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Background: Thrombocytopenia is a common haematological abnormality in malaria patients that is associated with an increased risk of mortality. Given the endemic nature of malaria in Ethiopia, it is crucial to comprehend the prevalence of thrombocytopenia in this setting to enhance clinical care. Therefore, this study aimed to systematically review and synthesize the available evidence on the prevalence of thrombocytopenia among malaria patients in Ethiopia. Methods: This systematic review and meta-analysis reviewed studies on thrombocytopenia prevalence in malaria patients, using databases including PubMed, Google Scholar, EMBASE, African Journals online database, and Hinary. STATA version 17 software was used for statistical analysis. A random-effects model was used to estimate pooled effect sizes. Heterogeneity among the included studies was assessed using Galbraith, Cochran's Q test, and I2 statistics. Subgroup analysis, sensitivity analysis, and meta-regression were conducted to identify the source of heterogeneity. Publication bias was evaluated using a funnel plot and Egger's test. Results: Of the 154 studies identified, 31 that fulfilled the eligibility criteria were included in the meta-analysis consisting of 1173 study participants and 823 thrombocytopenic cases. The pooled prevalence of thrombocytopenia was 70% (95% CI: 63, 77) with significant heterogeneity. Subgroup analysis showed the highest pooled prevalence of thrombocytopenia in the Southern Nations Nationalities and Peoples' region (78.34%) followed by the Amhara region (69.7%), whereas the lowest prevalence was observed in the Gambella Region (63.4%). The sample size was responsible for the observed heterogeneity among the studies, as indicated by the statistically significant result in the meta-regression analysis (p = 0.001). Conclusion: Thrombocytopenia is a frequent abnormality finding among malaria patients in Ethiopia, affecting a substantial percentage of individuals. The high frequency found in this research emphasizes the significance of regular platelet monitoring in the treatment of malaria patients. Further studies are needed to investigate the clinical implications of thrombocytopenia in malaria patients. [ABSTRACT FROM AUTHOR]

Introduction: Breast cancer remains the most common cancer and a leading cause of cancer-related deaths among women worldwide. In Ethiopia, the survival rate of breast cancer patients is influenced by various socio-demographic, clinical, and health system factors. This systematic review and meta-analysis aimed to identify and synthesize the predictors of survival rates among breast cancer patients in Ethiopia. Methods: We conducted a systematic review of observational cohort studies. The literature search was performed between August 1 and 30, 2024, using PubMed, Hinari, EMBASE, Google, Google Scholar, and Web of Science. The Newcastle Ottawa 2016 Critical Appraisal Checklist assessed methodological quality. Publication bias was evaluated using a funnel plot and Egger's test, and heterogeneity was examined with the I-squared test. Data were extracted with Microsoft Excel and analyzed using Stata 11. Results: A total of 15 articles with 6,375 study participants from six regions were included. We found that significant predictors of decreased survival rate among breast cancer patients were age (aHR 1.05, 95% CI 1.02–1.08), illiteracy (aHR 7.34, 95% CI 4.38–10.3), married (aHR 1.21, 95% CI 1.03–1.40), rural residence (aHR 1.71, 95% CI 1.06–2.36), two or more lymph node involvement (aHR 3.57, 95% CI 1.02–6.13), histological grade two or more (aHR 1.44, 95% CI 1.12–2.77), overweight (aHR 0.56, 95% CI 0.24–0.87), and having comorbidity (aHR 1.86, 95% CI 1.04–2.68). Conclusion: This systematic review and meta-analysis identified several key predictors of reduced survival rates among breast cancer patients in Ethiopia, including older age, illiteracy, rural residence, involvement of two or more lymph nodes, higher histological grade, marital status, and the presence of comorbidities. Interestingly, being overweight was associated with improved survival. Health stakeholders and policymakers emphasizing public health education, managing comorbidities, and expanding access to early detection and treatment, especially in rural areas, are critical. [ABSTRACT FROM AUTHOR]

Background: Ethiopian healthcare relies heavily on Health Extension Workers (HEWs), who deliver essential services to communities nationwide. By analyzing existing research, the authors explore how prevalent job satisfaction is and what factors affect it. This comprehensive analysis aims to improve HEW satisfaction through targeted interventions, ultimately leading to a more effective healthcare workforce and better health outcomes in Ethiopia. Specifically, this study estimates the pooled level of job satisfaction and associated factors among HEWs in Ethiopia using a systematic review and meta-analysis. Method: Studies were searched through the search engine of Cochrane Library, PubMed, Web of Science, Google Scholar. Data from included studies was extracted, organized in Excel, and then analyzed using STATA 17. The overall effect across all studies was calculated using a random-effect model. Potential publication bias and heterogeneity in the results between studies were assessed using Egger's test, forest plot, and I2 statistic, respectively. Results: The pooled level of job satisfaction among health extension workers in Ethiopia was 46% (95%CI: 32%–60%). Supportive supervision (AOR = 4.42; 95% CI: 2.23, 8.23), training opportunities (AOR = 4.69; 95% CI: 2.72, 6.61), and support from management (AOR = 4.90; 95% CI: 3.03, 6.77) were statistically associated with the level of job satisfaction among HEW in Ethiopia. Conclusion: The pooled level of job satisfaction was low. Getting supportive supervision from higher health experts, having favorable training opportunities, and having managerial support from kebele were found to be the statistically significant variables associated with job satisfaction among health extension workers in Ethiopia. [ABSTRACT FROM AUTHOR]

Background: Bacteremia is prevalent in neonates, largely attributed to factors inherent in the neonatal period. However, the prevalence of proven bacteremia in Ethiopian neonates has not been previously synthesized. Accordingly, this systematic review and meta-analysis aimed to analyze the prevalence of bacteremia and pathogen profiles in neonates hospitalized for clinical sepsis in Ethiopia. Methods: This systematic review and meta-analysis followed the preferred reporting items for systematic review and meta-analysis (PRISMA) 2020. The literature search was conducted across five databases including PubMed, Google Scholar, Web of Science, Science Direct, and Research for Life spanning from January 2015 to July 2023. The search strategy used MeSH terms and involved screening titles and abstracts, reviewing full-text articles, and including only observational studies published in English within the specified timeframe. Data extraction and quality assessment were performed by three experienced reviewers using a validated data collection tool and the Joanna Briggs Institute quality assessment tool, respectively. The prevalence of neonatal bacteremia was determined through a random effects model, with heterogeneity among studies assessed using the Q statistic and the I2 statistic. Publication bias was evaluated using a funnel plot and Egger's regression test, and STATA version 16.0 was used for all analysis at 95% confidence level. Results: A meta-analysis of nine studies revealed a bacteremia prevalence of 40.0% (95% CI: 34.0–46.0%). Subgroup analysis indicated variations in prevalence based on regions and study designs, with Oromia at 44.0% (95% CI: 28.0, 61.0%) and Amhara at 39.0% (95% CI: 27.0, 51.0%). Longitudinal studies exhibited a higher prevalence (47.0%, 95% CI: 27.0–68.0%) compared to cross-sectional designs (38.0%, 95% CI: 32.0–44.0%). Gram-negative bacteria were identified as the predominant etiological agents, representing 59.5% (95% CI: 56.8–62.3%) of cases. Among the bacterial species, Staphylococcus aureus emerged as the most prevalent (20.0%, 95% CI: 18.0%, 22.0%), followed by coagulase-negative staphylococci and Klebsiella pneumoniae, each contributing to 17.0% (95% CI: 15.0%, 20.0%) of bacteremia cases. Conclusion: The study revealed a significant high prevalence of bacteremia, with differences noted across regions and study designs. Key pathogens identified were Staphylococcus aureus, Klebsiella pneumoniae and coagulase-negative staphylococci. It is advisable to implement surveillance systems, targeted prevention strategies, diagnostic stewardship, and further research on regional variations and bacterial profiles to effectively enhance the ominous future. [ABSTRACT FROM AUTHOR]

Background: Hookworm infection is a common problem among schoolchildren and mothers in tropical and subtropical countries, causing cognitive impairment, growth retardation in children and anaemia, low birth weight, preterm birth, and intrauterine growth delay in susceptible mothers. Since schoolchildren generally have a higher prevalence due to behavioral and hygiene-related factors, our systematic review and meta-analysis aimed to determine the prevalence and risk factors for Hookworm infection among schoolchildren in Ethiopia. Methods: Relevant studies were retrieved from several search databases. The data were extracted via a standard data extraction format, and STATA version 11 was utilized for the analysis. Funnel plots and Egger's regression tests were used to evaluate publication bias, whereas the I2 test was used to determine heterogeneity. A random effects model meta-analysis was conducted to determine the pooled prevalence and associated factors of Hookworm infection among schoolchildren. Results: In this review, 48 studies with 43,285 participants were included. The pooled prevalence of Hookworm among schoolchildren was 13.01% (95% CI: 10.52, 15.51). Hookworm infection was significantly associated with the inability to use protective footwear (OR = 5.90, 95% CI: 2.86, 12.18) and the inability to use latrines (OR = 3.04, 95% CI: 1.77, 5.23). Subgroup analysis by diagnostic methods revealed that the highest prevalence of Hookworm was found to be 28.50% (95% CI: 24.09, 32.91) using combinations of Kato-Katz, McMaster, and spontaneous tube sedimentation techniques. Conclusion: Our study revealed that a significant prevalence of schoolchildren were affected by Hookworms, with substantial regional variations. This suggests that there is a need for better control measures such as improving hygiene, sanitation, and protective measures such as footwear. In addition, a combination of one or more diagnostic methods should be employed for better detection of parasites. This systematic review and meta-analysis have been registered in PROSPERO with reference number CRD42024558542. [ABSTRACT FROM AUTHOR]

Introduction: Promoting the involvement of male partners in skilled delivery care is a strategy supported by the World Health Organization (WHO) to improve maternal and infant health outcomes. This systematic review and meta-analysis aimed to estimate the pooled prevalence of male partner involvement in delivery care service in Ethiopia and its contributing factors. Methods: We retrieved observational studies conducted in Ethiopia from PubMed, Google Scholar, Embase, Cochrane Library, Hinari, and Mednar using Boolean search terms. The Newcastle Ottawa 2016 Critical Appraisal Checklist assessed the methodological quality of the studies. Publication bias was evaluated with a funnel plot and Egger's test, and heterogeneity was checked using the I-squared test. Data were extracted into Microsoft Excel and analyzed using Stata 11 software. Results: 10 articles with 5,307 participants were included for analysis. The pooled prevalence of male partner involvement in delivery care service was 52.99% (95% CI: 40.63–65.35). Paternal secondary education and above (OR 1.99, 95% CI: 1.69, 2.30), paternal knowledge (OR 3.129, 95% CI: 1.901, 4.356), partner attitude (OR 2.39, 95% CI: 1.45–3.34), having ANC accompanying experience (OR 8.09, 95% CI: 3.14, 19.32), and urban residence (OR 2.12, 95% CI: 1.61, 2.64) were significantly associated with male partner involvement in delivery care service in Ethiopia. Conclusion: This study found that more than half of male partners in Ethiopia were involved in delivery care services. The key contributing factors for male partner involvement in delivery care services were paternal secondary education and above, paternal knowledge, partner attitude, ANC accompanying experience, and urban residence. Campaigns should be organized to improve knowledge, attitude, and effectively recognize men's involvement in skilled birth care. [ABSTRACT FROM AUTHOR]

