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

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

Level of knowledge, attitude, and practice on modern contraceptive method and its associated factors among housemaids living in Debre Tabor town, northwest Ethiopia: a community-based cross-sectional study.

BACKGROUND: Contraception is widely recognized as an effective technique for avoiding unplanned pregnancies and sexually transmitted diseases. Promoting contemporary contraceptive methods would minimize the number of unplanned pregnancies and the high number of maternal fatalities connected with unsafe abortions. OBJECTIVE: This study aims to assess the level of knowledge, attitude, and practice of modern contraceptive methods and its associated factors among housemaid residents of Debre Tabor Town, northwest Ethiopia: METHODS: A structured questionnaire supplemented with face-to-face interviews was used to conduct a community-based cross-sectional study with 423 housemaids' women of reproductive age in Debre Tabor City. The data were analyzed using descriptive analysis, binary analysis, and multivariable logistic regression. RESULTS: A 12.8% of respondents in this study used modern contraceptive methods. A 44.68% of study participants had good knowledge of modern contraceptive methods, and 36.40% had a positive attitude towards them. Housemaids' older age, urban location, educational status, work experience, and family situation were found to be positive predictors of a good understanding of current contraceptive techniques. Housemaids' older age, urban residence, educational level, work experience, family situation, and first sex before now are all positive predictors of a positive attitude and good practices. CONCLUSIONS: Housemaids' knowledge, attitude, and practice of modern contraceptive methods were influenced by a variety of socio-demographic factors. As a result, housemaids should be educated about modern contraceptive methods by the health sector and other stakeholders to improve their knowledge, attitude, and practices.

In vivo antidiarrheal activity of the crude extract and solvent fractions of Rhamnus prinoides (Rhamnaceae) leaves.

Background: Even though numerous conventional anti-diarrheal agents are available, the inherent toxicities of the drugs urge the search for alternative drugs that are safe and effective. Objective: To evaluate the in-vivo anti-diarrheal activity of crude extract and solvent fractions of Rhamnus prinoides leaves. Materials and methods: The Rhamnus prinoides leaves were macerated using absolute methanol and then fractionated using solvents of different polarity indexes. For in-vivo antidiarrheal activity evaluation of the crude extract and solvent fraction, castor oil-induced diarrhea, castor oil-induced anti-enteropolling, and intestinal transit models were used. One-way analysis of variance was used to analyze the data, followed by a Tukey post-test. The standard and negative control groups were treated with loperamide and 2% tween 80 respectively. Results: A significant (p˂0.01) reduction in the frequency of wet stools and watery content of diarrhea, intestinal motility, intestinal fluid accumulation, and delaying the onset of diarrhea as compared with controls were observed in mice treated with 200 mg/kg and 400 mg/kg methanol crude extract. However the effect increased dose-dependently, and the 400 mg/kg methanol crude extract produced a comparable effect with the standard drug in all models. Amongst the solvent fractions, n-BF significantly delayed the time of diarrheal onset and reduced the frequency of defecation, and intestinal motility at doses of 200 mg/kg and 400 mg/kg. Furthermore, the maximum percentage inhibition of intestinal fluid accumulation was observed in mice treated with 400 mg/kg n-butanol extract (p˂0.01; 61.05%). Conclusions: The results of this study showed that crude extract and solvent fractions of Rhamnus prinoides leaves showed a significant anti-diarrheal activity which supports its traditional use as a diarrhea treatment.

Delay in reaching health facilities and its associated factors among mothers giving birth in South Gondar zone hospitals, Northwest Ethiopia, 2020: A facility-based cross-sectional study.

