Correction: Cervical cancer screening utilization and predictors among eligible women in Ethiopia: A systematic review and meta-analysis.

[This corrects the article DOI: 10.1371/journal.pone.0259339.].

Vitamin D deficiency and its associated factors among patients with type 2 diabetes mellitus: a systematic review and meta-analysis.

OBJECTIVE: The study intended to assess the pooled prevalence of vitamin D deficiency (VDD) and its associated factors among patients with type 2 diabetes mellitus (T2DM). DESIGN: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were employed to plan and conduct this systematic review and meta-analysis. DATA SOURCES: PubMed, Medline, Google Scholar, Web of Science, Science Direct and the Worldwide Science database were searched from their inception to 31 January 2023. METHODS: Data were extracted using a standardised data extraction format prepared in Microsoft Excel. The inverse variance (I2) test was used to evaluate the presence of heterogeneity across the included studies. To identify the possible source of heterogeneity, subgroup analysis was carried out. Funnel plot symmetry, Begg's and Egger's tests were used to evaluate the existence of publication bias. In addition, factors associated with VDD among patients with T2DM were examined. All statistical analyses were carried out with STATA V.14 software. RESULTS: A total of 54 studies with 38 016 study participants were included in the study. The pooled prevalence of VDD among patients with T2DM was found to be 64.2% (95% CI 60.6% to 67.8%) with a substantial level of heterogeneity (I2=98.2%; p<0.001). Results of the subgroup analysis indicated that the pooled prevalence of VDD among patients with T2DM was highest (70.9%) in African nations and lowest (57.1%) in Middle East countries. Being female (pooled OR (POR) 1.60, 95% CI 1.29 to 1.97), having poor glycaemic control (POR 2.50; 95% CI 1.74 to 3.59), hypertension (POR 1.21; 95% CI 1.08 to 1.36), obesity (body mass index ≥25) (POR 1.68; 95% CI 1.16 to 2.44), dyslipidaemia (POR 2.54, 95% CI 1.37 to 4.73), albuminuria (POR 2.22, 95% CI 1.71 to 2.95), nephropathy (POR 1.58; 95% CI 1.08 to 2.31) and retinopathy (POR 1.48: 95% CI 1.17 to 1.89) were predictors of VDD among patients with T2DM. CONCLUSIONS: More than half of patients with T2DM were suffering from VDD. Being female, having poor glycaemic control, hypertension, obesity, dyslipidaemia, albuminuria, nephropathy and retinopathy were the predictors of VDD among patients with T2DM.

Magnitude and predictors of unfavorable management outcome in surgically treated patients with intestinal obstruction in Ethiopia: a systematic review and meta-analysis.

BACKGROUND: Unless an emergency surgical intervention is conducted, intestinal obstruction may result in high morbidity and mortality. In Ethiopia, the magnitude and predictors of unfavorable management outcomes in surgically treated patients with intestinal obstruction are highly variable and inconsistent. The aim of this study was; therefore, to estimate the overall prevalence of unfavorable management outcome and its predictors among surgically treated patients with intestinal obstruction in Ethiopia. METHOD: We searched articles from databases from June 1, 2022, to August 30, 2022. Cochrane Q test statistics and I2 tests were applied. We used a random-effect meta-analysis model to overcome the impact of heterogeneity among the included studies. In addition, the association between risk factors and unfavorable management outcome in surgically treated patients with intestinal obstruction was investigated. RESULTS: This study included a total of twelve articles. The pooled prevalence of unfavorable management outcome in surgically treated patients with intestinal obstruction was 20.22% (95% CI: 17.48-22.96). According to a sub-group analysis by region, Tigray region had the highest prevalence of poor management outcome, which was 25.78% (95% CI: 15.69-35.87). Surgical site infection was the most commonly reported symptom of poor management outcome (8.63%; 95% CI: 5.62, 11.64). The length of postoperative hospital stays (95% CI: 3.02, 29.08), duration of illness (95% CI: 2.44, 6.12), presence of comorbidity (95% CI: 2.38, 10.11), dehydration (95% CI: 2.07, 17.40), and type of intraoperative procedure (95% CI: 2.12, 6.97) were all significantly associated with unfavorable management outcome of intestinal obstruction among surgically treated patients in Ethiopia. CONCLUSION: According to this study, the magnitude of unfavorable management outcome was high among surgically treated patients in Ethiopia. Unfavorable management outcome was significantly associated with the length of postoperative hospital stays, duration of illness, comorbidity, dehydration, and type of intraoperative procedure. Medical, surgical and public health measures are pivotal to reduce unfavorable management outcome in surgically treated intestinal obstruction patients in Ethiopia.

Sub-chronic toxicity of the aqueous leaf extract of Ocimum lamiifolium Hochst. ex Benth on biochemical parameters and histopathology of liver and kidney in rats: in vivo and in- silico toxicity studies.

