Individual and community level factors associated with discriminatory attitudes against people living with HIV/AIDS among women of reproductive age in three sub-Saharan African countries: evidence from the most recent demographic and health survey (2021/22).

INTRODUCTION: HIV-related stigma and discrimination significantly affects health, and well-being, willingness to be tested for HIV, initiation and adherence to antiretroviral therapy, and quality of life. However, the findings of the prior studies revealed that the prevalence of discrimination against people living with HIV is high. Thus, we aimed to assess the magnitude of discriminatory attitudes against people living with HIV/AIDS and associated factors in three sub-Saharan African countries. METHODS: The appended and most recent Demographic and Health Survey dataset of three sub-Saharan African countries from 2021 to 2022 was used for data analysis. A total of 56,690 women aged 15-49 years were included in this study as a weighted sample. The determinants of discriminatory attitudes against people living with HIV/AIDS were determined using a multilevel mixed-effects logistic regression model. Significant factors associated with discriminatory attitudes against people living with HIV/AIDS in the multilevel mixed-effect logistic regression model were declared significant at p-values < 0.05. The adjusted odds ratio (AOR) and confidence interval (CI) were used to interpret the results. RESULT: The overall prevalence of discriminatory attitudes against people living with HIV/AIDS was 28.19% (95% CI: 27.74%, 28.64%). In the multivariable analysis, individual level (being young, being an internet user, being tested for HIV, and having comprehensive knowledge about HIV) and community level (being a rural dweller) were factors associated with discriminatory attitudes against people living with HIV/AIDS. CONCLUSION: The prevalence of discriminatory attitudes against people living with HIV/AIDS in three sub-Saharan African countries was high. Individual and community-level variables were associated with discriminatory attitudes against people living with HIV/AIDS. Therefore, special consideration should be given to rural dwellers and young adults. In addition, better to strengthen the accessibility of Internet and HIV testing services, and improve HIV-related education to reduce the magnitude of discriminatory attitudes against people living with HIV/AIDS.

Prevalence of hyperemesis gravidarum and associated factors among pregnant women at comprehensive specialized hospitals in northwest Ethiopia: Multicenter cross-sectional study.

Background: Hyperemesis gravidarum is one of the problems encountered among pregnant women due to persistent and excessive vomiting starting before the end of the 22nd week of gestation. The current study aimed to assess the prevalence of hyperemesis gravidarum and associated factors among pregnant women at comprehensive specialized hospitals in northwest Ethiopia. Methods: A multi-facility-based cross-sectional study was conducted at comprehensive specialized hospitals from 1st June 2022 to 30th July 2022. The data were entered using EPI Data Version 4.6 statistical software and analyzed using SPSS Version 26. Descriptive statistics such as frequency, mean, and percentage were calculated. Univariable and multivariable binary logistic regression analyses were carried out to identify the associated factors of hyperemesis gravidarum. Results: In all, 404 study participants were enrolled. About 16.8% of pregnant women were found to have hyperemesis gravidarum. Age < 20 year (AOR = 3.170; 95% CI: 1.119, 8.980), study participants who cannot read and write (AOR = 5.662; 95% CI: 2.036, 15.7470), grade 1-8 (AOR = 4.679; 95% CI: 1.778, 12.316), and grade 9-10 (AOR = 8.594; 95% CI: 3.017, 24.481), being housewife (AOR = 6.275; 95% CI: 1.052, 37.442), living in urban area (AOR = 2.185; 95% CI: 1.035, 4.609), having previous hyperemesis gravidarum (AOR = 2.463; 95% CI: 1.210, 5.012), having family history of hyperemesis gravidarum (AOR = 2.014; 95% CI: 1.002, 4.047), unplanned pregnancy (AOR = 2.934; 95% CI: 1.030, 8.351), having recent abortion (AOR = 2.750; 95% CI: 1.010, 7.483), and gravidity (AOR = 1.956; 95%CI: 1.023, 3.737) were factors associated with hyperemesis gravidarum. Conclusion: The prevalence of hyperemesis gravidarum is higher. Low maternal age, lower educational level, being a housewife, being an urban resident, having previous hyperemesis gravidarum, having a family history, having an unplanned pregnancy, and having a recent abortion were significantly associated with hyperemesis gravidarum.

Aetiology, clinical profile, management and outcome of acute pancreatitis at public hospitals in Addis Ababa, Ethiopia: a prospective observational study.

