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Abstract Background In Ethiopia, there were an estimated 670,906 people living with the Human Immune Virus (HIV). Implementing an HIV test and treat strategy and rapid scale-up of anti-retroviral treatment (ART) provided health facilities increased the number of the number of people living with HIV/AIDS. In the same way, the expansion of viral load monitoring in these health facilities and poor adherence to ART increase the number of high-viral load (HVL) patients. To alleviate this problem, the World Health Organization (WHO) recommended EAC intervention for HVL patients. Therefore, the aim of this research was to determine the level of healthcare providers’ adherence to the EAC intervention protocol and explore barriers and facilitators of the intervention in West Amhara, Northwest Ethiopia. Method Descriptive cross-sectional study design with concurrent mixed-method evaluation was employed. The adherence dimension, with its sub-dimensions of content, coverage, frequency, and duration of the EAC intervention, was used with sixteen indicators. A total of 20 high-case-load public health facilities and 173 HVL patients were included in our study. Quantitative data was entered into Epi Info and exported to SPSS version 25 for analysis. Descriptive statistics are analyzed in terms of frequencies, percentages, variances, and means and presented as narrations, frequency tables, graphs, and charts. Qualitative data were transcribed, translated, coded, and analyzed thematically using Open Code version 4.0 software. The qualitative findings were used to triangulate the quantitative findings. Result The average adherence level of health care providers (HCPs) to the EAC intervention protocol was 55.3%, from which content, coverage, frequency, and duration of the intervention contributed 70.3%, 86.3%, 36.9%, and 27.7%, respectively. Most of the intervention contents were delivered during the session, but none of the providers developed a patient adherence plan at the end of the session. All HVL patients were linked and enrolled in the EAC intervention. But only 6% of them were tested for repeat VL. Conclusion The average adherence level of HCPs to the EAC intervention protocol was very inadequate. The main gap identified was difficulties in completing the EAC intervention sessions based on schedules. Implementing adherence improvement strategies, assigning an adequate number of EAC providers in ART and Prevention of Mother-to-Child Transmission (PMTCT) clinics, and allowing sufficient time during EAC sessions are important.

Abstract Background The way the healthcare delivery system is reflected by patient satisfaction. Establishing a health system with better results depends on it. It has been assumed that higher patient satisfaction levels correlate with quality healthcare outcomes. There is little national data to support patient satisfaction with inpatient health services in Ethiopia. In order to estimate the pooled proportion of patient satisfaction and determine the associated factors with inpatient health services at public hospitals, a systematic review and meta-analysis were conducted. Methods The Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines were followed in the extraction of the data. To get the included studies, the following electronic databases were searched: Pub-Med, Google Scholar, Med-Line, Web of Science, Scopus and Repositories. Software called STATA version 17 was used to analyze statistical data using the random effects model. Forest plots were used to display the pooled results. Results Of the 1583 records resulted in electronic databases searching, 11 studies with 3,958 participants were included in this systematic review and meta-analysis. The estimated pooled proportion of patient satisfaction with inpatient health services was found to be 57.4% (95% CI: 50.88–64.59, I 2 = 95.25%). Assuring privacy for patients (OR = 7.44, 95% CI: 3.63–15.25, I 2 = 0.0%), availability of direction signs (2.96, 95% CI: 1.91–4.57, I 2 = 0.0%), providing adequate information (OR = 3.27, 95% CI: 1.63–6,58, I 2 = 65.60%), history of previous admission (OR = 0.29, 0.18–0.46, I 2 = 86.36%) and providing on time treatment (OR = 1.63, 95% CI: 1.21–2.20, I 2 = 86.36%) were statistically significant factors associated with patient satisfaction with inpatient health services. Conclusion The estimated pooled level of patient satisfaction with inpatient health services is low in Ethiopia. A higher level of patient satisfaction with inpatient health treatments was predicted by factors such as privacy assurance, fast services, availability of direction signs, provision of services with adequate information transfer, and no history of previous admission. To improve patient satisfaction, the Ministry of Health and hospital administration must place a strong emphasis on ensuring the provision of high-quality, standard-based inpatient healthcare.

