Observational assessment of hand hygiene compliance among healthcare workers in public hospitals of Northeastern Ethiopia.

This study examined the magnitude and predictors of hand hygiene compliance among 325 healthcare workers in three public hospitals of Northeastern Ethiopia using standardized observational tool. A multivariable logistic regression analysis was computed to identify factors associated with non-compliance. The overall proportion of observed hand hygiene non-compliance was 41.8% (95%CI: 36.6-48.1). Having <5 years of work experience (AOR = 1.5; 95%CI: 1.2-2.5), absence of hand washing soap (AOR = 3.1; 95%CI: 2.3-5.4), work overload (AOR = 2.5; 95%CI: 1.9-4.1), pipe water supply interruption (AOR = 2.8; 95%CI: 2.1-4.9), lack of hand hygiene training (AOR = 3.1; 95%CI: 2.2-4.4), and absence of infection prevention committee (AOR = 2.1; 95%CI: 1.5-4.9) were determinant factors for hand hygiene non-compliance. Therefore, regional health bureau and hospitals' managers should work towards the provision of regular hand hygiene trainings, uninterrupted piped water supply, hand washing soap, and establishment of functional infection prevention committee. Moreover, healthcare workers should be also committed to comply with hand hygiene.

Occupational blood exposure beyond needle stick injuries: hospital-based cross-sectional study among healthcare workers in governmental hospitals of Northern Ethiopia.

BACKGROUND: Occupational blood exposure is one of the major public health problems that healthcare workers (HCWs) are encountering. Most previous occupational blood exposure studies are delimited to needle stick injury, which could underestimate the real level of blood exposure. On the other hand, others deal with crude blood and body-fluids exposure, which possibly overestimate the magnitude of blood exposure. Therefore, this study aimed at determining the prevalence of occupational blood exposure and identifying associated factors among HCWs in the Southern Tigrai zone governmental hospitals of Northern Ethiopia considering all the potential means of blood exposure (needle stick injury, sharp medical equipment injury, and blood splash) while excluding blood-free body-fluids. METHODS: A hospital based cross-sectional study design was employed to gather data from randomly selected HCWs in three governmental hospitals from February to March, 2020. A multivariable logistic regression model was used to identify the independent factors associated with the outcome variable. RESULTS: From the total of 318 HCWs, 148 (46.5 %) were exposed to blood at least once in their lifetime. Working for more than 40 h per week (AOR= 9.4; 95 % CI: 7.61, 11.41), lack of adequate personal protective equipment (PPE) (AOR=3.88; 95 % CI: 1.64, 5.42), Hepatitis B virus vaccination (AOR=0.54; 95 % CI: 0.12,0.78), recapping used needle sticks (AOR=3.18; 95 % CI: 1.28, 8.83), and lack of infection prevention and patient safety (IPPS) training (AOR=13.5; 95 % CI: 8.12,19.11) were detected to significantly increase the likelihood of occupational blood exposure. CONCLUSIONS: As nearly half of the HCWs were exposed to blood, reducing work load below 40 h per week by employing additional staff members, supplying adequate PPE, avoiding recapping of used needle sticks, and providing IPPS training for the HCWs should be practiced.

To do's after war: Priorities for acute diarrheal diseases intervention among under-five children in conflict settings of Raya Kobo district, Northeastern Ethiopia.

Introduction: Diarrheal diseases are significant causes of under-five children mortality and morbidity in developing countries. This is particularly alarming among the community living in conflict zones where less attention is given for basic services including water, food, and health. However, there are no detailed investigations on acute diarrhea among under-five children in conflict-affected areas, which impedes intervention approaches. Therefore, this study was designed to assess the prevalence of acute diarrhea and associated factors among under-five children in conflict-affected setting of Raya Kobo, Northeast Ethiopia. Methods: A community-based cross-sectional study was employed among 463 under-five children in Raya Kobo district, from February to March 2021. The study participants were selected from ten rural kebeles. Pre-tested questionnaire and observational checklist were used to collect the data. Bivariate and multivariable logistic regression analyses were computed to identify factors associated with the prevalence of acute diarrhea. Results: The prevalence of acute diarrhea among under-five children was 21% (95% confidence interval (CI): 18.50-23.91%). Unimproved drinking water source (Adjusted odds ratio (AOR) = 2.89; 95%CI: 1.38-6.06), disposal of garbage in open field (AOR = 3.33; 95%CI:1.66-6.67), having low monthly income (AOR = 5.73; 95%CI: 3.07-10.59), absence of latrine facility (AOR = 3.18; 95%CI: 1.09-8.78), poor hand washing practice at critical times (AOR = 2.52; 95%CI:1.28-4.05), not regularly cleaning food utensil before child feeding (AOR = 2.54; 95%CI:1.31-4.94), and not received Rota vaccine (AOR = 4.28; 95%CI: 1.82-10.11) were the determinant factors. Conclusions: To reduce the burden of acute diarrheal diseases, post-war intervention approaches should emphasize on advocating for Rota virus vaccination, regularly cleaning food utensils before feeding, improving hand washing practice at critical times, provision of improved drinking water source, and use of proper solid and domestic sewage discharge/disposal methods.

