Neurocognitive Impairment and Associated Factors Among People Living with HIV: A Systematic Review and Meta-Analysis of African Studies.

Background: Neurocognitive impairment (NCI) is one of the most common neurological complications in HIV-positive individuals, particularly in resource-limited countries. Neurocognitive impairments can occur at any stage of HIV infection, although the risk increases as the infection progresses. However, in Africa, there are few studies with highly variable and inconsistent results. Therefore, this study aimed to determine the prevalence and factors associated with NCI among HIV-positive people in Africa. Methods: For this systematic review and meta-analysis, we used PubMed/Medline, Scopus, Web of Science, the Cochrane Library, Embase, and PsycINFO to comprehensively search a number of papers. Studies reporting the prevalence of NCI and its factors were included in the estimation of the pooled prevalence. A consistent data extraction format was created in Microsoft Excel to extract the data, which was then imported into STATA 11 statistical software for analysis. The heterogeneity was evaluated using the I2 test, and a random effect meta-analysis model was employed to calculate the pooled prevalence of NCI because the included studies showed significant heterogeneity. Results: In all, Africa had a pooled prevalence of NCI of 45.15% (95% CI: 36.86, 53.43). According to the subgroup analysis of this study, West Africa had the lowest frequency, at 42.40% (95% CI: 22.03, 62.77), whereas Central and South Africa had the highest prevalence, at 49.33% (95% CI: 10.72-87.95). Conclusion: In Africa, the cumulative prevalence of NCI was high. Being a woman, not having a formal education, those with only an elementary education, being older, having late-stage HIV, and abusing drugs were all often associated with NCI. The average burden of NCI in Africa is high and that would be a significant figure for interventional actions in the area.

Determinants of pelvic organ prolapse among gynecologic patients, Northeastern Ethiopia, 2020: A case-control study.

BACKGROUND: The majority of women in developing countries, including Ethiopia, do not seek medical help; as a result, they face substantial impacts on their health. There is a lack of attention to screening women at high risk for pelvic organ prolapse. Identifying the determinants of pelvic organ prolapse is essential for the early screening and prevention of adverse health outcomes in women. OBJECTIVES: To identify the determinants of pelvic organ prolapse among gynecologic patients at Akesta Hospital, 2020. DESIGN: An unmatched case-control study was conducted among 70 cases and 140 controls. METHODS: The study participants were selected using a systematic sampling technique. Data were collected by reviewing patient charts. The data were entered into EpiData version 4.6 and analyzed using SPSS version 25. Text, tables, and figures were used for data presentation. P values less than 0.2 in binary logistic regression were entered in multivariable logistic regression. Finally, P values less than 0.05 were considered significant factors for the determinants of pelvic organ prolapse. RESULTS: A total of 189 respondents participated in the study. Of the total respondents, 63 were cases and 126 were controls. Patients whose parity was four or above developed pelvic organ prolapse three times more likely than those whose parity number was less than four (adjusted odds ratio = 3.05; 95% confidence interval: 1.35-6.90; P = 0.007). Patients who are overweight are 8.5 times more likely to develop pelvic organ prolapse than patients with normal weight (adjusted odds ratio = 8.5, 95% confidence interval: 2.75-26.51; P = 0.001). Patients with a history of intestinal obstruction were five times more likely to develop pelvic organ prolapse than their counterparts (adjusted odds ratio = 4.87, 95% confidence interval: 1.61-14.75, P = 0.005). CONCLUSION: Educational level, being overweight, having four parities and above, minimum duration of labor, history of urinary retention, and intestinal obstruction were determinants of pelvic organ prolapse. Screening should target women with illiteracy, overweight, and whose parity is four and above. Early diagnosis and treatment of urinary retention and intestinal obstruction should be provided to women with pelvic organ prolapse.

Incidence and predictors of common opportunistic infection among HIV -infected children attending antiretroviral treatment clinic at Northeast Ethiopia, public hospitals 2022: A multicenter retrospective follow-up study.

