Determinants of Health Care Providers' Attitudes Toward Safe Abortion Care in Ethiopia: A Systematic Review and Meta-Analysis.

Background: Unsafe abortion is a serious reproductive health problem in developing countries including Ethiopia. The attitude of healthcare providers toward abortion is one of contributing factors to unsafe abortion. This study aimed to determine the pooled effect of healthcare workers' attitudes toward safe abortion care and its determinants factors in Ethiopia. Methods: Search engines such as Scopus, CINAHL, EMBASE, PubMed, Web of Science, and CAB Abstracts were used to find published studies where as Google and Google Scholar were used to find unpublished research. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used. The analysis was performed using STATA 14 and the random-effects model was used to calculate the odds ratios of medical professionals' attitudes regarding safe abortion services. Study heterogeneity was assessed by using I2 and P-values. To evaluate the stability of pooled values to outliers and publication bias, respectively, sensitivity analysis and funnel plot were also performed. Results: A total of 15 published and unpublished articles with a sample size of 4060 were incorporated in this Review. The overall pooled prevalence of this study was 56% (95% CI: 45-67). Sex of participants (AOR: 2.37; 95% CI: 1.57, 3.58), having training (AOR: 2.86; 95% CI: 1.58, 5.17), Professional type (AOR: 1.55; 95% CI: 1.04, 4.46), and knowledge of abortion law (AOR:2.26; 95% CI: 1.14, 4.46) were the determinants factors that significantly associated with health care workers' attitude toward safe abortion care. Sensitivity analysis shows that the pooled odds ratios were consistently stable throughout all meta-analyses, and the funnel plot shows no evidence of publication bias. Conclusion: Half of health care providers sampled among the pooled studies have favorable attitudes toward abortion services in Ethiopia; which could hamper women's access to safe abortion care. Sex, training, type of profession, and knowing abortion law were determinants of health care workers' attitudes toward safe abortion services. Stakeholders should emphasize improving the attitude of healthcare workers toward safe abortion care which has a vital role in reducing maternal mortality. Moreover, working on modifiable factors like training, assigning personnel whose professions align with the service, and updating care providers about abortion law is also the essential key point to improve their intentions to deliver the services.

Insecticide-treated net utilization and associated factors among pregnant women in Ethiopia: a systematic review and meta-analysis.

Background: Malaria is a major public health problem in many developing countries, particularly in sub-Saharan Africa. The pregnant woman, fetus, and newborn infant are all at risk from malaria during pregnancy. Hence, insecticide-treated bed net (ITN) use is the most effective and advisable method for preventing malaria during pregnancy. Studies on the prevalence of ITN utilization among pregnant women in Ethiopia are inconsistently reported and highly varied. Therefore, this systematic review and meta-analysis aimed to estimate the pooled prevalence of ITN utilization and associated factors among pregnant women in Ethiopia. Methods: A comprehensive search of databases such as PubMed, CINAHL, Web of Science, SCOPUS, Science Direct, Google, and Google Scholar was performed to find studies conducted in Ethiopia. All original observational studies that reported the prevalence of ITN utilization were identified and screened. The Newcastle-Ottawa scale tool was used to assess the quality of the studies. Data were extracted in Microsoft Excel 2010 format and analyzed using STATA Version 14. A random-effect meta-analysis model was utilized to estimate the pooled prevalence of ITN utilization. The statistical heterogeneity was checked using the I2 test and subgroup analysis. The publication bias was assessed using funnel plots and Egger's regression test. The size of the pooled effect of the factors influencing the use of ITNs was estimated using an odds ratio (OR) with a 95% confidence interval (CI), and a P-value <0.05 was considered statistically significant. Results: Twenty-nine cross-sectional studies with 13,957 study participants were included in this meta-analysis. The overall pooled prevalence of ITN utilization among pregnant women in Ethiopia was 51% (95% CI: 43-60). A statistically significant heterogeneity was observed across studies (I2 = 99.09%; P < 0.001). Being literate [OR = 2.93 (95% CI: 2.14-4.01)], rural residence [OR = 1.76 (95% CI: 1.37-2.26)], and having knowledge of ITN [OR = 4.13 (95% CI: 1.57-10.81)] were factors significantly associated with ITN utilization among pregnant women. Conclusion: The utilization of ITNs among pregnant women was substantially lower than the national target, alarmingly highlighting the need for urgent and effective interventions. Maternal education status, place of residence, and knowledge of ITNs were independent predictors of ITN utilization. Health policymakers and programmers should design and implement the most effective strategies to scale up the utilization of ITNs by pregnant women and reduce malaria-related morbidity during pregnancy. Systematic Review Registration: CRD42022304432.