Association between illegal drug use and cigarette smoking among Ethiopian students: A systematic review and meta-analysis.

INTRODUCTION: Cigarette smoking is a persistent public health problem as it is a risk factor for many diseases. Previous studies on the role of illegal drug use in cigarette smoking have yielded disparate and inconclusive results, hindering the development of effective intervention strategies to address this issue. Therefore, this systematic review and meta-analysis aimed to estimate the pooled prevalence of cigarette smoking and its associated factors, with a specific focus on the influence of illegal drug use among students in Ethiopia. METHODS: We conducted a comprehensive search of international databases, including PubMed, Cochrane Library, Science Direct, CINAHL, African Journals Online, HINARI, Global Health, and Google and Google Scholar. Grey literature was also identified from various university digital libraries. The study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA) guidelines. Due to the high heterogeneity among the included studies (I2 = 98.6%; p-value <0.001), we employed a random-effects model with a 95% confidence interval (CI) to estimate the pooled effect using STATA 14 software. The publication bias was assessed using a statistical Egger regression test. RESULTS: A total of 22 studies involving 18,144 students met the eligibility criteria for this systematic review and meta-analysis. The pooled prevalence of lifetime and current cigarette smoking among students in Ethiopia was 13.8% (95% CI: 9.90-17.82) and 9.61% (95% CI: 7.19-12.03), respectively. Students who used illegal drugs were twenty-three times more likely to smoke cigarettes compared to their counterparts (OR = 23.57, 95% CI: 10.87-51.1). Living in urban settings (OR = 2.9; 95% CI: 1.15-7.28) and the habit of alcohol consumption (OR = 4.79; 95% CI: 1.57-14.64) were also identified as factors associated with cigarette smoking. CONCLUSIONS: We found that more than one in eight students in Ethiopia have engaged in lifetime cigarette smoking. Notably, students who used illegal drugs exhibited a significantly higher likelihood of cigarette smoking. In light of these findings, it is imperative to implement comprehensive public health interventions that target illegal drug use, cigarette smoking, and alcohol consumption, with a particular emphasis on urban residents.

Non-compliance with smoke-free law in public places: a systematic review and meta-analysis of global studies.

Introduction: Non-compliance with smoke-free law is one of the determinants of untimely mortality and morbidity globally. Various studies have been conducted on non-compliance with smoke-free law in public places in different parts of the world; however, the findings are inconclusive and significantly dispersed. Moreover, there is a lack of internationally representative data, which hinders the evaluation of ongoing international activities towards smoke-free law. Therefore, this meta-analysis aimed to assess the pooled prevalence of non-compliance with smoke-free law in public places. Methods: International electronic databases, such as PubMed/MEDLINE, Science Direct, Cochrane Library, CINAHL, African Journals Online, HINARI, Semantic Scholar, google and Google Scholar were used to retrieve the relevant articles. The study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA) guidelines. The Higgs I2 statistics were used to determine the heterogeneity of the reviewed articles. The random-effects model with a 95% confidence interval was carried out to estimate the pooled prevalence of non-compliance. Results: A total of 23 articles with 25,573,329 study participants were included in this meta-analysis. The overall pooled prevalence of non-compliance with smoke-free law was 48.02% (95% CI: 33.87-62.17). Extreme heterogeneity was observed among the included studies (I2 = 100%; p < 0.000). The highest non-compliance with smoke-free law was noted in hotels (59.4%; 95% CI: 10.5-108.3) followed by homes (56.8%; 95% CI: 33.2-80.4), with statistically significant heterogeneity. Conclusion: As the prevalence of non-compliance with smoke-free law is high in public places, it calls for urgent intervention. High non-compliance was found in food and drinking establishments and healthcare facilities. In light of these findings, follow-up of tobacco-free legislation and creating awareness that focused on active smokers particularly in food and drinking establishments is recommended.

Computer vision syndrome and ergonomic risk factors among workers of the Commercial Bank of Ethiopia in Addis Ababa, Ethiopia: an institutional-based cross-sectional study.