Abstract Background Parasitic zoonoses are infections transmitted between vertebrate animals and humans, posing serious public health risks and significant economic consequences. The study aimed at assessing government workers' knowledge, attitudes, and practices (KAP) regarding zoonotic parasites of pet animals in Ethiopia's central Gondar zone. Methods A cross-sectional study was carried out in selected towns of Central Gondar Zone, Northwest Ethiopia from January 2022 to August 2022. Four hundred randomly selected government employees participated in the study. Data were collected through semi-structured questionnaire administered by face-to-face interview. The chi-squared (χ2) was calculated for association and p-value less than 0.05 was considered as significant. Results A 57.25% of respondents were males and 42.75% were females. Most of the respondents, 67.5%, had completed college/university education. About 60% of the respondents had 'high knowledge', 57.25% had 'positive attitude', and 73% had 'good practice' regarding pet animals as a source of zoonotic parasites. The chi-square analysis revealed a significant discrepancy (p

Abstract Background Several studies were performed on transdermal (TD) insulin delivery in vitro and in vivo, and recently, the study groups included a clinical trial in humans. Therefore, this systematic review was conducted to get summary information about the effectiveness, safety, and preferability of TD insulin in comparison with subcutaneous insulin delivery. Methods We conducted a thorough search to find studies in the databases Cochrane Library, MEDLINE via PubMed, Web of Science Core Collection, EMBASE, Scopus, Hinari, Medlib, and Magiran until January 2024. We included 18 randomized clinical trials. Results Although there are various types of TD delivery methods, the TD insulin delivery methods that have undergone clinical trials are the TD patch, micro needle TD insulin delivery, and TD insulin jet injector. Eighteen studies were conducted on TD insulin delivery, which showed either superior or comparable effectiveness, safety, and preferability of TD insulin in comparison with SC insulin. About eleven out of eighteen studies (61.1%) showed more effective blood glucose control than SC delivery, and the remaining seven studies showed comparable effectiveness with SC delivery. Eleven studies (61.1%) showed equal tolerability of TD insulin versus SC insulin, and seven studies (38.9%) showed more tolerability of TD insulin over SC insulin. In most studies, eleven out of eighteen (61.1%) showed a higher preference for TD insulin delivery over traditional SC delivery; sixth out of eighteen (33.3%) showed equal preferability for TD insulin versus SC insulin; and only one study (5.6%) showed that TD insulin delivery was less preferable than SC insulin. Conclusion The review revealed that clinical trials have demonstrated the effectiveness of TD insulin delivery methods such as TD patches, MN-based insulin delivery, and insulin jet injectors compared to traditional SC routes of administration. The studies showed the superior or comparable effectiveness of TD insulin in controlling blood glucose levels. Additionally, TD insulin delivery was found to be equally or more tolerable than SC insulin delivery in all studies. Overall, the majority of studies favored TD insulin delivery over traditional SC delivery methods, highlighting its potential as a preferred option for insulin administration.

Abstract Introduction Head lice infestation remains a persistent public health concern among primary school children in resource-limited settings, affecting their well-being and academic performance. Despite previous studies, there is no consistent evidence on the prevalence and factors associated with head lice infestation. This study aimed to determine the prevalence and factors related to head lice infestation among primary school children in low and middle-income countries. Methods This review was conducted by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines. Relevant electronic databases, including PubMed, Cochrane Library, Web of Science, Science Direct, AJOL, and Google Scholar, were used to retrieve articles. The study included only published articles written in English languages between December 01, 2014 to January 31, 2024 for studies reporting the prevalence of head lice infestation or associated factors among primary school children in low- and middle-income countries. This review has been registered on PROSPERO with Prospero registration number CRD42024506959. The heterogeneity of the data was evaluated using the I2 statistic. A meta-analysis was conducted using STATA 17 software, with a 95% confidence interval. Publication bias was evaluated using funnel plots and statistical tests, such as Egger’s and Beggs’s tests, to identify publication biases in the included studies. Meta-regression was also carried out to assess the source of publication of publication bias. Results The review included 39 studies involving 105,383 primary school children. The pooled prevalence of head lice infestation among primary school children in low- and middle-income countries was 19.96% (95% CI; 13.97, 25.95). This review also found out that being a girl was 3.71 times (AOR = 3.71; 95% CI: 1.22–11.26) more likely to have head lice infestation as compared to boys, while children with a previous history of infestation were 4.51 times (AOR = 4.51; 95% CI: 2.31–8.83) more likely to have head lice infestation as compared to their counterparts. Conclusion The overall prevalence of head lice infestation among primary school children in low- and middle-income countries was found to be high. Female gender, children who had a previous history of infestation, and family size were significant predictors of head lice infestation. As a result, policymakers and program administrators should focus on the identified determinants.

