Determinants of Health Care Providers' Attitudes Toward Safe Abortion Care in Ethiopia: A Systematic Review and Meta-Analysis.

Background: Unsafe abortion is a serious reproductive health problem in developing countries including Ethiopia. The attitude of healthcare providers toward abortion is one of contributing factors to unsafe abortion. This study aimed to determine the pooled effect of healthcare workers' attitudes toward safe abortion care and its determinants factors in Ethiopia. Methods: Search engines such as Scopus, CINAHL, EMBASE, PubMed, Web of Science, and CAB Abstracts were used to find published studies where as Google and Google Scholar were used to find unpublished research. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used. The analysis was performed using STATA 14 and the random-effects model was used to calculate the odds ratios of medical professionals' attitudes regarding safe abortion services. Study heterogeneity was assessed by using I2 and P-values. To evaluate the stability of pooled values to outliers and publication bias, respectively, sensitivity analysis and funnel plot were also performed. Results: A total of 15 published and unpublished articles with a sample size of 4060 were incorporated in this Review. The overall pooled prevalence of this study was 56% (95% CI: 45-67). Sex of participants (AOR: 2.37; 95% CI: 1.57, 3.58), having training (AOR: 2.86; 95% CI: 1.58, 5.17), Professional type (AOR: 1.55; 95% CI: 1.04, 4.46), and knowledge of abortion law (AOR:2.26; 95% CI: 1.14, 4.46) were the determinants factors that significantly associated with health care workers' attitude toward safe abortion care. Sensitivity analysis shows that the pooled odds ratios were consistently stable throughout all meta-analyses, and the funnel plot shows no evidence of publication bias. Conclusion: Half of health care providers sampled among the pooled studies have favorable attitudes toward abortion services in Ethiopia; which could hamper women's access to safe abortion care. Sex, training, type of profession, and knowing abortion law were determinants of health care workers' attitudes toward safe abortion services. Stakeholders should emphasize improving the attitude of healthcare workers toward safe abortion care which has a vital role in reducing maternal mortality. Moreover, working on modifiable factors like training, assigning personnel whose professions align with the service, and updating care providers about abortion law is also the essential key point to improve their intentions to deliver the services.

Insecticide-treated net utilization and associated factors among pregnant women in Ethiopia: a systematic review and meta-analysis.

Background: Malaria is a major public health problem in many developing countries, particularly in sub-Saharan Africa. The pregnant woman, fetus, and newborn infant are all at risk from malaria during pregnancy. Hence, insecticide-treated bed net (ITN) use is the most effective and advisable method for preventing malaria during pregnancy. Studies on the prevalence of ITN utilization among pregnant women in Ethiopia are inconsistently reported and highly varied. Therefore, this systematic review and meta-analysis aimed to estimate the pooled prevalence of ITN utilization and associated factors among pregnant women in Ethiopia. Methods: A comprehensive search of databases such as PubMed, CINAHL, Web of Science, SCOPUS, Science Direct, Google, and Google Scholar was performed to find studies conducted in Ethiopia. All original observational studies that reported the prevalence of ITN utilization were identified and screened. The Newcastle-Ottawa scale tool was used to assess the quality of the studies. Data were extracted in Microsoft Excel 2010 format and analyzed using STATA Version 14. A random-effect meta-analysis model was utilized to estimate the pooled prevalence of ITN utilization. The statistical heterogeneity was checked using the I2 test and subgroup analysis. The publication bias was assessed using funnel plots and Egger's regression test. The size of the pooled effect of the factors influencing the use of ITNs was estimated using an odds ratio (OR) with a 95% confidence interval (CI), and a P-value <0.05 was considered statistically significant. Results: Twenty-nine cross-sectional studies with 13,957 study participants were included in this meta-analysis. The overall pooled prevalence of ITN utilization among pregnant women in Ethiopia was 51% (95% CI: 43-60). A statistically significant heterogeneity was observed across studies (I2 = 99.09%; P < 0.001). Being literate [OR = 2.93 (95% CI: 2.14-4.01)], rural residence [OR = 1.76 (95% CI: 1.37-2.26)], and having knowledge of ITN [OR = 4.13 (95% CI: 1.57-10.81)] were factors significantly associated with ITN utilization among pregnant women. Conclusion: The utilization of ITNs among pregnant women was substantially lower than the national target, alarmingly highlighting the need for urgent and effective interventions. Maternal education status, place of residence, and knowledge of ITNs were independent predictors of ITN utilization. Health policymakers and programmers should design and implement the most effective strategies to scale up the utilization of ITNs by pregnant women and reduce malaria-related morbidity during pregnancy. Systematic Review Registration: CRD42022304432.

