Alcohol use and its determinants among adults living with HIV/AIDS in Ethiopia: a systematic review and meta-analysis.

BACKGROUND: Alcohol use is a common practice of almost all communities worldwide and it is more common among persons with HIV infection. Alcohol consumption among people with HIV/AIDS may result in poor treatment adherence, further immunity suppression and increase the risk of comorbid illness (diseases) which collectively diminish the anti-retroviral therapy responses. Although there are separate studies conducted regarding alcohol use among people with HIV/AIDS in Ethiopia, the finding results are highly variable and inconsistent. Therefore, conducting a systematic review and meta-analysis has a paramount importance to show the pooled prevalence of alcohol use and to identify its determinants among people with HIV/AIDS. METHODS: A systematic search of electronic databases of PubMed/Medline, Science Direct, Hinnari and Cochrane library was employed. Additionally, the grey literature was searched from Google and Google Scholar. Data were extracted using a standardized data extraction format prepared in Microsoft Excel . STATA-version 14 statistical software was used for analysis. Heterogeneity of primary studies was found as evaluated using the I2 test result. As a result, a random-effect meta-analysis model was used to estimate the pooled prevalence of alcohol use. RESULTS: A total of 22 primary studies which comprises 8,368 study participants were included in this systematic review and meta-analysis. The pooled prevalence of lifetime, current and hazardous alcohol use among HIV patients in Ethiopia were 36.42% [95% CI (19.96, 52.89)], 19.00% [95% CI (12.98, 25.01)] and 21.64% [95% CI (12.72, 30.55)], respectively. Khat chewing [OR = 3.53, (95% CI 1.31, 9.51)] and cigarette smoking [OR = 7.04, (95% CI 3.53, 14.04)] were found as statistically significant determinants of hazardous alcohol use among people with HIV infection. CONCLUSIONS: The result of this review showed that alcohol drinking is highly practiced among people with HIV/AIDS in Ethiopia. The magnitude of alcohol use was highly variable based on the screening methods used to measure alcohol use. Comorbid substance use (khat and cigarette) increases the risk of alcohol consumption among HIV patients. This suggests a need for designing appropriate and culturally applicable intervention programs and policy responses. Trial registration PROSPERO 2019, "CRD42019132524."

Hepatoprotective effect of silymarin on fructose induced nonalcoholic fatty liver disease in male albino wistar rats.

BACKGROUND: Nonalcoholic fatty liver disease (NAFLD) is one of the most common causes of chronic liver disease in the Western world, and it's likely to parallel the increasing prevalence of type 2 diabetes, obesity, and other components of metabolic syndrome. However, optimal treatment for NAFLD has not been established yet. Therefore, this study investigated the hepatoprotective effect of silymarin on fructose-induced nonalcoholic fatty liver disease in rats. METHODS: Thirty male Wistar rats were randomly divided into five groups; normal control group that consumed tap water, silymarin control group that consumed tap water and silymarin (400 mg/kg/day), fructose control group that consumed 20% fructose solution, treatment group that consumed 20% fructose solution and silymarin (200 mg/kg/day), and another treatment group that consumed 20% fructose solution and silymarin (400 mg/kg/day). Hepatic triglyceride, serum lipid profile, lipid peroxidation, antioxidant level, morphological features, and histopathological changes were investigated. The data were analyzed using one-way analysis of variance (ANOVA) followed by Tukey multiple comparison test. Statistical significance was determined at p < 0.05. RESULTS: This study showed that the fructose control group had a significantly high value in the stage of steatosis grade, hepatic triglyceride, serum triglyceride, total cholesterol, low-density lipoprotein cholesterol, alanine aminotransferase, aspartate aminotransferase, and hepatic malondialdehyde concentration as compared to the normal control. However, significantly low values of reduced glutathione and plasma total antioxidant capacity were found. The altered parameters due to fructose drastic effect were ameliorated by silymarin treatment. CONCLUSIONS: The fructose control group developed dyslipidemia, oxidative stress, and mild steatosis that are the characteristics features of NAFLD. However, silymarin-treated groups showed amelioration in oxidative stress, dyslipidemia, and steatosis.

Magnitude, Symptom Presentation and Correlates of Psychological Distress Among People with Epilepsy in Southern Ethiopia: A Cross-Sectional Study.

