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United Nations program on HIV/AIDS 90-90-90 ambitious goal recommends 90% of people living with HIV and taking antiretroviral therapy should achieve viral suppression by 2020. However, virological failure is still a global public health problem, especially in sub-Saharan African countries. Thus, this systematic review and meta-analysis aimed at estimating the burden of virological failure and its associated factors among peoples living with HIV in sub-Saharan Africa. We searched Google Scholar, PubMed, Cochrane Library, and Scopus for studies that reported virologic failure and its associated factors. I-squared statistics and Egger's statistical test were used to detect heterogeneity and publication bias respectively. The pooled prevalence of virological failure was estimated using the DerSimonian-Laird random-effects model. Sensitivity analysis was done to check the presence of outlier results included in the studies. The estimated pooled prevalence of virological failure was 1.7.25%. Lower Adherence to ART drugs,longer ART duration, lower CD4 count,and being co-infected with TB were significantly associated with the pooled estimate of virological failure.Virological failure was found to be high in sub-Saharan Africa. Adherence, duration of ART, CD4 + count, and TB co-infection were the significant factors associated with the pooled estimate of virological failure. Therefore, to achieve the 90-90-90 target and sustainable development goal 3 policymakers should design mechanisms to improve ART adherence, and early detecting and prevent opportunistic infections such as TB.

Background. Chronic kidney disease (CKD) is a progressive loss of the kidney function which leads to a decreased kidneys’ ability to process waste in the blood and it affects the other important functions of the kidney. The disease has different stages that can alter the health status of individuals. During the early stages, patients may present with a normal or slight decrease in glomerular filtration rate (GFR) and albuminuria. Later, it progresses and leads to end-stage renal disease (ESRD) or kidney failure. Hypertension is considered as the major contributing risk factor of CKD. Objective. This study was aimed to assess the prevalence and associated factors of chronic kidney disease among adult hypertensive patients in referral hospitals of the Northwest Ethiopia. Methods. An institution-based cross-sectional study was conducted among 581 adult hypertensive patients in a chronic follow-up clinic in referral hospitals, Northwest Ethiopia, from July to August 2020. Systematic random sampling was used to select the study participants. Data were collected using the interviewer-administered questionnaire and participants medical records. Both bivariable and multiple logistic regression analyses were performed. Model fitness was assessed using a Hosmer—Lemeshow test. Result. The total prevalence of CKD among adult hypertensive patients was 17.6% (95% CI: 14.7–20.8). Diastolic blood pressure ≥90 mmHg (AOR = 8.65; 95% CI: 4.77–15.68), duration of hypertension ≥10 years (AOR = 8.81; 95% CI: 2.47–31.45), stage II HTN (AOR = 2.61; 95% CI: 1.04–6.50), comorbid disease (AOR = 7.0; 95% CI: 2.20–22.21), proteinuria (AOR = 4.59; 95% CI: 2.08–10.12), dyslipidemia (AOR = 3.40; 95% CI: 1.56–7.24), and serum creatinine ≥1 mg/dl (AOR = 8.88; 95% CI: 4.40–17.91) were associated with chronic kidney disease among adult hypertensive patients. Conclusion. In this study, the prevalence of CKD among hypertensive patients found was 17.6%. Regarding associated factors, dyslipidemia, proteinuria, comorbid disease, serum creatinine greater than 0.9 mg/dl, duration of hypertension greater than 10 years, and diastolic blood pressure greater than 90 mmHg are factors associated with the occurrence of chronic kidney disease among hypertensive patients.

Background Despite the implementation of various strategies such as the declaration of COVID-19 emergency state, staying at home, lockdown, and massive protective equipment distribution, still COVID-19 is increasing alarmingly. Therefore, the study aimed to assess the community’s perception of COVID-19 and its associated factors in Gondar town, Northwest Ethiopia. Methods A community-based cross-sectional study was employed among 635 Gondar administrative town residents, from April 20 to April 27, 2020. Study participants were selected using a cluster sampling technique. Data were collected using an interviewer-administered structured questionnaire. Epi-Data version 4.6 and STATA 14 were used for data entry and analysis, respectively. Logistic regressions (bivariable and multivariable) were performed to identify statistically significant variables at p < 0.05. Results Of the 635 study participants, 623 have completed the study with a 98.1% response rate. The mean age of participants was 36.32 years (SD ± 13.24). The overall magnitude of the community’s misconception about COVID-19 stood at 56.9% (349). Age and religion showed a negative association with misconceptions. To be specific, being in the age group of 27–33 (AOR = 0.52, 95% CI 0.32, 0.86) and being a Muslim (AOR 0.51, 95% CI 0.34, 0.78) were negatively associated with the misconception of COVID-19, whereas occupation and awareness showed positive associations with the misconception. To be specific, having an unemployed occupational status (AOR = 1.79, 95% CI 1.14, 2.82) and being unaware of the number of cases of COVID-19 (AOR 1.66, 95% CI 1.05, 2.62) were positively associated with the community’s misconception on COVID-19. Conclusion The magnitude of the community’s misconception about COVID-19 among Gondar town residents was high. Age, religion, unemployment, and unawareness about the number of COVID-19 cases were significant factors of misconception about COVID-19. Thus, stakeholders ought to build community perceptions about COVID 19. To resolve misinformation about COVID-19, accurate and relevant information should be provided to the community using appropriate communication media.