Undernutrition and associated factors among adult prisoners in Fiche town, central Ethiopia: a facility-based cross-sectional study.

Background: Undernutrition is a major public health problem worldwide, particularly in developing countries like Ethiopia. However, nutritional problems are frequently overlooked in low-income countries, especially among vulnerable populations such as imprisoned people. The scientific data on the rate of undernutrition among imprisoned people in Ethiopia is limited. Hence, this study aimed to assess the magnitude and associated factors of undernutrition among adult prisoners in Fiche town, central Ethiopia. Methods: A facility-based cross-sectional study was conducted from August 15 to September 15, 2020. A systematic random sampling technique was used to select participants. All prisoners whose age was 18 years and above who have been in prison for at least 6 months were included. Data were collected using interviewer-administered pretested semi-structured questionnaires and standard anthropometric measurements. A cut-off point of body mass index <18.5 kg/m2 was used to measure undernutrition. Data were coded, entered into Epi-data version 3.1, and analyzed using Statistical Package for Social Sciences version 20.0. A binary logistic regression analysis was conducted to identify factors associated with undernutrition. The adjusted odds ratio (AOR) with a 95% confidence interval (CI) was calculated to measure the strength of the association and a p-value of less than 0.05 was considered statistically significant. Results: The overall magnitude of undernutrition among adult prisoners was 20% (95% CI: 16.5-23.6). Duration of imprisonment, incarcerated for 25 to 59 months (AOR = 3.07; 95% CI: 1.33, 7.04) and for greater than 59 months (AOR = 4.56; 95% CI: 2.0, 10.45), mild and moderate depression (AOR = 1.9; 95% CI: 1.05, 3.45), and moderately severe and severe depression (AOR = 2.78; 95% CI: 1.17, 6.60) were significantly associated with increased odds of undernutrition. However, being female (AOR = 0.51; 95% CI: 0.26, 0.98), having financial support (AOR = 0.36; 95% CI: 0.15, 0.87), engaging in income-generating work within the prison (AOR = 0.27; 95% CI: 0.15, 0.47), having medium dietary diversity (AOR = 0.35; 95% CI: 0.15, 0.80), and having good dietary diversity (AOR = 0.23; 95% CI: 0.08, 0.61) significantly decreased the odds of undernutrition. Conclusion: The magnitude of undernutrition among adult prisoners was high, with one in five prisoners in Fiche town prison having undernutrition. Sex, financial support, duration of imprisonment, income-generating work in the prison, dietary diversity, and depression were predictors of undernutrition. Hence, access to healthy food and diversified diets should be ensured for prisoners, and implementing early screening and treatment of depression, as well as encouraging prisoners to engage in income-generating work within the prison is recommended to reduce the burden of undernutrition.

Relapse of acute malnutrition and associated factors after discharge from nutrition stabilization centers among children in Eastern Ethiopia.

Background: Acute malnutrition is a major global health problem primarily affecting under-five children. In sub-Saharan Africa, children treated for severe acute malnutrition (SAM) at an inpatient have high case fatality rate and is associated with relapse of acute malnutrition after discharge from inpatient treatment programs. However, there is limited data on the rate of relapse of acute malnutrition in children after discharge from stabilization centers in Ethiopia. Hence, this study aimed to assess the magnitude and predictors of relapse of acute malnutrition among children aged 6-59 months discharged from stabilization centers in Habro Woreda, Eastern Ethiopia. Methods: A cross-sectional study was conducted among under-five children to determine the rate and predictors of relapse of acute malnutrition. A simple random sampling method was used to select participants. All randomly selected children aged 6-59 months discharged from stabilization centers between June 2019 and May 2020 were included. Data were collected using pretested semi-structured questionnaires and standard anthropometric measurements. The anthropometric measurements were used to determine relapse of acute malnutrition. Binary logistic regression analysis was used to identify factors associated with relapse of acute malnutrition. An odds ratio with 95% CI was used to estimate the strength of the association and a p-value less than 0.05 was considered statistically significant. Results: A total of 213 children with mothers/caregivers were included in the study. The mean age in months of children was 33.9 ± 11.4. More than half (50.7%) of the children were male. The mean duration of children after discharge was 10.9 (± 3.0 SD) months. The magnitude of relapse of acute malnutrition after discharge from stabilization centers was 36.2% (95% CI: 29.6,42.6). Several determinant factors were identified for relapse of acute malnutrition. Mid-upper arm circumference less than 110 mm at admission (AOR = 2.80; 95% CI: 1.05,7.92), absence of latrine (AOR = 2.50, 95% CI: 1.09,5.65), absence of follow-up visits after discharge (AOR = 2.81, 95% CI: 1.15,7.22), not received vitamin A supplementation in the past 6 months (AOR = 3.40, 95% CI: 1.40,8.09), household food insecurity (AOR = 4.51, 95% CI: 1.40,15.06), poor dietary diversity (AOR = 3.10, 95% CI: 1.31,7.33), and poor wealth index (AOR = 3.90, 95% CI: 1.23,12.43) were significant predictors of relapse of acute malnutrition. Conclusion: The study revealed very high magnitude of relapse of acute malnutrition after discharge from nutrition stabilization centers. One in three children developed relapse after discharge in Habro Woreda. Programmers working on nutrition should design interventions that focus on improving household food insecurity through strengthened public Safety Net programs and emphasis should be given to nutrition counseling and education, as well as to continuous follow-up and periodic monitoring, especially during the first 6 months of discharge, to reduce relapse of acute malnutrition.