BACKGROUND: Psychological distress is a common co-morbid condition among people with epilepsy. Untreated comorbid psychosocial problems are associated with increased morbidity and health-care costs, and negatively affects treatment outcome of people with epilepsy. Therefore, the aim of this study was to describe the prevalence of psychological distress and to identify its associated factors among people with epilepsy attending outpatient treatment in Gedeo zone public hospitals, Southern Ethiopia. PATIENTS AND METHODS: This was an institution-based cross-sectional study conducted at Gedeo zone public hospitals from July 1st to October 1st, 2019. Self-reporting questionnaire was used to screen individuals with epilepsy for the presence of co-morbid psychological distress. A face to face interview was conducted among 321 anti-epileptic medication followers. The collected data were entered into Epi-Data version 3.1 and then exported to SPSS version 20 for further analysis. Binary logistic regression was computed to identify factors associated with psychological distress. Statistically, significant association was set at p-values of <0.05 in the final model with a corresponding 95% confidence interval. RESULTS: The prevalence of psychological distress was found to be 38.3% with 95% CI (34.1, 42.7) among people with epilepsy attending outpatient follow-up in Gedeo zone public hospitals. Being female [OR=1.57 (95% CI: 1.01-4.80)], uncontrolled seizures [OR=1.96 (95% CI: 1.21-3.18)], and longer duration of illness [OR= 3.16 (95% CI: 1.75-5.73)] were variables found to have statistically significant association with psychological distress. CONCLUSION: The findings of this study revealed that more than one-third of people with epilepsy screened positive for psychological distress. Therefore, this demonstrates a need to design and implement programs focusing on the prevention, early screening, and providing appropriate interventions for psychological distress among people with epilepsy.

Prevalence and Associated Factors of Low Birth Weight among Term Newborns in Dilla Town, Southern Ethiopia.

INTRODUCTION: Birth weight has emerged as the pointer of infant wellbeing and the fundamental focus of infant health policy. Low birth weight predisposes newborns to loads of health disarray like underweight, stunting, hypoglycemia, hypothermia, mental retardation, physical, and neurodevelopment problems which results in high rates of morbidity and mortality. This study aimed to assess the prevalence and associated factors of low birth weights in term newborns. OBJECTIVE: This study designed to assess the prevalence and associated factors of low birth weight among term newborns in Dilla town, Southern Ethiopia. MATERIALS AND METHODS: Institutional based cross-sectional study design was used on 472 term newborns. The study setting includes three health centers (Dilla, Wallemi, and Tumetecha) within Dilla town and Dilla University referral hospital from September 1, 2018, to January 30, 2019. The study subjects were mothers with term newborns delivered in the above institutions and those delivered at home and received care within the first 24 hours after delivery in the above health care settings. RESULTS: A total of 161 (34.1%) of the term newborns were low birth weight. Divorced mothers, rural residents, maternal age <20 years old, unwanted and unintended pregnancy, no ANC follow-up, no dietary counsel, no foliate supplementation, and cigarette smoking have shown an association with low birth weight of neonates. CONCLUSIONS: Even though the method of sampling used in this study has its confines, the prevalence of low birth weight in this study was higher than the estimate in Ethiopia. Therefore, it is recommended that special attention should be given to pregnant mothers to get adequate rest, additional diet, and antenatal services available and accessible to all pregnant women.

Knowledge, attitude, practice, and predictors of female genital mutilation in Degadamot district, Amhara regional state, Northwest Ethiopia, 2018.

BACKGROUND: Female genital mutilation is defined as all procedures that involve partial or total removal of external female genitalia, or other injuries to the female genital organs for cultural and religious purposes. In Ethiopia, the prevalence of female genital mutilation practice was 70.8% according to Ethiopian demographic and health survey 2016. This practice is against females' reproductive health rights with many serious consequences in physical, mental, social and psychological makeup. Therefore, this study aimed to assess knowledge, attitude, practice, and predictors of female genital mutilation in Degadamot district. METHODS: A community-based cross-sectional study design was conducted. Three hundred twenty-five mothers who had under 5 years old female children were selected using systematic random sampling from seven kebeles of Degadamot district. Data were collected using an adapted semi-structured face to face interview questionnaire. Data were entered into Epi-data version 3.1 and then exported to SPSS version 20 for analysis. Logistic regression analysis with 95% confidence intervals was carried out to determine the associations between predictor variables and outcome variables. RESULT: The finding of this study revealed that 56.6% of mothers had good knowledge about female genital mutilation and 54.2% of participants had a favorable attitude about female genital mutilation. 70.8% of under 5 years old female children's had female genital mutilation. Marital status AOR = 7.19(95%CI3.22-16.03), monthly income AOR = 1.97(95% CI 0.26-3.81), custom AOR = 2.13(95% CI 1.20-3.78), belief AOR =2.47(95% CI 1.39-4.39), value AOR = 0.37(95% CI 0.22-0.63), and attitude AOR = 24.4(95% CI 20.01-34.76) towards female genital mutilation had significant association with female genital mutilation practice. CONCLUSION: Prevalence of FGM practices among female children of under 5 years of age was found to be high as compared to the national level (64%). 56.6% of mothers had good knowledge about FGM. The majority of the women had a favorable attitude to keep FGM practice among their under 5 years old daughters. Marital status, monthly income, custom, belief, value, and attitude had a significant association with FGM practice.

