Prevalence of metabolic syndrome among people living with human immunodeficiency virus in sub-Saharan Africa: a systematic review and meta-analysis.

Metabolic syndrome (MetS) poses a significant clinical challenge for individuals living with HIV (PLHIV). In sub-Saharan Africa (SSA), this condition is becoming a growing concern, owing to lifestyle changes and an increasingly aging population. Several SSA countries have reported on the prevalence of MetS. However, these estimates may be outdated because numerous recent studies have updated MetS prevalence among PLHIV in these countries. Moreover, prior research has focused on various study designs to report the pooled prevalence, which is a methodological limitation. Therefore, this systematic review and meta-analysis aimed to determine the pooled estimates of MetS in PLHIV in SSA by addressing these gaps. We systematically searched Google Scholar, Science Direct, Scopus, Web of Sciences, EMBASE, and PubMed/Medline for the prevalence of MetS and its subcomponents among people with HIV in sub-Saharan Africa. The estimated pooled prevalence was presented using a forest plot. Egger's and Begg's rank regression tests were used to assess evidence of publication bias. Twenty-five studies fulfilled the inclusion criteria after review of the updated PRISMA guidelines. The pooled prevalence of MetS was 21.01% [95% CI: (16.50, 25.51)] and 23.42% [95% CI: (19.16, 27.08)] to the National Cholesterol Education Program Adult Treatment Panel III (NCEP/ATP III) and International Diabetes Federation (IDF) criteria, respectively. Low levels of high-density lipoprotein cholesterol (Low HDL) at 47.25% [95% CI: 34.17, 60.33)] were the highest reported individual subcomponent, followed by abdominal obesity at 38.44% [95% CI: (28.81, 48.88)]. The prevalence of MetS is high in sub-Saharan Africa. Low HDL levels and increased waist circumference/abdominal obesity were the most prevalent components of MetS. Therefore, early screening for MetS components and lifestyle modifications is required. Policymakers should develop strategies to prevent MetS before an epidemic occurs.PROSPERO: CRD42023445294.

Human papillomavirus vaccination uptake and determinant factors among adolescent schoolgirls in sub-Saharan Africa: A systematic review and meta-analysis.

Despite the ongoing global vaccination campaign aimed at preventing human papillomavirus (HPV) related health issues, the uptake of the HPV vaccine remains unacceptably low in developing regions, particularly in sub-Saharan Africa (SSA). Therefore, this systematic review and meta-analysis aimed at determining the pooled prevalence and associated factors of HPV vaccine uptake among adolescent school girls in SSA. Electronic bio-medical databases were explored. Pooled prevalence, publication bias, meta-regression, sub-group, and sensitivity analysis were performed. The estimated pooled prevalence of HPV vaccine uptake was 28.53% [95% CI: (5.25, 51.81)]. Having good knowledge and a positive attitude was significantly associated with HPV vaccine uptake in SSA. Subgroup analysis revealed the highest uptake was 62.52% from Kenya and the lowest was 3.77% in Nigeria. The HPV vaccine uptake is low. It underscores the need for community education, school-based immunization, and education programs that promote the uptake of the vaccine to increase coverage.

Knowledge, Attitude and Practice Towards Cervical Cancer Screening Among Women and Associated Factors in Hospitals of Wolaita Zone, Southern Ethiopia.

BACKGROUND: Cervical cancer is a worldwide public health concern, and approximately 85% of deaths occurs in developing countries. Thus study is designed to assess knowledge, attitude, and practice towards cervical cancer screening in Wolaita Zone, Southern Ethiopia. METHODS: We conducted a facility-based cross-sectional study. In this research, we used a multi-stage sampling procedure to select 520 participants. Information on socio-demographics, knowledge, attitude, and cervical cancer screening related questionnaires were collected using face-to-face interviews. Data were entered and cleaned in Epi-Data version 3.1 and exported to SPSS version 20 for analysis. For the analysis, we used logistic regression along with odds ratios and 95% confidence intervals. The statistical significance was determined by p <0.05. RESULTS: Approximately 154 (43.1%) of women had good knowledge, 235 (45.5%) had a favorable attitude, and nearly a quarter (118; 22.9%) had been screened for cervical cancer. Women 30-34 years [AOR=3.02, 95% CI: 1.11, 8.24), women with degree/diploma level of education [AOR=7.3, 95% CI 2.53-21.01), and having sourced information from a health professional [AOR=2.3, 95% CI: 1.27-4.17) were associated with good knowledge of cervical cancer screening. Being single [AOR=3.47, 95% CI: 1.03-11.75] and good knowledge of cervical cancer [AOR=4.76, 95%:2.65-8.57) were significant predictors of a positive attitude towards cervical cancer screening. Women who knew cervical cancer patients[AOR=2.47, 95% (1.37-4.44)] and high monthly income [AOR=3.8, 95% CI: 1.86-7.77] were associated with good practice related to cervical cancer screening. CONCLUSION: Knowledge, attitude, and practice towards cervical cancer screening were shallow. The concerned body should aggressively disseminate information on cervical cancer screening, improve the economic status of women, and provide counseling about cervical cancer during health care delivery visits.

Institutional Delivery Service Utilization among Women from Rural Districts of Wolaita and Dawro Zones, Southern Ethiopia; a Community Based Cross-Sectional Study.

INTRODUCTION: The highest number of maternal deaths occur during labour, delivery and the first day after delivery highlighting the critical need for good quality care during this period. Therefore, for the strategies of institutional delivery to be effective, it is essential to understand the factors that influence individual and household factors to utilize skilled birth attendance and institutions for delivery. This study was aimed to assess factors affecting the utilization of institutional delivery service of women in rural districts of Wolaita and Dawro Zones. METHODS: A community based cross-sectional study was done among mothers who gave birth within the past one year preceding the survey in Wolaita and Dawro Zones, from February 01 -April 30, 2015 by using a three stage sampling technique. Initially, 6 districts were selected randomly from the total of 17 eligible districts. Then, 2 kebele from each district was selected randomly cumulating a total of 12 clusters. Finally, study participants were selected from each cluster by using systematic sampling technique. Accordingly, 957 mothers were included in the survey. Data was collected by using a pretested interviewer administered structured questionnaire. The questionnaire was prepared by including socio-demographic variables and variables of maternal health service utilization factors. Data was entered using Epi-data version 1.4.4.0 and exported to SPSS version 20 for analysis. Bivariate and multiple logistic regressions were applied to identify candidate and predictor variables respectively. RESULT: Only 38% of study participants delivered the index child at health facility. Husband's educational status, wealth index, average distance from nearest health facility, wanted pregnancy, agreement to follow post-natal care, problem faced during delivery, birth order, preference of health professional for ante-natal care and maternity care were predictors of institutional delivery. CONCLUSION: The use of institutional delivery service is low in the study community. Eventhough antenatal care service is high; nearly two in every three mothers delivered their index child out of health facility. Improving socio-economic status of mothers as well as availing modern health facilities to the nearest locality will have a good impact to improve institutional delivery service utilization. Similarly, education is also a tool to improve awareness of mothers and their husbands for the improvement of health care service utilization.