Background: Computer vision syndrome (CVS) is the most pressing public health concern that affects vision and reduces quality of life and productivity, particularly in developing countries. Most of the previous studies conducted in Ethiopia focus on the knowledge and personal risk factors of bank workers. Moreover, ergonomic workstation design was not objectively assessed, which could hinder the implementation of effective intervention strategies. Therefore, this study aimed to determine CVS and ergonomic factors among commercial bank workers in Addis Ababa, Ethiopia. Methods: An institutional-based cross-sectional study was carried out among 466 study participants from May 26 to July 24, 2022. A multistage sampling technique was applied to select the study participants. Data were collected via a standardized tool of CVS (CVS-Q). Besides, workstation ergonomics were pertinently assessed. The collected data was entered into EpiData version 3.1 and exported to SPSS version 26 for data analysis and cleaning. Multivariable logistics regression analysis was performed to identify factors associated with CVS. The variables with a p-value < 0.05 were considered statistically significant factors. Results: Prevalence of CVS was 75.3% (95% CI: 71.2-79.2%). Blurred vision, eye redness, and headache, 59.8%, 53.7%, and 50.7%, respectively, were frequently reported symptoms. Glare (AOR = 4.45: 95% CI: 2.45-8.08), 20-20-20 principle (AOR = 1.98, 95% CI: 1.06-3.67), wearing non-prescription eyeglasses (AOR = 4.17; 95% CI: 1.92-9.06), and poor workstation (AOR = 7.39; 95% CI: 4.05-13.49) was significantly associated with CVS. Conclusion: The prevalence of CVS was found to be high. Glare at work, ignoring the 20-20-20 principle, wearing non-prescription eyeglasses, and poor workstation ergonomic design were independent predictors of CVS. Therefore, comprehensive interventional activities like adhering to the 20-20-20 principle, avoiding the use of non-prescription glasses, minimizing glare, and improving workstation ergonomic setup are essential to prevent CVS.

Prevalence of tobacco smoking and associated factors among adults in Ethiopia: a systematic review and meta-analysis.

Introduction: The public health concern of tobacco smoking is more prevalent in low- and middle-income countries including Ethiopia. Various studies have investigated tobacco smoking in various parts of Ethiopia. However, the findings have been inconsistent and characterized by significant variability. Besides, there is no nationally representative data on the subject, which could deter the design of effective intervention strategies to reduce tobacco-related problems. Therefore, this study aimed to estimate the pooled prevalence of tobacco smoking and associated factors among adults in Ethiopia. Methods: The study was conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols Guideline. A detailed search was conducted from international databases including PubMed, Cochrane Library, Science Direct, CINAHL, African Journals Online, HINARI, Global Health, and Google Scholar. The extracted data was analyzed using STATA 14 software. A random-effects model was used to estimate the effect size. The Egger regression test and I2 statistics were used to determine potential publication bias and heterogeneity among the reviewed articles, respectively. Results: A total of 32 studies with 69,897 study participants were included in this systematic review and meta-analysis. The pooled prevalence of lifetime tobacco smoking among adults in Ethiopia was 16.0% (95% confidence Interval (CI): 13.6-18.39) and there was significant heterogeneity among the included studies (I2 = 99.1%, p < 0.001). Male adults were three times more likely to smoke tobacco as compared with females [OR = 3.22 (95% CI: 2.06-5.03)]. Being an alcohol user [OR = 3.78 (95%CI: 1.27-11.24)] and having tobacco-smoking friends [OR = 7.21 (95%CI: 5.56-9.35)] are potential determinant factors for tobacco smoking. Conclusion: The pooled prevalence of lifetime and current tobacco smoking among adults in Ethiopia was high, which calls for urgent intervention. Therefore, prioritization of tobacco control strategies, such as creating awareness about the public health importance of tobacco smoking, can help prevent and mitigate the effects of tobacco smoking. Alcohol control law enforcement should also be strengthened.

Personal protective equipment utilization and its association with educational status among industry workers in Ethiopia: A systematic review and meta-analysis protocol.

INTRODUCTION: Ethiopia is experiencing high prevalence of occupational morbidity and disability. One of the main contributing reasons is a low utilization of personal protective equipment (PPE). Previous studies on PPE utilization and association with educational status among industry workers were largely inconsistent. Therefore, this meta-analysis is aimed to pool the magnitude of PPE utilization and its association with educational status among industry workers in Ethiopia. METHOD: A compressive search of international databases and libraries including Scopus, PubMed, MedNar, Embase, MEDLINE, the web of science, Google Scholar, the JBI Library, African Journals Online, and Science direct will be carried out to locate published reports. Two independent reviewers will screen the records for inclusion using standardized JBI tools. Before extracting and synthesizing data, the selected studies will undergo a rigorous critical appraisal. If appropriate, a meta-analysis will be conducted. Cochrane Q-test and I2-test statistics will be used to assess the heterogeneity between studies. If necessary, meta-regression and subgroup analyses will be conducted to explore potential reasons for any inconsistency and heterogeneity. Sensitivity analysis will be performed to assess the effect of a single study on the pooled magnitude estimates. Funnel plots, along with Egger's and Begg's tests, will be used to assess the presence of publication bias. PROSPERO registration number: PROSPERO, CRD42022364562.

Indigenous knowledge on the practice of milk container fumigation and its effect on microbial safety of milk among pastoral communities in west Guji zone, southern Ethiopia.

