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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.
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Neoplasias Colorrectales , Humanos , Etiopía/epidemiología , Neoplasias Colorrectales/mortalidad , Neoplasias Colorrectales/epidemiología , Tasa de Supervivencia , Masculino , Factores de Riesgo , Femenino , IncidenciaRESUMEN
Background: Neonatal seizure is a common medical emergency that signals severe insult to the neonatal brain. It is a major risk factor for neonatal morbidity and mortality. It has a wide worldwide variation, ranging from 5 per 1000 live births in the United States of America to 39.5 per 1000 live births in Kenya. To decrease this significant figure, it is better to investigate its causes further. Therefore, this study aimed to assess its determinants since there was no prior evidence about it in the context of study area. Objective: Aim to assess the determinants of neonatal seizures among neonates admitted to neonatal intensive care units in the Awi Zone Hospitals, 2023. Methods: An institution based unmatched case-control study was conducted on 531 admitted eligible neonates from January 1, 2023, to May 30, 2023. A pretested tool was employed to collect data. The collected data were coded, edited, and entered into Epi-data version 3.1 and then exported to SPSS 26. Chi-square and odds ratios were used to assess the relationship between factors associated with the occurrence of neonatal seizure. Model goodness of fit was tested by Hosmer and Lemeshow. Bivariate and multivariate analysis was declared at P < 0.25 and P < 0.05 respectively to show a significant association with neonatal seizure at a 95 % level of significance. Results: A total of 506 (130 cases and 376 controls) of admitted neonates were used in the final analysis model. Neonates admitted within 24 h of birth [AOR; 5.98 (95 %, CI: 2.18-16.43)], gestational age <32 weeks [AOR; 2.89 (95 %, CI: 1.29-6.53)], body temperature >37.5 °C [AOR; 4.82 (95 %, CI: 1.82-12.76)], blood glucose level <40 g/dl [AOR; 4.95 (95 %, CI: 2.06,11.88)], neonatal sepsis [AOR; 2.79 (95 %, CI: 1.46-5.35)] and perinatal asphyxia [AOR; 8.25 (95 %, CI: 4.23, 16.12)] were found to be determinants of neonatal seizure. Conclusion: and recommendations: In this study, neonatal seizure was determined by the factors of neonatal age, gestational age<32 weeks, body temperature >37.5 °C, blood glucose level <40 g/dl, neonatal sepsis, and perinatal asphyxia. Therefore, the presence of such factors requires prompt recognition and treatment.
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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.
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Vacunas contra la COVID-19 , COVID-19 , Conocimientos, Actitudes y Práctica en Salud , Humanos , Etiopía , Vacunas contra la COVID-19/administración & dosificación , COVID-19/prevención & control , Enfermedad Crónica , Aceptación de la Atención de Salud/psicología , Aceptación de la Atención de Salud/estadística & datos numéricos , Vacilación a la Vacunación/estadística & datos numéricos , Vacilación a la Vacunación/psicología , SARS-CoV-2/inmunología , Vacunación/psicología , Vacunación/estadística & datos numéricosRESUMEN
Introduction: The timely initiation of complementary feeding is essential to reduce infant mortality. In Ethiopia, 37.5 % of mothers did not initiate complementary feeding to their infants in time. However, previous studies could not identify the time to initiate complementary feeding among primipara mothers. Therefore, this study aims to identify the time to initiate complementary feeding and its predictors among primipara mothers with infants aged 6-12 months in the Awi zone, northwest Ethiopia. Methods: A community-based retrospective follow-up study was conducted among 732 primipara mothers who had infants aged 6-12 months from January 1, 2022, to December 30, 2022. A multistage sampling technique was used to select study participants through questionnaires administered by interviewers. Data were