Clinical profile and treatment outcome of acute intussusception among children in eastern Ethiopia: A seven years retrospective study.

Background: Acute intussusception is the main cause of abdominal surgical emergencies worldwide in young children, with an incidence of approximately 1 to 4 per 2,000 children. An accurate estimate of the treatment outcomes of acute intussusception in children is unknown in low-and middle-income countries like Ethiopia. Hence, this study aimed to determine the clinical profile, treatment outcomes of acute intussusception and its associated factors among children admitted to Hiwot Fana Specialized University Hospital in eastern Ethiopia. Methods: An institutional-based retrospective cross-sectional study was conducted from November 01 to 30, 2021, among children admitted and managed for acute intussusception. All medical records of children admitted and managed for acute intussusception at Hiwot Fana Specialized University hospital between January 2014 and December 2020 were included. Data were collected using pretested structured checklists through a review of medical records, entered and analyzed using Statistical Package for Social Sciences version 25.0. Chi-square (χ 2) tests were applied to determine the associated factors with treatment outcome. The statistical significance was considered at a p-value < 0.05. Results: In this chart review of children, 13.3% (95% CL: 11.8-14.8) died. The median age of the study participant was 13 months. The majority, 72% were male and 76% were less than 24 months old. Regarding the clinical profile; abdominal pain (94.7%), vomiting (93.3%), bloody diarrhea (70.7%), and abdominal distention (76.0%) were the most common clinical presentations. Age less than 24 months [X 2 = 8.13 (df = 1); p = 0.004], preoperative vital signs [X 2 = 19.21 (df = 2); p = 0.000], intraoperative findings [X 2 = 18.89 (df = 1); p = 0.000], and postoperative complications [X 2 = 14.60 (df = 1); p = 0.000] were significantly associated with treatment outcome of acute intussusception. Conclusion: In this chart review, the overall mortality rate in children was relatively high. One in seven children died from acute intussusception. Age less than 24 months, preoperative vital signs, intraoperative findings, and postoperative complications were significantly associated with acute intussusception treatment outcomes. Surgical management was the only treatment performed in all cases. Delayed presentation of patients and lack of other treatment modalities such as non-surgical interventions are serious concerns in this facility. The initiation of non-surgical reduction may reduce the need for surgical intervention-related complications, and child mortality.

COVID-19 vaccine acceptance among pregnant women attending antenatal care in public hospitals in eastern Ethiopia: A multi-center facility-based cross-sectional study.

Objectives: The Ethiopian government had planned to vaccinate the total population and started to deliver the COVID-19 vaccine but, there is limited evidence about vaccine acceptance among pregnant women. Thus, this study aimed to assess COVID-19 vaccine acceptance and associated factors among pregnant women attending an antenatal care unit clinic in Eastern Ethiopia. Study design: A facility-based cross-sectional study. Methods: A study was conducted from June 01 to 30/2021 among systematically selected pregnant women. Data were collected using a pre-tested structured questionnaire, which was adapted from previous studies, through a face-to-face interview. Predictors were assessed using a multivariable logistic regression model and reported using an adjusted odds ratio with 95% CI. Statistical significance was declared at p-value less than 0.05. Results: In this study, data from 645 pregnant women were used in the analysis. Overall, 62.2% of pregnant women were willing to be vaccinated if the vaccine is approved by the relevant authority. Fear of side effects (62.04%), a lack of information (54.29%), and uncertainty about the vaccine's safety and efficacy (25%) were the most common reasons for refusal to take the COVID-19 vaccine. The odds of unwillingness to accept the COVID-19 vaccine among pregnant women were increased significantly among mothers who were able to read and write [AOR = 2.9, 95% CI: (1.16, 7.23)], attain 9-12 grade level [AOR = 4.2, 95% CI: (2.1, 8.5)], lack information [AOR = 2.2, 95% CI: (1.41, 3.57)], and having a history of chronic diseases [AOR = 2.52, 95% CI: (1.34, 4.7)]. Conclusion: Less than two-thirds of pregnant women were willing to accept the COVID-19 vaccine. Extensive public health information dissemination aimed at women with lower educational backgrounds and a history of chronic disease could be critical.

