Basic coagulation parameters and platelet count among malaria patients attending at Addis Zemen Primary Hospital, Northwest Ethiopia.

BACKGROUND: Malaria is an intravascular parasitic-related blood disease that causes bleeding, coagulopathy, and thrombocytopenia. However, limited data shows the effect of Plasmodium species infection on basic coagulation parameters and platelet count. Thus, this study aimed to assess basic coagulation parameters and platelet count among malaria patients. METHOD: A cross-sectional study was conducted among 240 study participants (120 cases and 120 controls) from June 1, 2021, to February 30, 2022. A convenient sampling technique was employed to select study participants. The blood sample was collected by a trained laboratory technologist for platelet counts, prothrombin time (PT), partial thromboplastin time (PTT), international normalization ratio (INR), blood film, and serological testing. The collected data were analyzed in SPSS version 23. Data were analyzed by the Mann-Whitney U test, Kruskal Wallis H, and Spearman's rank-order correlation tests. Descriptive findings were presented through median, tables, and chart. In all cases, a P-value < 0.05 was considered statistically significant. RESULTS: The percentage of mild, moderate, and high malaria parasitemia levels per microliter of blood was 21.7%, 20%, and 58.3%, respectively. The overall median malaria parasitemia was 10,304 per microliter of blood. Among malaria patients, 77.5%, 61.7%, and 51.7% had prolonged PT, INR, and APTT, respectively as compared to control. Moreover, 26.7% of Plasmodium-infected participants had mild thrombocytopenia as compared to the control group (P < 0.001). CONCLUSION: The value of PT, APTT, and INR were significantly elevated, whereas the level of platelet count was inversely reduced when the malaria parasitemia level increased as compared to controls (p < 0.001).

The potential of circulating microRNAs as novel diagnostic biomarkers of COVID-19: a systematic review and meta-analysis.

INTRODUCTION: The COVID-19 pandemic has caused an unprecedented health threat globally, necessitating innovative and efficient diagnostic approaches for timely identification of infected individuals. Despite few emerging reports, the clinical utility of circulating microRNAs (miRNAs) in early and accurate diagnosis of COVID-19 is not well-evidenced. Hence, this meta-analysis aimed to explore the diagnostic potential of circulating miRNAs for COVID-19. The protocol for this study was officially recorded on PROSPERO under registration number CRD42023494959. METHODS: Electronic databases including Embase, PubMed, Scopus, and other sources were exhaustively searched to recover studies published until 16th January, 2024. Pooled specificity, sensitivity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic ratio (DOR), positive predictive value (PPV), negative predictive value (NPV), and area under the curve (AUC) were computed from the metadata using Stata 14.0 software. Risk of bias appraisal of included articles was carried out using Review Manager (Rev-Man) 5.3 package through the modified QUADAS-2 tool. Subgroup, heterogeneity, meta-regression and sensitivity analyses were undertaken. Publication bias and clinical applicability were also evaluated via Deeks' funnel plot and Fagan nomogram (scattergram), respectively. RESULT: A total of 43 studies from 13 eligible articles, involving 5175 participants (3281 COVID-19 patients and 1894 healthy controls), were analyzed. Our results depicted that miRNAs exhibit enhanced pooled specificity 0.91 (95% CI: 0.88-0.94), sensitivity 0.94 (95% CI: 0.91-0.96), DOR of 159 (95% CI: 87-288), and AUC values of 0.97 (95% CI: 0.95-0.98) with high pooled PPV 96% (95% CI: 94-97%) and NPV 88% (95% CI: 86-90%) values. Additionally, highest diagnostic capacity was observed in studies involving larger sample size (greater than 100) and those involving the African population, demonstrating consistent diagnostic effectiveness across various specimen types. Notably, a total of 12 distinct miRNAs were identified as suitable for both exclusion and confirmation of COVID-19 cases, denoting their potential clinical applicability. CONCLUSION: Our study depicted that miRNAs show significantly high diagnostic accuracy in differentiating COVID-19 patients from healthy counterparts, suggesting their possible use as viable biomarkers. Nonetheless, thorough and wide-ranging longitudinal researches are necessary to confirm the clinical applicability of miRNAs in diagnosing COVID-19.

Burden of early neonatal mortality in Sub-Saharan Africa. A systematic review and meta-analysis.

