The association between children's exposure to pesticides and asthma, wheezing, and lower respiratory tract infections. A systematic review and meta-analysis.

Background: Exposure to pesticides is a global public health problem, especially for children. Its association with chronic respiratory disease among children has attracted considerable attention, but the existing evidence remains inconclusive and cannot be certain. Therefore, this systematic review and meta-analysis aim to determine the global pooled effect size of association with pesticide exposure and asthma, wheezing, and respiratory tract infections among children. Methods: A comprehensive search was conducted for relevant literature from electronic databases, including PubMed, Google Scholar, Hinari, Semantic Scholar, and Science Direct. Studies that provided effect size on the association between pesticide exposure and childhood asthma, wheezing, and respiratory tract infections in children were included. The articles were screened, data was extracted, and the quality of each study was assessed with four independent reviewers. Random effects models for significant heterogeneity and fixed effect models for homogeneous studies were conducted to estimate pooled effect sizes with 95% confidence intervals using Comprehensive Meta-Analysis version 3.3.070 and MetaXL version 2. Funnel plot and Higgins I 2 statistics were used to determine the heterogeneity of the included studies. Subgroup analyses were computed based on the types of pesticide exposure, study design, sample size category, and outcome assessment technique. Result: A total of 38 articles with 118,303 children less than 18 years of age were included in this meta-analysis. Pesticide exposure among children increased the risk of asthma by 24%; (OR = 1.24, 95% CI: 1.14-1.35) with extreme heterogeneity (I 2 = 81%, p < 0.001). Exposure to pesticides increased the odds of developing wheezing among children by 34% (OR = 1.34, 95% CI: 1.14-1.57), with high heterogeneity (I 2 = 79%, p < 0.001) and also increased the risk of developing lower respiratory tract infection by 79% (OR = 1.79, 95% CI: 1.45-2.21) with nonsignificant low heterogeneity (I 2 = 30%, p-value = 0.18). Conclusion: This meta-analysis provided valuable evidence supporting the association between childhood asthma, wheezing, and lower respiratory tract infection with pesticide exposure. The findings would contribute to a better understanding of the estimate of the effect of pesticide exposure on respiratory health in children and inform evidence-based preventive strategies and public health interventions.

Exposure to indoor air pollution and adverse pregnancy outcomes in low and middle-income countries: a systematic review and meta-analysis.

Introduction: Exposure to indoor air pollution such as biomass fuel and particulate matter is a significant cause of adverse pregnancy outcomes. However, there is limited information about the association between indoor air pollution exposure and adverse pregnancy outcomes in low and middle-income countries. Therefore, this meta-analysis aimed to determine the association between indoor air pollution exposure and adverse pregnancy outcomes in low and middle-income countries. Methods: International electronic databases such as PubMed, Science Direct, Global Health, African Journals Online, HINARI, Semantic Scholar, and Google and Google Scholar were used to search for relevant articles. The study was conducted according to the updated Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. A random effect model at a 95% confidence interval was used to determine the association between indoor air pollution exposure and adverse pregnancy outcomes using STATA version 14. Funnel plot and Higgs I2 statistics were used to determine the publication bias and heterogeneity of the included studies, respectively. Results: A total of 30 articles with 2,120,228 study participants were included in this meta-analysis. The pooled association between indoor air pollution exposure and at least one adverse pregnancy outcome was 15.5% (95%CI: 12.6-18.5), with significant heterogeneity (I2 = 100%; p < 0.001). Exposure to indoor air pollution increased the risk of small for gestational age by 23.7% (95%CI: 8.2-39.3) followed by low birth weight (17.7%; 95%CI: 12.9-22.5). Exposure to biomass fuel (OR = 1.16; 95%CI: 1.12-1.2), particulate matter (OR = 1.28; 95%CI: 1.25-1.31), and kerosene (OR = 1.38; 95%CI: 1.09-1.66) were factors associated with developing at least one adverse pregnancy outcomes. Conclusions: We found that more than one in seven pregnant women exposed to indoor air pollution had at least one adverse pregnancy outcome. Specifically, exposure to particulate matter, biomass fuel, and kerosene were determinant factors for developing at least one adverse pregnancy outcome. Therefore, urgent comprehensive health intervention should be implemented in the area to reduce adverse pregnancy outcomes.

