Antenatal care dropout and associated factors among mothers delivering in public health facilities of Dire Dawa Town, Eastern Ethiopia.

INTRODUCTION: More than two-thirds of the pregnant women in Africa have at least one antenatal care contact with a health care provider. However, to achieve the full life-saving potential that antenatal care promises for women and babies, four visits providing essential evidence-based interventions - a package often called focused antenatal care are required. Hence, identifying the factors associated with dropout of maternal health care utilization would have meaningful implications. The study aimed to assess antenatal care dropout and associated factors among mothers delivering in the public health facilities of Dire Dawa town, Ethiopia. METHODS: Facility-based cross-sectional study was conducted from January 1 to 30, 2020. Proportionate sampling and simple random sampling techniques were used to select 230 women. Data were collected using a structured and pretested interview administered questionnaire during delivery. The data were entered into Epidata version 3.1 and analyzed using SPSS version 20. A binary logistic regression model with a 95 % confidence interval was used to analyze the results. Bivariable analysis (COR [crude odds ratio]) and multivariable analysis (AOR [adjusted odds ratio]) was used to analyze the results. From the bivariable analysis, variables with a p-value < 0.25 were entered into the multivariable logistic regression analysis. From the multivariable logistic regression analysis, variables with a significance level of p-value < 0.05 were taken as factors independently associated with ANC dropout. RESULT: The proportion of antenatal care dropouts was 86 (37.4 %) (95 % CI: 31.3-43.9). In logistic regression analyses, those who had no past antenatal care follow up were more likely to have ANC dropout (AOR = 7.89; 95 % CI: 2.109-29.498) and those who had no professional advice were more likely to have antenatal care dropout (AOR = 4.64 95 % CI: 1.246-17.254). CONCLUSIONS: This study indicates that a high number of women had antenatal care dropout. Having no past ANC follow-up and professional advice were the major factors of ANC service utilization dropout. Hence, giving more information during the ANC visit is important to reduce the dropout rate from the maternity continuum of care.

Prediction of Body Height Using Hand Length and Hand Breadth in Pharmacy and Nursing Students at Misrake Ghion College, Northeast Ethiopia: An Anthropometry Study.

Objectives: To predict body height using hand length and hand breadth in pharmacy and nursing students at Misrake Ghion College, Northeast Ethiopia. Methods: A cross-sectional prospective study was conducted from October 15 to January 20, 2021. The study was carried out on 316 students (160 males and 156 females). The study participants were from the Amhara ethnic groups, with the age range of 18 to 25 years. Body height, hand length, and hand breath were measured and analyzed using SPSS version 23. The strength of association was evaluated using correlation analysis. The significance level was set at p < 0.05. A paired sample t test was performed. Regression equations were derived using simple and multiple linear regression analysis. Results: Hand length and hand breadth had a positive significant correlation with body height in both male and females. In both males and females, left hand length had a strong significant correlation (males r = 0.768, females r = 0.670), followed by right hand length (males r = 0.711, females r = 0.626). Regarding hand length, right hand breadth (males r = 0.671, female r = 0.438) and left hand length (males r = 0.504, females r = 0.525). There was a significant bilateral difference in hand length and hand breadth on its right and left sides (p < 0.05). Simple and multiple regression equations were formulated for each sex. Conclusion: In both males and females, body height can be estimated from hand length and breadth using simple or multiple regression equations.

Undiagnosed hypertension and associated factors among long-distance bus drivers in Addis Ababa terminals, Ethiopia, 2022: A cross-sectional study.