entered into EPI-data 3.1 and exported to STATA 17 for further analysis. The Kaplan-Meier survival curve together with the log-rank test was used to assess the survival experience of the infant at specific times and to compare the survival of the infant in it between different categorical independent variables. Bivariable and multivariable Cox proportional hazard regression models were used to identify significant predictors. Model fitness was also assessed using the Schoenfield residual and the Cox-Snell global residual test. Statistical significance was declared at the p-value <0.05. Result: The median time to initiate complementary feeding among primipara mother-infant pairs was 6 ± 2 months. The overall incidence rate of complementary feeding initiation before, at and after 6 months of age of the infant was 7.28 (95%CI: 6.44, 8.25), 41.41 (95%CI: 36.05, 47.56), and 42.97 (95%CI: 36.89, 50.05) per 100 person-month observations, respectively. Among those mothers who initiated complementary feeding for their infants, 249, 200, and 165 initiated complementary feeding before, at and after 6 months of age of the infants. Furthermore, the age (15-24 years) of mothers (AHR: 1.63, 95%CI: 1.16, 2.29), rich wealth (AHR: 1.35, 95%CI: 1.05, 1.75), and richest wealth (AHR: 1.43, 95%CI: 1.10, 1.84) were identified as statistically significant predictors of the time to initiate complementary feeding. Conclusions: The median time to initiate complementary feeding among primipara mother-infant pairs was 6 months. The age of the mother and the wealth status of the household were found to be statistically independent predictors of the time to initiate complementary feeding. Therefore, community health professionals are better able to work on when to initiate complementary feeding to infants of rich and richest young primipara mothers.
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Background: Fighting health threats, especially the rise of new infectious diseases, is one of the main responsibilities of healthcare workers. However, their knowledge and attitudes toward monkeypox have not yet been assessed. Therefore, this study aimed to assess the knowledge, attitude, and factors associated with monkeypox infection among healthcare workers at Injibara General Hospital, Northwest Ethiopia. Methods: Institution-based cross-sectional study was conducted from December 1-30, 2022. Data were collected using a structured self-administered questionnaire. A simple random sampling technique was used to select study participants. Descriptive statistics and multivariable logistic regression analyses were computed. The degree of association was interpreted using an odds ratio with a 95% confidence interval and a p-value < 0.05. Results: Among the 200 healthcare workers who participated, 38.5% (95% CI: 32.5%-45%) and 62% (95% CI: 55-68.5%) had good knowledge and positive attitudes regarding monkeypox respectively. Having a master's degree or above (AOR = 11.25: 95% CI: 2.03-62.33), being vaccinated against COVID-19 (AOR = 2.60: 95% CI: 1.37-4.94), and having access to information about monkeypox (AOR = 3.37: 95% CI: 1.33-8.50) were the factors associated with good knowledge. Furthermore, a positive attitude was significantly associated with being 30 years of age or older (AOR = 2.95: 95% CI: 1.55-5.60) and having access to information about monkeypox (AOR = 4.14: 95% CI: 2.06, 8.30). Conclusion: Both good knowledge and positive attitudes were relatively low among healthcare workers. Factors such as age, education level, COVID-19 vaccination status, and access to information about monkeypox were significantly associated with the knowledge and attitude of healthcare workers. To enhance the knowledge and attitude of healthcare workers, hospitals should consider offering educational upgrades, hosting educational events like seminars, conferences, webinars, and campaigns, and ensuring comprehensive coverage of the topic in medical curricula.
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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.