Background: The duration between a patient's arrival at the Emergency Department (ED) and their actual departure, known as the Emergency Department Length of Stay (EDLOS), can have significant implications for a patient's health. In Ethiopia, various studies have investigated EDLOS, but a comprehensive nationwide pooled prevalence of prolonged EDLOS, which varies across different locations, is currently lacking. Therefore, the objective of this systematic review and meta-analysis is to provide nationally representative pooled prevalence of prolonged EDLOS and identify associated factors. Methods: In this study, we conducted a comprehensive systematic review and meta-analysis using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 checklist. We conducted a thorough search of numerous international databases, including PubMed/Medline, SCOPUS, Web of Science, and Google Scholar. The primary outcome was the prevalence of prolonged EDLOS. The secondary outcome was factors affecting the EDLOS. Random-effects model was used to since there was high heterogeneity. We also conducted subgroup analysis and meta-regression to investigate heterogeneity within the included studies. To assess publication bias, we used Egger's regression test and funnel plots. All statistical analyses were performed using STATA version 17.0 software to ensure accurate and reliable findings. Result: We have identified eight articles that met our inclusion criteria with a total sample size of 8,612 participants. The findings of this systematic review and meta-analysis indicate that the pooled estimate for the prevalence of prolonged EDLOS is 63.67% (95% CI = 45.18, 82.16, I2 = 99.56%, P = 0.0001). The study identified several significant factors associated with prolonged EDLOS, including patients admitted to overcrowded emergency departments (OR = 5.25, 95% CI = 1.77, 15.58), delays in receiving laboratory findings (OR = 3.12, 95% CI = 2.16, 4.49), and delays in receiving radiological results (OR = 3.00, 95% CI = 2.16, 4.16). Conclusion: In this review, the EDLOS was found to be very high. Overcrowding, delays in laboratory test findings, and delays in radiology test results make up the factors that have a statistically significant association with prolonged EDLOS. Given the high prevalence of prolonged EDLOS in this review, stakeholders should work to increase the timeliness of ED services in Ethiopia by proper disposition of non-emergency palliative patients to the appropriate destination, and implementing point-of-care testing and imaging. [ABSTRACT FROM AUTHOR]

Background: Seventy percent of epileptic patients may not experience seizures if they receive proper treatment with antiepileptic drugs (AEDs). However, many children and adolescents face poor seizure control (PSC). Therefore, the purpose of this review is to systematically and quantitatively summarize the pooled prevalence of PSC and its predictors among children with epilepsy in Ethiopia. Methods: The following databases were used to conduct a thorough literature search: Africa Journal of the Online Library, Hinari, Google Scholar, PubMed, Science Direct, EMBASE, Cochrane Database, Sci-Hub, and Scopus. To evaluate the quality of the studies, Newcastle‒Ottawa Scale (NOS) checklists were utilized. The data on study characteristics and prevalence estimates were then combined via random effects meta-analysis, followed by subgroup and sensitivity analyses. Both visual and statistical analyses were employed to assess for any potential publication bias. Results: This review analyzed a total of 12 main studies and reported that the overall prevalence of PSC was 42.42% (95% CI: 33.42–51.42). However, there was significant heterogeneity in the results based on the study region, design, and seizure-free period. The subgroup analysis revealed that the highest prevalence of PSC was found in Southern Nations, Nationalities, and Peoples' (SNNPs) studies (61.88%; 95% CI: 35.91–87.85), studies with a cross-sectional design (46.73%; 95% CI: 36.83–56.62), and studies with a seizure-free period < 6 months (44.69%; 95% CI: 34.51–54.86). However, the lowest prevalence was observed in the Amhara region (35.54%; 95% CI: 27.40–43.67), cohort studies (29.53%; 95% CI: 21.26–38.21), and studies with a seizure-free duration of six months or more (41.64%; 95% CI: 29.94–53.35). The results also revealed a significant correlation between PSC and medication nonadherence (4.64, 95% CI: 2.84–7.58), comorbidities (2.08, 95% CI: 1.01–4.26), and seizure type (3.59, 95% CI: 1.18–10.8). Conclusion: Based on this review, the findings suggest a notable prevalence of poorly controlled seizures (PSC) among children with epilepsy who are receiving antiepileptic drugs (AEDs) in Ethiopian outpatient epilepsy clinics. Seizures of tonic‒clonic status, comorbidities, and medication nonadherence were associated with poor seizure control. [ABSTRACT FROM AUTHOR]

Introduction: Obstetric fistula is a birth injury that causes the vagina to open abnormally. As a result, women may experience urinary leakage, which can lead to isolation, depression, and a lower quality of life. Due to the scarcity of evidence regarding the average recovery time for obstetric fistula in Ethiopia, Therefore, this study aimed to assess the recovery time for women with obstetric fistula in Ethiopia. Methods: Between September and 8 November 2023, published studies were searched using online databases including PubMed, Hinari, Epistemonikos, and Google Scholar. The systematic review was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria. Study quality was assessed using Egger's test and a visual inspection of funnel plot symmetry. Statistical analysis was performed using STATA version 17 software. A random-effects model was employed for analysis, and the Cochrane Q-test and I² statistics were used to assess heterogeneity among studies. Result: A total of six studies were included in this analysis. The minimum and maximum median survival times were 2.67 and 5.19 weeks, respectively. The pooled median recovery time was 4.05 weeks (95% CI: 2.92, 5.18) based on the random effects model. Heterogeneity among the included studies assessed by the I² statistic was 97.72% (p = 0.000). The p-value for Egger's regression test (0.017) was significant, indicating evidence of publication bias. Conclusion: The findings reveal a pooled median recovery time of 4.05 weeks, with considerable heterogeneity. Although these figures provide valuable insights, the presence of publication bias was evidenced by the asymmetric funnel plot and significant Egger's test. Efforts to address publication bias are essential to improve future meta- the reliability of the surveys has increased. Registration: : The protocol for this systematic review was pre-registered on the International Prospective Register of Systematic Reviews (Registration Number: CRD42023270497). [ABSTRACT FROM AUTHOR]

Background: Many adolescents are vulnerable to gender-based violence, and it is a major public health issue. Even though the burden of gender-based violence is still high in Ethiopia, there is a lack of summary information to address the problem. Therefore, this study aimed to assess the pooled magnitude and factors associated with gender-based violence among female students in Ethiopian higher educational institutions. Methods: The primary articles were searched using databases like PubMed, Google Scholar, CINAHL, SCOPUS, EMBASE, and African Journal Online. Articles that assessed the magnitude and factors associated with GBV among female students in Ethiopia were included. A Microsoft Excel spreadsheet was used to extract the data, which was then exported to Stata version 14 for further analysis. The statistical heterogeneity was evaluated using the I² test. Due to heterogeneity, a random effect meta-analysis model was employed. Publication bias was checked through Egger's weighted regression test and funnel plot. Results: This study included twenty-five primary studies with 13,013 participants. The prevalence of lifetime GBV (n = 7), sexual violence (n = 25), and physical violence (n = 7) was found to be 51.42% (42.38, 60.46), 46.53% (39.86, 53.21), and 37.93% (24.68, 51.18), respectively. Witnessing their mother's abuse by their father during childhood, a lack of open discussion in the family about reproductive health and related personal issues, alcohol consumption, and tight family control were some of the factors significantly associated with lifetime gender-based violence. Furthermore, those who had drunken friends, a regular boyfriend, multiple sexual partners, and chat chewing were factors significantly associated with lifetime sexual violence. Conclusions and recommendations: Our findings revealed that half of female students at higher institutions suffered from violence. So it is recommended to provide accessible information about the consequences of GBV and early intervention for students with the above factors. [ABSTRACT FROM AUTHOR]

This systematic review and meta-analysis aimed to examine the association between maternal education and completion of childhood vaccination among aged 12–23 months children in Ethiopia. Systematic review and meta-analysis. PubMed-Medline, EMBASE, SCOPUS, Global Health, and Google Scholar were searched for articles published from January 2010 to January 2020. The data extraction was reported based on the PRISMA guideline (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines. We performed the I2 test and a funnel plot to assess heterogeneity and check for publication bias. We assessed 841 studies for eligibility, of which 43 studies were included in the qualitative synthesis, and 28 studies were fully accessed for meta-analysis. The overall pooled effect of this systematic review and meta-analysis demonstrated a positive association between maternal education and completion of childhood vaccination. Having a primary level of maternal education was correlated with a 1.87 times higher likelihood (95% CI 1.76–1.98) of completing childhood vaccination compared to having no education. Furthermore, attending secondary education and above was associated with a 3.47 times higher likelihood (95% CI 3.18–3.78) of completing childhood vaccination compared to having no education. This systematic review and meta-analysis study revealed that as the level of maternal education increases, the completion of childhood vaccination accelerates. Therefore, investment in maternal education should be prioritized as an intervention. Empowering mothers through education can contribute to the reduction and prevention of vaccine-preventable diseases and associated risks. [ABSTRACT FROM AUTHOR]

Background Vaginal birth after caesarean section (VBAC) is an alternative to a caesarean section (CS) in the absence of repeat or new indications for primary CS. There is a knowledge gap regarding the trend and successful VBAC in Ethiopia. Therefore this systematic review and meta-analysis aimed to assess the trend, pooled prevalence of successful VBAC and its predictors in Ethiopia. Methods Electronic databases (SCOPUS, CINAHL, Embase, PubMed and Web of Science), Google Scholar and lists of references were used to search works of literature in Ethiopia. Stata version 14 was used for analysis and the odds ratios of the outcome variable were determined using the random effects model. Heterogeneity among the studies was assessed by computing values for I2 and p-values. Also, sensitivity analyses and funnel plots were done to assess the stability of pooled values to outliers and publication bias, respectively. Results A total of 12 studies with a sample size of 2080 were included in this study. The overall success rate of VBAC was 52% (95% confidence interval 42 to 65). Cervical dilatation ≥4 cm at admission, having a prior successful vaginal delivery and VBAC were the predictors of successful VBAC. Conclusions Meta-analyses and sensitivity analyses showed the stability of the pooled odds ratios and the funnel plots did not show publication bias. The pooled prevalence of successful VBAC was relatively low compared with existing evidence. However, the rate was increasing over the last 3 decades, which implies it needs more strengthening and focus to decrease maternal morbidity and mortality by CS complications. Promoting VBAC by emphasizing factors favourable for its success during counselling mothers who previously delivered by CS to enhance the prevalence of VBAC. [ABSTRACT FROM AUTHOR]

