Lifetime Experience of Childhood Abuse and Neglect Among High School Students at Debre Tabor Town, South Gondar Zone, Northwest Ethiopia: An Institution-Based Cross-Sectional Study.

Background: Childhood abuse and neglect is defined as any intentional harm or mistreatment of a child that results in actual or potential harm to the child's health, survival and development. It has been linked to an increased risk of a wide range of serious short- and long-term medical and mental health problems. Although it is a complex societal issue, it receives limited research attention in the area. Objective: To assess lifetime prevalence of childhood abuse and neglect among high school students in Debre Tabor town, south Gondar Zone, Northwest Ethiopia, 2022. Methods: A cross-sectional study design was used to assess 423 high school students, chosen through a systematic sampling technique. Data were collected using a pre-tested, structured and self-administered international child abuse screening tool, child version (ICAST-C). The effect of independent variables on the outcome variable was explored using logistic regression analyses. The level of significances were determined using an odds ratio with a 95% confidence interval. Results: Of the 423 study participants, 84.4% had lifetime experience of childhood abuse and neglect. Being female (AOR=4.5, 95% CI: 2.38, 8.60), parental marital status (AOR=5.4, 95% CI: 1.07, 27.3), illiteracy of father (AOR=1.65, 95% CI: 4.5, 6.03), birth order (AOR=4.5, 95% CI: 1.57, 13.0), open family discussion of sexual matters (AOR=0.37, 95% CI:1.74, 7.86), and watching pornography (AOR=0.08, 95% CI: 0.02, 0.40) were significantly associated with lifetime experience of childhood abuse and neglect. Conclusion: Lifetime experience of childhood abuse and neglect was high as compared with previous studies. Being female, parental marital status, illiterate fathers, watching pornography, and open family discussion of sexual matters were predictors of childhood abuse and neglect. Dealing with this issue should be considered an integral component of high school students' care, including parental education and respite care.

Level of episiotomy practice and its disparity among primiparous and multiparous women in Ethiopia: a systematic review and meta-analysis.

Background: Episiotomy at the time of vaginal birth is a common lifesaving surgical procedure. In Ethiopia, several studies have been conducted concerning the proportion of episiotomy. However, its prevalence varies across these series of studies. Thus, this systematic review and meta-analysis aimed to estimate the level of episiotomy practice and its disparity among primiparous and multiparous women in Ethiopia. Methods: This systematic review was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guideline. We systematically searched the PubMed/MEDLINE, EMBASE, Google Scholar, and Science Direct databases for studies conducted in Ethiopia focusing on episiotomy. We included all cross-sectional studies published until October 5,2022. Data were analyzed using R version 4.2.1 software. The pooled estimates with 95% confidence intervals (CIs) were presented using forest plots. A random-effects meta-analysis was conducted on extracted crude rates to calculate the national and regional pooled estimates for the country. The I-squared test and Egger's regression test were used to assess heterogeneity and publication bias, respectively. Results: Our search yielded 390 articles. A total of 13 studies covering five administrative regions and 6,404 women who delivered vaginally were involved. The mean age of the study participants ranged from 22 to 27.7 years. The estimated overall pooled prevalence rate of episiotomy in Ethiopian women was 42.75% (95% CI: 34.97%-50.54%). In the subgroup analysis, the pooled prevalence rate of episiotomy was 61.45% (95% CI: 51.11%-71.80%) among primiparous women. Meanwhile, the pooled estimate appears to be approximately 30.47% (95% CI: 22.08%-38.85%) among multiparous women. Conclusion: Our findings concluded that the pooled prevalence rate of episiotomy was higher than the evidence-based WHO recommendations for optimal patient care. Parallel to this, nulliparous women had a higher episiotomy rate than multiparous women. These findings highlight the importance of continued training for labor ward staff, particularly healthcare providers who often perform the majority of deliveries.

Individual and community-level determinants and spatial distribution of prenatal HIV test uptake in Ethiopia: Spatial and multilevel analysis.

Introduction: Human immunodeficiency virus (HIV) testing and counseling services are routine prenatal care services for the prevention of mother-to-child transmission of HIV. Although the prevalence of HIV infection is high among women, evidence suggests that the uptake of HIV testing during prenatal services in Ethiopia is scarce. Therefore, the aim of this study was to investigate individual- and community-level determinants and the spatial distribution of prenatal HIV test uptake in Ethiopia based on the 2016 Ethiopian Demographic and Health Survey. Methods: Data were accessed from the 2016 Ethiopian Demographic and Health Survey. A total weighted sample of 4,152 women aged 15-49 years who gave birth in the 2 years preceding the survey were included in the analysis. The Bernoulli model was fitted using SaTScan V.9.6 to identify cold-spot areas and ArcGIS V.10.7 to explore the spatial distribution of prenatal HIV test uptake. Stata version 14 software was used to extract, clean, and analyze the data. A multilevel logistic regression model was used to identify the individual- and community-level determinants of prenatal HIV test uptake. An adjusted odds ratio (AOR) with a corresponding 95% confidence interval (CI) was used to declare significant determinants of prenatal HIV test uptake. Results: The prevalence of HIV test uptake was 34.66% (95% CI: 33.23, 36.13%). The spatial analysis revealed that the distribution of prenatal HIV test uptake was significantly varied across the country. In the multilevel analysis, the following individual and community-level determinants were significantly associated with prenatal HIV test uptake: women who attained primary education (AOR = 1.47, 95% CI: 1.15, 1.87) and secondary and higher education (AOR = 2.03, 95% CI: 1.32, 3.11); women from middle (AOR = 1.46; 95% CI: 1.11, 1.91) and rich household wealth status (AOR = 1.81; 95% CI: 1.36, 2.41); those who had health facility visits in the last 12 months (AOR = 2.17; 95% CI: 1.77, 2.66); women who had higher (AOR = 2,07; 95% CI: 1.66, 2.59) and comprehensive HIV-related knowledge (AOR = 2.90; 95% CI: 2.09, 4.04); women who had moderate (AOR = 1.61; 95% CI: 1.27, 2.04), lower (AOR = 1.52; 95% CI: 1.15, 1.99), and no stigma attitudes (AOR = 2.67; 95% CI: 1.43, 4.99); those who had awareness of MTCT (AOR = 1.83; 95% CI: 1.50, 2.24); those from rural areas (AOR = 0.31; 95% CI: 0.16, 0.61); high community level of education for women (AOR =1.61; 95% CI: 1.04, 2.52); and those living in large central (AOR = 0.37; 95% CI: 0.15, 0.91) and small peripheral areas (AOR = 0.22; 95% CI: 0.08, 0.60). Conclusion: In Ethiopia, prenatal HIV test uptake had significant spatial variations across the country. Both individual- and community-level determinants were found to be associated with prenatal HIV test uptake in Ethiopia. Hence, the impact of these determinants should be recognized while developing strategies in "cold spot" areas of prenatal HIV test uptake to enhance prenatal HIV test uptake in Ethiopia.

