Visual Inspection with Acetic Acid Positivity in Screening and Early Detection of Cervical Dysplasia in Africa, 2023: A Meta-Analysis.

Background: Visual Inspection with Acetic acid (VIA) is the best feasible method of screening and early detecting for cervical dysplasia for resource limited settings like Africa. There is no study that can represent Africa on VIA positivity. Therefore, this metaanalysis was planned to verify the best available articles to pool the visual inspection with acetic acid positivity in screening and early detection of cervical dysplasia in Africa. Methods: The Cochrane Library, Web of Science, PubMed, Scopus, free Google database search engines, Google Scholar, and Science Direct databases were used to conduct a true search of this research article. STATA version 14.0 was used to do the metaanalysis. This meta-analysis was registered in PROSPERO database under the identity pf CRD42023392197. Result: This meta-analysis analyzed data from 21,066 women who had VIA examination to estimate the pooled VIA positivity in Africa. The overall pooled effect estimate of VIA positivity in Africa was 11.93 (95%CI: 11.48-12.37). Age <16 year during first intercourse 2.58(95%CI: 1.53-3.62), lifetime sexual partner ≥2 3.92(95%CI: 2.05-5.78) and HIV positivity 2.92(95%CI: 1.72-4.12) were the significant variables which influence VIA positivity. Conclusion: Overall pooled effect estimate of VIA positivity in Africa was high compared to other continents. The main factors that affect VIA positivity are age at first sexual contact being under 16 years old, the number of lifetime sexual partners being at least two, and HIV positivity. Therefore, the WHO's goal of creating Africa free of cervical cancer is still one that requires significant effort.

Existence of cholera outbreak, challenges, and way forward on public health interventions to control cholera outbreak in Guraghe Zones, southern Ethiopia, 2023.

Introduction: In Ethiopia, despite major improvements seen in health service delivery system, the country continues to be significantly affected by cholera outbreaks. Cholera remains a significant public health problem among the vulnerable populations living in many resource-limited settings with poor access to safe and clean water and hygiene practices. Recurring cholera outbreaks are an indication of deprived water and sanitation conditions as well as weak health systems, contributing to the transmission and spread of the cholera infection. Objective: To assess the cholera outbreak, its challenges, and the way forward on public health interventions to solve the knowledge and health service delivery gaps related to cholera control in Guraghe Zone, Ethiopia, 2023. Methods: Active surveillance of the cholera outbreak was conducted in all kebeles and town administrative of Guraghe zone from 7/8/2023 to 30/10/2023. A total of 224 cholera cases were detected during the active surveillance method. Data obtained from Guraghe zone offices were exported to SPSS version 25 for additional analysis. The case fatality rate, incidence of the cases, and other descriptive variables were presented and described using figures and tables. Result: A total of 224 cholera cases were detected through an active surveillance system. In this study, the case fatality rate of cholera outbreak was 2.6%. To tackle the cholera outbreak, the Guraghe zone health office collaborated with other stakeholders to prepare four cholera treatment centers. The absence of OCV, inaccessible safe water, low latrine coverage, inappropriate utilization of latrines, and absence of cholera laboratory rapid diagnostics test in Guraghe Zone are barriers to tackling the outbreak. Conclusion: Ethiopia National Cholera Plan targeted eradicating cholera by 2030, 222 cholera outbreak occurred in Guraghe Zone, Ethiopia. To minimize and control cholera mortality rate oral cholera vaccinations should be employed in all areas of the region. Sustainable WASH measures should be guaranteed for the use of safe water and good hygiene practices. Early diagnosis and treatment should be initiated appropriately for those who are infected.

Prevalence and associated factors of structural congenital anomalies in resource limited setting, 2023: a systematic review and meta-analysis.