Abstract Good-quality sleep is defined by its ability to minimize disturbances, provide adequate duration, and maintain a balanced progression through sleep stages. Sleep disturbance is a common complaint in people living with HIV/AIDS. Despite the influence of sleep disturbance on treatment adherence, quality of life, work productivity, risk of chronic illness. Studies have reported sleep disturbances among HIV/AIDS patients in sub-Saharan African countries (SSA), yielding varied results at the country level. Therefore, conducting a systematic review and meta-analysis is essential. This systematic review and meta-analysis aimed to evaluate the prevalence of poor sleep quality and identify associated factors among HIV/AIDS patients in sub-Saharan African countries. We systematically searched across various databases, including PubMed, African Journals Online, Scopus, Cochrane Library, HINARI, and Science Direct. Additionally, we conducted searches using Google and Google Scholar search engines. Microsoft Excel was used for data extraction, and the data were analysed using STAT version 17.0. We assessed heterogeneity using Cochran’s Q test and I2 test and checked for small study effects using funnel plot symmetry and Egger’s test. Pooled prevalence and associated factors were estimated using a random-effects model at a 95% confidence interval (CI) and significance level of p

Abstract Background Sexually transmitted infections (STIs) are illnesses mainly spread through unprotected sexual activity. There is a scarcity of aggregate evidence in Ethiopia. The aim of this review was to assess the pooled prevalence of STI, and its associated factors among students in Ethiopia to fill the aforementioned gap. Methods We extensively searched the bibliographic databases of PubMed, Scopus, and Google Scholar to obtain eligible studies. Further screening for a reference list of articles was also done. The Microsoft Excel Spreadsheet was used to extract data, and Stata 17 was used for analysis. The PRISMA-guidline and Newcastle-Ottawa quality assessment scale were used for quality appraisal. To check heterogeneity, the Higgs I2 and Cochran’s Q tests were employed. Sensitivity and subgroup analysis were implemented. To detect publication bias, Egger’s test and funnel plots were used. Results The pooled prevalence of STI among students in Ethiopia was 13.6% with a 95% CI (10.2, 17). Findings from sub group analysis based on student category shows that the pooled prevalence of STI were 14.5% among University students, 14.2% among college students and 10.6% among high school students. Having multiple sexual partners (AOR 3.31; 95% CI: 2.40–4.57), not using condoms during sexual intercourse (AOR 2.56; 95% CI: 1.72–3.81), and having poor knowledge about sexually transmitted infections were 3.08 times (AOR 3.08; 95% CI: 1.84–5.15) significantly associated with STI. Conclusion The pooled prevalence of STIs among students in Ethiopia was high, and factors like having multiple sexual partners, not using condoms during sexual intercourse, and having poor knowledge about sexually transmitted infections were significantly associated with STIs. Hence, reduce STIs among students, strengthening sexual and reproductive health services, raising awareness about transmission and prevention, and promoting consistent condom use through health information dissemination is crucial. Further qualitative studies are suggested to explore the barriers and facilitators of STI prevention.

Abstract Introduction Scabies is a widespread issue in prisons due to overcrowded living conditions and limited healthcare resources. A recent study published in the Journal of Infection and Public Health discovered that the prevalence of scabies varies greatly among prisoners in different regions and facilities. This review aimed to determine the global prevalence and predictors of scabies among prisoners by conducting a systematic review and meta-analysis. Methods We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis checklist to report the findings of our systematic review and meta-analysis. Relevant databases including PubMed, Cochrane Library, ScienceDirect, and other grey literature databases were used to search and retrieve articles. The study included both published and unpublished research written in English languages for studies reporting the prevalence of human scabies among prisoners. This review has been registered on PROSPERO. The heterogeneity of the data was evaluated using the I2 statistic. A meta-analysis was conducted using STATA 17 software, with a 95% confidence interval. The researchers also conducted publication bias and sensitivity analysis. Results The review included 7 studies involving 1, 309,323 prisoners. All included studies involved cross-sectional study design. The prevalence of scabies among prisoners ranges from 0.72% in Italy to 41.01% in Cameroon. The global pooled prevalence of human scabies among prisoners was found to be 6.57% (95% CI; 2.16–19.94). According to subgroup analysis, the overall prevalence of scabies among African prisoners was 19.55% (95% CI; 9.44–40.45), while the prevalence among prisoners outside of Africa was 1.57% (95% CI; 0.77–3.19). The length of time spent in prison, sharing of clothing or beds, and hygiene practices were found to be factors that were significantly associated with the likelihood of prisoners developing human scabies. Conclusion The overall prevalence of human scabies is high among prisoners worldwide. Prisoners who spent more time in prison shared clothing or beds, and had poor hygiene practices were more likely to develop human scabies. Thus, efforts should be made by policymakers and program administrators to decrease the prevalence of scabies in prisons. The protocol for this systematic review and meta-analysis was registered in the International Prospective Register of Systematic Reviews with registration number CRD42024516064.

