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Background: Poor attachment, suckling, and positioning contribute to ineffective breastfeeding techniques. Poor weight gain, stunting, and decreased immunity are caused by insufficient breast milk intake owing to ineffective breastfeeding techniques. Numerous primary studies conducted in Ethiopia have revealed negative effects of ineffective breastfeeding techniques. However, inconsistencies have been observed among these studies, and no review has been conducted to report the amalgamated magnitude and associated factors. Therefore, this review aimed to estimate the national prevalence and factors associated with ineffective breastfeeding techniques in Ethiopia. Methods: Using PRISMA standards, we systematically reviewed and meta-analyzed articles from PubMed, Cochrane Library, and Google Scholar to investigate the prevalence and associated factors of ineffective breastfeeding techniques. Q and I2 tests were used to assess heterogeneity across studies. To evaluate the national prevalence and effect size of the linked covariates, a weighted inverse variance random-effects model was used. Subgroup analysis was performed based on the region, sample size, and year of publication. Funnel plots and Egger's regression tests were used to examine publication bias. A sensitivity analysis was also performed to determine the impact of the studies. Results: The analysis included a total of eleven studies with 4,470 participants used in the analysis. The pooled prevalence of ineffective breastfeeding techniques in Ethiopia was 53.13% (45.49, 60.78) no formal education (AOR = 3.42; 95% CI:1.67–5.18; I2 = 72.2%; P = 0.0132), primipara (AOR = 2.72;95% CI:1.81–3.64; I2 = 46.7%; P = 0.131), postnatal care (PNC) (AOR = 1.84; 95% CI:1.35–2.32; I2 = 0%; P = 0.53), breastfeeding counseling (AOR = 1.93; 95% CI:1.23–2.63; I2 = 0%;P = 0.35), home delivery and having breast problem (AOR = 3.11; 95% CI:1.09–5.16; I2 = 0%;P = 0.877) and (AOR = 2.22; 95% CI:1.28–3.16; I2 = 0%;P = 0.80) respectively were significantly associated with ineffective breastfeeding techniques. Conclusion: The prevalence of ineffective breastfeeding techniques in Ethiopia remains high. Policymakers and program officials should focus on empowering women, increasing institutional delivery, and providing counseling on breastfeeding throughout the maternal continuum of care. These measures will improve breastfeeding techniques and lead to better health of both infants and women. [ABSTRACT FROM AUTHOR]

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

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

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

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

Background. Each year, immunization averts an estimated 2–3 million deaths from diphtheria, tetanus, pertussis, and measles. In 2011, nearly 107 million infants (83%) worldwide received at least 3 doses of DTP vaccine; however, approximately 22.4 million failed to receive 3 doses, and this causes large numbers of children susceptible to vaccine-preventable diseases and death. Nearly 8.4 million received at least 1 DTP dose. The aim of this was to assess coverage, opportunity, and challenges of EPI among children of age 12–23 months in Woldia town, Amhara region, Northeast Ethiopia. Method. In this mixed community-based cross-sectional study, 389 study subjects were selected by using a multistage sampling method. Interviewer-administered structured questioners were used. Data were entered and analyzed using SPSS Version 20 and presented by using tables and figures. Documented/recorded file from the qualitative data were transcribed into word narrative. Finally, it was presented by thematic analysis. Result. A total of 389 mothers/caretakers were interviewed. Based on vaccination card and mothers/caretakers' recall, 385 (99%) of the children took at least a single dose of vaccine. From total children, 4 (1%) were not immunized at all, 44 (11.3%) were partially immunized, and 343 (87.7%) were fully immunized. The dropout rate was 9% for BCG to measles, 2.4% for Penta1 to Penta3, 8.3% for penta1 to measles, and 1.6% for pcv1 to Pcv3. A qualitative study revealed that workload, shortage of vaccine, and noncompliance of the mother/caretaker for the next scheduled date was the major challenge faced by health professionals and health extension workers. Conclusion. Vaccination coverage was low compared with the Millennium Development Goals target. It is important to increase and maintain the immunization level to the intended target. Thus, the town health office and concerned stakeholders need to work more to improve the performance of the expanded program on immunization in this area. [ABSTRACT FROM AUTHOR]