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Background: Anemia is the reduction of red blood cells in size and numbers and an indicator of both poor nutrition and poor health. It is a major global public health problem. Anemia in adolescents and young adults can have negative effects on their cognitive performance and growth. In Ethiopia, previous studies yielded variable prevalence. This review aimed to determine the pooled prevalence of adolescent girls' anemia and associated factors in Ethiopia. Methods: We searched for studies reporting anemia and associated factors among adolescent girls as reported in peer reviews publications in Ethiopia from 1988 to 2021 from PubMed, Google Scholar, Web of Science, Science Direct, Cochrane Library, and Worldwide Science database. The search strategy identified 309 cross-sectional studies. After screening for potentially eligible articles, we identified 37 publications for full text review, following which 10 publications were included in the final review. Using data from the review, we performed meta-analysis to produce pooled estimates and assess the prevalence of anemia and associated risk factors. Data were extracted using a standardized data extraction format prepared in Microsoft Excel™ and transferred to Stata ™ Version 14.0 for management and further analysis. To identify the source of heterogeneity, subgroup analysis using sample size and study setup was computed, and I2 test was used to declare the presence or absence of significant heterogeneity during subgroup analysis. A random-effect meta-analysis model was used to estimate the pooled prevalence of adolescent girls' anemia. Moreover associated factors for adolescent anemia were assessed too. Results: The overall pooled prevalence of anemia among adolescent girls' in Ethiopia was 23.02% (95% CI: 17.21to 28.84). In the subgroup analysis, studies that have a higher sample size than mean have a higher pooled prevalence (27.35%) (95% CI: 21.42 to 33.28) compared to their counterparts. Age being 15–19 (OR: 2.13; 95% CI: 1.52 to 2.96), living in rural areas (OR: 2.05; 95% CI: 1.66 to 2.54), and low dietary diversity (OR: 1.35; 95% CI: 1.00 to 2.34), were the identified factors associated with anemia among adolescent girls'. Conclusion: The pooled prevalence of anemia among adolescent girls in Ethiopia was moderately high. Being in 15–19 years, rural residence, and low dietary diversity score were found to be the significant factors of anemia among adolescent girls in Ethiopia. [ABSTRACT FROM AUTHOR]

The Sustainable Development Goals adopted by world leaders on September 25, 2015, aimed to end poverty and hunger, promote gender equity, empower women and girls, and ensure human dignity and equality by all human beings in a healthy environment. These development goals were premised on international human rights norms and institutions, thereby acknowledging the relevance of human rights in achieving each goal. Particularly, sustainable development goal 3, whose objective is to achieve universal health coverage, enhance healthy lives, and promote well-being for all, implicitly recognizes the right to health as crucial. Our focus in this paper is to discuss how promoting patients' rights and enhancing effective nurse-patient communication in the healthcare setting is a significant and necessary way to achieve universal health coverage. Through a critical review of the empirical research evidence, we demonstrated that enhancing patients' rights and effect nurse-patient communication will promote people-centered care, improve patients' satisfaction of care outcomes, increase utilization of care services, and empower individuals and families to self-advocate for their health. These steps directly impact primary healthcare strategies and the social determinants of health as core components to achieving universal health coverage. We argue that without paying attention to the human rights dimensions or employing human rights strategies, implementing the other efforts will be inadequate and unsustainable in protecting the poorest and most vulnerable populations in the achievement of goal 3. [ABSTRACT FROM AUTHOR]

A face mask is a vital component of personal protective equipment to prevent potentially contagious respiratory infections. There was a lack of evidence showing the proportion and determinants of face mask use in Ethiopia. Therefore, this study aimed to identify face mask utilization determinants to prevent spread of the Covid-19 pandemic among quarantined adults in Tigrai region, northern Ethiopia. A total of 331 participants selected using a systematic random sampling method were included in the study. An interviewer-administered questionnaire was employed. After describing the variables using frequencies, means, and standard deviations, multivariable logistic regression determined factors associated with face mask utilization to prevent COVID-19 spread. The study participants were primarily males (70%) and mean age was 30.5 (SD = 11) years. Nearly half of the participants reported they did not wear a face mask when leaving home. Face mask utilization was significantly associated with knowledge score, employment status, gender, age, and educational status of the study participants. [ABSTRACT FROM AUTHOR]

