Analysis of heavy metals and minerals in edible vegetable oils produced and marketed in Gondar City, Northwest Ethiopia.

INTRODUCTION: Nowadays, food safety is regarded as one of the most critical global public health issues. Edible oil, a key ingredient in food processing, is widely used and consumed in every Ethiopian household. However, its safety is often overlooked. Currently, edible oil is produced in Ethiopia from small-scale operations to large industrial levels, as well as imported from other countries. OBJECTIVE: This study aimed to determine the levels of heavy metals and essential minerals in edible vegetable oils produced and marketed in Gondar City, Northwest Ethiopia. METHODS: A laboratory-based cross-sectional study was conducted from May to July 2021 in Gondar City. Seventeen edible oil samples were collected using simple random sampling techniques. Heavy metal content was determined using an atomic absorption spectrophotometer with the standard procedures and techniques after microwave digestion. The efficiency and validity of the method used were evaluated by determining the limit of detection (LOD), the limit of quantification (LOQ), accuracy, and precision. The collected data were entered into Microsoft Excel and transported to Stata for analysis. RESULT: A total of seventeen vegetable oil samples were analyzed. The accuracy of the method was evaluated by recovery studies, which ranged from 81 to 115%, and the relative standard deviations were found to be below 15%. The concentrations of Zn, Cu, Fe, Cd, and Pb were in the range of 0.07 to 0.8 mg/l, 0.002 to 0.06 mg/l, 0.01 to 0.8 mg/l, 0.08 to 0.18 mg/l, and 0.003 to 0.27 mg/l, respectively. In general, the lead and cadmium content was higher than other metals in some of the investigated edible vegetable oils. Most values fell within the permissible quality limits for edibility as prescribed by the World Health Organization (WHO) and the National Agency for Food and Drug Administration and Control (NAFDAC). However, the levels of Pb and Cd exceeded the reference levels in some locally produced vegetable oils. CONCLUSION: To address the exceeded levels of heavy metals, it is imperative to implement more careful handling, processing of raw materials, and filtering practices. Producers and marketers should take the necessary precautions to prevent contamination. Strict regulatory control from responsible bodies and stakeholders is recommended to ensure the safety and metal contents of vegetable oils originating from the study area.

Determinants of tobacco use among pregnant women in sub-Saharan Africa. A multilevel mixed-effect logistic regression model.

INTRODUCTION: Although it is known that maternal tobacco use during pregnancy substantially declined in higher-income countries, information on the magnitude and determinants of tobacco use among pregnant women in sub-Saharan Africa (SSA) remains limited. Establishing evidence on maternal tobacco during pregnancy is crucial for guiding targeted interventions in SSA. This study aimed to determine the overall prevalence of tobacco use and its determinants among pregnant women in SSA countries. METHODS: The study used data from Demographic and Health Surveys conducted in 33 countries across SSA from 2010 and 2021. Our analysis included a total weighted sample of 40,291 pregnant women. A multilevel logistic regression model was used to identify factors associated with maternal tobacco use during pregnancy. The measure of association between explanatory variables and the outcome was reported using adjusted odds ratios (AORs) with 95% confidence intervals (CIs). RESULTS: The pooled prevalence of tobacco use among pregnant women in SSA was 1.76% (95% CI: 1.41, 2.12). Our findings showed that pregnant women in the age groups of 25-34 years (AOR 1.44; 95% CI: 1.14, 1.82) and 35+ years (AOR 2.18; 95% CI: 1.68, 2.83) had higher odds of tobacco use during pregnancy. Pregnant women who attained primary education (AOR 0.57; 95% CI: 0.46, 0.70) and secondary or higher education (AOR 0.39; 95% CI: 0.30, 0.53) were associated with lower odds of tobacco use. Similarly, pregnant women who resided in households with a high wealth index (AOR 0.36; 95% CI: 0.55 0.90) and those with media exposure (AOR 0.81; 95% CI: 0.67, 0.99) were less likely to use tobacco during pregnancy. CONCLUSION: This study revealed that the overall prevalence of maternal tobacco use during pregnancy was relatively low in SSA, but some countries exhibited higher estimates. To address this, it is crucial to implement targeted smoking prevention and cessation strategies, particularly for young pregnant women, those facing socioeconomic disadvantages, and those with lower educational status.

Spatial variation and factors associated of solid fuel use in Ethiopia a multilevel and spatial analysis based on EDHS 2016.

