Mortality rate and predictors of colorectal cancer patients in Ethiopia: a systematic review and meta-analysis.

INTRODUCTION: The incidence of colorectal cancer (CRC) has been increasing in Sub-Saharan countries, including Ethiopia. However, the real mortality rate for CRC patients in Ethiopia has not been established. Therefore, this systematic review and meta-analysis aimed to determine the overall mortality rate and identify predictors among CRC patients in Ethiopia. METHODS: PubMed, EMBASE, Web of Science, Scopus, Science Direct, and Google Scholar were searched to identify relevant articles. The preferred reporting items for systematic reviews and meta-analyses (PRISMA) were followed. The quality of the included studies was assessed using the Newcastle-Ottawa Scale Critical Appraisal checklist. A random effect model was used to estimate the pooled mortality rate and adjusted hazard ratio (AHR). Publication bias was assessed using funnel plots and Egger's regression test, while heterogeneity was evaluated through the Cochran Q test and I2 statistics. RESULTS: After reviewing 74 articles, only 7 studies met the criteria and were included in the analysis. The analysis revealed that the overall mortality rate among CRC patients in Ethiopia was 40.5% (95% confidence interval [CI]: 32.05, 48.87) while the survival rates at 1 year, 3 years, and 5 years were 82.3% (95% CI: 73.33, 91.31), 48.8% (95% CI: 43.35, 54.32), and 26.6% (95% CI: 21.26, 31.91) respectively. Subgroup analysis indicated that studies conducted after 2017 had higher mortality rates compared to those studied earlier (43.0% vs. 38.2%). Older age (AHR: 1.89, 95% CI: 1.27, 2.82); being married (AHR: 2.53, 95% CI: 1.79, 3.57); having comorbidities (AHR: 1.84, 95% CI: 1.45, 2.35); having high CEA levels (AHR: 2.06, CI: 1.35, 3.13); being in stage II (AHR: 4.13, 95% CI: 1.85, 9.22), III (AHR: 8.62, 95% CI: 3.88, 19.15), and IV (AHR: 8.06, CI: 2.89, 22.49) were the most important predictors. CONCLUSION: In Ethiopia, the mortality rate among individuals diagnosed with CRC is high, with two out of five patients dying from this disease. Age, marital status, CEA level, comorbidities, and cancer stage were identified as predictors of mortality in CRC patients. Therefore, early detection and screening should be prioritized, particularly for older patients, those who are married, have comorbidities, elevated CEA levels, and advanced cancer stages.

Burden of chemical poisoning and contributing factors in the case of the Amhara Region, Ethiopia.

BACKGROUND: This study aimed to evaluate the burden of chemical poisoning and its associated factors at the Chemical, Biological, Radiological, and Nuclear (CBRN) pilot surveillance sites in the Amhara region, Northwest Ethiopia. The analysis of burdens and contributing factors is intended to inform targeted interventions and enhance public health strategies. METHODS: A cross-sectional study was conducted at TibebeGhionComprehensive Specialized Hospital(TGCSH) and FelegeHiwot Comprehensive Specialized Hospital(FHCSH) in the Amhara region of Ethiopia from June to November 2021. Data were collected using structured tools and analyzed with SPSS version 26. Descriptive statistics assessed the burden of chemical poisoning, while Chi-square analysis identified significant factors associated with the burden of chemical poisoning. RESULTS: The study reported a total of 184 chemical poisoning cases at TGCSH and FHCSH in the Amhara region, with a case fatality rate of 17%. The most affected age group was 16 to 25 years, and females accounted for 60% of the cases. Geographic distribution showed that Bahir Dar had the highest incidence, contributing to 64.7% of the cases, while the South Gondar zone, particularly the Fogera district, accounted for 30.88%. Organophosphates emerged as the most prevalent toxic agents, responsible for 53% of the cases. Chi-square analysis highlighted several significant associations with a higher burden of chemical poisoning, including being female (X² = 4.463, p = 0.035), being 35 years or younger (X² = 4.629, p = 0.031), ingestion of rodent poison (X² = 4.154, p = 0.042), intentional poisoning (X² = 7.488, p = 0.006), and inhalation exposure (X² = 4.154, p = 0.042) and educational level (X² = 5.764, p = 0.016). CONCLUSIONS AND RECOMMENDATIONS: The study reveals a significant burden of chemical poisoning in the Amhara Region, Ethiopia, with a 17% fatality rate, predominantly impacting young adults and females, particularly in areas with high pesticide use, such as Bahir Dar and South Gondar. Key issues include cases with no antidotes, inhalation exposure, and intentional poisoning. RECOMMENDATIONS: Implement stricter chemical regulations, limit pesticide sales, enhance community education on safe handling, and improve mental health support for high-risk groups. Develop sustained CBRN surveillance systems and conduct further research on regional disparities and chemical agent assessments.

