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.

Perceived Self Efficacy in Implementing COVID-19 Preventive Measures Among Residents of Harari Regional State, Eastern Ethiopia: A Community-Based Cross-Sectional Study.

Background: The COVID-19 outbreak has now become a major international public health concern and a major challenge for the entire world. Poor adherence to COVID-19 prevention measures continues to be a challenge in managing COVID-19 pandemics, including in Ethiopia. As a result, the current study sought to identify the determinants of community adherence to COVID-19 preventive measures among the adult population of Harari Regional State in Eastern Ethiopia. Methods: A community-based cross-sectional study was conducted in Harari Regional State, Eastern Ethiopia from January 5 to 30, 2021. All adults above the age of 18 who lived in Harari Regional State's selected kebeles were eligible to participate in the study. A systematic random sampling method was used to select the study participants. The study included a total of 1,320 participants. Pre-tested, structured, and self-administered questionnaires were used to collect data, which was then analyzed using STATA version 16 software. The consent was obtained from each individual and concerned body. Binary logistic regression was used to find the correlation between community adherence to COVID-19 preventive measures and sociodemographic, knowledge, self-efficacy, and risk perception. A P-value of 0.05 was used as the statistical significance cut-off point. Results: One thousand two hundred fifty-five (1,255) people took the survey, yielding a 95.1 % response rate. Adherence to COVID-19 preventive measures resulted in a mean cumulative score of 29.8. Six hundred eight (48.5%) of the participants had good adherence to COVID-19 preventive measures, whereas 647 (51.5%) did not. The researchers also discovered a statistically significant link between participants' residence, educational status, risk perception, income, and adherence to COVID-19 preventive measures. Conclusion: Appropriate implementation of COVID-19 preventive measures among community members is required to manage or control pandemics and reduce health-related consequences associated with COVID-19 pandemics. The current study, on the other hand, discovered that nearly half of the study participants had poor adherence. As a result, in order to manage this pandemic, the relevant organizations, including the government and non-governmental organizations, must take appropriate and timely measures.