BACKGROUND: Globally, with a neonatal mortality rate of 27/1000 live births, Sub-Saharan Africa has the highest rate in the world and is responsible for 43% of all infant fatalities. In the first week of life, almost three-fourths of neonatal deaths occur and about one million babies died on their first day of life. Previous studies lack conclusive evidence regarding the overall estimate of early neonatal mortality in Sub-Saharan Africa. Therefore, this review aimed to pool findings reported in the literature on magnitude of early neonatal mortality in Sub-Saharan Africa. METHODS: This review's output is the aggregate of magnitude of early neonatal mortality in sub-Saharan Africa. Up until June 8, 2023, we performed a comprehensive search of the databases PubMed/Medline, PubMed Central, Hinary, Google, Cochrane Library, African Journals Online, Web of Science, and Google Scholar. The studies were evaluated using the JBI appraisal check list. STATA 17 was employed for the analysis. Measures of study heterogeneity and publication bias were conducted using the I2 test and the Eggers and Beggs tests, respectively. The Der Simonian and Laird random-effect model was used to calculate the combined magnitude of early neonatal mortality. Besides, subgroup analysis, sensitivity analysis, and meta regression were carried out to identify the source of heterogeneity. RESULTS: Fourteen studies were included from a total of 311 articles identified by the search with a total of 278,173 participants. The pooled magnitude of early neonatal mortality in sub-Saharan Africa was 80.3 (95% CI 66 to 94.6) per 1000 livebirths. Ethiopia had the highest pooled estimate of early neonatal mortality rate, at 20.1%, and Cameroon had the lowest rate, at 0.5%. Among the included studies, both the Cochrane Q test statistic (χ2 = 6432.46, P <0.001) and I2 test statistic (I2 = 99.80%, p <0.001) revealed statistically significant heterogeneity. Egger's weighted regression (p <0.001) and funnel plot show evidence of publication bias in this meta-analysis. CONCLUSION: This review demonstrated that the pooled magnitude of early neonatal mortality in sub-Saharan Africa is substantial. Therefore, governmental and nongovernmental agencies, international organizations, healthcare providers and institutions and academic and research institutions should give a due attention and design strategies to reduce early neonatal mortality in Sub-Saharan Africa.

The serum level of vitamin D and prevalence of vitamin D deficiency among children with asthma in Asia and Africa: a systematic review and meta-analysis.

BACKGROUND: Several studies on the serum level of vitamin D and the percentage of vitamin D deficiency in children with asthma have been conducted in Asia and Africa, but the results have been inconsistent and inconclusive, requiring a systematic review and meta-analysis to assess the strength of the evidence. OBJECTIVE: The objective of this review is to synthesize evidence on serum levels of vitamin D and the percentage of vitamin D deficiency among children with asthma in Asia and Africa. METHODS: To identify relevant articles, a comprehensive search was conducted across various databases and repositories such as PubMed, Google Scholar, Hinary, Web of Science, ResearchGate, as well as gray literature sources. The Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines were followed during the retrieval process. Data extraction was performed following a standardized format based on the JBI (Joanna Briggs Institute) data extraction guidelines. Microsoft Excel was utilized for data extraction, and subsequently, the data was exported to STATA 17 for further analysis. To assess the heterogeneity among the included studies, Cochrane Q-statistics and the I2 tests were employed. Publication bias was assessed using the Egger test and funnel plot. RESULT: This meta-analysis investigated 33 articles encompassing a total of 3432 children diagnosed with asthma. The findings demonstrated that in low- or middle-income countries across Africa and Asia, children with asthma had an average serum vitamin D level of 21.9 ng/ml (95% confidence interval [CI]: 18.0-25.9 ng/ml), with 53.7% (95% CI: 40.5-66.9) experiencing vitamin D deficiency. Additionally, when considering the continent, children with asthma in Asia had an average serum vitamin D level of 18.5 ng/ml (95% CI: 13.8-23.3), while those in Africa had a level of 28.7 ng/ml (95% CI: 22.7-34.8). The analysis further explored different sub-group analyses. Depending on the study design, case-control studies yielded an average serum vitamin D level of 20.3 ng/ml (95% CI: 18.2-22.4), whereas cross-sectional studies resulted in 23.8 ng/ml (95% CI: 17.5-30.1). Based on publication year, studies published on or before 2015 had an average serum level of 21.0 ng/ml (95% CI: 18.0-24.0), while those published after 2015 had a level of 22.4 ng/ml (95% CI: 17.2-27.7). Moreover, when considering sample size, studies with 100 participants or less had an average serum level of 21.7 ng/ml (95% CI: 17.3-26.1), while studies with more than 100 participants had a level of 22.1 ng/ml (95% CI: 18.6-25.6). CONCLUSION: Children with asthma in Asia and Africa were found to have low serum levels of vitamin D and a high percentage of vitamin D deficiency. This highlights the importance of early detection and monitoring of vitamin D levels in these children to prevent potential complications associated with vitamin D deficiency. Taking proactive measures to address and manage vitamin D deficiency is crucial for the well-being of children with asthma in these regions.

Long non-coding RNA as potential diagnostic markers for acute myeloid leukemia: A systematic review and meta-analysis.

BACKGROUND: Acute myeloid leukemia (AML) is aggressive type of hematological malignancy. Its poses challenges in early diagnosis, necessitating the identification of an effective biomarker. This study aims to assess the diagnostic accuracy of long noncoding RNAs (lncRNA) in the diagnosis of AML through a meta-analysis. The study is registered on the PROSPERO website with the number 493518. METHOD: A literature search was conducted in the PubMed, Embase, Hinari, and the Scopus databases to identify relevant studies. We pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and area under the summary receiver operating characteristics (ROC) using Stata 14.1 software. Heterogeneity between studies was determined through the I2 statistic and Cochran-Q test. A random effect model was chosen due to significant heterogeneity among included studies. Meta-regression and subgroup analysis were performed to assess the potential source of heterogeneity. Furthermore, potential publication bias was estimated using Deek's funnel plot asymmetry test. RESULTS: A total of 14 articles covering 19 studies were included in this meta-analysis comprising 1588 AML patients and 529 healthy participants. The overall pooled sensitivity, specificity, PLR, NLR, DOR, and the area under the summary ROC curve were 0.85 (95% CI = 0.78-0.91), 0.82 (95% CI = 0.72-0.89), 4.7 (95% CI = 2.9-7.4), 0.18 (95% CI = 0.12-0.28), 26 (95% CI = 12-53), and 0.90 (95% CI = 0.87-0.93), respectively. Moreover, lncRNAs from non-bone marrow mononuclear cells (BMMC) had superior diagnostic value with pooled sensitivity, specificity, and AUC were 0.93, 0.82, and 0.95, respectively. CONCLUSION: This meta-analysis demonstrated that circulating lncRNAs can serve as potential diagnostic markers for AML. High accuracy of diagnosis was observed in non-BMMC lncRNAs, given cutoff value, and the GADPH internal reference gene used. However, further studies with large sample size are required to confirm our results.

