Tuberculosis treatment delay and contributing factors within tuberculosis patients in Ethiopia: A systematic review and meta-analysis.

Background: Tuberculosis (TB) is a significant public health disease and a major contributor to illness and death worldwide, including in Ethiopia. There are many information from first source which had inconclusive result in Ethiopia. Therefore, this review aimed to produce pooled evidence on the TB treatment delay and factors associated with it. Methods: The absence of a similar study with a systematic review and meta-analysis was confirmed. Articles from online available and unpublished sources conducted within Ethiopia between 2002 and 2024, were thoroughly screened using electronic sources such as Medline, Embase, Hinari, PubMed, the Cochrane Library, the Web of Science, and Google Scholar. Data analysis was performed using STATA version 14. Heterogeneity was assessed using Inverse of Variance (I2) and Cochrane Q tests. The funnel plot was employed to rule existence of publications subjectively while bias was checked using Egger's statistical method to quantify the bias. Result: Prevalence of TB treatment delay in Ethiopia was 50.42% at 95% (43.21, 57.64). Factors such as knowledge about TB, distance to health facilities less than 10 km, initial contact at a government service providing center for TB, having some educations, having pulmonary Tuberculosis, urban residency, were prtotective towards treatment delay. Female in gender, no chest pain symptom, disease severity with no restriction on daily activity, alcohol drinkers, and unmarried respondents were at higher risk to miss on time tuberculosis treatment. Conclusion and recommendation: The tuberculosis treatment delay in Ethiopia was considerably unexpected and basic personal variables and facility related variables were statistically associated with treatment. Therefore, Ethiopian TB control programs have to recognize and tackle the problem, obstacles, and vulnerability across the continuum patient care taking down and connecting to treatment post-diagnosis. This can be achieved by capacitating both government and non-governmental service provision centers and minimizing unfilled difference across professional awareness and skill, which will contribute further to minimizing delay.

Compliance with research ethics in epidemiological studies targeted to conflict-affected areas in Western Ethiopia: validity of informed consent (VIC) by information comprehension and voluntariness (ICV).

BACKGROUND: The conduct of research is critical to advancing human health. However, there are issues of ethical concern specific to the design and conduct of research in conflict settings. Conflict-affected countries often lack strong platform to support technical guidance and monitoring of research ethics, which may lead to the use of divergent ethical standards some of which are poorly elaborated and loosely enforced. Despite the growing concern about ethical issues in research, there is a dearth of information about ethical compliance in conflict areas. Valid and ethically informed decision-making is a premier pact with research participants in settling possible ethical issues before commencing the research, which is ensured by gaining informed consent from prospective participants of the research. AIMS: This research aimed to explore compliance with research ethics and consent validity in community-based epidemiological research conducted previously. METHODS: Research participants were recruited in the western part of Ethiopia in three districts subjected to conflicts. A community-based cross-sectional study design was utilized, and 338 residents were enrolled as study participants. All participants had previously been enrolled as research participants in epidemiological studies. Data was collected using a questionnaire that was pilot-tested before the commencement of the main data collection. The questionnaire focused on participants' experiences of the informed consent process followed when they were recruited for an epidemiological study and covered themes such as essential information provided, level of comprehension, and voluntarism of consent. RESULTS: Over half of the study participants, 176 (52%), were not provided with essential information before consenting. And 135 (40%) of them did not comprehend the information provided to them. One hundred and ninety (56%) participants freely and voluntarily agreed to partake in one of these epidemiological studies, with over a quarter (97; 28.7%) of them reporting they were subjected to undue influence. Written consent was obtained from only 32 (9.4%) of the participants.

Burden of intestinal parasitic infections and associated factors among pregnant women in East Africa: a systematic review and meta-analysis.

BACKGROUND: The ultimate goal of preventing intestinal parasites among pregnant women is to reduce maternal and newborn morbidity and mortality. Numerous primary studies were conducted in East Africa presented intestinal parasite infection and associated factors among pregnant women. However, the pooled finding is not known. Therefore, this review aimed to identify the pooled prevalence of intestinal parasite infection and its determinants among pregnant women in East Africa. METHODS: Articles published from 2009 to 2021 were searched in PubMed, Web of Science, EMBASE, and HINARI databases. The search for unpublished studies such as thesis and dissertations was checked in Addis Ababa University and Africa Digital Library. PRISMA checklist was used to report the review. Articles published in the English Language were considered. The data were extracted by two authors using data extraction checklists on Microsoft excel. Heterogeneity among the included studies was checked using I2 statistics on forest plots. Sensitivity and sub-group analyses were conducted to assess the presence of primary studies, and study characteristics responsible for the observed heterogeneity. RESULTS: Of the 43 identified articles, about 23 articles were removed due to duplications. Then, by assessing the abstracts and full texts, four articles were removed because they failed to meet the eligibility criteria. Finally, 16 articles were included in the systematic and meta-analysis.The pooled prevalence of intestinal parasites among pregnant women in East Africa was 38.54 (28.77, 48.32). In this study, variables like residing in rural areas (OR: 3.75; CI: 1.15,12.16), availability of latrine(OR: 2.94; 95% CI: 2.22, 3.91), eating raw fruits/vegetables (OR: 2.44; 95% CI: 1.16, 5.11). and sources of water as unprotected sources (OR: 2.20; 95% CI: 1.11,4.35) show statistically significant association with the increased burden of intestinal parasites among pregnant women. CONCLUSION: The burden of intestinal parasite infection among pregnant women in East Africa was high. Therefore, efforts should be made in deworming pregnant women at the community and institutional level by stakeholders to reduce the burden of intestinal parasite infections and related complications.

