Correction: Immunization coverage and its associated factors among children aged 12-23 months in Ethiopia: An umbrella review of systematic review and meta-analysis studies.

[This corrects the article DOI: 10.1371/journal.pone.0299384.].

Employing supervised machine learning algorithms for classification and prediction of anemia among youth girls in Ethiopia.

In developing countries, one-quarter of young women have suffered from anemia. However, the available studies in Ethiopia have been usually used the traditional stastical methods. Therefore, this study aimed to employ multiple machine learning algorithms to identify the most effective model for the prediction of anemia among youth girls in Ethiopia. A total of 5642 weighted samples of young girls from the 2016 Ethiopian Demographic and Health Survey dataset were utilized. The data underwent preprocessing, with 80% of the observations used for training the model and 20% for testing. Eight machine learning algorithms were employed to build and compare models. The model performance was assessed using evaluation metrics in Python software. Various data balancing techniques were applied, and the Boruta algorithm was used to select the most relevant features. Besides, association rule mining was conducted using the Apriori algorithm in R software. The random forest classifier with an AUC value of 82% outperformed in predicting anemia among all the tested classifiers. Region, poor wealth index, no formal education, unimproved toilet facility, rural residence, not used contraceptive method, religion, age, no media exposure, occupation, and having more than 5 family size were the top attributes to predict anemia. Association rule mining was identified the top seven best rules that most frequently associated with anemia. The random forest classifier is the best for predicting anemia. Therefore, making it potentially valuable as decision-support tools for the relevant stakeholders and giving emphasis for the identified predictors could be an important intervention to halt anemia among youth girls.

Incidence and predictors of virological failure among children receiving first-line anti-retroviral treatment in public comprehensive specialized hospitals found in Northeast Ethiopia: a retrospective follow-up study.

Background: Despite anti-retroviral treatment coverage in resource-limited countries being highly appreciated, the occurrence of first-line virological failure remains a priority agenda. Therefore, this study serves as an input for evidence of virological failure among children. Objective: This study aimed to assess the incidence and predictors of virological failure among children receiving first-line anti-retroviral treatment in public comprehensive specialized hospitals found in Northeast Ethiopia through a retrospective follow-up study. Methods: A multicenter institution-based retrospective follow-up study was conducted on the medical records of 481 human immunodeficiency virus (HIV)-infected children who were on first-line anti-retroviral therapy from 1 January 2017 to 31 December 2021. Data were retrieved from 15 May to 15 June 2022 at three public comprehensive specialized hospitals. Study participants were recruited using a simple random sampling technique. STATA-14 was used to analyze the data, which was entered using EpiData version 4.6.2.0. The Kaplan-Meier estimator was used to estimate the survival. Both bivariable and multivariable Cox regression models were fitted to identify predictors. Finally, adjusted hazards ratios (AHRs) with 95% confidence intervals (CIs) were computed, and variables with a P-value of <0.05 were considered statistically significant predictors of virological failure. Result: A total of 481 children records were included in the final analysis, with an observed follow-up period of 16,379 person-months. Among these, 60 (12.47%) had developed virological failure, resulting in an overall incidence density rate of 3.67 (95% CI; 2.84, 4.73) per 1000 person-month observations. The hazards of virological failure (VF) among children were found to be increased by being in recent WHO stages III and IV (AHR = 3.688; 95% CI: 1.449-6.388), poor adherence to anti-retroviral treatment (ART) (AHR = 3.506; 95% CI: 1.711-7.234), and living in a rural environment (AHR = 5.013; 95% CI: 1.958-8.351). Conversely, the hazard of VF was reduced by 60% when the age of caregivers was less than 40 years (AHR = 0.405; 0.003-0.449). Conclusion and recommendations: The incidence rate of virological failure was relatively high. Living in a rural area, poor adherence to ART, being in a recent advanced WHO clinical stage, and having a caregiver of 40 years of age or older were all independent predictors of virological failure in children. Patients or parents (caregivers) need to be aware of the importance of strictly adhering to treatment regimens to prevent virological failure.

Immunization coverage and its associated factors among children aged 12-23 months in Ethiopia: An umbrella review of systematic review and meta-analysis studies.

