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Background: Anxiety symptoms are the most frequent mental health problems in the world, and it is a serious public health concern, especially among adolescents, because if left untreated, adolescent anxiety can have a number of detrimental effects, including lower academic performance, strained relationships with friends and family, substance addiction, thoughts of suicide and homicide, and trouble finding work. While this vulnerability is concerning in all situations, it is particularly critical in armed conflict areas. Ethiopia is one of the most recent war-affected countries, but to the best of our knowledge, limited studies focused on adolescents in this context. Therefore, this study assessed the experience of war trauma and its effects on anxiety symptoms among high school students in Woldia town, Ethiopia. Objective: We assessed the experience of war trauma and its effects on anxiety among high school students, as well as associated risk factors, in war-affected areas in Woldia town, northeast Ethiopia. Methods: A cross-sectional study design was conducted from May 23 to June 08 2022. Data were collected from high school students in Woldia town. Bivariable and multivariable logistic regression analyses were used to identify independent factors associated with anxiety. Results: A total of 624 out of 660 students participated in the study (94.5% response rate). The prevalence of anxiety among high school students in Woldia town was 39.7%. In the multivariable analysis, having depression (AOR = 9.24, 95% CI: 6.27, 13.64), witnessing the murder of family/friends (AOR = 1.93, 95% CI: 1.05, 3.57), being of female sex (AOR=1.59, 95% CI: 1.08, 2.36), and having a family history of mental illness (AOR=1.69, 95% CI: 1.00, 2.85) were factors significantly associated with anxiety. Conclusions and recommendations: The prevalence of anxiety in this study was approximately two in five high school students. Therefore, we recommend that the Ministry of Education collaborate with the Ministry of Health to expand and implement mental health services in high schools to promote the wellbeing of students for the prevention of anxiety. [ABSTRACT FROM AUTHOR]

Background: Globally, Tuberculosis (TB) is the main cause of morbidity and mortality among infectious disease. TB and Human Immune Virus (HIV) are the two deadly pandemics which interconnected each other tragically, and jeopardize the lives of children; particularly in Sub-Saharan Africa. Therefore, this review was aimed to determine the aggregated national pooled incidence of tuberculosis among HIV- infected children and its predictors in Ethiopia. Methods: An electronic search engine (HINARI, PubMed, Scopus, web of science), Google scholar and free Google databases were searched to find eligible studies. Quality of the studies was checked using the Joanna Briggs Institute (JBI) quality assessment checklists for cohort studies. Heterogeneity between studies was evaluated using Cochrane Q-test and the I2 statistics. Result: This review revealed that the pooled national incidence of tuberculosis among children with HIV after initiation of ART was 3.63% (95% CI: 2.726–4.532) per 100-person-years observations. Being Anemic, poor and fair ART adherence, advanced WHO clinical staging, missing of cotrimoxazole and isoniazid preventing therapy, low CD4 cell count, and undernutrition were significant predictors of tuberculosis incidence. Conclusion: The study result indicated that the incidence of TB among HIV- infected children is still high. Therefore, parents/guardians should strictly follow and adjust nutritional status of their children to boost immunity, prevent undernutrition and opportunistic infections. Cotrimoxazole and isoniazid preventive therapy need to continually provide for HIV- infected children for the sake of enhancing CD4/immune cells, reduce viral load, and prevent from advanced disease stages. Furthermore, clinicians and parents strictly follow ART adherence. [ABSTRACT FROM AUTHOR]

