Determinants of severity levels of anemia among pregnant women in Sub-Saharan Africa: multilevel analysis.

Background: Anemia is a severe public health problem affecting 54% of pregnant women in SSA Yet, only a limited number of studies have provided a partial assessment of the pooled prevalence and related determinants of the severity levels of anemia in pregnant women in SSA. Therefore, this study provides the most recent estimates of anemia severity levels and related determinants. Methods: The most recent Demographic Health Survey (DHS) dataset of 21 Sub-Saharan African countries which were collected between 2015 and 2022 were used. A total of 14,098 pregnant women were included. Multilevel ordinal logistic regression was used. Results: The pooled prevalence of anemia was 51.26%. Pregnant women who were in the old age groups, and who have attended secondary and higher education were less likely to be at higher levels of anemia. Those women who have given birth to >1 children in the last 5 years, pregnant women in second and third trimester and living in poorest households had greater odds of being at higher levels of anemia. Conclusion: In Sub-Saharan Africa, anemia is a severe public health concern for pregnant mothers. When developing and implementing strategies for the prevention and control of anemia, it is imperative to take into account the individual and community circumstances. Programs for the prevention and control of anemia should incorporate the economic and educational empowerment of women.

Epidemiology and identification of Eimeria species affecting poultry in East Gojjam Zone, North West Ethiopia.

BACKGROUND: Despite the expansion of modernized poultry farming in Ethiopia, the presence of high prevalence of Eimeria species is the bottleneck in the sector causing high morbidity and mortality rate in poultry. OBJECTIVES: The objectives of this study were to estimate the prevalence and identify Eimeria species and investigate the major risk factors. METHOD: A cross-sectional study was conducted from November 2019 to April 2020 in East Gojjam Zone, North West Ethiopia. A total of 384 chickens were used. Both floatation and McMaster coprological techniques were employed. Univariate and multinomial logistic regression was used to calculate the odds ratio for the associated risk factors. Analysis of variance was used to analyse differences in Eimeria oocyst counts among the groups. RESULTS: Overall prevalence of Eimeria species in poultry from the study area was 26.5%. Age (OR = 0.25, p = 0.001), management system (OR = 12.44, p = 0.001) and production system (OR = 0.37, p = 0.001) were found significantly (p < 0.05) associated with the risk of Eimeria species in poultry. The mean Eimeria oocyst count was significantly different by age and management system (F = 6.526, p = 0.002), (F = 5.369, p = 0.005), respectively. The mean Eimeria oocyst count was significantly greater in 6-12 weeks (p = 0.004) and <6 weeks of age (p = 0.025). A total of 6 Eimeria species were identified. Eimeria tenella (46.07%), Eimeria necatrix (24.5%) and Eimeria acervulina (8.82%) were the most common Eimeria species encountered. CONCLUSION: The prevalence of Eimeria species was higher in poultry in North West Ethiopia. Therefore, tailor-made intervention is required to mitigate risk factors and reduce the prevalence of Eimeria species in poultry from the study area.

Knowledge, Attitude, and Practices Related to COVID-19 and Its Determinants Among Prisoners, Southern Ethiopia.

BACKGROUND: Coronavirus disease 2019 (COVID-19) may affect anybody, and prisoners are a susceptible group in terms of the risk of contracting infectious illnesses owing to a variety of situations such as overcrowding, confinement, and poor cleanliness. Therefore, this study aimed to assess prisoners' Knowledge, Attitude, and Practice (KAP) of COVID-19 and its determinants in southern Ethiopia. METHOD: The Institutional cross-section study was conducted among 404 prisoners selected using simple random sampling obtained from the prisoner's registration book. To collect data from prisoners, an interviewer-based face-to-face data-collecting technique was used. Multivariate ordinal logistic regression was used to identify determinants of KAP toward COVID-19. RESULTS AND CONCLUSIONS: The majority of the prisoners had limited understanding and poor preventive strategies application toward COVID-19. Being male, living in a rural area, having a low educational standing, and being a farmer were related to limited knowledge, negative attitude, and poor practice toward COVID-19. Furthermore, having little understanding was linked with poor practice toward COVID-19. As a result, the focus should be on convicts, creating awareness, and addressing specific socioeconomic features of prisoners, as well as boosting COVID-19 preventive activities that should get attention in the prison.

