Spatial distribution and determinants of exclusive breastfeeding practice among mothers of children under 24 months of age in Ethiopia: spatial and multilevel analysis.

BACKGROUND: Breast milk is the first, highly valuable, and solely natural food recommended for infants in their first six months of life, which is critical for children's overall growth and development. Evidence suggests that exclusive breastfeeding differs by geographic area in Ethiopia. However, little is known regarding the geographic distribution of exclusive breastfeeding practice. Hence, this study aimed to assess exclusive breastfeeding practice, its geographic variation and associated factors among Ethiopian mothers. METHOD: The study used the 2019 Ethiopian mini demographic and health survey data. All living children born 0-23 months before the survey were included. Global Moran's I statistics on Arc-GIS and Getis Ord Gi* statistics was used to visualize the spatial pattern and hotspot and cold spot areas, respectively. Kulldorff SaTScan was used to show purely significant spatial clusters. The associated factors were identified using a multilevel mixed-effects logistic regression model. Statistically significant factors were reported using the AOR with a 95% CI and a p-value of < 5%. RESULT: The coverage of exclusive breastfeeding practice in Ethiopia was 56.05% (95% CI: 53.95%, 58.10%). The spatial pattern was non-random across the country's regions. Somalia, Gambela, Benshangul Gumuz, Dire Dawa, and Harari regions had low clustering of exclusive breastfeeding practices, whereas Amhara, Eastern SNNPR, and Central and Northern Oromia regions had high clustering. Children born through caesarean delivery [AOR = 0.36; 95% CI: 0.21, 0.63], initiated breastfeeding within the first 1 h [AOR = 0.55; 95% CI: 0.34, 0.90], after 1-24 h of delivery [AOR = 0.36; 95% CI: 0.24, 0.54], after a day [AOR = 0.04; 95% CI: 0.02, 0.08], and women residing in the pastoralist region [AOR = 0.22; 95% CI: 0.12, 0.39] or city administrations [AOR = 0.49; 95% CI: 0.27, 0.89] had lower odds of exclusive breastfeeding practice. CONCLUSION: Exclusive breastfeeding practice in Ethiopia remained low. The practice had a spatial variation across the country. Caesarean section delivery, late breastfeeding initiation, and region were statistically significant variables. Therefore, promoting timely initiation of breastfeeding and improving the utilization of maternal health services and designing special intervention strategy for women residing in city administrations and pastoralist regions of the country may increase the coverage of exclusive breastfeeding practice.

Individual and community level factors associated with discriminatory attitudes against people living with HIV/AIDS among women of reproductive age in three sub-Saharan African countries: evidence from the most recent demographic and health survey (2021/22).

INTRODUCTION: HIV-related stigma and discrimination significantly affects health, and well-being, willingness to be tested for HIV, initiation and adherence to antiretroviral therapy, and quality of life. However, the findings of the prior studies revealed that the prevalence of discrimination against people living with HIV is high. Thus, we aimed to assess the magnitude of discriminatory attitudes against people living with HIV/AIDS and associated factors in three sub-Saharan African countries. METHODS: The appended and most recent Demographic and Health Survey dataset of three sub-Saharan African countries from 2021 to 2022 was used for data analysis. A total of 56,690 women aged 15-49 years were included in this study as a weighted sample. The determinants of discriminatory attitudes against people living with HIV/AIDS were determined using a multilevel mixed-effects logistic regression model. Significant factors associated with discriminatory attitudes against people living with HIV/AIDS in the multilevel mixed-effect logistic regression model were declared significant at p-values < 0.05. The adjusted odds ratio (AOR) and confidence interval (CI) were used to interpret the results. RESULT: The overall prevalence of discriminatory attitudes against people living with HIV/AIDS was 28.19% (95% CI: 27.74%, 28.64%). In the multivariable analysis, individual level (being young, being an internet user, being tested for HIV, and having comprehensive knowledge about HIV) and community level (being a rural dweller) were factors associated with discriminatory attitudes against people living with HIV/AIDS. CONCLUSION: The prevalence of discriminatory attitudes against people living with HIV/AIDS in three sub-Saharan African countries was high. Individual and community-level variables were associated with discriminatory attitudes against people living with HIV/AIDS. Therefore, special consideration should be given to rural dwellers and young adults. In addition, better to strengthen the accessibility of Internet and HIV testing services, and improve HIV-related education to reduce the magnitude of discriminatory attitudes against people living with HIV/AIDS.

Time to death and its predictors among adult patients on mechanical ventilation admitted to intensive care units in West Amhara comprehensive specialized hospitals, Ethiopia: a retrospective follow-up study.