BACKGROUND: The aerial part of Ocimum lamiifolium is commonly used in Ethiopian traditional medicine. Although this plant is mostly used in traditional medicine, its safety profile has not been documented yet. The aim of this study was to assess the sub-chronic toxicity of O. lamiifolium aqueous extract in rats and to determine the toxicity profile of GC-MS identified bioactive compounds obtained from essential oil of O. lamiifolium using in silico toxicity methods. METHODS: Eighty rats (40 male and 40 female) were randomly assigned to four groups of ten rats per sex/group. For 90 days, Groups I-III received 200, 400, and 600 mg/kg bw of aqueous extract of O. lamiifolium, respectively. Distilled water was given to Group IV (control). Clinical observations, food intake, and rat weight were all recorded during the experiment. In addition, several biochemical parameters, organ weight, and histology of the liver and kidney were all evaluated. For the in-silico toxicity study, GC-MS identified bioactive compounds in O. lamiifolium essential oil were obtained from published articles. The compounds two-dimensional structures were constructed using Chemdraw. The two-dimensional structures were converted into a simplified molecular input line entry system (SMILES) using the Swiss ADMET web tool. Furthermore, the toxicity parameters were predicted using the ProTox II server. RESULTS: The administration of an aqueous extract of O. lamiifolium leaves significantly (p < 0.05) reduced the test animals' food intake and body weight gain. In the high dose (600 mg/kg bw) treated group, the serum alanine aminotransferase, aspartate aminotransferase, and alkaline phosphatase levels were significantly increased (p < 0.05). In female rats given 600 mg/kg bw of O. lamiifolium, the levels of serum urea were also increased. In addition, rats given 600 mg/kg bw had significantly lower blood glucose levels than the control group (p < 0.05). Doses up to 400 mg/kg bw didn't bring a significant change to the histology of the liver. However, in the high dose (600 mg/kg bw) treated group, some female rats' livers showed mild sinusoidal and central vein dilatation, as well as parenchymal necrosis. our findings showed that all compounds derived from the essential oil of O. lamiifolium showed no mutagenicity or cytotoxicity. However, 30% of the compounds tested were hepatotoxic, 20% carcinogenic, and 20% immunotoxin. CONCLUSION: Our findings showed that oral administration of O. lamiifoliums aqueous extract up to a dose of 400 mg/kg bw is not toxic. However, high-dose (600 mg/kg bw) significantly affected the food consumption and weight gain of the experimental rats and the serum concentration of some liver and kidney enzymes were also significantly increased. Additionally, a considerable proportion of the tested compounds were predicted to be hepatotoxic, carcinogenic and immunotoxin. Furthermore, before employing O. lamiifolium preparations as drugs, a chronic toxicity research on the essential oil as well as its components that exhibited toxicity in the in-silico toxicity study is needed. Finally, use high doses of O. lamiifolium leaves with caution.

In silico Screening of Potential SARS-CoV-2 Main Protease Inhibitors from Thymus schimperi.

Background: COVID-19 is still instigating significant social and economic chaos worldwide; however, there is no approved antiviral drug yet. Here, we used in silico analysis to screen potential SARS-CoV-2 main protease (Mpro) inhibitors extracted from the essential oil of Thymus schimperi which could contribute to the discovery of potent anti-SARS-CoV-2 phytochemicals. Methods: The absorption, distribution, metabolism, excretion, and toxicity (ADMET) profiles of compounds were determined through SwissADME and ProToxII servers. AutoDock tools were used for molecular docking analysis studies, while Chimera, DS studio, and LigPlot were used for post-docking studies. Molecular dynamic simulations were performed for 200 ns under constant pressure. Results: All compounds exhibited a bioavailability score of ≥0.55 entailing that at least 55% of the drugs can be absorbed unchanged. Only five (9%), nine (16%) and two (3.6%) of the compounds showed active hepatotoxicity, carcinogenicity, and immunotoxicity, respectively. Except for flourazophore P, which showed a little mutagenicity, all other compounds did not show mutagenic properties. On the other hand, only pinene beta was found to have a little cytotoxicity. Five compounds demonstrated effective binding to the catalytic dyad of the SARS-CoV-2 Mpro substrate binding pocket, while two of them (geranylisobutanoate and 3-octane) are found to be the best hits that formed hydrogen bonds with Glu166 and Ser144 of SARS-CoV-2 Mpro. Conclusion: Based on our in silico analysis, top hits from Thymus schimperi may serve as potential anti-SARS-CoV-2 compounds. Further in vitro and in vivo studies are recommended to characterize these compounds for clinical applications.

The Developmental Toxicity of Thymus schimperi Essential Oil in Rat Embryos and Fetuses.