Acceptance of COVID-19 vaccine and associated factors among health care workers at public hospitals in Eastern Ethiopia using the health belief model.

Introduction: Acceptance of COVID-19 vaccination among Health Care Workers is mandatory to lessen and curve the spread of transmission of COVID-19. Even though the Health Belief Model is one of the most widely used models for understanding vaccination behavior against COVID-19 disease, COVID-19 vaccine acceptance among Health Care Workers in Ethiopia was not adequately explored by using the Health Belief Model domains. Purpose: This study aimed to assess COVID-19 vaccine acceptance and associated factors among Health care workers in eastern, Ethiopia. Methods: Institutional-based cross-sectional study design was used among 417 health care workers selected by a systematic random sampling method from June 1- 30/2021. The data were collected by face-to-face interviews using semi-structured questionnaires and analyzed using STATA version 14 statistical software. Multivariable binary logistic regression analysis with a 95% confidence interval was carried out to identify factors associated with willingness to COVID-19 vaccine acceptance and a statistical significance was declared at a P-value < 0.05. Results: The willingness of health care workers to accept the COVID-19 vaccine was 35.6%. Age 30-39 (AOR = 4.16;95% CI: 2.51, 6.88), age ≥ 40 years (AOR = 3.29;95% CI: 1.47, 7.39), good attitude (AOR = 1.97; 95% CI: 1.00, 3.55), perceived susceptibility (AOR = 1.93; 95% CI: 1.12, 3.32), and perceived severity (AOR = 1.78; 95% CI: 1.03, 3.10) were factors significantly associated with Health Care Workers acceptance of COVID-19 vaccine. Conclusion: The willingness to accept the COVID-19 vaccine among HCWs was low. Factors significantly associated with the willingness to accept the COVID-19 vaccine were age, good attitude, perceived susceptibility, and perceived severity of the disease. The low willingness of Health Care Workers to accept the COVID-19 vaccine was alarming and it needs more emphasis from the government in collaboration with other stakeholders to provide reliable information to avert misconceptions and rumors about the vaccine to improve the vaccine status of Health Care Workers to protect the communities.

Prevalence, indications, and outcomes of operative vaginal deliveries among mothers who gave birth in Ethiopia: A systematic review and meta-analysis.

Background: Operative vaginal deliveries represent an alternative to address problems during the second stage of labor. Clinicians have access to two different instruments obstetrics forceps and vacuum which should be conducted with indication. Understanding the pooled prevalence of operative vaginal deliveries, its indications, and outcomes would help in adopting suitable measures to reduce operative vaginal deliveries-related maternal and neonatal complications. Therefore, this systematic review and meta-analysis aimed to determine the prevalence, indications, and outcomes of operative vaginal deliveries among mothers who gave birth in Ethiopia. Methods: A literature search was done through databases such as PubMed, SCOPUS, Web of Sciences, CAB Abstract, and CINHAL (EBSCO) to search studies that have been conducted in Ethiopia. Relevant sources were consulted to retrieve unpublished studies. Original observational studies that reported the prevalence, indication and outcomes of operative vaginal deliveries conducted in the English language were identified and screened. Studies were independently assessed for inclusion, data extraction, and risk of bias. Results: Twelve studies were reviewed. The overall pooled prevalence of operative vaginal delivery among mothers who gave birth in Ethiopia was 10% (95% CI: 8 to 13) with I 2 = 98.82% and a p-value ≤ 0.001. Fetal distress, prolonged labor, and maternal exhaustion were the most common feto-maternal indications of OVDs whereas; neonatal death, poor Apgar score, admission to neonatal intensive care unit, perianal tear, and postpartum hemorrhage were complications that occur following the operative vaginal deliveries in Ethiopia. Conclusion: This systematic review and meta-analysis showed one out of 10 mothers undergo operative vaginal deliveries. Almost all feto-maternal complications that arise following operative vaginal deliveries were preventable. Thus, concerned stakeholders should encourage quality OVDs practice by avoiding unnecessary indications and scaling up the skill of health professionals through special training. Systematic review registration: http://www.crd.york.ac.uk/PROSPERO/, identifier CRD42022311432.

Magnitude of episiotomy practice and associated factors among women who gave birth at Hiwot Fana Specialized University Hospital, Eastern Ethiopia.

