Predictors of recovery from severe acute malnutrition among 6-59 months children admitted to a hospital.

Background and aim: Severe acute malnutrition is a threat to child survival as mortality rates in children with severe malnutrition are nine times higher. Globally, about 19 million children are severely malnourished. This study looked at children aged 6-59 months admitted to hospital to see how quickly they recovered from severe acute malnutrition as well as what factors predicted their recovery. Methods: The study included 543 systematically chosen children with severe acute malnutrition who were admitted to the stabilization center of a hospital. Data from the patient registry were gathered using a retrospective follow-up study design. In order to find predictors of recovery, the Cox proportional hazard model was applied. Results: From 543 children, 425 (78.27%) were recovered. The median survival time was 8 days. Having grade II edema, grade III edema, and pneumonia were negatively associated with recovery. Similarly, taking ceftriaxone, cloxacillin, and being on a nasogastric tube were associated with poor recovery. Conversely, better recovery rates were linked to exclusive breastfeeding and vitamin A supplementation. Conclusion: Both the recovery rate and the median survival time fell within acceptable bounds. To boost the recovery rate, efforts are needed to lessen comorbidities.

Prevalence and predictors of medication adherence among adolescents and adults with asthma in Ethiopia: a systematic review and meta-analysis.

OBJECTIVE: This review aimed to estimate the pooled prevalence and predictors of medication adherence among adolescents and adults with asthma in Ethiopia. DATA SOURCES: Primary studies were searched from PubMed, Scopus, HINARI, and Google Scholar from January 1, 2010 to December 10, 2023. In addition, we have used citation tracking. STUDY SELECTIONS: Observational studies (cross sectional, case control, and cohort) conducted among asthmatic patients ≥15 years old in Ethiopia, published in English language were included. After screening, the studies were assessed using Joanna Briggs Institute (JBI) critical appraisal tool and data were extracted using a checklist. Heterogeneity was assessed using forest plot, Q-statistics and I2. RESULTS: The review was performed among 13 institution-based studies with a total of 2901 participants with asthma. About 1058 participants had comorbid disease and 354 were cigarette smokers. The pooled prevalence of adherence to medications among patients with asthma was 40.50% (95% CI: 28.05, 52.96; p value < 0.001) with high heterogeneity (I2 = 98.25%, p < 0.001). Getting health education about asthma and having comorbid disease were predictors of medication adherence among adolescents and adults with asthma in Ethiopia. CONCLUSIONS: The pooled prevalence of medication adherence among adolescents and adults with asthma in Ethiopia is low and indicated that three out of five adolescents and adults with asthma were non-adherent to medications. This implies the Ministry of Health should develop different strategies to improve medication adherence including patient education and strengthening the health care system. Multicenter longitudinal studies should be further conducted by using objective methods of adherence measurement and large sample size.

Prevalence of medication adherence among adult asthmatic patients in four African countries: A systematic review and meta-analysis.

Non-adherence to medications has many deleterious effects including poor treatment outcomes, increased economic burden, increased morbidity, hospitalization rate, health care utilization, productivity loss, and mortality. Therefore, this review aimed to estimate the pooled prevalence of medication adherence among asthmatic adults in 4 African countries. Primary studies were extensively searched from databases such as PubMed, HINARI, Cochrane Library, CINHALand, Google Scholar, and Google search engines. After screening and assessing the quality of studies, data were extracted using a checklist. Heterogeneity was assessed using forest plot, Chocran's Q Test and I2. The random effects meta-analysis model was employed to pool the prevalence of medication adherence among adult asthmatic patients in Africa. Sub-group analysis and meta-regression were performed to identify the sources of heterogeneity. Publication bias was assessed using funnel plots with Egger's test. A sensitivity analysis was performed to assess the influence of individual studies on the overall estimate. The review was performed among 16 studies of which 14 were cross-sectional with a total of 4019 participants. The pooled random effects prevalence of adherence to medications among adult patients with asthma in Africa was 39% (95% CI: 32, 47; p < 0.001) with a heterogeneity (I2 = 94.82, p < 0.001). The pooled prevalence of medication adherence among adult asthmatic patients in Africa is low. Researchers should conduct further multicenter longitudinal studies by using objective methods of adherence measurement.

Covid-19 vaccine uptake and associated factors among health science University students in northeastern Ethiopia, a cross-sectional study.