BACKGROUND: Immunization estimated to prevent 2 to 3 million children deaths every year from vaccine preventable disease. In Ethiopia, limited and inconclusive studies have been conducted on immunization coverage so far. Therefore, this umbrella review was intended to estimate the pooled national immunization coverage and its associated factors among children age 12-23 months in Ethiopia. METHODS: This umbrella review included five systematic reviews and meta-analyses through literature search from PubMed, Science direct, and web of science, CINHALE, and data bases specific to systematic reviews such as the Cochrane Database of Systematic Reviews and Prospero, the International Prospective Register of Systematic Reviews from May 1 to 30/ 2023. Only systematic reviews and meta-analyses published in English from inception to May 1, 2023, were included. The quality of each study was assessed using Assessment of Multiple Systematic Reviews. Data were extracted using Microsoft excel 2016 and analyzed using STATA 17.0 statistical software. Heterogeneity among studies was assessed using the Cochran Q statistics and I2 test. The pooled effect sizes were determined using pooled proportion for the full vaccination coverage and odds ratios for the associated factors with the corresponding 95% confidence interval were used to declare statically significance. RESULTS: Five studies with 77,161 children aged 12-23 months were included. The overall pooled full vaccination coverage was 57.72% (95% CI 50.17, 65.28). Institutional delivery (OR: 2.12, 95% CI: 1.78-2.52), travel to vaccination site for <2 hours (OR: 2.43, 95%CI: 1.97-3.00), received at least one antenatal (ANC) visit (OR: 3.2, 95%CI: 2.46-4.1), good maternal knowledge of immunization (OR: 3.63, 95%CI: 2.82-4.67), being informed on immunization schedule (OR: 2.54, 95%CI: 2.02-3.2), living in urban areas (OR: 2, 95% CI: 1.54-2.6), and a household visit by health-care providers (HCP) during the postnatal period (OR: 2.23, 95%CI: 1.22-4.09) were the independent predictors of immunization coverage. CONCLUSION: This study showed the full immunization coverage in Ethiopia was lower compared to the WHO-recommended level. Besides, the current umbrella review identifies several factors that contribute to higher immunization coverage. These includes; institutional delivery, near to vaccination site, having ANC visit, being urban residence, household visited by HCP, having good knowledge and informed on immunization schedule. Thus, the government should intensify the growth of immunization services by emphasizing outreach initiatives to reach remote areas and professionals must combine child immunization service with other medical services offered by health institutions.

Knowledge, attitude and practice of home management of diarrhea among under-five children in East Africa: A systematic review and meta-analysis.

INTRODUCTION: Diarrhea is particularly prevalent in low-income or marginalized populations because these groups have less access to clean water sources, hygienic conditions, and healthcare. Dehydration due to electrolyte and fluid loss is the main cause of deaths associated with diarrhea. An especially important factor in this death from dehydration is the caregivers' knowledge, attitude, and diarrhea management techniques. While a number of research have been done on managing diarrhea at home, the results tend not to be consistent. This systematic review and meta-analysis aimed to assess the pooled estimate of knowledge, attitude and practice of home-based management of diarrhea in East Africa. METHODS: Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines was used to search articles from electronic databases (Cochrane library, Ovid platform (Medline, Embase, and Emcare), Google Scholar, CINAHL, PubMed, and institutional repositories in East Africa countries. The last search date was on 01/06/ 2023 Gregorian Calendar. The authors extracted year of publication, country, study design, knowledge level, attitude level and practice level of home-based management of diarrhea. A weighted inverse variance random-effects model was used to estimate the pooled prevalence of knowledge, attitude and practice of home-based management of diarrhea. Subgroup analysis was done by country, and sample size. Publication bias and sensitivity analysis were also done. RESULTS: A total of 19 articles with (n = 7470 participants) were included for the final analysis. From the random-effects model analysis, the pooled prevalence of good practice, good knowledge and favorable attitude towards home based management of diarrhea in East Africa was found to be 52.62% (95% CI: 45.32%, 59.92%) (95% CI: I2 = 78.3%; p < 0.001), 37.44% (95% CI: 26.99%, 47.89%) (95% CI: I2 = 89.2%; p < 0.001) and 63.05% (95% CI: 35.7%, 90.41%) (95% CI: I2 = 97.8%; p < 0.001) respectively. CONCLUSION AND RECOMMENDATIONS: The level of good knowledge, attitude and practice of home based management of diarrhea in East Africa is found to be low. A collaborative effort from different stakeholders to enhance the knowledge, attitude and practice is needed to tackle the burden of diarrhea and its consequences.

Incidence and predictors of attrition among human immunodeficiency virus infected children on antiretroviral therapy in Amhara comprehensive specialized hospitals, Northwest Ethiopia, 2022: a retrospective cohort study.