COVID-19 vaccine acceptance and its association with knowledge and attitude among patients with chronic diseases in Ethiopia.

COVID-19 vaccine acceptance is crucial for patients with chronic diseases, but previous studies in Ethiopia have yielded inconsistent and inconclusive findings. To fill this gap, we conducted a systematic review and meta-analysis following established guidelines. Our search included relevant articles published between 2019 and 2023 from various sources. We assessed study heterogeneity and publication bias, and performed subgroup and sensitivity analyses. Our findings indicate that the COVID-19 vaccine acceptance rate among patients with chronic diseases in Ethiopia was 55.4%. We also found that good knowledge and a favorable attitude toward the vaccine were positively associated with the acceptance rate. Based on these results, we recommend that healthcare professionals, policymakers, and healthcare guide developers should work more to address the relatively low acceptance rate. Improving the knowledge and attitude further about the COVID-19 vaccines is crucial. Future research should include community-based and qualitative studies to enhance our understanding of vaccines acceptance.

Covid-19 vaccine uptake and its associated factors among adult population in Dangila district, Awi Zone, Northwest Ethiopia: A mixed method study.

INTRODUCTION: Vaccination is the most cost-effective approach that significantly reduces morbidity and mortality related to Coronavirus disease -19 (COVID-19). Nevertheless, there is a lack of information on the COVID-19 vaccine uptake and related factors in Ethiopia including the research area. OBJECTIVE: To assess COVID-19 vaccine uptake and its associated factors among adult population in Dangila District, Awi Zone, Northwest Ethiopia, 2023. METHODS: A community-based mixed-type study design was conducted from Oct, 15-Nov 15/2022. The study population was chosen using the multistage stratified random sampling technique for the quantitative study and the purposive sampling method for the qualitative inquiry. The collected data were managed and analyzed using SPSS version 25. Bivariable and multivariable logistic regressions were employed to identify factors associated with vaccine uptakes. In the qualitative part of the study, key informant interview was applied. After the interview was listened, the transcripts were coded and categorized into themes, and analyzed using Atlas.ti 7 software. Finally, the finding was triangulated with the quantitative results. RESULT: The vaccine uptake among the adult population was found to be 47% (95% CL: 42.7%, 51.0%). History of having test for COVID-19 (AOR: 1.70, 95% CI: 1.02, 2.84), good knowledge about COVID-19 vaccine (AOR; 3.12, 95% CI; 2.11, 4.59), no formal education (AOR: 1.78, 95%: 1.26, 2.58), good attitude (AOR: 3.21, 95% CI: 2.13, 4.89), being in poor Income category (AOR: 1.83, 95% CI: 1.08, 3.06), being female (AOR: 1.75, 95% CI: 1.2, 2.58) and living in rural area (AOR: 3.1, 95% CI: 1.87, 5.12) were significantly associated with vaccine uptake rate. The study also identified that misperceptions about the vaccine efficacy and safety, availability of vaccine, lack of knowledge about the vaccine, mistrust of the corona virus vaccine, fear of adverse effects, social media influence and religious beliefs were found to be barriers of COVID -19 vaccine uptake. CONCLUSION: In the Dangila district, adult population vaccination uptake for COVID-19 was comparatively low. To raise the rate of vaccination uptake, interventions must focus on the identified modifiable factors.

Assessing healthcare workers' confidence level in diagnosing and managing emerging infectious virus of human mpox in hospitals in Amhara Region, Northwest Ethiopia: multicentre institution-based cross-sectional study.