Abstract Introduction There has been extensive research conducted on open defecation in Ethiopia, but a notable gap persists in comprehensively understanding the spatial variation and predictors at the household level. This study utilizes data from the 2021 Performance Monitoring for Action Ethiopia (PMA-ET) to address this gap by identifying hotspots and predictors of open defecation. Employing geographically weighted regression analysis, it goes beyond traditional models to account for spatial heterogeneity, offering a nuanced understanding of geographical variations in open defecation prevalence and its determinants. This research pinpoints hotspot areas and significant predictors, aiding policymakers and practitioners in tailoring interventions effectively. It not only fills the knowledge gap in Ethiopia but also informs global sanitation initiatives. Methods The study comprised a total weighted sample of 24,747 household participants. ArcGIS version 10.7 and SaT Scan version 9.6 were used to handle mapping, hotspots, ordinary least squares, Bernoulli model analysis, and Spatial regression. Bernoulli-based model was used to analyze the purely spatial cluster detection of open defecation at the household level in Ethiopia. Ordinary Least Square (OLS) analysis and geographically weighted regression analysis were employed to assess the association between an open defecation and explanatory variables. Results The spatial distribution of open defecation at the household level exhibited clustering (global Moran’s I index value of 4.540385, coupled with a p-value of less than 0.001), with significant hotspots identified in Amhara, Afar, Harari, and parts of Dire Dawa. Spatial analysis using Kuldorff’s Scan identified six clusters, with four showing statistical significance (P-value

IntroductionSeveral studies have been done on the utilization of sexual and reproductive health services by high school students in Ethiopia, but they have yielded inconsistent results. This study aimed to evaluate the extent to which high school students in Ethiopia are using sexual and reproductive health services by conducting a systematic review and meta-analysis.MethodsVarious electronic databases such as PubMed, Cochrane Library, AJOL, Google Scholar, and Grey Literature were used to search for relevant articles. Preferred Reporting Items for Systematic Reviews and Meta-Analysis Guidelines were followed for this review and meta-analysis. Heterogeneity was assessed using I2 and Cochrane Q statistical tests, and data analysis was done with STATA 17 software. Random effect meta-analyses were used to determine the overall utilization rate of sexual and reproductive health services.ResultThis review included 20 studies with 12, 215 study participants. The pooled magnitude of sexual and reproductive health service utilization among high school students in Ethiopia was 29.79% (95% CI: 25.14, 34.43). Students with grades 11–12 (AOR = 2.33, 95% CI: 1.39, 3.90), aged between 20 and 24 years (AOR = 2.61; 95% CI: 1.79–3.81), having higher level of knowledge towards sexual and reproductive health issues (AOR = 3.10; 95% CI: 1.67–5.77), previous history of sexual intercourse (AOR = 4.18; 95% CI: 2.59–6.75), previous history of sexually transmitted infection (AOR = 3.74; 95% CI: 2.22–6.31), presence of a reproductive health service facility in the school (AOR = 2.55; 95% CI: 1.72–3.77), and ever-discussed reproductive health issues (AOR = 4.04; 95% CI: 1.62–10.03) were more likely to utilize sexual and reproductive health services.ConclusionsThe overall utilization of sexual and reproductive services among high school students in Ethiopia was found to be low as compared to SDG 3.7. Older individuals with higher education levels and knowledge about sexual and reproductive health services, as well as those who have had previous sexual experiences or discussions about sexual health, are more likely to utilize reproductive health services. To increase utilization, the Ministry of Health and the Ministry of Education should prioritize these factors.