INTRODUCTION: Mechanical ventilation is the most common intervention for patients with respiratory failure in the intensive care unit. There is limited data from African countries, including Ethiopia on time to death and its predictors among patients on mechanical ventilators. Therefore, this study aimed to assess time to death and its predictors among adult patients on mechanical ventilation admitted in comprehensive specialized hospitals in West Amhara, Ethiopia. METHODS: An institutional-based retrospective follow-up study was conducted from January 1, 2020, to December 31, 2022. A simple random sampling was used to select a total of 391 patients' charts. Data were collected using data the extraction tool, entered into Epi-data version 4.6.0, and exported to STATA version 14 for analysis. Kaplan-Meier failure curve and the log-rank test were fitted to explore the survival difference among groups. The Cox regression model was fitted, and variables with a p-value < 0.25 in the bivariable Cox regression were candidates for the multivariable analysis. In the multivariable Cox proportional hazard regression, an adjusted hazard ratio with 95% confidence intervals were reported to declare the strength of association between mortality and predictors when a p value is < 0.05. RESULTS: A total of 391 mechanically ventilated patients were followed for 4098 days at risk. The overall mortality of patients on mechanical ventilation admitted to the intensive care units was 62.2%, with a median time to death of 16 days (95% CI: 11, 22). Those patients who underwent tracheostomy procedure (AHR = 0.40, 95% CI: 0.20, 0.80), received cardio-pulmonary resuscitation (AHR = 8.78, 95% CI: 5.38, 14.35), being hypotensive (AHR = 2.96, 95% CI: 1.11, 7.87), and had a respiratory rate less than 12 (AHR = 2.74, 95% CI: 1.48, 5.07) were statistically significant predictors of time to death among mechanically ventilated patients. CONCLUSION: The mortality rate of patients on mechanical ventilation was found to be high and the time to death was short. Being cardiopulmonary resuscitated, hypotensive, and had lower respiratory rate were significant predictors of time to death, whereas patients who underwent tracheostomy was negatively associated with time to death. Tracheostomy is needed for patients who received longer mechanical ventilation, and healthcare providers should give a special attention for patients who are cardiopulmonary resuscitated, hypotensive, and have lower respiratory rate.

Acceptance of e-learning and associated factors among postgraduate medical and health science students at first generation universities in Amhara region, 2023: using modified technology acceptance model.

BACKGROUND: Electronic learning is the process of remote teaching and learning through the use of electronic media. There is a dearth of research on the factors influencing e-learning acceptance in Ethiopia using the modified technology acceptance model (TAM). Previous research appears to have overlooked the mediating impact of factors on e-learning acceptability Therefore, the present study aimed to assess the acceptance of e-learning and its associated factors among postgraduate medical and health science students by applying TAM at first-generation universities in the Amhara region. METHODS: This institutional-based cross-sectional study was conducted from March 15 to April 20, 2023, at Amhara First Generation University, Ethiopia. A total of 659 students participated in the study. A self-administered questionnaire in the Amharic language was used to collect the data. SEM analysis was employed to test the proposed model and the relationships among factors using SPSS version 25 and AMOS version 26. RESULTS: The proportion of postgraduate students who agreed to use e-learning was 60.7%, 95% CI (56.9-64.4). SEM analysis revealed that perceived ease of use (ß = 0.210, p < 0.001), attitude (ß = 0.377, p < 0.001) and perceived usefulness (ß = 0.330, p < 0.001) had positive direct relationships with acceptance of e-learning. Perceived usefulness (ß = 0.131, p < 0.001), and perceived ease of use (ß = 0.029, p < 0.01) significantly mediate the relationship between self-efficacy, and acceptance of e-learning. Accessibility had a positive indirect effect on acceptance of e-learning through perceived ease of use (ß = 0.040, p < 0.01). Facilitating condition had a positive indirect on acceptance of e-learning through perceived ease of use (ß = 0.070, p < 0.01), and perceived usefulness (ß = 0.084, p < 0.001). CONCLUSION AND RECOMMENDATION: Overall, the proportion of postgraduate students who accepted e-learning is promising. Perceived ease of use perceived usefulness, and attitude had positive direct effects on the acceptance of e-learning. Facilitating conditions and self-efficacy had positive indirect effects on the acceptance of e-learning. Thus, implementers need to prioritize enhancing the provision of devices, students' skills, and knowledge of e-learning by providing continuous support to improve students' acceptance of the use of e-learning.

Mortality and its determinants among patients attending in emergency departments.