Effect of topical emollient oil application on weight of preterm newborns: A systematic review and meta-analysis.

BACKGROUND: Synthesizing current evidence on interventions to improve survival outcomes in preterm infants is crucial for informing programs and policies. The objective of this study is to investigate the impact of topical emollient oil application on the weight of preterm infants. METHODS: A systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted. To identify relevant studies, comprehensive searches were conducted across multiple databases, including PubMed, Cochrane, Scopus, Clinical trials, ProQuest Central, Epistemonikos, and gray literature sources. The inclusion criteria were based on the PICO (Population, Intervention, Comparison, and Outcomes) format. Study quality was assessed using the Cochrane risk of bias tool for randomized trials (RoB 2.0). Data analysis was performed using StataCrop MP V.17 software, which included evaluating heterogeneity, conducting subgroup analysis, sensitivity analysis, and meta-regression. The findings were reported in accordance with the PRISMA checklist, and the review was registered with PROSPERO (CRD42023413770). RESULTS: Out of the initial pool of 2734 articles, a total of 18 studies involving 1454 preterm neonates were included in the final analysis. Fourteen of these studies provided data that contributed to the calculation of the pooled difference in mean weight gain in preterm neonates. The random effects meta-analysis revealed a significant pooled difference in mean weight gain of 52.15 grams (95% CI: 45.96, 58.35), albeit with high heterogeneity (I2 > 93.24%, p 0.000). Subgroup analyses were conducted, revealing that preterm infants who received massages three times daily with either sunflower oil or coconut oil exhibited greater mean differences in weight gain. Meta-regression analysis indicated that the type of emollient oil, duration of therapy, and frequency of application significantly contributed to the observed heterogeneity. A sensitivity analysis was performed, excluding two outlier studies, resulting in a pooled mean weight difference of 78.57grams (95% CI: 52.46, 104.68). Among the nine studies that reported adverse events, only two mentioned occurrences of rash and accidental slippage in the intervention groups. CONCLUSION: The available evidence suggests that the application of topical emollient oil in preterm neonates is likely to be effective in promoting weight gain, with a moderate-to-high level of certainty. Based on these findings, it is recommended that local policymakers and health planners prioritize the routine use of emollient oils in newborn care for preterm infants. By incorporating emollient oils into standard care protocols, healthcare providers can provide additional support to promote optimal growth and development in preterm infants.

Virological Suppression and its Predictors Among HIV/AIDS Patients on Antiretroviral Therapy in Ethiopia: Systematic Review and Meta-analysis.

Background: Achieving viral load suppression is crucial for the prevention of complications and deaths related to HIV infection. Ethiopia has embraced the worldwide 95-95-95 target, but there is no national representative information regarding virological suppression. Therefore, this review aims to determine the pooled virological suppression rate and identify the pooled effect of contributing factors of viral suppression for HIV-positive patients on antiretroviral therapy in Ethiopia. Methods: We systematically searched websites and databases, including online repositories, to obtain primary studies. Two reviewers assessed the quality of the included articles using the Newcastle-Ottawa Scale appraisal checklist. Publication bias was checked using Egger's regression test, the heterogeneity of the studies was assessed using I2 statistics and Q statistics, and a sensitivity analysis was performed to identify any outlier results in the included studies. The Der Simonian Laird random-effects model was used to estimate the overall proportion of viral suppression, and STATA 17 statistical software was used for all types of analysis. Results: A total of 21 eligible articles primarily conducted in Ethiopia using HIV program data were used for this quantitative synthesis. The overall pooled virological suppression rate was 71% (95% CI, 64%-77%). The pooled effects of poor adherence to ART (adjusted odds ratio [AOR], 0.33; 95% CI, 0.28-0.40), body mass index (18.5-24.9 kg/m2; AOR, 1.8; 95% CI, 1.37-2.36), disclosure (AOR, 1.41; 95% CI, 1.05-1.89), absence of opportunistic infection (AOR, 1.68; 95% CI, 1.43-1.97), and high baseline viral load count (AOR, 0.65; 95% CI, 0.52-0.81) were identified as significant predictors of viral suppression. Conclusions: The overall pooled percentage of virological suppression was low compared with the global target of viral suppression and the Ethiopian Public Health Institute report. Poor adherence, normal body mass index, disclosure, absence of opportunistic infection, and high baseline viral load count were factors contributing to viral suppression in Ethiopia. Responsible stakeholders should maximize their efforts to achieve the global target of virological suppression by addressing significant predictors.

