Incidence and predictors of tuberculosis among HIV-infected children after initiation of antiretroviral therapy in Ethiopia: A systematic review and meta-analysis.

BACKGROUND: Globally, Tuberculosis (TB) is the main cause of morbidity and mortality among infectious disease. TB and Human Immune Virus (HIV) are the two deadly pandemics which interconnected each other tragically, and jeopardize the lives of children; particularly in Sub-Saharan Africa. Therefore, this review was aimed to determine the aggregated national pooled incidence of tuberculosis among HIV- infected children and its predictors in Ethiopia. METHODS: An electronic search engine (HINARI, PubMed, Scopus, web of science), Google scholar and free Google databases were searched to find eligible studies. Quality of the studies was checked using the Joanna Briggs Institute (JBI) quality assessment checklists for cohort studies. Heterogeneity between studies was evaluated using Cochrane Q-test and the I2 statistics. RESULT: This review revealed that the pooled national incidence of tuberculosis among children with HIV after initiation of ART was 3.63% (95% CI: 2.726-4.532) per 100-person-years observations. Being Anemic, poor and fair ART adherence, advanced WHO clinical staging, missing of cotrimoxazole and isoniazid preventing therapy, low CD4 cell count, and undernutrition were significant predictors of tuberculosis incidence. CONCLUSION: The study result indicated that the incidence of TB among HIV- infected children is still high. Therefore, parents/guardians should strictly follow and adjust nutritional status of their children to boost immunity, prevent undernutrition and opportunistic infections. Cotrimoxazole and isoniazid preventive therapy need to continually provide for HIV- infected children for the sake of enhancing CD4/immune cells, reduce viral load, and prevent from advanced disease stages. Furthermore, clinicians and parents strictly follow ART adherence.

Survival status and predictors of mortality from severe community-acquired pneumonia among under-five children admitted at Debre Tabor comprehensive specialized hospital: a prospective cohort study.

Background: Globally, Pneumonia continues to be the leading cause of mortality among under-five children. Ethiopia ranks fourth out of 15 countries worldwide in terms of the highest death rate of under-five children due to severe community-acquired pneumonia (SCAP). However, to date, there is no recent study that shows survival status and predictors of mortality from SCAP. Therefore, this study aimed to determine survival status and predictors of mortality from this dangerous disease among under-five children. Methods: A facility-based prospective cohort study was conducted from 1 November 2021 to 31 October 2022 at Debre Tabor comprehensive specialized hospital. All under-five children with SCAP admitted during the study period were included. Participants were selected using a systematic sampling technique. The collected data were coded, edited, and entered into epi-data version 4.2 and then exported to STATA version 17 for further analysis. The Kaplan Meier failure estimate with log-rank test was employed to determine the survival estimates. A cox-proportional hazard regression model was fitted to identify significant variables. Results: The overall incidence density rate of mortality was 5.7 /1000 children with a median hospital stay of 8.2 days. Heart disease (AHR: 4.37; 95%CI: 1.68-11.32), previous admission of SCAP (AHR: 3.87; 95% CI: 1.31-11.43), WFL < -3Z score (AHR: 3.57; 95% CI: 1.02-12.42), impaired consciousness level at admission 3.41(1.14-10.19), and pleural effusion (AHR: 3.42; 95%CI: 1.18-9.93) were significant predictors of mortality. Conclusion: In this study, the survival probability of children with SCAP was low. Children with heart disease, previous admission of SCAP, WFL < -3Z score, impaired consciousness level at admission, and pleural effusion had low survival. Therefore, much emphasis is needed on children with SCAP, particularly those with identified predictors.

Knowledge, attitude, and practice of health professionals working in emergency units towards disaster and emergency preparedness in South Gondar Zone hospitals, Ethiopia, 2020.

Introduction: catastrophe is a thoughtful community's well-being problem nowadays. Tragedies of any kind can strike at any time and have claimed many lives. Because, the emergency unit is at the frontline of disaster/emergency response system and helps as initial point to the most proper care of causalities, health professionals who are working in this area are the first caregivers, main players, and upfront role in calamity responses after pre-hospital medical services to disaster victims. The aim of this study was to assess emergency unit health professionals´ knowledge, attitude, practice, and related factors towards disasters and emergency preparedness at hospitals in the South Gondar Zone, Ethiopia, 2020. Methods: institution-based cross-sectional study with the census method was conducted at South Gondar Zone hospitals. All health professionals working in emergency units of South Gondar Zone hospitals were taken as a sample. A structured self-administered questionnaire was used to collect data. EPI-data version 4.2 and SPSS version 25 were used to enter and analyze data, respectively. The result was presented by narration, tables, and charts. Binary logistic regression was employed to determine the relations between dependent and independent variables. Results: the majority of the respondents (58.3%) were male. Regarding their profession, 52.2% were nurses, followed by physicians, 18.5%, while the rest were others. The mean age of the respondents was 29.48 ± 6.34 years. A substantial proportion (58.9%) of the study participants didn´t know whether their hospitals had a disaster management plan or not. In general, fifty-one-point seven percent´s (51.7%) of the study participants had poor knowledge toward disaster/emergency preparedness. Concerning their attitude, 55.0% had a negative attitude toward disaster preparedness. Regarding their levels of practice, 67.5% had inadequate practice disaster/emergency preparedness. Age category and profession of the respondents had a significant effect on the knowledge and attitude of respondents at P-value 0.05. Conclusion: more than half of the study participants had poor knowledge, negative attitudes, and inadequate practice about disaster/emergency preparedness.