Bacterial contamination of healthcare workers' mobile phones in Africa: a systematic review and meta-analysis.

BACKGROUND: Mobile phones are potential reservoirs for pathogens and sources of healthcare-associated infections. More microbes can be found on a mobile phone than on a man's lavatory seat, the sole of a shoe, or a door handle. When examining patients, frequent handling of mobile phones can spread bacteria. Nevertheless, evidence of bacterial contamination of mobile phones used by healthcare workers in Africa was inconclusive. Thus, this meta-analysis and systematic review was conducted to estimate the pooled prevalence of bacterial contamination of mobile phones used by healthcare workers and the most frequent bacterial isolates in Africa. METHODS: We systematically retrieved relevant studies using PubMed/MEDLINE, POPLINE, HINARI, Science Direct, Cochrane Library databases, and Google Scholar from July 1, 2023 to August 08, 2023. We included observational studies that reported the prevalence of bacterial contamination of mobile phones among healthcare workers. The DerSimonian-random Laird's effect model was used to calculate effect estimates for the pooled prevalence of bacterial contamination in mobile phones and a 95% confidence interval (CI). RESULTS: Among 4544 retrieved studies, 26 eligible articles with a total sample size of 2,887 study participants were included in the meta-analysis. The pooled prevalence of mobile phone bacterial contamination among healthcare workers was 84.5% (95% CI 81.7, 87.4%; I2 = 97.9%, p value < 0.001). The most dominant type of bacteria isolated in this review was coagulase-negative staphylococci (CONS) which accounted for 44.0% of the pooled contamination rate of mobile phones used by healthcare workers, followed by Staphylococcus aureus (31.3%), and Escherichia coli (10.7%). CONCLUSIONS: In this review, the contamination of mobile phones used by HCWs with various bacterial isolates was shown to be considerable. The most prevalent bacteria isolates were coagulase-negative staphylococci, Staphylococcus aurous, and Escherichia coli. The prevalence of bacterial contamination in mobile phones varies by country and sub-region. Hence, healthcare planners and policymakers should establish norms to manage healthcare workers' hand hygiene and disinfection after using mobile phones.

Prevalence of Trachoma after Implementation of Trachoma Elimination Interventions in Oromia Regional State, Ethiopia: Results of Impact Surveys in 131 Evaluation Units Covering 139 Districts.

PURPOSE: To determine the prevalence of trachomatous inflammation-follicular (TF), trachomatous trichiasis (TT), water, sanitation, and hygiene (WASH) access in 131 evaluation units (EUs) after implementation of trachoma elimination interventions in Oromia Region, Ethiopia. METHODOLOGY: A population-based cross-sectional survey was conducted in each EU using the World Health Organization-recommended two-stage cluster-sampling methodology. Twenty-six clusters, each with a mean of 30 households were enumerated in each EU. All residents aged ≥1 year in selected households were examined for TF and TT. Information on WASH access in surveyed households was also collected through questioning the household head and direct observation. RESULTS: A total of 419,858 individuals were enumerated in 131 EUs, of whom 396,134 (94%) were examined, 54% being female. Age-adjusted EU-level prevalence of TF in children aged 1-9 years ranged from 0.15% (95% confidence interval [CI]: 0.0-0.4) to 37.5% (95% CI: 31.1-43.7). The TF prevalence was <5% in 73/131 (56%) EUs. The EU-level age- and gender-adjusted prevalence of TT unknown to the health system among people aged ≥15 years ranged from 0.001% (95% CI: 0.00-0.02) to 2.2% (95% CI: 1.1-3.1) with 37/131 (28%) EUs having a prevalence <0.2%. Only 48% of all households surveyed had access to improved water sources for drinking. Approximately 96% of households did not have an improved latrine. CONCLUSION: Oromia is on the path towards elimination of trachoma as a public health problem.

Prevalence of Trachoma in Pre-validation Surveillance Surveys in 11 Evaluation Units (Covering 12 Districts) in Oromia Regional State, Ethiopia: Results from 2018-2020.

PURPOSE: Interventions to reduce the prevalence of trachoma and transmission of ocular Chlamydia trachomatis have been implemented in Oromia Region, Ethiopia. Following an impact survey in which the trachomatous inflammation-follicular (TF) prevalence in 1-9-year-olds is <5%, a surveillance survey is recommended 2 years later, without additional antibiotic treatment. We report results of surveillance surveys in 11 evaluation units (EUs) covering 12 districts in Oromia Region, to plan whether future interventions are needed. METHOD: We use a two-stage cluster-sampling cross-sectional survey design. In each EU, 26 clusters (villages) were systematically selected with probability proportional to size; from each cluster, 30 households were selected using compact segment sampling. Water, sanitation and hygiene (WASH) access was assessed in all selected households. All residents of selected households aged ≥1 year were examined for TF and trachomatous trichiasis (TT) by certified graders. RESULT: Of 31,991 individuals enumerated, 29,230 (91% of) individuals were examined. Eight EUs had an age-adjusted TF prevalence in 1-9-year-olds of ≥5% and seven had a TT prevalence unknown to the health system among adults aged ≥15 years of ≥0.2%. About one-third of visited households had access to an improved water source for drinking, and 5% had access to an improved latrine. CONCLUSION: Despite TF reductions to <5% at impact survey, prevalence recrudesced to ≥5% in all but three of the 11 EUs. Operational research is needed to understand transmission dynamics and epidemiology, in order to optimise elimination strategies in high-transmission settings like these.