Attrition rate is higher in developing nations and it leftovers a major obstacle to enhance the benefits of therapy and achieve the 90-90-90 plan targets. Despite this fact, data on the incidence and its predictors of attrition among human immune deficiency virus infected children on antiretroviral therapy are limited in developing countries including Ethiopia especially after the test and treat strategy implemented. This study aimed to assess the incidence and predictors of attrition among human immune deficiency virus infected children on antiretroviral therapy in Amhara Comprehensive Specialized Hospitals, Northwest Ethiopia. A retrospective follow-up study was conducted among 359 children on ART from June 14, 2014, to June 14, 2022. Study participants were selected using simple random sampling method and the data were collected using Kobo Toolbox software and analysis was done by STATA version 14. Both bi-variable and multivariable Cox regression models were fitted to ascertain predictors. Lastly, an AHR with a 95% CI was computed and variables with a p-value of < 0.05 were took an account statistically key predictors of attrition. The overall incidence of attrition rate was 9.8 (95% CI 7.9, 11.9) per 100 PYO. Children having baseline hemoglobin < 10 mg/dl (AHR 3.94; 95% CI 2.32, 6.7), suboptimal adherence (AHR 1.96; 95% CI 1.23, 3.13), baseline opportunistic infection (AHR 1.8; 95% CI 1.17, 2.96), and children who had experienced drug side effects (AHR 8.3; 95% CI 4.93, 13.84) were established to be a significant predictors of attrition. The attrition rate was relatively high. Decreased hemoglobin, suboptimal adherence, presence of drug side effects and baseline opportunistic infection were predictors of attrition. Therefore, it is crucial to detect and give special emphasis to those identified predictors promptly.

Factors associated with neonatal jaundice among neonates admitted at referral hospitals in northeast Ethiopia: a facility-based unmatched case-control study.

BACKGROUND: Neonatal jaundice is a significant contributor to illness and death in newborns, leading to frequent admissions to neonatal intensive care units. To better understand this issue, a study was conducted to identify the factors contributing to neonatal jaundice among newborns admitted to Dessie and Woldia comprehensive specialized hospitals in northeast Ethiopia. METHODS: The study took place from April 1 to May 30, 2022, using unmatched case-control design. A total of 320 neonates paired with their mothers were involved, including 64 cases and 256 controls. Data were collected through a structured interviewer-administered questionnaire and a review of medical records. The collected data were analyzed using SPSS Version 23, and a multivariate logistic regression model was employed to understand the relationship between independent factors and the occurrence of neonatal jaundice. Statistical significance was determined at a threshold of P value less than 0.05. RESULTS: The study findings revealed that maternal age over 35 years, residing in urban areas [adjusted odds ratio (AOR) = 2.4, 95% confidence interval (CI): 1.23, 4.82], male gender (AOR = 4.3, 95% CI: 1.90, 9.74), prematurity (AOR = 3.9, 95% CI: 1.88, 8.09), and ABO incompatibility (AOR = 2.6, 95% CI: 1.16, 5.96) were significant determinants of neonatal jaundice. Conversely, the study indicated that cesarean birth was associated with a 76% lower likelihood of infant jaundice compared to vaginal delivery (AOR = 0.24, 95% CI: 0.08, 0.72). CONCLUSION: To prevent, diagnose, and treat neonatal jaundice effectively, efforts should primarily focus on managing ABO incompatibility and early detection of prematurity. Additionally, special attention should be given to neonates born through vaginal delivery, those with mothers over 35 years old, and those residing in urban areas, as they are at higher risk of developing newborn jaundice. Close monitoring of high-risk mother-infant pairs during the antenatal and postnatal periods, along with early intervention, is crucial for reducing the severity of neonatal jaundice in this study setting.

Incidence and Predictors of Major Adverse Drug Reactions Among Human Immunodeficiency Virus-infected Children on Antiretroviral Treatment in West Amhara Comprehensive Specialized Hospitals, Northwest Ethiopia: A Multicenter Retrospective Follow-up Study.

PURPOSE: Major adverse drug reactions (ADRs) are the leading causes of poor adherence, switching of drugs, morbidity, and mortality. A limited studies was conducted to investigate major ADR in developing countries including Ethiopia, and the purpose of this study was to assess the incidence and predictors of major ADRs among HIV-infected children receiving antiretroviral therapy (ART) in West Amhara Comprehensive Specialized Hospitals, Northwest Ethiopia. METHODS: An institutional-based retrospective follow-up study was conducted among 460 children receiving ART from January 1, 2014 to December 31, 2021. A simple random sampling technique was employed, and data were collected using Kobo Toolbox software and then deployed to STATA 14 for analysis. The Kaplan-Meier survival curve and the log-rank test were used to estimate and compare survival times. Both bivariable and multivariable Weibull regression models were fitted to identify predictors. Finally, an adjusted hazards ratio (AHR) with a 95% CI was computed, and variables with P < 0.05 were considered statistically significant predictors of major ADR. FINDINGS: The overall incidence rate of major ADRs was 5.8 (95% CI, 4.6-7.3) per 1000 child months. Being female (AHR, 2.71; 95% CI, 1.52-4.84), tuberculosis (TB)-HIV co-infection (AHR, 2.49; 95% CI, 1.32-4.68), World Health Organization stage (III and IV) (AHR, 2.52; 95% CI, 1.39-4.56), zidovudine-based (AHR, 2.84; 95% CI, 1.11-7.31), and stavudine-based (AHR, 5.96; 95% CI, 1.63-21.84) regimens were found to be significant predictors of major ADRs. IMPLICATIONS: The major ADR incidence rate was high. Health professionals should employ early screening and close follow-up for children with advanced World Health Organization clinical staging, females, those with TB-HIV co-infection, and those receiving stavudine- and zidovudine-based initial regimens to reduce the incidence of major ADRs.