Background Coronavirus disease 2019 (COVID-19) is an emerging respiratory infection, and the crisis has become a worldwide issue, and society has become concerned in various aspects. Good information exposure related to transmission, prevention, and risk factors of COVID-19 can be the best means to reduce the risk of disease exposure and mitigate further spread. The countries that have well practiced this strategy (society information exposure) were controlling disease progression, but there is a low practice in sub-Saharan countries, including Ethiopia. Therefore, this study aimed to evaluate the information exposure level about COVID-19 and influencing factors among northwest community of Ethiopia. Methods and materials Community-based cross-sectional study design was employed among the community of Gondar city from April 20 to 27, 2020. A total of 623 study participants were involved in this interview, and a systematic sampling technique was applied to select the households. Data were entered into EpiData version 4.6 and then exported to STATA version 14 for analysis. A multivariable binary logistic regression was employed to identify factors associated with good information exposure about COVID-19. The adjusted odds ratio (AOR) with 95% confidence interval (CI) was estimated to show the strength of association. A p-value Results The overall rate of information exposure about COVID-19 was 44.9%. Age 18-26 years [AOR=0.53; 95% CI (0.28-0.99)] and 34-45 years [AOR=0.44; 95% CI (0.24-0.80)], elementary school [AOR=2.48; 95% CI (1.20-5.15)], secondary school [AOR=3.98; 95% CI (1.99-7.99)], college and above [AOR=8.38; 95% CI (4.10-17.26)], browsed or follow social media [AOR=2.21; 95% CI (1.44-3.38)] and those having a discussion with their family members [AOR=2.37; 95% CI (1.44-3.90)] and friends [AOR=2.15; 95% CI (1.38-3.34)] were the factors significantly associated with good information exposure towards COVID-19. Conclusion Communities total level of good information exposure from different information platforms about COVID-19 in this study area remains low. Age, high level of education, browsing social media, and those having interpersonal (family and friends) discussion were the factors that significantly influence communities who have good information exposure related to COVID-19. Therefore, efforts on community mobilization through regional/national mass media and other information conveying platforms are recommended.

Selam Fisiha Kassa,1 Workie Zemene Worku,2 Kendalem Asmare Atalell,1 Chilot Desta Agegnehu3 1Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia; 2Department of Community Health Nursing, School of Nursing, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia; 3School of Nursing College of Medicine and Health Sciences and Comprehensive Specialized Hospital, University of Gondar, Gondar, EthiopiaCorrespondence: Chilot Desta AgegnehuSchool of Nursing College of Medicine and Health Sciences and Comprehensive Specialized Hospital, University of Gondar, Gondar, EthiopiaTel +251918627403Email chilotdesta@gmail.comBackground: The magnitude of loss to follow-up is high and remains a major public health problem in developing countries. Therefore, the aim of this study determines the incidence rate and predictors of loss to follow-up among children with HIV on ART at the University of Gondar comprehensive specialized referral hospital.Methods: An institution-based retrospective data analysis was conducted on 361 children with HIV. The simple random sampling technique was used, and data were entered into Epi-info version 7.1 and were exported to Stata version 14 for analysis. The proportional hazard assumption was checked, and Cox regression was fitted. Finally, an adjusted hazard ratio with a 95% CI was computed, and variables with P-value < 0.05 in the multivariable analysis were taken as significant predictors of loss to follow-up.Results: The overall incidence rate of lost to follow-up was 6.2 events per 100 child-years observations (95% CI: 4.9– 7.7). Children who have got care from their biological parents (AHR 2.6, 95% CI: 1.2– 5.5), WHO clinical stage III/IV (AHR 2.0, 95% CI: 1.1– 3.8), history of regimen substitutions (AHR 1.7, 95% CI: 1.1– 2.9), poor/fair medication adherence (AHR 2.5, 95% CI 1.4– 4.2) and history of TB treatment (AHR 2.7, 95% CI: 1.6– 4.4) were the significant predictors of lost to follow-up.Conclusion: The incidence rate of loss to follow-up among children was found to be high. Children who have got care from their biological parent, WHO clinical stage III/IV, history of regimen substitution, poor/fair medication adherence, and history of TB treatment were the independent predictors of loss to follow-up. Therefore, strengthening HIV care intervention and addressing these significant predictors is highly recommended in the study setting.Keywords: ART, children, Gondar, lost to follow-up, the incidence

BackgroundEarly marriage is a global public health problem that is mainly practiced in South Asia, Latin America, and sub-Saharan Africa including Ethiopia. It raises the risk of early childbearing of women, higher rates of divorce, and an increased risk of maternal and child death. However, little is known about the spatial distribution and determinants of early marriage in Ethiopia. Therefore, this study aimed to assess the spatial distribution and determinants of early marriage among ever-married women in Ethiopia.MethodsA detailed analysis of the 2016 Ethiopian Demographic and Health Survey data was conducted. A total weighted sample of 11,646 reproductive-age married women were included in the analysis. To identify significant hotspot areas of early marriage the Bernoulli model was fitted using SaTScan version 9.6 software. Additionally, to explore the spatial distributions of early marriage across the country ArcGIS version 10.1 statistical software was used. For the determinant factors, the multilevel logistic regression model was fitted. Deviance was used for model comparison and checking of model fitness. In the multivariable multilevel analysis, Adjusted Odds Ratio (AOR) with 95% CI was used to declare significant determinants of early marriage.ResultsThe finding of this study revealed that the spatial distribution of early marriage was significantly varied across the country with Global Moran’s I = 0.719 and p value ConclusionThe spatial distribution of early marriage was significantly varied in Ethiopia. Women’s education, women’s autonomy, and region were found to be the significant determinants of early marriage. Therefore, public health interventions targeting those identified significant hotspot areas of early marriage are crucial to reduce the incidence of early marriage and its consequence. In addition, enhancing women's education and empowering them to make their own choices are vital for changing the customs of the community and eliminating early marriage in Ethiopia.