Providing healthcare services that respect and meet patients' and caregivers' needs are essential in promoting positive care outcomes and perceptions of quality of care, thereby fulfilling a significant aspect of patient-centered care requirement. Effective communication between patients and healthcare providers is crucial for the provision of patient care and recovery. Hence, patient-centered communication is fundamental to ensuring optimal health outcomes, reflecting long-held nursing values that care must be individualized and responsive to patient health concerns, beliefs, and contextual variables. Achieving patient-centered care and communication in nurse-patient clinical interactions is complex as there are always institutional, communication, environmental, and personal/behavioural related barriers. To promote patient-centered care, healthcare professionals must identify these barriers and facitators of both patient-centered care and communication, given their interconnections in clinical interactions. A person-centered care and communication continuum (PC4 Model) is thus proposed to orient healthcare professionals to care practices, discourse contexts, and communication contents and forms that can enhance or impede the acheivement of patient-centered care in clinical practice. [ABSTRACT FROM AUTHOR]

Introduction: Tropical diseases are public health problems affecting hundreds of millions of people globally. However, the development of adequate, affordable, and accessible treatments is mostly neglected, resulting in significant morbidity and mortality that could otherwise be averted. Leishmaniasis is one of the neglected tropical diseases caused by the obligate intracellular protozoan Leishmania parasite and transmitted by the bite of infected phlebotomine sandflies. No systematic review and meta-analysis has been done to identify the prevalence and risk factors of leishmaniasis to the authors' knowledge. Therefore, the objective was to determine the prevalence and risk factors of human leishmaniasis in Ethiopia. Methods: Eleven studies conducted in all regions of Ethiopia, which were fully accessible, written in any language, and original articles done on prevalence and risk factors of leishmaniasis, were included. STATA™ version 11.1 was used for statistical analysis. Chi-square, I2, and p values were assessed to check heterogeneity. A random effects model with heterogeneity taken from an inverse-variance model was employed to estimate the pooled effect. Subgroup meta-analysis was computed to reduce random variations among each article's point prevalence, and Egger and funnel plots were used to check for publication bias. Results: The highest proportion of human leishmaniasis was reported from a study done in Amhara region (39.1%), and the lowest was reported from a survey done in Tigray (2.3%). The overall pooled prevalence of leishmaniasis was 9.13% (95% CI 5–13.27). Subgroup analysis by region revealed moderate heterogeneity (I2 = 51.8%) in studies conducted in the Southern Nations Nationalities and Peoples Region (SNNPR). The presence of hyraxes and being male were associated with an increased risk of human leishmaniasis. Conclusion: The prevalence of leishmaniasis in Ethiopia remains high (9.13%), with significant risk factors being male and the presence of hyraxes within a 300-m radius of the sleeping area. [ABSTRACT FROM AUTHOR]

Background: Information and communications technologies (ICTs) have empowered people to communicate and network at a global scale. However, there is lack of in-depth understanding of the use of ICTs for women's empowerment. This study examines how the concept empowerment is defined, utilized and measured in research studies, the existing evidence on the use of ICTs for women's empowerment and the gaps in knowledge at the global level.Methods: The authors' conducted a scoping review using the Arksey and O'Malley methodology. The search identified papers from ten databases, including Scopus, Embase, ABI Inform, Soc Index, Sociological Abstracts, Gender Studies, Springer Link, PsychInfo, Science Direct, and Academic Search Complete over the period of 2012-2018. Search criteria included articles that focused on women's empowerment and utilized technologies as interventions. Out of a total of 4481 articles that were initially identified, 51 were included.Results: Technology played a variety of roles in supporting the development of women's capacities and resources. Results revealed the use of ICT interventions in the overarching areas of outreach (e.g., health promotion), education (e.g., health literacy opportunities), lifestyle (e.g., peer coaching and planning), prevention (e.g., screening opportunities), health challenges (e.g., intimate partner violence apps), and perceptions of barriers (i.e., uptake, utilization and ubiquity to ICTs for women). Despite the positive use of technology to support women in their daily lives, there was a lack of consensus regarding the definition and use of the term empowerment. The concept of empowerment was also inconsistently and poorly measured in individual studies making it difficult to determine if it was achieved.Conclusion: This scoping review provides a comprehensive review of current and emerging efforts to use ICTs to empower women. The findings suggest a need for collaborative efforts between researchers, program implementers and policy makers as well as the various communities of women to address the persistent gender disparities with respect to ICTs. [ABSTRACT FROM AUTHOR]

