Magnitude and determinants of undernutrition among tuberculosis patients in Ethiopia: systematic review and meta-analysis.

BACKGROUND: Undernutrition increases the risk of TB infection to be active TB, death and relapse of the disease. Undernutrition also disturbs the management process of tuberculosis. Therefore, this study aimed to estimate the pooled magnitude and determinants of undernutrition among TB patients in Ethiopia. METHODS: From August 20, 2022 to January 6, 2023, the research articles were identified via the search engines Google Scholar, Medline, Pub Med, Cochrane Library, and Web of Science. Stata version 14 was used for analysis, along with a standardized data extraction checklist. The Cochrane Q test statistic and I2 statistics were used to determine heterogeneity. A random-effect model was used to assess the extent of undernutrition among TB patients. OR with a 95% CI was used to report the relationship between undernutrition and independent factors. A funnel plot and Egger's test were used to examine publication bias. RESULTS: A total of 720 research articles were identified via several databases and 21 studies were included in the systematic review and meta-analysis. The pooled magnitude of undernutrition among TB patients was 48.23% (95% CI 42.84, 53.62). The current meta-analysis revealed that patients who had no formal education (OR = 2.11(95%CI: 1.09, 4.06), average monthly income < 1800 ETB (OR = 2.32 (95CI: 1.33, 4.04), unable to work (OR = 2.61(95CI:1.99, 3.43), patients who had eating disorder (OR = 2.73 (95CI: 2.09, 3.56), patients who had intestinal parasite (OR = 3.77 (95CI: 2.39, 5.94), patients of > 5 family size (OR = 3.79 (95CI: 1.06, 14.93), and patients who drank alcohol (OR = 1.47(95CI: 1.06, 2.05) were significantly associated with undernutrition. CONCLUSION: This meta-analysis examined the high magnitude of undernutrition among TB patients in Ethiopia. Strategic and police-oriented intervention to prevent factors contributing to the problem is mandatory.

Facilitators and Barriers to Lung Cancer Screening during Long COVID: A Global Systematic Review and Meta-Study Synthesis of Qualitative Research.

Background: Participation in targeted screening reduces lung cancer mortality by 30-60%, but screening is not universally available. Therefore, the study aimed to synthesize the evidence and identify facilitators and barriers to lung cancer screening participation globally. Methods: Two reviewers screened primary studies using qualitative methods published up to February 2023. We used two-phase synthesis consistent with a meta-study methodology to create an interpretation of lung cancer screening decisions grounded in primary studies, carried out a thematic analysis of group themes as specific facilitators and barriers, systematically compared investigations for similarities and differences, and performed meta-synthesis to generate an expanded theory of lung cancer screening participation. We used the Social Ecological Model to organize and interpret the themes: individual, interpersonal, social/cultural, and organizational/structural levels. Results: Fifty-two articles met the final inclusion criteria. Themes identified as facilitating lung cancer screening included prioritizing patient education, quality of communication, and quality of provider-initiated encounter/coordination of care (individual patient and provider level), quality of the patient-provider relationship (interpersonal group), perception of a life's value and purpose (cultural status), quality of tools designed, and care coordination (and organizational level). Themes coded as barriers included low awareness, fear of cancer diagnosis, low perceived benefit, high perceived risk of low-dose computerized tomography, concern about cancer itself, practical obstacle, futility, stigma, lack of family support, COVID-19 fear, disruptions in cancer care due to COVID-19, inadequate knowledge of care providers, shared decision, and inadequate time (individual level), patient misunderstanding, poor rapport, provider recommendation, lack of established relationship, and confusing decision aid tools (interpersonal group), distrust in the service, fatalistic beliefs, and perception of aging (cultural level), and lack of institutional policy, lack of care coordinators, inadequate infrastructure, absence of insurance coverage, and costs (and organizational status). Conclusions: This study identified critical barriers, facilitators, and implications to lung cancer screening participation. Therefore, we employed strategies for a new digital medicine (artificial intelligence) screening method to balance the cost-benefit, "workdays" lost in case of disease, and family hardship, which is essential to improve lung cancer screening uptake.

Time to first birth and its predictors among reproductive-age women in Ethiopia: multilevel analysis using shared frailty model.