Cooking and heating using solid fuels, such as dung, wood, agricultural residues, grass, straw, charcoal, and coal, is a main source of household air pollution. This indoor combustion encompasses a diversity of health detrimental pollutants, especially for people from low-income countries like Ethiopia since solid fuels are accessible easily at a lesser cost. Limited studies done showing factors affecting in choosing fuel type and no study, which revealed spatial heterogeneity of solid fuel used based on such nationally representative data. Therefore, this study, aimed at investigating spatial variation and determinants of solid fuel use in Ethiopia. This study was done using the data from the Ethiopian Demographic and Health Survey 2016, a national representative sample (16,650) households were included. Spatial and Multi-level logistic regression analysis was done by considering the DHS data hierarchal nature. Variables in the final model with a p-value < 0.05 were reported as significant predictors of using solid fuel. All analyses were done using ArcGIS V.10.7.1 and STATA V.14 software. The finding of this study revealed that 90.8% (95% CI (87.9%, 91.2%)) of households depend on solid fuel for cooking. Based on the final model ;Male household head (AOR 1.38, 95% CI (1.12-1.71)), age of household head (AOR 1.61, 95% CI (1.20, 2.17)), and 1.49 (OR 1.49, 95% CI (1.12, 1.99)) respectively for the age classes of < 30, and 30-40, education attainment no education (OR 3.14, 95% CI (1.13, 8.71)) and primary education (AOR 2.16, 95% CI (2.78, 5.96), wealth index Poorest (AOR 11.05, 95% CI (5.68, 15.78)), Poorer (OR 5.19, 95% CI (5.43, 13.19)), Middle (OR 3.08, 95% CI (2.44, 8.73)), and Richer (OR 1.30, 95IC (1.07, 13.49)) compared to richest, and not accessibility of electricity (AOR 31.21, 95% CI (35.41, 42.67)), were individual-level factors significantly associated with using solid fuel. Community-level factors like households found at large city (AOR 2.80, 95CI (1.65, 4.77)), small city (AOR 2.58, 95% CI (1.55, 4.32)) town (AOR 4.02, 95% CI (2.46, 6.55)), and countryside (AOR 14.40, 95% CI (6.23, 21.15)) compared households found in capital city, community level media exposure (AOR 6.00, 95% CI (4.61, 7.82)) were statistically predictors in using solid fuel for cooking. This finding revealed that a large proportion of households in Ethiopia heavily depend on biomass, especially wood, for cooking. There was a greater disparity on solid fuel use for cooking in Ethiopia. Implementing major policy interventions should be introduced to reduce solid fuel use for cooking and inequalities in accessing clean fuel in Ethiopia.

Attitude of mental healthcare providers toward tele-psychiatry services and associated factors at public referral hospitals in Addis Ababa city, Ethiopia.

INTRODUCTION: Health systems around the world are struggling with the massive numbers of people with mental disorders who require professional care. The treatment gap for mental disorders is high all over the world, with between 76 and 85% of people in low- and middle-income countries with severe mental disorders receiving no treatment for their mental health conditions. Tele-psychiatry is used as an alternative solution to the problem of limited mental health services and effective Tele-psychiatry service use may be achievable if mental health providers have a good attitude towards it. OBJECTIVE: To assess the attitude of mental healthcare providers toward Tele-psychiatry services and associated factors at public referral hospitals in Addis Ababa city, Ethiopia, 2022. METHOD: A Multicenter institution-based cross-sectional study was conducted among 413 mental health professionals working in public referral hospitals in Addis Ababa city, from May 04 to June 10, 2022. Data were collected by using a structured and self-administered questionnaire prepared by reviewing previous related studies. Epi Data version 3.1 and Stata version 14 were used for data entry and analysis respectively. Bivariate and multivariable logistic regression analyses were used to identify factors associated with attitudes toward Tele-psychiatry services. A statistical significance was declared at p-value < 0.05. RESULT: A total of 413 Participants were enrolled with a response rate of 91.8%. The majority of respondents 230 (55.69%) were male and the mean age of participants was 29 years (SD + 5.02). In this study the majority (49%) of mental health care professionals had a poor attitude toward Tele-psychiatry. Having electronic health technology experience [AOR 16.79; 95% CI (4.26, 29.3)], lack of training in telemedicine applications [(AOR 0.1; 95% CI (0.01, 0.41)], a good computer uses for daily work activities [AOR 3.65; 95% CI (1.14, 11.60)], availability of e-Health technology awareness program [AOR 0.16; 95% CI (0.03, 0.90)], having a positive perception about the importance of e-Health technologies[AOR 0.041; 95% CI (0.01, 0.29)] and having good knowledge of Tele-psychiatry services [AOR 6.89; 95% CI (1.8, 12.0)] were significantly associated with attitude towards Tele-psychiatry services. CONCLUSION: This study found that mental healthcare providers at a public referral hospital in Addis Ababa city generally had poor attitudes regarding Tele-psychiatry services. Considering the significant factors will improve the attitude to use tele-psychiatry services in Ethiopia.

Medical students' knowledge and attitude towards tele-education and associated factors at University of Gondar, Ethiopia, 2022: mixed method.