Background The key cause of HIV transmission is failure to provide adequate information about HIV/AIDS which is a substantial public health issue in low and middle-income countries. While global health coverage continues, there is still little understanding of HIV/AIDS among women of reproductive age (15–49 years) in Ethiopia. Therefore, the purpose of this study was to identify the determinants of comprehensive knowledge of HIV/AIDS among women of reproductive age in Ethiopia. Methods A secondary data analysis was employed using the 2016 Ethiopian demographic and health survey data. Data were extracted about comprehensive knowledge of HIV/AIDS among women of reproductive age. We used multi-variable mixed-effect binary logistic regression to identify factors associated with comprehensive knowledge of HIV/AIDS among women of reproductive age. The adjusted odds ratio with 95% confidence interval was used to declare statistical significance. Results We found that having primary (AOR = 1.75, 95% CI 1.56–1.97),secondary (AOR = 2.74, 95% CI 2.33–3.22), and higher (AOR = 4.07, 95% CI 3.32–4.99) educational statuses, being in highest wealth quintiles; richer (AOR = 1.20, 95% CI 1.01–1.43) and richest (AOR = 1.51, 95% CI 1.22–1.87), knowing the place for HIV test (AOR = 2.13, 95% CI 1.88–2.42), use of traditional contraceptive method (AOR = 1.93,95% CI 1.12–3.35), female household head (AOR = 1.18, 95% CI 1.07–1.31), watching television (AOR = 1.22, 95% CI 1.06–1.41) and own mobile phone (AOR = 1.18, 95% CI 1.05–1.33) were positively associated with comprehensive knowledge of HIV/AIDS among women of reproductive age in Ethiopia. Conclusion Women with higher education and higher wealth quintiles, knowing the place of HIV test, watching television, a traditional contraceptive method use, having a mobile phone and being in female headed household were positively associated with comprehensive knowledge of HIV/AIDS among women of reproductive age in Ethiopia. Programs working on HIV/AIDS should target women based on the identified factors so as to scale up their comprehensive knowledge towards HIV/AIDS. In this context, the media should actively contribute to raising awareness of HIV/AIDS.

Background Female genital mutilation (FGM) is a serious health problem globally with various health, social and psychological consequences for women. In Ethiopia, the prevalence of female genital mutilation varied across different regions of the country. Therefore, this study aimed to investigate the trend and determinants of female genital mutilation among reproductive-age women over time. Methods A secondary data analysis was done using 2000, 2005, and 2016 Demographic Health Surveys (DHSs) of Ethiopia. A total weighted sample of 36,685 reproductive-age women was included for analysis from these three EDHS Surveys. Logit based multivariate decomposition analysis was employed for identifying factors contributing to the decrease in FGM over time. The Bernoulli model was fitted using spatial scan statistics version 9.6 to identify hotspot areas of FGM, and ArcGIS version 10.6 was applied to explore the spatial distribution FGM across the country. Results The trends of FGM practice has been decreased from 79.9% in 2000 to 70.4% in 2016 with an annual reduction rate of 0.8%. The multivariate decomposition analysis revealed that about 95% of the overall decrease in FGM practice from 2000 to 2016 was due to the difference in the effects of women’s characteristics between the surveys. The difference in the effects of residence, religion, occupation, education, and media exposure were significant predictors that contributed to the decrease in FGM over time. The spatial distribution of FGM showed variation across the country. The SaTScan analysis identified significant hotspot areas of FGM in Somali, Harari, and Afar regions consistently over the three surveys. Conclusion Female genital mutilation practice has shown a remarkable decrease over time in Ethiopia. Public health programs targeting rural, non-educated, unemployed, and those women with no access to media would be helpful to maintain the decreasing trend of FGM practice. The significant Spatio-temporal clustering of FGM was observed across regions in Ethiopia. Public health interventions must target the identified clusters as well.

Hailemichael Kindie Abate, 1 Addisu Taye Abate, 1 Zewdu Baye Tezera, 1 Debrewok Tesgera Beshah, 2 Chilot Desta Agegnehu, 3 Mohmmed Adem Getnet, 1 Birhaneselassie Gebeyehu Yazew, 1 Mahlet Temesgen Alemu, 2 Chilot Kassa Mekonenn, 1 Chanyalew Worku Kassahun 1 1Department of Medical Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia; 2Department of Surgical Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia; 3Community Nursing Unit, College of Medicine and Health Sciences, University of Gondar, Gondar, EthiopiaCorrespondence: Hailemichael Kindie Abate Tel +251965321790Email haile206k@gmail.comIntroduction: Nursing professionalism is how nurses view their work and is a guide for the behavior of nurses in practice to ensure patient safety and quality care. Poorly perceived nursing professionalism can lead to poor patient outcomes, which decrease the promotion and career options of nurses.Objective: The aim of this study is to assess the perceived prevalence of nursing professionalism among nurses in Public Referral Hospitals of West Amhara Regional State, Ethiopia.Methods: An institution-based cross-sectional study was conducted among 423 nurses from January to February 2021. A simple random sampling method was used to reach the study subject. A self-administered questionnaire was used for data collection. To explain the study variables, frequency tables and percentages were used. A binary and multiple logistic regressions were conducted to see the relation between the dependent variable and independent variables.Results: A total of 407 nurses participated in the study with a response rate of 99.3%. The overall prevalence of good perceived nursing professionalism was found to be 24.8%. Variables such as having > 10 years experience (adjusted odds ratio (AOR)=1.2, 95%CI: 2.9– 5.57) a day working shift (AOR=2.36, 95%CI: 0.78– 6.67), having professional identification (AOR=5.44, 95%CI: 4.38– 8.45), and getting medical service (AOR=1.23, 95%CI: 1.11– 2.28) were significantly associated with perceived good nursing professionalism.Conclusion: The findings of this study showed that only one-fifth of nurses had perceived good nursing professionalism. In this study, variables such as nursing experience > 10 years, working shift, having professional identification, and getting medical services were significantly associated with good perceived nursing professionalism. The policymakers ought to incorporate free medical services to enhance the attitude of nurses toward nursing professionalism.Keywords: nursing, professionalism, hospital, Ethiopia