Correction to: Magnitude and predictors of common mental disorder among people with HIV/AIDS in Ethiopia: a systematic review and meta-analysis.

An amendment to this paper has been published and can be accessed via the original article.

Prevalence and determinants of alcohol use among adults living with HIV/AIDS in Ethiopia: a systematic review protocol.

BACKGROUND: Alcohol use is a challenging problem which attributes to more than 5% of the overall global burden of disease. It is more common among persons with HIV infection than the general population. Although there are separate studies regarding people with HIV/AIDS in Ethiopia, their results are highly variable and discrepant. The objectives of this study will be to evaluate the prevalence of alcohol use and to identify its associated factors among people with HIV/AIDS in Ethiopia. METHODS: A systematic search of electronic databases (from inception onwards) of PubMed/MEDLINE, Embase, PsycINFO, and Cochrane Library will be conducted. Moreover, grey literatures will be searched from different sources (such as Google Scholar, OpenGrey, and World Health Organization websites). Reference lists of the selected articles will also be searched manually. Observational studies (cross-sectional, case-control, cohort) reporting the prevalence of alcohol use and/or its associated factors among adults with HIV/AIDS in Ethiopia will be included. The primary outcomes will be the prevalence of alcohol use among HIV/AIDS population. Secondary outcomes will be the determinants of alcohol use described in the included studies. Two reviewers will independently screen all citations and full-text articles and extract data. The studies' methodological quality (or bias) will be appraised using an appropriate tool. If feasible, we will conduct a random effects meta-analysis of observational data. Heterogeneity of primary studies will be assessed using the I2 test. Prevalence estimates will be stratified according to gender, age, and geographical location. Small-study effects (publication bias) also will be examined. DISCUSSION: Our systematic review and meta-analysis will prevail the pooled prevalence of alcohol use and its determinants among people with HIV/AIDS in Ethiopia. The finding of this study will be helpful to design appropriate preventive and interventional strategies for alcohol use among people with HIV/AIDS. This can have direct or indirect policy responses and clinical implications. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42019132524.

Magnitude and predictors of common mental disorder among people with HIV/AIDS in Ethiopia: a systematic review and meta-analysis.

BACKGROUND: Common mental disorders are frequent psychiatric comorbid conditions among people with HIV/AIDS. The presence of such psychiatric disorders negatively affects the treatment adherence, viral load suppression, quality of life, treatment outcomes and functionality of people with HIV/AIDS. However, available studies in Ethiopia have a great variation and inconsistency of reported results have been observed regarding the magnitude and associated factors of common mental disorder. Thus, conducting a systematic review and meta-analysis of existing literatures can have a paramount importance to show its summarized figure. METHODS: Literatures search was performed using databases (PubMed/Medline, Science Direct and PsycINFO. Grey literatures were also searched from Google and Google Scholar. Data were extracted from primary studies using a data extraction format prepared in Microsoft Excel and exported to STATA-version 14 statistical software for analysis. The I2 test was used to assess the heterogeneity of primary articles. The result of the test showed that there was heterogeneity between primary studies. This leads us to execute a random effect meta-analysis to estimate the pooled prevalence of common mental disorder with corresponding 95% confidence interval. RESULTS: A total of 13 primary studies comply with the inclusion criteria were included in this systematic review. The pooled prevalence of common mental disorder was found to be 28.83% (95% CI: 17.93, 39.73) among people with HIV/AIDS in Ethiopia. The highest prevalence of common mental disorder (35.20%) was observed among studies in which Kessler-10 was used as a screening tool. Single marital status (OR = 1.83; 95%CI: 1.03, 3.27), HIV/AIDS-related stigma (OR = 2.21; 95%CI: 1.68, 2.90) and current job unavailability (OR = 1.38; 95%CI: 1.01, 1.88) had statistically significant association with common mental disorder. CONCLUSION: The result of this review showed that nearly one among three individuals with HIV/AIDS is suffering from common mental disorder in Ethiopia. This calls a need to integrate the mental health and psycho-social support into the HIV/AIDS care. TRIAL REGISTRATION: PROSPERO- CRD42019132402. Registered on 05/08/2019.