OBJECTIVE: To determine the time to first birth and its predictors among reproductive-age women in Ethiopia. DESIGN, SETTING AND PARTICIPANTS: Nationwide secondary data analysis using mini Ethiopian Demographic and Health Survey, 2019. A stratified, two-stage cluster sampling technique was used to select the sample. Among 9012 women of age 15-49 years, 8885 completed the interview yielding a response rate of 99%. MAIN OUTCOMES MEASURED: Time to first birth was determined. Kaplan-Meier method was used to estimate the time to first birth. The lognormal inverse Gaussian shared frailty model was used to model the data at a 95% CI. CI and adjusted time ratio (ATR) were reported as effect size. Statistical significance was declared at p-value<0.05. RESULTS: The overall median time to give first birth was 18 years (IQR: 15, 21). Age 20-29 (ATR=1.08; 95% CI, 1.05 to 1.12), Age>29 years (ATR=1.08; 95% CI, 1.05 to 1.11), northern regions (ATR=1.06; 95% CI, 1.03 to 1.08), rural residence (ATR=0.95; 95% CI, 0.93 to 0.98), never using contraceptive methods (ATR=0.98; 95% CI, 0.96 to 0.99), sex of household head (ATR=1.01; 95% CI, 1 to 1.03), poorest wealth index (ATR=1.04; 95% CI, 1.02 to 1.06) and richest wealth index (ATR=1.07; 95% CI, 1.04 to 1.1) were the significant predictors of time to first birth among reproductive-age women. CONCLUSION: In Ethiopia, women often gave birth to their first child at a younger age than what is recommended. Explicitly, women aged 20-29 and over 29, living in the northern region, leading a household as females, and belonging to the poorest or wealthiest wealth index tended to have a slightly delayed first childbirth. On the other hand, women in rural areas and those who had never used contraception were more likely to have an early first birth. The findings indicated the necessity of implementing targeted measures for rural Ethiopian women, especially those lacking knowledge about contraception.

Predictors of HIV Viral Load Suppression After Enhanced Adherence Counseling, Nekemte, Ethiopia.

BACKGROUND: Enhanced adherence counseling refers to the counseling intervention for Human Immunodeficiency Virus (HIV) patients with an elevated viral load result, a viral load of > 1000 copies/ml, on a routine or need-based viral load test. The Federal Ministry of Health, Ethiopia, has launched routine viral load testing and enhanced adherence counseling since 2016 for high-viral load people living with HIV, which is applicable throughout the country for all health facilities providing HIV care and treatment. Our study aimed to assess viral load suppression after enhanced adherence counseling and its predictors among high viral load people living with HIV who were on antiretroviral therapy. METHOD: We conducted a health facility-based retrospective follow-up study among 352 HIV-infected high-viral load people enrolled in enhanced adherence counseling from July 2018 to June 2021 in Nekemte town public health facilities. Cox proportional hazard analysis was used to identify independent predictors. RESULTS: The overall 65.1% of 352 persons on antiretroviral treatment achieved HIV viral load suppression after enhanced adherence counseling, (15.01 per 100 person months (95% CI13.02-16.99)). The median time to viral load suppression was 5 months. Age ≥ 15 years (AHR = 1.99, 95% CI: 1.11-3.57), no history of opportunistic infection (AHR = 2.01, 95% CI: 1.18-3.41), and not using substances (AHR = 2.48, 95% CI: 1.19-5.14) were more likely to have viral load suppressed, while having an initial viral load count greater than 50,000 RNA copies/ml (AHR = 0.56, 95% CI: 0.37-0.85) were less likely to have viral load suppressed after enhanced adherence counseling. CONCLUSION: Age, history of opportunistic infections, substance use, and an initial viral load count > 50,000 RNA copies/mL were significant predictors of viral load suppression. Enrolling all high-viral-load patients in enhanced adherence counseling is recommended for viral load suppression.

What role does community-based health insurance play in the utilisation of health services among households in Ethiopia? A community-based comparative cross-sectional study.

