Search

Background Aflatoxins are various poisonous carcinogens and mutagens produced by Aspergillus species. Exposure to aflatoxins during pregnancy results in adverse birth outcomes. This meta-analysis was carried out to determine the estimates of how much aflatoxin is harmful to the pregnancy and its outcome, including birthweight, birth length, low birthweight (LBW), small for gestational age (SGA), stunting, poverty, food insecurity, income, pesticides and stillbirth, in an African context. Methods Both published and unpublished studies in Africa were searched on MEDLINE, PubMed, Embase, SCOPUS, Web of Science and Google Scholar. Stata version 18.2 software was used for cleaning and analysis. The prevalence with a 95% confidence interval (CI) was estimated using the random effects model and a forest plot was used to present the findings. In addition, the heterogeneity of the study was assessed using Cochrane I2 statistics and publication bias was assessed using Egger's intercept and funnel plot. Results This review included 28 studies with a total of 6283 pregnant women and newborns. The analysis showed the overall level of exposure to aflatoxins was 64% (95% CI 48 to 78, τ2=0.66, I2=99.34%, p=0.001). In the subgroup analysis by publication year, the highest level of exposure to aflatoxins (82% [95% CI 69 to 92]) was observed among studies published from 2020 to 2023. This study also found that exposure to aflatoxins during pregnancy had an association with prematurity, LBW, SGA and stillbirth. Conclusions The data analysed in this study indicated that three of every five pregnant women had exposure to aflatoxins in Africa. Moreover, pregnant women exposed to aflatoxins had a higher likelihood of having a LBW and SGA newborn. Thus governments and all stakeholders should initiate policies that mitigate the toxicity of aflatoxins in pregnant women, foetuses and newborns. [ABSTRACT FROM AUTHOR]

Background: In sub-Saharan African countries, including Ethiopia, the utilization of sexual and reproductive health information during adolescence is considered to be low. The aim of this study was to assess the level of sexual and reproductive health literacy among adolescents in Ethiopia as well as the factors associated with sexual and reproductive health literacy in this population. Methods: An institutional-based cross-sectional study design was employed. Systematic sampling methods were used to select 909 study participants. A validated scale was used, consisting of 31 questions with a 5-point Likert scale. A total score was computed, ranging from 31 (minimum score) to 155 (maximum score), which was finally categorized into limited and adequate sexual and reproductive health literacy. A multivariate linear regression model was fitted to determine the factors influencing adolescents' sexual and reproductive health literacy. Results: The percentage of adolescents with slightly adequate and excellent sexual and reproductive health literacy was 38.9% and 6.3%, respectively. On the other hand, 677 (74.5%) participants overall had limited sexual and reproductive literacy. Healthcare workers and reading books were the preferred sources of sexual and reproductive health information that were associated with higher sexual and reproductive health literacy by 6.42 (95% CI 1.62-11.22) and 6.57 (95% CI 1.62-11.22), respectively. Adolescents' ability to pay for their healthcare was associated with better sexual and reproductive health literacy by 13.76 times (95% CI 8.21-19.32). Conclusion: More than three-quarters of the adolescents had limited sexual and reproductive health literacy. Sources of sexual and reproductive health information, including healthcare workers, books, and the Internet, were significantly associated with adolescents' sexual and reproductive health literacy. Hence, primary stakeholders need to incorporate sexual and reproductive health into the curriculum at high schools. [ABSTRACT FROM AUTHOR]

