Geographical variation in hotspots of stunting among under-five children in Ethiopia: A geographically weighted regression and multilevel robust Poisson regression analysis.

INTRODUCTION: Childhood stunting is a global public health concern, associated with both short and long-term consequences, including high child morbidity and mortality, poor development and learning capacity, increased vulnerability for infectious and non-infectious disease. The prevalence of stunting varies significantly throughout Ethiopian regions. Therefore, this study aimed to assess the geographical variation in predictors of stunting among children under the age of five in Ethiopia using 2019 Ethiopian Demographic and Health Survey. METHOD: The current analysis was based on data from the 2019 mini Ethiopian Demographic and Health Survey (EDHS). A total of 5,490 children under the age of five were included in the weighted sample. Descriptive and inferential analysis was done using STATA 17. For the spatial analysis, ArcGIS 10.7 were used. Spatial regression was used to identify the variables associated with stunting hotspots, and adjusted R2 and Corrected Akaike Information Criteria (AICc) were used to compare the models. As the prevalence of stunting was over 10%, a multilevel robust Poisson regression was conducted. In the bivariable analysis, variables having a p-value < 0.2 were considered for the multivariable analysis. In the multivariable multilevel robust Poisson regression analysis, the adjusted prevalence ratio with the 95% confidence interval is presented to show the statistical significance and strength of the association. RESULT: The prevalence of stunting was 33.58% (95%CI: 32.34%, 34.84%) with a clustered geographic pattern (Moran's I = 0.40, p<0.001). significant hotspot areas of stunting were identified in the west and south Afar, Tigray, Amhara and east SNNPR regions. In the local model, no maternal education, poverty, child age 6-23 months and male headed household were predictors associated with spatial variation of stunting among under five children in Ethiopia. In the multivariable multilevel robust Poisson regression the prevalence of stunting among children whose mother's age is >40 (APR = 0.74, 95%CI: 0.55, 0.99). Children whose mother had secondary (APR = 0.74, 95%CI: 0.60, 0.91) and higher (APR = 0.61, 95%CI: 0.44, 0.84) educational status, household wealth status (APR = 0.87, 95%CI: 0.76, 0.99), child aged 6-23 months (APR = 1.87, 95%CI: 1.53, 2.28) were all significantly associated with stunting. CONCLUSION: In Ethiopia, under-five children suffering from stunting have been found to exhibit a spatially clustered pattern. Maternal education, wealth index, birth interval and child age were determining factors of spatial variation of stunting. As a result, a detailed map of stunting hotspots and determinants among children under the age of five aid program planners and decision-makers in designing targeted public health measures.

A systematic review and meta-analysis protocol on knowledge of obstetric danger signs and associated factors among women in Africa.

Objective: This systematic review and meta-analysis will investigate the pooled knowledge level of obstetric danger signs and related factors among African women. Design: Systematic review and meta-analysis incorporating cross-sectional, case-control, and cohort study designs. Methods: Studies published with full texts in English language from the beginning to the present will be searched in the PubMed/MEDLINE, Cumulative Index to Nursing & Allied Health Literature, African Journals Online, and Google Scholar databases. Checklists from the Joanna Briggs Institute will be used to assess the quality of the studies' methodology. Data extraction, critical appraisal, and screening of all retrieved articles will be conducted by two independent reviewers. Statistical analysis will be performed using the STATA-14 and Review Manager 5.3 (RevMan 5.3) software packages. A random effect will be employed to demonstrate pooled estimates of knowledge among women. For determinants of knowledge, an effect size with a 95% confidence interval will be analyzed. Protocol Registration: This systematic review and meta-analysis protocol was registered in PROSPERO with the registration ID and link as follows: CRD42022379085; CRD register@york.ac.ukhttps://www.york.ac.uk/inst/crd. Discussion: Women who are more knowledgeable about obstetric danger signs are more likely to seek emergency care on time, closely attend antenatal care, and be better prepared for labor and any complications, which reduces both maternal and child mortality. This analysis will provide evidence of the pooled prevalence of knowledge of obstetric danger signs among African women, as well as contributing factors.

A systematic review and meta-analysis protocol on hypertension prevalence and associated factors among bank workers in Africa.

Objective: This systematic review and meta-analysis will investigate the pooled prevalence of hypertension and associated factors among bank workers in Africa. Methods: Studies published with full texts in English will be searched in the PubMed/MEDLINE, Cumulative Index to Nursing and Allied Health Literature, African Journals Online, and Google Scholar databases. Checklists from the Joanna Briggs Institute will be used to assess the studies' methodology quality. Data extraction, critical appraisal, and screening of all retrieved articles will be conducted by two independent reviewers. Statistical analysis will be performed using STATA-14 software packages. A random effect will be employed to demonstrate pooled estimates of hypertension among bank workers. For determinants of hypertension, an effect size with a 95% confidence interval will be analyzed. Results: Data extraction and statistical analyses will begin after identifying the most pertinent studies and evaluating their methodological quality. Data synthesis and the presentation of the results are scheduled for completion by the end of 2023. After the review is completed, the results will be presented at relevant conferences and published in a peer-reviewed journal. Conclusion: Hypertension is a major public health concern in Africa. More than 2 out of 10 people aged older than 18 years suffer from hypertension. A number of factors contribute to hypertension in Africa. These factors include female gender, age, overweight or obesity, khat chewing, alcohol consumption, and family history of hypertension and diabetes mellitus. To address the alarming rise in hypertension in Africa, behavioral risk factors should be given primary attention. Protocol registration: This systematic review and meta-analysis protocol is registered in PROSPERO with the registration ID and link as follows: CRD42022364354;CRD-register@york.ac.ukhttps://www.york.ac.uk/inst/crd.

Effectiveness of Neurodynamic Interventions in Patients With Stroke: Protocol for a Systematic Review and Meta-analysis.

BACKGROUND: Stroke is the most common and serious neurological condition, which can lead to death, limited functionality, and reduced quality of life. Studies with conflicting results and various methodological limitations have been conducted to assess the effectiveness of neurodynamic interventions for patients with stroke. OBJECTIVE: This systematic review and meta-analysis aimed to investigate the pooled effectiveness of different neurodynamic interventions on patients with stroke. METHODS: The PubMed, PEDro, and Google Scholar databases will be searched for studies published with full text in the English language from inception to date. Randomized controlled trials evaluating the effect of different neurodynamic techniques on patients with stroke will be included. The primary outcome measures will include pain, disability/function, and quality of life. Secondary outcome measures will include physical performance measures such as balance, range of motion, muscle strength, and specific diagnostic and neurodynamic test outcomes. The screening, data extraction, and methodological quality assessment will be performed by two independent reviewers. The PEDro scale will be used to systematically appraise the methodological quality. Review Manager V.5.4 software will be used for statistical analysis. Weighted mean difference or standardized mean difference with 95% CIs and P values will be used to calculate the treatment effect for each outcome variable. RESULTS: Search terms and search databases have been identified. The data extraction sheet has also been developed. This study is expected to be completed by the end of 2022. CONCLUSIONS: This study will provide up-to-date evidence on the effectiveness and use of neurodynamic interventions for patients with stroke in clinical practice. TRIAL REGISTRATION: PROSPERO CRD42022319972; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=319972. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/38956.