Work-Related Musculoskeletal Symptoms and Associated Factors Among Academic Staff in Ethiopian Universities.

Background: Work-related musculoskeletal symptoms (WMSs) are common injuries or pains that primarily affect various body structures. It is difficult to estimate the burden of WMSs in developing countries such as Ethiopia due to a lack of evidence, particularly among university academic staff. There is a universal and rapidly growing need for information about WMSs, as this is the main challenge to public health and economic burden. The purpose of this study was to determine the magnitude of work-related musculoskeletal symptoms and their associated factors among academic staff in Ethiopian universities. Methods: From February 2 to March 24, 2021, a web-based cross-sectional study was conducted among 422 academic staff members working in Ethiopian universities. A structured and self-administered Google Form questionnaire was sent and shared with the academic staff via their email addresses, Facebook, and Telegram accounts. Using a p-value of <0.05 and a 95% confidence interval, multivariable logistic regression was used to identify factors associated with the outcome variable. Results: Around 321 (77.2%) of the 416 participants were reported to have work-related musculoskeletal symptoms at least in one part of the body (95% CI: 73.1, 81.5%), with 28.1% reporting lower back pain. Respondents working in second-stage universities (AOR = 7.35, 95% CI 3.21, 16.79), being 44 years old or older (AOR = 7.89, 95% CI 2.10, 21.57), having a Ph.D. (AOR = 7.09, 95% CI 1.50, 17.93), engaging in physical activity (AOR = 3.32, 95% CI 1.43, 7.74), and working on a computer (AOR = 6.89, 95% CI 2. 0.72, 19.15) were the factors associated with work-related musculoskeletal symptoms. Conclusion: Almost three-quarters of academic staff reported work-related musculoskeletal symptoms in this survey. Factors such as university establishment stage, age, educational status, physical activity, and frequent computer use were found to be significantly associated with work-related musculoskeletal symptoms.

Prevalences of diabetic foot ulcer and foot self-care practice, and associated factors in adult patients with diabetes in south-east Ethiopia.

OBJECTIVE: We aimed to assess the prevalences of foot ulcer and foot self-care practices, and identify associated factors in adult patients with diabetes attending a referral hospital in south-east Ethiopia. METHODS: We performed a cross-sectional study of 267 diabetic patients. Multivariable binary logistic regression was used to identify factors associated with diabetic foot ulcer and foot self-care practice. RESULTS: The prevalence of diabetic foot ulcer was 11.2% (95% confidence interval [CI] 7.42-15.05). One hundred and forty-four (53.9%; 47.9, 59.9) patients demonstrated good foot self-care. Living rurally (adjusted odds ratio 2.27; 95% CI: 1.86-6.97), lack of regular exercise (3.91; 1.51-10.10), peripheral neuropathy (2.77; 1.05-7.33) and foot calluses (5.69; 1.74-18.59) were associated with diabetic foot ulcer. Urban inhabitants (2.01; 1.09-3.69), patients with diabetes for >10 years (2.92; 1.48-5.77), women (2.95; 1.66-5.22), and patients with a glucometer at home (2.05; 1.09-3.85) were more likely to have good foot self-care practice. CONCLUSION: The prevalence of diabetic foot ulcer was 11.2%. This prevalence is lower than those identified in other Ethiopian studies. However, patient awareness regarding foot self-care practice and risk reduction should be improved.

Prevalence and Factors Associated with Diabetic Retinopathy among Adult Diabetes Patients in Southeast Ethiopia: A Hospital-Based Cross-Sectional Study.