Knowledge of periconceptional folic acid supplementation and associated factors among pregnant women attending antenatal care at public health facilities in Hawassa, South Ethiopia.

BACKGROUND: Neural tube closure defect (NTD) such as spinal bifida and anencephaly are serious neurological disabilities that occur when the neural tube does not close completely within 28 days of conception. Even though Folic acid supplementation during and before pregnancy is proved to significantly reduces the risk of NTDs. Currently only 23% of folic acid preventable NTD achieved Worldwide; mainly due to lack of awareness about folic acid supplementation. This study was aimed to assess the knowledge of Folic acid supplementation among pregnant women attending antenatal care at public health facilities in Hawassa Ethiopia. METHODS: Institution based cross-sectional study was employed among 358 pregnant women attending antenatal care. Data were collected using an interviewer-administered structured questionnaire and analyzed using SPSS version 22. The knowledge of Folic acid supplementation was assessed using six multiple-choice questions. The association between the dependent and independent variables were analyzed using Binary Logistic regression model and statistically significant predictors at p-value <.05 at 95% CI. RESULTS: This study indicated that only 7.5% (95% CI, 5.3-10.1) of pregnant women had good knowledge of Folic acid supplementation. The pregnant women who had a history of at least one previous pregnancy loss AOR = 12.64 (95% CI: 4.98, 32.08) and those who had preconception consultation AOR = 11.77 (95% CI: 3.01, 46.07) were more likely to have good knowledge of periconceptional folic acid supplementation as compared to their counterpart. CONCLUSIONS: The knowledge of periconceptional folic acid supplementation among pregnant women was worryingly low in the study area. Alternative and more effective strategies are needed if the population of Ethiopia is to benefit fully from the folic acid prevention of NTDs. Thus, in Ethiopia the future strategies should focus on the possible way to reach the last group through fortification of staple foods with folic acid along with improving women's awareness on folic acid importance in reducing Neural tube defects.

HIV sero-status disclosure and associated factors among HIV positive women in East Africa: Systematic review and meta-analysis. Implications for prevention of mother-to-child HIV transmission.

Background: Women's HIV-positive disclosure plays a pivotal role to achieve the goal of preventing mother-to-child transmission (PMTCT) among pregnant women in particular. Although several primary studies were conducted in the different countries of East Africa, no study concluded the prevalence of women's HIV status disclosure and associated factors in East Africa. Therefore, the current study aimed to assess the pooled prevalence of disclosure status and associated factors among women in East Africa. Objectives: To assess the pooled prevalence of HIV sero-status disclosure and associated factors among women in East Africa. Methods: HINARI, PubMed, and Cochrane Library databases were searched. The data were extracted using a Microsoft Excel spreadsheet and STATA v 14.1 was used for the analysis. The Funnel plots and Egger's statistical test was used to check publication bias. Heterogeneity was assessed by conducting sensitivity and subgroup analyses. Result: The pooled prevalence of sero-status disclosure among women in East Africa was 73.77% (95%CI 67.76, 79.77). Knowing partner's sero-status (OR = 10.04(95%CI 3.36, 31.84), married (OR = 2.46 (95%CI 1.23, 4.89), smooth relationship (OR = 3.30 (95%CI 1.39, 7.84), and discussion on HIV before the test (OR = 6.96 (95%CI 3.21, 15.05) were identified determinants of HIV sero-status disclosure. Conclusion: The current systematic and meta-analysis revealed that nearly one-fourth of women had not disclosed HIV sero-status to at least one individual. Knowing the partner's HIV sero-status, being married, having a smooth relationship, and discussing on HIV before the test were determinants of disclosure status. Therefore, disclosure of HIV-positive sero-status among women living with HIV needs to be strengthened.

Time to recovery from severe acute malnutrition and its predictors among children aged 6-59 months at Asosa general hospital, Northwest Ethiopia. A retrospective follow up study.

