Maternal dietary diversity increases with women's high decision-making autonomy in Northwest Ethiopia, 2022.

Background: Dietary diversification is one of several approaches for improving micronutrient levels in women of reproductive age. Therefore, this study aimed to assess the magnitude of minimum dietary diversity among pregnant women, explore the association between women's decision-making autonomy and dietary diversity, and identify other potential determinants of dietary diversity in Northwest Ethiopia. Method: A community-based cross-sectional study of 621 pregnant women was conducted from November 2022 to December 2022. A cluster random sampling technique was employed. A binary logistic regression model was used to explore the association between dietary diversity and women's decision-making autonomy. Adjusted odds ratios with 95 % CIs were estimated to identify factors associated with the dietary diversity of pregnant women, and they were considered to be statistically significant at a P-value <0.05. Results: The minimum dietary diversity among pregnant women was 22.4 %. The study revealed a significant association between dietary diversity and women's decision-making autonomy (AOR: 2.82, 95 % CI: 1.73, 4.59; p value: 0.001). Primary education and above (AOR = 4.0, CI: 2.1, 7.67), monthly income 1000-2000 ETB (AOR = 4.46, CI: 2.53, 7.87) and >2000 ETB (AOR = 6.05, CI: 3.16, 11.59), having nutritional information (AOR = 2.15, CI: 1.32, 3.51), being food secure (AOR = 2.63, CI:1.6, 4.34), morbidity status (AOR: 0.278, CI: 0.14, 0.56), ANC visits one time (AOR = 2.08, CI = 1.003, 4.33) and two or three times (AOR = 2.45, CI: 1.15, 5.24) were potential predictors of pregnant women's dietary diversity. Conclusion: Maternal dietary diversity was significantly associated with women's decision-making autonomy. Thus, the government should strengthen women's empowerment, rights, access to education, and economic opportunities.

Association between social supports and depression among patients with diabetes mellitus in Ethiopia: a systematic review and meta-analysis.

OBJECTIVE: The adverse effects of poor social support on quality of life and adherence to treatment are established. However, the relationship between social support and depression is not well understood. In this systematic review and meta-analysis, we aim to examine the association between social support and depressive symptoms among type 2 patients with diabetes. DESIGN: Systematic review and meta-analysis. DATA SOURCES: We searched PubMed, African Journals Online, Web of Science, and the Cochrane Library electronic databases. Some studies were also identified through manual Google search and Google scholar. ELIGIBILITY CRITERIA: We systematically searched electronic databases for studies published up to October 2020. Only English-language articles were included. DATA EXTRACTION AND SYNTHESIS: Screening, data extraction and quality appraisal were conducted by two independent reviewers. A random-effect model was applied to estimate ORs with 95% CIs. The Higgins I2 test was used to assess the heterogeneity between the studies. The risk of publication bias was estimated using the Egger test. Leave-one-out analysis was done. Data were analysed using Stata V.11. RESULTS: Seven studies were included in the meta-analysis. The findings from included studies revealed that poor social support increases the odds of depression among patients with diabetes (adjusted OR=2.14, 95% CI 1.34 to 3.43, p=0.003). There was no risk of publication bias (p=0.064), and heterogeneity was substantial (I2=70.7%). The leave-one-out analysis confirmed the consistency of the findings. CONCLUSIONS: Our meta-analysis revealed that patients who had poor social support were significantly associated with an increased level of depression. Additional studies exploring factors that might moderate or mediate this association are needed. Targeted interventions for comorbid depression should be implemented in clinical practice. SYSTEMATIC REVIEW REGISTRATION: We have submitted the protocol for registration at the PROSPERO on 9 October 2020. But we have not yet received a registration number.

Effect of alcohol consumption on haemoglobin level among non-pregnant reproductive age women in Ethiopia: a cross-sectional secondary data analysis of the 2016 Ethiopian Demographic Health Survey.

