Diagnostic performance of plasma D-dimer, fibrinogen, and D-dimer to fibrinogen ratio as potential biomarkers to predict hypertension-associated acute ischemic stroke.

Background: Ischemic stroke is a common type of stroke that leads to death and functional disability in hypertensive patients. However, there are no well-studied non-invasive and less expensive fluid biomarkers routinely used to detect ischemic stroke in hypertensive patients. Hence, this study aimed to tease out the performance of D-dimer, fibrinogen, and the D-dimer to fibrinogen ratio (DDFR) in predicting hypertension-associated acute ischemic stroke. Methods: A hospital-based cross-sectional study was done from October 2022 to January 2022 at Yikatit 12 Hospital Medical College, Ethiopia. We recruited 55 hypertensive patients who had an ischemic stroke and 110 who did not. A ROC curve was used to calculate the areas under the curves (AUCs) and determine the diagnostic power of the D-dimer, fibrinogen, and DDFR. The Youden index was used to find the best cut-off points for biomarkers in detecting acute ischemic stroke. A De Long test was employed to show whether there was a significant difference between the AUCs of biomarkers in diagnosing ischemic stroke. Results: D-dimer yielded the highest diagnostic power (AUC = 0.776) in detecting acute ischemic stroke, followed by DDFR (AUC = 0.763) and fibrinogen (AUC = 0.694), but there was no significant difference between them. At 0.52 µg/ml cut-off point, D-dimer had 82.9% sensitivity, 66.7% specificity, 62.5% PPV, and 85.3% NPV to diagnose acute ischemic stroke. Fibrinogen could detect acute ischemic stroke at 405.85 mg/dl level, with 70.0% sensitivity, 57.1% specificity, 41.2% PPV and 81.6% NPV. At a 1.83 ratio, DDFR might also identify ischemic stroke with 80.0% sensitivity, 67.1% specificity, 51.1% PPV, and 88.7% NPV. Conclusion: We showed D-dimer, fibrinogen, and DDFR as promising, affordable, and non-invasive biomarkers for the detection of ischemic stroke among subjects with hypertension. This will help clinicians make an early diagnosis and better guide patient therapy.

Trends of Body Mass Index changes among adults on antiretroviral therapy in Northwest Ethiopia: a longitudinal data analysis.

Nutritional status is considered a major diagnostic and prognostic indicator of HIV/AIDS in adults. In this aspect, current HIV-treatment guidelines, particularly in low-income countries, recommend the regular monitoring of body mass index (BMI) to determine patients' clinical response to antiretroviral therapy (ART). However, data regarding the change in BMI status of HIV-positive adults on ART following the implementation of the test and treat strategy were limited in Ethiopia. Hence, this study is aimed at investigating the trends of BMI change over time and its associated factors among HIV-positive adults in Northwest Ethiopia. A retrospective longitudinal study was conducted among 404 randomly selected HIV-positive adults receiving ART in Felegehiwot Comprehensive Specialized Hospital (FHCSH), Northern Ethiopia. Data were extracted from the medical record charts of study participants, entered into Epi-data 4.6 software, and exported to Stata 14.2 software for analysis. A generalized estimating equation (GEE) model was fitted to determine the change in BMI status over time and its predictors in HIV-positive adults. The level of significance was declared at a p-value of < 0.05. More than half (201, or 51.73%) of the total 404 participants were female. In the cohort, both the baseline and follow-up mean body mass index levels of the participants fell in the normal range and increased from 20.34 (standard deviation/SD ± 2.8) to 21.41 (SD ± 3.13). The individual profile plots of 50 participants indicated that there is considerable variability in weight change across individuals. Duration of ART follow-up (ß = 0.203, 95% confidence interval (CI) 0.16 to 0.24), unemployment (ß = - 0.96, 95% CI 1.67 to - 0.25), WHO stage III/IV HIV disease (ß = - 0.92, 95% CI - 1.57 to - 0.35),and Tenofovir/Lamivudine/Dolutegravir (TDF/3TC/DTG)ART regimen (ß = 0.95, 95% CI 0.32 to 1.57) were identified as significant predictors of change in the BMI status of participants. Likewise, the interaction of TDF/3TC/DTG ART regimen * follow-up duration (ß = 2.16, 95% CI 1.84 to 2.84), WHO stage III/IV clinical disease * follow-up duration (ß = - 1.43, 95% CI - 1.71 to - 1.15) and TB/HIV co-infection * follow-up duration (ß = 1.89, 95% CI 1.57 to 2.87) significantly affects the trend in BMI change status of HIV-positive adults. In this study, the BMI status of HIV-positive adults receiving ART increased with a linear trend. Unemployment, stage III/IV HIV diseases, and Tenofovir/Lamivudine/Efavirenz (TDF/3TC/EFV) ART-drug regimen decreases the mean BMI status of HIV-positive adults. Special consideration and strict follow-up need to be given to those individuals with advanced HIV/AIDS diseases and other identified risk group.

Estimate the burden of malnutrition among children with cerebral palsy in Sub-Saharan Africa: a systematic review with meta-analysis.

