Machine learning prediction of adolescent HIV testing services in Ethiopia.

Background: Despite endeavors to achieve the Joint United Nations Programme on HIV/AIDS 95-95-95 fast track targets established in 2014 for HIV prevention, progress has fallen short. Hence, it is imperative to identify factors that can serve as predictors of an adolescent's HIV status. This identification would enable the implementation of targeted screening interventions and the enhancement of healthcare services. Our primary objective was to identify these predictors to facilitate the improvement of HIV testing services for adolescents in Ethiopia. Methods: A study was conducted by utilizing eight different machine learning techniques to develop models using demographic and health data from 4,502 adolescent respondents. The dataset consisted of 31 variables and variable selection was done using different selection methods. To train and validate the models, the data was randomly split into 80% for training and validation, and 20% for testing. The algorithms were evaluated, and the one with the highest accuracy and mean f1 score was selected for further training using the most predictive variables. Results: The J48 decision tree algorithm has proven to be remarkably successful in accurately detecting HIV positivity, outperforming seven other algorithms with an impressive accuracy rate of 81.29% and a Receiver Operating Characteristic (ROC) curve of 86.3%. The algorithm owes its success to its remarkable capability to identify crucial predictor features, with the top five being age, knowledge of HIV testing locations, age at first sexual encounter, recent sexual activity, and exposure to family planning. Interestingly, the model's performance witnessed a significant improvement when utilizing only twenty variables as opposed to including all variables. Conclusion: Our research findings indicate that the J48 decision tree algorithm, when combined with demographic and health-related data, is a highly effective tool for identifying potential predictors of HIV testing. This approach allows us to accurately predict which adolescents are at a high risk of infection, enabling the implementation of targeted screening strategies for early detection and intervention. To improve the testing status of adolescents in the country, we recommend considering demographic factors such as age, age at first sexual encounter, exposure to family planning, recent sexual activity, and other identified predictors.

Prevalence and determinants to COVID-19 vaccine hesitancy among people living with HIV in Bench Sheko zone, Southwest Ethiopia: A multi-center study.

Introduction: In 2019, the World Health Organization (WHO) identified coronavirus disease-2019 (COVID-19) as one of the top 10 threats to global health. Currently, vaccine hesitancy is the most common obstacle to reducing COVID-19 incidence and achieving herd immunity worldwide. Understanding the factors influencing vaccine hesitancy in this specific population is crucial for developing targeted interventions to improve vaccine uptake and protect vulnerable communities. Therefore, this study aimed to evaluate the prevalence and determinants of COVID-19 vaccine hesitancy among people living with human immunodeficiency virus (HIV) who receive care at public health facilities in Bench Sheko Zone, Southwest Ethiopia. Methods: A multi-center study was employed, involving multiple healthcare facilities within the Bench Sheko Zone from January 1 to 30 February 2023 to assess the prevalence and determinants of hesitancy to COVID-19 vaccination among people living with human deficiency virus (PLHIV). Data were collected by using pre-tested interviewer administered questionnaires and document review, and entered into Epi-data version 3.1 then exported to and analyzed by using SPSS version 24. Statistical significance was assessed by using multivariable logistic regression analysis by determining odds ratios and 95% confidence interval. Multi-Collinearity and model fitness were also checked. Results: According to the study, the prevalence of COVID-19 vaccine hesitancy was found to be 47.9%, [95% CI, 43.8-52.0]. One significant finding was that younger individuals (age ≤25years) [AOR = 2.30, 95%CI, 1.15-4.57] exhibited a higher level of hesitancy compared to their older counterparts. Additionally, the study identified monthly income≤3000 birr [AOR = 0.57, 95%CI, 0.31-0.92], urban residence [AOR = 0.61, 95%CI, 0.42-0.91], HIV stage one [AOR = 0.44, 95%CI, 0.27-0.73] and human immunodeficiency virus (HIV) clinical stage two of HIV [AOR = 0.60, 95CI, 0.39-0.93] as determinants of vaccine hesitancy. Conclusion: According to our study finding in southwest Ethiopia, individuals living with HIV were found to have a higher level of hesitancy towards receiving the COVID-19 vaccine as compared with center for disease control and prevention estimate of vaccine hesitancy. The study also identified several factors that contribute to vaccine hesitancy, including age, urban of residence, income level, and HIV clinical stage. Addressing the identified factors in this specific population could decrease the hesitancy. To ensure the success of vaccination campaigns in the region, policymakers and stakeholders should take steps to address these underlying factors and promote greater acceptance of the COVID-19 vaccine among the population.

Pandemic fatigue, behavioral intention and predictors of COVID-19 vaccination among individuals living with HIV in Bench Sheko Zone, in Southern Ethiopia, application of TBP: a facility based cross sectional study.