BACKGROUND: Due to the high burden of mortality from acute communicable and non-communicable diseases, emergency department's mortality has become one of the major health indices in Ethiopia that should be evaluated regularly in every health institution. However, there are inconsistencies between studies, and there is no systematic review or meta-analysis study about the prevalence of mortality in the emergency department. Therefore, this study aimed to determine the pooled prevalence of mortality and identify its determinants in the emergency departments of Ethiopian hospitals. METHODS: This systematic review was conducted according to the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and has been registered with PROSPERO. A structured search of databases (Medline/PubMed, Google Scholar, CINAHL, EMBASE, HINARI, and Web of Science) was undertaken. All observational studies reporting the prevalence of mortality of patients in emergency departments of Ethiopian hospitals, and published in English up to December 16, 2023, were considered for this review. Two reviewers independently assess the quality of the studies using the Joanna Briggs Institute (JBI) critical appraisal tool. A meta-analysis using a random-effects model was performed to estimate the pooled prevalence. The heterogeneity of studies was assessed using I2 statistics, and to identify the possible causes of heterogeneity, subgroup analysis and meta-regression were used. Egger's test and funnel plots were used to assess publication bias. STATA version 17.0 software was used for all the statistical analyses. A p-value less than 0.05 was used to declare statistical significance. RESULTS: A total of 1363 articles were retrieved through electronic search databases. Subsequently, eighteen studies comprised 21,582 study participants were included for analysis. The pooled prevalence of mortality among patients in the Emergency Department (ED) was 7.71% (95% CI: 3.62, 11.80). Regional subgroup analysis showed that the pooled prevalence of mortality was 16.7%, 12.89%, 10.28%, and 4.35% in Dire Dawa, Amhara, Oromia, and Addis Ababa, respectively. Moreover, subgroup analysis based on patients' age revealed that the pooled prevalence of mortality among adults and children was 8.23% (95% CI: 3.51, 12.94) and 4.48% (95% CI: 2.88, 6.08), respectively. Being a rural resident (OR; 2.30, 95% CI: 1.48, 3.58), unconsciousness (OR; 3.86, 95% CI: 1.35, 11.04), comorbidity (OR; 2.82, 95% CI: 1.56, 5.09), and time to reach a nearby health facility (OR; 4.73, 95% CI: 2.19, 10.21) were determinants of mortality for patients in the emergency departments. CONCLUSION AND RECOMMENDATIONS: This study found that the overall prevalence of mortality among patients in emergency departments of Ethiopian hospitals was high, which requires collaboration between all stakeholders to improve outcomes. Being a rural resident, unconsciousness, comorbidity, and time elapsed to reach health facilities were determinants of mortality. Improving pre-hospital care, training healthcare providers, early referral, and improving first-line management at referral hospitals will help to reduce the high mortality in our country.

Knowledge, practice and associated factors of infection prevention among healthcare workers in Debre Markos referral hospital, Northwest Ethiopia.

BACKGROUND: Healthcare-associated infections are a major global public health agenda. Health care workers are front line of protecting themselves and clients from infection. This study examined the knowledge and practice of healthcare workers on infection prevention and its associated factors among health professionals working at Debre Markos Referral Hospital. METHODS: A Hospital-based cross-sectional study was conducted with a structured pre-tested questionnaire among 150 participants. The healthcare workers were selected through systematic random sampling technique. Multivariate logistic regressions were computed to identify associated factors of knowledge and practice of infection prevention and variables with a p-value < 0.05 were considered statistically significant. RESULTS: More than two thirds (84.7%) of healthcare workers were found to be knowledgeable but only 86 (57.3%) of respondents demonstrated a good practice on infection prevention. Older age, lengthy work experience and higher educational status were significantly associated with both knowledge and practice of infection prevention. In-service training, availability of infection prevention supplies and adherence to infection prevention guidelines was also associated with the practice of infection prevention. CONCLUSIONS: The finding of this study revealed a good knowledge of infection prevention on the majority of participants with relatively minimal practice rate. Sociodemographic factors and health facility factors were associated with knowledge and practice of infection prevention. Hospitals and other concerned stakeholders should ensure constant availability of guidelines and the provision of training to health providers. Moreover, developing professionals' educational level, introducing infection prevention standard of practice and continuous mentorship was recommended.

Prevalence and types of elder abuse in Sub Saharan Africa, systematic review and meta-analysis, 2023.

BACKGROUND: Elder abuse is a single or repeated act, or lack of appropriate action, which causes harm to an older person. This systematic review and meta-analysis aimed to assess the prevalence of elder abuse in Sub Saharan Africa. METHODS: This systematic review and meta-analysis involved a comprehensive search of electronic databases, including PubMed, Scopus, Web of Science, African Journals Online and Google Scholar. Cochrane I2 statistics and Eggers test with funnel plot were done to check heterogeneity and publication bias, respectively. RESULT: Five studies with 2123 elderly people aged 60 and above were included in this review. The pooled prevalence of elder abuse was (46.73 % (45.08-48.38)) with a substantial level of heterogeneity (I2 =99.7 %; p < 0.001). To overcome the effect of high level heterogeneity subgroup analysis was deployed. Accordingly, the subgroup analysis by publication year revealed that the prevalence of elder abuse was highest among studies conducted after 2018 (64.034 (95 % CI: 12.66, 115.4). Similarly, sub-group analysis by country revealed that the prevalence of elder abuse was highest in Ethiopia (63.2(21.276, 105.124).The subgroup analysis by the sampling technique revealed that elder abuse was highest among studies conducted using systematic random sampling technique (84.57 (95 % CI: 79.22, 89.92). Subgroup analysis by type of abuse revealed that physical abuse was highest (29.27 (-7.854, 66.394)) CONCLUSION: The pooled prevalence of elder abuse was high and, physical abuse was the commonest type of abuse. As a result, there should be awareness creation about the caring of elders to minimize abuse.

