Uptake of human papilloma virus vaccine and its determinants among females in East Africa: a systematic review and meta-analysis.

INTRODUCTION: Cervical cancer is the most common malignant tumor among women. It is the main cause of death among women in sub-Saharan African countries. Particularly, the incidence and mortality rates are highest in East Africa. Even though the burden of human papilloma virus-related cervical cancer is high in East Africa, there is no conclusive evidence about the prevalence of human papilloma virus vaccine uptake and its predictors. OBJECTIVE: To assess the pooled prevalence of human papilloma virus vaccine uptake and its determinants in East Africa. METHOD: Eligible articles were searched on PubMed, Embase, Scopus, Cochrane Library, Google Scholar, and Google. Those articles incorporating the outcome of interest, both analytical and descriptive study designs, and published or unpublished articles at any time were included. Keywords and Medical Subjects Heading terms or synonyms of human papilloma virus vaccine and Boolean operators were used to retrieve the articles. To assure the quality of articles, Joana Brigg's Institute critical appraisal checklist for cross-sectional studies was used. Sensitivity analysis was conducted to assess the heterogeneity among the studies, and a random effect model was used to analyze the pooled effect size. RESULT: A total of 29 articles were included, and the pooled prevalence of HPV vaccine uptake in East Africa was 35% (95% CI: 26-45%). Good knowledge (OR = 1.6, 95%CI; 1.43-1.8), positive attitude (OR = 2.54, 95% CI; 2.13-3.03), ever heard about HPV vaccine (OR = 1.41, 95% CI; 1.03-1.94), mother educational status above college (OR = 1.84, 95%CI; 1.03-3.31), middle wealth index (OR = 1.33, 95%CI; 1.04-1.7), ≥ 9 family size (OR = 0.76, 95%CI; 0.68-0.98), availability of promotion (OR = 2.53, 95%CI: 1.51-4.26), availability of adequate vaccine (OR = 4.84, 95%CI; 2.9-8.08), outreach vaccination practice (OR = 1.47, 95%CI; 1.02-2.12) and family support (OR = 4.3, 95% CI; 2.98-6.21) were the significant factors for the uptake of human papilloma virus vaccine. CONCLUSION: As compared to the global strategic plan, the pooled prevalence of HPV vaccine uptake in east Africa was low. The uptake of the HPV vaccine was higher among adolescents than youths. Knowledge about the HPV vaccine, attitude towards the HPV vaccine, ever hearing about the HPV vaccine, residence, mother's educational status, mother's occupational status, wealth index, and family size were the significant determinants of HPV vaccine uptake. Therefore, we recommend focusing on awareness creation and behavioral change to expand the uptake of vaccines in East Africa.

Acute kidney injury and its predictors among HIV-positive patients in Africa: Systematic review and meta-analysis.

BACKGROUND: cute kidney injury(AKI) is a rapid loss of the kidney's excretory function, resulting in an accumulation of end products of nitrogen metabolism. The causes of AKI in HIV-positive patients are not well investigated, but it may be associated with antiretroviral drug side effects and HIV itself. Even though there were studies that reported the prevalence of AKI among HIV-positive patients in Africa, their findings were inconsistent across the studies. METHODS: We searched on PubMed, Embas, Ebsco, OVID, Cochrane Library, and other supplementary search engines, including Google and Google Scholar. Articles published upto July 2023 were included in this review study. The quality of the study was assessed using the Newcastle-Ottawa Scale for cross-sectional, case-control, and cohort studies. The data were extracted using a Microsoft Excel spreadsheet and exported to Stata version 14 for analysis. A random effect meta-analysis model was used to estimate the pooled prevalence of AKI among HIV-positive patients. Heterogeneity was evaluated using Cochrane Q statistics and I squared (I2). Furthermore, the graphic asymmetric test of the funnel plot and/or Egger's tests were computed to detect publication bias. Sensitivity analysis was computed to see the effect of a single study on the summary effects. To treat the publication bias, a trim and fill analysis was carried out. The protocol of this review has been registered in an international database, the Prospective Register of Systematic Reviews (PROSPERO),with reference number CRD42023446078. RESULTS: A total of twenty-four original articles comprising 7913HIV-positive patients were included in the study. The pooled prevalence of AKI among HI-positive patients was found to be 23.35% (95% CI: 18.14-28.56%, I2 = 97.7%, p-value <0.001). Low hemoglobin (Hgb <8mg/dl) was found to be the determinant factor for AKI among HIV-positive patients (AOR = 2.4; 95% CI:1.69-3.4, I2 = 0.0%, p-value = 0.40). In meta-regression analysis, sample size was the possible source of variation among the included studies (AOR = 3.11, 95%CI: 2.399-3.83). CONCLUSIONS: The pooled prevalence of AKI among HIV-positive patients was high. HIV-positive patients with low hemoglobin levels are at risk of developing AKI. Hence, regular monitoring of kidney function tests is needed to prevent or delay the risk of AKI among HIV-positive patients. Healthcare workers should provide an integrated healthcare service to HIV-positive patients on the prevention, treatment, and reduction of the progression of AKI to advanced stages and complications.

