Prevalence of anencephaly in Africa: a systematic review and meta-analysis.

Anencephaly is a severe anomaly of the brain that results from the failure of the cephalic part of the neural tube to close during the fourth week. It occurs at least in one per thousand births and is the major cause of fetal loss and disabilities in newborns. The objective of this review is to determine the birth prevalence of anencephaly in Africa. We identified relevant studies via a search of databases like PubMed Central, PubMed/Medline, Science Direct, Joanna Briggs Institute, African Journals Online, Embase, Google Scholar, Web of Science, and Cochrane Library. After examining the heterogeneity of studies via the Cochran Q test and I2 test (and Forest plot for visual inspection), the prevalence of anencephaly was estimated using the random-effect meta-analysis model. Consequently, we carried out subgroup, sensitivity, meta-regression, trim and fill, time-trend, and meta-cumulative analyses. In this systematic review and meta-analysis, the twenty-four studies reported a total of 4,963,266 births. The pooled birth prevalence of anencephaly in Africa was 0.14% (95% CI: 0.12, 0.15%). Higher burden of anencephaly was detected in Ethiopia (0.37%, CI: 0.15, 0.58%), Algeria (0.24%, CI: 0.24, 0.25%), and Eritrea (0.19%, CI: 0.19, 0.19%). The higher pooled prevalence of anencephaly was observed in the studies that included both live births and stillbirths (0.16%) and in studies done after the year 2010 (0.25%) whereas, the lower burden was detected among countries that had a mandatory folic acid fortification (0.05%). High birth prevalence of anencephaly was detected in Africa. Strong prevention and control measures should be the priority because of an increment in the magnitude of anencephaly. Helping in prevention programs, which should be the ultimate contribution of this study to the field.

Assessment of Morphological and Morphometrical Variations of Sacral Hiatus in Dry Human Sacrum in Ethiopia.

BACKGROUND: The sacral hiatus is an opening present at the lower end of the sacral canal. The anatomy of the sacral hiatus and its variations are clinically important during administration of caudal epidural block (CEB) in obstetrics and gynecology, orthopedic, urology and general surgical practices. The success and reliability of CEB depends upon the sound knowledge of anatomical variations of the sacral hiatus. OBJECTIVE: The aim of this study was to assess the morphological and morphometric variation of the sacral hiatus in dry human sacrum. METHODS: An institution-based observational cross-sectional study design was conducted to assess morphological and morphometric variations of the sacral hiatus in 61 dry human sacrum specimens at the anatomy departments of Gondar, Addis Ababa, Hawassa and Jimma universities and Hayat and Korea Medical Colleges in Addis Ababa. Descriptive analysis was applied to analyze the data. RESULTS: The most commonly recorded shape of the sacral hiatus is inverted-V (41%) followed by inverted-U (37.7%). The least common was complete bifida (1.6%). The apex of the sacral hiatus is mostly seen at the level of the 4th sacral vertebra (60.7%), while the base is commonly located at the level of the 5th sacral vertebra (78.7%). The mean length of the sacral hiatus is 22.67 ± 11.84 mm. The mean transverse width and mean anteroposterior diameter of the sacral hiatus at the apex are 13.14 mm ± 2.85 mm and 5.57 mm ± 1.53 mm, respectively. CONCLUSION: The sacral hiatus has anatomical variations. These variations should be kept in mind during administration of caudal epidural anesthesia and analgesia.

Attitude, Willingness, and Associated Factors in Organ Donation Among Health Professionals in Gondar, Northwest Ethiopia.

BACKGROUND: Organ transplantation is considered one of the greatest advances of modern science, and it has given many patients a renewed lease on life. The demand for organs far exceeds the supply. Health professionals are fundamental in the process of organ procurement. OBJECTIVE: To assess the attitude, willingness, and associated factors in organ donation among health professionals of Gondar, Ethiopia. METHODS: Our cross-sectional study was conducted among 382 randomly selected health professionals in Gondar using a self-administered questionnaire. Multivariable logistic regression analysis was applied to analyze the data. RESULTS: Among health professionals, 79.1% had favorable attitude toward organ donation and 74.6% were willing to donate their organs. After adjusting for covariates, the odds of having a favorable attitude about organ donation were 3.2 and 11.9 times higher in the professions of laboratory technologists and medical doctors, respectively. By keeping all other variables constant, attitude was found to be positively associated with awareness (adjusted odds ratio [aOR] 12.74, 95% confidence interval [CI] 3.71-43.8) and being a member of the Red Cross Association (aOR 5.24, 95% CI 1.46-18.96). Willingness was positively associated with awareness (aOR 6.25, 95% CI 2.0-19.53), a member of the Red Cross Association (aOR 5.09, 95% CI 1.5-17.22), a laboratory technologist (aOR 3.57, 95% CI 1.37-9.29), and a medical doctor (aOR 6.52, 95 % CI 1.93-22.01). CONCLUSIONS: The main findings indicated that the majority of health professionals in Gondar had a favorable attitude toward organ donation and were willing to donate their organs in times of need.