Mapping geographical inequalities of incomplete immunization in Ethiopia: a spatial with multilevel analysis.

Background: Immunization is one of the most cost-effective interventions, averting 3.5-5 million deaths every year worldwide. However, incomplete immunization remains a major public health concern, particularly in Ethiopia. The objective of this study is to investigate the geographical inequalities and determinants of incomplete immunization in Ethiopia. Methods: A secondary analysis of the mini-Ethiopian Demographic Health Survey (EDHS 2019) was performed, utilizing a weighted sample of 3,865 children aged 12-23 months. A spatial auto-correlation (Global Moran's I) statistic was computed using ArcGIS version 10.7.1 to assess the geographical distribution of incomplete immunization. Hot-spot (areas with a high proportion of incomplete immunization), and cold spot areas were identified through Getis-Ord Gi* hot spot analysis. Additionally, a Bernoulli probability-based spatial scan statistics was conducted in SaTScan version 9.6 software to determine purely statistically significant clusters of incomplete immunization. Finally, a multilevel fixed-effects logistic regression model was employed to identify factors determining the status of incomplete immunization. Results: Overall, in Ethiopia, more than half (54%, 95% CI: 48-58%) of children aged 12-23 months were not fully immunized. The spatial analysis revealed that the distribution of incomplete immunization was highly clustered in certain areas of Ethiopia (Z-score value = 8.379419, p-value < 0.001). Hotspot areas of incomplete immunization were observed in the Afar, Somali, and southwestern parts of Ethiopia. The SaTScan spatial analysis detected a total of 55 statistically significant clusters of incomplete immunization, with the primary SaTScan cluster found in the Afar region (zones 1, 3, and 4), and the most likely secondary clusters detected in Jarar, Doola, Korahe, Shabelle, Nogob, and Afdar administrative zones of the Somali region of Ethiopia. Indeed, in the multilevel mixed-effect logistic regression analysis, the respondent's age (AOR: 0.92; 95% CI: 0.86-0.98), residence (AOR: 3.11, 95% CI: 1.36-7.14), living in a pastoralist region (AOR: 3.41; 95% CI: 1.29-9.00), educational status (AOR: 0.26; 95% CI: 0.08-0.88), place of delivery (AOR: 2.44; 95% CI: 1.15-5.16), and having PNC utilization status (AOR: 2.70; 95% CI: 1.4-5.29) were identified as significant predictors of incomplete immunization. Conclusion and recommendation: In Ethiopia, incomplete immunization is not randomly distributed. Various factors at both individual and community levels significantly influence childhood immunization status in the country. It is crucial to reduce disparities in socio-demographic status through enhanced collaboration across multiple sectors and by bolstering the utilization of maternal health care services. This requires concerted efforts from stakeholders.

Hotspot areas of risky sexual behaviour and associated factors in Ethiopia: Further spatial and mixed effect analysis of Ethiopian demographic health survey.

INTRODUCTION: Sexual behaviour needs to take a central position in the heart of public health policy makers and researchers. This is important in view of its association with Sexually Transmitted Infections (STIs), including HIV. Though the prevalence of HIV/AIDS is declining in Ethiopia, the country is still one of the hardest hit in the continent of Africa. Hence, this study was aimed at identifying hot spot areas and associated factors of risky sexual behavior (RSB). This would be vital for more targeted interventions which can produce a sexually healthy community in Ethiopia. METHODS: In this study, a cross-sectional survey study design was employed. A further analysis of the 2016 Ethiopia Demographic and Health Survey data was done on a total weighted sample of 10,518 women and men age 15-49 years. ArcGIS version 10.7 and Kuldorff's SaTScan version 9.6 software were used for spatial analysis. Global Moran's I statistic was employed to test the spatial autocorrelation, and Getis-Ord Gi* as well as Bernoulli-based purely spatial scan statistics were used to detect significant spatial clusters of RSB. Mixed effect multivariable logistic regression model was fitted to identify predictors and variables with a p-value ≤0.05 were considered as statistically significant. RESULT: The study subjects who had RSB were found to account about 10.2% (95% CI: 9.64%, 10.81%) of the population, and spatial clustering of RSB was observed (Moran's I = 0.82, p-value = 0.001). Significant hot spot areas of RSB were observed in Gambela, Addis Ababa and Dire Dawa. The primary and secondary SaTScan clusters were detected in Addis Ababa (RR = 3.26, LLR = 111.59, P<0.01), and almost the entire Gambela (RR = 2.95, LLR = 56.45, P<0.01) respectively. Age, literacy level, smoking status, ever heard of HIV/AIDS, residence and region were found to be significant predictors of RSB. CONCLUSION: In this study, spatial clustering of risky sexual behaviour was observed in Ethiopia, and hot spot clusters were detected in Addis Ababa, Dire Dawa and Gambela regions. Therefore, interventions which can mitigate RSB should be designed and implemented in the identified hot spot areas of Ethiopia. Interventions targeting the identified factors could be helpful in controlling the problem.

