Vaccination dropout among children in Sub-Saharan Africa: Systematic review and meta-analysis.

Immunization is cost-effective preventive strategy for child morbidity and mortality. PubMed, Google Scholar, Scopus, Science Direct, and online institutional repository homes were searched. Data were extracted by Microsoft excel. Begg's rank test, and Egger's regression test was done. A pooled prevalence, Sub-group analysis, sensitivity analysis and meta-regression were conducted. A total of 12 articles were included in this study. The pooled prevalence of vaccination dropout was 26.06% (95% CI: 11.59, 30.53), I2 =91.2%. In sub-group analysis, Nigeria had the highest prevalence of immunization dropouts (33.59%). It was 18.01% and 29.25%, respectively, for published and unpublished research. Community-based studies and institutional-based studies also yield a prevalence of dropout 39.04% and 13.73% respectively. Dropout rate was 22.66% for sample sizes under 500 and 18.01% for sample sizes beyond 500. In Sub-Saharan Africa, the prevalence of vaccination dropout was high. Community education about vaccinations importance should be prioritized.

Levels and Determinants of Prenatal Breastfeeding Knowledge, Attitude, and Intention Among Pregnant Women: A Cross-Sectional Study in Northwest Ethiopia.

Background: Pregnant women are a critical part of the community to assess various determinants of their future breastfeeding practice. This study aimed to assess the levels and determinants of breastfeeding knowledge, attitude, and intention among pregnant women. Methods: A hospital-based cross-sectional study was conducted among 422 pregnant women from January 18 to February 27, 2022, at Debre Tabor Comprehensive Specialized Hospital (DTCSH) in Northwest Ethiopia. Data were collected via face-to-face interviews from participants selected by convenience sampling technique. Data analysis was made using Stata version 16.0. Multiple logistic regression analysis was used to assess the determinants of the knowledge, attitude, and intention of pregnant women, with a p-value < 0.05 considered statistically significant. Result: About 57.8% of participants had adequate breastfeeding knowledge and only 46.9% had a positive attitude. Almost two-thirds (65.4%) of them had good intentions to breastfeed. Pregnant women attaining secondary education (AOR = 2.0; 95% CI: 1.31, 3.19), achieving college or university education (AOR = 3.13; 95% CI: 1.63, 7.41), being multiparous (AOR = 2.11; 95% CI: 1.33, 3.43), having four or more ANC visits (AOR:1.45; 95% CI: 1.21, 4.31), and having prior breastfeeding experience (AOR: 3.53; 95% CI: 2.22, 5.65) were significant predictors of adequate knowledge. Attending college or university education (AOR = 2.71;95% CI: 2.33, 5.13), being multiparous (AOR = 1.56; 95% CI: 1.32, 8.25), and having adequate knowledge (AOR = 2.02; 95% CI: 1.88,7.14) were determinants of a positive breastfeeding attitude. Whereas, advanced age (AOR = 1.44; 95% CI: 1.12, 5.59), adequate knowledge (AOR: 5.21; 95% CI: 1.51,8.04), and positive attitude (AOR = 2.41;95% CI:1.50, 4.27) were independent predictors of good breastfeeding intention. Conclusion: The breastfeeding knowledge and attitude of pregnant women were generally suboptimal. Their overall breastfeeding intention was also unsatisfactory. This highlights the need to develop culture-specific interventions aimed at improving breastfeeding knowledge, attitudes, and intention to enhance the appropriate breastfeeding practice of their future children.

COVID-19 vaccine uptake and associated factors among pregnant women attending antenatal care in Debre Tabor public health institutions: A cross-sectional study.