OBJECTIVE: The aim of this study was to assess the effect of alcohol consumption on haemoglobin levels among non-pregnant reproductive age women using national representative data. METHOD: A secondary data analysis was conducted using data from the 2016 Ethiopia Demographic and Health Survey. The main outcome of interest was anaemia defined as a haemoglobin value <12 g/which was measured using HemoCue, and adjusted for both altitude and smoking status. The main exposure variable was alcohol consumption. Both multivariable logistic regression and generalised linear model were employed to assess the association between alcohol consumption and anaemia and to compare the mean of haemoglobin between the non-drinkers and three alcohol consumption frequency categories, respectively, after adjusting for the potential confounders. RESULT: In the current analysis, a total of 13 436 non-pregnant women were included. The overall prevalence of anaemia among non-pregnant women was 23.2% of which 17.9% were mildly anaemic, 4.6% were moderately anaemic and 0.7% were severely anaemic. There was a significant negative association between anaemia and respondents' history and frequency of alcohol consumption in the pooled sample. Among non-pregnant women, the odds of having anaemia were decreased with a history of alcohol drinking (adjusted OR (AOR)=0.32 (95% CI: 0.214 to 0.394)). Women who drunk alcohol less than once a week ((AOR=0.54 (95% CI: 0.31 to 0.94), those who drunk alcohol at least once a week (AOR=0.50 (95% CI: 0.28 to 0.88)) and who drunk alcohol almost every day in the last 12 months (AOR=0.42 (95% CI: 0.21 to 0.81)) had significantly lower odds of having anaemia than women who had not ever taken a drink that contain alcohol. CONCLUSION: This study showed that nearly a quarter of non-pregnant women in Ethiopia were found to be anaemic. Alcohol consumption increases haemoglobin concentration. Further cohort or experimental studies are therefore needed to further assess the relationship between alcohol consumption and haemoglobin level among Ethiopian populations.

Abusive maternal care and associated factors during childbirth in Northeast Ethiopia.

This study aimed to assess the abusive maternal care and associated factors during childbirth in North Wollo Hospitals, Northeast Ethiopia. The institutional-based cross-sectional study design was implemented with a sample size of 394. Stratified systematic random sampling was applied to select the study participants. The study population was women who gave birth in selected hospitals in the study period. Women with postpartum psychiatric problems and women who were referred for complications management after they gave birth in the other health institution were excluded. Data was collected by using a structured questionnaire adapted from the White Ribbon Alliance Declaration on on women's rights during childbirth. Data were entered by EPI- data version 3.1 and analyzed by SPSS version 23. The magnitude of abusive care among childbearing women was 47.1%. Women who attended their childbirth at general hospital (AOR =0.13, 95% CI: 0.06, 0.26), women who had no antenatal care (AOR =2.08, 95% CI: 1.27, 3.39), and women who had two birth attendants (AOR =0.56, 95% CI: 0.35, 0.92) were significant association with abusive maternal care. The level of abusive maternal care in health institutions is high as compared to national and international standards. Women who attended their childbirth at a general hospital, having antenatal care and the number of birth attendants were significant factors. Interventions should focus on increasing pregnant women's ANC follow-up. The health institutions also better increase the number of skilled birth attendants to address women's concerns during childbirth.

Effect of HIV-related knowledge on utilisation of voluntary HIV testing service among university students in Sub-Saharan Africa: a systematic review and meta-analysis protocol.

INTRODUCTION: Voluntary HIV testing is a vital preventive measure to reduce HIV transmission. Existing evidence on the association between HIV-related knowledge and HIV testing service utilisation shows inconsistent findings. Therefore, the aim of this review is to assess whether knowledge of HIV is related to improvement in voluntary HIV testing service utilisation among university students in Sub-Saharan Africa. METHODS AND ANALYSIS: A systematic review of studies on the association of HIV-related knowledge and voluntary HIV testing service utilisation among university students will be conducted. We will search several electronic databases, including PubMed/MEDLINE, African Journals Online, Web of Science and Cochrane Library, for all study types looking at the association between HIV-related knowledge and voluntary HIV testing service utilisation. Two reviewers will independently screen all retrieved records and full-text articles and extract data. The Higgins I2 test will be used to assess heterogeneity between studies. Random-effects meta-analysis will be conducted, if feasible and appropriate. Additional analyses will be performed to explore potential sources of heterogeneity. Stata statistical software (V.14) will be used to analyse the data. ETHICS AND DISSEMINATION: Formal ethical approval is not required because the systematic review relies on primary studies. The results will be disseminated through a peer-reviewed publication, conference presentation and the popular press.

Effect of overweight/obesity on caesarean section occurrence among reproductive-aged women in Ethiopia: a secondary data analysis.

