Determinants of respectful maternity care among women who gave childbirth in Southern Ethiopia.

BACKGROUND: Having a good provision of respectful maternity care (RMC) to a woman who gives childbirth is a crucial component of maternal health care to result in positive maternal and neonatal outcomes. Disrespect and lack of women-centered care in birth discourage a woman from seeking healthcare during childbirth contributing to poor healthcare-seeking behaviour and dissatisfaction with the maternity service. The current study aimed to assess key determinants of RMC during childbirth at selected public health facilities of the Gofa zone, Southern Ethiopia. METHODS: A cross-sectional study design was conducted from March to April 2021 among 390 women who gave birth in eight randomly selected public health facilities of Gofa zone, Southern Ethiopia. The level of RMC was measured using structured exit interview items. A structured-interviewer-administered questionnaire was used to collect data and then entered into Epi-data version 4.6 and exported to SPSS version 25 for further analysis. Bivariate and multivariate logistic regression analyses were used to identify determinants of RMC among women. RESULTS: A total of 390 women responded to the exit interview making a response rate of 100%. The mean (± SD) age of the 390 women was 27.9 (± 4.85) years. The overall prevalence of women who received RMC was 40.5%, 95% CI (36-45%). Two hundred and ninety-seven (76.2%; n = 297/390) women had antenatal care (ANC) attendance in the index pregnancy. A woman who had planned pregnancy (AOR = 1.72, CI: 1.04, 2.85), planned to deliver in a health facility (AOR = 1.68, CI: 1.00, 2.81), presence of familial support (AOR = 2.04, CI: 1.20, 3.48), and had information about service availability (AOR = 4.44, CI: 2.09, 9.42) were associated with RMC among women. CONCLUSION: The provision of respectful maternity care in the study area was low when compared with local studies. Planned pregnancy, plan to deliver in a health facility, family support, and presence of information about service availability were factors associated with RMC among women. More attention should be given to training and supportive supervision of health care professionals on respectful maternity care and its standards to increase service uptake and make service more women-centred.

Prevalence of meropenem-resistant Pseudomonas Aeruginosa in Ethiopia: a systematic review and meta­analysis.

INTRODUCTION: Antimicrobial resistance (AMR) is a pressing global health concern, particularly pronounced in low-resource settings. In Ethiopia, the escalating prevalence of carbapenem-resistant Pseudomonas aeruginosa (P. aeruginosa) poses a substantial threat to public health. METHODS: A comprehensive search of databases, including PubMed, Scopus, Embase, Hinari, and Google Scholar, identified relevant studies. Inclusion criteria encompassed observational studies reporting the prevalence of meropenem-resistant P. aeruginosa in Ethiopia. Quality assessment utilized JBI checklists. A random-effects meta-analysis pooled data on study characteristics and prevalence estimates, with subsequent subgroup and sensitivity analyses. Publication bias was assessed graphically and statistically. RESULTS: Out of 433 studies, nineteen, comprising a total sample of 11,131, met inclusion criteria. The pooled prevalence of meropenem-resistant P. aeruginosa was 15% (95% CI: 10-21%). Significant heterogeneity (I2 = 83.6%) was observed, with the number of P. aeruginosa isolates identified as the primary source of heterogeneity (p = 0.127). Subgroup analysis by infection source revealed a higher prevalence in hospital-acquired infections (28%, 95% CI: 10, 46) compared to community settings (6%, 95% CI: 2, 11). Geographic based subgroup analysis indicated the highest prevalence in the Amhara region (23%, 95% CI: 8, 38), followed by Addis Ababa (21%, 95% CI: 11, 32), and lower prevalence in the Oromia region (7%, 95% CI: 4, 19). Wound samples exhibited the highest resistance (25%, 95% CI: 25, 78), while sputum samples showed the lowest prevalence. Publication bias, identified through funnel plot examination and Egger's regression test (p < 0.001), execution of trim and fill analysis resulted in an adjusted pooled prevalence of (3.7%, 95% CI: 2.3, 9.6). CONCLUSION: The noteworthy prevalence of meropenem resistance among P. aeruginosa isolates in Ethiopia, particularly in healthcare settings, underscores the urgency of implementing strict infection control practices and antibiotic stewardship. Further research is imperative to address and mitigate the challenges posed by antimicrobial resistance in the country.

The magnitude and associated factors of immediate postpartum anemia among women who gave birth in Ethiopia: systematic review and meta-analysis, 2023.