OBJECTIVE: In Ethiopia, despite increased health service coverage, health service utilisation remains very low. However, evidence on the level of health service utilisation between insured and non-insured households in the study area was scanty. Therefore, this study aimed to assess health service utilisation and its predictors among insured and non-insured households of community-based health insurance in the East Wallaga Zone, Oromia region, Ethiopia, in 2022. METHODS: A community-based comparative cross-sectional study was employed. Data were collected using semi-structured interviewer-administered pretested questionnaire by face-to-face interviewing of heads of the households or spouse from 1 January 2022 to 30 January 2022, on 900 (450 insured and 450 non-insured). Epi-Data V.3.1 and Statistical Package for Social Science V.26 were used for data entry and analysis, respectively. The association between dependent (health service utilisation) and independent variables was analysed first using binary logistic regression. Multivariable logistic regression was used to identify potential predictor variables at a p<0.05. RESULTS: About 60.5% (95% CI 55.7% to 64.8%) of insured households had used health services compared with 45.9% (95% CI 41.4% to 50.9%) of non-insured households in the last 6 months. Family health status (Adjusted Odd Ratio (AOR) and 95% CI=2.74 (1.37 to 5.45), AOR and 95% CI=1.62 (1.01 to 3.14)); family with chronic disease (AOR and 95% CI=8.33 (5.11 to 13.57), AOR and 95% CI=4.90 (2.48 to 9.67)); perceived availability of drugs (AOR and 95% CI=0.34 (0.15 to 0.79), AOR and 95% CI=3.97 (1.69 to 9.34)); perceived transportation cost (AOR and 95% CI=0.44 (0.21 to 0.90), AOR and 95% CI=1.71 (1.00 to 2.93)); participated in indigenous community insurance (AOR and 95% CI=3.82 (1.96 to 7.45), AOR and 95% CI=0.13 (0.06 to 0.29)) and >10 km travel distance from nearby health facilities (AOR and 95% CI=1.52 (1.02 to 2.60), AOR and 95% CI=8.37 (4.54 to 15.45)) among insured and non-insured households, respectively, were predictors of health service utilisation. CONCLUSION: Insured households were more likely to utilise health services compared with non-insured households. Family health status, family with chronic disease, perceived availability of drugs, perceived transportation cost, participation in indigenous community insurance and >10 km travel were predictors of health service utilisation among insured and non-insured households. Hence, the greatest emphasis should be given to enhancing enrolment in the community-based health insurance scheme to achieve universal health coverage.

Prevalence of homebirth preference and associated factors among pregnant women in Ethiopia: Systematic review and meta-analysis.

BACKGROUND: Homebirth preference is the intention/plan to give birth outside health facilities with the help of unskilled birth attendants. The preference to give birth at home without a skilled birth attendant leads to care-seeking delays, intrapartum mortality, multiple stillbirths, and postpartum morbidities and mortality. Therefore, this study aimed to estimate the pooled prevalence of homebirth preference and associated factors among pregnant women in Ethiopia. METHODS: Search of Google Scholar, Medline, PubMed, Cochrane Library and Web of Science were done for this study from 20th August 2022 to 6th November 2022. For data extraction and analysis, the standardized data extraction checklist and Stata version 14 were used respectively. Sentence as "Cochrane Q test statistics and I2 statistics were used to check heterogeneity of the studies. The pooled prevalence of homebirth preference was estimated using a random-effects model. The association between homebirth preference and independent variables was determined using an odd ratio with a 95% confidence interval. A funnel plot and Egger's test were used to assess publication bias. RESULTS: A total of 976 research articles were identified. Seven studies that fulfilled eligibility criteria were included in this systematic review and meta-analysis. The pooled prevalence of homebirth preference in Ethiopia was 39.62% (95% CI 27.98, 51.26). The current meta-analysis revealed that average monthly income <1800 ETB (OR = 2.66, 95% CI 1.44, 4.90) lack of ANC follow-up (OR = 2.57, 95%CI 1.32, 5.01), being multipara (OR = 1.77, 95%CI 1.39, 2.25), poor knowledge about obstetric danger sign (OR = 5.75, 95%CI 1.o2, 32.42), and not discussing the place of delivery with a partner (OR = 5.89 (95%CI 1.1, 31.63) were significantly associated with homebirth preference. CONCLUSION: This systematic review and meta-analysis examined the substantial prevalence of homebirth preference in Ethiopia which may contribute maternal and child health crisis. The homebirth preference was associated with low average monthly income (<1800 ETB), lack of ANC follow-up, multipara, poor knowledge about obstetric danger signs, and not discussing with their partner the place of delivery. Improving knowledge of pregnant women about the benefit of health facility delivery and obstetric danger signs is necessary to decrease the prevalence of homebirth preference; for these can reduce negative outcomes occurred during delivery.

Time to recovery and its predictors among under five children in outpatient therapeutic feeding programme in Borena zone, Southern Ethiopia: a retrospective cohort study.