Risk perception of patients with chronic illnesses toward the SARS-CoV-2 in northeastern Ethiopia in 2020.

Introduction: Sever Acute Respiratory Syndrome Corona Virus 2 infections have been sharply rising in Ethiopia, and the virus significantly increases morbidity and fatality rates in patients with coexisting chronic conditions. Therefore, the purpose of this study was to evaluate Risk perception of patients with chronic illnesses toward the SARS-CoV-2 in northeastern Ethiopia in 2020. Methods: From July 21 to August 5, 2020, a cross-sectional study was carried out in a hospital setting with individuals who had chronic illnesses. The study populations included all patients with chronic conditions. The study employed multivariable logistic regression analysis to determine the factors that influence patients' evaluation of the Sever Acute Respiratory Syndrome Corona Virus 2 as low-risk. Results: Four hundred thirteen chronic illness patients participated in this study. Overall, individuals' perceptions of their risk of contracting the Sever Acute Respiratory Syndrome Corona Virus 2 were low in 37.3 % (95 % CI: 32.4-41.9). The results of multivariable analysis showed that low perception of risk towards the outcome was strongly correlated with young adults (AOR = 2.21; 95 % CI: 1.26-3.87), female sex (AOR = 2.16; 95 % CI: 1.37-3.42), and face mask nonusers (AOR = 2.17; 95 % CI: 1.35-3.49). Conclusion: According to this survey, a significant number of patients thought the pandemic posed little risk. The sense of low-risk towards the disease was independently predicted by being female, being a young adult, and not wearing face masks. Patients with chronic illnesses must get focused and enhanced health education in order to lower their elevated risk of morbidity and death.

Patterns of help-seeking behavior among people with mental illness in Ethiopia: a systematic review and meta-analysis.

Background: Despite the availability of evidence-based and effective treatments, significant numbers of people living with mental illness do not receive treatment or do not seek help from providers of formal modern treatment. Although numerous primary studies have been conducted on patterns of help-seeking behavior among individuals with mental illness with respect to modern therapy, the evidence has not been aggregated nationwide. Therefore, the aim of this review was to investigate pooled data on patterns of help-seeking behavior among individuals with mental illness in Ethiopia. Methods: All available primary studies were searched via the Google Scholar, HINARI, and PubMed databases from June 22 to December 20, 2023; 912 articles were identified. Sixteen articles were included in the final review; data from them were extracted to an Excel spreadsheet and exported to Stata version 17 for analysis. The search terms used were: "Pattern of help-seeking behavior'' OR "Pattern of treatment-seeking behavior" OR "Health care-seeking behavior" OR "Help-seeking intention" OR "Help-seeking preferences" OR "Perceived need" OR "Pathways to psychiatric care", AND "Common mental disorders" OR "Mental illness" OR "Mental health problems" OR "Depression", AND "Predictors" OR "Determinate factors" OR "Associated factors", AND "Ethiopia". The quality of the studies included was critically appraised using the modified The Joanna Briggs Institute (JBI) Joanna Briggs Institute quality assessment tool, adapted for observational studies. During critical appraisal, disagreements between the two authors conducting the assessment were resolved by the involvement of a third author. Effect sizes were pooled using the random effects model, and the presence of publication bias was detected based on asymmetry of the funnel plot and a statistically significant result of Egger's test (p<0.05). Results: The pooled rate of positive help-seeking behavior with respect to modern treatment among people living with mental illness was 42.21% (95% CI: 29.29, 55.12; I2 = 99.37%, P=0.00). Factors significantly associated with a positive pattern of help-seeking behavior were: having a secondary education or above (AOR=5.47, 95% CI: 2.33, 12.86); believing that mental illness requires treatment (AOR=2.76, 95% CI: 2.02, 3.78); having strong social support (AOR=2.00, 95% CI: 1.64, 2.44); having a family history of mental illness (AOR=2.68, 95% CI: 1.38, 3.97); having awareness of the availability of treatment (AOR=2.92, 95% CI: 1.56, 5.46); having previously engaged in positive help-seeking behavior (AOR=3.28, 95% CI: 1.63, 6.60); having comorbid disorders (AOR=4.25, 95% CI: 1.69, 10.66); not using alcohol (AOR=3.29, 95% CI: 1.73, 6.27); and the perceived severity of mental illness (AOR=2.54, 95% CI: 1.490, 4.33). Conclusions: The majority of people with mental illness in Ethiopia exhibited a poor pattern of help-seeking behavior with respect to modern treatment. Therefore, mobilization of the community should be encouraged via regular public awareness campaigns regarding mental illness and the availability of evidence-based and effective modern treatment in Ethiopia. Moreover, the design of effective community-based mental health interventions is recommended in order to improve public attitudes and rates of help-seeking behavior in relation to mental health problems.

Trends of Body Mass Index changes among adults on antiretroviral therapy in Northwest Ethiopia: a longitudinal data analysis.