Client satisfaction and contributing factors towards sexual and reproductive health services delivery system among youth at Family Guidance Association of north Ethiopia (FGAE) clinics, 2023: mixed method study.

BACKGROUND: The Family Guidance Association of Ethiopia (FGAE) operates as a non-governmental organization dedicated to offering family planning and reproductive health services to the Ethiopian population. The gap in the study regarding client satisfaction and contributing factors towards sexual and reproductive health services for youth at FGAE clinics highlights the need for a comprehensive investigation to fill this void. By conducting a mixed-method study, this research aims to provide a holistic understanding of the factors influencing client satisfaction in the delivery of sexual and reproductive health services to youth at FGAE clinics. The added value of this study lies in its potential to offer valuable insights and recommendations for improving service delivery systems and enhancing client satisfaction levels, ultimately contributing to the overall well-being and health outcomes of youth in North Ethiopia. Therefore study aimed to asses Client Satisfaction and Contributing Factors towards in sexual and reproductive health services delivery system among youth at Family Guidance Association of North Ethiopia (FGAE) Clinics, 2023. METHOD: The study was conducted within the clinics of the Family Guidance Association of Ethiopia (FGAE), spanning Dessie, Kombolcha, and Woldia city administrations, involving a participant cohort of 416 clients. Facility-based concurrent type mixed method study design both quantitative and qualitative techniques were applied. Quantitative research employed a simple random sampling technique and conversely, the qualitative study utilized a heterogeneous type of purposive sampling strategy to recruit participants The collected data underwent a rigorous process of entry, cleaning, and coding using Epi-Data 4.6 software, followed by analysis in STATA V17. Descriptive statistics and binary logistic regression were employed to highlight the impact of independent variables on the dependent variable. A more comprehensive examination was provided through multivariable logistic regression. Crude and adjusted odds ratios, along with a 95% confidence interval, were computed, with significance set at a p-value ≤ 0.05. RESULT: Nearly more than half of the clients 194 (47.8%) came to receive family planning services followed by maternal and child health 107 (26.4%). Sixty patients (14.8%) didn't receive all the services they wanted or came for. Half of the participants 30 (50%) raised the unavailability of the service as a reason for not taking the service followed by not having enough time in the clinic 12 (20%). About 65.52% (60.74-70.00%) of the participants were satisfied with the Sexual and Reproductive Health services provided by the clinics of FGAE in northeast Ethiopia. Clients in the age group of 25-34 (AOR = 2.04; 95%CI: 1.11-3.72). Clients who had primary and secondary education (AOR = 2.49; 95%CI: 1.03-6.02) and (AOR = 3.05; 95%CI: 1.25-7.49) respectively. Clients who responded that physicians show respect (AOR = 5.59; 95%CI: 1.89-16.49). clients who received an explanation about the side effects of the utilized methods and follow-up dates (AOR = 4.59;95%CI:1.68-12.53) and (AOR = 2.89;95%CI:1.53-5.49) respectively. CONCLUSION: The proportion of client satisfaction with Client Satisfaction in the Services delivery system at Family Guidance Association of Ethiopia (FGAE) Clinics was low as compared to the previous study. Age group 25-34 years, primary and secondary education, showing respect, explaining side-effects and follow-up visits were significant associated factors of client service satisfaction. Enhancing service delivery at Family Guidance Association of Ethiopia (FGAE) Clinics by targeting specific areas identified in the study. Strategies should focus on improving communication regarding side effects, ensuring respectful interactions, and prioritizing follow-up visits, particularly for clients aged 25-34 with primary and secondary education backgrounds.

Prevalence and associated factors of depression among breast cancer patients in Sub-Saharan Africa: A systematic review and meta-analysis.