BACKGROUND: Severe Acute Malnutrition (SAM) has become a major public health challenge in developing countries including Ethiopia, especially among the underprivileged population. Ethiopia is among the developing countries with the highest burden of acute malnutrition among under-five children. Though, plenty of studies were done on the magnitude of acute malnutrition among under-five children in Ethiopia, there is a limited evidence on time to recovery from SAM and its predictors among children aged 6-59 months in Ethiopia, particularly in the study area. OBJECTIVES: The study was aimed to assess the time to recovery from SAM and its predictors among children aged 6-59 months at Asosa general hospital (AGH), Benishangul Gumuz, Ethiopia. METHODS: A Five years retrospective follow-up study design was employed among 454 children admitted with SAM in AGH from January 2015 to December 2019. The data were extracted from the patient medical records using checklist. The data were coded and entered into Epi-Data 3.1; then exported to STATA/SE-14 for analysis. Proportional Cox regression was performed to identify predictors of recovery time. A proportional hazard assumption was checked. Variables with AHR at 95% CI and P-value less than 0.05 in the multivariable Cox proportional regression was considered as significant predictors of recovery time. FINDINGS: Among the 454 included records of children with SAM, 65.4% (95%CI: 50.1, 69.2) of them were recovered at the end of the follow-up with a median recovery time of 15 IQR(11-18)days. The incidence rate of recovery was 5.28 per 100 child days' observations. Being HIV Negative (AHR = 2.19: 95% CI 1.28, 3.73), Marasmic (AHR = 1.69: 95% CI 1.18, 2.42), and marasmic-kwashiorkor child (AHR = 1.60: 95% CI (1.09, 2.37) independently predicted recovery time. CONCLUSIONS: Though the time to recovery from severe acute malnutrition was in the acceptable range, the proportion of recovery was found to be low in the study area compared to sphere standard. The prognosis of children with severe acute malnutrition was determined by the HIV status of the child and the type of malnutrition experienced. Further strengthening of malnutrition therapeutic centers and routine checkup of the nutritional status of HIV positive children should be emphasized to reduce child mortality and morbidity from under-nutrition.

Pregnant women's knowledge, attitudes, and associated factors toward physical exercise during pregnancy among those attending antenatal care at Bahir Dar city, Northwest Ethiopia.

Background: Exercise during pregnancy is among the cost-effective options that can significantly reduce the burden of chronic metabolic diseases leading to an adverse birth outcome. Despite the negative consequences of sedentary life among pregnant women, little is known about the pregnant mothers' knowledge, attitude, and associated factors toward exercise during pregnancy in Ethiopia, particularly in the study area. Objective: To assess knowledge, attitude, and associated factors toward exercise during pregnancy among women attending antenatal care at Bahir Dar city, Northwest Ethiopia, 2020. Methodology: A health facility-based cross-sectional study design was employed among 475 pregnant women from March 12 to May 12, 2020. A systematic random sampling technique was used to select the study participants. Interviewer-administered questionnaire was used to collect the data from pregnant women attending the antenatal care unit. Data were coded and entered using Epidata version 3.1 and analyzed by Statistical Package for Social Science (SPSS) version 25. Binary and multivariable logistic regressions were used to identify possible determinants and an odds ratio was used to measure the strength of associations at a p-value of <0.05. Result: The study showed that 55.8% (95% CI: 48.45-59.12) of pregnant women were knowledgeable about benefits and contraindication of exercise during pregnancy; 53.3% (95% CI: 49.05-57.62) of them had positive attitudes toward exercise during pregnancy. Educational status adjusted odd ratio (AOR) = 3.95 (95% CI: 1.712-9.108), practicing physical exercise before becoming pregnant AOR = 3.64 (95% CI: 1.091-12.118), and women who heard about exercise during pregnancy AOR = 4.74 (95% CI: 2.563-8.756) were found to have statistically significant association with knowledge of women about exercise during pregnancy. Women who were knowledgeable about exercise during pregnancy AOR = 4.45 (95% CI: 2.39-8.29) and women who heard about exercise during pregnancy AOR = 4.2 (95% CI: 2.19-8.08) were more likely to have a positive attitude toward benefits of exercise during pregnancy. Conclusion: The level of mothers' knowledge and attitude toward exercise during pregnancy in the study area was low. Educational status, physical exercise before pregnancy, ever heard about exercise during pregnancy were independent determinants of women's knowledge, while ever heard and knowledgeable about exercise during pregnancy were determinants of favorable attitude toward exercise during pregnancy. Empowering women through health education about physical exercise during pregnancy should get due attention.

Survival status and predictors of neonatal mortality among neonates admitted to Neonatal Intensive care Unit (NICU) of Wollega University referral hospital (WURH) and Nekemte Specialized hospital, Western Ethiopia: A prospective cohort study.

BACKGROUND: The neonatal period is the most vulnerable time for survival in which children face the highest risk of dying in their lives. Neonatal mortality (NM) remains a global public concern, especially in sub-Saharan African (SSA) countries. Although, better progress has been made in reducing NM before 2016, Ethiopia is currently one of the top ten countries affected by NM. Studies are limited to secondary data extraction in Ethiopia which focus only on survival status during admission, and no study has been conducted in the study area in particular. OBJECTIVE: To assess the survival status and predictors of neonatal mortality among neonates admitted to the NICU of WURH and Nekemte Specialized Hospital, Western Ethiopia. METHODS: An institution-based prospective cohort study was conducted among a cohort of 412 neonates admitted to the NICU of WURH and Nekemte Specialized Hospital from September 1, 2020 to December 30, 2020. All neonates consecutively admitted to the NICU of the two hospitals during the study period were included in the study. Data entry was performed using Epidata version 3.0 and the analysis was performed using STATA version 14. A Kaplan Meier survival curve was constructed to estimate the cumulative survival probability. A cox proportional hazards regression model was used to identify the predictors of NM. Hazard Ratios with 95% CI were computed and all the predictors associated with the outcome variable at p-value ≤ 0.05 in the multivariable cox proportional hazards analysis were declared as a significant predictor of NM. RESULTS: A total of 412 neonates were followed for a median of 27 days with an IQR of 22-28 days. During the follow-up period, a total of 9249 person day observations (PDO) were detected. At the end of follow-up, 15.3% of neonates died with an overall incidence rate of death 6.81/1000 PDO. The median time to death was 10 days, and the highest incidence rate of death was observed during the first week of the neonatal period. The study found that rural residence (AHR = 2.04, 95%CI: 1.14, 3.66), lack of ANC visits (AHR = 7.77, 95%CI: 3.99, 15.11), neonatal hypothermia (AHR = 3.04, 95%CI: 1.36, 6.80), and delayed initiation of breastfeeding (AHR = 2.26, 95% CI: 1.12, 4.56) as independent predictors of NM. However, a decreased number of pregnancies decrease the risk of NM. CONCLUSIONS AND RECOMMENDATIONS: The incidence rate of neonatal death was high particularly in the first week of life in the study area. The study found that lack of ANC visit, neonatal hypothermia, increased number of pregnancies, rural residence, and delayed initiation of breastfeeding positively predicted NM. Therefore, there is a need to encourage programs that enhance ANC visits for pregnant mothers and community-based neonatal survival strategies, particularly for countryside mothers.

