Pregnant women's perception of midwifery-led continuity care model in Ethiopia: a qualitative study.

BACKGROUND: A Midwifery-led continuity care (MLCC) model is the provision of care by a known midwife (caseload model) or a team of midwives (team midwifery model) for women throughout the antenatal, intrapartum, and postnatal period. Evidence shows that a MLCC model becomes the first choice for women and improves maternal and neonatal health outcomes. Despite this, little is known about pregnant women's perception of the MLCC model in Ethiopia. Therefore, this study aimed to explore pregnant women's perception and experience of a MLCC model in Ethiopia. METHODS: A qualitative study was conducted in Gurage zone public hospital, Southwest Ethiopia, from May 1st to 15th, 2022. Three focused group discussions and eight in-depth interviews were conducted among pregnant women who were selected using a purposive sampling method. Data were first transcribed and then translated from Amharic (local language) to English. Finally, the thematic analysis technique using open code software was used for analysis. RESULTS: Thematic analysis revealed that women want a continuity of care model. Four themes emerged. Three were specific to women's improved care. That is, (1) improved continuum of care, (2) improved woman-centred care, and (3) improved satisfaction of care. Theme four (4), barrier to implementation, was concerned with possible barriers to implementation of the model. CONCLUSION: The finding of this study shows that pregnant women had positive experiences and showed a willingness to receive midwifery-led continuity care. Woman-centred care, improved satisfaction of care, and continuum of care were identified as the main themes. Therefore, it is reasonable to adopt and implement midwifery-led continuity care for low-risk pregnant women in Ethiopia.

Blood Biomarkers as Prognostic Indicators for Neurological Injury in COVID-19 Patients: A Systematic Review and Meta-Analysis.

Coronavirus disease 2019 (COVID-19) has been linked to various neurological complications. This meta-analysis assessed the relationship between glial fibrillary acidic protein (GFAP) and neurofilament light chain (NfL) levels in the blood and neurological injury in COVID-19 patients. A comprehensive search of various databases was conducted until 18 August 2023, to find studies reporting GFAP and NfL blood levels in COVID-19 patients with neurological complications. GFAP and NfL levels were estimated between COVID-19 patients and healthy controls, and meta-analyses were performed using RevMan 5.4 software for analysis. In the 21 collected studies, it was found that COVID-19 patients had significantly higher levels of pooled GFAP (SMD = 0.52; 95% CI: 0.31, 0.73; p ≤ 0.001) and NfL (SMD = 0.60; 95% CI: 0.37, 0.82; p ≤ 0.001) when compared to the healthy controls. The pooled GFAP (SMD = 0.86; 95% CI: 0.26, 1.45; p ≤ 0.01) and NfL (SMD = 0.87; 95% CI: 0.48, 1.26; p ≤ 0.001) were significantly higher in non-survivors. These findings indicate a significant association between COVID-19 severity and elevated levels of GFAP and NfL, suggesting that GFAP and NfL could serve as potential diagnostic and prognostic markers for the early detection and monitoring of COVID-19-related neurological injuries.

Predictors for low coverage of uptake of second dose of measles vaccine among children in sub-Saharan Africa, 2023: a systematic review and meta-analysis.

Background: Measles became a public health important disease in sub-Saharan Africa. World Health Organization recommended measles-containing vaccine dose 2 (MCV2) through routine service delivery. This study aims to determine coverage of second-dose measles vaccination uptake and its predictors among children aged 24-35 months in sub-Saharan Africa. Methods and materials: We conducted an extensive search of literature as indicated in the guideline of reporting systematic review and meta-analysis (PRISMA). The databases used were PubMed, Google Scholar, and HINARI literature. Results: The overall uptake of the second dose of measles vaccine uptake was 41% (95% CI: 28.90-53.47). Caregiver's awareness of the importance of the second dose of measles (2.51, 95% CI 1.77, 3.25), educational status of mothers (1.30, 95% CI 1.16, 1.45), distance from vaccination site (1.22, 95% CI 1.12, 1.32), and attending four and above ANC visit (2.72, 95% CI 2.29, 3.15) were determinants for second dose measles vaccine uptake. Conclusion: Coverage of the second dose of measles uptake in Sub-Saharan Africa was low (41%) which is lower than the recommendation from WHO. Therefore policymakers and stakeholders should increase mother's awareness. Also, special strategies should be developed for those who are far from the vaccination site. Abbreviation and acronyms: ANC: Ante Natal Care; JBI: Joanna Briggs Institute; MCV1: Measles containing vaccine dose 1; MCV2: Measles containing vaccine dose 2; WHO: World Health Organization.

Providing anti-retroviral treatment did not achieve the ambition of 'Joint united nations program on HIV/AIDS (UNAIDS) among HIV positive patient in Ethiopia': a systematic review and meta-analysis.