Background: Episiotomy is an intentional surgical incision made on the perineum with the aim of enlarging the introits during the second stage of labor or just before delivery of the baby. It sometimes also interferes with the mother's comfort during the postpartum period and has associated complications especially when it is done without indication. However, there is limited information regarding episiotomy practice in the study area. Objective: This study aimed to determine the magnitude of episiotomy practice and associated factors among women who gave birth at the Hiwot Fana Specialized University Hospital, Eastern Ethiopia, 2021. Methods: A facility-based cross-sectional study was conducted among 408 systematically selected mothers who gave birth at the Hiwot Fana Specialized University Hospital, from 1 January to 30 December 2021. Datas were collected from delivery medical records using a pretested checklist. The extracted data were checked, coded, and entered into the Epi-data version 3.1 and exported to the STATA version 16 software for analysis. Binary logistic regression was fitted to identify factors associated with episiotomy practice. P-values < 0.05 were considered to declare the presence of statistical significance. Results: The overall prevalence of episiotomy practice was found to be 43.4 % (95% CI: 38.7, 48.9), and mediolateral was the most commonly practiced episiotomy type (41.4%). Parity [AOR: 6.2; 95% CI (3.8-17.6)], 1st min Apgar score [AOR: 1.6; 95% CI (1.04-2.67)], presence of maternal medical disease [AOR: 3.3; 95% CI (1.09-6.9)], and induced labor [AOR: 1.6; 95%CI (1.12, 4.13)] were significantly associated with the episiotomy practice. Conclusion: The prevalence of episiotomy practice in the study area was high. Parity, presence of maternal medical disease, induction of labor, and 1st min APGAR score were significant factors associated with episiotomy practice. Considering the presence of appropriate indications or preventing unjustifiable indications, can help to reduce the current high practice rates.

Magnitude of cesarean-section and associated factors among diabetic mothers in Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia: A cross-sectional study.

Background: Gestational diabetes is associated with multiple adverse pregnancy outcome as a result of unfavorable labor and delivery process with a consequent increase in obstetric interventions including cesarean-section. Even though diabetes mellitus increases the cesarean-section rate; there is no study conducted in Ethiopia. therefore, this study aimed to assess the magnitude of cesarean-section and associated factors among diabetic mothers in Tikur Ambessa Specialize Hospital, Addis Ababa, Ethiopia. Methods: A facility-based retrospective cross-sectional study was conducted in Tikur Anbessa Specialized Hospital from 1 February to 30 April 2018 among 346 diabetic mothers. All required data were extracted from patients' charts using checklists, and incomplete records were excluded. The collected data were entered into Epi data version 4.2 and exported to SPSS version 20 for analysis. Multiple logistic regression models were fitted to identify factors associated with cesarean section. Adjusted odds ratios along with 95% CI were estimated to measure the strength of the association and declared statistical significance at a p-value <0.05. Results: The magnitude of cesarean-section was 57.8% (95% CI: 51.7, 63.3). Pregnancy-induced hypertension [AOR: 3.35, (95% CI: (1.22, 9.20)], previous C/S [AOR: 1.62, (95% CI: (2.54, 4.83)], and fetal distress [AOR: 4.36, (95% CI: 1.30, 14.62)] were factors significantly associated with cesarean-section. Conclusion: A considerable number of diabetic mothers gave birth by cesarean-section. Pregnancy-induced hypertension, previous cesarean-section, and fetal distress were factors more likely to increase the rate of cesarean-section. Most of the factors were modifiable by following the WHO recommendation for cesarean-section.

Postabortion Family Planning and Associated Factors Among Women Attending Abortion Service in Dire Dawa Town Health Facilities, Eastern Ethiopia.

