPI DATA version 3, analyzed using SPSS version 21, and presented in frequencies, percentages, tables, and graphs. Bivariable and multivariable analysis was investigated using a binary logistic regression model.Results: The prevalence of stress, anxiety, and depression among graduating class students was 22.2%, 39.6%, and 40.2% respectively. Living in an urban area, living with a family, sedentary lifestyle, unable to practice COVID-19 preventive measures, and having a contact history increases the risk of developing stress. Living in an urban area, substance use, sedentary lifestyle, and fear of infecting family increase the risk of developing anxiety. Students who came from an urban area, live with a family, study non-health departments, had confirmed cases in the family and did not perform physical exercise had higher odds of developing depression.Conclusion: More than one-fifth, more than one-third, and nearly two-fifths of graduating students had stress, anxiety, and depression respectively. It is better to develop effective strategies and interventions, train students about self-protection, and establish a psychological crisis intervention team to minimize the psychological impact of the COVID-19 pandemic.Keywords: anxiety, COVID-19, depression, stress, graduating class students

Belayneh Shetie Workneh,1 Enyew Getaneh Mekonen2 1Department of Emergency and Critical Care Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia; 2Department of Surgical Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, EthiopiaCorrespondence: Enyew Getaneh Mekonen Tel +251946607528Email enyewgetaneh12@gmail.comIntroduction: Low back pain is a very common health problem that most people experience at some point in their working life. It results in sick leave, disability, producing significant restrictions on usual activity and participation among many office workers. The working style of bank workers is sedentary mostly and the alignment of their chairs, table, and computers is not designed based on their health aspects which exposes them to low back pain.Objective: This study aimed to assess the prevalence and associated factors of low back pain among bank workers in Gondar city.Methods: Institution-based cross-sectional study was conducted from 20th October to 10th November 2020 at banks in Gondar city. A simple random sampling technique was employed to select 296 bank workers. A structured pretested self-administered questionnaire was used to collect data. Data were entered in epi-info version 7, analyzed using SPSS version 21, and presented by frequencies, percentages, and tables. Bivariable and multivariable analyses were employed using a binary logistic regression model. Variables with a p-value < 0.05 were considered as factors significantly associated and the odds ratio with a 95% CI was used to determine the strength of association.Results: The prevalence of low back pain among bank workers in the last 12 months was 55.4%. Being female, work-related stress, lack of physical activity, using a fixed chair and a chair without an armrest, and lifting heavy objects increases the risk of developing low back pain.Conclusion: The prevalence of low back pain among bank workers in Gondar city was high. It is better to establish a health screening team, avail a movable chair and a chair with an armrest, and give special attention to female workers and bank workers with stress, and do physical activity to reduce the risk of developing low back pain.Keywords: banks, bank workers, low back pain, prevalence, associated factors, Ethiopia

Background: The duration between a patient's arrival at the Emergency Department (ED) and their actual departure, known as the Emergency Department Length of Stay (EDLOS), can have significant implications for a patient's health. In Ethiopia, various studies have investigated EDLOS, but a comprehensive nationwide pooled prevalence of prolonged EDLOS, which varies across different locations, is currently lacking. Therefore, the objective of this systematic review and meta-analysis is to provide nationally representative pooled prevalence of prolonged EDLOS and identify associated factors., Methods: In this study, we conducted a comprehensive systematic review and meta-analysis using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 checklist. We conducted a thorough search of numerous international databases, including PubMed/Medline, SCOPUS, Web of Science, and Google Scholar. The primary outcome was the prevalence of prolonged EDLOS. The secondary outcome was factors affecting the EDLOS. Random-effects model was used to since there was high heterogeneity. We also conducted subgroup analysis and meta-regression to investigate heterogeneity within the included studies. To assess publication bias, we used Egger's regression test and funnel plots. All statistical analyses were performed using STATA version 17.0 software to ensure accurate and reliable findings., Result: We have identified eight articles that met our inclusion criteria with a total sample size of 8,612 participants. The findings of this systematic review and meta-analysis indicate that the pooled estimate for the prevalence of prolonged EDLOS is 63.67% (95% CI = 45.18, 82.16, I 2  = 99.56%, P = 0.0001). The study identified several significant factors associated with prolonged EDLOS, including patients admitted to overcrowded emergency departments (OR = 5.25, 95% CI = 1.77, 15.58), delays in receiving laboratory findings (OR = 3.12, 95% CI = 2.16, 4.49), and delays in receiving radiological results (OR = 3.00, 95% CI = 2.16, 4.16)., Conclusion: In this review, the EDLOS was found to be very high. Overcrowding, delays in laboratory test findings, and delays in radiology test results make up the factors that have a statistically significant association with prolonged EDLOS. Given the high prevalence of prolonged EDLOS in this review, stakeholders should work to increase the timeliness of ED services in Ethiopia by proper disposition of non-emergency palliative patients to the appropriate destination, and implementing point-of-care testing and imaging., Competing Interests: Declarations Ethics approval and consent to participate Not applicable. Consent for publication Not Applicable. Competing interests The authors declare no competing interests., (© 2024. The Author(s).)

Objectives: Vaccination is a crucial public health intervention protecting individuals and communities from vaccine-preventable diseases. However, unvaccinated children in low- and middle-income countries pose a significant challenge. Ethiopia, a Global Alliance for Vaccines and Immunisation (GAVI)-supported country, ranks fifth in zero-dose immunisation burden, indicating concerning vaccine coverage gaps. Despite the severity of this issue, there is a dearth of research investigating the disparities, prevalence and contributing factors associated with zero-dose children in Ethiopia. This study aimed to assess the prevalence, spatial distribution and determinants of zero-dose children in Ethiopia., Study Design: A community-based cross-sectional study was conducted using data from the 2019 Ethiopian Mini Demographic and Health Survey (EMDHS). Data were collected from 21 March 2019 to 28 June 2019., Methods: The study included a total of 1334 children aged 12-35 months (weighted sample). For spatial and multilevel analyses, ArcGIS 10.8 and Stata 17 software were used, respectively. The measure of association was determined by computing the adjusted odds ratio (AOR) at a 95 % confidence interval (95 % CI), and a p-value <0.05 was considered statistically significant., Results: The prevalence of zero-dose children in Ethiopia was 46.5 % (95 % CI: 43.8, 49.2). Southeast Amhara, Afar, Somali, Oromia and SNNPR (Southern Nations, Nationalities and Peoples' Region) regions had high zero-dose proportions. Maternal age 15-19 years (AOR = 1.63; 95 % CI: 1.05, 2.64), lack of antenatal care (AOR = 1.77; 95 % CI: 1.34, 2.35), rural residence (AOR = 1.94; 95 % CI: 1.17, 3.19) and region were significantly associated to zero-dose status in Ethiopia., Conclusions: The prevalence of zero-dose children in Ethiopia was high and the distribution exhibited significant variation across the country's clusters. Individual and community factors were key contributors. It is essential that areas with a high prevalence of zero-dose children have access to recommended childhood vaccines. This proactive approach can help protect children from morbidity and mortality caused by vaccine-preventable diseases., (Copyright © 2024 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.)

Background: Poor maternal nutrition during pregnancy is a common cause of poor maternal and infant outcomes. Micronutrient deficiencies are common among pregnant women in low- and middle-income countries, including sub-Saharan Africa. Pregnant women are recommended to take micronutrients like iron or folic acid and deworming medication during pregnancy. Therefore, this study was conducted to assess micronutrient intake and its associated factors among pregnant women in three countries using the most recent demographic and health survey., Methods: We used data from the most recent demographic and health surveys, which were carried out between 2019 and 2022 in three sub-Saharan African countries. The study included a weighted sample of 13,568 reproductive-age women who had given birth within the five years prior to the survey. Utilizing multilevel logistic regression, the factors associated with the dependent variable were identified. Model comparison and fitness were assessed using the deviance (-2LLR), likelihood ratio test, median odds ratio, and intra-class correlation coefficient. Ultimately, factors were deemed statistically significant if they had a p -value less than 0.05., Results: The pooled prevalence of micronutrient intake among pregnant women during pregnancy of last birth was 77.56% (95% CI: 76.85%-78.25%). Factors like age [AOR = 1.78; 95% CI (1.14, 2.77)], educational status [AOR = 1.49; 95% CI (1.23, 1.79)], marital status [AOR = 0.66; 95% CI (0.58, 0.75)], working status [AOR = 1.17; 95% CI (1.01, 1.34)], media exposure [AOR = 1.20; 95% CI (1.05, 1.38)], preceding birth interval [AOR = 1.17; 95% CI (1.01, 1.34)], number of ANC visits [AOR = 1.65; 95% CI (1.29, 2.10)], and residence [AOR = 1.19; 95% CI (1.03, 1.37)] were significantly associated with micronutrient intake among pregnant women., Conclusions: More than three-fourths of the study subjects were micronutrient supplemented during their pregnancy. Improving women's education, disseminating nutrition information through media, providing more attention to young pregnant women who live in rural areas, increasing the number of ANC visits, and women's empowerment are strongly recommended., 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., (© 2024 Mekonen, Zegeye, Workneh, Ali, Gonete, Alemu, Tamir, Tekeba, Wassie and Kassie.)

Background: Traditional birth attendant utilization has become a common malpractice and a leading cause of maternal morbidity and mortality in the developing world, such as Ethiopia. Therefore, this study was aimed at determining the geospatial variation and determinant factors of traditional birth attendant utilization among mothers of reproductive age in Ethiopia., Methods: The data were taken from the 2019 Ethiopian Demographic and Health Survey. Arc GIS, Excel, and STATA-14 software were used for the data analysis. The adjusted odds ratio with a 95% confidence interval was used to declare significant determinants of traditional birth attendance among mothers of reproductive age in Ethiopia., Results: Among 5,753 mothers of reproductive age, 34.59% of them utilized traditional birth attendants in Ethiopia during the 2019 Ethiopian Demographic and Health Survey. There was a geospatial variation of traditional birth attendants among mothers of reproductive age in Ethiopia; the Global Moran's index value was 0.39 with a p -value <0.001. The significant factors associated with traditional birth attendant utilization were the age of mothers; higher odds were observed among older mothers aged 35-49 years (AOR = 1.31; 95% CI (1.04-1.63)); educational level of mothers (AOR = 3.04; 95% CI (2.13-4.33)); higher odds were observed in uneducated mothers, wealth index (AOR = 2.76; 95% CI (1.83-4.19)); higher odds were observed among the poorer and poorest households, place of residence (AOR = 5.69; 95% CI (3.35-9.67)); and the regions; the highest odds were observed in Somali (AOR = 12.1; 95% CI (4.99-25.68)) and Afar (AOR = 7.13; 95% CI (2.37-21.38))., Conclusions: The utilization of traditional birth attendants among reproductive-age mothers became a major public health concern, and the distribution showed geo-spatial variations among the regions of the country. We recommend taking appropriate measures to alleviate the current problem by improving access to maternal healthcare services., 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) 2024.)