Background: Diabetic retinopathy (DR) is the most prevalent microvascular consequence of diabetes mellitus, and it can result in blindness that is irreversible. Due to delayed diagnosis and limited access to diabetic care, the situation is even worse in developing countries. Scientific evidence on the prevalence of DR and its associated factors among diabetes patients in low-income countries, such as Ethiopia, is limited. This study aimed to determine the prevalence of DR and associated factors among adult diabetes patients in southeast Ethiopia. Methods: A hospital-based cross-sectional study was conducted among diabetes patients who visited Madda Walabu University Goba Referral Hospital. Fundus and slit-lamp examination were performed for screening of DR. Multivariate binary logistic regression was computed to identify factors associated with DR. Results: A total of 256 patients (144 men, 56.2%) aged 50.15±15.71 years were included in the study. The prevalence of any DR was 19.9% (95% CI 15.4%-25.3%), mild nonproliferative diabetic retinopathy (NPDR) 10.9% (95% CI 7.6%-15.4%), moderate NPDR 5.9% (95% CI 3.5%-9.5%), severe NPDR 0.9% (95% CI 0.2%-3.9%), and proliferative DR 2.3% (95% CI 1.0%-5.1%). Duration of diabetes ≥10 years (AOR 10.22, 95% CI 1.70-61.44), central obesity (AOR 5.42, 95% CI 1.38-21.19), overweight/obese (AOR 2.65, 95% CI 1.02-6.92), lower high-density lipoprotein (HDL) cholesterol (AOR 5.82, 95% CI 1.86-18.24), moderate triglyceride:HDL cholesterol ratio (AOR 4.13, 95% CI 1.13-15.15), and urban dwelling (AOR 2.84, 95% CI 1.04-7.78) were significantly associated with DR. Conclusion: One in every five DM patients had DR. Sociodemographic, anthropometric, and blood lipids were independently associated with DR. To reduce the burden of diabetes, strategies that focus on lifestyle modifications targeted at identified modifiable risk factors are essential.

Incidence and risk factors of gestational diabetes mellitus in Goba town, Southeast Ethiopia: a prospective cohort study.

OBJECTIVE: Gestational diabetes mellitus (GDM) is becoming a public health concern in low/middle-income countries, and is known to cause severe morbidity and mortality for mothers and newborns. However, evidence reported for the incidence and risk factors of GDM is scant in Ethiopia. We aimed to assess the incidence of, and risk factors for, GDM in Goba town, Southeast Ethiopia. DESIGN: Prospective cohort study. SETTING: Goba town, Southeast Ethiopia. PARTICIPANTS: Four hundred eighty pregnant women on antenatal care follow-up from 30 April to 30 September 2021. PRIMARY AND SECONDARY OUTCOMES: Incidence and risk factors of GDM using fasting capillary blood glucose. Log-binomial model was used to identify the risk factors of GDM. Adjusted relative risk (aRR), along with 95% CIs, were calculated to estimate the strength of associations. RESULTS: The cumulative incidence rate of GDM in this study was 15.7% (95% CI: 12.3% to 19.2%). Being unemployed (aRR=2.73; 95% CI: 1.36 to 5.47), having a family history of diabetes mellitus (DM) (3.01; 2.09 to 4.35), low physical activity (2.43; 1.11 to 5.32), inadequate dietary diversity (1.48; 1.29 to 1.92), anaemia (2.51; 1.32 to 3.54) and antenatal depression (4.95; 3.35 to 7.31) were significantly associated with GDM. CONCLUSION: The cumulative incidence of GDM was relatively high among the study participants. Having antenatal depression symptoms, low physical activity, inadequate dietary diversity, being unemployed, anaemia and a family history of DM were significant risk factors for GDM.

Case fatality rate and its determinants among admitted stroke patients in public referral hospitals, Northwest, Ethiopia: A prospective cohort study.

According to the global burden of disease 5.5 million deaths were attributable to stroke. The stroke mortality rate is estimated to be seven times higher in low-income countries compared to high-income countries. The main aim of the study was to assess the 28 days case fatality rate and its determinants among admitted stroke patients in public referral hospitals, in Northwest Ethiopia. A hospital-based prospective cohort study was conducted from December 2020 to June 2021. The study population was 554 stroke patients. Based on Akakian Information Criteria, the Gompertz model was fitted to predict the hazard of death. The study included admitted stroke patients who were treated in the general medical ward and neurology ward. The mean age of the participants was 61 ± 12.85 years and 53.25% of the patients were female. The 28-days case fatality rate of stroke was 27.08%. The results from Gompertz parametric baseline hazard distribution revealed that female sex adjusted hazard rate (AHR = 0.27, 95% CI:0.18-0.42), absence of a family history of chronic disease (AHR = 0.50, 95%CI:0.29-0.87), good GCS score (AHR = 0.21, 95% CI:0.09-0.50) and the absence of complication during hospital admission (AHR = 0.16, 95% CI:0.08-0.29) were factors which decrease hazard of 28 days case fatality rate. While, hemorrhagic stroke sub-type (AHR = 1.38, 95% CI:1.04-3.19), time from symptom onset to hospital arrival (AHR = 1.49, 95% CI:1.57-2 .71), time from confirmation of the diagnosis to initiation of treatment (AHR = 1.03, 95% CI:1.01-1.04), a respiratory rate greater than 20 (AHR = 7.21, 95% CI:3.48-14.9), and increase in NIHSS score (AHR = 1.16, 95% CI:1.10-1.23) were factors increasing hazard of 28 days case fatality rate of stroke. At 28-days follow-up, more than one-fourth of the patients have died. The establishment of separate stroke centers and a network of local and regional stroke centers with expertise in early stroke evaluation and management may address challenges.

