Non-Adherence to Anti-Retroviral Therapy Among Adult People Living with HIV in Ethiopia: Systematic Review and Meta-Analysis.

Human immunodeficiency virus remains a global public health problem. Despite efforts to determine the prevalence of non-adherence to ART and its predictors in Ethiopia, various primary studies presented inconsistent findings. Therefore, this review aimed to determine the pooled prevalence of non-adherence to ART and identify its predictors. We have searched PubMed, Google Scholar and Web of Science databases extensively for all available studies. A weighted inverse-variance random-effects model was used to compute the overall non-adherence to ART. The pooled prevalence of non-adherence to ART was 20.68% (95% CI: 17.74, 23.61); I2 = 98.40%; p < 0.001). Educational level of primary school and lower [AOR = 3.5, 95%CI: 1.7, 7.4], taking co-medications [AOR = 0.45, 95%CI: 0.35, 0.59], not using memory aids [AOR = 0.30, 95%CI: 0.13, 0.71], depression [AOR = 2.0, 95%CI: 1.05, 3.79], comorbidity [AOR = 2.12, 95%CI: 1.16, 3.09), under-nutrition [AOR = 2.02, 95%CI: 1.20, 3.43], not believing on ART can control HIV [AOR = 2.31, 95%CI: 1.92, 2.77], lack of access to health facilities [AOR = 3.86, 95%CI: 1.10, 13.51] and taking ART pills uncomfortably while others looking [AOR = 5.21, 95%CI: 2.56, 10.53] were significantly associated with non-adherence to anti-retroviral therapy. The overall pooled prevalence of non-adherence to ART was considerably high in Ethiopia. Educational status, taking co-medications, not using memory aids, depression, comorbidity, under nutrition, not believing on anti-retroviral therapy controls HIV, lack of access to health facilities and taking ART pills uncomfortably were independent predictors of non-adherence to ART in Ethiopia. Therefore, healthcare providers, adherence counselors and supporters should detect non-adherence behaviors and patients' difficulties with ART early, and provide intensive counseling to promote adherence.

Lifetime Experience of Childhood Abuse and Neglect Among High School Students at Debre Tabor Town, South Gondar Zone, Northwest Ethiopia: An Institution-Based Cross-Sectional Study.

Background: Childhood abuse and neglect is defined as any intentional harm or mistreatment of a child that results in actual or potential harm to the child's health, survival and development. It has been linked to an increased risk of a wide range of serious short- and long-term medical and mental health problems. Although it is a complex societal issue, it receives limited research attention in the area. Objective: To assess lifetime prevalence of childhood abuse and neglect among high school students in Debre Tabor town, south Gondar Zone, Northwest Ethiopia, 2022. Methods: A cross-sectional study design was used to assess 423 high school students, chosen through a systematic sampling technique. Data were collected using a pre-tested, structured and self-administered international child abuse screening tool, child version (ICAST-C). The effect of independent variables on the outcome variable was explored using logistic regression analyses. The level of significances were determined using an odds ratio with a 95% confidence interval. Results: Of the 423 study participants, 84.4% had lifetime experience of childhood abuse and neglect. Being female (AOR=4.5, 95% CI: 2.38, 8.60), parental marital status (AOR=5.4, 95% CI: 1.07, 27.3), illiteracy of father (AOR=1.65, 95% CI: 4.5, 6.03), birth order (AOR=4.5, 95% CI: 1.57, 13.0), open family discussion of sexual matters (AOR=0.37, 95% CI:1.74, 7.86), and watching pornography (AOR=0.08, 95% CI: 0.02, 0.40) were significantly associated with lifetime experience of childhood abuse and neglect. Conclusion: Lifetime experience of childhood abuse and neglect was high as compared with previous studies. Being female, parental marital status, illiterate fathers, watching pornography, and open family discussion of sexual matters were predictors of childhood abuse and neglect. Dealing with this issue should be considered an integral component of high school students' care, including parental education and respite care.

Pooled prevalence and its determinants of stunting among children during their critical period in Ethiopia: A systematic review and meta-analysis.

BACKGROUND: Stunting is a major public health concern, particularly in low and middle-income countries. Globally, nearly 149 million under-five children are suffering from stunting. Despite it can occur in all age groups, the impact is more severe among children age less than 24 months as this period is critical time of very rapid growth and development. Therefore, this review aimed to determine the pooled prevalence and determinants of stunting among children during this critical period in Ethiopia. METHODS: The literature search was conducted using international electronic data bases (pumed, Google scholar, CINHAL, Hinari, open Google) and the hand search of reference lists of eligible articles. The presence of heterogeneity between studies was evaluated using Cochrane Q-test and I2 test statistics and sensitivity analysis was also checked. Small study effect was checked through graphical and statistical test. Sub-group analysis was performed to handle heterogeneity. RESULTS: This study included 14 studies with a total sample size of 8,056 children. The overall pooled estimate of stunting was 35.01(95% CI: 24.73-45.28, I2 = 98.98%) in the country with the highest prevalence in Amhara region. Increased Child's age (OR = 3.83; 95% CI: 2.47-5.18, I2 = 97.76%), no maternal education (OR = 2.90; 95%CI: 1.59-4.20, I2 = 89.73%), no maternal postnatal follow up (OR = 1.81; 95% CI:1.51-2.10) less than four food diversity of the child (OR = 2.24;95%CI; 1.94-2.55,I2 = 21.55%), low maternal body mass index, failure to colostrum and exclusive breast feeding, two and more under five children in the household and poor wealth index of the family were significant factors of stunting. CONCLUSION AND RECOMMENDATIONS: The pooled prevalence of stunting among children during their critical time is high. Increased Child's age, no maternal education and no maternal postnatal follow up, less than four food diversity of the child, low maternal body mass index, failure to colostrum and exclusive breast feeding, two and more under five children in the household and poor wealth index of the family were determinants of stunting. Therefore, providing continuous maternal postnatal follow up, increase awareness of mothers on importance of colostrum and exclusive breast feeding, feeding of children the recommended variety of foods and at large to improve the wealth status of the households are crucial interventions to meet national and international targets of zero stunting in children less than 2 years.