INTRODUCTION: Hypertension is a major public health problem that is often unrecognized, and its detection and control should be prioritized. The level of undiagnosed hypertension and its associated factors among long-distance bus drivers in Ethiopia is unknown. OBJECTIVE: This study aimed to assess the magnitude of undiagnosed hypertension and its associated factors among long-distance bus drivers in Addis Ababa bus terminals. METHODS: A facility-based cross-sectional study was conducted on 391 long-distance bus drivers from December 15, 2021, to January 15 2022 at five cross-country bus terminals in Addis Ababa. A standardized and structured questionnaire was adapted based on the WHO stepwise approach to a non-communicable disease study and translated into Amharic. Data were coded, cleaned, and entered using Epi-data version 4.6 and exported to SPSS version 26. Logistic regression analysis was performed. Variables with a P-value < 0.25 in the bivariable analysis were selected for multivariable logistic regression analysis. Independent variables with a P-value < 0.05 were considered statistically significant. The magnitude of association between independent and dependent variables was measured by odds ratio with a 95% confidence interval. RESULTS: In this study, 391 study participants were involved with a response rate of 97.1%. The prevalence of undiagnosed hypertension was 22.5% (CI: 18.7%, 26.6%). Poor level of knowledge (AOR: 2.00, CI: 1.08, 3.70), long duration of driving per day (AOR: 2.50, 95% CI: 1.37-4.56), habit of chewing of chat (AOR: 2.61, 95% CI: 1.44, 4.73), regular alcohol consumption (AOR = 3.46; 95% CI: 1.70, 7.05), overweight (AOR:3.14, 95%CI: 1.54,6.42) obesity (AOR: 3.21, 95% CI 1.35, 7.61) and regular physical exercise (AOR: 0.16, 95% CI: 0.09, 0.29) were statistically significantly associated with undiagnosed hypertension. CONCLUSION: This study revealed that the prevalence of undiagnosed hypertension among long-distance bus drivers was 22.5%, which was associated with modifiable behavioral factors, lack of regular physical exercise, lack of adequate awareness and high body mass index. RECOMMENDATION: Stakeholders must implement the necessary preventive measures. These include increasing the level of awareness of hypertension among long-distance drivers and developing prevention of hypertension strategies and policies focusing on lifestyle and behavioral modifications.

Bacterial profile and extended spectrum beta lactamase screening of urinary tract infection among asymptomatic and symptomatic pregnant women attending antenatal care in ALERT Hospital, Addis Ababa, Ethiopia.

Introduction: The occurrence of extended spectrum beta lactamase-producing uropathogens, especially in pregnant women can result in life-threatening condition and morbidity for both the mother and the newborn due to very limited drug options for treatment of these pathogens. The aim of this study was to determine the bacterial profile, associated factors, and their antimicrobial susceptibility patterns and to identify extended spectrum beta lactamase-producing bacterial uropathogens. Methods: A hospital-based cross-sectional study was conducted from July to September 2018 on a total of 177 pregnant women with and without symptoms of urinary tract infection at ALERT Hospital, Addis Ababa, Ethiopia. From these study participants, 72 have symptoms, whereas 105 have no symptoms. All urine samples were inoculated onto cysteine lactose electrolyte deficient medium and MacConkey agar. Colonies were counted to check the presence of significant bacteriuria. Pure isolates of bacterial pathogen were characterized and identified at species level by colony morphology, gram stain, and standard biochemical procedures. All Gram-negative isolates were put into Muller-Hinton agar plates for antibiotic susceptibility test by Kirby-Bauer disc diffusion technique. Extended spectrum beta lactamase was detected using double-disk synergy methods on Muller-Hinton agar. The data were double entered into epidemiological Information system and analyzed using Statistical Package for Social Science version 26. Results: The overall proportion of urinary tract infection among pregnant women was 14.7% (n = 26/177). Klebsiella pneumoniae was the predominant bacterial etiologic agent of urinary tract infection 26.9% (n = 7/26). The proportion of extended spectrum beta lactamase among Gram-negative isolates was 50% (n = 6/12). Among extended spectrum beta lactamase-producing isolates (100%), all are resistance to amikacin and gentamicin while intermediate level resistance rate of 66.7% was observed among trimethoprim-sulphamethoxazole. They were susceptible for some limited drugs, and these were Nitrofurantoin (83.3%) and Chloramphenicol (83.3%). Conclusions: Majority of extended spectrum beta lactamase-producing isolates exhibited co-resistance to other commonly prescribed antibiotics. This indicates that the option of treatment for these pathogens rapidly decreased from time to time which results serious life-threatening conditions, especially in mother and newborn unless the appropriate measure is taken.

Antiretroviral Therapy Service Quality and Associated Factors at Selected Public Hospitals, Addis Ababa, Ethiopia, 2021.