Preconception care in sub-Saharan Africa: A systematic review and meta-analysis on the prevalence and its correlation with knowledge level among women in the reproductive age group.

Objective: Preconception care is aimed to promote optimal health in women before conception to reduce or prevent poor pregnancy outcomes. Although there are several published primary studies from sub-Saharan African countries on preconception care, they need to quantify the extent of preconception care utilization, the knowledge level about preconception care, and the association among women in the reproductive age group in this region. This systematic review and meta-analysis aimed to estimate the pooled utilization of preconception care, pooled knowledge level about preconception care, and their association among women in the reproductive age group in sub-Saharan Africa. Methods: Databases including PubMed, Science Direct, Hinari, Google Scholar, and Cochrane library were systematically searched for relevant literature. Additionally, the references of included articles were checked for additional possible sources. The Cochrane Q test statistics and I 2 tests were used to assess the heterogeneity of the included studies. A random-effect meta-analysis model was used to estimate the pooled prevalence of preconception care, knowledge level of preconception care, and their correlation among reproductive-aged women in sub-Saharan African countries. Results: Of the identified 1593 articles, 20 studies were included in the final analysis. The pooled utilization of preconception care and good knowledge level about preconception care among women of reproductive age were found to be 24.05% (95% confidence interval: 16.61, 31.49) and 33.27% (95% confidence interval: 24.78, 41.77), respectively. Women in the reproductive age group with good knowledge levels were greater than two times more likely to utilize the preconception care than the women with poor knowledge levels in sub-Saharan African countries (odds ratio: 2.35, 95% confidence interval: 1.16, 4.76). Conclusion: In sub-Saharan African countries, the utilization of preconception care and knowledge toward preconception care were low. Additionally, the current meta-analysis found good knowledge level to be significantly associated with the utilization of preconception care among women of reproductive age. These findings indicate that it is imperative to launch programs to improve the knowledge level about preconception care utilization among women in the reproductive age group in sub-Saharan African countries.

Epidemiology of Ixodid tick infestation and tick-borne haemopathogens in small ruminant from Enarje Enawuga, North Western Ethiopia.

BACKGROUND: Small ruminant playing significant economic development and cultural roles for smallholders and reared in different agroecological systems in Ethiopia. However, ticks and tick-borne haemopathogens are major threats to the health of small ruminants leading to loss of production and productivity in Ethiopia especially in north-western Ethiopia, due to climate and agroecological system favourable to the tick survival in the area. OBJECTIVES: The objectives of this study were to determine the prevalence of Ixodid tick infestation and tick-borne haemopathogens, to identify the existing Ixodid tick species and to investigate major risk factors associated with tick infestation and tick-borne haemopathogens. METHODS: A cross sectional study was conducted on 396 small ruminants (sheep =198 and goats = 198). Ticks were identified to the species level according to their morphological key structures. Thin blood smear were prepared and laboratoricaly examined to investigate tick-borne haemopathogens. Logistic regression was employed to assess the association between potential risk factors with tick infestation and tick-borne haemopathogens. RESULTS: The overall prevalence of tick infestation and tick-borne haemopathogens were 47.22% and 4.29%, respectively. Age, species, body condition, agroecological system and season were found significantly (p < 0.05) associated with tick infestation. Season was found to be significantly (p < 0.05) associated with occurrence of tick-borne haemopathogen. Amblyomma variegatum (18.2%) and Rhipicephalus evertsi evertsi (13.4%) were the predominant tick species encountered. Anaplasma ovis, Anaplasma marginale and Babesia ovis were prevalent tick-borne haemopathogens. CONCLUSIONS: The present study reported that there was higher tick infestation and tick-borne haemopathogens infections on small ruminants in the study area. Therefore, based on tick epidemiology, a strategic tick control programs were needed in this region. Further detailed studies on the role of Ixodid tick species in causing tick-borne diseases in small ruminants and their economic impact on livelihoods should be conducted.

