Level of adherence to option B+ program and associated factors among HIV-positive women in Ethiopia: A systematic review and meta-analysis.

BACKGROUND: Despite policy initiatives and strategic measures highly focused on preventing mother-to-child transmission through the implementation of the Option B+ program, adherence to the treatment is still challenging. The level of adherence and determinants of Option B+ program utilization reported by different studies were highly inconsistent in Ethiopia. Hence, this systematic review and meta-analysis aimed to estimate the pooled prevalence of adherence to the Option B+ program and its predictors among HIV-positive women in Ethiopia. METHODS: PubMed, Google Scholar, EMBASE, HINAR, Scopus, and Web of Sciences were searched for published articles from March 2010 to March 2022. The pooled prevalence of adherence was estimated using a weighted DerSimonian-Laird random effect model. The I2 statistics was used to identify the degree of heterogeneity. Publication bias was also assessed using the funnel plot and Egger's regression test. RESULTS: A total of 15 studies were included. The pooled estimate of the option B+ program among HIV-positive women in Ethiopia was 81.58% (95% CI: 77.33-85.84). Getting social and financial support (AOR = 3.73, 95% CI: 2.12, 6.58), disclosure of HIV status to partners (AOR = 2.05, 95% CI: 1.75, 2.41), time to reach a health facility (AOR = 0.33, 95% CI: 0.16, 0.67), receiving counseling on drug side effects (AOR = 4.09, 95% CI: 2.74, 6.11), experience of drug side effects (AOR = 0.17, 95% CI: 0.08, 0.36), and knowledge (AOR = 4.73, 95% CI: 2.62, 8.51) were significantly associated with adherence to the Option B+ program. CONCLUSION: This meta-analysis showed that the level of adherence to the Option B+ program in Ethiopia is lower than the 95% level of adherence planned to be achieved in 2020. Social and financial support, disclosure of HIV status, time to reach the health facility, counseling, drug side effects, and knowledge of PMTCT were significantly associated with option B+ adherence. The findings of this meta-analysis highlight that governmental, non-governmental, and other stakeholders need to design an effective strategy to scale up the level of disclosing one's own HIV status, access health facilities, improve knowledge of PMTCT, and counsel the potential side effects of Option B+ drugs, and advocate the program to reduce the multidimensional burden of HIV/AIDS. TRIAL REGISTRATION: Prospero registration: CRD42022320947. https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022320947.

Knowledge and skills of newborn resuscitation among health care professionals in East Africa. A systematic review and meta-analysis.

INTRODUCTION: Newborn resuscitation is a medical intervention to support the establishment of breathing and circulation in the immediate intrauterine life. It takes the lion's share in reducing neonatal mortality and impairments. Healthcare providers' knowledge and skills are the key determinants of the success of newborn resuscitation. Many primary studies have been conducted in various countries to examine the level of knowledge and skills of newborn resuscitation and associated factors among healthcare providers. However, these studies had great discrepancies and inconsistent results across East Africa. Hence, this review aimed to synthesize the pooled level of knowledge and skills of newborn resuscitation and associated factors among healthcare providers in East Africa. METHOD: Studies were systematically searched from February 11, 2023, to March 10, 2023, using PubMed, Google Scholar, HINARI, and grey literature. The effect size measurement of knowledge and skill of health care newborn resuscitation was estimated using the Random Effect Model. The data were extracted by Excel and analyzed using Stata 17 software. The Cochran's Q test and I2 statistic were used to assess the heterogeneity of studies. The symmetry of the funnel plot and Egger's test were used to check for publication bias. A subgroup analysis was done on the study years, sample sizes, and geographical location. Percentages and odds ratios (OR) with 95% CI were used to pool the effect measure. RESULTS: In this systematic review and meta-analysis, a total of 1953 articles were retrieved from various databases and registers. Finally, 17 studies with 7655 participants were included. The overall levels of knowledge and skills of healthcare providers on newborn resuscitation were 58.74% (95% CI: 44.34%, 73.14%) and 46.20% (95% CI: 25.16%, 67.24%), respectively. Newborn resuscitation training (OR = 3.95, 95% CI: 2.82, 5.56) and the availability of newborn resuscitation guidelines (OR = 2.71, 95% CI: 1.90, 3.86) were factors significantly associated with knowledge of health care professionals on newborn resuscitation. Work experience (OR = 5.92, 95% CI, 2.10, 16.70), newborn resuscitation training (OR = 2.83, 95% CI, 1.8, 4.45), knowledge (OR = 3.05, 95% CI, 1.78, 5.30), and the availability of newborn resuscitation equipment (OR = 4.92, 95% CI, 2.80, 8.62) were determinant factors of skills of health care professionals on newborn resuscitation. CONCLUSION: The knowledge and skills of healthcare providers on newborn resuscitation in East Africa were not adequate. Newborn resuscitation training and the availability of resuscitation guidelines were determinant factors of knowledge, whereas work experience, knowledge, and the availability of newborn resuscitation equipment and training were associated with the skills of healthcare providers in newborn resuscitation. Newborn resuscitation training, resuscitation guidelines and equipment availability, and work experience are recommended to improve healthcare providers' knowledge and skills.

Early Post-natal Care Services Utilization and its associated factors among mothers Systemic Review and Meta-Analysis.