Background: It is important to offer high-quality HIV/AIDS treatment and antiretroviral medication to people living with the disease to improve health outcomes. The quality of health services has become a public health issue. Objective: To assess ART service quality and associated factors at a selected public hospital, Addis Ababa, Ethiopia, in 2021. Methods: A mixed study design was used from April to May 2021. Donabedian's structure-process-outcome model of health care quality was employed as a framework. A total of 420 clients were interviewed to obtain quantitative data, and 08 key informant interviews and 357 program documents were reviewed. Quantitative data were checked, coded, and entered into Epi Info version 7.2 and exported into SPSS windows version 25.0. In the multivariable logistic regression analysis, variables with p-values < 0.05 and adjusted odds ratio (AOR) with 95% confidence interval (CI) were used to identify factors associated with client satisfaction. Qualitative data were transcribed and analysed using the ATLAS.ti version 8 software program and used to complement the quantitative findings. Results: The overall quality of ART services was 73.3% for the availability of resources, 79.5% for healthcare providers' compliance with the national guidelines, and 86.4% for client satisfaction with the quality of ART clinical services. Patients who disclosed their HIV status [AOR 10.7, 95% CI: 5.2-22], months of ART [AOR 10.4, 95% CI: 3.89-27.8], age group 34-44, 45-55, and 56-76 years were found to be 5.1, 8.1, and 5 [AOR 5.1,95% CI:1.2-22, AOR 8.1,95% CI:1.9-35.5, AOR 5,95% CI:2.97-9.44], respectively, and consultation time [AOR 3.5, 95% CI: 1.6-7.35] were associated with client satisfaction on the quality of ART clinical services. Conclusion: This study revealed that the overall quality of ART services in selected Addis Ababa public hospitals was good, although with the availability of resources and compliance health care providers need improvement.

The Global Landscape of the Burden of Depressive Symptoms/Major Depression in Individuals Living With HIV/AIDs and Its Effect on Antiretroviral Medication Adherence: An Umbrella Review.

Background: People living with HIV/AIDS have a higher rate of depression/depressive symptoms and this highly affects antiretroviral medication adherence. Therefore, much stronger evidence weighing the burden of depressive symptoms/major depression is warranted. Methods: We investigated PubMed, Scopus, Psych-Info, and Embase databases for systematic review studies. A PRISMA flow diagram was used to show the search process. We also used the Assessment of Multiple Systematic Reviews (AMSTAR) checklist scores. A narrative review and statistical pooling were accompanied to compute the pooled effect size of outcome variables. Results: Overall, 8 systematic review studies addressing 265 primary studies, 4 systematic review studies addressing 48 primary studies, and six systematic review studies addressing 442 primary studies were included for depressive symptoms, major depression, and their effect on medication non-adherence, respectively. Globally, the average depressive symptoms prevalence using the random effect model was 34.17% (24.97, 43.37). In addition, the average prevalence of major depressive disorder was obtained to be 13.42% (10.53, 16.31). All of the 6 included systematic review studies reported a negative association between depressive symptoms and antiretroviral medication non-adherence. The pooled odds ratio of antiretroviral medication adherence among patients with depressive symptoms was 0.54 (0.36, 0.72) (I 2 = 0.0%, p = 0.487). Conclusion: Globally, the prevalence of depressive symptoms and major depression is high. There existed a high degree of association between depressive symptoms and antiretroviral medication non-adherence. So, focused intervention modalities should be developed and implemented.

Birth prevalence of omphalocele and gastroschisis in Sub-Saharan Africa: A systematic review and meta-analysis.

