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Background: Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are commonly used diabetes and obesity medications but have been associated with gastrointestinal (GI) adverse events. However, real-world evidence on comparative GI adverse reaction profiles is limited. Objectives: This study aimed to evaluate GI adverse events among GLP-1 RA users and compare semaglutide, dulaglutide, liraglutide, and exenatide safety regarding the GI adverse reaction profile. Methods: This retrospective cross-sectional analysis utilized real-world data on 10,328 adults with diabetes/obesity in the National Institutes of Health All of Us cohort. New GLP-1 RA users were identified, and GI adverse events were examined. Logistic regression determined factors associated with GI adverse events. Results: The mean age of the study population was 61.4 ± 12.6 years, 65.7% were female, 51.3% were White, and they had a high comorbidity burden. Abdominal pain (57.6%) was the most common GI adverse event, followed by constipation (30.4%), diarrhea (32.7%), nausea and vomiting (23.4%), GI bleeding (15.9%), gastroparesis (5.1%), and pancreatitis (3.4%). Dulaglutide and liraglutide had higher rates of abdominal pain, constipation, diarrhea, and nausea and vomiting than semaglutide and exenatide. Liraglutide and exenatide had the highest pancreatitis (4.0% and 3.8%, respectively). Compared to semaglutide, dulaglutide and liraglutide had higher odds of abdominal pain, and nausea and vomiting. They also had higher odds of gastroparesis than semaglutide. No significant differences existed in GI bleeding or pancreatitis risks between the GLP-1 RAs. Conclusions: In this real-world cohort, GI adverse events were common with GLP-1 RAs. Differences in GI safety profiles existed between agents, with exenatide appearing safer than other GLP-1 RAs, except for gastroparesis. These findings can inform GLP-1 RA selection considering GI risk factors. Further studies are needed to evaluate the causal relationship and GLP-1 RA safety with concomitant medication use.

BackgroundSuicide is a global issue. It is the third responsible for death among the reproductive age group. Pregnancy is a complicated event and crucial in the life of a woman with considerable physiological, hormonal changes, social, and mental changes. However, third-world countries like Ethiopia have not been investigated well. Therefore, the study planned to assess the magnitude and factors associated with suicidal ideation. Furthermore, it will identify the role of hyperemesis gravidarum on suicidal ideation.MethodA Cross-sectional study was employed for 543 pregnant participants attending antenatal care at Hiwot Fana Specialized University Hospital and Jugal General Hospital, Harari regional state, eastern Ethiopia from June 1 to August 1, 2022. The recruited participants were selected by systematic random sampling method. Suicide was assessed using Composite International Diagnostic by interview methods data collection. Epi data and STATA version 14.1 were used for data entry and analysis respectively. Candidate variables were entered into a multivariate logistic regression then those variables that have p-value < 0.05 were considered as significantly associated.ResultsThe magnitude of suicidal ideation in this study was found to be 11.15% at (95% CI: 8.75-14.11). Regarding the associated factor, unwanted pregnancy (AOR = 3.39: at 95% CI = 1.58-7.27), Hyperemesis gravidarum (AOR = 3.65: at 95% CI = 1.81-7.34), having depressive symptoms (AOR = 2.79: at 95% CI = 1.49-5.23), having anxiety symptoms (AOR = 3.37; at 95% CI = 1.69-6.68), experiencing intimate partner violence (AOR = 2.88: at 95% CI = 1.11-7.46), and having stress (AOR = 3.46; at 95% CI = 1.75-6.86) were significantly associated variable with suicidal ideation among pregnant women.Conclusion and recommendationThis study revealed that suicidal ideation is common among pregnant women. Regarding the associated factors unwanted pregnancy, hyperemesis gravidarum, having depressive and anxiety symptoms, experiencing intimate partner violence, and stress were significantly associated with suicidal ideation. Thus, giving awareness and early screening and interferences for antenatal suicide should be warranted.