Background: Early Post-natal Care Services are defined as the care given to the mother and the newborn baby after childbirth of a few weeks. This time is the most life-threatening time since most maternal and neonatal mortality takes place. Methods: The preferred reporting elements for the Systematic Review and Meta-analysis (PRISMA) checklist methodology were used to build the current systematic review and meta-analysis. A systematic literature search was done at the electronic database using the Pub Med database, PubMed/MED-LINE, CINAHL, Google Scholar, Google, Web of Sciences, and Google Scholar to identify potential research. The retrieved author/year, study region, design, and sample size of all the authors. A standardized data-gathering measuring tool was used to obtain the data. I2 test statics were used to verify the heterogeneity among the investigations. The statistical program STATA 17 was used to analyze the data. Analysis of sensitivity was verified. The asymmetry of the funnel plot and statistically significant Egger's test at a 5 % significant level indicated the presence of publication bias. The pooled prevalence of mothers' use of early postnatal care services and the factors associated with it were determined using a random effect model. Result: A total of 4498 mothers were involved in 10 studies. The pooled prevalence of Early Postnatal Care Services Utilization and Its Associated Factors among Mothers in Ethiopia was (28.51 % (95%CI, [20.95, 36.06]). According to the pooled effect, utilizing postnatal care services early was associated with formal education four points, or seven times (OR = 4.73 (95%CI, 3.12, 7.18)) higher likelihood. An early postnatal care service user is three times more likely to know early post-care visits (OR = 3.63 (95%CI, 1.25, and 10.50)).Early postnatal care service consumption is five times more likely to be associated with birth complications (OR = 4.93 (95%CI, 2.62, 9.27)). Being three times more likely to use early post-natal care services if an ANC is present (OR = 3.56 (95%CI, 2.03, 6.26)). Women who had traveled fewer than 2 h were three times as likely to have used early post-natal care services (OR = 3.47 (95%CI, 2.32, 5.20)). Early Post-natal care services utilization history ((OR = 2.26 (95%CI, 1.68, 3.04)) women who had previously used early post-natal care services. Conclusion and recommendation: In comparison to national guidelines, the WHO, and other research, Ethiopia's pooled prevalence of accessing early postnatal care services is low. Prenatal care service use and birth complications also have a significant impact on the use of early postnatal care services. Improving early postnatal care service usage requires expanding the availability of antenatal care services on a national scale. Strengthening prenatal care services, increasing the number of health centers and health posts, increasing delivery at health facilities, and emphasizing or improving mothers' knowledge of and attitudes toward early post-natal care contact are all critical to improving quality of life and lowering neonatal and maternal morbidity and mortality. Future studies and the Ethiopian Ministry of Health should concentrate on improving the use of prenatal care services, minimizing and managing birth complications, and enhancing the use of early postnatal care services.

Baseline soil-transmitted helminth and schistosome infection in the Geshiyaro project, Ethiopia: A unique transmission interruption project using biometric fingerprinting for longitudinal individual analysis.

BACKGROUND: The Geshiyaro project aims to assess the feasibility of interrupting transmission of soil-transmitted helminths (STH) and schistosome (SCH) infection in the Wolaita zone of southern Ethiopia through high coverage community-wide mass drug administration (MDA), in combination with improved water, sanitation, and hygiene services and behaviour change communication delivered through the existing health care infrastructure. To accurately measure treatment coverage a population census was conducted enrolling individuals with biometric fingerprinting and barcoded ID cards. This paper details the baseline census and parasitology surveys conducted before the start of any interventions. METHODS: The census was conducted in five of the 15 Wolaita districts between October 2018 and December 2019, enrolling all consenting participants from every household. Simultaneously, a cross-sectional parasitology survey was conducted in 130 out of 361 randomly selected communities from all 15 districts, with 100 individuals across all age groups (infant to adult) per community providing stool and urine for analysis by duplicate Kato-Katz and a point-of-care circulating cathodic antigen (POC-CCA) to test for Schistosoma mansoni and STH, and microhaematuria and urine filtration for Schistosoma haematobium. Of the 130 communities, 30 were randomly selected for annual, longitudinal parasitological monitoring, with 150 randomly selected individuals from infant to adult providing two days of stool and urine samples for analysis by the same diagnostic tests per community. RESULTS: In total 97,919 households participated in the baseline census enrolling 466,071 individuals, with parasitological data obtained from 10,785 people. At baseline, 15.5% were infected with at least one STH species, with Ascaris lumbricoides (9.5%), followed by hookworm (7.2%) and Trichuris trichiura (1.8%). Substantial heterogeneity in STH prevalence was observed between communities ranging from 0% to 61% where most infections were low intensity. Schistosoma mansoni infection was the dominant schistosome infection (0.85% by Kato-Katz and 13.3% by POC-CCA trace negative and 21.5% trace positive), with few Schistosoma haematobium infections identified (2.77% haematuria positive and 0.13% positive by urine filtration). CONCLUSIONS: While the national control program in Ethiopia has made good progress in reducing prevalence of STH and SCH in Wolaita since it was launched in 2015, there remain areas of persistent infection suggesting the existence of environmental or behavioural risk factors that contribute to ongoing transmission. This project aims to identify the most efficient intervention strategies to reduce community burden and reach interruption of transmission.

Sexual and reproductive health issues and associated factors among female night school students in Amhara Region, Ethiopia: an institution-based cross-sectional study.