Objectives: This systematic review and meta-analysis aimed to: i) determine the pooled prevalence of acute diarrhea; and ii) synthesize and summarize current evidence on factors of acute diarrheal illnesses among under-five children in Ethiopia. Methods: A comprehensive systematic search was conducted in PubMed, SCOPUS, HINARI, Science Direct, Google Scholar, Global Index Medicus, Directory of Open Access Journals (DOAJ), and the Cochrane Library. This systematic review and meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. The methodological quality of each included article was assessed using the Joanna Briggs Institute (JBI) quality assessment tool for cross-sectional and case-control studies. A randomeffect meta-analysis model was used to estimate the pooled prevalence of diarrheal illnesses. Heterogeneity and publication bias were assessed using I2 test statistics and Egger's test, respectively. The statistical analysis was done using STATA™ software version 14. Results: Fifty-three studies covering over 27,458 under-five children who met the inclusion criteria were included. The pooled prevalence of diarrhea among under-five children in Ethiopia was found to be 20.8% (95% CI: 18.69-22.84, n = 44, I2 = 94.9%, p < 0.001). Our analysis revealed a higher prevalence of childhood diarrhea in age groups of 12-23 months 25.42% (95%CI: 21.50-29.35, I2 = 89.4%, p < 0.001). In general, the evidence suggests that diarrheal risk factors could include: i) child level determinants (child's age 0-23 months, not being vaccinated against rotavirus, lack of exclusive breastfeeding, and being an under-nourished child); ii) parental level determinants {mothers poor handwashing practices [pooled odds ratio (OR) = 3.05; 95% CI:2.08-4.54] and a history of maternal recent diarrhea (pooled OR = 3.19, 95%CI: 1.94-5.25)}; and iii) Water, Sanitation and Hygiene (WASH) determinants [lack of toilet facility (pooled OR = 1.56, 95%CI: 1.05-2.33)], lack handwashing facility (pooled OR = 4.16, 95%CI: 2.49-6.95) and not treating drinking water (pooled OR = 2.28, 95% CI: 1.50-3.46). Conclusion: In Ethiopia, the prevalence of diarrhea among children under the age of five remains high and is still a public health problem. The contributing factors to acute diarrheal illnesses were child, parental, and WASH factors. A continued focus on improving access to WASH facilities, along with enhancing maternal hygiene behavior will accelerate reductions in diarrheal disease burden in Ethiopia. [ABSTRACT FROM AUTHOR]

Background: Diabetes is a major health concern globally and in Ethiopia. Ensuring optimal diabetes management through minimizing drug therapy problems is important for improving patient outcomes. However, data on the prevalence and factors associated with unmet drug-related needs in patients with diabetes in Ethiopia is limited. This systematic review and meta-analysis aims to provide a comprehensive analysis of the prevalence of unmet drug-related needs among patients with diabetes mellitus in Ethiopia. Methods: A thorough exploration of databases, including PubMed, Scopus, Hinari, and Embase and Google Scholar, was conducted to identify pertinent studies. Inclusion criteria involved observational studies that reported the prevalence of unmet drug-related needs in Ethiopian patients with diabetes. The quality of the studies was assessed using Joanna Briggs Institute (JBI) checklists. A random-effects meta-analysis was employed to amalgamate data on study characteristics and prevalence estimates, followed by subsequent subgroup and sensitivity analyses. Graphical and statistical assessments were employed to evaluate publication bias. Results: Analysis of twelve studies involving 4,017 patients revealed a pooled prevalence of unmet drug-related needs at 74% (95% CI 63-83%). On average, each patient had 1.45 unmet drug-related needs. The most prevalent type of unmet need was ineffective drug therapy, 35% (95% CI 20-50). Type 2 diabetes, retrospective study designs, and studies from the Harari Region were associated with a higher prevalence. Frequently reported factors associated with the unmet drug-related needs includesmultiple comorbidities, older age, and polypharmacy. Notably, the results indicated significant heterogeneity (I² = 99.0%; p value < 0.001), and Egger's regression test revealed publication bias with p<0.001. Conclusion: The prevalence of unmet drug-related needs among diabetes patients with diabetes in Ethiopia is high with the most prevalent issue being ineffective drug therapy. Targeted interventions are needed; especially patients on multiple medications, advanced age, with comorbidities, and prolonged illness duration to improve diabetes management and outcomes. Systematic review registration: https://www.crd.york.ac.uk/prospero, identifier CRD42024501096. [ABSTRACT FROM AUTHOR]

Background: One of the main factors contributing to maternal morbidity and mortality is induced abortion. The WHO estimates that over 44 million induced abortions take place annually around the world. The majority of these abortions—about 50%—are unsafe, significantly increasing maternal morbidity and contributing to 13% of maternal deaths. Thus, this review aimed to estimate the pooled prevalence of induced abortion and its associated factors in Africa. Methods: To find literature on the prevalence of induced abortion and its associated factors, a thorough search of the internet databases such as PubMed/MEDLINE, African Journals Online, and Google Scholar was conducted. The data were extracted using a structured method of data collection. Software called STATA 14 was used to do the analysis. funnel plot and Egger regression test were used to evaluate potential publication bias. I2 statistics and Cochrane's Q were used to measure the heterogeneity at a p-value < 0.05. Results: 976 studies were found through a thorough search of electronic databases. Finally, 46 full-text abstract papers were included in this study. The estimated pooled prevalence of induced abortion was 16% (95% CI: 13%-19%). According to the sub-group analysis, most studies were conducted in Ethiopia, and the pooled prevalence was 19% (95% CI: 10%–30%). Similarly, the subgroup analysis by year of study showed that the prevalence of induced abortion was 39% (95% CI: 17%–64%) among studies conducted in 2019. Conclusion: The results of this study thus imply that the pooled prevalence of induced abortion is higher than that of earlier studies that were published in some nations. the data from this study are needed to support reproductive and adolescent health programmers and policymakers and to formulate recommendations for future clinical practice and guidelines. [ABSTRACT FROM AUTHOR]

Introduction: Neisseria gonorrhea (N. gonorrhea) represents a significant causative agent of sexually transmitted infections (STIs), posing considerable global health challenges. Despite the presence of diagnostic tools and empirically guided therapies, the escalating AMR of N. gonorrhea continues to pose a threat. This study aims to assess the prevalence of N. gonorrhea among STI suspected patients in Ethiopia and explore the patterns of AMR to common antimicrobials. Methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we conducted a systematic review and meta-analysis. A thorough search of electronic databases from July 11 to July 24, 2023, identified 10 eligible studies. Data were extracted and analyzed using a random-effects model. Heterogeneity was assessed using the I² statistic, and publication bias was evaluated through Egger's regression test and funnel plots. Results: The overall pooled prevalence of N. gonorrhea among STI suspected patients in Ethiopia was 20% (95% confidence interval (CI): 8--30, I² = 99.0%; p-value <0.001). Substantial regional variations were observed, with the highest prevalence in Addis Ababa (55, 95% CI: 45--65) and the lowest in the Southern Nations, Nationalities, and Peoples' Region (SNNPR) (4, 95% CI: 2--8). The pooled prevalence of AMR to ciprofloxacin, ceftriaxone, azithromycin, benzylpenicillin, tetracycline, and spectinomycin was 37, 9, 10, 79, 93, and 2%, respectively. Significant heterogeneity existed between studies (I² = 99.0%; p value <0.001). Publication bias, identified through funnel plot examination and Egger's regression test (p < 0.001), execution of trim and fill analysis resulted in an adjusted pooled prevalence of (6.2, 95% CI: -6.8 to 19.3). Conclusion: The prevalence of N. gonorrhea among STI suspected patients in Ethiopia is alarming, particularly in specific regions. The elevated AMR to ciprofloxacin underscores the immediate need for alternative treatment options and enhanced surveillance systems. Future initiatives should prioritize strengthening laboratory capacities and implementing targeted interventions to curtail N. gonorrhea transmission and prevent the emergence of AMR. [ABSTRACT FROM AUTHOR]

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 [ABSTRACT FROM AUTHOR]

Background: Depression is a major public health problem and negatively affects the quality of life of patients with epilepsy. Despite multiple studies investigating the magnitude and predictors, the results have been inconsistent. Therefore, this study aimed to estimate the pooled prevalence and factors associated with depressive symptoms among patients with epilepsy in Ethiopia. Methods: The primary articles were searched using databases like PubMed, Google Scholar, CINAHL, SCOPUS, EMBASE, and African Journal Online. A total of 10 primary articles that assessed the prevalence and factors associated with depressive symptoms among patients with epilepsy in Ethiopia were included. A Microsoft Excel spreadsheet was used to extract the data, which was then exported to Stata version 14 for further analysis. The statistical heterogeneity was evaluated using the I2 test. Due to heterogeneity, a random effect metaanalysis model was employed. Publication bias was checked through Egger’s weighted regression test and funnel plot. Results: A total of 10 primary studies with 3,532 participants were included. The pooled prevalence of depressive symptoms among patients with epilepsy was found to be 41.69% (95% CI, 37.70, 45.68). The pooled prevalence of depressive symptoms was 48.61, 42.98, 40.68, 38.27, and 34.80% in Oromia, SNNPs, Amhara, Addis Ababa, and Tigray, respectively, based on a sub-group analysis per regional state. Perceived stigma (AOR  =  3.30, 95% CI: 1.40, 7.80), seizure frequency (AOR  =  3.81, 95% CI: 1.03, 14.09), and perceived stress (AOR  =  4.6, 95% CI: 1.05, 20.06) were factors associated with depressive symptoms. Conclusion: We found that depressive symptoms affects at least four out of ten patients with epilepsy, indicating an immense burden. Depressive symptoms were extremely prevalent in those who had high levels of stigma, a monthly seizure frequency of once or more, and perceived stress. Therefore, physicians should take extra precautions when treating patients with epilepsy who have certain conditions. Systematic review registration: This study was registered according to The International Prospective Register of Systemic Review (PROSPERO) with the registration ID (CRD42023484308). [ABSTRACT FROM AUTHOR]

