Knowledge and Attitude of Women Towards Herbal Medicine Usage During Pregnancy and Associated Factors Among Mothers Who Gave Birth in the Last Twelve Months in Dega Damot District, Northwest Ethiopia.

Background: The use of herbal medicine is increasing globally, particularly in developing countries including Ethiopia, yet little is known regarding its effect and safety during pregnancy. Pregnant women prefer herbal medicine due to easy accessibility, traditional and cultural beliefs, and comparatively low cost. This study aimed to assess women's knowledge and attitude towards the effects of herbal medicine usage during pregnancy and associated factors among women who gave birth in the last twelve months in Dega Damot district. Methods: A community-based cross-sectional study was conducted from January 1st to February 30th, 2021. A total of 872 women were selected using a stratified cluster sampling technique. Data were collected by face-to-face interviews using a structured, pretested, and interviewer-administered questionnaire. Data were entered into EPI data version 4.6 and exported to SPSS version 25 for analysis. Multivariable logistic regression was done and a p-value of ≤ 0.05 was used to declare the level of significance. Results: Women's knowledge and positive attitude towards the effects of herbal medicine usage during pregnancy was 49.1% (95% CI: 46-52) and 57.3% (95% CI: 54-61), respectively. Access to media, had antenatal care visit, being urban dweller, history of herbal medicine usage, and a short distance to reach the nearby health facility were significantly associated with women's knowledge about effects of herbal medicine usage. Besides, being primiparous and short traveling time to reach the nearby health facility was significantly associated with women's attitude towards the effects of herbal medicine usage during pregnancy. Conclusion: Women's knowledge and positive attitude towards the effects of herbal medicine usage during pregnancy was low. It is important to design strategies to improve the accessibilities of maternal health services, and expand access to media will have a great role in improving women's knowledge and attitude towards herbal medicine usage during pregnancy.

Perinatal mortality and its association with antenatal care visit, maternal tetanus toxoid immunization and partograph utilization in Ethiopia: a meta-analysis.

Despite remarkable progress in the reduction of under-five mortality; perinatal mortality is the major public health problem in Africa. In Ethiopia, the study findings on perinatal mortality and its predictors were inconsistent. Therefore, this systematic review and meta-analysis estimated the pooled perinatal mortality, and its association with antenatal care visit, maternal tetanus toxoid immunization, and partograph monitoring. International databases like PubMed, SCOPUS, Google Scholar and Science Direct were systematically searched. I squared statistics was used to determine the levels of heterogeneity across studies and the pooled estimate was computed using a random-effect model. The meta-analysis showed that a pooled prevalence of perinatal mortality in Ethiopia was 6.00% (95% CI 5.00%, 7.00%). The highest proportion of perinatal mortality was a stillbirth, 5.00% (95% CI 4.00%, 7.00%). Women who had antenatal care visit [OR = 0.20 (95% CI 0.12, 0.34)], maternal tetanus toxoid immunization [OR = 0.43 (95% CI 0.24, 0.77)] and partograph monitoring [POR = 0.22 (95% CI 0.06, 0.76)] reduced the risk of perinatal mortality. Whereas, previous history of perinatal mortality [POR = 7.95 (95% CI 5.59, 11.30)] and abortion history (POR = 2.02 (95% CI 1.18, 3.46)) significantly increased the risk of perinatal mortality. Therefore, antenatal care visit, maternal tetanus toxoid vaccination uptake, and partograph utilization should be an area of improvements to reduce perinatal mortality.

Drug-Drug interaction among admitted patients at primary, district and referral hospitals' medical wards in East Gojjam Zone, Amhara Regional State, Ethiopia.

OBJECTIVES: This study was aimed to assess the type, prevalence, characteristics of drug interaction and factors associated from admitted patients in medical wards at primary, district and referral hospitals in East Gojjam Zone, Amhara Regional State, Ethiopia. METHODS: A facility-based retrospective cross-sectional study design was conducted among admitted patients in medical wards at different hospitals of East Gojjam Zone from September 2019 to February 2020. Patient-specific data were extracted from patient medical prescription papers using a structured data collection tool. Potential drug-drug interaction was identified using www.drugs.com as drug-drug interaction checker. Data were analyzed using SPSS version 23.0. To identify the explanatory predictors of potential drug-drug interaction, logistic regression analysis was done at a statistical significance level of p-value < 0.05. RESULTS: Of the total 554 prescriptions, 51.1% were prescribed for females with a mean (±standard deviation) age of 40.85 ± 23.09 years. About 46.4% prescriptions of patients had one or more comorbid conditions, and the most frequent identified comorbid conditions were infectious (18.6%) and cardiac problems (6.3%) with 0.46 ± 0.499 average number of comorbid conditions per patient. Totally, 1516 drugs were prescribed with 2.74 ± 0.848 mean number per patient and range of 2-6. Two hundred and forty-two (43.7%) prescriptions had at least one potential drug-drug interaction, and it was found that 292 drug interactions were presented. Almost half of the drug-drug interaction identified was moderate (50%). Overall, the prevalence rate of drug-drug interaction was 43.7%. Older age (adjusted odds ratio = 8.301; 95% confidence interval (5.51-12.4), p = 0.000), presence of comorbidities (adjusted odds ratio = 1.72; 95% confidence interval (1.10-2.68), p = 0.000) and number of medications greater or equal to 3 (adjusted odds ratio = 2.69; 95% confidence interval (1.42-5.11), p = 0.000) were independent predictors for the occurrence of potential drug-drug interaction. CONCLUSION: The prevalence of potential drug-drug interaction among admitted patients was relatively high. Pharmacodynamic drug-drug interaction was the common mechanism of drug-drug interaction with moderate degree. Therefore, close follow-up of hospitalized patients is highly recommended.