Malnutrition is more prevalent among children with cerebral palsy and a major factor for child morbidity and mortality in children with different co-morbidity, especially in Sub-Saharan Africa: The main aim of this systematic review and meta-analysis was to estimate the burden of malnutrition among children with cerebral palsy in Sub-Saharan Africa. We searched PubMed, Web of Science, Google Scholar, Research Gate, and institutional repositories for papers that reported the proportion of malnutrition among children with cerebral palsy that were published between December 2010 and September 2023. Data were retrieved using the standardized JBI data extraction checklist through Microsoft Excel, and then exported to STATA 17 for further analysis. DerSimonian and Laird's estimator was used to calculate the pooled effect size in the random-effects model. Statistics such as the Cochran Q test and I2 test were employed to measure heterogeneity. Egger's test and the funnel plot were used to look for publication bias. This systematic review and meta-analysis used 16 studies from Sub-Saharan Africa to estimate the proportion of malnutrition among 2,120 children with cerebral palsy. The pooled proportion of malnutrition among children with cerebral palsy in Sub-Saharan Africa by using random-effects model analysis was found to be 59.7% (95% CI; 49.8-69.6). The proportion of malnutrition was also estimated by sample sizes categorized as ≤ 120 and > 120, and the proportion of malnutrition was found to be 54.0 (95% CI: 44.7-63.3) and 64.5 (95% CI: 50.5-78.5). Moreover, the proportion of malnutrition was estimated by accounting for the difference in the year of publication. In this regard, the study classified before ≤ 2017 and > 2017, and the proportion of malnutrition was found to be 53.7 (95% CI: 38.0-69.3) and 62.5 (95% CI: 49.7-75.3) in Sub-Saharan Africa respectively. Malnutrition among children with cerebral in Sub-Saharan Africa was found to be very high. Hence, enhancing and developing strategic guidelines for malnutrition screening, prevention, and nutritional support are crucial among children with cerebral palsy. Furthermore, systematic review, randomized control trials, and qualitative studies are recommended to understand the burden more among children with cerebral palsy in the continent.

Dental caries and mean values of DMFT among children with cerebral palsy: a systematic review and meta-analysis.

INTRODUCTION: One of the most prevalent causes of physical disability in children is cerebral palsy (CP), which is a series of complicated neurological disorders. Children with cerebral palsy suffer from multiple problems and potential disabilities, including dental caries. Hence, this study aimed to determine the pooled prevalence of dental caries and mean DMFT (Decayed, Missed, and Filled Permanent Teeth) among children with cerebral palsy in Africa and Asia. METHODS: A comprehensive search of the literature was made to locate relevant studies in PubMed/Medline, HINARI, Web of Science, Science Direct, the Cochrane Library, the Worldwide Science Database, and Google Scholar. The data were extracted in Microsoft Excel and transferred to Stata version 17 software for further analysis. A random-effect model was employed to estimate the pooled prevalence of dental caries and the pooled mean value of DMFT among children with cerebral palsy in Africa and Asia. Heterogeneity between studies was checked using the Cochrane Q test and I2 test statistics. Sub-group analysis by continent was done, and sensitivity analysis was checked. A small study effect was checked using Egger's statistical test at the 5% level of significance. RESULTS: In this study, 25 original studies conducted in 17 countries in Africa and Asia that fulfilled the eligibility criteria were included in the review. The overall pooled prevalence of dental caries in Africa and Asia among children with cerebral palsy was 55.6% (95% CI: 42.4, 68.8). The pooled prevalence of dental caries among children with cerebral palsy in Africa was 42.43% (95% CI: 30.39, 54.58), and it was slightly higher in Asia with 64% (95% CI: 48.32, 79.72). In the random effect model analysis, the pooled mean DMFT of dental caries in children with cerebral palsy was 2.25 (95% CI: 1.86, 2.64). The pooled mean DMFT in Africa was 1.47 (95% CI: 0.86, 2.09), and in Asia it was 3.01 (95% CI: 2.43, 3.60). CONCLUSION: In this study, we found that children with cerebral palsy experienced an alarming rate of dental caries. In these settings, dental caries affected roughly more than half of the children with cerebral palsy. Hence, oral health promotion initiatives should target children with CP, and this group of children must receive early preventive dental care.

Hotspot areas of tetanus-unprotected births and its associated factors in Ethiopia: Spatial analysis of EDHS data.