Introduction: People living with HIV often face inequalities and negative outcomes, which make them vulnerable. To protect this population and achieve herd immunity, it is crucial for COVID-19 vaccination efforts to prioritize and encourage vaccination among people living with HIV (PLWH). However, in Ethiopia, there is a lack of motivation in this regard. To tackle this issue, a study was conducted in the Bench Sheko Zone of Southwest Ethiopia. The study aimed to assess pandemic fatigue, behavioral intention to get vaccinated, and factors influencing COVID-19 vaccine acceptance among PLWH in that region. Methods: A facility-based cross-sectional study was conducted among individuals living with HIV who were over 18 years old in Bench-Sheko Zone, located in Southwest Ethiopia. The study included a total of 590 participants from four ART healthcare facilities within the zone. The researchers utilized the Theory of Planned Behavior to examine the predictors of intention to use preconception care. Multiple linear regression analysis was employed to determine these predictors, with a p-value of less than 0.05 considered as indicative of a significant association. The final analysis of the study involved the use of linear regression analysis, and the measure of association was presented as the standardized B coefficient following a multivariable logistic regression analysis. Result: In the conducted study, the response rate was an impressive 98%. The researchers aimed to investigate the behavioral intention toward the COVID-19 vaccine, which was found to be 55.7%. The average age of the participants in the study was 34.65 ± 6.67. The study was the assessment of pandemic fatigue, which had a mean value of 17.22 ± 5.28. During the multivariate linear regression analysis, four predictor variables were identified. Among these, three variables, namely subjective norm, pandemic fatigue, and age, positively influenced the behavioral intention toward the COVID-19 vaccine. Comprehending these factors can assist healthcare professionals and policymakers in formulating precise interventions and strategies aimed at enhancing the acceptance and adoption of vaccines. Conclusion: The study indicates that individuals living with HIV have shown lower vaccine intention compared to previous research. The study identifies subjective norm, pandemic control measures, income, and age as predictors of individuals' intention to receive the COVID-19 vaccine.

Determinants of Cervical Cancer Screening Among Women Aged 30-49 Years Old in Four African Countries: A Cross-Sectional Secondary Data Analysis.

BACKGROUND: Early-stage cervical cancer screening is essential for providing women with a better chance of receiving effective treatment for precancerous and cancer stages. Delay in cervical cancer screening results in late presentation and cancer metastasis. National-level cervical cancer screening in resource-limited countries was scarce and not well studied in Africa based on national data specifically in Kenya, Cameroon, Nambia, and Zimbabwe. OBJECTIVE: To determine the prevalence and determinants of cervical cancer screening among eligible women in Kenya, Cameroon, Nambia, and Zimbabwe. METHODS: This study analyzed demographic and health survey data from Kenya, Cameroon, Nambia, and Zimbabwe. The data were extracted and analyzed by STATA version 15 and further analysis was done. Intraclass correlation coefficient, median odds ratio, and proportional change in variance were calculated to check the appropriateness of multilevel analysis. Variables with P-value < .25 were selected for multivariable multilevel logistic regression analysis. Finally, statistical significance between dependent and independent variables was assessed by odds ratios and 95% confidence intervals. RESULTS: The prevalence of cervical cancer screening in 4 African countries (Nambia, Kenya, Cameroon, and Zimbabwe) was 23.4 [95%CI: 22.8-24.1]. The determinants identified in this study were women of age 41-50 years [AOR = 1.47; 95% CI 1.24, 1.73], rural residence [AOR = .67; 95% CI .55, .81], women who have their own work [AOR = 1.1; 95% CI 1.0, 1.37], smoking status [AOR = 1.89; 95% CI 1.17, 3.0], age at first birth >=35 [AOR = 5.27; 95% CI 1.29-21.52], condom use [AOR = 1.79; 95% CI 1.46,2.19], husbands having worked [AOR = 1.5; 95% CI 1.08,2.11], rich household wealth [AOR = 1.43; 95% CI 1.13,1.8], and having health insurance [AOR = 2.2; 95% CI 1.8,2.7]. CONCLUSION: The prevalence of cervical cancer screening in Kenya, Cameroon, Nambia, and Zimbabwe was low as compared to World Health Organization (WHO) recommendations. Age, residence, work status, smoking status, women's age at first birth, condom use, husbands having work, wealth status, and health insurance were the identified determinants of cervical cancer screening. Programme and policy interventions could address younger, rural residence women, poor wealth status women, women without work, and those who never use health insurance for the uptake of cervical cancer screening.

Spatial distribution, and predictors of late initiation of first antenatal care visit in Ethiopia: Spatial and multilevel analysis.

BACKGROUND: Despite the proven benefit of early initiation of first antenatal care visits as a means to achieve good maternal and neonatal health outcomes through early detection and prevention of risks during pregnancy, shreds of evidence showed that most of the women in Ethiopia start their ANC visits lately. OBJECTIVE: To determine the spatial distribution and predictors of late initiation of first antenatal care visits among reproductive-age women in Ethiopia. METHOD: The 2019 Ethiopian Mini Demographic and Health Survey (EMDHS) data were used. A total weighted sample of 2,935 reproductive-age women who gave birth in the five years preceding the survey and who had antenatal care visits for their last child was included. To check the nature of the distribution of late initiation of ANC visits, the global Moran's I statistics were applied. Gettis-OrdGi statistics and spatial interpolation using the Ordinary Kriging method were done to identify the spatial locations and to predict unknown locations of late initiation of first ANC visits, respectively. For the predictors, a multilevel mixed-effect logistic regression model was applied. Finally, statistical significance was declared at a p-value < 0.05. RESULTS: The prevalence of late initiation of first ANC visits in Ethiopia was 62.6%. The spatial analysis showed that the late initiation of first ANC visits significantly varied across regions of Ethiopia. The spatial interpolation predicted the highest rates of late initiation of first ANC visits in the eastern SNNPRs, southern and western Oromia, and some parts of the Somalia region. Being rural residents, attending higher education, having medium wealth status, richer wealth status, richest wealth status, having ≥ 5 family size, a household headed by male, living in SNNPRs, and Oromia regions were significant predictors of late initiation of first ANC visits. CONCLUSION: A clustered pattern of areas with high rates of late initiation of the first ANC visit was detected in Ethiopia. Public health intervention targeting the identified hotspot areas, and women's empowerment would decrease the late start of the first ANC visit. Furthermore, the identified predictors should be underscored when designing new policies and strategies.