OBJECTIVES: This study aimed to assess the time to recovery and its predictors among 6-59 months aged children treated at an outpatient therapeutic feeding programme in Borena zone. DESIGN: A retrospective cohort study. SETTING: Facility based; 23 treatment sites included in this study. PARTICIPANTS: Among the cohorts of 601 children aged 6-59 months enrolled from July 2019 to June 2021, records of 590 children were selected using systematic random sampling. Transfers and incomplete records were excluded. PRIMARY AND SECONDARY OUTCOME MEASURES: Time to recovery was a main outcome while its predictors were secondary outcomes. RESULTS: The median recovery time was 49 days (95% CI=49 to 52) with a recovery rate of 79.8% (95% CI=76.4 to 83.0). Absence of comorbidity (adjusted HR, AHR=1.72, 95% CI=1.08 to 2.73), referral way by trained mothers on screening (AHR=1.91, 95% CI=1.25 to 2.91), new admission (AHR=1.59, 95% CI=1.05 to 2.41) and adequate Plumpy'Nut provision (AHR=2.10, 95% CI=1.72 to 2.56) were significantly associated with time to recovery. It is also found that being from a distance ≥30 min to treatment site lowers a chance of recovery by 27% (AHR=0.73, 95% CI=0.60 to 0.89). CONCLUSIONS: The findings showed that a time to recovery was within an acceptable range. Incidence of recovery is enhanced with early case detection, proper management, nearby service, new admissions, provision of adequate Plumpy'Nut and enabling mothers to screen their own children for acute malnutrition. However, we did not observe a statistically significant association among breastfeeding status, type of health facility, wasting type, vaccination and routine medications. Service providers should improve adherence to treatment protocols, defaulter tracing, community outreach and timely case identification.

Latrine utilization and associated factors among districts implementing and not-implementing community-led total sanitation and hygiene in East Wollega, Western Ethiopia: A comparative cross-sectional study.

INTRODUCTION: Discharge of excreta to the environment lead to surface and groundwater contamination and human exposure to disease-causing micro-organisms. There is limitation of evidences regarding the latrine utilization among community-led total sanitation and hygiene implemented and non-implemented districts of the East Wollega Zone. Hence, this study aimed to determine the magnitude and associated factors of latrine utilization among households in community-led total sanitation and hygiene implemented and non-implemented Districts in East Wollega Zone, Western Ethiopia. METHODS: A cross-sectional study was conducted. A Multi-stage sampling technique was applied to select the 461 households. Data were collected using interviews and observations guided by a pre-structured questionnaire. Data were entered using Epi Data and exported to SPSS software version 25 for data recording, cleaning, and statistical analysis. Bivariable logistic regression was run to identify the candidate variables at p-value <0.25. Variables that had associations with latrine utilization in the bi-variable analysis were entered together into multivariable logistic regression. An Adjusted odds ratio with a 95% confidence interval was calculated and P-value< 0.05 was used to declare a statistically significant association. RESULT: The overall prevalence of latrine utilization was found to be 52.7% (95%CI:48%, 57.3%). Religion (AOR = 0.149;95%CI:0.044,0.506), education (AOR = 3.861;95%CI:1.642,9.077), occupation, absence of children <5 years (AOR = 4.724;95%CI:2.313,9.648), toilet cleaning (AOR = 10.662;95%CI:5.571,20.403), frequency of latrine construction (AOR = 6.441;95%CI:2.203,18.826), maintenance need (AOR = 6.446; 95%CI:3.023,13.744), distance from health institution (AOR = 0.987; 95%CI:0.978, 0.996), distance from kebele office (AOR = 6.478; 95%CI:2.137,19.635), and latrine distance from dwelling (AOR = 11.656; 95%CI:2.108, 64.44) were the factors associated with latrine use. CONCLUSION: The latrine utilization in this study is low as compared to other studies. Religion, education, occupation, absence of children <5 years, toilet cleaning, frequency of latrine construction, maintenance need of the toilet, distance from health institution, distance from kebele, and latrine distance from dwelling are the associated factors of latrine utilization. Both households and health workers have to work together to improve latrine utilization and the safe disposal of children's feces.

Sociodemographic and institutional determinants of zinc bundled with oral rehydration salt utilisation among under-five children with diarrhoeal diseases in East Wallaga zone, western Ethiopia: a community-based cross-sectional study.

OBJECTIVE: This study aimed to assess the sociodemographic and institutional determinants of zinc bundled with oral rehydration salt (ORS) utilisation among under-five children with diarrhoeal diseases in East Wallaga zone, western Ethiopia, in 2022. METHODS: A community-based cross-sectional study was conducted among 560 randomly selected participants from 1 to 30 April 2022. Data were entered into EpiData V.3.1, then exported to the Statistical Package for Social Science (SPSS) V.25 for analysis. An adjusted OR (AOR) along with a 95% confidence level was estimated to assess the strength of the association, and a p value <0.05 was considered to declare the statistical significance. RESULTS: About 39.6% of the participants had used zinc bundled with ORS for their children with diarrhoea at least once in the last 12 months. Being aged 40-49 years for mothers or caregivers (AOR 3.48, 95% CI 1.41, 8.53); merchant (AOR 4.11, 95% CI 1.73, 8.12); mothers or caregivers able to read and write (AOR 5.77, 95% CI 1.22, 11.67); visited secondary level (AOR 2.82, 95% CI 1.30, 6.10) and tertiary level health facilities (AOR 0.016, 95% CI 0.03, 0.97); degree and above (AOR 0.06, 95% CI 0.03, 0.12) and doctorate (AOR 0.13, 95% CI 0.04, 0.44) holder healthcare professionals were statistically associated with utilisation of zinc bundled with ORS. CONCLUSION: The study found that about two in five of the participants had used zinc bundled with ORS for their under-five children with diarrhoeal diseases. Age, occupation, educational status, level of health facilities visited and level of health professionals provided care were determinants of zinc bundled with ORS utilisation. So, health professionals at different levels of the health system have to enhance the maximisation of its bundled uptake.