Background: Potentially life-threatening maternal conditions (PLTCs) is an important proxy indicator of maternal mortality and the quality of maternal health services. It is helpful to monitor the rates of severe maternal morbidity to evaluate the quality of maternal care, particularly in low- and lower-middle-income countries. This study aims to systematically identify and synthesize available evidence on PLTCs. Methods: We searched studies in English from 2009‒2023 in PubMed, the National Library of Medicine (NLM) Gateway, the POPLINE database, and the Science Direct website. The study team independently reviewed the illegibility criteria of the articles. Two reviewers independently appraised the included articles using the Joanna Briggs Instrument for observational studies. Disputes between the reviewers were resolved by consensus with a third reviewer. Meta-analysis was conducted in Stata version 16. The pooled proportion of PLTCs was calculated using the random effects model. The heterogeneity test was performed using the Cochrane Q test, and its level was determined using the I2 statistical result. Using Egger's test, the publication bias was assessed. Result: Thirty-two cross-sectional, five case–control, and seven cohort studies published from 2009 to 2023 were included in the meta-analysis. The highest proportion of PLTC was 17.55% (95% CI: 15.51, 19.79) in Ethiopia, and the lowest was 0.83% (95% CI: 0.73, 0.95) in Iraq. The pooled proportion of PLTC was 6.98% (95% CI: 5.98–7.98). In the subgroup analysis, the pooled prevalence varied based on country income level: in low-income 13.44% (95% CI: 11.88–15.00) I2 = 89.90%, low-middle income 7.42% (95% CI: 5.99–8.86) I2 = 99.71%, upper-middle income 6.35% (95% CI: 4.21–8.50) I2 = 99.92%, and high-income 2.67% (95% CI: 2.34–2.99) I2 = 99.57%. Similarly, it varied based on the diagnosis criteria; WHO diagnosis criteria used 7.77% (95% CI: 6.10–9.44) I2 = 99.96% at P = 0.00, while the Centers for Disease Controls (CDC) diagnosis criteria used 2.19% (95% CI: 1.89–2.50) I2 = 99.41% at P = 0.00. Conclusion: The pooled prevalence of PLTC is high globally, predominantly in low-income countries. The large disparity of potentially life-threatening conditions among different areas needs targeted intervention, particularly for women residing in low-income countries. The WHO diagnosis criteria minimize the underreporting of severe maternal morbidity. Trial registration: CRD42023409229. [ABSTRACT FROM AUTHOR]

Background and Aims: Tuberculosis (TB) remained a major public health threat, particularly in developing countries with vulnerable groups, particularly prison inmates. A systematic review and meta‐analysis of individual studies with varying prevalence rates were performed to identify risk factors associated with the recent magnitude of TB among prisoners. Methods: A systematic search of research articles on the magnitude and risk factors of TB among prisoners in Ethiopia was conducted in registers, databases, and other sources. Cochran's Q, inverse variance (I2), sensitivity analysis, funnel plot, Begg's, and Egger's regression tests were used to check heterogeneity and publication bias. A random‐effects model was used to calculate the pooled burden of TB among prisoners. Results: The total national prevalence of TB among prisoners was 9.84% (95% confidence interval [CI]: 7.16–12.52). According to the subgroup analysis, the highest prevalence was observed in patients infected by latent TB (51.20%), the Southern nations, nationalities and people's region (SNNPR) (29.63%), studies conducted in ≤200 (17.50%) sample sizes, and from 2017 to 2022 (11.49%) study periods. TB infection among prisoners was significantly associated with a history of contact with TB patients (adjusted odds ratio [AOR] = 2.75; 95% CI: 0.98–4.52), coughing for ≥2 weeks (AOR = 0.08; 95% CI: −0.16–0.33), being incarcerated in overcrowded cells with poor ventilation (AOR = 0.39; 95% CI: −0.01–0.78), and increasing with the duration of imprisonment (AOR = 1.29; 95% CI: −0.39–2.97]. Conclusion: Expectably high TB magnitude is found among prison inmates in Ethiopia. Duration of incarceration, coughing, ventilation of the cell, and contact with TB patients were all predictors of TB among prisoners. The management of TB requires early diagnosis, adequate medication, and the implementation of preventative and control measures suitable for prison inmates. [ABSTRACT FROM AUTHOR]

Introduction: Physical activity and exercise during pregnancy have paramount importance for both the mother and fetus. Regardless of the benefits of exercise during pregnancy, significant proportion of women usually opt sedentary lifestyle during pregnancy. The aim of this systematic review and meta-analysis is to synthesis evidences on knowledge, attitude, and practice towards antenatal physical exercise among pregnant women in Ethiopia. Methods: The systematic review and meta-analysis was conducted on knowledge, attitude, practice, and associated factors towards antenatal physical exercise among pregnant women in Ethiopia. The systematic review and meta-analysis protocol was registered on PROSPERO website with registration number CRD42023444723. Articles were searched on international databases using medical subject heading and keywords. After ensuring eligibility, data were extracted using Microsoft excel and imported to STATA 17 for analysis. Cochran Q test and I2 statistics were used to check presence of heterogeneity. Weighted Inverse variance random effect model was used to estimate the pooled level of knowledge, attitude, and practice on antenatal physical exercise among pregnant women in Ethiopia. Funnel plot and egger's test were used to check presence of publication bias. Results: A total of 11 studies were included in this systematic review and meta-analysis. The pooled prevalence of adequate knowledge, favorable attitude and good practice towards antenatal physical exercise were 46.04% with 95% CI (44.45%-47.63%), 43.71%, 95% CI (41.95%-45.46%) and 34.06, 95% CI (20.04%-48.08%) respectively. Good knowledge AOR 2.38 95% CI(1.80–3.14), unfavorable attitude AOR 0.43 95% CI (0.32–0.58), having no pre-pregnancy habit of physical exercise AOR 0.44 95 CI (0.24–0.79) and having diploma or above education status AOR 3.39 95% CI (1.92–5.98) were significantly associated with practice of antenatal physical exercise. Conclusion: The level of knowledge, attitude and practice towards antenatal physical exercise among pregnant women was far below the recommended level in Ethiopia. Knowledge, attitude, education status and pre-pregnancy habit of physical exercise were significantly associated factors with antenatal physical exercise practice. It is highly essential to disseminate health information on the benefits of antenatal physical exercise for all pregnant women during antenatal care contacts. [ABSTRACT FROM AUTHOR]

Background: Neonatal deaths remain a serious public health concern in Ethiopia; being one of the top five countries contributing to half of the neonatal deaths worldwide. Although antenatal care (ANC) is assumed as one of the viable options that contribute to neonatal survival, findings from original studies indicated disparities in the effect of ANC on neonatal mortality. Thus, this review aimed to determine the pooled effect of ANC on neonatal mortality in Ethiopia. Methods: Databases such as PubMed, EMBASE, CINAHL, HINARI, and Cochrane Central Library were searched for articles using keywords. Selection of eligible articles and data extraction were conducted by an independent author. The risk of a bias assessment tool for non-randomized studies was used to assess the quality of the articles. Comprehensive meta-analysis version 2 software was used for meta-analysis. Heterogeneity and publication bias of included studies were assessed using I2 test statistic and Egger test, respectively. The random-effect model was employed; an outcome is reported using a risk ratio with a 95% confidence interval. Results: Of 28 included studies, 20 showed receiving at least one ANC visit had a significant association with neonatal mortality. Accordingly, the estimated pooled risk ratio for neonatal mortality was 0.59 (95% CI 0.45, 0.77) among infants born to women who had at least one ANC visit compared to infants born to women who had no ANC visits. Conclusion: This finding indicated that neonatal mortality was decreased among infants born to women who had at least one ANC visit compared to infants born to women who had no ANC visit. Therefore, promoting and strengthening ANC service utilization during pregnancy would accelerate the reduction of neonatal mortality in Ethiopia. Significance: In some studies, providing ANC services reduces the risk of neonatal mortality, in others, the ANC visits did not significantly decrease neonatal mortality in Ethiopia, which represents a dismal picture of neonatal mortality (NM) in sub-Saharan Africa (SSA) region. Therefore, evidence emanated from comprehensive searches of review performed with several studies represented from various regions of the country which determine the effect of ANC on NM is essential to reinforce strategies that could help for newborn survival and wellbeing of neonates in Ethiopia. Hence, this study aimed to systematically examine the effect of ANC on NM by combining a wide range of reviews, to provide concrete evidence for policymakers. [ABSTRACT FROM AUTHOR]

Background: Vaccines are playing a great role in prevention of many infectious diseases worldwide. Health professionals' knowledge towards vaccine cold chain management is an essential element of maintaining vaccine's potency at shelf and during transportation. Studies on health professionals' knowledge on vaccine cold chain management system and associated factors in Ethiopia have inconclusive findings. This systematic review and meta-analysis is aimed to produce the overall level of health professionals' knowledge on vaccine cold chain management system and to identify its associated factors in Ethiopia. Methods: Systematic review and meta-analysis was conducted on health professionals' knowledge on vaccine cold chain management in Ethiopia. It is registered under PROSPERO website with registration number CRD42023391627. Literature search was made on international data bases using medical subject heading and key words. Data were extracted using Microsoft excel and imported to STATA version 17 for analysis. Heterogeneity was checked using Cochrane Q test and I2 statistics. Weighted Inverse variance random effect model was used to estimate the pooled level of health professionals' knowledge on vaccine cold chain management. Publication bias was checked using funnel plot and using Egger's test. Results: A total of nine studies were included in the review. The pooled health professionals' good knowledge on vaccine cold chain management in Ethiopia is 49.92% with 95% CI (48.06–51.79). Having five years or more experience AOR 2.27 95% CI (1.72–2.99), being nurse AOR 3.03 95% CI (1.47–6.27), received on job training AOR 6.64 95% CI (4.60–9.57), EPI guideline available at facility AOR 2.46 95% CI (1.75.-3.48) are factors positively associated with health professionals' knowledge on vaccine cold chain management in Ethiopia. Conclusion: The pooled prevalence of good knowledge on vaccine cold chain management among health professionals is much lower than the expected level. There is a need to plan on job trainings for all vaccine handlers and other health professionals supposed to work on vaccination program. [ABSTRACT FROM AUTHOR]

