Trend, burden and determinants of undiagnosed hypertension in the Horn of Africa: A systematic review and meta-analysis.

BACKGROUND: Hypertension is a silent killer disease and the global report revealed that half of the world's population lives with undiagnosed hypertension. The problem is expected to be worse in low-income countries such as in Horn of Africa countries. Thus, we planned to determine the trend, burden, and determinates of undiagnosed hypertension in this region and provide conclusive and tangible evidence for interventions. METHOD: Articles were searched on Google, Google Scholar, PubMed/Medline, EMBASE, SCOPUS, and the published articles' reference list. The JBI critical appraisal checklist was used for quality assessment. A sensitivity test and I2 statistics were conducted to evaluate the heterogeneity. The Begg's statistics in the random effect model were done to evaluate the publication bias. RESULT: The pooled prevalence of undiagnosed hypertension in the Horn of Africa was 17% (95% CI: 15%-20%) and it ranges from from 13% in 2006 to 20% in 2023. A trip time to a medical institution of less than 35 minutes (OR = 0.52, 95%CI: 0.35-0.79), no regular exercise (OR = 2.26, 95% CI: 1.54-3.32), age > = 45 years (OR = 2.51, 95% CI: 1.66-3.8), age 35-44 years (OR = 1.88, 95% CI: 1.5-2.37), male (OR = 1.72, 95% CI: 1.34-2.2), poor knowledge (OR = 3.29, 95%CI: 2.39,4.53), normal BMI (OR = 3.84, 95% CI: 2.96-4.98), Overweight (OR = 1.97, 95% CI: 2.96-4.98), poor health seeking (OR = 2.79, 95%CI: 2.01-3.86), low vegetable consumers (OR = 1.99, 95%CI:1.36-2.91), smoking (OR = 1.47, 95%CI: 1.13-1.93), high triglyceride (OR = 1.83, 95%CI:1.33-2.52), chat chewing (OR = 2.18, 95%CI: 1.54-3.09), and alcohol drinking (OR = 1.75, 95%CI: 1.32-2.33) were the determinats of undiagnosed hypertension. CONCLUSION AND RECOMMENDATION: The pooled prevalence of undiagnosed hypertension was low in the Horn of Africa but its trend was increased over time. Individual level variables were identified that affect the undiagnosed hypertension. Therefore, healthy lifestyle is recommended.

Spatial pattern and associated factors of timely vaccination in Ethiopia using EDHS-2016 data: A multilevel and spatial analysis.

BACKGROUND: Age-appropriate vaccination or vaccine timeliness is the administering of vaccines on the specified schedule of immunization. One of the qualities of the immunization program is an age-appropriate vaccine, it has become an ignored indicator of program performance. Even though age-appropriate vaccination is critical for child health, there are no national-level studies to generate conclusive and tangible evidence about the determination of timely vaccination in Ethiopia. OBJECTIVE: To assess the spatial pattern and associated factors of timely vaccination in Ethiopia using EDHS-2016 data: A multilevel and spatial analysis. METHOD: Community based cross-sectional study design was employed from 18 January to 27 June 2016. To select the participants, two-stage cluster sampling was employedin the Ethiopian Demographic Health Survey 2016 data. Permission was obtained via online request by explaining the aim of this particular study from DHS international. A statistical package for social science-21 software was used for data cleaning, recoding, and analysis. Arc GIS 10.3 software was used to show the spatial variation of age-appropriate vaccination practices. A generalized linear mixed-effect model was used. For all models, intra-class correlation, a proportional change in variance, the log-likelihood test, and the Akaike information criterion were calculated. The best model was selected by the lowest value Akaike information criterion. Variables with a p-value less than 0.05 and a 95% confidence level were considered for the statistically significant association. RESULT: The spatial distribution of age-appropriate vaccination practice in Ethiopia was non-randomly distributed with the global Moran's I value of 0.22 (p-value <0.001). The prevalence of age-appropriate vaccination practice in Ethiopia was 33.8%. Women who receive ≥ 2 TT vaccines (AOR = 1.48; 1.22, 1.79), women who lived in rural residences (AOR = 0.77; 0.62, 0.96), gave birth at a health facility (AOR = 1.2; 1.12, 1.37), ANC follow up (AOR = 174; 1.45, 2.1), richest (AOR = 1.65; 1.15, 2.37), richer (AOR = 1.72; 1.3, 2.22), middle-level income (AOR = 1.65; 1.16, 2.36), poorer (AOR = 1.47; 1.11, 1.96) were the factors of age-appropriate vaccination practice. CONCLUSION: The spatial distribution of age-appropriate vaccination practice in Ethiopia was non-randomly distributed across the regions. Age-appropriate vaccination practice was low in Ethiopia. Wealth index, usual caretaker of the child, ANC utilization, history of TT vaccination, place of delivery, and residence were associated with age-appropriate vaccination practice.