Introduction: Antiretroviral Treatment (ART) has great importance in reducing viral load. Though a global effort was made to suppress viral load, the level of viral load suppression among ART patients is still high in Ethiopia. Objective: This study aims to assess the magnitude and contributing factors for viral load suppression among patients attending ART clinics in Ethiopia. Methods: The articles were searched using different databases using the guideline of reporting systematic review and meta-analysis (PRISMA). A random effect model was used to ascertain the pooled prevalence of viral load suppression in Ethiopia using STATA 14 software. Results: The pooled prevalence of suppressed viral load was 75.25% (95% CI: 68.61-81.89). Having good adherence (OR: 2.71, 95% CI 2.27, 3.15), baseline CD4 count (OR: 1.74, 95% CI 1.53, 1.96), and being female (OR: 1.41, 95% CI 1.04, 1.79) were determinants of pooled estimates of suppressed viral load. Conclusion: The pooled prevalence of suppressed viral load was 75% which is lower than the targeted level by the sustainable development goal (SDG) 2020, which was 90%. Therefore, the stakeholders should be focused on the existing strategies to decrease viral load among ART patients. They should work to adhere to patients for ART treatment.

Hematological Parameters of Gasoline Station Workers at Hosanna Town, Southwest Ethiopia: A Comparative Cross-Sectional Study.

Background: Human exposure to benzene is associated with many adverse health effects. It is mainly related to impairment of the hematopoietic system and bone marrow suppression, causing abnormalities in hematological parameters. However, the reports obtained from different studies are contradictory, and there are little data regarding the hematological parameters of gas station workers in the study area. Therefore, this study aimed to evaluate the hematological parameters of gas station workers in Hosanna town, southwest Ethiopia, from May 01 to June 15, 2020. Methods: A comparative cross-sectional study was conducted by involving 180 (60 gas-stations workers and 120 controls) participants. Socio-demographic and related data of the study participants were collected using a pre-tested structured questionnaire through face-to-face-interviews. All phases of quality assurance were maintained, and hematological parameters were determined using Uni-Cel DxH 800 automated hematological analyzer. Independent sample T-test, Mann-Whitney U-test, and one-way ANOVA were used for data analysis. Statistical significance was declared at P<0.05. Results: Statistically significant difference was observed in hematological parameters of gasoline-workers and control groups. The mean of red blood cell count among gasoline-workers was significantly reduced as compared to control groups (p=0.007). In addition, the median of hemoglobin levels among gasoline-workers was significantly decreased as compared to the control groups (p=0.001). In contrast, a significant increase was observed in median of absolute eosinophil count among the gasoline-workers as compared to control groups (p=0.01). The mean of mean cell volume was significantly decreased with respect to the duration of work experience (p=0.04). Conclusion: In this study, a statistically significant difference was observed in some hematological parameters of gas station workers compared to the control group. Therefore, medical observation and periodic medical check-ups of the hematological profile should be considered to prevent the development of medical complications.

Diagnostic utility of haematological parameters in predicting the severity of HIV infection in southwestern Ethiopia: a comparative cross-sectional study.

OBJECTIVES: This study aimed to evaluate the diagnostic utility of haematological parameters as a predictive marker of the severity of HIV infection in southwestern Ethiopia. DESIGN: Comparative cross-sectional study. SETTING: This study was conducted in southwestern Ethiopia. PARTICIPANTS: Venous blood samples were collected from 344 participants (172 HIV, 172 healthy controls (HC)) and haematological parameters were determined using the automated haematology analyser. The diagnostic utility of haematological parameters was determined by a receiver operating curve analysis. Data were analysed using SPSS V.21 and the p value was set at less than 0.05 for the statistical significance. RESULTS: In this study, red cell count (RCC) distinguishes HIV-infected patients from HC at a threshold value of 4.05×109/L with sensitivity, specificity and an area under the curves (AUC) of 73.8%, 78.5% and 0.87, respectively. At a cut-off value of 4.25×109/L, RCC significantly distinguishes non-severe HIV-infected patients from HC with a sensitivity of 72.7%, specificity of 81.7% and an AUC of 0.86. Haemoglobin (Hgb) significantly differentiates severe HIV-infected patients from HC with sensitivity, specificity and an AUC of 95.9%, 86.7% and 0.96, respectively. Platelet count (PLT) significantly discriminates HC from non-severe and severe HIV-infected patients with an AUC of 0.74 and 0.963, respectively. CONCLUSION: RCC, PLT and Hgb demonstrated better diagnostic performance in predicting the severity of HIV infection and have been identified as the best haematological markers in predicting the presence and severity of HIV infection. Thus, the haematological profiles (RCC, PLT and Hgb) should be used as an alternative marker to predict the severity of HIV infection and may provide supportive information for evidence-based interventions and early diagnosis of infections.

Magnitude of Red Blood Cell Alloimmunization Among Pregnant Women Attending Antenatal Care at Wolaita Sodo University Comprehensive Specialized Hospital, Southwest Ethiopia.