The aim of this study is to assess COVID-19 vaccine uptake and associated factors among health science students at Wollo University, Northeast Ethiopia. Institution based cross-sectional study was conducted among 403 health science students at Wollo University from 1 to 15 July, 2022. The data was collected using a structured self-administered questionnaire and analysis was performed using SPSS version 26. Adjusted Odds Ratio (AOR), with 95% CI and p-value <.05 were used to declare factors significantly associated with COVID-19 vaccine uptake. The prevalence of COVID-19 vaccine uptake was 23.3% (95% CI: 19.2, 27.4). Being in the age category of 22-25 years old (AOR = 0.392, 95% CI (0.197, 0.780)), being >25 years old (AOR = 0.253, 95% CI (0.086, 0.741)), have a known disease (AOR = 0.202, 95% CI (0.044, 0.935)), source of income is self (AOR = 2.504, 95% CI (1.104, 5.677)) and screened for COVID-19 disease (AOR = 4.278, 95 % CI (2.418, 7.570)) before are significantly associated with uptake of COVID-19 vaccine. In conclusion, majority of the respondents didn't take COVID-19 vaccine with age greater than 22 years and have a known disease found to be negative predictors of COVID-19 disease.

Anemia and associated factors among 6 to 59 months age children attending health facilities in Kombolcha town, Northeast Ethiopia: a facility-based cross-sectional study.

BACKGROUND: Childhood anemia is an important public health problem in Ethiopia. The northeast part of the country is among the areas affected by recurrent drought. Despite its significance, studies are scarce on childhood anemia particularly, in the study area. This study aimed to assess the proportion and factors associated with anemia among under-five children in Kombolcha town. METHODS: A facility-based cross-sectional study was conducted among 409 systematically selected 6 to 59 months aged children visited health institutions in Kombolcha town. Data were collected using structured questionnaires from mothers/caretakers. The data entry and analysis were done using EpiData version 3.1 and SPSS version 26 respectively. Binary logistic regression was fitted to identify factors associated with anemia. Statistical significance was declared at p-value ≤ 0.05. The effect size was reported using the adjusted odds ratio with its 95% confidence interval. RESULTS: Of the participants, 213(53.9%) were males with a mean age of 26 months (SD ± 15.2). The proportion of anemia was 52.2% (95% CI, 46.8-57%). Being in the age of 6-11 months (AOR = 6.23, 95% CI: 2.44, 15.95), 12-23 months (AOR = 3.74, 95%CI: 1.63, 8.60), having low dietary diversity score (AOR = 2.61, 95% CI: 1.55, 4.38), having a history of diarrhea (AOR = 1.87, 95% CI: 1.12, 3.12) and having the lowest family monthly income (AOR = 16.97, 95% CI: 4.95, 58.20) were positively associated with anemia. Whereas, maternal age ≥ 30 years (AOR = 0.37 (0.18, 0.77) and exclusive breastfeeding until six months (AOR = 0.27, 95% CI: 0.16, 0.45) were negatively associated with anemia. CONCLUSIONS: Childhood anemia was a public health problem in the study area. Child age, maternal age, exclusive breastfeeding, dietary diversity score, diarrhea, and family income were significantly associated with anemia.

Covid-19 Vaccine Side Effects and Its Associated Factors Among Healthcare Workers at Dessie Hospital, Ethiopia.

Background: Vaccines are a powerful choice to stop disease outbreaks, including covid-19. However, people are hesitant to take vaccinations due to uncertainty about side effects. So, this study aimed to assess covid-19 vaccine side-effect and its associated factors among healthcare workers in Dessie comprehensive specialized hospital, in Ethiopia. Methods: An institution-based cross-sectional study was conducted at Dessie Comprehensive and Specialized Hospital among 351 vaccinated healthcare workers from April 25 to May 25, 2021. Self-administrated questionnaires were used by consented health workers. Variance inflation factor (VIF) was used to assess the multicollinearity of independent variables. Bivariable and multivariable binary logistic regression were used to identify significant factors of vaccine side effects. The adjusted odds ratio (AOR) with a 95% confidence interval (CI) was reported as the effect size. Statistical significance was considered at p-value <0.05. Results: Overall, of vaccinated healthcare workers, 56.98% (95% CI, 50.86-61.26%) experienced at least one side effect. The majority of the side effects were fever (44.44%), headache (39.03%), fatigue (27.35%), injection site pain (25.93%), and nausea (24.22%). Healthcare workers with (≥10 years) of work experience (AOR: 3.74, 95% CI, 1.32-10.59), Hesitancy to take the first dose of the Covid-19 vaccine (AOR: 3.01, 95% CI, 1.82-4.99), underlying chronic disease (AOR: 14.41, 95% CI, (5.07-40.92)), being on antihypertensive medication (AOR: 0.15; 95% CI (0.02-0.93)), and unsafe perception of vaccine safety (AOR:3.50; 95% CI, 1.43-8.57) were independent factors of Covax vaccine side effect development. Conclusion: Overall, common vaccine side effects were identified in healthcare workers who have taken the Covax vaccine. Healthcare workers with (≥10 years) of work experience, Hesitancy to take the first dose, unsafe perception of vaccine safety, and underlined chronic disease were predictors of vaccine side effect occurrence. So, providing vaccine-related information to the community to be vaccinated is mandatory to reduce hesitancy and flaws regarding vaccine safety.