Determinants of early initiation of first antenatal care visit in Ethiopia based on the 2019 Ethiopia mini-demographic and health survey: A multilevel analysis.

BACKGROUND: Early initiation of the first antenatal care visit provides a critical opportunity for health promotion, disease prevention, and curative care for women and their unborn fetuses. However, in developing countries, including Ethiopia, it is underutilized and most of the pregnant women didn't attend antenatal care visits during the first trimester (early). Therefore, the objective of this study was to estimate the prevalence of early initiation of antenatal care visits and its determinants among reproductive-age women in Ethiopia. METHODS: A secondary data analysis was done based on the 2019 intermediate Ethiopian demographic health survey. The data were weighted by sampling weight for probability sampling and non-response to restore the representativeness of the data and have valid statistical estimates. Then, a total weighted sample of 2,935 women aged 15-49 years who gave birth in the five years preceding the survey and who had antenatal care visits for their last child was included. A multilevel mixed-effects logistic regression model was fitted to examine the determinants of early initiation of first antenatal care visits. Finally, statistical significance was declared at a p-value < 0.05. RESULTS: In this study, the overall magnitude of early initiation of the first antenatal care visit was 37.4% (95%CI: 34.6-40.2%). Women who attend higher education (AOR = 2.26: 95%CI; 1.36-3.77), medium wealth status (AOR = 1.80: 95%CI; 1.17-2.76), richer wealth status (AOR = 1.86: 95%CI; 1.21, 2.85), richest wealth status (AOR = 2.34: 95%CI; 1.43-3.83), living in Harari region (AOR = 2.24: 95%CI; 1.16-4.30), and living at Dire-Dawa city (AOR = 2.24: 95%CI; 1.16-4.30) were higher odds of early initiation of first ANC visits. However, women who were rural resident (AOR = 0.70: 95%CI; 0.59-0.93), household headed by male (AOR = 0.87: 95%CI; 0.72, 0.97), having ≥ 5 family size (AOR = 0.71: 95%CI; 0.55-0.93), and living in SNNPRs (AOR = 0.44: 95%CI; 0.23-0.84) were lower odds of early initiation of first ANC visits. CONCLUSION: The prevalence of early initiation of first antenatal care remains low in Ethiopia. Women's education, residence, wealth status, household head, having ≥ 5 family sizes, and region were determinants of early initiation of first antenatal care visits. Improving female education and women's empowerment through economic transitions with special attention given to rural and SNNPR regional state residents could maximize the early initiation of first antenatal care visits. Furthermore, to increase early antenatal care uptake, these determinants should be considered when designing new policies or updating policies and strategies on antenatal care uptake to help increase early attendance, which can help in the reduction of maternal and neonatal mortality and to achieve sustainable development goals 3 by 2030.

The magnitude of oral rehydration salt utilization in diarrhea hot spot regions of Ethiopia and its associated factors among under-five children: A multilevel analysis based on Bayesian approach.

Background: Diarrhea leads the children to severe dehydration or death as a result of the loss of water and electrolytes (namely, potassium, chloride, sodium, and bicarbonate). To compensate for the losses, ORS is given to children who experienced diarrhea. Objective: To estimate the magnitude of ORS utilization in diarrhea hotspot regions of Ethiopia and to assess its associated factors among under-five children. Methods: To conduct this study, we used the 2016 Ethiopian demographic and health survey data. A total of 1,079 weighted sample children were selected. Each sample was selected randomly. Then, to identify factors associated with ORS utilization in diarrhea hotspot regions of Ethiopia, a multilevel analysis based on the Bayesian approach was applied. Finally, the credible interval of AOR that does not include 1 was considered statistically significant. Results: The magnitude of ORS utilization for children in diarrhea hotspot regions of Ethiopia was 28%. Being urban resident (AOR = 1.92; 95% CrI: 1.13-3.3), woman household head (AOR = 2.11; 95% CrI: 1.3-3.9), having higher educational level (AOR = 1.52; 95% CrI: 1.04-2.22), member of health insurance (AOR = 1.73; 95% CrI: 1.14-2.43), and being exposed for media (AOR = 1.43; 95% CrI: 1.18-2.5) increases ORS utilization for diarrhea management. Conclusion: Residence, educational level, health insurance, and media exposure were the factors of ORS utilization. So, to increase the practice of ORS utilization for diarrhea management in Ethiopia, the Ministry of Health and the Government of Ethiopia should consider those factors when they design diarrhea prevention and control strategies.

Multilevel analysis of the predictors of completion of the continuum of maternity care in Ethiopia; using the recent 2019 Ethiopia mini demographic and health survey.