Background: Maternal red cell alloimmunization occurs when a woman's immune system becomes sensitive to unfamiliar red blood cell antigens. This leads to the production of alloantibodies, which can have serious implications for the fetus and newborn. However, there is a lack of comprehensive information about the extent of red cell alloimmunization in underdeveloped countries like Ethiopia. Therefore, this study aimed to determine the magnitude of red cell alloimmunization among pregnant women attending antenatal care at Wolaita Sodo University Comprehensive Specialized Hospital from September 01 to November 30, 2022. Methods: In this institutional-based cross-sectional study, 422 pregnant women were participated and recruited using a systematic random sampling technique. Data on sociodemographic characteristics, obstetric history, and other clinical information were collected using structured questionnaires through face-to-face interview. Blood grouping and indirect antihuman globulin tests were performed. The relationship between red cell alloimmunization and the independent variables was determined using the chi-square test. P-value <0.05 was considered statistical significance. Results: In this study, the blood group distributions among the participants were as follows: O, 177 (41.9%); A, 124 (29.4%); B, 76 (18%); and AB, 45 (3.86%). Among the pregnant women included in the study, a total of 51 (12.08%) were identified as RhD-negative. Out of these RhD-negative women, 5 (9.8%) were found to have developed alloimmunization with red blood cell antigens. Miscarriage and post-partum hemorrhage were found to be important factors associated with the occurrence of red cell alloimmunization in these women. Conclusion: This study showed that one out of ten pregnant women was alloimmunized. Therefore, antenatal blood grouping and indirect antihuman globulin screening should be performed routinely to manage and minimize the undesirable outcomes of alloimmunization during pregnancy.

Anemia and associated factors among patients admitted with metabolic syndromes at Worabe Comprehensive Specialized Hospital, Southern Ethiopia: A cross-sectional study.

BACKGROUND: Anemia is a condition in which the number of red blood cells is inadequate to meet the physiologic needs of the human body oxygen and it is highly prevalent among individuals with metabolic syndromes as a complication in turn speed up the progression and the number of adverse outcomes unless the proper measure is undertaken. Determination of anemia may play a major role in the management and early aversion of complications in an admitted patient with metabolic syndromes. Therefore, this study aimed to determine anemia and its associated factors among patients with admitted metabolic syndromes at Worabe Comprehensive Specialized hospital, Southern Ethiopia from March 1 to May 30, 2021. METHODS AND MATERIALS: An institutional-based cross-sectional study design was conducted on 324 adult patients admitted with metabolic syndromes. Structured questionnaires through face-to-face interviews and participants' medical records were used to collect information on determinants related to anemia. A blood sample was collected to determine hematological parameters, biochemical profile, and blood film preparation. Data were analyzed by SPSS version 22. Binary logistic regression analyses were done to identify factors associated with anemia. The p-value was set at <0.05 with a 95% confidence interval of the adjusted odds ratio. RESULTS: A total of 324 admitted adult patients with metabolic syndromes were involved. The overall prevalence of anemia among study participants was 25.3% (95%CI: 20.7, 30.2), of which 52.4% had moderate anemia and 56% had microcytic types of anemia. Being alcoholic (AOR = 6.25, 95% CI: (3.05, 12.82)), obese (AOR = 3.34, 95% CI: (1.02, 11.21)), dyslipidemic (AOR = 2.06, 95% CI: (1.02, 4.17)), and diabetic (AOR = 2.61, 95%CI: (1.31, 5.21)) were significantly associated with anemia. CONCLUSION: The prevalence of anemia among patients admitted with metabolic syndrome observed in this study was a moderate public health problem. Taking alcohol, being dyslipidemic, obese and diabetic was significantly associated with anemia. The finding of this study should be taken into consideration to implement preventive interventions on identified factors in study percipients. Taking fruit and vegetable, and promoting physical exercise, routine determination of fasting blood glucose and hemoglobin level in adult admitted metabolic syndromes patients were recommended to minimize the emergence of anemia.

Prevalence of completion of maternity continuum of care and its associated factors in Ethiopia: a systematic review and meta-analysis.