Background: Opportunistic infections (OIs) are illnesses that attack people with weakened immune systems, such as HIV patients, more frequently and severely. The majority of opportunistic infections (OIs) are the leading causes of morbidity and mortality in HIV/AIDS patients, emerging at the end of the illness. The objective of this study was to assess the incidence and risk factors of opportunistic infections (OIs) in HIV-infected children receiving antiretroviral therapy in public hospitals in Northeast Ethiopia. Methods: A multicenter retrospective follow-up study was undertaken at public hospitals in northeast Ethiopia from September 1, 2010, to January 30, 2022. A total of 341 HIV-infected children on antiretroviral therapy were included in the study. Data was entered using Epi-Data Manager version 4.6.1, and it was analyzed using STATA version 16.1. The opportunistic infection free-survival time was estimated using the Kaplan-Meier survival curve. Bivariable and multivariable Cox proportional hazard models were used to investigate the determinants of opportunistic infections. Results: The overall incidence rate of opportunistic infections (OIs) was 6.0 (95% CI: 5.0-7.1) per 100 child-years of observation. This study's participants were observed for a minimum of 9 months and a maximum of 122 months, for a total of 21,629 months, or 1802.4 years. Children with WHO clinical stages III and IV (AHR: 1.77; 95% CI: 1.13, 2.77), non-users of Cotrimoxazole Preventive Therapy (CPT) (AHR: 2.10; 95% CI: 1.40, 3.08), and low hemoglobin levels (10 mg/dl) (AHR: 1.88; 95% CI: 1.25, 2.82) were identified as significant predictors of opportunistic infection. Conclusion: In this study, the incidence rate of opportunistic infections among HIV-infected children was found to be high when compared to other studies. Low hemoglobin levels (10 mg/dl), low CD4 counts or percentages, clinical stages III and IV, and non-users of CPT were all associated with higher rates of opportunistic infection.

Nurse-Physician Inter-Professional Collaboration and Associated Factors at Public Hospitals in Dessie City, Amhara, Northeastern Ethiopia, 2021.

Introduction: Nurse-physician collaboration is an integral part of quality improvement in health care. Collaboration enables individuals to work together to achieve defined and common health purposes. There is limited evidence related to nurse-physician inter-professional collaboration and its associated factors in Ethiopia, particularly in Dessie city public hospitals. Objective: To assess nurse-physician inter-professional collaboration and associated factors at public hospitals in Dessie city, Ethiopia, 2021. Methods: An institutional-based cross-sectional study was conducted among nurses and physicians at public hospitals in Dessie city. A self-administered questionnaire was used for data collection. Stratified simple random sampling techniques were used to select study participants proportional to the sample size allocation. The final sample size was 260 and allocated proportionally to Dessie Comprehensive Specialized Hospital and Boru Meda General Hospital. The data were entered and analyzed using EPI-data version 4.6 and SPSS version 26 software respectively. During analysis, p-values less than 0.25 in binary logistic regression were entered into multivariable logistic regression. Finally, p-values less than 0.05 in multi-variable logistic regression were considered statically significant. Results: The mean score for inter-professional collaboration was 97.40 ± 19.6SD. In this study, inter-professional collaboration among nurses and physicians was 44.2%. This study showed that favorable attitude [AOR=3.205; CI: 1.781-5.766], respondents working in the gynecological department [AOR=0.210; CI: 0.052-0.849], satisfied organizational support [AOR=2.062; CI: 1.140-3.729] and urban residents [AOR=3.996; CI: 1.069-14.931] were factors associated with nurse-physician inter-professional collaboration. Conclusion: In this study, nurse-physician inter-professional collaboration was low. Training on the importance of health teamwork, timely monitoring and evaluation of organizational support, and professional empowerment towards a favorable attitude of nurse-physician inter-professional collaboration shall be provided at hospital levels. Routine assessment and timely intervention of the gynecological department for nurse-physician inter-professional collaboration shall be done at hospital levels. Moreover, both quantitative and qualitative research shall be performed for future research.

Undernutrition and Associated Factors Among Children Aged 6-23 Months in Dessie Town, Northeastern Ethiopia, 2021: A Community Based Cross-Sectional Study.

Background: Globally about 159, 101, and 52 million children are stunted, underweight, and wasted, respectively. According to the 2016 Ethiopian Demographic and Health Survey, about 38% of Ethiopian children are stunted and 46, 28.4, and 9.8% of children in Amhara Region are stunted, underweight and wasted, respectively. This study aimed to assess undernutrition and associated factors among children aged 6-23 months old at Dessie town, 2021. Method: A community-based cross-sectional study was conducted from October - November 2021 in Dessie Town. A total of 421 Mothers/caregivers with children aged 6-23 months old were selected by a systematic sampling method from the health extension registration book. Epi-data 3.01 was used for data entry, SPSS version 20 for statistical analysis, and WHO Anthro version 3.2.2 software for calculating the z scores. Binary logistic regression and multivariate logistic regression were used to analyze the data. AOR with 95% CI and P-values less than 0.05 were considered to see the statistical significance. Results: A total of 421 mothers or care givers paired with 6-23 months old children participated in the study. The prevalence of stunting, underweight, wasting were 36.8% (95% CI: 32%, 41.6%), 27.6% (95% CI: 23.6%, 32.2%), and 11.5% (95% CI: 8.4%, 14.7%) respectively. Sex of the child (AOR = 1.55; 95% CI: 1.02, 2.34), handwashing practice (AOR = 2.32; 95% CI: 1.05, 5.11) and maternal family planning use (AOR = 0.39; 95% CI: 0.19, 0.77) were significantly associated with stunting. Age of child 12-17 months (AOR = 4.62; 95% CI: 2.65, 8.06) and sex of the child (AOR = 1.93; 95% CI: 1.21, 3.07) were associated with underweight. Age of child 12-17 months (AOR = 2.25; 95% CI: 1.06, 4.78) and treatment of drinking water (AOR = 0.21; 95% CI: 0.07, 0.59) were associated with wasting. Conclusion and Recommendation: In this study, the prevalence of undernutrition among children aged 6-23 months was higher for stunting (36.8%), underweight (27.6%) and wasting (11.5%) compared to WHO classification. Improved access to water, hygiene and sanitation, family planning services, avoiding gender discrimination during child feeding, and age-appropriate feeding practices are recommended. Moreover, implementation of public policies on food and nutrition is required for children 6-23 months of age.