OBJECTIVE: This study aimed to assess the prevalence of sexual and reproductive health (SRH) issues and associated factors among female night school students in the Amhara Region, Ethiopia. DESIGN: Institution-based cross-sectional study. SETTING: 16 night schools were selected from 4 zones in the Amhara Region. The data were collected between 1 January and 28 February 2019. PARTICIPANTS: 1428 female night school students aged 15-24 years. OUTCOMES: Prevalence of SRH issues, defined as those who had experienced at least one SRH issue during their lifetime (including sexual violence, sexually transmitted diseases, teenage pregnancy, unwanted pregnancy, early marriage and abortion). Bivariable and multivariable logistic regression models were used in the analysis. RESULTS: The prevalence of SRH issues was 32.7% (95% CI 29.5% to 35.9%). Having secondary education (adjusted (OR) AOR = 1.49, 95% CI 1.19 to 1.86), being single in marital status (AOR = 1.33, 95% CI 1.01 to 1.74), not discussing SRH issues with their families (AOR = 2.69, 95% CI 2.13 to 3.40) and poor knowledge of SRH services (AOR = 2.63, 95% CI 2.08 to 3.32) were significantly associated with SRH issues. CONCLUSION: The lifetime prevalence of SRH issues among female night school students was high. Being single, having a secondary education, not discussing SRH issues with family, and having a poor understanding of SRH services were associated with SRH issues. Qualitative studies should be conducted to explore students' feelings and intentions about SRH issues.

Transactional sex among women in Sub-Saharan Africa: A systematic review and meta-analysis.

INTRODUCTION: Transactional sex is casual sex between two people to receive material incentives in exchange for sexual favors. Transactional sex is associated with negative consequences, which increase the risk of sexually transmitted diseases, including HIV/AIDS, unintended pregnancy, unsafe abortion, and physiological trauma. In Sub-Saharan Africa, several primary studies have been conducted in various countries to examine the prevalence and associated factors of transactional sex among women. These studies had great discrepancies and inconsistent results. Hence, this systematic review and meta-analysis aimed to synthesize the pooled prevalence of the practice of transactional sex among women and its associated factors in Sub-Saharan Africa. METHOD: Data source: PubMed, Google Scholar, HINARI, the Cochrane Library, and grey literature were searched from March 6 to April 24, 2022, and included studies conducted from 2000 to 2022. The pooled prevalence of transactional sex and associated factors was estimated using Random Effect Model. Stata (version 16.0) was used to analyze the data. The I-squared statistic, a funnel plot, and Egger's test were used to check for heterogeneity and publication bias, respectively. A subgroup analysis was done based on the study years, source of data, sample sizes, and geographical location. RESULTS: The pooled prevalence of transactional sex among women in Sub-Saharan Africa was 12.55% (9.59%-15.52%). Early sexual debut (OR = 2.58, 95% CI: 1.56, 4.27), substance abuse (OR = 4.62, 95% CI: 2.62, 8.08), history of sexual experience (OR = 4.87, 95% CI: 2.37, 10.02), physical violence abuse (OR = 6.70, 95% CI: 3.32, 13.53), orphanhood (OR = 2.10, 95% CI: 1.27, 3.47), and sexual violence abuse (OR = 3.76, 95% CI: 1.08, 13.05) were significantly associated with transactional sex. CONCLUSION: The prevalence of transactional sex among women in sub-Saharan Africa was high. Alcohol consumption, substance abuse, early sex debuts, having a history of sexual experiences, physical violence, and sexual violence increased the practice of transactional sex.

Therapeutic efficacy of pyronaridine-artesunate (Pyramax®) against uncomplicated Plasmodium falciparum infection at Hamusit Health Centre, Northwest Ethiopia.

BACKGROUND: Early case detection and prompt treatment are important malaria control and elimination strategies. However, the emergence and rapid spread of drug-resistant strains present a major challenge. This study reports the first therapeutic efficacy profile of pyronaridine-artesunate against uncomplicated Plasmodium falciparum in Northwest Ethiopia. METHODS: This single-arm prospective study with 42-day follow-up period was conducted from March to May 2021 at Hamusit Health Centre using the World Health Organization (WHO) therapeutic efficacy study protocol. A total of 90 adults ages 18 and older with uncomplicated falciparum malaria consented and were enrolled in the study. A standard single-dose regimen of pyronaridine-artesunate was administered daily for 3 days, and clinical and parasitological outcomes were assessed over 42 days of follow-up. Thick and thin blood films were prepared from capillary blood and examined using light microscopy. Haemoglobin was measured and dried blood spots were collected on day 0 and on the day of failure. RESULTS: Out of 90 patients, 86/90 (95.6%) completed the 42-day follow-up study period. The overall PCR-corrected cure rate (adequate clinical and parasitological response) was very high at 86/87 (98.9%) (95% CI: 92.2-99.8%) with no serious adverse events. The parasite clearance rate was high with fast resolution of clinical symptoms; 86/90 (95.6%) and 100% of the study participants cleared parasitaemia and fever on day 3, respectively. CONCLUSION: Pyronaridine-artesunate was highly efficacious and safe against uncomplicated P. falciparum in this study population.

Active management of the third stage of labour in Ethiopia: A systematic review and meta-analysis.