Outcome of Poisoning and Associated Factors Among Patients Admitted at Referral Hospitals in Northwest Ethiopia, 2022: A Multicenter Retrospective Study.

Background: Poisonings are the most common reason for visiting emergency departments and hospitals globally. Poisoning-related mortalities increase instantly, and it is a principal public health problem in Ethiopia. Hence, understanding the treatment outcome and identifying the associated factors is necessary to reduce poisoning-related mortality. Objective: To assess outcome of poisoning and associated factors among patients admitted to Referral Hospitals in Northwest Ethiopia, 2022. Methods: An institutional-based retrospective cross-sectional study was conducted in Western Amhara referral hospitals from June 2019 to May 2022. A total of 400 medical charts were reviewed. A stratified sampling technique was used. The data were entered into Epi Info version 7.2.1.0 and exported to SPSS version 25.0 software for analysis. Multivariable binary logistic regression analysis was used to determine factors associated with the outcome of poisoning. Results: The mortality rate of poisoning was 18% (95% CI: 14.4-22.1). Being rural dwellers (AOR=2.65, 95% CI: 1.07-6.63), being unconscious (AOR=4.86, 95% CI: 1.89-12.48), not treated in triage area (AOR=4.64, 95% CI: 1.608-13.407), transport by Bajaj (AOR=6.78, 95% CI: 1.86-24.73), spo2 <95% (AOR=4.42, 95% CI: 1.19-10.78), and stayed >48 hours in the hospital (AOR=0.08, 95% CI: 0.02-0.36) were significantly associated with a mortality of poisoning. Conclusion: The mortality rate from poisoning was considerably high. Residence, level of consciousness, treatment at the triage area, mode of arrival, Spo2, and prolonged hospital stay were significantly associated. All stakeholders should focus on planning and improving care for patients with poisoning. Improving ambulance service in rural areas and providing treatment at the triage area for all patients are recommended.

Global prevalence of COVID-19-induced acute respiratory distress syndrome: systematic review and meta-analysis.

