Prevalence and factors associated with intestinal parasites among under-five children attending Woreta Health Center, Northwest Ethiopia.

BACKGROUND: Environmental, social, geographical, and other factors could affect the distribution of intestinal parasites. Parasitic infections would impose on health and social problems like mal-absorption, diarrhea, impaired work capacity, and reduced growth rate. However, there is a scarcity of information regarding the prevalence of intestinal parasites and associated factors in the study area. METHODS: Institution based cross-sectional study was conducted among 310 study participants from April-May, 2017. Study participants were selected using a systematic random sampling technique. EPI Info version 7 and SPSS version 20 were used to enter and analyze the data. Both bivariate and multivariate logistic regression analyses were computed. In multivariate analysis, variables with P-value < 0.05 were considered statistically significant. RESULTS: In this study, the mean age of participants was 29.25 Months. The overall prevalence of intestinal parasites was 18.7% (95% CI = 14.4-23.3). Children who rarely feed fresh meal (AOR = 7.74, 95% CI: 1.61, 7.84), Children whose nails were sometimes trimmed (AOR = 3.41, 95% CI: 2.20-10.28), children who had no clean playing ground (AOR = 2.43, 95% CI: 1.25-5.18), and children who had open defecation of the family (AOR = 3.40, 95% CI: 1.27-10.86) were significantly associated with intestinal parasitic infections. Among the intestinal parasites, 31(53.5%) were G.lamblia (Giardia lamblia) and 21(36.2%) were E. histolytica/E. dispar/E. moshkovskii. CONCLUSION: In this study, the prevalence of intestinal parasites was found low compared with the WHO annual or biannual population prevalence and treatment. However, strengthening of health education about food, personal and environmental hygiene of both children and mothers/guardians is crucial to limit the transmission. Besides, improving mothers/guardian awareness about the mode of intestinal parasites transmission is necessary.

Associated factors of safe child feces disposal in sub-Saharan Africa: Evidence from recent demographic and health surveys of 34 sub-Saharan countries.

INTRODUCTION: Children's feces are thought to pose a greater public health risk than those of adults' due to higher concentrations of pathogens. The aim of this study was to determine the associated factors of safe child feces disposal among children under two years of age in Sub-Saharan Africa. METHODS: The most recent demographic and health survey datasets of 34 sub-Saharan countries were used. A total weighted sample of 78, 151 mothers/caregivers of under two children were included in the study. Both bivariable and multivariable multilevel logistic regression were done. The Odds Ratio (OR) with a 95% Confidence Interval (CI) was calculated for each independent variables included in the model. RESULTS: Those mothers/caregivers from urban residence (AOR = 1.42; CI: 1.36, 1.48), mothers with primary education (AOR = 1.49; CI: 1.44, 1.56), richer (AOR = 1.78; CI: 1.69, 1.88) and richest wealth quintiles (AOR = 2.17; CI: 2.01, 2.31), family size <5 (AOR = 1.06; CI: 1.02-1.09), access to improved water source (AOR = 1.29; CI: 1.25, 1.34), mothers who owned toilet (AOR = 3.09; 2.99-3.19) and who had media exposure (AOR = 1.19; CI: 1.15, 1.24) had higher odds of practicing safe child feces disposal than their counter parts. However, mothers/care givers who are not currently working (AOR = 0.83; CI: 0.80, 0.86), higher education (AOR = 0.85; CI: 0.76-0.94) and from Western region of Africa (AOR = 0.82; CI: 0.79-0.86) had reduced chance of safe child feces disposal as compared to their counter parts. CONCLUSION: Residence, mothers' level of education, wealth index, water source, toilet ownership and media exposure were factors associated with safe child feces disposal. It is advisable to implement health promotion and behavioral change intervention measures especially for those women /caregivers from rural residence, poor economic status, who cannot access improved water and for those with no media exposure to improve the practice of safe child feces disposal.

Assessment of Knowledge, Attitude, and Practice of HIV Positive Mothers on Antiretroviral Treatment towards Infant Feeding in Gondar Town Health Institutions, North West Ethiopia, 2017.