BACKGROUND: Post-partum haemorrhage occurs in over 10% of all births and is the leading cause of maternal mortality, accounting for 25% of all maternal deaths worldwide. Active management of the third stage of labor is the most important intervention for reducing maternal morbidity and mortality by preventing postpartum hemorrhage. Previously, documented primary studies had been great discrepancy, inconsistent results, and there is a lack of comprehensive study. Hence, this systematic review and meta-analysis were intended to assess the prevalence and associated factors of the practice of active management of the third stage of labour among obstetric care providers in Ethiopia. METHOD: Cross-sectional studies were systematically searched from January 01, 2010, to December 24, 2020, using PubMed, Google Scholar, HINARI, Cochrane Library, and grey literature. The pooled prevalence of active management of the third stage of labour practice and associated factors was estimated using DerSemonial-Laird Random Effect Model. Stata (version 16.0) was used to analyze the data. The I-squared statistic was used to assess the studies' heterogeneity. A funnel plot and Egger's test were used to check for publication bias. A subgroup analysis was performed to minimize the underline heterogeneity depending on the study years and the sample sizes. RESULTS: Seven hundred fifty articles were extracted. The final ten studies were included in this systematic review, including 2438 participants. The pooled prevalence of practices of active management of the third stage of labour among obstetric care providers in Ethiopia was 39.65% (30.86, 48.45%). Educational status (OR = 6.11, 95%CI, 1.51-10.72), obstetric care training (OR = 3.56, 95% CI: 2.66, 4.45), work experience (OR = 2.17, 95%CI, 0.47, 3.87) and knowledge of active management of the third stage of labour (OR = 4.5, 95% CI: 2.71, 6.28) were significantly associated with active management of the third stage of labour practices. CONCLUSION: The practice of active management of the third stage of labour in Ethiopia was low. This study showed that educational status, taking obstetric care training, knowledge of AMTSL, and work experience of obstetric care providers were associated with of practices of active management of the third stage of labour. Therefore, obstetric care professionals should improve their academic level, knowledge, and skills in order to provide useful service to AMTSL and save mothers' lives. All obstetric care providers should get obstetric care training. Furthermore, the government should increase obstetric care professionals' educational level.

Female adolescents' knowledge and acceptability of human papillomavirus vaccine in Debre Tabor Town, Ethiopia: a cross-sectional study.

OBJECTIVE: This study aimed to assess the knowledge and acceptability of the human papillomavirus (HPV) vaccine and associated factors among female adolescent students in Debre Tabor Town, Ethiopia, 2021. DESIGN: Cross-sectional study was done from 9 December 2020 to 28 February 2021. ANALYSIS: The data were entered into EpiData V.4.2 and analysed with SPSS V.23 software. The OR, 95% CI and p<0.05 were used to determine the bivariable and multivariable statistical association. SETTING: Three high schools (grades 9 and 10) and six primary schools (grades 7 and 8) were included in the study. PARTICIPANTS: Adolescent female students in Debre Tabor Town. RESULTS: The overall knowledge score in the questionnaire was six, and it was divided into two groups based on scoring level: poor (score <3) and good (score ≥3). More than half respondents (59.2%) scored good knowledge. The proportion of acceptability of the HPV vaccine was 61.9%. Age (adjusted OR, AOR 1.70, 95% CI 1.17 to 3.88), and having a source of information (AOR 1.94, 95% CI 1.06 to 3.22) were significantly associated with the knowledge of the HPV vaccine. Place of birth (AOR 1.55, 95% CI 1.15 to 1.95), fathers' educational status (AOR 2.80, 95% CI 1.18 to 5.65), having a source of information (AOR 2.14, 95% CI 1.05 to 4.32) and knowledge about the HPV vaccine (AOR 6.41, 95% CI 3.45 to 11.90) were significantly associated with the acceptance of the female adolescent HPV vaccine. CONCLUSION: In this study, the knowledge and acceptability of students of the HPV vaccine were low. Health authorities, through the mass media, should strengthen HPV vaccine promotion in schools, religious institutions and health facilities.

Therapeutic efficacy of Chloroquine for the treatment of uncomplicated Plasmodium vivax infection in Shewa Robit, Northeast Ethiopia.

BACKGROUND: The development of drug resistance to chloroquine is posing a challenge in the prevention and control efforts of malaria globally. Chloroquine is the first-line treatment for uncomplicated P.vivax in Ethiopia. Regular monitoring of anti-malarial drugs is recommended to help early detection of drug-resistant strains of malaria parasites before widely distributed. The emergence of P.vivax resistance to chloroquine in the country endangers the efficacy of P.vivax treatment. This study aimed to assess the therapeutic efficacy of chloroquine among uncomplicated P.vivax infections at Shewa Robit Health Center, northeast Ethiopia. METHODS: One-arm in vivo prospective chloroquine efficacy study was conducted from November 2020 to March 2021. Ninety participants aged between 16 months to 60 years confirmed with P.vivax mono-infection microscopically were selected and treated with a 25 mg/kg standard dose of chloroquine over three days. Thick and thin blood smears were prepared and examined. Clinical examination was performed over 28 follow-up days. Hemoglobin concentration level was measured on days 0, 14, and 28. RESULT: Of the 90 enrolled participants, 86 (96%) completed their 28 days follow-up period. The overall cure rate of the drug was 98.8% (95% CI: 95.3-100%). All asexual stages and gametocytes were cleared within 48 hours with rapid clearance of fever. Hemoglobin concentration had significantly recovered between days 0 and 14, 0 and 28, and 14 and 28 days (P = 0.032, P<0.001, and P = 0.005), respectively. Fast resolution of clinical signs and symptoms was also observed. Severe adverse events were not recorded. CONCLUSION: The present study revealed that chloroquine remains an efficacious and safe drug in the study setting for treating uncomplicated P.vivax in the study area. Large-scale continuous surveillance is needed to monitor the development of resistance in due time.

Intimate partner violence during pregnancy and adverse birth outcomes in Ethiopia: A systematic review and meta-analysis.