Recurrence and associated factors of breast cancer among women in sub saharan africa, systematic review and meta-analysis.

BACKGROUND: Recurrence of breast cancer is a critical indicator of disease progression and survival rates. Therefore, this systematic review and meta-analysis aimed to assess the prevalence of recurrence and associated factors of breast cancer in Sub Saharan Africa. METHODS: We conducted a thorough search of the following international databases between January 1 and February 7, 2024: PubMed, EMBASE, CINAHL, Google Scholar, Science Direct, and the Cochrane Library. A data extraction format was used by two authors to independently extract all required data. STATA Version 14 was used to evaluate the quantitative data and the Cochrane Q test statistics and I2 test were used to evaluate the heterogeneity among the included studies using a random effects meta-analysis model. RESULTS: The overall prevalence of breast cancer recurrence is 27.44 % (95%CI: 26.41, 28.46). The highest prevalence was found in Uganda (89.927 % (87.0, 92.851)), followed by Tanzania (82.174 % (77.228, 87.120)). Involved deep surgical margin (OR: 3.62, 95 % CI: 2.11, 5.12), positive lymph node status (OR: 6.85, 95 % CI: 1.42, 12.3)), and histological grade III (OR: 7.43, 95 % CI: 3.56, 11.3)) were all significantly associated factors. CONCLUSION: The pooled prevalence of breast cancer recurrence in this review was significantly high. Histological grade III, positive lymph node statuses, clinical staging III, and involved deep surgical margin were associated factors. Therefore, frequent monitoring, regular screenings, imaging tests, and consultations with oncologists, take extra care to ensure clear and deep surgical margins using advanced imaging techniques are highly recommended.

Prolonged time to recovery and its predictors among trauma patients admitted to the intensive care units in comprehensive specialized hospitals in Northwest Ethiopia: a multicenter retrospective follow-up study, 2022.

Introduction: A prolonged time to recovery in the intensive care units has adverse effects on both the patients and the healthcare providers. However, there is limited evidence in African countries, including Ethiopia. Therefore, this study aimed to assess the time to recovery and its predictors among trauma patients admitted to intensive care units. Methods: An institutional-based retrospective follow-up study was conducted on trauma patients hospitalized in intensive care units between 9 January 2019 and 8 January 2022. The charts of 450 patients were chosen using a simple random sampling technique. Data collection was conducted using smartphones and tablets. The data were then exported into STATA version 16 for analysis. The log-rank test and the Kaplan-Meier survival curve were fitted for analysis. An adjusted hazard ratio with 95% confidence intervals was reported to declare the strength of association between time to recovery and predictors in the multivariable Weibull regression analysis. Results: The overall incidence density rate of recovery was 6.53 per 100 person-day observations, with a median time to recovery of 10 days. Significant predictors of time to recovery included being on mechanical ventilation (AHR = 0.47, 95% CI: 0.34, 0.64), having a Glasgow Coma Scale (GCS) score between 9-12 and 13-15 (AHR = 1.58, 95% CI: 1.01, 2.47, and AHR = 1.66, 95% CI: 1.09, 2.53, respectively), experiencing polytrauma (AHR = 0.55, 95% CI: 0.39, 0.78), and having complications (AHR = 0.43, 95% CI: 0.31, 0.59). Conclusion and recommendations: The incidence rate of recovery for trauma patients is lower than the national standard, and the median time to recovery is longer. Being on mechanical ventilation, mild and moderate GCS scores, polytrauma, and the presence of complications were significantly associated with prolonged time to recovery. Therefore, special attention has to be given to trauma patients who had polytrauma, complications, received mechanical ventilation, and had a lower GCS score.

Patterns, Clinical Outcome, and Factors Associated with Poisoning Outcomes among Poisoned Patients in Northwest Ethiopia.

Introduction: Poison is a substance that can hurt or cause dysfunction in the body due to its chemical action. Poisoning related to pesticides used in agriculture is a major public health issue in developing countries. However, there is a limited epidemiological data on poisoning in Ethiopia. Objective: The aim of this study was to determine poisoning patterns, clinical outcome, and factors associated with poisoned patients in Northwest Ethiopia. Methods: A cross-sectional study was conducted in July 2021 to include data of 1 year period. Data of all poisoned patients were collected using a standardized checklist from the registration book and patient medical records. The association between variables and outcomes was analyzed using a multivariable logistic regression model. A p-value of < 0.05 was considered to declare a statistically significant association. Result: Over one-third of the poisoning cases (35.9%) were seen in the spring, according to a survey of 315 patient medical data. The majority of patients were in the age group of 21-30 years (44.1%). The most common form of poison consumed was organophosphate (OP), which accounts for 61.3% of all visits, and the least common was food poisoning, which accounts for 1.9%. About 82.5% of poisoning cases survived, while the remaining 17.5% were died. Time of arrival to the hospital ≥1 h (adjusted odds ratio (AOR) = 7.02; 95% confidence interval (CI): 1.16, 11.40), lack of oxygen support (AOR = 6.64; 95% CI: 3.56-6.78), and lack of adrenaline/dopamine medication (AOR = 3.57; 95% CI: 1.17-5.78) were all substantially linked with death of poisoned cases. Conclusions: Three-fourth of poisoning cases survived, while the remaining one-fourth died. Ingestion of OPs is the most prevalent type of poisoning, and most cases are intentional. Delayed arrival ≥1 h, lack of oxygen support, and adrenaline/dopamine treatment were all linked to death. On-time arrival, oxygen assistance, and adrenaline/dopamine treatment in a healthcare setting are all recommended.