Introduction: Milk is a high-risk food and has been implicated in many foodborne illnesses. Thus, the pastoral communities in rural Ethiopia used a traditional practice of milk container fumigation to maintain the quality and safety of milk. Objective: to assess the indigenous knowledge on milk container fumigation practice and its effect on the microbial safety of milk among pastoral communities in the west Guji zone, southern Ethiopia. Methods: A cross-sectional study design was conducted in six randomly selected kebeles of the pastoral districts in the west Guji zone, Southern Ethiopia from December to June/2022. The preservative plants and raw milk samples were collected and transported to the laboratory, to analyze the efficacy of plants on the microbial safety throughout milk storage. A variance analysis was used to compare the means of microbiological growth and pH measure among the treatments and control; while thematic analysis was for qualitative data. Result: Four species of plants, namely: Olea africana, Clerodendrum myricoides (Hochst) vatke, Rhamnus staddo, and Rhus natalensis were identified from the study area; as they were used for fumigating milk storage containers to prevent a contamination of milk. According to respondents, the fumigation of milk containers was practiced by holding the container upside down over the smoke from a burning chip of each plant species. Accordingly, it was demonstrated that the R. staddo has relatively better efficacy in inhibiting microbial growth in milk than O. africana and C. myricoides (Hochst) vatke; while R. natalensis has no significant impact on microbial growth in milk over the storage period. Conclusion: Pastoralists in the West Guji zone were fumigated the milk storage container by using smoke of O. africana, R. staddo, C. myricoides (Hochst) vatke, and R. natalensis plants. As such, it was identified that R. staddo has relatively better efficacy in inhibiting microbial growth in milk than O. africana and C. myricoides (Hochst) vatke; and it is a better plant to be recommended for the preservation of cow milk.

The association between children's exposure to pesticides and asthma, wheezing, and lower respiratory tract infections. A systematic review and meta-analysis.

Background: Exposure to pesticides is a global public health problem, especially for children. Its association with chronic respiratory disease among children has attracted considerable attention, but the existing evidence remains inconclusive and cannot be certain. Therefore, this systematic review and meta-analysis aim to determine the global pooled effect size of association with pesticide exposure and asthma, wheezing, and respiratory tract infections among children. Methods: A comprehensive search was conducted for relevant literature from electronic databases, including PubMed, Google Scholar, Hinari, Semantic Scholar, and Science Direct. Studies that provided effect size on the association between pesticide exposure and childhood asthma, wheezing, and respiratory tract infections in children were included. The articles were screened, data was extracted, and the quality of each study was assessed with four independent reviewers. Random effects models for significant heterogeneity and fixed effect models for homogeneous studies were conducted to estimate pooled effect sizes with 95% confidence intervals using Comprehensive Meta-Analysis version 3.3.070 and MetaXL version 2. Funnel plot and Higgins I 2 statistics were used to determine the heterogeneity of the included studies. Subgroup analyses were computed based on the types of pesticide exposure, study design, sample size category, and outcome assessment technique. Result: A total of 38 articles with 118,303 children less than 18 years of age were included in this meta-analysis. Pesticide exposure among children increased the risk of asthma by 24%; (OR = 1.24, 95% CI: 1.14-1.35) with extreme heterogeneity (I 2 = 81%, p < 0.001). Exposure to pesticides increased the odds of developing wheezing among children by 34% (OR = 1.34, 95% CI: 1.14-1.57), with high heterogeneity (I 2 = 79%, p < 0.001) and also increased the risk of developing lower respiratory tract infection by 79% (OR = 1.79, 95% CI: 1.45-2.21) with nonsignificant low heterogeneity (I 2 = 30%, p-value = 0.18). Conclusion: This meta-analysis provided valuable evidence supporting the association between childhood asthma, wheezing, and lower respiratory tract infection with pesticide exposure. The findings would contribute to a better understanding of the estimate of the effect of pesticide exposure on respiratory health in children and inform evidence-based preventive strategies and public health interventions.

Exposure to indoor air pollution and adverse pregnancy outcomes in low and middle-income countries: a systematic review and meta-analysis.