Nutritional status is considered a major diagnostic and prognostic indicator of HIV/AIDS in adults. In this aspect, current HIV-treatment guidelines, particularly in low-income countries, recommend the regular monitoring of body mass index (BMI) to determine patients' clinical response to antiretroviral therapy (ART). However, data regarding the change in BMI status of HIV-positive adults on ART following the implementation of the test and treat strategy were limited in Ethiopia. Hence, this study is aimed at investigating the trends of BMI change over time and its associated factors among HIV-positive adults in Northwest Ethiopia. A retrospective longitudinal study was conducted among 404 randomly selected HIV-positive adults receiving ART in Felegehiwot Comprehensive Specialized Hospital (FHCSH), Northern Ethiopia. Data were extracted from the medical record charts of study participants, entered into Epi-data 4.6 software, and exported to Stata 14.2 software for analysis. A generalized estimating equation (GEE) model was fitted to determine the change in BMI status over time and its predictors in HIV-positive adults. The level of significance was declared at a p-value of < 0.05. More than half (201, or 51.73%) of the total 404 participants were female. In the cohort, both the baseline and follow-up mean body mass index levels of the participants fell in the normal range and increased from 20.34 (standard deviation/SD ± 2.8) to 21.41 (SD ± 3.13). The individual profile plots of 50 participants indicated that there is considerable variability in weight change across individuals. Duration of ART follow-up (ß = 0.203, 95% confidence interval (CI) 0.16 to 0.24), unemployment (ß = - 0.96, 95% CI 1.67 to - 0.25), WHO stage III/IV HIV disease (ß = - 0.92, 95% CI - 1.57 to - 0.35),and Tenofovir/Lamivudine/Dolutegravir (TDF/3TC/DTG)ART regimen (ß = 0.95, 95% CI 0.32 to 1.57) were identified as significant predictors of change in the BMI status of participants. Likewise, the interaction of TDF/3TC/DTG ART regimen * follow-up duration (ß = 2.16, 95% CI 1.84 to 2.84), WHO stage III/IV clinical disease * follow-up duration (ß = - 1.43, 95% CI - 1.71 to - 1.15) and TB/HIV co-infection * follow-up duration (ß = 1.89, 95% CI 1.57 to 2.87) significantly affects the trend in BMI change status of HIV-positive adults. In this study, the BMI status of HIV-positive adults receiving ART increased with a linear trend. Unemployment, stage III/IV HIV diseases, and Tenofovir/Lamivudine/Efavirenz (TDF/3TC/EFV) ART-drug regimen decreases the mean BMI status of HIV-positive adults. Special consideration and strict follow-up need to be given to those individuals with advanced HIV/AIDS diseases and other identified risk group.

Estimate the burden of malnutrition among children with cerebral palsy in Sub-Saharan Africa: a systematic review with meta-analysis.

Malnutrition is more prevalent among children with cerebral palsy and a major factor for child morbidity and mortality in children with different co-morbidity, especially in Sub-Saharan Africa: The main aim of this systematic review and meta-analysis was to estimate the burden of malnutrition among children with cerebral palsy in Sub-Saharan Africa. We searched PubMed, Web of Science, Google Scholar, Research Gate, and institutional repositories for papers that reported the proportion of malnutrition among children with cerebral palsy that were published between December 2010 and September 2023. Data were retrieved using the standardized JBI data extraction checklist through Microsoft Excel, and then exported to STATA 17 for further analysis. DerSimonian and Laird's estimator was used to calculate the pooled effect size in the random-effects model. Statistics such as the Cochran Q test and I2 test were employed to measure heterogeneity. Egger's test and the funnel plot were used to look for publication bias. This systematic review and meta-analysis used 16 studies from Sub-Saharan Africa to estimate the proportion of malnutrition among 2,120 children with cerebral palsy. The pooled proportion of malnutrition among children with cerebral palsy in Sub-Saharan Africa by using random-effects model analysis was found to be 59.7% (95% CI; 49.8-69.6). The proportion of malnutrition was also estimated by sample sizes categorized as ≤ 120 and > 120, and the proportion of malnutrition was found to be 54.0 (95% CI: 44.7-63.3) and 64.5 (95% CI: 50.5-78.5). Moreover, the proportion of malnutrition was estimated by accounting for the difference in the year of publication. In this regard, the study classified before ≤ 2017 and > 2017, and the proportion of malnutrition was found to be 53.7 (95% CI: 38.0-69.3) and 62.5 (95% CI: 49.7-75.3) in Sub-Saharan Africa respectively. Malnutrition among children with cerebral in Sub-Saharan Africa was found to be very high. Hence, enhancing and developing strategic guidelines for malnutrition screening, prevention, and nutritional support are crucial among children with cerebral palsy. Furthermore, systematic review, randomized control trials, and qualitative studies are recommended to understand the burden more among children with cerebral palsy in the continent.

Dental caries and mean values of DMFT among children with cerebral palsy: a systematic review and meta-analysis.