BACKGROUND: Despite the significant benefit of the continuum of care to avert maternal and neonatal mortality and morbidity, still the dropout from the continuum of care remains high and continued to become a challenge in Ethiopia. Therefore, this study aimed to assess the level of completion along the continuum of maternity care and its predictors among reproductive-age women in Ethiopia. METHODS: A secondary data analysis was done using the 2019 mini Ethiopian demographic health survey. A total weighted sample of 2,905 women aged 15-49 years who gave birth in the last five years preceding the survey and who had antenatal care visits was included. A multilevel mixed-effects logistic regression model was used to examine the predictors that affect the completion of the continuum of maternity care services. Finally, statistical significance was declared at a p-value < 0.05. RESULTS: In this study, the overall prevalence of completion along the continuum of maternity care was 12.9% (95%CI: 11.1 - 14.9%). Attending higher education (AOR = 2.03: 95%CI; 1.14 - 3.61), belonged to medium wealth status (AOR = 1.69: 95%CI; 1.07 - 2.66), belonged to rich wealth status (AOR = 2.05: 95%CI; 1.32, 3.17), and informed about danger signs during pregnancy (AOR = 2.23: 95%CI; 1.61, 3.10) were positively associated with the completion of the maternity continuum of care. However, late initiaton of first antenatal care visits (AOR = 0.66: 95%CI; 0.49, 0.89), being rural resident (AOR = 0.67: 95%CI; 0.42 - 0.93), lived in the Afar (AOR = 0.36: 95%CI; 0.12 - 0.83) and Gambella (AOR = 0.52: 95%CI; 0.19 - 0.95) regional states were negatively associated with the completion of the continuum of maternity care. CONCLUSION: Despite most of the women using at least one of the maternity services, the level of completion along the continuum of care after antenatal care booking remains low in Ethiopia. Therefore, enhancing female education and economic transitions with special consideration given to rural, Afar, and Gambella regional state residents. Counseling towards the danger signs of pregnancy and its complications during antenatal care follow-upshould be strengthened. . Furthermore, the identified predictors should be considered when designing new policies or updating policies and strategies on maternity services uptake to step-up its full utilization, which in turn helps in the achievement of the sustainable development goals of ending preventable causes of maternal, neonatal, and child death by 2030.

Spatial exploration of non-resilience to food insecurity, its association with COVID-19 and household coping strategies in East Gojjam districts, Northwest Ethiopia, 2020.

The coronavirus disease-2019 (COVID-19) pandemic has posed a significant multifaceted threat to the global community. Ethiopia, as a Sub-Saharan African country, is suffering from chronic food insecurity, and the emergence of such a pandemic will exacerbate the situation. As a result, this study investigated the spatial variation of non-resilience to food insecurity, its relationship with COVID-19, and household coping strategies to become resilient in the long run among households in the East Gojjam Zone of Northwest Ethiopia. From September 22 to December 24, 2020, an agro-ecological-based cross-sectional study of 3532 households was conducted to assess the spatial distribution and associated factors of non-resilience to household food insecurity. The enumeration areas (EAs) and households were chosen using a multistage sampling technique. Data were gathered using a semi-structured questionnaire and checklist using an Android device loaded with an Open Data Kit (ODK) template. Binary logistic regression was used to identify the specific factors associated with household non-resilience to food insecurity. A thematic analysis was conducted to investigate the opportunities and challenges of resilience for household food insecurity. Nearly two-thirds (62.5%) of the households were farmers, 67.9% lived in rural areas, and nearly three-quarters (73.8%) earned less than or equal to ETB 2100 per month. Males headed more than four-fifths of the households (81.7%). We found that nearly two-thirds of the households (60.02%), 95% CI 58.40, 61.64) were food insecure. After bivariate logistic regression, we found that households who were divorced (AOR = 2.54 (1.65, 3.87)), daily laborers (AOR = 2.37 (1.15, 4.87)), government employees (AOR = 2.06 (1.05, 4.05)), residents of highland and hot areas (AOR = 11.5 (5.37, 16.77)) and lowland areas (AOR = 1.35 (1.02, 3.15)) were frustrated by COVID-19 (AOR = 1.23 (1.02, 1.50)) and price inflation (1.89 (AOR = 1.42, 2.56))) were at higher odds of being non-resilient to household food insecurity at a 95% confidence level. Geospatial hot spot analysis revealed that Kurar kebele (the lowest government administrative unit) in Dejen District and Debre Markos town were the red-hotspot areas of household non-resilience to food insecurity. Less than a quarter of the households attempted to cope with food insecurity by adjusting their food consumption, while more than 60% of the households chose none of the coping strategies tested. According to the thematic analysis, the degree of poverty (lack of asset ownership), the COVID-19 pandemic, farm decreased variety, and low crop productivity were identified as challenges to coping with the hardship of resilience to food insecurity. During the COVID-19 pandemic and public emergency, the proportion of households that were unprepared for food insecurity reached its peak. It was recognized that a segment of the population with low economic capacity was more vulnerable to food insecurity and less resilient. Tough developmental gains will be undermined in this case. As a result, each responsible body and stakeholder should develop and implement solid corrective plans for the local context.

Preconception care utilization and associated factors among reproductive age women in Mizan-Aman town, Bench Sheko zone, Southwest Ethiopia, 2020. A content analysis.