Neonatal tetanus persists as a public health problem in many developing countries including Ethiopia. Maternal tetanus toxoid vaccination is a cornerstone to prevent neonatal tetanus. However, its prevalence is low in Ethiopia, and little has been devoted to its spatial epidemiology and associated factors. Hence, this study aimed to explore the spatial pattern and factors affecting tetanus-unprotected births in Ethiopia. A further analysis of the 2016 Ethiopia Demographic and Health Survey data was conducted, and a weighted sample of 7590 women was used for analysis. Spatial analysis was done using ArcGIS and SaTScan software. A binary logistic regression model was fitted to identify factors and variables with a p-value <.05 were considered as statistically significant. About 54.13% (95% CI: 53.01, 55.25) of births were not protected against neonatal tetanus, and spatial clustering of tetanus unprotected births was observed (Moran's I = 0.144, p-value = .028). The primary and secondary SaTScan clusters were detected in Northeastern Tigray, Eastern Amhara, and almost the entire Afar (RR = 1.34 & LLR = 66.5, p < .01), and in the Somali region, and the western border of Gambela (RR = 1.44 & LLR = 31.3, p < .01), respectively. Tetanus unprotected births were higher among women without formal education (AOR = 1.63; 95% CI: 1.29, 2.04), came from poor households (AOR = 1.27; 95% CI: 1.12, 1.45), who had no ANC contact (AOR = 6.97; 95% CI: 6.21, 7.88), and who were not exposed to the media (AOR = 1.26; 95% CI: 1.09, 1.47). Hence, tetanus-unprotected birth hotspots require priority interventions, and it is good if the targeted interventions consider the identified factors.

Trends and factors associated with teenage pregnancy in Ethiopia: multivariate decomposition analysis.

Teenage is a time of transition from childhood to adulthood. This stage is a time of change and needs particular care and ongoing support. Adolescent pregnancy remains a common health care problem in low- and middle-income countries, and it is associated with higher maternal and neonatal complications. Thus, this study aimed to determine the trends and factors associated with them that either positively or negatively contributed to the change in teenage pregnancy in Ethiopia. Ethiopian Demographic and Health Survey data from 2005 to 2016 were used for this study. A total weighted sample of 10,655 (3265 in 2005, 4009 in 2011, and 3381 in 2016) teenagers was included. Trends and the proportion of teenage pregnancies for each factor over time were explored. Then, a logit-based multivariate decomposition analysis for a non-linear response model was fitted to identify the factors that contributed to the change in teenage pregnancy. Statistical significance was declared at p-value < 0.05 and the analysis was carried out on weighted data. Teenage pregnancy declined significantly from 16.6% (95% CI: 15.4, 17.9) to 12.5% (95% CI: 11.4, 13.6) in the study period, with an annual reduction rate of 2.5%. About 49.8% of the decrease in teenage pregnancy was attributed to the change in the effect of the characteristics. The compositional change in primary educational status (41.8%), secondary or above educational status (24.55%), being from households with a rich wealth index (1.41%) were factors positively contributed to the decline in teenage pregnancy, whereas being from a Muslim religion (-12.5%) was the factor that negatively contributed to the reduction in teenage pregnancy. This study has shown that teenage pregnancy declined significantly; however, it is still unacceptably high. The changes in compositional factors of teenagers were responsible for the observed reduction in the prevalence of teen pregnancy rates in Ethiopia. Educational status, religion, and wealth index were found to be significant factors that contributed to the reduction in teenage pregnancy. Therefore, intervention programs targeting adolescents should address the socio-economic inequalities of these influential factors to reduce teenage pregnancy and related complications.

Anthropometric Measurements of Singleton Live Full-Term Newborns in Comparison to Who Standard at University of Gondar Comprehensive Specialised Hospital, Ethiopia.

BACKGROUND: Anthropometry is a universally applicable, non-expensive, rapid and noninvasive technique used to evaluate and reflect the nutritional status of an individual. Anthropometric measurements of newborns reflect their general health, nutritional status and future survival by tracking trends in growth and development over time. It has also considerable significance in terms of determining the risk of death and extra uterine complications. Most previously conducted studies assessing newborn anthropometry had used birth weight as the sole parameter. But it is apparent that other anthropometric measurements, such as length and head circumference, are also important in predicting short-term and long-term outcomes. So this study assesses anthropometric measurements of singleton live full-term newborns at University of Gondar comprehensive specialised hospital, Ethiopia. MATERIAL AND METHODS: Hospital-based cross-sectional study was conducted among 333 newborn from 5 June to 11 July 2022, in the maternity and neonatal ward of University of Gondar comprehensive specialised hospital. A systematic random sampling technique was employed to select the study participants. The Kobo toolbox software platform was used for data collection, and STATA software version 16 was used for analysis. RESULTS: The mean birth weight, length and head circumference of the newborns in the current study were 2977 grams (95% CI: 2935.7, 3018.3), 47.05 centimeters (95% CI: 46.72-47.37) and 34.7 centimeters (95% CI: 34.6, 34.88), respectively. The prevalence of SGA (< 10th percentile) and LGA (> 90th percentile) was 20.12% and 6.01%, respectively. Independent samples t-test was done to see the association of newborn sex with anthropometric indices, and the result showed that the difference was statistically insignificant in all of anthropometric parameters. CONCLUSION: This study of normal reference values will provide basic step for future standardisation of Ethiopian term newborns anthropometric parameters to be used for accurate assessment of newborns.

Early marriage and its associated factors among women in Ethiopia: Systematic reviews and meta-analysis.