Background: Safe working environment is a key part, and professional right of nurses. But findings indicated nurses work environment as stressful and complex. The negative effects of a negative nurses’ work environment lead to poor nurse-sensitive patient outcomes, such as increased mortality, pressure ulcers, medication errors, and complications. It has also an effect on their professionalism, practice of patient’s handover. Studies have shown working conditions, professionalism, patient handover and nurse-sensitive patient outcomes are interrelated and form a critical foundation for promoting patients’ and nurses’ safety in hospitals. However, in Ethiopia, there is scarcity of data on this issue. Therefore, the objective of this study was to assess the working environment of nurses in Public Referral Hospitals in Public Referral Hospitals of West Amhara Regional State, Ethiopia, 2021.Methods: An institution based cross-sectional study was conducted among 423 nurses from January to February 2021. Random sampling was used to select nurses from each hospital. Structured, self-administered questionnaires were used to collect the data. EPI- DATA 3.1 was used for data entry and SPSS version-23 software for data analysis. Descriptive statistics were made using statistical measurements. Frequency, percentages, means, and standard deviations were calculated. Practice Environment Scale of the Nursing Work Index tool was used to measure the outcome variable. Binary and multivariable logistic regression analyses were computed to identify associated factors. Finally, texts, tables and graphs were used to report findings. Results: The response rate for the study was 96.2%. One hundred eighty eight (46.2%) nurses perceived that their working environment was conducive, while 219 (53.8 %,) perceived it as not conducive. Nurses who were working in pediatrics wards (AOR= 0.13, 0.02, 0.1) and nurses who gave care for 7-12 patients per day (AOR =0.21, 0.05, 0.98) were less likely to have a conducive working environment, respectively. Nurses who perceived the Ministry of Health to give focus to the nursing profession were 0.27 more likely to have a conducive environment (AOR= 0.27; 0.09, .82).Conclusion and recommendations: More than half of nurses reported that their working environment was not conducive to appropriate practice. Hence, introducing systems to improve participation of nurses in hospital affairs and patient care is essential. It is also important to give attention to nurses who are working at pediatrics wards, and for nurses who give care more than the standards.

Background The magnitude of childhood anemia was increased from time to time. Thus, Even if the Ethiopian government applied tremendous efforts, anemia in children continues as a major public health problem. There is limited evidence on the spatial variation of and determinant factors of childhood anemia at the national level. Therefore, this study aimed to explore spatial distribution and determinants of anemia among children aged 6 to 59 months in Ethiopia. Method A stratified two-stage cluster sampling technique was used in Ethiopian Demographic Health Survey 2016 data. In this study 8602 children aged 6–59 months were included. Bernoulli model was used to explore the presence of purely spatial clusters of Anemia in children in age 6–59 months using Sat scan. ArcGIS version 10.3 was used to know the distribution of anemia cases across the country. A mixed-effects Logistic regression model was used to identify determinant factors of anemia. Results The finding indicates that the spatial distribution of childhood anemia was non-random in the country with Moran’s I: 0.65, p P-value1.36,95%CI:1.13, 1.65), moderate stunting (AOR = 1.31,95%CI: 1.13, 1.50),Severely stunting (AOR = 1.82,95%CI: 1.54, 2.16), religion, wealth index, and number of under-five children in the household were statistically significant associated with childhood anemia. Conclusion Spatial variation of childhood anemia across the country was non-random. Age of the child, wealth index, stunting, religion, number of under-five children in the household, fever in the last 2 weeks, anemic mother, and working status of the mother were determinants of childhood anemia. Therefore, interventions should be a priority concern for high-risk (hot spot) areas regarding allocation of resources and improved access to health facilities, and to reduce the consequence of anemia among the generation policymakers and concerned bodies should be implemented these specific determinant factors.

Background Maternal anemia continues as a global public health concern particularly in developing countries including Ethiopia. It is associated with an increased risk of maternal death, obstetric complications, preterm birth, and low birth weight. Even though maternal anemia is the commonest problem in Ethiopia, there is limited evidence on the spatial distribution and determinants of iron supplementation. Therefore, this study aimed to investigate the spatial distribution and determinants of iron supplementation among pregnant women in Ethiopia. Method A secondary data analysis was conducted based on the 2016 Ethiopian Demographic and Health Survey (EDHS) data. A total weighted sample of 7589 women was included for analysis. For the spatial analysis; ArcGIS version 10.6, and SaT Scan version 9.6 statistical software were employed to explore the spatial distribution, and to identify significant hotspot areas of iron supplementation in Ethiopia. For the determinant factors, multilevel logistic regression analysis was fitted to identify significant individual and community level determinants of iron supplementation. Deviance, Median Odds Ratio (MOR), and Intra-class Correlation Coefficient (ICC) were used for model comparison and for assessing model fitness. Variables with a p-value of less than 0.2 in the bivariable analysis were considered in the multivariable multilevel analysis. In the multivariable multilevel analysis, the Adjusted Odds Ratio (AOR) with 95% Confidence Interval (CI) was used to declare significant determinants of iron supplementation. Results The spatial distribution of iron supplementation was significantly varied across the country with Global Moran’s index value of 0.3 (p P Conclusion Iron supplementation among pregnant women were significantly varied across the country. Therefore, the finding of this study could help to design effective public health interventions targeting areas with low iron supplementation and maternal health services should be delivered in all areas of our country. Besides, public health programs should enhance iron supplementation through promoting ANC visits, media exposure, and giving special emphasis to marginalized and remote areas.