Prevalence of anemia and its associated factors among children aged 6-23 months, in Ethiopia: a systematic review and meta analysis.

INTRODUCTION: Despite several strategies exist for anemia prevention and control, it has been the major public health important problem in the world. Numerous immediate and long-term health issues were reported in children who have history of anemia including decreased work productivity in adult hood period. Although analyzing data on burden and risk factors of anemia are the recommended action areas of World Health Organization framework for accelerating anemia reduction, the aggregated national burden and contributors of anemia in Ethiopia has not been determined so far. There for, this systematic and meta-analysis study is aimed to assess the pooled prevalence and associated factors of anemia among children aged 6-23 months in Ethiopia. METHODS: The electronic databases including PubMed, Scopus, EMBASE, Web of Science, Science Direct, Google scholar and institutional repositories were searched using search terms. The studies that reported the prevalence and/or risk factors of anemia in children 6-23 months of age were included. The JBI quality assessment tool was used to evaluate the quality of each study. The data was extracted with Microsoft Excel, 2019 and analyzed with STATA 17.0 statistical software. A random effect model was used to estimate the pooled prevalence of anemia and its associated factors. The Cochrane Q-test statistics and I2 test were used to measure heterogeneity between the included studies. Furthermore, publication bias was examined using the funnel plot graph and statistical tests (Egger's and begg tests). Outliers also visualized using Galbraith plot. When necessary, sensitivity analysis was also employed to detect small study effect. RESULT: Ten studies with a total population of 14, 733 were included for analysis. The pooled prevalence of anemia among children aged 6-23 months of age in Ethiopia was found to be 57.76% (95%CI; 51.61-63.91; I2 = 97.192%; p < 0.001). Having history of diarrhea AOR = 2.44 (95%CI: 1.03-3.85), being stunted AOR = 2.00 (95%CI: 1.38-2.61), living in food insecure house hold AOR = 2.08 (95%CI: 1.10-3.07), consuming less diversified food AOR = 2.73 (95%CI: 2.06-3.39) and being 6-11 months of age AOR = 1.59 (95%CI: 1.23-1.95) were associated with anemia. CONCLUSION AND RECOMMENDATION: The prevalence of anemia is in the range of severe public health problem among children aged 6-23 months in Ethiopia. Diarrhea, stunting, house hold food insecurity, dietary diversity, and age were the predictors of anemia. Further, prospective cohort and random controlled trial studies are recommended. Further, random controlled trial especially effectiveness of nutritional education interventions trial is important. To reduce prevalence of anemia, strengthening diarrhea reduction program, securing household food insecurity, preventing stunting, giving special attention for infants age 6-11 months and encouraging food diversification are important.

The application of machine learning approaches to determine the predictors of anemia among under five children in Ethiopia.

Health professionals need a strong prediction system to reach appropriate disease diagnosis, particularly for under-five child with health problems like anemia. Diagnosis and treatment delay can potentially lead to devastating disease complications resulting in childhood mortality. However, the application of machine learning techniques using a large data set provides scientifically sounded information to solve such palpable critical health and health-related problems. Therefore, this study aimed to determine the predictors of anemia among under-5 year's age children in Ethiopia using a machine learning approach. A cross-sectional study design was done using the Ethiopian Demographic and Health Survey 2016 data set. A two-stage stratified cluster sampling technique was employed to select the samples. The data analysis was conducted using Statistical Package for Social Sciences/SPSS version 25 and R-software. Data were derived from Ethiopian Demographic and Health Survey. Boruta algorism was applied to select the features and determine the predictors of anemia among under-5 years-old children in Ethiopia. The machine learning algorism showed that number of children, distance to health facilities, health insurance coverage, youngest child's stool disposal, residence, mothers' wealth index, type of cooking fuel, number of family members, mothers' educational status and receiving rotavirus vaccine were the top ten important predictors for anemia among under-five children. Machine-learning algorithm was applied to determine the predictors of anemia among under- 5 year's age children in Ethiopia. We have identified the determinant factors by conducting a feature importance analysis with the Boruta algorithm. The most significant predictors were number of children, distance to health facility, health insurance coverage, youngest child's stool disposal, residence, mothers' wealth index, and type of cooking fuel. Machine learning model plays a paramount role for policy and intervention strategies related to anemia prevention and control among under-five children.

Incidence and predictors of recurrent acute coronary syndrome among adult patients with acute coronary syndrome in West Amhara, Ethiopia: a multicenter retrospective follow-up study.