Introduction: Exposure to indoor air pollution such as biomass fuel and particulate matter is a significant cause of adverse pregnancy outcomes. However, there is limited information about the association between indoor air pollution exposure and adverse pregnancy outcomes in low and middle-income countries. Therefore, this meta-analysis aimed to determine the association between indoor air pollution exposure and adverse pregnancy outcomes in low and middle-income countries. Methods: International electronic databases such as PubMed, Science Direct, Global Health, African Journals Online, HINARI, Semantic Scholar, and Google and Google Scholar were used to search for relevant articles. The study was conducted according to the updated Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. A random effect model at a 95% confidence interval was used to determine the association between indoor air pollution exposure and adverse pregnancy outcomes using STATA version 14. Funnel plot and Higgs I2 statistics were used to determine the publication bias and heterogeneity of the included studies, respectively. Results: A total of 30 articles with 2,120,228 study participants were included in this meta-analysis. The pooled association between indoor air pollution exposure and at least one adverse pregnancy outcome was 15.5% (95%CI: 12.6-18.5), with significant heterogeneity (I2 = 100%; p < 0.001). Exposure to indoor air pollution increased the risk of small for gestational age by 23.7% (95%CI: 8.2-39.3) followed by low birth weight (17.7%; 95%CI: 12.9-22.5). Exposure to biomass fuel (OR = 1.16; 95%CI: 1.12-1.2), particulate matter (OR = 1.28; 95%CI: 1.25-1.31), and kerosene (OR = 1.38; 95%CI: 1.09-1.66) were factors associated with developing at least one adverse pregnancy outcomes. Conclusions: We found that more than one in seven pregnant women exposed to indoor air pollution had at least one adverse pregnancy outcome. Specifically, exposure to particulate matter, biomass fuel, and kerosene were determinant factors for developing at least one adverse pregnancy outcome. Therefore, urgent comprehensive health intervention should be implemented in the area to reduce adverse pregnancy outcomes.

Urban-rural disparities in minimum acceptable diet intake among children aged 6-23 months in Ethiopia: A multivariable Decomposition analysis of Ethiopian demographic and health survey 2019.

Introduction: The achievement of the minimum acceptable diet intake (MAD) stands at 14% among urban and 10% among rural under-five children in Ethiopia. Consequently, identifying the determinants of the urban-rural gap is vital for advancing Sustainable Development Goals (SDGs), fostering healthier communities, and developing evidence-driven approaches to enhance health outcomes and address disparities. Objective: The objective of the study was to decompose the urban-rural disparities in minimum acceptable diet intake in Ethiopia using the Ethiopian Mini-Demographic and Health Survey 2019 data. Method: The study was conducted using the Ethiopian Demographic and Health Survey 2019 report. A total of 1,496 weighted children aged 6-23 months were included using stratified sampling techniques. The main outcome variable minimum acceptable diet was calculated as a combined proportion of minimum dietary diversity and minimum meal frequency. A decomposition analysis was used to analyze the factors associated with the urban-rural discrepancy of minimum acceptable diet intake, and the results were presented using tables and figures. Result: The magnitude of minimum acceptable diet among children aged 6-23 months in Ethiopia was 11.0%. There has been a significant disparity in the intake of minimum acceptable diet between urban and rural under-five children with 14 and 10%, respectively. Endowment factors were responsible for 70.2% of the discrepancy, followed by 45.1% with behavioral coefficients. Educational status of college and above was responsible for narrowing the gap between urban and rural residents by 23.9% (ß = 0.1313, 95% CI: 0.0332-0.245). The number of children in the household and the age of the child between 18 and 23 months were responsible for widening the gap in minimum acceptable diet intake discrepancy between urban and rural residents by 30.7% and 3.36%, respectively (ß = -0.002, 95% CI: -0.003 to -0.0011 and ß = -30.7, 95% CI: -0.025 - -0.0085). From the effect coefficients, the effect of institutional delivery was responsible for 1.99% of the widening of the gap between urban and rural residents in minimum acceptable diet intake (ß = -0.0862, 95% CI: -0.1711 - -0.0012). Conclusion: There is a significant variation between urban and rural residents in minimum acceptable diet. The larger portion of the discrepancy was explained by the endowment effect. Educational status of mothers with college and above, parity, age of child, and place of delivery were the significant factors contributing to the discrepancy of minimum acceptable diet intake between urban and rural residents.

Explainable machine learning for modeling predictors of unintended pregnancy among married/in-union women in sub-Saharan Africa, a multi-country analysis of MICS 6 survey.

Introduction: Unintended pregnancy is defined as a pregnancy that is either mistimed (wanted at a later time) or unwanted (not wanted at all). It has been a concerning issue for reproductive health and public health, with significant negative effects on the mother, child, and the public at large. It is a worldwide public health issue that can have a major impact on the health of pregnant women and newborns. Methods: The study was conducted using secondary data from IPUMS Multiple Indicator Cluster Surveys round 6. The analysis was based on a data merged from six sub-Saharan Africa countries such as Gambia, Ghana, Lesotho, Malawi, Nigeria, and Sierra Leone. A total weighted sample of 28,027married/in-union reproductive-age women was included in the study. Seven machine learning algorithms were trained and their performance compared in predicting unintended pregnancy. Finally, Shapley Additive exPlanations model explanation technique was used to identify the predictors of unintended pregnancy. Results: XGBoost was the top-performing model, achieved the highest area under receiver operating characteristic curve (0.62) and accuracy (65.92%), surpassing all other models. SHAP global feature importance identified top predictors of unintended pregnancy, with women from Malawi, Ghana, and Lesotho, women having primary education and secondary education, with parity of more than three, have higher likelihood of unintended pregnancy. In the other hand, women from Nigeria and Sierra Leone, whose husband/partner has more wives or partners (polygamy relation), and women who owns mobile phone had lower risk of unintended pregnancy. Conclusion: These findings highlight the importance of considering contextual factors, such as country-specific sociocultural norms and individual characteristics, in understanding and addressing unintended pregnancies. By strategically addressing the identified predictors, policymakers, and healthcare providers can develop impactful programs that address the root causes of unintended pregnancies, ultimately contributing to improved reproductive health outcomes worldwide.