OBJECTIVE: The present study aimed to estimate the pooled prevalence of completion of the maternity continuum of care (CoC) and its associated factors in Ethiopia. STUDY DESIGN: Systematic review and meta-analysis. STUDY SETTING: Ethiopia. STUDY PARTICIPANTS: A total of 6245 reproductive-age women were included. PRIMARY OUTCOME: The pooled prevalence of completion of the maternity CoC. SECONDARY OUTCOME: Factors associated with completion of the maternity CoC. METHODS: We systematically searched international databases such as PubMed, Scopus, African Journals Online, Google Scholar and Web of Sciences to retrieve related articles. The Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines were used for this study. Publication bias was assessed using the funnel plot and Egger's test. Evidence of heterogeneity was checked using Cochrane Q test and I2 statistics. Subgroup analysis was computed based on the study regions. Data were analysed using STATA V.14 statistical software. Weighted inverse variance random effect models were used to estimate the pooled prevalence of completion of the maternity CoC. RESULTS: The pooled prevalence of completion of maternity continuum care in Ethiopia was 25.82% (95% CI: 16.69% to 34.94%). Urban residence(adjusted odds ratio (AOR)=2.77, 95% CI: 1.99 to 3.86), having secondary and above educational status (AOR=3.50, 95% CI: 2.50 to 50), prepregnancy contraceptive utilisation (AOR=3.25, 95% CI: 2.02 to 5.22), women's autonomy (AOR=3.81, 95% CI: 2.74 to 5.31), following mass media (AOR=2.51, 95% CI: 1.79 to 3.50), early initiation of antenatal care (ANC) (AOR=4.98, 95% CI: 3.28 to 7.57), planned pregnancy (AOR=2.93, 95% CI: 1.99 to 4.32), birth preparedness and complication readiness (AOR=1.80, 95% CI: 1.29 to 2.51) and distance from a health facility<30 min (AOR=3.29, 95% CI: 2.45 to 4.42) were factors associated with completion of maternity continuum care in Ethiopia. CONCLUSION: The pooled prevalence of completion of maternity continuum care in Ethiopia was low. Therefore, policymakers and stakeholders should improve the completion of ANC, the rate of skilled birth attendants and postnatal follow-up. Enhancing the accessibility of health facilities, women's awareness and empowering women's decision-making are recommended. PROSPERO REGISTRATION NUMBER: CRD42022312692.

COVID-19 vaccine hesitancy among medical and health science students attending Wolkite University in Ethiopia.

BACKGROUND: Medical and health science students are among the frontline health care workers who are at high risk of acquiring COVID-19 infection during their clinical attachments and future career. As health care providers, they are expected to promote and administer the COVID-19 vaccine and counsel vaccine-hesitant patients. It is, therefore, imperative to assess COVID-19 vaccine hesitancy among medical and health science students. Thus, this study aimed to assess COVID-19 vaccine hesitancy and its associated factors among medical and health science students of Wolkite University. METHOD: An institutional-based cross-sectional study design was conducted among 420 medical and health science students attending Wolkite University from March 1 to 30, 2021. Simple random sampling technique was used to select study participants. Self-administered and structured questionnaires were used to collect data. Data were entered into Epi-Data version 4.2.0 and exported to SPSS version 23 software package for further analysis. Bivariable and multivariable analysis was used to identify associated factors. P values <0.05 result were considered as a statistically significant association. RESULTS: The level of COVID-19 vaccine hesitancy was 41.2% (95% CI; 35.2%-50.4%). Student age ≤23 years were 1.9 times more likely vaccine hesitant [aOR = 1.94, 95% CI; 1.14-3.28], being female were 1.7 times more likely vaccine hesitant [aOR = 1.76, 95% CI; 1.14-2.72], resided in rural area were 1.6 times more likely vaccine hesitant [aOR = 1.63, 95% CI; 1.06-2.49], source of information from social media were 2.7 times more likely vaccine hesitant [aOR = 2.68, 95% CI; 1.58-4.54], and good practice to COVID-19 mitigation measures were 47% less likely vaccine hesitant [aOR = 0.53, 95% CI; 0.34-0.83] compared to their counterpart. CONCLUSIONS: COVID-19 vaccine hesitancy is found to be high. Therefore, students are advised to receive COVID-19 vaccine information from government lead mass media (i.e. television and radio), increase awareness and adherence to COVID-19 mitigation measures is recommended.

Red Blood Cell Distribution Width as Novel Biomarker in Cardiovascular Diseases: A Literature Review.

Red blood cell distribution width (RDW) is a measure of the change in size of red blood cells and it is used in combination with other hematological parameters for the differential diagnosis of anemias. Recent evidence suggested that the change in RDW level may be a predictive biomarker of morbidity and mortality in cardiovascular diseases (CVDs). Cardiovascular diseases are the most common cause of death globally as compared to cancer and communicable diseases. Early diagnosis and prompt intervention of these diseases are very important to minimize their complications. Nowadays, the diagnosis of most cardiovascular diseases majorly depends on clinical judgment, electrocardiography and biochemical parameters. Red blood cell distribution width as a new predictive biomarker may play a pivotal role in assessing the severity and progression of CVDs. However, the underlying mechanisms for the association between RDW and CVDs are not clear. A deeper understanding of their association could help the physicians in more careful identification, early prevention, intervention, and treatment to prevent adverse cardiovascular events. This review aims to elaborate on the recent knowledge on the association between RDW and cardiovascular diseases and some possible pathophysiological mechanisms.

Thrombocytopenia Among Pregnant Women in Southwest Ethiopia: Burden, Severity, and Predictors.