Introduction: Acute coronary syndrome (ACS) is the most common cause of morbidity and mortality in patients with coronary heart disease. Furthermore, the recurrence of this problem has significant adverse outcomes. However, there is insufficient information pertaining to this problem in Ethiopia; hence, this study aims to assess the incidence rate and identify the predictors of ACS recurrence in the West Amhara region. Methods: A retrospective follow-up study was conducted among 469 patients diagnosed with primary ACS. Data from the patient chart were collected using a pre-tested structured data extraction tool. The study employed the Weibull regression analysis model, and the effect size was measured using an adjusted hazard ratio (HR) with a 95% confidence interval (CI). The statistical significance of the findings was established based on a p-value <0.05. Result: A total of 429 patients were included in the final analysis [average age, 60 ± 13.9 years; and 245 (57.1%) men]. A total of 53 patients (12.35%; 95% CI: 9.55%-15.83%) experienced recurrent ACS. The overall risk time was found to be 93,914 days (3,130.47 months), and the recurrence rate was 17/1,000 patients/month. The identified predictors were the typical symptoms of ACS such as syncope (HR: 3.54, p = 0.013), fatigue (HR: 5.23, p < 0.001), history of chronic kidney disease (HR: 8.22, p < 0.001), left ventricular ejection fraction of <40% (HR: 2.34, p = 0.009), not taking in-hospital treatments [aspirin (HR: 9.22, p < 0.001), clopidogrel (HR: 4.11, p = 0.001), statins (HR: 2.74, p = 0.012)], and medication at discharge [statins (HR: 4.56, p < 0.001)]. Conclusion: This study found a higher incidence rate of recurrent ACS. Hence, the implementation of guideline-recommended anti-ischemic treatment should be strengthened.

Incidence and predictors of respiratory distress syndrome among low birth weight neonates in the first seven days in Northwest Ethiopia Comprehensive Specialized Hospitals, 2023: A retrospective follow-up study.

INTRODUCTION: Respiratory distress syndrome is a catastrophic respiratory problem among low birth weight neonates. It increases the suffering of neonates and the economic expenditure of the countries. Notably, it is a major public health issue in low-income and middle-income countries such as Ethiopia. Despite this, studies regarding respiratory distress syndrome among low birth weight neonates were limited in Ethiopia. OBJECTIVE: To assess the incidence and predictors of respiratory distress syndrome among low birth weight neonates in the first 7 days in Northwest Ethiopia Comprehensive Specialized Hospitals. METHOD: Multicentred institution-based retrospective follow-up study was conducted from 19 September 2021 to 1 January 2023, among 423 low birthweight neonates. A simple random sampling technique was used. The data were collected using a data extraction checklist from the medical registry of neonates. The collected data were entered into EPI-DATA V.4.6.0.6. and analysed using STATA V.14. The Kaplan-Meier failure curve and log-rank test were employed. Bivariable and multivariable Weibull regression was carried out to identify predictors of respiratory distress syndrome. Statistical significance was declared at a p≤0.05. RESULT: The incidence rate of respiratory distress syndrome was found to be 10.78 (95% CI 9.35 to 12.42) per 100 neonate days. Fifth minute Appearance, Pulse, Grimace, Activity, Respiration (APGAR score) <7 (AHR 1.86; 95% CI 1.18 to 2.92), multiple pregnancy (AHR 1.43; 95% CI 1.04 to 1.96), caesarean section delivery (AHR 0.62; 95% CI 0.41 to 0.93), prematurity (AHR 1.56; 95% CI 1.06 to 2.30) and birth weight <1000 g (AHR 3.14; 95% CI 1.81 to 5.40) and 1000-1499 g (AHR 2.06; 95% CI 1.42 to 2.83) were significant predictors. CONCLUSION: The incidence of respiratory distress syndrome was higher than other studies conducted on other groups of neonates. Multiple pregnancy, fifth minute APGAR score, caesarean section, prematurity, extremely low birth weight and very low birth weight were predictors of respiratory distress syndrome. However, it needs further prospective study. Therefore, the concerned stakeholders should give due attention and appropriate intervention for these predictors.

Physical Activity and Its Associated Factors among Patients with Hypertension at Amhara Region Comprehensive Specialised Hospitals, Northwest Ethiopia: An Institutional Based Cross-Sectional Study.