Background: Acute pancreatitis (AP) is a rare gastrointestinal pathology that has recently become increasingly common owing to lifestyle changes. Its clinical presentation ranges from mild discomfort to organ failure and death. Previous studies in Ethiopia reported that AP is rare. However, lifestyle changes have recently increased. Therefore, this study aimed to assess the aetiology, clinical profile, management, and outcomes of AP. Methods: This prospective observational study included 59 adults diagnosed with AP using the Revised Atlanta Classification between November 2021 and August 2022 at five public hospitals in Addis Ababa. The data were analyzed using SPSS 25. The mean ± standard deviation and adjusted odds ratio (AOR) at 95% CI were used. Results: The mean age was 38.2 (SD±11.5 years), mostly aged 30-44, with 67% males and 89.8% patients presenting with new-onset AP. Abdominal pain and nausea were the most common presentations in 93.2% of patients. More than 52.5% of AP cases were caused by alcohol, followed by gallstones (28.8%), and gallstones (47.1%) underwent cholecystectomy during the index admission. One patient (1.7%) died. The length of hospital stay ranges from 1-47 days and increases with the severity of AP. Patients with recurrent AP had a 2.4 folds increase in complications compared to new-onset AP (AOR=2.4, 95% CI=1.38, 15.71). Conclusion: Most AP cases were caused by alcohol consumption, followed by gallstones, smoking, and hypertriglyceridemia. One death in a 60-year-old male with an alcohol and smoking history was diagnosed and triaged as severe AP with persistent multiple organ failure; BISAP score 4, his Creatinine=2.55 mg/dl, haematocrit 72.6%; and left shift of WBC, was associated.

Coverage and determinants of second-dose measles vaccination among under-five children in East Africa countries: a systematic review and meta-analysis.

Background: One of the biggest breakthroughs of contemporary medicine is measles vaccination. It is essential for the total elimination of measles. Understanding the magnitude and determinants of effective second-dose measles vaccination coverage is a critical task. Accordingly, we set out to check the best available evidence of the pooled second-dose measles vaccination coverage among under-five children in East Africa. Method: We searched electronic databases such as PubMed, Google Scholar, Cochrane, and others. Two reviewers separately carried out the search of the Joanna Briggs Institute, selection of studies, critical appraisal, and data extraction. A third party was involved in resolving the disagreement among the reviewers. Seven studies included in this study, four from Ethiopia, two from Kenya, and one from Tanzania were cross-sectional and published in English language, with publication dates before 29 November 2023. Articles lacking full-text, the intended outcome, and that are not qualitative studies were excluded from the analysis. The Microsoft Excel checklist was used to extract the data and then exported to STATA 11. In addition, I2, Funnel plots, and Egger's test were employed to measure heterogeneity and detect publication bias, respectively. A random effect model was used. Result: The meta-analysis includes a total sample size of 4,962 children from seven articles. The pooled prevalence of second-dose measles vaccination among under-five children in East Africa was found to be 32.22% [95% CI; (18.82, 45.63)], and the significant factors were as follows: birth order (1.72; OR = 95% CI: 1.32, 2.23), information about measles-containing second-dose vaccine (MCV 2) (7.39; OR = 95% CI: 5.21, 10.50), mother's marital status (1.47; OR = 95% CI: 1.05, 2.07), complete immunization for other vaccines (2.17; OR = 95% CI: 1.49, 3.17), and distance of vaccination site (3.31; OR = 95% CI: 2.42, 4.53). Conclusion: The current study found that pooled prevalence of second-dose measles vaccination coverage among under-five children was still very low. It was also observed that birth order, distance of the vaccination site, complete immunization for other vaccines, mother's marital status, and information about MCV were factors associated with second-dose measles vaccination. These factors imply that there is a need for countries and their partners to act urgently to secure political commitment, expand primary health service and health education, and increase vaccination coverage.

Recommended homemade fluid utilization for the treatment of diarrhea and associated factors among children under five in sub-Saharan African countries: a multilevel analysis of the recent demographic and health survey.

INTRODUCTION: Diarrhea is a common public health problem and the third leading cause of death in the world among children under the age of five years. An estimated 2 billion cases and 1.9 million deaths are recorded among children under the age of five years every year. It causes body fluid loss and electrolyte imbalance. Even though, early initiation of recommended homemade fluid is a simple and effective approach to prevent diarrhea-related complications and mortality of children, recommended homemade fluid utilization for the treatment of diarrhea is still low in sub-Saharan African countries. Therefore, this study aimed to assess the magnitude of recommended homemade fluid utilization for the treatment of diarrhea and associated factors among children under five in sub-Saharan African countries. METHOD: The most recent Demographic and Health Survey dataset of 21 sub-Saharan African countries from 2015 to 2022 was used for data analysis. A total of 33,341 participants were included in this study as a weighted sample. Associated factors were determined using a multilevel mixed-effects logistic regression model. Significant factors in the multilevel mixed-effect logistic regression model were declared significant at p-values < 0.05. The adjusted odds ratio (AOR) and confidence interval (CI) were used to interpret the results. RESULT: The overall recommended homemade fluid utilization for the treatment of diarrhea among children under five in sub-Saharan African countries was 19.08% (95% CI = 18.66, 19.51), which ranged from 4.34% in Burundi to 72.53% in South Africa. In the multivariable analysis, being an educated mother/caregiver (primary and secondary level) (AOR = 1.15, 95% CI: 1.04, 1.27) and (AOR = 1.30, 95% CI: 1.15, 1.1.47), the primary and secondary level of fathers education (AOR = 1.53, 95% CI: 1.37, 1.71) and (AOR = 1.41, 95% CI: 1.19, 1.1.68), having antenatal care follow-up (AOR = 1.16, 95% CI: 1.01, 1.33), having multiple children (AOR = 1.17, 95% CI: 1.07, 1.28), and being an urban dweller (AOR = 1.15, 95% CI: 1.04, 1.27) were factors associated with recommended homemade fluid utilization. CONCLUSION: The overall recommended homemade fluid utilization for the treatment of diarrhea was low. Individual and community-level variables were associated with recommended homemade fluid utilization for the treatment of diarrhea. Therefore, special consideration should be given to rural dwellers and caregivers who have three and below children. Furthermore, better to strengthen the antenatal care service, mother/caregiver education, and father's education to enhance recommended homemade fluid utilization for the treatment of diarrhea.