Background: Postabortion family planning is a part of comprehensive package of postabortion care. However, it did not receive due attention to break the cycle of repeated abortion, unintended pregnancies, and abortion-related maternal morbidity and mortality. Therefore, this study aimed to determine the utilization of postabortion family planning and associated factors among women attending abortion service in Dire Dawa health facilities, Eastern Ethiopia. Methods: A facility-based cross-sectional study design was employed among 483 clients who sought abortion service in Dire Dawa from 15 May to 30 June 2020. A structured interviewer-administered questionnaire was used for data collection. The collected data were entered into EpiData version 3.2 and exported to SPSS version 22 for analysis. The multivariate logistic regression models were fitted to identify factors associated with utilization of postabortion family planning. Adjusted odds ratios (AORs) along with 95% CI were estimated to measure the strength of the association and statistical association was declared statistical at a p-value < 0.05. Results: More than three-fourths (77.8%) [95% CI: (73.4-81.6%)] of respondents were utilized postabortion family planning methods. Respondents with age 15-24 years [AOR: 5.59, (95% CI: (1.5, 19.7)], attended postsecondary [AOR: 7.6, (95% CI: (2.7, 21.2)], single marital status [AOR: 11.1, (95% CI: (4.6, 26.5)], a monthly income 500-1,000 birr [AOR: 7.9, (95% CI: (3.2, 19.4)], parity ≥ 5 [AOR: 0.41, (95% CI: (0.18, 0.92)], desire of current pregnancy [AOR: 4.2, (95% CI: (1.9, 9.3)], and ever used family planning [AOR: 4.4, (95% CI: (2.2, 8.9)] were major factors significantly associated with postabortion family planning utilization. Conclusion: In this study, more than three-fourths of respondents utilize postabortion family planning. Most of the factors associated with postabortion family planning were modifiable. Therefore, policymakers and health planners need to integrate with comprehensive abortion care to improve the utilization of postabortion family planning.

Food handler's level of COVID-19 prevention practice and preparedness of food and drinking establishments to combat the pandemic in Eastern Ethiopia.

Background: Food and drinking establishments are potential hotspots for the spread of coronavirus. Food handler's have a higher risk of contracting the disease and transmitting it to others. The aim of this study was to assess the food handler's level of preventive practices toward COVID-19 and the preparedness of food and drinking establishments to tackle the pandemic in Eastern Ethiopia. Methods: The cross-sectional study design was conducted from September 1 to 30, 2020. A stratified sampling technique was used to select 276 licensed public food and drinking establishments and a simple random sampling technique was employed to select 422 food handlers from the selected establishments. A face-to-face interview and checklist-based observation were used to collect data. The collected data were entered into Epidata 3.1 and exported to STATA version 16 for analysis. Binary logistic regression analysis were conducted to identify factors associated with COVID-19 preventive practice. Statistical significance was declared at p < 0.05. Results: About 406 food handler's participated in this study, making the response rate 96.2%. The study showed that 38.4% of study participants (95% CI: 33.5, 43.1) had good preventive practices for COVID-19. Only 10.5% of food and drinking establishments fulfilled all requirements to prevent COVID-19 transmission. Being male [AOR = 0.61, 95% CI(0.61, (0.39, 0.93)], attending secondary education [AOR = 2.20, (95% CI: 1.37, 3.53)], having a favorable attitude toward COVID-19 [AOR = 1.89, (95% CI: 1.22, 2.95)], and having good knowledge about COVID-19 [AOR = 1.78, (95% CI: 1.13, 2.81)] were significantly associated with the level of COVID-19 preventive practices. Conclusion: The level of good COVID-19 preventive practice was found to be low among the food handler's. Only one in ten food and drink establishments fulfilled the national guideline for preventing COVID-19 transmission. Being male, attending secondary education, having knowledge about COVID-19, and having a favorable attitude toward COVID-19 were significantly associated with good COVID-19 preventive practices. A vibrant guideline on prevention practices should be in place at all establishments, and compliance should be monitored. Local health office experts should take comprehensive measures to make all food and drinking establishments accountable for practicing all preventive measures.

Determinants of potentially harmful traditional cord care practices among mothers in Ethiopia.

Background: Globally, newborn deaths have declined from 5 million in 1990 to 2.4 million in 2019; however, the risk of death in the first 28 days is high. Harmful umbilical cord care contributes to neonatal infection, which accounts for millions of neonatal deaths. This study assessed determinants of potentially harmful traditional cord care practices in Ethiopia using data from a nationally representative survey. Materials and methods: Secondary data analyses were employed using data from the 2016 Ethiopian Demographic and Health Survey. Weighted samples of 4,402 mothers who gave birth in the last 3 years prior to the survey were included in the analysis. Binary logistic regression was fitted to identify associations of outcome variables with explanatory variable analysis, and the results were presented with an adjusted odds ratio (AOR) at a 95% confidence interval (CI), declaring statistical significance at a p-value < 0.05 in all analyses. Results: About 13.70% (95% CI: 12.7%, 14.7%) of mothers practice harmful traditional umbilical cord care. Maternal age (25-34 years, AOR = 1.77, 95% CI: 1.36, 2.31, 35-49 years, AOR = 1.53, 95% CI: 1.07, 2.19), maternal education (primary: AOR = 0.54, 95% CI: 0.41, 0.70 and secondary and above: AOR = 0.61, 95% CI: 0.40, 0.94), parity (para two, AOR = 0.71, 95% CI: 0.55, 0.92), and place of delivery (home delivery, AOR = 1.96, 95% CI: 1.51, 2.56) were factors associated with potentially harmful traditional umbilical cord care practices. Conclusion: Maternal educational status, parity, maternal age, and place of delivery were associated with harmful traditional cord care practices. Thus, improving mothers' education, strengthening antenatal and postnatal care (PNC), and utilization of institutional delivery would help to reduce harmful traditional cord care practices.