Introduction: Globally, nearly half of all deaths among children under the age of five are linked to undernutrition. These tragic outcomes are most prevalent in low- and middle-income countries. The far-reaching impact of malnutrition affects not only individuals but also their families, communities, and entire nations. By examining underweight, we gain valuable insights into the intricate network of factors influencing child health. Therefore, this study aims to assess underweight prevalence and its associated factors among under-five children in low and lower-middle-income African countries., Method: We conducted a secondary analysis of standard demographic and health surveys in 30 low and lower-middle-income African countries spanning from 2012 to 2022. Our analysis included a total sample of 200,655 children under the age of 5 years. We employed a three-level hierarchical model to assess the determinants of underweight among children in this age group. Measures of association were evaluated using adjusted odds ratios with a 95% confidence interval. Explanatory variables with a p -value less than the level of significance (0.05) were considered statistically significant., Result: The pooled prevalence of underweight among children under the age of five in low and lower-middle income African countries was estimated at 17.60%, with a 95% confidence interval (CI) ranging from 17.44 to 17.77%. The hierarchical analysis identified several factors significantly associated with underweight, including male gender, birth size, maternal body mass index, maternal educational level, household wealth index, antenatal care (ANC) visits, community poverty level, and income level of countries., Conclusion: The high prevalence of underweight among children under the age of five in low and lower-middle income African countries underscores the need for targeted interventions. By addressing individual, community, and country-level factors, we can work toward improving child nutrition and well-being., 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., (Copyright © 2024 Tamir, Zegeye, Workneh and Mekonen.)

Introduction: Pneumococcal disease is a serious global public health concern. The primary causative agent of severe illnesses such as pneumonia, meningitis, acute otitis media, and bacteremia is the pneumococcus bacterium. The pneumococcal conjugate vaccine is a key strategy to reduce the burden of pneumococcal disease. Understanding the spatial distribution of complete childhood pneumococcal conjugate vaccine utilization and its associated factors is crucial for designing strategies to improve vaccination implementation. Therefore, this study aimed to determine the spatial distribution of complete childhood pneumococcal conjugate vaccination coverage and identify its determinants in Ethiopia., Method: A spatial and multilevel analysis was conducted using data from the 2019 Ethiopian Mini Demographic and Health Survey. The analysis included a total of 2,055 weighted children. The association between the outcome variable and the explanatory variables was determined by calculating adjusted odds ratios at a 95% confidence interval. Explanatory variables were considered significantly associated with the outcome if the p-value was less than 0.05., Result: The prevalence of complete childhood pneumococcal conjugate vaccination in Ethiopia was 53.94% (95% CI: 51.77, 56.08). Higher complete childhood pneumococcal vaccination coverage was observed in the Addis Ababa, Tigray, Amhara, Benishangul-Gumuz, and Oromia regions, while lower coverage was seen in the Afar, Somali, and SNNPR regions of Ethiopia. Factors significantly associated with complete childhood pneumococcal conjugate vaccination included maternal age, antenatal care visits, place of delivery, region, community women's literacy level, community poverty level, and community antenatal care utilization., Conclusion: The distribution of complete childhood pneumococcal conjugate vaccination exhibited spatial variability across Ethiopia. Approximately half of children aged twelve to thirty-five months received the full dose of the childhood pneumococcal conjugate vaccine in the country. Several factors were identified as statistically significant determinants of complete childhood pneumococcal conjugate vaccination, including maternal age, antenatal care visits, place of delivery, region, community women's literacy level, community poverty level, and community ANC utilization. Therefore, policies and strategies aimed at combating pneumococcal disease should consider these determinants and address areas with low vaccination coverage., (© 2024. The Author(s).)

Background: Diversity in the mother's diet can have major effects on the developing fetus throughout pregnancy. Approximately 1 million neonates die on their first day of life as a result of inadequate nutrition, which also complicates the mother's pregnancy and has a negative impact on the delivery outcome. Dietary diversity during pregnancy is poorly recognized in developing countries, despite the fact that it is detrimental. As a result, this study aimed to assess the prevalence and associated factors of inadequate dietary diversity in Burkina Faso, Ghana, Kenya, and Tanzania among pregnant women., Methods: Secondary data analysis was conducted using data from the most recent Demographic and Health Surveys, which included four countries in Sub-Saharan Africa between 2021 and 2022. A total of 80,083 pregnant women were included in this study. The women's dietary diversity was computed from 10 food categories. Based on the minimum diversity score, women were categorized as having inadequate dietary diversity if their diversity score was less than five food items and as having adequate dietary diversity if they took five or more food groups. A multilevel mixed-effects logistic regression model was used to identify the factors associated with inadequate dietary diversity. At p -values <0.05, significant factors correlated with inadequate diversity were identified. The result was interpreted using 95%CI and adjusted odds ratio. The best-fit model was determined to be the one with the lowest deviance and highest loglikelihood ratio., Results: The prevalence of inadequate dietary diversity among pregnant women in Burkina Faso, Ghana, Kenya, and Tanzania was 94.46%. Factors such as no formal education (AOR = 3.39, 95% CI: 2.54, 4.54), distance to health facilities (AOR = 1.36, 95% CI: 1.16, 1.60), poor wealth quantiles (AOR = 2.97, 95% CI: 2.41, 3.65), no media exposure (AOR = 1.84, 95% CI: 1.45, 2.35), low community ANC utilization (AOR = 1.21, 95% CI: 1.16, 1.60), and reside Burkina Faso (AOR = 1.47, 95% CI: 1.09, 1.99) were among the factors associated with inadequate dietary diversity., Conclusion: According to this study finding, pregnant women had a high percentage of inadequate dietary diversity. Factors at the individual and community levels contributed to the lack of diversity in nutrition. Thus, when developing policies and strategies, the health ministries of Burkina Faso, Kenya, Ghana, and Tanzania should to consider the women who underutilize antenatal care services, live in low wealth quantiles and who did not get formal education., 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., (Copyright © 2024 Zegeye, Mekonen, Tamir and Workneh.)

Introduction: Inappropriate feeding practices are a major contributor to child malnutrition. To monitor the feeding practices of young children, current and frequent studies are required. However, as far as our searches are concerned, there is a scarcity of up-to-date information on attainment of the minimum acceptable diet and its predictors in the study area. Therefore, this study aimed to assess the magnitude of attainment of the minimum acceptable diet and its associated factors among children aged 6-23 in Ghana by using the most recent data., Methods: Secondary data analysis was conducted based on the demographic and health survey data conducted in Ghana in 2022. A total weighted sample of 2,621 children aged 6-23 months in the 5 years preceding the survey was included in this study. A multi-level logistic regression model was used to identify the determinants of the minimum acceptable diet. The adjusted odds ratio at 95% Cl was computed to assess the strength and significance of the association between explanatory and outcome variables. Factors with a p -value of <0.05 are declared statistically significant., Results: The national prevalence of the attainment of the minimum acceptable diet in Ghana was 26.40% (95% CI: 24.82-28.06). Child from mother with higher education (AOR = 1.96; 95% CI: 1.56-3.31) and father with higher education (AOR = 1.59; 95% CI: 1.04-2.41), Children having postnatal visit (AOR = 1.29; 95% CI: 1.03-1.62), being in the child age of 9-11 months (AOR = 2.09; 95% CI: 1.42-5.03) and 12-23 months (AOR = 3.62; 95% CI: 2.61-5.03), being in a middle (AOR = 1.66; 95% CI: 1.14-3.06), and rich wealth quintile (AOR = 2.06; 95% CI: 1.37-3.10), breastfed children (AOR = 3.30; 95% CI: 2.38-4.56), being in a high-community poverty (AOR = 0.65; 95% CI: 0.44-0.96), and being in the Savannah region (AOR = 0.32; 95% CI: 0.16-0.67) were factors significantly associated with the minimum acceptable diet use., Conclusion: Many children are still far behind in meeting the minimum acceptable diet in Ghana as per 90% of WHO-recommended coverage. Measures should be taken to optimize the minimum acceptable diet attainment in the country. Thus, policymakers, the government, and other relevant authorities should focus on the early initiation of complementary feeding, the Savannah region, further empowering women, and enhancing breast-feeding and household wealth status., 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., (Copyright © 2024 Tekeba, Workneh, Zegeye, Gonete, Zeleke and Tamir.)

Cervical cancer is the fourth most common cancer, with 99% of cases linked to human papillomavirus (HPV) infection. It reflects global inequity as its burden is highest in low- and middle-income countries. The aim of this study was to determine the HPV vaccination coverage and its determinant factors among young women in the three sub-Saharan African countries. Data from the Demographic and Health Surveys among three sub-Saharan African countries were used for analysis. A total of 4,952 women were included in the study. Stata 14 was used to analyze the data. The determinants of the outcome variable were identified using a multilevel mixed-effects logistic regression model. Factors with p-values < 0.05 at 95% confidence interval were declared statistically significant. About 7.5% young women were vaccinated for HPV vaccine against cervical cancer in the current study. Younger age, use of internet, rich economic class, and individual-level media exposure were found to be favorable conditions, whereas being employed was negatively associated with HPV vaccination. Only few segments of young women in these three countries got HPV vaccination. The authors recommend that increasing internet use, media exposure, and economic level of young women will increase the HPV vaccination rates. Furthermore, creating awareness among employed women will also increase the possibility of HPV vaccination.

Rotavirus is the most common cause of diarrhea in children worldwide. In 2016, rotavirus infection resulted in 258 173 300 episodes of diarrhea and 128 500 child deaths in the globe. The study aimed to assess the magnitude of Rotavirus vaccine dose-two dropout and associated factors among children who received rotavirus vaccine dose-one in sub-Saharan African countries. The appended and most recent demographic and health survey (DHS) dataset of 17 sub-Saharan African countries was used for data analysis. A total of 73,396 weighted samples were used. Factors associated with the outcome variable were considered significant if their p -values were ≤ .05 in the multilevel mixed-effect logistic regression model. The overall Rotavirus vaccine dose-two dropouts was 10.77% (95% CI 10.55%, 11.00%), which ranged from 2.77% in Rwanda to 37.67% in Uganda. Being younger, late birth order, having difficulty accessing health facilities, having no media exposure, having no work, having home delivery, having no antenatal follow-up, and having no postnatal checkup were factors significantly associated with the outcome variable. The overall Rotavirus vaccine dose-two dropout was higher in sub-Saharan African countries which implies that vaccine dropout is still a great issue in the region. Special attention should be given to those mothers who are young, who have no work, who give birth at home, who experienced difficulty in accessing health facilities, and late birth orders. Furthermore, targeted interventions should be considered for improving access and utilization of media, antenatal care, and postnatal care services.