Background: Several studies have been conducted on structural congenital anomalies (CA). However, there is a paucity of studies that provide a comprehensive review of structural anomalies. We aimed to verify the available research articles to pool the possible risk factors of structural CA in resource-limited settings. Setting: The research articles were genuinely searched using PubMed, Scopus, Cochrane Library, Web of Science, free Google database search engines, Google Scholar, and ScienceDirect databases. Published studies were searched and screened for inclusion in the final analysis, and studies without sound methodologies and review and meta-analysis were not included in the analysis. Participants: This review analyzed data from 95,755 women who gave birth as reported by primary studies. Ten articles were included in this systematic review and meta-analysis. The articles that had incomplete information and case reports were excluded from the study. Results: The overall pooled effect estimate (EI) of structural CA was 5.50 (4.88-6.12) per 100 births. In this systematic review and meta-analysis, maternal illness EI with odds ratio (OR) = 4.93 (95% CI: 1.02-8.85), unidentified drug use with OR = 2.83 (95% CI: 1.19-4.46), birth weight with OR = 4.20 (95% CI: 2.12-6.28), chewing chat with OR = 3.73 (95% CI: 1.20-6.30), chemical exposure with OR = 4.27 (95% CI: 1.19-8.44), and taking folic acid tablet during pregnancy with OR = 6.01 (95% CI: 2.87-14.89) were statistically significant in this meta-regression. Conclusions: The overall pooled effect estimate of structural CA in a resource-limited setting was high compared to that in countries with better resources. Maternal illness, unidentified drug use, birth weight, chewing chat, chemical exposure, and never using folic acid were found to be statistically significant variables in the meta-regression. Preconception care and adequate intake of folic acid before and during early pregnancy should be advised. Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42022384838.

Structural congenital anomalies in resource limited setting, 2023: A systematic review and meta-analysis.

BACKGROUND: A number of studies have looked at neonatal structural birth defects. However, there is no study with a comprehensive review of structural anomalies. Therefor we aimed to verify the best available articles to pool possible risk factors of structural congenital anomalies in resource limited settings. SETTING: Genuine search of the research articles was done via PubMed, Scopes, Cochrane library, the Web of Science; free Google database search engines, Google Scholar, and Science Direct databases. Published and unpublished articles were searched and screened for inclusion in the final analysis and Studies without sound methodologies, and review and meta-analysis were not included in this analysis. PARTICIPANTS: This review analyzed data from 95,755 women who have birthed from as reported by primary studies. Ten articles were included in this systematic review and meta-analysis. Articles which have no full information important for the analysis and case reports were excluded from the study. RESULTS: The overall pooled effect estimate of structural congenital anomalies was 5.50 [4.88-6.12]. In this systematic review and meta-analysis maternal illness effect estimate (EI) with odds ratio (OR) = 4.93 (95%CI 1.02-8.85), unidentified drug use OR = 2.83 (95%CI 1.19-4.46), birth weight OR = 4.20 (95%CI 2.12-6.28), chewing chat OR = 3.73 (95%CI 1.20-6.30), chemical exposure OR = 4.27 (95%CI 1.19-8.44) and taking folic acid tablet during pregnancy OR = 6.01 (95%CI 2.87-14.89) were statistically significant in this meta-regression. CONCLUSIONS: The overall pooled effect estimate of structural congenital anomalies in a resource limited setting was high compared to better resource countries. On the Meta-regression maternal illness, unidentified drug use, birth weight, chewing chat, chemical exposure and never using folic acid were found to be statistically significant variables Preconception care and adequate intake of folic acid before and during early pregnancy should be advised.

Do pregnant African women exercise? A meta-analysis.

INTRODUCTION: Antenatal exercise can reduce gestational weight gain, backache; pregnancy induced medical disorders, caesarean section rates, and improves pregnancy outcomes. American College of Obstetrics and Gynecology (ACOG) recommends prenatal exercise, which is associated with minimal risk and has been shown to be beneficial for pregnancy outcomes, although some exercise routines may need to be modified. Consequently, this meta-analysis is intended to verify the pooled practice of antenatal exercise in Africa using available primary articles. METHODS: Genuine search of the research articles was done via PubMed, Scopes, Cochrane library, the Web of Science; free Google databases search engines, Google Scholar, and Science Direct databases. Published and unpublished articles were searched and screened for inclusion in the final analysis and Studies without sound methodologies, and review and meta-analysis were not included in this analysis. The Newcastle-Ottawa scale was used to assess the risk of bias. If heterogeneity exceeded 40%, the random effect method was used; otherwise, the fixed-effect method was used. Meta-analysis was conducted using STATA version 14.0 software. Publication bias was checked by funnel plot and Egger test. RESULTS: This review analyzed data from 2880 women on antenatal care contact from different primary studies. The overall pooled effect estimate of antenatal exercise in Africa was 34.50(32.63-36.37). In the subgroup analysis for pooled antenatal exercise practice by country, it was 34.24 (31.41-37.08) in Ethiopia and 37.64(34.63-40.65) in Nigeria. CONCLUSION: The overall pooled effect estimate of antenatal exercise in Africa was low compared to other continent. As it was recommended by ACOG antenatal exercise to every patient in the absence of contraindications, it should be encouraged by professionals providing antenatal care service.