INTRODUCTION: One of the most prevalent causes of physical disability in children is cerebral palsy (CP), which is a series of complicated neurological disorders. Children with cerebral palsy suffer from multiple problems and potential disabilities, including dental caries. Hence, this study aimed to determine the pooled prevalence of dental caries and mean DMFT (Decayed, Missed, and Filled Permanent Teeth) among children with cerebral palsy in Africa and Asia. METHODS: A comprehensive search of the literature was made to locate relevant studies in PubMed/Medline, HINARI, Web of Science, Science Direct, the Cochrane Library, the Worldwide Science Database, and Google Scholar. The data were extracted in Microsoft Excel and transferred to Stata version 17 software for further analysis. A random-effect model was employed to estimate the pooled prevalence of dental caries and the pooled mean value of DMFT among children with cerebral palsy in Africa and Asia. Heterogeneity between studies was checked using the Cochrane Q test and I2 test statistics. Sub-group analysis by continent was done, and sensitivity analysis was checked. A small study effect was checked using Egger's statistical test at the 5% level of significance. RESULTS: In this study, 25 original studies conducted in 17 countries in Africa and Asia that fulfilled the eligibility criteria were included in the review. The overall pooled prevalence of dental caries in Africa and Asia among children with cerebral palsy was 55.6% (95% CI: 42.4, 68.8). The pooled prevalence of dental caries among children with cerebral palsy in Africa was 42.43% (95% CI: 30.39, 54.58), and it was slightly higher in Asia with 64% (95% CI: 48.32, 79.72). In the random effect model analysis, the pooled mean DMFT of dental caries in children with cerebral palsy was 2.25 (95% CI: 1.86, 2.64). The pooled mean DMFT in Africa was 1.47 (95% CI: 0.86, 2.09), and in Asia it was 3.01 (95% CI: 2.43, 3.60). CONCLUSION: In this study, we found that children with cerebral palsy experienced an alarming rate of dental caries. In these settings, dental caries affected roughly more than half of the children with cerebral palsy. Hence, oral health promotion initiatives should target children with CP, and this group of children must receive early preventive dental care.

Hotspot areas of tetanus-unprotected births and its associated factors in Ethiopia: Spatial analysis of EDHS data.

Neonatal tetanus persists as a public health problem in many developing countries including Ethiopia. Maternal tetanus toxoid vaccination is a cornerstone to prevent neonatal tetanus. However, its prevalence is low in Ethiopia, and little has been devoted to its spatial epidemiology and associated factors. Hence, this study aimed to explore the spatial pattern and factors affecting tetanus-unprotected births in Ethiopia. A further analysis of the 2016 Ethiopia Demographic and Health Survey data was conducted, and a weighted sample of 7590 women was used for analysis. Spatial analysis was done using ArcGIS and SaTScan software. A binary logistic regression model was fitted to identify factors and variables with a p-value <.05 were considered as statistically significant. About 54.13% (95% CI: 53.01, 55.25) of births were not protected against neonatal tetanus, and spatial clustering of tetanus unprotected births was observed (Moran's I = 0.144, p-value = .028). The primary and secondary SaTScan clusters were detected in Northeastern Tigray, Eastern Amhara, and almost the entire Afar (RR = 1.34 & LLR = 66.5, p < .01), and in the Somali region, and the western border of Gambela (RR = 1.44 & LLR = 31.3, p < .01), respectively. Tetanus unprotected births were higher among women without formal education (AOR = 1.63; 95% CI: 1.29, 2.04), came from poor households (AOR = 1.27; 95% CI: 1.12, 1.45), who had no ANC contact (AOR = 6.97; 95% CI: 6.21, 7.88), and who were not exposed to the media (AOR = 1.26; 95% CI: 1.09, 1.47). Hence, tetanus-unprotected birth hotspots require priority interventions, and it is good if the targeted interventions consider the identified factors.

Neonatal outcomes of preterm neonates and its predictors in Ethiopian public hospitals: Multicenter prospective follow-up study.

Introduction: Preterm birth remains the most significant clinical and public health encounter. Preterm infant outcomes pose key evidence for clinicians and policymakers and are extensively used to set clinical and policy verdicts to improve services. It is necessary to conduct the outcomes of neonates frequently, as it varies from place to place and even from time to time in a similar place. There is limited literature in Ethiopia about preterm neonates' outcomes and their predictors. Objective: This study aimed to assess the neonatal outcomes of preterm neonates and their predictors in South Gondar zone public hospitals, Northwest Ethiopia, 2021. Methods: A prospective observational study was employed on 462 preterm neonates in South Gondar Zone Public Hospitals. The data were entered into Epidata 4.6 and analyzed using STATA version 16/MP software. A parametric log-normal survival model was used to identify possible predictors for preterm neonate death. Statistical significance was declared at a P-value less than 0.05. Result: The overall preterm survival rate was 71.1% (95% CI: 66.7, 75.1). Thirty-six percent of preterm neonates were diagnosed with sepsis. One-fourth of the neonates had respiratory distress syndrome. Gestational age greater than 34 weeks (ß = 1.04; 95% CI: 0.53, 1.56), respiratory distress syndrome (ß = 0.85; 95% CI: 0.49, 1.22), body mass index (ß = -1.34; 95% CI: -1.87, -0.80), non-union marital status (ß = -0.71; 95% CI: -1.34, -0.09), multiple pregnancies (ß = -0.66; 95% CI: -0.99-0.32), multiparous (ß = 0.35; 95% CI: 0.01, 0.69), hypothermia (ß = -1.19; 95% CI: -1.76, -0.62), Kangaroo Mother Care (ß = -1.9; 95% CI: -2.34, -1.41) and non-cephalic presentation (ß = -1.23; 95% CI: -1.99,-0.46) were significant predictors. Conclusion: In this study, the preterm survival rate was low. Gestational age greater than 34 weeks, no respiratory distress syndrome, and multiparous mothers were positively associated with the survival of preterm neonates. Though, high pre-pregnancy maternal body mass index, non-union marital status of mothers, multiple pregnancies, hypothermia, Kangaroo mother care is not given, and non-cephalic presentation were negatively associated. A significant focus should be given to implementing WHO recommendations on preventing and caring for preterm births.