Background: Vaccination is the best means of reducing the increased risk of severe COVID-19 during pregnancy. Data on COVID-19 vaccine uptake among pregnant women in Ethiopia is scarce. Thus, this study aimed to assess COVID-19 vaccine uptake and associated factors among pregnant women. Method: An institution-based cross-sectional study was conducted among 634 pregnant women attending antenatal care in Debre Tabor public health institutions from March 14 to 30, 2022. Participants were recruited using a multistage sampling technique and data were collected via face-to-face interviews using a pre-tested structured questionnaire. Stata version 16.0 software was used for data analysis. Multiple logistic regression analysis was used to assess factors associated with COVID-19 vaccine uptake, with a p-value< 0.05 considered statistically significant. Result: Only 14.4% (95% CI: 11.7%-17.3%) of participants had received at least one dose of COVID-19 vaccines. The main reasons for declining vaccination were fear that the COVID-19 vaccine may have harmful side effects on the fetus or the mother. Being 45 or older (AOR: 1.75, 95%CI: 1.01-2.95), being married (AOR: 1.26, 95%CI: 1.12, 2.96), having good knowledge (AOR:3.52, 95%CI:1.83-3.87), and a positive attitude (AOR:4.81, 95% CI: 1.42-7.33) were positive predictors of COVID-19 vaccine uptake. But attaining a college or university education (AOR: 0.43, 95%CI: 0.12-0.69) was found to be a barrier to vaccine uptake by pregnant women. Conclusion: COVID-19 vaccination among pregnant women was substantially low. Old age, being married, low education, good knowledge, and a positive attitude were significant predictors of COVID-19 vaccine uptake. To enhance the COVID-19 vaccine uptake, the government should improve the knowledge and attitude of pregnant women toward the COVID-19 vaccine.

Mutational Pattern, Impacts and Potential Preventive Strategies of Omicron SARS-CoV-2 Variant Infection.

Since the emergence of COVID 19, the authentic SARS-CoV-2 has evolved into a range of novel variants that are of more global concern. In late November 2021, the Omicron (lineage B.1.1.529) variant was identified as a new variant and considered as the fifth variant of concern. Omicron harbors a genetic profile that is exceedingly unusual, with a huge number of mutations. Above thirty mutations are localized in the S protein, while some are found in other structural and non-structural proteins. Half of the mutations in the S protein are in the RBD, which is a major target of antibodies, showing that Omicron mutations may affect antibody binding affinity to the S protein. The Omicron variant has been found to result in immune escape, therapeutic or vaccine escape, as well as increased transmissibility and reinfection risk, explaining its rapid international spread that sparks a global alarm even more serious than the previously reported variants. Omicron has the capability to bypass at least some of the multi-faceted immune responses induced by prior infection or vaccination. It is shown to extensively escape neutralizing antibodies while evading cell mediated immune defense to a lesser extent. The efficacy of COVID 19 vaccines against Omicron variant is decreased with primary vaccination, showing that the vaccine is less efficient in preventing Omicron infections. However, after receiving a booster vaccine dose, the immunological response to Omicron significantly improved and hold promising results. Despite the mild nature of the disease in most vaccinated people, the rapid spread of Omicron, as well as the increased risk of re-infection, poses yet another major public health concern. Therefore, effort should be devoted to maintaining the existing COVID 19 preventive measures as well as developing new vaccination strategies in order to control the fast dissemination of Omicron.

The magnitude of episiotomy among women who gave birth in Ethiopia: Systematic review and meta-analysis

Episiotomy is one of the most common obstetric procedures done by health providers putting the client at high risk of developing complications and lacerations. These days, episiotomy has been done at an alarming rate in Ethiopia as compared to the slant set by World Health Organization. Be that as it may, there is a need for nationally representative data. This study aimed to determine the pooled prevalence of episiotomy practice among women who gave birth at public health institutions in Ethiopia. We accessed PubMed, Web of Science, Google Scholar, EMBASE, and manual search was used to retrieve articles. The extractions of the data were done by using Microsoft Excel and analyzed by STATA version 11 statistical software. The publication bias was checked by funnel plot visually and Egger's test and Begg's test, with P < 0.05 considered indicating potential publication bias. I2 was used to check the presence of heterogeneity of the studies. Overall estimated analysis was done. Subgroup analysis was done by region. We carried out a leave-one-out sensitivity analysis. The Joanna Briggs Institute risk of bias assessment tool was used. Out of 254 articles retrieved, 9 studies met the eligibility criteria and are thus included in this study. The overall episiotomy practice in Ethiopia was 45.01% (95% CI: 36.288, 53.741). Based on the sub-group analysis, prevalence of episiotomy practice was 49.32% (95%CI: 12.67, 85.97), 46.92% (95%CI: 29.47, 64.37), 44.23 (95%CI: 37.77, 50.99) and 38.29 (95%CI: 32.38, 44.20) among South region, Addis Ababa, Amhara region and Tigray region respectively. The findings revealed that the prevalence of episiotomy practice in Ethiopia was high (45.01%). Therefore, it is better to have periodic training for birth attendants on the indication of episiotomy and the appropriate use of guidelines to reduce the rate of episiotomy. (Afr J Reprod Health 2022; 26[4]: 98-109).