Incidence and predictors of loss to follow-up among women on option B+ PMTCT program in northwest Ethiopia. A retrospective follow-up study.

BACKGROUND: Loss to follow-up from lifelong antiretroviral therapy continued to be a major challenge affecting virtual elimination of mother-to-child transmission of human immunodeficiency virus, especially in Sub-Saharan Africa. Although there was a study conducted in Ethiopia, loss to follow-up was not clearly defined and some important variables were not addressed. Thus, this study was conducted to determine the incidence of loss to follow-up and its predictors among women on option B+ lifelong antiretroviral therapy program in Pawi district health facilities, northwest Ethiopia. METHODS: An institutional-based retrospective follow-up study was conducted among 365 women who were enrolled for option B+ prevention of mother-to-child transmission service between June 2013 and March 2021 in Pawi district health facilities. A standard pretested checklist was used to extract data from all eligible women's records. The Kaplan-Meier survival curve for estimating survival probability and Cox proportional hazards model to identify independent predictors of loss to follow-up were employed after checking for proportional hazards assumptions using STATA-14 statistical software. RESULT: The overall incidence of loss to follow-up was 12.04 (95% CI: 9.50, 15.20) per 1000 person-months of observation time. Residing outside the catchment area (adjusted hazard ratio (AHR): 3.08, 95% CI: 1.59, 5.98), lactating at enrollment (AHR: 2.43, 95% CI: 1.24, 4.77), living in a sero-discordant relationship (AHR: 2.5, 95% CI: 1.13, 5.53), lack of sero-status disclosure (AHR: 2.59, 95% CI: 1.15, 5.85), new enrollment to lifelong antiretroviral therapy (AHR: 2.07, 95% CI: 1.05, 4.11), and fair (AHR: 2.69, 95% CI: 1.2, 6.04) or poor (AHR: 5.78, 95% CI: 2.76, 12.12) antiretroviral drug adherence level were independent predictors of loss to follow-up. CONCLUSION: We found a higher incidence of loss to follow-up relative to previous studies in Ethiopia. Thus, strengthening adherence support interventions, and effective counseling on sero-status disclosure and male partner involvement are important to retain women in care.

Prevalence and predictors of malnutrition during adolescent pregnancy in southern Ethiopia: a community-based study.

BACKGROUND: Adolescent pregnancy is a major public health problem with significant medical, nutritional, social and economic risk for mothers and their infants. The purpose of this study was to determine prevalence and predictors of malnutrition among pregnant adolescents in Kore district, southern Ethiopia. METHODS: Data were obtained from randomly selected consenting four hundred twenty five pregnant adolescents on March 2018 using interviewer-administered questionnaire and mid upper arm circumference (MUAC) measurement. A multivariable logistic regression analysis was used to identify the predictors of malnutrition in adolescent pregnancy. RESULTS: The study showed that 26.4% of study participants were malnourished (MUAC < 22 cm). Not owning livestock (AOR = 1.67, 95% CI = 1.26-2.19), unintended pregnancy (AOR = 1.36, 95% CI = 1.08-1.65), excess physical work in pregnancy (AOR = 1.29, 95% CI = 1.02-1.62) and being in the second (AOR = 1.70, 95% CI = 1.09-2.65) or third (AOR = 1.99, 95% CI = 1.29-3.07) pregnancy trimester were positively associated with malnutrition risk. Improved dietary intake in pregnancy (AOR = 0.46, 95% CI = 0.33-0.63) and support perceived by adolescents in pregnancy (AOR = 0.59, 95% CI = 0.43-0.82) were negatively associated with malnutrition risk. CONCLUSION: More than one-quarter of the study population were malnourished. The information provides insight into the public health strategies to reduce malnutrition risk of the pregnant adolescents. Interventions aimed at improving socioeconomic status, dietary practice and physical work/activity through effective supports in pregnancy are recommended.

Knowledge, attitude, practice, and factors associated with prevention practice towards COVID-19 among healthcare providers in Amhara region, northern Ethiopia: A multicenter cross-sectional study.