Introduction: Even though breast cancer incidence is lower in Sub-Saharan Africa, its mortality is higher in these countries. However, the impact does not end with diagnosis and treatment; rather many patients struggle with depression which is very common among these patients. This systematic review and meta-analysis helps to provide valuable insights into the overall prevalence of depression and associated factors among breast cancer patients in Sub-Saharan Africa. Method: We searched several databases, including MEDLINE, Embase, Scopus, Hinary, CINHAL and Google Scholar to retrieve relevant literatures from inception up to 15 June 2023. All observational studies, published in English at any time were included, while, letters to editor, review articles, commentaries, interventional and qualitative studies, and, abstracts presented in conferences or seminars were excluded. The results of this systematic review and meta-analysis have been written based on the PRISMA 2020 checklist and the protocol have been registered in PROSPERO database (CRD42023428910). Result: We have included nine articles with 2226 study participants. The result showed that, the pooled prevalence of depression among breast cancer patients in Sub-Saharan Africa was 45.6% (95% CI: 30%-61%) with significant heterogeneity I2 = 98.9%, (Cochrane) Q < 0.0001. There was no single study effect and publication bias but substantial heterogeneity was observed. In addition, there has been a publication bias with eggers test (p < 0.0033). However, there were no studies imputed after trim and fill analysis. From the factors, breast cancer patients who had poor financial support were 1.47 (95% CI: 1.02-2.13) times more at risk of developing depression than their counterparts. Conclusion: The prevalence of depression among breast cancer patients in Sub-Saharan Africa countries were higher than other regions. Thus, Emphasis should be given on developing financial assistance programs designed to cover the medical costs and improving the health care infrastructure.

The efficacy of theory of planned behavior to predict breast self-examination among women: systematic review and meta-Analysis.

Background: Even though a few studies have been conducted, the result is inconsistent between studies. The Theory of Planned Behavior (TPB) is a widely used framework for predicting and understanding health behaviors. In the study area, the theory of planned behavior ability to predict breast self-examination among women was not done before. Therefore, this study aimed to determine the efficacy of the Theory of Planned Behavior to predict breast self-examination among women. Methods: This study used a systematic review and meta-analysis of studies conducted from 2008 to 2018 globally. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. PubMed, Semantic Scholar, Hinari, and Google Scholar electronic databases were searched. The analysis was performed using STATA 17 software. Heterogeneity and publication bias were assessed using forest plots, I2, Cochran's Q statistics, Funnel plots, and the Egger test respectively. Pooled analysis was conducted using the random-effects model of the DerSimonian-Laird method. Results: A total of 5 articles were included in this systematic review and meta-analysis. The overall Pooled Proportion of variance of the Theory of Planned Behavior ability to predict breast self-examination among women was explained at 38% (95%CI: 26.9, 49.1). Conclusions: The overall Pooled Proportion of variance explained by the Theory of Planned Behavior ability to predict breast self-examination among women was low as compared to the original assumption of variance explained. While the Theory of Planned Behavior provides a useful framework for understanding health behaviors, it may not fully capture all the complex factors contributing to breast self-examination. Additionally, future studies should consider using alternative measures of variance explained to provide a more comprehensive understanding of the predictive power of the theory of planned behavior.

Determinants of cervical cancer screening utilization among women attending health facilities of Dessie town, Northeast Ethiopia.

INTRODUCTION: Despite the higher burden of cervical cases, screening programs in highly affected developing countries remained low. This made the disease to be present at an advanced stage which is almost always fatal, causing enormous pain and suffering for the individual and having significant adverse effects on the welfare of their families and community. Thus, this study aimed to assess determinants of cervical cancer screening utilization among women attending health facilities in Dessie Town, Northeast Ethiopia. METHODS: An institution-based unmatched case-control study design was employed on 430 women (146 cases and 284 controls) at selected health facilities of Dessie town, South Wollo Zone, from July 1/2020 to August 30/2020. Cases were selected for all women screened for cervical cancer during the data collection period until the required sample size was attained and using a consecutive sampling technique, every 3 participants from women who come for services other than cervical cancer screening. were included as controls. Pretested and structured questionnaires were used to collect the data. Data were analyzed by SPSS version 25 software. Bivariable and multivariable logistics regression analysis was done. An adjusted odds ratio with 95% CI was estimated to measure the strength of the association. The level of statistical significance was declared at a p-value < 0.05. RESULT: Age group of 35 and more [AOR = 11.52(6.09-21.77)], being a private employee [AOR = 4.67(2.41-9.03)], having symptoms of vaginal bleeding or pelvic pain or postcoital bleeding or vaginal discharge [AOR = 3.08(1.37-6.95)], being recommended by a physician for screening [[AOR = 3.07(1.45-6.49)] and positive attitude towards cervical cancer screening [AOR = 5.3(2.8-10.59)] were determinants of cervical cancer screening. CONCLUSION: Age group of 35 and more, current occupation as a private employee, having symptoms of cervical cancer, being recommended by a physician for screening, and positive attitude towards cervical cancer screening were determinants of cervical cancer screening utilization.