Adherence to IMCI guidelines for key symptoms in Ethiopian children: A 2021-2022 national service provision survey.

BACKGROUND: The Health Services Provision Assessment in Ethiopia (SPA-ET) is a survey that generates data on the availability and quality of health services in Ethiopia. Despite the presence of integrated management of childhood illness guidelines in healthcare settings, there has been inadequate exploration or assessment of how effectively and consistently health professionals follow the guidelines. OBJECTIVE: This study aims to identify factors influencing healthcare worker adherence to the integrated management of childhood illness guidelines to identify spatial clusters. METHODS: The data for this study were gathered from the Service Provision Assessment (SPA) survey in Ethiopia, which was conducted nationwide from August 11, 2021, to February 4, 2022. It included a total of 788 health professionals who assessed sick children experiencing at least one of the three main childhood illness symptoms: fever, cough, or diarrhea. We employed STATA version 16 for data analysis, utilizing cross-tabulations to explore relationships between variables and logistic regression modeling to identify factors influencing adherence. To account for the hierarchical structure of the health survey data, we employed multilevel logistic regression. Model selection was based on comparison parameters including the Bayesian Information Criterion (BIC) and Akaike Information Criterion (AIC). We computed adjusted odds ratios with 95% confidence intervals, and statistical significance was determined at a significance level of p < 0.05. RESULTS: The rate of adherence to the integrated management of childhood illness guideline was 33% (95% CI: 29.70%, 36.26%). The analysis revealed several factors influencing adherence to IMCI protocols. child's age (being ≥24 months) [aOR = 0.66, 95% CI: (0.45, 0.87)], facility type (health center) [aOR = 2.61, 95% CI: (1.84, 3.37)], place of residency (being rural) [aOR = 0.54, 95% CI: (0.38, 0.77)], and care provider's qualification (health officer) [aOR = 1.71, 95% CI: (1.18, 2.48)] were all statistically significant. Moreover, the primary cluster is situated in the west Oromia region, with a central focus at coordinates (7.982108 N, 36.203355 E) and extends to a radius of 78.28 km. CONCLUSION: This study confirms a low adherence rate (33%) among health professionals in Ethiopia to the IMCI guideline for assessing the three main symptoms of sick children. The study identified child's age, facility type, academic qualification, and place of residence as crucial factors correlated with adherence rate. Furthermore, 5 secondary clusters (hotspot areas) were identified using SaTScan software. To address the higher protocol refusal, interventional plan needs to be based on academic qualification of care provider, facility type, age of child and place of residency. Moreover, interventions to reduce non-adherence to IMCI guidelines should be location-tailored based on identified hotspot areas to restore guidelines adherence equality.

Proportional Hazards Model on Attrition and its Predictors in Community Antiretroviral Refill Groups among ART Users in Eastern Ethiopia.

BACKGROUND: The HIV epidemic continues to be a major public health challenge worldwide, particularly in sub-Saharan African countries such as Ethiopia. Community-based antiretroviral refill groups are emerging as a patient-centered approach, but there is limited evidence. Therefore, this study aimed to assess attrition and predictors in community antiretroviral refill groups among ART users in Eastern Ethiopia. METHODS: Institutional-based retrospective cohort study was conducted. Systematic random sampling techniques were used. Data were collected via Kobo Collect and exported to Stata. Statistically significant effects were assumed for a P-value < 0.05 at a confidence interval of 95%. RESULTS: The incidence of attrition in community-based ART refill groups was 6.63 (95% CI: 5.78, 7.48) per 100 person-years. The median duration of months in CAGs from the start till the end of the follow-up period was 9 months (IQR = 24). Thus, recruitment level from health facilities, history of LTFU, and stage IV were statistically significant variables. CONCLUSION: The findings of this study highlight the importance of improving the use of community antiretroviral groups in care. Healthcare programs can ultimately improve health outcomes for individuals living with HIV.

Food safety knowledge, attitude, and practice of street food vendors and associated factors in low-and middle-income countries: A Systematic review and Meta-analysis.