BACKGROUND: The immediate postpartum period is a very crucial phase for both the life of the mother and her newborn baby. Anemia is the most indirect leading cause of maternal mortality. However, anemia in the immediate postpartum period is a neglected public health problem in Ethiopia. Therefore, this systematic review and meta-analysis aimed to estimate the pooled magnitude of immediate postpartum anemia and the pooled effect size of associated factors in Ethiopia. METHODS: Searching of published studies done through PubMed, Medline, Cochrane, African index Medicus, List of Reference Index, Hinari, and Google Scholar. This systematic review and meta-analysis follow the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) godliness. The quality of studies was assessed by using a Newcastle- Ottawa Scale (NOS) assessment tool. Analysis was performed using a random effect model by using STATA 17 version software. Egger's weighted regression and I2 test were used to evaluate publication bias and heterogeneity respectively. RESULTS: In this systematic review and meta-analysis, a total of 6 studies were included. The pooled magnitude of immediate postpartum anemia in Ethiopia was 27% (95%CI: 22, 32). Instrumental mode of delivery (OR = 3.14, 95%CI: 2.03, 4.24), mid-upper arm circumference (MUAC) measurement < 23 cm (OR = 3.19, 95%CI: 1.35, 5.03), Antepartum Hemorrhage (OR = 4.75, 95%CI: 2.46, 7.03), postpartum hemorrhage (OR = 4.67, 95%CI: 2.80, 6.55), and no iron/foliate supplementation (OR = 2.72, 95%CI: 1.85, 3.60) were the identified factors associated with developing anemia in the immediate postpartum period. CONCLUSION: The overall pooled magnitude of anemia in the immediate postpartum period among Ethiopian women was still a moderate public health problem. Instrumental mode of delivery, mid upper arm circumference (MUAC) measurement < 23 cm, antepartum hemorrhage, postpartum hemorrhage, and no iron/foliate supplementation were the identified factors associated with higher odds of developing anemia among immediate postpartum women in Ethiopia. Therefore, midwives, and doctors, shall focus on prevention of maternal hemorrhage, nutritional advice and counseling including iron /foliate supplementation, and avoid unnecessary instrumental delivery to prevent and reduce anemia related maternal mortality and morbidity in Ethiopia. PROSPERO REGISTRATION: CRD42023437414 with registration date on 02/08/2023.

Comorbid depression among adults with heart failure in Ethiopia: a hospital-based cross-sectional study.

BACKGROUND: Depression is a common comorbidity in adults with heart failure. It is associated with poor clinical outcomes, including decreased health-related quality of life and increased morbidity and mortality. There is a lack of data concerning the extent of this issue in Ethiopia. Consequently, this study aimed to assess the prevalence of comorbid depression and associated factors among adults living with heart failure in Ethiopia. METHODS: A hospital-based cross-sectional study was conducted at the cardiac outpatient clinics of two selected specialist public hospitals in Addis Ababa, Ethiopia: St. Paul's Hospital Millennium Medical College and St. Peter Specialized Hospital. An interviewer-administered questionnaire was used to collect data from 383 adults with heart failure who attended the clinics and met the inclusion criteria. Depression was measured using the Patient Health Questionnaire (PHQ-9). A binary logistic regression model was fitted to identify factors associated with depression. All statistical analyses were conducted using STATA version 17 software. RESULTS: The mean age of the participants was 55 years. On average, participants had moderate depression, as indicated by the mean PHQ-9 score of 11.02 ± 6.14, and 217 (56.6%, 95%CI 51.53-61.68) had comorbid depression. Significant associations with depression were observed among participants who were female (AOR: 2.31, 95%CI:1.30-4.08), had comorbid diabetes mellitus (AOR: 3.16, 95%CI: 1.47-6.82), were classified as New York Heart Association (NYHA) class IV (AOR: 3.59, 95%CI: 1.05-12.30), reported poor levels of social support (AOR: 6.04, 95%CI: 2.97-12.32), and took more than five medications per day (AOR: 5.26, 95%CI: 2.72-10.18). CONCLUSIONS: This study indicates that over half of all adults with heart failure in Ethiopia have comorbid depression, influenced by several factors. The findings have significant implications in terms of treatment outcomes and quality of life. More research in the area, including interventional and qualitative studies, and consideration of multifaceted approaches, such as psychosocial interventions, are needed to reduce the burden of comorbid depression in this population.

Hematological, clinical, cytogenetic and molecular profiles of confirmed chronic myeloid leukemia patients at presentation at a tertiary care teaching hospital in Addis Ababa, Ethiopia: a cross-sectional study.