Prevalence of HIV/AIDS Among Elderly People and Associated Factors in Habru Woreda, Amhara Region, Northeast Ethiopia.

INTRODUCTION: Sub-Saharan African countries are the most affected region by HIV/AIDS. Data from Demographic and Health Survey (DHS) indicated that in Ethiopia older adults who are HIV positive were 2.1% which accounted 17.7% from all HIV positive people aged ≥15. Scarce data are available regarding the prevalence of HIV and associated factors among elderly peoples in Habru district. OBJECTIVE: To assess the prevalence of HIV and associated factors among older people ≥50 years' age in the study area. METHODS: A community-based cross-sectional study was employed. A multi-stage simple random sampling technique was employed and a total of 1689 study subjects were involved. Data were collected by trained health professionals and analyzed using descriptive and analytical statistics. Binary and multivariate logistic regressions were used to identify factors associated with the prevalence of HIV. P-value ≤0.05 was considered statistically significant. RESULTS: Total of 1689 participants were involved and tested for HIV sero-status of which 51.1% were females and the mean age was 62.4±12.34 years. The prevalence for HIV+ was 6.2%. From the multivariate regression model, significant association between prevalence and condom use at last sexual intercourse [AOR= 11.099; 95% CI (2.357,52.268)], condom use at high-risk sexual intercourse [AOR=0.088; 95% CI (0.020, 0.398)], marital status [AOR= 0.409; 95% CI (0.252,0.666)], religion [AOR= 0.431; 95% CI (0.241, 773)], types of previous work [AOR= 0.301; 95% CI (0.117, 0.770)], older people self-perception to risk of HIV infection [AOR= 3.731; 95% CI (2.280, 6.104)], care for HIV infected and non-infected grand children [AOR= 0.434; 95% CI (0.235, 800)], presence of care and support program [AOR= 6.128; 95% CI (1.532, 24.514)] was noticed. CONCLUSION: The prevalence of HIV in Habru was higher (6.2%) than the national level (2.1%) and efforts should be concentrated on designing new HIV intervention programs targeting older people aged ≥50years.

Homing defects of B cells in HIV-1 infected children impair vaccination responses.

BACKGROUND: Successful vaccinations rely on antibody responses. Chemokine receptors play an important role in B cell homing to differentiation niches. We assessed CXCR4, CXCR5 and CCR6 expression on B cells during HIV-1 infection and relate it to antibody responses against a HBV vaccine. METHODS: Blood was obtained from 54 healthy controls and 38 ART-treated HIV-1 infected children, aviremic (n = 25) or viremic (n = 13). Frequency of naïve and memory B cell subsets was studied by immunostaining. Homing capacity of blood B cells to lymphoid and inflamed tissues was evaluated through CXCR4, CXCR5 and CCR6 expression. Plasma CXCL12 and CXCL13 levels and antibody titers to HBV antigen were determined by ELISA. RESULTS: The frequency of naïve and resting memory (RM) B cells in ART treated children was comparable to control subjects. Profound defects in the homing phenotypes of naïve and memory B cells were identified, with lower CXCR4 and CXCR5 expression. Increased CXCL13 levels were observed in infected children, inversely correlating to CXCR5 expressing B cell subpopulations. Antibody titers to HBV vaccine correlated with frequency of resting and switched memory B cells in HIV-1 infected children. CONCLUSIONS: Homing defects of B cells to germinal center may underlie impaired vaccine responses during HIV-1 infection.

T follicular helper cells and antibody response to Hepatitis B virus vaccine in HIV-1 infected children receiving ART.

HBV vaccine has 95% efficacy in children to prevent HBV infection and related cancer. We conducted a prospective study in HIV-1 infected children receiving ART (n = 49) and controls (n = 63) to assess humoral and cellular responses to HBV vaccine provided with three doses under an accelerated schedule of 4 weeks apart. At 1 month post-vaccination all children, except 4 HIV-1 infected, displayed protective antibody (ab) titers to HBV vaccine; ab titers were lower in infected children (P < 0.0001). Ab titers decreased (P < 0.0001) in both HIV-1 infected and control children at 6 months. The frequency of circulating Tfh (cTFh) cells was 20.3% for controls and 20.8% for infected children prior to vaccination and remained comparable post-vaccination. Cytokine expression by cTfh cells upon activation with HBV antigen was comparable in the two groups at baseline and 1 month post-vaccination. Higher plasma levels (P < 0.0001) of CXCL13 were found in infected children which correlated with cTfh cell frequency at baseline. In conclusion, a lower ab response to HBV vaccine was measured in HIV-1 infected children. The frequency and activation profile of cTfh cells was comparable in infected children and controls suggesting that cells other than Tfh cells are responsible for impaired ab response to HBV vaccine.