First-line virologic-based ART treatment failure and associated factors among adult HIV Positives in Southwest Shoa, Central Ethiopia.

Background: The function of antiretroviral therapy is to enhance immunity and prevent the occurrence of opportunistic infection. But antiretroviral therapy showed a failure to manage infection after a time. Nowadays, an accepted criterion to confirm Antiretroviral therapy (ART) treatment failure is a virologic failure. Regarding this virologic failure, there are no well-addressed findings, especially in this study area. Therefore in this research, the magnitude and factors that contribute for virological ART treatment failure have been identified. Methods: Facilitybased cross-sectional study was conducted on adult patients taking ART. Data entry was conducted using Epi Data Version3 and exported to Stata SE version 14 for analysis. Bivariable logistic regression was used to find covariates significantly associated with firs line ART treatment failure. In this case, variables with P-value ≤ .25 were a candidate for multiple logistic regressions. A backward logistic regression model was used. Finally, variables with P-value ≤ .05 were considered as factors significantly associated with first-line ART treatment failure and the result was presented with a description, graph, and tables. Results: In this study, three hundred and fifty peoples were a candidate for the study and all have been involved. The magnitude of first-line ART treatment failure based on virologic criteria was 20.85%. Greater than three-fourth (84.29%) of study participants have support from somebody. Those patients who have initiated first-line ART with NVP based regimen have 1.83 times more likely to face first-line ART treatment failure as compared with those who have started with Efeverence (EFV) based regimen [AOR = 1.83, 95% CI (1.035, 3.245)]. Patients who have initiated first-line ART at the health center were 3.093 times more likely to face first-line ART treatment failure as compared those who have initiated ART at hospitals [AOR = 3.093, 95% CI (1.101, 8.685)]. Patients who have not developed a common opportunistic infection after ART initiation was 47.3% less likely to encounter first-line ART treatment failure as compared with those who have opportunistic infection [AOR = 0.527, 95% CI (0.289, 0.961)]. Conclusion: Based on virologic criteria, NVP based ART initiation, having history recorded opportunistic infection after ART initiation, being male, Institution where initiate ART, are significantly associated with the occurrences of first-line ART treatment failure. The action has to be directed on those identified factors to maintain the patient stay on First-line ART by concerned stakeholders.

Incidence and predictors of death from COVID-19 among patients admitted to treatment center of Wollega University Referral Hospital, Western Ethiopia: A retrospective cohort study.

INTRODUCTION: Currently, COVID-19 contributes to mortality and morbidity in developed as well as in developing countries since December 2019. However, there is scarcity of evidence regarding the incidence and predictors of death among patients admitted with COVID-19 in developing country including Ethiopia, where the numbers of deaths are under-reported. Hence, this study aimed to assess the incidence and predictors of death among patients admitted with COVID-19 in Wollega University Referral Hospital (WURH), western Ethiopia. METHODS: An institution based retrospective cohort study design was conducted among 318 patients admitted with COVID-19 in WURH treatment center. Patients who were tested positive for COVID-19 by using rRT-PCR test and admitted with the diagnosis of severe COVID-19 cases from September 30, 2020 to June 10, 2021 were a source population. Epidata version 3.2 was used for data entry, and STATA version 14 for analysis. A Cox proportional hazard regression analysis was used to determine factors associated with mortality from COVID-19. Multivariable Cox regression model with 95% CI and Adjusted Hazard Ratio (AHR) was used to identify a significant predictor of mortality from COVID-19 at p-value < 0.05. RESULTS: A total of 318 patients were included in final analysis with mean age of 44 (SD±16.7) years and about two third (67.9%) were males. More than half (55.7%) of patients had no comorbidity on admission. The majority, 259 (81.45%) of patients recovered from COVID-19 and 267 (84%) of patients were censored at the end of follow up. The incidence rate of mortality was 14.1 per/1000 (95%CI: 10.7, 18.5) person days observation. Age ≥ 59 years (AHR: 5.76, 95%CI: 2.58, 12.84), low oxygen saturation (AHR: 2.34, 95% CI: (2.34, 4.17), and delayed presentation (AHR: 5.60, 95%CI: 2.97, 10.56) were independent predictors of mortality among COVID-19 patients. CONCLUSION: The mortality rate of COVID-19 pandemic was high in the study area, and most of death was happened during the first 10 days. Being old age, low oxygen saturation and delayed presentation were factors which predict mortality due to COVID-19. Hence, strengthening the health care delivery system to satisfy the need of the patients should get due attention to reduce the incidence of mortality from COVID-19 cases.