BACKGROUND: Intimate partner violence is a significant public health issue that affects maternal and neonatal health worldwide. Several studies have been conducted to investigate the prevalence of intimate partner violence during pregnancy as well as the factors that contribute to it. As a result, the purpose of this study was to determine the impact of intimate partner violence on birth outcomes. METHODS: International databases including Scopus, PubMed, Google Scholar, Embase, and CINAHL were used to search primary studies. The quality and strength of the included studies were evaluated using the Newcastle-Ottawa Scale quality assessment tool. The studies heterogeneity and publication biases were assessed using I2 statistics and Egger's regression test. The Meta-analysis was carried out using STATA version 16 software. RESULTS: A total of nine hundred and fifty-eight articles were retrieved from various databases, and seventeen articles were included in the review. The pooled prevalence of intimate violence during pregnancy in Ethiopia was 32.23% (95% CI 28.02% -36.45%). During pregnancy, intimate partner violence was a significant predictor of low birth weight (AOR: 3.69, 95%CI 1.61-8.50) and preterm birth (AOR: 2.23, 95%CI 1.64-3.04). CONCLUSION: One in every three pregnant women experiences intimate partner violence. Women who experienced intimate partner violence during their pregnancy are more likely to experience adverse outcomes such as premature delivery and low birth weight infants.

Knowledge, attitude, and uptake of human papilloma virus vaccine and associated factors among female preparatory school students in Bahir Dar City, Amhara Region, Ethiopia.

BACKGROUND: The human papillomavirus vaccine is one of the main preventative measures for cervical cancer. However, global vaccine uptake is low; the problem is particularly acute in low and middle-income countries. The purpose of this study is to assess female preparatory school students' knowledge, attitude, and uptake of the human papillomavirus vaccine and associated factors in Bahir Dar City, Ethiopia. METHODS: Institutional-based cross-sectional study was conducted among 633 female preparatory school students in Bahir Dar city from March 1-30, 2021. Participants were selected using the multistage sampling technique. Data were collected using a structured self-administered questionnaire and entered into Epi-data and exported to SPSS for analysis. Binary and multivariable logistic regression analyses were done using an odds ratio with a 95% confidence interval. Finally-value < 0.05 was considered significant in multivariable analysis. RESULT: The proportion of Human Papillomavirus (HPV) vaccine uptake, knowledge of the vaccine, and respondents' attitudes toward the vaccine were 45.3% (95% CI = 41.6-49.4%), 58.1% (95% CI = 54.4-61.9%), and 16% (95% CI = 13.2-19.5%), respectively. Having a history of sexual contact AOR = 2.80 (95% CI = 1.64-4.76), hearing about HPV infection AOR = 1.59 (95% CI = 1.13-2.24), and having a positive attitude toward HPV vaccine AOR = 1.46 (95% CI = 1.03-2.08) were significantly associated with knowledge about the HPV vaccine. Discussion of reproductive health issues with family AOR = 2.558 (95%CI = 1.800-3.636), and having good knowledge about HPV vaccine AOR = 3.571(95%CI = 2.494-5.113) were associated with a positive attitude toward the HPV vaccine. Good knowledge AOR = 2.36(95%CI = 1.48-3.76) and a positive attitude toward HPV vaccine AOR = 2.87(95%CI = 1.70-4.85) were strongly associated with HPV vaccine utilization. CONCLUSION: In this study, there was a very low uptake of HPV vaccination among female students, and only a small proportion of them had good knowledge of the HPV vaccine and a favorable attitude toward the HPV vaccine.

Association between water, sanitation, and hygiene access and the prevalence of soil-transmitted helminth and schistosome infections in Wolayita, Ethiopia.

BACKGROUND: The Geshiyaro project is a 5-year intervention to assess the impact of community- and school-based water, sanitation, and hygiene (WaSH) interventions on reducing infection with soil-transmitted helminths (STH) and schistosome parasites in combination with deworming in Wolayita zone, Ethiopia. METHODS: A population-based, cross-sectional census and parasitological mapping activity was conducted between 2018 and 2019. Individuals in the census were identified using either a registered study ID card or biometric fingerprint to enable linkage of their household WaSH data with baseline STH and schistosome prevalence for risk analysis. RESULTS: Prevalence of STH was 15.5% for any STH species, 9.47% for Ascaris lumbricoides, 1.78% for Trichuris trichiura, and 7.24% for hookworm. Intestinal schistosomiasis (Schistosoma mansoni) infection prevalence was 0.85% by Kato Katz, 21.6% by POC-CCA trace positive (Tr +), and 13.3% trace negative (Tr-). Microhaematuria was 2.77%, with 0.13% of people examined with S. haematobium eggs detected by urine filtration. At the household level, increased (> 30 min) time taken to collect drinking water, sharing a latrine, and lack of handwashing facilities were all associated with a greater risk of A. lumbricoides, hookworm, and S. mansoni infection. Not disposing of infant stool at the household and clothes washing/recreational freshwater contact were significantly associated with higher risk of schistosomiasis infection. Aggregating WaSH data at the community level showed odds of A. lumbricoides, hookworm, and T. trichiura infection were significantly lower as both community sanitation coverage and access to improved drinking water improved. CONCLUSIONS: The principal finding of this study is that lack of access to WaSH, such as improved drinking water and shared toilet and hand-washing facilities, were linked to an increased risk of infection with STH and schistosome parasites. These associations are difficult to establish at an individual household level because of wide variability in access between houses but are detectable when coverage is aggregated at the community level. Maintenance of WaSH facilities as well as increased access within the whole community is important in influencing the community-wide prevalence of infection with STH and schistosome parasites.

Determinants of neonatal jaundice in Ethiopia: a systematic review and meta-analysis.