Prevalence and associated factors of stunting and thinness among primary school-aged children in Gudeya Bila district, West Ethiopia: a cross-sectional study.

OBJECTIVES: This study aimed to assess the prevalence and associated factors of stunting and thinness among primary school-age children in the Gudeya Bila district. METHODS AND ANALYSIS: A community-based cross-sectional study was conducted in the Gudeya Bila district which is located in the Western part of Ethiopia. Among the calculated sample size of 561 school-aged children, 551 children were randomly selected by systematic random sampling technique and participated in this study. Critical illness, physical disability and the inability of caregivers to respond were exclusion criteria. Under-nutrition was the primary outcome while factors associated were the second outcome of this study. Semi-structured interviewer-administered questionnaires were used to collect the data while interview and body measurement were used as data collection techniques. Health Extension Workers collected the data. Data were entered into Epi Data V.3.1 and transported into SPSS V.24.0 software for data cleaning and analysis. Both bivariable and multivariable logistic regressions were run to identify the associated factors of under-nutrition. Model fitness was checked by using Hosmer-Lemeshow's test. Variables with p values <0.05 were considered statistically significant in the multivariable logistic regression. RESULTS AND CONCLUSION: The prevalence of stunting and thinness among primary school children was 8.2% (95% CI 5.6% to 10.6%) and 7.1% (95% CI 4.5% to 8.9%), respectively. Being male caregiver (adjusted OR (AOR)=4.26;95% CI 1.256% to 14.464%), family size ≥4 (AOR=4.65; 95% CI 1.8 51% to 11.696%), separated kitchen room (AOR=0.096; 95% CI 0.019 to 0.501) and hand washing after toilet use (AOR=0.152; 95% CI 0.035% to 0.667%) were significantly associated with stunting. Moreover, drinking coffee (AOR=2.25; 95% CI 1.968% to 5.243%) and child dietary diversity score <4 (AOR=2.54; 95% CI 1.721% to 8.939%) were significantly associated with thinness. Under-nutrition in this study was high compared with the global target of eradicating under-nutrition. Community-based nutritional education programmes and implementing health extension programmes are important to reduce the problem of under-nutrition to an undetectable level and to eradicate chronic under-nutrition.

Surgical management outcome and its associated factors among intestinal obstruction patients admitted to adult surgical ward of Wollega University Referral Hospital, Ethiopia.

BACKGROUND: Globally, bowel obstruction is the most common cause of surgical emergencies. It remains a challenge to healthcare workers in spite of improvements in management techniques. There is a lack of the study to determine the surgical management outcome and its associated factors in the area of study. Hence, this study aimed to determine management outcome and its associated factors among surgically treated intestinal obstruction patients at Wollega University Referral Hospital, 2021. METHODS: Facility-based cross-sectional study was conducted among all cases surgically managed for intestinal obstruction between September 1, 2018 and September 1, 2021. Data were collected using a structured checklist. The collected data were checked for completeness and entered into data entry software and then exported to SPSS version 24 for data cleaning and analysis. Both bi-variable and multivariable logistic regressions were run. P-value < 0.05 was used to declare a statistically significant association in multivariable logistic regression. The odds ratio along with 95%CI was estimated to measure the strength of the association. RESULT: 116 (59.2%) patients had favorable surgical management outcome for intestinal obstruction. Male sex (AOR = 3.694;95%CI:1.501,9.089), absence of fever (AOR = 2.636; 95%CI:1.124,6.18), ≤ 48 h duration of illness before operation (AOR = 3.045; 95%CI:1.399,6.629), viable intraoperative bowel condition (AOR = 2.372; 95%CI:1.088, 5.175), having bowel resection and anastomosis (AOR = 0.234; 95%CI:0.101,0.544) were the significantly associated factors of the favorable surgical management outcome for intestinal obstruction. CONCLUSION AND RECOMMENDATION: The favorable management outcome of patients with intestinal obstruction who were treated surgically in this study was low. Factors like sex, fever, short duration of illness, viable intraoperative bowel condition, and bowel resection and anastomosis were found to influence the surgical management outcome of patients with intestinal obstruction. The patient with intestinal obstruction should seek health care on time. Health professionals have to be skilled and provide appropriate care for the patients to reduce the risk of complications.

