Recommended homemade fluid utilization for the treatment of diarrhea and associated factors among children under five in sub-Saharan African countries: a multilevel analysis of the recent demographic and health survey.

INTRODUCTION: Diarrhea is a common public health problem and the third leading cause of death in the world among children under the age of five years. An estimated 2 billion cases and 1.9 million deaths are recorded among children under the age of five years every year. It causes body fluid loss and electrolyte imbalance. Even though, early initiation of recommended homemade fluid is a simple and effective approach to prevent diarrhea-related complications and mortality of children, recommended homemade fluid utilization for the treatment of diarrhea is still low in sub-Saharan African countries. Therefore, this study aimed to assess the magnitude of recommended homemade fluid utilization for the treatment of diarrhea and associated factors among children under five in sub-Saharan African countries. METHOD: The most recent Demographic and Health Survey dataset of 21 sub-Saharan African countries from 2015 to 2022 was used for data analysis. A total of 33,341 participants were included in this study as a weighted sample. Associated factors were determined using a multilevel mixed-effects logistic regression model. Significant factors in the multilevel mixed-effect logistic regression model were declared significant at p-values < 0.05. The adjusted odds ratio (AOR) and confidence interval (CI) were used to interpret the results. RESULT: The overall recommended homemade fluid utilization for the treatment of diarrhea among children under five in sub-Saharan African countries was 19.08% (95% CI = 18.66, 19.51), which ranged from 4.34% in Burundi to 72.53% in South Africa. In the multivariable analysis, being an educated mother/caregiver (primary and secondary level) (AOR = 1.15, 95% CI: 1.04, 1.27) and (AOR = 1.30, 95% CI: 1.15, 1.1.47), the primary and secondary level of fathers education (AOR = 1.53, 95% CI: 1.37, 1.71) and (AOR = 1.41, 95% CI: 1.19, 1.1.68), having antenatal care follow-up (AOR = 1.16, 95% CI: 1.01, 1.33), having multiple children (AOR = 1.17, 95% CI: 1.07, 1.28), and being an urban dweller (AOR = 1.15, 95% CI: 1.04, 1.27) were factors associated with recommended homemade fluid utilization. CONCLUSION: The overall recommended homemade fluid utilization for the treatment of diarrhea was low. Individual and community-level variables were associated with recommended homemade fluid utilization for the treatment of diarrhea. Therefore, special consideration should be given to rural dwellers and caregivers who have three and below children. Furthermore, better to strengthen the antenatal care service, mother/caregiver education, and father's education to enhance recommended homemade fluid utilization for the treatment of diarrhea.

Coverage and determinants of second-dose measles vaccination among under-five children in East Africa countries: a systematic review and meta-analysis.

Background: One of the biggest breakthroughs of contemporary medicine is measles vaccination. It is essential for the total elimination of measles. Understanding the magnitude and determinants of effective second-dose measles vaccination coverage is a critical task. Accordingly, we set out to check the best available evidence of the pooled second-dose measles vaccination coverage among under-five children in East Africa. Method: We searched electronic databases such as PubMed, Google Scholar, Cochrane, and others. Two reviewers separately carried out the search of the Joanna Briggs Institute, selection of studies, critical appraisal, and data extraction. A third party was involved in resolving the disagreement among the reviewers. Seven studies included in this study, four from Ethiopia, two from Kenya, and one from Tanzania were cross-sectional and published in English language, with publication dates before 29 November 2023. Articles lacking full-text, the intended outcome, and that are not qualitative studies were excluded from the analysis. The Microsoft Excel checklist was used to extract the data and then exported to STATA 11. In addition, I2, Funnel plots, and Egger's test were employed to measure heterogeneity and detect publication bias, respectively. A random effect model was used. Result: The meta-analysis includes a total sample size of 4,962 children from seven articles. The pooled prevalence of second-dose measles vaccination among under-five children in East Africa was found to be 32.22% [95% CI; (18.82, 45.63)], and the significant factors were as follows: birth order (1.72; OR = 95% CI: 1.32, 2.23), information about measles-containing second-dose vaccine (MCV 2) (7.39; OR = 95% CI: 5.21, 10.50), mother's marital status (1.47; OR = 95% CI: 1.05, 2.07), complete immunization for other vaccines (2.17; OR = 95% CI: 1.49, 3.17), and distance of vaccination site (3.31; OR = 95% CI: 2.42, 4.53). Conclusion: The current study found that pooled prevalence of second-dose measles vaccination coverage among under-five children was still very low. It was also observed that birth order, distance of the vaccination site, complete immunization for other vaccines, mother's marital status, and information about MCV were factors associated with second-dose measles vaccination. These factors imply that there is a need for countries and their partners to act urgently to secure political commitment, expand primary health service and health education, and increase vaccination coverage.

Prompt treatment of fever and its associated factors among under-five children in sub-Saharan Africa: A multilevel analysis of evidence from 36 countries.