Self-Care Practice and Associated Factors Among Patients with Type 2 Diabetes Mellitus at a Referral Hospital in Northern Ethiopia - A Mixed Methods Study.

Introduction: Diabetes self-care is important to maintain optimal glycemic control and prevent debilitating and costly complications. Diabetes self-care may be improved through the identification of individual and group barriers to regimen adherence and subsequent development of specific plans to overcome these barriers. This study assessed the self-care practice and associated factors among type 2 diabetes patients attending their treatment at Dessie Referral Hospital, Dessie, North-Eastern Ethiopia. Methods: The study employed parallel mixed methods design which followed a cross-sectional interview and in-depth interview methods, respectively, from September to October 2019. The collected data were subjected to descriptive and inferential analysis for the quantitative part and a thematic analysis for the qualitative part. Results: A total of 328 type 2 diabetes patients participated in the study of which 50.3% reported good self-care practice. Being in the age category of 60-69 years old (AOR = 0.334, 95% CI (0.135, 0.951)), being ≥70 years old (AOR = 0.359, 95% CI (0.135, 0.951)), having complications (AOR = 1.956, 95% CI (1.172, 3.262)), having co-morbidity (AOR = 0.443, 95% CI (0.262, 0.749)) and diabetes education (AOR = 2.684, 95% CI (1.633, 4.412)) were significantly associated with good diabetes self-care. Accessibility, social support, knowledge and beliefs and diabetes-related morbidities were identified as barriers to diabetes self-care by the patients. Conclusion: The findings from this study revealed that only half of the type 2 diabetes patients who participated in this study reported good self-care practice. Different factors, including diabetes education, were significantly associated with good diabetes self-care according to the quantitative study. This was supported by the findings from the qualitative part and thus the recommendation to strengthen diabetes health education to patients and their families.

Time to under-five mortality and its predictors in rural Ethiopia: Cox-gamma shared frailty model.

BACKGROUND: Under-five mortality (U5M) is one of the most important and sensitive indicators of the health status of the community. Despite there having been a substantial reduction in U5M since 1990, its rate is still high in Sub-Saharan African countries. Thus, this study aimed to assess time to under-five mortality and its predictors in rural Ethiopia. METHODS: This study utilized a secondary analysis of the 2016 Ethiopia Demographic and Health Survey (EDHS). A total of 9,807 weighted under-five children selected at different stages were included in the analysis. The Kaplan-Meier and Cox's-gamma shared frailty models were used to estimate survival time and to identify predictors of under-five mortality, respectively. An adjusted Hazard Ratio (AHR) along with a 95% Confidence Interval (CI) was used to measure the effect size and direction of the association. RESULTS: The study indicated that 6.69% (95% CI: 6.13, 7.30) of children died before celebrating their fifth birthday in rural Ethiopia. Of all the deaths, the median time to death was 27 months. After controlling the effect of cluster and other confounding factors, female sex (AHR = 0.62, 95% CI: 0.52, 0.75), ever born greater than five children (AHR = 1.40, 95% CI: 1.07, 1.83), very large size at birth (AHR = 1.33, 95% CI: 1.03 1.71), very small size at birth (AHR = 1.41, 95% CI: 1.10, 1.82), twin pregnancy (AHR = 3.5, 95% CI: 2.47, 4.88), not ever breastfeeding (AHR = 11.29, 95% CI: 9.03, 14.12), unimproved latrine (AHR = 3.44, 95% CI: 1.91, 6.17), covered by health insurance (AHR = 0.29, 95% CI: 0.12, 0.70) were predictors of under-five mortality. CONCLUSIONS: Still under-five mortality was high in rural Ethiopia as compared to the global under-five mortality rate. In the final model, sex of a child, the total number of children ever born, children's size at birth, type of pregnancy, breastfeeding, type of toilet, and being covered by health insurance were significant predictors of under-five mortality. Further emphasis should be given to twin and not breastfeeding children, as well as households' better encouraging membership of community health insurance and utilization of improved latrines.