Background: In low- and middle-income countries where vaccination rates are low, tetanus is still an important threat to public health. Although maternal and neonatal tetanus remains a major global health concern, its magnitude and determinates are not well studied. Therefore, this study aimed to assess the number of tetanus toxoid injections and associated factors among pregnant women in low- and middle-income countries., Methods: Data from the most recent Demographic and Health Surveys, which covered 60 low- and middle-income countries from 2010 to 2022, was used for secondary data analysis. The study included a total of 118,704 pregnant women. A statistical software package, STATA 14, was used to analyze the data. A negative binomial regression of a cross-sectional study was carried out. Factors associated with the number of tetanus vaccinations were declared significant at a p-value of < 0.05. The incidence rate ratio and confidence interval were used to interpret the results. A model with the smallest Akaike Information Criterion and Bayesian Information Criterion values and the highest log likelihood was considered the best-fit model for this study., Results: In low- and middle-income countries, 26.0% of pregnant women took at least two doses of the tetanus toxoid vaccine. Factors such as maternal education, primary (IRR = 1.22, 95% CI: 1.17, 1.26), secondary (IRR = 1.19, 95% CI: 1.15, 1.23), higher (IRR = 1.16, 95% CI: 1.12, 1.20), employment (IRR = 1.11, 95% CI: 1.09, 1.13), 1-3 ANC visits (IRR = 2.49, 95% CI: 2.41, 2.57), ≥4 visits (IRR = 2.94, 95% CI: 2.84, 3.03), wealth index (IRR = 1.06; 95% CI: 11.04, 1.08), ≥birth order (IRR = 1.04, 95% CI: 1.02, 1.27), distance to health facility (IRR = 1.02, 95% CI: 1.00, 1.03), and health insurance coverage (IRR = 1.08; 95% CI: 1.06, 1.10) had a significant association with the number of tetanus vaccinations among pregnant women., Conclusions and Recommendations: This study concludes that the number of tetanus toxoid vaccinations among pregnant women in low- and middle-income countries is low. In the negative binomial model, the frequency of tetanus vaccinations has a significant association with maternal employment, educational status, wealth index, antenatal care visits, birth order, distance from a health facility, and health insurance. Therefore, the ministries of health in low and middle-income countries should give attention to those women who had no antenatal care visits and women from poor wealth quantiles while designing policies and strategies.

Objectives: Overnutrition, a leading cause of global mortality, has seen a significant rise in low- and middle-income countries, including sub-Saharan Africa. Despite emerging evidence linking overnutrition to non-communicable diseases, limited action has been taken to address this issue. While undernutrition studies have received more attention, research on overnutrition and women's health remains scarce in sub-Saharan Africa. Our study aims to assess the prevalence and associated factors of overnutrition among reproductive women in this region METHODS: We conducted a secondary analysis of 2019-2023 Demographic and Health Survey datasets in sub-Saharan Africa. Our study included a weighted sample of 65,161 women aged 15-49 y. Using a multilevel mixed-effects logistic regression model, we identified factors associated with overnutrition. The adjusted odds ratio, along with a 95% confidence interval and a significance level of p < 0.05, determined the statistical significance of the explanatory variables., Results: The pooled prevalence of overnutrition among women of reproductive age in sub-Saharan Africa was 34.79% (95% CI: 34.42-35.16). Specifically, the prevalence of overweight and obesity was 21.81% and 12.99%, respectively. Women's educational status, age, media use, household wealth, urbanization, community poverty, and country income level were significantly associated with higher odds of overnutrition., Conclusions: The prevalence of overnutrition among women of reproductive age in sub-Saharan Africa is relatively high. Key factors associated with this issue include women's educational status, age, media utilization, household wealth, place of residence, community poverty level, and national income status. These multilevel determinants highlight the need for a comprehensive, evidence-based approach to address overnutrition in this population. Effective strategies should target individual behaviors while considering broader social, economic, and environmental contexts. Integrating overnutrition prevention into maternal and reproductive health services, as well as strengthening social protection measures, are recommended steps to tackle this growing challenge in sub-Saharan Africa., Competing Interests: Declaration of competing interest This manuscript is free of any conflict of interest., (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)

Introduction: Despite remarkable achievements in improving maternal and child health, early neonatal deaths still persist, with a sluggish decline in Ethiopia. As a pressing public health issue, it requires frequent and current studies to make appropriate interventions. Therefore, by using the most recent Ethiopian Mini Demographic Health Survey Data of 2019, we aimed to assess the magnitude and factors associated with early neonatal mortality in Ethiopia., Methods: Secondary data analysis was conducted based on the demographic and health survey data conducted in Ethiopia in 2019. A total weighted sample of 5,753 live births was included for this study. A multilevel logistic regression model was used to identify the determinants of early neonatal mortality. The adjusted odds ratio at 95% Cl was computed to assess the strength and significance of the association between explanatory and outcome variables. Factors with a p-value of < 0.05 are declared statistically significant., Results: The prevalence of early neonatal mortality in Ethiopia was 26.5 (95% Cl; 22.5-31.08) per 1000 live births. Maternal age 20-35 (AOR, 0.38; 95% Cl, 0.38-0.69), richer wealth index (AOR, 0.47; 95% Cl, 0.23-0.96), having no antenatal care visit (AOR, 1.86; 95% Cl, 1.05-3.30), first birth order (AOR, 3.41; 95% Cl, 1.54-7.56), multiple pregnancy (AOR, 18.5; 95% Cl 8.8-38.9), presence of less than two number of under-five children (AOR, 5.83; 95% Cl, 1.71-19.79) and Somali region (AOR, 3.49; 95% Cl, 1.70-12.52) were significantly associated with early neonatal mortality., Conclusion: This study showed that, in comparison to other developing nations, the nation had a higher rate of early newborn mortality. Thus, programmers and policymakers should adjust their designs and policies in accordance with the needs of newborns and children's health. The Somali region, extreme maternal age, and ANC utilization among expectant moms should all be given special consideration., (© 2024. The Author(s).)

Background: During the Coronavirus Disease 2019 (COVID-19) pandemic, intimate partner violence increased globally, but most notably in Africa. Conditions such as movement restrictions, staying home, and school closures increased the risk of domestic violence against women. Intimate partner violence is violence demonstrated by an intimate partner against women including physical, sexual, and psychological violence. Despite existing laws against intimate partner violence in Ethiopia, enforcement by law and the judicial system remains inadequate. Thus, this research aims to identify factors contributing to intimate partner violence among women during the COVID-19 pandemic, drawing insights from the current literature., Method: We searched electronic databases, including PubMed, Google Scholar, CINAHL, Cochrane, and others. Two reviewers separately carried out the search, study selection, critical appraisal, and data extraction. A third party was involved in resolving disagreements among the reviewers. All 10 studies included in this study were published in English, with publication dates before 25 February 2024. Articles lacking an abstract and/or full-text, studies that did not identify the intended outcome, and qualitative studies were excluded from the analysis. A Microsoft Excel checklist was used to extract the data, which were then exported to STATA 11. I 2 , funnel plots, and Egger's test were employed to measure heterogeneity and detect publication bias, respectively. A random-effects model was used to estimate the pooled prevalence of intimate partner violence and associated factors among women during the COVID-19 pandemic., Result: The meta-analysis includes a sample size of 6,280 women from 10 articles. The pooled prevalence of intimate partner violence and associated factors among women during the COVID-19 pandemic was found to be 31.60% (95% CI: 21.10-42.11) and significant factors were partner alcohol use with a pooled odds ratio of 1.93 (95% CI: 1.60-2.23), income loss during the COVID-19 pandemic with a pooled odds ratio of 9.86 (95% CI: 6.35-15.70), partner's literacy level/education status with a pooled odds ratio of 2.03 (95% CI: 1.57-2.63), and decision-making in the household with a pooled odds ratio of 1.82 (95% CI: 1.33-2.50)., Conclusion: This systematic review and meta-analysis found preliminary evidence that intimate partner violence increased during the COVID-19 pandemic. A partner who has a history of alcohol use, women who had lost income during COVID-19, a partner who has no formal education, and household decisions made by the husband alone were statistically significant factors for intimate partner violence during the COVID-19 pandemic. This implies that the health sector must play a significant role in providing women who are victims of violence with comprehensive healthcare, advocating that violence against women should be viewed as unacceptable, and improving literacy to minimize the consequences of intimate partner violence among women., 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., (© 2024 Alemu, Tamir, Workneh, Mekonen, Ali, Zegeye, Wassie, Kassie, Tekeba, Gonete and Techane.)

Background: In the intensive care unit (ICU), mechanical ventilation (MV) is a typical way of respiratory support. The severity of the illness raises the likelihood of death in patients who require MV. Several studies have been done in Ethiopia; however, the mortality rate differs among them. The objective of this systematic review and meta-analysis is to provide a pooled prevalence of mortality and associated factors among ICU-admitted patients receiving MV in Ethiopian hospitals., Methods: We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 criteria to conduct a comprehensive systematic review and meta-analysis in this study. We searched PubMed/Medline, SCOPUS, Embase, Hinari, and Web of Science and found 22 articles that met our inclusion criteria. We used a random-effects model. To identify heterogeneity within the included studies, meta-regression and subgroup analysis were used. We employed Egger's regression test and funnel plots for assessing publication bias. STATA version 17.0 software was used for all statistical analyses., Results: In this systematic review and meta-analysis, the pooled prevalence of mortality among 7507 ICU-admitted patients from 22 articles, who received MV was estimated to be 54.74% [95% CI = 47.93, 61.55]. In the subgroup analysis by region, the Southern Nations, Nationalities, and Peoples (SNNP) subgroup (64.28%, 95% CI = 51.19, 77.37) had the highest prevalence. Patients with COVID-19 have the highest mortality rate (75.80%, 95% CI = 51.10, 100.00). Sepsis (OR = 6.85, 95%CI = 3.24, 14.46), Glasgow Coma Scale (GCS) score<8 (OR = 6.58, 95%CI = 1.96, 22.11), admission with medical cases (OR = 4.12, 95%CI = 2.00, 8.48), Multi Organ Dysfunction Syndrome (MODS) (OR = 2.70, 95%CI = 4.11, 12.62), and vasopressor treatment (OR = 19.06, 95%CI = 9.34, 38.88) were all statistically associated with mortality., Conclusion: Our review found that the pooled prevalence of mortality among mechanically ventilated ICU-admitted patients in Ethiopia was considerably high compared to similar studies in the United States (US), China, and other countries. Sepsis, GCS<8, medical cases, MODS, and use of vasopressors were statistically associated with mortality. Clinicians should exercise caution while mechanically ventilating ICU-admitted patients with these factors. However, it should be noted that the exact cause and effect relationship could not be established with this meta-analysis, as the available evidence is not sufficient. Thus, more studies using prospective methods will be required., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Ayenew 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: Each year, vaccine-preventable diseases cost the lives of 8.8 million under-five children. Although vaccination prevents 1-2 million childhood deaths worldwide, measles vaccination dropouts are not well studied in developing countries, particularly in Ethiopia. Therefore, this study aims to assess the spatial distribution of the measles vaccination dropout and its determinants among under-five children in Ethiopia., Methods: Data from Ethiopian Demographic and Health Survey 2019 was used for data analysis. The study used a total of 5,753 children. Spatial autocorrelations was used to determine the spatial dependency of measles vaccination dropout. Ordinary interpolation was employed to forecast measles vaccination dropout. Factors associated with measles vaccination dropout were declared significant at p-values <0.05. The data were interpreted using the confidence interval and adjusted odds ratio. A model with the lowest deviance and highest logliklihood ratio was selected as the best-fit model., Results: In Ethiopia, one in three under-five children had measles vaccination dropouts. Factors such as birth interval (AOR = 1.87, 95% CI: 1.30, 2.70), unmarried marital status women (AOR = 3.98, 95% CI: 1.08, 8.45), ≤1 number of under-five children (AOR = 3.86, 95% CI: 2.56, 5.81), rural place of residence (AOR = 2.43, 95% CI: 2.29, 3.11), low community-level ANC utilization (AOR = 3.20, 95% CI: 2.53, 3.56), and residing in Benishangul Gumuz (AOR = 1.80, 95% CI: 1.061, 3.06) had higher odds of measles vaccination dropout., Conclusions: Measles vaccination dropout rates in Ethiopia among under-five children were high compared to the maximum tolerable vaccination dropout level of 10% by the WHO. Both individual and community-level variables were determinants of measles vaccination dropout. The ministry of health in Ethiopia should give attention to those mothers of under-five children who reported underutilization of ANC services and rural residences while designing policies and strategies in areas of high spatial clustering of vaccine dropout in Ethiopia., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Zegeye 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.)