BackgroundAntimicrobial-resistant (AMR) bacterial infection is a significant global threat to the healthcare systems. Pseudomonas aeruginosa, the leading infectious agent in the healthcare setting is now one of the major threats due to AMR. A comprehensive understanding of the magnitude of AMR, particularly highly public health important pathogens such as P. aeruginosa, is necessary for the management of infections based on local information.ObjectiveThis systematic review and meta-analysis aimed to determine the country-wide AMR of P. aeruginosa.MethodsSystematic searches were performed to retrieve articles from PubMed, Scopus, Web of Science, ScienceDirect electronic databases, Google Scholar search engine, and repository registrars from 2015 to 31st December 2023. Twenty-three studies that provided important data on AMR in P. aeruginosa were systematically reviewed and analyzed to determine the country-wide magnitude of P. aeruginosa AMR profile from healthcare-associated infections. AMR of P. aeruginosa to 10 different antibiotics were extracted separately into Microsoft Excel and analyzed using STATA 17.0. Cohen's kappa was computed to determine the agreement between reviewers, the Inverse of variance (I2) was used to evaluate heterogeneity across studies, and Egger's test to identify publication bias. A random effect model was used to determine the pooled resistance to each antibiotic. Subgroup analysis was performed by infection type and year of publication.ResultsThis systematic review and meta-analysis revealed that the pooled prevalence of P. aeruginosa in clinical specimens associated with HAI was 4.38%(95%CI: 3.00-5.76). The pooled prevalence of AMR in P. aeruginosa for different antibiotics varies, ranging from 20.9% (95%CI: 6.2-35.8) for amikacin to 98.72% (95%CI: 96.39-101.4) for ceftriaxone. The pooled resistance was higher for ceftriaxone (98.72%), Trimethoprim-sulfamethoxazole (75.41), and amoxicillin-clavulanic acid (91.2). In contrast relatively lower AMR were observed for amikacin (20.9%) and meropenem (28.64%). The pooled multi-drug resistance (MDR) in P. aeruginosa was 80.5% (95%CI: 66.25-93.84). Upon subgroup analysis by infection types and year of publication, P. aeruginosa isolated from healthcare-associated infections exhibited higher resistance to ceftazidime (94.72%) compared to isolates from mixed types of healthcare-associated infections (70.84%) and surgical site infections (57.84%). Antimicrobial resistance in gentamicin was higher during the periods of 2018-2020 (73.96%), while comparatively lower during 2021-2023 (42.69%) and 2015-2017 (29.82%).ConclusionsSignificantly high AMR and MDR were observed from this systematic review and meta-analysis. AMR obtained from this systematic review and meta-analysis urges the need for improved infection control, antimicrobial stewardship practices, and strengthened surveillance systems to control the spread of AMR and ensure effective treatment of P. aeruginosa infections.Protocol registrationThis systematic review and meta-analysis was registered on PROSPERO (Registration ID: CRD42024518145).

BackgroundDespite the decline in tuberculosis (TB) incidence across many regions worldwide, including Ethiopia, the disease remains highly concentrated among vulnerable or socially marginalized populations and in high-risk settings. This systematic review and meta-analysis aims to estimate the pooled prevalence of pulmonary tuberculosis (PTB) among key and vulnerable populations (KVPs) residing in hotspot settings in Ethiopia.MethodsPotential papers were searched systematically in PubMed, Scopus, ScienceDirect databases, Google Scholar search engine, and institutional electronic repositories/registrars. A total of 34 potential articles that provide necessary information on the prevalence of PTB were reviewed and data were analyzed to determine the pooled prevalence of PTB among KVPs. The relevant data were recorded and analyzed using STATA 17.0. Cohen's kappa was computed to determine the agreement between reviewers, the Inverse of variance (I2) to evaluate heterogeneity across studies, and Egger's test to identify publication bias. A random effect model was used to determine the pooled prevalence of PTB, subgroup analysis was computed by types of hotspot settings and year of publication.ResultsThis meta-analysis demonstrates that the pooled prevalence of PTB among populations residing in hotspot settings in Ethiopia was 11.7% (95% confidence interval (95CI): 7.97-15.43) with an I2 of 99.91% and a p< 0.001. Furthermore, the subgroup analysis unveiled the pooled prevalence of PTB among KVPs residing in different hotspot settings as follows: Prison inmates 8.8% (95CI: 5.00-12.55%), University students 23.1% (95CI: 15.81-30.37%), Refugees 28.4% (95CI: -1.27-58.15%), Homeless peoples 5.8% (95CI: -0.67-12.35%), Healthcare settings 11.1% (95CI: 0.58-21.63%), Spiritual holy water sites attendees 12.3% (95CI: -6.26-30.80%), and other high-risk settings 4.3% (95CI: 0.47-8.09%). Besides, the subgroup analysis revealed that the pooled prevalence of PTB post-2015 was 10.79% (95CI: 5.94-15.64%), whereas it stood at 14.04% (95CI: 10.27-17.82%) before 2015.ConclusionThe prevalence of PTB among KVPs residing in the hotspot settings in Ethiopia remains significant, with a weighted pooled prevalence of 11.7%. Thus, the national TB control programs should give due attention and appropriate control measures should be instituted that include regular systematic TB screening, compulsory TB testing for presumptive TB cases among KVPs, and tightened infection control at hotspot settings.

Abstract Antiretroviral Treatment (ART) has significantly decreased HIV-related morbidity and mortality among children despite the issue of drug resistance and subsequent treatment failure appearing as a challenge. Different studies have been conducted in Ethiopia regarding the prevalence of first-line ART failure among children but the magnitudes of these studies were inconsistent and had great variability. This review aimed to estimate the pooled prevalence of first line ART failure among children and its association with drug substitution and sex of children among first-line ART users in Ethiopia. The review was conducted using both published and unpublished studies until September 2020 in Ethiopia. MEDLINE, PubMed, Hinari, Web of Science, Google Scholar, Africa journal online (AJOL), Open gray literature, and online repository articles were searched. The quality of individual studies was assessed by Joanna Briggs Institute's (JBI) critical appraisal checklist. The statistical analysis was done by STATA-14 software and a random effect model was used. Heterogeneity was assessed using forest plot Cochrane Q–test and I-squared statistic. Publication bias was checked by using a funnel plot and Egger’s and Begg’s statistical tests. The interpretation was made by an odds ratio and with their respective 95% confidence intervals. The heterogeneity rate was 90% and Begg’s and Egger’s for publication bias were insignificant with p-values of 0.89 and 0.11 respectively. The pooled prevalence of pediatric first line ART failure in Ethiopia was 14.98% (95% CI 11.74, 18.21). Subgroup analysis showed that the highest failure rate was virological (9.13%). Female children had 1.4 times more risk of first-line ART failure (OR = 1.42; 95% CI 1.08, 1.85). First-line ART failure among children in Ethiopia is considerably high. Being female increases the likelihood of facing first line ART failure. More attention should be given to female children.