Prevalence of visual impairment due to refractive error among children and adolescents in Ethiopia: A systematic review and meta-analysis.

INTRODUCTION: Globally, the prevalence of refractive error was 12%, and visual impairment due to refractive error was 2.1%. In sub-Saharan Africa, the prevalence of refractive error and visual impairment due to refractive error was 12.6% and 3.4%, respectively. In Ethiopia, the prevalence of visual impairment due to refractive error varies from 2.5% in the Gurage zone to 12.3% in Hawassa city. Hence, this Meta-analysis aimed to summarize the pooled prevalence of visual impairment due to refractive error in Ethiopia. METHODS: A systematic search of the literature was conducted by the authors to identify all relevant primary studies. All articles on the prevalence of visual impairment due to refractive error in Ethiopia were identified through a literature search. The databases used to search for studies were PubMed, Science Direct, POPLINE, HENARI, Google Scholar, and grey literature was searched on Google until December 15, 2021. In this meta-analysis, the presence of publication bias was evaluated using funnel plots and Begg's tests at a significance level of less than 0.05. The sensitivity analysis was conducted to check for a single study's effect on the overall prevalence of refractive error. RESULT: About 1664 studies were retrieved from initial electronic searches using international databases and google searches. A total number of 20,088 children and adolescents were included in this meta-analysis. The pooled prevalence of visual impairment due to refractive error in Ethiopia using the random effects model was estimated to be 6% (95% CI, 5-7) with a significant level of heterogeneity (I2 = 94.4%; p < 0.001). The pooled prevalence of visual impairment due to refractive was analyzed by subtypes, and pooled prevalence was estimated to be 4%, 5.2%, and 1% for myopia, hyperopia, and astigmatism, respectively. CONCLUSION: The pooled prevalence of visual impairment due to refractive error was high in Ethiopia. About one in twenty-five Ethiopian children and adolescents are affected by visual impairment due to myopia.

Prevalence of depression and associated factors among people living with HIV/AIDS in public hospitals of Southeast Ethiopia.

BACKGROUND: Depression is the most frequent mental health condition among human immune deficiency virus or acquired immune deficiency syndrome (HIV/AIDS) patients. It has been related to negative health outcomes. This could lead to hospitalization and an increase in medical expenses. This study aimed to assess the prevalence of depression and associated factors among HIV/AIDS patients in public hospitals Bale Zone, Southeast Ethiopia. METHODS: A hospital-based cross-sectional study design was randomly employed among 554 study participants. A systematic random sampling technique was used to select the study subjects. A structured Patients Health Questionnaires- 9 was used to measure the depression status of HIV/AIDS patients. Data were collected using a pretested interviewer administered structured questionnaire as well as review of patients medical charts or records. Descriptive statistics were computed. Multivariable logistic regression analyses were conducted identify factors associated with the prevalence of depression. Adjusted odds ratio (AOR), along with a 95% confidence interval (CI), was used to estimate the strength of the association. A p-value of < 0.05 was considered statistically significant. RESULTS: The prevalence of depression among the study participants was found to be 44.9% (95% CI: 40.79%, 49.1%). Perceived HIV related stigma is the single most dominant predictor of depression [(AOR = 8.2, 95% CI: (4.96, 13.68)], low income level [(AOR = 3.1, 95% CI: (1.59, 6.22)] Experiencing any form of a side effect of highly active anti-retroviral therapy (HAART) [(AOR = 1.5, 95% CI: (1.04, 2.56)], having normal BMI [(AOR = 0.49, 95% CI: (0.29, 0.8)] being HIV patients at WHO clinical stage II [(AOR = 0.44, 95% CI: (0.22, 0.9)], were significantly associated with prevalence of depression. CONCLUSION: The study revealed that the prevalence of depression among people living with HIV in the study settings was high, almost two out of every five HIV patients were depressed. Low income level, side effect to HAART, and having HIV related stigma were more likely to suffer from depression.

Prevalence of central obesity and its associated risk factors among adults in Southeast Ethiopia: A community-based cross-sectional study.