Utilization of growth monitoring and promotion services and associated factors among children aged 0-23 months in Banja District, Northwest Ethiopia 2020: A cross-sectional study.

BACKGROUND: Growth monitoring and promotion are the basic malnutrition preventive strategies usually used to assess the growth of children using anthropometric measurements in comparison with world health organization standards. However, the utilization of growth monitoring and promotion services is inadequate in most developing countries. Therefore, this study aimed to assess the utilization of growth monitoring and promotion service and associated factors among children aged 0-23-month in Banja District, Northwest Ethiopia, 2020. METHODS: A community-based cross-sectional study was conducted from February 2 to April 1, 2020. A total of 572 children were selected using a simple random sampling technique. Data were collected using structured and pre-tested interviewer-administered questionnaires. Data were entered into Epi data version 4.6 and analyzed using the statistical package for social science (SPSS) version 25. Both binary and multivariable logistic regression analyses with a 95% confidence level were used to identify the associated factors. Statistical significance was set at p <0.05. RESULTS: This finding revealed that the proportion of growth monitoring and promotion services utilization was 38.9% [95%CI: 34.8%, 43.0%]. Child age from 0-11 months [AOR = 4.98 (95% CI: 2.75,8.37)], mothers who can read and write Amharic language [AOR = 2.04 (95%CI: 1.02,4.08)], know the benefits of weighing their child monthly [AOR = 2.9 (95%CI: 1.23, 6.94)], presence of growth monitoring service nearby [AOR = 3.2 (95%CI: 1.59,6.31)] and monthly income ≥2000 Ethiopian birr [AOR = 1.75(95% CI = 1.08, 3.02)] were some of the factors significantly associated with utilization of growth monitoring and promotion services. CONCLUSION AND RECOMMENDATION: The findings indicate that utilization of growth monitoring and promotion services is mainly affected by child age, mother/caregiver ability to read and write Amharic language, having maternal information on the benefit of the weighing child, presence of service nearby health facility, and mother/caregiver monthly income. Preparation of growth monitoring charts in local language (Awigna) and creating awareness on the proper utilization of growth monitoring and promotion services is strongly recommended.

Predictors of Virological Failure after Adherence-Enhancement Counseling among First-Line Adults Living with HIV/AIDS in Kombolcha Town, Northeast Ethiopia.

BACKGROUND: HIV virological failure is a common challenging problem, even after adherence-enhancement counseling. However, there have been few studies on the determinants of virological failure after adherence-enhancement counseling among adult patients on antiretroviral therapy in Ethiopia in general, and there is variation across clients and settings for unknown reasons. Therefore, this study aimed to identify predictors of virological failure after adherence-enhancement counseling among adults living with HIV/AIDS. METHODS: A case-control study was conducted in the town of Kombolcha from January 1, 2019 to March 30, 2019 using simple random sampling for 338 participants. Data were collected through face-to-face interviews for social and personal characteristics and document review for clinical profiles. Descriptive statistics were used for frequency, proportions, and summary measures. Binary logistic regression analysis was carried out to identify the predictors of virological failure after adherence-enhancement counseling among adults. For multivariate logistic regression,P<0.05 was considered statistically significant. AORs are presented with 95% CIs. RESULTS: The odds of virological failure after adherence-enhancement counseling were higher following poor antiretroviral medication adherence (AOR 7.3, 95% CI 2.57-20.79) and for patients who had had a first high viral load (≥10,000 copies/mL, (AOR 5, 95% CI 1.86-13.56) and a history of opportunistic infection (AOR 3.7, 95% CI 1.11-8.44) compared with their counterparts. CONCLUSION: Poor antiretroviral medication adherence during adherence-enhancement counseling session, first viral load ≥10,000 copies/mL, and recent history of opportunistic infection were predictors of virological failure. Therefore, efforts should be strengthened to improve adherence to antiretroviral medication, which helps to boost immunity and suppress viral replication.