IntroductionCervical cancer is a prevalent cancer among women in low and middle-income countries, but it can be largely prevented through screening programs and HPV vaccination. This study aimed to determine the level of knowledge, attitudes, and practices regarding cervical cancer screening among healthcare providers in Sub-Saharan African countries.MethodsSystematic review and meta-analysis were conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Relevant databases including PubMed, Cochrane Library, AJOL, Google Scholar, and ScienceDirect databases were used to retrieve and search articles. The study included published and unpublished research written in English between January 2013 and May 16, 2024 for studies reporting knowledge, attitude, and practice towards cervical cancer screening among healthcare providers in Sub-Saharan Africa. This review has been registered on PROSPERO. The heterogeneity of the data was evaluated using the I2 statistic. A meta-analysis was conducted using STATA 17 software, with a 95% confidence interval. The researchers also conducted publication bias and sensitivity analysis.ResultsThe review included 30 studies involving 7542 healthcare providers. The pooled magnitude of good knowledge status towards cervical cancer was 67.93% (95% CI: 53.36–82.50) whereas the pooled magnitude of positive attitude towards cervical cancer was 55.26% (95% CI: 34.28– 76.23). The results also showed that about 49.68% (95% CI: 33.18–66.17) of healthcare providers had good knowledge status about cervical cancer screening, 66.63%(95% CI: 50.36– 82.89) had a positive attitude towards it, and only 17.23% (95% CI; 6.08-28.37) had ever screened for cervical cancer.ConclusionThe overall magnitude of knowledge and attitude of healthcare providers in Sub-Saharan Africa towards cervical cancer and its screening was suboptimal. Furthermore, a low percentage of female healthcare providers in the region had undergone screening for cervical cancer. As a result, policymakers and program administrators should focus on improving the knowledge, attitude, and practices of healthcare providers to meet the global health goal of cervical cancer screening and effectively eliminating cervical cancer. Healthcare providers must serve as role models for other women who should also undergo screening.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/, identifier CRD42023495241.

Abstract Background Access to health care services is a basic human right, and an individual’s health and overall quality of life may suffer as a result of barriers to accessing health services. Access to comprehensive and quality health care is fundamental for promoting and maintaining health, preventing and treating diseases, and reducing premature deaths. However, only half of the African population has access to modern health services. Therefore, this study aimed to assess the health care access and associated factors among female youths in low-income East African countries. Methods This study used secondary data from 2016 to 2021 demographic and health surveys of 7 low-income East African countries. A total weighted sample of 51,064 youths was included. A multilevel binary logistic regression was employed to identify the associated factors of access to health care since the data has a hierarchical structure. Adjusted Odds Ratio (AOR) with a 95% confidence interval (CI) at a p-value less than 0.05 was used to measure the association of variables whereas Intra-class correlation coefficient (ICC), Median Odds Ratio (MOR), and proportional change in variance (PCV) were used to measure random effects. Result The overall magnitude of access to healthcare among female youths in low-income East African countries was 38.84% (95% CI: 38.41, 39.26). Youth’s educational level, rich wealth status, media exposure, and community level education were the positive while higher youth’s age and rural residence were the negative predictors of access to healthcare among female youths. Besides, living in different countries compared to Burundi was also an associated factor for accessing healthcare in low-income East African countries. Conclusion About six in ten female youths were not accessing health care in low-income East African countries. Therefore, to increase healthcare access, health managers and policymakers needed to develop strategies to improve the poor household wealth index, and redistribution of health services for rural residents. The decision-makers and program planners should also work on increasing access to education and media exposure for youths. Further research including health system and quality of service-related factors for accessing healthcare should also be considered by researchers.

Abstract Introduction Ethiopia strives to achieve Universal Health Coverage (UHC) through Primary Health Care (PHC) by expanding access to services and improving the quality and equitable comprehensive health services at all levels. The Health Extension Program (HEP) is an innovative strategy to deliver primary healthcare services in Ethiopia and is designed to provide basic healthcare to approximately 5000 people through a health post (HP) at the grassroots level. Thus, this review aimed to assess the magnitude of health extension service utilization in Ethiopia. Methods The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) checklist guideline was used for this review and meta-analysis. The electronic databases (PubMed, Cochrane Library, and African Journals Online) and search engines (Google Scholar and Grey literature) were searched to retrieve articles by using keywords. The Joanna Briggs Institute (JBI) meta-analysis of statistics assessment and review instrument was used to assess the quality of the studies. Heterogeneity was assessed using the I2 statistic. The meta-analysis with a 95% confidence interval using STATA 17 software was computed to present the pooled utilization of health extension services. Publication bias was assessed by visually inspecting the funnel plot and statistical tests using Egger’s and Begg’s tests. Result 22 studies were included in the systematic review with a total of 28,171 participants, and 8 studies were included in the meta-analysis. The overall pooled magnitude of health extension service utilization was 58.5% (95% CI: 40.53, 76.48%). In the sub-group analysis, the highest pooled proportion of health extension service utilization was 60.42% (28.07, 92.77%) in the mixed study design, and in studies published after 2018, 59.38% (36.42, 82.33%). All studies were found to be within the confidence interval of the pooled proportion of health extension service utilization in leave-out sensitivity analysis. Conclusions The utilization of health extension services was found to be low compared to the national recommendation. Therefore, policymakers and health planners should come up with a wide variety of health extension service utilization strategies to achieve universal health coverage through the primary health care.