BACKGROUND: Tele-education is the use of ICTs to conduct remote learning. It has been utilized to deliver ongoing training for many years. The world's modern culture is increasingly reliant on the use of information technology to enhance standards of education. However, in order to deploy successful e-learning systems in a developing nation, understanding of user characteristics is required in the creation and usage of e-learning systems. Thus, this study will enable us to understand the user's level of knowledge and attitude towards tele-education. METHODS: An institution-based quantitative cross-sectional study supported by qualitative design was used 397 medical students at University of Gondar from May to June 2022. A pre-tested self-administered structured questionnaires and in-depth interview were used to collect quantitative and qualitative data respectively. Thematic-content analysis was conducted using open-code software for analyzing qualitative data. Quantitative data was entered to Epi-data version 4.6 and exported to SPSS version 25 software for further statistical analysis. Binary logistic regression was conducted. The adjusted odds ratio(AOR) was used to measure the association between the dependent and independent variables. RESULTS: A total of 397 medical students were participated in this study with a response rate of 93.63%. In this study nearly six out of ten 230(57.9%) of study participants had good knowledge towards tele-education. More than half. 211(53.1%) of medical students participated on the study also had a favorable attitude towards tele-education. Factors associated with knowledge about tele-education is training related to ICT (AOR = 2.27 95% CI; (1.13,4.55)), knowledge of medical education digitization (AOR = 3.80 95% CI; (2.12,6.84)), high computer literacy (AOR = 2.82 95% CI; (1.68,4.72)) and favorable attitude towards tele-education (AOR = 3.52 95% CI; (2.12,5.84)). Factors associated with attitude towards tele-education is age group > 21 (AOR = 3.89, 95% CI; (1.33,11.39)) and good knowledge towards tele-education (AOR = 3.42,95%CI;(2.06,5.66)). CONCLUSION: The study revealed that the knowledge of the medical students was good and nearly five out of ten of them had a favorable attitude towards tele-education. The study shows that training related to ICT, knowledge of medical education digitization, high computer literacy and favorable attitude towards tele-education were associated significantly with knowledge of tele-education. In this study age group > 21 and good knowledge towards tele-education of study participants were associated significantly with attitude towards tele-education.

Awareness and readiness of mental healthcare providers to implement telemental health services and associated factors at public referral hospitals in Addis Ababa City, Ethiopia.

OBJECTIVE: To assess the awareness and readiness of mental healthcare providers to implement telemental health services and the associated factors at public referral hospitals in Addis Ababa City, Ethiopia. STUDY DESIGN: A cross-sectional study was conducted among mental health professionals working at public referral hospitals in Addis Ababa City from 4 May to 10 June 2022. PARTICIPANTS: A total of 413 (55.7% male and 44.3% female) health professionals participated in the study. The study participants were selected using a simple random sampling technique. All mental healthcare providers working at public referral hospitals in Addis Ababa City were considered as the source population. Mental healthcare providers who meet the inclusion criteria were considered the study population. Having a minimum diploma qualification and 6 months or more of work experience and giving written consent were considered the inclusion criteria. OUTCOME MEASURE: The main outcome measure was awareness and readiness to implement telemental health services. RESULT: A total of 413 participants were enrolled, with a response rate of 90.6%. The prevalence of good awareness towards telemental health services was 41% (95% CI 37%, 47%). Being female (adjusted OR (AOR)=0.34; 95% CI 0.15, 0.76), having poor information technology support (AOR=0.32; 95% CI 0.11, 0.99) and having electronic health technology experience (AOR=1.21; 95% CI 1.1, 2.44) were significantly associated with awareness of telemental health services, whereas computer access at the workplace (AOR=0.04; 95% CI 0.003, 0.55) and awareness (AOR=4.34; 95% CI 1.02, 18.48) and attitude (AOR=1.01; 95% CI 1.03, 2.19) towards telemental health services were the variables that showed statistically significant association with readiness of mental healthcare providers for telemental health services. CONCLUSION: Although majority of healthcare providers in this survey were prepared to implement telemental health services, there was typically little awareness among mental healthcare providers.

Post COVID-19 Vaccination Side Effects and Associated Factors Among Vaccinated Clients in Bahir Dar City, Ethiopia.

Introduction: The lack of local side effect profiles for vaccines could hinder vaccination uptake. Since all COVID-19 vaccines are brand-new medications, it is crucial to keep track of any safety related concern. Objective: This study is aimed to investigate post-vaccination side effects of COVID-19 vaccines and associated factors in Bahir Dar city. Method: An institutional-based cross-sectional study was conducted among vaccinated clients. A simple random and a systematic random sampling method were used to select the health facilities and the participants, respectively. Bi-variable and multivariable binary logistic regression analyses were executed with odds ratio at 95% confidence intervals at p < .05. Results: A total of 72(17.4%) participants reported at least one side effect following vaccination. The proportion prevalence was higher after the first dose than that of the second dose and the difference was also found to be statistically significant. In the multivariable logistic regression analysis female participants (AOR = 3.39, 95% CI = 1.53, 7.52), participants with a history of regular medication use (AOR = 3.34, 95% CI = 1.52, 7.33), participants aged 55 and above (AOR = 2.93, 95% CI = 1.23, 7.01), and participants who had taken only the first dose (AOR = 14.81, 95% CI = 6.40, 34.31) were more likely to develop side effects for COVID 19 vaccination compared to their counterparts. Conclusion: A significant number (17.4%) of participants reported at least one side effect following vaccination. Sex, medication, occupation, age, and type of vaccination dose were factors statistically associated with the reported side effects.

Healthcare professionals' knowledge, attitude and its associated factors toward electronic personal health record system in a resource-limited setting: A cross-sectional study.