Use of tranexamic acid in decreasing blood loss during and after delivery among women in Africa: a systematic review and meta-analysis.

BACKGROUND: Africa is a developing continent with a high maternal mortality rate. It is beneficial to implement interventions that alleviate the problem. As a result, this systematic review and meta-analysis was carried out to summarize evidence that will assist concerned bodies in proposing strategies to reduce maternal mortality due to post-partum hemorrhage. METHODS: This systematic review and meta-analysis includes randomized control trials (RCT) studies searched from various databases (PubMed, Web of Sciences, SCOPUS, African Journal Online, Clinical trials, and African indexes Medics). Data synthesis and statistical analysis were conducted using a combination of review manager 5.3 and STATA Version 14 software. The effect measure utilized was the standardized mean difference for estimated mean blood loss and mean hemoglobin level. RESULTS: This systematic review and meta-analysis includes a total of 3308 women. The pooled standardized mean difference showed that tranexamic acid statistical significantly reduced the estimated amount of blood loss after vaginal delivery (standardized mean difference with 95% CI - 0.93 [- 1.45, - 0.41]) and during and after cesarean delivery (standardized mean difference with 95% CI - 1.93 [- 2.40, - 1.47]). CONCLUSION: Tranexamic acid has been found to be a good choice for reducing blood loss during and after delivery in Africa regardless of the mode of delivery. Tranexamic acid had no effect on hemoglobin levels before and after delivery. To reduce maternal mortality due to post-partum hemorrhage, it is critical to implement and strengthen interventions aimed at increasing tranexamic acid uptake in Africa.

COVID-19 vaccine acceptance among pregnant women attending antenatal care in public hospitals in eastern Ethiopia: A multi-center facility-based cross-sectional study.

Objectives: The Ethiopian government had planned to vaccinate the total population and started to deliver the COVID-19 vaccine but, there is limited evidence about vaccine acceptance among pregnant women. Thus, this study aimed to assess COVID-19 vaccine acceptance and associated factors among pregnant women attending an antenatal care unit clinic in Eastern Ethiopia. Study design: A facility-based cross-sectional study. Methods: A study was conducted from June 01 to 30/2021 among systematically selected pregnant women. Data were collected using a pre-tested structured questionnaire, which was adapted from previous studies, through a face-to-face interview. Predictors were assessed using a multivariable logistic regression model and reported using an adjusted odds ratio with 95% CI. Statistical significance was declared at p-value less than 0.05. Results: In this study, data from 645 pregnant women were used in the analysis. Overall, 62.2% of pregnant women were willing to be vaccinated if the vaccine is approved by the relevant authority. Fear of side effects (62.04%), a lack of information (54.29%), and uncertainty about the vaccine's safety and efficacy (25%) were the most common reasons for refusal to take the COVID-19 vaccine. The odds of unwillingness to accept the COVID-19 vaccine among pregnant women were increased significantly among mothers who were able to read and write [AOR = 2.9, 95% CI: (1.16, 7.23)], attain 9-12 grade level [AOR = 4.2, 95% CI: (2.1, 8.5)], lack information [AOR = 2.2, 95% CI: (1.41, 3.57)], and having a history of chronic diseases [AOR = 2.52, 95% CI: (1.34, 4.7)]. Conclusion: Less than two-thirds of pregnant women were willing to accept the COVID-19 vaccine. Extensive public health information dissemination aimed at women with lower educational backgrounds and a history of chronic disease could be critical.