Introduction: Neonatal mortality is still a major public health problem in middle- and low-income countries like Ethiopia. Despite strategies and efforts made to reduce neonatal death, the mortality rate declines at a slower pace in the country. Though there are studies conducted on neonatal mortality and its determinants, our searches of the literature have found no study on the extent of mortality of neonates born to mothers of extreme reproductive age in the study area. Therefore, this study aimed to assess the magnitude and factors associated with the mortality of neonates born to mothers of extreme reproductive age in Ethiopia., Methods: Secondary data analysis was conducted using 2016 Ethiopian Demographic and Health Survey data. The final study contained an overall weighted sample of 2,269 live births. To determine the significant factors in newborn deaths, a multilevel binary logistic regression was fitted. For measuring the clustering impact, the intra-cluster correlation coefficient, median odds ratio, proportional change in variance, and deviation were employed for model comparison. The adjusted odds ratio with a 95% confidence interval was presented in the multivariable multilevel logistic regression analysis to identify statistically significant factors in neonatal mortality. A P -value of less than 0.05 was declared statistically significant., Results: The neonatal mortality rate of babies born to extreme aged reproductive women in Ethiopia was 34 (95% Cl, 22.2%-42.23%) per 1,000 live birth. Being twin pregnancy (AOR = 10; 95% Cl: 8.61-20.21), being from pastoralist region (AOR = 3.9; 95% Cl: 1.71-8.09), having larger baby size (AOR = 2.93; 95% Cl: 1.4-9.12) increase the odds of neonatal mortality. On the other hand, individual level media exposure (AOR = 0.3; 95% Cl: 0.09-0.91) and community level media exposure (AOR = 0.24; 95% Cl: 0.07-0.83), being term gestation (AOR = 0.14; 95% Cl: 0.01-0.81) decreases the odds of neonatal mortality born to mothers of extreme reproductive age., Conclusion: Ethiopia had a greater rate of neonatal death among babies born at the extremes of reproductive age than overall reproductive life. Multiple pregnancies, larger baby sizes, emerging regions, term gestation, and media exposure were found to be significant factors associated with the mortality of neonates born to mothers of extreme reproductive age. Therefore, the concerned bodies should give emphasis to mothers giving birth before the age of 20 and above 35, access to media, healthy pregnancy, and special attention to pastoralists to reduce the burden of neonatal mortality., 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., (© 2024 Tekeba, Techane, Workneh, Zegeye, Gonete, Alemu, Wassie, Kassie, Ali, Mekonen and Tamir.)

Background: Poor infant and child feeding practices, in combination with increased rates of infectious diseases, are the main immediate causes of malnutrition during the first two years of life. Non-breastfed children require milk and other dairy products, as they are rich sources of calcium and other nutrients. As far as our search is concerned, there is no evidence on the pooled magnitude and determinants of minimum milk feeding frequency among non-breastfed children in sub-Saharan Africa conducted using the most recent indicators for assessing infant and young child feeding practices published in 2021. Therefore, this study is intended to determine the magnitude and associated factors of minimum milk feeding frequency among non-breastfed children aged 6-23 months in sub-Saharan Africa using the most recent guideline and demographic and health survey dataset., Methods: Data from the most recent health and demographic surveys, which were carried out between 2015 and 2022 in 20 sub-Saharan African countries, were used. The study comprised a weighted sample consisting of 13,315 non-breastfed children between the ages of 6 and 23 months. STATA/SE version 14.0 statistical software was used to clean, recode, and analyze data that had been taken from DHS data sets. Utilizing multilevel mixed-effects logistic regression, the factors associated with the outcome variable were identified. Model comparison and fitness were assessed using deviance (-2LLR), likelihood ratio test, median odds ratio, and intra-class correlation coefficient. Finally, variables with a p-value < 0.05 and an adjusted odds ratio with a 95% confidence interval were declared statistically significant., Results: The pooled magnitude of minimum milk feeding frequency among non-breastfed children aged 6-23 months in sub-Saharan African countries was 12.39% (95% CI: 11.85%, 12.97%). Factors like maternal educational level [AOR = 1.61; 95% CI (1.35, 1.91)], marital status of the mother [AOR = 0.77; 95% CI (0.67, 0.89)], maternal working status [AOR = 0.80; 95% CI (0.71, 0.91)], media exposure [AOR = 1.50; 95% CI (1.27, 1.77)], wealth index [AOR = 1.21; 95% CI (1.03, 1.42)], place of delivery [AOR = 1.45; 95% CI (1.22, 1.72)], ANC visit attended during pregnancy [AOR = 0.49; 95% CI (0.39, 0.62)], PNC checkup [AOR = 1.57; 95% CI (1.40, 1.76)], child's age [AOR = 0.70; 95% CI (0.53, 0.93)], and residence [AOR = 2.15; 95% CI (1.87, 2.46)] were significantly associated with minimum milk feeding frequency., Conclusions: In sub-Saharan Africa, the proportion of minimum milk feeding frequency among non-breastfed children aged between 6 and 23 months was low. The likelihood of minimum milk feeding frequency increases with high levels of education, unemployment, media exposure, rich wealth status, being unmarried, having a child born in a health facility, getting PNC checks, being between 6 and 8 months old, and living in an urban area. Hence, promoting women's education, increasing the economic status of the household, disseminating nutrition information through media, strengthening maternal health service utilization like health facility delivery and PNC services, and giving prior attention to mothers with older children and from rural areas are strongly recommended., (© 2024. The Author(s).)

Background: In developing nations, the phenomenon of adolescent fatherhood poses significant challenges, including increased risk of poverty, limited educational opportunities, and potential negative health outcomes for both the young fathers and their children. However, an overwhelming majority of research has concentrated on teenage motherhood. Adolescent fatherhood in poor nations has been the subject of little research. Few public health initiatives address adolescent fatherhood, in contrast to adolescent motherhood. Although there is currently more being done in industrialized nations to recognize adolescent fatherhood in clinical settings and the academic community. Undeveloped nations such as East Africa still have more problems that need to be resolved. Therefore, this study aimed to investigate the prevalence of and factors contributing to adolescent fatherhood in East Africa., Methods: Data from the Demographic and Health Surveys (DHS), collected between 2011 and 2022 in 12 East African nations, were used in this analysis. For a weighted sample of 36,316 male adolescents aged 15-24 years, we examined variables, as well as the prevalence of adolescent fatherhood. Univariate and multivariable logistic regression analyses were performed to identify candidate factors and significant explanatory variables associated with the outcome variable. The results are presented using adjusted odds ratios (AORs) at 95% confidence intervals (CIs). P values of ≤ 0.2 and < 0.05 were used to investigate statistically significant factors in the univariate and multivariable logistic regression analyses, respectively., Results: The overall prevalence of adolescent fatherhood was 11.15% (95% CI = 10.83,11.48) in East Africa. Age at first sex 20-24 years (AOR = 0.44, 95% CI:0.41,0.48), age-20-24 years old (AOR = 17.03,95% CI = 15.01,19.33), secondary/higher education (AOR = 0.57, 95% CI = 0.49,0.67), poor wealth (AOR = 2.27, 95% CI = 2.05,2.52), middle wealth (AOR = 1.70, 95% CI = 1.51,1.90), employed (AOR = 3.92, 95% CI = 3.40,4.54), utilized modern contraceptives (AOR = 0.75, 95% CI = 0.69,0.81), and female household heads (AOR = 0.43, 95% CI = 0.39,0.48) were associated with adolescent fatherhood., Conclusions: Adolescent fatherhood is more prevalent, in East Africa. These findings highlight the complexity of adolescent fatherhood and suggest that multiple factors, including socio-demographic characteristics and reproductive health behaviors, play a role in determining the likelihood of becoming an adolescent father. Understanding these associations can inform targeted interventions and policies aimed at reducing adolescent fatherhood rates and addressing the specific needs and challenges faced by young fathers in East Africa. Further research and interventions should focus on promoting education, economic opportunities, and access to modern contraceptives, while also addressing gender dynamics and social norms that contribute to adolescent fatherhood in the region., (© 2024. The Author(s).)

Introduction: Preterm birth is the leading cause of both infant and neonatal mortality. It also had long-term consequences for the physical and neurological development of a growing child. The majority of these and related problems occur in low- and middle-income countries, particularly in sub-Saharan Africa, due to resource scarcity to sustain the lives of premature babies. Despite this, there is a paucity of recent information on the pooled prevalence and factors associated with preterm birth in sub-Saharan Africa. Therefore, this study aimed to update the pooled prevalence and determinants of preterm birth in sub-Saharan Africa based on the most recent Demographic and Health Survey data., Methods: A cross-sectional study design using the most recent demographic and health survey data from eight sub-Saharan African countries was used. We included a total weighted sample of 74,871 reproductive-aged women who gave birth in the five years preceding the survey. We used a multilevel logistic regression model to identify associated factors of preterm birth in sub-Saharan Africa. The adjusted odds ratio at 95% Cl was computed to assess the strength and significance of the association between explanatory and outcome variables. Factors with a p-value of <0.05 are declared statistically significant., Results: In this study, the pooled prevalence of preterm birth among reproductive-aged women in eight sub-Saharan African countries was 3.11% (95% CI: 2.98-3.25). Working mothers (AOR = 0.61; 95% CI: 0.38-0.97), being married (AOR = 0.63; 95% CI: 0.40-0.99), and having media exposure (AOR = 0.59; 95% CI: 0.36-0.96) decrease the odds of preterm birth. On the other hand, being low birth weight (AOR = 17.7; 95% CI: 10.7-29.3), having multiple pregnancies (AOR = 3.43; 95% CI: 1.82-6.45), having a history of terminated pregnancies (AOR = 1.56; 95% CI: 1.01-2.41), being un-educated (AOR = 3.16; 95% CI: 1.12-8.93), being of a maternal age above 35 (AOR = 1.63; 95% CI: 1.08-2.45), maternal alcohol use (AOR = 19.18; 95% CI: 13.6-38.8), and being in the low socio-economic status (AOR = 1.85; 95% CI: 1.11-3.07) of the community increase the odds of preterm birth., Conclusion: The burden of preterm birth among reproductive-age women in sub-Saharan Africa showed improvements as compared to previous findings. To further lessen the burden, policymakers and other pertinent organizations must prioritize maternal health, expand media access, educate and empower women, and promote a healthy lifestyle for reproductive-age women., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Tekeba 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.)

