Global burden of out-of-hospital cardiac arrest in children: a systematic review, meta-analysis, and meta-regression.

The incidence of out-of-hospital cardiac arrest (OHCA) and its mortality among children decreased globally over the years. However, the incidence, mortality, and its determinants are heterogeneous globally. The current study was designed to investigate the incidence of OHCA, mortality, and its determinants based on a systematic review of published literature. A comprehensive search was conducted in PubMed/Medline; Science Direct, Cochrane Library, Hinari, and LILACS without language and date restrictions. The data were extracted with two independent authors in a customized format. The methodological quality of the included studies was evaluated using the Newcastle-Ottawa appraisal tool. A total of 2526 articles were identified from different databases with an initial search. Forty-eight articles with 138.3 million participants were included in the systematic review. The meta-analysis showed that the pooled rate of mortality was found to be 70% (95% CI: 57-81%, 42 studies, 28,345 participants). The incidence of OHCA and mortality among children was very high among children with significant regional disparity. Those children with cardiovascular causes of arrest, and initial nonshockable rhythm were independent predictors of OHCA-related mortality. This systematic review and meta-analysis is registered in Prospero (CRD42022316602). IMPACT: This systematic review addresses a significant health problem in a global context from 1995 to 2022. The meta-regression revealed that the incidence of OHCA and mortality of children decline over the years in high-income countries despite regional dispraises among individual studies. Body of evidence on the incidence of OHCA and mortality is lacking in low- and middle-income countries.

Efficacy and safety of wound infiltration modalities for postoperative pain management after cesarean section: a systematic review and network meta-analysis protocol.

BACKGROUND: Postoperative pain after a cesarean section has negative consequences for the mother during the postoperative period. Over the years, various postoperative pain management strategies have been used following cesarean section. Opioid-based analgesics and landmark approaches have negative side effects, while ultrasound-based regional analgesia necessitates resources and experience, but various wound infiltration adjuvants are innovative with few side effects and are simple to use. The efficacy and safety of each adjuvant, however, are unknown and require further investigation. OBJECTIVE: This network meta-analysis is intended to provide the most effective wound infiltration drugs for postoperative management after cesarean section. METHOD: A comprehensive search will be conducted in PubMed/MEDLINE, Cochrane Library, Science Direct, CINHAL, and LILACS without date and language restrictions. All randomized trials comparing the effectiveness of wound infiltration drugs for postoperative pain management after cesarean section will be included. Data extraction will be conducted independently by two authors. The quality of studies will be evaluated using the Cochrane risk of bias tool, and the overall quality of the evidence will be determined by GRADEpro software. DISCUSSION: The rate of postoperative acute and chronic pain is very high which has a huge impact on the mother, family, healthcare practitioners, and healthcare delivery. It is a basic human right to give every patient with postoperative pain treatment that is realistic in terms of resources, technique, cost, and adverse event profile. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42021268774.

Stressful life experience of the first married women in polygamous families in Gedeo zone, South Ethiopia: a qualitative study, 2021.

INTRODUCTION: Polygamy is commonly referred to as the union of a man with multiple women or the practice of having more than one wife at a time. In Ethiopia, polygamy has practiced in all regions. In particular, the stress of polygamous family life predisposes mothers to psychological problems. Being a serious public health issue, the stressful experience among polygamous women was not known in Ethiopia. AIM: To explore a stressful life experience among first married polygamous women in Gedeo Zone, South Ethiopia, 2021. METHODS: This study was conducted using a phenomenological study approach from February 20-30, 2021. A purposive sampling method was used and an in-depth interview was conducted. Data were collected from 13 first married women from polygamous. FINDINGS: Three themes emerged from the study including reaction to polygamy, socio-economic challenges in polygamy, and bonds of families in polygamy families. The finding indicated that the status of life experience among first married women in a polygamous family was stressful. They experienced various degrees of psychological difficulties including anger, mistrustfulness, emotional distress, loneliness, emptiness, unhappiness, and lack of intimacy with their husbands. CONCLUSION AND RECOMMENDATIONS: This study highlighted how polygamy is a complex issue and common practice in the Gedeo zone. There has to be a mechanism for serious follow-up to educate women properly. A long-lasting measure to empower women in the economy, social, political, and creating a level of consciousness to resist polygamy is important.