Introduction: Electronic personal health record (e-PHR) system enables individuals to access their health information and manage it themselves. It helps patient engagement management of health information that is accessed and shared with their healthcare providers using the platform. This improves individual healthcare through the exchange of health information between patients and healthcare providers. However, less is known about e-PHRs among healthcare professionals. Objective: Therefore, this study aimed to assess Health professionals' Knowledge and attitude and its associated factors toward e-PHR at the teaching hospital in northwest Ethiopia. Methods: An institution-based cross-sectional study design was used to determine healthcare professionals' knowledge and attitude and their associated factors toward e-PHR systems in teaching hospitals of Amhara regional state, Ethiopia, from 20 July to 20 August 2022. Pretested structured self-administered questionnaires were used to collect the data. Descriptive statistic was computed based on sociodemographic and other variables presented in the form of table graphs and texts. Bivariable and multivariable logistic analyses were performed with an adjusted odds ratio (AOR) and 95% CI to identify predictor variables. Result: Of the total study participants, 57% were males and nearly half of the respondents had a bachelor's degree. Out of 402 participants, ~65.7% [61-70%] and 55.5% [50-60%] had good knowledge and favorable attitude toward e-PHR systems, respectively. Having a social media account 4.3 [AOR = 4.3, 95% CI (2.3-7.9)], having a smartphone 4.4 [AOR = 4.4, 95% CI (2.2-8.6)], digital literacy 8.8 [(AOR = 8.8, 95% CI (4.6-15.9)], being male 2.7 [AOR = 2.7, 95% CI (1.4-5.0)], and perceived usefulness 4.5 [(AOR = 4.5, 95% CI (2.5-8.5)] were positively associated with knowledge toward e-PHR systems. Similarly, having a personal computer 1.9 [AOR = 1.9, 95% CI (1.1-3.5)], computer training 3.9 [AOR = 3.9, 95% CI (1.8-8.3)], computer skill 19.8 [AOR = 19.8, 95% CI (10.7-36.9)], and Internet access 6.0 [AOR = 6.0, 95% CI (3.0-12.0)] were predictors for attitude toward e-PHR systems. Conclusion: The findings from the study showed that healthcare professionals have good knowledge and a favorable attitude toward e-PHRs. Providing comprehensive basic computer training to improve healthcare professionals' expectation on the usefulness of e-PHR systems has a paramount contribution to the advancement of their knowledge and attitude toward successfully implementing e-PHRs.

Machine learning to predict virological failure among HIV patients on antiretroviral therapy in the University of Gondar Comprehensive and Specialized Hospital, in Amhara Region, Ethiopia, 2022.

BACKGROUND: Treatment with effective antiretroviral therapy (ART) reduces viral load as well as HIV-related morbidity and mortality in HIV-positive patients. Despite the expanded availability of antiretroviral therapy around the world, virological failure remains a serious problem for HIV-positive patients. Thus, Machine learning predictive algorithms have the potential to improve the quality of care and predict the needs of HIV patients by analyzing huge amounts of data, and enhancing prediction capabilities. This study used different machine learning classification algorithms to predict the features that cause virological failure in HIV-positive patients. METHOD: An institution-based secondary data was used to conduct patients who were on antiretroviral therapy at the University of Gondar Comprehensive and Specialized Hospital from January 2020 to May 2022. Patients' data were extracted from the electronic database using a structured checklist and imported into Python version three software for data pre-processing and analysis. Then, seven supervised classification machine-learning algorithms for model development were trained. The performances of the predictive models were evaluated using accuracy, sensitivity, specificity, precision, f1-score, and AUC. Association rule mining was used to generate the best rule for the association between independent features and the target feature. RESULT: Out of 5264 study participants, 1893 (35.06%) males and 3371 (64.04%) females were included. The random forest classifier (sensitivity = 1.00, precision = 0.987, f1-score = 0.993, AUC = 0.9989) outperformed in predicting virological failure among all selected classifiers. Random forest feature importance and association rules identified the top eight predictors (Male, younger age, longer duration on ART, not taking CPT, not taking TPT, secondary educational status, TDF-3TC-EFV, and low CD4 counts) of virological failure based on the importance ranking, and the CD-4 count was recognized as the most important predictor feature. CONCLUSION: The random forest classifier outperformed in predicting and identifying the relevant predictors of virological failure. The results of this study could be very helpful to health professionals in determining the optimal virological outcome.

Spatial and multilevel analysis of sanitation service access and related factors among households in Ethiopia: Using 2019 Ethiopian national dataset.