BACKGROUND: Acute respiratory distress syndrome (ARDS) is potentially a fatal form of respiratory failure among COVID-19 patients. Globally, there are inconsistent findings regarding ARDS among COVID-19 patients. Therefore, this study aimed to estimate the pooled prevalence of COVID-19-induced ARDS among COVID-19 patients worldwide. METHODS: To retrieve relevant studies, the authors searched Embase, MEDLINE, PubMed, Web of Science, Cochrane Library, Google, and Google Scholar using a combination of search terms. The search was conducted for articles published from December 2019 to September 2022. Articles were searched and screened by title (ti), abstract (ab), and full-text (ft) by two reviewers independently. The quality of each included article was assessed using the Newcastle-Ottawa Assessment Scale. Data were entered into Microsoft Word and exported to Stata version 14 for analysis. Heterogeneity was detected using the Cochrane Q statistics and I-square (I2). Then the sources of variations were identified by subgroup and meta-regression analysis. A random effect meta-analysis model was used. The publication bias was detected using the graphic asymmetry test of the funnel plot and/or Egger's test (p value < 0.05). To treat the potential publication bias, trim and fill analysis were computed. The protocol has been registered in an international database, the Prospective Register of Systematic Reviews (PROSPERO) with reference number: CRD42023438277. RESULTS: A total of 794 studies worldwide were screened for their eligibility. Of these 11 studies with 2845 participants were included in this systematic review and meta-analysis. The overall pooled prevalence of COVID-19-induced ARDS in the world was found to be 32.2% (95%CI = 27.70-41.73%), I2 = 97.3%, and p value < 0.001). CONCLUSION: The pooled prevalence of COVID-19-induced ARDS was found to be high. The virus remains a global burden because its genetic causes are constantly changing or it mutated throughout the pandemic to emerge a new strain of infection. Therefore, interventions such as massive vaccination, early case detection, screening, isolation, and treatment of the cases need to be implemented to tackle its severity.

Two-week prevalence of acute diarrhea and associated factors among under five years' children in Simada Woreda, South Gondar Zone, Northwest Ethiopia, 2021: a multi-central community based cross-sectional study.

Introduction: even if there were different control and prevention strategies were implemented in worldwide in general and in Ethiopia in particular. Diarrheal disease was still one of the top ten leading causes of morbidity. Hence, this study aims to assess prevalence and associated factors of acute diarrhea among under five years' children in Simada District, Ethiopia, 2021. Methods: community based cross-sectional study design, simple and systematic random sampling technique was used to select 8 kebeles and 717 study unit respectively from August 1-15 /2021 in Simada District. Data were analyzed by Statistical Package for Social Science (SPSS), version 25. Binary logistic regression model was used to measure the association between dependent and independent variables. Bi-variables analysis at P < 0.05 was used to select independent variable to multi variable analysis. Results: two-week prevalence of acute diarrhea was 14.5% (CI: 12.3%-17.3%). Mothers/caregivers child whose latrine was not clean (AOR=11.48(5.64-23.35)). Mothers/caregivers who had not handwashing facility (AOR=7.07(3.84-13.03)), mothers/caregivers who did not practice handwashing at critical time (AOR=5.92(2.58-13.70), mothers/caregivers who store water at home by jerican (AOR=8.6 (1.51-48.84)), and mothers/caregivers child who start supplementary feeding before six months (AOR=6.49(2.01-20.96)) had significant association with acute diarrhea morbidity. Conclusion: two-week prevalence of acute diarrhea was low. Latrine cleanness, availability of handwashing facilities around latrine, handwashing practice at critical time for handwashing, knowledge on diarrhea transmission and prevention methods, storage of water by jerican and time of initiation of supplementary food had determinant factor of diarrheal disease's occurrence.

Working environment of nurses in public referral hospitals of West Amhara, Ethiopia, 2021.

BACKGROUND: Healthy working environment for nurses is a foundation for promoting patients' and nurses' safety in hospitals. However, in Ethiopia, there is scarcity of data on this issue. Therefore, the objective of this study was to assess the working environment of nurses in Public Referral Hospitals in Public Referral Hospitals of West Amhara Regional State, Ethiopia, 2021. METHODS: An institution based cross-sectional study was conducted among 423 nurses from January to February 2021. Systematic random sampling was used to select nurses from each hospital. Structured, self-administered questionnaires were used to collect the data. EPI- DATA and SPSS were used for data entry and analysis respectively. Frequency, percentages, and means were calculated. Practice Environment Scale of the Nursing Work Index tool was used to measure the outcome variable. Binary and multivariable logistic regression analyses were computed to identify associated factors. Finally, texts, tables and graphs were used to report findings. RESULTS: The response rate for the study was 96.2%. Around 210 (51.6%) of the study participants were male. One hundred eighty eight (46.2%) nurses reported that their working environment was healthy, while 219 (53.8%,) reported it as not healthy. Nurses who were working in pediatrics wards (AOR = 0.13, 0.02, 0.1) and nurses who gave care for 7-12 patients per day (AOR = 0.21, 0.05, 0.98) were less likely to have a healthy working environment, respectively. Nurses who reported the Ministry of Health to give focus to the nursing profession were 73% more likely to have a healthy work environment (AOR = 0.27; 0.09, .82). CONCLUSION: and recommendations. More than half of nurses reported that their working environment was not healthy to appropriate practice. Hence, introducing systems to improve participation of nurses in hospital affairs and patient care is essential. It is also important to give attention to nurses who are working at pediatrics wards, and for nurses who give care more than the standards.