Comparison of circulating lipid profiles, D-dimer and fibrinogen levels between hypertensive patients with and without stroke.

Background: Stroke is one of the leading causes of global mortality and disability, particularly in hypertensive patients. This study aimed to compare lipid profile, fibrinogen, and D-dimer levels between hypertensive patient with and without stroke. Methods: This was a facility-based cross-sectional study conducted from November 2022 to January 2023 among 115 hypertensive patients (70 patients without stroke and 45 with stroke) who had follow-up at Yikatit 12 Hospital Medical College, Ethiopia. All data analyses were done using SPSS version 25.0 and comparisons of variables between groups were made using the Chi-square test, independent sample t-test, and Mann-Whitney U test. Multiple logistic regression analysis was done to identify predictors of stroke among hypertensive patients. A p-value <0.05 was assumed to be statistically significant for all statistical tests. Results: Significantly elevated levels of TC, LDL-C, D-DI, and fibrinogen were observed in the stroke group than in the non-stroke group (p-value<0.05). The mean values of TC, D-DI, and fibrinogen were significantly higher in patients with ischemic stroke compared to those with hemorrhagic stroke. Duration of hypertension (AOR: 1.21; CI: 1.10, 2.09), TC (AOR:1.07; CI: 1.01, 1.22), D-DI (AOR: 1.15; CI: 1.05, 1.69) and fibrinogen (AOR:1.19; CI: 1.10, 2.89) were identified to be independent predictors of stroke in hypertensive patients. Conclusion: The circulating levels of TC, LDL-C, D-DI and fibrinogen in hypertensive patients with stroke were significantly higher than in those without stroke. But only TC, D-DI, and fibrinogen were found to be predictors of stroke in hypertensives. Considerably higher TC, D-DI, and fibrinogen levels were also seen in patients with ischemic stroke than in those with hemorrhagic stroke. This confirms the key roles of dyslipidemia (hypercholesterolemia) and aberrant hemostatic activation to stroke development, notably ischemic stroke.

Survival status and predictors of mortality from severe community-acquired pneumonia among under-five children admitted at Debre Tabor comprehensive specialized hospital: a prospective cohort study.

Background: Globally, Pneumonia continues to be the leading cause of mortality among under-five children. Ethiopia ranks fourth out of 15 countries worldwide in terms of the highest death rate of under-five children due to severe community-acquired pneumonia (SCAP). However, to date, there is no recent study that shows survival status and predictors of mortality from SCAP. Therefore, this study aimed to determine survival status and predictors of mortality from this dangerous disease among under-five children. Methods: A facility-based prospective cohort study was conducted from 1 November 2021 to 31 October 2022 at Debre Tabor comprehensive specialized hospital. All under-five children with SCAP admitted during the study period were included. Participants were selected using a systematic sampling technique. The collected data were coded, edited, and entered into epi-data version 4.2 and then exported to STATA version 17 for further analysis. The Kaplan Meier failure estimate with log-rank test was employed to determine the survival estimates. A cox-proportional hazard regression model was fitted to identify significant variables. Results: The overall incidence density rate of mortality was 5.7 /1000 children with a median hospital stay of 8.2 days. Heart disease (AHR: 4.37; 95%CI: 1.68-11.32), previous admission of SCAP (AHR: 3.87; 95% CI: 1.31-11.43), WFL < -3Z score (AHR: 3.57; 95% CI: 1.02-12.42), impaired consciousness level at admission 3.41(1.14-10.19), and pleural effusion (AHR: 3.42; 95%CI: 1.18-9.93) were significant predictors of mortality. Conclusion: In this study, the survival probability of children with SCAP was low. Children with heart disease, previous admission of SCAP, WFL < -3Z score, impaired consciousness level at admission, and pleural effusion had low survival. Therefore, much emphasis is needed on children with SCAP, particularly those with identified predictors.

Health care providers' preparedness and health care protection against the third wave of COVID-19 pandemics in a resource-limited setting in Southwest Ethiopia: a multi-center cross-sectional study.

Introduction: the provision of quality health care during the COVID-19 pandemic depends largely on the health of health care providers. Health care providers as frontline caregivers dealing with infected patients play a significant role in limiting the outbreak of the disease by implementing safety and prevention practices. However, low and middle-income countries experience barriers to preparedness due to limited resources. Methods: an institutional-based cross-sectional study was conducted among 326 health care providers from August 10-25, 2021 in Gurage zonal public hospitals. A simple random sampling technique was used to select the study participants. A pretested self -administered structured questionnaire was used as a data collection tool. The data were entered into the Epi-data 3.1 and exported to Statistical package for the social sciences (SPSS) version 25.0 for analysis. Both descriptive statistics and inferential statistics were presented. Results: this study showed that 53.1%, of health care providers, had adequate preparation against COVID-19 pandemics. The finding showed that monthly income, occupation, and working experience were found to be significantly associated with health care providers' preparedness. Nearly one-quarter (24.8%), 28.3%, 34.5%, and 39.8% of health care providers had access to facemasks, alcohol sanitizer, glove, and isolation gowns respectively. Conclusion: the levels of health care providers' preparedness and health care protection against the third wave COVID-19 pandemic were found to be low. Based on our findings, the government and other stakeholders should design interventions to increase health care providers' preparedness to respond to the ongoing pandemic and purchase an adequate supply of personal protective equipment to protect the health care providers.