BACKGROUND: Obesity and overweight are known public health problems that affect populations across the world. These conditions have been associated with a wide range of chronic diseases including type 2 diabetes mellitus, cardiovascular disease, and cancers. In Ethiopia, the literature regarding the burden of central (abdominal) obesity is scarce. This study aimed to fill this gap by assessing the prevalence and risk factors associated with central obesity among adults in Ethiopia. METHODS: From May to July 2021, a community-based cross-sectional survey was conducted on a sample of 694 adults aged ≥18 years in administrative towns of Bale zone, Southeast Ethiopia. Multi-stage sampling followed by systematic random sampling was employed to identify study participants. Waist and hip circumferences were measured using standard protocols. The World Health Organization STEPS wise tool was used to assess risk factors associated with central obesity. Bi-variable and multi-variable binary logistic regression were used to identify factors associated with central obesity. Adjusted odds ratios (AOR) and their corresponding 95% confidence intervals (CI) have been reported to estimate the strength of associations. RESULTS: The overall prevalence of central obesity using waist circumference was 39.01% [(95% CI: 35.36-42.76; 15.44% for men and 53.12% for women)]. Multi-variable binary logistic regression analysis revealed that female sex (AOR = 12.93, 95% CI: 6.74-24.79), Age groups: 30-39 years old (AOR = 2.8, 95% CI: 1.59-4.94), 40-49 years (AOR = 7.66, 95% CI: 3.87-15.15), 50-59 years (AOR = 4.65, 95% CI: 2.19-9.89), ≥60 years (AOR = 12.67, 95% CI: 5.46-29.39), occupational status like: housewives (AOR = 5.21, 95% CI: 1.85-14.62), self-employed workers (AOR = 4.63, 95% CI: 1.62-13.24), government/private/non-government employees (AOR = 4.68, 95% CI: 1.47-14.88), and skipping breakfast (AOR = 0.46, 95% CI: 0.23-0.9) were significantly associated with central obesity. CONCLUSIONS: Abdominal obesity has become an epidemic in Bale Zone's towns in Southeastern Ethiopia. Female sex, age, being employed were positively associated with central obesity, while skipping breakfast was a protective factor.

The Elevation of Pancreatic Enzymes in Serum and Their Distribution at Different Stages of Renal Insufficiency Among Diabetic Patients Attending Goba Referral Hospital.

Introduction: Acute pancreatitis is auto-cell destruction that is manifested by increased leakage of amylase and lipase into circulation. During pancreatitis, the activity of serum amylase and lipase is elevated three times above the upper limit of the normal range. This elevation was observed in both prediabetic and diabetic patients. Severe acute pancreatitis can result in acute kidney injury and other multi-organ dysfunction, which is one of the reasons for death. Objective: This study aimed to evaluate the elevation of serum amylase and lipase and their distribution at different stages of renal insufficiency among diabetic patients. Methods: This study included 286 diabetic patients (36 type 1 and 250 type 2), and data were collected from May 1 to June 30, 2019. The study design used was an institution-based cross-sectional study. A face-to-face interview was used to collect data, and serum creatinine, amylase, and lipase levels were measured using a chemistry analyzer. For data entry and statistical analysis, respectively, Epidata software version 3.02 and SPSS version 21 were used. Results: The mean serum amylase among diabetic patients suffering from G3b and G4 was 106.79 IU/L ± 118.18 IU/L and 104.85 ± 90.42 IU/L, respectively. Their mean serum lipase activity was 105.07 IU/L ± 127.54 IU/L and 106.98 IU/L ± 88.35 IU/L, respectively. Serum lipase activity was elevated above the normal range and three times above the upper limit of the normal range with a magnitude of 11.2% and 4.2%, respectively. Similarly, 9.1% and 0.7% of diabetic patients had increased serum amylase above the normal range and three-fold above the normal range, respectively. Conclusion: As glomerular filtration decreases, particularly in moderate-to-severe chronic kidney disease, serum amylase and lipase activity rise above the upper limit.

Individual and community-level determinants of underweight among lactating mothers in Ethiopia: A multilevel analysis.

BACKGROUND: Determining the nutritional status of lactating women is important because underweight lactating mothers will have low energy levels and reduced cognitive abilities, which will affect the inadequate care of their young children. Thus, malnutrition is passed down from generation to generation, perpetuating the vicious cycle. There is scarce national data on determinants of underweight among lactating mothers in Ethiopia. Hence, this study aimed to identify individual and community-level determinants of underweight among lactating mothers in Ethiopia. METHODS: Data from the Ethiopian Demographic and Health Survey (EDHS) from 2016 were used. A total of 3848 lactating mothers were included in this study, and a multilevel, multivariable logistic regression model was fitted to identify determinants of underweight among lactating mothers. RESULTS: The odds of being underweight among rural lactating mothers were 65% higher (AOR = 1.65, 95% CI = 1.13, 2.41) than lactating mothers in the urban area. The odds of being underweight among lactating mothers who have toilet facilities were 33% lower (AOR = 0.67, 95%CI = 0.54, 0.83) compared with those do not have toilet facilities. Those mothers in the age group of 25-34 years and greater than 35 years had (AOR = 0.61,95%CI = 0.48, 0.79), and (AOR = 0.66, 95%CI = 0.47, 0.95) times lower chance of being underweight compared with those who had 15-24 years of age, respectively. The likelihood of being underweight among lactating mothers in high community poverty (AOR = 1.40, 95%CI = 1.08, 1.82) was higher than the lower community poverty level. CONCLUSION: Underweight among lactating mothers was significantly associated with individual-level (age and toilet facilities) variables and community-level (residence and community poverty). Therefore, focusing on these identified factors could improve underweight among lactating mothers in Ethiopia.