Background Perinatal asphyxia is one of the leading causes of neonatal mortality and morbidity in Ethiopia. Understanding associated factors of perinatal asphyxia are important to identify vulnerable groups and to improve care during the perinatal period. Thus, this study aimed to assess the prevalence and associated factors of perinatal asphyxia among newborns admitted to NICU at the Gondar University Comprehensive Specialized Hospital Northwest Ethiopia, Ethiopia. Method Institutional based cross-sectional study was conducted on 364 newborns from November 2018 - August 2019. Data was collected using a structured and pre-tested questionnaire. It was then cleaned, coded, and entered using EPI INFO version 7, then analyzed with SPSS statistics version 20.0. Binary logistic regression analysis was used to identify variables with p P-value of Result The prevalence of perinatal asphyxia in this study was 19.8, 95%CI (15.9, 24.2). Absence of maternal formal education (AOR = 4.09, 95%CI: 1.25, 13.38), pregnancy-induced hypertension (AOR = 4.07, 95%CI: 1.76, 9.40), antepartum hemorrhage (AOR = 6.35, 95%CI: 1.68, 23.97), prolonged duration of labor (AOR = 3.69, 95%CI: 1.68, 8.10), instrumental delivery (AOR = 3.17, 95%CI: 1.22, 8.21), and meconium-stained amniotic fluid (AOR = 4.50, 95%CI: 2.19, 9.26) were significantly associated with perinatal asphyxia. Conclusion The prevalence rate of perinatal asphyxia in this study was comparable to other resource poor countries. The absence of maternal formal education, pregnancy-induced hypertension, and Antepartum hemorrhage, prolonged duration of labor, Instrumental assisted delivery, and meconium-stained amniotic fluid was having significant association with perinatal asphyxia in this study.

Background. Complications of peripheral intravenous catheters cause problems in clinical practice and bring high costs in terms of morbidity and mortality of patients. Therefore, this study aimed to assess the incidence and associated factors of failed first peripheral intravenous catheters among adult patients in selected Public Referral Hospitals of West Amhara Regional State, Ethiopia, 2021. Materials and Methods. An institution-based prospective observational study was conducted among 423 adult patients from January to February 2021. Patients were selected using systematic random sampling techniques. The data were collected using interviewer-based, structured questionnaires and observational checklists. EPI-DATA 3.1 and SPSS version-23 were used for data entry and analysis, respectively. Frequency, percentages, and means were calculated. The outcome variable was determined and graded based on phlebitis and infiltration scales. Binary and multivariable logistics regressions were computed. Results. Four hundred and seventeen first peripheral cannula sites from 418 patients were followed for 2,565 peripheral catheter hours. A failed first peripheral intravenous catheter was observed in 124 (29.7%, CI: 25.6–34) adult patients. Patients who were female (AOR = 0.4, 95% CI: 0.22–0.74) had cannula duration of 49–72 hours (AOR = 0.31, 95% CI: 0.14–0.7) and 73–96 hours (AOR = 0.39, 95% CI: 0.17–0.9), and patients who had been given electrolytes (AOR = 0.31, 95% CI: 0.11–0.86) were more likely to have failed first peripheral intravenous cannula. Conclusions. Failed first peripheral intravenous cannula is much higher as compared to the acceptable rate of ≤5% by the Infusion Nurses Society. Hence, all patients with peripheral intravenous catheters are screened for catheter failure at least once a day. Providing appropriate nursing care and patient education is also required to reduce the risks.

ObjectiveTuberculosis is a major public health problem and is the second leading cause of death worldwide. BCG vaccination is a life-saving and important part of standard tuberculosis control measures, particularly in Ethiopia where tuberculosis is endemic. The End Tuberculosis Strategy targets of 2020 have not been achieved. Exploring spatial variations in BCG vaccination among children is vital to designing and monitoring effective intervention programmes. Therefore, this study aimed to explore the spatial variation in BCG vaccination among children in Ethiopia.DesignCross-sectional study design.SettingEthiopia.ParticipantsChildren aged 0–35 months.Primary outcomeBCG vaccination coverage.MethodsData from the 2016 Ethiopian Demographic and Health Survey were used and a total of 4453 children aged 0–35 months were included. Spatial autocorrelation analysis, cluster and outlier analysis, hotspot analysis, spatial interpolation, and spatial scan statistics were carried out to identify geographical risk areas for BCG vaccine utilisation. ArcGIS V.10.6 and SaTScan V.9.6 statistical software were employed to explore spatial pattern and significant hotspot areas for BCG vaccination among children.ResultsBCG vaccination was spatially clustered in Ethiopia at the regional level (Global Moran’s I=0.516, pConclusionA low probability of receiving BCG vaccination was found among children in the Somali and Afar regions. Therefore, these areas should be given attention when designing effective immunisation strategies to improve BCG vaccination among children in order to reduce the burden of tuberculosis in Ethiopia.