Introduction The coronavirus disease is still not under the control globally and has caused various mental health problems such as depression, anxiety, suicide, and aggressive behavior in different populations. The pandemic-related issues which are applied to control the pandemic such as protection measures against COVID-19, social distancing, isolation, and quarantine can also trigger mental health problems. Objective This study aimed to assess suicidal behavior and aggression, and its correlates during COVID-19 among populations within institutional quarantine and isolation centers in Ethiopia. Method A cross-sectional study was conducted among a sample of 392 participants. The convenience sampling method was used to select the study participants. Suicide Behavioral Questionnaire-Revised (SBQ-R) and the Modified Overt Aggression Scale (MOAS)were applied to determine the suicide and aggressive behavior of study participants respectively. Epi-data 3.1 and SPSS 20.0were used to enter and analyze the data respectively. Logistic and linear regressions were fitted to explore correlates associated with suicidal behavior and aggression respectively. Results The prevalence of suicidal behavior was 8.7% (95% CI: 6.1, 11.5) whereas the mean total score of behavioral aggression was 2.45±5.90 (95% CI: 1.84, 3.08). Being female (AOR = 2.63, 95% CI: 1.09, 6.32), having common mental disorders (AOR = 6.08, 95% CI: 2.32, 15.93), manifesting the symptoms of COVID-19 (AOR = 2.17, 95% CI: 1.48, 2.86), and poor social support (AOR = 7.30, 95% CI: 1.44, 37.10) were significantly associated with suicidal behavior, whereas male gender (β coefficient = 3.0, 95% CI: 1.35, 4.70), low level of knowledge about COVID-19 (β coefficient = 1.87, 95% CI: 1.09, 3.41), and substance use (β coefficient = 1.7, 95% CI: 1.23, 6.47) were positively associated with mean overt aggression score. Conclusion The present study revealed that suicidal and aggressive behaviors were prevalent with significant correlates. Therefore, it is important and required to provide focused mental health and psycho-social services for the selected and high-risk populations such as those in quarantine and isolation centers for being suspected.

Background: Adolescent girls are more likely to develop anemia as a result of physical and physiological changes that place a greater strain on their nutritional needs. Primary studies, on the other hand, may not be sufficient to provide a complete picture of anemia in adolescent girls and its major risk factors. Objective: The study aimed to describe the pooled prevalence of adolescent girls’ anemia and the factors that contribute. Methods: We conducted a systematic review of observational studies using the databases CINAHL (EBSCO), PubMed, Science Direct, Cochrane Library, and Google Scholar. The Newcastle-Ottawa Scale was used to assess the quality of the articles, and studies of fair to good quality were included. We pooled anemia prevalence among adolescents and odds ratio estimates for risk factors. Subgroup analysis employing sample size and study setup was computed to determine the source of heterogeneity, and the I 2 test was used to identify the existence or absence of substantial heterogeneity during subgroup analysis. The pooled prevalence of adolescent girls’ anemia was calculated using a random-effects meta-analysis model. Results: The overall pooled prevalence of anemia among adolescent girls in Ethiopia was 23.03% (95% confidence interval: 17.07, 28.98). Low dietary diversity (odds ratio: 1.56; 95% confidence interval: 1.05, 2.32), illiterate mothers (odds ratio: 1.45; 95% confidence interval: 1.13, 1.86), household size greater than five (odds ratio: 1.65; 95% confidence interval: 1.14, 2.38), food-insecure households (odds ratio: 1.48; 95% confidence interval: 1.21, 1.82), and menstrual blood flow more than 5 days (odds ratio: 6.21; 95% confidence interval: 1.67, 23.12) were the identified factors associated with anemia among adolescent girls. Conclusion: The pooled prevalence of anemia among adolescent girls in Ethiopia was moderately high. Therefore, to combat the burden of anemia among adolescent girls offering nutritional education is crucial. Iron supplementation is also recommended for adolescent females who have a menstrual cycle that lasts longer than 5 days.