BACKGROUND: In low-income countries there is insufficient evidence on hematological, clinical, cytogenetic and molecular profiles among new CML patients. Therefore, we performed this study among newly confirmed CML patients at Tikur Anbesa Specialized Hospital (TASH), Ethiopia. OBJECTIVE: To determine the hematological, clinical, cytogenetic and molecular profiles of confirmed CML patients at tertiary care teaching hospital in Addis Ababa, Ethiopia. METHODS: A facility-based cross-sectional study was conducted to evaluate hematological, clinical, cytogenetic and molecular profiles of confirmed CML patients at TASH from August 2021 to December 2022. A structured questionnaire was used to collect the patients' sociodemographic information, medical history and physical examination, and blood samples were also collected for hematological, cytogenetic and molecular tests. Descriptive statistics were used to analyze the sociodemographic, hematological, clinical, cytogenetic and molecular profiles of the study participants. RESULTS: A total of 251 confirmed new CML patients were recruited for the study. The majority of patients were male (151 [60.2%]; chronic (CP) CML, 213 [84.7%]; and had a median age of 36 years. The median (IQR) WBC, RBC, HGB and PLT counts were 217.7 (155.62-307.4) x103/µL, 3.2 (2.72-3.6) x106/µL, 9.3 (8.2-11) g/dl and 324 (211-499) x 103/µL, respectively. All patients had leukocytosis, and 92.8%, 95.6% and 99.2% of the patients developed anemia, hyperleukocytosis and neutrophilia, respectively. Fatigue, abdominal pain, splenomegaly and weight loss were the common signs and symptoms observed among CML patients. Approximately 86.1% of the study participants were Philadelphia chromosome positive (Ph+) according to fluorescence in situ hybridization (FISH). P210, the major breakpoint protein, transcript was detected by both qualitative polymerase chain reaction (PCR) and quantitative real time polymerase chain reaction (PCR). CONCLUSION: During presentation, most CML patients presented with hyperleukocytosis, neutrophilia and anemia at TASH, Addis Ababa. Fatigue, abdominal pain, splenomegaly and weight loss were the most common signs and symptoms observed in the CML patients. Most CML patients were diagnosed by FISH, and p120 was detected in all CML patients diagnosed by PCR. The majority of CML patients arrive at referral center with advanced signs and symptoms, so better to decentralize the service to peripheral health facilities.

Female genital mutilation: trends, economic burden of delay and basis for public health interventions.

BACKGROUND: The practice of female genital mutilation (FGM) is a health and social problem. Millions of girls and women have undergone FGM or will soon, and more information is needed to effectively reduce the practice. The aim of this research is to provide an overview of the FGM trendlines, the inequality of its prevalence, and the economic burden. The findings shed light on 30-year trends and the impact of the pandemic on planned efforts to reduce FGM which helps with public health interventions. METHODS: Temporal trend analysis, and graphical analysis were used to assess the change and inequality over the last 30 years. We included 27 countries in which FGM is prevalent. We calculated the extra economic burden of delayed interventions to reduce FGM like COVID-19. RESULTS: For the 27 countries analyzed for temporal trendlines, 13 countries showed no change over time while 14 had decreasing trends. Among the 14, nine countries, Uganda, Togo, Ghana, Benin, Kenya, Nigeria, Central African Republic, Chad, and Ethiopia had high year-decrease (CAGR - 1.01 and - 10.26) while five, Côte d'Ivoire, Egypt, Gambia, Djibouti, and Mali had low year-decrease (CAGR>-1 and < 0). Among these five are the highest FGM prevalence similar distribution regardless the wealth quintiles or residence. There is an economic burden of delay or non-decline of FGM that could be averted. CONCLUSION: Findings indicate that some countries show a declining trend over time while others not. It can be observed that there is heterogeneity and homogeneity in the FGM prevalence within and between countries which may indicate inequality that deserves further investigation. There is considerable economic burden due to delays in the implementation of interventions to reduce or eliminate FGM. These insights can help in the preparation of public health interventions.

Determinants of externally visible birth defects among perinatal deaths at Adama Comprehensive Specialized Hospital: a case-control study.

BACKGROUND: Birth defects (BDs) are the major causes of infant morbidity and mortality in both developed and developing countries. Regardless of their clinical importance, few studies on predisposing factors have been conducted in Ethiopia. However, due to a lack of advanced diagnostic materials, we only considered the externally visible BDs. OBJECTIVE: To assess the determinants of externally visible birth defects among perinatal deaths at Adama Comprehensive Specialized Hospital. METHODS: A retrospective unmatched case-control study design was conducted from November 01 to 30, 2021. The sample size was determined by Epi Info version 7 software considering sample size calculation for an unmatched case-control study. A total of 315 participants (63 cases, and 252 controls) were selected by simple random sampling. Data were collected by an open data kit (ODK) and transported to a statical package for social sciences (SPSS) version 26 software for analysis. The bivariate followed by multivariable logistic regression analyses were done to determine the factors associated with the BD. RESULTS: This study showed that drinking alcohol during pregnancy (AOR = 6.575; 95% CI: 3.102,13.937), lack of antenatal care (ANC) follow-up during pregnancy (AOR = 2.794; 95% CI: 1.333, 5.859), having a history of stillbirth in a previous pregnancy (AOR = 3.967; 95% CI: 1.772, 8.881), exposure to pesticides during pregnancy (AOR = 4.840; 95% CI: 1.375, 17.034), having a history of BDs in a previous pregnancy (AOR = 4.853; 95% CI: 1.492, 15.788), and lack of folic acid supplementation during early pregnancy (AOR = 4.324; 95% CI: 2.062, 9.067) were significant determinants of externally visible BDs among perinatal deaths. CONCLUSION: In this study, alcohol use, exposure to pesticides, and lack of folic acid supplementation during pregnancy were identified as the major determinants of externally visible BDs among perinatal deaths. Thus, health education regarding the associated factors of BDs and their preventive strategies should be given to pregnant mothers.