Epidemiological and therapeutic studies on sheep lice in Sayint district, South Wollo Zone, Northeast Ethiopia.

An epidemiological (cross-sectional) and therapeutic (randomized controlled field trial) study was conducted on sheep lice in Sayint district, South Wollo, Northeast Ethiopia. The aim of the study was to (i) quantify the magnitude of sheep lice burden and the prevailing lice species, (ii) identify and quantify risk factors affecting lice infestation in sheep, and (iii) evaluate the efficacy of commonly used acaricides (diazinon and ivermectin) against sheep lice infestation. A total of 232 randomly selected sheep, 15 naturally infested sheep, and 80 viable Bovicola ovis lice were used for epidemiological, in vivo, and in vitro based therapeutic studies, respectively. Three naturally infested treatment groups each with five sheep (Group I-treated with diazinon, Group II-treated with ivermectin, and Group III-untreated/control) were used for in vivo therapeutic study. Lice count for the corresponding treatment groups was conducted on weekly basis using clinical and parasitological examinations. We used logistic regression to quantify the association between different putative risk factors and lice infestation, and the independent t-test and one-way ANOVA to compare the within and between treatment group mean lice count variations. The overall prevalence of sheep lice in the study area was 48.3%, where Bovicola ovis (83%) was the dominant lice species. Hair length, body condition, agroecology, and season were significantly (P < 0.05) associated with sheep lice infestation. Analysis of variance revealed that mean lice count significantly (P < 0.05) varies between treatment groups. A significant (P < 0.05) low mean lice cunt was recorded in diazinon- and ivermectin-treated groups when compared to untreated group. The in vivo efficacy of ivermectin (81%) was lower than diazinon (99%) when compared to the efficacy standard limit (98-100%). However, no significant mean lice count variation was recorded between the two groups. In vivo (99%) and in vitro (95%) assay evidence revealed that diazinon was highly effective for the treatment of sheep lice. According to this study, it can be concluded that the magnitude of sheep lice burden in Sayint district was found to be high and this could have a potential negative impact on sheep productivity and health performances. Thus, applying an appropriate intervention measure including the right choice of effective acaricides could help to control sheep lice in the study area.

Effectiveness of Prophylactic Bolus Ephedrine Versus Norepinephrine for Management of Postspinal Hypotension during Elective Caesarean Section in Resource Limited Setting: A Prospective Cohort Study.

Background: Spinal anaesthesia for caesarean section is the preferred technique since it provides better maternal safety and neonatal outcome compared to general anaesthesia. Hypotension is the most common complication after spinal anaesthesia. The study aims to determine the effectiveness of a prophylactic bolus dose of norepinephrine and ephedrine on the management of postspinal hypotension during caesarean section. Method: An institutional-based prospective cohort study was conducted on 84 pregnant women undergoing elective caesarean section. Based on the responsible anaesthetist's postspinal hypotension management plan, patients were divided into two groups. Those patients who received ephedrine are grouped into the ephedrine (EPH, n = 42) group, and patients who received norepinephrine are grouped under the norepinephrine group (NE, n = 42) by data collectors. After aseptic technique, spinal anaesthesia was administered with 0.5% (3 ml) bupivacaine using a 23G spinal needle. During spinal anaesthesia, a prophylactic bolus dose of 10 mg (2 ml) EPH or 16 g (2 ml) NE was given based on management plan of the shift anaesthetist. Mean arterial pressure (MAP), the heart rate (HR), number of boluses of vasopressor used, incidence of nausea and vomiting, and the Apgar score of babies at 1 and 5 min between the groups were recorded. Results: The norepinephrine group had a statistically significant higher MAP compared to the ephedrine group in the first 10 and 15 min (p < 0.05) of the study period. Thereafter, there was no statistically significant difference in MAP between the groups until the end of the study period (p > 0.05). The ephedrine group had a statistically significant higher heart rate throughout the procedure compared to the norepinephrine group (p < 0.05). The norepinephrine group required a lower bolus number of vasopressors compared to the ephedrine group to maintain blood pressure. The Apgar scores of all babies at 1 and 5 min were above seven. Significant differences regarding maternal complications (nausea and vomiting) between the groups were not detected (nausea, p=0.21 and vomiting, p=0.092). Conclusion: Norepinephrine can be used instead of ephedrine to keep a pregnant mother's blood pressure stable during a caesarean section under spinal anaesthesia without causing harm to the mother or baby. Trial registration. ClinicalTrials.gov Identifier: NCT05522088 (Date of registration: 30/08/22).