Oxygen therapy practice and associated factors among nurses working at an Ethiopian Referral Hospital.

Objective: Supplemental oxygen therapy is suppling oxygen at quantities higher than those found in the atmosphere (>21 %) and is mostly prescribed for hypoxic patients. To avoid hypoxemia, hypercapnia, and oxygen poisoning, nurses closely monitor patients receiving oxygen therapy. There are considerable gaps in nurses' practice of oxygen therapy. Patients who receive inappropriate oxygen therapy may have negative effects, and it has financial repercussions for both individuals and nations. The aim of this study was to assess oxygen therapy practices and associated factors influencing oxygen administration among nurses in an Ethiopian Regional Hospital. Method: From March 1 to March 30, 2019, a cross-sectional institutional study using quantitative methods was performed amongst nurses working at a referral hospital in northwestern Ethiopia. Data was gathered using structured self-administered questionnaires. Result: In this study, 147 participants (91.3 %) were found to have inadequate practice with oxygen therapy. Nurses' lack of knowledge about carbon monoxide, adult patients' typical breathing rates, cardiopulmonary function, and devices (face mask, nasal cannula, oxygen concentrators, pulse oximeter and others) that are difficult for patients to accept were found to be factors associated with oxygen administration practice. Conclusion: The findings of this study showed that nurses' use of oxygen administration was subpar. The institutional factors, knowledge gaps, and attitudes of nurses were identified as the determinants affecting oxygen administration practice. Nurses would do better to read up on oxygen administration, interact with one another and undertake further training.

Sleep quality among patients with chronic illness in Ethiopia: systematic review and meta-analysis.

Background: Poor sleep quality impedes the progression of chronic illnesses, while chronic illnesses themselves are caused by poor sleep quality. Despite this fact, there is no research that has been conducted in Ethiopia that provides a thorough estimate of the self-reported sleep quality among patients with chronic illnesses. In order to present a complete picture of poor sleep quality among diabetes, hypertension, heart failure, cancer, HIV/AIDS and epilepsy patients, this systematic review and meta-analysis was carried out. Methods: Systematic review and meta-analysis was conducted to estimate the quality of sleep among patients with chronic illness in Ethiopia. The Preferred Reporting Items for Systematic Review and Meta Analysis standard was followed in the reporting of this systematic review and meta-analysis. An extensive exploration of digital repositories, including PubMed, EMBASE, Cochrane, Africa Journal of Online, Google Scholar, and an advanced Google search, was conducted to obtain published studies until December 1st, 2023 detailing poor sleep quality of patients with chronic illness. STATA version 17 commands were used to create the pooled estimate. The I2 test and Egger's test, respectively, were used to identify the presence of heterogeneity and publication bias. To manage heterogeneity, a subgroup analysis and random effect model were used. Results: A total 21 articles with a total of 7393 participants were included in the final systematic review and meta-analysis. The pooled estimate of poor sleep quality among patients with chronic illness was 52% (95% of CI: 48%, 59%; I2 = 97.26%). In subgroup analysis, the highest pooled estimate of poor sleep quality was observed in cancer patients 63% (95% CI: (95% CI: 45% - 80%). Regarding to data collection period, the highest pooled estimate of poor sleep quality was seen during spring 68% (95% CI: 42% - 94%). Conclusions: Patients with chronic illnesses in Ethiopia had a high pooled estimate of poor sleep quality. Patients with cancer had the highest pooled estimate of poor-quality sleep compared with other patients. Patients with chronic illnesses had trouble sleeping in the spring, according to this systematic review and meta-analysis. Therefore, attention and intervention should be given to enhance the quality of sleep for patients with chronic illnesses.

Prevalence of mortality among mechanically ventilated patients in the intensive care units of Ethiopian hospitals and the associated factors: A systematic review and meta-analysis.