Number of tetanus toxoid injections before birth and associated factors among pregnant women in low and middle income countries: Negative binomial poisson regression.

BACKGROUND: In low- and middle-income countries where vaccination rates are low, tetanus is still an important threat to public health. Although maternal and neonatal tetanus remains a major global health concern, its magnitude and determinates are not well studied. Therefore, this study aimed to assess the number of tetanus toxoid injections and associated factors among pregnant women in low- and middle-income countries. METHODS: Data from the most recent Demographic and Health Surveys, which covered 60 low- and middle-income countries from 2010 to 2022, was used for secondary data analysis. The study included a total of 118,704 pregnant women. A statistical software package, STATA 14, was used to analyze the data. A negative binomial regression of a cross-sectional study was carried out. Factors associated with the number of tetanus vaccinations were declared significant at a p-value of < 0.05. The incidence rate ratio and confidence interval were used to interpret the results. A model with the smallest Akaike Information Criterion and Bayesian Information Criterion values and the highest log likelihood was considered the best-fit model for this study. RESULTS: In low- and middle-income countries, 26.0% of pregnant women took at least two doses of the tetanus toxoid vaccine. Factors such as maternal education, primary (IRR = 1.22, 95% CI: 1.17, 1.26), secondary (IRR = 1.19, 95% CI: 1.15, 1.23), higher (IRR = 1.16, 95% CI: 1.12, 1.20), employment (IRR = 1.11, 95% CI: 1.09, 1.13), 1-3 ANC visits (IRR = 2.49, 95% CI: 2.41, 2.57), ≥4 visits (IRR = 2.94, 95% CI: 2.84, 3.03), wealth index (IRR = 1.06; 95% CI: 11.04, 1.08), ≥birth order (IRR = 1.04, 95% CI: 1.02, 1.27), distance to health facility (IRR = 1.02, 95% CI: 1.00, 1.03), and health insurance coverage (IRR = 1.08; 95% CI: 1.06, 1.10) had a significant association with the number of tetanus vaccinations among pregnant women. CONCLUSIONS AND RECOMMENDATIONS: This study concludes that the number of tetanus toxoid vaccinations among pregnant women in low- and middle-income countries is low. In the negative binomial model, the frequency of tetanus vaccinations has a significant association with maternal employment, educational status, wealth index, antenatal care visits, birth order, distance from a health facility, and health insurance. Therefore, the ministries of health in low and middle-income countries should give attention to those women who had no antenatal care visits and women from poor wealth quantiles while designing policies and strategies.

Rotavirus vaccine dose-two dropout and its associated factors among children who received rotavirus vaccine dose-one in Sub-Saharan African countries: A multilevel analysis of the recent demographic and health survey.

Rotavirus is the most common cause of diarrhea in children worldwide. In 2016, rotavirus infection resulted in 258 173 300 episodes of diarrhea and 128 500 child deaths in the globe. The study aimed to assess the magnitude of Rotavirus vaccine dose-two dropout and associated factors among children who received rotavirus vaccine dose-one in sub-Saharan African countries. The appended and most recent demographic and health survey (DHS) dataset of 17 sub-Saharan African countries was used for data analysis. A total of 73,396 weighted samples were used. Factors associated with the outcome variable were considered significant if their p-values were ≤ .05 in the multilevel mixed-effect logistic regression model. The overall Rotavirus vaccine dose-two dropouts was 10.77% (95% CI 10.55%, 11.00%), which ranged from 2.77% in Rwanda to 37.67% in Uganda. Being younger, late birth order, having difficulty accessing health facilities, having no media exposure, having no work, having home delivery, having no antenatal follow-up, and having no postnatal checkup were factors significantly associated with the outcome variable. The overall Rotavirus vaccine dose-two dropout was higher in sub-Saharan African countries which implies that vaccine dropout is still a great issue in the region. Special attention should be given to those mothers who are young, who have no work, who give birth at home, who experienced difficulty in accessing health facilities, and late birth orders. Furthermore, targeted interventions should be considered for improving access and utilization of media, antenatal care, and postnatal care services.