Background: Delays in reaching health facilities are one of three models identified as major contributors to maternal mortality and morbidity in developing countries, including Ethiopia. However, little is known about the prevalence and associated factors of delays in reaching healthcare facilities in Ethiopia, particularly in rural areas. Objective: The aim of this study was to assess the prevalence of delays in reaching health facilities and associated factors among mothers who gave birth in South Gondar zone hospitals, Northwest Ethiopia, 2020. Methods: A cross-sectional study design was used from 28 November to 25 December 2020, with 417 mothers who had recently given birth participating in the study, selected through a simple random sampling technique. Data were collected using a face-to-face interview with pretested structured questionnaires. The EpiData software (version 3.1) was used to record collected data and then exported to SPSS (version 23) for statistical analysis. Bivariable and multivariable analyses were conducted, and the odds ratio with 95% CI was used to identify factors associated with delays in reaching health facilities. The statistical significance was declared at p < .05. Results: The prevalence of delay in reaching health facilities among mothers who gave birth in South Gondar zone hospitals were 50.6%. Mothers who had no antenatal care (ANC) visits [adjusted odd ratio (AOR) = 3.16, 95% CI = 1.52, 6.56], an unplanned pregnancy (AOR = 1.78, 95% CI = 1.16, 2.72), and a distance from home to a health facility greater than 5 km (AOR = 1.69, 95% CI = 1.08, 2.65) were positively associated with delays in reaching health facilities. Conclusions: The prevalence of delays in reaching health facilities was higher in the study area. Women's empowerment through health education about ANC follow-up, choice of family planning methods, and creating accessibility to health facilities are essential measures to minimize delays in reaching health facilities.

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

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

Incidence, time to occurrence and predictors of peripheral intravenous cannula-related complications among neonates and infants in Northwest Ethiopia: an institutional-based prospective study.

BACKGROUND: Peripheral intravenous cannulas (PIVC) are venous access devices commonly used for the administration of intravenous fluids, drugs, blood products, and parenteral nutrition. Despite its frequent use, it has complications that can seriously threaten patient safety, prolong hospital stays, and increases medical care costs. PIVC complications are associated with increased morbidity and reinsertion attempts are painful and anxiety-provoking for children and their parents. Therefore, this study was aimed to assess the incidence, time to occurrence and identify predictors for PIVC complications among infants admitted to Debre Tabor Comprehensive Specialized Hospital (DTCSH), Northwest Ethiopia. METHODS AND SETTING: An institutional-based prospective cohort study was conducted on 358 infants admitted to a neonatal intensive care unit and pediatric ward, DTCSH from January 1 to April 30, 2022. A systematic sampling technique was employed. RESULTS: The incidence rate of PIVC complication was 11.6 per 1000 person-hours observation. PIVC complication was observed in 56.4% (202) of PIVCs, of which infiltration (42.1%) was the most common complication followed by phlebitis (29.7%). The median time to complication was 46 h. Anatomical insertion site (AHR = 2.85, 95%CI: 1.63-6.27), admission unit (AHR = 1.88, 95%CI: 1.07-4.02), sickness (AHR = 0.24, 95% CI: 1.31-4.66), medication type (AHR = 2.04, 95%CI: 1.13-3.66), blood transfusion (AHR = 0.79, 95%CI: 0.02-0.99), clinical experience (AHR = 0.52, CI:0.26-0.84), and flushing (AHR = 0.71, 95%CI: 0.34-0.98) were potential predictors of PIVC complication. CONCLUSION: Knowing the predictor factors helps clinicians to provide effective care and to detect complications early.

COVID-19 vaccine hesitancy in Ethiopia in 2021: a multicenter cross-sectional study.

Introduction: Worldwide, hesitancy to be immunized against SARS-CoV-2 is the most common barrier to reducing COVID-19 incidence. Our study investigated determinants for hesitancy and will be helpful to community mobilizers, health professionals and policymakers. Objective: To assess the prevalence and determinants of hesitancy to COVID-19 vaccination among patients attending public hospitals in South Gondar zone, Ethiopia. Methods: A multicenter facility-based cross-sectional study was conducted from 1 November to 30 December 2021 to assess the prevalence and determinants of hesitancy to COVID-19 vaccination. Chi-square test and multivariable logistic regression methods were employed using SPSS 23. Significance level was examined using an odds ratio at 95% CI. Multi-collinearity and model fitness were also checked. Results: A total of 415 participants were included in the study, with a questionnaire response rate of 100%. The prevalence of hesitancy to COVID-19 vaccination was 46.02%. Age of >49 years, rural residency, fear of the adverse effects of the vaccines, myths about vaccine ineffectiveness and poor practices in COVID-19 prevention were the most common determinants of hesitancy. Conclusions: Despite increased global morbidity and mortality due to COVID-19, the prevalence of vaccine hesitancy is still high. Therefore, it is important to create awareness in highly hesitant groups.