Incidence and Associated Factors of Failed First Peripheral Intravenous Catheters among Adult Patients at Medical Surgical Wards in Public Referral Hospitals of West Amhara, Ethiopia, 2021.

BACKGROUND: Complications of peripheral intravenous catheters cause problems in clinical practice and bring high costs in terms of morbidity and mortality of patients. Therefore, this study aimed to assess the incidence and associated factors of failed first peripheral intravenous catheters among adult patients in selected Public Referral Hospitals of West Amhara Regional State, Ethiopia, 2021. MATERIALS AND METHODS: An institution-based prospective observational study was conducted among 423 adult patients from January to February 2021. Patients were selected using systematic random sampling techniques. The data were collected using interviewer-based, structured questionnaires and observational checklists. EPI-DATA 3.1 and SPSS version-23 were used for data entry and analysis, respectively. Frequency, percentages, and means were calculated. The outcome variable was determined and graded based on phlebitis and infiltration scales. Binary and multivariable logistics regressions were computed. RESULTS: Four hundred and seventeen first peripheral cannula sites from 418 patients were followed for 2,565 peripheral catheter hours. A failed first peripheral intravenous catheter was observed in 124 (29.7%, CI: 25.6-34) adult patients. Patients who were female (AOR = 0.4, 95% CI: 0.22-0.74) had cannula duration of 49-72 hours (AOR = 0.31, 95% CI: 0.14-0.7) and 73-96 hours (AOR = 0.39, 95% CI: 0.17-0.9), and patients who had been given electrolytes (AOR = 0.31, 95% CI: 0.11-0.86) were more likely to have failed first peripheral intravenous cannula. CONCLUSIONS: Failed first peripheral intravenous cannula is much higher as compared to the acceptable rate of ≤5% by the Infusion Nurses Society. Hence, all patients with peripheral intravenous catheters are screened for catheter failure at least once a day. Providing appropriate nursing care and patient education is also required to reduce the risks.

Depression Among HIV-Positive Pregnant Women at Northwest Amhara Referral Hospitals During COVID-19 Pandemic.

BACKGROUND: Depression is the most common mental health disorder among HIV-positive pregnant mothers, which increases mortality, poor quality of life; it also increases the burden of disease. Depression hurts birth outcomes and maternal health. OBJECTIVE: To assess depression and its associated factors among HIV-positive pregnant women attending antenatal care at Northwest Amhara referral hospitals, 2021. METHODS: An institution-based cross-sectional study was conducted among 291 HIV-positive pregnant mothers from March 15, 2021 to April 30, 2021 at Northwest Amhara referral hospitals. Census was applied to reach the study participants. An interviewer-administered questionnaire was used for data collection. A binary logistic regression was conducted to see the relationship between dependent variables and independent. Those variables having a p-value of ≤0.05 were found to be statistically associated with the response. RESULTS: Depression among HIV-positive pregnant women was found to be 28.7% [95% CI (24.8-33.40)] with a response rate of 96.04. Age ≥30 years [AOR = 1.32, 95% CI (1.24-3.35)], urban residency [AOR = 1.76, 95% CI (1.57-4.61)], having first pregnancy <18 years [AOR = 3.82, 95% CI (1.54-17.34)], known HIV serostatus during pregnancy [AOR = 1.29, 95% CI (1.08-2.47)], and COVID-19-related knowledge [AOR = 0.32, 95% CI (0.12-1.12) were significantly associated with depression. CONCLUSIONS AND RECOMMENDATIONS: Nearly one-third of the pregnant women attending antenatal care were depressed. The age of the mother, residence, known HIV serostatus during pregnancy, age in the first pregnancy, and COVID-19-related knowledge were significantly associated with depression, and strengthening the existing care provided was the recalled interventions to combat antenatal depression during the COVID-19 pandemic.