BACKGROUND: Early marriage is defined as the union of one or both partners before reaching the age of 18 for the first time. This practice is widely prevalent in underdeveloped countries, particularly in Ethiopia, and has been observed to have detrimental effects on the educational and personal development of both male and female individuals. METHODS: The present study conducted a comprehensive search of the Science Direct, Scopus, Google Scholar, EMBASE, and PubMed databases. The data were extracted using Microsoft Excel (version 14) and analyzed using STATA statistical software. To examine publication bias, a forest plot, rank test, and Egger's regression test were utilized. Heterogeneity was assessed by calculating I2 and conducting an overall estimated analysis. Additionally, subgroup analysis was performed based on the study region and sample size. The pooled odds ratio was calculated. RESULTS: Out of a total of 654 articles, 14 papers with 67,040 research participants were included in this analysis. The pooled prevalence of early marriage among women in Ethiopia was 56.34% (95% CI: 51.34-61.34), I2 = 78.3%). The Amhara region exhibited the highest prevalence of early marriage, with a rate of 59.01%, whereas the Oromia region demonstrated the lowest incidence, with a prevalence rate of 53.88%. The prevalence of early marriage was found to be 58.1% for a sample size exceeding 1000, and 50.9% for a sample size below 1000. No formal education (AOR = 5.49; 95%CI: 2.99, 10.07), primary education (AOR = 3.65; 95%CI: 2.11, 6.32), secondary education (AOR = 2.49; 95%CI: 1.60, 3.87), rural residency (AOR = 4.52; 95%CI: 1.90, 10.74) and decision made by parents (AOR = 2.44; 95%CI: 1.36, 4.39) were associated factors. CONCLUSION AND RECOMMENDATION: In Ethiopia, there was a high rate of early marriage among women. The research findings indicate that early marriage is more prevalent among mothers who possess lower levels of educational attainment, reside in rural areas, and are subject to parental decision-making. Our stance is firmly in favor of expanding the availability of maternal education and promoting urban residency. Furthermore, the promotion of autonomous decision-making by clients regarding their marital affairs is of paramount importance to family leaders.

Tuberculosis and its associated risk factors among HIV-positive pregnant women in northwest Ethiopia: A retrospective follow-up study.

Background: People living with the human immunodeficiency virus have a higher risk of developing active tuberculosis disease. Human immunodeficiency virus infected pregnant women are at a much higher risk of getting active tuberculosis infection, partly due to immune modulation. However, very little is known about the epidemiology of tuberculosis among pregnant women infected with the virus, particularly in resource-limited settings where the burdens of these infections are substantial. Hence, this study aimed to estimate tuberculosis incidence and identify its risk factors among human immunodeficiency virus infected pregnant women in northwest Ethiopia. Methods: An institutional-based retrospective follow-up study was conducted among pregnant women who were enrolled in option B+ prevention of mother to child transmission service between June 2013 and April 2021 in Pawe district. The Kaplan-Meier survival curve and Weibull regression model were used to estimate survival probability and identify risk factors of tuberculosis, respectively. The best model between the Cox and parametric models was chosen using the Akaike and Bayesian information criteria. Result: Out of 289 human immunodeficiency virus infected pregnant women included in the final analysis, 29 (10.03 %) developed active tuberculosis. The overall incidence of tuberculosis was 17.4 per 1000 person-months of observation (95 % CI: 12.1, 25.1). Lack of isoniazid preventive therapy (AHR: 6.68, 95 % CI: 2.67, 16.7), new enrollment to care (AHR: 2.62, 95 % CI: 1.14, 6.03), under-nutrition (AHR: 5.09, 95 % CI: 2.02, 12.83), low CD4 count (AHR: 2.61, 95 % CI: 1.01, 6.78), and suboptimal antiretroviral therapy adherence (AHR: 3.17, 95 % CI: 1.46, 6.86) were predictors of tuberculosis among HIV-positive pregnant women. Conclusion: This study found a high incidence of tuberculosis among human immunodeficiency virus infected pregnant women. Thus, strengthening the provision of tuberculosis preventive therapy, reinforcing adherence support, and controlling under-nutrition should be considered to decrease the risk of tuberculosis.

Prevalence and factors associated with hypertension among peoples living with HIV in East Africa, a systematic review and meta-analysis.

BACKGROUND: In recent years, improved access to effective antiretroviral therapy has meant that people living with human immune virus are living longer than before. The burden of non-communicable diseases particularly, hypertension parallels with the increase in age. Although hypertension screening is thought to be an effective indicator of overall health status and paves the way for early interventions in peoples living with human immune virus, the exact prevalence of hypertension in this population remained unknown. We aimed to report the prevalence of hypertension and examine the factors associated with hypertension among people living with human immune virus in East Africa. METHODS: In this systematic review and meta-analysis, we searched PubMed, Science Direct, Scopus, Cochrane library, and Google Scholar databases for studies published until January 1, 2023. The search period was from January 10/2023, to February 10/ 2023. Random-effect models were used to calculate the pooled prevalence of hypertension. Subgroup analyses were conducted to explore potential heterogeneity. The Funnel plot and Egger's test were used to assess publication bias. RESULT: A total of 15 studies with 10,916 individuals were included in the present meta-analysis. The pooled prevalence of hypertension among people living with human immune virus was19.75% (95% CI, 16.07%-23.42%)),). The prevalence of hypertension was not differed between studies conducted 2014- 2019 and, studies conducted 2020-2022. The prevalence of hypertension was lowest in Ethiopia (16.13%) and highest in Tanzania (26.76%). Alcohol consumption (Adjusted Odds Ratio (AOR): 3.39, 95% CI: 2.35-4.43), diabetes (AOR: 2.64, 95% CI: 1.89-3.39), longer duration of HIV (AOR: 1.72, 95% CI: 1.15-2.3), male sex (AOR: 1.62, 95% CI: 1.43-1.8), obesity (AOR: 2.89, 95% CI: 1.94-3.84), and older age (AOR: 2.25, 95% CI: 2.0-2.5), were the factors associated with the presence of hypertension in people living with human immune virus. CONCLUSION: Our study shows that one in five peoples living with human immune virus have hypertension causing symptoms and impairment, therefore requiring treatment. Designing effective health screening and hypertension management intervention programs helps to prevent the occurrence of hypertension and promotes peoples' overall quality of life.