Utilization of provider-initiated HIV testing and counselling in Ethiopia: a systematic review and meta-analysis.

BACKGROUND: Provider-initiated HIV testing, and counseling (PITC) is a service in which health professionals provide HIV testing to all patients in health facilities. Provider-initiated HIV testing, and counseling is an important opportunity for early screening of individuals, and it is fundamental for both HIV treatment and prevention. Although there are studies conducted in different parts of Ethiopia, their findings are variable. Therefore, this systematic review and meta-analysis aimed to summarize the pooled utilization of PITC in Ethiopia. METHOD: All studies conducted on utilization of provider-initiated HIV testing and counseling at outpatient departments (OPD), inpatient departments (IPD), antenatal clinic care (ANC), and tuberculosis (TB) clinics in Ethiopia are eligible for these meta-analyses. A systematic search of the literature was conducted by the authors to identify all relevant primary studies. The databases used to search for studies were PubMed, Science Direct, POPLINE, HENARI, Google Scholar, and Scopus. The extracted data were imported into STATA version 14 software for statistical analysis. The risk of bias was assessed using the Joana Briggs Institute (JBI) criteria for prevalence studies. The heterogeneity among all included studies was assessed by I2 statistics and the Cochran's Q test. Pooled utilization along with its corresponding 95% CI was presented using a forest plot. RESULT: About 1738 studies were retrieved from initial electronic searches using international databases and Google, and a total of 10,676 individual clients were included in the meta-analysis. The pooled utilization of PITC in Ethiopia using the random effects model was estimated to be 78.9% (95% CI 73.87-83.85) with a significant level of heterogeneity (I2 = 98.5%; P < 0.001). Subgroup analysis conducted on PITC showed the highest percentage among studies conducted in Addis Ababa (93.5%), while lower utilization was identified from a study conducted in the Tigray Region (35%). LIMITATION OF THE STUDY: The drawbacks of this review and meta-analysis were being reported with significant heterogeneity, and the protocol was not registered. CONCLUSION: About 21% of health facility clients missed opportunities for PITC in Ethiopia.

Virological and Immunological Antiretroviral Treatment Failure and Predictors Among HIV Positive Adult and Adolescent Clients in Southeast Ethiopia.

BACKGROUND: Antiretroviral therapy (ART) regimen failure is linked to an increased risk of disease progression and death, while early detection of ART failure can help to prevent the development of resistance. This study aimed to evaluate virological and immunological ART failure and predictors among HIV-positive adult and adolescent clients in southeast Ethiopia. METHODS: A retrospective cohort study was implemented from January 2016 to November 30, 2020; all HIV-positive nave patients on follow-up during the study period from four hospitals were included. Virological and immunological treatment failure was the primary outcome of the study. Cox proportional hazards regression models were employed for analysis. Hazard ratios with 95% confidence intervals were reported and variables with p-values <0.05 were considered statistically significant predictors of treatment failure. RESULTS: A total of 641 HIV patients' charts were reviewed, 62.6% of the study participants were females. Of the total study participants, 18.4% and 15% developed virological and immunological ART regimen treatment failure respectively. The median time to virological failure was 40 months. WHO stage IV [AHR = 4.616; 95% CI: (2.136-9.974)], WHO stage III [AHR = 2.323; 95% CI: (1.317-4.098)], poor adherence to HAART regimen [AHR = 3.097; 95% CI: (1.349-7.108)], and fair adherence [AHR = 2.058; 95% CI: (1.234-3.432)] were significantly associated with virological treatment failure among adolescent and adult study participants in southeast Ethiopia. CONCLUSION: The prevalence of virological treatment failure was 18.4% (95% CI: 15.4 -21.4) and the prevalence of immunological treatment failure was 15% (95% CI: 11.8-18.4). WHO clinical stage III/IV and non-adherence were independent predictors of virological ART treatment failure. Early management of clinical WHO stages and improving patients' ART regimen adherence are important to decrease the prevalence of ART regimen treatment failure.

Prevalence of anemia and associated factors among adult diabetic patients attending Bale zone hospitals, South-East Ethiopia.