Introduction: HIV-related stigma and discrimination significantly affects health, and well-being, willingness to be tested for HIV, initiation and adherence to antiretroviral therapy, and quality of life. However, the findings of the prior studies revealed that the prevalence of discrimination against people living with HIV is high. Thus, we aimed to assess the magnitude of discriminatory attitudes against people living with HIV/AIDS and associated factors in three sub-Saharan African countries., Methods: The appended and most recent Demographic and Health Survey dataset of three sub-Saharan African countries from 2021 to 2022 was used for data analysis. A total of 56,690 women aged 15-49 years were included in this study as a weighted sample. The determinants of discriminatory attitudes against people living with HIV/AIDS were determined using a multilevel mixed-effects logistic regression model. Significant factors associated with discriminatory attitudes against people living with HIV/AIDS in the multilevel mixed-effect logistic regression model were declared significant at p-values < 0.05. The adjusted odds ratio (AOR) and confidence interval (CI) were used to interpret the results., Result: The overall prevalence of discriminatory attitudes against people living with HIV/AIDS was 28.19% (95% CI: 27.74%, 28.64%). In the multivariable analysis, individual level (being young, being an internet user, being tested for HIV, and having comprehensive knowledge about HIV) and community level (being a rural dweller) were factors associated with discriminatory attitudes against people living with HIV/AIDS., Conclusion: The prevalence of discriminatory attitudes against people living with HIV/AIDS in three sub-Saharan African countries was high. Individual and community-level variables were associated with discriminatory attitudes against people living with HIV/AIDS. Therefore, special consideration should be given to rural dwellers and young adults. In addition, better to strengthen the accessibility of Internet and HIV testing services, and improve HIV-related education to reduce the magnitude of discriminatory attitudes against people living with HIV/AIDS., (© 2024. The Author(s).)

Introduction: Acute stress disorder (ASD) is a mental disorder that happens after someone experienced traumatic event within duration of less than a month. Other studies conducted in different countries revealed that adults with a trauma had experienced acute stress disorder. This results in substantial distress and interferes with social and day to day activities. Despite the high burden of this problem, very little is known about the prevalence and risk factors for acute stress disorder in adults with traumatic injuries in Ethiopia., Objective: This study was aimed to assess the prevalence of acute stress disorder and associated factors among adult trauma patients attending in northwest Amhara Comprehensive Specialized Hospitals, Ethiopia 2022., Methods: An institutional based cross-sectional study design was employed among 422 adult trauma patients from May- June 2022. Systematic sampling technique was applied to recruit study participants. Data were collected through interviewer administered questionnaires using the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, acute stress disorder measurement tools. Then, it was entered into Epi-Data version 4 and exported to STATA version 14 for analysis. Bivariate and multivariable binary logistic regressions model were carried out to identify factors significantly associated acute stress disorder., Result: The prevalence of acute stress disorder among adult trauma patients in northwest Amhara comprehensive specialized hospitals was found to be 44.15% (95% CI: 39.4%, 49.0%) with 99% of response rate. In multivariate logistic analysis younger age (21-29) (AOR = 0.33 95% CI: 0.14-0.77), (30-39) (AOR = 0.35 95% CI: 0.15-0.85), (40-49) (AOR = 0.28 95% CI: 0.10-0.76) respectively, presence of complication (AOR = 2.22 95% CI: 1.36-3.60), prolonged length of hospital stay (AOR = 1.89 95% CI: 1.21-2.95) and having low (AOR = 3.21, 95% CI: 1.66-6.19) and moderate (AOR = 1.99, 95%, CI: 1.14-3.48) social support were factors significantly associated with acute stress disorder., Conclusion and Recommendation: This study showed that the prevalence of acute stress disorder among the adult study participants who experienced traumatic events was high as compared to other literatures. Age, complication, prolonged hospital stay and social support were factors significantly associated with ASD at p-value < 0.05. This indicates the need for early identification and interventions or ASD care services from health workers of psychiatric ward., (© 2024. The Author(s).)

Introduction: Polio eradication is a current and common strategy throughout the globe. The study of the newly introduced inactivated poliovirus vaccine provides a grasp on the current status of immunization and identifies any disparities in the implementation of the vaccine throughout Ethiopia. Thus, this study aimed to demonstrate the spatial distribution, coverage, and determinants of inactivated poliovirus vaccine immunization in Ethiopia., Method: Spatial distribution and determinants of inactivated poliovirus vaccine immunization in Ethiopia were conducted using Ethiopian mini-demographic and health survey 2019 data. A total of 2,056 weighted children aged 12 to 35 months were included in the analysis. The association between the outcome and explanatory variables was determined by commuting the adjusted odds ratio at a 95% confidence interval. The p-value of less than 0.05 was used to declare factors as significantly associated with the inactivated poliovirus vaccine immunization., Result: The weighted national coverage of inactivated poliovirus vaccine immunization in Ethiopia was 51.58% at a 95% confidence interval (49.42, 53.74). While the rates of inactivated poliovirus vaccine immunization were observed to be greater in Addis Ababa, Tigiray, Amahara, and Benishangul Gumuz provinces and lower in the Somali, Afar, and SNNPR provinces of Ethiopia, Antenatal care follow-up, place of delivery, place of residence, and region were significantly associated with inactivated poliovirus immunization in Ethiopia., Conclusion: The distribution of inactivated poliovirus immunization was spatially variable across Ethiopia. Only about half of the children aged twelve to thirty-five months received the inactivated poliovirus vaccine in the country. The factors, both at the individual and community level, were significantly associated with inactivated poliovirus immunization. Therefore, policies and strategies could benefit from considering antenatal care follow-up, place of delivery, place of residence, and region while implementing inactivated poliovirus vaccine immunization., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Tamir 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.)

Introduction: Despite the decrease in the global under-five mortality rate, the highest rates of mortality are reported in sub-Saharan Africa. More than one-third of all deaths among under-five children are either from lower respiratory tract infections, diarrhea, or malaria. Poor treatment-seeking behavior for fever among mothers of under-five children is a big concern in sub-Saharan Africa. However, the pooled prevalence of prompt treatment of fever and its associated factors among under-five children in the region using nationally representative data is not known. Therefore, the findings of this study will inform policymakers and program managers who work on child health to design interventions to improve the timely and appropriate treatment of fever among under-five children., Methods: Data from the recent demographic and health surveys of 36 countries in sub-Saharan Africa conducted between 2006 and 2022 were used. A total weighted sample of 71,503 living children aged under five years with a fever was included in the study. Data extracted from DHS data sets were cleaned, recorded, and analyzed using STATA/SE version 14.0 statistical software. Multilevel mixed-effects logistic regression was used to determine the factors associated with the outcome variable. Intra-class correlation coefficient, likelihood ratio test, median odds ratio, and deviance (-2LLR) values were used for model comparison and fitness. Finally, variables with a p-value <0.05 and an adjusted odds ratio with a 95% confidence interval were declared statistically significant., Results: The pooled prevalence of prompt treatment of fever among under-five children in sub-Saharan African countries was 26.11% (95% CI: 25.79%, 26.44%). Factors like maternal education [AOR = 1.18; 95% CI (1.13, 1.25)], maternal working status [AOR = 1.34; 95% CI (1.27, 1.41)], media exposure [AOR = 1.05; 95% CI (1.01, 1.10)], household wealth index [AOR = 1.13; 95% CI (1.06, 1.19)], distance to a health facility [AOR = 1.18; 95% CI (1.13, 1.23)], healthcare decisions [AOR = 1.34; 95% CI (1.01, 1.77)], visited healthcare facility last 12 months [AOR = 1.45; 95% CI (1.38, 1.52)], antenatal care attendance [AOR = 1.79; 95% CI (1.61, 1.99)], place of delivery [AOR = 1.55; 95% CI (1.47, 1.63)], and community-level antenatal care utilization [AOR = 1.08; 95% CI (1.02,1.14)] were significantly associated with prompt treatment of fever among under-five children., Conclusion: The pooled prevalence of prompt treatment of fever among under-five children in sub-Saharan African countries was low. Educated women, working mothers, having media exposure, rich household wealth status, perceiving distance to a health facility was not a big problem, making healthcare decisions with husband or partner, visiting healthcare facility in the last 12 months, antenatal care attendance, health facility delivery, and high community-level antenatal care utilization increase the odds of prompt treatment of fever. Therefore, women's empowerment, information dissemination through mass media, maintaining regular visits to healthcare facilities, and strengthening health facility delivery and antenatal care services are strongly recommended., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Mekonen 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.)

Introduction: Diarrhea is a common public health problem and the third leading cause of death in the world among children under the age of five years. An estimated 2 billion cases and 1.9 million deaths are recorded among children under the age of five years every year. It causes body fluid loss and electrolyte imbalance. Even though, early initiation of recommended homemade fluid is a simple and effective approach to prevent diarrhea-related complications and mortality of children, recommended homemade fluid utilization for the treatment of diarrhea is still low in sub-Saharan African countries. Therefore, this study aimed to assess the magnitude of recommended homemade fluid utilization for the treatment of diarrhea and associated factors among children under five in sub-Saharan African countries., Method: The most recent Demographic and Health Survey dataset of 21 sub-Saharan African countries from 2015 to 2022 was used for data analysis. A total of 33,341 participants were included in this study as a weighted sample. Associated factors were determined using a multilevel mixed-effects logistic regression model. Significant factors in the multilevel mixed-effect logistic regression model were declared significant at p-values < 0.05. The adjusted odds ratio (AOR) and confidence interval (CI) were used to interpret the results., Result: The overall recommended homemade fluid utilization for the treatment of diarrhea among children under five in sub-Saharan African countries was 19.08% (95% CI = 18.66, 19.51), which ranged from 4.34% in Burundi to 72.53% in South Africa. In the multivariable analysis, being an educated mother/caregiver (primary and secondary level) (AOR = 1.15, 95% CI: 1.04, 1.27) and (AOR = 1.30, 95% CI: 1.15, 1.1.47), the primary and secondary level of fathers education (AOR = 1.53, 95% CI: 1.37, 1.71) and (AOR = 1.41, 95% CI: 1.19, 1.1.68), having antenatal care follow-up (AOR = 1.16, 95% CI: 1.01, 1.33), having multiple children (AOR = 1.17, 95% CI: 1.07, 1.28), and being an urban dweller (AOR = 1.15, 95% CI: 1.04, 1.27) were factors associated with recommended homemade fluid utilization., Conclusion: The overall recommended homemade fluid utilization for the treatment of diarrhea was low. Individual and community-level variables were associated with recommended homemade fluid utilization for the treatment of diarrhea. Therefore, special consideration should be given to rural dwellers and caregivers who have three and below children. Furthermore, better to strengthen the antenatal care service, mother/caregiver education, and father's education to enhance recommended homemade fluid utilization for the treatment of diarrhea., (© 2024. The Author(s).)