Job Satisfaction and Associated Factors Among Health Care Professionals Working in Public Health Facilities in Ethiopia: A Systematic Review.

BACKGROUND: Job satisfaction is a feeling that measure cognitive and behavioral aspects of workers' towards their job. According to the World Health Organization report, it predicts that 40% of health care professionals' (nurses, midwives, and doctors) will leave their job as a result of job dissatisfaction. METHODS: Studies were searched systematically using International databases from PubMed, Google Scholar, Cochrane Library, Embase, and CINAHL. The quality of searched articles assessed using the New Castle Ottawa scale for a cross-sectional study design. Statistical analysis was performed by using STATA version 14 software for window and systemic review carried out using a random effect method. The Preferred Reporting Item for Systematic Review and Meta-Analyses (PRISMA) guideline was followed for reporting results. RESULTS: From the total 1120 records screened, 8 studies with 4092 participants who fulfilled the inclusion criteria were included in this systematic review. The estimated pooled prevalence of job satisfaction of health care professionals in Ethiopia was 41.17%. CONCLUSION: About one in three health care professionals were satisfied. Therefore, the government and health institution should focus on strategies to promote health care professionals' of job satisfaction.

Determinants of Dietary Adherence Among Type 2 Diabetes Patients Aimed COVID-19 at the University of Gondar Comprehensive Specialized Hospital.

BACKGROUND: People with diabetes are proving to be at higher risk of severe coronavirus infection than the general population. Non-adherence to dietary recommendation is a critical problem in individuals with type 2 diabetes; particularly, in the era of coronavirus. This study aimed to explore determinants that affect adherence to the recommendations of diet during coronavirus pandemic. OBJECTIVE: This study aimed to determine dietary adherence among diabetes type 2 patients aimed at coronavirus pandemic and its associated factors. METHODS: An institutional-based cross-sectional study was conducted among type 2 diabetes patients on follow-up. Systematic random sampling was employed to get representative study participants. Dietary adherence was dichotomized and with logistic regression analysis to assess the association between dependent and explanatory variables. The degree of association was interpreted by using both crude odds ratios and adjusted odds ratios with 95% confidence intervals and P-values <0.05 were considered statistically significant. RESULTS: In this study, 576 participants took part with a 99.3% response rate. The dietary adherence was found to be 48.3% with [95% CI (44.1-52.4)]. The educational level of College and above was [AOR=3.64, 95% CI (1.59-8.34)], being a government-employed [AOR=2.38, 95% CI (1.13-4.99)], being urban [AOR=1.30, 95% CI (1.09-2.42)], family size of less than five [AOR=1.27, 95% CI (1.08-1.97)], medium level of wealth-status[AOR=2.26, 95% CI (1.67-4.54)], family history of diabetes [AOR=2.18, 95% CI (1.14-4.19)], duration of diabetes more than 15 years [AOR=5.39, 95% CI (1.57-18.52)], and knowledge related to coronavirus [AOR=4.33,95% CI (2.71-6.92)] were significantly associated with adherence to the dietary recommendation. CONCLUSION: The dietary adherence was relatively low aimed at coronavirus pandemic. Knowledge about COVID-19 was found significantly associated with dietary adherence. RECOMMENDATIONS: There has to be a strong commitment to aware the community to minimize the risk of coronavirus severity among diabetes patients. This could be through adherence to dietary recommendations of particularly in the era of coronavirus pandemic.