Water treatment at the point-of-use and treatment preferences among households in Ethiopia: A contemporaneous systematic review and meta-analysis.

BACKGROUND: Water is essential for maintaining human life, health, and dignity. Untreated water consumption causes 1.8 million deaths annually, over 99.8% of which happen in developing nations and 90% of which include children. Point-of-use water treatment enables people without reliable access to safe drinking water to reduce contamination and minimize microbial risk levels. This Systematic Review and Meta-analysis was, therefore, used to identify, select, and critically appraise relevant evidence about water treatment practices and their associated factors among Ethiopian households. METHODS: PubMed, Science Direct, Web of Science, Scopus, Embase, Google Scholar, ProQuest, and other databases were searched for studies published before May 5, 2022. The final synthesis included twelve investigations. Microsoft Excel was used to extract the data, and STATA 16 was used for the analysis. The Joanna Briggs Institute's Critical assessment checklist for prevalence studies was used to evaluate the quality of the included studies. Egger's test and funnel plot were used to assess publication bias. I2 statistics were calculated to check for study heterogeneity. The DerSimonian and Laird random-effects model was used to analyze the pooled effect size, odds ratios, and 95% confidence intervals across studies. Analysis of subgroups was done by publication year and geographic region. RESULTS: Of the 550 identified articles, 12 studies were eligible for analysis (n = 4849 participants). The pooled prevalence estimate of point-of-use water treatment practice among Ethiopian homes was 36.07% (95% CI: 21.94-50.19, I2 = 99.5%). Receiving training from Community health workers (OR, 1.7; 95% CI: 1.33-2.08), female headship (OR, 2.52; 95% CI: 1.60-3.44), and household wealth (OR, 1.6; 95% CI: 1.19-2.16) were significantly associated with point-of-use water treatment practice. CONCLUSION: Despite the absence of safely managed water sources, very few homes routinely treated their drinking water. Adoption of water treatment practices necessitates ongoing communication and assistance from health extension personnel. Moreover, program planners must be aware of the many user categories that households may fall under to guarantee that ongoing training messages and treatment products reach every home.

Epidemiological study on Ixodid tick infestation and tick borne haemopathogens on cattle in Awi Zone, northwest Ethiopia.

BACKGROUND: Tick and tick borne haemopathogens are the main challenge of livestock production and productivity in Ethiopia particular in northwest Ethiopia due to favourable climate condition. OBJECTIVES: The objectives of this study was to determining the prevalence of Ixodid tick infestation and tick borne haemopathogens on cattle, identifying the existing Ixodid tick species, assessing seasonal variation and major risk factors associated with tick infestation and tick borne haemopathogens. METHODS: A cross-sectional study was conducted from December 2020 to july 2021 on Ixodid tick infestation and tick borne haemopathogens on cattle in the northwest Ethiopia. A toatal of 384 cattle were used for this study. Tick species were identified using morphological identification keys under a stereomicroscope. Thin blood smear examination were conducted to assess tick borne haemopathogens. RESULTS: The overall prevalence of Ixodid tick infestation and tick borne haemopathogens were 45% and 3%, respectively. Babesia bigemina was the only haemoparasite detected in the present survey. Potential risk factors were investigated for their association with tick infestation and B. bigemina using logistic regression and chi-square test, respectively. Accordingly, age, body condition, agroecological systems and season were significantly (p < 0.05) associated with tick infestation whereas season and body condition were significantly (p < 0.05) associated with B. bigemina infection. A total seven tick species were identified. Amblyomma varigatum (55%) and Boophilus decoloratus (15.7%) were the predominant Ixodid tick species encountered. A total of 128 blood samples were collected from Jawi district and examined using thin blood smear. Of them, 3% were infected by the B. bigemina CONCLUSIONS: Tick infestation in this study was high and seems to play vital role for the reduction of production, productivity and for the transmission B. bigemina. Therefore, sound and effective tick control and prevention strategies are needed to mitigate the risk factors for tick infestation and B. bigemina infection in Ethiopia.