Background: Thrombocytopenia is a worldwide public health problem in pregnant women and is associated with significant maternal-fetal complications and mortality. Determination of burden, severity, and predictors of thrombocytopenia in pregnant women is imperative to develop intervention measures to mitigate their risk and public health impact, which is not well known in Ethiopia, particularly in the selected study area. Thus, this study aimed to determine the burden, severity, and predictors of thrombocytopenia among pregnant women in Wolkite University Specialized Hospital, southwest Ethiopia. Materials and Methods: A cross-sectional study was employed among 422 pregnant women from May to August 2021. A structured questionnaire was used to collect data on socio-demographic, reproductive, and related characteristics. Venous blood samples were collected and platelet counts were determined by Sysmex XP-300 hematology analyzer. A binary logistic regression analysis was performed using SPSS version 22 software to identify independent predictors of thrombocytopenia. The p-value <0.05 was considered statistically significant. Results: The overall burden of thrombocytopenia among pregnant women was 14.5% (95% CI: 11.4-17.8). Among them, 77%, 16.4%, and 6.6% had mild, moderate, and severe thrombocytopenia, respectively. Rural residence (AOR: 2.9, 95% CI: 1.5-5.8), increasing age (AOR: 1.9, 95% CI: 1.04-3.44), alcohol consumption (AOR: 2.48, 95% CI: 1.3-4.5), and HIV infection (AOR: 8.5, 95% CI: 1.9-18.4) were independent predictors of thrombocytopenia among the pregnant women. Conclusion: A high burden of thrombocytopenia (14.5%) was observed among the pregnant women in this study area. Rural residence, increasing age, consumption of alcohol, and HIV infection were identified as independent predictors of thrombocytopenia. The findings of this study should be taken into consideration to conduct appropriate intervention measures on identified predictors and implement routine screening of platelet count, thrombocytopenia diagnosis, and treatments to reduce the burden of morbidity and mortality among pregnant women.

Role of platelet indices as diagnostic and predictive biomarkers for comorbidity of diabetes and metabolic syndrome in southern Ethiopia: A comparative cross-sectional study.

BACKGROUND: Metabolic syndromes (MetS) and diabetes mellitus (DM) comorbidity is a growing major global public health problem with huge morbidity and mortality. It is a pro-inflammatory and prothrombotic disorder characterized by alteration of platelet indices and increased platelet activation, however, the tendency to use them in diagnosis is not yet fully evaluated in our context and there is limited evidence on the role of platelet indices in predicting and differentiating DM+MetS comorbidity in Ethiopia. Thus, this study aimed to evaluate platelet indices in HC, DM, and DM+MetS, and to determine their role in the prediction of DM+MetS comorbidity risk and the distinction between DM+MetS and DM or healthy persons in southwest Ethiopia. METHOD AND MATERIALS: A comparative cross-sectional study was conducted in Wolkite University specialized hospital from March to August 2021. A total of 336 study participants (112 healthy controls (HC), 112 DM, 112 DM+MetS) was included in this study. Anthropmetric data were measured and the venous blood sample was collected to determine platelet indices, lipid profiles, and blood glucose levels. The SPSS version 21 statistical software was used to perform receiver operating curve (ROC), one-way ANOVA, and independent T-test analysis. The p-value for statistical significance was set at <0.05. RESULT: In the present study, we found a significant difference in the mean value of PLT, MPV, and PDW between DM+MetS, DM, and HC. A statistically significant difference in the mean value of MPV and PDW was observed between HC and DM+MetS as well as DM and DM+MetS (p-value<0.001). At the cutoff value of 9.65fl with a sensitivity of 81.3% and a specificity of 67.9%, MPV differentiates DM+MetS from HC with an AUC of 0.859. MPV can differentiate DM+MetS from DM at a cutoff value of 10.05fl with sensitivity, specificity, and an AUC of 67.9%, 65.2%, and 0.675, respectively. At the cutoff value of 9.65fl with a sensitivity of 69.6% and a specificity of 67.9%, MPV differentiates DM from HC with an AUC of 0.747. The best platelet parameter identified in this study for predicting the presence of DM+MetS comorbidity was MPV (AUC=0.859; 95%CI=0.81-0.90). CONCLUSION: In this study, a significant difference in the mean value of PLT, MPV, and PDW was found between DM+MetS, DM, and HC. The mean value of platelet indices showed significant increases in DM+MetS patients in comparison to HC and DM. MPV has been identified as a good potential marker to predict DM+MetS comorbidity and to differentiate DM+MetS comorbidity from the HC or DM. Our results show that MPV could be a good hematological marker to differentiate DM+MetS comorbidity from the HC or DM, and may offer supportive information for early diagnosis, prevention, and control. Thus, the findings of this study should be taken into account for the prevention and control of DM+MetS comorbidity.

Determinants of COVID-19 vaccine acceptance in Ethiopia: A systematic review and meta-analysis.