Background. Pastoralist communities rely on their livestock for at least 50% of their food supply and source of income. Home births raise the risk of maternal morbidity and death, whereas institutional births lessen the likelihood of difficulties during labor. Around 70% of labors in pastoralist regions of Ethiopia were assisted by traditional birth attendants. Methods. Studies done from January 2004 to January 2023, accessed in PubMed, EMBASE, Medline, and other search engines, were included. PRISMA guidelines and JBI critical appraisal checklist were used to assure the quality of the review. Ten articles were included in this review. Data were extracted with Excel and exported to STATA 16 for analysis. Heterogeneity of literatures was evaluated using I 2 statistics and publication bias using the Egger regression asymmetry test and the Duval and Tweedie trim-fill analysis. Statistical significance was declared at p value less than 0.05. Result. The pooled estimate of institutional delivery among the pastoralist community in Ethiopia is 21.2% (95% CI: 16.2-26.1). Husbands who were involved to decide place of delivery (OR = 3.47 ; 95% CI: 1.61, 7.50), women with good knowledge of MCH services (OR = 2.283 ; 95% CI: 1.51, 3.44), women who had a positive attitude towards MCH services (OR = 1.69 ; 95% CI: 0.79, 3.6), availability of health institutions (OR = 2.6 ; 95% CI: 0.95, 7.20), and women who had an ANC follow-up (OR = 2.78 ; 95% CI: 2.07, 3.73) were higher institutional delivery prevalence among pastoralist women. Moreover, institutional delivery among women who were educated above the college level was more than two times (OR = 2.56 ; 95% CI: 1.985, 3.304) higher than among women who were not educated. Conclusion. Pastoralist women in Ethiopia were found to be a disadvantaged group for institutional delivery at national level. Husband involvement, educational level, ANC visit, knowledge and attitude for MCH service, and health facility distance were identified to have significant association with institutional delivery. [ABSTRACT FROM AUTHOR]

Background: Although Ethiopia is working towards measles elimination, a recurrent measles outbreak has occurred. To take appropriate measures, previously, many fragmented and inconsistent outbreak investigations were done, but there is no consolidated evidence on attack rate, case fatality rate, and determinants of measles infection during the measles outbreak. This systematic review and meta-analysis aimed to identify cumulative evidence on attack rate, case fatality rate, and determinants of measles infection during the outbreak. Methods: A systematic literature review and Meta-analysis was used. We searched Google Scholar, Medline/PubMed, Cochrane/Wiley Library, EMBASE, Science Direct, and African Journals Online databases using different terms. Investigations that applied any study design, data collection- and analysis methods related to the measles outbreak investigation were included. Data were extracted in an Excel spreadsheet and imported into STATA version 17 software for meta-analysis. The I2 statistics were used to test heterogeneity, and 'Begg's and 'Egger's tests were used to assess publication bias. The odds ratio (OR) with a 95% confidence interval (CI) was presented using forest plots. Results: Eight measles outbreak investigations with 3004 measles cases and 33 deaths were included in this study. The pooled attack rate (A.R.) and case fatality rate were 34.51/10,000 [95% CI; 21.33–47.70/10,000] population and 2.21% [95% CI; 0.07-2.08%], respectively. Subgroup analysis revealed the highest attack rate of outbreaks in the Oromia region (63.05 per 10,000 population) and the lowest in the Amhara region (17.77 per 10,000 population). Associated factors with the measles outbreak were being unvaccinated (OR = 5.96; 95% CI: 3.28–10.82) and contact history (OR = 3.90; 95% CI: 2.47–6.15). Conclusion: Our analysis revealed compelling evidence within the outbreak descriptions, highlighting elevated attack and case fatality rates. Measles infection was notably linked to being unvaccinated and having a contact history. Strengthening routine vaccination practices and enhancing contact tracing measures are vital strategies moving forward. [ABSTRACT FROM AUTHOR]

Background: Numerous deaths in under-five children occur from preventable and treatable causes. Seeking medical care for a sick child is an important aspect of child health. Parents decide the type and frequency of health care service utilization for their children. A number of factors influence mothers'/caregivers' health care seeking behavior for sick children. This systematic review and meta-analysis aimed to estimate the pooled prevalence of health care seeking behavior and factors associated with common childhood illnesses in Ethiopia. Methods: Studies were accessed via electronic web-based searches of PubMed, Web of Science, African Journals Online, the Cochrane Library, HINARI (Health Inter-Network Access to Research Initiative), and Google Scholar. We included all studies reporting the prevalence of health care seeking behavior for common childhood illnesses in Ethiopia and published in the English language. The data were analyzed using Stata Version 14.1 software. A forest plot and I-squared test were carried out to assess the heterogeneity of the studies. A funnel plot and Egger's regression test were done to check the publication bias. A random effect model was used to estimate the pooled prevalence and subgroup analysis performed to identify the probable source of heterogeneity. Results: Twelve articles comprising 16,873) study participants, were included in this review. The pooled prevalence of health care seeking behavior for common childhood illnesses in Ethiopia was 46.6% (95% CI: 38.7, 54.4) with severe heterogeneity (I2 = 99.0%; p value <0.001) and significant publication bias. Being of the male sex (OR = 1.21; 95% CI: 1.02, 1.43), severity of the illness (OR = 4.04; 95% CI: 2.45, 6.66), rural place of residence (OR = 0.29; 95% CI: 0.13, 0.67), and having an educated mother/caregiver (OR = 1.15; 95% CI: 0.37, 3.65) were factors associated with health care seeking behavior for common childhood illnesses. Conclusion: Mothers'/caregivers' health care seeking behavior for common childhood illnesses was low in Ethiopia. The sex of the child, severity of the illness, place of residence, and maternal educational status were the major factors that determined the health care seeking behavior for common childhood illness. We recommend that awareness-raising activities should be strengthened, with a focus on rural residents and less educated mothers/caregivers. [ABSTRACT FROM AUTHOR]

Background: One of the most challenging problems in developing countries including Ethiopia is improving maternal health. About 303,000 mothers die globally, and one in every 180 is at risk from maternal causes. Developing regions account for 99% of maternal deaths. Maternal near miss (MNM) resulted in long-term consequences. A systematic review and meta-analysis was performed to assess the prevalence and predictors of maternal near miss in Ethiopia from January 2015 to March 2023. Methods: A systematic review and meta-analysis cover both published and unpublished studies from different databases (PubMed, CINHAL, Scopus, Science Direct, and the Cochrane Library) to search for published studies whilst searches for unpublished studies were conducted using Google Scholar and Google searches. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used. Duplicated studies were removed using Endnote X8. The paper quality was also assessed based on the JBI checklist. Finally, 21 studies were included in the study. Data synthesis and statistical analysis were conducted using STATA Version 17 software. Forest plots were used to present the pooled prevalence using the random effect model. Heterogeneity and publication bias was evaluated using Cochran's Q test, (Q) and I squared test (I2). Subgroup analysis based on study region and year of publication was performed. Result: From a total of 705 obtained studies, twenty-one studies involving 701,997 pregnant or postpartum mothers were included in the final analysis. The national pooled prevalence of MNM in Ethiopia was 140/1000 [95% CI: 80, 190]. Lack of formal education [AOR = 2.10, 95% CI: 1.09, 3.10], Lack of antenatal care [AOR = 2.18, 95% CI: 1.33, 3.03], history of cesarean section [AOR = 4.07, 95% CI: 2.91, 5.24], anemia [AOR = 4.86, 95% CI: 3.24, 6.47], and having chronic medical disorder [AOR = 2.41, 95% CI: 1.53, 3.29] were among the predictors of maternal near misses from the pooled estimate. Conclusion: The national prevalence of maternal near miss was still substantial. Antenatal care is found to be protective against maternal near miss. Emphasizing antenatal care to prevent anemia and modifying other chronic medical conditions is recommended as prevention strategies. Avoiding primary cesarean section is recommended unless a clear indication is present. Finally, the country should place more emphasis on strategies for reducing MNM and its consequences, with the hope of improving women's health. [ABSTRACT FROM AUTHOR]

Background: Visual impairment is a public health problem in both developing and developed countries, especially, in developing countries where most visually impaired communities are found. Knowledge of the pooled prevalence of visual impairment among adults is useful in planning, preventive programs and the provision of eye-care services for communities. Methods: Original observational studies published in English were included in this systematic review and meta-analysis. Eleven studies with a total sample size of 8,161 study participants were included. PubMed/Medline, HINARI, Google Scholar, Cochrane library, Web of Science, and African Journals Online databases were used to search for published articles. Data were extracted on a Microsoft Excel spreadsheet and analyzed using Revman 5.4.1 Software. Meta-analysis of further pooled prevalence estimates using the inverse variance heterogeneity model. The pooled estimate of visual impairment in the current review was estimated using a random-effects model. Forest plots were used to illustrate heterogeneity and to quantify the pooled prevalence of visual impairment. Publication bias was assessed using funnel plots. Visual impairment was defined as a presenting visual acuity of less than 6/18 in the betting-seen eye. Results: A total of 538 studies were identified from several Databases and digital libraries, of which eleven articles were selected for the final meta-analysis. Significant heterogeneity was observed across studies, suggesting a random-effects model to estimate the pooled prevalence of visual impairment. The prevalence of visual impairment in Ethiopia ranges from 10.3% in Addis Ababa central Ethiopia to 37.58% in the Northern Ethiopia. The pooled prevalence of visual impairment in the current review was 22% (95% CI: 17%–27%; I2 = 97%) using a random-effects model. There was also evidence of symmetry in the funnel plots. Conclusion: This systematic review and meta-analysis demonstrated a greater burden of visual impairment among Ethiopians in various study populations. Further, intervention strategies are required to reduce the burden of visual impairment and improve quality of life. [ABSTRACT FROM AUTHOR]

Background: In the absence of minimum acceptable diet, children aged 6–23 months are vulnerable to malnutrition. Not feeding at least the minimum acceptable diet is a major global problem, particularly in developing countries. Even though many studies have been conducted in Ethiopia there are inconsistencies. Therefore, this review aimed to estimate the pooled prevalence of a minimum acceptable diet in Ethiopia. Methods: Published articles from various electronic databases, such as PubMed/MEDLINE, EMBASE, Google Scholar, and Science Direct were systematically searched. All cross-sectional studies conducted on the minimum acceptable diet of children aged 6–24 months and published up to October 30/2021 were included in this review. Data were extracted using an Excel spreadsheet and analyzed using STATA version 14.1. The random-effects model was used to estimate the pooled prevalence, and a subgroup analysis was performed to identify the possible source of heterogeneity. Begg's and Egger's tests were used to identify possible publication bias. Results: Nine cross-sectional studies involving 4,223 participants were included. Significant heterogeneity was observed across the studies (I2 = 99.4%). The pooled prevalence of minimum acceptable diet in Ethiopia was found to be 25.69% (95% CI: 11.96, 39.41) Conclusion: This review revealed that the minimum acceptable dietary intake among children aged 6–23 months in Ethiopia was relatively low; only 1 in 4 of children met the minimum acceptable diet. This indicates that the government should promote child feeding practices according to guidelines to increase the proportion of children with a minimum acceptable diet. [ABSTRACT FROM AUTHOR]