Aims and Objectives: The aim of this article is to provide an integrative review of rural family members' experiences of a relative's inter‐facility transfer to an urban tertiary care centre for advanced critical care services. Background: Although there is an increasing awareness of the negative consequences of a relative's critical illness for family members, there has been limited research conducted on the impacts of this experience for families of patients in rural settings who require an inter‐facility transfer for advanced services. Search strategy: The search strategy for this review was framed by the study purpose, research question, and a conceptual structure of key constructs. Databases and reference lists were electronically and manually searched. Inclusion and exclusion criteria: Articles were included if they were research articles, available in English, and focused on family members' experiences of inter‐facility transfer during critical illness. Articles focusing on critical care transfers within a single urban setting, elective transfers undertaken for patient or family preference, transfers not associated with critical illness, and systematic or scoping reviews were excluded. Conclusion: Stress and anxiety are central to the rural family members' experience of this phenomenon. These constructs are influenced by modifiable factors, including the actions of health care providers, the financial burden associated with the transfer, the family members' physical proximity to the patient, and their access to information and support networks. Further research is required to explore potential short‐ and long‐term consequences of this experience and the experience of family members who are left behind and to develop and test interventions to support families. Relevance to clinical practice: This review highlights the concern that health care providers frequently misunderstand the needs of family members who are experiencing this phenomenon. Through a better understanding of this phenomenon, health care providers will be better positioned to effectively support these individuals during this unique experience. [ABSTRACT FROM AUTHOR]

Background: Hypertension is dramatically increasing in Africa with evidence of increased severity and resistance to treatment. Although angiotensin converting enzyme gene polymorphism is associated with higher prevalence of hypertension, the evidence is inconclusive on its influence on the emerging pattern in Africa. This meta-analysis is conducted to pool the available evidence to inform future research and interventions. Methods: Articles published through May 2018 were systematically searched in PubMed, Scopus and EMBASE databases. Studies were assessed for inclusion by two independent researchers. Six models were used to assess the effect of angiotensin converting enzyme deletion-insertion gene polymorphism. Heterogeneity and publication bias were tested and sensitivity analysis was carried out. Odds ratio and 95% confidence intervals were measured for pooled effect. Both random effect and fixed effect models were used, whilst the frequency of DD, II and DI genotypes were computed and compared. Result: Patients with D allele were 1.49 times more likely to develop essential hypertension compared with patients who carry the I allele (OR:1.49; CI:1.07, 2.07). Similarly, patients who had homozygous co-dominance genotype DD (i.e., DD vs II) were at a 2.17 times higher risk of essential hypertension compared to the co-dominant genotype II (OR:2.17, CI:1.79, 3.18), dominant model (I.e., DD+ID vs II) (OR:1.48; CI:1.03, 2.12), and recessive model (OR:1.64; CI:1.03, 2.61). On subgroup analysis, participants from Sub-Saharan Africa were more genetically susceptible to hypertension compared to their North Africa counterparts. There was no publication bias found, but there was high to moderate heterogeneity. Conclusion: ACE I/D polymorphism is associated with essential hypertension in Africa in the allele contrast model, as well as the dominant, recessive and homozygous codominance model. On subgroup analysis, ACE I/D was associated with essential hypertension in patients from Sub-Saharan Africa but not in North Africa. A future large scale study, which includes different ethnic groups, is recommended. [ABSTRACT FROM AUTHOR]

In Tanzania's Arusha District, anaemia is a significant public health problem. Recently, home fortification with multiple micronutrient powder was recommended, and daily use of one sachet has shown to be effective. However, it is a challenge for deprived families with low income to afford the daily sachet. The aim of this study was to compare the efficacy of different administration frequencies of micronutrient powder in reducing anaemia in children aged 6–59 months. This research used a community-based, randomized longitudinal trial design with the intent to treat anaemia. Children aged 6 to 59 months (n=369) were randomly assigned to one of four intervention groups which received, on a weekly basis, either five sachets (n=60), three sachets (n=80), two sachets (n=105), or one sachet (n=124) for six months; 310 children completed the study. Using the HemoCue technique, a finger-prick blood was taken at baseline, middle, and end points of the intervention to determine haemoglobin levels. The effect of treatment on haemoglobin was assessed with analysis of covariates with Bonferroni post hoc to test group difference (p>0.05) from each other. At the end, haemoglobin levels were significantly higher in participants who received three or five sachets of micronutrient powder per week compared to those who received one or two micronutrient powder sachets per week (p<0.05). The prevalence of illnesses was reduced from 65% to 30.5% in all groups. This finding indicates that economically challenged families may opt for three times per week sachet administration rather than a more costly daily administration. This trial is registered with PACTR201607001693286. [ABSTRACT FROM AUTHOR]