INTRODUCTION: Despite the decrease in the global under-five mortality rate, the highest rates of mortality are reported in sub-Saharan Africa. More than one-third of all deaths among under-five children are either from lower respiratory tract infections, diarrhea, or malaria. Poor treatment-seeking behavior for fever among mothers of under-five children is a big concern in sub-Saharan Africa. However, the pooled prevalence of prompt treatment of fever and its associated factors among under-five children in the region using nationally representative data is not known. Therefore, the findings of this study will inform policymakers and program managers who work on child health to design interventions to improve the timely and appropriate treatment of fever among under-five children. METHODS: Data from the recent demographic and health surveys of 36 countries in sub-Saharan Africa conducted between 2006 and 2022 were used. A total weighted sample of 71,503 living children aged under five years with a fever was included in the study. Data extracted from DHS data sets were cleaned, recorded, and analyzed using STATA/SE version 14.0 statistical software. Multilevel mixed-effects logistic regression was used to determine the factors associated with the outcome variable. Intra-class correlation coefficient, likelihood ratio test, median odds ratio, and deviance (-2LLR) values were used for model comparison and fitness. Finally, variables with a p-value <0.05 and an adjusted odds ratio with a 95% confidence interval were declared statistically significant. RESULTS: The pooled prevalence of prompt treatment of fever among under-five children in sub-Saharan African countries was 26.11% (95% CI: 25.79%, 26.44%). Factors like maternal education [AOR = 1.18; 95% CI (1.13, 1.25)], maternal working status [AOR = 1.34; 95% CI (1.27, 1.41)], media exposure [AOR = 1.05; 95% CI (1.01, 1.10)], household wealth index [AOR = 1.13; 95% CI (1.06, 1.19)], distance to a health facility [AOR = 1.18; 95% CI (1.13, 1.23)], healthcare decisions [AOR = 1.34; 95% CI (1.01, 1.77)], visited healthcare facility last 12 months [AOR = 1.45; 95% CI (1.38, 1.52)], antenatal care attendance [AOR = 1.79; 95% CI (1.61, 1.99)], place of delivery [AOR = 1.55; 95% CI (1.47, 1.63)], and community-level antenatal care utilization [AOR = 1.08; 95% CI (1.02,1.14)] were significantly associated with prompt treatment of fever among under-five children. CONCLUSION: The pooled prevalence of prompt treatment of fever among under-five children in sub-Saharan African countries was low. Educated women, working mothers, having media exposure, rich household wealth status, perceiving distance to a health facility was not a big problem, making healthcare decisions with husband or partner, visiting healthcare facility in the last 12 months, antenatal care attendance, health facility delivery, and high community-level antenatal care utilization increase the odds of prompt treatment of fever. Therefore, women's empowerment, information dissemination through mass media, maintaining regular visits to healthcare facilities, and strengthening health facility delivery and antenatal care services are strongly recommended.

Number of tetanus toxoid injections before birth and associated factors among pregnant women in low and middle income countries: Negative binomial poisson regression.

BACKGROUND: In low- and middle-income countries where vaccination rates are low, tetanus is still an important threat to public health. Although maternal and neonatal tetanus remains a major global health concern, its magnitude and determinates are not well studied. Therefore, this study aimed to assess the number of tetanus toxoid injections and associated factors among pregnant women in low- and middle-income countries. METHODS: Data from the most recent Demographic and Health Surveys, which covered 60 low- and middle-income countries from 2010 to 2022, was used for secondary data analysis. The study included a total of 118,704 pregnant women. A statistical software package, STATA 14, was used to analyze the data. A negative binomial regression of a cross-sectional study was carried out. Factors associated with the number of tetanus vaccinations were declared significant at a p-value of < 0.05. The incidence rate ratio and confidence interval were used to interpret the results. A model with the smallest Akaike Information Criterion and Bayesian Information Criterion values and the highest log likelihood was considered the best-fit model for this study. RESULTS: In low- and middle-income countries, 26.0% of pregnant women took at least two doses of the tetanus toxoid vaccine. Factors such as maternal education, primary (IRR = 1.22, 95% CI: 1.17, 1.26), secondary (IRR = 1.19, 95% CI: 1.15, 1.23), higher (IRR = 1.16, 95% CI: 1.12, 1.20), employment (IRR = 1.11, 95% CI: 1.09, 1.13), 1-3 ANC visits (IRR = 2.49, 95% CI: 2.41, 2.57), ≥4 visits (IRR = 2.94, 95% CI: 2.84, 3.03), wealth index (IRR = 1.06; 95% CI: 11.04, 1.08), ≥birth order (IRR = 1.04, 95% CI: 1.02, 1.27), distance to health facility (IRR = 1.02, 95% CI: 1.00, 1.03), and health insurance coverage (IRR = 1.08; 95% CI: 1.06, 1.10) had a significant association with the number of tetanus vaccinations among pregnant women. CONCLUSIONS AND RECOMMENDATIONS: This study concludes that the number of tetanus toxoid vaccinations among pregnant women in low- and middle-income countries is low. In the negative binomial model, the frequency of tetanus vaccinations has a significant association with maternal employment, educational status, wealth index, antenatal care visits, birth order, distance from a health facility, and health insurance. Therefore, the ministries of health in low and middle-income countries should give attention to those women who had no antenatal care visits and women from poor wealth quantiles while designing policies and strategies.

Rotavirus vaccine dose-two dropout and its associated factors among children who received rotavirus vaccine dose-one in Sub-Saharan African countries: A multilevel analysis of the recent demographic and health survey.

Rotavirus is the most common cause of diarrhea in children worldwide. In 2016, rotavirus infection resulted in 258 173 300 episodes of diarrhea and 128 500 child deaths in the globe. The study aimed to assess the magnitude of Rotavirus vaccine dose-two dropout and associated factors among children who received rotavirus vaccine dose-one in sub-Saharan African countries. The appended and most recent demographic and health survey (DHS) dataset of 17 sub-Saharan African countries was used for data analysis. A total of 73,396 weighted samples were used. Factors associated with the outcome variable were considered significant if their p-values were ≤ .05 in the multilevel mixed-effect logistic regression model. The overall Rotavirus vaccine dose-two dropouts was 10.77% (95% CI 10.55%, 11.00%), which ranged from 2.77% in Rwanda to 37.67% in Uganda. Being younger, late birth order, having difficulty accessing health facilities, having no media exposure, having no work, having home delivery, having no antenatal follow-up, and having no postnatal checkup were factors significantly associated with the outcome variable. The overall Rotavirus vaccine dose-two dropout was higher in sub-Saharan African countries which implies that vaccine dropout is still a great issue in the region. Special attention should be given to those mothers who are young, who have no work, who give birth at home, who experienced difficulty in accessing health facilities, and late birth orders. Furthermore, targeted interventions should be considered for improving access and utilization of media, antenatal care, and postnatal care services.