Predictors of Under-Five Caregivers' Utilization of Co-Packaged Zinc and Oral Rehydration Salts for Childhood Diarrhea in East Wollega Zone, Western Ethiopia.

Introduction: Diarrhea morbidity and mortality remain child health and economic burdens in low resource settings. In Ethiopia, diarrheal disease treatment service utilization remains very low. However, evidence on the level of utilization of zinc bundled with ORS among under-five caregivers' was not addressed. Objective: The study aimed to identify predictors of under-five caregivers' utilization of co-packaged zinc and oral rehydration salts for childhood diarrhea in East Wollega Zone, Western Ethiopia, in 2022. Methods: The study design used was a community-based cross-sectional study that was conducted among 540 randomly selected participants from April 1 to 30, 2022. Data were collected using interviewer-administered semi-structured questionnaires. It was entered into Epi-data version 3.1 and analyzed using SPSS version 26. An adjusted odds ratio along with a 95% confidence level was estimated, and a P value <0.05 was considered to declare the statistical significance in the multivariable analysis. Results: About 39.6% of under-five caregivers' had utilized co-packaged zinc and oral rehydration salts for their childhood diarrhea at least once in the last 12 months. Having family size less than 5 [AOR and 95% CI = 5.72 (2.93,11.15)]; heard about the co-pack [AOR and 95% CI = 9.52 (4.95,23.68)]; perceived health status for the recent episode as poor [AOR and 95% CI = 5.90 (2.58, 15.96)] and medium [AOR and 95% CI = 2.20 (1.02, 4.83)]; perceived severity for recent episodes [AOR and 95% CI = 4.48 (1.36, 14.76)] and being community-based health insurance non-member [AOR and 95% CI = 2.28 (1.34, 6.90)] were statistically associated with co-packaged zinc and ORS utilization. Conclusion: The study found that co-packaged zinc and oral rehydration salt utilization was low. Family size, heard about the co-pack, perceived health status, perceived severity, and CBHI membership were predictors of co-packaged utilization of zinc and ORS. Hence, concerned bodies in the health system should have devoted to maximize its uptake.

Outcomes following COVID-19 vaccination and associated factors among healthcare professionals in Oromia region, Ethiopia.

Vaccines are not free from adverse outcomes. However, the evidence of adverse outcomes following COVID-19 vaccination among health-care professionals (HCPs) in the study setting was scanty. Aimed to assess outcomes following COVID-19 vaccination and associated factors among health-care professionals in Oromia region, Ethiopia. An online cross-sectional survey was conducted from 1 October to 30 October 2021. Data were collected using questionnaire created on Google forms. A snowball sampling technique through the authors' network on the popular social media was used. Data analysis was performed using SPSS version 25. The Adjusted Odd Ratio (AOR) along with the 95% confidence level and variables with a p value <.05 were considered to declare the statistical significance. About 93.9% of the participants had experienced mild-to-moderate adverse outcomes following COVID-19 vaccination. Being married [AOR = 4.19, 95% CI:2.07,8.45] ,family size >5 [AOR = 5.17, 95% CI: 1.74, 15.34], family not tested for COVID-19 [AOR = 0.39, 95% CI: 0.15,0.97], lack of family support to take the vaccine [AOR = 3.58, 95% CI: 1.75, 7.33], heard anything bad about the vaccine [AOR = 4.17, 95% CI: 1.90,9.13] and very concerned as the vaccine could cause Adverse Events Following Immunization (AEFI) [AOR = 6.24, 95% CI: 1.96,19.86] were statistically associated with the outcome. The study showed that over nine out-of-often participants had experienced mild-to-moderate adverse outcomes following COVID-19 vaccination. However, severe adverse outcome experienced was very low, which could not hinder to take the vaccine due to fear of its side effects. Marital status, family size, family tested for COVID-19, lack of family support to take the vaccine, hearing anything bad about the vaccine, and being concerned about as the vaccine could cause adverse events were factors associated with the outcome.

Determinants of community-based health insurance membership renewal decision among rural households in Kellem Wollega zone, Oromia regional state, Ethiopia: a community-based cross-sectional study.