A rare case of cecal foreign body leading to cecal perforation in 12-year-old child: a clinical case report and review of literature.

Introduction and importance: Cecal foreign bodies are uncommon causes of acute abdomen, and their presentation can often mimic acute appendicitis (AA), making it challenging to diagnose. The authors present the case of a 12-year-old male from Ethiopia who initially presented with symptoms suggestive of AA. However, during surgery, the authors found a multiple magnetic fields result in perforation. This case highlights the importance of considering unusual etiologies. Case presentation: A 12-year-old boy with AA associated with anorexia, nausea, and low-grade fever was referred from a private clinic. Otherwise, no history of recent respiratory infection and diarrhea, and was previously in good health. The patient did not report any history of a foreign body (FB), even to his own family, and, except for himself, no one was aware of the ingested FB. The work has been reported in line with the Surgical CAse REport (SCARE) 2023 criteria. Discussion: In this case, the authors experienced multiple magnetic FB in the cecum, which were not observed on ultrasound (U/S). However, this case closely resembled appendicitis. U/S can aid in differentiation. However, it may not always identify the underlying etiology, specifically in a resource-limited setting. Conclusion: Based on the patient's presentation, AA was diagnosed and emergency surgery was presumed to be inflamed. However, three magnetic FB were the underlying cause of the presentation, which created pressure on the cecal wall, and the authors successfully performed surgical management. This case reminds us of uncommon etiologies, such as magnets in patients with symptoms of appendicitis. This underscores the importance of an open-minded approach to unexpected findings during surgery.

Knowledge, practice and associated factors towards intravenous cannula-related infection prevention among nurses working at Northwest Amhara Regional State Comprehensive Specialized Hospitals, Ethiopia.

BACKGROUND: Intravenous cannula-related infections are one of the leading causes of healthcare-associated infections. It leads to morbidity and mortality in hospitalized patients. Nurses play a significant role in the prevention of these infections. Whereas in Ethiopia, there is limited information and published studies done on nurses' knowledge, practice, and associated factors and also most of other available studies done only the magnitude it lack associated factors. The purpose of this study was to assess nurses' knowledge, practice, and associated factors toward intravenous cannula-related infection prevention. METHODS: An institution-based cross-sectional study was conducted at Northwest Amhara Regional State Comprehensive Specialized Hospitals on May 1-30/2022. By using single population proportion formula the sample size was determined; we used a 50% proportion value (0.05), and 95% Confidence Interval 5% margin of error. A simple random sampling method was used to select 423 nurses. The data were collected by using structured pretested self-administered questionnaires. Then coded, and enter into epi-data version 4.6 and exported into the statistical package for social science version 23 for cleaning and analyzing the data. Data were presented by texts, tables, and figures. A binary logistic regression model was used to assess the association between variables. Based on the adjusted odds ratio, variables having a p-value less than 0.05 with a 95% confidence interval were used to state associated with the outcome variables. RESULTS: A total of 412 nurses participated in this study with 97.4% response rate. The participants had good knowledge and practice in proportions of (54. 9%) and (53. 4%) respectively. Being male, working wards/units, having training, and a higher educational level were factors that were significantly associated to having good knowledge. Working wards/units, having good knowledge, training, and access to guidelines were significantly associated with performing good practice. CONCLUSION: The finding of this study revealed that nearly half of the nurses had poor knowledge and practice in intravenous cannula-related infection prevention. As a result, hospital administrators and other concerned stakeholders better to prepare and ensure that guidelines are available, provide training, and develop the educational levels of nurses.

Prevalence and associated factors of structural congenital anomalies in resource limited setting, 2023: a systematic review and meta-analysis.

Background: Several studies have been conducted on structural congenital anomalies (CA). However, there is a paucity of studies that provide a comprehensive review of structural anomalies. We aimed to verify the available research articles to pool the possible risk factors of structural CA in resource-limited settings. Setting: The research articles were genuinely searched using PubMed, Scopus, Cochrane Library, Web of Science, free Google database search engines, Google Scholar, and ScienceDirect databases. Published studies were searched and screened for inclusion in the final analysis, and studies without sound methodologies and review and meta-analysis were not included in the analysis. Participants: This review analyzed data from 95,755 women who gave birth as reported by primary studies. Ten articles were included in this systematic review and meta-analysis. The articles that had incomplete information and case reports were excluded from the study. Results: The overall pooled effect estimate (EI) of structural CA was 5.50 (4.88-6.12) per 100 births. In this systematic review and meta-analysis, maternal illness EI with odds ratio (OR) = 4.93 (95% CI: 1.02-8.85), unidentified drug use with OR = 2.83 (95% CI: 1.19-4.46), birth weight with OR = 4.20 (95% CI: 2.12-6.28), chewing chat with OR = 3.73 (95% CI: 1.20-6.30), chemical exposure with OR = 4.27 (95% CI: 1.19-8.44), and taking folic acid tablet during pregnancy with OR = 6.01 (95% CI: 2.87-14.89) were statistically significant in this meta-regression. Conclusions: The overall pooled effect estimate of structural CA in a resource-limited setting was high compared to that in countries with better resources. Maternal illness, unidentified drug use, birth weight, chewing chat, chemical exposure, and never using folic acid were found to be statistically significant variables in the meta-regression. Preconception care and adequate intake of folic acid before and during early pregnancy should be advised. Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42022384838.

