Uncontrolled hypertension among hypertensive patients in Sub-Saharan Africa: A systematic review and meta-analysis.

INTRODUCTION: Hypertension is a major global public health problem. It currently affects more than 1.4 billion people worldwide, projected to increase to 1.6 billion by 2025. Despite numerous primary studies have been conducted to determine the prevalence of uncontrolled hypertension and identify its associated factors among hypertensive patients in Sub-Saharan Africa, these studies presented inconsistent findings. Therefore, this review aimed to determine the pooled prevalence of uncontrolled hypertension and identify its associated factors. METHODS: We have searched PubMed, Google Scholar, and Web of Science databases extensively for all relevant studies. A manual search of the reference lists of included studies was performed. A weighted inverse-variance random-effects model was used to compute the overall pooled prevalence of uncontrolled hypertension and the effect size of its associated factors. Variations across the included studies were checked using forest plot, funnel plot, I2 statistics, and Egger's test. RESULTS: A total of twenty-six primary studies with a sample size of 11,600 participants were included in the final meta-analysis. The pooled prevalence of uncontrolled hypertension was 50.29% (95% CI: 41.88, 58.69; I2 = 98.98%; P<0.001). Age of the patient [AOR = 1.57: 95% CI: 1.004, 2.44], duration of diagnosis [AOR = 2.57: 95% CI: 1.18, 5.57], non-adherence to physical activity [AOR = 2.13: 95% CI: 1.15, 3.95], khat chewing [AOR = 3.83: 95% CI: 1.59, 9.24] and habitual coffee consumption [AOR = 10.79: 95% CI: 1.84, 63.24] were significantly associated with uncontrolled hypertension among hypertensive patients. CONCLUSIONS: The pooled prevalence of uncontrolled hypertension was considerably high. Older age, duration of diagnosis, non-adherence to physical activity, khat chewing and habitual coffee consumption were independent predictors of uncontrolled hypertension. Therefore, health professionals and other responsible stakeholders should encourage hypertensive patients to adhere to regular physical activity, and abstain from khat chewing and habitual coffee consumption. Early identification of hypertension and management of comorbidities is crucial, and it should be emphasized to control hypertension easily.

Decision to Delivery Interval, Fetal Outcomes and Its Factors Among Emergency Caesarean Section Deliveries at South Gondar Zone Hospitals, Northwest Ethiopia: Retrospective Cross-Sectional Study, 2020.

PURPOSE: Although its fetal outcomes and practicality are unclear time interval between decision-to-delivery ≤30 minutes in emergency caesarean section (CS) is the internationally accepted standard of practice. This study aimed to determine whether a decision to delivery interval (DDI) of approximately 30 minutes was achieved in daily practice, its fetal outcomes, and associated factors among emergency caesarean section delivery at South Gondar Zone Hospitals, Northwest Ethiopia. PATIENTS AND METHODS: Retrospective cross-sectional study was carried out from August 1-30/2020 among emergency caesarean sections. Information was collected from the birth register book and individual files of standardized facility booking forms. The data was encoded and entered into Epi-Data version 4.2 and exported to SPSS version 23 for analysis. A bivariable and multivariable logistic regression analysis was conducted and a significant association was recorded at p<0.05. RESULTS: Only 17.5% of parturients attained a decision-to-delivery interval ≤30 minutes. The average median of decision to delivery interval was 54 minutes with interquartile range (IQR) of 48-80 minutes. Time taken to collect material with Adjusted odds ratio (AOR=10.3, 95% CI 5.87-45.7), time of decision (AOR=0.32, 95% CI, 0.15-0.67), and time taken from decision to delivery to delivery of anesthesia (AOR=4.74, 95% CI, 1.30-17.3) were the predictors of prolonged delivery time interval. Significant fetal adverse outcomes were not observed in a decision to delivery interval higher than 30 minutes. CONCLUSION: In most cases, delivery was not completed within the prescribed ≤30-minutes interval, particularly in developing countries with infrastructural challenges, however, fetal outcomes were not directly correlated. Despite lack of substantial linkage between the delivery time declaration and fetal events, an unreasonable gap from the decision-making to birth of the child is not appropriate and should be discouraged.

Men's Knowledge of Vasectomy and Its Associated Factors in Debre Tabor Town, Northwest Ethiopia: A Community-Based Cross-Sectional Study.

PURPOSE: Even though vasectomy is one of the safest, simplest, and most effective family planning methods available for men, it is one of the least used contraceptive methods in the developing world, including Ethiopia. The goal of this study was to assess the level of knowledge towards vasectomy and its associated factors among married men in Debre Tabor Town. METHODS: A community-based cross-sectional study was conducted from December 5-25, 2019. A total of 413 married men participated and selected by simple random sampling. Data was entered using EpiData version 4.2 and analyzed by SPSS version 23. A bivariable and multivariable logistic regression model was carried out. Finally, variables having a P-value of <0.05 at 95% CI were considered as statistically significant. RESULTS: In this study, 38.5% of men had an adequate level of knowledge about vasectomy. Multivariable logistic regression showed that an educational status of secondary education and college and above (AOR=4.70, 95% CI=1.26-17.55; and AOR=8.36, 95% CI=2.41-28.97, respectively), having four or more alive children (AOR=0.51, 95% CI=0.29-0.89), and positive attitude (AOR=2.47, 95% CI=1.58-3.86) were significantly associated with knowledge of vasectomy. CONCLUSION: Knowledge of married men towards vasectomy was relatively low. Educational status, number of children, and attitude were statistically significant with the men's knowledge about vasectomy. Emphasis should therefore be put on improving the educational status of men and positively changing the male upbringing culture right from their childhood which will also improve their attitude towards vasectomy in the future.

Postpartum Modern Contraceptive Utilization and Associated Factors Among Women Who Gave Birth in the Last 12 Months in Addis Zemen, South Gondar, Ethiopia: Community-Based Cross-Sectional Study.

INTRODUCTION: While family planning (FP) is important throughout an individual's and couple's reproductive life, postpartum family planning (PPFP) focuses on the prevention of unintended and closely spaced pregnancies through the first 12 months following childbirth. However, modern contraception utilization practice during the postpartum period is underemphasized in Ethiopia. OBJECTIVE: This study aimed to assess postpartum modern contraceptive utilization and associated factors among postpartum women in Addis Zemen, South Gondar, Ethiopia in 2019. METHODS: Community-based cross-sectional study was conducted from January 1 to February 30, 2019 on 402 women. Study subjects were selected by simple random sampling technique. The data were collected by a structured and pretested, face-to-face, interviewer-administered questionnaire, entered into EpiData 4.2 and analyzed by using SPSS 23 software. Bivariate and multivariable analyses were used to examine the association. Odds ratio, 95% confidence interval (CI) and P-value <0.05 were used to determine the statistical association. RESULTS: The prevalence of postpartum family planning utilization was 54.7%. Maternal educational status (adjusted odd ratio (AOR)=2.99, 95% CI (1.72, 5.19)), menses return (AOR=4.76, 95% CI (3.03, 7.48)), less than four alive children (AOR=3.61, 95% CI (1.51, 4.51)), postnatal care follow-up (AOR=2.96, 95% CI (1.57, 5.57)), length of time after delivery (AOR=1.80, 95% CI (1.16, 2.79)) and knowledge (AOR=1.69, 95% CI (1.07, 2.66)) were significantly associated with postpartum modern contraceptive utilization. CONCLUSION: The postpartum modern contraceptive utilization was low. Therefore, health care providers should strengthen the integration of family planning services with maternal and child health service, provide health information about timely use of contraceptives and improve postnatal care follow-up after giving birth.