A multilevel analysis of improved drinking water sources and sanitation facilities in Ethiopia: Using 2019 Ethiopia mini demographic and health survey.

Background: Access to water, sanitation, and hygiene is an important element for communicable disease control including the existing COVID-19 pandemic. This is due to the growing water demand and decreasing water availability, because of shrinking resources, increased urbanization, and pollution. This problem is higher, particularly among least developed countries like Ethiopia. This study, therefore, aimed at investigating the level of improved water sources and sanitation as well as their predictors in Ethiopia using EMDHS-2019. Method: Mini Ethiopian Demographic and Health Surveys 2019 database survey was used in this study. Data collection took place over 3 months, from 21 March 2019 to 28 June 2019. A total of 9,150 households were selected for the sample, of which 8,794 were engaged. Among involved households, 8,663 were successfully interviewed at a response rate of 99%. The dependent variables measured in this study were improved drinking water sources and sanitation facilities. Due to the nested nature of DHS data, multilevel binary logistic regression analysis was done using Stata-16. Results: The majority (72.62%) of household heads were men, and 69.47% of participants were from rural areas. Close to half (47.65%) of study participants did not have any form of formal education, while the lowest proportion (9.89%) of them had higher education. Approximately 71.74 and 27.45% of the households have accessed improved water sources and sanitation, respectively. Based on the final model results, wealth index, educational status, and having a television individual-level variables while community-level poverty, community-level education, community-level media exposure, and place of residence were statistically significant predictors of getting improved water source and sanitation. Conclusion: The level of access to improved water sources is moderate but it lacks progress, while access to improved sanitation was lower. Based on these findings, great improvements should be made in providing access to an improved water source and sanitation facilities in Ethiopia. Based on these findings, great improvements should be made in providing access to improved water source and sanitation facilities in Ethiopia.

Spatial distribution and determinants of newborn care within 2 days of postpartum period among women with at least one antenatal care visit in Ethiopia: Mixed effect multilevel analysis.

INTRODUCTION: Neonatal mortality is pervasive in developing countries like Ethiopia. Though the risk of neonatal mortality is preventable through consolidating simple, low-cost, and less time-consuming essential care, there is a scarcity of evidence about the spatial distribution of newborn care in Ethiopia. OBJECTIVE: The current study aimed to demonstrate spatial distribution and determinants of newborn care within 2 days of the postpartum period in Ethiopia. METHODS: A cross-sectional study was employed based on Ethiopian demographic and health survey 2016 data and 2796 post-partum period women were included. Arc GIS version 10.7 and SaTScan version 9.6 software were used. Mixed effect analysis was done by STATA version 14 software. Bivariate analysis was done and variables with a p value<0.2 were taken as a candidate for multilevel multivariable logistic regression. Intra Class Correlation Coefficient (ICC), Proportion Change in Variance (PCV), and Median Odds Ratio (MOR) were used for model comparison and an Adjusted Odds Ratio (AOR) with respect to a 95% confidence interval was used for declaring statistical significance. In the multivariable analysis, a p-value≤0.05 was considered as a cut point of statistical significance with the outcome variable. RESULTS: The spatial distribution of newborn care was not random and the overall prevalence was 48.39%. Secondary educational level (Adjusted Odds Ratio (AOR = 1.5;95% CI 1.06,2.62), college and above (AOR = 2.47; 95% CI 1.22,5.01), number of antenatal cares three (AOR = 1.5; 95% CI 1.10, 2.04), antenatal care four and above (AOR = 1.6; 95% CI 1.22; 2.19), place of delivery (AOR = 9.67; 7.44, 12.57) and child is a twin (AOR = 3.33; 95% CI 1.23, 9.00) were variables significantly associated with newborn care. CONCLUSIONS: Newborn care practice in Ethiopia is below half per hundred participants. Even the distribution was not random. There is a need to pay attention to those cold spot areas and factors significantly associated with newborn care. Improving women's educational levels secondary and above, and consolidating the continuation of antenatal care and health facility delivery were the priority areas to improve newborn care in Ethiopia. Maternal and neonatal health program managers and policymakers should pay attention to those cold spots of newborn care to achieve the sustainable development goal.