Prevalence of Pre-Hypertension/Hypertension and Its Associated Factors Among Adults in the Wolaita Zone of Southern Ethiopia: A Cross-Sectional Study.

Preventing the development of high blood pressure and resulting complication requires estimating the prevalence of prehypertension/hypertension and identifying associated risk factors. Information about pre-hypertension/hypertension in Ethiopia, especially in the southern region, is scarce, and limited knowledge exists regarding the prevalence and risk factors associated with pre-hypertension/hypertension. Objective of this study was to assess prevalence of pre-hypertension/hypertension and its associated factors among adults in Wolaita Zone of Southern Ethiopia, 2023. This cross-sectional study was conducted among adults attending outpatient departments in governmental hospitals in South Ethiopia in 2023. Face-to-face interviews were used to gather information on sociodemographic data, dietary and behavioral patterns, and medical history. Digital weighing scales, Stadiometers, and digital sphygmomanometers were used to measure height, blood pressure, and weight, respectively. Epi-Data version 3.1 was used to enter the data before exporting it to SPSS version 25 for analysis. To find factors associated with prehypertension/hypertension, binary logistic regressions were conducted and odds ratios with 95% confidence intervals were computed. The overall prevalence of prehypertension/hypertension was 42.8% (95% confidence interval: 39.56, 49.47). Factors associated with prehypertension/hypertension in this study were older age, male gender, obesity, diabetes mellitus comorbidity, alcohol drinking, and family history of hypertension. Lifestyle modification is demanded for pre-hypertensive/hypertensive patients to prevent progression to severe complications, including premature death and permanent disabilities.

Time to initiation of antenatal care and its predictors among pregnant women in Ethiopia: a multilevel mixed-effects acceleration failure time model.

OBJECTIVE: To assess the time to initiation of antenatal care (ANC) and its predictors among pregnant women in Ethiopia. DESIGN: Retrospective follow-up study using secondary data from the 2019 Ethiopian Mini-Demographic and Health Survey. SETTING AND PARTICIPANTS: 2933 women aged 15-49 years who had ANC visits during their current or most recent pregnancy within the 5 years prior to the survey were included in this study. Women who attended prenatal appointments but whose gestational age was unknown at the first prenatal visit were excluded from the study. OUTCOME MEASURES: Participants were interviewed about the gestational age in months at which they made the first ANC visit. Multivariable mixed-effects survival regression was fitted to identify factors associated with the time to initiation of ANC. RESULTS: In this study, the estimated mean survival time of pregnant women to initiate the first ANC visit in Ethiopia was found to be 6.8 months (95% CI: 6.68, 6.95). Women whose last birth was a caesarean section (adjusted acceleration factor (AAF)=0.75; 95% CI: 0.61, 0.93) and women with higher education (AAF)=0.69; 95% CI: 0.50, 0.95) had a shorter time to initiate ANC early in the first trimester of pregnancy. However, being grand multiparous (AAF=1.31; 95% CI: 1.05, 1.63), being previously in a union (AAF=1.47; 95% CI: 1.07, 2.00), having a home birth (AAF=1.35; 95% CI: 1.13, 1.61) and living in a rural area (AAF=1.25; 95% CI: 1.03, 1.52) were the impediments to early ANC initiation. CONCLUSION: Women in this study area sought their initial ANC far later than what the WHO recommended. Therefore, healthcare providers should collaborate with community health workers to provide home-based care in order to encourage prompt ANC among hard-to-reach populations, such as rural residents and those giving birth at home.

Impact of COVID-19 on antenatal care provision at public hospitals in the Sidama region, Ethiopia: A mixed methods study.