The prevalence of AstraZeneca COVID-19 vaccine side effects among Nigist Eleni Mohammed memorial comprehensive specialized hospital health workers. Cross sectional survey.

INTRODUCTION: The best way to eradicate corona virus disease (COVID-19) viral infection is mass vaccination. Many studies demonstrate vaccination is associated with some local and systemic side effects. This study aimed to provide evidence on AstraZeneca COVID-19 vaccine side effects. METHODOLOGY: Institutional based cross-sectional survey was conducted among 254 health workers at Nigist Eleni Mohammed memorial comprehensive specialized hospital (from July 01/ 2021 to July 30/2021). Data were collected consecutively through self-administered online survey created on Google Forms of platform which had been randomly delivered via (Facebook or telegram pages). Demographic data of participants, side effect after first and second dose of vaccine were covered. RESULT: The prevalence of at least one side effect after first dose was 91.3% and after second dose was 67%. Injection site pain (63.8% vs. 50.4%), headache (48.8% vs. 33.5%), fever (38.8% vs. 20.9%), muscle pain (38.8% vs. 21.7%), fatigue (26% vs. 28.7%, tenderness at the site (27.6% vs. 21.7%), and joint pain (27.6% vs. 20.9%) were the most commonly reported side effects after first and second dose vaccine respectively. Most of participants reported that their symptoms emerged after 6hr of vaccination and only less than 5% of participant's symptoms lasted more than 72hr of post vaccination. The younger age (≤29 year) were more susceptible to at least one side effect (χ 2 = 4.2; p = 0.04) after first dose. CONCLUSION: The prevalence of side effect after first and second dose vaccine was higher. Most of the symptoms were short lived and mild. This result might help to solve an emerging public health challenge (vaccine hesitancy) nurtured by misinformation related to vaccines safety.

Prevalence and associated factors of intimate partner violence among pregnant women attending health care facilities, Northern Ethiopia: comparative cross-sectional study.

Intimate partner violence (IPV) is a major public health problem. While it is high among pregnant women in Ethiopia, the cases are under-reported, and the true extent of the issue is uncertain. The study is intended to determine the prevalence and determinants of IPV among pregnant women seeking antenatal care (ANC). A comparative cross-sectional survey was conducted in healthcare facilities, Northern Ethiopia, in 2019. A sample of 324 pregnant women visiting ANC service was selected by systematic sampling. Binary logistic regression was conducted to identify significant determinants. The prevalence of IPV during pregnancy was 36.3%. Lack of formal schooling, rural life, husband's additional sexual partners, lack of shared decisions, and partners' alcohol intake were identified as a predictor of IPV. It is important to consider raising awareness, enhancing women's decision-making abilities, and educating women. Furthermore, partner involvement should be addressed to minimize violence against women in the community.IMPACT STATEMENTWhat is already known on this subject? Intimate partner abuse (IPV) is a global public health problem as well as a significant violation of human rights, and Ethiopia has the world's highest rates of physical and sexual IPV. The immediate effect of IPV during pregnancy (sexually transmitted infections (STI), intrauterine growth retardations (IUGR), preterm labour, miscarriage, abortion, antepartum haemorrhage, perinatal death) was known.What do the results of this study add? Even though the outcome of IPV among pregnant women was recognised, the underlying factors of the violence were not well understood. As a result, this research will contribute to our understanding of the determinants of IPV among pregnant women.What are the implications of these findings for clinical practice and/or further research? In this research, we revealed that the majority of the determinants of IPV among pregnant women were linked to their husband's behaviour, and that women's decision-making capacity and educational level were also root causes of the violence. Therefore, Women empowerment and partner participation during antenatal care would offer outstanding feedback to reduce partner violence. Aside from that, more research in family health would provide in-depth knowledge about the root cause of the violence.