On-Site Solid Waste Handling Practice and Associated Factors among Condominium Residents in Gondar City, Northwest Ethiopia, 2021: A Community-Based Cross-Sectional Study.

Background: Solid waste is one type of waste that is released from human day-to-day activities and it is considered useless or unwanted for further use. Population growth, rapid urbanization, a booming economy, and an increase in the standards of living of the community have substantially enhanced the rate of solid waste generation in developing countries. Solid wastes can be used as a resource for industrial production or energy generation. However, it causes environmental and human health problems due to poor management. There is scanty information about on-site solid waste management practice in the study area. Therefore, assessing on-site solid management practices and their associated factors, especially for condominium residents is very important. Objective: To assess on-site solid waste handling practice and its associated factors among condominium residents in Gondar city, northwest Ethiopia, 2021. Methods: A community-based cross-sectional study was conducted from March 1 to June 15/2021 among condominium residents in Gondar city. The study included a total of 450 condominium households, with a 99.3% response rate. A binary logistic regression model was used to assess the association between dependent and independent variables. Those variables which have a p value <0.25 in the bivariate analysis were entered into a multivariable logistic regression model. A p value of less than 0.05 with 95% CI was considered a statistically significant factor. Result: In this study, 79.8% with 95% CI (76.4%, 83.3%) of condominium residents had poor on-site solid waste handling practices. The finding also showed that 42.2% and 50.2% of study participants have favorable attitudes and good knowledge towards on-site solid waste handling practices, respectively. In multivariable logistic regression analysis, male household heads (AOR = 1.90; 95% CI, 1.11-3.28), large family size (AOR = 1.87; 95% CI, 1.03-3.40), negative attitude towards on-site solid waste handling practices (AOR = 1.79; 95% CI, 1.07-3.00), not receiving training (AOR = 3.40; 95% CI, 1.77-6.55), and not having legal enforcement (AOR = 2.85; 95% CI, 1.39-5.84) were significantly associated with on-site solid waste handling practices. Conclusion: The on-site solid waste handling practice of condominium households was very poor. The provision of training and enforcement of rules regarding solid waste handling is necessary.

Prevalence and associated factors of delay antenatal care at public health institutions in Gondar city, Northwest Ethiopia, 2021: a cross-sectional study.

BACKGROUND: Antenatal care is critical for women's and unborn children's health. In Ethiopia there is still a delay in getting antenatal care visit in the first trimester as recommended by the World Health Organization. Therefore, the purpose of this study was to assess the prevalence of delayed antenatal care visits and associated factors among pregnant women who attend antenatal care at a public health facility in Gondar town, Northwest Ethiopia. METHODS: An institutional-based cross-sectional study was conducted between August 20 to September 15/2021. A simple random sampling technique was used to select 392 women. Data were collected using a pre-tested structured questionnaire through a face-to-face interview. Epi Info version 7 and SSPS 26.0 were used for data entry and further analysis. Descriptive statistics and multivariable logistic regression analyses were performed. An adjusted odds ratio with 95% confidence interval at p-value < 0.05 was declared that the outcome can be statistically significant. RESULTS: A total of 392 study participants with a response rate of 98% were participated. The mean age of study participants was 29.1 ± 6.5 (SD) years. In this study, the prevalence of delay antenatal care was 63.8%( 95% CI: 58.9, 68.9). Age (Adjusted odds ratio = 0.51; 95% CI: 0.28, 0.93), types of health facilities (Adjusted odds ratio = 2.02; 95% CI :( 1.12, 3.64), and satisfaction with health service (Adjusted odds ratio = 3.23, 95%CI: (2.02, 5.16) were significantly associated with delay antenatal care. CONCLUSION: The current study found high prevalence of delay antenatal care. Age between 31 and 34, hospital health facility and satisfaction with health service quality were associated factors for delay antenatal care visit. To begin antenatal care follow-up in the recommended time frame, a collaborative effort between the Minister of Health, health facilities, and relevant stakeholders is needed.

Magnitude and associated factors of intimate partner violence among youth women in Ethiopia: multilevel analysis based on 2016 Ethiopian Demographic and Health Survey.

BACKGROUND: The period of youth is important for the foundation of healthy and stable relationships, women's health and well-being. Youth women face a higher risk of experiencing violence than older women. Intimate partner violence (IPV) against youth women is a significant public health concern. Despite paramount negative health consequences of IPV for the survivor, as per our knowledge, research study on IPV and associated factors among youth women in Ethiopia is scarce. Therefore, this study aimed to assess the magnitude and associated factors of IPV among youth women in Ethiopia. METHODS: The data was accessed from 2016 Ethiopia demographic and health survey (EDHS) which was a cross sectional population based household survey. It was also conducted using a multi-stage stratified random cluster sampling approach. The data were cleaned, weighted, and analyzed using STATA Version 14 software. The total weighted sample of 1077 youth women were used in this study. Multilevel logistic regression modeling was used to determine factors associated with IPV among youth women. Adjusted odds ratio (AOR) with 95% confidence interval (CI) and p value < 0.05 were used to declare the significant variables. RESULTS: Among the total participants, 30.27% (95% CI 27.59, 33.09) of youth women experienced IPV. Individual level variables such as: Being widowed/divorced/separated (AOR = 2.28; 95% CI 1.33, 3.91), having a partner who drinks alcohol (AOR = 5.76; 95% CI 3.42, 9.69), witnessing inter-parental violence during childhood (AOR = 3.45; 95% CI 2.21, 5.37), being afraid of partners (AOR = 7.09; 95% CI 4.30, 11.68), and from community level variables, youth women residing in communities with a low proportion of educated youth women (AOR = 0.31; 95% CI 0.13, 0.78) were significantly associated with having experience of IPV. CONCLUSION: The magnitude of intimate partner violence among youth women in Ethiopia was relatively high as compared to the global estimate of IPV. Individual and community level variables such as currently widowed/divorced/separated women, having a partner who drinks alcohol, witnessing inter-parental violence, being afraid of partner, and women from a low proportion of community level youth women's education were significantly associated with intimate partner violence. To decrease this public health problem, it is better to strengthen legislation on the purchase and sale of alcohol, provide legal protection for separated/divorced women, establish effective legal response services for IPV, promote gender equality, and provide psychological support for those who witnessed inter-parental violence during childhood to reduce IPV.