Home based postpartum care and determinants in Ethiopia: A multilevel analysis.

INTRODUCTION: Neonatal mortality remains a persisting public health challenge in Ethiopia. Timely intervention to neonatal morbidity and early neonatal care visit could reduce the burden of mortality. Studies related to home based postnatal care is limited in Ethiopia. Therefore, this study aimed to assess home based postnatal care visits and determinants in Ethiopia. METHODS: A secondary data analysis using 2016 EDHS data was conducted among 7590 women who had live births two years preceding the survey. A multilevel mixed-effect logistic regression analysis model was used and those variables with a P-value ≤ of 0.05 in multivariable analysis were considered as predictors. Results: Home based postpartum care by health care providers was 6.3% and 67.9% of women gave birth at home. Women perceived that distance is not big problem [AOR = 1.37; 95% CI: 1.06, 1.68], richer wealth index [AOR = 1.69; 95% CI: 1.15, 2.48], attending antenatal care visit [AOR = 2.17; 95% CI:1.57, 2.99], giving birth in health institution [AOR = 2.07; 95% CI:1.53, 2.80], giving birth by cesarean section [AOR = 3.41; 95% CI: 2.33, 4.99], and having awareness about neonatal danger sign [AOR = 3.68; 95% CI: 2.90,4.70] were factors associated with home based postpartum care. CONCLUSION: Home based care by health care providers was low. Therefore, measures should be taken in increasing the number of nearby health care facility, strengthen the continuum of care on antenatal care follow-up, institutional delivery and improve mother's knowledge about neonatal danger sign.

Self-reported syndromes of sexually transmitted infections and its associated factors among reproductive (15-49 years) age women in Ethiopia.

BACKGROUND: Sexually Transmitted Infections (STIs) are among the most important causes of maternal and neonatal morbidity and mortality. It remains a significant public health problem and disproportionately affects women posing a large public health burden in low and middle-income countries. However, there is little information on the magnitude of self-reported syndromes of STIs among reproductive-age women in Ethiopia. AIM: This study aimed to determine the magnitude of self-reported syndromes of sexual transmitted infections and its associated factors among women of reproductive age in Ethiopia. METHODS: The study was based on the data from the Ethiopian Demographic Health Survey of 2016. The data on the status of self-reported STIs were extracted from the individual women dataset, and a total of 15,683 reproductive-age women were involved in the study. Since the data has a hierarchical and cluster nature sampling weight was applied for all analysis procedures to account for complex survey design. Rao-scot chi-square test that adjusts for complex sample design was used to examine the association of outcome and independent variables. In, multivariable analysis, the level of statistical significance was declared at P-value ≤ 0.05. FINDINGS AND CONCLUSIONS: The magnitude of self-reported STIs was 3.0 % (95% CI: 2.92-3.08). Among self-reported syndromes of STIs only, 33.3 % (158) seek care for sexually transmitted infections. Age (Adjusted Odds Ratio (AOR = 2.15; 95%CI:1.4, 3.4)), marital status (AOR = 1.72; 95%CI:1.02, 2.90), women attending higher education and above (AOR = 2.67; 95%CI:1.57,4.57), history of termination of pregnancy (AOR = 2.85; 95%CI:2.0,4.08), and risky sexual behavior (AOR = 1.72; 95%CI:1.02,2.90) were found to be associated with self-reported syndrome of sexually transmitted infections. The magnitude of self-reported syndromes of STI and health care seeking behaviors among reproductive-age women was found low. Therefore, the government should enhance the awareness of women for sexually transmitted syndromes, and increase accessibility of STI services. Moreover, qualitative studies should be done to identify the demand, supply, and barriers related to STI among women of reproductive age women in Ethiopia.

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.

Correction: Youth friendly sexual and reproductive health service utilization among high and preparatory school students in Debre Tabor town, Northwest Ethiopia: A cross sectional study.

[This corrects the article DOI: 10.1371/journal.pone.0240033.].

Contraceptive Demand, Utilization and Associated Factors Among University Female Students in Amhara Region, Ethiopia: Institution-Based Cross-Sectional Study.