Introduction: Stroke is one of the most common causes of death and acquired disability worldwide. The burden of death and disability-adjusted life-years lost (DALYs) in lower-and-middle income countries (LMIC), were 86% and 89%, respectively. Ethiopia, one of SSA countries, is being affected by stroke and its consequence. The conception and development of this systematic review and meta-analysis protocol primarily based on the gap we noted from the previous systematic review and meta-analysis. Thus, this review will fill knowledge gap by identifying and analyzing studies that used sound method in determiningthe last ten years stroke prevalence in Ethiopia. Methods: This systematic review and meta-analysis will follow Preferred Reporting Items for Systematic Reviews and Meta-analyses guideline. Both published articles and gray literature will be gathered from online databases. Cross-sectional, case control, and cohort studies will be included as long as these studies report the magnitude of the problem under study. Both community and facility-based studies conducted in Ethiopia will be included. Those studies that did not report the main outcome variable will be excluded. Joanna Bridge Institute appraisal checklist will be used to assess the quality of individual studies. Two reviewers will independently appraise the full articles of studies related to our topic of interest. I2 and p-value will be used to check for heterogeneity of the studies' outcome. Meta-regression will be used to identify source of heterogeneity. We will assess the presence of publication bias using funnel plot. PROSPERO registration number: CRD42022380945. [ABSTRACT FROM AUTHOR]

Oral hygiene refers to taking care and maintaining the cleanness of gum and teeth; a good oral hygiene practice promotes better oral health in general. Oral hygiene is the top public health concern of the population. Tooth brushing is a technique to keep oral hygiene from related complications. Therefore, this study provides the pooled prevalence of tooth brushing practice in Ethiopia. Databases searched for articles systematically across PubMed, Google Scholar, Hinari, EMBASE, and African Journals Online. Two reviewers independently conducted the selection, screening, reviewing, and data extraction using a Microsoft Excel spreadsheet and used the Joanna Briggs Institute prevalence critical appraisal tools to assess the quality of evidence. All studies conducted in Ethiopia from 2010 to 2020, reporting tooth-brushing practices extracted for and imported into the Comprehensive meta-analysis version 3.0 for further analysis. Beggs and Eggers's tests evaluated for publication bias with Higgins's method evaluated for heterogeneity. A random-effects meta-analysis model with a 95% confidence interval was computed to estimate the pooled effect size (prevalence). Furthermore, the authors employed subgroup analysis based on the study area and sample size. After reviewing 36, 10 articles fulfilled the inclusion criteria, and were included in the meta-analysis. The pooled prevalence of tooth brushing practice was 12.2% (95% CI 7.6–19.2%). The review reported a lower level of tooth-brushing practice in Ethiopia. We recommended that special attention should be given to the oral hygiene of the Ethiopian people. [ABSTRACT FROM AUTHOR]

Background: Administration of potent vaccine in a manner of well-maintained cold chain system is one of the public health focus areas in developing regions of the world. Health professionals' adherence towards good vaccine cold chain management practices is an important element to ensure potent vaccine reached to users. Studies on health professionals' practice on vaccine cold chain maintenance and associated factors in Ethiopia have shown wide variations. The aim of this systematic review and meta-analysis is to produce the overall/pooled prevalence of health professionals' good vaccine cold chain management practice and to identify its associated factors in Ethiopia. Methods: Systematic review and meta-analysis was conducted on vaccine cold chain management practice and associated factors among health professionals in Ethiopia. Literature search was made on international data bases using medical subject heading and key words. Data were extracted using Microsoft excel and imported to STATA version 17 for analysis. Heterogeneity was checked using Cochrane Q test and I2 statistics. Weighted inverse variance random effect model was used to estimate the pooled level of good vaccine cold chain management practice among health professionals. Publication bias was checked using funnel plot and using Egger's test. Results: A total of ten studies were included in the review. The overall/pooled prevalence of good vaccine cold chain management practice in Ethiopia is 27.48% with 95% CI (25.70–29.26). Having good knowledge on vaccine cold chain management AOR 2.27 95% CI (1.72–2.99), and have received on-job training AOR 6.64 95% CI (4.60–9.57) are factors positively associated with vaccine cold chain management practice among health professionals in Ethiopia. Conclusion: The overall/pooled prevalence of good vaccine cold chain management practice is much lower than the expected level. There is a need to plan on-job trainings for all vaccine handlers and other health professionals supposed to work on vaccination program. [ABSTRACT FROM AUTHOR]

Food taboos have a negative impact on pregnant women and their fetuses by preventing them from consuming vital foods. Previous research found that pregnant women avoided certain foods during their pregnancy for a variety of reasons. This review aimed to determine the pooled prevalence of food taboo practices and associated factors in Ethiopia. In compliance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline, we searched the literature using PubMed/MEDLINE, AJOL (African Journal Online), HINARI, Science Direct, Google Scholar, and Google electronic databases. The random-effects model was used to estimate the pooled prevalence of food taboo and its determinants at a 95% confidence interval with their respective odds ratios. The pooled food taboo practice among Ethiopian pregnant women was 34.22% (95% CI 25.47–42.96), and after adjustment for publication bias with the trim-and-fill analysis, the pooled food taboo practice of pregnant women was changed to 21.31% (95% CI: 10.85–31.67%). Having less than a secondary education level (OR = 3.57; 95% CI 1.43–8.89), having no ANC follow-up (OR = 4.35; 95% CI 1.12–16.94), and being a rural resident (OR = 3.08; 95% CI 1.14–8.28) were the significant factors. Dairy products, some fruits, green leafy vegetables, meat, and honey are among the taboo foods. The most frequently stated reasons for this taboo practice were: fear of producing a big fetus, which is difficult during delivery; attachment to the fetus's body or head; and fear of fetal abnormality. [ABSTRACT FROM AUTHOR]

Background: Epilepsy remains one of the world’s most common neurological diseases, but it appears to be widely misunderstood, particularly in under-resourced countries like Ethiopia. Improving individuals’ knowledge and attitude toward epilepsy is critical for reducing the multifaceted impacts of epilepsy. Therefore, in this study, we sought to estimate the pooled levels of good knowledge and a favorable attitude toward epilepsy and also identify the associated factors using available data collected from dierent segments of the population. Methods: Articles were searched in international electronic databases. A standardized Microsoft Excel spreadsheet and STATA software version 16 were used for data extraction and analysis, respectively. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) checklist was used to write this report. The random-eect meta-analysis model was used to estimate Der Simonian-Laird’s pooled eect. Statistical heterogeneity of the meta-analysis was checked via Higgins and Thompson’s I 2 statistics (0–100%), and Cochran’s Q test at P < 0.10. Subgroups, based on the study regions, and sensitivity analyses were also performed. Publication bias was examined subjectively using funnel plots and objectively using the nonparametric rank correlation test of Begg and the regression-based test of Egger for small study eects with P < 0.05 considered to indicate potential publication bias. Furthermore, the Trim-and-fill method of Duval and Tweedie was used to explore sources of publication bias for the favorable level of attitudes toward epilepsy. Result: A total of 12 studies with 6,373 study participants and 10 studies with 5,336 study participants were included to estimate the pooled level of good epilepsy knowledge and favorable attitudes respectively. The overall estimated levels of good epilepsy knowledge and favorable attitudes toward epilepsy among Ethiopians were 47.37% [(95% CI: 35.00, 59.74), I 2 = 99.2, P < 0.001] and 46.83%[(95% CI: 32.75, 60.90), I 2 = 99.2, P < 0.001] respectively. Subgroup analysis revealed that the pooled level of good epilepsy knowledge was 48.51% [(95% CI: 38.95, 58.06), I 2 = 95.6%, P < 0.001] in the Amhara region. Conclusion: In the current review, we found out that there is a huge knowledge gap and an unfavorable level of attitudes towardepilepsy, which demand immediate public health action as well as a targeted policy intervention. [ABSTRACT FROM AUTHOR]

Background: Tinea capitis accounts for25 to 30% of all fungal infections, but it is often ignored because it is not life threatening in nature. It is more common among schoolchildren particularly in developing countries. Due to the presence of significant variability among the previous studies, this study was conducted to provide a pooled prevalence and associated factors of tinea capitis in Ethiopian schoolchildren. Method: We conducted a systematic search in five major databases for articles similar to our topic. This review included school-based cross-sectional studies that were reported in English and conducted from 2006 through 2022. The data were extracted using Microsoft Excel and further analysis was done using StataTM Version 17.0 statistical software. Forest plots were used to assess the presence of heterogeneity with 95% confidence intervals. A random effects meta- analysis model was used to pool primary estimates. To declare the presence or absence of association, 95% confidence interval with odds ratio was used. Results: Fourteen studies with a total of 9465 schoolchildren were included. The pooled prevalence was 29.03% (95%CI: 15.37–42.71). There was observed heterogeneity, which could be explained by publication bias (P = 0.04). Family history of tinea capitis (OR: 9.18, 95%CI: 3.5–24.02), under the age of 10 years (OR: 1.65, 95%CI: 1.17–2.33) were factors increasing the development of tinea capitis among schoolchildren and schoolchildren who had hair wash at least once a week (OR: 0.31, 95%CI: 0.24–0.42) was significantly associated with reduced risk for tinea capitis. Conclusion: One of the most prevalent childhood health condition in Ethiopia is tinea capitis, which affects over one in every four schoolchildren. Schoolchildren who had family history of tinea capitis and under the age of 10 years were the identified risk factors but they had hair wash at least once a week was the protective factor of tinea capitis among schoolchildren. Clinical and public engagement activities are needed to overcome the burden of the disease. [ABSTRACT FROM AUTHOR]