BACKGROUND: Billions of people have faced the problem of accessing appropriate sanitation services. This study aimed to explore the spatial distribution of households' access to sanitation services and identify associated factors in Ethiopia. METHODS: The 2019 Ethiopian Mini Demographic and Health Survey data was used with a total of 6261 weighted samples. A cross-sectional study design with a two-stage cluster sampling technique was used. Global Moran's I statistic measure, Getis-Ord Gi*, and the ordinary Kriging Gaussian interpolation were used for spatial autocorrelation, hot spot analysis, and interpolation of unsampled areas, respectively. A purely spatial Bernoulli-based model was employed to determine the geographical locations of the most likely clusters. A multilevel logistic regression model was used, and predictors with a P value of less than 0.05 with a 95% CI were considered significant factors. RESULTS: Overall, 19.7% of households had access to improved sanitation services in Ethiopia. Poor sanitation service access was significantly clustered, with hotspots of poor access identified in the South Nations Nationality and People's Region (SNNPR), Oromia, Amhara, and Benishangul Gumuz regions. A total of 275 significant clusters were identified. Households in the circled area were more vulnerable to poor sanitation service access. Rural households, on-premises water access, media exposure, and rich wealth status were statistically significant factors for access to sanitation services. CONCLUSIONS: Access to sanitation services among households in Ethiopia is insufficient. The majority of the households had no access to sanitation services. Stakeholders are recommended to raise household members' awareness of sanitation services, give priority to the hotspot areas, and encourage poor households to have access to toilet facilities. Household members recommended using the available sanitation service and keeping the sanitation service clean. Households are recommended to construct clean shared sanitation facilities.

Predicting healthcare professionals' acceptance towards electronic personal health record systems in a resource-limited setting: using modified technology acceptance model.

OBJECTIVES: Personal health record systems allow users to manage their health information in a confidential manner. However, there is little evidence about healthcare providers' intentions to use such technologies in resource-limited settings. Therefore, this study aimed to assess predicting healthcare providers' acceptance of electronic personal health record systems. METHODS: An institutional-based cross-sectional study was conducted from 19 July to 23 August 2022 at teaching hospitals in the Amhara regional state of Ethiopia. A total of 638 health professionals participated in the study. Simple random sampling techniques were used to select the study participants. Structural equation modelling analysis was employed using AMOS V.26 software. RESULT: Perceived ease of use had a significant effect on the intention to use electronic personal health records (ß=0. 377, p<0.01), perceived usefulness (ß=0.104, p<0.05) and attitude (ß=0.204, p<0.01); perceived ease of use and information technology experience had a significant effect on perceived usefulness (ß=0.077, p<0.05); and digital literacy (ß=0.087, p<0.05) and attitude had also a strong effect on intention to use electronic personal health records (ß=0.361, p<0.01). The relationship between perceived ease of use and the intention to use was mediated by attitude (ß=0.076, p<0.01). CONCLUSION: Perceived ease of use, attitude and digital literacy had a significant effect on the intention to use electronic personal health records. The perceived ease of use had a greater influence on the intention to use electronic personal health record systems. Thus, capacity building and technical support could enhance health providers' acceptance of using electronic personal health records in Ethiopia.

eHealth literacy and its associated factors in Ethiopia: Systematic review and meta-analysis.

INTRODUCTION: Electronic health has the potential benefit to the health system by improving health service quality efficiency effectiveness and reducing the cost of care. Having good e-health literacy level is considered essential for improving healthcare delivery and quality of care as well as empowers caregivers and patients to influence control care decisions. Many studies have done on eHealth literacy and its determinants among adults, however, inconsistent findings from those studies were found. Therefore, this study was conducted to determine the pooled magnitude of eHealth literacy and to identify associated factors among adults in Ethiopia through systematic review and meta-analysis. METHOD: Search of PubMed, Scopus, and web of science, and Google Scholar was conducted to find out relevant articles published from January 2028 to 2022. The Newcastle-Ottawa scale tool was used to assess the quality of included studies. Two reviewers extracted the data independently by using standard extraction formats and exported in to Stata version11 for meta-analysis. The degree of heterogeneity between studies was measured using I2 statistics. The publication bias between studies also checked by using egger test. The pooled magnitude of eHealth literacy was performed using fixed effect model. RESULT: After go through 138 studies, five studies with total participants of 1758 were included in this systematic review and Meta-analysis. The pooled estimate of eHealth literacy in Ethiopia was found 59.39% (95%CI: 47.10-71.68). Perceived usefulness (AOR = 2.46; 95% CI: 1.36, 3.12),educational status(AOR = 2.28; 95% CI: 1.11, 4.68), internet access (AOR = 2.35; 95% CI: 1.67, 3.30), knowledge on electronic health information sources(AOR = 2.60; 95% CI: 1.78, 3.78), electronic health information sources utilization (AOR = 2.55; 95%CI: 1.85, 3.52), gender (AOR = 1.82; 95% CI: 1.38, 2.41) were identified significant predictors of e-health literacy. CONCLUSION AND RECOMMENDATION: This systematic review and meta-analysis found that more than half of study participants were eHealth literate. This finding recommends that creating awareness about importance of eHealth usefulness and capacity building to enhance and encouraging to use electronic sources and availability of internet has para amount to solution to increase eHealth literacy level of study participants.

Health Information Technologies in a Resource-Limited Setting: Knowledge, Attitude, and Practice of Health Professionals.