BACKGROUND: Worldwide, university students fall in the youth group which is prone to unattended sexual risks, including unintended pregnancies and sexually transmitted diseases. One of the key strategies to prevent these problems is to use contraceptives. Therefore, the study was aimed at assessing contraceptive utilization and factors hindering their utilization. OBJECTIVE: The objective of the study was to assess contraceptive demand, utilization, and associated factors among university female students in Amhara region, Ethiopia. METHODS: An institution-based cross-sectional study was conducted. From seven universities, three of them were randomly selected. A multistage sampling method was used. Finally, a simple random sampling method was used to select the respondents. Data were entered via Epi-data version 3.1 and exported to SPSS version 20 for analysis. Bivariable and multivariable logistic regression analyses were employed. Results are presented using text, tables, and graphs. RESULTS: A total of 1276 respondents participated in the study with a response rate of 98.8%. The median age of the participants is 21.37 years (SD=1.88 years). About 398 (31.2%) of the respondents had sexual intercourse within the last 12 months. However, only 207 (16.2%) of the respondents were currently using contraceptives. Marital status, year of study, history of having information and previous discussion on contraceptives were found to be significantly associated. Married participants had a 94.4% lower contraceptive utilization compared with unmarried participants [0.056 (0.03- 0.12)]. Third year students were 50% less likely to use contraceptives compared to 2nd year students [0.50 (0.30- 0.82)]. Those having previous information on contraceptives [7.7 (1.01- 59.8)] and discussions with someone else [2.3 (1.5-3.6)] were 7.7- and 2.3-times more likely to use contraceptives than their counterparts, respectively. CONCLUSION: Contraceptive utilization among university female students is low. For students, new information, education and communication strategies for sexual and reproductive health issues should be launched.

Youth friendly sexual and reproductive health service utilization among high and preparatory school students in Debre Tabor town, Northwest Ethiopia: A cross sectional study.

BACKGROUND: Youth continue to fall victim to sexual and reproductive health problems. Despite, reproductive health needs of youth had been supported by different organizations, utilization of those services is low. All efforts have not been felt across the Ethiopian learning institutions as is evidenced by persistent reproductive health problems. Therefore, this study aimed to assess the magnitude of youth friendly sexual and reproductive health service utilization and associated factors among high and preparatory school youths in Debre Tabor town, Northwest Ethiopia. METHODS: An institution based cross- sectional study was conducted from March 1 to 28, 2016. The data were collected using a pre-tested and structured self-administered questionnaire. Multistage cluster sampling method was used to select the study participants. The data were entered into Epi-data version 4.2.0.0 and analyzed using SPSS version 20. Binary logistics regression was used for analysis. Odds ratio along with 95%CI was estimated to measure the strength of the association. Level of statistical significance was declared at p value ≤0.05. RESULTS: Overall utilization of reproductive health service was 28.8%. Being male (AOR = 1.54, 95% CI: 1.05, 2.25), prior discussion on reproductive health issues (AOR = 6.33, 95% CI: 4.22, 9.51), and previous sexual intercourse within the past one year (AOR = 1.95, 95% CI: 1.10, 3.44) were significantly associated with youth friendly health service utilization. CONCLUSIONS: Youth friendly health service utilization among high school and preparatory students in Debre Tabor town was low. Ensuring gender empowerment and advocating sexual and reproductive service discussion among themselves and with others might be important in improving reproductive health utilization and health. Future researcher should address segment of population who does not enter school.

Women's knowledge and associated factors in preconception care in adet, west gojjam, northwest Ethiopia: a community based cross sectional study.

BACKGROUND: Preconception care is the provision of biomedical, behavioural and social health interventions to women and couples before the occurrence of conception to improve their health status. There is poor maternal and child health and lack of knowledge in developing countries about preconception care. Therefore, this study aimed to assess women's knowledge and associated factors in preconception care in Adet Town, Gojjam, Northwestern Ethiopia. METHODS: A community based cross-sectional study was conducted among 422 systematically selected reproductive age group women who are living in the Adet town from March 1 to 30, 2016. The data were collected using pre tested and structured questionnaires through face-to-face interviews. The data were entered into Epi-Info version 3.5, and cleaned and analysed using SPSS version 20. Descriptive summary of the data and logistic regression were used to identify possible predictors using odds ratio with 95% confidence interval and P-value of 0.05. RESULTS: The study revealed that the overall knowledge of preconception care was 27.5% (95% CI: 23.2, 32.0). Women who attended secondary educational and whose age is from 25 to 34 years were more likely to have better knowledge on preconception care than their counterparts were; (AOR 6.52, CI 2.55, 16.69) and (AOR 4.10, CI 1.78, 9.44) respectively. However, Women who had no history of family planning use were 85% less knowledgeable than those who had a history of family planning use (AOR: 0.15; 95% CI: 0.05, 0.44). CONCLUSIONS: In this finding level of women's knowledge of preconception care is relatively low. Having a history of family planning use, having high levels of educational status, and being older age were associated with good knowledge. This finding suggests that there is a need to give emphasis and deliver health education about preconception care for women in order to increase their knowledge.