BACKGROUND: Neonatal jaundice is a common condition characterized by a yellowish discoloration of the skin, conjunctiva, and sclera caused by elevated serum or plasma bilirubin levels during the newborn period. The condition is usually not dangerous, but it can progress to severe hyperbilirubinemia, which can lead to acute bilirubin encephalopathy and kernicterus, a bilirubin-induced neurological damage. Therefore, this study aimed to assess the pooled prevalence of neonatal jaundice and its determinants in Ethiopia. METHODS: Scopus, PubMed, Google Scholar, Embase, and CINAHL databases were searched for studies published between January 1, 2010 and July 30, 2021. A weighted DerSimonian Laird random-effects model was used to estimate the pooled prevalence of neonatal jaundice and its associated factors. The I2 was used to calculate the degree of heterogeneity. The funnel plot and Egger's regression test were used to assess publication bias. RESULTS: Totally 697 articles were generated from various databases, and the review included a total of eight articles. The pooled prevalence of neonatal jaundice was 30.96% [95% confidence interval (CI) 16.61%-45.31%)] in Ethiopia. This review showed that prolonged labor [adjusted odd ratio (AOR) = 3.39; 95% CI 2.41-4.77), low birth weight (AOR = 5.12; 95% CI 3.11-8.72), birth asphyxia (AOR = 3.75; 95% CI 2.11-6.66), cephalohematoma (AOR = 7.07; 95% CI 2.72-18.38), ABO incompatibility (AOR = 6.05; 95% CI 2.95-12.42), Rhesus (RH) incompatibility (AOR = 3.77; 95% CI 2.04-6.96), male sex (AOR = 4.53; 95% CI 3.39-6.07), and neonatal sepsis (AOR = 2.47; 95% CI 1.49-4.08) were identified as a determining factor for neonatal jaundice in Ethiopia. CONCLUSIONS: In low- and middle-income countries, neonatal jaundice is a significant healthcare burden, accounting for a significant portion of global childhood mortality and morbidity. However, some low-cost, effective, practical, and dependable solutions have been implemented. Prolonged labor, ABO incompatibility, RH incompatibility, birth asphyxia, neonatal sepsis, low birth weight, cephalohematoma, and male sex were identified as risk factors for neonatal jaundice in Ethiopia.

Knowledge and practice of essential newborn care and associated factors among women in Ethiopia: systematic review and meta-analysis.

BACKGROUND: In developing countries, including Ethiopia the risk of neonatal death can be easily prevented and avoided by implementing essential newborn care with simple, low cost, and a short period time immediately after delivery. However, the problem is still persisting due to lack of adequate maternal and newborn care practice. Hence, this review aimed to estimate the pooled prevalence of women's knowledge and practice of essential newborn care and its associated factors in Ethiopia using systematic review and meta-analysis. METHOD: An intensive literature search was performed from PubMed, Google Scholar, EMBASE, HINARI, Scopus, and Web of Sciences from April 1-30, 2021. Data were extracted by using a pre-tested and standardized data extraction format. The data were analyzed by using STATA 14 statistical software. I2 tests assessed heterogeneity across the included studies. A random-effect model was used to estimate the pooled prevalence of knowledge and practice of essential newborn care. RESULTS: From 1275 identified studies, 25 articles were included. The national pooled prevalence of essential newborn care knowledge and practice among women was 55.05% and 41.49% respectively. Secondary education (AOR = 2.75, 95% CI 1.62, 4.66), multiparity (AOR = 2.14, 95% CI 1.41, 3.26), antenatal care (AOR = 2.94; 95% CI 2.03, 4.26), and postnatal follow-up (AOR = 1.64, 95% CI 1.20, 2.23) were significantly associated with knowledge level whereas; primary education (AOR = 7.08, 95% CI 4.79, 10.47), urban residency (AOR = 2.22, 95% CI 1.65, 3.00), attending monthly meetings (AOR = 2.07, 95% CI 1.64, 2.62), antenatal care (AOR = 2.89, 95% CI 1.97, 4.26), advised during delivery (AOR = 2.54, 95% CI 1.80, 3.59), postnatal follow-up (AOR = 7.08, 95% CI 4.79, 10.47) and knowledge (AOR = 2.93; 95% CI 1.81, 4.75) were statistically significant with essential newborn practice. CONCLUSIONS: The current systematic review and meta-analysis findings reported that the level of knowledge and practice of essential newborn care among Ethiopian women was low. Therefore, improvement of essential newborn through the provision of community-based awareness creation forum, improving antenatal and postnatal care follow up, education on essential newborn care to all pregnant and postnatal women are very important. Trial registration Prospero registration: CRD 42021251521.

Essential newborn care (ENC) is a single most cost-effective intervention to reduce neonatal mortality and morbidity both in developed and developing countries. An intensive electronic search from PubMed, Google Scholar, EMBASE, HINAR, Scopus, and Web of Sciences were performed to identify the primary studies. In this meta-analysis a total of 25 articles were included to estimate the polled prevalence of ENC knowledge and practice among Ethiopian women. Accordingly, the national pooled prevalence of ENC knowledge and practice among women was 55.05% and 41.49% respectively. In the current systematic review and meta-analysis, Secondary education, multiparity, antenatal care, and postnatal follow-up were significantly associated with knowledge level whereas; primary education, urban residency, attending monthly meetings, antenatal care, advised during delivery, postnatal follow-up and knowledge on ENC were found to be statistically significant with essential newborn practice. As per finding the knowledge and practice regarding essential newborn care among women in Ethiopian was significantly low. Hence, improvement of essential newborn through the provision of community-based awareness creation forum, improving antenatal and postnatal care follow up, education on essential newborn care to all pregnant and postnatal women are very important.