Background: Undernutrition is a significant public health challenge and one of the leading causes of child mortality in a wide range of developing countries, including Ethiopia. Poor access to water, sanitation, and hygiene (WASH) facilities commonly contributes to child growth failure. There is a paucity of information on the interrelationship between WASH and child undernutrition (stunting and wasting). This study aimed to assess the association between WASH and undernutrition among under-five-year-old children in Ethiopia.Methods: A secondary data analysis was undertaken based on the Ethiopian Demographic and Health Surveys (EDHS) conducted from 2000 to 2016. A total of 33,763 recent live births extracted from the EDHS reports were included in the current analysis. Multilevel logistic regression models were used to investigate the association between WASH and child undernutrition. Relevant factors from EDHS data were identified after extensive literature review.Results: The overall prevalences of stunting and wasting were 47.29% [95% CI: (46.75, 47.82%)] and 10.98% [95% CI: (10.65, 11.32%)], respectively. Children from households having unimproved toilet facilities [AOR: 1.20, 95% CI: (1.05,1.39)], practicing open defecation [AOR: 1.29, 95% CI: (1.11,1.51)], and living in households with dirt floors [AOR: 1.32, 95% CI: (1.12,1.57)] were associated with higher odds of being stunted. Children from households having unimproved drinking water sources were significantly less likely to be wasted [AOR: 0.85, 95% CI: (0.76,0.95)] and stunted [AOR: 0.91, 95% CI: (0.83, 0.99)]. We found no statistical differences between improved sanitation, safe disposal of a child's stool, or improved household flooring and child wasting.Conclusion: The present study confirms that the quality of access to sanitation and housing conditions affects child linear growth indicators. Besides, household sources of drinking water did not predict the occurrence of either wasting or stunting. Further longitudinal and interventional studies are needed to determine whether individual and joint access to WASH facilities was strongly associated with child stunting and wasting. [ABSTRACT FROM AUTHOR]

Adolescence is a dynamic and complex period in any society, but within the Aboriginal population this time is one of significant social pressures, critical decisions, and struggles to emerge healthy. The Positive Leadership, Legacy, Lifestyles, Attitudes, and Activities for Aboriginal Youth (PL³A³Y) project created youth and Elder teams to explore cultural practices that may inform the youth's paths to living well. Using a community-based participatory research approach, Elder-youth dyads developed and delivered five modules to 78 students at a local elementary school in response to the research question: What are the critical components of a "Living Well" healing initiative for Aboriginal youth? Through a 4-step process that included engagement, module creation, co-delivery, and knowledge sharing, the project's community-based research team innovatively and using culturally appropriate approaches brought forward critical topics of Leaders and Leadership, Legacy, Lifestyles, Attitudes, and Activities. Not only did the Elder-youth dyads develop a series of highly relevant, creative, useful products that were shared extensively with youth in the community, but the experience became a culturally appropriate leadership development opportunity for the youth researchers. The involvement of Elder-youth teams was a strength in linking past to present and in jointly envisioning a positive, healthier future for Aboriginal youth. With youth as co-researchers, the Elders as partners were highly effective in the development and delivery of culturally relevant teachings and knowledge that strengthened youth's ability to achieve holistic personal and community wellness. [ABSTRACT FROM AUTHOR]