Trend, determinants, and future prospect of child marriage in the Amhara region, Ethiopia: a multivariate decomposition analysis.

Background: Child marriage is a harmful traditional practice, which compromises children of their childhood and threatens their lives and health. In Ethiopia, 58% of women and 9% of men get married before the age of 18 years. Surprisingly, parents in the Amhara region make marriage promises of their children before they are even born, which will hinder the region from attaining the Sustainable Development Goal of ending child marriage. Thus, this study aimed to assess the trends, determinants, and future prospects of child marriage in the Amhara region of Ethiopia. Methods: A repeated cross-sectional study was conducted using four consecutive nationally representative Ethiopian demographic and health surveys (2000-2016). A logit-based multivariate decomposition analysis for a non-linear response model was fitted to identify factors that contributed to the change in child marriage over time. Statistical significance was declared at a p-value of < 0.05. The child marriage practice in the Amhara region by the year 2030 was also predicted using different forecasting features of Excel. Results: The trend of child marriage over the study period (2000-2016) decreased from 79.9% (76.7, 82.8) to 42.9% (39.1, 46.9), with an annual average reduction rate of 2.9%. Approximately 35.2% of the decline resulted from an increase in the proportion of women who attained secondary and above-secondary education over the two surveys. A decrease in the proportion of rural women and a change in the behavior of educated and media-exposed women also contributed significantly to the decline in child marriage. The prevalence of child marriage in the Amhara region by the year 2030 was also predicted to be 10.1% or 8.8%. Conclusion: Though there has been a significant decline in child marriage in the Amhara region over the past 16 years, the proportion is still high, and the region is not going to eliminate it by 2030. Education, residence, and media exposure were all factors associated with the observed change in child marriage in this study. Therefore, additional efforts will be required if child marriage is to be eliminated by 2030, and investing more in education and media access will hasten the region's progress in this direction.

Hygienic practice during complementary feeding and its associated factors among mothers/caregivers of children aged 6-24 months in Wolaita Sodo town, southern Ethiopia.

Introduction: Complementary feeding is an important stage in a child's development as it provides the necessary nutrients for optimal growth and development. However, improper handling, storage, and preparation of complementary foods can result in contamination by microorganisms, leading to foodborne illnesses and malnutrition. Therefore, this study aimed to determine hygienic practices during complementary feeding and associated factors among mothers of children aged 6-24 months in Wolaita Sodo town, southern Ethiopia. Methods: A community-based, cross-sectional study was undertaken among mothers/caregivers of children aged 6-24 months from December 1-30, 2022. A total of 602 participants were recruited using a simple random sampling procedure. The hygienic practice of complementary feeding was assessed based on a related seven items questionnaire (Cronbach's alpha 0.72). Data were entered into Epi-data version 4.6 and analyzed using Statistical Package for Social Science version 26. Multivariable binary logistic regression was used to identify the statistically significant factors associated with proper hygienic practice of complementary feeding. Variables with a p-value of <0.05 in the multivariable logistic regression analysis model were considered statistically significant. Results: The study indicated that 42.0%, (95% confidence interval (CI): 38, 45.8) of the mothers/caregivers of children aged 6-24 months had proper hygienic practices during complementary feeding. Mothers who could read and write (adjusted odd ratio (AOR): 3.36, 95% CI (1.53, 7.41)) and those who had completed primary school (AOR: 1.7, 95% CI (1.02, 2.85)), media exposure (AOR: 3.38, 95% CI (2.1, 5.4)), and attitude toward hygienic practice (AOR: 3.29, 95% CI (2.2, 4.91)) were independent predictors of hygiene practices during complementary feeding. Conclusion: This study found that the prevalence of hygiene practices during complementary feeding was relatively low. Being educated, access to media, and positive attitudes toward hygienic practices were predicting factors. As a result, strengthening training and counseling services for mothers regarding complementary feeding and processing is recommended.