Fetoplacental Weight Relationship in Normal Pregnancy and Pregnancy Complicated by Pregnancy-Induced Hypertension and Abruption of Placenta among Mothers Who Gave Birth in Southern Ethiopia, 2018.

INTRODUCTION: Placenta is a complex multifunctional organ that maintains pregnancy and promotes normal fetal development. The fetal outcome is adversely influenced by pathological changes in the placenta because it is a mirror that reflects the intrauterine status of the fetus. Placental abnormalities are considered a leading cause of maternal and prenatal mortality. This study aimed to assess the fetoplacental weight relationship in pregnancy-induced hypertension and abruption placenta and compare with the normal one. OBJECTIVE: This study designed to assess fetoplacental weight relationships in normal pregnancy and pregnancy complicated by pregnancy-induced hypertension and abruption of placenta among mothers who gave birth in Dilla University Referral Hospital, southern Ethiopia, 2018. MATERIALS AND METHODS: Institution-based comparative cross-sectional study was used on 50 placentas from mothers with pregnancy-induced hypertension, 50 placentas from mothers with abruption of placenta, and 50 placentas from mothers with normal pregnancy (control) with an age range of 19-34 years. The weight of the placenta and newborn were taken and the fetoplacental ratio was calculated. RESULTS: Placental index as well as the weight of the newborn shows statistically significant (p < 0.001) difference in pregnancy-induced hypertension and abruption placenta group compared with the normal group. The mean of the fetoplacental ratio in the normal group was 5.52 ± 0.07, in pregnancy-induced hypertension was 5.15 ± 0.11, whereas the abruption placenta was 4.99 ± 0.82. CONCLUSION: Both PIH and abruption placenta were associated with remarkable changes in the placenta index such as small placental weight and diameter and results in different kinds of congenital anomalies and low birth weight of the baby. Hence, fetoplacental ratio was altered. The lowest fetoplacental ratio was 4.99 for abruption placenta, and the highest was for a normal group of the placenta which was 5.52. Therefore, an examination of the placenta before and after birth guarantees for feto-maternal health.

Postpartum Contraceptive Use and Its Determinants in Ethiopia: A Systematic Review and Meta-analysis.

BACKGROUND: Postpartum contraceptive use is defined as the avoidance of short spaced pregnancies and unintended pregnancy through the first 12 months after delivery. In Ethiopia, different studies have been conducted to assess the prevalence of postpartum contraceptive use and associated factors. The findings of these studies were inconsistent and characterized by great variability. Therefore, the aim of this systematic review and meta-analysis was to estimate the pooled prevalence of postpartum contraceptive use and determinants in Ethiopia using the accessible studies. METHODS: The articles were identified through electronic search of reputable databases (MEDLINE through PubMed, EMBASE, HINARI, Science Direct, and Cochrane Library) and the hand search of reference listed in previous prevalence studies to retrieve more. 18 articles are included based on a comprehensive list of inclusion and exclusion criteria. Two authors independently extracted all necessary data using a standardized data extraction format. STATA 14 statistical software was used to analyze the data. The Cochrane Q and I 2 test were used to assess the heterogeneity between the studies. A random effects model was calculated to estimate the pooled prevalence of postpartum contraceptive use. Moreover, the determinants for family planning use were reviewed. RESULTS: The pooled prevalence of family planning use among mothers during the postpartum period in Ethiopia was 48.11% (95% CI: 36.96, 59.27). Besides, subgroup analysis revealed that the highest family planning use prevalence among postpartum mothers was observed in Addis Ababa, 65.41 (95% CI: 48.71, 82.11). Resumed sexual activity: 7.91 (95% CI: 4.62, 13.55), antenatal care: 4.98 (95% CI: 2.34, 10.21), secondary school and above level of maternal education: 3.53 (95% CI: 1.67, 7.45), postnatal care: 3.16 (95% CI: 1.7, 5.88), menses resumption: 3.12 (95% CI: 1.52, 6.39), and ≥6 months of postpartum period: 2.78 (95% CI: 1.97, 3.93) have shown a positive association with the use of family planning among mothers in the postpartum epoch. CONCLUSIONS: In this study, family planning use among mothers of the postpartum period in Ethiopia was significantly low compared to the existing global commendation on postpartum contraceptive use. Resumed sexual activity, antenatal care, secondary and above level of maternal education, postnatal care, menses resumption, and postpartum period ≥ 6 months were found to be significantly associated with postpartum contraceptive use.