BACKGROUND: Preconception care is highly important in reducing a number of adverse pregnancy outcomes and helps to improve maternal health. Preconception care optimizes women's health and improves pregnancy outcomes. It is a cost-effective first-line preventive strategy for birth defects. However, preconception care utilization in Ethiopia was very low. Studies on these issues are limited in Ethiopia in general and in Mizan-Aman town in particular. OBJECTIVE: To assess preconception care utilization and associated factors among reproductive age women in Mizan-Aman town, Bench-Sheko Zone, Southwest Ethiopia. METHODS: A community based cross-sectional study design was employed from April 16 to May 26, 2020 in Mizan-Aman town. The total study participants were 624 reproductive age women. Data were collected by using pre-tested interviewer administered questionnaires and entered into Epi-data version 3.1 then exported to STATA version 14 and analyzed accordingly. Univeriate and Bivariable analysis was done by analysis of variance (ANOVA) and independent t-test. Multivariable statistical analysis using generalized linear regression model (GLM) approach was used to classify factors of preconception care utilization. Since our response variable is measured in terms of count variable, we used a Poisson regression model with a log link function. Finally, Statistical significance between dependent and independent variables were assessed by odds ratios and 95% confidence intervals. RESULTS: Overall, 28.6% of the women receipt atleast one item of preconception care while only 1.5% were taken the whole recommended components of preconception care services. The most common item received in the study area was taking micronutrient supplementation (18.5%). Age of women, educational status, husbands educational status, husbands occupation, wealth status, distance from the health facility, waiting time to get services, planning to pregnancy, age at first pregnancy, previous ANC use, Previous PNC use, adverse pregnancy experience, women's knowledge of preconception care, and attitude on preconception care were determinants of preconception service utilization. CONCLUSIONS: Preconception care component utilization was lower as compare with recommended service with different disparities. Multipurpose tailored strategies which incorporate a woman with no formal education, poor knwledge on preconception care,never take maternal services previously and distant from health facility could improve preconception care service utilization. Advocative strategies on preconception care component and planning pregnancy may elicite more women to use the services of preconception care.

Factors associated with preterm birth among mothers who gave birth at public Hospitals in Sidama regional state, Southeast Ethiopia: Unmatched case-control study.

BACKGROUND: Preterm birth remains the commonest cause of neonatal mortality, and morbidity representing one of the principal targets of neonatal health care. Ethiopia is one of the countries which shoulder the highest burden of preterm birth. Therefore, this study was aimed to assess factors associated with preterm birth at public hospitals in Sidama regional state. METHODS: Facility-based case-control study was conducted at public hospitals in Sidama regional state, from 1st June to 1st September/2020. In this study, a total of 135 cases and 270 controls have participated. To recruit cases and controls consecutive sampling methods and simple random sampling techniques were used respectively. Data were collected using pretested structured interviewer-administered questionnaire, and checklist via chart review. Data were entered using EpiData version 3.1 and exported to SPSS version 20 for analysis. Independent variables with P-value < 0.25 in the bivariate logistic regression were candidates for multivariable logistic regression analysis. Finally, statistical significance was declared at P-value < 0.05. RESULTS: The response rate was 100%. Rural resident (AOR = 2.034; 95%CI: 1.242, 3.331), no antenatal care service utilization (AOR = 2.516; 95%CI: 1.406, 4.503), pregnancy-induced hypertension (AOR = 2.870; 95%CI: 1.519, 5.424), chronic medical problem during pregnancy (AOR = 2.507; 95%CI: 1.345, 4.676), urinary tract infections (AOR = 3.023; 95%CI: 1.657, 5.513), birth space less than 2 years (AOR = 3.029; 95%CI: 1.484, 6.179), and physical intimate violence (AOR = 2.876; 95%CI: 1.534, 5.393) were significantly associated with preterm birth. CONCLUSION: Most of the risk factors of preterm birth were found to be modifiable. Community mobilization on physical violence during pregnancy and antenatal care follow-up are the ground for the prevention of preterm birth because attentive and critical antenatal care screening practice could early identify risk factors. Besides, information communication education about preterm birth prevention was recommended.

Prevalence and its predictors of intimate partner violence against pregnant women amid COVID-19 pandemic in Southwest Ethiopia, 2021: A cross-sectional study.

OBJECTIVES: Preventive measures like staying-at-home and social distancing are among the top strategies on the list to avert the spread of coronavirus disease 2019 and its consequences. However, this strategy brings off another shadow pandemic of intimate partner violence against women, and no study has been done to assess the magnitude of intimate partner violence against pregnant women during the pandemic in Ethiopia. Therefore, this study was aimed to determine the prevalence of intimate partner violence and its predictors in Southwest Ethiopia amid the coronavirus disease 2019 pandemic. METHODS: A community-based cross-sectional study was conducted, from 15 June 2021 to 15 August 2021, on a total of 590 pregnant women recruited by systematic random sampling techniques. Pretested structured questionnaires were used to collect data, and the data were entered using EpiData version 3.1 and analyzed by SPSS version 24. Logistic regression analysis was used to identify predictors of intimate partner violence. Finally, statistical significance was declared at a p-value <0.05. RESULTS: The prevalence of intimate partner violence was 39.2%. Of this, 29.8%, 26.8%, and 22.2% of the pregnant women had experienced physical, sexual, and emotional intimate partner violence, respectively. Being illiterate (adjusted odds ratio = 2.36, 95% confidence interval: 1.33-4.19), having illiterate husbands (adjusted odds ratio = 4.79, 95% confidence interval: 2.69-8.55), household decisions made by the husband alone (adjusted odds ratio = 4.91, 95% confidence interval: 3.74-9.33), and pandemic-induced economic downturns (adjusted odds ratio = 9.03, 95% confidence interval: 5.18-15.98) were the predictors that were significantly associated with intimate partner violence. CONCLUSION: The prevalence of intimate partner violence against pregnant women during the coronavirus disease 2019 pandemic has been found to be high in the study area. Thus, more efforts should be tried to integrating intimate partner violence screening in maternal and child healthcare services, and early identification of high-risk individuals, and continuous community-based awareness creation activities are recommended.