Risky sexual behavior and associated factors among reproductive age women in eastern African countries: a multilevel analysis of the recent demographic and health survey.

INTRODUCTION: Risky sexual behavior exposes an individual to the risk of contracting sexually transmitted infections including human immunodeficiency virus (HIV). Even though risky sexual behavior is a devastating problem in low- and middle-income countries, studies on risky sexual behavior and associated factors among reproductive-age women in Eastern African countries are limited. Therefore, this study aimed to assess the magnitude of risky sexual behavior and associated factors among reproductive-age women in Eastern African countries that help to target high-risk groups and set appropriate intervention. METHOD: The appended and recent Demographic and Health Survey dataset of 10 Eastern African countries from 2012 to 2022 was used for data analysis. A total of 111,895 participants were included in this study as a weighted sample. Associated factors were determined using a multilevel mixed-effects logistic regression model. Significant factors in the multilevel mixed-effect logistic regression model were declared significant at p-values < 0.05. The adjusted odds ratio (AOR) and confidence interval (CI) were used to interpret the results. RESULT: The overall magnitude of risky sexual behavior among reproductive-age women in Eastern African countries was 28.16% (95% CI 27.90%, 28.43%), which ranged from 3.80% in Ethiopia to 67.13% in Kenya. In the multivariable analysis, being a younger woman, being an educated woman, being tested for human immunodeficiency virus, having work, drinking alcohol, and being an urban dweller were factors that were significantly associated with higher odds of risky sexual behavior. CONCLUSION: The overall magnitude of risky sexual behavior among reproductive-age women in Eastern African countries was high. Individual-level (being a younger woman, being an educated woman, being tested for human immunodeficiency virus, having work, and drinking alcohol) and community-level (being an urban dweller) variables were associated with higher odds of risky sexual behavior. Therefore, policymakers and other stakeholders should give special consideration to urban dwellers, educated, worker and younger women. Better to improve the healthy behavior of women by minimizing alcohol consumption and strengthening HIV testing and counseling services to reduce the magnitude of risky sexual behavior.

Individual and community-level determinants of knowledge about fertile periods among adolescent girls and young women (10-24 years) in Sub-Saharan Africa: A multilevel mixed effect analysis of a recent demographic and health survey.

Background: Identifying fertility periods accurately will protect teenage girls and young women from unintended pregnancies and related complications. However, in Sub-Saharan Africa, knowledge of the fertile period among adolescent girls and young women is not well studied. Thus, the purpose of this study was to assess adolescents' and young women's knowledge regarding fertility periods and its determinants in Sub-Saharan Africa. Methods: The most recent demographic and health surveys' data were used. The study had 140,064 participants in all. The data was analyzed using STATA/SE version 14. Using a multilevel logistic regression model, factors associated with knowledge of fertile periods have been determined. P-values <0.05 showed the significance of the factors associated with the outcome variable. The data were interpreted using the adjusted odds ratio and confidence interval. The best-fit model was determined to be the one with the highest logliklihood ratio and the lowest deviance. Results: One in five (20%) women between the ages of 10 and 24 had accurate knowledge about the fertile period. Age (AOR = 1.44, 95% CI: 1.40, 1.49), educational level (AOR = 1.68, 95% CI: 1.60, 1.77), knowledge of family planning (AOR = 1.33, 95% CI: 1.27, 1.39), distance (AOR = 2.31, 95% CI: 2.02, 2.98), residence (AOR = 1.06, 95% CI: 1.02, 1.10), and low community poverty (AOR = 3.06, 95% CI: 3.01, 3.12) had higher odds of knowledge about fertile period. Conclusion: This research finds that adolescents and young women in sub-Saharan Africa have low knowledge of the reproductive period. It was discovered that factors at the individual and communal levels influence women's knowledge of the fertile period. While developing policies and strategies, the health ministries of Sub-Saharan African countries had to take into consideration input from women whose experiences indicated that obtaining reproductive health services was hindered by distance.

Appropriate feeding practices and associated factors during diarrheal disease among children aged 6 to 23 months in Sub-Saharan Africa: a multilevel analysis of the recent demographic and health survey.