Background COVID-19 is the novel coronavirus responsible for the ongoing global outbreak of acute respiratory disease and viral pneumonia. In order to tackle the devastating condition of the virus, countries need to attack the virus with aggressive and targeted tactics. Thus, to strengthen the COVID-19 mitigation measures and to give rapid response, there is an urgent need to understand the public’s knowledge and attitude about of the pandemic at this critical moment. Objective This study was aimed to assess the knowledge and attitude of communities about COVID-19 and associated factors among Gondar City residents. Methods A community based cross-sectional study was done among 623 respondents in Gondar city from April 20-27/2020. Data were collected using a structured questionnaire adapted from different literatures. The data were entered using Epi data version 3.1 and then exported into STATA version 14 for analysis. Bi-variable and multivariable binary logistic regression were performed. Adjusted odds ratio with 95% CI was used to declare statistically significant variables on the basis of p value less than 0.05 in the multivariable binary logistic regression model. Results The overall knowledge and attitude of the community towards COVID19 was 51.85% [95% CI (47.91%-55.78%)] and 53.13% [95% CI (49.20, 57.06%)], respectively. In this study, being married [AOR = 0.60 at 95% CI: (0.42, 0.86)], educational level; primary [AOR = 3.14 at 95% CI: (1.78,5.54)], secondary [AOR = 2.81 at 95% CI: (1.70,4.63)], college and above [AOR = 4.49 at 95% CI: 7.92, 13.98)], and family size [AOR = 1.80, at 95% CI: (1.05, 3.08)] were emerged as statistically significant factors impacting the knowledge of the community about COVID-19. Besides, educational level; primary [AOR = 1.76 at 95% CI: (1.03, 3.01)], secondary [AOR = 1.69 at 95% CI: (1.07, 2.68)], and college & above [AOR = 2.38 at 95% CI: (1.50, 3.79)], and family size; four to six members [AOR = 1.84 at 95% CI (1.27, 2.67)], above seven members [AOR = 1.79 at 95% CI (1.08, 2.96)] were factors identified as significantly attribute for positive attitude of the communities towards COVID-19. Conclusion More than half of the respondents had better knowledge and attitude regarding COVID-19. Higher educational level and larger family size were significant factors predominantly affecting the knowledge and attitude of the communities towards COVID-19.

Chilot Desta Agegnehu,1 Mehari Woldemariam Merid,2 Melaku Kindie Yenit2 1School of Nursing, College of Medicine and Health Sciences and Comprehensive Specialized Hospital, University of Gondar, Gondar, Ethiopia; 2Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, EthiopiaCorrespondence: Chilot Desta AgegnehuSchool of Nursing, College of Medicine and Health Sciences and Comprehensive Specialized Hospital, University of Gondar, P.O. Box: 196, Gondar, EthiopiaTel +251 9-18-62-74-03Email chilotdesta@gmail.comBackground: Globally, anemia is a common hematological disorder among HIV-infected patients. People with anemia often suffer from impaired physical functioning, psychological distress, and poor quality of life. Therefore, the aim of this study was to determine the incidence of anemia and its determinants among HIV positive individuals in northwest Ethiopia.Methods: A total of 486 adult HIV positive patients on the first-line ART with complete information were enrolled in the adult care clinics of northwest Amhara referral hospitals from December 2015 to December 2018. EpiData version 4.2 was used for data entry and Stata version 14 for analysis. Variables having time to event nature were presented with the Kaplan–Meier function. The Cox regression model was used to identify predictors of anemia. Variables with P-values less than 0.2 in the bivariable analysis were considered in the multivariable regression. Adjusted hazard ratio with 95% CI was computed, and variables with less than 0.05 P-values in the multivariable Cox regression were taken as significant predictors of anemia.Results: This study noted an overall 26.4 per 100 person-year observations (95% CI: 23.46, 30.74) incidence rate of anemia. According to the multivariable Cox regression, TB co-infection (AHR =1.99, 95% CI: 1.45, 2.74), zidovudine-based regimen (AHR=1.39, 95CI: 1.1, 1.85), CD4 level (AHR= 1.7, 95% CI: 1.23, 2.35), advanced WHO stage (AHR=1.32, 95% CI: 1.01, 1.74), and being underweight (AHR= 1.53, 95% CI: 1.14, 2.07) were predictors of anemia.Conclusion: Anemia is a burden among HIV patients in the study setting. Baseline clinical variables, TB co-infection, and zidovudine-based were predictors of anemia. Therefore, early identification of anemia and addressing significant predictors are highly suggested to the study setting.Keywords: anemia incidence, HIV, first-line HAART, Ethiopia

Background Skilled birth attendant (SBA) delivery is vital for the health of mothers and newborns, as most maternal and newborn deaths occur at the time of childbirth or immediately after birth. This problem becomes worsen in Ethiopia in which only 28% of women give birth with the help of SBA. Therefore, this study aimed to explore the spatial variations of SBA delivery and its associated factors in Ethiopia. Methods A secondary analysis was carried out using the 2016 Ethiopian Demographic and Health Survey. A total weighted sample of 11,023 women who had a live birth in the 5 years preceding the survey was included in the analysis. Arc-GIS software was used to explore the spatial distribution of SBA and a Bernoulli model was fitted using SaTScan software to identify significant clusters of non-SBA delivery. The Geographic Weighted Regression (GWR) was employed in modeling spatial relationships. Moreover, a multilevel binary logistic regression model was fitted to identify factors associated with SBA delivery. Results In this study, SBA delivery had spatial variations across the country. The SaTScan spatial analysis identified the primary clusters’ spatial window in southeastern Oromia and almost the entire Somalia. The GWR analysis identified different predictors of non- SBA delivery across regions of Ethiopia. In the multilevel analysis, mothers having primary and above educational status, health insurance coverage, and mothers from households with higher wealth status had higher odds of SBA delivery. Being multi and grand multiparous, perception of distance from the health facility as big problem, rural residence, women residing in communities with medium and higher poverty level, and women residing in communities with higher childcare burden had lower odds of SBA delivery. Conclusion Skilled birth attendant delivery had spatial variations across the country. Areas with non-skilled birth attendant delivery and mothers who had no formal education, not health insured, mothers from poor households and communities, Primiparous women, mothers from remote areas, and mothers from communities with higher childcare burden could get special attention in terms of allocation of resources including skilled human power, and improved access to health facilities.