BACKGROUND: Accurate evaluation of physical activity for patients with hypertension is important to determine patients' health outcomes and intervention measures. Information about physical activity among patients with hypertension in Ethiopia is not well known. OBJECTIVE: This study was aimed to assess the physical activity and associated factors among patients with hypertension. STUDY DESIGN: An institution-based cross-sectional study was conducted. STUDY SETTING: The study was conducted at the Tertiary Hospital Northwest, Ethiopia. OUTCOME MEASURES: Physical activity was assessed by Global Physical Activity Questionnaire as the primary outcome and factors significantly associated with physical activity were secondary outcomes. PARTICIPANTS: Four hundred and twenty patients with hypertension took part in the study; among those 233 were men and 187 were women. The study participants were chosen using a systematic random sampling method. SPSS V.20 statistical software was used to analyse the data. In the multivariable logistic regression analysis model, adjusted OR (AOR) with a 95% CI and p value<0.05 were used to identify the associated factors with physical activities. RESULTS: Our study showed that 19.1% of study participants had inadequate physical activity, being old age with AOR: 10.27 (3.21 to 33.01), low or poor self-efficacy with AOR: 10.34 (4.89 to 21.84), poor self-rated health with AOR: 5.91 (1.73 to 20.13) and lack of adequate facilities with AOR: 4.07 (1.72 to 9.66) were significantly associated with inadequate physical activity. CONCLUSION: Inadequate physical activity was detected in one-fifth of the study participants, according to our research. Being elderly, having low self-efficacy, having inadequate facilities and having poor self-rated health were all linked to inadequate physical activity.

Incidence and predictors of mortality in children with diabetic ketoacidosis in the comprehensive specialized referral hospitals of West Amhara Region, Northwest Ethiopia: a retrospective follow-up study.

Background: Diabetic ketoacidosis is one of the major life-threatening conditions associated with acute metabolic complications. It remains a major public health problem in developing countries such as Ethiopia. Objective: To assess the incidence and prediction of mortality in children with diabetic ketoacidosis in West Amhara Region Comprehensive Specialized Referral Hospitals, Northwest Ethiopia, in 2022. Methods: An institution-based retrospective follow-up study was conducted among 423 study participants with a confirmed diagnosis of diabetic ketoacidosis from 01/01/2017 to 31/12/2021. Data were entered, coded, cleaned, and checked using Epi-Data version 4.6 and exported to Stata version 14 for data analysis. Results: A total of 401 child records were included in the final analysis and were followed for 3781 days during the study period. The overall mortality of children with diabetic ketoacidosis was 10.6 per 1000 person-days observed (95% CI: 7.8-14.4) during the entire follow-up period. Hypoglycemia (AHR=4.6; 95% CI: 2.13-10.1), rural residence (AHR=2.9; 95% CI=1.01-8.11), age younger than five (AHR=4.4; 95% CI=1.4-13.7) or between five and 10 (AHR=3.1; 95% CI=1.1-8.8), and female gender (AHR=2.6; 95% CI=1.1-5.8) were significant predictors of mortality. Conclusions: The incidence rate of mortality in children with diabetic ketoacidosis was relatively high. Age, rural residence, female gender, and hypoglycemia were significantly predictive of mortality. Community education or mass campaigns about the signs and symptoms of diabetic ketoacidosis may reduce the mortality rate in children.

Perceived work-ability and its associated factors among nurses working in the Northwest of Amhara regional state Referral Hospitals, Northwest Ethiopia, 2022.

BACKGROUND: Nurses with reduced work ability had a high risk of disability pension, sickness absences, retirement intention, and leave their job and profession early. Nurses frequently suffer from job related stress, occupational fatigue and sleep problems, which can further compromise their work ability. AIMS OF THE STUDY: The aim of this study was to assess perceived work ability and its associated factors among nurses working in the Northwest of Amhara regional state Referral Hospitals, Northwest Ethiopia, 2022. METHODS: A multicenter, an institutional based, cross-sectional study was conducted among 410 nurses working in five selected Referral hospitals, found in the Northwest of Amhara regional state, Northwest Ethiopia, 2022. The data were collected using a structured, self-administered questionnaire and entered using Epi info version 7.2.5 software, analyzed using SPSS version 25. Summary statistics (median or IQR for continuous data and frequency and percentage for categorical variables) were used. The ordinal logistic regression was used to assess' the presence of association between dependent and independent variables. RESULTS: The findings of this study revealed that 59.0% of nurses had poor level of work ability, whereas 34.4% and 6.6% of nurses had sub-optimal and optimal level of work ability respectively. Multivariable ordinal logistic regression revealed that being male [AOR = 2.43; 95% CI (1.52, 3.91)], being BSC nurse [AOR = 0.21; 95% CI (0.08, 0.51)], nurses who had poor sleep quality [AOR = 0.34; 95% CI (0.12, 0.98)] and nurses who had chronic disease [AOR = 0.18; 95% CI (0.08, 0.41)] were significantly associated with nurses' level of work ability, p-value < 0.05. CONCLUSIONS: In this study, the prevalence of poor level of work ability among nurses was high. Nurses with a female sex, nurses who had chronic disease, BSC holders and nurses who had poor sleep quality had a poor level of work ability. The federal Minister of health and the study hospitals collaborative with concerned stakeholders to design strategies to enhance work ability among nurses.