Objective: To systematically summarize the burden of gastroschisis and omphalocele in Sub-Saharan Africa. Methods: Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, systematically reviewed and meta-analyzed literatures from Medline (PubMed), Cochrane Library, HINARI, and Google Scholar that investigated at the prevalence of major congenital abdominal wall malformation. The pooled prevalence of major abdominal wall defects was estimated using a weighted inverse variance random-effects model. The Q statistic and the I2 statistics were used to examine for heterogeneity among the included studies. The funnel plot and Egger's regression test were used to check for publication bias. Results: A total of 1951 studies were identified; 897 from PubMed, 26 from Cochrane Library, 960 from Google Scholar, and 68 from other sources. Fourteen articles that met the eligibility criteria were selected for this meta-analysis with 242,462 total enrolled participants and 4693 births with congenital anomaly. The pooled prevalence of ompahalocele among congenital defect patients in Sub-Saharan Africa was found to be 4.47% (95% confidence interval: 3.04-5.90; I2 = 88.3%; p < 0.001). The pooled prevalence of omphalocele among births with congenital defect was found to be 4.04% (95% confidence interval: 2.62-5.46) in cross-sectional studies and 4.43% (95% confidence interval: 306-5.81) in cohort studies. The average prevalence of omphalocele among births with congenital defect was found to be 8% (95% confidence interval: 5.53-10.47) in Uganda and 6.65% (95% confidence interval: 4.18-9.13) in Nigeria. The pooled prevalence of gastroschisis among congenital birth defect in Sub-Saharan Africa was found to be 3.22% (95% confidence interval: 1.83-4.61; I2 = 33.1%; p = 0.175). Conclusion: Based on this review, the pooled prevalence of omphalocele and gastroschisis in sub-Saharan Africa are high. Therefore, a perinatal screening program for congenital anomalies should be implemented. In addition, early referral of suspected cases of congenital anomalies is required for better management until advanced diagnostic centers are established in various locations of Sub-Saharan Africa.

Acute Adverse Effects of Formaldehyde Treated Cadaver on New Innovative Medical Students and Anatomy Staff Members in the Dissection Hall at Wollo University, Northeast Ethiopia.

INTRODUCTION: Formaldehyde is the most frequently used chemical for the preservation of a cadaver. However, its toxicity in the dissection hall is frequently ignored. OBJECTIVE: To assess the acute adverse effects of formaldehyde treated cadaver on preclinical new innovative medical students and anatomy staff members in the dissection hall at Wollo University, Ethiopia. METHODS: This institutional-based cross-sectional study was carried out from January 20 to February 25, 2020. A total of 88 study participants were surveyed at the department of Human Anatomy, Wollo University, Ethiopia. The participants were those who were exposed to formaldehyde vapors during the dissection of a cadaver in the dissection hall. A self-administered questionnaire which contains the clinical symptoms observed after formaldehyde exposure was used to collect data. The data were entered into EpiData version 4.2 and then exported to SPSS Version 21 for analysis. Finally, the data were expressed in texts, tables, and figures. RESULTS: The study comprised 84 (95.5%) male and 4 (4.5%) female. In this study, the top three most common acute adverse effects of formaldehyde during dissection of a cadaver in the cadaver room were unpleasant smells, Tiredness/dizziness, and watering of eyes (lacrimation), each accounted for 64 (72.7%), 39 (44.3%) and 35 (39.8%), respectively. The other acute adverse effects were running nose with tingling sensation 27 (30.7%) followed by lack of concentration 24 (27.3%) and headache 22 (25%). CONCLUSION: In dissection hall, preclinical medical students and instructors are at high risk to develop various acute adverse symptoms of formaldehyde. Therefore, a free-aldehyde preservation solution should be assumed to prevent its toxicity.

Prediction of Birth Weight by Using Neonatal Anthropometric Parameters at Birth in Finote Selam Hospital, Ethiopia.

INTRODUCTION: Birth weight is an indicator of a newborn's chances for survival and growth. However, developing countries lack enough weighing scales to identify low birth weight babies. Therefore, finding an alternative to weighing scales is vital. OBJECTIVE: To predict birth weight from neonatal anthropometric parameters at birth in Finote Selam Hospital, Ethiopia. METHODS: A hospital-based cross-sectional study was carried out from July 13 to October 27, 2020. A total of 424 live-delivered neonates were enrolled. Based on eligibility, birth weight and neonatal anthropometric parameters like crown-heel length, foot length, hand length, mid-upper arm circumference, umbilical-nipple distance, intermammary distance and head circumference were measured within 24 hours of birth. The association between birth weight and neonatal anthropometric parameters was evaluated using correlation analysis. Birth weight predictive regression models were formulated by using simple and multiple linear regression analysis. RESULTS: All neonatal anthropometric parameters had positive significant correlation with birth weight at p<0.05. Amongst the neonatal anthropometric parameters, the highest significant correlation with birth weight was observed on mid-upper arm circumference (MUAC) followed by foot length (FL), each being r=0.474 and r=0.461, respectively. The best predictive regression models were formulated as birth weight (kg)=0.117+[0.284×MUAC (cm)] and birth weight (kg)=1.137+[0.254×FL (cm)]. As compared to individual neonatal anthropometric parameters, a combination of MUAC, hand length (HL), FL and crown-heel length (CHL) had the highest significant correlation (r=0.661), and a multiple regression equation used to estimate birth weight was formulated as birth weight (kg)=-2.489+[0.192×MUAC(cm)]+[0.078×HL(cm)]+[0.11×FL (cm)]+[0.036×CHL(cm)]. CONCLUSION: Using a combination of MUAC, HL, FL and CHL followed by individual MUAC neonatal anthropometric parameters has high significance to identify low birth weight. Prediction of neonatal birth weight from neonatal anthropometric parameters is crucial to minimize the death of neonates due to low birth weight.