Epidemiological study on calf diarrhea and coccidiosis in dairy farms in Bahir Dar, North West Ethiopia.

BACKGROUND: A longitudinal prospective study was conducted from October 2017 to April 2018 on calf diarrhea and coccidiosis in dairy farms in Bahir Dar, North West Ethiopia with the objectives of determining the incidence of calf diarrhea and calf coccidiosis from diarrheic calves, assessing the major risk factors associated with calf diarrhea and coccidiosis and identifying the existing Eimeria species. A total of 237 calves, 86 calves from 52 smallholder dairy farms and 151 calves from 8 large dairy farms, were used for this study. Fresh fecal samples were collected from 86 diarrheic calves for identification of Eimeria species. RESULTS: Overall incidences of calf diarrhea and coccidiosis found in this study were 33.5 and 20.1%, respectively. In total, 19 potential risk factors were investigated for their association with calf diarrhea and coccidiosis from diarrheic calves using Cox regression. Age of calf (HR = 2.057, P = .002), body condition (HR = 1.802, P < .001), house condition (HR = 2.072, P = .004) and age at first colostrum feeding time (HR = 2.107, P = .002) were found significantly (P < 0.05) associated with the risk of diarrhea by multivariate Cox regression. Among the risk factors tested, age (HR = 13.36, P < .001) and sex of calves (HR = 3.500, P = .020) were found significantly (P < 0.05) associated with coccidiosis by multivariate Cox regression. A total of nine Eimeria species were identified. E. bovis (28.6%), E. zuernii (19.0%) and E. auburnensis (14.3%) were the most common Eimeria species encountered. CONCLUSION: The incidence of calf diarrhea and coccidiosis was high in the dairy herds in North West Ethiopia. Therefore, sound dairy calf management practices are needed to mitigate risk factors for calf diarrhea and coccidiosis with a view to reducing the incidence of calf diarrhea and coccidiosis in Ethiopian dairy farms.

Prevalence and species composition of ixodid ticks infesting horses in three agroecologies in central Oromia, Ethiopia.

A cross-sectional study was conducted to determine the species composition and prevalence of ixodid ticks infesting horses in three agroecological zones in central Ethiopia. For this purpose, a total of 1,168 horses were examined for tick infestation. An overall prevalence of 39.04% of tick infestation on horses was recorded. A total of 917 adult ticks were collected from infested horses. Amblyomma, Boophilus, Rhipicephalus, and Hyalomma genera with the respective prevalence of 3.2%, 1.8%, 29.2%, and 4.7% were identified. In the study, Rhipicephalus evertsi evertsi was encountered with the highest prevalence (15.8%) whereas Amblyomma gemma was with lowest prevalence (1.5%). From the highland, Hyalomma marginatum rufipes (3.1%), Hyalomma truncatum (1.0%), and Boophilus decoloratus (0.3%) were identified. From the midland, R. evertsi evertsi (27.5%), Rhipicephalus pulchellus (18%), Amblyomma variegatum (3.6%), B. decoloratus (2.8%), H. marginatum rufipes (2.6%), H. truncatum (1.8%), and A. gemma (1.5%) were identified. R. evertsi evertsi, 107 (27.5%), was with the highest prevalence in the midland. From the lowland, R. pulchellus (22.3%), R. evertsi evertsi (20%), H. truncatum (3.6%), A. gemma (3.1%), B. decoloratus (2.3%), H. marginatum rufipes (2.1%), and A. variegatum (1.5%) were identified. In the lowland, R. pulchellus, 87 (22.3%), was the most abundant tick species. The overall prevalence of tick infestation on horses was significantly (P<0.05) higher both in the midland, 225 (57.8%), and the lowland, 214 (54.87%), than the highland, 17 (4.4%). This suggests that horses in midland and lowland are at higher risk of tick infestation than those horses in the highland. Further studies on the role of ticks in transmission of diseases to equines and the importance of horses as alternative hosts in different parts of Ethiopia are needed.