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Lactancia Materna , Madres , Lactante , Femenino , Embarazo , Niño , Humanos , Estudios Prospectivos , Etiopía/epidemiología , Fenómenos Fisiológicos Nutricionales del LactanteRESUMEN
INTRODUCTION: Hypertension is a major public health problem that is often unrecognized, and its detection and control should be prioritized. The level of undiagnosed hypertension and its associated factors among long-distance bus drivers in Ethiopia is unknown. OBJECTIVE: This study aimed to assess the magnitude of undiagnosed hypertension and its associated factors among long-distance bus drivers in Addis Ababa bus terminals. METHODS: A facility-based cross-sectional study was conducted on 391 long-distance bus drivers from December 15, 2021, to January 15 2022 at five cross-country bus terminals in Addis Ababa. A standardized and structured questionnaire was adapted based on the WHO stepwise approach to a non-communicable disease study and translated into Amharic. Data were coded, cleaned, and entered using Epi-data version 4.6 and exported to SPSS version 26. Logistic regression analysis was performed. Variables with a P-value < 0.25 in the bivariable analysis were selected for multivariable logistic regression analysis. Independent variables with a P-value < 0.05 were considered statistically significant. The magnitude of association between independent and dependent variables was measured by odds ratio with a 95% confidence interval. RESULTS: In this study, 391 study participants were involved with a response rate of 97.1%. The prevalence of undiagnosed hypertension was 22.5% (CI: 18.7%, 26.6%). Poor level of knowledge (AOR: 2.00, CI: 1.08, 3.70), long duration of driving per day (AOR: 2.50, 95% CI: 1.37-4.56), habit of chewing of chat (AOR: 2.61, 95% CI: 1.44, 4.73), regular alcohol consumption (AOR = 3.46; 95% CI: 1.70, 7.05), overweight (AOR:3.14, 95%CI: 1.54,6.42) obesity (AOR: 3.21, 95% CI 1.35, 7.61) and regular physical exercise (AOR: 0.16, 95% CI: 0.09, 0.29) were statistically significantly associated with undiagnosed hypertension. CONCLUSION: This study revealed that the prevalence of undiagnosed hypertension among long-distance bus drivers was 22.5%, which was associated with modifiable behavioral factors, lack of regular physical exercise, lack of adequate awareness and high body mass index. RECOMMENDATION: Stakeholders must implement the necessary preventive measures. These include increasing the level of awareness of hypertension among long-distance drivers and developing prevention of hypertension strategies and policies focusing on lifestyle and behavioral modifications.
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Hipertensión , Obesidad , Humanos , Estudios Transversales , Etiopía/epidemiología , Consumo de Bebidas Alcohólicas , Hipertensión/epidemiologíaRESUMEN
Background: There is mounting evidence that Ethiopia is becoming a more street-food-consuming nation. The hygienic and safety procedures, however, are not adequately evaluated. Objectives: This study aimed to determine the magnitude of food safety and hygiene practices and associated factors among street food vendors of Bahir Dar City. Method: A community-based cross-sectional study design was conducted from March 10 to April 10, 2019. The data were collected using an interviewer-administered questionnaire with an observational checklist. The collected data were entered into EPI Data and analyzed by R software. Descriptive statistics were computed. A Binary logistic regression model was fit to identify the association and strength of exploratory variables and food safety and hygiene practices at a 95 % confidence interval and p-value <0.05. Results: A total of 421 participants participated. The level of good food safety and hygiene practices was 36 % (95%CI: 31, 41). Monthly income of >2500 Birr (AOR = 4.99; 95%CI: 2.42, 10.3), work experience of >2 years (AOR = 2.05; 95%CI: 1.15, 3.65), having supervision by health professionals (AOR = 2.45; 95%CI: 1.25, 4.85), having good knowledge about food safety and hygiene (AOR = 3.84; 95%CI: 1.42, 10.36), and having a favorable attitude towards food safety and hygiene (AOR = 2.71; 95%CI: 1.12, 6.57) were determinants of food safety and hygiene practice. Conclusions: The level of good food safety and hygiene practices was low. Monthly income, work experience, supervision by health professionals, knowledge, and attitude toward food safety and hygiene were identified as the determinants of good food safety and hygiene practice.
