Prevalence of pneumonia and its associated factors among under-five children in East Africa: a systematic review and meta-analysis.

BACKGROUND: Pneumonia is defined as an acute inflammation of the Lungs' parenchymal structure. It is a major public health problem and the leading cause of morbidity and mortality in under-five children especially in developing countries. In 2015, it was estimated that about 102 million cases of pneumonia occurred in under-five children, of which 0.7 million were end up with death. Different primary studies in Eastern Africa showed the burden of pneumonia. However, inconsistency among those studies was seen and no review has been conducted to report the amalgamated magnitude and associated factors. Therefore, this review aimed to estimate the national prevalence and associated factors of pneumonia in Eastern Africa METHODS: Using PRISMA guideline, we systematically reviewed and meta-analyzed studies that examined the prevalence and associated factors of pneumonia from PubMed, Cochrane library, and Google Scholar. Heterogeneity across the studies was evaluated using the Q and the I2 test. A weighted inverse variance random-effects model was applied to estimate the national prevalence and the effect size of associated factors. The subgroup analysis was conducted by country, study design, and year of publication. A funnel plot and Egger's regression test were used to see publication bias. Sensitivity analysis was also done to identify the impact of studies. RESULT: A total of 34 studies with 87, 984 participants were used for analysis. The pooled prevalence of pneumonia in East Africa was 34% (95% CI; 23.80-44.21). Use of wood as fuel source (AOR = 1.53; 95% CI:1.30-1.77; I2 = 0.0%;P = 0.465), cook food in living room (AOR = 1.47;95% CI:1.16-1.79; I2 = 0.0%;P = 0.58), caring of a child on mother during cooking (AOR = 3.26; 95% CI:1.80-4.72; I2 = 22.5%;P = 0.26), Being unvaccinated (AOR = 2.41; 95% CI:2.00-2.81; I2 = 51.4%;P = 0.055), Child history of Acute Respiratory Tract Infection (ARTI) (AOR = 2.62; 95% CI:1.68-3.56; I2 = 11.7%;P = 0.337) were identified factors of pneumonia. CONCLUSION: The prevalence of pneumonia in Eastern Africa remains high. This review will help policy-makers and program officers to design pneumonia preventive interventions.

Prevalence of neonatal hypothermia and its associated factors in East Africa: a systematic review and meta-analysis.

BACKGROUND: Neonatal hypothermia is a global health problem and a major factor for neonatal morbidity and mortality, especially in low and middle-income countries. Therefore, this systematic review and meta-analysis aimed to assess the prevalence of neonatal hypothermia and its associated factors in Eastern Africa. METHODS: We used the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines to search electronic databases (PubMed, Cochrane Library and Google Scholar; date of last search: 15 October 2019) for studies reporting the prevalence and associated factors of neonatal hypothermia. The data was extracted in the excel sheet considering prevalence, and categories of associated factors reported. A weighted inverse variance random-effects model was used to estimate the magnitude and the effect size of factors associated with hypothermia. The subgroup analysis was done by country, year of publication, and study design. RESULTS: A total of 12 potential studies with 20,911 participants were used for the analysis. The pooled prevalence of neonatal hypothermia in East Africa was found to be 57.2% (95%CI; 39.5-75.0). Delay in initiation of breastfeeding (adjusted Odds Ratio(aOR) = 2.83; 95% CI: 1.40-4.26), having neonatal health problem (aOR = 2.68; 95% CI: 1.21-4.15), being low birth weight (aOR =2.16; 95%CI: 1.03-3.29), being preterm(aOR = 4.01; 95%CI: 3.02-5.00), and nighttime delivery (aOR = 4.01; 95% CI:3.02-5.00) were identified associated factors which significantly raises the risk of neonatal hypothermia. CONCLUSIONS: The prevalence of neonatal hypothermia in Eastern Africa remains high. Delay in initiation of breastfeeding, having a neonatal health problem, being low birth weight, preterm, and nighttime delivery were identified associated factors that significantly raises the risk of neonatal hypothermia.

Practice of and associated factors regarding prevention of surgical site infection among nurses working in the surgical units of public hospitals in Addis Ababa city, Ethiopia: A cross-sectional study.