Background: In Ethiopian traditional medicine, the aerial parts of Thymus schimperi are widely used to treat diseases such as gonorrhea, cough, liver disease, kidney disease, hypertension, stomach pain, and fungal skin infections. In addition, they have been used as vegetables to flavor a broad variety of food products. However, there is an insufficient investigation of the toxic effect of Thymus schimperi essential oil. The aim of this study was, therefore, to evaluate the developmental toxicity of the essential oil of Thymus schimperi leaves on developing rat embryos and fetuses. Methods: Essential oil of the aerial parts of Thymus schimperi was extracted by hydrodistillation. Pregnant Wistar albino rats were randomly divided into five groups. The doses 65 mg/kg, 130 mg/kg, and 260 mg/kg of the essential of Thymus schimperi were administered by force feeding to the III-V groups, respectively. Groups I and II were negative and ad libitum control groups. The embryos and fetuses were revealed on days 12 and 20 of gestations, respectively. The embryos were examined for developmental delays or growth retardation. Gross external, skeletal, and visceral anomalies in the fetuses were examined. Results: In this study, the developmental scores of the number of implantation sites, crown-rump length, the number of somites, and morphological scores were significantly lower while the score of fetal resorptions was increased in a 12-day-old rat embryos treated with 260 mg/kg of the Thymus schimperi essential oil. There was also a significant delay in the development of the otic system, olfactory system, and a reduction in the number of branchial bars in 12-day-old embryos treated with 130 mg/kg and 260 mg/kg of the essential oil. However, external morphological examinations of rat fetuses revealed no detectable structural abnormalities. The fetal skull, vertebrae, hyoid, forelimb, and hindlimb ossification centers did not differ significantly across all the groups. Furthermore, there were no skeletal or soft-tissue malformations as a result of the essential oil treatment. Although the difference was not statistically significant, fetuses of the high-dose treatment group had a reduced number of ossification centers in the caudal vertebrae and hind limp phalanges. Conclusion: The essential oil of Thymus schimperi at high doses has a detrimental effect on the development of rat embryos and fetuses. Its developmental toxicity is evidenced by significant delays in fetal and embryonic development, a decrease in the number of implantation sites, and an increase in fetal resorption. Furthermore, administration of the essential oil in higher doses resulted in a significant decrease in placenta weight and litter weight. In addition, the present study provided evidence that using the Thymus schimperi essential oil in a high dose could affect the developing embryo and fetus. Thus, it is recommended to discourage the use of Thymus schimperi essential oil in high doses.

Computer vision syndrome and predictors among computer users in Ethiopia: a systematic review and meta-analysis.

BACKGROUND: A computer is one of the most widely used office tools. The leading occupational health problem of the twenty-first century is computer vision syndrome (CVS). Research findings across Ethiopia on the magnitude and predictors of CVS among computer users are highly variable and inconsistent. Therefore, this study aimed to estimate the overall prevalence of CVS and its predictors among computer users in Ethiopia. METHODS: We searched articles in all databases and other sources. Cochrane Q test statistics and I2 tests were used. A random-effect meta-analysis model was used. In addition, the association between risk factors and CVS among computer users was examined. RESULTS: Eight eligible studies were included. The pooled prevalence of CVS among computer users in Ethiopia was 73.21% (95% CI 70.32-76.11). Sub-group analysis by profession has shown that the highest prevalence of CVS was observed in bank employees [73.76% (95% CI 70.40-77.13)]. The most common reported symptoms of CVS were blurred vision (34.26%; 95% CI 22.08, 46.43). The previous history of eye disease (95% CI 2.30, 5.47), inappropriate sitting position (95% CI 1.76, 3.22), the frequent use of a computer (95% CI 2.04, 3.60), and using eyeglass/spectacles (95% CI 1.10, 3.91) were significantly associated with CVS among computer users in Ethiopia. CONCLUSIONS: According to this study, computer vision syndrome was high among computer users in Ethiopia. Computer vision syndrome (CVS) was significantly associated with a previous history of eye disease, inappropriate sitting position, frequent use of a computer, and the use of spectacles. Based on the findings, it is suggested that efforts be made to optimize computer exposure time. It is also worth noting that employees should be properly seated when using a computer. Furthermore, people with vision problems should be extra cautious when using a computer. Finally, community awareness of the safety precautions that can be taken to reduce CVS is critical.

Non-prescribed drug use and predictors among pregnant women in Ethiopia: systematic review and meta-analysis.

BACKGROUND: The use of non-prescribed drugs are common to pregnant women. It may lead to undesirable effects, such as birth defects. Study results on the occurrence and predictor of non-prescribed drug use among pregnant women throughout Ethiopia are highly variable and inconsistent. Therefore, the objective of this systematic review and meta-analysis was to estimate the pooled prevalence of non-prescribed drug use and predictors among pregnant women in Ethiopia. METHODS: We systematically searched studies from the international databases, including PubMed, EMBASE, Web of Science, Science Direct, Google Scholar, the Cochrane Library and others. The meta-analysis was conducted using Stata15. I2 test and Egger's test were used to assess the heterogeneity and publication bias respectively. The random-effect model was used to estimate the pooled prevalence of non-prescribed drug use at a 95% CI. RESULTS: Eleven studies with a total of 4492 pregnant women fulfilled the inclusion criteria and were included. The pooled national level non-prescribed drug use among pregnant women was 30.38% (95% CI: 20.28, 40.48). The highest use of non-prescribed drug among pregnant women was observed in Amhara region 36.71%, while the lowest was in Tigray region 9.67%, respectively. The most frequently consumed non prescribed drugs by pregnant mothers were paracetamol 34.38%, amoxicillin 14.73%, aspirin 4.25%, metronidazole 2.81% and ciprofloxacin 2.80%. Maternal previous history of self-medication, maternal illness during pregnancy and maternal marital status were significantly associated with women non-prescribed drug use during pregnancy. CONCLUSIONS: The overall prevalence of non- prescribed drug use among pregnant women in Ethiopia is relatively high, and varies across different regions. The most frequently consumed non- prescribed drug by pregnant mothers was paracetamol. Maternal; previous history of self-medication, illness during pregnancy and marital status were significantly associated with pregnant women non-prescribed drug use. Awareness of the possible side effects of taking non-prescribed drugs for all pregnant women is very relevant in the media and in the maternity ward. In particular, it is important to make clear to mothers who have a history of self-medication, to those who have a history of illness during pregnancy and to those who are pregnant, unmarried or divorced.