Background: Anemia remains a global public health problem. Despite WHO recommended all pregnant women to have iron supplementation, nearly 50% of maternal anemia in SSA was occurred due to lack of iron supplementation during pregnancy. Maternal anemia is associated with an increased risk of maternal death, obstetric complications, preterm birth, and low birth weight. There is limited evidence on the spatial pattern and determinants of iron supplementation using spatial and multilevel analysis methods. Therefore, this study aimed to investigate the spatial pattern, and determinants of iron supplementation in Ethiopia. Methods: We used Ethiopian Demographic Health Survey in 2016 data explore the spatial distribution and associated factors of iron supplementation among women in Ethiopia. A weighted sample of 7589 women were included in the analysis. Bernoulli model was used to explore the purely spatial clusters of pregnant women using SaTScan version 9.6 and ArcGIS version10.3. Multilevel logistic regression analysis was fitted to identify significant individual and community level determinants of iron supplementation. Results: Spatial analysis revealed that there was significant spatial variation of iron supplementation among reproductive age women in Ethiopia with Global Moran’s index value of 0.3 (p

Background Although the World Health Organization recommends for all pregnant women taking iron tablet should be a routine activity, more than 50% of anemia in pregnant women was occurred due to lack of iron supplementation and remains global public health problem and varies with in country. Lack of iron tablet supplementation during pregnancy leads to maternal anemia, which intern increases the risk of maternal death, obstetric complications, preterm birth and low birth weight. Therefore, studying spatial distribution and determinants of iron supplementation use among pregnant women in Ethiopia is vital to design appropriate maternal health services and preventing the determinants earlier. Method: A stratified two-stage cluster sampling technique was used in the Ethiopian Demographic Health Survey in 2016 data. A total of a weighted sample of 7589 pregnant women were included for analysis. Bernoulli model was used to explore the purely spatial clusters of pregnant women using SaTScan version 9.6 and ArcGIS version10.3.A multi-level logistic regression model was used to identify determinant factors of iron supplementation use among pregnant women. Results Spatial distribution of iron supplementation use among pregnant women was non –random in the country with Moran’s index 0.3 (p

ObjectiveOverweight/obesity among women is associated with an increased risk of gestational diabetes, pre-eclampsia, postpartum haemorrhage, low birth weight, congenital malformation and neonatal deaths. Although the magnitude of overweight and obesity among the reproductive age group women is a common problem in Ethiopia, there are limited studies that determine the associated factors of overweight and obesity at the national level. Therefore, this study aimed to identify the determinant factors of overweight/obesity among reproductive age group women in Ethiopia.DesignCross-sectional study design.SettingEthiopia.ParticipantsNon-pregnant women aged 15–49 years.Primary outcomeOverweight/obesity.MethodsThe present study used the Ethiopia Demographic Health Survey (EDHS) data for 2016. A total of 10 938 non-pregnant reproductive age group women were included in the analysis. Both bivariable and multivariable multilevel logistic regression were performed to determine the determinants of overweight and obesity among women in Ethiopia. The OR with a 95% CI was estimated for potential determinants included in the final model.ResultsThose women with secondary education (adjusted OR (AOR)=1.48, 1.01, 2.18), higher education (AOR=1.78, 1.13, 2.81), richer (AOR=1.85, 1.15, 2.98) and richest wealth index (AOR=3.23, 1.98, 5.29), urban residence (AOR=4.46, 2.89, 6.87), married (AOR=1.79, 1.21, 2.64), widowed (AOR=2.42, 1.41, 4.15), divorced (AOR=1.84, 1.13, 3.00), aged 25–34 years (AOR=2.04, 1.43, 2.89), 35–44 years (AOR=2.79, 1.99, 3.93) and 45–49 years (AOR=2.62, 1.54, 4.45) had higher odds of developing overweight and obesity.ConclusionWomen with higher education level, high wealth status, older age, formerly married and those urban dwellers had higher odds of overweight and obesity. Therefore, regular physical activity, reducing consumption of fat/energy-dense food as well as modifying the mode of transportation is recommended.

Additional file 1. Significant clusters of areas with a high proportion of non-SBA delivery among women in Ethiopia.

