Prevalence and determinants of under-nutrition among children on ART in Ethiopia: A systematic review and meta-analysis.

BACKGROUND: Children living with HIV/AIDS are particularly vulnerable to under-nutrition. Under-nutrition associated with HIV/AIDS infection increases the rate of morbidity and mortality in children. To reaffirm a future objective, there needs to be evidence regarding the current national burden of under-nutrition and related factors among children infected with HIV. Hence, the objective of this systematic review and meta-analysis was to estimate the pooled prevalence of under-nutrition, and the pooled effect sizes of associated factors among HIV-infected children in Ethiopia. METHODS: We searched Ethiopian universities' online libraries, Google, Google Scholar, PubMed, CINAHL, Cochrane Library, and Scopus to find the primary studies for this review. Publication bias was checked through Egger's regression test. Heterogeneity among the included studies was assessed using the I2 test. The data were extracted using Microsoft Excel and exported to STATA Version 14 statistical software. A random effect meta-analysis model was performed to estimate the pooled prevalence of Under-nutrition. RESULTS: After reviewing 1449 primary studies, 16 articles met the inclusion criteria and were included in the final meta-analysis. The estimated pooled prevalence of stunting, underweight, and wasting among children living with HIV/AIDS was 32.98% (95% CI: 22.47, 43.50), 29.76% (95% CI: 21.87, 37.66), and 21.16% (95% CI: 14.96, 27.35) respectively. CONCLUSIONS: This study showed that under-nutrition among HIV-infected children in Ethiopia was significantly high. Under-nutrition is more common among HIV-infected children with opportunistic infections, child feeding problems, do not adhere to dietary recommendations, and have diarrhea. The national policies and strategies for ART service- provider centers should maximize their emphasis on reducing under-nutrition among HIV-infected children. Based on this finding, we recommend HIV intervention programs to address nutritional assessment and interventions for HIV-infected children. PROTOCOL REGISTRATION: The protocol has been registered in the PROSPERO database with a registration number of CRD-394170.

Global prevalence of post-abortion depression: systematic review and Meta-analysis.

BACKGROUND: Depression after abortion is a common problem for all women of reproductive age. However, there are not any data on post-abortion depression at a global level. Consequently, the purpose of this study was to find out the global prevalence of post-abortion depression. METHODS: The present study involved a comprehensive search of several databases, including Science Direct, Scopus, EMBSE, Google Scholar, and PubMed. The search was conducted between February 1, 2023, and March 10, 2023. The data was extracted using Microsoft Excel (version 14) and analyzed using STATA statistical software. To evaluate publication bias, a forest plot, Begg's test, and Egger's test were employed. Heterogeneity was assessed using I2, and a pooled estimated analysis was conducted. Additionally, subgroup analysis was performed based on the study continent/region, World Bank income group, screening instrument, and study design. RESULTS: This analysis included 15 papers with a total of 18,207 research participants out of a total of 657 articles. The overall pooled prevalence of post-abortion depression was found to be 34.5% (95% CI: 23.34, 45.68), with an I2 value of 71.6%. The prevalence of post-abortion depression varied based on geographic location, World Health Organization (WHO) regions, World Bank income category, screening approach, and study design. The highest proportion of post-abortion depression was observed in Asia (37.5%), while the WHO's Eastern Mediterranean region had the greatest rate of post-abortion depression (43.1%). Lower-middle-income countries had the highest frequency of post-abortion depression (42.91%) based on World Bank economic classification. The Center of Epidemiological Studies Depression Scale was found to have the highest incidence of reported depression prevalence (30%) across diagnostic tools. Furthermore, the prevalence of depression was higher in cross-sectional study designs (36.42%) compared to cohort studies (22.7%). CONCLUSION: In conclusion, the occurrence of post-abortion depression has been observed to be widespread globally. The prevalence of post-abortion is found to be influenced by several factors, including the methodology employed in the study, the diagnostic tool utilized, the geographical location, and the socioeconomic status of the population. Healthcare providers should prioritize the provision of post-abortion counseling, care, and emotional support to women.

Intention to use maternal waiting home and its predictors among pregnant women in Ethiopia: systematic review and meta-analysis.