Magnitude and determinants of unmet need for family planning among reproductive age women in East Africa: multilevel analysis of recent demographic and health survey data.

INTRODUCTION: Unmet need for family planning is the main obstacle to achieve healthy timing and desired number of children. Decreasing the unmet need for FP respects and protects human right and help to decrease the influence on biodiversity. Unmet need for family planning is the contributor and devastating issue of maternal health. Therefore, meeting the unmet need of contraceptive averts the maternal death and poverty. Therefore, determining the magnitude and its determinants is very important to intervene and design appropriate program umbrella. OBJECTIVE: To determine the magnitude and its determinants of unmet need for family planning among reproductive age women in East Africa. METHOD: This study was analyzed secondary data from Demographic and Health Surveys (DHS) of which contained detailed family planning for all interviewed women aged 15 to 49 years. The data were weighted using sampling weight before any statistical analysis to account the sampling design. STATA version 15 was used for extracting, editing, recoding, and multilevel analysis. Median odds ratio (MOR), proportional change in Variance (PCV), Intraclass correlation coefficient (ICC), and Akaike Information Criteria (AIC) was analyzed. Four model was build and the best model was selected based on the smallest Akaike Information Criteria (AIC). Both bivariable and multivariable multilevel analysis was done. Variable with p-value< 0.25 were selected for multivariable multilevel logistic regression analysis. Variables with p-value ≤5% declared as statistical significant with outcome variable. RESULTS: The magnitude of unmet need for family planning was 24.66% (95%CI: 24.1-25.2). The identified determinants of unmet need for family planning was 30-39 years (AOR = 0.7; 95% CI 0.54-0.91), age of 40-49 (AOR = 0.76; 95% CI 0.58-0.99), rural residence (AOR = 1.17; 95% CI 1.02-1.34), female household head (AOR = 0.66; 95% CI 0.61-0.73), women having 4-6 child (AOR = 1.76; 95% CI 1.55-1.99), women having 7-9 child (AOR = 2.77; 95% CI 2.34-3.28) women having ≥10 child (AOR = 3.51; 95% CI 2.58-4.78), women who give their first birth 19-25 years (AOR = 1.1; 95% CI 1.0-1.26), 26-34 years (AOR = 1.4; 95% CI 1.19-1.83) ≥35 years (AOR = 2.1; 95% CI 1.1-4.27) and no fertility desire (AOR = 1.52; 95% CI 1.36-1.67) were the determinants of unmet need for family planning in east Africa. CONCLUSION: Unmet need in east Africa is high as compare to other previous study. Maternal age, residence, sex of household head, number of children, age at first birth and fertility desire were the determinants identified in this study. Therefore, health interventions that reduce unmet need which enhance family planning service delivery among rural, male-headed household, women having more than three children and women who had no fertility desire needed in advance. Policies and programs of unmet need should be tailored the rural, young and no fertility desire women as well as male headed households.

The bayesian approach of factors associated with preterm birth among mothers delivered at public hospitals in Southeast Ethiopia.

Background: Preterm birth remains the commonest cause of neonatal mortality, and morbidity represents one of the principal targets of neonatal healthcare. Ethiopia is one of the countries which accounts for the highest burden of preterm birth. Therefore, this study aimed to assess factors associated with preterm birth at public hospitals in Sidama regional state. Methods: A facility-based cross-sectional study was conducted at public hospitals in Southeast Ethiopia from 1 June to 1 September 2020. To recruit the study participants, systematic random sampling techniques were used. Data were collected using pretested structured interviewer-administered questionnaire and a checklist via chart review. Data were entered using EpiData version 3.1 and exported to R software version 4.0 for analysis. Then, factors associated with preterm birth among mothers were assessed based on the Bayesian statistical approach. Results: The study showed that the prevalence of preterm birth was 20.6%. Being a rural resident (AOR = 2; 95% CrI: 1.2-3.5), having no antenatal care service utilization (AOR = 2.3; 95% CrI: 1.1-4.8), hypertensive disorder of pregnancy (AOR = 3.5; 95% CrI: 1.8-6.9), birth space less than 2 years (AOR = 3.4; 95% CrI: 1.5-7.9), having premature rupture of membrane (AOR = 2.4; 95% CrI: 1.3-5.4), and physical intimate violence (AOR = 2.876; 95%CI: 1.534, 5.393) were risk factors of preterm birth. Whereas, women who had primary, secondary, and higher education levels (AOR = 0.2; 95% CrI: 0.1-0.4, AOR = 0.1; 95% CrI: 0.06-0.3, and AOR = 0.2; 95% CrI: 0.1-0.4), respectively, were preventive factors. Conclusion: Most of the risk factors of preterm birth were found to be modifiable. Community mobilization on physical violence during pregnancy and antenatal care follow-up are the ground for the prevention of preterm birth because attentive and critical antenatal care screening practices could early identify risk factors. In addition, information communication education about preterm birth prevention was recommended.

Multilevel analysis of factors associated with HIV among women of reproductive age (15-49 years old) in Ethiopia: Bayesian approach.