Cervical cancer screening utilization and predictors among eligible women in Ethiopia: A systematic review and meta-analysis.

BACKGROUND: Despite a remarkable progress in the reduction of global rate of maternal mortality, cervical cancer has been identified as the leading cause of maternal morbidity and mortality, particularly in sub-Saharan African countries. The uptake of cervical cancer screening service has been consistently shown to be effective in reducing the incidence rate and mortality from cervical cancer. Despite this, there are limited studies in Ethiopia that were conducted to assess the uptake of cervical cancer screening and its predictors, and these studies showed inconsistent and inconclusive findings. Therefore, this systematic review and meta-analysis was conducted to estimate the pooled cervical cancer screening utilization and its predictors among eligible women in Ethiopia. METHODS AND FINDINGS: Databases like PubMed, Web of Science, SCOPUS, CINAHL, Psychinfo, Google Scholar, Science Direct, and the Cochrane Library were systematically searched. All observational studies reporting cervical cancer screening utilization and/ or its predictors in Ethiopia were included. Two authors independently extracted all necessary data using a standardized data extraction format. Quality assessment criteria for prevalence studies were adapted from the Newcastle Ottawa quality assessment scale. The Cochrane Q test statistics and I2 test were used to assess the heterogeneity of studies. A random effects model of analysis was used to estimate the pooled prevalence of cervical cancer screening utilization and factors associated with it with the 95% confidence intervals (CIs). From 850 potentially relevant articles, twenty-five studies with a total of 18,067 eligible women were included in this study. The pooled national cervical cancer screening utilization was 14.79% (95% CI: 11.75, 17.83). The highest utilization of cervical cancer screening (18.59%) was observed in Southern Nations Nationalities and Peoples' region (SNNPR), and lowest was in Amhara region (13.62%). The sub-group analysis showed that the pooled cervical cancer screening was highest among HIV positive women (20.71%). This meta-analysis also showed that absence of women's formal education reduces cervical cancer screening utilization by 67% [POR = 0.33, 95% CI: 0.23, 0.46]. Women who had good knowledge towards cervical screening [POR = 3.01, 95%CI: 2.2.6, 4.00], perceived susceptibility to cervical cancer [POR = 4.9, 95% CI: 3.67, 6.54], severity to cervical cancer [POR = 6.57, 95% CI: 3.99, 10.8] and those with a history of sexually transmitted infections (STIs) [POR = 5.39, 95% CI: 1.41, 20.58] were more likely to utilize cervical cancer screening. Additionally, the major barriers of cervical cancer screening utilization were considering oneself as healthy (48.97%) and lack of information on cervical cancer screening (34.34%). CONCLUSIONS: This meta-analysis found that the percentage of cervical cancer screening among eligible women was much lower than the WHO recommendations. Only one in every seven women utilized cervical cancer screening in Ethiopia. There were significant variations in the cervical cancer screening based on geographical regions and characteristics of women. Educational status, knowledge towards cervical cancer screening, perceived susceptibility and severity to cervical cancer and history of STIs significantly increased the uptake of screening practice. Therefore, women empowerment, improving knowledge towards cervical cancer screening, enhancing perceived susceptibility and severity to cancer and identifying previous history of women are essential strategies to improve cervical cancer screening practice.

Composition of the Essential Oil Thymus schimperi and Evaluation of Its Acute and Subacute Toxicity in Wistar Albino Rats: In Silico Toxicity Studies.