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Background: Time management is of utmost importance in healthcare facilities since time squandered by health professionals is time not invested in patients, and this affects the quality of care given to patients. This study aimed to assess time management practice and factors affecting it among health professionals at public hospitals in Bahir Dar, Ethiopia. Methods: Institution-based cross-sectional study supplemented with a qualitative study was conducted from April 21 to May 20, 2022, among health professionals working in public hospitals in Bahir Dar, Ethiopia. A simple random sampling technique was used to select 416 study participants. A pretested self-administered questionnaire was used to collect quantitative data, and an interviewer guide was used to collect qualitative data to complement quantitative data. Purposive sampling was used in the qualitative study, and 12 in-depth interviews were carried out till saturation was reached. The quantitative data were entered into Epi Data version 4.0 and analyzed using SPSS 25.0 whereas the qualitative data were analyzed manually using thematic analysis. To identify the associated factors, bi-variable and multivariable logistic regression analyses were used. The degree of associations was interpreted using odds ratio and 95% confidence interval at <0.05 p-value. Results: Of 416 invited participants, 410 of them participated in the study yielding a 98.5% response rate. The magnitude of time management practice among health professionals was 66.1% (95% CI: 61.5-70%). Age ranges 25-29 (AOR = 3.961, 95% CI: 1.068, 14.682) and 30-34 (AOR = 6.240, 95% CI: 1.640, 23.749), planning (AOR = 6.032, 95% CI: 3.478, 10.463), compensation and benefits packages (AOR = 1.888, 95% CI: 1.077, 3.309), responsible to work (AOR = 2.119, 95% CI: 1.192, 3.768), time waster (AOR = 1.855, 95% CI: 1.058, 3.251) and staff shortage (AOR = 0.535, 95% CI: 0.319, 0.896) were factors associated with time management practice. From the qualitative study, two major themes and five categories have emerged. Conclusion and recommendations: Healthcare facilities could improve their time management practices by providing training on planning, being a low time-waster and highly responsible at work, and designing compensation and benefits packages.
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Hospitales Públicos , Administración del Tiempo , Humanos , Adulto , Etiopía , Estudios Transversales , Personal de SaludRESUMEN
Background: Globally, neonatal mortality remains a serious catastrophic problem for newborns, particularly in a low-resource setting. There were no neonatal mortality trend studies in the study area. Objective: This study aimed to determine the trends and risk factors of neonatal mortality at the neonatal intensive care unit of Felege Hiwot Comprehensive Specialized Hospital, Northwest Ethiopia. Methods: An institution-based retrospective cross-sectional study was conducted among 870 admitted neonates from January 1, 2016 to December 31, 2020 in the neonatal intensive care unit by a stratified simple random sampling technique. Data were entered into EpiData and then exported to STATA 14.0 for analysis. A linear regression statistical model was used for trend analysis and binary logistic regression was carried out to identify explanatory variables of neonatal mortality. Results: Overall, neonatal mortality averagely increased by 2.1% per year throughout the 5 consecutive years. In this study, rural residency [adjusted odds ratio (AOR): 1.96, 95% confidence interval (CI): (1.26, 3.06)], birth asphyxia (AOR: 7.73, 95% CI: 4.31, 13.84), congenital deformity (AOR: 3.61, 95% CI: 1.17, 11.18), low birth weight (AOR: 2.13, 95% CI: 1.23, 3.67), respiratory distress syndrome (AOR: 3.32, 95% CI: 1.97, 5.59), Ambu-bag resuscitation (AOR: 0.16, 95% CI: 0.07, 0.38), taking antibiotics (AOR: 0.50, 95% CI: 0.27, 0.90), glucose (AOR: 0.47, 95% CI: 0.30, 0.72), and oxygen (AOR: 0.26, 95% CI: 0.16, 0.41) were associated with neonatal mortality. Conclusions: This 5-year trend analysis revealed an increased trend of NMR, indicating more work is still needed to make progress toward meeting the SDG goal by 2030. Rural residency, birth asphyxia, congenital deformity, low birth weight, respiratory distress syndrome, Ambu-bag resuscitation, taking antibiotics, glucose, and oxygen were associated with neonatal mortality. Therefore, all stakeholders shall give due attention to reducing this timely-increasing trend of neonatal mortality.