Background Food-borne diseases related to the consumption of meat and its products had public health importance worldwide. The problem became worst in Ethiopia as the result of the tradition of eating raw cattle meat. Salmonella species and Escherichia coli are important food-borne pathogens associated with meat contamination. Hence the current study aimed to assess the prevalence and antimicrobial susceptibility of Salmonella species and Extended-spectrum β-lactamase producing Escherichia coli from raw cattle meat at butcher houses in Hawassa city, Sidama regional state, Ethiopia. Method A cross-sectional study was done on the prevalence and antimicrobial susceptibility pattern of Salmonella species and Extended-spectrum β-lactamase producing E.coli from raw cattle meat at butcher houses in Hawassa city from September to December 2020. Socio-demographic data were collected using a structured questionnaire and raw cattle meat and swab samples were collected from meat cutting equipment. The collected samples transported using icebox to Hawassa University College of Medicine and Health Sciences Microbiology Laboratory for identification. Samples were grown on different culture media and antimicrobial susceptibility tests were determined by using Kirby disc diffusion method. Data were entered and analyzed into SPSS version 23. Descriptive statistics were done and P-value < 0.05 was considered as statistically significant. Result The overall prevalence of salmonella and ESBL producing E.coli among 556 samples collected from 278 butcher houses was 36 (6.47%) (95% CI: 1.68–1.79) of which 13 (2.3%) were ESBL producing E.coli and 23(4.1%) were salmonella species. Poor hand washing practice (AOR = 2.208; 95% CI: 1.249–3.904) and touching birr while selling meat (AOR = 0.75; 95% CI: (0.433–1.299) were found to be significantly associated with the prevalence of salmonella species and E.coli on cattle meat. The isolates showed moderate levels of resistance (60–70%) against Amoxicillin/ clavulanic acid and high susceptibility (85–100%) against gentamicin, cotrimoxazole, ceftazidime, and tetracycline and the overall multidrug resistance was 33.3%. Conclusion This study revealed moderately high prevalence of salmonella and E.coli due to poor hygiene and sanitation practices in the butcher shops. Furthermore, the existence of ESBL producing E.coli isolates clearly indicate the possible threat to public health. Therefore, inspection by the right agencies must be implemented in order to prevent food-borne outbreaks and antimicrobial resistance.

BackgroundFood-borne diseases related to the consumption of meat and its products had public health importance worldwide. The problem became worst in Ethiopia as the result of the tradition of eating raw cattle meat. Salmonella species and Escherichia coli are important food-borne pathogens associated with meat contamination. Hence the current study aimed to assess the prevalence and antimicrobial susceptibility of Salmonella species and Extended-spectrum β-lactamase producing Escherichia coli from raw cattle meat at butcher houses in Hawassa city, Sidama regional state, Ethiopia.MethodA cross-sectional study was done on the prevalence and antimicrobial susceptibility pattern of Salmonella species and Extended-spectrum β-lactamase producing E.coli from raw cattle meat at butcher houses in Hawassa city from September to December 2020. Socio-demographic data were collected using a structured questionnaire and raw cattle meat and swab samples were collected from meat cutting equipment. The collected samples transported using icebox to Hawassa University College of Medicine and Health Sciences Microbiology Laboratory for identification. Samples were grown on different culture media and antimicrobial susceptibility tests were determined by using Kirby disc diffusion method. Data were entered and analyzed into SPSS version 23. Descriptive statistics were done and P-value < 0.05 was considered as statistically significant.ResultThe overall prevalence of salmonella and ESBL producing E.coli among 556 samples collected from 278 butcher houses was 36 (6.47%) (95% CI: 1.68-1.79) of which 13 (2.3%) were ESBL producing E.coli and 23(4.1%) were salmonella species. Poor hand washing practice (AOR = 2.208; 95% CI: 1.249-3.904) and touching birr while selling meat (AOR = 0.75; 95% CI: (0.433-1.299) were found to be significantly associated with the prevalence of salmonella species and E.coli on cattle meat. The isolates showed moderate levels of resistance (60-70%) against Amoxicillin/ clavulanic acid and high susceptibility (85-100%) against gentamicin, cotrimoxazole, ceftazidime, and tetracycline and the overall multidrug resistance was 33.3%.ConclusionThis study revealed moderately high prevalence of salmonella and E.coli due to poor hygiene and sanitation practices in the butcher shops. Furthermore, the existence of ESBL producing E.coli isolates clearly indicate the possible threat to public health. Therefore, inspection by the right agencies must be implemented in order to prevent food-borne outbreaks and antimicrobial resistance.