Limited handwashing facility and associated factors in sub-Saharan Africa: pooled prevalence and multilevel analysis of 29 sub-Saharan Africa countries from demographic health survey data.

INTRODUCTION: Handwashing is fundamentally an inexpensive means of reducing the spread of communicable diseases. In developing countries, many people die due to infectious diseases that could be prevented by proper hand hygiene. The recent coronavirus (COVID-19) pandemic is a threat to people who are living in resource-limited countries including sub-Saharan Africa (SSA). Effective hand hygiene requires sufficient water from reliable sources, preferably accessible on premises, and access to handwashing facility (water and or soap) that enable hygiene behaviors. Therefore, this study aims to determine the prevalence of limited handwashing facility and its associated factors in sub-Saharan Africa. METHODS: Data from the Demographic and Health Surveys (DHS) were used, which have been conducted in 29 sub-Saharan African countries since January 1, 2010. A two-stage stratified random cluster sampling strategy was used to collect the data. This study comprised a total of 237,983 weighted samples. The mixed effect logistic regression model with a cluster-level random intercept was fitted. Meta-analysis and sub-group analysis were performed to establish the pooled prevalence. RESULTS: The pooled prevalence of limited handwashing facility was found to be 66.16% (95% CI; 59.67%-72.65%). Based on the final model, household head with age group between 35 and 60 [AOR = 0.89, 95% CI; 0.86-0.91], households with mobile type of hand washing facility [AOR = 1.73, 95% CI; 1.70-1.77], unimproved sanitation facility [AOR = 1.58, 95% CI; 1.55-1.62], water access more than 30 min round trip [AOR = 1.16, 95% CI; 1.13-1.19], urban residential area [AOR = 2.08, 95% CI; 2.04-2.13], low media exposure [AOR = 1.47, 95% CI; 1.31-1.66], low educational level [AOR = 1.30, 95% CI; 1.14-1.48], low income level [AOR = 2.41, 95% CI; 2.33-2.49] as well as lower middle-income level [AOR = 2.10, 95% CI; 2.14-2.17] and households who had more than three children [AOR = 1.25, 95% CI; 1.20-1.31] were associated with having limited handwashing facility. CONCLUSION AND RECOMMENDATION: The pooled coverage of limited handwashing facility was high in sub-Saharan Africa. Raising awareness of the community and promoting access to handwashing materials particularly in poorer and rural areas will reduce its coverage.

Pooled prevalence and determinants of informed choice of contraceptive methods among reproductive age women in Sub-Saharan Africa: A multilevel analysis.

Background: Despite the commitments of the government to minimize unintended pregnancy, abortion, and unmet need for contraceptives, as per our search of the literature, there is no study on the pooled prevalence and determinants of informed choice of contraceptive methods in sub-Saharan Africa. Therefore, this study aimed to assess the pooled prevalence and determinants of informed choice of contraceptive methods among reproductive-aged women in sub-Saharan Africa. Methods: This study was based on the 32 Sub-Saharan African countries Demographic and Health Survey data. A total weighted sample of 65,487 women aged 15-49 was included in the study. The data were cleaned, weighted, and analyzed using STATA Version 14 software. Multilevel logistic regression modeling was used to identify determinants of an informed choice of contraceptive methods. Adjusted odds ratio (AOR) with 95% Confidence Interval (CI) and p-value < 0.05 were used to declare the significant determinants. Result: The pooled prevalence of informed choice of contraceptive methods among reproductive age (15-49) women in sub-Saharan Africa was 49.47% (95%CI: 44.33, 54.62%) with I 2 =99.5%, and variations in range of 19.42 to 78.42%. Women aged 25-34 years old (AOR = 1.26 95%CI: 1.21, 1.32) and 35-49 years (AOR = 1.33 95%CI: 1.27, 1.40), attending primary education (AOR = 1.26, 95% CI: 1.20, 1.32), secondary education (AOR = 1.50, 95% CI: 1.43, 1.58) and higher education (AOR = 2.01, 95% CI: 1.84, 2.19), having media exposure (AOR = 1.12, 95%CI: 1.07, 1.16), utilizing IUD (AOR = 1.98, 95%CI: 1.79, 2.19), injectable (AOR = 1.29, 95%CI: 1.23, 1.36) and implants (AOR = 1.70, 95%CI: 1.61, 1.79), survey year 2016-2020 (AOR = 1.38, 95%CI: 1.31, 1.44), women from lower middle (AOR = 1.25, 95%CI: 1.19, 1.31) and upper middle income level countries (AOR = 1.37, 95%CI: 1.23, 1.53) were associated with increased odds of informed choice of contraceptive methods. While, women who accessed contraceptives from private clinics (AOR = 0.64, 95%CI: 0.61, 0.67), pharmacies (AOR = 0.37, 95%CI: 0.35, 0.40), and others (AOR = 0.47, 95%CI: 0.43, 0.52), women in East Africa (AOR = 0.70, 95% CI: 0.67, 0.73), Central Africa (AOR = 0.52, 95% CI: 0.47, 0.57), and South Africa (AOR = 0.36, 95% CI: 0.32, 0.40) were associated with decreased odds of informed choice of contraceptive methods. Conclusion: The pooled prevalence of informed choice of contraceptive methods in Sub-Saharan Africa is low with high disparities among the countries. Enhancing maternal education and media exposure, providing greater concern for the source of contraceptive methods, and strengthening the economic status of the country are recommended to enhance informed choice of contraceptive methods.