BACKGROUND: Human immunodeficiency virus remains the leading cause of morbidity and mortality throughout the world. Sub-Saharan Africa regions are the most affected regions and accounted for 67% of HIV infections worldwide, and 72% of the world's AIDS-related deaths. OBJECTIVE: To estimate the prevalence of HIV and identify factors associated with it among women of reproductive age in Ethiopia. METHODS: This study was conducted based on the 2016 Ethiopian Demographic and Health Surveys data. The data were weighted using sampling weight for probability sampling and non-response to restore the representativeness of the data and get valid statistical estimates. Then, a total of 14,161 weighted sample women were used to investigate the study. Finally, a multilevel analysis was done based on the Bayesian approach to identify factors associated with HIV among women of reproductive age in Ethiopia. RESULTS: This study showed the prevalence of HIV among reproductive age group women was 0.85%. Being rural resident (adjusted odds ratio = 0.20; 95% CrI = 0.1-0.4), secondary education level (adjusted odds ratio = 0.20; 95% CrI = 0.1-0.4), rich wealth status (adjusted odds ratio = 4; 95% CrI = 3-6), married women but living separately (adjusted odds ratio = 2.3; 95% CrI = 1.2-4.5), long distance from the health facility (adjusted odds ratio = 0.4; 95% CrI = 0.3-0.5), and exposure to media (adjusted odds ratio = 2.9; 95% CrI = 1.8-4.7) were significantly associated with HIV. CONCLUSION: Being rural residents, women whose marital status is separated, wealthy, travel a long distance to get health facility, and are exposed to media are risky to be infected by HIV. Whereas being a rural resident and educated are preventive factors for HIV. Therefore, the government of Ethiopia and the ministry of health should consider those factors when they design HIV prevention and control strategies.

Psychoactive Substance Use and Its Associated Factors among Truck Drivers in Ethiopia.

BACKGROUND: Road traffic accidents (RTAs) remain an important public health issue worldwide. Psychoactive substance use is one of the main contributors to the occurrence of traffic accidents, and its use by truck drivers is a global problem. Also, psychoactive substance use is a commonly observed behavior among truck drivers. To the best of our knowledge, no evidence shows the prevalence and factors associated with psychoactive substance use among truck drivers in Ethiopia. Therefore, this study was aimed at assessing the prevalence and factors associated with psychoactive substance use among truck drivers in Ethiopia. METHODS: A cross-sectional study was conducted among 400 systematically selected truck drivers at Modjo dry port in Ethiopia, from February 1 to March 1, 2018. The data were collected through face-to-face individual interviews using a structured questionnaire. The collected data were entered into EpiData version 4.2.0.0 and analyzed using SPSS version 20. Binary logistic regression analysis was computed to determine the association using crude and adjusted odds ratios at 95% confidence intervals. The level of significance was declared at p value < 0.05 in the multivariable binary logistic regression analysis. RESULTS: Of the 400 truck drivers interviewed, the overall one-month self-reported prevalence of psychoactive substance use was 70% (n = 280). In the multivariable binary logistic regression analysis, aged 38 years and above (AOR = 0.40, 95% CI [0.23-0.69]), Christianity religion (AOR = 0.52, 95% CI [0.28-0.97]), college and university education (AOR = 3.47, 95% CI [1.27-9.47]), having a family size of 3 or more (AOR = 0.34, 95% CI [0.20-0.60]), having 6 or more hours spent sleeping at night (AOR = 0.46, 95% CI [0.28-0.75]), and rest breaks between driving (AOR = 2.13, 95% CI [1.14-3.97]) were significantly associated with psychoactive substance use. CONCLUSION: The one-month prevalence of psychoactive substance use among truck drivers was remarkably high. We can conclude that psychoactive substance use is a public health problem among truck drivers, which is a major threat to themselves and others on the road. The sociodemographic and occupational factors are the factors associated with drivers' psychoactive substance use. Therefore, devising health education and counseling program for drivers to tackle the problem plays paramount importance.

Trends and determinants of diarrhea among under-five children in Ethiopia: cross-sectional study: multivariate decomposition and multilevel analysis based on Bayesian approach evidenced by EDHS 2000-2016 data.

BACKGROUND: Despite significant progress in the reduction of under-five child deaths over the last decades in Ethiopia, still diarrhea remains the second cause of morbidity and mortality among under five children next to pneumonia. OBJECTIVE: To show trends and determinants of diarrhea among under five children in Ethiopia based on the four Ethiopian Demographic and health surveys data (2000-2016). METHODS: A total of 10,753 in 2000, 10,039 in 2005, 10,946 in 2011 and 10,337 in 2016 under five age children were involved in this study. Multivariate decomposition and multilevel analysis based on Bayesian approach was performed. RESULTS: Ninety seven percent of the change in diarrhea prevalence over time was attributable to difference in behavior. Being twin (AOR = 1.3; 95% CrI 1.1-1.5), big weight (AOR = 1.63; 95% CrI 1.62-2.02), not vaccinated for rotavirus (AOR = 1.44; 95% CrI 1.12-1.9) and for measles (AOR = 1.2; 95% CrI 1.1-1.33), poor wealth status (AOR 2.6; 95% CrI 1.7-4.06), having more than three under-five children (AOR 1.3; 95% CrI 1.1-1.61), member of health insurance (AOR 2.2; 95% CrI 1.3-3.8) and long distance from the health facility (AOR 2.7; 95% CrI 2.2-3.5) were more likely to experience diarrhea. CONCLUSION: The prevalence of diarrhea was significantly declined over the last sixteen years and the decline was due to difference in behavior between the surveys. Being twin, weight of child at birth, vaccinated for measles and rotavirus, number of under-five children, wealth status, distance to health facility, health insurance and child waste disposal method were significantly associated with diarrhea among under five children in Ethiopia. Therefore Ethiopian government should focus on the strengthening and scaling up of behavioral change packages of the community regarding to keeping hygiene and sanitation of the community and their environment, vaccinating their children, accessing health care services to prevent diarrheal disease.