Background: In both high- and low-income countries, including Ethiopia, overweight and obesity have emerged as public health issues of the 21st century. Hence, obtaining conclusive evidence concerning the factors that influence adults' body mass index is important. Therefore, using representative data, our study sought to provide solid evidence on factors influencing overweight and obesity among adults in Ethiopia. Methods: The 2016 Ethiopia Demographic and Health Survey (EDHS), a dataset composed of a nationally representative sample of the survey, served as the basis for the study. Both descriptive and analytic findings were produced using STATA version 14. The data collection were conducted from January to June 2016. A total sample of 39,749 adults, 18 years and older, were included. Predictors were assessed using multivariable ordinal logistic regression analysis, and the results were presented as an adjusted proportional ratio (POR) with a 95% confidence interval. Statistical significance was declared at a p-value of <0.05. Results: Overall, the magnitude of overweight and obesity among adults in Ethiopia was 8.5% (95% CI: 8.2% to 8.7%) and 2.9% (95% CI: 2.7% to 3.1%), respectively. Predictor variables such as smoking (POR = 0.53, 95% CI: 0.42-- 0.67); being female (POR = 1.21, 95% CI: 1.13--1.30); being married (POR = 1.91, 95% CI: 1.26--2.90); having a secondary education (POR = 1.42, 95% CI: 2.23-- 1.64); having a diploma and above education (POR = 1.78, 95% CI: 1.44--2.21); having a poorer (POR = 1.22, 95% CI: 1.13--1.31), middle (POR = 1.30, 95% CI: 1.20--1.40), richer (POR = 1.35, 95% CI: 1.25--1.47), and richest (POR = 3.13, 95% CI: 2.79--3.51) wealth index rating; and having a rural residence (POR = 0.48, 95% CI: 0.43--0.54) were significantly associated with overweight and obesity. Conclusions: Overall, 8.5% and 2.9% of Ethiopian adults were overweight and obese, respectively. Factors such as smoking, sex, marital status, educational status, wealth index, residence, and region were significantly associated with overweight and obesity among adult households. As a result, enhancing lifestyle modifications is enormous, and it is necessary to have more tangible evidence concerning the factors influencing body mass index utilizing more representative data from local and global. [ABSTRACT FROM AUTHOR]

Breast milk is one of the many distinct forms of food that can be contaminated with aflatoxin M1 (AFM1). They may be consumed by eating contaminated foods, such as contaminated meat and crops, which would then be present in breast milk and cause health problems, including nervous system disorders and cancers of the lungs, liver, kidneys, and urinary tract. However, the prevalently inconsistent explanation of prevalence and concentration remains a big challenge. Thus, this meta-analysis was conducted to determine the prevalence and concentration of harmful chemicals in breast milk in an African context. The databases MEDLINE, PubMed, Embase, SCOPUS, Web of Science, and Google Scholar were searched for both published and unpublished research. To conduct the analysis, the collected data were exported to Stata version 18. The results were shown using a forest plot and a prevalence with a 95% confidence interval (CI) using the random-effects model. The Cochrane chi-square (I2) statistics were used to measure the studies' heterogeneity, and Egger's intercept was used to measure publication bias. This review included twenty-eight studies with 4016 breast milk samples and newborns. The analysis showed the overall prevalence and concentration of aflatoxin M1 in breast milk were 53% (95% CI 40, 65; i2 = 98.26%; P = 0.001). The pooled mean aflatoxin M1 concentration in breast milk was 93.02 ng/l. According to this study, the eastern region of Africa was 62% (95% CI 39–82) profoundly affected as compared to other regions of the continent. In subgroup analysis by publication year, the highest level of exposure to aflatoxins (68%; 95% CI 47–85) was observed among studies published from 2010 to 2019. This finding confirmed that more than half of lactating women's breast milk was contaminated with aflatoxin M1 in Africa. The pooled mean aflatoxin M1 concentration in breast milk was 93.02 ng/l. According to this study, the eastern region of Africa was profoundly affected compared with other regions. Thus, the government and all stakeholders must instigate policies that mitigate the toxicity of aflatoxins in lactating women, fetuses, and newborns. [ABSTRACT FROM AUTHOR]

Background: Unsafe abortion is a serious reproductive health problem in developing countries including Ethiopia. The attitude of healthcare providers toward abortion is one of contributing factors to unsafe abortion. This study aimed to determine the pooled effect of healthcare workers' attitudes toward safe abortion care and its determinants factors in Ethiopia. Methods: Search engines such as Scopus, CINAHL, EMBASE, PubMed, Web of Science, and CAB Abstracts were used to find published studies where as Google and Google Scholar were used to find unpublished research. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used. The analysis was performed using STATA 14 and the random-effects model was used to calculate the odds ratios of medical professionals' attitudes regarding safe abortion services. Study heterogeneity was assessed by using I 2 and P -values. To evaluate the stability of pooled values to outliers and publication bias, respectively, sensitivity analysis and funnel plot were also performed. Results: A total of 15 published and unpublished articles with a sample size of 4060 were incorporated in this Review. The overall pooled prevalence of this study was 56% (95% CI: 45-67). Sex of participants (AOR: 2.37; 95% CI: 1.57, 3.58), having training (AOR: 2.86; 95% CI: 1.58, 5.17), Professional type (AOR: 1.55; 95% CI: 1.04, 4.46), and knowledge of abortion law (AOR:2.26; 95% CI: 1.14, 4.46) were the determinants factors that significantly associated with health care workers' attitude toward safe abortion care. Sensitivity analysis shows that the pooled odds ratios were consistently stable throughout all meta-analyses, and the funnel plot shows no evidence of publication bias. Conclusion: Half of health care providers sampled among the pooled studies have favorable attitudes toward abortion services in Ethiopia; which could hamper women's access to safe abortion care. Sex, training, type of profession, and knowing abortion law were determinants of health care workers' attitudes toward safe abortion services. Stakeholders should emphasize improving the attitude of healthcare workers toward safe abortion care which has a vital role in reducing maternal mortality. Moreover, working on modifiable factors like training, assigning personnel whose professions align with the service, and updating care providers about abortion law is also the essential key point to improve their intentions to deliver the services. [ABSTRACT FROM AUTHOR]