Background: The actual burden of bacteriologically confirmed extrapulmonary tuberculosis (EPTB) and risk factors in Ethiopia is not well known due to the lack of a strong surveillance system in Ethiopia. Thus, this study was conducted to estimate the pooled prevalence of bacteriologically confirmed EPTB and the associated risk factors among persons suspected to have non-respiratory tuberculosis in Ethiopia. Methods: A systematic review and meta-analysis of published studies reporting the prevalence of EPTB from searched electronic databases; Science Direct, PubMed, and Google Scholar was estimated spread across the research periods, nationally, and in different areas, using a fixed-effects model. We used I2 to analyze heterogeneity in the reported prevalence of bacteriologically confirmed extrapulmonary tuberculosis. Results: After reviewing 938 research articles, 20 studies (19 cross-sectional and 1 retrospective) from 2003 to 2021 were included in the final analyses. The pooled prevalence of bacteriologically confirmed EPTB was 43% (95%CI; 0.34–0.52, I2 = 98.45%). The asymmetry of the funnel plot revealed the presence of publication bias. Specifically the pooled prevalence of bacteriologically confirmed EPTB based on smear microscopy, Xpert MTB/RIF assay, and culture were 22% (95%CI; 0.13–0.30, I2 = 98.56%), 39% (95%CI; 0.23–0.54, I2 = 98.73%) and 49% (95%CI; 0.41–0.57, I2 = 96.43%) respectively. In this study, a history of pulmonary tuberculosis (PTB) contact with PTB patients, contact with live animals, consumption of raw milk, HIV-positive, male, and lower monthly income, were found to be independently associated with bacteriologically confirmed EPTB. Conclusion: Ethiopia has a high rate of bacteriologically confirmed EPTB. A history of previous PTB, being HIV-positive and having contact with PTB patients were the most reported risk factors for EPTB in the majority of studies. Strengthening laboratory services for EPTB diagnosis should be given priority to diagnose EPTB cases as early as possible. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Background: The beneficial effect of the dietary practice is significant reduction in the risk of developing diabetes related complication. Dietary practice among type 2 diabetes is not well-implemented in Ethiopia. Up to now, in the nation, several primary observational studies have been done on dietary adherence level and its determinants among type 2 diabetes. However, a comprehensive review that would have a lot of strong evidence for designing intervention is lacking. So, this review with a meta-analysis was conducted to bridge this gap. Methods: A systematic review of an observational study is conducted following the PRISMA checklist. Three reviewers have been searched and extracted from the World Health Organization- Hinari portal (SCOPUS, African Index Medicus, and African Journals Online databases), PubMed, Google Scholar and EMBASE. Articles' quality was assessed using the Newcastle-Ottawa Scale by two independent reviewers, and only studies with low and moderate risk were included in the final analysis. The review presented the pooled proportion dietary adherence among type2 diabetes and the odds ratios of risk factors favor to dietary adherence after checking for heterogeneity and publication bias. The review has been registered in PROSPERO with protocol number CRD42020149475. Results: We included 19 primary studies (with 6, 308 participants) in this meta-analysis. The pooled proportion of dietary adherence in the type 2 diabetes population was 41.05% (95% CI: 34.86–47.24, I2 = 93.1%). Educational level (Pooled Odds Ratio (POR): 3.29; 95%CI: 1.41–5.16; I2 = 91.1%), monthly income (POR: 2.50; 95%CI: 1.41–3.52; I2 = 0.0%), and who had dietary knowledge (POR: 2.19; 95%CI: 1.59–2.79; I2 = 0.0%) were statistically significant factors of dietary adherence. Conclusion: The overall pooled proportion of dietary adherence among type 2 diabetes in Ethiopia was below half. Further works would be needed to improve dietary adherence in the type 2 diabetes population. So, factors that were identified might help to revise the plan set by the country, and further research might be required to health facility fidelity and dietary education according to diabetes recommended dietary guideline. [ABSTRACT FROM AUTHOR]

Bovine mastitis remains a major prevalent disease in cattle and places a significant economic burden on the global dairy industry. The goal of this systematic review and meta-analysis was to examine the overall prevalence of mastitis and its associated risk factors among dairy cows. Scientific articles written in English were recovered from PubMed, ScienceDirect, Web of Science, Google Scholar, Cochrane Library, and other sources from Google Engine and University Library Databases. "Prevalence," "bovine mastitis," "clinical mastitis," "subclinical mastitis," "associated factors," "dairy cows," and "Ethiopia" were search terms used for this study. For critical appraisal, PRISMA 2009 was applied. Heterogeneity and publication bias were evaluated using Cochran's Q, inverse variance (I2), and funnel plot asymmetry tests. A random-effects model was used to calculate the pooled burden of mastitis and its associated factors among dairy cows, along with the parallel odds ratio (OR) and 95% confidence interval (CI). A total of 6438 dairy cows were included in the 17 eligible studies for this meta-analysis. The overall pooled prevalence of mastitis among dairy cows in Ethiopia was 43.60% (95% CI: 34.71, 52.49), of which 12.59% (95% CI: 7.18, 18.00) and 32.21% (95% CI: 24.68, 39.74) were clinical and subclinical cases, respectively. Of the regions, the highest and lowest pooled prevalence estimates of mastitis among dairy cows were 49.90% (95% CI: 31.77, 68.03) and 25.09% (95% CI: 3.86, 46.32) in the Oromia and Amhara regions, respectively. The highest pooled prevalence estimate in the study period was recorded between 2017 and 2022, with a pooled prevalence estimate of 46.83% (95% CI: 35.68, 57.97), followed by the study period from 2005 to 2016, with a pooled prevalence estimate of 39.97% (95% CI: 25.50, 54.44). Gram-positive bacteria (84.70%) were the most prevalent mastitis-causing agents compared with Gram-negative bacteria (15.30%). Breed (AOR: 2.17, 95% CI: 1.44, 2.90), lactation stage (AOR: 1.59, 95% CI: 1.04, 2.15), parity (AOR: 3.31, 95% CI: 1.69, 4.94), history of mastitis (AOR: 3.56, 95% CI: 2.40, 4.71), floor type (AOR: 1.59, 95% CI: −0.16, 3.34), and teat injury (AOR: 6.98, 95% CI: 0.33, 13.64) were factors significantly associated with mastitis among dairy cows in Ethiopia. Early diagnosis and proper medication, as well as implementing appropriate prevention and control measures, are necessary for the management of mastitis in dairy cows. [ABSTRACT FROM AUTHOR]

Background: There is no pooled evidence regarding the prevalence and potential associated factors of depression among cancer patients in Ethiopian community. Hence, the current review aimed to examine the prevalence and associated factors of depression among cancer patients in Ethiopia. Method: A computerized systematic literature search was made in MEDLINE, Scopus, PubMed, Science Direct, and Google Scholar. Each database was searched from its start date to June 2020. More over we will also add scholars and gray literature consultations. All articles will be included if they were published in English, which evaluated the prevalence and associated factors of depression among cancer patients in Ethiopia. Pooled estimations with a 95% confidence interval (CI) were calculated with DerSimonian-Laird random-effects model. Publication bias was evaluated by using inspection of funnel plots and statistical tests. Discussion: Since we are using existing anonymized data, ethical approval is not required for this study. Our results can be used to guide clinical decisions about the most efficient way to prevent and treat depression among cancer patients. Systematic review registration Submitted to Prospero. [ABSTRACT FROM AUTHOR]

Background: Risky sexual behavior is defined as the behavior that increases the susceptibility of an individual to problems related to sexuality and reproductive health. The main aim of this study was to determine the pooled prevalence of risky sexual behavior and its associated factors in Ethiopia. Methods: Systematic review and meta-analysis (PRISMA) rules were used. During the searching period, MEDLINE, PUBMED, Cochrane Library, EMBASE, Google Scholar, and CINAHL were used with search terms. The STATA form 14 program was utilized to perform the meta-analysis. I2 statistics was used to test heterogeneity, and publication bias was assessed using Begg's and Egger's tests. Odds ratio (OR) with a 95% confidence interval (CI) was presented using forest plots. Results: There were 24 studies, and 13,440 study participants were included in this meta-analysis. The pooled prevalence of risky sexual behavior in Ethiopia was 40% (95% CI: 32%, 48%). The associated factors for risky sexual behavior were substance use [OR: 2.41 (95% CI: 1.49, 3.89)], watching pornography [OR: 2.59 (95% CI: 1.01, 6.69)], and night club visit, [OR: 2.53 (95% CI: 1.64, 3.90)]. Conclusion: Risky sexual behavior among secondary school and above-education-level Ethiopian students was high. [ABSTRACT FROM AUTHOR]

The emergence of drug‐resistant tuberculosis (DR‐TB) is becoming a challenge to the national TB control programmes including Ethiopia. Different risk factors are associated with DR‐TB. Identifying these risk factors in a local setting is important to strengthen the effort to prevent and control DR‐TB. Thus, this study aimed to assess the risk factors associated with DR‐TB in Ethiopia. The Preferred Reporting Items for Systematic Reviews and Meta‐analyses checklist was followed to conduct this study. We systematically searched the articles from electronic databases and grey literature sources. We used the JBI tools to assess the quality of studies. Data were analysed using STATA version 15. We estimated the pooled odds ratio (OR) along with 95% Confidence Interval (CI). The forest plot and I2 heterogeneity test were used to assess heterogeneity among studies. We explored the presence of publication bias through visual inspection of the funnel plot and Egger's regression test. After screening 2238 articles, 27 studies were included in the final analysis. Based on the pooled analysis of the OR, unemployment (OR; 2.71, 95% CI; 1.64, 3.78), previous TB history (OR; 4.83, 95% CI; 3.02, 6.64), contact with known TB patient (OR; 1.72, 95% CI; 1.05, 2.40), contact with the known multi‐drug resistant (MDR) TB patient (OR; 2.54, 95% CI; 1.46, 3.63) and having pulmonary TB (PTB; OR; 1.80, 95% CI; 1.14, 2.45) were found to be the risk factors of DR‐TB, while elders (OR; 0.77, 95%CI; 0.60, 0.95) including above 45 years (OR; 0.76, 95%CI; 0.55, 0.97) and males (OR; 0.86, 95%CI; 0.76, 0.97) had lower DR‐TB risk, compared to their counterparts. A previous history of TB treatment is a major risk factor for acquiring DR‐TB in Ethiopia that might be due to poor adherence during the first‐line anti‐TB treatment. Besides, having contact with a TB patient, contact with an MDR‐TB patient, having PTB and being unemployed were the risk factors of DR‐TB in Ethiopia. Thus, active screening of TB contacts for DR‐TB might help to detect DR‐TB cases as early as possible and could help to mitigate its further transmission across the community. [ABSTRACT FROM AUTHOR]

Objective. To assess the pooled prevalence of mothers' or caregivers' healthcare-seeking behavior for childhood diarrhea, fever, and respiratory tract infections and associated factors in Ethiopia. Study Design. Systematic review and meta-analysis. Methods. Literature searches were conducted through databases (Google Scholar, PubMed, CINHAL, ScienceDirect, HINARI, and gray literatures) from September 1 to 30, 2021, using key terms in accordance with the PRISMA guidelines. The characteristics of the original articles were described using text and tables. Heterogeneity among the reported prevalence of studies was checked by using a heterogeneity χ 2 test and I 2 test. Publication bias was examined by performing Egger's correlation and Begg's regression intercept tests at a 5% significant level. A random-effect model was employed to estimate the pooled prevalence of the outcome variable and its determinants in Ethiopia. Results. Of the total identified studies, 25 studies were included in the review, with a total of 29,993 study participants. The overall pooled prevalence of mothers' or caregivers' health-seeking behavior for childhood diarrhea, fever, and respiratory tract infections was 60.33% (95% CI: 50.14-70.52). The significant factors were residence (AOR = 3.06 , 95% CI: 1.11–8.39), wealth index (AOR = 2.18 , 95% CI: 1.92-2.48), perceived severity of illness (AOR = 2.7 , 95% CI: 1.12–6.51), and knowledge of the illness (AOR = 1.95 , 95% CI: 1.37–2.75). Conclusion. This review suggests that the overall pooled prevalence of mothers' or caregivers' HSB for childhood diarrhea, fever, and respiratory tract infections was 60.33%. Residence, wealth index, perceived severity of illness, and knowledge of the illness by mothers were the significant factors. Therefore, providing interventions by considering the above factors will improve the overall seeking behavior. [ABSTRACT FROM AUTHOR]