BackgroundType 2 diabetes is becoming highly prevalent worldwide and it is one of the leading causes of mortality. The cause of mortality among these patients is mostly related to the dominant presence of modifiable cardiovascular risk factors such as obesity. The aim of the current study is therefore to determine the prevalence of obesity and its associated factors among patients with type 2 diabetes mellitus at Sidama region, Ethiopia.MethodInstitution-based cross-sectional study design was implemented to determine the prevalence of obesity and its associated factor among patients with type two diabetes at Hawassa University Comprehensive Specialized Hospital and Yirgalem General Hospital from October 16 2018 to December 21, 2018. A simple random sampling technique was implemented to select 314 study participants. After obtaining consent, different patients' related data were collected using a questionnaire. Patients' records were also reviewed. 4ml of the blood sample was collected from each study participant and analyzed for lipid profile test. Blood glucose level was done using COBAS INTEGRA 6000. A binary logistic regression was used to assess factors that have an association with obesity. A P-value of ResultThe majority of the study participants (67.2%) were male and 61.8% of the study participants were aged >45years. The overall prevalence of overweight and obesity among the study participants was 36.3% and 18.8% respectively. About 41% of the study participants have a normal BMI. Females were more obese (28.2% Vs 14.2%) than males and BMI stratification by sex was statistically significant (P = 0.02). Sex (AOR = 3.0, CI = 1.6-5.7, P-Value = 0.001) and TG (AOR = 3.6, CI = 1.6-8.3, P-Value = 0.003) are factors that were independently associated with obesity among type 2 DM patients.ConclusionOverweight and obesity among type two diabetic patients were prevalent. In addition, obesity and overweight disorder are common among T2DM and gender and triglycerides levels were associated with obesity.

Background Type 2 diabetes is becoming highly prevalent worldwide and it is one of the leading causes of mortality. The cause of mortality among these patients is mostly related to the dominant presence of modifiable cardiovascular risk factors such as obesity. The aim of the current study is therefore to determine the prevalence of obesity and its associated factors among patients with type 2 diabetes mellitus at Sidama region, Ethiopia. Method Institution-based cross-sectional study design was implemented to determine the prevalence of obesity and its associated factor among patients with type two diabetes at Hawassa University Comprehensive Specialized Hospital and Yirgalem General Hospital from October 16 2018 to December 21, 2018. A simple random sampling technique was implemented to select 314 study participants. After obtaining consent, different patients’ related data were collected using a questionnaire. Patients’ records were also reviewed. 4ml of the blood sample was collected from each study participant and analyzed for lipid profile test. Blood glucose level was done using COBAS INTEGRA 6000. A binary logistic regression was used to assess factors that have an association with obesity. A P-value of Result The majority of the study participants (67.2%) were male and 61.8% of the study participants were aged >45years. The overall prevalence of overweight and obesity among the study participants was 36.3% and 18.8% respectively. About 41% of the study participants have a normal BMI. Females were more obese (28.2% Vs 14.2%) than males and BMI stratification by sex was statistically significant (P = 0.02). Sex (AOR = 3.0, CI = 1.6–5.7, P-Value = 0.001) and TG (AOR = 3.6, CI = 1.6–8.3, P-Value = 0.003) are factors that were independently associated with obesity among type 2 DM patients. Conclusion Overweight and obesity among type two diabetic patients were prevalent. In addition, obesity and overweight disorder are common among T2DM and gender and triglycerides levels were associated with obesity.

BackgroundThere was limited data on treatment outcomes among patients with diabetic ketoacidosis (DKA) in Ethiopia.ObjectiveThe aim of the study was to determine the treatment outcomes of DKA patients attending Debre Tabor General Hospital.MethodA retrospective study was conducted at Debre Tabor General Hospital and data were collected from June 1 to June 30 of 2018. Participants included in the study were all diabetic patients with DKA admitted from August 2010 to May 31, 2018. The primary outcomes were the treatment outcomes of DKA including (in-hospital glycemic control, the length of hospital stay and in-hospital mortality). The statistical analysis was carried out using Statistical Package for Social Sciences (SPSS) version 22. Descriptive statistics was presented in the form of means with standard deviation and binary regression was conducted to determine factors that affect length of hospital stay among DKA patients.Result387 patients were included in the study. The mean age of patients was 33.30± 14.96 years. The most common precipitating factor of DKA was new onset diabetes mellitus 150(38.8%). The mean length of hospital stay was 4.64(±2.802) days. The mean plasma glucose at admission and discharge was 443.63(±103.33) and 172.94 (±80.60) mg/dL, respectively. The majority 370 (95.60%) of patients improved and discharged whereas 17 (4.40%) patients died in the hospital. Patients with mild and moderate DKA showed short hospital stay; AOR: 0.16 [0.03-0.78] and AOR:0.17[0.03-0.96] compared with severe DKA. Diabetic ketoacidosis precipitated by infection were nearly five times more likely to have long hospital stay than DKA precipitated by other causes; AOR: 4.59 [1.08-19.42]. In addition, serum glucose fluctuation during hospitalization increased the likelihood of long hospital stay, AOR: 2.15[1.76-2.63].ConclusionsNew onset type 1 diabetes was the major precipitating factor for DKA. Admitted DKA patients remained in hospital for a duration of approximately five days. About five out of hundred DKA patients ended up with death in the hospital. Infection, serum glucose fluctuations and severity of DKA were determinants of long hospital stay. Early prevention of precipitating factors and adequate management of DAK are warranted to reduce length of hospital stay and mortality.