BACKGROUND: Coronavirus disease 2019 (COVID-19) continues to pose a global public health threat. The pandemic overstretched already weak health systems in low- and low-middle-income countries, including Ethiopia. There is a paucity of studies on the impact of COVID-19 on antenatal care access, uptake, and provision in Ethiopia. This study examines the impact of COVID-19 on antenatal care provision in the Sidama region, Ethiopia. METHODS: A concurrent mixed-methods study was conducted between 14 February and 10 May 2022 at 15 public hospitals in the Sidama region. An interrupted times series design was applied for a quantitative study, which included data from all pregnant women who attended antenatal care before COVID-19 (12 months, March 2019 to February 2020) and during COVID-19 (six months, March to August 2020) at 15 public hospitals in the region. The total numbers in the antenatal care 1 cohort (at least one antenatal care contact) and antenatal care 4 cohort (at least four antenatal care contacts) were 15,150 and 5,850, respectively, forming a combined final dataset of 21,000 women. Routinely collected monthly data were derived from the hospitals' health management information system and imported into Stata version 17 for analysis. The mean monthly incidence rate ratio of antenatal care uptake was calculated using a Poisson regression model with a 95% confidence interval. Simultaneously, an exploratory study design was conducted for qualitative using in-depth interviews to explore maternity care providers' perceptions of the impact of COVID-19 on antenatal care access, uptake, and provision. Qualitative data were thematically analysed. The quantitative and qualitative findings were then integrated using the joint display technique. RESULTS: Our findings indicate a significant monthly decrease of 0.7% in antenatal care 1 and 1.8% in antenatal care 4 during the first six months of the pandemic. A lack of medical supplies, fear of contracting COVID-19, inadequate personal protective equipment, discrimination against those attending the hospital, and the absence of antenatal care guidelines for care provision, COVID-19 vaccine hesitancy and long waiting times for ANC led to disrupted access, uptake, and provision of antenatal care during COVID-19. CONCLUSION AND RECOMMENDATIONS: Our findings demonstrate that the COVID-19 pandemic affected antenatal care access, uptake, and provision in the study area from March to August 2020. To mitigate disrupted antenatal care access, uptake and provision, antenatal care clinics should be equipped with medical supplies. It is crucial to maintain rapport between the community and maternity care providers and provide training for maternity care providers regarding the adapted/adopted guidelines during COVID-19 at the hospital grassroots level for use in the current and future pandemics. Pregnant women should have timely access to maternity care providers in order to maintain at least a minimum standard of care in current and future pandemics.

Personal protective equipment utilization and its association with educational status among industry workers in Ethiopia: A systematic review and meta-analysis protocol.

INTRODUCTION: Ethiopia is experiencing high prevalence of occupational morbidity and disability. One of the main contributing reasons is a low utilization of personal protective equipment (PPE). Previous studies on PPE utilization and association with educational status among industry workers were largely inconsistent. Therefore, this meta-analysis is aimed to pool the magnitude of PPE utilization and its association with educational status among industry workers in Ethiopia. METHOD: A compressive search of international databases and libraries including Scopus, PubMed, MedNar, Embase, MEDLINE, the web of science, Google Scholar, the JBI Library, African Journals Online, and Science direct will be carried out to locate published reports. Two independent reviewers will screen the records for inclusion using standardized JBI tools. Before extracting and synthesizing data, the selected studies will undergo a rigorous critical appraisal. If appropriate, a meta-analysis will be conducted. Cochrane Q-test and I2-test statistics will be used to assess the heterogeneity between studies. If necessary, meta-regression and subgroup analyses will be conducted to explore potential reasons for any inconsistency and heterogeneity. Sensitivity analysis will be performed to assess the effect of a single study on the pooled magnitude estimates. Funnel plots, along with Egger's and Begg's tests, will be used to assess the presence of publication bias. PROSPERO registration number: PROSPERO, CRD42022364562.

Respiratory-related deaths and associated factors in Alicho-Weriro district, southern Ethiopia: verbal autopsy data analysis.

BACKGROUND: Respiratory diseases disproportionately affect people living in resource-limited settings. However, obtaining information that explains respiratory-related deaths has been difficult, mainly due to a lack of medical certification of death and the fact that most deaths occur outside of health institutions. This study aimed to determine the proportion of respiratory-related deaths and identify associated factors in Alicho-Weriro district, southern Ethiopia, using the verbal autopsy method. METHODS: A community-based cross-sectional study was conducted from April to June 2022. All deceased people in the study area from January 2020 to December 2021 were included in the study. Trained physicians ascertained the cause of death from verbal autopsy data that were collected using a pre-tested and modified WHO-designed questionnaire. The binary logistic regression models were used to identify factors associated with respiratory-related deaths. RESULTS: Respiratory-related deaths accounted for 25% of the deaths from all causes, with 20.8% of male and 29.5% of female deaths. Of which, 9.7% were from tuberculosis, 8.3% were from asthma and 6.2% were from acute lower-respiratory tract infections. Moreover, being female (adjusted OR, AOR: 3.3; 95% CI: (1.75 to 6.22)), age 50-64 years (AOR: 9.3; 95% CI: (1.16 to 73.90)), age above 64 years (AOR: 8.9; 95% CI: (1.130 to 70.79)), family size of five persons or more (AOR: 1.9; 95% CI: (1.15 to 3.29)), smoking (AOR: 3.9; 95% CI: (1.86 to 8.35)), using wood and/or animal dung for household cooking (AOR: 6.6; 95% CI: (1.92 to 22.59)) and poor house ventilation (AOR: 3.1; 95% CI: (1.75 to 5.38)) were significantly associated with increased odds of dying from respiratory-related diseases. CONCLUSION: This study has determined that about a quarter of deaths from all causes were due to respiratory diseases, mainly tuberculosis, asthma and acute lower respiratory tract infections. Therefore, interventions to reduce this burden should focus on supporting early case detection and treatment, promoting healthy lifestyles, exercising women's equality at the household level and improving housing conditions.