Nurses' Knowledge and Practicing Level of Cognitive Behavioral Pain Relief Methods in Public Hospitals of Eastern Ethiopia.

Introduction: Despite the fact that cognitive behavioral therapy is regarded as a superior pain relief method and an alternative to drug therapy, little is known about its scope of application and determinant factors. As a result, the study sought to assess nurses' knowledge and practicing level of cognitive behavioral pain relief methods in public hospitals in eastern Ethiopia. Objective: To assess the knowledge and practicing level of cognitive behavioral pain relief among nurses working in public hospitals of eastern Ethiopia. Methods: A cross-sectional study was conducted among randomly selected 390 nurses. The data were collected using a self-administered questionnaire. The data were entered into Epi-data 3.1 and exported to SPSS 22 for analysis. Bivariate and multivariate logistic regression models were used to identify factors associated with cognitive behavioral therapy. Result: In this study, more than half (54.1%) of the respondents had good cognitive behavioral methods practicing levels. Nearly two-thirds (58.8%) of the participants had adequate knowledge about pain relief methods. Having adequate knowledge (adjusted odds ratio [AOR] 2.664; 95% confidence interval [CI]: 1.75, 4.7), having training (AOR 1.7; 95% CI: 1.03, 3.01), and positive attitude (AOR 4.02; 95% CI: 4.5, 12.4) were significantly associated with cognitive behavioral therapy. Conclusion: In this study, more than half of nurses had good cognitive behavioral methods practicing levels. Having a positive attitude, being knowledgeable, and having training were determinant factors in the practice of cognitive behavioral therapy. Continuing education and training should be considered for nurses to enhance their cognitive behavioral therapy practice.

Prevalence, indications, and outcomes of operative vaginal deliveries among mothers who gave birth in Ethiopia: A systematic review and meta-analysis.

Background: Operative vaginal deliveries represent an alternative to address problems during the second stage of labor. Clinicians have access to two different instruments obstetrics forceps and vacuum which should be conducted with indication. Understanding the pooled prevalence of operative vaginal deliveries, its indications, and outcomes would help in adopting suitable measures to reduce operative vaginal deliveries-related maternal and neonatal complications. Therefore, this systematic review and meta-analysis aimed to determine the prevalence, indications, and outcomes of operative vaginal deliveries among mothers who gave birth in Ethiopia. Methods: A literature search was done through databases such as PubMed, SCOPUS, Web of Sciences, CAB Abstract, and CINHAL (EBSCO) to search studies that have been conducted in Ethiopia. Relevant sources were consulted to retrieve unpublished studies. Original observational studies that reported the prevalence, indication and outcomes of operative vaginal deliveries conducted in the English language were identified and screened. Studies were independently assessed for inclusion, data extraction, and risk of bias. Results: Twelve studies were reviewed. The overall pooled prevalence of operative vaginal delivery among mothers who gave birth in Ethiopia was 10% (95% CI: 8 to 13) with I 2 = 98.82% and a p-value ≤ 0.001. Fetal distress, prolonged labor, and maternal exhaustion were the most common feto-maternal indications of OVDs whereas; neonatal death, poor Apgar score, admission to neonatal intensive care unit, perianal tear, and postpartum hemorrhage were complications that occur following the operative vaginal deliveries in Ethiopia. Conclusion: This systematic review and meta-analysis showed one out of 10 mothers undergo operative vaginal deliveries. Almost all feto-maternal complications that arise following operative vaginal deliveries were preventable. Thus, concerned stakeholders should encourage quality OVDs practice by avoiding unnecessary indications and scaling up the skill of health professionals through special training. Systematic review registration: http://www.crd.york.ac.uk/PROSPERO/, identifier CRD42022311432.

Magnitude of episiotomy practice and associated factors among women who gave birth at Hiwot Fana Specialized University Hospital, Eastern Ethiopia.