Background Nowadays, malnutrition among the advanced age (60 years and older) population is becoming a public health problem worldwide, especially in low-income countries including Africa. Hence, the prevalence in Africa is still not known. So, this review aimed to assess the pooled prevalence of under-nutrition among the advanced age population in Africa. Methods A study search was carried out using databases (such as African Journals Online, Web of Science, Global Index Medicus, Embess, and PubMed) and gray literature following PRISMA guidelines from April 20, 2022, to May 30, 2022, with no restriction on date of publication. We used a standardized extraction format to compile eligible studies as per the inclusion criteria. Then, systematic review and meta-analysis were employed using a random effect model to obtain the pooled prevalence of malnutrition among aged population living in Africa. The counter-funnel plot and at the 5% significance level, Egger’s test and Begg’s test were used to check for publication bias. Furthermore, a meta-regression analysis was carried out to identify the relationship between the outcome of interest and different predictors. Results A total of 731 studies were identified and 28 met the inclusion criteria, which were conducted in 17 African countries. The pooled prevalence of under-nutrition in Africa was 17% (95%CI; 13.5–20.6). The prevalence of malnutrition among the elderly varied significantly across countries, ranging from 1.8% (95% CI; 0.96–2.63) in South Africa to 39.47% (95% CI; 31.70–47.24) in Kenya. According to meta-regression analysis, the likelihood of a malnutrition problem would be reduced by a factor of 9.84 (β = -9.84, 95 percent CI; _-14.97, -4.70, P = 0.00) in upper-middle income countries. In addition, based on the publication year, malnutrition has decreased by a factor of 0.75 (β = -0.75, 95%CI:-1.49, -0.01, P = 0.04) from 1998 to 2021. Conclusion There is a high prevalence of malnutrition among the aged population. So, this underserved population should be targeted for intervention programs and/or integrated into maternal and child nutrition programs.

BackgroundNowadays, malnutrition among the advanced age (60 years and older) population is becoming a public health problem worldwide, especially in low-income countries including Africa. Hence, the prevalence in Africa is still not known. So, this review aimed to assess the pooled prevalence of under-nutrition among the advanced age population in Africa.MethodsA study search was carried out using databases (such as African Journals Online, Web of Science, Global Index Medicus, Embess, and PubMed) and gray literature following PRISMA guidelines from April 20, 2022, to May 30, 2022, with no restriction on date of publication. We used a standardized extraction format to compile eligible studies as per the inclusion criteria. Then, systematic review and meta-analysis were employed using a random effect model to obtain the pooled prevalence of malnutrition among aged population living in Africa. The counter-funnel plot and at the 5% significance level, Egger's test and Begg's test were used to check for publication bias. Furthermore, a meta-regression analysis was carried out to identify the relationship between the outcome of interest and different predictors.ResultsA total of 731 studies were identified and 28 met the inclusion criteria, which were conducted in 17 African countries. The pooled prevalence of under-nutrition in Africa was 17% (95%CI; 13.5-20.6). The prevalence of malnutrition among the elderly varied significantly across countries, ranging from 1.8% (95% CI; 0.96-2.63) in South Africa to 39.47% (95% CI; 31.70-47.24) in Kenya. According to meta-regression analysis, the likelihood of a malnutrition problem would be reduced by a factor of 9.84 (β = -9.84, 95 percent CI; _-14.97, -4.70, P = 0.00) in upper-middle income countries. In addition, based on the publication year, malnutrition has decreased by a factor of 0.75 (β = -0.75, 95%CI:-1.49, -0.01, P = 0.04) from 1998 to 2021.ConclusionThere is a high prevalence of malnutrition among the aged population. So, this underserved population should be targeted for intervention programs and/or integrated into maternal and child nutrition programs.

Abstract Objective The purpose of this study was to determine the prevalence of intestinal parasitic infections among patients who had attended Hawassa University students’ clinic, Southern Ethiopia. Result Over the 10 years period, a total of 13,679 patients visiting Hawassa University students’ clinic were included in the study. A total of 6553 (47.9%) patients were positive for at least one intestinal parasite. The overall prevalence of intestinal helminth and protozoan infections was 20.3% and 27.6% respectively. There were four dual infections and one triple infection. E. histolytica/E. dispar trophozoite was the most common identified parasite, which was seen in 18% of the patients while Enterobius vermicularis (0.1%) was the least reported parasite. Other parasites identified were Ascaris lumbricoides (15.0%), Hookworm species (2.0%), Taenia species (1.8%), Hymenolepis nana (0.7%), Strongyloides stercoralis (0.3%), Trichuris trichuria (0.2%), and Shistosoma mansoni (0.2%). The prevalence of helminthes was higher in females (23.3%) than in males (19.5%) (P