BACKGROUND: The burden of overweight/obesity increased worldwide and it has unpredictable effect on maternal morbidity and mortality. Different adverse perinatal outcomes observed in overweight/obese women, of those caesarean section occurred frequently. In Ethiopia, the national caesarean section and overweight/obesity rate among reproductive-aged women increased tremendously. Therefore, we intend to assess the association between overweight/obesity with caesarean section in Ethiopia. METHOD: The data were extracted from the 2016 Ethiopia Demographic and Health Survey in nine regions and two city administrations. A stratified two-stage random sampling design was used to collect data. The exposure variable was overweight/obesity, and the outcome variable was a caesarean section. The final analytical sample consisted of 6928 participants. SPSS V.23 was used to analyse the data. Descriptive statistics and cross-tabulation were performed to describe the study variables. Univariable and multivariable logistic regression models were regressed. RESULTS: The prevalence of caesarean section among women aged between 15-49 years old who gave birth in the last 5 years was 245 (3.54%). The occurrence of caesarean section among overweight/obese women was 2.05 higher as compared with normal-weight women (AOR: 2.05, 95% CI: 1.09 - 3.83). CONCLUSION AND RECOMMENDATION: Promoting weight reduction programmes throughout the country would have a greater contribution to reduce caesarean section rate and health cost, and to improve the health of the mother.

Factors associated with dietary diversity among adolescents in Woldia, Northeast Ethiopia.

BACKGROUND: Consuming diversified food during the adolescent period is essential to build a healthy and active mind for their later life. Food prices increased in the local market due to fewer production of crops. Thus, exploring the dietary diversity of adolescents in this area is crucial to estimate diet quality. So the aim of the study was to identify determinant factors of dietary diversity. METHODS: An institution-based cross-sectional study was conducted among adolescent students in Woldia town. A total of four hundred eleven students were included in the study. A simple random sampling technique was used to select the participants. The outcome variable was dietary diversity; it was calculated by summing of the number of food group consumed by individuals in the given reference period. Bivariable and multivariable logistic analysis was done. The odds ratio with a 95% confidence interval was computed to measure an association. A variable with a P-value less than 0.05 is considered a significant factor. RESULTS: The proportion of inadequate dietary diversity was 49.1% (95% CI 44.5-53.8). Being female (AOR =5.53, 95% CI 3.447-8.859), secondary and above mothers' education level (AOR=0. 27, 95%CI 0.153-0.477), living in a family size five and above (AOR= 2.09, 95CI% 1.31-3.34), and poor knowledge about nutrition (AOR=4.56, 95% CI 2.727-7.639) were significantly associated with inadequate dietary diversity. CONCLUSIONS AND RECOMMENDATIONS: Inadequate dietary diversity was associated with sex, knowledge of nutrition, maternal education level, and family size. It is better to design a nutrition intervention program that focus on nutrition education to scale up diversified food consumption among adolescents.

A five-year trend in pre-eclampsia admission and factors associated with inpatient eclampsia: a retrospective study from a resource-limited hospital in northeast Ethiopia.

OBJECTIVE: To investigate the 5-year trend of pre-eclampsia admission, magnitude and factor associated with inpatient eclampsia among deliveries involving pre-eclampsia which have been attended at one of the resource-limited public hospitals in northeast Ethiopia. DESIGN: Retrospective medical record review study. SETTING: Woldia General Hospital Medical archive, Woldia town, Ethiopia. PARTICIPANTS: All antenatal admission and deliveries involving pre-eclampsia attended from 2011 to 2016 at the hospital were included in the review. PRIMARY AND SECONDARY OUTCOME MEASURES: Trend of pre-eclampsia admission was determined using non-parametric Mann-Kendall correlation. Case management, clinical and patient-related factors were tested for possible association with the development of inpatient eclampsia using binary logistic regression. P value less than 0.05 considered significant. RESULT: Across the 5-year period, there were 8764 deliveries attended at the hospital's labour and delivery ward, of them 241 (2.76%) were co-diagnosed with pre-eclampsia. The trend showed marginal decrement through years (tau-b correlation coefficient (Tb)=-0.4, p=0.035) with the highest caseload (4.4%) observed on year 2013/2014. The rate of inpatient eclampsia was 19.6 per 10 000 births and the likelihood of its occurrence among pre-eclamptic women was 7.1% (95% CI 2.7% to 11.5%). In multivariate analysis, being multigravida (adjusted OR (AOR) 0.154, 95% CI 0.029 to 0.831) and spontaneous onset of labour (AOR 5.628, 95% CI 1.1247 to 9.401) were associated with inpatient eclampsia. CONCLUSION: In the study setting, the overall magnitude of pre-eclampsia admission was comparable with the global average, but its yearly trend showed marginal decrement from 2011 to 2016. High rate of inpatient eclampsia might indicate undertreatment which alarms further study and/or corrective measures. Waiting for spontaneous onset of labour could increase the risk of developing inpatient eclampsia whereas neither type of anticonvulsant nor duration of its usage has made significant association.