BACKGROUND: Diarrhea is the second leading cause of morbidity and mortality for under-five children which cause about 525,000 deaths annually. Even though diarrheal diseases have decreased substantially at the global level, low-income countries are still faced with a huge number of diarrheal diseases. Thus, our aim was to assess the child feeding practices during diarrheal diseases and associated factors among children aged 6 to 23 months in Sub-Saharan African countries using the recent demographic and health survey. METHODS: The appended and most recent demographic and health survey (DHS) dataset of 19 Sub-Saharan African countries from 2015 to 2020 was used for data analysis. A total of 64,628 living children aged 6-23 months with diarrhea were used as a weighted sample. The determinants of appropriate feeding practice were determined using a multilevel mixed-effects logistic regression model. Significant factors associated with appropriate feeding practice in the multilevel mixed-effect logistic regression model were declared significant at p-values < 0.05. The adjusted odds ratio (AOR) and confidence interval (CI) were used to interpret the results. RESULT: The overall prevalence of appropriate child feeding practice during diarrhea in this study was 6.24% (95% CI: 6.06, 6.43). Maternal age (15 to 19 years and 20 to 35 years) (AOR = 1.32, 95%CI: 1.12, 1.55 and AOR = 1.14, 95%CI: 1.03, 1.27), mothers education (primary and secondary level) (AOR = 1.23, 95%CI: 1.12, 1.35 and AOR = 1.28, 95%CI: 1.15, 1.43), having media exposure(AOR = 1.36, 95%CI: 1.26, 1.46), being married (AOR = 1.18, 95%CI: 1.01, 1.38), currently working (AOR = 1.08, 95%CI:1.00, 1.15), vaccinated for Rotavirus (AOR = 1.30, 95%CI:1.19, 1.43) and living in Central and eastern African countries (AOR = 1.82, 95%CI: 1.12, 2.97) and (AOR = 2.23, 95%CI: 1.37, 3.61) respectively were significantly associated with appropriate feeding practice. CONCLUSION: The prevalence of appropriate feeding practice during child diarrheal disease aged 6-23 months of age was strictly low which implies that child diarrhea and appropriate feeding practice is still a great issue in in Sub-Saharan African countries. Enhancing maternal education, strengthening media exposure and vaccination for rotavirus, and designing interventions that address the mother's marital status, mother's work status, and country category are recommended to enhance appropriate feeding practices. Furthermore, special consideration should be given to older mothers to increase appropriate feeding practices during diarrheal disease.

Complementary feeding practices and associated factors among mothers of children aged 6 to 23 months in Sub-saharan African countries: a multilevel analysis of the recent demographic and health survey.

INTRODUCTION: Malnutrition is a public health problem in sub-Saharan Africa with an increased morbidity and mortality rate than in other parts of the world. Poor complementary feeding practices are one of the major causes of malnutrition during the first two years of life. Therefore, this study aimed to determine the prevalence and associated factors of appropriate complementary feeding practices among mothers of children aged 6 to 23 months in sub-Saharan African countries. METHODS: A multilevel mixed-effect analysis was carried out using recent demographic health survey data from 19 sub-Saharan African countries, which were conducted between 2015 and 2020. A total weighted sample of 60,266 mothers of children aged 6 to 23 months were included in the study. The demographic health survey employs a stratified two-stage sampling technique. Data extracted from the recent DHS data sets were cleaned, recorded, and analyzed using STATA/SE version 14.0 statistical software. Multilevel mixed-effects logistic regression was used to determine the factors associated with complementary feeding practice. Variables with a p-value less than 0.05 and adjusted odds ratio (AOR) with a 95% confidence interval (CI) were reported as statistically significant variables associated with appropriate complementary feeding practices. RESULTS: The prevalence of appropriate complementary feeding practices among mothers of children aged 6 to 23 months in sub-Saharan African countries was 13.02% (95% CI: 12.75-13.29%). Maternal educational level [AOR = 0.69, 95% CI (0.64, 0.74)] and [AOR = 0.52, 95% CI (0.47, 0.57)], marital status of the mother [AOR = 0.85, 95% CI (0.74, 0.96)], sex of household head [AOR = 1.78, 95% CI (1.09, 1.27)], total children ever born [AOR = 1.52, 95% CI (1.18, 1.96)], [AOR = 1.43, 95% CI (1.14, 1.81)], and [AOR = 1.31, 95% CI (1.04, 1.64)], media exposure [AOR = 0.74, 95% CI (0.69, 0.79)], ANC visits attended during pregnancy [AOR = 0.73, 95% CI (0.63, 0.80)] and [AOR = 0.67, 95% CI (0.62, 0.74)], place of delivery [AOR = 0.92, 95% CI (0.85, 0.98)], currently breastfeeding [AOR = 1.12, 95% CI (1.01, 1.23)], PNC checkup [AOR = 0.75, 95% CI (0.70, 0.80)], the current age of the child [AOR = 0.26, 95% CI (0.24, 0.28)] and [AOR = 0.14, 95% CI (0.13, 0.16)], birth order [AOR = 1.31, 95% CI (1.09, 1.58)], number of under 5 children in the household [AOR = 0.76, 95% CI (0.59, 0.97)], community illiteracy [AOR = 1.09, 95% CI (1.02, 1.18)], and country category [AOR = 1.62, 95% CI (1.18, 2.22)] were significantly associated with appropriate complementary feeding practices. CONCLUSION: The prevalence of appropriate complementary feeding practices among mothers of children aged 6 to 23 months in sub-Saharan Africa was relatively low. Higher maternal educational level, female household head, having media exposure, attending more ANC visits, health facility delivery, currently breastfeeding, having PNC follow-up, low community illiteracy, and living in the West Africa region increase the odds of appropriate complementary feeding practices. Women empowerment, increasing maternal health services accessibility, promoting breastfeeding behavior, increasing media exposure of the household, and improving the proportion of health facility delivery are strongly recommended.

Unhealthy food consumption and its determinants among children aged 6 to 23 months in sub-Saharan Africa: a multilevel analysis of the demographic and health survey.