Prevalence and determinants of depression among old age: a systematic review and meta-analysis.

BACKGROUND: Depression is a leading cause of disability worldwide and is a major contributor to the overall global burden of disease. It is also one of the most common geriatric psychiatric disorders and a major risk factor for disability and mortality in elderly patients. Even though depression is a common mental health problem in the elderly population, it is undiagnosed in half of the cases. Several studies showed different and inconsistent prevalence rates in the world. Hence, this study aimed to fill the above gap by producing an average prevalence of depression and associated factors in old age. OBJECTIVE: This study aims to conduct a systematic review and meta-analysis to provide a precise estimate of the prevalence of depression and its determinants among old age. METHOD: A comprehensive search of PubMed, Scopus, Web of sciences, Google Scholar, and Psych-info from database inception to January 2020. Moreover, the reference list of selected articles was looked at manually to have further eligible articles. The random-effects model was employed during the analysis. Stata-11 was used to determine the average prevalence of depression among old age. A sub-group analysis and sensitivity analysis were also run. A graphical inspection of the funnel plots and Egger's publication bias plot test were checked for the occurrence of publication bias. RESULT: A search of the electronic and manual system resulted in 1263 articles. Nevertheless, after the huge screening, 42 relevant studies were identified, including, for this meta-analysis, n = 57,486 elderly populations. The average expected prevalence of depression among old age was 31.74% (95% CI 27.90, 35.59). In the sub-group analysis, the pooled prevalence was higher among developing countries; 40.78% than developed countries; 17.05%), studies utilized Geriatrics Depression Scale-30(GDS-30); 40.60% than studies that used GMS; 18.85%, study instrument, and studies having a lower sample size (40.12%) than studies with the higher sample; 20.19%. CONCLUSION: A high prevalence rate of depression among the old population in the world was unraveled. This study can be considered as an early warning and advised health professionals, health policymakers, and other pertinent stakeholders to take effective control measures and periodic care for the elderly population.

A systematic review and meta-analysis of HIV associated neurocognitive disorders (HAND) among people with HIV in Ethiopia.

BACKGROUND: Ethiopia, being in the Sub Saharan region of Africa, is one of the countries with a substantial burden of HIV infection. Because of the high burden of HIV and poor health care settings, HAND is prevalent as demonstrated in various cross-sectional studies. However, no review has been conducted to report the consolidated magnitude of HAND among people with HIV in Ethiopia. Therefore, this systematic review and meta-analysis aimed to estimate the prevalence of HAND in Ethiopia. METHODS: Following the PRISMA guidelines, we systematically reviewed and meta-analyzed studies that investigated the prevalence of HAND in Ethiopia from PubMed, Google Scholar, Science Direct, HINARI, EMBASE, and Cochrane library databases. We also looked at the reference lists of the included studies to include other relevant studies. Subgroup analysis was performed based on publication year, study location, and sample size. Heterogeneity across studies was evaluated using the I2 test. Potential publication bias was assessed using Egger's test and visual inspection of symmetry in the funnel plots. RESULTS: In the present meta-analysis, 627 articles were initially identified and evaluated. Of these, 8 studies that met the inclusion criteria were included in the final analysis. The pooled prevalence of HAND in people with HIV in Ethiopia was 39.15% (95% CI 29.36, 48.94). The highest prevalence observed in the Southern Nations, Nationalities, and Peoples' Region (SNNPR) with 53.20% (95% CI 25.96, 80.44) followed by others 34.87% (Tigray, Addis Ababa, and Oromia) (95% CI 33.49, 36.24) and Amhara 34.07% (95% CI 25.39, 42.74).The funnel plot was asymmetrical. However, Egger's regression tests provided no evidence of publication bias in the prevalence of HAND. CONCLUSION: In this meta-analysis, the pooled prevalence of HAND, in Ethiopia, was high. Older age, substance use, advanced stages of the disease, and lack of education were the main determinants of HAND in Ethiopia. Health education, early screening of people with HIV, and training of health professionals working in hospitals on HAND are highly recommended.