The median time to stopover exclusive breastfeeding among employed and unemployed mothers of infants aged 6-12 months in Ethiopia, 2019.

Early discontinuation of breastfeeding is known to be associated with avoidable childhood morbidity and mortality. The effect of maternal employment on the duration of exclusive breastfeeding and its determinants has not been addressed adequately in in Ethiopia in general and in the stud area in particular. Hence, this study was aimed to compare the time to stop exclusive breastfeeding and its determinants among employed and unemployed mothers of infants 6-12 months of age. A community-based comparative cross-sectional study was conducted from March 1 to 30, 2019. A total of 426 mothers were recruited using a simple random sampling technique. The Kaplan-Meier curve with log-rank test was used to compare the difference in cessation of exclusive breastfeeding before 6 months. Bivariate and Cox proportional hazards model were computed. Hazard ratios and their 95% confidence intervals were computed to determine the level of significance. Four hundred twenty-six (213 employed and 213 un-employed) mothers were included in the final analysis. The median duration of exclusive breastfeeding was 4 months and 6 months for infants of employed and unemployed mothers, respectively. The likelihood of ceasing of exclusive breastfeeding before 6 months of age was significantly associated with family support of exclusive breastfeeding [AHR = 3.99, 95% CI (1.9, 8.3)], and lack of exclusive breastfeeding counseling during postnatal care [AHR = 7.76, 95% CI (2.99, 20.1)], primipara mothers [AHR = 1.5, 95% CI (1.14, 2.04)], maternity leave of 4 months [AHR = 7, 95% CI 2.2, 22.2)] and employed mothers [AHR = 3.77, 95% CI (2.4, 5.9)]. The median duration of exclusive breastfeeding was shorter among employed mothers than un-employed mothers. It is clear from this study that cessation of exclusive breastfeeding was associated with the duration of paid maternity leave for employed mothers. Family support and perceived adequacy of breast milk were associated with cessation of exclusive breastfeeding before 6 months among unemployed mothers.

Maximizing the detection rate of hypoglycemia among preterm neonates admitted in Neonatal intensive care unit in Ethiopia, 2021.

The burden of hypoglycemia is high in resource limited countries, such as Ethiopia. However, there are no sufficient studies conducted in Ethiopia in general and in the study setting in particular in the previous era. Hence, this study aims to assess the proportion of hypoglycemia and associated factors among preterm neonates admitted to the neonatal intensive care unit at Debre Tabor Comprehensive Specialized Hospital, Ethiopia, in 2021. A hospital-based cross-sectional study was conducted from October 1 to December 30, 2021, at Debre Tabor Comprehensive Specialized Hospital in the neonatal intensive care unit ward. The data was entered in Epi-info 7 and exported to STATA version 14. A binary and multivariable logistic regression was computed at 95% confidence interval (CI). During bivariable analysis, variables having a p-value of less than 0.25 were chosen for multivariable logistic regression analysis, and variables having a p-value of less than 0.05 in multivariable analysis, were significant associations with the dependent variable. The study included 267 preterm neonates, and 23.59% (95% CI 18.9-29.1) were develop hypoglycemia. Moreover, 49 (18.35%) preterm neonates died during the study period. In this study, preterm neonates with hypothermia [Adjusted Odds Ratio (AOR = 4.5; 95 CI 3.4, 7.2)], birth asphyxia (AOR = 5.1; 95 CI 3.9, 27.1), seizure (AOR = 4.7; 95 CI 2.8, 17.8), and also preterm neonates born from diabetic mothers (AOR = 6.7; 95 CI 3.3, 27.2) were significantly associated with the occurrence of hypoglycemia in the neonatal intensive care. The proportion of hypoglycemia and associated factors among preterm neonates admitted to the neonatal intensive care unit at Debre Tabor Comprehensive Specialized Hospital was found to be high. The associated factors for the occurrence of hypoglycemia were discovered to be neonates with hypothermia, birth asphyxia, seizure, and neonates born with a diabetes mother. Thus, recognizing and treating the above associated factors is essential to preventing, and controlling hypoglycemia.

Magnitude of stunting and its determinant factors among children age 6-59 months at Debre Tabor comprehensive specialized hospital, South Gondar zone, North central Ethiopia, 2020.

Introduction: malnutrition continues to be a significant public health and development concern not only in the developing country but also in the world. It is a serious problem because it is causing the deaths of 3.5 million children under 5 years old per- year. Methods: Institution based cross-sectional study design was employed using sample of 342 children selected through systematic simple random sampling technique from May 1st -July30 /2020. Bivariate and multivariate logistic regression analysis was used. The variables which had significant association were identified on the bases of P value<0.05 and AOR 95% CI. Result: The analysis this study revealed that, 42.6% of children were stunted. The main associated factors of stunting were found to be birth order of the child, maternal occupation, frequency meal per day, mother who did not wash their hand before breastfeeding, (AOR=1.636:95%CI:1.00-2.674), children who were not vitamin A, supplemented (AOR=1.901, 95%CI: 1.162-3.109), and child whose mother were not use family planning (AOR=2.916, 95%CI: 1.064-7.989 were associated with outcome variable. Conclusion and recommendation: From the findings of this study, it is concluded that stunting is still an important problem among children aged 6-59 months. Especial attention should be given on intervention of malnutrition.