ObjectiveTo assess the rate of glycemic control and associated factors among type 2 diabetes mellitus patients at Dilchora Referral Hospital, Dire Dawa, Eastern Ethiopia.MethodsA cross-sectional study was conducted from 13 May to 16 August 2019. Type 2 diabetic patients on follow up at Dilchora Referral Hospital who fulfilled the inclusion criteria of the study were included. Systematic random sampling was used to select study participants. Data was collected by a face-to-face interview and review of medical records. The primary outcome was the level of blood glucose during three consecutive visits. Poor glycemic control was defined as a blood sugar level of more than 154 mg/dL based on the average of measurements from three consecutive visits. Multivariate logistic regression analysis was used to identify determinants of glycemic control.ResultA total of 394 participants responded to the interview and were included in the final analysis. The overall prevalence of poor glycemic control was 45.2% (95%CI: 40.6%-50.0%). Patients who were on oral anti-diabetic drug plus insulin had more than two times greater chance of poor glycemic control than patients on oral anti-diabetic drug alone: 2.177(95%CI:1.10-4.29). The odds of poor glycemic control in patients who did not understand the pharmacist's instructions was two times higher than patients with good understanding of instructions 1.86(95%CI: 1.10-3.13). Patients who had poor level of practice were found to have poor glycemic control: 1.69(95% CI: 1.13-2.55).ConclusionThe overall prevalence of poor glycemic control was high among type 2 diabetes patients. Oral anti-diabetic drugs in combination with insulin, lack of understanding of pharmacist's advice, and poor practice of diabetic patients were significant factors of poor glycemic control. Pharmacists should reassure the understanding of patients before discharge during counseling. Optimization of the dose of antidiabetic medications and combination of oral hypoglycemic agents should be considered.

Abstract Background A considerable proportion of cardiovascular events could be attributed to poor adherence to antihypertensive medications. Adverse effects can be severe enough to affect adherence to antihypertensive medications. This study aimed to measure the contribution of adverse effects on antihypertensive medications adherence. Methods The study was conducted from May 1 to June 30, 2017, at the ambulatory clinic of University of Gondar Comprehensive Specialized Hospital (UOGCSH) in Gondar town. A binary logistic regression was performed to determine the significance of the association between adverse effects and adherence to antihypertensive medications. An institution-based cross-sectional study was conducted by administering a questionnaire to hypertensive patients who came for follow-up at the ambulatory clinic of UOGCSH. Level of adherence to antihypertensive medications was used as outcome measure. Results A total of 249 patients were included in the final analysis with a mean age of 56.51 years and a female majority (53%). The following variables were identified as predictors of poor adherence: tiredness [AOR (95% CI): 3.802 (1.723–8.391), p = 0.001], muscle pain [AOR (95% CI): 5.199 (1.407–19.214), p = 0.013], poor sleep [AOR (95% CI): 4.891 (1.578–15.160), p = 0.006] and, believing that the symptoms were caused by antihypertensive medications [AOR (95% CI): 3.249 (1.248–8.456), p = 0.016]. Conclusion Adverse effect significantly contributes to antihypertensive medication non-adherence among hypertensive patients.

BackgroundGlobally, the prevalence of obesity is on the rise and has nearly tripled since 1975. In Ethiopia, despite not having well-documented evidence, abdominal obesity has been increasing dramatically, particularly in urban settings. Therefore, this study is intended to determine the prevalence and risk factors of abdominal obesity among adults in Dilla town, Ethiopia.MethodsA community-based cross-sectional study was conducted between January and February 2018 in Dilla Town. A multi-stage sampling technique was employed to recruit 663 adults. The study was conducted in accordance with the World Health Organization (WHO) STEP wise approach. Waist circumference was measured using a flexible metric tape mid-way between the lowest rib and iliac crest with the participant standing at the end of gentle expiration. Abdominal obesity was determined using the International Diabetes Federation cutoff. A logistic regression model was fitted to identify risk factors of abdominal obesity. Adjusted odds ratio (AOR) with corresponding 95% confidence interval (CI) was calculated to show the strength of association.ResultsA total of 634 adults participated in the study with a response rate of 95.6%. This study revealed that 155 (24.4%) [95% CI: (21.50, 27.80)] adults were abdominally obese. Higher odds of being abdominally obese were noted among adults with a high [AOR = 4.61, 95% CI: (2.51-8.45)] and middle [AOR = 3.22, 95% CI: (1.76-5.88)] wealth rank, consuming less diversified diet [AOR = 2.05, 95% CI: (1.31-3.19)], physical inactivity [AOR = 2.68, 95% CI: (1.70-4.22)] and being female [AOR = 1.92, 95% CI: (1.13-3.28)].ConclusionsThe prevalence of abdominal obesity among adults in Dilla town is considerably high, and became an emerging nutrition related problem. Being in the middle and high wealth rank, physical inactivity, consuming less diversified diet, and being female were the risk factors of abdominal obesity.

[This corrects the article DOI: 10.1371/journal.pone.0207242.].