Individual and community level predictors of utilization of deworming medications among pregnant women in Ethiopia: A multilevel analysis.

BACKGROUND: Deworming is one strategy for reducing the burden of anaemia in pregnant women caused by intestinal parasites and it is one of the components of prenatal treatment offered to pregnant women in Ethiopia during antenatal care visits. However, there is limited evidence on the levels of deworming utilization and its determinants in Ethiopia. Hence, this study was aimed to assess the levels of deworming utilization and its individual and community level determinants among pregnant women in Ethiopia. METHOD: This study used a total weighted sample of 7590 reproductive-aged women who gave birth in the five years preceding the survey from the 2016 EDHS data. The data were cleaned and weighted using STATA version 16. Results were presented with tables and texts. Individual and community level determinants for deworming use among Ethiopian pregnant women were identified using a multilevel binary logistic regression model. In the multivariable multilevel analysis, those variables with p-value < 0.05 were considered to be significantly associated with utilization of deworming medication and reported with adjusted odd ratio with 95% confidence level. RESULTS: The overall utilization of deworming among pregnant women was 5.69% (95% CI: 5.24%, 6.33) in Ethiopia. Having occupation [AOR = 1.59; 95% CI; 1.27, 1.99], wanted pregnancy [AOR = 1.51; 95% CI; [1.16, 1.95], having ANC visit [AOR = 2.72; 95% CI; 2.03,3.64], media exposure [AOR = 1.67; 95%CI; 1.30,2.15], and high community level poverty [AOR = 0.59; 95% CI; 0.40,0.87] were significantly associated with utilization of deworming among pregnant women's. CONCLUSION: According to the findings of this study, out of twenty pregnant women, only one pregnant woman utilizes deworming medication in Ethiopia. Pregnant woman having an occupation, being exposed for media, having wanted pregnancy, having ANC visits and live with low level community poverty were more likely to use deworming medication. Therefore, intervention efforts to enhance utilization of deworming in Ethiopia requires working on enabling factors like media exposure, ANC visit and pregnancy desirability. In addition, Furthermore, increasing the community's economic capacity could support in increasing deworming medication uptake.

Perception of risk regarding the use of COVID-19 vaccine among pregnant women in Motta town and Hulet Eji Enese district, northwest Ethiopia.

BACKGROUND: COVID-19 vaccination during pregnancy is a common practice in developing countries like Ethiopia. Despite there being a rumor from the community that the use of COVID-19 vaccination during pregnancy is associated with many pregnancy adverse outcomes. However, there is a paucity of empirical evidence on the perception of risk COVID-19 vaccination during pregnancy in Ethiopia. This study assessed the perception of risk COVID-19 vaccination during pregnancy and associated factors in Motta town and Hulet Eji Enese district, northwest Ethiopia. METHODS: A community-based cross-sectional study was conducted from December 12 to February 12, 2021. A total of 851 women' were selected using the stratified cluster sampling technique. Data were collected by face-to-face interview using a semi-structured pretested and interviewer-administered questionnaire. A multivariable logistic regression model was fitted to identify factors associated with the perception of risk COVID-19 vaccination during pregnancy. The adjusted odds ratio (AOR) with a 95% confidence interval at a p-value of ≤ 0.05 was used to declare the level of significance. RESULTS: Perception of risk COVID-19 vaccination during pregnancy was 34.2% (95%CI (Confidence Interval): 31-37). Unplanned pregnancy (AOR = 3.66; 95%CI: 2.31-5.81), long travel time to the nearby health care facility (AOR: 4.57; 95% CI: 2.34-8.91), have no formal education (AOR: 3.15; 95%CI: 1.71-5.79), attending secondary educational level (AOR: 5.18; 95% CI: 2.17-12.4), no ANC (Antenatal Care) service utilization (AOR: 7.07; 95% CI: 4.35-11.5) and negative attitude towards COVID-19 vaccination (AOR: 6.05; 95%CI: 3.88-9.43) were significantly associated with the perception of risk COVID-19 vaccination during pregnancy. CONCLUSIONS: Most of the participants perceive COVID-19 vaccination during pregnancy as a risk for the outcome of pregnancy. Designing strategies to increase women's educational status, promoting the need for maternal and child health services, and awareness creation regarding COVID-19 vaccination will have a great role in changing the perception of pregnant women. Therefore, the government should design public health programs targeting the identified factor, and should minimize the perception of risk acquiring infection from COVID-19 vaccine to improve maternal and neonatal health outcome.

Level of activity limitations and predictors in women with pregnancy-related pelvic girdle pain: Prospective cross-sectional study.