Background: Episiotomy is an intentional surgical incision made on the perineum with the aim of enlarging the introits during the second stage of labor or just before delivery of the baby. It sometimes also interferes with the mother's comfort during the postpartum period and has associated complications especially when it is done without indication. However, there is limited information regarding episiotomy practice in the study area. Objective: This study aimed to determine the magnitude of episiotomy practice and associated factors among women who gave birth at the Hiwot Fana Specialized University Hospital, Eastern Ethiopia, 2021. Methods: A facility-based cross-sectional study was conducted among 408 systematically selected mothers who gave birth at the Hiwot Fana Specialized University Hospital, from 1 January to 30 December 2021. Datas were collected from delivery medical records using a pretested checklist. The extracted data were checked, coded, and entered into the Epi-data version 3.1 and exported to the STATA version 16 software for analysis. Binary logistic regression was fitted to identify factors associated with episiotomy practice. P-values < 0.05 were considered to declare the presence of statistical significance. Results: The overall prevalence of episiotomy practice was found to be 43.4 % (95% CI: 38.7, 48.9), and mediolateral was the most commonly practiced episiotomy type (41.4%). Parity [AOR: 6.2; 95% CI (3.8-17.6)], 1st min Apgar score [AOR: 1.6; 95% CI (1.04-2.67)], presence of maternal medical disease [AOR: 3.3; 95% CI (1.09-6.9)], and induced labor [AOR: 1.6; 95%CI (1.12, 4.13)] were significantly associated with the episiotomy practice. Conclusion: The prevalence of episiotomy practice in the study area was high. Parity, presence of maternal medical disease, induction of labor, and 1st min APGAR score were significant factors associated with episiotomy practice. Considering the presence of appropriate indications or preventing unjustifiable indications, can help to reduce the current high practice rates.

Magnitude of cesarean-section and associated factors among diabetic mothers in Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia: A cross-sectional study.

Background: Gestational diabetes is associated with multiple adverse pregnancy outcome as a result of unfavorable labor and delivery process with a consequent increase in obstetric interventions including cesarean-section. Even though diabetes mellitus increases the cesarean-section rate; there is no study conducted in Ethiopia. therefore, this study aimed to assess the magnitude of cesarean-section and associated factors among diabetic mothers in Tikur Ambessa Specialize Hospital, Addis Ababa, Ethiopia. Methods: A facility-based retrospective cross-sectional study was conducted in Tikur Anbessa Specialized Hospital from 1 February to 30 April 2018 among 346 diabetic mothers. All required data were extracted from patients' charts using checklists, and incomplete records were excluded. The collected data were entered into Epi data version 4.2 and exported to SPSS version 20 for analysis. Multiple logistic regression models were fitted to identify factors associated with cesarean section. Adjusted odds ratios along with 95% CI were estimated to measure the strength of the association and declared statistical significance at a p-value <0.05. Results: The magnitude of cesarean-section was 57.8% (95% CI: 51.7, 63.3). Pregnancy-induced hypertension [AOR: 3.35, (95% CI: (1.22, 9.20)], previous C/S [AOR: 1.62, (95% CI: (2.54, 4.83)], and fetal distress [AOR: 4.36, (95% CI: 1.30, 14.62)] were factors significantly associated with cesarean-section. Conclusion: A considerable number of diabetic mothers gave birth by cesarean-section. Pregnancy-induced hypertension, previous cesarean-section, and fetal distress were factors more likely to increase the rate of cesarean-section. Most of the factors were modifiable by following the WHO recommendation for cesarean-section.

Food handler's level of COVID-19 prevention practice and preparedness of food and drinking establishments to combat the pandemic in Eastern Ethiopia.

Background: Food and drinking establishments are potential hotspots for the spread of coronavirus. Food handler's have a higher risk of contracting the disease and transmitting it to others. The aim of this study was to assess the food handler's level of preventive practices toward COVID-19 and the preparedness of food and drinking establishments to tackle the pandemic in Eastern Ethiopia. Methods: The cross-sectional study design was conducted from September 1 to 30, 2020. A stratified sampling technique was used to select 276 licensed public food and drinking establishments and a simple random sampling technique was employed to select 422 food handlers from the selected establishments. A face-to-face interview and checklist-based observation were used to collect data. The collected data were entered into Epidata 3.1 and exported to STATA version 16 for analysis. Binary logistic regression analysis were conducted to identify factors associated with COVID-19 preventive practice. Statistical significance was declared at p < 0.05. Results: About 406 food handler's participated in this study, making the response rate 96.2%. The study showed that 38.4% of study participants (95% CI: 33.5, 43.1) had good preventive practices for COVID-19. Only 10.5% of food and drinking establishments fulfilled all requirements to prevent COVID-19 transmission. Being male [AOR = 0.61, 95% CI(0.61, (0.39, 0.93)], attending secondary education [AOR = 2.20, (95% CI: 1.37, 3.53)], having a favorable attitude toward COVID-19 [AOR = 1.89, (95% CI: 1.22, 2.95)], and having good knowledge about COVID-19 [AOR = 1.78, (95% CI: 1.13, 2.81)] were significantly associated with the level of COVID-19 preventive practices. Conclusion: The level of good COVID-19 preventive practice was found to be low among the food handler's. Only one in ten food and drink establishments fulfilled the national guideline for preventing COVID-19 transmission. Being male, attending secondary education, having knowledge about COVID-19, and having a favorable attitude toward COVID-19 were significantly associated with good COVID-19 preventive practices. A vibrant guideline on prevention practices should be in place at all establishments, and compliance should be monitored. Local health office experts should take comprehensive measures to make all food and drinking establishments accountable for practicing all preventive measures.