Background The desire to have children among mothers living with HIV remains a serious public health issue in nations with low coverage for antiretroviral therapy and the prevention of mother-to-child transmission, even if it is feasible to have an HIV-negative child. Therefore, this study aimed to assess fertility desire and associated factors among antiretroviral therapy-attending HIV-positive women at Hiwot Fana Specialized University Hospital, in Harari, Ethiopia. Methods A facility-based cross-sectional study design was employed among 639 anti retro-viral therapy attending HIV - positive women by systematic random sampling method selected from June 15 to November 30, 2020. A binary logistic regression model was fitted to identify the associated factors with fertility desire. Descriptive results were presented in percentages, whereas analytical results were reported in adjusted ORs (AORs) with a 95% CI. At p=0.05, statistical significance was declared. Results A total of 639 participants were included in the study; 69.5%(95% CI 65.7 to 72.9%) of the participants had fertility desire. Younger age (<35 years) (AOR=2.35, 95% CI 1.27 to 4.35), married women (AOR=3.02, 95% CI 1.32 to 12.25), childless women (AOR=2.86, 95% CI 1.17 to 4.82) and women whose duration of HIV diagnosis was ≤5 years (AOR=0.41, 95% CI 0.20 to 0.71) were significantly associated with fertility desire. Conclusion The majority of the study participants have a desire to have children. In light of the high prevalence of fertility desire among antiretroviral therapy-attending HIV-positive women, it is recommended to counsel younger women on reproductive planning and encourage partner testing. [ABSTRACT FROM AUTHOR]

Background: Even though effective neonatal resuscitation prevents the consequences of neonatal death related to birth asphyxia, a significant portion of healthcare personnel lacked understanding or performed it inconsistently. It is critical to have a comprehensive study that demonstrates the overall level of knowledge of healthcare providers regarding neonatal resuscitation in Eastern Africa. Methods: Articles were searched from Science Direct, JBI databases, Web of Sciences, PubMed, and Google Scholar. The primary outcome was the level of knowledge of health care providers regarding neonatal resuscitation. Data were analyzed using Stata version 18 statistical software. The overall estimates with a 95% confidence interval were estimated using a random effect model. Results: In this meta-analysis study, 7916 healthcare providers were included. The overall level of knowledge on neonatal resuscitation among healthcare providers in Eastern Africa was 59% [95% CI: 48–70]. Trained health care providers (OR = 3.63, 95% CI: 2.26, 5.00), and work experience of 5 years and above (OR = 2.08, 95% CI: 1.00, 3.16) were determinants of the level of knowledge. However, the level of education and availability of equipment were found to be insignificantly associated with the level of knowledge. Conclusions: The results of this meta-analysis showed that healthcare professionals in Eastern Africa lacked sufficient knowledge about neonatal resuscitation. Having 5 years of work experience and training in neonatal resuscitation was found to be strongly associated with knowledge level. Thus, continuing education, training courses, and frequent updates on neonatal resuscitation protocols are required for healthcare professionals. Paper context: Main findings: The overall level of knowledge on neonatal resuscitation among healthcare providers in Eastern Africa was 59% [95% CI: 48–70]. Added knowledge: This study provides cumulative evidence on the level of knowledge of healthcare providers regarding neonatal resuscitation, and there are regional disparities and inconsistent explanations of risk factors. Global health impact for policy and action: There is insufficient knowledge among healthcare providers on neonatal resuscitation in Eastern Africa, which can contribute to higher rates of neonatal mortality, highlighting the urgent need for targeted policy interventions. [ABSTRACT FROM AUTHOR]