INTRODUCTION: The world health organization recommends feeding practices for infants born from Human Immunodeficiency Virus infected mothers to be safe to both the infant and the mother. This includes prevention of mother to child transmission of the virus and at the same time meeting nutritional requirements of the child. This requires prioritizing prevention of HIV transmission through breastfeeding against non-HIV morbidity and mortality especially from malnutrition and serious illnesses such as diarrhea, among nonbreastfed infants. OBJECTIVE: This study was aimed at assessing knowledge, attitude, and practice of HIV positive mothers on antiretroviral therapy towards infant feeding. METHOD: Institution based cross-sectional study was conducted among 402 HIV positive mothers at ART clinics of Gondar town from March 1 to April 18, 2017. Systematic random sampling technique was used to select study participants. Data was collected using a structured, pretested, interviewer-administered questionnaire. The collected data was entered into Epi Info version 7 and analyzed using SPSS version 20 software. RESULT: A total of 402 participants were interviewed with a 100% response rate. The mean age of participants was 29.24 (SD±10.06) years. The overall level of participant good knowledge and favorable attitude was 68.91% and 75.87%, respectively. Only 23.7% of mothers were practicing infant feeding according to WHO recommendation.

Maternal HIV infection and preeclampsia increased risk of low birth weight among newborns delivered at University of Gondar specialized referral hospital, Northwest Ethiopia, 2017.

INTRODUCTION: Globally, more than 20 million infants are born with low birth weight. The risk of neonatal mortality among low birth weight infants is 25 to 30 times greater than neonates with birth weight ≥ 2500 g. Low birth weight infants are at increased risk of infection, difficulty of feeding, and neurologic problems following birth. So far, the prevalence and factors associated with low birth weight have not been studied in the study area after completion of the time set for millennium development goals. Therefore, the study was aimed at assessing the prevalence and associated factors of low birth weight among newborns delivered at University of Gondar specialized referral hospital, Northwest Ethiopia, 2017. METHODS: Institution-based retrospective cross-sectional study was conducted from April 1 to May 28, 2017. A total of 240 newborns were included in the study. Systematic random sampling technique was used for selecting study participant's medical record charts from delivery registration log book. Data were collected using data extraction tool. Binary logistic regression followed by multivariable regression model was fitted and interpretation was made based on the adjusted odds ratio and p-value of less than 0.05 with corresponding 95% CI. RESULTS: The prevalence of low birth weight was 12.9% (95%CI: 8.94, 17.83%). No history of preeclampsia (AOR = 0.193, 95%CI: 0.0516, 0.723), negative maternal HIV infection (AOR = 0.015, 95%CI: 0.001, 0.277), and being preterm (AOR = 17.6, 95%CI: 5.18, 60.17) were significantly associated with low birth weight. CONCLUSION AND RECOMMENDATIONS: The result of this study highlighted that the burden of low birth weight is a public health concern among babies delivered in University of Gondar specialized referral Hospital. Maternal HIV infection, preeclampsia, and prematurity were associated with low birth weight. Prevention and treatment of Human immunodeficiency virus infection during pregnancy, tackling prematurity and prevention of preeclampsia through strengthening of antenatal care service and other comprehensive strategies are strongly recommended.

Survival and predictors of mortality among children co-infected with tuberculosis and human immunodeficiency virus at University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia. A retrospective follow-up study.