INTRODUCTION:Heart failure (HF), a major cardiovascular disorder, remains a grievous clinical condition regardless of advances in medical care. Hyponatremia is classified as a serum sodium concentration of

Human pathogens can survive and grow in hot springs. For water quality assessment, Escherichia coli or Enterococci are the main thermotolerant enteric bacteria commonly used to estimate the load of pathogenic bacteria in water. However, most of the environmental bacteria are unculturable thus culture methods may cause bias in detection of most pathogens. Illumina sequencing can provide a more comprehensive and accurate insight into environmental bacterial pathogens, which can be used to develop better risk assessment methods and promote public health awareness. In this study, high-throughput Illumina sequencing was used to identify bacterial pathogens from five hot springs; Maiwooi, Akwar, Garbanabra, Elegedi and Gelti, in Eritrea. Water samples were collected from the five hot springs. Total community DNA was extracted from samples using the phenol-chloroform method. The 16S rRNA gene variable region (V4-V7) of the extracted DNA was amplified and library construction done according to Illumina sequencing protocol. The sequence reads (length >200 bp) from Illumina sequencing libraries ranged from 22,091 sequences in the wet sediment sample from Garbanabra to 155,789 sequences in the mat sample from Elegedi. Taxonomy was assigned to each OTU using BLASTn against a curated database derived from GreenGenes, RDPII, SILVA SSU Reference 119 and NCBI. The proportion of potential pathogens from the water samples was highest in Maiwooi (17.8%), followed by Gelti (16.7%), Akwar (13.6%) and Garbanabra (10.9%). Although the numbers of DNA sequence reads from Illumina sequencing were very high for the Elegedi (104,328), corresponding proportion of potential pathogens very low (3.6%). Most of the potential pathogenic bacterial sequences identified were from Proteobacteria and Firmicutes. Legionella and Clostridium were the most common detected genera with different species. Most of the potential pathogens were detected from the water samples. However, sequences belonging to Clostridium were observed more abundantly from the mat samples. This study employed high-throughput sequencing technologies to determine the presence of pathogenic bacteria in the five hot springs in Eritrea.

There was a paucity of data on the magnitude of potentially inappropriate prescriptions (PIPs) among Ethiopian elderly cardiovascular patients.The aim of this study was to assess PIPs and associated factors in the elderly population with cardiovascular disorders using the START/STOPP screening criteria.A hospital-based cross-sectional study was conducted at medical wards of a teaching hospital in Ethiopia from 1 December 2016-30 May 2017. Included patients were hospitalized elderly patients aged 65 years or older with cardiovascular disorders; their medications were evaluated using the START/STOPP screening criteria from admission to discharge. Multivariable logistic regression was applied to identify factors associated with inappropriate medications. One Way Analysis Of Variance (ANOVA) was carried out to test significant differences on the number of PIPs per individual diagnosis.Two hundred thirty-nine patients were included in the analysis. More-than a third of the patients were diagnosed with heart failure, 88 (36.82%). A total of 221 PIPs were identified in 147 patients, resulting in PIP prevalence of 61.5% in the elderly population. Of the total number of PIPs, occurrence of one, two and three PIPs accounted for 83 (56.4%), 52(35.4%), and 12(8.2%) respectively. One way ANOVA test showed significant differences on the mean number of PIPs per individual diagnosis (f = 5.718, p

This study aimed to compare the perceptions of pharmacy clerkship students and clinical preceptors of preceptors’ teaching behaviors at Gondar University. A cross-sectional study was conducted among pharmacy clerkship students and preceptors during June 2014 and December 2015. A 52-item structured questionnaire was self-administered to 126 students and 23 preceptors. The responses are presented using descriptive statistics. The Mann-Whitney U test was applied to test the significance of differences between students and preceptors. The response rate was 89.4% for students and 95.6% for preceptors. Statistically significant differences were observed in the responses regarding two of the five communication skills that were examined, six of the 26 clinical skills, and five of the 21 parameters involving feedback. The mean scores of preceptors (2.6/3) and students (1.9/3) regarding instructors’ ability to answer questions were found to be significantly different (P= 0.01). Students and preceptors gave mean scores of 1.9 and 2.8, respectively, to a question regarding preceptors’ application of appropriate up-to-date knowledge to individual patients (P= 0.00). Significant differences were also noted between students and instructors regarding the degree to which preceptors encouraged students to evaluate their own performance (P= 0.01). Discrepancies were noted between students and preceptors regarding preceptors’ teaching behaviors. Preceptors rated their teaching behaviors more highly than students did. Short-term training is warranted for preceptors to improve some aspects of their teaching skills.

The World Health Organization (WHO) early warning indicators (EWIs) of HIV drug resistance (HIVDR) assess factors at individual ART sites that are known to create situations favourable to the emergence of HIVDR.In 2014, the Namibia HIV care and treatment program abstracted the following adult and pediatric EWIs from all public ART sites (50 main sites and 143 outreach sites): On-time pill pick-up, Retention in care, Pharmacy stock-outs, Dispensing practices, and Viral load suppression. Comparisons were made between main and outreach sites and between 2014 and 2012 using the Wilcoxon signed-rank test in a matched analysis.The national estimates were: On-time pill pick-up 81.9% (95% CI 81.1-82.8) for adults and 82.4% (81.3-83.4) for pediatrics, Retention in care 79% retained on ART after 12 months for adults and 82% for pediatrics, Pharmacy stock-outs 94% of months without a stock-out for adults and 88% for pediatrics, and Dispensing practices 0.01% (0.001-0.056) dispensed mono- or dual-therapy for adults and 0.01% (0.001-0.069) for pediatrics. Viral load suppression was significantly affected by low rates of Viral load completion. Main sites had higher On-time pill pick-up than outreach sites for adults (p