Abstract Background Abdominal injuries exert a significant impact on global morbidity and mortality. The aggregation of mortality data and its determinants across different regions holds immense importance for designing informed healthcare strategies. Hence, this study assessed the pooled mortality rate and its predictors across sub-Saharan Africa. Method This meta-analysis employed a comprehensive search across multiple electronic databases including PubMed, Africa Index Medicus, Science Direct, and Hinari, complemented by a search of Google Scholar. Subsequently, data were extracted into an Excel format. The compiled dataset was then exported to STATA 17 statistical software for analysis. Utilizing the Dersimonian-Laird method, a random-effect model was employed to estimate the pooled mortality rate and its associated predictors. Heterogeneity was evaluated via the I 2 test, while publication bias was assessed using a funnel plot along with Egger's, and Begg's tests. Result This meta-analysis, which includes 33 full-text studies, revealed a pooled mortality rate of 9.67% (95% CI; 7.81, 11.52) in patients with abdominal injuries across sub-Saharan Africa with substantial heterogeneity (I2 = 87.21%). This review also identified significant predictors of mortality. As a result, the presence of shock upon presentation demonstrated 6.19 times (95% CI; 3.70-10.38) higher odds of mortality, followed by ICU admission (AOR: 5.20, 95% CI; 2.38-11.38), blunt abdominal injury (AOR: 8.18, 95% CI; 4.97-13.45), post-operative complications (AOR: 8.17, 95% CI; 4.97-13.44), and the performance of damage control surgery (AOR: 4.62, 95% CI; 1.85-11.52). Conclusion Abdominal injury mortality is notably high in sub-Saharan Africa. Shock at presentation, ICU admission, blunt abdominal injury, postoperative complications, and use of damage control surgery predict mortality. Tailored strategies to address these predictors could significantly reduce deaths in the region.

Abstract Background Health literacy is the important for the prevention of non-communicable disease to make informed health decisions, and practice healthy and protective behaviours. Therefore, application of socioecological model to this study aimed to identify multilevel factors on health literacy among patients and develop scientific health communication interventional strategies to improve health literacy on non-communicable disease prevention and care. Objective To explore barriers of health literacy on non-communicable disease prevention and care among patients in north wollo zone public Hospitals, Northeast Ethiopia, 2023. Method In this study phenomenological study design was conducted from February 5 to 30/2023.We have used purposive sampling technique to select study participants from chronic follow up clinics. Data were collected using in-depth interview and focused group discussion in which audio was recorded, transcribed verbatim and translated to English. Thematic analysis was performed with atlas ti. 7 software. Result In this study four main themes with seven subthemes were developed. The main themes were factors at the organizational, community, interpersonal, and intra-personal factors. The poor knowledge, lack of enough money for transportation and medication at the hospital were identified as barrier to get early diagnosis and treatment. Some participants explored that they have no any support from family or others. The cultural norms like weeding and funeral ceremonies enforce patients to consume prohibited substances like alcohol and salty foods. Conclusion In this study different barriers of health literacy were explored. Lack of knowledge, economic problems, lack of social support, poor communication with health care providers, cultural influences, lack of regular health education, lack of access to health care services and poor infrastructure were main barriers of health literacy in patients with NCD. Therefore, we recommended all concerned bodies to work on social and behavioral change communication intervention focusing on awareness creation, supply of drugs and create supportive environment to get accessible and affordable health care service to decrease the impact of non-communicable disease at personal, community and national level.