Epilepsy knowledge, attitude, practice, and associated factors among primary, secondary, and preparatory schoolteachers in Lay-Armachiho District, Northwest Ethiopia.

Epilepsy is one of the most common neurological disorders encountered worldwide. It is poorly understood by the community, and it has been associated with numerous beliefs and misconceptions. Social stigma towards epilepsy is common in developing countries especially in Ethiopia, and its social, economic, and psychological consequences have become a major public health problem. The aim of this study was to assess epilepsy knowledge, attitude, practice, and associated factors among primary, secondary, and preparatory schoolteachers in Lay-Armachiho District, Northwest Ethiopia. An institution-based cross-sectional study design was conducted with 568 teachers working in ten schools of the district, using self-administered questionnaires. Descriptive analysis, binary, and multivariable logistic regression analyses were applied to analyze the data. In this study, 52.8% of the teachers had good knowledge (confidence interval (CI): 48.7, 56.9), 52.1% of the teachers had an unfavorable attitude (CI: 48.0, 56.2), and 55.3% of the teachers had a poor practice towards epilepsy (CI: 51.2, 59.3). After adjusting for covariates, being a male (adjusted odds ratio (AOR) = 1.5), urban resident (AOR = 2.4), degree holder (AOR = 2.3), above fourteen years teaching experience (AOR = 2.1), family history of epilepsy (AOR = 15.2), and previous first aid training (AOR = 1.8) were positively associated with the knowledge of epilepsy. The odds of having a positive attitude for epilepsy were 3.1 and 3.4 times higher among the teachers whose age is above 42 years and degree holders, respectively. Moreover, the odds of having a good practice for epilepsy were 2.1, 3.5, and 1.7 times higher among teachers of degree holders, a history of previous first aid training, and a history of providing first aid for students with epilepsy in the time of need, respectively. The main findings indicated that the majority of schoolteachers had good knowledge about, but unfavorable attitude and poor practice towards epilepsy. Therefore, the authors recommend that incorporating special need course in the educational curriculum with the help of first aid training and health promotion intervention to all levels of schoolteachers is very important.

Assessment of knowledge, attitude and risk behaviors towards HIV/AIDS and other sexual transmitted infection among preparatory students of Gondar town, north west Ethiopia.

BACKGROUND: The first case of HIV in Ethiopia was reported in 1984. Since then, HIV/AIDS has become a major public health concern in the country, leading the Government of Ethiopia to declare a public health emergency in 2002. Although the epidemic is currently stable, HIV/AIDS remains a major development challenge for Ethiopia. The spread of HIV in any community is in part determined by the knowledge of attitude towards sexuality of its members and by their actual sexual practices. The aim of the study was to assess students' knowledge, attitudes and practices regarding HIV/AIDS and STDs in Gondar, North West Ethiopia. METHODS: A cross sectional study was conducted between February 1 to March 1, 2009 in preparatory high school students. Pre-tested questioner was used to generate the data and analysis was made by SPSS version 15. Chi -square value was calculated and p-value < 0.05 was considered statistically significant. RESULTS: All the students had heard about AIDS before the interview. Knowledge on some aspect of the disease was quite low in the study group. Only half of the students knew that at present, AIDs is incurable and that HIV infection can be acquired through sexual contact with a 'familiar' person. Knowledge about STI was also quite low, 39% knew that pus in the urine is a symptom of STI and 45.4% knew that acquisition of other STIs is increases the chance of HIV transmission following unsafe sex with known cases. 25% of the study group had previous sexual intercourse and exposed at least one risk behavior. About 34% of the respondents had negative attitude towards AIDS and STDs. CONCLUSION: Awareness about STDs and methods of prevention of HIV and STDs was low. More risk behavior was observed in male and those with alcohol and drugs of abuse.