BACKGROUND: Unhealthy food consumption that begins early in life is associated with a higher risk of nutrient inadequacy and related chronic diseases later in life. Healthy eating and consumption of important nutrients help to maintain a healthy body weight and reduce the risk of developing chronic conditions. Research from sub-Saharan Africa regarding consumption of unhealthy foods remains limited, with no studies quantifying the pooled prevalence among young children. Therefore, this study is intended to assess the pooled prevalence and determinants of unhealthy food consumption among children aged 6 to 23 months. METHODS: Data from the most recent demographic and health surveys of five countries in sub-Saharan Africa conducted between 2015 and 2022 were used. A total weighted sample of 16,226 children aged 6 to 23 months was included in the study. Data extracted from DHS data sets were cleaned, recorded, and analyzed using STATA/SE version 14.0 statistical software. Multilevel mixed-effects logistic regression was used to determine the factors associated with the dependent variable. Intra-class correlation coefficient, likelihood ratio test, median odds ratio, and deviance (-2LLR) values were used for model comparison and fitness. Finally, variables with a p-value < 0.05 and an adjusted odds ratio with a 95% confidence interval were declared statistically significant. RESULTS: The pooled prevalence of unhealthy food consumption among children aged 6 to 23 months was 13.41% (95% CI: 12.89-13.94%). Higher consumption of unhealthy foods was reported among mothers with low education [adjusted odds ratio (AOR) = 0.37; 95% confidence interval (CI) (0.30, 0.46)], unmarried women [AOR = 1.19; 95% CI (1.05, 1.34)], who had no media exposure [AOR = 0.64; 95% CI (0.56, 0.72)], delivered at home [AOR = 0.74; 95% CI (0.62, 0.87)], who hadn't had a PNC checkup [AOR = 0.66; 95% CI (0.60, 0.73)], wealthier households [AOR = 1.20; 95% CI (1.05, 1.37)], older children (aged ≥ 9 months) [AOR = 3.88; 95% CI (3.25, 4.63)], and low community level media exposure [AOR = 1.18; 95% CI (1.04, 1.34)]. CONCLUSION: Nearly one out of seven children aged 6 to 23 months consumed unhealthy foods. Maternal educational level, marital status of the mother, exposure to media, wealth index, place of delivery, PNC checkup, and the current age of the child were factors significantly associated with unhealthy food consumption. Therefore, improving women's education, disseminating nutrition-related information through the media, providing more attention to poor and unmarried women, and strengthening health facility delivery and postnatal care services are recommended.

Incidence and predictors of mortality among traumatic brain injury patients admitted to Amhara region Comprehensive Specialized Hospitals, northwest Ethiopia, 2022.

INTRODUCTION: Traumatic brain injury is a substantial cause of mortality and morbidity with a higher burden in low and middle-income countries due to healthcare systems that are unable to deliver effectively the acute and long-term care the patients require. Besides its burden, there is little information on traumatic brain injury-related mortality in Ethiopia, especially in the region. Therefore, this study aimed to assess the incidence and predictors of mortality among traumatic brain injury patients admitted to comprehensive specialized hospitals in the Amhara region, northwest Ethiopia, 2022. METHODS: An institution-based retrospective follow-up study was conducted among 544 traumatic brain injury patients admitted from January 1, 2021, to December 31, 2021. A simple random sampling method was used. Data were extracted using a pre-tested and structured data abstraction sheet. Data were entered, coded, and cleaned into EPi-info version 7.2.0.1 software and exported to STATA version 14.1 for analysis. The Weibull regression model was fitted to determine the association between time to death and covariates. Variables with a P-value < 0.05 were declared statistically significant. RESULTS: The overall incidence of mortality among traumatic brain injury patients was 1.23 per 100 person-day observation [95% (CI: 1.0, 1.5)] with a median survival time of 106 (95% CI: 60, 121) days. Age [AHR: 1.08 (95% CI; 1.06, 1.1)], severe traumatic brain injury [AHR: 10 (95% CI; 3.55, 28.2)], moderate traumatic brain injury [AHR: 9.2 (95% CI 2.97, 29)], hypotension [AHR: 6.9 (95% CI; 2.8, 17.1)], coagulopathy [AHR: 2.55 (95% CI: 1.27, 5.1)], hyperthermia [AHR: 2.79 (95% CI; 1.4, 5.5)], and hyperglycemia [AHR: 2.28 (95% CI; 1.13, 4.6)] were positively associated with mortality while undergoing neurosurgery were negatively associated with mortality [AHR: 0.47 (95% CI; 0.27-0 0.82)]. CONCLUSION: The overall incidence of mortality was found to be high. Age, severe and moderate traumatic brain injury, hypotension at admission, coagulopathy, presence of associated aspiration pneumonia, undergoing a neurosurgical procedure, episode of hyperthermia, and hyperglycemia during hospitalization were the independent predictors of time to death. Therefore, interventions to reduce mortality should focus on the prevention of primary injury and secondary brain injury.

Prevalence of anaemia and its associated factors among HIV-infected adults at the time of ART initiation at Debre Markos Comprehensive Specialized Hospital, Northwest Ethiopia: a retrospective cross-sectional study.