BACKGROUND: Anemia found in diabetes patients is often unrecognized like many other chronic diseases. The occurrence of anemia is also an additional burden to the micro vascular complications of patients with diabetes. In the selected study structure no published data were found on the prevalence of anemia and associated factors in diabetic patients. Hence, the findings of this study are very fruitful as an input for further studies and after the repetition of similar studies in different frameworks. It is helpful as input for the development of guidelines at diabetes clinics to request the laboratory assessment of hemoglobin as a routine activity. OBJECTIVE: This study aimed to assess the prevalence of anemia and its associated factors among diabetic patients who attended Bale zone hospitals. METHODS: A cross-sectional study design was conducted from September 2020-to January 2021 GC among adult diabetic patients who had follow-up at Bale zone hospitals. A total of 238 study participants were determined by single population proportion sample size calculation formula taking prevalence of anemia among adult diabetic patients 19.0%. Systematic random sampling technique was used to select the study participants. Information on demographic and associated factors of anemia in diabetic patients was collected using an interviewer-administered questionnaire. Blood sample collection was performed under aseptic conditions by a licensed medical laboratory professional. Data were entered into EpiData version 3.1, cleaned and exported to statistical package for the social sciences (SPSS) version 25 software tools. Logistic regression was used to assess factors associated with anemia in diabetic patients. P-value less than 0.05 and 95% CI were considered as statistically significant. The odds ratios were reported to indicate the strength of associations. Frequencies, percentages, charts and tables were used to summarize the characteristics of study participants. RESULTS: In this study anemia among adult diabetic patients is 18.1% (95% CI (13.2, 23.0%). Multivariable logistic regression analysis revealed that the sex of the study participants and the type of diabetes mellitus were found to be statistically significant to associate with anemia. The odds of having anemia among females are nearly three times higher when compared with males (AOR 2.78, 95% CI 1.40-5.52). In addition, the odds of having anemia among adult diabetic patients who had type II diabetes mellitus (AOR 2.18, 95%CI 1.04-4.54) were 2.18 times higher than those who had type I diabetes mellitus patients. CONCLUSION: Nearly one out of five adult diabetic patients had anemia. Sex of the patients and the type of diabetes are associated with anemia among adult diabetic patients.

Knowledge, attitude, and utilization of drugs toward COVID-19 pandemic among Bale Zone residents, Southeast Ethiopia.

BACKGROUND: Coronavirus disease is a highly transmittable and pathogenic viral infection caused by severe acute respiratory syndrome coronavirus 2, which poses therapeutic dilemmas. Some suggestions for drug treatment seem problematic. Beliefs about the causes of health problems are determinants of treatment seeking decisions. Hence, one of the alternatives for the solution of health problems is employing traditional medicine to prevent coronavirus disease 19. OBJECTIVE: To assess the knowledge, attitude, and utilization of drugs toward the coronavirus disease 19 pandemic among Bale zone residents. METHODS: Community-based cross-sectional study was conducted among the Bale Zone population from May 30 to June 30, 2020. Eight hundred fifty-four participants were selected using a single population formula, and a multistage sampling technique was employed. Data were analyzed using SPSS version 25.0. Descriptive and binary logistic regression was used to analyze the outcomes. A p value ⩽ 0.05 was considered statistically significant. RESULTS: Out of the total 854 respondents, about 534 (62.5%) got information about coronavirus disease 19 from TV/radio. More than two-thirds (71.9%) of the respondents have known that severe acute respiratory syndrome coronavirus 2 has no curative drugs, and 65.4% had a more appropriate attitude toward overall drug use in coronavirus disease 19. Level of education and, attitude towards drug use were singnificantly associated with knowledge of drugs, source of information about coronavirus disease 19 and having good practice were significantly associated with atittude toward drug utilization. CONCLUSION: One out of two study participants have good knowledge regarding drugs to the coronavirus disease 19 pandemic. Illiterate people in the community were identified to have poor knowledge about drugs, hence community educuation program is important to improve the knowledge about drugs towards the coronavirus disease 19 pandemic.

COVID-19-Related Anxiety and the Coping Strategies in the Southeast Ethiopia.

BACKGROUND: The pandemic of coronavirus disease spreading is impacting mental health globally. Even though the pandemic is challenging for patients, the community, policymakers, as well as health organizations, and teams, the data on COVID-19 and its association with anxiety and coping mechanisms towards infection among community members are currently limited. Thus, the study is intended to assess COVID-19-related levels of anxiety and coping strategies among community members of Bale and East Bale Zones, Southeast Ethiopia. METHODS: A community-based survey was carried out among 634 study participants of Bale and East Bale Zones from June 1 to 20, 2020. The level of anxiety was determined by using the 5-item Coronavirus Scale and the coping strategies were determined by using the 15-item Coping and Adaptation Processing Scale. Interviewer-administered questionnaires were used to collect the data. Bi-variable analysis and multiple logistic regression analysis were used to estimate the relationship among the variables. RESULTS: COVID-19-related dysfunctional level of anxiety was found 95 (16.58%). About 290 (50.6%) respondents were copied from anxiety that occurred as a result of COVID-19. Factors significantly associated with the dysfunctional level of anxiety related to COVID-19 were being an urban resident (AOR = 0.44, 95% CI: 0.23, 0.86), those who had no information from TV/radio (AOR=1.76, 95% CI: 1.09, 2.84), and walking a long distance more than 1 hour from the health institution (AOR=0.58, 95% CI: 0.34, 0.97). CONCLUSION: COVID-19-related dysfunctional levels of anxiety were 16.58% in the study community. Half of the community was coped with COVID-19-related anxiety. Being an urban resident and walking along distances more than 1 hour from the health facility were the factors that decreased the odds of having a dysfunctional anxiety, whereas respondents who had no information from TV/radio increased the odds of having a dysfunctional anxiety. Accordingly, focusing on these identified factors could improve a dysfunctional level of anxiety in the study community.