Histopathologic patterns and factors associated with cervical lesions at Jimma Medical Center, Jimma, Southwest Ethiopia: A two-year cross-sectional study.

BACKGROUND: The cervix is the lower portion of the uterus, which connects this organ to the vagina through the endocervical canal. OBJECTIVE: This study aimed to determine the histopathologic patterns and factors associated with cervical lesions at Jimma Medical Center from September 12, 2017, to September 12, 2019. METHODS: A 2-year facility-based cross-sectional study was conducted from May 1 to June 30, 2020. RESULT: In this study, cervical cancer was the most common (71%) cause of cervical lesions. Squamous cell carcinoma was the most frequent cervical cancer diagnosed during the study, accounting for 96.4% of 331 cancerous cases, followed by adenocarcinoma (3.3%). High-grade squamous intraepithelial lesions were the most frequently diagnosed precancerous lesions, accounting for 68.4% of cases. Endocervical polyps were the most commonly diagnosed benign lesions, accounting for 59.3% of cases. CONCLUSION: The maximum age distribution of cervical lesions was in the 41-50-year age range. Squamous cell carcinoma was the most frequent type of cervical cancer. High-grade squamous intraepithelial lesions were the most frequently diagnosed precancerous cervical lesions. The most common benign cervical lesions were endocervical polyps. RECOMMENDATION: We recommend educating the community to improve health-seeking behavior and on possible preventive strategies for cervical cancer.

Mental health dynamics of adolescents: A one-year longitudinal study in Harari, eastern Ethiopia.

AIMS: This study aims to assess the dynamics of in-school adolescents' mental health problems in Harari regional state, eastern Ethiopia for a year. MATERIALS AND METHODS: Using multistage sampling technique, we conducted a year-long longitudinal study at three public high schools between March 2020 and 2021. Three hundred fifty-eight in-school adolescents were chosen by systematic random sampling for the baseline assessment, and 328 completed the follow-up assessment. We used self-administered, adolescent version of SDQ-25 Questionnaire to collect the data. Wilcoxon matched-pairs signed-rank test and McNemara's Chi-squared tests were used to examine the median difference and distribution of mental health problems between times one and two. Random-effects logistic regressions on panel data was used to identify factors associated with mental health problems. A p-value < 0.05 was considered as statistically significant. RESULTS: The magnitude of overall mental health problems at baseline assessment was 20.11% (95% CI: 16-25), with internalizing problems accounting for 27.14% (95% CI: 23-32) and externalizing problems accounting for 7.01% (95% CI: 4.6-10.3). At the follow-up assessment, these proportions rose to 22.56% (95% CI, 18-27) for overall problems and 10.3% (95% CI, 7.7-14.45) for externalizing problems. On other hand, internalizing problems decreased unexpectedly to 22.86% (95% CI, 18.6-27.7) at follow-up assessment. Internalizing problem scores at time two were significantly lower than baseline among older adolescents, girls and those with average wealth index in our study cohort. CONCLUSIONS: The prevalence of mental health problems were high among the study cohort. The proportion of overall problems and externalizing problems has increased over time, indicating a deterioration in the mental health of the study cohort. However, the decrease in internalizing problems among older adolescents, girls, and those with an average wealth index is a positive sign. The findings highlight that tailored interventions are required to reduce externalizing problems and maintain the decrease in internalizing problems. These interventions should target middle-aged and male adolescents from low-income families.

Prevalence and patterns of third molar impaction among Ethiopians in Addis Ababa: a retrospective pilot study.

Tooth impaction is a condition in which a tooth does not reach its normal position and is often observed in the third mandibular molar due to inadequate space. This study aimed to investigate the prevalence and configuration of the impacted third molars with an emphasis on angular orientations in a sample of the Ethiopian population. This cross-sectional study included a retrospective analysis of 291 patient records and orthopantomography data from the archives of a private dental clinic in Addis Ababa, during the study period from December 2020 to November 2022. Demographic details and data on the position and level of the impacted third molars were evaluated using the Winter classification. Data were analyzed for frequency distribution. The prevalence of impacted third molars was 22% (n = 64), with a greater incidence on the right side (60.9%) and a higher frequency in the mandible (67.2%). Vertical angulation (32.8%), followed by mesioangular angulation (31.2%), was the most common impaction pattern. The results highlight the need for improved treatment protocols for third molar impaction, emphasizing the prevalence in the mandible and the importance of addressing vertical impaction. Regular dental check-ups are essential for assessing third molar impaction and planning appropriate management. These data can inform policymaking and treatment considerations for impacted third molars in the Ethiopian population.