BACKGROUND: In the intensive care unit (ICU), mechanical ventilation (MV) is a typical way of respiratory support. The severity of the illness raises the likelihood of death in patients who require MV. Several studies have been done in Ethiopia; however, the mortality rate differs among them. The objective of this systematic review and meta-analysis is to provide a pooled prevalence of mortality and associated factors among ICU-admitted patients receiving MV in Ethiopian hospitals. METHODS: We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 criteria to conduct a comprehensive systematic review and meta-analysis in this study. We searched PubMed/Medline, SCOPUS, Embase, Hinari, and Web of Science and found 22 articles that met our inclusion criteria. We used a random-effects model. To identify heterogeneity within the included studies, meta-regression and subgroup analysis were used. We employed Egger's regression test and funnel plots for assessing publication bias. STATA version 17.0 software was used for all statistical analyses. RESULTS: In this systematic review and meta-analysis, the pooled prevalence of mortality among 7507 ICU-admitted patients from 22 articles, who received MV was estimated to be 54.74% [95% CI = 47.93, 61.55]. In the subgroup analysis by region, the Southern Nations, Nationalities, and Peoples (SNNP) subgroup (64.28%, 95% CI = 51.19, 77.37) had the highest prevalence. Patients with COVID-19 have the highest mortality rate (75.80%, 95% CI = 51.10, 100.00). Sepsis (OR = 6.85, 95%CI = 3.24, 14.46), Glasgow Coma Scale (GCS) score<8 (OR = 6.58, 95%CI = 1.96, 22.11), admission with medical cases (OR = 4.12, 95%CI = 2.00, 8.48), Multi Organ Dysfunction Syndrome (MODS) (OR = 2.70, 95%CI = 4.11, 12.62), and vasopressor treatment (OR = 19.06, 95%CI = 9.34, 38.88) were all statistically associated with mortality. CONCLUSION: Our review found that the pooled prevalence of mortality among mechanically ventilated ICU-admitted patients in Ethiopia was considerably high compared to similar studies in the United States (US), China, and other countries. Sepsis, GCS<8, medical cases, MODS, and use of vasopressors were statistically associated with mortality. Clinicians should exercise caution while mechanically ventilating ICU-admitted patients with these factors. However, it should be noted that the exact cause and effect relationship could not be established with this meta-analysis, as the available evidence is not sufficient. Thus, more studies using prospective methods will be required.

Mortality of acute poisoning and its predictors in Ethiopia: A systematic review and meta-analysis.

Introduction: Poison is defined as any chemical that has the potential to affect or harm human physiology due to its chemical activity. Poisoning is becoming a major preventable public health issue in many countries, including Ethiopia. There is a variation in acute poisoning mortality among the existing evidence in Ethiopia. This study aims to determine the pooled mortality rate from acute poisoning and its predictors in Ethiopia. Methods: We searched available evidence of acute poisoning mortality in databases such as PubMed, Hinari, Cochrane, ScienceDirect, and other search engines. Using the Microsoft Excel data extraction form, three authors independently extracted all relevant data. The Higgins I2 test statistics were used to examine heterogeneity among included studies A random-effects model was used to analyze the pooled estimates and predictors in Stata MP version 17. Results: We retrieved 2685 relevant records from different database sources, and after screening, 21 studies (17 published and 4 unpublished) were included. The pooled mortality rate for acute poisoning was 4.69(95 % CI: 3.69, 5.69 I2 = 94.7 %). The most common poisoning agents are organophosphate (29.9 %), household cleansing agents (17.5 %), and pharmaceuticals/medications (9.3 %). The majority of poisoning cases were intentional poisoning committed suicide. Poisoning cases in rural areas [RR: 3.98(95 % CI: 1.41, 11.25)] and delayed arrival times [RR: 2.90(95 % CI: 1.45, 5.84)] were identified predictors of mortality. Conclusions: In this study, the pooled mortality from acute poisoning was 4.69 %. Poisoned cases from rural areas and delayed arrival times to the hospital were predictors of mortality. To prevent mortality, healthcare professionals should give special attention to rural residents and delayed arrival of poison cases. To control this avoidable death, poison control centers should be strengthened, and other preventive measures implemented at the national level.

Ineffective breastfeeding techniques and associated factors among breastfeeding mothers who gave birth in the last 6 months in Sinan Woreda, Northwest Ethiopia.

Background: Optimal infant feeding is critical for children's growth and development during their first years of life. Plenty of evidence on ineffective breastfeeding techniques, yet the problem is still deep-rooted and requires further research in Ethiopia. Objective: To determine the proportion of ineffective breastfeeding techniques and associated factors among breastfeeding mothers who gave birth in the last 6 months in Sinan Woreda. Design and methods: A community-based cross-sectional study was conducted from March 10 to April 8, 2021 with a total of 389 samples. A computer-generated simple random sampling was used to select mothers. An observational checklist and interviewer-administered questionnaires were used. EpiData 4.2 for data entry and SPSS 25 for cleaning and analysis were used. Variables with a p-value < 0.05 and 95% confidence interval (CI) corresponding adjusted odds ratio (AOR) were used to identify factors of ineffective breastfeeding techniques. Results: The proportion of ineffective breastfeeding techniques was 66.8%. The mean (SD) age of mothers was 29.4 ± 5.95 years. No formal education [AOR: 5.88 (95% CI: (2.97, 11.65)], primipara [AOR: 4.34 (95% CI: 2.25, 8.36)], home delivery [AOR: 3.02 (95% CI: 1.12, 8.14)], not received breastfeeding counseling during antenatal care [AOR: 4.94 (95% CI: 1.83, 13.36)], breast problem [AOR: 2.62 (95% CI: 1.25, 5.48)], and breastfeeding experience [AOR: 1.82 (95% CI: 1.01, 3.28)] were statistically significant factors. Conclusions: The proportion of ineffective breastfeeding techniques 66.8% was unacceptable. Socio-demographic and maternal health care services were identified factors. Strengthening maternal care, improving health education and promotions, and designing appropriate strategies were required.