Utilization of Rehabilitation Services and Associated Factors Among Adults with Cancer Diagnoses at Hawassa Comprehensive Specialized Hospital, Ethiopia.

Background: Rehabilitation is a type of treatment that focuses on improving a person's physical, social, cognitive, and emotional functioning. Currently, there is a significant unmet need for rehabilitation. Despite the expansion of rehabilitation services in Ethiopia, little is known about its utilization and associated factors. Objective: This study aimed to assess the utilization of rehabilitation services and associated factors among adults with cancer diagnoses at Hawassa Comprehensive Specialized Hospital, Ethiopia. Methods: An institutional-based cross-sectional study was employed among 325 participants selected using a systematic sampling technique. Data were collected using a pre-tested, interviewer-administered questionnaire and a review of medical records. Participants were considered as utilized if they attended at least one cancer rehabilitation service at the hospital in the last 1 year. The data were entered into EpiData version 4.6 and exported to Statistical Package for Social Science Version 23 for analysis. Binary logistic regression analysis was used to identify factors associated with the utilization of rehabilitation services. Variables with a P-value of < 0.05 were considered statistically significant. Results: Utilization of rehabilitation service among adults with cancer diagnoses in the last 1 year were found to be 33.2% (95% CI; 27.93-41.25). Being male (AOR=5.76; 95% CI: 2.60, 12.75), urban residence (AOR=2.56; 95% CI: 1.04, 6.26), ability to perform the activity of daily living independently (AOR=2.68; 95% CI: 1.20, 6.00), receiving education on cancer rehabilitation services (AOR=2.44; 95% CI: 1.21, having strong social support (AOR=2.10; 95% CI: 1.02, 4.87), 4.91) and satisfaction with cancer care (AOR=3.21; 95% CI: 1.42, 5.76) were factors associated with the utilization of rehabilitation services. Conclusion: Only 33.2% of adults with cancer diagnoses at Hawassa Comprehensive Specialized Hospital utilized rehabilitation services. To improve the utilization of rehabilitation services, patients should receive adequate education on the benefits of rehabilitation.

Knowledge, practice and associated factors of nurses towards prevention of catheter-associated urinary tract infection in intensive care unit of public hospitals administered by Federal Government in Addis Ababa, Ethiopia: a cross-sectional institutional-based study.

BACKGROUND: Urinary catheterization is one of the most common procedures performed in hospitals specifically, in the intensive care units and is associated with a high risk for acquired urinary tract infections. More than 70% of acquired urinary tract infections are due to catheter use. Nurses are the primary healthcare providers responsible for inserting and maintaining urinary catheters. The data regarding nurses' knowledge, practice and associated factors towards prevention of catheter-associated urinary tract infections are limited in Ethiopia. Therefore, this study aimed to assess the knowledge, practice, and associated factors of nurses towards prevention of catheter-associated UTIs in the Intensive Care Unit (ICU) of public hospitals in Addis Ababa, Ethiopia. METHODS: An institutional-based descriptive cross-sectional study was conducted from March 01 to April 15, 2021, among nurses working in the ICU of public hospitals in Addis Ababa, Ethiopia. All 204 nurses working in the ICU of four public hospitals were included in the study using the census sampling method. Data were collected using a pretested self-administered semi-structured questionnaire. Data were cleaned and entered into Epi data version 4.6 and analyzed using Statistical Package for Social Sciences version 26.0. Pearson Chi-square and Fischer exact tests were performed to see the association between independent and dependent variables. The level of significance is considered at P-value less than 0.05. RESULTS: A total of 184 nurses participated in the study, making a response rate of 90.2%. The mean (±SD) age of the study participant was 29.07(±4.78). The study findings showed that more than half (63.04%) of nurses had poor knowledge and 88(47.83%) of nurses had poor practice towards prevention of catheter-associated UTIs. In this study, there was a statistically significant association between professional work experience and nurses' knowledge in preventing catheter-associated UTIs (at P-value = 0.031). CONCLUSION: In this study, nurses' knowledge and practice towards the prevention of catheter-associated urinary tract infection was relatively poor. Professional work experience had a significant statistical association with the level of knowledge. Therefore, increasing the knowledge of nurses through appropriate educational programs and training on the preventive measures of device-associated infections was recommended to prevent catheter-associated UTIs.