Prevalence of metabolic syndrome and associated factors among patient with type 2 diabetes mellitus in Ethiopia, 2023: asystematic review and meta analysis.

BACKGROUND: Metabolic syndrome is a complex pathophysiologic state which characterized by abdominal obesity, insulin resistance, hypertension, and hyperlipidaemia. The Adult Treatment Panel III report (ATP III) of the National Cholesterol Education Programme identified the metabolic syndrome as a serious public health issue in the modern era. In Western and Asian nations, the frequency of metabolic syndrome is rising, especially in developing regions experiencing rapid socio-environmental changes, in Sub-Saharan Africa; metabolic syndrome may be present in more than 70% of people with type 2 diabetes mellitus. Therefore the objective of our study was to estimate the pooled prevalence of metabolic syndrome and associated factors among type II diabetes mellitus patient. METHOD: This systematic review and meta-analysis included original articles of cross sectional studies published in the English language. Searches were carried out in PubMed, Web of Science, Google Scholar, and grey literature Journals from 2013 to June 2023. A random-effects model was used to estimate the pooled prevalence of metabolic syndrome among type II Diabetes mellitus patient in Ethiopia. Heterogeneity was assessed using the I2 statistic. Subgroup analysis was also conducted based on study area. Egger's test was used to assess publication bias. Sensitivity analysis was also conducted. RESULTS: Out of 300 potential articles, 8 cross sectional studies were included in this systematic review and meta-analysis study. The pooled prevalence of metabolic syndrome among patient with type II diabetes mellitus in Ethiopia was found to be 64.49% (95% CI: 62.39, 66.59) and 52.38% (95% CI: 50.05, 54.73) by using NCEP/ATP III and IDF criteria, respectively. The weighted pooled prevalence of metabolic syndrome among type II diabetes mellitus patients by sub group analysis based on the study region was 63.79% (95% CI: 56.48, 71.11) and 52.23% (95%CI: 47.37, 57.22) by using NCEP/ATP III and IDF criteria, respectively. Being female and increased body mass index were factors associated with metabolic syndrome among type II diabetes mellitus patients. CONCLUSION: The prevalence of metabolic syndrome among type II patient is high. Therefore, policymakers, clinicians, and concerned stakeholders shall urge effective strategies in the control, prevention, and management of metabolic syndrome among type II diabetes mellitus.

Isolation and Identification of Pasteurella multocida and Mannheimia haemolytica from Pneumonic Small Ruminants and Their Antibiotic Susceptibility in Haramaya District, Eastern Ethiopia.

Background: Pasteurella species are frequently encountered as serious diseases in small ruminants. It is the main cause of respiratory pasteurellosis in sheep and goats of all age groups. Methods: The cross-sectional study was conducted from December 2022 to April 2023 in Haramaya district, eastern Ethiopia, to isolate and identify Pasteurella multocida and Mannheimia haemolytica and estimate their prevalence, associated risk factors, and antimicrobial sensitivity of isolates in small ruminants using a purposive sampling method. A total of 384 samples (156 nasal swabs from clinic cases and 228 lung swabs from abattoir cases) were collected. STATA 14 software was used to analyze the data. In addition, multivariable logistic regression analysis was performed to assess an association of risk factors. Results: Out of the 384 samples examined, 164 were positive for pasteurellosis, resulting in a 42.70% prevalence. Similarly, 63 (38.4%) of the 164 positive results were from nasal swabs, while 101 (61.6%) came from lung samples. M. haemolytica accounted for 126 (76.82%) of the isolates, while P. multocida accounted for 38 (23.17%). Of the 63 nasal swab isolates, 33 (37%) were from goats and 30 (42.8%) were from sheep. And 17 (10.89%) and 46 (29.58%), respectively, were P. multocida and M. haemolytica. Of the 46 (40%) of the 101 (44.3%) isolates of the pneumonic lung, samples were from goats, while 55 (48.47%) were from sheep. In this study, the risk factors (species, age, and body condition score) were found to be significant (p < 0.05). Pasteurella isolates evaluated for antibiotic susceptibility were highly resistant to oxacillin (90.90%), followed by gentamycin (72.72%), and penicillin (63.63%). However, the isolates were highly sensitive to chloramphenicol (90.90%), followed by tetracycline (63.63%), and ampicillin (54.54%). Conclusion: This study showed that M. haemolytica and P. multocida are the common causes of mannheimiosis and pasteurellosis in small ruminants, respectively, and isolates were resistant to commonly used antibiotics in the study area. Thus, an integrated vaccination strategy, antimicrobial resistance monitoring, and avoidance of stress-inducing factors are recommended.