Background: Urinary tract infection is a major public health problem in developing countries among immunocompromized populations where there are limited health-care services. People living with human immunodeficiency virus (HIV) are more likely to develop urinary tract infections (UTI) due to the suppression of their immunity. There is no single representative figure as well as the presence of significant heterogeneity among studies conducted on people living with HIV in Ethiopia. Hence, this study tried to pool the magnitude of UTI among people living with HIV in Ethiopia. Method: To find relevant studies, researchers looked through Web of Science, Science Direct, PubMed, EMBASE, the Cochrane Library, Google Scholar, and Worldwide Science. The I2 statistic was used to examine for heterogeneity among the studies that were included. To evaluate the pooled effect size across studies, a random-effects model was used. The presence of publication bias was determined using a funnel plot and Egger's regression test. STATATM version 14.0 software was used for all statistical analyses. Results: A total of 7 studies with 2257 participants were included in this meta-analysis. UTI was shown to be prevalent in 12.8% (95% CI: 10.8–14.79, I2 = 50.7%) of HIV patients. Being male (0.35, 95% CI:0.14, 1.02), rural residents(OR:1.41,95% CI: 0.85, 2.34), no history of catheterization (OR: 0.35, 95% CI: 0.06, 1.85), had no history of DM (OR:0.84, 95% CI:0.12, 0.597) and having CD4 count greater than 200 (OR:0.36 95% CI: 0.06, 2.35) were the factors which were the associated factors assessed and having association with UTI among people living with HIV but not statistically significant. Conclusions: In Ethiopia, one in every eight HIV-positive people is at risk of acquiring UTI. Regardless, we looked for a link between sex, residency, CD4, catheterization history, and DM and UTI, but there was none. To avoid this phenomina, every HIV patient should have a UTI examination in every follow-up. [ABSTRACT FROM AUTHOR]

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Antenatal Care (ANC) is a health service by trained health workers for mothers during their pregnancy, which must be carried out routinely, according to standards and in an integrated manner. ANC services are indispensable and recommended for pregnant women in order to maintain the health of the mother and fetus during pregnancy, detect and treat abnormalities early and prepare the mother for safe delivery. In fact, there are still many pregnant women who do not access ANC services according to standards, so this situation can contribute to morbidity and mortality rate (MMR). The research was conducted in November 2020 - March 2021 by searching for secondary data from two electronic databases, namely Google Scholer and Pubmed (2015 to 2020). Studies were selected through the PRISMA protocol and critically assessed using JBI's Critical Appraisal Tool. Test for heterogeneity, summary effect and publication bias using the JASP application version 0.14.1. Odd ratio with 95% confidence level (CI) was used to calculate the effect size. From the selected data, the husband's knowledge and support factors have quite a lot of differences in research results, so it is necessary to re-analyze the relationship of husband's knowledge and support during pregnancy with ANC visits by pregnant women to produce more accurate conclusions. Based on the inclusion criteria, there were 17 studies that could be included in the meta-analysis, with 3.956 respondents from Indonesia, Ethiopia and Vietnam. Homogeneous data with the combined OR value of knowledge of pregnant women with ANC visits is 2,48 (95% CI; 2,01-3,03) and the relationship of husband's support during pregnancy with ANC visits is 2,03 (95% CI; 1,65-2,51), and there are publications biased. This meta-analysis confirms that there is a significant positive relationship between husband's knowledge and support during pregnancy and ANC visits. [ABSTRACT FROM AUTHOR]

Background: Diarrhoea is the leading cause of morbidity and mortality in the world particularly in developing countries and among vulnerable groups of the population. Gram-negative enteric bacterial pathogens (GNEBPs) are a group of organisms that reside mainly in the intestine and induce diarrhoea. Antimicrobial agents are usually the part of their treatment regimen. The therapeutic effect of antimicrobials is hindered by the emergence and spread of drug-resistant strains. The information regarding the prevalence and antimicrobial resistance patterns of GNEBPs in Ethiopia is limited and found in a scattered form. Objectives: This study was designed to determine the pooled prevalence and drug resistance patterns of GNEBPs by meta-analysis of data from diarrhoeic patients in Ethiopia. Method: A comprehensive literature search was conducted through internet searches using Google Scholar, PubMed, Science Direct, HINARI databases, and reference lists of previous studies. Published articles were included in the study based on priorly set inclusion and exclusion criteria. Results were presented in the forest plot, tables, and figures with a 95% confidence interval (CI). The inconsistency index (I2) test statistics was used to assess heterogeneity across studies. The pooled prevalence estimate of GNEBPs and their drug resistance patterns were computed by a random-effects model. Software for Statistics and Data Science (STATA) version 14 statistical software was used for the analysis. Result: After removing those articles which did not fulfil the inclusion criteria, 43 studies were included in the analysis. Studies were conducted in 8 regions of the country and most of the published articles were from the Amhara region (30.23%) followed by Oromia (18.60%) and Southern Nations, Nationalities, and Peoples' region (SNNP) (18.60%). The pooled prevalence of GNEBPs was 15.81% (CI = 13.33–18.29). The funnel plot indicated the presence of publication bias. The pooled prevalence of GNEBPs in Addis Ababa, Amhara, SNNP, and Oromia regions were 20.08, 16.67, 12.12, and 11.61%, respectively. The pooled prevalence was 14.91, 18.03, and 13.46% among studies conducted from 2006–2010, 2011–2015, and 2016–2021, respectively and it was the highest (20.35%) in children having age less than or equal to 15 years. The pooled prevalence of Escherichia coli, Campylobacter spp., Shigella spp., and Salmonella enterica were 19.79, 10.76, 6.24, and 5.06%, respectively. Large proportions (60–90%) of the isolates were resistant to ampicillin, amoxicillin, tetracycline, and trimethoprim-sulphamethoxazole. The pooled prevalence of multidrug resistance (MDR) was 70.56% (CI = 64.56–76.77%) and MDR in Campylobacter spp., Shigella spp., E. coli, and S. enterica. were 80.78, 79.08, 78.20, and 59.46%, respectively. Conclusion: The pooled estimate showed a high burden of GNEBPs infections and a high proportion of drug resistance characters to commonly used antimicrobial agents in Ethiopia. Therefore, performing drug susceptibility tests, establishing an antimicrobial surveillance system and confirmation by molecular techniques are needed. [ABSTRACT FROM AUTHOR]

Background. Antenatal care service satisfaction is a measure of the degree to which a woman seeking care is happy with the antenatal care service provided to her. Thus, this systematic review and meta-analysis aims to identify factors that determine antenatal care service satisfaction among women in Ethiopia. Methods. PubMed, Hinari, and Google Scholar were systematically searched for eligible studies. In addition, national university digital libraries were also searched. The Joanna Briggs Institute's (JBI) critical appraisal tools were used to assess the quality of the included articles. The Cochrane Q-statistics and I2 tests were used to assess heterogeneity among the included studies. Publication bias was assessed using Egger's test. Joanna Briggs Institute Critical Appraisal Checklist for Analytical Cross-Sectional Studies. The extracted data were analyzed using STATA version 14 software and the results were presented using the forest plot. Results. Of the 274 articles identified through the systematic search of the literature, 13 studies fulfilling the inclusion criteria were included in this meta-analysis. First antenatal care visit (AOR: 0.62 and 95% CI: 0.40, 0.96), women waited <60 min (AOR: 1.87 and 95% CI: 1.40–2.50), women whose privacy was maintained (AOR: 3.91 and 95% CI: 1.97–7.77), women treated respectfully (AOR: 5.07 and 95% CI: 2.34–10.96), and unplanned pregnancies (AOR = 0.28 and 95% CI: 0.10–0.77) were significantly associated with antenatal care service satisfaction. Conclusion. The study assessed the determinants of antenatal care service satisfaction in Ethiopia. First antenatal care visit, waiting time (<60 min) to see the care provider, maintenance of privacy, respectful treatment, and pregnancy unplanned were found to be determinants of antenatal care service satisfaction. Counseling a woman to comply with a minimum required antenatal care visits and compassionate and respectful maternity care will increase maternal satisfaction with the antenatal care services. [ABSTRACT FROM AUTHOR]

Although extensive efforts were made to improve maternal and child health, the magnitude of home child-birth is considerably high in Ethiopia. Therefore, this meta-analysis aimed to estimate the effect of lack of ANC visit and unwanted pregnancy on home child-birth among reproductive-age women in Ethiopia. International databases, including Cochrane Library, Google Scholar, PubMed, Global Health, HINARI, and CINAHL were searched systematically to identify studies reporting the prevalence of home child-birth and its association with lack of ANC visit and unwanted pregnancy among reproductive-age women in Ethiopia. STATA/SE version-14 was used to analyze the data and Der Simonian and Liard's method of random effect model was used to estimate the pooled effects. The heterogeneity between study and publication bias was assessed by using I-squared statistics and Egger's test respectively. A total of 19 studies with 25,228 study participants were included in this meta-analysis. The pooled prevalence of home child-birth among reproductive-age women in Ethiopia was 55.3%. Sever heterogeneity was exhibited among the included studies (I2 = 99.8, p = 0.000). The odds of home child-birth among mothers who have no ANC visit was 3.64 times higher compared to their counterparts [OR = 3.64, 95%, CI: (1.45, 9.13)]. There was significant heterogeneity among the included studies (I2 = 94%, p = 0.000). However, there was no statistical evidence of publication bias in the pooled effect of lack of ANC visit on home child-birth (P = 0.302). Women who experienced unwanted pregnancy were 3.02 times higher to give birth at home compared to women with a wanted pregnancy [OR = 3.02, 95%CI: (1.19, 7.67)]. Severe heterogeneity was exhibited (I2 = 93.1%, p = 0.000) but, there was no evidence of significant publication bias in the pooled effect of unwanted pregnancy on home child-birth (P = 0.832). The proportion of home child-birth among reproductive-age women in Ethiopia remains high. Lack of ANC visit and unwanted pregnancy had a significant effect on the practice of home child-birth. Strengthening behavioral change communication programs should be the primary focus area to improve institutional delivery service utilization among women with lack of ANC visit and unwanted pregnancy. [ABSTRACT FROM AUTHOR]