Knowledge and willingness of parents towards child girl HPV vaccination in Debre Tabor Town, Ethiopia: a community-based cross-sectional study.

BACKGROUND: Cervical cancer is currently the second-leading cause of cancer death among women in Ethiopia. Vaccination against the human papillomavirus (HPV) is an effective primary prevention strategy for HPV-related illnesses. The knowledge and willingness of parents toward the HPV vaccine are crucial to increasing the uptake of the vaccine. The vaccine's acceptance by children and young adolescents is dependent on parental consent. Therefore, this study aimed to assess knowledge, willingness, and associated factors of the human papillomavirus vaccine among parents of girls aged 9-14 years at Debre Tabor Town. METHOD: A community-based cross-sectional study was conducted among participants from December 10, 2020, to January 15, 2021. A simple random sample technique was used to include 638 participants. A structured face-to-face interviewer-administered questionnaire was used to collect data. The data were entered and analyzed using Epi-Data and SPSS software, respectively. Bivariate and multivariable analyses were used to examine the association. The Odds Ratio (OR), 95% CI, and p-values less than 0.05 were used to determine the statistical association. RESULTS: Thirty-five percent (35.4%, 95% CI = 31.4%, 38.8%) and 44.8% (95% CI = 40.40%, 48.67%) of participants were knowledgeable about HPV vaccination and willing to get it, respectively. Being government employees (AOR = 5.46, 95% CI = 2.42, 9.34), and having a family history of sexually transmitted diseases (STD) (AOR = 1.76, 95% CI = 1.14, 2.72) were significantly associated with knowledge of the human papilloma virus (HPV) vaccine. Participants' age (AOR = 1.43, 95% CI = 1.16, 2.87), secondary education and above (AOR = 1.70, 95% CI = 1.05, 2.74), fear of HPV infection (AOR = 2.29, 95% CI = 1.21, 4.32), and having good knowledge of the HPV vaccine (AOR = 3.30, 95% CI = 2.21, 4.93) were significantly associated with willingness to receive the HPV vaccine. CONCLUSION AND RECOMMENDATION: The knowledge and willingness of parents toward the HPV vaccine were low. Then, health officials should boost HPV vaccination promotion through public media. In schools, churches, mosques, and health facilities, health extension workers and health professionals provide information about the HPV vaccine for the parents. Mixed quantitative and qualitative studies are preferable for future research to address "why" issues.

Infection with the Human Papillomavirus (HPV) causes nearly 99% of cervical cancer cases and more than 20% of breast, neck, and anogenital cancers. The HPV vaccines protect against high-risk types of HPV (types 16 and 18), which account for approximately 70% of cervical cancers. Global coverage of the HPV vaccine was 39.7%, with high-income countries (68%), middle-income countries (28%), and lower-middle-income countries (2.7%). For different reasons, cervical cancer screening is very poor in Ethiopia (below 2%). Cervical cancer is mostly asymptomatic more than 20 years after infection. Primary prevention (enhancing the HPV vaccine) is the best way to protect women from cervical cancer. Adolescents' uptake and acceptance of the vaccine depend on parental consent. Assessing parental knowledge and willingness at a community level is very crucial.A simple random sample technique was used to include 638 participants. A structured and pre-tested face-to-face interviewer-administered questionnaire was used to collect the data. The data were entered and analyzed using Epi-Data, and SPSS software, respectively. Bivariate and multivariable analyses were used to examine the association.Nearly one-third (35.4%) and less than half (44.8%) of participants were knowledgeable and willing to receive the HPV vaccination. The knowledge and willingness of the parents are significantly lower. Being government employees and having a family history of sexually transmitted diseases (STD) were factors affecting the knowledge of parents about the human papillomavirus vaccine. Participants' age, secondary education and above, fear of HPV infection, and having good knowledge of the HPV vaccine were significantly associated with their willingness to use the HPV vaccine. The knowledge and willingness of the parents are significantly lower. Health officials and stakeholders should scale up HPV vaccine promotion through public media.

Availability, Utilization, and Quality of Basic Emergency Obstetric and Newborn Care Services in Farta District, Rural Health Centers, Ethiopia.

BACKGROUND: Emergency obstetric and neonatal care (EmONC) is a cost-effective priority intervention to reduce maternal and neonatal morbidity and mortality in poorresource settings. In most sub-Saharan African countries, all signal functions perform below the appropriate United Nations standard. OBJECTIVE: This study aims to assess the availability, utilization, and quality of basic emergency obstetric and newborn care services in Farta District, Ethiopia primary health care centers. METHODS: A cross-sectional descriptive study was conducted in primary health care centers in Farta District, South Gondar zone, Ethiopia. RESULTS: Out of ten rural health centers, 50% administered parenteral antibiotics, 50% administered parenteral anticonvulsants, 30% performed assisted vaginal delivery, 40% performed manual placenta removal, and 70% administered oxytocin for treatment of postpartum hemorrhage and 60% performed neonatal resuscitation with bag and mask. CONCLUSION: All of the health centers in the study area were not fully implementing the BEmONC signal functions.

Comparing the accuracy of two diagnostic methods for detection of light Schistosoma haematobium infection in an elimination setting in Wolaita Zone, South Western Ethiopia.