BACKGROUND: Vaccination is the promising strategy to control the coronavirus disease 2019 (COVID-19) pandemic. However, the success of this strategy will rely mainly on the rate of vaccine acceptance among the general population. Therefore, this systematic review and meta-analysis aimed to estimate the pooled prevalence of COVID-19 vaccine acceptance and its determinants in Ethiopia. METHODS: We searched PubMed, Scopus, Google Scholar, African Journals Online, and Web of Sciences database to retrieve related articles. Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines were used for this study. Funnel plot and Eggers test were done to assess publication bias. Cochrane Q-test and I2 statistic were done to chick evidence of heterogeneity. Subgroup analysis was computed based on the study region and the study population. Data were extracted using a Microsoft Excel spreadsheet and analyzed using STATA version 14 statistical software. Weighted inverse variance random effect model was run to estimate the pooled prevalence of COVID-19 vaccine acceptance. RESULTS: A total of 12 studies with 5,029 study participants were included. The pooled prevalence of COVID-19 vaccine acceptance in Ethiopia was 51.64% (95%CI; 43.95%-59.34%). Being male (AOR = 4.46, 1.19-16.77, I2 = 88%), having secondary and above educational status (AOR = 3.97, 1.94-8.12, I2 = 69%), good knowledge (AOR = 3.36, 1.71-6.61, I2 = 93%), and positive attitude (AOR = 5.40, 2.43-12.00, I2 = 87%) were determinants of COVID-19 vaccine acceptance in Ethiopia. CONCLUSION: The pooled prevalence of COVID-19 vaccine acceptance was low. Being male, having secondary and above educational status, good knowledge, and positive attitude were the determinants of COVID-19 vaccine acceptance. High level of COVID-19 vaccine acceptance among the general population is crucial to achieve herd immunity in the community. Therefore, policymakers, vaccine campaign program planners, and stakeholders should target to improve public awareness of vaccination that enhances vaccine acceptance and in turn helps to control the pandemic.

Red Blood Cell Parameters and Their Correlation with Glycemic Control Among Type 2 Diabetic Adult Patients in Eastern Ethiopia: A Comparative Cross-Sectional Study.

Background: Diabetes has been proposed to inflict an insult on the hematopoietic milieu marked by changes in hematological indices including red blood cell parameters. Thus, this study aimed to assess the red blood cell parameters and their correlation with glycemic control in type 2 diabetic adult patients in comparison with apparently healthy individuals. Methods: A comparative cross-sectional study was conducted at the chronic illness clinic of Hiwot Fana Comprehensive Specialized University Hospital from May 20 to July 10, 2022. A total of 220 (110 type 2 diabetic patients and 110 controls) study participants were selected by a simple random sampling technique. Five milliliters of venous blood were collected by the vacutainer blood collection technique. Red blood cell parameters and blood glucose levels were determined using UniCel DxH 800 and Biosystems A25 analyzers, respectively. Independent sample t-test and Pearson correlation test were used for the data analysis. P-value <0.05 was considered statistically significant. Results: Statistically significant difference was observed in RBC parameters of T2DM patients and the control group. The mean RBC count, Hgb, Hct (P < 0.001), and MCHC (P = 0.002) in patients with type 2 diabetes was significantly lower than in the control group. However, the mean of RDW was significantly increased in type 2 diabetic patient groups than in the control group (P < 0.001). The mean RBC count, Hct, and Hgb in patients with good glycemic control were significantly higher than the patients with poor glycemic control. Besides, a statistically significant negative correlation was observed between glycemic control and RBC count, Hgb, and Hct level in diabetic patients. Conclusion: In this study, a statistically significant difference was observed in red blood cell parameters of type 2 diabetic patients compared to the control group. A significant negative correlation was noted between glycemic control and RBC parameters in type 2 diabetic patients. Therefore, evaluation of RBC parameters should be considered for better management of patients with type 2 diabetes mellitus.

Patterns of Calcium- and Chloride-Ion Disorders and Predictors among Obese Outpatient Adults in Southern Ethiopia.

BACKGROUND: Obesity is a condition characterized by abnormal or excess accumulation of fat in body tissue, which may impair health and result in electrolyte derangement. Hypercalcemia and hypochloremia are significant problems in obese patients, and can cause substantial morbidity and mortality. Determination of patterns of calcium and chloride may play a major role in the management of obese patients. Therefore, this study aimed to determine calcium and chloride disorders and their predictors among obese adults in the outpatient department at Wolkite University Specialized Hospital, southern Ethiopia from May to August 2020. METHODS: This institution-based cross-sectional study was conducted on 250 obese adults attending the outpatient department from May to August 2020. Structured questionnaires through face-to-face interviews and participants' medical records were used to collect information on determinants related to calcium- and chloride-ion disturbances. Levels of serum calcium and chloride were measured using an ion-selective electrode analyzer. Bivariate and multivariate logistic regression analyses were done to identify determinants associated with calcium and chloride disorders. Using ORs and 95% CIs,P<0.05 was considered significant. RESULTS: Among the 250 patients, 18% (95% CI 53.02-111) and 17.6% (95% CI 0.78-12) of study participants were hypochloremic and hypercalcemic, respectively. Age ≥50 years (AOR 3.58, 95% CI 2.57-11.10), diuretic use (AOR 2.35, 95% CI 1.31-4.23), and obesity (AOR, 6.82, 95% CI 2.26-14.62) were independent predictors of hypochloremia on multivariate logistic regression, and obesity (AOR 9.21, 95% CI 2.50-14.81), overweight (AOR 8.32, 95% CI 1.61-10.20) and physical inactivity (AOR 4.28, 95% CI 1.71-10.44) were predictors of hypercalcemia. CONCLUSION: High burdens of hypochloremia (18%) and hypercalcemia (17.6%) were observed in these patients. Increased age, diuretic use, being overweight, and physical inactivity were predictors of electrolyte disorders. The findings of this study should be taken into consideration to implement preventive interventions on these predictors in obese patients. Promoting sufficient fruit and vegetable consumption and physical exercise and determination of serum-chloride and -calcium levels in adult overweight/obese patients are recommended to minimize the emergence of electrolyte disorders.