Prevalence of HIV infection and associated factors among infants born to HIV-positive mothers in health institutions, northwest Ethiopia, 2021.

BACKGROUND: Mother-to-child transmission of the HIV remains the main source of HIV infection in children. Targeting pregnant women attending antenatal care follow-up provides a unique opportunity for implementing prevention of mother-to-child transmission programs against HIV infection in newborn babies. OBJECTIVE: The objective of this study was to assess the prevalence of HIV infection and associated factors among infants born to HIV-positive mothers in the prevention of mother-to-child transmission clinic in the Gondar city health institutions, Northwest Ethiopia, 2021. METHODS: Documents were reviewed at the facility. Infants who had been exposed to HIV were enrolled in the study from 1 May-20 June 2021 prevention of mother-to-child transmission service in Gondar health institutions. To collect data from the charts, a structured data extraction tool was developed. The data were entered and analyzed with SPSS version 25 software. Both bivariate and multivariate logistic regression models were fitted to identify factors associated with HIV infection. The crude and adjusted odds ratios with a 95% confidence interval were calculated to determine the significance level. RESULT: The prevalence of HIV infection among infants born to HIV-positive mothers at the prevention of mother-to-child transmission level was found to be 8.1% (95% confidence interval = 7.3-12.9). Mixed infant feeding practice (adjusted odds ratio = 5.15, 95% confidence interval = 1.82-14.56), mothers' lack of education (adjusted odds ratio = 3.43, 95% confidence interval = 2.26-5.0), absence of antenatal care follow-up (adjusted odds ratio = 1.82, 95% confidence interval = 1.17-4.02), and home delivery (adjusted odds ratio = 2.24, 95% confidence interval = 2.10-7.45) were statistically significantly associated with infants' HIV infection. CONCLUSION: The prevalence of HIV infection in babies born to HIV-positive mothers was found to be high. Significant factors include mixed infant feeding practice, mothers' lack of education, antenatal care follow-up, and home delivery. We also proposed that skilled delivery care and community education could reduce HIV transmission from mother to child.

Prevalence and determinants of the involvement of married men in family planning services in Ethiopia: A systematic review and meta-analysis.

BACKGROUND: Male involvement in family planning includes not only using contraceptives but also encouraging and supporting their partners' contraception needs and choices, encouraging peers to use family planning, and influencing policy to make male-related programs more conducive. In Ethiopia, the prevalence and associated factors of male involvement in family planning were highly inconsistent across studies. As a result, the goal of this study was to use a systematic review and meta-analysis to estimate the pooled prevalence of male involvement in family planning and its associated factors in Ethiopia. METHODS: Electronic literature search using PubMed, Google Scholar, EMBASE, HINAR, Scopus, and Web of Sciences were performed without time restriction to identify the primary studies. Data were extracted using a pretested standardized data extraction format and analyzed using STATA 14 statistical software. A random-effect model was used to estimate the pooled prevalence of male involvement. RESULTS: A total of 17 studies were included to give the pooled prevalence of male involvement in family planning in Ethiopia, which was 39.66% (95% confidence interval = 29.86, 49.45). Educational status (adjusted odds ratio = 1.99, 95% confidence interval = 1.26, 3.14), discussion of family planning with wife (adjusted odds ratio = 4.15, 95% confidence interval = 2.21, 7.80), knowledge (adjusted odds ratio = 1.83, 95% confidence interval = 1.26, 2.64), positive attitude about family planning (adjusted odds ratio = 2.57, 95% confidence interval = 1.70, 3.90), and approval of contraceptive use (adjusted odds ratio = 2.57, 95% confidence interval = 1.70, 3.90) were found to be significantly associated with involvement of men in family planning service. CONCLUSION: The overall prevalence of male involvement in family planning in Ethiopia was significantly low. Male involvement in family planning should be made available, accessible, and advocated for by government and non-governmental organizations, service providers, program planners, and stakeholders. In addition, to increase the role of men in the use of family planning services, a conducive environment for education, behavioral change, and open discussion about reproductive health issues is required.