Knowledge, Attitude and Practice Towards COVID-19 in Ethiopia: A Systematic Review; 2020.

BACKGROUND: Novel coronavirus disease is a very fast spreading respiratory disease. This disease is becoming a public health emergency across the world. Despite many efforts by countries, organizations, and institutions to prevent and control, the pandemic remains a world health danger. Ethiopia is one of the countries which is severely affected by the pandemic. However, a systematic review of the knowledge, attitude, and practice about coronavirus disease in Ethiopia has not previously done. Thus, the main aim of this systematic review is to investigate the status of people's knowledge, attitude, and practice about coronavirus disease preventive measures in Ethiopia in 2020. METHODS: Data were extracted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies were accessed through electronic web-based search from PubMed, Cochrane Library, Google, Google Scholar, and Embase. All statistical analyses were done using Stata version 11 software with a random-effects model. RESULTS: A total of 11 studies with 3818 participants were included in this systematic review and the overall estimated status of the knowledge, attitude, and practice about coronavirus in Ethiopia are 61.78%, 72.39%, and 52.83%, respectively. According to region subgroup analysis, the highest estimated statuses of the knowledge, attitude, and practice are 74% in Tigray, 86.13% in Southern nations, nationalities, and Peoples' of the region, and 72% in Tigray region, respectively. Subgroup analysis was done based on the focused group and way of questionnaire administration. CONCLUSION: This systematic review revealed people's knowledge, attitude, and practice about coronavirus disease preventive measures were generally more than 50%. However, government and every individual should address those behaviors stipulated by the World Health Organization and Center for Communicable Disease and Control guidelines to prevent coronavirus disease.

Sleep Quality and Associated Factors Among Diabetes Mellitus Patients in a Follow-Up Clinic at the University of Gondar Comprehensive Specialized Hospital in Gondar, Northwest Ethiopia: A Cross-Sectional Study.

INTRODUCTION: Diabetic mellitus has a negative impact on the quality of sleep. It is one of the leading public health conditions which can result in poor sleep quality. Poor sleep quality is an unreported and unrecognized problem which can affect the prognosis of diabetes patients. OBJECTIVE: The aim of this study is to assess the prevalence of poor sleep quality and its associated factors among patients with diabetes mellitus attending follow-up clinics at the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia, 2019. METHODS: An institution-based cross-sectional study was conducted among 430 diabetes mellitus patients at the University of Gondar Comprehensive Specialized Hospital from February 1, 2020 to March 28, 2020. A systematic random sampling method was used to reach the study subjects. An interviewer-administered questionnaire was used for data collection. Pittsburgh sleep quality index was used for assessing sleep quality. To explain study variables, frequency tables and percentages were used. A binary logistic regression was conducted to see the relation between dependent and independent variables. RESULTS: A total of 430 diabetes mellitus patients participated in the study with a response rate of 100%. The overall prevalence of poor sleep quality was 47.2%. Drinking alcohol (AOR = 2.45, 95% CI: 1.28-4.69), smokers (AOR = 6.26, 95% CI: 2.04-19.21), comorbidity (AOR = 1.80, 95% CI: 1.10-2.96), BMI ≥ 30 (AOR = 4.87, 95% CI: 1.07-22.09), having type 2 diabetes mellitus (AOR = 2.16, 95% CI: 1.04-4.50), poor glycemic control (AOR = 2.61, 95% CI: 1.81-4.81) and having depression (AOR = 9.95, 95% CI: 4.85-20.38) were associated with poor sleep quality. CONCLUSION: In this study, nearly half of the patients had poor sleep quality. Drinking alcohol, smoking, comorbidities, higher BMI, type 2 diabetes mellitus, poor glycemic control and having depression were factors in poor sleep quality. Creating awareness of the need for weight reduction, minimizing alcohol intake, cessation of smoking, and improving sleep hygiene for DM patients would be effective management for improving poor sleep quality.