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

BACKGROUND: Malaria infection during pregnancy endangers the pregnant woman, fetus, and newborn child. Thus, the use of an insecticide-treated net (ITN) is one of the most frequently advised methods for preventing malaria during pregnancy. Contrary findings have been reported in various studies on ITN utilization among pregnant women in Ethiopia. Therefore, this study was aimed to estimate the pooled prevalence of ITN utilization and its associated factors among pregnant women in Ethiopia. METHODS: Published articles from PubMed, Google Scholar, Science Direct, AJOL and Cochrane library were systematically searched. All cross-sectional studies on ITN utilization among pregnant women were included in this meta-analysis. To estimate the pooled prevalence and odds ratio, a random-effect model was used; and a subgroup analysis was performed to identify the possible source of heterogeneity. Begg's and Egger's tests were used to identify possible publication bias. RESULTS: Ten cross-sectional studies with 7,161 participants were included. The pooled prevalence of ITN utilization among all pregnant women who had access to ITN in Ethiopia was 59.42% (95% CI 51.14, 67.69). Statistically significant heterogeneity was observed (I2 = 97.7%; p < 0.0001). Higher educational status (OR = 3.47, 95% CI 2.32, 5.2), pregnant women who had antenatal care visits (OR = 2.37, 95% CI 1.97, 2.65) and having good knowledge of malaria prevention practices (OR = 10.63, 95% CI 5.31, 21.29) were associated with ITN utilization among pregnant women. CONCLUSION: The utilization of ITNs among pregnant women was much lower than the national target. Higher education status, attending ANC and a good level of knowledge were found to be independent predictors of ITN utilization. Improving women's understanding of ITNs will enhance their use, and the government and health sectors should encourage pregnant mothers to enroll in antenatal care.

Comparison of circulating lipid profiles, D-dimer and fibrinogen levels between hypertensive patients with and without stroke.

Background: Stroke is one of the leading causes of global mortality and disability, particularly in hypertensive patients. This study aimed to compare lipid profile, fibrinogen, and D-dimer levels between hypertensive patient with and without stroke. Methods: This was a facility-based cross-sectional study conducted from November 2022 to January 2023 among 115 hypertensive patients (70 patients without stroke and 45 with stroke) who had follow-up at Yikatit 12 Hospital Medical College, Ethiopia. All data analyses were done using SPSS version 25.0 and comparisons of variables between groups were made using the Chi-square test, independent sample t-test, and Mann-Whitney U test. Multiple logistic regression analysis was done to identify predictors of stroke among hypertensive patients. A p-value <0.05 was assumed to be statistically significant for all statistical tests. Results: Significantly elevated levels of TC, LDL-C, D-DI, and fibrinogen were observed in the stroke group than in the non-stroke group (p-value<0.05). The mean values of TC, D-DI, and fibrinogen were significantly higher in patients with ischemic stroke compared to those with hemorrhagic stroke. Duration of hypertension (AOR: 1.21; CI: 1.10, 2.09), TC (AOR:1.07; CI: 1.01, 1.22), D-DI (AOR: 1.15; CI: 1.05, 1.69) and fibrinogen (AOR:1.19; CI: 1.10, 2.89) were identified to be independent predictors of stroke in hypertensive patients. Conclusion: The circulating levels of TC, LDL-C, D-DI and fibrinogen in hypertensive patients with stroke were significantly higher than in those without stroke. But only TC, D-DI, and fibrinogen were found to be predictors of stroke in hypertensives. Considerably higher TC, D-DI, and fibrinogen levels were also seen in patients with ischemic stroke than in those with hemorrhagic stroke. This confirms the key roles of dyslipidemia (hypercholesterolemia) and aberrant hemostatic activation to stroke development, notably ischemic stroke.

The psychological impact of COVID-19 pandemic and associated factors among college and university students in Ethiopia: a systematic review and meta-analysis, 2022.

Background: The Corona virus disease 19 (COVID-19) pandemic is a human tragedy that occurred in this era. It poses an unprecedented psychological, social, economic, and health crisis. The mental health and well-being of entire societies are suffering as a result of this crisis, but the suffering is greater in students at all levels of education and must be addressed immediately. Thus, this study was aimed to estimate the pooled prevalence and associated factors of the psychological impact of COVID-19 among higher education students. Methods: The potential studies were searched via PubMed, HINARI, the Cochrane Library, and Google Scholar. Studies were appraised using the Joanna Briggs Institute appraisal checklist. Micro Soft Excel was used to extract the data, which was then exported to Stata version 14 for analysis. Heterogeneity between studies was tested using Cochrane statistics and the I2 test, and small-study effects were checked using Egger's statistical test. A random-effects model was employed to estimate the pooled prevalence of the psychological impact of COVID-19 and its associated factor. Results: After reviewing 227 studies, eight fulfilled the inclusion criteria and were included in the meta-analysis. The pooled prevalence of the psychological impact of Corona virus disease 19 among higher education students in Ethiopia, including depression, anxiety, and stress was 43.49% (95% CI: 29.59, 57.40%), 46.27% (95% CI: 32.77, 59.78%), and 31.43% (95% CI: 22.71, 40.15), respectively. Having a medical illness, being an urban resident, living with parents, having relative death due to pandemics, and having a non-health field of study were identified as significant associated factors for the impact of the pandemic in higher education students. Conclusion: The COVID-19 pandemic had a significant psychological impact on college and university students. Depression, anxiety, and stress were the most commonly reported psychological impacts across studies among higher education students. Hence, applying tele-psychotherapy using, smartphones, and social media platforms has an effect on reducing the impact. Programs for preventing and controlling epidemics should be developed by the government and higher education institutions that incorporate mental health interventions and build resilience.