Healthcare providers (HCPs) are at an increased risk of getting COVID-19 as a result of their front-line works. Health behaviors of HCPs can influence prevention and control actions implemented in response to the pandemic. Hence, this study aimed to assess the knowledge, attitude, and practice (KAP) and factors associated with prevention practice towards COVID-19 among healthcare providers in Amhara region, northern Ethiopia. A multicenter cross-sectional study was conducted among 422 HCPs in selected public health facilities of Amhara region, between 20th September and 20th October 2020. Data related to HCP's KAP and socio-demographic characteristics were collected using a pre-tested self-administered questionnaire. Bloom's cut-off ≥ 80%, ≥90%, and ≥75% was used to determine adequate knowledge, positive attitude, and good prevention practice, respectively. Data were analyzed using SPSSS version 25.0. A multivariable logistic regression analysis was performed to identify factors significantly associated with COVID-19 prevention practice. Statistical significance was determined at a p-value of < 0.05 and the presence of association was described using odds ratio (OR) with their 95% confidence interval (CI). Overall, 368 (89.8%), 387 (94.4%), and 326 (79.5%) HCPs had adequate knowledge, positive attitude, and good prevention practice towards COVID-19, respectively. Factors significantly associated with good COVID-19 prevention practice were being a Nurse in profession (AOR = 2.13, 95% CI = 1.13-3.99), having < 5 years of working experience (AOR = 0.46, 95% CI = 0.24-0.86), using social media (AOR = 6.20, 95% CI = 2.33-16.51) and television and or radio (AOR = 4.03, 95% CI = 1.56-10.38) as sources of COVID-19 information. HCPs had adequate knowledge, positive attitude and good prevention practice towards COVID-19. Being a Nurse, having < 5 years of working experiences, using social media and television and or radio were factors associated with good prevention practice. Thus, developing HCP's professional carrier through training opportunities, sharing experiences and using verified information sources are crucial to better improve COVID-19 prevention practice.

COVID-19 and Global Health Security: Overview of the Global Health Security Alliance, COVID-19 Response, African Countries' Approaches, and Ethics.

Public health emergencies can arise from a wide range of causes, one of which includes outbreaks of contagion. The world has continued to be threatened by various infectious outbreaks of different types that have global consequences. While all pandemics are unique in their level of transmission and breadth of impact, the 2019 coronavirus disease (COVID-19) pandemic is the deepest global crisis of the 21st century, which has affected nearly every country globally. Yet, going forward, there will be a continued need for global health security resources to protect people around the world against increasing infectious disease outbreaks frequency and intensity. Pandemic response policies and processes all need to be trusted for effective and ethical pandemic response. As the world can learn during the past few years about frequent infectious disease outbreaks, (these) diseases respect no borders, and, therefore, our spirit of solidarity must respect no borders in our efforts to stop the ongoing COVID-19 pandemic and be better prepared to respond effectively to a health crisis in the future.

Incidence and predictors of mortality among neonates referred to comprehensive and specialized hospitals in Amhara regional state, North Ethiopia: a prospective follow-up study.

BACKGROUND: Neonatal mortality is a major global public health problem. Ethiopia is among seven countries that comprise 50 % of global neonatal mortality. Evidence on neonatal mortality in referred neonates is essential for intervention however, there is no enough information in the study area. Neonates who required referral frequently became unstable and were at a high risk of death. Therefore, this study aimed to assess the incidence and predictors of mortality among referred neonates. METHOD: A prospective follow-up study was conducted among 436 referred neonates at comprehensive specialized hospitals in the Amhara regional state, North Ethiopia 2020. All neonates admitted to the selected hospitals that fulfilled the inclusion criteria were included. Face-to-face interviews, observations, and document reviews were used to collect data using a semi-structured questionnaire and checklists. Epi-data™ version 4.2 software for data entry and STATA™ 14 version for data cleaning and analysis were used. Variables with a p-value < 0.25 in the bi-variable logistic regression model were selected for multivariable analysis. Multivariable analyses with a 95% confidence level were performed. Variables with P < 0.05 were considered statistically significant. RESULT: Over all incidence of death in this study was 30.6% with 95% confidence interval of (26.34-35.16) per 2 months observation. About 23 (17.83%) deaths were due to sepsis, 32 (24.80%) premature, 40 (31%) perinatal asphyxia, 3(2.33%) congenital malformation and 31(24.03%) deaths were due to other causes. Home delivery [AOR = 2.5, 95% CI (1.63-4.1)], admission weight < 1500 g [AOR =3.2, 95% CI (1.68-6.09)], travel distance ≥120 min [AOR = 3.8, 95% CI (1.65-9.14)], hypothermia [AOR = 2.7, 95% CI (1.44-5.13)], hypoglycemia [AOR = 1.8, 95% CI (1.11-3.00)], oxygen saturation < 90% [AOR = 1.9, 95% (1.34-3.53)] at admission time and neonate age ≤ 1 day at admission [AOR = 3.4, 95% CI (1.23-9.84) were predictors of neonatal death. CONCLUSION: The incidence of death was high in this study. The acute complications arising during the transfer of referral neonates lead to an increased risk of deterioration of the newborn's health and outcome. Preventing and managing complications during the transportation process is recommended to increase the survival of neonates.