OBJECTIVE: The aim of this study was to assess the prevalence of anaemia and its associated factors at the time of antiretroviral therapy (ART) initiation among HIV-infected adults at Debre Markos Comprehensive Specialized Hospital. METHODS: An institution-based retrospective cross-sectional study was conducted among 473 patients' charts enrolled from 2014 to 2018 at Debre Markos Comprehensive Specialized Hospital. Patients' chart numbers were selected from the computer using a simple random sampling technique. Data were entered using Epi Info V.7.2.2.6 and analysed with Stata V.14.0. Anaemia prevalence at the time of ART initiation was computed and described using frequency tables. To identify factors for anaemia, bivariate and multivariate logistic regression models were fitted. Model fitness was checked using the Hosmer-Lemeshow goodness-of-fit test. RESULTS: From 473 patients' charts, 468 charts were included in the analysis, and a total of 164 anaemia cases were recorded. The overall prevalence of anaemia among HIV-infected adults at the time of ART initiation was 35.04% (95% CI: 30.84% to 39.49%). After multivariate analysis, an increased risk of anaemia was seen among males (adjusted OR (AOR)=2.45; 95% CI: 1.51 to 3.98); those not attending formal education (AOR=2.38; 95% CI: 1.12 to 5.05); those who had baseline CD4+ T cell count ≤200 cells/mm3 (AOR=4.67; 95% CI: 2.78 to 7.85); had body mass index (BMI) <18.5 kg/m2 (AOR=2.43; 95% CI: 1.42 to 4.16) and had ambulatory/bedridden baseline functional status (AOR=2.69; 95% CI: 1.41 to 5.12). CONCLUSION: The current study showed that a significant proportion of HIV-infected adults developed anaemia at the time of ART initiation. Hence, giving special attention to those who have not attended formal education, were males, had decreased baseline CD4+ T cell count, had lower BMI and patients with ambulatory/bedridden baseline functional status is crucial to reduce the health impact of anaemia. The result will provide insight into the development of new anaemia preventive strategies.

Preventive foot self-care practice and associated factors among diabetic patients attending the university of Gondar comprehensive specialized referral hospital, Northwest Ethiopia, 2021.

BACKGROUND: Diabetes mellitus is emerging as a major worldwide health problem that has a social, financial, and developmental impact on developing countries. Foot complications are among the most serious and costly complications of diabetes which lead to lower extremity amputation due to diabetic foot ulcers. Poor diabetic foot self-care practice is identified by different studies as a major contributing factor to diabetic foot ulcers. Therefore, this study was intended to assess foot self-care practice and associated factors among diabetic patients attending the University of Gondar comprehensive specialized referral hospital. METHODS: A hospital-based cross-sectional study was conducted from July 1 to August 30, 2021, at the University of Gondar comprehensive specialized referral hospital. A systematic random sampling technique was employed to select 384 diabetic patients. A structured pretested interviewer-administered questionnaire was used to collect data. The data was entered in epi-info version 7, analyzed using SPSS version 21, and presented using frequencies, percentages, tables, and graphs. Bivariable and multivariable analyses were investigated using a binary logistic regression model. P-value < 0.05 and an odds ratio with a 95% confidence interval were used to determine the significance and strength of the association. RESULTS: Of the 384 diabetic patients, 46.4% (95% CI (41.1%-51.6%)) of them had poor foot self-care practice. Being male [AOR = 0.54, 95% CI (0.32, 0.89)], couldn't read and write and completed primary education [AOR = 2.35, 95% CI (1.01, 5.43)] & [AOR = 2.92, 95% CI (1.39, 6.12)], living in rural area [AOR = 3.84, 95% CI (1.91, 7.75)], having diabetic complications [AOR = 2.19, 95% CI (1.07, 4.46)], taking both injection and pills [AOR = 0.33, 95% CI (0.12, 0.88)], having previous information about foot care [AOR = 0.12, 95% CI (0.06, 0.24)], and family support [AOR = 0.57, 95% CI (0.34, 0.94)] were determinants of poor foot self-care practice. CONCLUSION: The adherence of diabetic patients toward foot self-care practice was poor. Being male, having low educational status, living in a rural area, having diabetic-related complications, taking both injections and pills, not having previous information about foot care, and having poor family support increases the odds of having poor foot self-care practice. Giving health education to patients and their caregivers about the basic principles of diabetes foot care, like regular inspection of feet and appropriate footwear at their regular follow-up time, should be emphasized.

Determinants of undernutrition among private and public primary school children: A comparative cross-sectional study toward nutritional transition in northwest Ethiopia.

OBJECTIVES: Undernutrition is a major public health concern, particularly in children. The burden is higher in developing countries. Undernutrition is considered when there is one or more of the following: stunting, underweight, or wasting. Childhood undernutrition can have numerous long-term effects: a lower physical capacity for work, lower intellectual quotients, greater risk for morbidity and mortality, and cognitive impairment. Undernourished children also can have poor cognitive scores, a high absenteeism rate, and high class repetition compared with non-undernourished children. The aim of this study was to assess undernutrition and its associated factors among public and private primary school children in Gondar town, northwest Ethiopia. METHODS: A school-based, cross-sectional study was conducted from March 5 to April 9, 2019. A multistage sampling technique was applied to select study participants. A simple random (lottery) sampling method was used to select seven public schools and five private schools. Systematic random sampling was used to select 774 study participants. The data were collected through face-to-face interviews. Multivariable logistic regressions were conducted to identify factors associated with undernutrition. The World Health Organization (WHO) AnthroPlus software was used to determine the status of undernutrition. Participants with a Z-score less than -2 were considered to be undernourished. Statistical significance was declared at P < 0.05 and odds ratios (ORs) were reported with a 95% confidence interval (CI). RESULTS: The prevalence of undernutrition was higher among public school children (37.1%) than those attending private schools (28.3%). Not having family car (adjusted OR [aOR], 0.28; 95% CI, 0.09-0.84), snack frequency no more than twice a day (aOR, 5.29; 95% CI, 1.37-20.37), and vigorous intensity sports (aOR, 0.53; 95% CI, 0.32-0.91) were significantly associated with undernutrition among public primary school students. Family income below the median (aOR, 2.12; 95% CI, 1.23-3.53), no preference for sweets (aOR, 0.59; 95% CI, 0.36-0.97), and not habits while reading (aOR, 0.42; 95% CI, 0.19-0.89) were the factors significantly associated with undernutrition among private primary school students. CONCLUSION: The prevalence of undernutrition was high. Children in public schools were highly vulnerable to undernutrition compared with those in private schools. Not having a family car, snack frequency no more than twice daily, and vigorous intensity sports increase the risk for undernutrition among public school children. Family income below the median, not preferring sweets, and not having a habit of eating while reading increase the risk for undernutrition among private school children. It is better to give attention to healthy dietary habits and healthy lifestyles to reduce childhood undernutrition.