Prevalence of Group B Streptococcus Recto-Vaginal Colonization, Vertical Transmission, and Antibiotic Susceptibility Among Pregnant Women in Ethiopia: A Systematic Review and Meta-Analysis.

Background: Maternal Group B Streptococcus (GBS) recto-vaginal colonization is the most common route for early onset neonatal GBS diseases. A good understanding of the rate of maternal GBS colonization, vertical transmission rate, and antibiotic susceptibility profiles is needed to formulate a broad protection mechanism, like vaccine preparation. For that reason, this meta-analysis aimed at determining the pooled prevalence of GBS recto-vaginal colonization, vertical transmission rate, and antibiotic susceptibility profiles in Ethiopia. Methods: Both published and unpublished studies were searched from MEDLINE/PubMed, CINAHL (EBSCO), Embase, Cochrane Library, SCOPUS, Web of Sciences databases, and Google Scholar. Independent selection was then carried out by the authors based on the eligibility criteria and data extraction using Microsoft excel. The authors then used STATA version 14.1 software for further cleaning and analysis. The review was based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses) PRISMA guidelines. Using the random-effect model, the prevalence with a 95% confidence interval (CI) and forest plot were used to present the findings. Besides, the studies' heterogeneity was assessed using Cochrane chi-square (I2) statistics, while Egger intercept was used to assess publication bias. Results: This review included nineteen studies. The pooled prevalence of recto-vaginal colonization was 15% (95% CI: 11, 19), while the prevalence of vertical transmission was 51% (95% CI: 45, 58) and highest-level susceptibility to vancomycin was 99% (95% CI: 98, 100). However, the GBS susceptibility to tetracycline was 23% (95% CI: 9, 36). Conclusions: Nearly one out of seven pregnant women in Ethiopia had recto-vaginal colonization of GBS. As a result, half of the pregnancies end with vertical transmission of GBS. Hence, the review emphasizes that policy and programs should consider planning and implementing prophylactic programs. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021287540.

Magnitude of Anemia and Its Associated Factors Among Pregnant Women Attending Antenatal Care in Hiwot Fana Specialized University Hospital in Eastern Ethiopia.

Background: Anemia is a significant public health issue, accounting for 20-40% of maternal deaths. Despite the government's commitment and the interventions of various stakeholders, the magnitude and major risk factors of anemia remain unabated. Though there are few documented studies on anemia among pregnant women in eastern Ethiopia in general, in the study area in particular, some of the variables such as helminthics and history of caesarian section in relation to anemia need to be studied. As a result, the purpose of this study was to determine the magnitude of anemia and associated factors among pregnant women attending antenatal care in University Hospital in eastern Ethiopia. Methods: A facility-based cross-sectional study was conducted on a sample of 456 clients who were attending antenatal care in Hiwot Fana specialized university hospital from 01 to 30 June 2021. Systematic sampling was used to select the study participants. A pretested and structured interviewer-administered questionnaire and sample collection were used to collect the data. The data were coded, double-entered to Epi data version 3.1, cleaned, and exported to SPSS version 20 for analysis. Descriptive statistics were used to present frequency distributions. Variables with p-value < 0.25 during bivariate analysis were entered into the multivariate logistic regression models to control for all possible confounders to identify the factors associated with a magnitude of anemia. Odds ratio along with 95% CI were estimated to measure the strength of the association. The level of statistical significance was declared at a p-value of < 0.05. Result: A total of 456 participants were interviewed, with a response rate of 96.9%. The magnitude of anemia among pregnant women was 112 [(25.3%) 95%CI: (21.5-29.2%)], of which, 27 (6.10%), 36 (8.13%), and 49 (11.08%) had mild, moderate, and severe anemia, respectively. Birth interval < 2 years [AOR: 3.24, (95% CI: (1.88, 4.32)], number of children ≥2 [AOR: 2.54, (95% CI: (1.12, 4.64)], monthly income < 1,000 birr [AOR: 2.89, (95% CI: (1.31, 5.58)], third trimester pregnancy [AOR: 2.89, (95% CI: 4.86, 12.62)], and abnormal menstrual history [AOR: 2.28, (95% CI: (1.69, 5.24)] were the factors significantly associated with anemia. Conclusion: Anemia among pregnant women was relatively high compared to previous studies. Birth intervals, number of children, history of menstrual disorder, monthly income, and trimester of pregnancy were all significantly associated with anemia in pregnant women.