Background: Neonatal sepsis is a leading cause of sickness and death in the entire world. Diagnosis is usually difficult because of the nonspecific clinical symptoms and the paucity of laboratory diagnostics in many low- and middle-income nations (LMICs). Clinical prediction models may increase diagnostic precision and rationalize the use of antibiotics in neonatal facilities, which could lead to a decrease in antimicrobial resistance and better neonatal outcomes. Early detection of newborn sepsis is critical to prevent serious consequences and reduce the need for unneeded drugs. Objective: The aim is to develop and validate a clinical prediction model for the detection of newborn sepsis. Methods: A cross-sectional study based on an institution will be carried out. The sample size was determined by assuming 10 events per predictor, based on this assumption, the total sample sizes were 467. Data will be collected using a structured checklist through chart review. Data will be coded, inputted, and analyzed using R statistical programming language version 4.0.4 after being entered into Epidata version 3.02 and further processed and analyzed. Bivariable logistic regression will be done to identify the relationship between each predictor and neonatal sepsis. In a multivariable logistic regression model, significant factors (P<  0.05) will be kept, while variables with (P<  0.25) from the bivariable analysis will be added. By calculating the area under the ROC curve (discrimination) and the calibration plot (calibration), respectively, the model's accuracy and goodness of fit will be evaluated. [ABSTRACT FROM AUTHOR]

Background: Previous reviews explored the association between maternal use of folic acid and multivitamin supplements and risk of neural tube defect (NTD) in children, with no definitive conclusion. These reviews had produced contradictory results, and there had been no umbrella review. Therefore, the objective of this umbrella review is to combine the inconsistent data on the effect of prenatal folic acid and/or multivitamin supplementation for the prevention of NTD in offspring., Methods: Using the PRISMA guideline, PubMed, Embase, Scopus, Web of Sciences, Cochrane Database of Systematic Reviews, Scopus, and Google Scholar reported that the effects of folic acid and/or multivitamin supplementation for the prevention of NTD in offspring were searched. The quality of the included studies was assessed using Assessment of Multiple Systematic Reviews (AMSTAR). A weighted inverse variance random-effects model was applied to find the pooled estimates. The subgroup analysis, heterogeneity, publication bias, and sensitivity analysis were also assessed., Result: Ten SRM with 296,816 study participants were included. The random-effects model analysis from 10 included systematic review and meta-analysis revealed that the pooled effect of either folic acid or multivitamin supplementation for the prevention of NTD globally is found to be 0.43 (95% CI: 0.29, 0.58) (I2 = 93.50%; p ≤0.001). In the subgroup analysis, the pooled effect was found to be 0.23 (0.09, 0.37) in folic acid group, while this estimate is 0.63 (0.53, 0.72) and 0.61 (0.46, 0.75) in groups who took multivitamin. The pooled effect of prevention of NTD was found to be 0.50 (0.34, 0.66) in SRMs aimed at occurrence prevention (primary prevention) group, while this estimate is 0.20 (-0.01, 0.41) among SRMs, which aimed at reoccurrence (secondary) prevention, and 0.61 (0.46, 0.75) among those SRMs aimed to assess the effect folic acid or multivitamin for the prevention of both occurrence and reoccurrence. The pooled effect of either folic acid or multivitamin supplementation for the prevention of NTD was found to be 0.45 (0.03, 0.87) in SRMs of observational studies, while this estimate is 0.43 (0.32, 0.54) among SRMs of randomized controlled trials., Conclusion: This umbrella review of systematic review and meta-analysis found that prenatal folic acid and/or multivitamin supplementation was associated with a 57% reduction in NTD. Participants who took folic acid supplementation were associated with a slightly higher (77%) percentage of reduction in NTD compared with those who took multivitamin (37%). Reductions of 80% and 50% were observed for reoccurrence and occurrence prevention of NTD. Reductions of 57% and 55% of NTD have been found in SRM of RCTs and observational studies. This umbrella review revealed that both folic acid and multivitamin were associated with significantly lower levels of NTD in children. Considering the incorporation of those supplements in NTD prevention strategies during the preconception period is recommended. More large-scale prospective cohort and RCTs are needed to understand the protective effect of multivitamins and/or folic acid on NTD risk addressing the molecular mechanisms and to determine the optimal dose, duration, and timing of maternal multivitamin and folic acid intake for best child NTD risk reduction., (© 2024 S. Karger AG, Basel.)