Acute respiratory distress syndrome among patients with severe COVID-19 admitted to treatment center of Wollega University Referral Hospital, Western Ethiopia.

BACKGROUND: Acute respiratory distress syndrome is a life-threatening condition that has a significant effect on the occurrence of morbidity and mortality among patients with severe Coronavirus disease 2019 (COVID-19). To the best of researchers' knowledge, there is no Study on ARDS of COVID-19 in Ethiopia. Therefore, this study aimed to identify the prevalence of ARDS and associated factors among severe COVID-19 patients at Wollega University Referral Hospital. METHODS: An institution-based retrospective cross-sectional study was conducted from September 20, 2020, to June 10, 2021. Real-Time Reverse transcription-polymerase Chain Reaction (rRT-PCR) test was used to test Patients for COVID-19. Epi-data version 3.2 was used for data entry, and the final data analysis was through STATA version 14. After checking the assumption P-value<0.25 in the bivariable analysis was used to select a candidate variable for multi-variable analysis, and a p-value of <0.05 was used to declare statistical significance. RESULTS: In this study, the prevalence of ARDS was 32%. Almost all the patients had the clinical feature of cough (93.7%), followed by shortness of breath (79.9%), fever (77.7%), and headache (67%). Age older than 65 years (AOR = 3.35, 95%CI = 1.31, 8.55), male gender (AOR = 5.63, 95%CI = 2.15, 14.77), and low oxygen saturation level (AOR = 4.60, 95%CI = 1.15, 18.35) were the independent predictors of ARDS among severe COVID-19 patients. CONCLUSION: The prevalence of ARDS among patients with severe COVID-19 was high in the study area. Therefore, elders and patients with critical conditions (low oxygen saturation) better to get special attention during COVID-19 case management to enhance good care and monitoring of the patients.

Health professionals' COVID-19 vaccine acceptance and associated factors in Wollega University referral hospital, Western Ethiopia: A cross-sectional study.

BACKGROUND: Health professionals' willingness to accept the COVID-19 vaccine is very important, and evidence suggests that only a limited proportion of health-care workers were ready to accept a COVID-19 vaccine, which is very low when compared with the risk of the disease. This study aimed to assess health professionals' acceptability and associated factors in Wollega University referral hospital, Western Ethiopia. METHODS: An institution-based cross-sectional study was conducted among health-care workers in Wollega University referral hospital from March 26-28, 2021. The data were collected by using a self-administered questionnaire. Epi-data version 3.2 was used for data entry, and STATA version 14 was used for data analysis. The binary logistic regression model was employed to determine factors associated with the acceptability of the COVID-19 vaccine. Adjusted Odds Ratio (AOR) with 95% confidence intervals was computed and statistical significance was declared at a 5% level (p-value <.05). RESULTS: A total of 191 health professionals have participated in the study. The study indicates that 65.4% (95% CI: 58.6%, 72.2%) of health professionals had the willingness to receive the COVID-19 vaccine if available. Age of health professionals (AOR = 3.58, 95% CI: 1.38, 8.38), knowledge of the COVID-19 vaccine (AOR = 2.98, 95% CI: 1.22, 7.23), and perception of COVID 19 vaccine (AOR = 5.71, 95% CI: 2.50, 13.00) were significantly associated with vaccine acceptability. CONCLUSIONS AND RECOMMENDATIONS: Nearly, two-thirds of health professionals were willing to accept the COVID-19 vaccine, which is low. In general, continuous communication and health education have to be provided to enhance overall awareness of the COVID-19 vaccine.

Nurses are leaving the nursing profession: A finding from the willingness of the nurses to stay in the nursing profession among nurses working in selected public hospitals of Wollega Zones, Oromia, Ethiopia.

Background: The willingness of nurses to stay in nursing profession is nurses stay in the nursing profession without having intention to shift their works to other professions. In healthcare systems, nurses are currently leaving their work. To give quality of health, nurses have to stay in their work. The aim of this study was to find the willingness of the nurses to stay in the nursing profession and associated factors. Methods: An institution-based cross-sectional study was employed among nurses in selected hospitals. After checking for completeness, the data were interred into Epi Data version 3 and exported to Stata SE version 14 for analysis. Then, the descriptive statistics were computed. To find association, logistic regression was computed. Covariates from binary logistic regression were a candidate for multivariate logistic regression at p-value ⩽ 0.25. Variables in the final model were selected by the stepwise backward selection procedure. In the end, variables with a p-value ⩽ 0.05 were considered as statistically significant. Results: In this study, 349 nurses have participated with a 100% response rate and more than half of the participants were male 188 (53.87%). The proportion of nurses who have the willingness to stay in the nursing proportion is 54.44% (95% confidence interval = 0.491, 0.59). Getting relatively high salary (adjusted odd ratio = 1.81 (95% confidence interval = 1.05, 3.11)), no presence of support among colleagues (adjusted odd ratio = 0.10 (95% confidence interval = 0.05, 0.22)), not having participation in training (adjusted odd ratio = 0.49 (95% confidence interval = 028, 0.86)), having relative low experience in nursing profession that is less than 6 years (adjusted odd ratio = 0.46 (95% confidence interval = 0.26, 1.81)), having good autonomy in the nursing profession (adjusted odd ratio = 0.41 (95% confidence interval = 0.23, 0.70)), and having a good sense of self-calling for the nursing profession among nurses (adjusted odd ratio = 2.85 (95% confidence interval = 1.64, 4.97)) are the factors related with willingness of the nurses to stay in the nursing profession. Conclusion and recommendation: To bring development in the nursing profession, it is a must to staying experienced nurses in the nursing profession. Therefore, to increase the willingness of nurses in the nursing profession, it is better to increase the salary of nurses, giving frequent training for the nurses, initiate the nurses to support one another, and encourage the nurses to have sense of self-calling for nursing profession. This is accomplished if there is a harmonious relationship between the governments, nurses, and other stakeholders in the healthcare delivery system.