Background: One of the biggest breakthroughs of contemporary medicine is measles vaccination. It is essential for the total elimination of measles. Understanding the magnitude and determinants of effective second-dose measles vaccination coverage is a critical task. Accordingly, we set out to check the best available evidence of the pooled second-dose measles vaccination coverage among under-five children in East Africa., Method: We searched electronic databases such as PubMed, Google Scholar, Cochrane, and others. Two reviewers separately carried out the search of the Joanna Briggs Institute, selection of studies, critical appraisal, and data extraction. A third party was involved in resolving the disagreement among the reviewers. Seven studies included in this study, four from Ethiopia, two from Kenya, and one from Tanzania were cross-sectional and published in English language, with publication dates before 29 November 2023. Articles lacking full-text, the intended outcome, and that are not qualitative studies were excluded from the analysis. The Microsoft Excel checklist was used to extract the data and then exported to STATA 11. In addition, I 2 , Funnel plots, and Egger's test were employed to measure heterogeneity and detect publication bias, respectively. A random effect model was used., Result: The meta-analysis includes a total sample size of 4,962 children from seven articles. The pooled prevalence of second-dose measles vaccination among under-five children in East Africa was found to be 32.22% [95% CI; (18.82, 45.63)], and the significant factors were as follows: birth order (1.72; OR = 95% CI: 1.32, 2.23), information about measles-containing second-dose vaccine (MCV 2) (7.39; OR = 95% CI: 5.21, 10.50), mother's marital status (1.47; OR = 95% CI: 1.05, 2.07), complete immunization for other vaccines (2.17; OR = 95% CI: 1.49, 3.17), and distance of vaccination site (3.31; OR = 95% CI: 2.42, 4.53)., Conclusion: The current study found that pooled prevalence of second-dose measles vaccination coverage among under-five children was still very low. It was also observed that birth order, distance of the vaccination site, complete immunization for other vaccines, mother's marital status, and information about MCV were factors associated with second-dose measles vaccination. These factors imply that there is a need for countries and their partners to act urgently to secure political commitment, expand primary health service and health education, and increase vaccination coverage., 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., (Copyright © 2024 Alemu, Tamir, Workneh, Mekonen, Ali, Zegeye, Wassie, Kassie, Tekeba and Gonete.)

Introduction: Risky sexual behavior exposes an individual to the risk of contracting sexually transmitted infections including human immunodeficiency virus (HIV). Even though risky sexual behavior is a devastating problem in low- and middle-income countries, studies on risky sexual behavior and associated factors among reproductive-age women in Eastern African countries are limited. Therefore, this study aimed to assess the magnitude of risky sexual behavior and associated factors among reproductive-age women in Eastern African countries that help to target high-risk groups and set appropriate intervention., Method: The appended and recent Demographic and Health Survey dataset of 10 Eastern African countries from 2012 to 2022 was used for data analysis. A total of 111,895 participants were included in this study as a weighted sample. Associated factors were determined using a multilevel mixed-effects logistic regression model. Significant factors in the multilevel mixed-effect logistic regression model were declared significant at p-values < 0.05. The adjusted odds ratio (AOR) and confidence interval (CI) were used to interpret the results., Result: The overall magnitude of risky sexual behavior among reproductive-age women in Eastern African countries was 28.16% (95% CI 27.90%, 28.43%), which ranged from 3.80% in Ethiopia to 67.13% in Kenya. In the multivariable analysis, being a younger woman, being an educated woman, being tested for human immunodeficiency virus, having work, drinking alcohol, and being an urban dweller were factors that were significantly associated with higher odds of risky sexual behavior., Conclusion: The overall magnitude of risky sexual behavior among reproductive-age women in Eastern African countries was high. Individual-level (being a younger woman, being an educated woman, being tested for human immunodeficiency virus, having work, and drinking alcohol) and community-level (being an urban dweller) variables were associated with higher odds of risky sexual behavior. Therefore, policymakers and other stakeholders should give special consideration to urban dwellers, educated, worker and younger women. Better to improve the healthy behavior of women by minimizing alcohol consumption and strengthening HIV testing and counseling services to reduce the magnitude of risky sexual behavior., (© 2024. The Author(s).)

Background: Identifying fertility periods accurately will protect teenage girls and young women from unintended pregnancies and related complications. However, in Sub-Saharan Africa, knowledge of the fertile period among adolescent girls and young women is not well studied. Thus, the purpose of this study was to assess adolescents' and young women's knowledge regarding fertility periods and its determinants in Sub-Saharan Africa., Methods: The most recent demographic and health surveys' data were used. The study had 140,064 participants in all. The data was analyzed using STATA/SE version 14. Using a multilevel logistic regression model, factors associated with knowledge of fertile periods have been determined. P-values <0.05 showed the significance of the factors associated with the outcome variable. The data were interpreted using the adjusted odds ratio and confidence interval. The best-fit model was determined to be the one with the highest logliklihood ratio and the lowest deviance., Results: One in five (20%) women between the ages of 10 and 24 had accurate knowledge about the fertile period. Age (AOR = 1.44, 95% CI: 1.40, 1.49), educational level (AOR = 1.68, 95% CI: 1.60, 1.77), knowledge of family planning (AOR = 1.33, 95% CI: 1.27, 1.39), distance (AOR = 2.31, 95% CI: 2.02, 2.98), residence (AOR = 1.06, 95% CI: 1.02, 1.10), and low community poverty (AOR = 3.06, 95% CI: 3.01, 3.12) had higher odds of knowledge about fertile period., Conclusion: This research finds that adolescents and young women in sub-Saharan Africa have low knowledge of the reproductive period. It was discovered that factors at the individual and communal levels influence women's knowledge of the fertile period. While developing policies and strategies, the health ministries of Sub-Saharan African countries had to take into consideration input from women whose experiences indicated that obtaining reproductive health services was hindered by distance., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors.)

Background: Unhealthy food consumption that begins early in life is associated with a higher risk of nutrient inadequacy and related chronic diseases later in life. Healthy eating and consumption of important nutrients help to maintain a healthy body weight and reduce the risk of developing chronic conditions. Research from sub-Saharan Africa regarding consumption of unhealthy foods remains limited, with no studies quantifying the pooled prevalence among young children. Therefore, this study is intended to assess the pooled prevalence and determinants of unhealthy food consumption among children aged 6 to 23 months., Methods: Data from the most recent demographic and health surveys of five countries in sub-Saharan Africa conducted between 2015 and 2022 were used. A total weighted sample of 16,226 children aged 6 to 23 months was included in the study. Data extracted from DHS data sets were cleaned, recorded, and analyzed using STATA/SE version 14.0 statistical software. Multilevel mixed-effects logistic regression was used to determine the factors associated with the dependent variable. Intra-class correlation coefficient, likelihood ratio test, median odds ratio, and deviance (-2LLR) values were used for model comparison and fitness. Finally, variables with a p-value < 0.05 and an adjusted odds ratio with a 95% confidence interval were declared statistically significant., Results: The pooled prevalence of unhealthy food consumption among children aged 6 to 23 months was 13.41% (95% CI: 12.89-13.94%). Higher consumption of unhealthy foods was reported among mothers with low education [adjusted odds ratio (AOR) = 0.37; 95% confidence interval (CI) (0.30, 0.46)], unmarried women [AOR = 1.19; 95% CI (1.05, 1.34)], who had no media exposure [AOR = 0.64; 95% CI (0.56, 0.72)], delivered at home [AOR = 0.74; 95% CI (0.62, 0.87)], who hadn't had a PNC checkup [AOR = 0.66; 95% CI (0.60, 0.73)], wealthier households [AOR = 1.20; 95% CI (1.05, 1.37)], older children (aged ≥ 9 months) [AOR = 3.88; 95% CI (3.25, 4.63)], and low community level media exposure [AOR = 1.18; 95% CI (1.04, 1.34)]., Conclusion: Nearly one out of seven children aged 6 to 23 months consumed unhealthy foods. Maternal educational level, marital status of the mother, exposure to media, wealth index, place of delivery, PNC checkup, and the current age of the child were factors significantly associated with unhealthy food consumption. Therefore, improving women's education, disseminating nutrition-related information through the media, providing more attention to poor and unmarried women, and strengthening health facility delivery and postnatal care services are recommended., (© 2024. The Author(s).)

Introduction: Malnutrition is a public health problem in sub-Saharan Africa with an increased morbidity and mortality rate than in other parts of the world. Poor complementary feeding practices are one of the major causes of malnutrition during the first two years of life. Therefore, this study aimed to determine the prevalence and associated factors of appropriate complementary feeding practices among mothers of children aged 6 to 23 months in sub-Saharan African countries., Methods: A multilevel mixed-effect analysis was carried out using recent demographic health survey data from 19 sub-Saharan African countries, which were conducted between 2015 and 2020. A total weighted sample of 60,266 mothers of children aged 6 to 23 months were included in the study. The demographic health survey employs a stratified two-stage sampling technique. Data extracted from the recent DHS data sets were cleaned, recorded, and analyzed using STATA/SE version 14.0 statistical software. Multilevel mixed-effects logistic regression was used to determine the factors associated with complementary feeding practice. Variables with a p-value less than 0.05 and adjusted odds ratio (AOR) with a 95% confidence interval (CI) were reported as statistically significant variables associated with appropriate complementary feeding practices., Results: The prevalence of appropriate complementary feeding practices among mothers of children aged 6 to 23 months in sub-Saharan African countries was 13.02% (95% CI: 12.75-13.29%). Maternal educational level [AOR = 0.69, 95% CI (0.64, 0.74)] and [AOR = 0.52, 95% CI (0.47, 0.57)], marital status of the mother [AOR = 0.85, 95% CI (0.74, 0.96)], sex of household head [AOR = 1.78, 95% CI (1.09, 1.27)], total children ever born [AOR = 1.52, 95% CI (1.18, 1.96)], [AOR = 1.43, 95% CI (1.14, 1.81)], and [AOR = 1.31, 95% CI (1.04, 1.64)], media exposure [AOR = 0.74, 95% CI (0.69, 0.79)], ANC visits attended during pregnancy [AOR = 0.73, 95% CI (0.63, 0.80)] and [AOR = 0.67, 95% CI (0.62, 0.74)], place of delivery [AOR = 0.92, 95% CI (0.85, 0.98)], currently breastfeeding [AOR = 1.12, 95% CI (1.01, 1.23)], PNC checkup [AOR = 0.75, 95% CI (0.70, 0.80)], the current age of the child [AOR = 0.26, 95% CI (0.24, 0.28)] and [AOR = 0.14, 95% CI (0.13, 0.16)], birth order [AOR = 1.31, 95% CI (1.09, 1.58)], number of under 5 children in the household [AOR = 0.76, 95% CI (0.59, 0.97)], community illiteracy [AOR = 1.09, 95% CI (1.02, 1.18)], and country category [AOR = 1.62, 95% CI (1.18, 2.22)] were significantly associated with appropriate complementary feeding practices., Conclusion: The prevalence of appropriate complementary feeding practices among mothers of children aged 6 to 23 months in sub-Saharan Africa was relatively low. Higher maternal educational level, female household head, having media exposure, attending more ANC visits, health facility delivery, currently breastfeeding, having PNC follow-up, low community illiteracy, and living in the West Africa region increase the odds of appropriate complementary feeding practices. Women empowerment, increasing maternal health services accessibility, promoting breastfeeding behavior, increasing media exposure of the household, and improving the proportion of health facility delivery are strongly recommended., (© 2024. The Author(s).)