Knowledge, health belief, and associated factors towards the prevention of osteoporosis among post-menopausal women in Metu Town, southwest Ethiopia: A community-based cross-sectional study.

INTRODUCTION: Osteoporosis is a condition where bones lose mass and strength. It is a common cause of morbidity and mortality in women, especially those of post-menopausal age. It is estimated that 30% of postmenopausal women globally suffer from osteoporosis. This study aimed to assess knowledge, health beliefs, and associated factors towards the prevention of osteoporosis among post-menopausal women in Metu Town, southwest Ethiopia, 2021. METHODS: A community-based cross-sectional study was conducted among 422 post-menopause women. A simple random sampling technique was employed to select study participants. Data was collected using a structured interviewer-administered questionnaire. Bivariate and multivariate analyses were condcuted to identify factors significantly associated with the outcome variable. RESULTS: The results showed that 38.4% and 44.5% of participants had adequate knowledge and positive health beliefs towards the prevention of osteoporosis. Age, marital status, educational status, employment status, and self and family history of osteoporosis were significantly associated with knowledge. Age, educational status, self and family history of osteoporosis, and sources of information were significantly associated with health beliefs. CONCLUSION: More than 40% of participants had adequate knowledge and positive health beliefs. Being younger, better educated, and having a personal and family history of osteoporosis increased the odds of having adequate knowledge and positive health beliefs. Being employed and getting information from families and friends had a significant association with higher odds of adequate knowledge and positive health beliefs.

Determinants of risky sexual behaviour among undergraduate students at the University of Gondar, Northwest Ethiopia.

Risky sexual behaviour (RSB) is defined as behaviours leading to sexually transmitted diseases and unintended pregnancies. According to the Joint United Nations Program on HIV/AIDS, HIV infection was very high among adolescents and youths living in sub-Saharan Africa including Ethiopia. This study was aimed to assess the prevalence of RSB and associated factors among undergraduate students at the University of Gondar.An institution-based cross-sectional study was conducted from June to July 2019 and a simple random sampling technique was employed to select 420 students. Data were collected using a structured self-administered questionnaire, entered into Epi-info version 7.0 and exported to Statistical Package for Social Sciences (SPSS) version 25 for analysis, and presented in frequencies, percentages and tables. Bivariable and multivariable logistic regression analysis were carried out to identify variables having significant association with RSB.The prevalence of RSB among undergraduate students at the University of Gondar was 44.0%. Age [adjusted odds ratio (AOR): 2.12; 95% confidence interval (CI) (1.19-3.79)], residence [AOR: 2.14; 95% CI (1.22-3.75)], living arrangement [AOR: 9.79; 95% CI (5.34-17.9)], daily religious attendance[AOR: 0.57; 95% CI (0.33-0.99)], drink alcohol [AOR: 9.19; 95% CI (3.74-22.59)] and having information about reproductive health and sexually transmitted diseases [AOR:3.05; 95% CI (1.00-9.27)] were factors significantly associated with RSB.Nearly half of the respondents engaged in risky sexual activity. This prevalence is high and the students are at high risk of exposure to sexually transmitted diseases that need reproductive health intervention like counselling and discussion. Creating awareness is needed for the students regarding reproductive health and the risk of sexually transmitted diseases. In addition, giving special attention is required for students who use alcohol, who did not live with family and who have urban residence.

Determinant factors of poor adherence to iron supplementation among pregnant women in Ethiopia: A large population-based study.

INTRODUCTION: Anemia during pregnancy increases the risk of premature delivery as well as maternal and child mortality. More than 40% and almost one-third of pregnant women are anemic worldwide and in Ethiopia respectively. Iron supplementation is important to prevent anemia during pregnancy in developing countries including Ethiopia. Despite this fact, it is at a substandard level in Ethiopia. Therefore, this study was conducted to identify the determinant factors of poor adherence to iron supplementation among pregnant women in Ethiopia. METHODS: A cross-sectional study was conducted based on the EDHS data for 2016 from two city administrations and nine regions of Ethiopia. A total of 3, 266 women were included. Bivariable and multivariable logistic regression analysis was employed. P-value < 0.05 and odds ratios were used to determine the significance and strength of association. RESULTS: Those pregnant women who had no mobile telephone [AOR; 0.79, 95% CI (0.65-0.95)], a history of cigarette smoking & alcohol use [AOR; 0.20, 95% CI (0.09-0.45)] and [AOR; 0.77, 95% CI (0.64-0.93)], and less than four antenatal care visits [AOR; 0.56, 95% CI (0.46, 0.68)] had higher odds of poor adherence. CONCLUSION: Not having a mobile telephone, a history of smoking and alcohol use, and less than four antenatal care visits were determinant factors of poor adherence to iron supplementation. It is important to empower women, strengthen communication for behavioral change, and give attention to counseling pregnant women.

Determinants of knowledge, attitude, and practice towards first aid among kindergarten and elementary school teachers in Gondar city, Northwest Ethiopia.