Abstract Introduction Globally, chest trauma remain as a prominent contributor to both morbidity and mortality. Notably, patients experiencing blunt chest trauma exhibit a higher mortality rate (11.65%) compared to those with penetrating chest trauma (5.63%). Aim This systematic review and meta-analysis aimed to assess the mortality rate and its determinants in cases of traumatic chest injuries. Methods The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist guided the data synthesis process. Multiple advanced search methods, encompassing databases such as PubMed, Africa Index Medicus, Scopus, Embase, Science Direct, HINARI, and Google Scholar, were employed. The elimination of duplicate studies occurred using EndNote version X9. Quality assessment utilized the Newcastle-Ottawa Scale, and data extraction adhered to the Joanna Briggs Institute (JBI) format. Evaluation of publication bias was conducted via Egger’s regression test and funnel plot, with additional sensitivity analysis. All studies included in this meta-analysis were observational, ultimately addressing the query, what is the pooled mortality rate of traumatic chest injury and its predictors in sub-Saharan Africa? Results Among the 845 identified original articles, 21 published original studies were included in the pooled mortality analysis for patients with chest trauma. The determined mortality rate was nine (95% CI: 6.35–11.65). Predictors contributing to mortality included age over 50 (AOR 3.5; 95% CI: 1.19–10.35), a time interval of 2–6 h between injury and admission (AOR 3.9; 95% CI: 2.04–7.51), injuries associated with the head and neck (AOR 6.28; 95% CI: 3.00–13.15), spinal injuries (AOR 7.86; 95% CI: 3.02–19.51), comorbidities (AOR 5.24; 95% CI: 2.93–9.40), any associated injuries (AOR 7.9; 95% CI: 3.12–18.45), cardiac injuries (AOR 5.02; 95% CI: 2.62–9.68), the need for ICU care (AOR 13.7; 95% CI: 9.59–19.66), and an Injury Severity Score (AOR 3.5; 95% CI: 10.6–11.60). Conclusion The aggregated mortality rate for traumatic chest injuries tends to be higher in sub-Saharan Africa. Factors such as age over 50 years, delayed admission (2–6 h), injuries associated with the head, neck, or spine, comorbidities, associated injuries, cardiac injuries, ICU admission, and increased Injury Severity Score were identified as positive predictors. Targeted intervention areas encompass the health sector, infrastructure, municipality, transportation zones, and the broader community.

IntroductionThis study delves into individual and community-level factors influencing the availability of water, soap, and cleansing agents for handwashing in Ethiopia. Its comprehensive exploration offers nuanced insights, informing targeted interventions and policies to effectively enhance handwashing resources across Ethiopia. Therefore, this study aimed to assess individual and community-level factors of availability of observed water, soap, and other cleansing agents for hand washing practices in Ethiopia.MethodsData from the 2021 PMA-ET, encompassing 24,747 household participants, informed this study. Employing STATA version 17.0, a multi-level mixed-effect logistic regression analysis was performed to identify individual and community-level factors. Adjusted odds ratios with a 95% confidence interval conveyed the strength and direction of associations, with significance determined at p

Introduction: Hypertensive crises are a leading cause of visits to emergency departments, carrying grave health implications. A significant number of patients presenting with these crises have a known history of hypertension. Objective: The aim of this systematic review and meta-analysis is to examine the combined prevalence of hypertensive crises among individuals with either a history of hypertension or unknown status (newly diagnosed with a hypertensive crisis). Methods: This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and was registered with the Prospective Register of Systematic Reviews (PROSPERO). Research databases, including PubMed, Embase, Scopus, Africa Index Medicus, Science Direct, HINARI, and Google Scholar, were systematically searched. Study quality was evaluated using the Newcastle–Ottawa Scale, while publication bias was explored through Egger's regression test, funnel plots, and sensitivity analyses. Data collection adhered to the Joanna Briggs Institute (JBI) format. Meta-analysis was performed using STATA version 17, employing the random-effects DerSimonian–Laird model. Results: Amongst the 15 studies analyzed, the application of the random-effects DerSimonian-Laird statistical model indicated that the prevalence of hypertensive crisis was determined to be 9.09 %, with a 95 % confidence interval (CI) ranging from 7.41 % to 10.77 %. Factors such as poor medication adherence (POR 5.00; 95 % CI: 3.61, 6.93), patients with comorbidities (POR 4.73; 95 % CI: 3.29, 6.80), patients with a history of hypertension (POR 5.64; 95 % CI: 4.57, 6.94), patients aged >65 (POR 2.77; 95 % CI: 2.16, 6.59), and excessive alcohol intake (POR 5.01; 95 % CI: 3.82, 6.58) were associated with higher odds of hypertensive crisis. Conclusion: The findings indicate a markedly higher incidence of hypertensive crisis among hospital-presenting patients in Africa. Factors such as medication non-adherence, co-existing comorbidities, historical hypertension, being over 65, and alcohol misuse significantly contribute to this condition. These insights call for a comprehensive healthcare strategy that targets both the management of hypertension and its complications, aiming to improve the overall health outcomes of affected patients.