Medical Students' Attitude and Perception Towards Basic Medical Science Subjects at Wollo University, Northeast Ethiopia.

INTRODUCTION: The knowledge of basic medical science could help to remember a fact and be used to understand causal mechanisms of disease process that improve the accuracy of diagnostic formulations. OBJECTIVE: To assess the perception and attitude of medical students towards basic medical science subjects along with retention rate and clinical relevance in Wollo University. METHODS: Institutional-based cross-sectional study design was employed in Wollo University from September, 2020 to October, 2020. A pre-tested and structured self-administered questionnaire was used for data collection. All opinions were rated using a positive-point Likert scale, which ranges from "strongly disagree" to "strongly agree." The data were entered and analyzed using SPSS version 20. RESULTS: A total of 153 students participated with a 100% response rate. Among them, 45 (29.4%), 38 (24.8%), 39 (25.5%), and 31 (20.3%) were PC-II, C-I, C-II, and Intern students, respectively. Ninety-six (62.7%) of medical students were very much interested in basic medical science subjects. But, 113 (73.9%) of them did not have plans to join the subjects as a future career. The main reasons in more than half 85 (55.7%) of the respondents were less financial growth followed by less chance of promotion 31 (20.3%). There were 66.7% of the students who considered anatomy as clinically relevant, whereas 53.6% and 47.1% considered physiology and biochemistry, respectively, to be clinically relevant. The number of students who could recall anatomy and physiology during relevant clinical discussions was 102 (66.7%) and 85 (55.6%), respectively. This percentage was relatively less for biochemistry (26.8%). CONCLUSION: In conclusion, medical students have a positive attitude towards basic medical science subjects. However, they are hesitant to join the field because it offers them less financial growth and few chances of promotion. Moreover, anatomy and physiology were highly relevant subjects during clinical practice. But, the retention rate of basic medical science knowledge during their clinical year was low.

Toxicity of Methanolic Extracts of Seeds of Moringa stenopetala, Moringaceae in Rat Embryos and Fetuses.

Moringa stenopetala is a medicinal plant that has been used in Ethiopian traditional medicine as a remedy for the treatment of hypertension, diabetes, and stomach pain. The study is aimed at assessing the toxicity of the methanol extracts of the seeds of Moringa stenopetala on the developing embryo and fetuses of rats. The seeds of Moringa were extracted by maceration using 80% methanol. The extract (250-1000 mg/kg) was orally administered to pregnant Swiss albino rats from days 6 to12 of gestation. Embryos and fetuses were recovered by laparotomy on gestational day 12 and day 20, respectively, and were assessed for developmental anomalies. On day 20, significant prenatal growth retardation such as reduced litter weight and crown-rump length were observed in near term fetuses of 1000 mg/kg treated rats. Litter weight in 1000 mg/kg and pair-fed control groups was 2.41 g ± 0.108 and 3.08 g ± 0.093, respectively. Delay in the development of an otic, optic, and olfactory system, as well as a reduction in a number of branchial bars, occurred on day 12 embryos of 1000 mg/kg treated rats. The rate of fetal resorption in 1000 mg/kg and pair-fed control groups was 1.6 ± 0.55 and 0.42 ± 0.52, respectively. There was also a high incidence of fetal death in the 1000 mg/kg treated group but it was not statistically significant. The offspring's of Moringa-treated rats did not show gross external malformations at all doses. These findings suggest that the methanol seed extract of Moringa stenopetala is not safe to rat embryos and fetuses. Its toxic effects were evidenced by a significant delay in embryonic and fetal development and an increase in fetal resorptions and fetal death.