Influence of deficit irrigation levels on agronomic performance of pepper (Capsicum annuum L.) under drip at alage, central rift valley of Ethiopia.

Water scarcity is one of the most significant constraints on agricultural production in the world, notably in Ethiopia. In the location where this study was conducted, production is only possible once a year. To make the most use of available water, effective water application technologies must be used, and the feasibility of producing crops in water-stressed scenarios must also be researched. In areas of water shortage, deficit irrigation was an essential approach for raising water production and improving water use efficiency. For this purpose, a field experiment was carried out at Alage ATVET College in Ethiopia's Central Rift Valley during the 2019/20 dry season. The regularly grown cash crop pepper was chosen for experimentation under drip irrigation. The study aimed were to investigate the influence of deficit irrigation levels on agronomic performance and water productivity. Seven deficit levels (DI) namely 60, 50, 40, 30, 20, 10 and 0% were laid out in a randomized complete block design with three replications by using drip irrigation. Water application was used in all deficit levels by managing the demand side. Full irrigation produced the maximum plant height, branch number, fruit weight per plant, fruit diameter, fruit length, marketable and total yield. However, at 20% DI levels, stem diameter, flower and fruit number per plant increased. There were only significant variations in total dry yield at 50% and 60% deficiency levels. Marketable yield was significantly different across all deficit levels. It was not possible to determine the water stress threshold level of pepper due to the large variation in yield, but at 30% DI, the yield reduction was about one-quarter of the 0% deficiency level by withholding 33.4% water. CWUE was significantly different at all deficit levels, demonstrating that as stress levels rise, so does CWUE. IWUE exhibited significant difference only at 0 and10% DI. As a result, it is possible to conclude that using at 30% deficit by withholding 33.4% of water can be used to optimize the yield and water productivity of pepper production at Alage and other areas with comparable agro-ecology.

Spatial distribution and determinants of tetanus toxoid immunization among pregnant women in Ethiopia using data from Ethiopian demographic and health survey 2016.

INTRODUCTION: Tetanus is a major public health problem caused by clostridium tetani. Although it is vaccine-preventable, the case fatality rate among neonates in areas with poor immunization coverage and limited access to clean deliveries reaches 80-100%. Vaccination of pregnant mothers with the tetanus toxoid (TT) vaccine is the most effective way to protect against neonatal tetanus. This study aimed to examine the spatial distribution and determinants of tetanus toxoid immunization among pregnant mothers using the 2016 EDHS data. METHOD: Secondary analysis of the Ethiopia Demographic and Health Survey 2016 was done to assess the spatial distribution and determinants of tetanus toxoid vaccine among pregnant women in Ethiopia. Spatial autocorrelation analysis and hot spot analysis were used to detect spatial dependency and spatial clustering of the tetanus toxoid vaccine in Ethiopia. Spatial interpolation was used to predict the tetanus toxoid vaccine coverage in unsampled areas. The multilevel binary logistic regression model was fitted to identify factors associated with tetanus toxoid vaccination. An adjusted odds ratio with 95% CI was calculated and used as the measure of association and a p-value less than 0.05 were considered statistically significant. RESULT: From the total of 7043 pregnant women, 42.4% of them have taken at least two doses of tetanus toxoid immunization. Spatial clustering of TT immunization was observed in the Northern, Southwestern and Southwestern parts of Ethiopia. Whereas, low TT coverage was observed in the Eastern and Western parts of the country. Increased ANC visits and the richest economic status favored TT immunization, whereas living in Addis Ababa and Dire Dewa cities decreased the TT immunization coverage. CONCLUSION: The finding of this study reveals that TT immunization had spatial dependency, with the highest immunization coverage observed in the Northern, Southwestern and Southeastern parts of the Country. Thus, geographically targeted interventions should be implemented particularly in the eastern and western parts of the country.

Structural congenital anomalies in resource limited setting, 2023: A systematic review and meta-analysis.