Delay in making decision to seek care on institutional delivery and associated factors among postpartum mothers in South Gondar zone hospitals, 2020: A cross-sectional study.

Background: Delay in seeking emergency obstetric care contributes to high maternal mortality and morbidity in developing countries. One of the major factors contributing to maternal death in developing countries is a delay in seeking emergency obstetric care. This study aimed to assess the proportion and associated factors of delay in deciding to seek emergency obstetric care on institutional delivery among postpartum mothers in the South Gondar zone hospitals, Ethiopia, 2020. Methods: An institution-based cross-sectional study design was conducted from September to October 2020. A total of 650 postpartum mothers were recruited using a systematic random sampling technique. We collected the data through personal interviews with pretested semi-structured questionnaires. We used a logistic regression model to identify statistically significant independent variables, and entered the independent variables into multivariable logistic regression. The Adjusted Odds Ratio was used to identify associated variables with delay in deciding to seek emergency obstetric care, with a 95% confidence interval at P-value < 0.05. Results: The proportion of delay in deciding to seek emergency obstetric care on institutional delivery was 36.3% (95% CI: 32.6-40.1). The mean age of the respondents was 27.23, with a standard deviation of 5.67. Mothers who reside in rural areas (AOR = 3.14,95%, CI:2.40-4.01), uneducated mothers (AOR = 3.62, 95%, CI:2.45-5.52), unplanned pregnancy (AOR: 2.01, 95% CI: 1.84-7.96), and no health facilities in Kebele (AOR: 1.62, 95% CI: 1.43-6.32) were significantly associated with delay in a decision to seek emergency obstetric care. Conclusion: The proportion of delay in deciding to seek emergency obstetric care was 36.3% among postpartum mothers in the South Gondar zone hospitals. One of the factors contributing to maternal death is a delay in seeking emergency obstetric care in South Gondar zone. Pregnant mothers living in the rural area, unplanned pregnancy, uneducated mothers, no health facilities in Kebele were associated factors in the study area. Therefore, stakeholders must address them to reduce the proportion of delay in deciding to receive on-time obstetric care as per the standards.

A systematic review and meta-analysis of women's satisfaction with skilled delivery care and the associated factors in Ethiopia.

Evidence of variation in maternity health service practices has increased the government's interest in quantifying and advancing the quality of institutional delivery care in the developing world, including Ethiopia. Therefore, we conducted a systematic review and meta-analysis to update and provide more representative data on women's satisfaction with skilled delivery care and the associated factors in Ethiopia. This systematic review and meta-analysis followed the Preferred Reporting Items 2015 guideline. We searched PubMed/Medline, SCOPUS, Embase, Web of Science, and Google Scholar electronic databases for all 36 included studies. The pooled prevalence of women's satisfaction with skilled delivery care and the associated factors were estimated using a random-effects model. Subgroup analysis and meta-regression were performed to identify the source of heterogeneity. Furthermore, publication bias was checked using eggers and funnel plots. All statistical analyses were performed using STATA version 14.0 software. The pooled prevalence of women's satisfaction with skilled delivery care was 67.31 with 95% confidence interval (60.18-74.44). Wanted pregnancy (adjusted odds ratio = 2.86, 95% confidence interval: (2.24-3.64)), having a plan to deliver at a health facility (adjusted odds ratio = 2.09, 95% confidence interval: (1.42-3.09)), access to ambulance service (adjusted odds ratio = 1.52, 95% confidence interval: (1.00-2.31)), waiting time < 15 min (adjusted odds ratio = 3.66, 95% confidence interval: (2.51-5.33)), privacy assured (adjusted odds ratio = 3.94, 95% confidence interval: (2.23-6.94)), short duration of labour < 12 hr (adjusted odds ratio = 2.55, 95% confidence interval: (1.58-4.12)), proper labour pain management (adjusted odds ratio = 3.01, 95% confidence interval: (1.46-6.22)), and normal newborn outcome (adjusted odds ratio = 3.94, 95% confidence interval: (2.17-7.15)) were associated with women's satisfaction. Almost two-thirds of women were satisfied with skilled delivery care. In comparison, the remaining one-third were not satisfied with the care. The quality of intrapartum care, unwanted pregnancy, lack of ambulance services, prolonged duration of labour, poor labour pain management, and complicated newborn outcome were factors affecting women's satisfaction with skilled delivery care in Ethiopia. Therefore, strategies need to be developed to increase the satisfaction level by considering the abovementioned factors during routine delivery care.