BACKGROUND: Tuberculosis (TB) is the leading cause of death in Human immunodeficiency virus (HIV) infected children globally. The aims of this study were to determine the mortality rate and to identify the predictors of mortality among TB/HIV co-infected children at University of Gondar Comprehensive Specialized Hospital. METHOD: A retrospective follow-up study was conducted among TB/HIV co-infected children from February 2005 to March 2017. A Kaplan-Meier curve was used to estimate the median survival time. Bivariate and multivariable Cox proportional hazards models were fitted to identify the predictors of mortality. RESULTS: A total of 271 TB/HIV co-infected children were included in the analysis. Of these, 38(14.02%) children were died during the follow-up period. This gives a total of 1167.67 child-years of observations. The overall mortality rate was 3.27(95%CI: 2.3-4.5) per 100 child-years. The independent predictors of time to death were age 1-5 years (as compared to age <1 year) (AHR = 0.3; 95%CI:0.09-0.98)), being anemic (AHR = 2.6; 95%CI:1.24-5.3), cotrimoxazole preventive therapy(CPT) non-users (AHR = 4.1; 95%CI:1.4-16.75), isoniazid preventive therapy(IPT) non-users (AHR = 2.95; 95%CI:1.16-7.5), having extra pulmonary tuberculosis(EPTB) (AHR = 2.43; 95%CI:1.1-5.3)) and fair or poor adherence to Anti-Retroviral Therapy (ART)(AHR = 3.5; 95%CI:1.7-7.5). CONCLUSION: Mortality rate among TB/HIV co-infected children was high at University of Gondar Comprehensive Specialized Hospital. Age, extra-pulmonary tuberculosis, anemia, adherence, CPT and IPT were the independent predictors of mortality.

Male and undernourished children were at high risk of anemia in Ethiopia: a systematic review and meta-analysis.

BACKGROUND: Anemia is one of the global public health problems affecting more than one-third of the world population. It has been strongly associated with limited psychomotor development; and poor growth and performance in cognitive, social, and emotional function in children. Despite published data revealed that anemia is a public health problem among children in Ethiopia, there is no a pooled national estimate on the prevalence and associated risk factors of anemia. METHODS: Published articles until December 31, 2017, were searched using comprehensive search strings through PubMed/Medline, EMBASE, SCOPUS, HINARI, Web of Science, Google Scholar and Google. Reference probing of published articles and hand searching were employed for grey literature. Two groups of review authors independently appraised the studies for eligibility and extracted the data. The quality of articles was assessed using Joana Brigg's institute critical appraisal checklist for prevalence and analytical studies. The pooled estimates were determined using random effect model. Heterogeneity between the included studies was assessed using the I2 statistics. Subgroup analysis was employed in the evidence of heterogeneity. Publication bias was assessed by visual inspection of the funnel plot and Egger's regression test statistic. RESULTS: Of the total 871 articles retrieved, 34 articles which involved 61,748 children were eligible for meta-analysis. The overall pooled prevalence of anemia using random effect model was 31.14% (95% CI: 24.62, 37.66%). In subgroup analysis, the pooled prevalence of anemia was higher among preschool-aged children (44.17%; 95% CI: 37.19, 51.15%) than school-aged children (22.19%; 95% CI: 17.54, 26.83%). Furthermore, the odds of anemia was higher among children who were male (OR = 1.11; 95% CI: 1.03, 1.19), stunted (OR = 1.95; 95% CI: 1.52, 2.51), and wasted (OR = 2.05; 95% CI: 1.36, 3.10). CONCLUSION: The pooled prevalence of anemia among children was high, indicating that it had been continuing to be a public health problem. Therefore, there is a need to design a comprehensive prevention and control strategies to reduce its burden.

Magnitude of prelacteal feeding practice and its association with place of birth in Ethiopia: a systematic review and meta-analysis, 2017.

BACKGROUND: Prelacteal feeding is one of the commonest inappropriate child feeding practice which exposes to malnutrition, infection, and neonatal mortality. However, there is no systematic review and meta-analysis that estimates the pooled prevalence of prelacteal feeding and its association with place of birth in Ethiopia. Therefore, this study aimed at investigating the magnitude of prelacteal feeding practice and its association with home delivery in the country. METHODS: Primary studies were accessed through, HINARI and PubMed databases. Additionally, electronics search engines such as Google Scholar, and Google were used. The Joana Briggs Institute quality appraisal checklist was used to appraise the quality of studies. Data were extracted using Microsoft Excel spreadsheet. Heterogeneity between the studies was examined using the I2 heterogeneity test. The DerSimonian and Liard random-effect model was used. The random effects were pooled after conducting subgroup and sensitivity analyses. Publication bias was also checked. RESULTS: A total of 780 primary studies were accessed. However, about 24 studies were included in the qualitative description and quantitative analysis of the prevalence of prelacteal feeding. To examine the association between home delivery and prelacteal feeding practice, only six studies were included. The prevalence of prelacteal feeding ranged from 6.1-75.8%. The pooled prevalence of prelacteal feeding among Ethiopian children was 26.95% (95% CI: 17.76%, 36.14%). The highest prevalence was observed in the Afar region. The pooled odds of prelacteal feeding among women who gave birth at home was increased by 5.16 (95% CI: 3.7, 7.2) folds as compared to those who gave birth at Health institutions. CONCLUSION: Prelacteal feeding practice in Ethiopia was found to be high. Home delivery was strongly associated with prelacteal feeding practice. Therefore, promoting institutional delivery and strengthening of the existing child nutrition strategies are recommended.