BACKGROUND: In Ethiopian traditional medicine, the aerial part of Thymus schimperi is widely used to treat diseases such as gonorrhea, cough, liver disease, kidney disease, hypertension, stomach pain, and fungal skin infections. However, there is insufficient investigation on the toxic effect of the essential oil of T. schimperi. The aim of this study was, therefore, to evaluate the acute, subacute, and in silico toxicity of Thymus schimperi essential oil in the Wistar albino rats. METHOD: Essential oil of the aerial part of T. schimperi extracted by hydrodistillation was analyzed by GC-MS. The oil was subjected to toxicity studies. In the acute toxicity study, rats were randomly divided into seven groups (n = 5). The control group received only distilled water with 2% of tween 80, whereas the experimental groups received single doses of 300, 600, 900, 1200, 1500, and 2 000 mg/kg of the oil. In the subacute toxicity study, rats were randomly divided into four groups (n = 10). The control group received distilled water with 2% of tween 80, whereas the experimental groups received 65 mg/kg, 130 mg/kg, and 260 mg/kg of the oil orally for 28 days. At the end of the experiment, blood samples were collected for hematology and clinical chemistry evaluation. Gross pathology and histopathology of the liver and the kidneys were also evaluated. For the in silico toxicity study, PubChem CID numbers of GC-MS identified bioactive compounds in the essential oil of T. schimperi obtained from PubChem. Chemdraw (8.0) was used to construct two-dimensional structures of the compounds. The Swiss ADMET web tool was used to convert the two-dimensional structures into a simplified molecular-input line input system (SMILES). In addition, the toxicity parameters were predicted via vNN and ADMET servers. RESULTS: In this study, the LD50 of the essential oil of T. schimperi was found to be 1284.2 mg/kg. According to the World Health Organization, the oil is classified as moderately hazardous in its oral administration. In the subacute toxicity study, rats showed no significant changes in behavioral indices, gross pathology, body weight, biochemical, and most hematological parameters. However, hematological profiles showed a significant decrement in WBC counts and a significant increment of MCV in high dose (260 mg/kg) groups as compared to the control group. Furthermore, no significant differences were observed between the control and essential oil-treated groups, observed in the gross histopathology of the liver and the kidneys. In the in silico toxicity study, all compounds derived from the essential oil showed no cardiac toxicity (h-ERG Blocker), AMES (Ames Mutagenicity), and cytotoxicity via ADMET and vNN-ADMET toxicity predictors. However, by using these servers, about 8.6% of the compounds showed hepatotoxicity, only 3.45% caused drug-induced liver injury, and only 1.75% were potentially toxic to the mitochondrial membrane. CONCLUSION: From the results of this study, oral administration of the essential oil T. schimperi up to a dose of 130 mg/kg is not harmful. However, in the high-dose (260 mg/kg) group, the WBC count was significantly decreased and the MCV was significantly increased. In the in silico toxicity study, most of the components of the oil were found to be nontoxic, although a few of the compounds showed hepatotoxicity and mitochondrial membrane potential toxicity. It is, therefore, essential to conduct chronic toxicity of the essential oil as well as its components, which showed toxicity in the in silico study before using preparations containing the essential oil of T. schimperi.

Prevalence and predictors of uterine rupture among Ethiopian women: A systematic review and meta-analysis.

BACKGROUND: Uterine rupture has a significant public health importance, contributing to 13% of maternal mortality and 74%-92% of perinatal mortality in Sub-Saharan Africa, and 36% of maternal mortality in Ethiopia. The prevalence and predictors of uterine rupture were highly variable and inconclusive across studies in the country. Therefore, this systematic review and meta-analysis aimed to estimate the pooled prevalence and predictor of uterine rupture in Ethiopia. METHODS: This systematic review and meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2009 checklist. PubMed, Cochrane Library, Google Scholar, and African Journals Online databases were searched. The Newcastle- Ottawa quality assessment tool was used for critical appraisal. I2 statistic and Egger's tests were used to assess the heterogeneity and publication bias, respectively. The random-effects model was used to estimate the pooled prevalence and odds ratios with a 95% confidence interval. RESULTS: Sixteen studies were included, with a total of 91,784 women in the meta-analysis. The pooled prevalence of uterine rupture was 2% (95% CI: 1.99, 3.01). The highest prevalence was observed in the Amhara regional state (5%) and the lowest was in Tigray region (1%). Previous cesarean delivery (OR = 9.95, 95% CI: 3.09, 32.0), lack of antenatal care visit (OR = 8.40, 95% CI: 4.5, 15.7), rural residence (OR = 4.75, 95% CI: 1.17, 19.3), grand multiparity (OR = 4.49, 95% CI: 2.83, 7.11) and obstructed labor (OR = 6.75, 95%CI: 1.92, 23.8) were predictors of uterine rupture. CONCLUSION: Uterine rupture is still high in Ethiopia. Therefore, proper auditing on the appropriateness of cesarean section and proper labor monitoring, improving antenatal care visit, and birth preparedness and complication readiness plan are needed. Moreover, early referral and family planning utilization are the recommended interventions to reduce the burden of uterine rupture among Ethiopia women.

Prevalence and associated factors of birth defects among newborns in sub-Saharan African countries: a systematic review and meta-analysis.

INTRODUCTION: Birth defects are the most serious causes of infant mortality and disability in sub-Saharan African countries with variable magnitude. Hence, this study was aimed to determine the pooled prevalence of birth defects and its associated risk factors among newborn infants in sub-Saharan African countries. METHODS: A total of 43 eligible studies were identified through literature search from Medline (PubMed), EMBASE, HINARI, Google scholar, Science Direct, Cochrane Library and other sources. Extracted data were analyzed using STATA 15.0 statistical software. A random effect meta-analysis model was used. RESULTS: Twenty-five studies in 9 countries showed that the pooled prevalence of birth defects was 20.40 per 1,000 births (95% CI: 17.04, 23.77). In the sub-group analysis, the highest prevalence was observed in southern Africa region with a prevalence of 43 per 1000 (95% CI: 14.89, 71.10). The most prevalent types of birth defects were musculo-skeletal system defects with a pooled prevalence of 3.90 per 1000 (95% CI: 3.11, 4.70) while the least was Down syndrome 0.62 per 1000 (95% CI: 0.40, 0.84). Lack of folic acid supplementation (95% CI: 1.95, 7.88), presence of chronic disease (95% CI: 2.00, 6.07) and intake of drugs (95% CI: 3.88, 14.66) during pregnancy were significantly associated with the birth defects. CONCLUSION: The prevalence of birth defects is relatively high with high degree of regional variabilities. The most common types of birth defects were musculoskeletal defects. Lack of folic acid supplementation, presence of chronic disease and intake of drugs during pregnancy were significantly associated with birth defects.