Magnitude and determinants of delay in diagnosis of tuberculosis patients in Ethiopia: a systematic review and meta-analysis: 2020.

BACKGROUND: Tuberculosis (TB) remains a main public health concern in the world resulting in significant morbidity and mortality as well as in Ethiopia. In Ethiopia, there are various primary studies with inconsistent findings. Delay in the diagnosis of TB is determined by different factors like the type of TB, marital status, TB-HIV co-infection, employment status, place of residence, educational status, type of first visited a health facility, and gender of the patient. This review will produce pooled evidence on delay in diagnosis and associated factors among TB that might have huge public health impacts, like unfavorable treatment outcomes, increase transmission of the disease in the community for better intervention. METHODS: The presence of systematic reviews and meta-analysis on similar topics was checked and the topic was registered on PROSPERO to prevent duplication with the registration number of (CRD42020158963). Both published and unpublished studies conducted in Ethiopia from 2002 to April 1 2020 were searched thoroughly using electronic databases. Data were analyzed using STATA version 14. Heterogeneity was checked by using I2 and Cochrane Q test. In the presence of heterogeneity, a random effect model was employed to estimate the pooled magnitude and determinants of diagnosis delay of TB. Publication bias was checked by using the graphical funnel plot and Egger's statistical test. RESULT: The Pooled magnitude of tuberculosis diagnosis delay in Ethiopia was 45.42% [95%CI 34.44, 56.40]. Residing in urban, having educational status and patients with positive serostatus were protective against TB diagnostic delay while having extra-pulmonary TB and not being married were risk factors for delaying TB diagnosis. CONCLUSION: TB diagnosis delays in Ethiopia are significantly high. Sociodemographic and institutional factors were significantly contributing to the delay. Therefore, national TB control programs need to identify and address gaps, barriers, and weaknesses along the entire patient care cascade, to improve appropriately.

Attitude of health professionals towards COVID-19 vaccination and associated factors among health professionals, Western Ethiopia: A cross-sectional survey.

INTRODUCTION: Even though people of the world were eagerly waiting for the hope of vaccine development, vaccine hesitancy is becoming the top concern in both developed and developing countries. However, there is no adequate evidence regarding the attitude and perception of health professionals towards the COVID 19 vaccine in resource-limited settings like Ethiopia. The aim of this study was to assess health professionals' attitudes and perceptions towards COVID 19 vaccine in Western Ethiopia. METHODS: An institution-based cross-sectional study was conducted among health care workers found in Nekemte town from April 14-21, 2021. A total of 439 health professionals present on duty during the study period was included in the study. The data were collected by using self-administered questionnaire. Epidata version 3.2 was used for data entry, and STATA version 14 was used for data analysis. The binary logistic regression model was employed to determine factors associated with the attitude towards COVID-19 vaccination. Adjusted Odds Ratio (AOR) with 95% confidence intervals was computed and statistical significance was declared at a 5% level (p-value < 0.05). RESULT: A total of 431 health professionals participated in the study yielding a response rate of 98.1%. The results indicated that 51.28% (95%CI: 45.12%, 57.34%) of health professionals had a favorable attitude towards COVID-19 vaccination. Having good knowledge about the COVID-19 vaccine (AOR = 0.38, 95%CI: 0.22, 0.64, P-value <0.001) was negatively associated with unfavorable attitude towards COVID-19 vaccine, whereas age less than 30 years (AOR = 2.14, 95%CI:1.25,3.67, P-value <0.001), working in a private clinic (AOR = 7.77, 95% CI: 2.19, 27.58, P-value <0.001) and health center (AOR = 2.45, 95%CI: 1.01, 5.92, P-value = 0.045) were positively associated with unfavorable attitude towards COVID-19 vaccine. CONCLUSION AND RECOMMENDATION: In general, the attitude and perception of health care professionals toward the COVID-19 vaccine in the study area were unsatisfactory. Knowledge about the COVID-19 vaccine, age of health care workers, and place of work are the factors which affects attitude towards COVID-19 vaccine. Thus, we recommend the media outlets and concerned bodies to work to develop trust among the public by disseminating accurate and consistent information about the vaccine.