Background: Diarrhea is the second leading cause of morbidity and mortality for under-five children which cause about 525,000 deaths annually. Even though diarrheal diseases have decreased substantially at the global level, low-income countries are still faced with a huge number of diarrheal diseases. Thus, our aim was to assess the child feeding practices during diarrheal diseases and associated factors among children aged 6 to 23 months in Sub-Saharan African countries using the recent demographic and health survey., Methods: The appended and most recent demographic and health survey (DHS) dataset of 19 Sub-Saharan African countries from 2015 to 2020 was used for data analysis. A total of 64,628 living children aged 6-23 months with diarrhea were used as a weighted sample. The determinants of appropriate feeding practice were determined using a multilevel mixed-effects logistic regression model. Significant factors associated with appropriate feeding practice in the multilevel mixed-effect logistic regression model were declared significant at p-values < 0.05. The adjusted odds ratio (AOR) and confidence interval (CI) were used to interpret the results., Result: The overall prevalence of appropriate child feeding practice during diarrhea in this study was 6.24% (95% CI: 6.06, 6.43). Maternal age (15 to 19 years and 20 to 35 years) (AOR = 1.32, 95%CI: 1.12, 1.55 and AOR = 1.14, 95%CI: 1.03, 1.27), mothers education (primary and secondary level) (AOR = 1.23, 95%CI: 1.12, 1.35 and AOR = 1.28, 95%CI: 1.15, 1.43), having media exposure(AOR = 1.36, 95%CI: 1.26, 1.46), being married (AOR = 1.18, 95%CI: 1.01, 1.38), currently working (AOR = 1.08, 95%CI:1.00, 1.15), vaccinated for Rotavirus (AOR = 1.30, 95%CI:1.19, 1.43) and living in Central and eastern African countries (AOR = 1.82, 95%CI: 1.12, 2.97) and (AOR = 2.23, 95%CI: 1.37, 3.61) respectively were significantly associated with appropriate feeding practice., Conclusion: The prevalence of appropriate feeding practice during child diarrheal disease aged 6-23 months of age was strictly low which implies that child diarrhea and appropriate feeding practice is still a great issue in in Sub-Saharan African countries. Enhancing maternal education, strengthening media exposure and vaccination for rotavirus, and designing interventions that address the mother's marital status, mother's work status, and country category are recommended to enhance appropriate feeding practices. Furthermore, special consideration should be given to older mothers to increase appropriate feeding practices during diarrheal disease., (© 2024. The Author(s).)

Background: Pregnancy termination is one of the common causes of maternal mortality, particularly in developing countries, and remains a global public health concern despite the efforts made to enhance maternal healthcare services. Maternal mortality is still the highest in sub-Saharan Africa, including Kenya, due to pregnancy termination., Objectives: This study aimed to investigate the current burden of pregnancy termination and its determinants among reproductive-age women in Kenya., Design: A cross-sectional study design with multilevel analysis., Methods: The total weighted samples of 19,530 women of reproductive age were included in this study. The data were taken from the Kenyan Demographic and Health Survey 2022. A multilevel multivariable logistic regression model was used to identify the determinant factors of pregnancy termination. In the multivariable multilevel analysis, the adjusted odds ratio (AOR) with a 95% confidence interval (CI) was used to declare significant determinants of pregnancy termination among women of reproductive age., Results: The overall prevalence of pregnancy termination among women of reproductive age in Kenya was 14.19%. The determinant factors associated with pregnancy termination were the age of the women; as age increased, the risk of pregnancy termination increased, 25-29 years (AOR = 2.23; 95 CI (1.08-4.60)), 30-34 years (AOR = 2.98; 95% CI (1.43-6.18)), 35-39 years (AOR = 3.24; 95% CI (1.55-6.76)), 40-44 years (AOR = 4.57; 95% CI (2.16-9.68)), 45- 49 years (AOR = 5.16; 95% CI (2.33-9.98)); marital status: married (AOR = 5.63; 95% CI (3.08-10.29)), ever married (AOR = 5.05; 95% CI (2.74-9.33)); wealth index: richest (AOR = 1.32; 95% CI (1.05-1.63)); employment status: employed (AOR = 1.23; 95% CI (1.09-1.38)); preceding birth interval: greater than 24 months (AOR = 1.21; 95% CI (1.06-1.38)); urban residence (AOR = 1.25; 95% CI (1.06-1.46)); and Islamic followers (AOR = 1.64; 95% CI (1.31-2.06))., Conclusion: Pregnancy termination among women of reproductive age in Kenya has become an important public health concern. Policymakers and other stakeholders should focus on maternal healthcare service programs to prevent the termination of pregnancy. The determinant factors are an important input to developing strategies to improve the accessibility of maternal healthcare services in the country.

Background: Nurses with reduced work ability had a high risk of disability pension, sickness absences, retirement intention, and leave their job and profession early. Nurses frequently suffer from job related stress, occupational fatigue and sleep problems, which can further compromise their work ability., Aims of the Study: The aim of this study was to assess perceived work ability and its associated factors among nurses working in the Northwest of Amhara regional state Referral Hospitals, Northwest Ethiopia, 2022., Methods: A multicenter, an institutional based, cross-sectional study was conducted among 410 nurses working in five selected Referral hospitals, found in the Northwest of Amhara regional state, Northwest Ethiopia, 2022. The data were collected using a structured, self-administered questionnaire and entered using Epi info version 7.2.5 software, analyzed using SPSS version 25. Summary statistics (median or IQR for continuous data and frequency and percentage for categorical variables) were used. The ordinal logistic regression was used to assess' the presence of association between dependent and independent variables., Results: The findings of this study revealed that 59.0% of nurses had poor level of work ability, whereas 34.4% and 6.6% of nurses had sub-optimal and optimal level of work ability respectively. Multivariable ordinal logistic regression revealed that being male [AOR = 2.43; 95% CI (1.52, 3.91)], being BSC nurse [AOR = 0.21; 95% CI (0.08, 0.51)], nurses who had poor sleep quality [AOR = 0.34; 95% CI (0.12, 0.98)] and nurses who had chronic disease [AOR = 0.18; 95% CI (0.08, 0.41)] were significantly associated with nurses' level of work ability, p-value < 0.05., Conclusions: In this study, the prevalence of poor level of work ability among nurses was high. Nurses with a female sex, nurses who had chronic disease, BSC holders and nurses who had poor sleep quality had a poor level of work ability. The federal Minister of health and the study hospitals collaborative with concerned stakeholders to design strategies to enhance work ability among nurses., (© 2023. The Author(s).)

Background: From time to time, the magnitude and type of health emergencies and disasters are increasing. Hospital emergency and disaster preparedness, on the other hand, is still in its early stages in many low- and middle-income countries. In Ethiopia, research on hospital disaster preparedness is severely limited. As a result, the purpose of this study was to determine the level of hospital emergency and disaster preparedness at public hospitals in the east Gojjam zone of Northwest Ethiopia., Methods: A census method was used to include ten hospitals in the East Gojjam zone in a cross-sectional descriptive study. An adopted World Health Organization observation checklist was used to assess disaster and emergency preparedness. Each question was assigned a score out of three points, with one indicating low readiness and three indicating the highest level of preparation. Finally, the level of preparedness was classified as "low" if the average percentage score ranged from 33.3% to 66.6 %, and as "high" if the percentage score ranged from 66.7 % to 100 %. The results were then presented in the form of texts, tables, and percentages., Results: The evaluated hospitals' overall level of emergency and disaster preparedness falls into the low category, with an average calculated preparedness score of 54.75 %. The domain with the lowest preparedness is logistics and finance (43.33 %), while the domain with the highest preparedness is patient care and support services (60 %)., Conclusion: According to the findings of this study, the level of emergency and disaster preparedness in the hospitals studied is low. It is therefore recommended that the ministry of health, regional health bureaus, and hospital administrators collaborate to develop an appropriate intervention strategy to address this issue., Competing Interests: The authors declare that they have no competing interests, (© 2022 The Authors. Published by Elsevier B.V. on behalf of African Federation for Emergency Medicine.)

Introduction: Injuries among technical and vocational school students are considered one of the most serious health problems worldwide today. Getting injuries in a technical and vocational school are high as different machines are used. Therefore, this study aimed to assess knowledge, attitude, and associated factors toward first aid among graduating students at technical and vocational schools in Addis Ababa, Ethiopia., Methods: School-based cross-sectional study was conducted from April to June 2019. A simple random sampling technique was employed. Data were entered in Epi-info version 7 and analyzed using SPSS version 24. Bivariable and multivariable analyses were employed using a binary logistic regression model. Variables with a p-value of <0.05 are considered as factors significantly associated., Results: The result of this study reveals 53.2% and 60.3% of the respondents had good knowledge and favorable attitude, respectively. Training (adjusted odds ratio: 5.14; 95% confidence interval = (2.82, 9.38)), participating in school first aid club (adjusted odds ratio: 3.66; 95% confidence interval = (2.23, 6.00)), and mother's level of education (adjusted odds ratio: 1.90; 95% confidence interval = (1.02, 3.55)) were significantly associated with knowledge. Being female (adjusted odds ratio = 2.10; 95% confidence interval = (1.24, 3.39)), training (adjusted odds ratio: 3.18; 95% confidence interval = (1.73, 5.82)), and participating in school first aid club (adjusted odds ratio: 4.82; 95% confidence interval = (2.98, 7.81)) were significantly associated with attitude., Conclusion: Only half and nearly two-thirds of the participants have good knowledge and favorable attitude, respectively. Training, participating in school first aid club, and having an educated mother increase the odds of having good knowledge. Being female, training, and participating in school first aid clubs increase the odds of a favorable attitude. Since first aid is a frontline and lifesaving intervention during life-threatening situations, it is better to give attention to enhance students' knowledge and attitude toward first aid by giving training, establishing first aid clubs, and considering first aid courses to be included in the curriculum., 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.)