Association of Acute Respiratory Infections with Indoor Air Pollution from Biomass Fuel Exposure among Under-Five Children in Jimma Town, Southwestern Ethiopia.

Background: Most of the households in developing countries burn biomass fuel in traditional stoves with incomplete combustion that leads to high indoor air pollution and acute respiratory infections. Acute respiratory infection is the most common cause of under-five morbidity and mortality accounting for 2 million deaths worldwide and responsible for 18% of deaths among under-five children in Ethiopia. Although studies were done on acute respiratory infections, the majority of studies neither clinically diagnose respiratory infections nor use instant measurement of particulate matter. Methods: The community-based cross-sectional study design was employed among under-five children in Jimma town from May 21 to June 7, 2020. A total of 265 children through systematic random sampling were included in the study. The data were collected using a pretested semistructured questionnaire and laser pm 2.5 meter for indoor particulate matter concentration. Associations among factors were assessed through correlation analysis, and binary logistic regression was done to predict childhood acute respiratory infections. Variables with p-value less than 0.25 in bivariate regression were the candidate for the final multivariate logistic regression. Two independent sample t-tests were done to compare significant mean difference between concentrations of particulate matter. Results: Among 265 under-five children who were involved in the study, 179 (67.5%) were living in households that predominantly use biomass fuel. Prevalence of acute respiratory infections in the study area was 16%. Children living in households that use biomass fuel were four times more likely to develop acute respiratory infections than their counterparts (AOR: 4.348; 95% CI: 1.632, 11.580). The size of household was significantly associated with the prevalence of acute respiratory infections. Under-five children living in households that have a family size of six and greater had odds of 1.7 increased risk of developing acute respiratory infections than their counterparts (AOR: 1.7; 95% CI: 1.299, 2.212). The other factor associated with acute respiratory infection was separate kitchen; children living in households in which there were no separate kitchen were four times at increased risk of developing acute respiratory infection than children living in households which have separate kitchen (AOR: 4.591; 95% CI: 1.849, 11.402). The concentration of indoor particulate matter was higher in households using biomass fuel than clean fuel. There was statistically higher particulate matter concentration in the kitchen than living rooms (t = 4.509, p ≤ 0.001). Particulate matter 2.5 concentrations (µg/m3) of the households that had parental smoking were significantly higher than their counterparts (AOR: 20.224; 95% CI: 1.72, 12.58). Conclusion: There is an association between acute respiratory infections and biomass fuel usage among under-five children. Focusing on improved energy sources is essential to reduce the burden and assure the safety of children.

The impact of being of the female gender for household head on the prevalence of food insecurity in Ethiopia: a systematic-review and meta-analysis.

BACKGROUND: Ethiopia signed both for Millennium Development Goals (MDGs) previously and Sustainable Development Goals (SDGs) currently to improve food security through gender equality and empowerment of women by positioning them as household leader. However, there is no concrete evidence about the impact of being of the female gender for household head on the prevalence of food insecurity at the national level, the authors' intention being to fill this gap. METHODS: Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol (PRISMA-P) guideline was followed. All major databases such as PubMed/MEDLINE, WHOLIS, Cochrane Library, Embase, PsycINFO, ScienceDirect, Web of science, and reference lists were used to identify published articles, whereas shelves, author contact, Google, and Google Scholar were also searched to identify unpublished studies. Joanna Briggs Institute Meta-Analysis of Statistical Assessment and Review Instrument (JBI-MAStARI) was used for critical appraisal of studies. Meta-analysis was conducted using the STATA software version 14. The random effect model was used to estimate the pooled prevalence of food insecurity at 95% confidence level, while subgroup analysis and meta-regression were employed to identify the possible source of heterogeneity and the associated factors respectively. Moreover, Begg's test was used to check publication bias. RESULTS: A total of 143 articles were identified, of which 15 studies were included in the final model with a total sample size of 2084 female-headed households. The pooled estimate of food insecurity among female-headed households was 66.11% (95% confidence level (CL) 54.61, 77.60). Female-headed households had 1.94 (95% CL 1.26, 3.01) times the odds of developing food insecurity as compared with male-headed households in Ethiopia. However, considerable heterogeneity across studies was also exhibited (I 2 = 92.5%, p value < 0.001). CONCLUSION: This review found that severity of food insecurity among female-headed households in Ethiopia was a more pronounced issue as compared with the general national estimate of food insecurity. Food insecurity among them was two-fold increased as compared with their men counterparts.So that, the government of Ethiopia needs to outlook how cultural and social restriction of women's involvement in every aspect of activity affects their level of household food security. Beyond this, previous success and current gap of food insecurity among female-headed households should be explored in future research to run in accordance with Sustainable Development Goals (SDGs) specially with goals 2 and 5.