Evaluation of uric acid disorders and associated factors in essential hypertensive patients at Wolkite University specialized hospital, Southern Ethiopia.

BACKGROUND: Essential hypertension is a condition characterized by a rise in blood pressure of undetermined cause, includes 90% of all hypertensive cases and is a highly important public health challenge with major modifiable cause of morbidity and mortality. Uric acids disorders in particular hyperuricemia are significant problems in essential hypertensive patients and can cause substantial morbidity and mortality. Determination of uric acid disorders may play a major role in the management and early aversion of complications in hypertensive patient. Therefore, this study aimed to determine uric acid disorders and associated factors among essential hypertensive adults in the outpatient department at Wolkite University specialized Hospital, Southern Ethiopia from November 1 to February 30, 2021. METHODS AND MATERIALS: An institional based cross sectional study was conducted on 270 essential hypertensive adults on follow-up in outpatient department from November 1 to February 30, 2021. Structured questionnaires through face to face interviews and participants' medical records were used to collect information on determinants related with uric acid disorders. The blood specimen was collected and level of serum uric acid, blood sugar and lipid profile was measured using standard principles and procedures with an ABX Pentra 400 automated chemistry analyzer. Bivariate and multivariate logistic regression analyses were done to identify factors associated with hyperuricemia. The p-value was set at <0.05 with a 95% confidence interval of the adjusted odds ratio. RESULTS: A total of 270 adult essential hypertensive patients were participated in the study, among those 196(27.4%) of study participants were hyperuricemic with 95%CI (21.9, 33.3). Being alcoholic [(AOR: 15.68, 95% CI: (5.93, 21.41)], taking antihypertensive medication [(AOR: 11.56, 95% CI: (3.94, 23.80)], BMI > = 30 [(AOR: 4.89, 95% CI: (1.46, 25.5)] and being centrally obese [(AOR: 6.87, 95% CI: (2.53, 18.63)] were factors significantly associated with hyperuricemia. CONCLUSION: In this study, the high burden of hyperuricemia (27.4%) was observed in essential hypertensive patients with follow-up in outpatient department. Taking alcohol and antihypertensive medication, being overweight and centrally obese were identified factors of uric acid disorders. The finding of this study should be taken into consideration to implement preventive interventions on identified predictors in hypertensive patients. Taking fruit and vegetable, and promoting physical exercise and determinations of serum uric acid level in adult essential hypertensive patients was recommended to minimize the emergence of hyperuricemia.

Evaluation of Hematological Parameters of Helicobacter pylori-Infected Adult Patients at Southern Ethiopia: A Comparative Cross-Sectional Study.

BACKGROUND: Helicobacter pylori (H. pylori) infection is a global public health problem, a higher burden of the infection was reported in developing countries including Ethiopia. It has been associated with several gastrointestinal diseases, and recently implicated in some hematological abnormalities. Despite the high prevalence of H. pylori infection in Ethiopia, there was limited data regarding the relationship between hematological parameters with H. pylori infection. Therefore, this study aimed to evaluate selected hematological parameters of H. pylori-infected patients attending Wachemo University Nigist Eleni Mohammed Memorial Referral Hospital (WUNEMMRH), Hosanna, Southern, Ethiopia. METHODS AND MATERIALS: A comparative cross-sectional study was conducted from January to May 2019 among 374 (187 H. pylori-infected patients and 187controls) study participants. Data on socio-demographic characteristics were collected using a structured questionnaire. A five-milliliter venous blood sample was collected for hematological parameter analysis. Approximately two gram of stool specimen was collected to assess the presence of H. pylori antigen. Data were entered and analyzed by using SPSS version 21. Pearson correlation analysis and independent sample T-test was performed, and P-value < 0.05 was considered statistically significant. RESULTS: Mean value of Hgb (p<0.001), RBC count (p<0.001), HCT (p<0.001), MCV (p=0.003), MCH (p=0.008), and MCHC (p=0.006) of H. pylori-infected patients were significantly lower than control group. However, the mean value of RDW (p=0.003) in H. pylori-infected patients was significantly higher than in the control group. About 13.3%, 7%, 6.4%, and 18.2% of H. pylori-infected patients showed reduced Hgb concentration, RBC count, HCT, and MCV values, respectively. CONCLUSION: The study showed a statistically significant difference in the mean value of Hgb, RBC count, HCT, MCV, MCH, MCHC, and RDW of H. pylori-infected patients and controls. Thus, hematological parameters should be considered for proper diagnosis and management of H. pylori-infected patients and eradication of this microorganism from infected patients, determination of hematological parameters for H. pylori-infected patients were recommended.