Are the Things Told to Care Providers Kept Confidential?: Perceived Breaches of Confidentiality and Associated Factors Among HIV/AIDS Clients on ART at Nekemte Specialized Hospital, Western Ethiopia, 2021.

INTRODUCTION: HIV clients' mistrust in providers' handling of their medical information can be a reason for them not to utilize services. Compromised confidentiality of HIV clients can affect the entire community, as other people may become reluctant to seek HIV testing and counseling. In Ethiopia, there are few data on perceived breaches of confidentiality among HIV/AIDS clients. Thus, this study aimed to assess perceived breaches of confidentiality and associated factors among people living with HIV (PLHIV) on anti-retroviral therapy (ART) at Nekemte Specialized Hospital, Western Ethiopia. METHODS: A facility-based cross-sectional study was conducted among 423 HIV/AIDS clients at Nekemte Specialized Hospital from January 15 to February 20, 2021. Data were collected by an investigator-administered questionnaire. Collected data were entered into EpiData version 3.1, and Stata version 14.0 was used for analysis. Bivariable and multivariable logistic regression analyses were performed. Variables with a P-value of <0.2 in the bivariable analysis were exported to the multivariable analysis. Adjusted odds ratios (AORs) with 95% confidence intervals (CIs) and P-values of <0.05 were used to report significantly associated variables. RESULTS: A total of 423 PLHIV were included in the study. Nearly one-fourth of the respondents (23.60%) had perceived breaches of confidentiality (95% CI 19.8-27.9%). Delayed ART start [(AOR 1.97) 95% CI (1.05-3.71)], being female [(AOR 4.03) 95% CI (2.14-7.59)], being widowed [(AOR 4.11) 95% CI (1.50-11.20)], college education and above [(AOR 10.89) 95% CI (3.93-30.14)], normal BMI [(AOR 2.72) 95% CI (1.06-6.99)], substance use [(AOR 1.93) 95% CI (1.04-3.58)], not knowing other ART user(s) [(AOR 2.89) 95% CI (1.53-5.47)], and CD4 count ≤200 cells/mm3 [(AOR 2.63) 95% CI (1.22-5.68)] were significantly associated variables. CONCLUSION: One in four HIV/AIDS clients reported experiencing perceived breaches of confidentiality. Thus, early ART initiation, further HIV serostatus disclosure, and encouraging patients to decide on the type of care and information they want need to be strengthened in order to reduce breaches of confidentiality.

Medication Errors Among Hospitalized Adults in Medical Wards of Nekemte Specialized Hospital, West Ethiopia: A Prospective Observational Study.

PURPOSE: A high prevalence of medication errors in older adults are due to a combination of different factors such as polypharmacy, polymorbidity, enrolment in several disease-management programs, and fragmentation of care that causes medication errors in all age groups. This study aims to assess the incidence and determinants of medication errors among hospitalized adults in medical wards of Nekemte Specialized Hospital (NSH), West Ethiopia. PATIENTS AND METHODS: A prospective observational study design was conducted at Nekemte Specialized Hospital among hospitalized adults from October 30, 2018 to January 30, 2019. Data were collected by using checklist-guided observation and review of medication order sheets, medication administration records, and patient charts. To identify the independent predictors of medication errors, logistic regression analysis was used. Statistical significance was considered at a p-value <0.05. RESULTS: A total of 351 patients were included in the present study. The mean age of the patients was 40.67+15.78 years. A total of 813 medication errors were recorded. The most common stage for medication errors was physician ordering 263 (32.4%). In the multivariable analysis, age ≥65 years (AOR: 2.54, 95%CI: 1.12-5.75, p=0.025), hospital stay ≥7 days (AOR: 2.16, 95%CI: 1.17-3.98, p=0.014), number of medication taken (AOR: 1.75, 95%CI: 1.13-2.73, p=0.013) and presence of comorbidity (AOR: 1.57, 95%CI: 1.01-2.46, p=0.049) had shown statistical significance in predicting medication errors. CONCLUSION: Medication errors are common at Nekemte Specialized Hospital with an incidence of 48.3 per 100 orders, 231.6 per 100 admissions, and 433.4 per 1000 patient days. In particular, adults with older age, increased hospital stay, a greater number of medications, and presence of comorbidities were at greater risk for medication errors.

Burden and Determinants of Chronic Kidney Disease Among Diabetic Patients in Ethiopia: A Systematic Review and Meta-Analysis.