Tuberculous Meningitis in Children: Treatment Outcomes at Discharge and Its Associated Factors in Eastern Ethiopia: A Five Years Retrospective Study.

Background: Tuberculous meningitis is a serious public health problem, particularly in low-income countries. It is associated with high rates of mortality and morbidity. The outcome of tuberculous meningitis in children is not well documented in Ethiopia, particularly in eastern Ethiopia. This study aimed to determine the treatment outcomes of tuberculous meningitis at discharge and its associated factors in eastern Ethiopia. Methods: An institutional-based retrospective cross-sectional study was conducted on 121 children who were admitted and treated for tuberculous meningitis between January 2017 and December 2021. Data were collected using a pretested checklist, coded and entered into EpiData version 3.1, and analyzed using Statistical Package for the Social Sciences (SPSS) version 25. Factors associated with treatment outcomes were identified using multivariable logistic regression analyses. The association was described using the adjusted odds ratio (AOR) at a 95% confidence interval (CI). Finally, statistical significance was set at a p-value <0.05. Results: Of the 121 medical records of children, 33.9% (95% CI:25-42%) died. Among the survivors, 28.1% were discharged with neurological sequelae and the remains (38.0%) were discharged with normal outcomes. In multivariable analyses, nutritional status (AOR=2.87; 95% CI:1.04-7.94), duration of illness (AOR = 0.33; 95% CI: 0.15-0.86), hydrocephalus (AOR=3.78; 95% CI:1.08-13.34), and stage-III Tuberculous Meningitis (AOR = 5.29; 95% CI:1.88-14.84) were identified as significantly associated factors with poor clinical outcomes. Conclusion: The treatment outcomes for tuberculous meningitis in children are unfavorable. Two-thirds of children had poor treatment outcomes. Malnutrition, disease stage, hydrocephalus, and illness duration were associated with poor treatment outcomes at discharge. Health workers in primary health care should be aware of the importance of early screening, diagnosis, and treatment to improve clinical outcomes and reduce associated mortality and disability. In practice, more attention should be paid to children with malnutrition and hydrocephalus.

Prevalence of Group B Streptococcus Recto-Vaginal Colonization, Vertical Transmission, and Antibiotic Susceptibility Among Pregnant Women in Ethiopia: A Systematic Review and Meta-Analysis.

Background: Maternal Group B Streptococcus (GBS) recto-vaginal colonization is the most common route for early onset neonatal GBS diseases. A good understanding of the rate of maternal GBS colonization, vertical transmission rate, and antibiotic susceptibility profiles is needed to formulate a broad protection mechanism, like vaccine preparation. For that reason, this meta-analysis aimed at determining the pooled prevalence of GBS recto-vaginal colonization, vertical transmission rate, and antibiotic susceptibility profiles in Ethiopia. Methods: Both published and unpublished studies were searched from MEDLINE/PubMed, CINAHL (EBSCO), Embase, Cochrane Library, SCOPUS, Web of Sciences databases, and Google Scholar. Independent selection was then carried out by the authors based on the eligibility criteria and data extraction using Microsoft excel. The authors then used STATA version 14.1 software for further cleaning and analysis. The review was based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses) PRISMA guidelines. Using the random-effect model, the prevalence with a 95% confidence interval (CI) and forest plot were used to present the findings. Besides, the studies' heterogeneity was assessed using Cochrane chi-square (I2) statistics, while Egger intercept was used to assess publication bias. Results: This review included nineteen studies. The pooled prevalence of recto-vaginal colonization was 15% (95% CI: 11, 19), while the prevalence of vertical transmission was 51% (95% CI: 45, 58) and highest-level susceptibility to vancomycin was 99% (95% CI: 98, 100). However, the GBS susceptibility to tetracycline was 23% (95% CI: 9, 36). Conclusions: Nearly one out of seven pregnant women in Ethiopia had recto-vaginal colonization of GBS. As a result, half of the pregnancies end with vertical transmission of GBS. Hence, the review emphasizes that policy and programs should consider planning and implementing prophylactic programs. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021287540.