Access to safe food is considered a basic human right, but food-borne disease presents a significant public health concern globally. The problem is exacerbated in low- and middle-income countries. Due to the rise in urbanization and the popularity of street food in low- and middle-income countries, understanding the Knowledge, Attitude, and Practice (KAP) of street food vendors is crucial to ensuring food safety. Therefore, this review was aimed to estimate the pooled proportion of KAP of street food vendors toward food safety and its associated factors in low- and middle-income countries. A comprehensive search of published studies before January 30, 2023, was identified using databases like PubMed/MEDLINE, Cochrane Library, HINARI, Science Direct, and African Journals Online, as well as other sources. The preferred reporting items for systematic reviews and meta-analysis guidelines were followed. Data were extracted using Microsoft Excel, and analysis was performed using STATA 14/SE software. The quality of the included studies was assessed using the Joanna Briggs Institute's quality appraisal tool. A random-effects model was used to estimate the pooled proportion of KAP of street food vendors toward food safety and associated factors. The funnel plot and Egger's regression test were used to assess publication bias, and I2 test statistics were used to assess heterogeneity. Furthermore, sensitivity analysis and subgroup analysis was also conducted. In this study, fourteen eligible studies with a total of 2,989 study populations were included. The pooled proportions of good knowledge 62% (95% CI: 51-73), positive attitude 66% (95% CI: 47-86), and good practice 51% (95% CI: 36-65) toward food safety were found among street food vendors. Being of secondary school education (OR = 5.95, 95% CI: 4.05-7.85), having training in food safety (OR = 4.64, 95% CI: 2.62-6.67), having a higher monthly income (OR = 2.98, 95% CI: 1.06-4.9), and having good knowledge of food handling (OR = 2.26, 95% CI: 1.17-3.16) were found to be associated factors in the food safety practice of street food vendors. Based on the findings of this study, there was a significant gap in the KAP of street food vendors toward food safety. Therefore, the provision of training and strengthening health education about food safety are invaluable strategies for improving food safety.

COVID-19 vaccine acceptance and associated factors among health workers in West Guji zone, Southern Ethiopia: Cross-sectional study.

Background: Currently, different COVID-19 vaccines are being developed and distributed worldwide to increase the proportion of the vaccinated people and as a result to halt the pandemic. However, the vaccination progress is different from place to place even among health care workers due to variation in vaccine acceptance. Therefore, this study aimed to assess the acceptance of COVID-19 vaccine and determinant factors among healthcare workers in west Guji zone, southern Ethiopia. Method and materials: An institutional-based cross-sectional study design was employed to assess COVID-19 vaccine acceptance and associated factors among health care workers from July to August 2021. A simple random sampling technique was used to choose 421 representative healthcare workers from three hospitals in the west Guji Zone. The self-administrated questionnaire was used to collect data. Bivariate and multivariable logistic regression analyses were computed to identify factors associated with the acceptance of the COVID-19 vaccine. P < 0.05 was considered for significantly associated factors. Result: From the representative health workers, 57, 47.02, and 57.9% of healthcare workers had good practice of COVID-19 prevention, adequate knowledge, and a positive attitude toward the COVID-19 vaccine consecutively. 38.1% of healthcare workers said they had a willingness to accept the COVI-19 vaccine. Profession (AOR-6, CI: 2.92-8.22), previous history of vaccine side effects (AOR: 3.67, CI: 2.75-11.41), positive attitude toward vaccine acceptance (AOR: 1.38, CI: 1.18-3.29), adequate knowledge toward COVID-19 vaccine (AOR: 3.33, CI: 1.36-8.12), and adequate practice of COVID-19 prevention measure (AOR: 3.45, CI: 1.39-8.61) were significant associated with COVID-19 vaccine acceptance. Conclusion: The proportion of COVID-19 vaccine acceptance among health workers was found to be low. From the study variables, profession, previous history of vaccine side effects, positive attitude toward vaccine acceptance, adequate knowledge to ward off COVID-19 vaccine, and adequate practice of COVID-19 prevention measures were significantly associated with COVID-19 vaccine acceptance.

Household water treatment practice and associated factors in Ethiopia: A systematic review and meta-analysis.

The provision of potable water is crucial to ensuring the health and dignity of individuals. In many developing countries, including Ethiopia, waterborne disease has become a major public health problem. There is a significant gap in accessing comprehensive national-wide evidence on Household Water Treatment (HWT) practices and associated factors in Ethiopia. Therefore, this study aims to assess the pooled HWT practice and associated factors in Ethiopia. A comprehensive search of published studies before October 15, 2022, was identified using databases and other sources. Data were extracted using Microsoft Excel, and analysis was performed using STATA 14/SE software. A random-effects model was used to estimate the pooled proportion of HWT practices and the odds ratio of associated factors. The funnel plot and Egger's regression test were used to assess publication bias, and I2 test statistics was used to assess heterogeneity. Duval and Tweedie's "trim and fill" method was performed to adjust the pooled estimate. A subgroup analysis was also conducted to identify the sources of heterogeneity. In this study, a total of 708 articles were retrieved, and 16 eligible studies were included. The pooled proportion of HWT practice in Ethiopia was found to be 21% (95% CI: 17-24). Having a formal education (OR: 2.42, 95% CI (2.11-2.74)), being male (OR: 1.32, 95% CI (1.13-1.51)), owning radio (OR: 1.33, 95% CI (1.18-1.47)), having a higher income (OR: 1.73, 95% CI (1.41-2.04)), unimproved water source (OR: 1.71, 95% CI (1.41-2.01)), fetching water at more frequently (OR: 3.31, 95% CI (1.99-4.64)), dipping methods of water drawing (OR: 2.08, 95% CI (1.66-2.51)), and taken training of water treatment (OR: 2.15, 95% CI (1.55-2.75)) were all found to be associated with HWT practice. Based on the findings of this study, the pooled proportion of HWT practice in Ethiopia was found to be one-fifth, which indicated that it was significantly low. Therefore, the authors recommend that households could better receive adequate information about HWT practices through strengthened health education and intensive training on HWT.