BACKGROUND: A number of studies have looked at neonatal structural birth defects. However, there is no study with a comprehensive review of structural anomalies. Therefor we aimed to verify the best available articles to pool possible risk factors of structural congenital anomalies in resource limited settings. SETTING: Genuine search of the research articles was done via PubMed, Scopes, Cochrane library, the Web of Science; free Google database search engines, Google Scholar, and Science Direct databases. Published and unpublished articles were searched and screened for inclusion in the final analysis and Studies without sound methodologies, and review and meta-analysis were not included in this analysis. PARTICIPANTS: This review analyzed data from 95,755 women who have birthed from as reported by primary studies. Ten articles were included in this systematic review and meta-analysis. Articles which have no full information important for the analysis and case reports were excluded from the study. RESULTS: The overall pooled effect estimate of structural congenital anomalies was 5.50 [4.88-6.12]. In this systematic review and meta-analysis maternal illness effect estimate (EI) with odds ratio (OR) = 4.93 (95%CI 1.02-8.85), unidentified drug use OR = 2.83 (95%CI 1.19-4.46), birth weight OR = 4.20 (95%CI 2.12-6.28), chewing chat OR = 3.73 (95%CI 1.20-6.30), chemical exposure OR = 4.27 (95%CI 1.19-8.44) and taking folic acid tablet during pregnancy OR = 6.01 (95%CI 2.87-14.89) were statistically significant in this meta-regression. CONCLUSIONS: The overall pooled effect estimate of structural congenital anomalies in a resource limited setting was high compared to better resource countries. On the Meta-regression maternal illness, unidentified drug use, birth weight, chewing chat, chemical exposure and never using folic acid were found to be statistically significant variables Preconception care and adequate intake of folic acid before and during early pregnancy should be advised.

Do pregnant African women exercise? A meta-analysis.

INTRODUCTION: Antenatal exercise can reduce gestational weight gain, backache; pregnancy induced medical disorders, caesarean section rates, and improves pregnancy outcomes. American College of Obstetrics and Gynecology (ACOG) recommends prenatal exercise, which is associated with minimal risk and has been shown to be beneficial for pregnancy outcomes, although some exercise routines may need to be modified. Consequently, this meta-analysis is intended to verify the pooled practice of antenatal exercise in Africa using available primary articles. METHODS: Genuine search of the research articles was done via PubMed, Scopes, Cochrane library, the Web of Science; free Google databases search engines, Google Scholar, and Science Direct databases. Published and unpublished articles were searched and screened for inclusion in the final analysis and Studies without sound methodologies, and review and meta-analysis were not included in this analysis. The Newcastle-Ottawa scale was used to assess the risk of bias. If heterogeneity exceeded 40%, the random effect method was used; otherwise, the fixed-effect method was used. Meta-analysis was conducted using STATA version 14.0 software. Publication bias was checked by funnel plot and Egger test. RESULTS: This review analyzed data from 2880 women on antenatal care contact from different primary studies. The overall pooled effect estimate of antenatal exercise in Africa was 34.50(32.63-36.37). In the subgroup analysis for pooled antenatal exercise practice by country, it was 34.24 (31.41-37.08) in Ethiopia and 37.64(34.63-40.65) in Nigeria. CONCLUSION: The overall pooled effect estimate of antenatal exercise in Africa was low compared to other continent. As it was recommended by ACOG antenatal exercise to every patient in the absence of contraindications, it should be encouraged by professionals providing antenatal care service.

Major maternal related determinants of non-breastfeeding among mothers in Ethiopia: A multilevel analysis from DHS Ethiopia 2016.

INTRODUCTION: In Ethiopia, the burden of non-breastfeeding is still high despite substantial improvements in breastfeeding. However, the determinants of non-breastfeeding were poorly understood. Therefore, the aim of this study was to identify the maternal -related factors associated with non-breastfeeding. METHODS: An in-depth analysis of data from the Ethiopian Demographic and Health Survey 2016 (EDHS 2016) was used. A total weighted sample of 11,007 children was included in the analysis. Multilevel logistic regression models were fitted to identify factors associated with non-breastfeeding. A p-value < of 0.05 was used to identify factors significantly associated with non-breastfeeding. RESULTS: The prevalence of non-breastfeeding in Ethiopia was 5.28%. The odds of not breastfeeding were 1.5 times higher among women aged 35to 49 years (AOR = 1.5 CI: 1.034, 2.267) than among women aged 15to 24 years. The odds of not breastfeeding were higher among children whose mothers had BMIs of 18.5-24.9 (AOR = 1.6 CI: 1.097, 2.368) and 25-29.9 (AOR = 2.445 CI: 1.36, 4.394) than among women with BMIs of < 18.5. In addition, not breastfeeding was also significantly associated with ANC follow-up, where mothers who had 1-3 ANC follow-up had a 54% decreased odds (AOR = 0.651 CI: 0.46,0.921) compared to mothers who had no ANC follow-up. Demographically, mothers from Somalia region were five times (AOR = 5.485 CI: 1.654, 18.183) and mothers from SNNP region were almost four times (AOR = 3.997 CI: 1.352, 11.809) more likely to not breastfeed than mothers residing in Addis Ababa. CONCLUSIONS: Although breastfeeding practices are gradually improving in Ethiopia, the number of children not breastfed remains high. Individual-level characteristics (women's age, body mass index, and ANC follow-up) and community-level characteristics (geographic region) were statistically significant determinants of non-breastfeeding. Therefore, it is good for the federal minister of Health, planners, policy and decision- makers, and other concerned child health programmers to prioritize both individual and community factors.