Background: For many pregnant women, pelvic girdle pain caused by pregnancy has an impact on their daily living. Women with lumbo-pelvic pain have moderate to severe discomfort that makes daily activities like getting out of a chair, bending, and walking difficult. The aim of this study was to determine the extent of daily activity restrictions and to discover predictors of pregnancy-related pelvic girdle pain. Study design: Prospective cross-sectional study. Methods: This prospective cross-sectional study was undertaken from January October 2018 to October 29/2019 among 337 gravid mothers with pregnancy-related limbo-pelvic pain. A structured questionnaire adapted from the activity limitation-related pelvic girdle pain questionnaire was used for data collection. Epi-info version 7.1 for data entry and STATA version 14 for statistical analysis were used. Ordinal regression with an odds ratio of 95% confidence interval and p-value < 0.05 were cast-off to assess the association between the outcome and dependent variables. Results: Among 324 pregnant women with pelvic girdle pain 96 (29.6%) had small extent level of activity limitation, 185 (57.1%) had moderate activity limitation, and 43 (13.3%) large extent level of activity limitation. Having previous children (AOR = 0.37, 95% CI:0.14, 0.98), occupation (AOR = 1.77, 95% CI: 1.06, 2.95) and taking alcohol (AOR = 0.43, 95% CI: 0.19, 0.99) were the independent predictors for activity limitation. Conclusion: Nearly one-third of the participants had a modest degree of activity restriction, while more than half of the pregnant women with PPGP had a moderate to high level of restriction. Previous children, occupation, and alcohol consumption were all independent predictors of activity limitation among pregnant women.

Community and individual level determinants and spatial distribution of deworming among preschool age children in Ethiopia: spatial and multi-level analysis.

BACKGROUND: Soil-transmitted helminths caused millions of morbidity of preschool age children in sub-Saharan Africa with low socio-economic status and lack of clean water and sanitation. In Ethiopia, nearly half of children are affected by intestinal parasites. Despite this prevalence, deworming medication utilization among preschool age children is low. Hence, this study aimed to assess the community and individual level determinants and spatial distributions of deworming among preschool age children in Ethiopia. METHODS: Crossectional collected 2016 Ethiopian Demographic and Health Survey datasets with a total weighted 8146 children 12-59 months old were used for this study. The data were cleaned, extracted, and analyzed using STAT Version 16 software and exported to MS excel for spatial analysis. In addition, ArcGIS and SaTScan software were used to detect the geographic distribution of deworming utilization among preschool age children. RESULTS: The magnitude of deworming among preschool age children in Ethiopia was 13.32% (95% CI: 12.60, 14.08) and ranges from the lowest 3.34% (95% CI: 1.01, 10.45) Afar region to the highest 28.66% (95% CI:24.95, 32.69) Tigray region. In multilevel multivariable logistics regression analysis; variables such as secondary and above women education [AOR = 1.89; 95%CI; 1.32, 2.73], women who have occupation [AOR = 1.47; 95%CI; 1.23, 1.76], child with 12-23 months old [AOR = 2.00; 95%CI; 1.62, 2.46], having ANC visit [AOR = 1.68; 95%CI; 1.35, 2.08], households that have media exposure [AOR = 1.50; 95%CI; 1.22, 1.85] were significantly associated with deworming among preschool age children. Afar, Eastern Amhara, Dire Dewa, Harari, Somalia, and Eastern SNNPE regions were cold spot regions with Global Moran's I value 0.268 (p < 0.0001) for deworming of preschool age children. CONCLUSIONS: The prevalence of deworming among preschool age children in Ethiopia is relatively low. Individual-level factors such as; maternal education and occupation, having ANC visit, child age, household media exposure, and community-level variables such as; community media usage had a significant association with deworming among preschool age children in Ethiopia. These findings highlight that, the Ministry of Health (MOH) Ethiopia should prepare a regular campaign for deworming programs for preschool age children. Mass media promotion of deworming should be strengthened. The Ministry of Education should work to strengthen women's education, household and community media exposure. Prior attention should be given to low deworming regions such as Afar, Somalia, Diredewa, and Harari regions.

Distal and/or Proximal Joint Stiffness Among Post-Fracture Patients Treated in University of Gondar Comprehensive Specialized Hospital, Gondar, Ethiopia.

Background: Stiffness, or more precisely, a restriction in the range of motion, is a potential complication following any intra- or extra-articular injury. The passive or active range of motion of the physiological joint is an important factor in determining the significance of joint stiffness. The goals of this study were to assess the incidence of joint stiffness following a fracture, using a standard goniometer, and to identify potential predictors of joint stiffness among post-fracture patients. Methods: A prospective hospital-based cross-sectional study was conducted from July 1, 2021 to September 13, 2021, at University of Gondar Comprehensive Specialized Hospital. A total of 230 study participants participated in the study, and systematic sampling methods were used to recruit the study participants. Bivariate and multivariable binary logistic regression model analyses were conducted, with SPSS version 23, to identify factors associated with post-fracture joint stiffness. Results: The overall prevalence of post-fracture stiffness was 25.7% (n=59). Having a left-side fracture (AOR=10.83; 95% CI 1.71-17.74), patients having no physiotherapy follow-up (AOR=6.72; 95% CI 1.79-25.13), and patients using assistive devices (AOR=11.95; 95% CI 3.63-39.35) were significantly associated with post-fracture stiffness, with p-values of less than 0.05. Conclusion: The study found that one-quarter of the study participants experienced post-fracture joint stiffness. A fracture on the left side, individuals with no physiotherapy follow-up, and the use of assistive devices were found to be independent predictors of joint stiffness. Early referral of fracture patients to the rehabilitation center is recommended to prevent post-fracture complications and joint stiffness.