Low birth weight and its associated factors in Ethiopia: a systematic review and meta-analysis.

BACKGROUND: Different primary studies in Ethiopia showed the burden of low birth weight. However, variation among those studies was seen. This study was aimed to estimate the national prevalence and associated factors of low birth weight in Ethiopia. METHODS: PubMed, Web of Science, Cochrane library, and Google Scholar were searched. A funnel plot and Egger's regression test were used to see publication bias. I-squared statistic was applied to check heterogeneity of studies. A weighted inverse variance random-effects model was applied to estimate the national prevalence and the effect size of associated factors. The subgroup analysis was conducted by region, study design, and year of publication. RESULT: A total of 30 studies with 55,085 participants were used for prevalence estimation. The pooled prevalence of LBW was 17.3% (95% CI: 14.1-20.4). Maternal age < 20 years (AOR = 1.7; 95% CI:1.5-2.0), pregnancy interval < 24 months (AOR = 2.8; 95%CI: 1.4-4.2), BMI < 18.5 kg/m2 (AOR = 5.6; 95% CI: 1.7-9.4), and gestational age < 37 weeks at birth (AOR = 6.4; 95% CI: 2.5-10.3) were identified factors of LBW. CONCLUSIONS: The prevalence of low birth weight in Ethiopia remains high. This review may help policy-makers and program officers to design low birth weight preventive interventions.

Prevalence of anemia and its associated factors among children in Ethiopia: a protocol for systematic review and meta-analysis.

BACKGROUND: Anemia is one of the global public health problems that affect more than one third of the world population. It has been strongly associated with poor growth and development, limited psychomotor development, and poor long-term performance in cognitive, social, and emotional functioning in children. There is not a single national figure about childhood anemia in Ethiopia. There is also inconclusive evidence about factors associated with anemia. Moreover, the present meta-analysis will generate concrete evidence in which the result may urge policy makers and program managers to design appropriate intervention to control childhood anemia. Thus, the aim of this review is to estimate the pooled prevalence and to identify associated factors of anemia among children in Ethiopia. METHOD: Published relevant cross-sectional studies will be searched using comprehensive search strings through PubMed/Medline, SCOPUS, HINARI, EMBASE, Web of Science databases. In addition, Google Scholar and Google will be searched for grey literature.Reference lists and communication with content experts will be used to get additional relevant studies. Two groups of review authors will independently appraise the studies for scientific quality and extract the data using the Joanna Briggs Institute (JBI) tools. The pooled estimate will be determined using random effect model. Heterogeneity between the studies will be assessed using the I2 statistics. Sensitivity and subgroup analysis will be employed in the case of heterogeneity. Publication bias will be assessed by visual inspection of the funnel plot, and using Egger's and Begg's statistical tests. DISCUSSION: Childhood anemia is known to have negative consequences on mental, physical and social development of children. The burden and its associated factors are greatly varied as to the social, economic, and geographical differences of the target population.Therefore, the proposed systematic review will generate evidence about the pooled prevalence of anemia and its associated factors among children in Ethiopia. PROTOCOL REGISTRATION: The protocol was registered at PROSPERO International Prospective Register of Systematic Reviews.(Registration number: CRD42018088223).