Poor adherence to highly active antiretroviral therapy and associated factors among people living with HIV in Eastern Ethiopia.

Objective: Sustained adherence to highly active antiretroviral therapy is necessary to suppress viral replication and improve immunological and clinical outcomes. Although different studies tried to identify factors affecting adherence to highly active antiretroviral therapy, there are few studies after initiation of test and start strategy and the first-line drug regimen change in the study area. Therefore, this study aimed to determine the level of adherence to highly active antiretroviral therapy and associated factors among people living with HIV in Eastern Ethiopia. Methods: Institutional-based cross-sectional study design was conducted from 2 March 2020, to 30 March 2020. A total of 501 study participants were recruited using systematic random sampling. Data were collected using face-to-face interviews at the end of the clinic visit and a review of participants' medical records. The level of adherence to highly active antiretroviral therapy was measured using the eight-item Morisky Medication Adherence Scale. The score ranges from 0 to 8, and a score of less than 8 indicates poor adherence. The data were entered into EpiData and exported to STATA for further analysis. The binary logistic regression analysis model was employed to identify associated factors. The association was reported with an adjusted odds ratio and a 95% confidence level. The significance level was declared at p = 0.05. Results: A total of 501 participants participated in the study, giving a response rate of 98.2%. The majority (314 or 62.7%) of study participants were females. The participants' mean (standard deviation) age was 38.17 (8.75). The level of poor adherence to highly active antiretroviral therapy was found to be 33.73% (confidence interval: 29.70, 38.00). Age category 35 to 44 (1.65 (confidence interval: 1.02, 2.69)), no shortage of highly active antiretroviral therapy (0.46 (confidence interval: 0.28, 0.75)), substance use (1.67 (confidence interval: 1.11, 2.25)), having moderate depressive symptoms (4.00 (confidence interval: 1.94, 8.48)), and moderate anxiety symptoms (5.22 (confidence interval: 2.31, 8.84)) were significantly associated with the poor adherence to highly active antiretroviral therapy among adult people living with HIV. Conclusion: The level of poor adherence to highly active antiretroviral therapy was found to be high in this study. Poor adherence to highly active antiretroviral therapy was significantly associated with age, availability of highly active antiretroviral therapy drugs, substance usage, depressive symptoms, and anxiety symptoms. Improving the adherence levels requires stringent counseling, assuring continuous drug availability, and timely screening and management of depression and anxiety.

Patients' perceptions of nurses' communication in public hospitals of Harari Regional State, Eastern Ethiopia.

Introduction: The quality of nursing care has been evaluated using patient perception. Patients' participation in nursing care and decision-making is regarded as a prerequisite for effective clinical practice; however, poor communication can lead to incorrect diagnosis and delayed, or ineffective medical treatment. Objectives: This study sought to assess admitted adult patients' perceptions of, and factors influencing, nurse communication at public hospitals in Harar, eastern Ethiopia. Methods: Facility-based cross-sectional study was conducted among 377 admitted adult patients in Harar Town public Hospitals from 15 April to 30 May 2020. A proportionate stratified sampling technique was used to select the study participants. A pretested and structured questionnaire was used to collect data through a face-to-face interview and which were entered into EpiData and analyzed using SPSS. Bivariate and multivariate logistic regression analyses were conducted, odds ratio and confidence intervals were calculated and statistical significance was declared at p < 0.05. Results: This study outlined that the overall prevalence of good perception toward nurses' communication was 41.9% (95% confidence interval = 37.1%, 46.9%). Patients whose age group were 26-35 years (adjusted odds ratio = 0.46 (95% confidence interval: 0.24, 0.86), Being female patients (adjusted odds ratio = 1.89; 95% confidence interval: 1.20, 2.98), admitted in private room (adjusted odds ratio = 3.25; 95% confidence interval: 1.91, 5.51), patients who have family support (adjusted odds ratio = 2.56; 95% confidence interval: 1.16, 3.64), urban residence (adjusted odds ratio = 0.65; 95% confidence interval: 0.02, 0.66) and language difference (adjusted odds ratio = 0.61; 95% confidence interval: 0.40, 0.94) were statistically significant. Conclusion: This study pointed out that less than half of the study participants had good perceptions toward nurses' communication. As a result, increasing the number of health care providers who speak the same language as the patients and communication and behavioral change training must be prioritized.