Survival status and predictors of mortality among preterm neonates admitted in Bench Sheko Zone, Sheka Zone and Keffa Zone Governmental Hospitals, Southwest Ethiopia (2021): prospective follow-up study.

INTRODUCTION: Prematurity presents a significant challenge to the global community due to the rapid increase in its incidence and its disproportionate contribution to increased infant mortality rates. OBJECTIVE: To assess the survival status and predictors of mortality among preterm neonates. DESIGN: A multicentre prospective follow-up study was used. SETTING: 625 preterm neonates were admitted to hospitals for secondary level of care. The study covers the Bench Maji Zone, Keffa Zone, Sheka Zone, nearby woredas and portions of the Gambella area in Southwest Ethiopia. PARTICIPANTS: 614 preterm neonates with gestational age less than 37 weeks were entered for follow-up and 400 neonates were censored. Neonates with severe fetal malformations and neonates who need urgent referral were excluded from the study. RESULTS: Overall, 200 (32.57%) participants died with an incidence rate of 61.69 deaths per 1000 person-day observations (95% CI: 53.71 to 70.86). Poor kangaroo mother care (KMC) services (adjusted HR (AHR)=0.19, 95% CI: 0.12 to 0.29), sex (AHR=0.66, 95%, CI: 0.47 to 0.94), not initiating breast feeding (HR=2.78, 95% CI: 1.8 to 4.28), hypothermia (AHR=0.63, 95% CI: 0.44 to 0.92), anaemia (AHR=6.2, 95% CI: 2.34 to 16.43) and gestational age less than 28 weeks (AHR=9.28, 95% CI: 1.78 to 48.42) were independent predictors. CONCLUSION AND RECOMMENDATION: The rate of preterm neonatal mortality was high compared with the Ethiopia Demographic and Health Survey report nationally. Healthcare workers should encourage KMC services and breastfeeding initiation and prevent preterm neonates from being anaemic to increase their chances of survival.

Long-term monitoring of SARS-CoV-2 seroprevalence and variants in Ethiopia provides prediction for immunity and cross-immunity.

Under-reporting of COVID-19 and the limited information about circulating SARS-CoV-2 variants remain major challenges for many African countries. We analyzed SARS-CoV-2 infection dynamics in Addis Ababa and Jimma, Ethiopia, focusing on reinfection, immunity, and vaccination effects. We conducted an antibody serology study spanning August 2020 to July 2022 with five rounds of data collection across a population of 4723, sequenced PCR-test positive samples, used available test positivity rates, and constructed two mathematical models integrating this data. A multivariant model explores variant dynamics identifying wildtype, alpha, delta, and omicron BA.4/5 as key variants in the study population, and cross-immunity between variants, revealing risk reductions between 24% and 69%. An antibody-level model predicts slow decay leading to sustained high antibody levels. Retrospectively, increased early vaccination might have substantially reduced infections during the delta and omicron waves in the considered group of individuals, though further vaccination now seems less impactful.

Anthropometric failures and its predictors among under five children in Ethiopia: multilevel logistic regression model using 2019 Ethiopian demographic and health survey data.

BACKGROUND: Composite Index of Anthropometric Failure (CIAF) combines all three forms of anthropometric failures to assess undernutrition status of children. There is no study on CIAF to identify the real and severe form of under nutrition among Ethiopian children that addressed community level factors. So, this study determined CIAF and identified important factors which helps to design appropriate intervention strategies by using multi-level advanced statistical model. METHODS: The study included 5,530 under five children and utilized a secondary data (EMDHS 2019) which was collected through community-based and cross-sectionally from March 21 to June 28, 2019. Composite index of anthropometric failure among under five children was assessed and a two-stage sampling technique was used to select the study participants. Descriptive summary statistics was computed. A multi-level binary logistic regression model was employed to identify important predictors of CIAF in under five children. Adjusted odds ratio with its 95% CI was estimated and level of significance 0.05 was used to determine significant predictors of CIAF. RESULTS: The prevalence of composite index of anthropometric failure (CIAF) was 40.69% (95% CI: 39.41, 42.00) in Ethiopia. Both individual and community level predictors were identified for CIAF in under five children. Among individual level predictors being male sex, older age, short birth interval, from mothers who have not formal education, and from poor household wealth quintile were associated with higher odds of CIAF among under five children. Low community women literacy and being from agriculturally based regions were the community level predictors that were associated with higher odds of CIAF in under five children in Ethiopia. CONCLUSIONS: The burden of composite index of anthropometric failure in under five children was high in Ethiopia. Age of child, sex of child, preceding birth interval, mother's education, household wealth index, community women literacy and administrative regions of Ethiopia were identified as significant predictors of CIAF. Therefore, emphasis should be given for those factors to decrease the prevalence of CIAF in under five children in Ethiopia.