Exclusive breastfeeding practice and its associated factors among children aged 6-23 months in Woldia Town, Northwest Ethiopia.

Background: Inappropriate practice of exclusive breastfeeding (EBF) is still a major problem worldwide. Objective: To identify exclusive breastfeeding practice and its associated factors among children aged 6-23 months in Woldia Town. Methods: A Community based cross-sectional study was carried out.Interviewer-administered questionnaire was utilized to collect the data. The questionnaire was adapted from the 2016 Ethiopia Demographic and Health Survey. Hosmer-Lemeshow model was fitted at a P-value of 0.91. Finally, Variables having P-Value <0.05 with 95% CI was considered as significant factors. Result: The prevalence of exclusive breastfeeding practice was 46.2% (95% CI: 42.0, 49.8). Being employed mothers (AOR=0.62,95% CI:0.44,0.87), being head of a household (AOR=0.52,95% CI:0.32,0.83), not g getting husband support (AOR:0.5,95%CI:0.34,0.74), not fed colostrum's (AOR:0.36,95%CI:0.23,0.57), not affected by traditional belief (AOR:3.59, 95% CI:2.09-6.17) shows significant association with Exclusive breast feeding practice. Conclusion: The prevalence of exclusive breast feeding practice was relatively lower than the National prevalence. Some demographic variable and traditional beliefs were significantly associated with exclusive breast feeding. Designing model policies that empower the role of women and eradicating bad traditional beliefs in the community is fundamental step.

The association between combined oral contraceptive use and overweight/obesity: a secondary data analysis of the 2016 Ethiopia Demographic and Health Survey.

OBJECTIVES: In this study, we aimed to assess the association between combined oral contraceptive (OC) use and overweight/obesity among Ethiopian adult women of reproductive age. DESIGN, SETTING AND PARTICIPANTS: The data were extracted from the 2016 Ethiopia Demographic and Health Survey; these data were collected from nine regions and two city administrations. We analysed the data from a total of 11 018 women aged 18-49 years who met eligibility criteria. MAIN OUTCOME MEASURES: We employed WHO criteria to classify the body mass index of women. Specifically we tested the association between combined OC utilisation with overweight/obesity after controlling for confounding variables. RESULT: The prevalence of combined OC utilisation was 1.7% and the prevalence of overweight/obesity was 8.6% among adult women of reproductive age. Use of combined OC increases the odds of overweight/obesity by two times among adult women of reproductive age after controlling for potential confounders (adjusted OR=1.902 (1.064-3.399)). CONCLUSION: In conclusion there is significant association between combined OC use and overweight/obesity. The findings have important implications for policymakers to design evidence based policy approachs to obesity prevention for women and at large for government to recognise the negative consequences of combined OC on women health.

Epidemiology of HIV Infection in the Amhara Region of Ethiopia, 2015 to 2018 Surveillance Data Analysis.

BACKGROUND: Globally, over 37.9 million people are living with HIV in 2018 and sub-Saharan Africa carries 71% of the global HIV epidemics. In Ethiopia, there were an estimated 613,000 HIV cases in 2017. This study aimed to assess the trend of HIV incidence in the Amhara Region, Ethiopia. METHODS: A retrospective descriptive study was conducted using routine HIV data from 2015 to 2018. We extracted HIV records from the Amhara Regional Health Bureau database. Data confidentiality was secured through data anonymity. Data were entered, cleaned and analyzed by IBM SPSS version 22 (Armonk, NY, USA). Various descriptive statistics such as counts, proportions and trends were computed to see the magnitude of HIV in the study area. RESULTS: A total of 57,293 new HIV cases were reported from 2015 to 2018 and 33,720 (59%) were females. The majority, 40,054 (70%), of HIV cases were among people in 25-49 years. The overall incidence rate of HIV from 2015 to 2018 was 6.9 per 1000 population. The annual HIV incidence rates were 7.3. 6.3, 7.4 and 6.63 per 1000 population in 2015, 2016, 2017 and 2018, respectively. The incidence rate per 1000 population was high in Dessie town (5.74), Bahir Dar city (4.27) and Gondar town (3.00). About 49,564 (86.5%) of HIV cases have started ART and 33% of them had TB infection where 54% of them were females. Only 14869 (30%) people on ART had normal nutritional status. CONCLUSION: HIV remains a public health concern in the Amhara Region and the burden varied by place, time, gender and age groups. Improving awareness creation and community mobilization, managing TB infection and undernutrition problems, and making HIV screening services available in all healthcare facilities are crucial to decrease HIV infection. Special attention is also required to avoid risk factors that increased HIV incidence among females.