Magnitude and Predictors of Pneumonia among Under-Five Children in Ethiopia: A Systematic Review and Meta-Analysis.

Background: Pneumonia is currently the leading cause of morbidity and mortality among under-five children in developing countries, including Ethiopia. Although these problems are easily preventable and treatable, it contributes to more than 18% of deaths of under-five children every year in Ethiopia. Regardless of these facts, there is a paucity of information regarding the magnitude and its predictors of pneumonia in Ethiopia. Therefore, the main objective of this review is to determine the pooled magnitude of pneumonia and its predictors among under-five children in Ethiopia. Methods: The international databases such as MEDLINE/PubMed, EMBASE, Google Scholar, and Science Direct were scientifically explored. Articles were also searched by examining the gray literature on institutional databases and by reviewing reference lists of already identified articles. We considered all primary studies reporting the magnitude of pneumonia among under-five children and its predictors in Ethiopia. We retrieved all necessary data by using a standardized data extraction format spreadsheet. STATA 14 statistical software was used to analyze the data, and Cochrane's Q test statistics and I 2 test were used to assess the heterogeneity between the studies. Significant variability was found between the studies in such a way that a random-effect model was used. Result: The pooled magnitude of pneumonia among under-five children was 20.68% (I 2 = 97.9%; P ≤ 0.001) out of 12 studies in Ethiopia. Children who have unvaccinated (OR = 2.45), food cooking in the main house (OR = 2.46), vitamin A supplementation status (OR = 2.85), malnutrition (OR = 2.98), mixed breastfeeding (OR = 2.46), and child history of respiratory tract infection (OR = 4.11) were potential determinates of pneumonia. Conclusion and Recommendations. This review showed that the magnitude of pneumonia was relatively high. Hence, appropriate intervention on potential determinates such as health education on exclusive breastfeeding and nutrition, place of food cooking, increased immunization and vitamin A supplementation, and early control of respiratory tract infection was recommended to prevent those risk factors.

Diabetes mellitus and its associated risk factors in patients with human immunodeficiency virus on anti-retroviral therapy at referral hospitals of Northwest Ethiopia.

BACKGROUND: The use of highly active anti- retroviral therapy (HAART) as well as human immunodeficiency virus (HIV) per se have been shown to be related with diabetes among patients living with HIV. There is limited evidence on the prevalence of diabetes among HIV-infected patients in developing countries like Ethiopia. Therefore, the aim of this study is to determine the prevalence of diabetes among patients living with HIV/AIDS at referral hospitals of Northwest Ethiopia. MATERIALS AND METHODS: a hospital based cross-sectional study was conducted at referral hospitals of Northwest Ethiopia between February 2019 and April 2019. Using WHO stepwise approach, sociodemographic, behavioral and clinical data were collected from 407 included adult patients. Simple random sampling methods was used to select the study participants. Lipid profiles, fasting blood sugar as well as anthropometric indicators were also measured. SPSS version 25 was used for analysis of data; bivariate and multivariate binary logistic regression analysis was performed. RESULT: From a total of 415 patients living with HIV deemed eligible for inclusion, 407 with complete data were included in the final analysis giving a response rate of 98%. From 407 study subjects included in the analysis, 161 (39.6%) were men. The prevalence of diabetes mellitus was found to be 8.8% (95% CI 6.05, 11.55). Multivariate logistic regression analysis revealed that age [AOR (95% CI) 1.04 (1.001,1.084), p < 0.05], educational status [AOR (95% CI) 6.27 (1.72, 22.85), p < 0.05, diploma; AOR (95% CI) 9.64 (2.57, 36.12), p < 0.05, degree and above], triglyceride level [AOR (95% CI) 1.007 (1.003, 1.010), p < 0.01] have shown statistically significant association with odds of diabetes mellitus. CONCLUSION: The prevalence of diabetes was notably high in patients living with HIV/AIDS. Factors such as increased age, educational status and higher level of serum triglyceride were found to contribute to this high prevalence of diabetes.

Herbal medicine use and predictors among pregnant women attending antenatal care in Ethiopia: a systematic review and meta-analysis.