Postpartum intrauterine contraceptive device use and its associated factors in Ethiopia: systematic review and meta-analysis.

BACKGROUND: The intrauterine contraceptive device, a type of long-acting reversible contraception, is one of the most effective and safe contraceptive methods. In Ethiopia, intrauterine contraceptive device is little known and practised to delay pregnancy. Therefore, this study aimed to assess post-partum intrauterine contraceptive device utilisation and its associated factors among women in Ethiopia. METHOD: In the current meta-analysis, variables were searched from different electronic database systems, including PubMed, Google Scholar, EMBASE, HINAR, Scopus, Web of Sciences, and Grey literature. Data were extracted using a standardised data collection measurement tool. The data were also analysed by using STATA 16 statistical software. I2 tests assessed heterogeneity between the studies. A random-effect model was used to forecast the pooled utilisation of postpartum intrauterine contraceptive device. RESULTS: Twelve full-article studies were included. The pooled prevalence of post-partum intrauterine contraceptive device among women in Ethiopia was 21.63%. Occupation (OR = 4.44, 95% CI, 2.24-8.81), educational level of college and above (OR = 5.93, 95% CI, 2.55-13.8), antenatal care (OR = 2.09, 95% CI, 1.4-3.12), age (OR = 4.8, 95% CI, 2.3-10.04), good knowledge (OR = 4.16, 95% CI, 1.65-10.49), counseling (OR = 3.05, 95%CI, 1.41-6.63), husband support (OR = 11.48, 95% CI, 6.05-21.79) and awareness about IUCD (OR = 3.86, 95% CI, 1.46-10.2) were positively associated with utilization of postpartum intrauterine contraception device. CONCLUSIONS: Utilisation of post-partum intrauterine contraceptive device was significantly low. Scaling up women's educational status and ANC use has paramount importance in increasing post-partum IUD use, which further improves maternal and child health in general. This finding may be useful in both reproductive health promotion at an individual level and policy-making regarding this issue.

Family planning (FP) is widely recognised as a life-saving and health-improving intervention for women and children. An IUCD is a small, "T-shaped" intrauterine contraceptive device inserted into a woman's uterus. It is also referred to as an IUD, a loop, or a coil. Post-partum IUCD is an intrauterine contraceptive device inserted during the post-partum period. Although several primary studies have been conducted in various regions of Ethiopia, there is no nationally representative evidence on the PPIUCD utilisation and the pooled effects of its determinants in Ethiopia. In this review, some of the factors associated with the post-partum intrauterine contraceptive device were pooled quantitatively, and some were not because of inconsistent classification (grouping) of the exposures concerning the outcome (post-partum intrauterine contraceptive device).This systematic review and meta-analysis used the following electronic database; PubMed, Google Scholar, EMBASE, HINAR, Scopus, Web of Sciences, and Grey literature to search the primary articles. A total of 12 primary studies assessing the utilisation of postpartum intrauterine contraceptive device (PPIUCD) were included based on study eligibility criteria.And also, in this study we found that the pooled prevalence of post-partum intrauterine contraceptive device among women in Ethiopia was 21.63%. Occupation, educational status, good knowledge, husband support, age, counselling, antenatal care follow-up, and awareness about IUCD were factors that affect the use of post-partum intrauterine contraceptive devices.This systematic review and meta-analysis report that utilisation of post-partum intrauterine contraceptive device was significantly low. Therefore, scaling up women's educational status, and ANC use has paramount importance in increasing post-partum IUD use, which further improves maternal and child health in general. Beside this health professional also should be give health education and promotion about the importance of PPIUCD.