BACKGROUND: Surgical site infections are one of the commonest types of healthcare-associated infections. Up to 60% of these infections are estimated to be preventable by using evidence-based guidelines. As a front line caregiver, nurses are responsible for the majority of preventive activities. Hence, the enhanced practical skill of nurses is an essential component in preventive actions. OBJECTIVE: The aim of this study was to assess the practice of nurses and identify factors associated with it regarding prevention of surgical site infections in Addis Ababa city public hospitals. METHODS: An institution-based cross-sectional study was carried out from March 01-30, 2018. An adapted and pretested, self-administered questionnaire was utilized as a data collection tool. A stratified random sampling technique was employed by considering the level of hospitals as a stratum. Data were entered into a computer using Epi-data 3.1 statistical package. Then, it was exported to SPSS Version 23 for further analysis. Descriptive statistics were computed for the study variables. Bivariate regression analysis was also run to assess the association between independent variables and the level of nurse's practice. To see the relative effect of independent variables on the nurse's practice, a multivariable regression analysis was carried out. RESULT: A total of 409 nurses returned the questionnaire with a response rate of 98%. Majority (60.4%) of the participants were females and 84.1% were BSc holders. Less than half, (48.9%) of the participants were found to have good practice regarding prevention of surgical site infection. Being male, having more work experience, higher educational level and using available infection prevention guidelines were significantly associated with practice at p <0.05. CONCLUSION: More than half of the participants have inadequate practice regarding prevention of surgical site infection. Training nurses, making surgical site infection prevention guidelines easily accessible and ensuring possessed knowledge by nurses is potent enough and can be translated into desirable actions are recommended.

Determinants of Anemia among HIV-Positive Children on Highly Active Antiretroviral Therapy Attending Hospitals of North Wollo Zone, Amhara Region, Ethiopia, 2019: A Case-Control Study.

Introduction. Anemia is one of the most commonly observed hematological abnormalities and an independent poor prognostic marker of HIV disease. The rate of progression and mortality in this subgroup of patients is high compared to nonanemic patients. WHO estimates that over two billion people are anemic worldwide and young children bear the world's highest prevalence rate of anemia. In Ethiopia, there is limited information about the determinant factors associated with anemia among HIV positive children. Thus, this study aimed to determine the determinant factors of anemia among HIV-infected children on HAART. OBJECTIVE: The main purpose of this study was to assess the determinants of anemia among children on highly active antiretroviral therapy attending hospitals of North Wollo Zone, Amhara Region, Ethiopia. METHODS: A case-control study was conducted on 350 HIV-infected children on HAART attending Hospitals of North Wollo Zone, from February 1 to March 30, 2019. The study participants were selected with a consecutive sampling technique. An adapted, interviewer-administered, and pretested questionnaire and chart review were employed to collect the data. Besides, blood and stool samples were investigated to determine hematologic indices and malaria and to investigate intestinal parasites, respectively. Data were analyzed by using the SPSS version 24 statistical software and bivariate and multivariate logistic regression was used to identify predictors. RESULTS: A total of 350 HIV positive children (117 cases and 234 controls) were included in this study with an overall response rate of 100%. On multivariate analysis, variables which have spastically significant association with anemia were as follows: had amebiasis (AOR = 7.29, 1.22-43.56), had history of opportunistic infections (AOR = 9.63, 1.94-47.85), had malaria infection (malaria pf) (AOR = 4.37, 1.16-16.42), eating nondiversified food (AOR = 10.39, 2.25-48.0), WGT-Age Z score value between -2_-3 (AOR = 9.80, 2.46-39.14), level of adherence (AOR = 2.31, 1.92, 7.77), and being from a rural area (AOR = 8.8, 2.07-37.79). CONCLUSION: In this study, having parasitic infections, having a history of opportunistic infections, being malnourished, having poor adherence to ART, caregivers living in the rural area, and eating nondiversified foods were significantly associated with hemoglobin status. Therefore, intervention aimed at prevention, early diagnosis, and treatment of anemia is essential in these patients.

The practice of key essential nutrition action messages and associated factors among mothers of children from birth up to 2 years old in Wereilu Wereda, south Wollo zone, Amhara, Northeast Ethiopia: a community based cross-sectional study.

BACKGROUND: The 1000 days, between a woman's pregnancy and her child's second birthday, offer a unique window of opportunity to build healthier and more prosperous societies. The right nutrition during this time can have a profound impact on a child's ability to grow, learn, and rise out of poverty. An essential nutrition action is one of the most effective preventive actions for reducing nutrition-related morbidity and mortality among young children. Nonetheless, there is limited evidence regarding the practice of essential nutrition action and its associated factors. OBJECTIVE: The main aim of this study was to assess the practice of key essential nutrition action messages and associated factors among mothers of children from birth up to 2 years old in Wereilu Wereda, South Wollo Zone, Northeast Ethiopia. METHODS: A community-based cross-sectional study was conducted on 563 mothers of children from birth up to 2 years old in Wereilu Wereda from April 1-30, 2018. A multi-stage sampling technique was employed. A structured, adapted and pre-tested questionnaire was used to collect the data. The data was collected through the interviews. The data were entered in EPI-data Version 4.2 and exported to SPSS version 24.0 for analysis. Bivariate and multivariable logistic regression was carried out to asses' associations between the outcome and independent variables. A p-value of < 0.05 was considered statistically significant in this study. RESULTS: The prevalence of good practice was 256 (46.5%). Educational status of the mother and the father, monthly income, parity, place of birth, postnatal care follow-up, level of knowledge and level of attitude were predictors of good practice. CONCLUSION: The practices of key essential nutrition action messages in the study area were found to be low. So, it is better to improve access to information to the community on key essential nutrition action messages through trained health workers coupled with media.