Unmet need for family planning among reproductive-age women living with HIV in Ethiopia: A systematic review and meta-analysis.

BACKGROUND: Closing the gap of unmet for family planning is crucial to eliminate new pediatric HIV infections likewise to improve maternal and child health among reproductive-age women living with HIV. However, studies conducted on unmet need for family planning among reproductive-age women living with HIV showed inconsistent and non-conclusive findings on the magnitude of the problem. Moreover, there was no meta-analysis conducted in this area. So this systematic review and meta-analysis were conducted to estimate the pooled prevalence unmet need for family planning among reproductive-age women living with HIV in Ethiopia. METHODS: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was followed to review both published and unpublished studies in Ethiopia. All studies in PubMed, Cochrane Library, Hinari, Google Scholar, CINAHL, and Global Health databases were searched. Meta-analysis was performed using STATA 14 software. The heterogeneity and publication bias were assessed using the I2 statistics and Egger regression asymmetry test, respectively. Forest plots were used to present the pooled prevalence with a 95% confidence interval (CI). RESULTS: This review included 7 studies, and 3333 study participants. The pooled prevalence of unmet need for family planning among reproductive-age women living with HIV in Ethiopia was 25.13% (95%CI: 19.97, 30.29). The pooled prevalence of unmet need for spacing and limiting was 13.91% (95%CI: 10.11, 17.72) and 9.11% (95%CI: 6.43, 11.78), respectively. CONCLUSIONS: One-fourths of reproductive-age women living with HIV had an unmet need for family planning. A variety of programmatic investments are needed to achieve more meaningful progress toward the reduction of unmet need for family planning among reproductive-age women living with HIV.

Urban-rural disparities in institutional delivery among women in East Africa: A decomposition analysis.

BACKGROUND: Though institutional delivery plays a significant role in maternal and child health, there is substantial evidence that the majority of rural women have lower health facility delivery than urban women. So, identifying the drivers of these disparities will help policy-makers and programmers with the reduction of maternal and child death. METHODS: The study used the data on a nationwide representative sample from the most recent rounds of the Demographic and Health Survey (DHS) of four East African countries. A Blinder-Oaxaca decomposition analysis and its extensions was conducted to see the urban-rural differences in institutional delivery into two components: one that is explained by residence difference in the level of the determinants (covariate effects), and the other components was explained by differences in the effect of the covariates on the outcome (coefficient effects). RESULTS: The findings showed that institutional delivery rates were 21.00% in Ethiopia, 62.61% in Kenya, 65.29% in Tanzania and 74.64% in Uganda. The urban-rural difference in institutional delivery was higher in the case of Ethiopia (61%), Kenya (32%) and Tanzania (30.3%), while the gap was relatively lower in the case of Uganda (19.2%). Findings of the Blinder-Oaxaca decomposition and its extension showed that the covariate effect was dominant in all study countries. The results were robust to the different decomposition weighting schemes. The frequency of antenatal care, wealth and parity inequality between urban and rural households explains most of the institutional delivery gap. CONCLUSIONS: The urban-rural institutional delivery disparities were high in study countries. By identifying the underlying factors behind the urban-rural institutional birth disparities, the findings of this study help in designing effective intervention measures targeted at reducing residential inequalities and improving population health outcomes. Future interventions to encourage institutional deliveries to rural women of these countries should therefore emphasize increasing rural women's income, access to health care facilities to increase the frequency of antenatal care utilization.

Determinants of change in timely first antenatal booking among pregnant women in Ethiopia: A decomposition analysis.