BackgroundPsychosocial distress is a chronic burden for cancer survivors, which impacts both their quality of life and their oncologic prognosis. Although the national cancer prevention and control program in Ethiopia has made efforts in cancer prevention, control, and management by implementing the national cancer control plan 2016–2020, there was no enough evidence about psychosocial distress among adult cancer patients. So, it is critical to understand the magnitude of psychosocial distress and the factors that contribute to it.ObjectiveThe purpose of this study was to assess the prevalence of psychosocial distress and associated factors among adult cancer patients at oncology units in the Amhara regional state, Ethiopia. 2022.MethodsA multicenter institution-based cross-sectional study was conducted among a sample of 605 adult cancer patients from 30 April to 22 June 2022. A systematic random sampling technique was employed to select the study units. In addition, data were collected through interviewers administered questionnaires by using the validated and pretested tools. Distress was assessed using the Questionnaire on Stress in Cancer Patients Revised 10. Both bivariable and multivariable logistic regression was used to describe the association between dependent and independent variables. Independent variable with p < 0.25 in the bivariable logistic regression analyses were entered into multivariable logistic regression model. Variables with p

Abstract Introduction Countries with humanitarian crises and fragile conditions contribute to 61% of the global burden of maternal mortality. Emergency Obstetric and Newborn Care (EmONC) services reduce direct obstetric complications, which cause approximately 70–80% of maternal deaths and 10% to 15% of neonatal deaths. Therefore, this study was aimed to assess the service availability and readiness to provide comprehensive emergency obstetric and newborn care services in post-conflict at North Wollo Zone hospitals, Northeast Ethiopia. Methods A facility-based mixed cross-sectional study design was conducted from May 10 to May 25, 2022, among North Wollo zone hospitals. Quantitative data were collected by using structured interviewer-administered questionnaires with observation and record review, entered by using Epi Data Version 4.6, and exported to SPSS 25 for analysis. Qualitative data were collected by key informant interviews and analyzed through thematic analysis. A descriptive data analysis was done to analyze the study variables. Results Only three of the six hospitals (Woldia, Shediho Meket, and Saint Lalibella) performed all signal functions of comprehensive emergency obstetric and newborn care in the preceding three months. Cesarean section was the least performed signal function in post-conflict. The overall readiness to provide comprehensive emergency obstetric and newborn care services was 77.7%. Only one of the six hospitals had sufficient blood without interruption, and three of the six facilities had done screening for hepatitis B, HIV, and syphilis. Lack of supplies, equipment, and drugs were the challenges for the performance of EmONC signal functions. Conclusions Post-conflict availability and readiness for comprehensive emergency obstetric and newborn care services in the North Wollo Zone was suboptimal. Shortage of medical supplies, equipment and emergency transportation was the challenges to provide these services. Thus, the hospital decision makers should strengthen leadership commitment, which focuses on recovering and rebuilding the destructed hospitals with resource mobilization and support.

Objective: Health literacy helps an individual to have the capacity to obtain, process, and understand basic health information to make appropriate health decisions. This study aimed to review the association between health literacy and COVID-19 vaccine acceptance. Method: This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses steps. Databases including PubMed/MEDLINE, Web of Science, Scopus, EMBASE, World Health Organization libraries, and Google Scholar were used to search all published articles in the area of health literacy and COVID-19 vaccine acceptance until August 1, 2022. Result: In this review, 1348 articles were retrieved. Finally, 13 articles were included in the review after the removal of duplicates that did not meet our inclusion criteria. In all, 10 articles showed that health literacy was significantly associated with COVID-19 vaccine acceptance. This review also showed that positive perception of the vaccine, vaccine hesitancy, adverse reaction from vaccines, residence, socioeconomic status, level of education, younger age, being a health worker, and positive belief have associations with health literacy and COVID-19 vaccine acceptance. There was significant heterogeneity in the study population and measurement tools used for health literacy and COVID-19 vaccine acceptance. Conclusion: This systematic review provides comprehensive evidence on health literacy and COVID-19 vaccine acceptance globally. There was significant heterogeneity in the study population and measurement tools used for health literacy and COVID-19 vaccine acceptance. Most studies reported that health literacy is significantly associated with COVID-19 vaccine acceptance. Therefore, investing in health literacy using different vaccine promotion strategies may improve COVID-19 vaccine acceptance and health decision-making to decrease the impact of the COVID-19 pandemic.