Determinants of knowledge of the highest conception probability period among reproductive age women in Low-Income African countries: A multilevel analysis based on the recent Demographic and Health Survey.

BACKGROUND: Adequate knowledge about the highest conception probability period in the reproductive cycle allows individuals and couples to attain or avoid their fertility probabilities. Poor knowledge of conception probability period leads to undesirable outcomes like unwanted pregnancy, miscarriage, and abortion. Determinants of knowledge of highest conception probability period were not well studied on economically disadvantaged countries. Therefore, our study aimed to identify individual and community level factors of knowledge of the highest conception probability period among women of reproductive age in low income African countries. METHODS: The appended and latest Demographic and Health Survey datasets of 15 low-income African countries was used for analysis. Model fitness was done using the Intraclass correlation coefficient, median odds ratio, and deviance. A model with the lowest deviance (model-III) was selected as the best model. Multilevel logistic regression model was used to identify determinant factors of knowledge of the highest conception probability period. In the final model, adjusted odds ratio with 95% confidence interval was reported and variables with p<0.05 were considered as statistically significant with knowledge of the highest conception probability period. RESULTS: Total weighted sample of 235,574 reproductive aged women with a median age of 27 years were included. The correct knowledge of the highest conception probability period among the study participants was 24.04% (95%CI = 23.87-24.22%). Maternal age groups ((20-24 (AOR = 1.49; 95%CI = 1.44-1.55), 25-29 (AOR = 1.62; 1.56-1.68), 35-39 (AOR = 1.76; 1.68-1.84), 40-44 (AOR = 1.75; 1.67-1.83), and 45-49 (AOR = 1.83; 1.74-1.93)), marital status((currently in union (AOR = 1.75; 1.16; 1.13-1.20), formerly in union (AOR = 1.75; 1.11; 1.06-1.16)), better educational status ((secondary (AOR = 2.08; 2.01-2.14) and higher(AOR = 3.36; 3.18-3.55)), higher wealth index ((middle (AOR = 1.08; 1.04-1.12), richer (AOR = 1.24; 1.20-1.28), and richest (AOR = 1.51; 1.45-1.57)), knowledge of contraceptive methods (AOR = 2.63; 2.49-2.77), current contraceptive use (AOR = 1.14; 1.11-1.16), and urban residency (AOR = 1.26; 1.21-1.29) were statistically significant with knowledge of the highest conception probability period. CONCLUSION: In this study, knowledge of the highest conception probability period among women of reproductive age in low-income African countries was low. Therefore, improving the fertility awareness through comprehensive reproductive education or counseling could be one of the operational ways to control unintended pregnancy.

Ecofriendly green synthesis and characterization of silver zinc oxide nanocomposite using the aqueous leaf extract of Rumex Crispus: Evaluation of its antimicrobial and antioxidant activity.

The hydrothermal approach is used in the current study to create an environmentally friendly silver zinc oxide nanocomposite utilizing an aqueous leaf extract of Rumex Crispus. The photochemical components of Rumex Crispus, a synthetic nanocomposite with antioxidant and antibacterial activity, were also assessed. The Response Surface Methodology of Definitive Screen Design (DSD) was used to examine and optimize the effects of four independent variables on the amount of green synthesized silver zinc oxide nanocomposite in Rumex Crispus extract. According to the experimental findings, the green synthesized silver zinc oxide nanocomposite's maximum 1.89 absorbance intensity was achieved at a reaction temperature of 60 °C, a concentration of silver nitrate salt of 100 mM, a pH value of 11, and a reaction period of 3 h. The synthesized nanocomposite was characterized using Fourier-transform infrared, UV, X-ray, UV-vis, Dynamic Light Scattering, thermogravimetric analysis, and differential thermal analysis to determine its functional group, structure, bandgap energy, size distribution, a mass of loss, and energy gain or loss, respectively. The minimum lethal doses for the gram-positive, gram-negative, and fungal strains were 1.25, 0.625, and 2.5 g ml-1 respectively. The 1-1-diphenyl-2-picryl hydrazyl (DPPH) which was used to measure antioxidant activity is scavenged by Ag-ZnO nanocomposites, and the IC50 value of a Rumex Crispus extract is 29.31 g ml-1 IC50 value is.29.31 µg ml-1. Their findings show that Rumex Crispus extract-derived synthetic silver zinc oxide nanocomposite is a promising alternative against both Gram-positive and Gram-negative bacterial strains and fungal strains, as well as a prospective choice for antioxidants under the given conditions.

Prevalence, spatial distribution and determinants of infant mortality in Ethiopia: Findings from the 2019 Ethiopian Demographic and Health Survey.