Level of emergency and disaster preparedness of public hospitals in Northwest Ethiopia: A cross-sectional study.

Background: From time to time, the magnitude and type of health emergencies and disasters are increasing. Hospital emergency and disaster preparedness, on the other hand, is still in its early stages in many low- and middle-income countries. In Ethiopia, research on hospital disaster preparedness is severely limited. As a result, the purpose of this study was to determine the level of hospital emergency and disaster preparedness at public hospitals in the east Gojjam zone of Northwest Ethiopia. Methods: A census method was used to include ten hospitals in the East Gojjam zone in a cross-sectional descriptive study. An adopted World Health Organization observation checklist was used to assess disaster and emergency preparedness. Each question was assigned a score out of three points, with one indicating low readiness and three indicating the highest level of preparation. Finally, the level of preparedness was classified as "low" if the average percentage score ranged from 33.3% to 66.6 %, and as "high" if the percentage score ranged from 66.7 % to 100 %. The results were then presented in the form of texts, tables, and percentages. Results: The evaluated hospitals' overall level of emergency and disaster preparedness falls into the low category, with an average calculated preparedness score of 54.75 %. The domain with the lowest preparedness is logistics and finance (43.33 %), while the domain with the highest preparedness is patient care and support services (60 %). Conclusion: According to the findings of this study, the level of emergency and disaster preparedness in the hospitals studied is low. It is therefore recommended that the ministry of health, regional health bureaus, and hospital administrators collaborate to develop an appropriate intervention strategy to address this issue.

A systematic review and meta-analysis of women's satisfaction with skilled delivery care and the associated factors in Ethiopia.

Evidence of variation in maternity health service practices has increased the government's interest in quantifying and advancing the quality of institutional delivery care in the developing world, including Ethiopia. Therefore, we conducted a systematic review and meta-analysis to update and provide more representative data on women's satisfaction with skilled delivery care and the associated factors in Ethiopia. This systematic review and meta-analysis followed the Preferred Reporting Items 2015 guideline. We searched PubMed/Medline, SCOPUS, Embase, Web of Science, and Google Scholar electronic databases for all 36 included studies. The pooled prevalence of women's satisfaction with skilled delivery care and the associated factors were estimated using a random-effects model. Subgroup analysis and meta-regression were performed to identify the source of heterogeneity. Furthermore, publication bias was checked using eggers and funnel plots. All statistical analyses were performed using STATA version 14.0 software. The pooled prevalence of women's satisfaction with skilled delivery care was 67.31 with 95% confidence interval (60.18-74.44). Wanted pregnancy (adjusted odds ratio = 2.86, 95% confidence interval: (2.24-3.64)), having a plan to deliver at a health facility (adjusted odds ratio = 2.09, 95% confidence interval: (1.42-3.09)), access to ambulance service (adjusted odds ratio = 1.52, 95% confidence interval: (1.00-2.31)), waiting time < 15 min (adjusted odds ratio = 3.66, 95% confidence interval: (2.51-5.33)), privacy assured (adjusted odds ratio = 3.94, 95% confidence interval: (2.23-6.94)), short duration of labour < 12 hr (adjusted odds ratio = 2.55, 95% confidence interval: (1.58-4.12)), proper labour pain management (adjusted odds ratio = 3.01, 95% confidence interval: (1.46-6.22)), and normal newborn outcome (adjusted odds ratio = 3.94, 95% confidence interval: (2.17-7.15)) were associated with women's satisfaction. Almost two-thirds of women were satisfied with skilled delivery care. In comparison, the remaining one-third were not satisfied with the care. The quality of intrapartum care, unwanted pregnancy, lack of ambulance services, prolonged duration of labour, poor labour pain management, and complicated newborn outcome were factors affecting women's satisfaction with skilled delivery care in Ethiopia. Therefore, strategies need to be developed to increase the satisfaction level by considering the abovementioned factors during routine delivery care.

COVID-19-related attitude and risk perception among pregnant women attending antenatal care, and the associated factors, at public health facilities of East Gojjam Zone, Ethiopia, 2020: a multi-center cross-sectional study.