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BACKGROUND: Coronavirus disease has spread worldwide since late 2019. Vaccination is critical in controlling this pandemic. However, vaccine acceptance among pregnant women is not well-studied. Therefore, this study aimed to assess the COVID-19 vaccine acceptance and associated factors among pregnant women attending antenatal care clinics in Gondar town, Northwest Ethiopia. METHODS: An institution-based cross-sectional study was conducted among pregnant women attending antenatal care clinics at Gondar town, Northwest Ethiopia, 2021. About 510 study subjects were selected using a systematic random sampling technique from August 25 to September 10/2021. Data collection was done by using an interviewer-administered, structured questionnaire. Epi-info 7.2 was used to enter data and then exported to SPSS version 25 software for analysis. Bivariable and multivariable binary logistic regression models were used to identify factors associated with the outcome variable. Variables with a p-value < 0.2 in the bivariable analysis were entered into the multivariable analysis to control for possible confounders. Statistical significance is determined using an adjusted odds ratio and 95% confidence interval (CI) at a p-value of < 0.05. RESULTS: Of 510 participants, 211 (41.4%) were willing to take COVID-19 vaccines. Maternal age ≥ 35 years (AOR: 5.678, 95% CI: 1.775-18.166), having contact history with COVID-19 diagnosed people (AOR: 7.724, 95% CI: 2.183, 27.329), having a pre-existing chronic disease (AOR: 3.131, 95% CI: 1.700-5.766), good knowledge about COVID-19 vaccine (AOR: 2.391, 95% CI: 1.144, 4.998) and good attitude towards COVID-19 vaccine (AOR: 2.128, 95% CI: 1.348) were significantly associated with the outcome variable. CONCLUSIONS: The willingness to take COVID-19 vaccine among pregnant mothers was low. Age, contact history with COVID-19 diagnosed people, chronic disease, knowledge, and attitude towards COVID-19 vaccine were factors associated with COVID-19 vaccine willingness. To enhance the COVID-19 vaccine acceptance, the government with different stakeholders should strengthen public education about the importance of getting COVID-19 vaccine.
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COVID-19 , Mujeres Embarazadas , Femenino , Humanos , Embarazo , Adulto , Estudios Transversales , Vacunas contra la COVID-19/uso terapéutico , COVID-19/epidemiología , COVID-19/prevención & control , Etiopía/epidemiología , Instituciones de Atención AmbulatoriaRESUMEN
BACKGROUND: Applying evidence-based practice during care provision is essential because it improves the quality of care, reduces health care costs, and increases patient and family satisfaction. However, information on evidence-based nursing practice and associated factors were not well studied and documented in the study area. Hence, this study aimed to assess utilization and associated factors of evidence-based practice among nurses working in Amhara Region Referral Hospitals, Ethiopia. METHODS: An institution-based cross-sectional study was conducted from March 18 to April 16, 2019, in Amhara Region Referral Hospitals. A simple random sampling technique was used to select 684 respondents. Data were collected using a pretested and self-administered questionnaire. Data were entered into Epi Info version 7.1.2.0 and exported to SPSS version 22.0 for analysis. The bivariable analysis was used primarily and variables with p-value < 0.2 were further examined using a multivariable logistic regression model to control con-founders. Then, variables' p-value < 0.05 with 95% CI was used to determine associated factors. RESULTS: From 684 proposed nurses, 671 of them completed the questionnaire giving 98.1% response rate. Of these, 55% (95% CI: 51.2, 58.9) of them had good evidence-based practice utilization. Variables including single (AOR = 1.662: 95% CI: 1.089-2.536), fewer work experience (AOR = 1.849: 95% CI: 1.049-3.257), good knowledge (AOR = 2.044: 95% CI: 1.406-2.972), effective communication skill (AOR = 2.537: 95% CI: 1.744-3.689), EBP training (AOR = 3.224 95% CI: 1.957-5.311), internet access (AOR = 1.655: 95% CI: 1.119-2.448) and evidence-based guideline availability (AOR = 1.827: 95% CI: 1.249-2.673) were found to be predictors of evidence-based practice utilization. CONCLUSIONS: The study revealed that evidence-based practice utilization among nurses is low. Availing evidence-based guidelines in the work area, improving facilities' internet access, and building nurses' evidence-based practice competencies through either by giving separate training or incorporating as part of the curriculum would improve its utilization.