Household Solid Fuel Use and Associated Factors in Ethiopia: A Multilevel Analysis of Data From 2016 Ethiopian Demographic and Health Survey.

Solid fuels are types of fuel that comprise coal, biomass, charcoal, wood, or straw and are used for cooking, heating, lighting, boiling water, and generating revenue at home. Globally, 3 billion of the world's poorest people continue to rely on inefficient solid fuels, which produce health-damaging contaminants. In Ethiopia, more than 90% of households rely on wood as their primary source of energy. The actual and potential determinants of solid fuel use have not been fully identified, particularly at the national level in Ethiopia. Therefore, this study aimed to determine the magnitude of solid fuel use and its associated factors in Ethiopia. We used the Ethiopian Demographic and Health Survey (EDHS), which was conducted in 2016. The data was conducted using a 2-stage stratified cluster sampling approach. A total of 16 650 weighted samples were taken. Multilevel logistic regression models were fitted to identify factors associated with solid fuel use, and a cluster-level random intercept was introduced in the mixed model. An adjusted odds ratio with a 95% confidence level was reported to show the strength of the association and its significance. The goodness of fit of the model was checked using proportional change deviance (PCV). The magnitude of solid fuel use among households in Ethiopia was 94.03% (95% CI = 93.66, 94.37). Household heads completed in primary school (AOR, 3.09, 95% CI = 2.44, 3.91), outdoor cooking places (AOR, 4.13, 95% CI = 2.96, 5.76), and small peripheral regions (AOR, 14.44, 95% CI = 6.12, 34.04) were all significantly associated with solid fuel use. The intra-cluster correlation coefficient (ICC) showed that about 81% of the variations in the use of solid fuel were attributed to the difference at the 643 cluster level, but the remaining 19% were attributed to individual household factors. The PCV was 90%, which showed that the variation in solid fuel use among study households was explained by factors at both the individual and community levels. The deviation test of the fourth model had the lowest value (3528) and was chosen as the best-fitted model. Due to different influencing factors, the use of solid fuel is still high in Ethiopia. Promoting access to education and raising awareness toward solid fuel impact is very important.

Open defecation practice and its determinants among households in sub-Saharan Africa: pooled prevalence and multilevel analysis of 33 sub-Saharan Africa countries demographic and health survey.

BACKGROUND: Open defecation facilitates the transmission of pathogens that cause diarrheal diseases, which is the second leading contributor to the global burden of disease. It also exposed hundreds of millions of girls and women around the world to increased sexual exploitation. Open defecation is more practice in sub-Saharan African (SSA) countries and is considered an indicator of low socioeconomic status. However, there is little evidence on the pooled prevalence and factors contributing to open defecation practice among households in SSA. OBJECTIVES: This study aimed to assess the pooled prevalence, wealth-related inequalities, and other determinants of open defecation practice among households in sub-Saharan Africa. METHODS: Demographic and Health Survey data sets of 33 SSA countries with a total sample of 452,281 households were used for this study. Data were weighted, cleaned, and analyzed using STATA 14 software. Meta analyses were used to determine the pooled prevalence of open defecation practice among households in SSA. Multilevel analysis was employed to identify factors contributing to open defecation practice among households in SSA. Moreover, concentration index and graph were used to assess wealth-related inequalities of open defecation practice. The associations between dependent and independent variables were presented using adjusted odds ratios and 95% confidence intervals with a p value of < 0.05. RESULTS: The pooled prevalence of open defecation practice among households in sub-Saharan African countries was 22.55% (95%CI: 17.49%, 27.61%) with I2 = 99.9% and ranges from 0.81% in Comoros to 72.75% in Niger. Individual level factors, such as age, educational attainment, media exposure, wealth status, and access to drinking water, as well community level factors, such as residence, country income status, and region in SSA, had a significant association with open defecation practice. The concentration index value [C = - 0.55; 95% CI: - 0.54, - 0.56] showed that open defecation practice was significantly disproportionately concentrated on the poor households (pro-poor distribution). CONCLUSIONS: Open defecation practice remains a public health problem in sub-Saharan Africa. Individual level factors, such as age, educational attainment, media exposure, household wealth status, and access to drinking water had an association with open defecation practice. Moreover, community level factors such as residence, country income status and region in SSA have a significant effect on open defecation. There is a significantly disproportional pro-poor distribution of open defecation practice in SSA. Each country should prioritize eliminating open defecation practices that focused poorest communities, rural societies, and limited water access areas. Media exposure and education should be strengthened. Moreover, public health interventions should target to narrow the poor-rich gap in the open defecation practice among households including provisions of subsidies to the poor. Policymakers and program planners better use this evidence as preliminary evidence to plan and decide accordingly.

Pesticide Use Knowledge, Attitude, Practices and Practices Associated Factors Among Floriculture Workers in Bahirdar City, North West, Ethiopia, 2020.