Prevalence and Patterns of Adverse Drug Events Among Adult Patients with Human Immune Virus Infection on Dolutegravir-Based Antiretroviral Drug Regimens in Amhara Comprehensive Specialized Hospitals, Northwest Ethiopia: A Multicenter Retrospective Follow-Up Study.

Background: Antiretroviral therapy (ART) refers to any HIV treatment that uses a combination of two or more drugs to suppress viral load and preserve immunofunction. Despite the success of ART, adverse events persist, in particular in patients with baseline viral loads >100,000 copies/mL. Apart from premarketing surveillance, the safety and risk profile of dolutegravir has not been thoroughly researched in Ethiopia. Therefore, this study aimed to assess the prevalence and patterns of adverse drug events among HIV-infected adult patients on dolutegravir-based ART regimens at Amhara comprehensive specialized hospitals, northwest Ethiopia. Methods: A retrospective follow-up study was conducted from January 1, 2019 to December 31, 2021 at Amhara comprehensive specialized hospitals, with a sample size of 423. Simple random sampling was employed and data collected using kobo tool box software by four trained BSc nurses from March to April, 2022. SPSS 25 was used for analysis. Descriptive summary statistics are used and data presented using tables and text. Results: A total of 372 patient charts were included in the final analysis, and the prevalence of adverse events associated with dolutegravir was found to be 37.6% (95% CI 32.1%-42.1%). Nearly two-thirds (60.7%) of the participants had neuropsychiatric symptoms, followed by gastrointestinal symptoms (23.6%) and hepatic problems (7.14%). All recorded adverse events were mild. Conclusion: Dolutegravir adverse events were relatively low compared to previous studies. Common adverse events reported were neuropsychiatric symptoms and gastrointestinal symptoms, followed by hepatic and renal events. All adverse events were mild and none was severe or life-threatening events. Therefore, we recommend the use of dolutegravir in clinical settings.

Assessment of Quality of Education in the Case of Bahir Dar Health Science College, Northwest Ethiopia:- A Mixed Method Approach.

Introduction: The concept of quality in higher education is highly complex, difficult to define, and multi-dimensional and education is a cornerstone of a nation's development and quality is at the heart of education. Thus, the study aimed to assess the quality of education at Bahir Dar Health Science College, BahirDar, Ethiopia, 2021. Methods: A mixed method approach was employed from May 1- June 30, 2021. Systematic random sampling and purposive sampling methods were used to collect quantitative and qualitative data respectively. Self-administered questionnaires and in-depth key informant interviews were conducted. The data were analyzed via stata 14 and presented by descriptive frequencies and tables. Thematic analysis was employed for qualitative data. Results: Most instructors 26 (59.1%) are not satisfied with library services and 33 (75%) of them did not conduct a research project or participate in any community services. The findings also stated that the college has made its level best to improve the quality of education via the implementation of continuous assessment, active learning approach, remedial and affirmative action and training. Regarding students, half of them 166 (50.6%) are not comfortable with the college environment. Students were also greatly grouchy the services delivered in the college such as cafeteria, dormitory, student clinic and guidance and counseling. Conclusion: The study found out that there is a relatively low level of satisfaction among both groups and the quality of education is below the acceptable level. Therefore, the college should create an opportunity to engage in national and regional networks to share best practices in quality education and it requires the office to develop the capacity of their services.

Knowledge, Attitude and Practice of Mothers on Prevention and Control of Intestinal Parasitic Infestations in Sekota Town, Waghimra Zone, Ethiopia.

BACKGROUND: Intestinal parasites (IP) are a major public health problem in several developing countries. It accounts for 1.5 billion infections with one or more intestinal parasitic agents. The prevalence of helminthiases in Ethiopia is 29.8% with variable degree of prevalence among the different regions. Young children have a high infestation rate and suffer a substantial burden of Ascaris lumbricoides, Trichuris trichiura, and Schistosomes. Intestinal parasitic infections have serious consequences for human health; such as hepatomegaly, splenomegaly, esophageal varices, and delay in physical development. Therefore, this study was intended to assess mothers' knowledge, attitude, and practice on prevention and control of intestinal parasitic infestations. METHODS: A cross-sectional study was carried out on 378 mothers who had under six and over two year old children. Although 384 mothers were selected using sample size calculation, the data were collected from 378 mother-child pairs using a face to face interview-based questionnaire. The level of maternal knowledge, attitude, and practice are presented in the form of percentage, frequency, and tables. In order to ensure the quality of data, in all of the data collection, data analysis, and write up, a standard operational procedure was followed. RESULTS: The overall level of good maternal knowledge, positive attitude, and good practice in preventing and controlling intestinal parasitic infection concerning pre-school children in Sekota town was 45.2%, 55.3%, and 51.1% respectively. Seventy-seven (20.4%) respondents reported that they knew about A. lumbricoides, and 62 (16.4%) participants washed vegetables as a means of intestinal prevention. CONCLUSION: The overall level of optimum knowledge, attitude, and practice of mothers on prevention and control of intestinal parasites is significantly low. Therefore, community awareness about intestinal parasitic infestation prevention and control should be created through campaigns or structured training.