Reagent urinalysis dipstick and filtration have been recommended diagnostic methods for the detection of urogenital schistosomiasis. However, the accurate diagnosis of light infections using these methods presents a major challenge. This study evaluates the diagnosis accuracy of light infection with Schistosoma haematobium in study participants living in Wolaita Zone, an area targeted for sustainable control of Schistosomiasis, and ultimately interrupt transmission. Urine samples were collected from children and adults in surveys carried out during baseline and longitudinal sentinel site surveys conducted from 2018 to 2020. All urine samples were tested using a reagent urinalysis dipstick test (Haemastix) to detect microhaematuria with reference urine filtration technique as a proxy for S. haematobium infection. Sensitivity and specificity were determined in diagnosing urogenital schistosomiasis. Cohen's Kappa statistics was done for the agreement of these diagnostic methods. A total of 12,102 participants were enrolled in the current baseline study. Among them, 285 (2.35%) samples tested positive for microhaematuria and 21 (0.20%) positive for S. haematobium eggs. A total of 4,357 samples were examined in year 1 and year 2 using urine dipsticks, and urine filtration 172 (3.95%) and 2 (0.05%) were positive for microhaematuria and S. haematobium eggs. The reagent urinalysis dipsticks showed the highest sensitivity and specificity for diagnosing light intensity of infection,100% (95% CI:85.18-100.00) and 97.4% (95% CI: 97.10-97.60), respectively. There is a slight agreement between the two methods (Kappa = 0.09, 95% CI: 0.01-0.18). The present study revealed very low prevalence and light intensity of S. haematobium infections. The study also highlights that the dipstick test is considered a useful adjunct diagnostic tool for population-based control of urogenital schistosomiasis.

Youth-friendly sexual and reproductive health services utilization and its determinants in Ethiopia: A systematic review and meta-analysis.

BACKGROUND: In most developing countries, meeting young people's sexual and reproductive health (SRH) needs remains a problem. Despite policy initiatives and strategic measures aimed at increasing youth utilization of sexual and reproductive health services in Ethiopia, its utilization remains very low. Therefore, this study aimed to assess Ethiopia's youth-friendly sexual and reproductive health services' utilisation and determinants. METHODS: Scopus, Medline, Google Scholar, and CINAHL databases were searched for articles published until March 2021. The pooled prevalence and effect size of youth-friendly sexual and reproductive health service use and associated factors were estimated using a weighted DerSimonian-laird random effect model. The I2 statistics were used to determine the degree of heterogeneity. The funnel plot and Egger's regression test were used to examine publication bias. Subgroup analyses were performed to reduce underlying heterogeneity. RESULTS: One thousand one hundred and ninety-one articles were generated from various databases, and a final 26 articles were included in the review, including 16246 participants. Ethiopia's pooled prevalence of youth-friendly sexual and reproductive health service utilization was 42.73 % (95% CI: 35.38-50.09). The findings of this study showed that grade level 11-12, grade level 9-10, close to home sexual and reproductive health services, male sex, and discussion of sexual and reproductive health service with family, friends, and groups, ever experience sexual activity were associated with utilization of youth-friendly sexual and reproductive health services. Maternal educational status secondary school and above, age 15-19 years, age 20-24 years, having ever experienced reproductive problems, living with a partner, living alone, knowing about sexual and reproductive health, having a convenient working hour for youth-friendly service, and participation in a school clubs were also associated with the utilization of youth-friendly sexual and reproductive health services. CONCLUSION: We found several determinant factors for adolescent and youth utilization of sexual and reproductive health services. The review highlights the importance of improving service usage through youth education and promotion and the scaling up and institutionalizing of youth-friendly services through extensive capacity building.

Coverage evaluation surveys following soil-transmitted helminthiasis and schistosomiasis mass drug administration in Wolaita Zone of Ethiopia-The Geshiyaro project.

INTRODUCTION: The Geshiyaro project aims to break transmission of soil-transmitted helminths and schistosomiasis in the Wolaita Zone of Ethiopia through a combination of two interventions: behavior change communication (BCC) for increased water, sanitation and hygiene (WaSH) infrastructure use alongside preventive chemotherapy (PC) using albendazole (ALB) and praziquantel (PZQ), targeted to reach 90% treatment coverage. Coverage evaluation surveys (CES) were conducted post-treatment, and the resultant survey coverage was compared to reported administrative coverage. This provided a secondary confirmation of the Geshiyaro project coverages, and is used to monitor the success of each Mass Drug Administration (MDA) round. METHODS: A community-based cross-sectional study was conducted in 13 woredas (districts) of the Wolaita Zone. All eligible individuals from the selected households were invited for an interview. The study design, sample size, analysis and report writing were conducted according to the World Health Organization (WHO) CES guidelines for PC. RESULTS: The study interviewed a total of 3,568 households and 18,875 individuals across 13 woredas in the Wolaita Zone. Overall, the survey coverage across all studied woredas was 81.5% (95% CI; 80.9-82.0%) for both ALB and PZQ. Reported administrative coverage across all studied woredas was higher than survey coverage, 92.7% and 91.2% for ALB and PZQ, respectively. A significant portion of individuals (17.6%) were not offered PC. The predominant reason for not achieving the target coverage of 90% was beneficiary absenteeism during MDA (6.6% ALB, 6.8% PZQ), followed by drug distributors failing to reach all households (4.7% ALB, 4.8% PZQ), and beneficiaries not informed of the program (1.3% ALB, 1.7% PZQ). CONCLUSION: Programmatic actions will need to be taken during the next MDA campaign to achieve the targeted Geshiyaro project coverage threshold across data collection and program engagement. Adequate training and supervision on recording and reporting administrative coverage should be provided, alongside improved social mobilization of treated communities to increase participation, and strengthened institutional partnerships and communication.