Background: Chronic kidney disease (CKD) among diabetic patients is becoming a global health burden with a high economic cost to health systems. The incidence of CKD is higher in low-income countries such as Ethiopia. In Ethiopia, there is no national representative evidence on the burden and determinants of CKD among patients with diabetes. Therefore, this review aimed to estimates the pooled burden and determinants of CKD among patients with diabetes. Methods: Published articles from various electronic databases such as Pub Med, Google Scholar, CINAHL, Scopes, Cochrane library, the Web of Science, and African Journals Online were accessed. Also, unpublished studies from Addis Ababa digital library were identified. We included all observational studies (cross-sectional, case-control, and cohort) in the review. Data were extracted on the Microsoft Excel spreadsheet and analyzed using STATA 14.1 version. A random-effects model was used to estimate the pooled estimate with a 95% confidence interval (CI). Forest plots were used to visualize the presence of heterogeneity and estimate the pooled burden and determinants of chronic kidney disease among diabetic patients. The presence of publication bias was assessed by funnel plots and Egger's statistical tests. Results: Published (297) and unpublished (2) literature were identified from several databases and digital libraries, of which twelve articles were selected for final meta-analysis. Significant heterogeneity was observed across studies (I2 = 85.2%), which suggests a random-effects model to estimate pooled burden. The analysis found that the pooled burden of CKD among patients with diabetes was 18.22% (95% CI: 15.07-21.38). Factors such as hypertension (OR = 2.65, 95%, CI: 1.38, 5.09), type of DM (OR = 0.33, 95%, CI: 0.14-0.76), and duration of DM (OR = 0.51, 95%, CI: 0.34-0.77) were found to have significant association with CKD. Conclusion: The current review revealed a higher burden of CKD among patients with diabetes in Ethiopia. The presence of hypertension, type II diabetes, and duration of diabetes for a longer duration were found to be independent determinants of CKD among patients with diabetes. For better control of chronic kidney disease, integrated management of hypertension and DM should be designed with a special focus on chronic diabetic patients.

Time to Antiretroviral Therapy Initiation and Its Predictors Among Newly Diagnosed HIV-Positive People in Nekemte Town, Western Ethiopia: Claim of Universal Test and Treat.

BACKGROUND: HIV continuum of care demands early ART initiation for all HIV-infected individuals. Early ART initiation reduces onward HIV transmission facilitating rapid viral suppression. Despite this, delayed ART use is a challenge among newly diagnosed HIV-positive individuals, and there is limited evidence on time to ART initiation among this group in Ethiopia. Thus, this study aimed to assess time to ART initiation and its predictors among newly diagnosed HIV-positive individuals in Nekemte town, Western Ethiopia. METHODS: An institution-based retrospective follow-up study was conducted on 518 newly diagnosed HIV-positive people from September 5, 2016 to December 20, 2020 at Nekemte town, Western Ethiopia. Data were collected from ART intake forms, registration log books and patient charts. The collected data were entered into Epi Data version 3.1 and STATA version 14.0 was used for analysis. Survival probability was checked graphically by Kaplan-Meier curve and statistically by Log rank test. Both bivariable and multivariable Cox Proportional hazards regression models were conducted to identify the predictors of ART initiation. Hazard ratio with 95% CI and p-value of <0.05 was used to declare a statistical significance. RESULTS: By the end of the follow-up, 371 (71.6%) individuals had initiated ART with an overall incidence rate of 51.9 per 1000 [95% CI: 54.07-66.32] person days; median time to ART initiation was 4 [IQR: 1-9] days. Being female (AHR = 1.33, 95% CI: 1.06-1.67), urban dwellers (AHR = 2.02, 95% CI: 1.37-2.97), having baseline OIs (AHR = 1.62, 95% CI: 1.60-4.30); being tested via VCT (AHR = 1.33, 95% CI: 1.02-1.74); linked from OPD (AHR = 0.64, 95% CI: 0.47-0.85); disclosing HIV sero-status (AHR = 2.07, 95% CI: 1.17-3.68); and college and above education level (AHR = 1.43, 95% CI: 1.00-2.0) were identified as significant predictors of early initiation of ART. CONCLUSION: The proportion and incidence of ART initiation was high; a short median time to ART initiation was revealed in this study. Strictly screening OIs, encouraging HIV sero-status disclosure and voluntary HIV testing are recommended to increase early ART initiation.

Survival from a Triple Co-Infection of COVID-19, HIV, and Tuberculosis: A Case Report.

INTRODUCTION: The triple burden of COVID-19, human immune virus (HIV), and TB co-infection is one of the contemporary challenges to this globe. People living with chronic medical diseases such as HIV and TB are more likely to experience poor outcomes from COVID-19. This study aimed to report survival from triple co-infection with PTB, HIV, and COVID-19 in Wollega University referral hospital (WURH), western Ethiopia. CASE PRESENTATION: A 55-year-old male known HIV patient on HAART for the last 3 years presented to WURH on May 26, 2021, with chief complaints of shortness of breath of 5 days' duration associated with productive cough, history of high-grade fever, and severe headache. He had produced a lot of bloody sputum one month prior to the current complaints. On 1st day of his presentation, a Gene Expert test was done from sputum, and he was positive for pulmonary TB. On the same day, a nasopharyngeal sample for COVID-19 using polymerase chain reaction (PCR) was positive. On his 2nd day of admission, he was transferred to the COVID-19 treatment center with the diagnosis of severe COVID-19, PTB, and WHO stage-3 RVI. During his stay in the hospital, he was provided with oxygen via a nasal cannula. Intensive phase anti-TB treatment was initiated on the 3rd day of admission. HAART was continued with the same regimen he was taking prior to his presentation. On June 6, 2021, the patient was recovered and discharged from the hospital after 10 days of hospital stay. CONCLUSION: This case report suggests, after 10 days of admission with triple infections, there is a good clinical prognosis and survival from COVID-19. On admission, further diagnosis and investigations of TB co-infection should be performed for all patients admitted with COVID-19 due to their similar and non-specific clinical manifestations.