BACKGROUND: A high maternal death rate is a result of maternal delays in seeking emergency obstetric care, particularly in countries with limited resources like Ethiopia. Utilizing maternity waiting homes is a strategy to overcome geographical barriers and improve maternal and neonatal health outcomes. Pregnant women must intend to use this service in addition to it being available. Therefore, the goal of this study was to assess pregnant women's intentions to use maternity waiting homes and associated characteristics. METHODS: PubMed, Google Scholar, Scopus, Science Direct, and online institutional repository homes were searched. Data were extracted using Microsoft Excel and analyzed using STATA statistical software (v. 14). Publication bias was checked by forest plot, Begg's, and Egger's tests. To look for heterogeneity, I2 was computed, and an overall estimated analysis was carried out. Subgroup analysis was done by study region, sample size, and publication. The pooled odds ratio for associated factors was also computed. RESULTS: Out of 258 articles assessed, 8 studies with 4111 study participants met the criteria and were included in this study. The pooled prevalence of intention to use maternity waiting home was 52.25% (95% CI 45.88-58.66), I2 = 93.8%). Amhara region had a higher intention to use maternal waiting for home prevalence (63.5%), per subgroup analysis. In studies with sample sizes higher than 5000, the usage of maternity waiting homes was less prevalent (45.2%). Between published research (52.9%) and unpublished studies (51.3%), there was no appreciable difference in the intention to use a maternity waiting home. Experience of maternity waiting home (AOR = 3.337; 95% CI 2.038-5.463), direct subjective norm (AOR = 2.763; 95% CI 1.395-5.471), and direct perceived behavioral control (AOR = 23.147; 95% CI 2.341-4.231). CONCLUSION: In Ethiopia, the intention to use maternity waiting was low. There was an intentional variation in to use of maternity waiting homes across regions of Ethiopia. Improving behavioral perception through intervention programs such as antenatal education should have been strengthened.

Mothers' health care seeking behavior for neonatal danger sign in southern Ethiopia: Community based cross-sectional study.

BACKGROUND: Over the previous few decades, significant progress has been made in reducing newborn mortality, but the worldwide scale of the problem remains high. A considerable number of newborn death and difficulties owing to neonatal danger signs could be avoided if mothers sought appropriate health care for common neonatal risk indications, according to a number of studies presently underway in Ethiopia. The aim of this study is to assess health care seeking behavior of mothers' in related to neonatal danger signs. METHOD: A community-based cross-sectional study was conducted among 410 participants in Wolaita Sodo, From October 1 to October 30, 2019. To collect data, structured interviewer administered questionnaire was used. Data was coded, cleaned, recoded and entered in to epi-data version 3.1 and transported to SPSS window version 21 for analysis. Multivariable logistic regression was carried out and p-value of less than or equal to 0.05 was considered statistically significant. RESULT: A total of 410 mothers participated in this study, 110 (47.6%) mothers preferred health intuition for their neonate. Husband educational status (AOR = 2.4, 95% CI = 1.1, 5.5), communication media (AOR = 4.3, 95% CI = 2.4, 7.5), place of residence (AOR = 3.5, 95% C.I = 1.9, 6.7), ANC follow up (AOR = 2.8, 95% CI = 1.4, 5.8), and PNC follow (AOR = 1.7, 95% CI = 1.1, 3.1) were all factors that significantly associated with health care seeking practice neonatal dander signs. CONCLUSION: Overall, there was a low degree of health-seeking practice. The educational status of the mother's husband, communication media, residence, ANC follow-up, and PNC follow-up all predicted the mothers' health-care seeking behavior. The study also identifies the Wolaita Zone and Sodo town health offices, the health development army, one to five local community organizations with and health extension workers as key contributors.

Knowledge, attitude, and intention to accept COVID-19 vaccine among patients with chronic diseases in southern Ethiopia: Multi-center study.

Background: Most of the COVID-19 fatal cases and severe illnesses like acute respiratory distress syndrome occur in older adults and other people who have underlying medical comorbidities. Understanding patients with chronic disease' knowledge, attitudes, and intention to take the COVID-19 vaccine and related factors are necessary to control the mortality of COVID-19 infection. Therefore, this study aimed to assess knowledge, attitudes, and intention to take the COVID-19 vaccine among patients with chronic disease in Southern Ethiopia. Methods and materials: A facility-based cross-sectional study was conducted among 409 patients with chronic diseases having a follow-up at the hospitals of the Southern region of Ethiopia from November 14, 2021, to December 24, 2021. A structured, interviewer-administered questionnaire was used to collect data. Bivariate and multivariable logistic regression was conducted to show the association of variables with knowledge, attitude, and intention to take the COVID-19 vaccine. The associations of variables were declared with the use of a 95% CI and P-value < 0.05. Results: Overall, 79.2, 70.9, and 58.2% of participants had good knowledge, favorable attitude, and intent to take the COVID-19 vaccine, respectively. Age ≥49 years old (AOR = 1.643; 95% CI = 1.008-3.060) and college and above level of education (AOR = 3.002; 95% CI = 1.897-5.021) were found to be significantly associated with knowledge about COVID-19 vaccine. College and above level of education (AOR = 1.510; 95% CI = 1.002-3.975) and good knowledge (AOR = 3.560; 95% CI = 1.481-6.120) were found to be significantly associated with intention to take COVID-19 vaccine. Conclusion and recommendation: Intention to take the COVID-19 vaccine was low among patients with chronic diseases to achieve herd immunity. Therefore, a holistic and multi-sectoral partnership is necessary for a successful COVID-19 vaccination campaign. Further health education and communication are very crucial methods to improve vaccine acceptance and lastly to achieve herd immunity.