Magnitude of Anemia and Its Associated Factors Among Pregnant Women Attending Antenatal Care in Hiwot Fana Specialized University Hospital in Eastern Ethiopia.

Background: Anemia is a significant public health issue, accounting for 20-40% of maternal deaths. Despite the government's commitment and the interventions of various stakeholders, the magnitude and major risk factors of anemia remain unabated. Though there are few documented studies on anemia among pregnant women in eastern Ethiopia in general, in the study area in particular, some of the variables such as helminthics and history of caesarian section in relation to anemia need to be studied. As a result, the purpose of this study was to determine the magnitude of anemia and associated factors among pregnant women attending antenatal care in University Hospital in eastern Ethiopia. Methods: A facility-based cross-sectional study was conducted on a sample of 456 clients who were attending antenatal care in Hiwot Fana specialized university hospital from 01 to 30 June 2021. Systematic sampling was used to select the study participants. A pretested and structured interviewer-administered questionnaire and sample collection were used to collect the data. The data were coded, double-entered to Epi data version 3.1, cleaned, and exported to SPSS version 20 for analysis. Descriptive statistics were used to present frequency distributions. Variables with p-value < 0.25 during bivariate analysis were entered into the multivariate logistic regression models to control for all possible confounders to identify the factors associated with a magnitude of anemia. Odds ratio along with 95% CI were estimated to measure the strength of the association. The level of statistical significance was declared at a p-value of < 0.05. Result: A total of 456 participants were interviewed, with a response rate of 96.9%. The magnitude of anemia among pregnant women was 112 [(25.3%) 95%CI: (21.5-29.2%)], of which, 27 (6.10%), 36 (8.13%), and 49 (11.08%) had mild, moderate, and severe anemia, respectively. Birth interval < 2 years [AOR: 3.24, (95% CI: (1.88, 4.32)], number of children ≥2 [AOR: 2.54, (95% CI: (1.12, 4.64)], monthly income < 1,000 birr [AOR: 2.89, (95% CI: (1.31, 5.58)], third trimester pregnancy [AOR: 2.89, (95% CI: 4.86, 12.62)], and abnormal menstrual history [AOR: 2.28, (95% CI: (1.69, 5.24)] were the factors significantly associated with anemia. Conclusion: Anemia among pregnant women was relatively high compared to previous studies. Birth intervals, number of children, history of menstrual disorder, monthly income, and trimester of pregnancy were all significantly associated with anemia in pregnant women.

Insecticide-Treated Nets Utilization and Associated Factors Among Pregnant Women in Miesso Woreda, Eastern Ethiopia: Observational Study.

Background: Even though most sub-Saharan Africa adopted the World Health organization guidelines for malaria prevention, the coverage of insecticide-treated nets by pregnant women is low, where 28 million pregnant women did not receive insecticide-treated nets services. Likewise, only 13-51.4% of pregnant women utilize insecticide-treated nets in Ethiopia. Methods: A community-based cross-sectional study was conducted in Miesso woreda from April 01 to 30, 2017, among 424 pregnant women. A multi-stage cluster sampling technique was used to select the study participants. A structured interviewer-based administered questionnaire and observational checklist were used to collect the data. The collected data were entered into Epi data version 3.1 and exported to SPSS version 23 for analysis. Multiple logistic regression models were fitted to identify factors associated with insecticide-treated nets utilization. Adjusted odds ratios along 95% CI were estimated to measure the strength of the association and declared statistical significance at a p-value < 0.05. Results: Of a total respondents, 39.9% (95% CI: 34.9-44.2%) utilize insecticide-treated nets. Pregnant women from rural (AOR = 2.05, 95% CI: 1.14, 3.38), employed women (AOR = 1.80, 95% CI: 1.13, 2.86), monthly income >1050 Ethiopian total birr (AOR = 2.02, 95% CI: 1.06, 3.84), third trimester pregnancy (AOR = 2.19, 95% CI: 1.09, 4.40), and having antenatal care for current pregnancy (AOR = 3.86, 95% CI: 1.63, 9.10) were factors significantly associated with insecticide-treated nets. Conclusion: The utilization of insecticide-treated nets is relatively low. Residence, occupational status, monthly income, stage of pregnancy, and antenatal care status were factors significantly associated with insecticide-treated net utilization among pregnant women.