The use of health information technology significantly enhances patient outcomes. As a result, policymakers from developing countries have placed strong emphasis on formulating eHealth policies and initiatives. However, there have not been many successful deployments to show for. The role of individual factors in the successful implementation of these technologies is indispensable. Therefore, this study assesses healthcare professionals' knowledge, attitudes, and practice of health information technology. An institution-based cross-sectional study was conducted at the University of Gondar Comprehensive Specialized Hospital from November 15 to December 29, 2020. A structured, self-administered questionnaire was used to collect data. Student's t-test was used to learn if there were any significant differences in practice habits between participants with and without previous information technology-related training. In addition, first-order partial correlation was conducted to identify the relationship of knowledge and attitude with practice. A total of 347 health professionals responded to the questionnaire, yielding an 87.2% response rate. Most health professionals are not aware of how to use health information technologies. Notably, practice levels were low and needed prompt action from responsible authorities. Previous training did not work very well to improve the practice levels of health professionals. However, the positive attitude of these professionals encourages policymakers and implementers to engage closely.

Tele-pharmacy perception, knowledge and associated factors among pharmacy students in northwest Ethiopia: an input for implementers.

BACKGROUND: Tele-pharmacy is a subset of telemedicine in which pharmacies use telecommunication technology to provide patient care. Tele-pharmacy can improve pharmaceutical care service delivery by reducing medication errors, improving access to health professionals and facilities in remote and rural areas, and minimizing adverse drug events. However, there is limited evidence regarding future pharmacists' knowledge and perceptions of the Tele-pharmacy system in Ethiopia. As a result, this study aimed to assess tele-Pharmacy perception, knowledge and associated factors among pharmacy students in Northwest Ethiopia. METHODS: An institutional-based cross-sectional study was conducted among 376 pharmacy students in Northwest Ethiopia between July 15 and August 27, 2022. A pre-tested self-administered questionnaire was used to collect data. The data were entered using Epi info version 7.0 and analyzed using SPSS version 25. Descriptive statistics, bivariable and multivariable logistic regression analysis were used to describe pharmacy students' knowledge and perceptions of Tele-pharmacy and identify associated factors. An adjusted odds ratio (OR) and a p-value with a 95% confidence interval (CI) were calculated to declare statistical significance. RESULTS: From a total of 352 participants, about 32.4% with [95% CI (27%-37%)] and 48.6% with [95% CI (43%-54%)] had good knowledge and a positive perception toward Tele-pharmacy, respectively. Being age group of 26-30 (AOR = 0.35, 95% CI: 0.17-0.68), being male (AOR = 2.38, 95% CI: 1.26-4.49), Having a CPGA of > 3.5 (AOR = 2.28, 95% CI: 1.24-4.19), Taking basic computer training (AOR = 2.00, 95% CI: 1.17-3.39), Management support (AOR = 1.84, 95% CI: 1.06-3.19) were found to be significantly associated with pharmacy students' knowledge of Tele-pharmacy. Similarly, having access to electronic devices (AOR = 3.80, 95% CI: 1.81-7.97), training related to pharmacy information systems (AOR = 6.66, 95% CI: 3.34-13.29), availability of guidelines (AOR = 2.99, 95% CI: 1.62-5.50) were found to be significantly associated with pharmacy students' perceptions of Tele-pharmacy. CONCLUSION: This study found that pharmacy students have limited knowledge and perceptions of the Tele-pharmacy system. A continuing Tele-pharmacy training package, incorporating pharmacy information system guidelines as part of their education, and providing managerial support could be recommended to improve pharmacy students' knowledge and perception of Tele-pharmacy.

Electronic Medical Record System Use and Determinants in Ethiopia: Systematic Review and Meta-Analysis.

BACKGROUND: The strategic plan of the Ethiopian Ministry of Health recommends an electronic medical record (EMR) system to enhance health care delivery and streamline data systems. However, only a few exhaustive systematic reviews and meta-analyses have been conducted on the degree of EMR use in Ethiopia and the factors influencing success. This will emphasize the factors that make EMR effective and increase awareness of its widespread use among future implementers in Ethiopia. OBJECTIVE: This study aims to determine the pooled estimate of EMR use and success determinants among health professionals in Ethiopia. METHODS: We developed a protocol and searched PubMed, Web of Sciences, African Journals OnLine, Embase, MEDLINE, and Scopus to identify relevant studies. To assess the quality of each included study, we used the Joanna Briggs Institute quality assessment tool using 9 criteria. The applicable data were extracted using Microsoft Excel 2019, and the data were then analyzed using Stata software (version 11; StataCorp). The presence of total heterogeneity across included studies was calculated using the index of heterogeneity I2 statistics. The pooled size of EMR use was estimated using a random effect model with a 95% CI. RESULTS: After reviewing 11,026 research papers, 5 papers with a combined total of 2439 health workers were included in the evaluation and meta-analysis. The pooled estimate of EMR usage in Ethiopia was 51.85% (95% CI 37.14%-66.55%). The subgroup study found that the northern Ethiopian region had the greatest EMR utilization rate (58.75%) and that higher (54.99%) utilization was also seen in publications published after 2016. Age groups <30 years, access to an EMR manual, EMR-related training, and managerial support were identified factors associated with EMR use among health workers. CONCLUSIONS: The use of EMR systems in Ethiopia is relatively low. Belonging to a young age group, accessing an EMR manual, receiving EMR-related training, and managerial support were identified as factors associated with EMR use among health workers. As a result, to increase the use of EMRs by health care providers, it is essential to provide management support and an EMR training program and make the EMR manual accessible to health professionals.