BACKGROUND: Injuries continue to be an important cause of morbidity and mortality in the developed and developing world. School-age children are more likely to experience unintentional injuries in the school, while they are playing and teachers are the primarily responsible body for keeping the welfare of the students. Knowing the knowledge, attitude, and practice of kindergarten and elementary school teachers towards first aid will be used as an input for policymakers to intervene and provide training. Therefore, this study was aimed to assess knowledge, attitude, practice, and associated factors towards first aid among kindergarten and elementary school teachers in Gondar city, Northwest Ethiopia, 2021. METHODS: An institution-based cross-sectional study was conducted from January 01 to 20, 2021. A simple random sampling technique was employed to recruit 346 participants. A structured pretested self-administered questionnaire was used to collect data. Data were entered in Epi-info version 7, analyzed using SPSS version 21, and presented by frequencies, percentages, tables, and graphs. Bivariable relationships between the independent and outcome variable were investigated using a binary logistic regression model and a multivariable analysis was run to control potential confounding factors. Variables with a p-value < 0.05 were considered as factors significantly associated and the strength of association was determined using an odds ratio with a 95% CI. RESULTS: Only 41.1% of the teachers had good knowledge of first aid. Nearly two-thirds (64.8%) of the teachers had a favorable attitude towards first aid. The majority (85.8%) of the teachers who faced a child in need of first aid in their school gave first aid. Factors like working experience [AOR: 2.45; 95% CI (1.26, 4.73)], school level [AOR: 4.72; 95% CI (1.96, 11.4)], school type [AOR: 4.23; 95% CI (2.07, 8.64)], and having information about first aid [AOR: 2.09; 95% CI (1.11, 3.92)] were significantly associated with knowledge. School-level [AOR = 5.4, 95% CI (2.18-11.67)], school type [AOR = 0.45, 95% CI (0.21-0.94)], and working experience [AOR = 0.33, 95% CI (0.13-0.86)] were the factors significantly associated with attitude. CONCLUSION: Less than half and nearly two-thirds of the teachers had good knowledge and a favorable attitude towards first aid. The majority of the teachers who encountered a child in need of first aid gave first aid. Having higher working experience, working in elementary and private schools, and having previous information increases the odds of having good knowledge. Teachers who work in elementary and private schools and have the lower working experience had higher odds of favorable attitude towards first aid. It is better to give attention to the training of staff on first aid specifically for teachers working in kindergarten and governmental schools and new employees and consider integrating first aid in teachers' training curriculum.

Satisfaction and associated factors towards inpatient health care services among adult patients at Pawie General Hospital, West Ethiopia.

INTRODUCTION: Improving the quality of services is the primary goal of the Ethiopia reform program to satisfy patients. Patient satisfaction is an attitude resulting from a person's general orientation towards a total experience of health care. According to world health organization consumer satisfaction is playing an increasingly important role in the quality of care reforms and health-care delivery more generally. OBJECTIVE: To assess patient's satisfaction and associated factors with health care services among admitted patients in Pawie General Hospital, Benishangul Gumuze Region, West Ethiopia, 2020. METHODS: Institution based cross-sectional study was conducted among adult patients admitted to Pawie General Hospital. A systematic random sampling technique was employed to recruit 334 participants and a structured interviewer-administered questionnaire was used to collect data. Data were entered into Epi Data version 3.1, analyzed using SPSS version 23, and presented in tables and graphs. Bivariable and multivariable logistic regressions were computed to identify factors associated with patient satisfaction. P-values < 0.05 and adjusted odds ratios were used to declare the significance and strength of the association. RESULT: The overall patient's satisfaction towards inpatient health care services at Pawie General Hospital was 60.8% with 95% CI (55.4, 65.9). Factors like admission ward [AOR = 2.60; 95% CI (1.34, 5.03)] and privacy [AOR = 12.5; 95% C I (2.89, 54.1)] were significantly associated with patient's satisfaction. CONCLUSION: The satisfaction level of patients admitted to Pawie General Hospitals was low. Admission ward and perceived privacy assured were factors significantly associated with patient satisfaction among patients admitted to Pawie General Hospital. The hospital administration system is better to work together to fill the gaps identified and improve the level of patient satisfaction.

Prevalence and Associated Factors of Low Back Pain Among Bank Workers in Gondar City, Northwest Ethiopia.

INTRODUCTION: Low back pain is a very common health problem that most people experience at some point in their working life. It results in sick leave, disability, producing significant restrictions on usual activity and participation among many office workers. The working style of bank workers is sedentary mostly and the alignment of their chairs, table, and computers is not designed based on their health aspects which exposes them to low back pain. OBJECTIVE: This study aimed to assess the prevalence and associated factors of low back pain among bank workers in Gondar city. METHODS: Institution-based cross-sectional study was conducted from 20th October to 10th November 2020 at banks in Gondar city. A simple random sampling technique was employed to select 296 bank workers. A structured pretested self-administered questionnaire was used to collect data. Data were entered in epi-info version 7, analyzed using SPSS version 21, and presented by frequencies, percentages, and tables. Bivariable and multivariable analyses were employed using a binary logistic regression model. Variables with a p-value < 0.05 were considered as factors significantly associated and the odds ratio with a 95% CI was used to determine the strength of association. RESULTS: The prevalence of low back pain among bank workers in the last 12 months was 55.4%. Being female, work-related stress, lack of physical activity, using a fixed chair and a chair without an armrest, and lifting heavy objects increases the risk of developing low back pain. CONCLUSION: The prevalence of low back pain among bank workers in Gondar city was high. It is better to establish a health screening team, avail a movable chair and a chair with an armrest, and give special attention to female workers and bank workers with stress, and do physical activity to reduce the risk of developing low back pain.