BACKGROUND: The use of herbal medicine among pregnant women is increasing in many low- and high-income countries due to their cost-effectiveness in treatment and ease of access. Research findings across Ethiopia on the prevalence and predictors of herbal medicine use among pregnant women attending antenatal care are highly variable and inconsistent. Therefore, this systematic review and meta-analysis aims to estimate the overall prevalence of the use of herbal medicine and its predictors among pregnant women attending antenatal care in Ethiopia. METHOD: We searched articles in Medline (PubMed), EMBASE, HINARI, Google Scholar, Science Direct, Cochrane Library, and other sources. The study included a total of eight studies that reported the prevalence and predictors of herbal medicine use among pregnant women from different regions of Ethiopia. Cochrane Q test statistics and I2 tests were used to assess heterogeneity. A random effect meta-analysis model was used to estimate the pooled prevalence. In addition, the association between risk factors and herbal medicine use in pregnant women attending antenatal care were examined. RESULTS: A total of eight studies were included in this review. The pooled prevalence of herbal medicine use among pregnant women attending antenatal care in Ethiopia was 47.77% (95% CI: 28.00-67.55). Subgroup analysis by geographic regions has showed that the highest prevalence (57.49%;95% CI: 53.14, 61.85) was observed in Oromia Region and the lowest prevalence was observed in Addis Ababa (31.39%; 95% CI: 2.83, 79.96). The herbal medicines commonly consumed by women during pregnancy were ginger: 41.11% (95% CI: 25.90, 56.32), damakasse: 34.63% (95% CI: 17.68, 51.58), garlic: 32.98% (95% CI: 22.21, 43.76), tenaadam: 19.59% (95% CI: 7.54, 31.63) and eucalyptus: 4.71% (95% CI: 1.1, 8.26). Mothers' previous history of self-medication (95% CI: 1.91, 51.35), illness during pregnancy (95% CI: 1.56, 23.91), employment status (95% CI: 3.89, 10.89), educational status (95% CI: 1.52, 2.68), and place of residence (95% CI: 1.86, 3.23) were predictors of herbal medicine use by women during pregnancy. CONCLUSION: In this study, about half of women attending antenatal care use herbal medicine and it is relatively high. The most commonly consumed herbal medicine during pregnancy was ginger followed by damakasse, garlic, tenaadam and eucalyptus. During pregnancy, it is not known that these most commonly consumed plant species have harmful fetal effects. However, many of the medicinal plant species are poorly studied, and it is not possible to rule out teratogenic effects. Teamwork between healthcare professionals and traditional practitioners to educate on the use of medicinal plants will encourage healthier pregnancies and better health for mothers and infants.

Essential newborn care utilization and associated factors in Ethiopia: a systematic review and meta-analysis.

BACKGROUND: Globally, newborn death accounted for 46% of under-five deaths and more than 80% of newborn deaths are the result of preventable and treatable conditions. Findings on the prevalence and associated factors of essential newborn care utilization are highly variable and inconsistent across Ethiopia. Therefore, this systematic review and meta-analysis aimed to estimate the pooled prevalence of essential newborn care utilization and associated factors in Ethiopia. METHODS: The international databases accessed included MEDLINE/PubMed, EMBASE, Web of Sciences, Scopus, and Grey literature databases, Google Scholar, Science Direct and Cochrane library were scientifically explored. We considered all primary studies reporting the prevalence of essential newborn care utilization and associated factors in Ethiopia. We retrieved all necessary data by using a standardized data extraction format spreadsheet. STATA 14 statistical software was used to analyze the data and Cochrane Q test statistics and I2 test was used to assess the heterogeneity between the studies. There significant heterogeneity between the studies so a random effect model was employed. RESULTS: The pooled estimate of essential newborn care utilization from 11 studies in Ethiopia was 48.77% (95% CI: 27.89, 69.65). Residence [OR = 2.50 (95% CI: 1.64, 3.88)], Postnatal care [OR = 5.53, 95% CI = (3.02, 10.13], counseling during pregnancy and delivery [OR = 4.39, 95% CI = (2.99, 6.45], antenatal care follows up (OR = 6.84; 95% CI: 1.15, 4.70) and maternal educational status [OR = 1.63 (95% CI: 1.12, 2.37)] were identified as associated factors of essential newborn care utilization. CONCLUSION: Based on the current study essential newborn care utilization in Ethiopia was significantly low in comparison with the current global recommendation on essential newborn care utilization. Place of residence, Postnatal care, counseling during pregnancy and delivery, antenatal care follow up, and maternal educational status were associated risk factors. Therefore, on the basis of the results, it is suggested that special attention should be given to attempts to ensure that education should focus on women during ante and postnatal follow-up, counseling during pregnancy and delivery, as well as rural and illiterate mothers. Finally, appropriate newborn services at health facilities and raising mother's level of awareness about newborn care practices are imperative in addressing the gaps in essential newborn care utilization in Ethiopia.

Prevalence and root causes of surgical site infection among women undergoing caesarean section in Ethiopia: a systematic review and meta-analysis.