Hepatitis B vaccination status and associated factors among students of medicine and health sciences in Wolkite University, Southwest Ethiopia: A cross-sectional study.

BACKGROUND: Hepatitis B virus (HBV) infection is a significant global public health problem. Health care providers and medical students in developing countries including Ethiopia are at an increased risk of contracting HBV due to the high burden of this infection. The most effective way of prevention against HBV infection is vaccination of health care providers. However, there is a paucity of data on the HBV vaccination coverage among students of health science in Ethiopia. Therefore, this study aimed to determine HBV vaccination coverage and associated factors, level of knowledge, attitudes, and practices (KAP) towards HBV among students of medicine and health science at Wolkite University. MATERIALS AND METHODS: A cross-sectional study was conducted at Wolkite University among 417 study participants from November to December 2020. The study participants were recruited by using a simple random sampling technique. Data were collected using a self-administered structured questionnaire and analyzed using SPSS version 21. A binary logistic regression model was used to determine the factors associated with full-dose vaccination status. Statistical significance was set at P-value <0.05. RESULTS: Out of the 417 study participants, 5.8% (95%CI: 3.8-7.9) received a full-dose of the HBV vaccine in this study. Unavailability and high cost of the vaccine were frequently mentioned reasons for not being vaccinated against HBV. About 73.6%, 36.2%, and 47% of participants had good knowledge, positive attitudes, and good practices towards HBV, respectively. Being male gender (AOR: 8.8; 95%CI: 2.9-27), rural residence (AOR: 3.6; 95%CI:1.2-10.6), positive attitude (AOR: 0.44; 95%CI: 0.1-1.1), good practice (AOR: 0.17; 95%CI: 0.05-0.5), medicine department (AOR: 5.9; 95%CI: 1.2-29), being second-year student (AOR: 11.7; 95%CI: 2.7-50.9), third-year student (AOR: 19; 95%CI: 4.25-45), and fourth-year student (AOR: 27; 95%CI: 5.8-56) were significantly associated factors with full-dose vaccination status. CONCLUSION: Our study revealed that only small proportions (5.8%) of study participants received full-dose HBV vaccination. Vaccinations of students before starting clinical attachments, provisions of training for students on infection prevention mechanism and universal precautions particularly on HBV, increasing the uptake of the HBV vaccine, creating awareness on attitude and practice of students towards HBV to enhance uptake of the vaccine are recommended.

Predictors of Lipid Profile Abnormalities Among Patients with Metabolic Syndrome in Southwest Ethiopia: A Cross-Sectional Study.

BACKGROUND: Lipid profile abnormalities are an integral part of metabolic syndrome (MetS) and major underlying causes of cardiovascular disease (CVD) and type-2 diabetes mellitus (T2DM). Lipid profile abnormalities in a patient with MetS are resulted due to the presence of central obesity and insulin resistance. In Ethiopia, the burden and predictors of lipid profile abnormalities in a patient with MetS are not well known. Thus, this study aimed to determine the prevalence of lipid profile abnormalities and predictors among patients with MetS in southwest Ethiopia. METHODS AND MATERIALS: A cross-sectional study was conducted among 381 patients with MetS from September to December 2019 with a response rate of 100%. A structured questionnaire was used to collect data on socio-demographic and behavioral factors. Waist circumference, height, weight, and blood pressures were measured. The venous blood sample was collected for glucose and lipid profile determination. Data were entered and analyzed by using SPSS version 21. Binary logistic regression and Pearson's correlation analyses were performed. A p-value was set at a <0.05 for statistical significance. RESULTS: In this study, about 58% of participants were at least one or more lipid profile abnormalities with the 95% CI (52.8-62.7). About 67.2%, 44.6%,18.4%, and 14.2% of study participants were low HDL, high TG, LDL, and TC, respectively. Central obesity (adjusted odds ratio (AOR): 1.89, 95% CI: 1.14-3.14), increasing age (AOR: 2.08, 95% CI: 1.27-3.4), higher BMI (AOR: 2.06, 95% CI: 1.23-3.4), being hypertensive (AOR: 3.48, 95% CI: 2.12-5.7) and increasing blood glucose level (AOR: 2.34, 95% CI: 1.36-4.03) were independent predictors of lipid profile abnormalities (dyslipidemia). CONCLUSION: In this study area, a high (58%) prevalence of dyslipidemia was observed in study participants, and increasing age, higher BMI, central obesity, hypertension, and high blood glucose level were identified as independent predictors of dyslipidemia among patients with MetS. Prevention and control of dyslipidemia and its predictors among patients with MetS were recommended.