INTRODUCTION: Infant mortality declined globally in the last three decades. However, it is still a major public health concern in Ethiopia. The burden of infant mortality varies geographically with the highest rate in Sub-Saharan Africa. Although different kinds of literature are available regarding infant mortality in Ethiopia, an up to date information is needed to design strategies against the problem. Thus, this study aimed to determine the prevalence, show the spatial variations and identify determinants of infant mortality in Ethiopia. METHODS: The prevalence, spatial distribution, and predictors of infant mortality among 5,687 weighted live births were investigated using secondary data from the Ethiopian Demographic and Health Survey 2019. Spatial autocorrelation analysis was used to determine the spatial dependency of infant mortality. The spatial clustering of infant mortality was studied using hotspot analyses. In an unsampled area, ordinary interpolation was employed to forecast infant mortality. A mixed multilevel logistic regression model was used to find determinants of infant mortality. Variables with a p-value less than 0.05 were judged statistically significant and adjusted odds ratios with 95 percent confidence intervals were calculated. RESULT: The prevalence of infant mortality in Ethiopia was 44.5 infant deaths per 1000 live births with significant spatial variations across the country. The highest rate of infant mortality was observed in Eastern, Northwestern, and Southwestern parts of Ethiopia. Maternal age between 15&19 (adjusted odds ratio (AOR) = 2.51, 95% Confidence Interval (CI): 1.37, 4.61) and 45&49(AOR = 5.72, 95% CI: 2.81, 11.67), having no antenatal care follow-up (AOR = 1.71, 95% CI: 1.05, 2.79) and Somali region (AOR = 2.78, 95% CI: 1.05, 7.36) were significantly associated with infant mortality in Ethiopia. CONCLUSION: In Ethiopia, infant mortality was higher than the worldwide objective with significant spatial variations. As a result, policy measures and strategies aimed at lowering infant mortality should be devised and strengthened in clustered areas of the country. Special attention should be also given to infants born to mothers in the age groups of 15-19 and 45-49, infants of mothers with no antenatal care checkups, and infants born to mothers living in the Somali region.

Foreign intervention and legacies in the Ethiopian Orthodox Tewahido Church.

This paper examines foreign intervention and the legacies remain in the affairs of the Ethiopian Orthodox Tewahido Church (EOTC). It discusses the so-called Jesuit missionaries' intervention in the EOTC during the 16th and 17th centuries and some of their legacies. It also explores Italy's intervention in the EOTC in the 19th and 20th centuries and the legacies left in the EOTC. To deal with these issues, this article used a qualitative research approach, including primary and secondary data collection instruments. It shows that contradictory religious teachings, ethnocentrism, and ethnic division, which are evident in the contemporary ecclesiastics of the EOTC, are the legacies of the Jesuit missionaries and Italy in the EOTC. It concludes that the current contradictory and divisive religious teachings in the EOTC were initiated and originated by the Jesuit missionaries, and the ethnocentric tendency and ethnic-based division of top ecclesiastics of the current EOTC are the legacies of Italy. Currently, such divisions are consolidated and celebrated by Ethiopians, including the top authorities of the EOTC, but at least in part, their source is foreign intervention. Thus, the EOTC should disclose the roots of such destructive and divisive legacies to strengthen its unity.

Trachoma Prevention Practice and Associated Factors in Rural Lemo District, Southern Ethiopia, 2021.

Background: Trachoma is a leading cause of preventable blindness. It is more prevalent in areas where there is poor personal and environmental sanitation. Implementing a SAFE strategy will reduce the incidence of trachoma. The purpose of this study was to look into trachoma prevention practices and associated factors in rural Lemo, South Ethiopian communities. Methods: We conducted a community-based cross-sectional study in the rural Lemo district of south Ethiopia, covering 552 households, from July 1 - July 30, 2021. We used a multistage sampling technique. Seven Kebeles were selected using a simple random sampling method. Then, a systematic random sampling procedure with a five-interval size was applied to select the households.Our study assessed the association between the outcome variable and explanatory variables using binary and multivariate logistic regressions. The adjusted odds ratio was calculated, and variables with a p-value below 0.05 at the 95% confidence interval (CI) were considered statistically significant. Results: The study found that 59.6% (95% CI: 55.5%-63.7%) of participants had good trachoma prevention practices. Having a favorable attitude (odds ratio [AOR]: 1.91, 95% CI: 1.26-2.89), receiving health education (AOR: 2.16, 95% CI: 1.46-3.21), and obtaining water from a public pipe (AOR: 2.48, 95% CI: 1.09-5.66) were significantly associated with good trachoma prevention practice. Conclusions: Fifty-nine percent of the participants had good prevention practices for trachoma. Health education, a favorable attitude, and a water source from public pipes were variables associated with good trachoma prevention practice. Improving water sources and disseminating health information are vital to increasing trachoma prevention practices.