BACKGROUND: Surgical site infection is a common complication in women undergoing Caesarean section and the second most common cause of maternal mortality in obstetrics. In Ethiopia, prevalence and root causes of surgical site infection post-Caesarean section are highly variable. This systematic review and meta-analysis estimate the overall prevalence of surgical site infection and its root causes among women undergoing Caesarean section in Ethiopia. METHOD: Systematic review and meta-analysis were conducted to assess the prevalence and root causes of surgical site infection in Ethiopia. The articles were searched from the databases such as Medline, Google Scholar and Science Direct. A total of 13 studies from different regions of Ethiopia reporting the prevalence and root causes of surgical site infection among women undergoing Caesarean section were included. A random effect meta-analysis model was computed to estimate the overall prevalence. In addition, the association between risk factor variables and surgical site infection related to Caesarean section were examined. RESULTS: Thirteen studies in Ethiopia showed that the overall prevalence of surgical site infection among women undergoing Caesarean section was 8.81% (95% CI: 6.34-11.28). Prolonged labor, prolonged rupture of membrane, presence of anemia, presence of chorioamnionitis, presence of meconium, vertical skin incision, greater than 2 cm thickness of subcutaneous tissue, and general anesthesia were significantly associated with surgical site infection post-Caesarean section. CONCLUSION: Prevalence of surgical site infection among women undergoing Caesarean section was relatively higher in Ethiopians compared with the report of center of disease control guideline. Prolonged labor, prolonged rupture of membrane, presence of anemia, chorioamnionitis, presence of meconium, vertical skin incision, greater than 2 cm thickness of subcutaneous tissue and/or general anesthesia were significantly associated with surgical site infection post-Caesarean section.

Prevalence and determinants of antenatal depression among pregnant women in Ethiopia: a systematic review and meta-analysis.

BACKGROUND: Antenatal depression is more prevalent in low and middle income countries as compared to high income countries. It has now been documented as a global public health problem owing to its severity, chronic nature and recurrence as well as its negative influence on the general health of women and development of children. However, in Ethiopia, there are few studies with highly variable and inconsistent findings. Therefore, the aim of this study was to determine the prevalence of antenatal depression and its determinants among pregnant women in Ethiopia. METHODS: In this systematic review and meta-analysis, we exhaustively searched several databases including PubMed, Google Scholar, Science Direct and Cochrane Library. To estimate the pooled prevalence, studies reporting the prevalence of antenatal depression and its determinants were included. Data were extracted using a standardized data extraction format prepared in Microsoft Excel and transferred to STATA 14 statistical software for analysis. To assess heterogeneity, the Cochrane Q test statistics and I2 test were used. Since the included studies exhibit considerable heterogeneity, a random effect meta- analysis model was used to estimate the pooled prevalence of antenatal depression. Finally, the association between determinant factors and antenatal depression were assessed. RESULTS: The overall pooled prevalence of antenatal depression, in Ethiopia, was 24.2% (95% CI: 19.8, 28.6). The subgroup analysis of this study indicated that the highest prevalence was reported from Addis Ababa region with a prevalence of 26.9% (21.9-32.1) whereas the lowest prevalence was reported from Amhara region, 17.25 (95% CI: 6.34, 28.17). Presence of previous history of abortion (OR: 3.0, 95% CI: 2.1, 4.4), presence of marital conflict (OR: 7.2; 95% CI: 2.7, 19.0), lack of social support from husband (OR: 3.2: 95% CI: 1.2, 8.9), and previous history of pregnancy complication (OR: 3.2: 95% CI: 1.8, 5.8) were found to be determinants of antenatal depression. CONCLUSION: The pooled prevalence of antenatal depression, in Ethiopia, was relatively high. Presence of previous history of abortion, presence of marital conflict, lack of social support from husband, presence of previous history of pregnancy complications were the main determinants of antenatal depression in Ethiopia.

Computer Vision Syndrome and Associated Factors among Computer Users in Debre Tabor Town, Northwest Ethiopia.

Background: Globally, computer is one of the common office tools used in various institutions. Using computer for prolonged time led to the users at greater health risk of computer vision syndrome (CVS). Computer vision syndrome is the leading occupational health problem of the twenty-first century. About 70 percent of computer users are suffered from CVS. Besides the health problems, CVS causes inefficiency at workplace and deteriorate quality of work. The problem of CVS and its risk factors are not well known in Ethiopia. Method: A cross-sectional study was conducted to assess the prevalence of CVS and associated factors among computer user government employees in Debre Tabor town from February to March, 2016. Multistage random sampling method was applied to select 607 study participants, and the data were collected by using a structured questionnaire. Computer vision syndrome was measured by self-reported method. Bivariate and multivariable binary logistic regression analyses were performed using SPSS version 20. Significance level was obtained at 95% CI and p value < 0.05. Results: The prevalence of CVS was 422 (69.5%) with 95% CI of 65.60, 73.0%. Blurred vision, eyestrain, and eye irritation were the commonest reported symptoms of CVS with proportion of 62.60%, 47.63%, and 47.40%, respectively. Occupation: officer (adjusted odds ratio (AOR) = 4.74) and secretary (AOR = 9.17), daily computer usage (AOR: 2.29), and preexisting eye disease (AOR = 3.19) were risk factors for CVS. However, computer users with high payment, who took regular health break, and with good knowledge on computer safety measures were less impacted by CVS. Conclusion: The prevalence of computer vision syndrome was found to be higher in Debre Tabor town. Monthly income, occupation, daily computer usage, regular health break, knowledge, and preexisting eye disease were predictor variables for CVS. Optimizing exposure time, improving awareness on safety measures, and management support are important to tackle CVS.