Prevalence and Determinants of Stunting Among Adolescent Girls in Ethiopia.

PURPOSE: The purpose of this study was to assess the prevalence of stunting and identify factors associated with it among adolescent girls in Ethiopia. DESIGN AND METHODS: From 15,683 women participants of the 2016 Ethiopian Demographic and Health Survey (EDHS), a sub-sample of 3,498 adolescents aged 15-19 years were selected; from which 2,733 adolescents who had a complete response to all variables of interest were retained for analysis. Variables were selected using conceptual framework. We used height-for-age Z-score index (HAZ) growth standards less than -2 to identify stunting. We adjusted for weights and sampling design. Bivariable and multivariable regression analysis was carried out. RESULTS: The prevalence of stunting was 410(15%); comprising of 353 (12.9%) moderate and 57(2.2%) severe stunting cases. The odds of being stunted among respondents living in Tigray (AOR = 3.38, 95%CI: 1.47, 7.79), Amhara (AOR = 2.66, 95%CI: 1.18, 6.012) and Addis Ababa (AOR = 4.24, 95%CI: 1.84, 9.79) were higher compared to respondents living in Dire-Dawa. Adolescent girls living in rural areas (AOR = 2.29, 95%CI: 1.10, 4.75) had higher odds of stunting compared to those living in urban areas. Adolescent girls from the lowest wealth quintile (AOR = 2.38, 95%CI: 1.56, 9.67) had higher odds of stunting compared to the highest wealth quintile. Respondents who have one child (AOR = 3.33, 95%CI: 5.78, 15.31), and two children (AOR = 4.01, 95% CI: 1.39, 7.73) had higher odds of being stunted compared to those who have no children. The odds of stunting among adolescent girls having no access to safe water supply (AOR = 3.17, 95% CI: 1.21-8.37) and having no access to hygienic toilet (AOR = 1.44, 95% CI: 1.17, 1.95) were higher compared to those having access to safe water supply and hygienic toilets respectively. CONCLUSIONS: The current study revealed that stunting is an important public health problem among adolescent girls in Ethiopia. PRACTICE IMPLICATIONS: Health care workers should screen nutritional status of adolescent girls and assess the risk factors of stunting giving emphasis to adolescent girls living in rural areas, who are within the lowest wealth quintile, who have children, and those who have no access to safe water supply and have no access to hygienic toilets.

Prevalence and risk factors of intestinal parasitic infestations among preschool children in Sekota town, Waghimra zone, Ethiopia.

BACKGROUND: Intestinal parasitic infestations triggered considerable gastrointestinal morbidity, malnutrition, and mortality worldwide. In particular, young children in developing countries affected most. Helminthiasis infestation accounts for 10-20% of prevalence on preschool children worldwide. Unfortunately, small children below 5 years are uniquely susceptible to intestinal parasitic infestations in poor communities. This is because of children's behavior like playing with soil and putting hand -to- mouth habit. Thus, the aim of this study was to assess the prevalence and risk factors of intestinal parasitic infestations among preschool children in Sekota town, Ethiopia. METHODS: A community-based cross-sectional study was carried out on 378 preschool children in Sekota town from February 15 - March 10/2019. Stool specimens were collected and examined for intestinal parasites using wet mount and formal ether concentration technique. The risk factors of intestinal parasites were assessed using a pretested structured questionnaire. The data were entered and analyzed using Epi-data version 4.2.0.0 and SPSS-version 23 statistical software respectively. Both bivariable and multivariable analysis was carried out, and potential co-linearity was tested for closely similar variables. Variables with P value less than 0.05 in multivariable analysis was considered as statistically significant and reported with 95% CI and odds ratio. RESULTS: The prevalence of intestinal parasitic infestations in Sekota town on wet mount and formal ether concentration techniques was 83(21.9%), (95% CI, 17.7-26.3%) and 113(29.9%), (95% CI, 25.1-34.8%) respectively. In multivariable analysis, not taking medication as periodical deworming (AOR, 95% CI), (2.5, 1.5-4.3), presence of animals in the living room (AOR, 95% CI) (3.1, 1.8-5.3), and being a government employee as an occupation (AOR, 95% CI), (3.4, 1.1-10.0) were increasing the odds of intestinal parasitic infestations. CONCLUSIONS: The prevalence of intestinal parasitic infestations in Sekota town is high, which is a public health problem. The risk factors that contributed to intestinal parasitic infestations in this study were preventable and modifiable. Therefore, the concerned bodies need to emphasis on periodical deworming and keeping animals in separate room.