Violence against women and associated factors among female construction workers in Addis Ababa, Ethiopia.

BACKGROUND: Violence against Women (VAW) is a global public health problem; almost one in three global women experienced one form of violence. Violence free environment is the one that everyone cherishes. However, millions of women worldwide suffer from violence. In Ethiopia, VAW is very common and considered a private matter though it has serious consequences for girls and women. Studies pointed out that it varies by workplace, and hence important to assess it among female construction workers in Addis Ababa. OBJECTIVE: To assess the prevalence and factors contributing to gender-based violence on female construction workers in Addis Ababa, Ethiopia, 2021. METHODS: A cross-sectional study design with a multistage cluster sampling technique was used to select 827 study participants and a face-to-face interview was held from February 24 to April 24, 2021. Data entry was done using Epi info-7 and exported to SPSS version 26 for analysis. Both bivariable and multivariable binary logistics regression analysis were employed. RESULTS: A total of 827 female workers were interviewed in this study. The mean age of the respondents was 24.97 years with SD of ± 5.6. The magnitude of violence against female in the workplace was 70.9% (95% CI: 67.7, 73.9). This study found that females in the age group 15-19 years (AOR = 2.37, 95%CI: 1.26, 4.45), females who live in Addis Ababa for less than 3 years (AOR = 3.02, 95%CI: 1.59, 5.73) and for 3-7 years (AOR = 2.14, 95% CI: 1.14, 4.00) and females who have no formal education (AOR = 3.16, 95%CI: 1.80, 5.54) had higher odds of violence at their workplace. CONCLUSION: The magnitude of overall VAW among female construction workers in Addis Ababa was high compared to other workplaces. Age and the number of years lived in Addis Ababa were found to be significant factors of violence among female construction workers. Hence, emphasis shall be given for female construction workers in Addis Ababa.

Congenital anomalies and risk factors in Africa: a systematic review and meta-analysis.

OBJECTIVE: To evaluate the pooled prevalence and identify risk factors of congenital anomalies among neonates in Africa. METHODS: The pooled birth prevalence of congenital anomalies was the first outcome of this review, and the pooled measure of association between congenital anomalies and related risk factors in Africa was the second. We conducted a thorough search of the databases PubMed/ Medline, PubMed Central, Hinary, Google, Cochrane Library, African Journals Online, Web of Science and Google Scholar up to 31 January 2023. The JBI appraisal checklist was used to evaluate the studies. STATA V.17 was used for the analysis. The I2 test and Eggers and Beggs tests were used to measure study heterogeneity and publication bias respectively. The pooled prevalence of congenital anomalies was calculated using DerSimonian and Laird random-effect model. Subgroup analysis, sensitivity analysis and meta-regression were also performed. RESULT: This systematic review and meta-analysis includes 32 studies with a total of 626 983 participants. The pooled prevalence of congenital anomalies was 23.5 (95% CI 20 to 26.9) per 1000 newborns. Not taking folic acid (pooled OR=2.67; 95% CI (1.42 to 5.00)), history of maternal illness (pooled OR=2.44, 95% CI (1.2 to 4.94)), history of drug use (pooled OR=2.74, 95% CI (1.29 to 5.81)), maternal age (>35 years.) (Pooled OR=1.97, 95% CI (1.15 to 3.37)), drinking alcohol (pooled OR=3.15, 95% CI (1.4 to 7.04)), kchat chewing (pooled OR=3.34, 5% CI (1.68 to 6.65)) and urban residence (pooled OR=0.58, 95% CI (0.36 to 0.95)) were had significant association with congenital anomalies. CONCLUSION: The pooled prevalence of congenital abnormalities in Africa was found to be substantial, with significant regional variation. Appropriate folate supplementation during pregnancy, proper management of maternal sickness, proper antenatal care, referring healthcare personnel before using drugs, avoiding alcohol intake and kchat chewing are all important in lowering the occurrence of congenital abnormalities among newborns in Africa.

Prevalence of anemia and its associated factors among adult asthmatic patients in Northwest Ethiopia.