Inappropriate Antibiotic Use Among Inpatients Attending Madda Walabu University Goba Referral Hospital, Southeast Ethiopia: Implication for Future Use.

BACKGROUND: Ethiopia is one of the countries where the healthcare system is not yet developed to the required level; hence, it is not uncommon that drugs, particularly antimicrobials, are inappropriately used for infections by any causative agents, with or without prescription, in combination or not, and, of more concern, without sensitivity tests. So, it was considered important to assess the magnitude of inappropriate antimicrobial use among inpatients attending Madda Walabu University Goba Referral Hospital, southeast Ethiopia. METHODS: A health institution-based cross-sectional study was conducted from September 2018 to April 2019. Patient folders from collaborating wards were reviewed for antibiotic use. Inappropriateness of a drug or its dosage, or both, was considered in reference to the Ethiopian national treatment guideline. The information obtained was analyzed using SPSS version 20. Patterns of prescription of antimicrobials for the hospitalized patients were analyzed using simple descriptive statistics. RESULTS: A total of 801 antibiotics were written as prescriptions to 471 clients, 228 (47.6%) of whom had received two or more antibiotics at the time of the study. Of the total prescribed antibiotics, 142 (30.1%) had an inappropriate prescription. Genitourinary tract infections accounted for 42 (30.4%) of the inappropriate prescriptions due to the wrong dose and drugs. Cephalosporins were the most extensively prescribed class of antibiotics, 24.4% of which were inappropriately prescribed. Intravenous formulations made up the largest proportion of prescriptions, at 335 (41.8%). The most commonly prescribed antimicrobials were cephalosporins, 178 (38%); nitroimidazoles, 115 (24.5%); and macrolides, 53 (11.3%), while ceftriaxone was prescribed in 249 (53%) and metronidazole in 123 (26.2%) cases. CONCLUSION: Low dose, inadequate duration and empiric use of antibiotics were major causes of inappropriate use in the study area. Therefore, local antimicrobial sensitivity tests, antibiotic stewardship and following the national treatment guideline are recommended to overcome inappropriate antimicrobial use.

Treatment Outcomes and Predictors Among Tuberculosis Patients at Madda Walabu University Goba Referral Hospital, Southeast Ethiopia.

BACKGROUND: Tuberculosis (TB) remains a main public health threat worldwide. Over 90% of tuberculosis cases occur in low- and middle-income countries that have fragile health infrastructures and constrained resources available. Ethiopia ranks third in Africa and eighth of 22 from TB burdened countries globally. Case detection as early as possible and ensuring a successful treatment rate should be the main focus points to decrease the burden of TB. OBJECTIVE: To evaluate tuberculosis treatment outcomes and predictors among tuberculosis treatment follow-up patients at Madda Walabu University Goba Referral Hospital. METHODS: Retrospective document review was conducted among TB patients in the tuberculosis clinic at Goba Referral Hospital from January 1, 2015 to December 30, 2019. Data were analyzed using SPSS version 25.0. Descriptive and logistic regressions analyses were performed to identify the rate and predictors of tuberculosis treatment outcomes. The odds ratio and 95% confidence interval were calculated to check the association between variables. P ≤ 0.05 was considered statistically significant. RESULTS: The mean age of participants was 33.8 ± 17.3 years, and more than half of them (58.4%, 218) were males. From the total 373 participants, 65 (17.4%) registered TB patients were diagnosed HIV-positive. The overall success rate was 320 (91.2%) with [95% CI, 88-94.3]. Among these, 91 (25.9%) were cured and 229 (65.2%) completed treatment whereas 8.8% with [95% CI, 5.7-12] were unsuccessful treatment outcomes. Among them, the majority 18 (5.1%) died, 6 (1.7%) were moved to MDR-TB center, 4 (1.1%) were lost to follow-up and 3 (0.9%) were documented as treatment failed. CONCLUSION: The treatment failure rate was 8.8% with [95% CI, 5.7-12]. The proportion of TB patents who died was relatively higher. HIV-positive patients and old age people were predictors of unsuccessful treatment outcomes. Thus, the health facility should strengthen the evaluation of HIV-positive patients and old age patients to minimize mortality.