Pesticides are substances that are used to kill, decrease, or repel pests and are used extensively to boost agricultural production. Ethiopian floriculture is one of the pesticide-intensive agricultural production centers and it provides jobs for 1000s of Ethiopians. Despite its significant contribution to the national economy, many issues are raised by the workers. The study aimed to assess the knowledge, attitudes, practices, and factors associated with the practices of workers against pesticide exposure among floriculture workers in Bahirdar city. A cross-sectional occupational study was done. The participants were recruited using a stratified sample technique. The final study participants were chosen using a simple random sampling procedure. The survey received 300 responses, 95.2% response rate from the entire sample size. The mean age of floriculture workers was 20 (SD ± 3.21) years, with a range of 17 to 48 years. The majority of workers (228) were females, and 36 (12.0%) of workers were illiterate. About 259 (86.3%) of floriculture workers did not know the name of the pesticide they were using. More than three-fourth 256 (85.3%) of respondents know at least one type of pesticide-related health problem. In this study, the most known type of pesticide routes of entry into the body were eyes (72.3%), skin (67.3%) followed by ingestion (67.0%). About 100 (33.3%) of the participants had good overall knowledge related to pesticide use and 134 (44.7%) of workers had a positive attitude on safe pesticide application. The level of good practice was 61.3% (N = 184). Knowing the impact of pesticide on environment (AOR, 0.54; 95% CI, 0.30-0.96), Knowing pesticide health problems, (AOR, 0.36; 95% CI, 0.20-0.63), willingness to wear and invest for PPE (AOR, 0.53; 95% CI, 0.28-0.98) and PPE supply (AOR, 0.29; 95% CI, 0.16-0.51) were significantly associated with workers pesticide handling practices. Workers who didn't know pesticide health problems were 36% less likely to have a good practice. The likelihood of having good practices among works who disagree to wear and invest on PPE 53% lower than those who agree on it. The likelihood of having good practices among workers who didn't have any PPE supply was lower than their counterparts with (AOR, 0.29; 95% CI, 0.16-0.51). Floriculture workers had poor handling practices therefore continuous pesticide training programs for workers could be implemented.

COVID-19 vaccine acceptance and associated factors in 13 African countries: A systematic review and meta-analysis.

Background: The COVID-19 pandemic has severely affected the entire world, especially sub-Saharan Africa. As a result, researchers and government agencies are working to create effective COVID-19 vaccinations. While vaccination campaigns are moving rapidly in high-income nations, COVID-19 is still ruthlessly affecting people in low-income nations. However, this difference in the spread of the disease is not because of a lack of a COVID-19 vaccine but mainly due to people's reluctance. As a result, this review summarized the data on COVID-19 vaccination adoption and factors related among nations in sub-Saharan Africa. Method: Comprehensive searches were conducted using PubMed, Embase, Medline, Web of Science, Google Scholar, and the Cochrane Library databases. The risk of bias and methodological quality of each published article that fit the selection criteria were evaluated using Critical Appraisal Checklist tools. All statistical analysis was done by STATA 16. Results: This review was based on 29 studies with 26,255 participants from sub-Saharan Africa. Using a random-effects model, the pooled prevalence of COVID-19 vaccine acceptance among study participants was 55.04% (95 % CI: 47.80-62.27 %), I2 = 99.55%. Being male [POR = 1.88 (95% CI: 1.45, 2.44)], having a positive attitude toward the COVID-19 vaccine [POR = 5.56 (95% CI: 3.63, 8.51)], having good knowledge in the COVID-19 vaccine [POR = 4.61 (95% CI: 1.24, 8.75)], having government trust [POR = 7.10 (95% CI: 2.37, 21.32)], and having undergone COVID-19 testing in the past [POR = 4.41 (95%CI: (2.51, 7.75)] were significant predictor variables. Conclusion: This analysis showed that respondents had a decreased pooled prevalence of COVID-19 vaccination acceptance. Sex, attitude, knowledge, government trust, and COVID-19 testing were statistically significantly correlated characteristics that affected the acceptability of the COVID-19 vaccine. All stakeholders should be actively involved in increasing the uptake of the COVID-19 vaccine and thereby reducing the consequences of COVID-19. The acceptance of the COVID-19 vaccination can be increased by using this conclusion as an indicator for governments, healthcare professionals, and health policymakers in their work on attitude, knowledge, government trust, and COVID-19 testing.

Pneumonia among Under-Five Children in Northwest Ethiopia: Prevalence and Predictors-A Community-Based Cross-Sectional Study.

BACKGROUND: Acute respiratory infections in particular pneumonia constitutes the leading cause of morbidity and mortality among children under five years of age throughout the world. In Ethiopia, pneumonia continues to be the major childhood problem and killer, particularly in the study area. However, evidence dealing with the problem is still unavailable. The current study is aimed at determining the magnitude and risk factors of childhood pneumonia in Gondar City. METHODS: A community-based cross-sectional study was employed in five randomly selected clusters/subcities of Gondar City. A total of 792 child-mother/caregiver pairs in the selected subcities/clusters were included. A pretested and validated questionnaire was used by trained supervisors through house-to-house visits to collect the data. Binary logistic regression (bivariable and multivariable) was employed. An adjusted odds ratio with 95% confidence interval was used to declare statistically significant variables on the basis of p < 0.05 in the multivariable logistic regression model. RESULTS: The prevalence of pneumonia among under-five children in the current study was found to be 12% with 95% CI: 10% to 14.4%. The presence of unpaved road within 100 m of the house (AOR = 2.27, 95% CI: 1.41-3.66), living within 100 m of heavy traffic (AOR = 1.94, 95% CI: 1.19-3.16), the habit of not opening doors while cooking (AOR = 1.62, 95% CI: 1.01-2.62), the presence of cockroach infestation (AOR = 1.98, 95% CI: 1.25-3.14), and new carpet in the house (AOR = 1.75, 95% CI: 1.01-3.03) were statistically significant variables associated with childhood pneumonia. CONCLUSIONS: This study indicated that the prevalence of childhood pneumonia is still high. As such, enhancing strategies that would address unpaved roads within 100 m of the house, living within 100 m of heavy traffic, the habit of not opening doors while cooking, cockroach infestation, and new carpet in the house to reduce the burden of childhood pneumonia needs to be advocated.