Birth asphyxia, determinants, and its management among neonates admitted to NICU in Harari and Dire Dawa Public Hospitals, eastern Ethiopia.

Background: Despite a declining neonatal mortality rate globally, Ethiopia has scored 29-30 deaths per 1,000 live births. Birth asphyxia is a major contributor to neonatal mortality, where 4-9 million newborns develop birth asphyxia each year. This study aimed to assess the prevalence of birth asphyxia, its determinants, and its management among neonates admitted to the NICU in Harari and Dire Dawa public hospitals. Methods: A facility-based cross-sectional study was conducted among 409 randomly selected neonates and their index mothers admitted to neonatal intensive care units of public hospitals in Harari and Dire Dawa from June 20 to August 20, 2021. Data were collected through card review and interviewer-administered questionnaires. The collected data were entered into Epi data version 3.1 and exported to SPSS version 20 for analysis. Logistic regression models were fitted to identify factors associated with birth asphyxia. Adjusted odds ratios along with 95% CIs were estimated to measure the strength of the association, and statistical significance was declared at p-value <0.05. Results: One-fifth of neonates [20.8% (95% CI: 16.4, 24.6%)] had birth asphyxia. Neonates born by instrumental delivery (AOR = 2.29, 95% CI: 1.10, 4.76) and neonates born to mother with PIH (AOR = 3.49, 95% CI: 1.47, 8.27), PROM (AOR = 2.23, 95% CI: 1.17, 4.26), and chorioamnionitis (AOR = 3.26, 95% CI: 1.10, 9.61) were more likely to have birth asphyxia compared to their counterpart. Ventilation with a bag and mask 50(58.8), putting on free oxygen 19(22.4), and endotracheal intubation 15(17.6) were taken as management methods. Conclusion: One out of five neonates had birth asphyxia. This urges care providers to adhere to national guidelines of obstetrics and neonatal continuum care. They also need to decrease instrumental delivery and treat PIH, PROM, and chorioamnionitis.

Birth Outcomes among Diabetic Mothers Who Delivered in Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia.

INTRODUCTION: Diabetes develops in 4% of all the pregnancies worldwide, and its prevalence ranges from 1 to 14%, and 7% are complicated and results in prenatal morbidity and mortality. The disease affects women and their babies during pregnancy, labor, and delivery. However, little is known about its prevalence, birth outcomes, and associated factors in the study setting. METHOD: A facility-based retrospective cross-sectional study was done on all deliveries attended from January 1, 2015, to December 31, 2017, to determine the prevalence of diabetes and birth outcome. The mothers who had complete data record were identified and consecutively reviewed. The data were entered in EpiData Version 4.2 and exported to SPSS Version 23.0 for analysis. RESULTS: Of the 14039 women who gave birth during the study period, 2.6% of them had diabetes mellitus, and from reviewed data, 54.6% had gestational diabetes and 45.4% had pregestational diabetes. Out of the diabetic mothers, 57.8% delivered by cesarean section, 39.9% by spontaneous vaginal delivery, and 26% of the pregnancies ended up with pregnancy-induced hypertension. Regarding the fetal outcome, 17.9% were preterm delivery, 17.6% macrocosmic, 9.2% respiratory distress, 10.1% low birth weight, and 65% admitted to neonatal intensive care unit. Class I obesity and history of PIH were associated with adverse maternal outcomes at aOR = 95%CI 3.8 (1.29, 8.319) and aOR = 95%CI 2.1 (1.03, 4.399), respectively. Being a house wife and preterm deliveries were associated with adverse fetal outcomes at aOR = 95%CI 2.117 (1.315, 3.405) and aOR = 95%CI 9.763 (4.560, 20.902), respectively. CONCLUSION: The prevalence of diabetes mellitus delivered in the hospital was 2.6%. Class I obesity and previous history of pregnancy-induced hypertension were significantly associated with adverse maternal outcomes, whereas preterm delivery and being housewife were associated with adverse fetal outcome.