OBJECTIVE: To assess healthcare workers' (HCWs) confidence level in diagnosing and managing mpox disease and its associated factors in hospitals in the Amhara Region. DESIGN: Institution-based cross-sectional study. SETTING: Hospitals in the Amhara Region, Northwest Ethiopia. PARTICIPANTS: A total of 640 HCWs, with a response rate of 96.9%, participated from 1 October to 30 December 2022. A multistage stratified random sampling technique with proportional allocation was used to recruit study participants. Data were collected using the KoboCollect toolbox and exported to STATA V.17 for analysis. Descriptive statistics were used to describe data. Ordinal logistic regression analysis was used to identify predictors of confidence level to diagnose and manage mpox at p<0.05. PRIMARY OUTCOME: HCWs' confidence level in diagnosing and managing mpox disease and its associated factors. RESULTS: The overall proportion of HCWs who had high confidence level in diagnosing and managing mpox disease was found to be 31.5% (95% CI: 27.9%, 35.2%). Similarly, 26.8% (95% CI: 23.2%, 30.3%) and 41.8% (95% CI: 38.1%, 45.4%) of HCWs expressed medium and low confidence level to diagnose and manage the disease, respectively. The odds of higher confidence versus lower or medium confidence level in diagnosing and managing mpox were greater for HCWs who regularly visit amenable websites (adjusted OR (AOR)=1.59, 95% CI: 1.16, 2.2), were physicians (AOR=1.9, 95% CI: 1.32, 2.73), were aged 30-35 years old (AOR=1.64, 95% CI: 1.12, 2.39), had got public health emergency epidemic disease management training (AOR=2.8, 95% CI: 1.94, 4.04) and had positive attitudes (AOR=1.72, 95% CI: 1.26, 2.36) compared with their counterparts. CONCLUSION: The overall confidence level of HCWs in diagnosing and managing mpox disease in the study area was low. Therefore, the HCWs should be regularly updated about mpox disease through morning sessions and training in the diagnosis and clinical management of mpox disease including infection prevention and control.

The effect of parity on time to initiate complementary feeding among mother-infant pairs in Awi Zone, Northwest Ethiopia.

INTRODUCTION: Despite strategies and recommendations for complementary feeding initiation were applied globally, mothers initiated complementary feeding to the infants on time was low. Previous works of literatures were not identified the effect of parity on time to initiate complementary feeding. Particularly, evidences regarding to this in Ethiopia is scanty. Therefore, this study aimed to identify the effect of parity on time to initiate complementary feeding among mother-infants pairs in Northwest Ethiopia. METHODS: A community-based prospective cohort study was carried out among 732 primipara, and 1464 multipara mothers who had a live birth in Northwest Ethiopia. Data were collected using Kobo collect software at the start of and on a monthly bases until the end of the follow up period. Parity as exposure variable and other confounders were analyzed using cox proportional hazard regression. Kaplan-Meier survival curve and the Schoenfeld residuals global test (P-value = 0.4861) was performed. Hazard ratio (HR) with 95% confidence intervals (CI) was used to declare statistical significance of predictors. RESULTS: The overall incidence rate of initiation of complementary feeding among primipara and multipara mothers were 16.27 (95%CI: 15.04, 17.61) and 13.30 (95%CI: 12.53, 14.12) person months' observations respectively. The median time to initiate complementary feeding among primipara and multipara mothers for their infants was 5 and 6 months respectively. Primipara mothers had a 30% higher rate to initiate complementary feeding early (AHR = 1.30, 95%CI: 1.17, 1.43). Age from 15 to 24 and 25-34 years (AHR = 1.69, 95%CI: 1.36, 2.09; and AHR = 1.45, 95%CI: 1.17, 1.81) and Birth type (twin) (AHR = 1.29, 95%CI: 1.02, 1.64) were statistically significant predictors for time to initiate complementary feeding. CONCLUSIONS: Parity was identified as a statistically significant predictor for time to initiate complementary feeding. The incidence rate of early and late initiation of complementary feeding was higher among primipara than multipara mothers. Besides, the median time to initiate complementary feeding was earlier among primipara than multipara mothers. So, a parity based complementary feeding practice education should be advocated to tackle the gap and further reduce infants and children malnutrition. Relatively younger age and twin delivered mothers initiated complementary feeding against the recommendation. Therefore, intervention considering such statistically significant predictors could have a public health importance.