BACKGROUND: Even though maternal health was highly targeted in different global strategies, maternal mortality could not be decreased as was expected. Besides this, prior decomposition analysis to the possible cause of changes to timely first antenatal booking has not been conducted. Therefore, this study aimed to assess determinants of change in timely first antenatal booking among pregnant women in Ethiopia. METHODS: The study utilized three consecutive Ethiopia Demographic and Health Survey (EDHS) datasets which were collected through cross-sectional study design. The number of pregnant women who gave birth in 2005, 2011 and 2016 survey included in the analysis was 7,307, 7,908 and 7,590 respectively. The data were analyzed by using Stata/SE version 14.0. Logit-based decomposition analysis was done to identify contributing factors for change in timely first antenatal booking and statistical significance was determined by using P-value. RESULTS: The trend of timely first antenatal booking was increased from 6% to 20% in the last ten years. The analysis revealed that 14% of the overall change was because of the change in women's composition. Changes in the composition of women according to region, education and occupation status were the major sources of this change. The remaining, 86% of the change was due to differences in the coefficient. Mostly, the change in behaviors of the Oromia population, those who have lived in the rural areas and male household head were some of the contributing factors for the increase in timely first antenatal booking. CONCLUSIONS: There was a significant increase in timely first antenatal booking among pregnant women in Ethiopia from 2005 to 2016 EDHS. The change in the women composition according to residency, education and occupation status of women and the difference in behaviors like: behavior of rural residents and male household head contributed to the majority of the change. Interventions targeting the male household head, rural residents and those women who lived in the Oromia region should be emphasized to increase further timely booking. In addition, promoting women in terms of education and creating job opportunities could be the other recalled intervention areas of the country.

Lost to follow-up and associated factors among patients with drug resistant tuberculosis in Ethiopia: A systematic review and meta-analysis.

BACKGROUND: One third of global antmicrobial resistance deaths are attributed to drug resistant tuberculosis. Lost to follow-up is one of the causes of the development of acquired drug resistant tuberculosis. There is a gap in nationally representative reliable information on lost to follow-up among patients with drug-resistant tuberculosis in Ethiopia. OBJECTIVE: To estimate the pooled prevalence and associated factors of lost to follow-up among patients with drug resistant tuberculosis in Ethiopia. METHODS: Observational studies searched from PubMed, HINARI and CINAHL were screened for eligibility. After assessing the quality of studies, data were extracted using a checklist. Heterogeneity was assessed using forest plot, Q and I2. The random effects meta-analysis model was employed to pull the prevalence of lost to follow-up. Sub-group analysis and meta regression were performed to identify the sources of heterogeneity. Publication bias was assessed using funnel plots with Egger's and Begg's tests. Sensitivity analysis was performed to assess the influence of individual studies on the overall estimate. The odds ratios were used to measure associations. RESULTS: The review was performed among 11 studies of which 9 were cohort studies. The sample sizes ranged from 90 to 612 and comprised a total of 3,510 participants. The pooled prevalence of lost to follow-up was 8.66% (95% CI, 5.01-13.14) with a high heterogeneity (I2 = 93.49%, p<0.001). Pulmonary multi-drug resistant tuberculosis patients were 50% less likely to loss from follow-up compared to extra pulmonary tuberculosis patients. CONCLUSION: There was a high prevalence of lost to follow-up among multi-drug resistant tuberculosis patients in Ethiopia. Anatomical site of tuberculosis was a significant factor affecting lost to follow-up. Strengthening the health care system and patient education should be given a due emphasis. REGISTRATION NUMBER: CRD42020153326; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=153326.

Self-Medication Practices among Undergraduate University Students in Northeast Ethiopia.

BACKGROUND: Inappropriate self-medication is a public-health problem worldwide. Major problems associated with self-medication include wastage of resources, increased resistance of pathogens, and adverse drug reactions. OBJECTIVE: The aim of this study was to assess self-medication practices and associated factors among undergraduate Wollo University students in Northeast Ethiopia. METHODS: A cross-sectional study was conducted among 341 undergraduate university students using a pretested and self-administered questionnaire from January to February 2019. Simple random sampling was used to select study participants. Data were collected using the self-administered questionnaire and analyzed with SPSS version 20. Multiple logistic regression was employed in data analysis, with P<0.05 considered statistically significant. RESULTS: The prevalence of self-medication in this study was 64.98%. Mildness of disease (57, 34.13%) and dissatisfaction with health-care services, (44, 26.34%) were the main reasons for self-medication practice. The most common types of diseases for self-medication were headache (80, 47.9%), gastrointestinal infections (74, 44.31%), and respiratory tract infections (48, 28.74%). Analgesics (94, 56.28%) and antibiotics (60, 35.9%) were the leading classes of medicine used in self-medication. Multivariate regression analysis indicated that agriculture students (AOR 0.163, 95% CI 0.049-0.545) were 84% less likely to practice self-medication than medicine and health-science students. CONCLUSION: This study revealed that self-medication practices are common among study participants and significantly associated with their field of study. Awareness promotion on the risk of inappropriate self-medication for university students is highly recommended.