Background: Despite the fact that community-based health insurance (CBHI) is a promising program to achieve the goal of universal health coverage (UHC), it faces challenges that are not only due to low enrollment but also due to membership renewal decision that impact its sustainability. Hence, the study aimed to identify the determinants of CBHI membership renewal decision among rural households in Kellem Wollega zone, Ethiopia. Methods: The study was conducted in Kellem Wollega, Ethiopia, among rural households from March 30-April 30, 2022, using a community-based cross-sectional study design. An interviewer-administered structured questionnaire through face-to-face interviews was used. Using a systematic random sampling method, 551 households were selected making 540 (98%) response rates. The data was entered into EPI Data 3.1 and analyzed using SPSS 25 software. Descriptive statistics, binary, and multiple logistic regressions were performed. Using multiple logistic regressions, a significant association between the CBHI membership renewal decision and independent variables was identified, declaring the statistical significance level using a 95% confidence interval (CI) at p < 0.05. Results: The overall rate of CBHI membership renewal decision among households was estimated to be 365 (67.6%, 95% CI = 63.7-71.5%). The factors that significantly influenced the households' membership renewal decision were family size (AOR = 0.46, 95% CI = 0.25-0.86), low literacy status (AOR = 0.28 95% CI = 0.12-0.64), lower than middle-level of wealth index (AOR = 9.80, 95% CI = 2.75-34.92), premium affordability (AOR = 4.34, 95% CI = 2.08-9.04), unavailability of services (AOR = 0.26, 95% CI = 0.12-0.55), trusting in health facilities (AOR = 5.81, 95% CI = 2.82-11.94), favorable providers' attitude toward members (AOR = 8.23, 95% CI = 3.96-19.64), good quality of service (AOR = 4.47, 95% CI = 2.28-8.85) and health care seeking behavior (AOR =3.25, 95% CI = 1.32-7.98). Conclusion: The overall CBHI membership dropout decision rate among rural households was high, which could affect health service provision and utilization. Therefore, the insurance scheme and contracted health facilities should consider and work on family size and wealth status when membership premiums are calculated, the education level of households when creating awareness about the scheme, building trust in the contracted health facilities by providing all promised benefit packages of health services with good quality, and improving the attitude of health care providers towards the scheme members.

Assessment of Blood Donation Practice and Its Associated Factors Among Wollega University Undergraduate Students, Ethiopia.

Introduction: Blood donation is the process of collecting blood from donors who are at low risk for infection and unlikely to jeopardize their own health. Blood donation addresses maternal and child mortality and contributes to saving millions of lives. But many African countries including Ethiopia are far below the minimum blood collection rate. Furthermore, the blood donation practice is not well studied among young university students in the study area. Hence, this study was done to assess the blood donation practice and associated factors among Wollega University students, Ethiopia. Methods: A cross-sectional study was conducted among 387 students of Wollega University. The students were selected by systematic random sampling. Self-administered questionnaire was used to collect the data. The data were entered into Epidata V.3.1 and exported to SPSSV.25 for analysis. Both bivariate and multivariate logistic regressions were used to identify the associated factors. Adjusted odds ratio with 95% confidence interval and P-value <0.05 were used to declare the statistically significant associations in the multivariable regression. The analyzed result was presented using tables, graphs, and text. Results: Of the 360 respondents, 147 (40.8%; 95% CI: 35.7-46.1%) ever donated blood. Blood donation practice was significantly associated with college of the students (AOR = 3.247; 95% CI: 1.348-7.820), not taking part in blood donation campaigns (AOR = 0.285; 95% CI: 0.161-0.503), knowledge of blood bank location (AOR = 5.297; 95% CI: 3.081-9.110), knowledge about blood donation (AOR = 2.035; 95% CI: 1.123-3.686) and attitude toward blood donation (AOR = 2.266; 95% CI: 1.122-4.577). Conclusion: The magnitude of blood donation in this study was found to be less than the recommended level by the World Health Organization. Absence of the blood donation campaigns, college of study, lack of knowledge, and poor attitude toward blood donation were the factors that influence the blood donation practice. All health and related institutions including the Wollega University must work in coordination to improve the blood donation practice focusing on the regular voluntary blood donors.

Assessment of COVID-19 vaccination refusal among healthcare workers in Ethiopia.

Background: Even though the emergence of the coronavirus disease 2019 (COVID-19) vaccine and the increasing vaccination rates are promising, there are reports of refusal to get vaccinated in a different segment of the population, including health care workers. Objective: This study determines the acceptance/refusal of the COVID-19 vaccination and its predictors among health care workers in Ethiopia. Methods: A cross-sectional survey was conducted among a group of health care workers at different health facilities in Ethiopia. Data were collected from 1 to 30 July 2020. Data were collected from 403 participants through an online Google submission form. Data were entered into Epi-info 7 and exported to SPSS version 20 for analysis. Results: Approximately 38.5% of the health care workers in the study had refused COVID-19 vaccination. Younger age groups vs. 40 and above years (age 20-24 year [AOR: 0.03, 95% CI (0.00, 0.48)], age 25-29 year [AOR: 0.02, 95% CI (0.00, 0.49)], and age 30-34 year [AOR: 0.04 (0.00, 0.49)] and medical doctors vs. Nurses [AOR: 0.06, 95% CI, (0.01, 0.42)] were reported as risk factors; also, academic working staff vs. hospital staff [AOR: 4.42, 95% CI (1.85, 10.54)] was reported as a protective factor toward refusal of COVID-19 vaccination. Conclusion: Two-fifths of health care workers in Ethiopia were indicated to refuse COVID-19 vaccination, implying a significant barrier to achieving WHO's a target of 70% double vaccination rate by mid-2022.