Objective: The aim of this study was to assess the prevalence of anaemia and its associated factors at the time of antiretroviral therapy (ART) initiation among HIV-infected adults at Debre Markos Comprehensive Specialized Hospital., Methods: An institution-based retrospective cross-sectional study was conducted among 473 patients' charts enrolled from 2014 to 2018 at Debre Markos Comprehensive Specialized Hospital. Patients' chart numbers were selected from the computer using a simple random sampling technique. Data were entered using Epi Info V.7.2.2.6 and analysed with Stata V.14.0. Anaemia prevalence at the time of ART initiation was computed and described using frequency tables. To identify factors for anaemia, bivariate and multivariate logistic regression models were fitted. Model fitness was checked using the Hosmer-Lemeshow goodness-of-fit test., Results: From 473 patients' charts, 468 charts were included in the analysis, and a total of 164 anaemia cases were recorded. The overall prevalence of anaemia among HIV-infected adults at the time of ART initiation was 35.04% (95% CI: 30.84% to 39.49%). After multivariate analysis, an increased risk of anaemia was seen among males (adjusted OR (AOR)=2.45; 95% CI: 1.51 to 3.98); those not attending formal education (AOR=2.38; 95% CI: 1.12 to 5.05); those who had baseline CD4+ T cell count ≤200 cells/mm 3 (AOR=4.67; 95% CI: 2.78 to 7.85); had body mass index (BMI) <18.5 kg/m 2 (AOR=2.43; 95% CI: 1.42 to 4.16) and had ambulatory/bedridden baseline functional status (AOR=2.69; 95% CI: 1.41 to 5.12)., Conclusion: The current study showed that a significant proportion of HIV-infected adults developed anaemia at the time of ART initiation. Hence, giving special attention to those who have not attended formal education, were males, had decreased baseline CD4+ T cell count, had lower BMI and patients with ambulatory/bedridden baseline functional status is crucial to reduce the health impact of anaemia. The result will provide insight into the development of new anaemia preventive strategies., 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.)

Objectives: Undernutrition is a major public health concern, particularly in children. The burden is higher in developing countries. Undernutrition is considered when there is one or more of the following: stunting, underweight, or wasting. Childhood undernutrition can have numerous long-term effects: a lower physical capacity for work, lower intellectual quotients, greater risk for morbidity and mortality, and cognitive impairment. Undernourished children also can have poor cognitive scores, a high absenteeism rate, and high class repetition compared with non-undernourished children. The aim of this study was to assess undernutrition and its associated factors among public and private primary school children in Gondar town, northwest Ethiopia., Methods: A school-based, cross-sectional study was conducted from March 5 to April 9, 2019. A multistage sampling technique was applied to select study participants. A simple random (lottery) sampling method was used to select seven public schools and five private schools. Systematic random sampling was used to select 774 study participants. The data were collected through face-to-face interviews. Multivariable logistic regressions were conducted to identify factors associated with undernutrition. The World Health Organization (WHO) AnthroPlus software was used to determine the status of undernutrition. Participants with a Z-score less than -2 were considered to be undernourished. Statistical significance was declared at P < 0.05 and odds ratios (ORs) were reported with a 95% confidence interval (CI)., Results: The prevalence of undernutrition was higher among public school children (37.1%) than those attending private schools (28.3%). Not having family car (adjusted OR [aOR], 0.28; 95% CI, 0.09-0.84), snack frequency no more than twice a day (aOR, 5.29; 95% CI, 1.37-20.37), and vigorous intensity sports (aOR, 0.53; 95% CI, 0.32-0.91) were significantly associated with undernutrition among public primary school students. Family income below the median (aOR, 2.12; 95% CI, 1.23-3.53), no preference for sweets (aOR, 0.59; 95% CI, 0.36-0.97), and not habits while reading (aOR, 0.42; 95% CI, 0.19-0.89) were the factors significantly associated with undernutrition among private primary school students., Conclusion: The prevalence of undernutrition was high. Children in public schools were highly vulnerable to undernutrition compared with those in private schools. Not having a family car, snack frequency no more than twice daily, and vigorous intensity sports increase the risk for undernutrition among public school children. Family income below the median, not preferring sweets, and not having a habit of eating while reading increase the risk for undernutrition among private school children. It is better to give attention to healthy dietary habits and healthy lifestyles to reduce childhood undernutrition., (Copyright © 2021 The Author(s). Published by Elsevier Inc. All rights reserved.)

Risky sexual behaviour (RSB) is defined as behaviours leading to sexually transmitted diseases and unintended pregnancies. According to the Joint United Nations Program on HIV/AIDS, HIV infection was very high among adolescents and youths living in sub-Saharan Africa including Ethiopia. This study was aimed to assess the prevalence of RSB and associated factors among undergraduate students at the University of Gondar.An institution-based cross-sectional study was conducted from June to July 2019 and a simple random sampling technique was employed to select 420 students. Data were collected using a structured self-administered questionnaire, entered into Epi-info version 7.0 and exported to Statistical Package for Social Sciences (SPSS) version 25 for analysis, and presented in frequencies, percentages and tables. Bivariable and multivariable logistic regression analysis were carried out to identify variables having significant association with RSB.The prevalence of RSB among undergraduate students at the University of Gondar was 44.0%. Age [adjusted odds ratio (AOR): 2.12; 95% confidence interval (CI) (1.19-3.79)], residence [AOR: 2.14; 95% CI (1.22-3.75)], living arrangement [AOR: 9.79; 95% CI (5.34-17.9)], daily religious attendance[AOR: 0.57; 95% CI (0.33-0.99)], drink alcohol [AOR: 9.19; 95% CI (3.74-22.59)] and having information about reproductive health and sexually transmitted diseases [AOR:3.05; 95% CI (1.00-9.27)] were factors significantly associated with RSB.Nearly half of the respondents engaged in risky sexual activity. This prevalence is high and the students are at high risk of exposure to sexually transmitted diseases that need reproductive health intervention like counselling and discussion. Creating awareness is needed for the students regarding reproductive health and the risk of sexually transmitted diseases. In addition, giving special attention is required for students who use alcohol, who did not live with family and who have urban residence.

Background: Nonpharmacological pain management refers to providing pain management intervention that does not involve the use of drugs. Effective management of a patient's pain is a vital nursing activity, and it needs a nurse's adequate pain-related knowledge and a favorable attitude. Globally, many studies stated that the lack of knowledge and unfavorable attitude of nurses towards nonpharmacological pain management was the prevailing persistent challenge., Objective: To assess knowledge, attitude, and associated factors towards nonpharmacological pain management among nurses working in Amhara region Comprehensive Specialized Hospitals, Ethiopia, 2021., Method: An institutional-based cross-sectional study was conducted from April to May 30, 2021. A total of 845 nurses were selected using a simple random sampling technique. Data were collected by using a pretested self-administered structured questionnaire. Then, data were checked, coded, and entered into Epi Info version 7.0 and exported to SPSS version 25.0 software for analysis., Results: A total of 775 nurses participated in this study, with a response rate of 91.8%. Of the total participants, 54.2% (95% CI: 50.6-57.9) and 49.8% (95% CI: 46.1-53.2) of nurses had adequate knowledge and a favorable attitude, respectively. The study revealed that educational status (AOR = 3.51 (95% CI: 1.37, 8.99)), years of experience (AOR = 5.59 (95% CI: 2.86, 10.94)), working unit (AOR = 5.61 (95% CI: 2.25, 13.96)), nurse-to-patient ratio (AOR = 2.33 (95% CI: 1.44, 3.78)), and working hours (AOR = 2.15 (95% CI: 1.27, 3.62)) were significantly associated. This finding also revealed that monthly income (AOR = 4.38 (95% CI: 1.64, 11.69)), nurse-to-patient ratio (AOR = 1.89 (95% CI: 1.19, 3.01)), and nurses' adequate knowledge (AOR = 4.26 (95% CI: 2.91, 6.24)) were significantly associated with the attitude of nurses. Conclusion and Recommendations . More than half and nearly half of the nurses had adequate knowledge and a favorable attitude towards nonpharmacological pain management, respectively. Educational qualification, years of experience, working unit, nurse-to-patient ratio, and prolonged working hours per day were significantly associated with nurse's adequate knowledge. Monthly income, nurse-to-patient ratio, and nurse's knowledge were significantly associated with the attitudes of nurses. It is better to give attention to reviewing the nursing curriculum, achieving a standardized nurse-to-patient ratio, recruiting additional nurses, training, and upgrading nurses with continuing education., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2021 Esayas Alemshet Tekletsadik et al.)

Background: Injuries continue to be an important cause of morbidity and mortality in the developed and developing world. School-age children are more likely to experience unintentional injuries in the school, while they are playing and teachers are the primarily responsible body for keeping the welfare of the students. Knowing the knowledge, attitude, and practice of kindergarten and elementary school teachers towards first aid will be used as an input for policymakers to intervene and provide training. Therefore, this study was aimed to assess knowledge, attitude, practice, and associated factors towards first aid among kindergarten and elementary school teachers in Gondar city, Northwest Ethiopia, 2021., Methods: An institution-based cross-sectional study was conducted from January 01 to 20, 2021. A simple random sampling technique was employed to recruit 346 participants. A structured pretested self-administered questionnaire was used to collect data. Data were entered in Epi-info version 7, analyzed using SPSS version 21, and presented by frequencies, percentages, tables, and graphs. Bivariable relationships between the independent and outcome variable were investigated using a binary logistic regression model and a multivariable analysis was run to control potential confounding factors. Variables with a p-value < 0.05 were considered as factors significantly associated and the strength of association was determined using an odds ratio with a 95% CI., Results: Only 41.1% of the teachers had good knowledge of first aid. Nearly two-thirds (64.8%) of the teachers had a favorable attitude towards first aid. The majority (85.8%) of the teachers who faced a child in need of first aid in their school gave first aid. Factors like working experience [AOR: 2.45; 95% CI (1.26, 4.73)], school level [AOR: 4.72; 95% CI (1.96, 11.4)], school type [AOR: 4.23; 95% CI (2.07, 8.64)], and having information about first aid [AOR: 2.09; 95% CI (1.11, 3.92)] were significantly associated with knowledge. School-level [AOR = 5.4, 95% CI (2.18-11.67)], school type [AOR = 0.45, 95% CI (0.21-0.94)], and working experience [AOR = 0.33, 95% CI (0.13-0.86)] were the factors significantly associated with attitude., Conclusion: Less than half and nearly two-thirds of the teachers had good knowledge and a favorable attitude towards first aid. The majority of the teachers who encountered a child in need of first aid gave first aid. Having higher working experience, working in elementary and private schools, and having previous information increases the odds of having good knowledge. Teachers who work in elementary and private schools and have the lower working experience had higher odds of favorable attitude towards first aid. It is better to give attention to the training of staff on first aid specifically for teachers working in kindergarten and governmental schools and new employees and consider integrating first aid in teachers' training curriculum.