BACKGROUND: Asthma is a heterogeneous disease characterized by chronic airway inflammation. The pathophysiologic processes of asthma can disrupt iron homeostasis, resulting in anemia. However, the association between asthma and anemia among adult asthma patients remains limited. Therefore, the main aim of this study was to determine the prevalence and factors associated with anemia among adult asthmatic patients from May to August 2021. METHODS: An institution-based, cross-sectional study was conducted among 291 asthmatic patients in Northwest Ethiopia. A pre-tested structured questionnaire and checklist were used to collect sociodemographic and clinical data. A blood specimen was collected from asthmatic patients for a complete blood count analysis and morphology assessment. The data were entered into the Epi data software and exported to the statistical package for social science version 20 software for analysis. Non-parametric Mann-Whitney U test was used to compare red blood cell parameters among groups with acute and chronic exacerbations. Binary logistic regression models were used to determine the factors associated with anemia. A p-value less than 0.05 was considered statistically significant. RESULT: The overall prevalence of anemia in this study was 11% (95% CI: 7.2-14.8%). Acutely exacerbated asthmatic patients had significantly lower median values of red blood cell parameters such as red blood cell count, hemoglobin, and mean cell hemoglobin when compared to chronic exacerbations. In addition, using systemic corticosteroids (AOR = 4.07, 95% CI: 1.126-14.71, p = 0.032) and being hospitalized in the emergency department (AOR = 3.74, 95% CI: 1.26-11.07, p = 0.017) were found to be significantly associated with anemia. CONCLUSION: This study demonstrated that anemia was predominant in adult asthma patients. Red blood cell number, hemoglobin level, and mean corpuscular hemoglobin were significantly lower in acute asthma exacerbations. Therefore, appropriate intervention strategies should be undertaken to reduce the prevalence of anemia among adult asthma patients to reduce further complications and provide better monitoring of asthma patients.

Global prevalence of sexual dysfunction among diabetic patients from 2008 to 2022: Systematic review and meta-analysis.

Background: Both men and women can have a wide range of physical, emotional, and sexual issues as a result of diabetes. One of them is sexual dysfunction, which has an effect on marital relationships as well as the effectiveness of therapy and can develop into a serious social and psychological condition. As a result, the purpose of this study was to identify the global prevalence of sexual dysfunction among diabetic patients. Methods: Science Direct, Scopus, Google Scholar, and PubMed were all searched for information. Data were extracted using Microsoft Excel (v. 14), STATA statistical software, and STATA. Publication bias was investigated by a forest plot, rank test, and Egger's regression test. To detect heterogeneity, I2 was calculated and an overall estimated analysis was performed. Subgroup analysis was done by study region and sample size. The pooled odds ratio was also computed. Results: The study was able to include 15 of the 654 publications that were evaluated since they met the criteria. 67,040 people participated in the survey in all. The pooled global prevalence of sexual dysfunction among diabetic patients was 61.4% (95% CI: 51.80, 70.99), I2 = 71.6%. The frequency of sexual dysfunction was highest in the European region (66.05%). For males, the prevalence of sexual dysfunction was 65.91%, while for females, it was 58.81%. Patients with type 2 diabetes mellitus were more likely (71.03%) to experience sexual dysfunction. Conclusion: Finally, sexual dysfunction was fairly common all across the world. There were variations in the prevalence of sexual dysfunction depending on the sex, type of diabetes, and location of the study participant. Our findings imply that screening and appropriate treatment are required for diabetes persons exhibiting sexual dysfunction.

Concurrent stunting and overweight or obesity among under-five children in sub-Saharan Africa: a multilevel analysis.

BACKGROUND: Globally, the co-occurrence of stunting and overweight or obesity (CSO) in the same individual is becoming an emerging layer of malnutrition and there is a paucity of information in low- and middle-income countries, particularly in sub-Saharan Africa. Hence, this study aimed to determine the pooled prevalence and determinants of concurrent stunting and overweight or obesity among under-five children in SSA. METHODS: Secondary data analysis was conducted from a recent nationally representative Demographic and Health Survey dataset of 35 SSA countries. A total weighted sample of 210,565 under-five children was included in the study. A multivariable multilevel mixed effect model was employed to identify the determinant of the prevalence of under-5 CSO. The Intra-class Correlation Coefficient (ICC) and Likelihood Ratio (LR) test were used to assess the presence of the clustering effect. A p-value of p < 0.05 was used to declare statistical significance. RESULT: The pooled prevalence of concurrent stunting and overweight/obesity among under-five children was 1.82% (95% CI: 1.76, 1.87) in SSA. Across the SSA regions, the highest prevalence of CSO was reported in Southern Africa (2.64%, 95% CI: 2.17, 3.17) followed by the Central Africa region (2.21%, 95% CI: 2.06, 2.37). Under five children aged 12-23 months (AOR = 0.45, 95% CI: 0.34, 0.59), 24-35 months (AOR = 0.41, 95% CI: 0.32, 0.52), 36-59 months (AOR = 055, 95% CI: 0.43, 0.70), ever had no vaccination (AOR = 1.25, 95% CI: 1.09, 1.54), under-five children born from 25 to 34 years mother (AOR = 0.75, 95% CI: 0.61, 0.91), under-five children born from overweight/obese mothers (AOR = 1.63, 95% CI: 1.14, 2.34), and under-five children living in West Africa (AOR = 0.77, 95% CI: 0.61, 0.96) were significant determinants for under-five CSO. CONCLUSION: Concurrent stunting and overweight or obesity is becoming an emerging layer of malnutrition. Under five children born in the SSA region had almost a 2% overall risk of developing CSO. Age of the children, vaccination status, maternal age, maternal obesity, and region of SSA were significantly associated with under-five CSO. Therefore, nutrition policies and programs should base on the identified factors and promote a quality and nutritious diet to limit the risk of developing CSO in early life.