Fertility desire and associated factors among people on antiretroviral treatment at a public health facility in Hawassa city, Southern Ethiopia.

Background: Fertility desire is the plan of people to have a child or more children in the face of being diagnosed with HIV and plan to a commitment to implement the desire. Methods: An institutional-based cross-sectional study was conducted in Hawassa city public health facilities from May 09 -July 07/07/2019. Four hundred (400) study participants were selected using a simple random sampling technique. Data were collected by using interviewer-administered pre-tested structured questionnaires and chart review. The collected data were entered into EPI data version 3.1 software and then transported to SPSS version 20 for cleaning and data analysis. Bivariate and multivariate logistic regression was used to identify associated factors at p<0.05 was taken as a significant value with a 95% confidence level. Results: A total of 400 clients were included in the study giving a response rate of 97 %. The overall fertility desire was 53.6 %(95%CI: 48.7%, 58.2%). Age, sexual practice in the last six months and discussing reproductive health with ART providers were significantly associated with fertility desire. Younger age was positively associated with fertility desire, age group (18-29), [Adjust odds ratio = 5.75 95%CI (2.85, 11.57)] , age group(30-39), [Adjust odds ratio= 4.71 95%CI:(2.55, 8.71)] Sexual practice in the last six months [Adjust odds ratio = 3.00 95%CI(1.46 , 6.16)] and counseling reproductive health with ART provider[Adjust odds ratio = 3.10 95%CI:(1.86,5.15)]. Conclusion: The prevalence of fertility desire in this study was higher than previous studies while factors associated with fertility desire were age, sexual practice in the last six months, and discussing reproductive health with ART providers.

Behavioral intention and its predictors toward COVID-19 vaccination among people most at risk of exposure in Ethiopia: applying the theory of planned behavior model.

Acceptance of a vaccine or hesitancy has great public health implications as these partly determine the extent to which people are exposed to infections that could have otherwise been prevented. There is a high need for a more updated understanding of the behavioral intention of the public toward COVID-19 vaccines and associated factors in light of the COVID-19 pandemic to give appropriate public health messages or actions. Thus, the study aimed to assess behavioral intention and its predictors toward COVID-19 vaccine among people most at risk of exposure in Ethiopia. A population-based anonymous online survey was conducted on individuals aged greater than 18 years from May 01, 2021 to June 30, 2021. The data were collected using a convenient sampling method through an online self-administered, structured questionnaire that was created onto Google survey tool (Google Forms) and disseminated to the public on different social media channels through online sharable platforms. Descriptive statistics were done. Bivariateand multivariable logistic regression was done to show the association of behavioral intention toward the COVID-19 vaccine. The associations of variables were declared with the use of 95% CI and P-value. A total of 1080 participants were included in this survey. Seven hundred one (64.9%) of the respondents had a behavioral intention to receive the COVID-19 vaccine. Males (AOR = 1.41 (95% CI = 1.004-2.53)), degree in level of education (AOR = 0.815 (95% CI = 0.254-0.916)), good knowledge (AOR = 4.21 (95% CI = 2.871-6.992)), attitude (AOR = 2.78 (95% CI = 1.654-4.102)), subjective norm (AOR = 1.214 (95% CI = 1.008-4.309)) and perceived behavioral control (AOR = 3.531 (95%CI = 1.689-5.201)) were found to be significantly associated with behavioral intention toward COVID-19 vaccine. Generally, the prevalence of behavioral intention in Ethiopia is low. Males, degree level of education, knowledge about vaccine, attitude toward vaccine subjective norm and perceived behavioral control were found to be significantly associated with intention to receive COVID-19 vaccine. Health education and communication from government sources are very crucial methods to alleviate the negative attitude, poor knowledge, and action need to improve or change the attitude and behavior of influential people within the community or organization to improve intention to take the vaccine.