Background Globally, HIV/AIDS remains a significant public health issue particularly in Sub-Saharan Africa. Media exposure plays a significant role in raising community knowledge about HIV. Therefore, this study aimed to investigate the effect of media on comprehensive knowledge of HIV and its spatial distribution among reproductive-age women in Ethiopia. Methods A secondary data analysis was done based on the 2016 Ethiopian Demographic and Health Surveys (EDHS). A total weighted sample of 15,683 reproductive-age women was included for analysis. For the spatial analysis, ArcGIS version 10.3 and SaTScan version 9.6 software were employed to explore the spatial distribution of comprehensive knowledge of HIV/AIDS and for identifying significant hotspot areas. For associated factors, the mixed-effect logistic regression model was fitted. Deviance and ICC were used for model comparison. In the multivariable analysis, Adjusted Odds Ratio (AOR) with 95% Confidence Interval (CI) was reported to declare significantly associated factors of comprehensive knowledge of HIV/AIDS. Results The spatial analysis revealed that the spatial distribution of comprehensive knowledge of HIV/AIDS among reproductive-age women was significantly varied across the country. The SaTScan analysis identified significant clusters in the entire Somali region, the eastern part of Dire Dawa and Harari regions. Being rural (AOR = 1.52,95% CI:1.21–1.91), maternal age 25–34 years (AOR = 1.26,95% CI:1.14–1.40), aged ≥35 years (AOR = 1.20,95%CI:1.07–1.35), being Muslim (AOR = 0.68,95% CI:0.60–0.78), being protestant (AOR = 0.83,95% CI:0.71–0.96), poorer wealth (AOR = 1.26,95%CI:1.06–1.51), middle wealth (AOR = 1.34,95%CI:1.11–1.60), richer wealth (AOR = 1.36,95% CI:1.12–1.63), richest wealth (AOR = 1.72,95% CI:1.37–2.15), reading newspaper (AOR = 1.20,95%CI: 1.06–1.37), listening radio (AOR = 1.24,95% CI:1.10, 1.41), covered by health insurance (AOR = 1.23,95%CI:1.01–1.51), having primary education (AOR = 1.77,95% CI:1.57–1.99), having secondary education (AOR = 2.45,95%CI:2.10–2.86) and having higher education (AOR = 3.04,95%CI:2.52–3.65) were significantly associated with comprehensive knowledge of HIV/AIDS. Conclusion Spatial distribution of comprehensive knowledge of HIV/AIDS among reproductive-age women was significantly varied across the country with significant hotspot areas with poor comprehensive knowledge of HIV/AIDS identified in the Somali region, the eastern part of Dire Dawa and Harari Regions. media exposure was a significant predictor of comprehensive knowledge of HIV/AIDS among reproductive-age women in Ethiopia. Therefore, the government should scale up public health programs in the hot spot areas and provide health information using different media.

BackgroundHealth insurance is one of the instruments to achieve universal health coverage. However, in Ethiopia, the coverage of health insurance is very low and varies from place to place as well. Therefore, exploring the spatial distribution of health insurance is important to prioritize and design targeted intervention programs in the country.MethodsA total of 16,583 reproductive age group women (15–49 years) were included in this study. The Bernoulli model was used by applying Kulldorff methods using the SaTScan software to analyse the purely spatial clusters of health insurance coverage. ArcGIS version 10.3 was used to visualize the distribution of health insurance coverage across the country. Mixed-effect logistic regression analysis was also used to identify predictors of health insurance coverage.ResultsHealth insurance coverage among women aged 15–49 years had spatial variations across the country (Moran’s I: 0.115,p p p ConclusionHealth insurance coverage was very low in Ethiopia and had spatial variations across the country. The hot spot areas with low health insurance coverage need more coherent and harmonized action such as strengthening financial protection through national health packages, sharing experience from regions which have better health insurance coverage and using mass media to increase awareness and confidence of potentials in the systems, which may encourage them to enrol.

Background Although the United Nations program on HIV/AIDS 90–90-90-targets recommends achieving 90% of viral suppression for patients on first-line antiretroviral therapy by 2020, virological failure is still high and it remains a global public health problem. Therefore, assessing the incidence and predictors of virological failure among adult HIV patients on first-line ART in Amhara regional referral hospitals, Ethiopia is vital to design appropriate prevention strategies for treatment failure and preventing the unnecessary switching to second-line regimens. Method An institution-based retrospective follow-up study was conducted on 490 adult HIV patients. The simple random sampling technique was used, and data were entered into Epi data Version 4.2.0.0 and was exported to Stata version 14 for analysis. The proportional hazard assumption was checked, and the Weibull regression was fitted. Cox-Snell residual was used to test the goodness of fit, and the appropriate model was selected by AIC/BIC. Finally, an adjusted hazard ratio with a 95% CI was computed, and variables with P-value Results The overall incidence rate of virological failure was 4.9 events per 1000 person-month observations (95%CI: 3.86–6.38). Users of CPT (AHR = 0.55, 95%CI: 0.31–0.97), poor adherence (AHR = 5.46, 95%CI: 3.07–9.74), CD4 Count 3 (AHR = 3.9, 95%CI: 1.07–13.9) and 201–350 cells/mm3 (AHR 4.1, 95%CI: 1.12–15) respectively, and NVP based first line drug regimen (AHR = 3.53, 95%CI: 1.73–7.21) were significantly associated with virological failure. Conclusion The incidence rate of virological failure was high. CPT, poor adherence, low baseline CD4 count and NVP based first-line drug regimen were independent risk factors associated with virological failure. Therefore, strengthening HIV care intervention and addressing these significant predictors is highly recommended in the study setting.

Background Epidemiological studies during the early phase of the coronavirus (COVID-19) pandemics reported different level of people’s risk perception in different countries. There is a paucity of data on perceived high risk of COVID-19 and associated factors in Ethiopia. We sought to assess the prevalence of community’s perceived high risk about COVID-19 infections and associated factors among Gondar town community. Methods A cross-sectional study was carried out from April 20 to 27, 2020 in Gondar town community, Northwest Ethiopia. Multistage cluster sampling technique was used to recruit 635 participants. Structured and pre-tested questionnaire was used to collect the data. Descriptive statistics, bivariate and multivariable binary logistic regression were used to summarize the results. Results A total of 623 participants were considered in the analysis with a response rate of 98.1%. The prevalence of coronavirus high risk perceptions of the respondents was found to be 23.11% (95% CI; 19.80%–26.43%). Age above 45 years (AOR = 1.41, 95%CI; 1.19–2.66), college and above educational level (AOR = 0.28, 95%CI; 0.21–0.98), and poor knowledge towards COVID-19 virus (AOR = 1.57, 95%CI; 1.09–2.23) were significantly associated with perceived high risk about COVID-19. Conclusions The prevalence of perceived high risk of COVID-19 was found to be low. Factors such as age, educational status, and knowledge about COVID-19 virus were found to be independent predictors of perceived high risk towards COVID-19. Government and non-government organizations should use formal and informal means of educating the community.