Prevalence of occupational respiratory symptoms and associated factors among industry workers in Ethiopia: A systematic review and meta-analysis.

BACKGROUND: Occupational respiratory diseases are major global public health problems, particularly for industry workers. Several studies have investigated occupational respiratory symptoms in various parts of Ethiopia. The findings have been inconsistent and inconclusive, and there is no nationally representative data on the subject. Therefore, this study aimed to estimate the pooled prevalence and factors associated with occupational respiratory symptoms among industry workers in Ethiopia (2010-2022). METHODS: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis framework Guidelines, search was conducted on several international databases including PubMed, CINAHL, African Journals Online, Hinari, Global Health, and Google scholar. The extracted data was analyzed using STATA 14. Random effect model was used to estimate the effect size. Egger regression test and I2 statistics were used to determine potential publication bias and heterogeneity, respectively among the reviewed articles. RESULTS: The meta-analysis included a total of 15 studies with 5,135 participants, revealing a pooled prevalence of 51.6% (95% CI: 43.6-59.6) for occupational respiratory symptoms among industry workers in Ethiopia. The absence of personal protective equipment (OR = 1.97, 95% CI: [1.17-3.32]), lack of occupational health and safety training (OR = 3.04, 95% CI: [2.36-3.93]), previous dust exposure (OR = 3.17, 95% CI: [2.3-4.37]), poor working environment (OR = 2.4, 95% CI: [1.7-3.2]), work experience greater than five years (OR = 4.04, 95% CI: [1.61-10.16]), smoking (OR = 6.91, 95% CI: [2.94-16.2]), and previous respiratory illness (OR = 4.25, 95% CI: [2.44-7.42]) were found to associate with the symptoms. CONCLUSIONS: The high prevalence of occupational respiratory symptoms among industry workers in Ethiopia underscores the urgent need for effective interventions. The provision of personal protective equipment and improvement of working environments by the government, industry owners, and other stakeholders are crucial in reducing occupational respiratory symptoms. Additionally, prioritizing occupational health and safety training for industry workers can help prevent and mitigate the impact of occupational respiratory diseases. REGISTRATION: This systematic review has been registered in the International Prospective Registry of Systematic Review (PROSPERO) with a specific registration number CRD42022383745.

A Retrospective Study on the Burden of Malaria in Northeastern Ethiopia from 2015 to 2020: Implications for Pandemic Preparedness.

Background: Regardless of various prevention and control strategies, malaria continues to be a significant public health problem in Ethiopia. As there are few studies on malaria trend analysis in Northeastern Ethiopia, it hinders the evaluation of ongoing and prioritization of new malaria intervention strategies, particularly during the period of pandemics. Therefore, the present study investigated the trend of malaria prevalence in Northeastern Ethiopia from 2015 to 2020. Methods: An institution-based retrospective study was employed to assess the trend of malaria prevalence over a 6-year period (2015-2020) in three districts (Jile tumuga, Aruma fursi, and Dawachefa) of Northeastern Ethiopia. Data were extracted from clinical records of malaria cases by trained medical laboratory technologists. The associations between the prevalence of malaria and independent variables (age group, malaria transmission season, and districts) were assessed using chi-square test. P-values with a cut-off point of 0.05 were used to determine statistically significant associations. Results: In our study area, a total of 212,952 malaria suspected patients were diagnosed over the 6 years. Of these, 33,005 (15.5%) were confirmed malaria cases. The identified Plasmodium species were Plasmodium falciparum and P. vivax, accounting for 66.4% and 33.6%, respectively. These with the age of >15 years old were the most affected (41.9%). The highest numbers of malaria cases (34.6%) were recorded during spring season (September to November). The prevalence of Plasmodium species showed a significant association with age (X2=9.7; p=0.002), districts (X2=13.5; p<0.001), and malaria transmission season (X2=16.5; p<0.001). Conclusion: In our study area, P. falciparum is the dominant species. We noted that malaria remains a public health concern and fluctuates throughout the years. Therefore, national, regional, zonal, and district health bureaus should strengthen the ongoing and devise appropriate prevention and control strategies even during the period of pandemics.