Aim: This study aimed to assess COVID-19 (coronavirus disease 2019)-related attitude and risk perception among pregnant women attending antenatal care, and the associated factors, at public health facilities of the East Gojjam Zone, Ethiopia. Subjects and methods: A multi-center cross-sectional study was conducted, from December 1-30, 2020. A total of 847 pregnant women were included in the study using a simple random sampling technique. To collect the data, we used an interviewer-administered questionnaire. Bi-variable and multi-variable logistic regression analyses were used to identify factors associated with pregnancy-related anxiety. A p-value of < 0.05 with a 95% confidence level was used to declare statistical significance. Results: The magnitude of COVID-19-related positive attitude and high-level risk perception among pregnant women was 51.12% and 37.2% respectively. Having adequate knowledge [AOR: 2.09, 95% CI = (1.49-2.95)], ≥ 3 ANC visits [AOR: 1.43, 95% CI = 1.0-1.98], and a low level of risk perception [AOR: 6.27, 95% CI = (4.42-8.89)] were factors associated with a positive attitude of pregnant women with regard to the COVID-19 pandemic. Being urban residents [AOR: 2.24, 95% CI: 1.6-3.10], having wanted pregnancy [AOR: 3.35, 95% CI: 1.18-9.49], having a negative attitude [AOR: 6.21, 95% CI: 4.43-8.70], and a complicated pregnancy [AOR: 1.67, 95% CI: 1.02--2.75] were factors significantly associated with risk perception of pregnant women with regard to the COVID-19 pandemic. Conclusions: Despite its high fatality, COVID-19 pandemic-related attitude and risk perception among pregnant women were low. As a result, health caregivers and other concerned bodies should consider interventions to improve pregnant women's risk perception and attitude during antenatal care and through various community information platforms. Supplementary Information: The online version contains supplementary material available at 10.1007/s10389-022-01797-x.

Familiarity with emergency preparedness and its predictors among nurses and physicians working at public hospitals in east Gojjam zone, northwest Ethiopia.

Objective: Emergency preparedness and response operations for all types of catastrophes rely heavily on healthcare facilities and their staff. On the other hand, hospital employees suffer significant gaps in emergency preparedness knowledge and skills when it comes to treating mass casualties. The objective of this study was to assess the nurses' and physicians' familiarity with emergency preparedness and identify the associated factors. Methods: A facility-based cross-sectional survey was conducted by census utilizing a self-administered questionnaire among all nurses and physicians working in emergency departments in East Gojjam zone public hospitals. The collected data were entered into Epi-data version 4.2 and exported to SPSS 25.0 for further analysis. Frequency, mean, and standard deviation were computed to describe individual and other characteristics of the sample. A simple and multiple linear regression model was fitted to identify factors associated with familiarity with emergency preparedness. An unstandardized adjusted beta (ß) coefficient with a 95 % confidence level was used to report the result of the association at a p-value of 0.05 statistical significance. Results: In this study, a total of 237 individuals completed the questionnaire, yielding a response rate of 94 %. The mean score of familiarity with emergency preparedness was 106.1 ± 31.8 (95% CI: 102, 110.1), with approximately 52.3 % scoring higher than the mean score. Self-regulation (B = 3.8, 95% CI: 2.6, 5), health care climate (B = 1.4, 95% CI: 0.4, 2.43) and participation in actual major disaster event (B = 15.5, 95% CI: 7.8, 23.2) were significant predictors of familiarity. Conclusion: According to the findings of this study, nurses' and physicians' expertise in emergency and disaster preparedness is inadequate. Previous engagement in actual disaster events, self-regulation, and the healthcare climate were significant predictors of familiarity. As a result, the responsible stakeholders should develop strategy to enhance self-regulation (motivation), job satisfaction of emergency department employees, and drills and hands-on training in mass casualty management.

Treatment adherence and associated factors among glaucoma patients attending Ophthalmic units of referral hospitals in North West Ethiopia, 2019.

Objective: Glaucoma is one of the common eye disorders resulting from optic neuropathy, which leads to irreversible blindness if left untreated. Poor adherence to glaucoma medical treatments typically leads to some serious consequences, such as progressive visual impairment and blindness. The aim of this study was to assess adherence to treatment and associated factors among patients with glaucoma attending at Northwest Ethiopia referral hospitals. Method: From March 1st to April 30th, 2019, an institution-based cross-sectional study was conducted on 382 consecutive glaucoma patients attending at Northwest Ethiopia referral hospitals. Data about adherence to glaucoma treatment was collected by using a standardized tool, the Morisky Medication Adherence Scale-8, through an interviewer-administered questionnaire. Each collected data set was coded and entered into Epi-Data version 4.2, and analysis was done by using STATA version 14.0 statistical software. A logistic regression model was fitted to assess the effect of an independent variable on the dependent variable. A p-value < 0.05 was considered to declare a statistically significant association. The study proposal was approved by the Debre Markos University ethical review committee. Results: Among the study participants, 189 (49.5%) were adherent to glaucoma treatment. In this study, occupation (farmer), good knowledge, favorable attitude, a short distance from patients' homes to hospitals, and scheduling problems for glaucoma medical follow-up visits were significant factors associated with adherence to glaucoma treatments. Conclusion: The study has identified the adherence level as being low. Patient related factors and health care system related factors were significantly associated with adherence to glaucoma treatments. Appropriate patient education and planning a patient follow-up strategy might improve patients' adherence to glaucoma treatment. Care providers should place emphasis on the importance of adherence.