Epidemiology, Predisposing Factors, Biomarkers, and Prevention Mechanism of Obesity: A Systematic Review.

Background. Globally, obesity is becoming a public health problem in the general population. Various determinants were reported by different scholars even though there are inconsistencies. Different biomarkers of obesity were identified for the prediction of obesity. Even though researchers speculate the factors, biomarkers, consequences, and prevention mechanisms, there is a lack of aggregate and purified data in the area of obesity. Summary. In this review, the epidemiology, predisposing factors, biomarkers, consequences, and prevention approaches of obesity were reviewed. Key Messages. The epidemiology of obesity increased in low-, middle-, and high-income countries. Even if the factors vary across regions and socioeconomic levels, sociodemographic, behavioral, and genetic factors were prominent for the development of obesity. There are a lot of biomarkers for obesity, of which microRNA, adipocytes, oxidative stress, blood cell profile, nutrients, and microbiota were promising biomarkers for determination of occurrence of obesity. Since the consequences of obesity are vast and interrelated, multidimensional prevention strategy is mandatory in all nations.

Epidemiology and determinant factors of neural tube defect: Narrative review.

BACKGROUND: The epidemiology of neural tube defect (NTD) is face ignorance from the global community. However, the problem is complex and it is a cause for child mortality and morbidity. We provide the latest insights with respect to determinant factors of NTD. METHODS: Google Scholar and PubMed were systematically searched to identify potential research articles concerning the epidemiology and its determinant factors of NTD. RESULTS: The epidemiology of Neural tube defects increased in some countries. The epidemiology and determinant factors were varies across countries,geographical regions and socioeconomic status of the populations. In general, the determinant factors of NTD were summarized as behavioral, nutrition-related, environmental, medical illness, and health service-related factors. CONCLUSION: Birth defect is fatal which affects the new generation; specifically, NTD is the problem of middle- and low-income countries. It is a direct cause for neonatal and perinatal mortality rate globally. Even if little factors identified, yet conducting experimental and clinical trial researches are a better approach to slow down the progress.

Determinants of scabies outbreak in Takusa district of Amhara Region, Northwest Ethiopia.

BACKGROUND: Human scabies is a highly contagious human dermatitis disease. As indicated by the national and regional reports, the epidemic of scabies became a major public health problem in Ethiopia since 2015. OBJECTIVE: To identify the determinant factors of scabies outbreak in Takusa district, Northwest Ethiopia, 2017. METHODS: A community based unmatched case-control study among 188 participants (63 cases and 125 controls) was conducted in Takusa district from September to October 2017. Data were collected using a pretested structured questionnaire. Multivariable logistic regression analysis was computed using SPSS version 22 to identify factors associated with scabies. Odds ratio at 95% CI and p-value less than 0.05 were used to describe the strength of the association and statistical significance. RESULTS: The median age of cases was 20 years (ranges1-61). Presence of person with itching in the family (AOR=7.7, 95% CI:1.9-30.5), sleeping with scabies patient (AOR=3.99, 95% CI:1.37-11.7), travel to scabies epidemic area in the last six weeks (AOR=3.79, 95%CI:1.28-11.1) and infrequent use of detergent for showering (AOR=4.85; 95% CI: 1.3-17.9)) were found to be determinant factors of scabies outbreak. CONCLUSION: Frequent contact with people who develop scabies at home, not using detergents for washing, and mobility of people from non-epidemic to the epidemic areas were determinant factors. Giving special emphasis on regular awareness creation to the rural community is important to prevent scabies outbreak.