Community-based new born care practice and its associated factors among women who give birth at home in Ethiopia: cross-sectional study.

BACKGROUND: In Ethiopia, perinatal mortality rate was 33 per 1000 pregnancies and 64.4% of this death was occurred within the first 7 days of neonatal life. Moreover, more than 2.1% of new born babies were died within their first seven days of life in Ethiopia. Majority of neonatal deaths are preventable by applying an effective and lifesaving interventions. However, little is known about newborn care practice at the community level. METHODS: A community-based cross-sectional study design was used. Multi-stage sampling techniques were used to get a total of 540 mothers who gave birth at home within the past six months from their kebeles in Ethiopia. Data was collected by using face-to-face interview with structured questionnaires. Then the data was coded, cleaned, and entered into Epidemiological data version 3.1 and exported to statistical package for social science version 23.0 for analyses. Bivariate and multivariable logistic regression model was used to identify statistically significant associations between dependent and independent variables. The odds ratio at 95% confidence interval with P-Value 0.05% was computed. RESULTS: A total of 540 women were participated with a response rate of 98.3%. Only 208 (44%) of the women had good practice towards essential newborn care. Head of households [AOR (95%CI) 2.7417 (1.80-4.25)], type of birth attendant [AOR (95%CI) 3.962 (3.329-7.171)] and bad obstetrical history [AOR (95%CI) 3.151 (2.209-4.969)] were significantly associated with maternal newborn care practice. CONCLUSION: Less than half of the mothers had good newborn care practice. In this study, head of household, type of birth attendant, and bad obstetrical history were significantly associated with maternal newborn care practice. Therefore, Ministry of Women and Woreda women and Child offices needs to promote the socioeconomic empowerment of women to increase the practice of essential newborn care practices.

Assessment of HIV discordance and associated risk factors among couples receiving HIV test in Dilla, Ethiopia.

BACKGROUND: About 60% of new HIV infections occur in HIV sero-discordant couples as 30% of married HIV positives have negative spouse. Although HIV-discordant couples are at 10% annual risk of acquiring HIV infection and large number of new HIV infections occur in stable partnerships, most HIV prevention programs focus on reducing casual sexual partners, condom use, and increasing fidelity among married partners. The purpose is assessment of sero-discordance among couples and associated factors. METHODS: The study was facility based cross sectional survey of couples who tested for HIV in 2011 and lived together at least 1 year period. The sample size was 154 couples (308 individuals) and necessary ethical issues were considered. RESULTS: Among 152 couples (304 individuals) who received VCT, HIV sero-prevalence in this study was found to be 11(3.6%). The prevalence in females 8(5.3%) was higher than that in males 3(2.0%). Of all participants, 9(3.0%) were found to be sero-discordant, 2(0.7%) concordant positive and 293(96.4%) concordant negative. Of all couples 9(5.9%) were found to be sero-discordant, 2(1.3%) concordant positive and 141(92.8%) concordant negative. Of the 9 sero-discordant couples, the 7(4.6%) prevalence in females was higher than 2(1.3%) in males. And, among 9 discordant couples, 5 of them were premarital sex partner and the rest 4 were married couples. Premarital couples were significantly discordant than married couples, AOR=1.68; 95%CI (1.36- 5.40). HIV discordance was also significantly associated with having number of two or more sexual partners than one sexual partner AOR=4.06; 95%CI (2.41-10.13). CONCLUSION: The study indicated high prevalence of HIV discordance and increased risk of vulnerability. Therefore, couples should be aware of their own and their partners' sero-status before and after engagement. Again, the following risk reduction methods were recommended: education of discordant couples on 100% correct condom use, and if condom breaks, or if they forget to use, Post-Exposure Prophylaxis must be established; for those who are not volunteer to use condom and/or have a child, early initiation of ART to positive partner.

Epidemiology of needlestick injuries among health-care workers in Awassa City, Southern Ethiopia.

Accidental needlestick injuries sustained by health-care workers are a common occupational hazard and a public health issue in health-care settings. An analytical cross-sectional study was conducted and 30.9% of health-care workers had experienced at least one needlestick injury in the previous year.