Developmental Toxicity of Ethanolic Extracts of Leaves of Achyranthes aspera, Amaranthaceae in Rat Embryos and Fetuses.

INTRODUCTION: Achyranthes aspera is one of the medicinal plants widely used for fertility control in the local health system of Ethiopia. OBJECTIVE: Assessment of developmental toxicity of ethanolic extracts of leaves of Achyranthes aspera in rat embryos and fetuses. METHODS: Fresh leaves were extracted by mixing the grinded powder with 70% ethanol. Then, the extract was given orally to gravid Wistar rats at doses of 250 mg/kg, 500 mg/kg and 1000 mg/kg from day 6-12 of gestation. On gestational days 12 and 20, embryos and fetuses were examined for developmental and gross malformations. RESULTS: On day 12 embryos, the number of implantation sites and somites in 1000 mg/kg treated rats were significantly reduced. The number of implantation sites in pair-fed control and 1000 mg/kg groups was 11.2±0.86 and 8.34±0.65, respectively. Retarded development of hindlimb, forelimb, optic and olfactory systems was detected at a high dose. In addition, the number of branchial bar was significantly reduced in 1000 mg/kg dose. In near-term fetuses, significant reduction of litter weight and crown-rump length was seen at 1000 mg/kg dose. Crown-rump length in pair-fed control and 1000 mg/kg treated groups was 2.82±0.17 cm and 2.31±0.11 cm, respectively. Fetal resorptions and deaths in 1000 mg/kg were 1.45±0.65 and 0.81±0.67, respectively. However, external anomalies were not detected for all offspring at all doses. CONCLUSION: The finding suggests that ethanolic leaf extracts of A. aspera have detrimental effects on the development of rat embryos and fetuses at a higher dose. The possible teratogenic effects were indicated with the substantial retardation in embryonic and fetal development, decrease in number of implantation sites and rise in fetal resorptions and death. Moreover, it resulted in significant reduction in litter weight and crown-rump length at a higher dose.

Estimation of Gestational Age Using Neonatal Anatomical Anthropometric Parameters in Dessie Referral Hospital, Northeast Ethiopia.

INTRODUCTION: Estimation of gestational age is a key for the identification of a given low birth weight neonate is either preterm or growth retarded. OBJECTIVE: To estimate gestational age from neonatal anatomical anthropometric parameters in Dessie Referral Hospital, Ethiopia. METHODS: Institutional-based cross-sectional study design was employed in Dessie Referral Hospital from October 2019 to April 2020, with 424 consecutively live-born of 28-42 weeks of gestation. After considering the inclusion criteria, neonatal anthropometric parameters were measured within 3 days of birth. Foot length, hand length, mid-upper arm circumference, head circumference, crown-heel length, intermammary distance, umbilical nipple distance, and birth weight were measured and summarized using descriptive statistics, and the power of association was evaluated using correlation analysis. Regression equations of gestational age (GA) in completed weeks with anthropometric parameters were formulated using simple and multiple linear regression analysis. RESULTS: Except for hand length, all other neonatal anthropometric measurements were positively correlated with GA in completed weeks at p< 0.05. Anthropometric parameters individually, mid-upper arm circumference (MUAC) and BW (birth weight) were correlated well with GA at correlation coefficient (r) of 0.406 and 0.334, respectively. Regression formula was formulated as GA (weeks) = 26.12+ [1.11×MUAC (cm)] and GA (Weeks) = 33.19 + [1.53×BW (kg)]. Multiple regression contributed correlation with GA and used for prediction of GA as GA (weeks) = 28.12 - [0.393×HL (cm)] + [1.07×BW (kg)] + [0.87×MUAC (cm)] (r= 0.458). CONCLUSION: The overall relative better correlation for prediction of GA, alone and in combination, is found by combined parameters (HL, MUAC, and BW). The relatively better individual anthropometric parameter for GA assessment is MUAC. Hence, using this neonatal parameter as a prediction of gestational age, the death of neonate due to preterm can be minimized.