A systematic review and meta-analysis of immediate postpartal intrauterine contraceptive device use in Ethiopia.

Background: Immediate postpartum intrauterine device (IPPIUCD) use remains too low in Ethiopia and there are high levels of unmet need for IPPIUCD. This systematic review and meta-analysis investigates individual studies conducted in Ethiopia on IPPIUCD use and influencing factors. Method: Extensive database searching was done using Google Scholar, PubMed, Scopes, Cochrane library, Web of Science, and Science Direct search engines. Data were extracted and analyzed using Cochrane review manager version 5.4.1. A random-effects model with a 95% confidence interval (CI) was used to estimate the pooled magnitude of IPPIUCD use. Forest plot was used to estimate the pooled IPPIUCD use and inverse variance was used to identify the presence of heterogeneity. Publication bias was assessed by using funnel plots and Egger's statistical tests. Result: This study showed that the pooled use of IPPIUCD in Ethiopia was 8.37% (95% CI: 4.32, 16.21). Those who had heard about IPPIUCD were 4.2 times (OR = 4.2, 95% CI: 1.51, 11.68) more likely, had birth interval >3 years were 3.90 times (OR = 3.90, 95% CI: 1.68, 9.05) more likely, had good knowledge were 4.44 times (OR = 4.44, 95% CI: 2.26, 8.76) more likely and counseled clients were 3.99 times (OR = 3.99, 95% CI: 1.28, 12.37) more likely to use IPPIUCD; and the odds of using IPPIUCD was 45% (OR = 0.55, 95% CI: 0.40, 0.77) less likely among aged 15-24 years old to use IPPIUCD. Conclusion: IPPIUCD use in Ethiopia was low. Age category, ever heard about IPPIUCD, level of knowledge, birth interval and being counseled about IPPIUCD were statistically significant factors influencing IPPIUCD use.

Hepatitis B surface antigen and associated factors among mothers who had antenatal care contact in Attat Hospital, southern Ethiopia.

INTRODUCTION: Hepatitis B virus is a viral infection which can cause both acute and chronic liver disease. Predominately, this virus transmitted through the mother-to-child route. It is an endemic disease in low-resource setting countries like Ethiopia. OBJECTIVE: Therefore, this study was used to assess magnitude and associated factors of hepatitis B surface antigen among pregnant mothers, who had antenatal care in Attat Hospital. METHOD: The cross-sectional study was conducted from 1 September 2019 to 30 January 2020. The data were collected from serological testing in laboratory and interview in antenatal care on 422 pregnant mothers. The data were entered into Epi Data version 3.1 and exported to SPSS version 24.0 for further analysis. Variables on bivariate analysis at p < 0.25 were taken to multivariate analysis. A p value of less than 0.05 on multivariate analysis was considered significant. RESULT: From 438 total samples, 422 respondents were participated and the mean age of the participants was 25.4 years (standard deviation ± 4.85). Magnitude of hepatitis B surface antigen was 10.9% (95% confidence interval: 8.3, 14.0). Respondents whose occupation was in government or self-employed were 67% (adjusted odds ratio = 0.33, 95% confidence interval: 0.12, 0.91) and whose number of gravidity was 3 and below were 79% (adjusted odds ratio = 0.21, 95% confidence interval: 0.04, 0.68) less likely to have hepatitis B surface antigen. Respondents who respond that hepatitis B surface antigen has cured were 1.52 times (adjusted odds ratio = 1.52, 95% confidence interval: 1.7, 9.4) more likely to have hepatitis B surface antigen. Respondents who answered hepatitis B surface antigen has vaccine were 57% (adjusted odds ratio = 0.43, 95% confidence interval: 0.05, 0.75) less likely to have hepatitis B surface antigen. CONCLUSION: Magnitude of hepatitis B surface antigen among mothers who were on antenatal care in Attat Hospital was high compared to other studies. Being employed in government or self-employed, gravida 3 and below, those who think that the disease has vaccine and those who think hepatitis B surface antigen was curable were statistically significant factors. Health promotion should be an important recommendation to be done by the hospital.