Prediction of contraceptive discontinuation among reproductive-age women in Ethiopia using Ethiopian Demographic and Health Survey 2016 Dataset: A Machine Learning Approach.

BACKGROUND: Globally, 38% of contraceptive users discontinue the use of a method within the first twelve months. In Ethiopia, about 35% of contraceptive users also discontinue within twelve months. Discontinuation reduces contraceptive coverage, family planning program effectiveness and contributes to undesired fertility. Hence understanding potential predictors of contraceptive discontinuation is crucial to reducing its undesired outcomes. Predicting the risk of discontinuing contraceptives is also used as an early-warning system to notify family planning programs. Thus, this study could enable to predict and determine the predictors for contraceptive discontinuation in Ethiopia. METHODOLOGY: Secondary data analysis was done on the 2016 Ethiopian Demographic and Health Survey. Eight machine learning algorithms were employed on a total sample of 5885 women and evaluated using performance metrics to predict and identify important predictors of discontinuation through python software. Feature importance method was used to select top predictors of contraceptive discontinuation. Finally, association rule mining was applied to discover the relationship between contraceptive discontinuation and its top predictors by using R statistical software. RESULT: Random forest was the best predictive model with 68% accuracy which identified the top predictors of contraceptive discontinuation. Association rule mining identified women's age, women's education level, family size, husband's desire for children, husband's education level, and women's fertility preference as predictors most frequently associated with contraceptive discontinuation. CONCLUSION: Results have shown that machine learning algorithms can accurately predict the discontinuation status of contraceptives, making them potentially valuable as decision-support tools for the relevant stakeholders. Through association rule mining analysis of a large dataset, our findings also revealed previously unknown patterns and relationships between contraceptive discontinuation and numerous predictors.

Spatial distribution of vitamin A rich foods intake and associated factors among children aged 6-23 months in Ethiopia: spatial and multilevel analysis of 2019 Ethiopian mini demographic and health survey.

BACKGROUND: Inadequate micronutrients in the diet and vitamin A deficiency are worldwide public health problems. In developing regions, many preschool children are undernourished, become blind every year and died before the age of 23 months. This study was aimed to explore the spatial distribution of vitamin A rich foods intake among children aged 6-23 months and identify associated factors in Ethiopia. METHODS: Ethiopian Mini Demographic and Health Survey 2019 dataset with a total 1407 children aged 6-23 months was used. Data management and processing were done using STATA version 15 software and Microsoft Office Excel. ArcMap version 10.7 software was used for mapping and spatial visualization of the distribution. Spatial scan statistics was performed using SaTScan version 9.5 software for Bernoulli-based model. Multilevel mixed effect logistic regression model was employed to identify associated factors. RESULTS: Overall, 38.99% (95% CI: 36.46-41.62) of children aged 6- 23 months took vitamin A rich foods. Poor intake of vitamin A rich foods was significantly clustered Dire Dawa city, Somali and Harari regions of Ethiopia. Children aged 6-23 months lived in the primary cluster were 70% (RR = 1.70, P-value < 0.001) more likely to intake vitamin A rich foods than children lived outside the window. In the multilevel mixed effect logistic regression analysis, Primary educational status (AOR:1.42, 95% CI: 1.05, 1.93) and higher educational status (AOR:3.0, 95% CI: 1.59, 5.65) of mother, Dire Dawa (AOR:0.49, 95% CI: 0.22, 1.12) city, Afar (AOR: 0.16, 95% CI: 0.07, 0.36), Amhara (AOR: 0.37, 95% CI: 0.19, 0.71) and Somali (AOR: 0.02, 95% CI: 0.003, 0.08) regions of Ethiopia, children aged 13-23 months (AOR: 1.80, 95% CI: 1.28, 2.36), Mothers' exposure to media (AOR: 1.41, 95% CI: 1.04, 1.92) were statistically significant factors for vitamin A rich foods intake among children aged 6-23 months. CONCLUSIONS: Only 4 out of ten children took vitamin A rich foods which is too low compared to the national target and significantly clustered in Ethiopia. Mother's educational status, Region, Child age and Mother's media exposure are significant factors vitamin A rich foods intake. Stakeholders should strengthen mothers' education status, creating awareness for mothers on child feeding and using locally available natural resource to produce vitamin A rich foods.

Geographical clustering and geographically weighted regression analysis of home delivery and its determinants in developing regions of Ethiopia: a spatial analysis.