Assessment of quality of routine health information system data and associated factors among departments in public health facilities of Harari region, Ethiopia.

BACKGROUND: Despite the improvements in the knowledge and understanding of the role of health information in the global health system, the quality of data generated by a routine health information system is still very poor in low and middle-income countries. There is a paucity of studies as to what determines data quality in health facilities in the study area. Therefore, this study was aimed to assess the quality of routine health information system data and associated factors in public health facilities of Harari region, Ethiopia. METHODS: A cross-sectional study was conducted in all public health facilities in the Harari region of Ethiopia. The department-level data were collected from respective department heads through document reviews, interviews, and observation checklists. Descriptive statistics were used to data quality and multivariate logistic regression was run to identify factors influencing data quality. The level of significance was declared at P value < 0.05. RESULT: The study found good quality data in 51.35% (95% CI 44.6-58.1) of the departments in public health facilities in the Harari Region. Departments found in the health centers were 2.5 times more likely to have good quality data as compared to those found in the health posts. The presence of trained staffs able to fill reporting formats (AOR = 2.474; 95% CI 1.124-5.445) and provisions of feedbacks (AOR = 3.083; 95% CI 1.549-6.135) were also significantly associated with data quality. CONCLUSION: The level of good data quality in the public health facilities was less than the expected national level. Lack of trained personnel able to fill the reporting format and feedback were the factors that are found to be affecting data quality. Therefore, training should be provided to increase the knowledge and skills of the health workers. Regular supportive supervision and feedback should also be maintained.

COVID-19 Vaccine Uptake and Associated Factors Among Health Professionals in Ethiopia.

BACKGROUND: Ethiopia has received 2.2 million doses of COVID-19 vaccine from the COVID-19 Vaccines Global Access (COVAX) facility and planned to vaccinate 20% of its population by the end of 2021. However, evidence on the current uptake of the vaccine in our country is scanty. Therefore, this study aimed to assess COVID-19 vaccine uptake and associated factors among health professionals in Ethiopia. METHODS: A national online cross-sectional E-survey was conducted on COVID-19 vaccine Uptake and associated factors among health professionals in Ethiopia from June 1 to 30, 2021. A semi-structured questionnaire was created on Google forms and disseminated online. The snowball sampling technique through the authors' network with Ethiopian residents on the popular social media like Facebook, telegram, and email was used. Descriptive statistics were performed. Multivariable logistic regression analysis was performed using Statistical Package for Social Sciences version 25, and all variables with P-value <0.05 and adjusted odds ratio at 95% CI were used to declare the predictors of the outcome variable. RESULTS: A total of 522 health professionals participated in the survey, of which about 324 (62.1%) of them were vaccinated with any of the COVID-19 vaccines at least once. The study indicated that COVID-19 vaccine uptake was associated with age range from 35 to 44 years [AOR = 12.97, 95% CI: 2.36-71.21], age beyond 45 years [AOR = 18.95, 95% CI = 2.04-36.29], being male [AOR = 2.91, 95% CI = 1.05,8.09], being only an academician [AOR = 0.23, 95% CI: 0.10-0.49], academicians working in University hospitals [AOR = 0.19, 95% CI: 0.05-0.83], perceiving their family as healthy [AOR = 4.40, 95% CI: 2.21-8.75], no history of receiving other vaccine before as an adult [AOR = 4.07, 95% CI: 2.07-8.01] and no history of contact with confirmed COVID-19 patients or clients [AOR = 0.42, 95% CI: 0.20-0.86]. CONCLUSION: The study found that COVID-19 vaccine uptake among health professionals was low. This was not sufficient to achieve herd immunity as at least nine out of ten health professionals are required for herd immunity. Ages, sex, place of work, perceived family health status, previous experience of receiving a vaccine as an adult and history of contact with COVID-19 clients or patients were the factors that influence the vaccine uptake among health professionals in Ethiopia. Hence, decision makers and health managers should consider instituting mandatory vaccination for health professionals and design strategies for the provision of the vaccine.