BACKGROUND: Nearly three-fourths of pregnant women in Ethiopia give birth at home. However, the spatial pattern and spatial variables linked to home delivery in developing regions of Ethiopia have not yet been discovered. Thus, this study aimed to explore the geographical variation of home delivery and its determinants among women living in emerging (Afar, Somali, Gambella, and Benishangul-Gumuz) regions of Ethiopia, using geographically weighted regression analysis. METHODS: Data were retrieved from the Demographic and Health Survey program's official database ( http://dhsprogram.com ). In this study, a sample of 441 reproductive-age women in Ethiopia's four emerging regions was used. Global and local statistical analyses and mapping were performed using ArcGIS version 10.6. A Bernoulli model was applied to analyze the purely spatial cluster discovery of home delivery. GWR version 4 was used to model spatial regression analysis. RESULTS: The prevalence of home delivery in the emerging regions of Ethiopia was 76.9% (95% CI: 72.7%, 80.6%) and the spatial distribution of home delivery was clustered with global Moran's I = 0.245. Getis-Ord analysis detected high-home birth practice among women in western parts of the Benishangul Gumz region, the Eastern part of the Gambela region, and the Southern and Central parts of the Afar region. Non-attendance of antenatal care, living in a male-headed household, perception of distance to a health facility as a big problem, residing in a rural area, and having a husband with no education significantly influenced home delivery in geographically weighted regression analysis. CONCLUSIONS: More than three-fourths of mothers in the developing regions of Ethiopia gave birth at home, where high-risk locations have been identified and the spatial distribution has been clustered. Thus, strengthening programs targeted to improve antenatal care service utilization and women's empowerment is important in reducing home birth practice in the study area. Besides, supporting the existing health extension programs on community-based health education through home-to-home visits is also crucial in reaching women residing in rural settings.

HIV risk behavior and associated factors among people living with HIV/AIDS in Ethiopia: A systematic review and meta-analysis.

BACKGROUND: HIV risk behavior among people living with HIV/AIDS (PLWHA) is a major public health concern as it increases HIV transmission. In Ethiopia, findings regarding HIV risk behavior have been inconsistent and inconclusive. Therefore, this meta-analysis aimed to estimate the pooled prevalence of HIV risk behavior and associated factors among PLWHA in Ethiopia. METHODS: International databases, including Google Scholar, Cochrane library, HINARI, Pub Med, CINAHL, and Global Health were systematically searched to identify articles reporting the prevalence of HIV risk behavior and associated factors among PLWHA in Ethiopia. The data were analyzed using STATA/SE version-14. The random-effects model was used to estimate the pooled effects. I-squared statistics and Egger's test were used to assess the heterogeneity and publication bias respectively. RESULTS: A total of 4,137 articles were reviewed and fourteen articles fulfilling the inclusion criteria were included in this meta-analysis. The pooled prevalence of HIV risk behavior in Ethiopia was 34.3%% (95% CI: 28.2, 40.3). Severe heterogeneity was observed between the included research articles (I2 = 96.6, p = 0.000). Alcohol use (OR = 1.9, 95%, CI: [1.6, 2.3]), HIV status non-disclosure (OR = 2.3, 95% CI: [1.3, 4.0]) and perceived stigma (OR = 2.3, 95% CI: [1.3, 4.1]) had a significant association with HIV risk behavior. CONCLUSION: The prevalence of HIV risk behavior among PLWHA in Ethiopia was high. Alcohol use, HIV status non-disclosure, and perceived stigma had a significant association with HIV risk behavior. In addition to promoting access to Antiretroviral Therapy (ART) treatment and improving medication adherence among PLWHA, various intervention programs focusing on the associated factors have to be implemented to tackle high-risk sexual behavior and go forward toward ending the HIV/AIDS pandemic.

Time to under-five mortality and its predictors in rural Ethiopia: Cox-gamma shared frailty model.

BACKGROUND: Under-five mortality (U5M) is one of the most important and sensitive indicators of the health status of the community. Despite there having been a substantial reduction in U5M since 1990, its rate is still high in Sub-Saharan African countries. Thus, this study aimed to assess time to under-five mortality and its predictors in rural Ethiopia. METHODS: This study utilized a secondary analysis of the 2016 Ethiopia Demographic and Health Survey (EDHS). A total of 9,807 weighted under-five children selected at different stages were included in the analysis. The Kaplan-Meier and Cox's-gamma shared frailty models were used to estimate survival time and to identify predictors of under-five mortality, respectively. An adjusted Hazard Ratio (AHR) along with a 95% Confidence Interval (CI) was used to measure the effect size and direction of the association. RESULTS: The study indicated that 6.69% (95% CI: 6.13, 7.30) of children died before celebrating their fifth birthday in rural Ethiopia. Of all the deaths, the median time to death was 27 months. After controlling the effect of cluster and other confounding factors, female sex (AHR = 0.62, 95% CI: 0.52, 0.75), ever born greater than five children (AHR = 1.40, 95% CI: 1.07, 1.83), very large size at birth (AHR = 1.33, 95% CI: 1.03 1.71), very small size at birth (AHR = 1.41, 95% CI: 1.10, 1.82), twin pregnancy (AHR = 3.5, 95% CI: 2.47, 4.88), not ever breastfeeding (AHR = 11.29, 95% CI: 9.03, 14.12), unimproved latrine (AHR = 3.44, 95% CI: 1.91, 6.17), covered by health insurance (AHR = 0.29, 95% CI: 0.12, 0.70) were predictors of under-five mortality. CONCLUSIONS: Still under-five mortality was high in rural Ethiopia as compared to the global under-five mortality rate. In the final model, sex of a child, the total number of children ever born, children's size at birth, type of pregnancy, breastfeeding, type of toilet, and being covered by health insurance were significant predictors of under-five mortality. Further emphasis should be given to twin and not breastfeeding children, as well as households' better encouraging membership of community health insurance and utilization of improved latrines.