Background: With the approaching sunset on the Millennium Development Goals (MDGs), Tanzania continues with its final national push towards achievement of MDG #4 and MDG #5. The Mama Kwanza Socio-economic Health Initiative (MKSHI) was introduced in the hope of contributing to improving maternal, newborn, and child health in Arusha and Ngorongoro. The MKSHI project is a holistic, inter-sectoral approach to maternal, newborn, and child health which aligns with the Government of Tanzania's Vision 2025. At the project onset, a baseline assessment was conducted to launch ongoing benchmarking, monitoring, and evaluation of the project's impacts and implications. The aim of this baseline assessment was twofold. First it was to determine the state of maternal, newborn, and child health in the two project sites. Second it was to ensure that a baseline of key indicators was established as well as identification of unique indicators relevant to the populations of interest. Results: The baseline study was a mixed methods approach to identify maternal, newborn, and child risk factors and indicators in the two target sites. This paper focuses on the qualitative methods and findings. The qualitative component included a series of five community dialogue meetings and thirty-seven individual/dyad interviews with women, providers, and stakeholders. Initially, community meetings were held as open dialogues on maternal, newborn, and child health issues, opportunities, and preferred futures. Individual/dyad interviews were held with women, providers, and stakeholders who held unique information or experiences. Both community dialogue and interview data was analysed for themes and guiding or critical comments. Three over-arching findings emerged: What took you so long to come? How do we know what you know? and How will it change for our daughters? Conclusions: Participant voices are vital in ensuring the achievement of local and global efforts and preferred futures for maternal, newborn, and child health services. This study contributes to the inclusion of women in all aspects of the planning, implementation, and delivery of maternal, newborn, and child health services in the target areas and beyond. [ABSTRACT FROM AUTHOR]

Concurrent wasting and stunting (WaSt) is a condition where both wasting and stunting exist in a child at the same time. This study aimed to assess the prevalence of WaSt and to identify potential associated factors in Ethiopia. A total of 33,650 children aged between 0 and 59 months were included in the analysis from the four waves of the Ethiopian Demographic and Health Survey. A mixed-effects logistic regression model was used to identify the determinants of WaSt. The prevalence of WaSt was found to be 4.7% (95% confidence interval [CI]: (4.5-4.9)), with respectively 2.5% (95% CI: 2.1-3.1) and 4.9% (95% CI: 4.7-5.2) among children in urban and rural settings. Children: (i) in the age group 12-23 months (adjusted odds ratio [AOR]: 4.16, 95% CI: (3.20-5.42)) and 24-59 months (AOR: 3.08, 95% CI: (2.28-4.17)); (ii) who were perceived by their mothers to be smaller than normal at birth (AOR: 1.98, 95% CI: (1.57-2.50)); (iii) had diarrhoea (AOR: 1.38, 95% CI: (1.11-1.71)); and (iv) fever in the past 2 weeks (AOR: 1.38, 95% CI: (1.10-1.71)) reported higher odds of WaSt. Being a female child (AOR: 0.57, 95% CI: (0.48-0.69)), having received measles vaccination (AOR: 0.71, 95% CI: (0.55-0.89)), having a mother with a normal body mass index (18.5-24.9 kg/m²) (AOR: 0.57, 95% CI: (0.48-0.68)), having a wealthier household (AOR: 0.67, 95% CI: (0.50-0.90)), and living in rural setting (AOR: 0.49, 95% CI: (0.32-0.74)) were associated with reduced odds of WaSt. The prevalence of WaSt was high, with approximately 1 in 20 Ethiopian children suffering from the condition and needing a prompt response to minimize the poor health and developmental outcomes. Children perceived by their mother to be smaller than normal at birth, older children, and babies with diarrhoea and fever had higher odds of WaSt. [ABSTRACT FROM AUTHOR]

It is recognized that community development efforts are often impacted and subjected to the realities of a range of inequities. In the slums of Kibera, Kenya, the challenges of gender inequities amongst young men and women were considered using a participatory diagramming approach. Such a critical technique rigorously delayers the contexts and issues which create, embed, and sustain the inequities. This research used four diagrams in an effort to fully explore and reveal the issues, increase awareness of the social injustices, and probe for desired actions towards the preferred futures for the 49 youth participants involved in the study. The key learnings from the participants included their understanding that social status and roles were highly influenced by age, gender, marital status, and ethnicity. These participants felt that, with the exception of marital status, these factors were outside of their control, which limited their ability to change the structures and situations in which they lived. Further, the participants acknowledged the differential for risks for poverty, health, employment, and social status across genders. They clearly articulated systemic barriers such as resource ownership, inheritance, and entitlements which clearly disempowered women. A clear distinction across genders was in the perception of political will, in which women felt that the government was bringing people together whereas their male counterparts felt the government was ineffectual and perpetuated the inequalities. The participants strongly articulate the need for visibility and voice in the political context in order to affect social change. It is through education and training that these individuals felt they could overcome the inequities they experience and contribute fully to their families, communities, and nation. [ABSTRACT FROM AUTHOR]

Introduction: Body mass index (BMI) is a simple and cost-effective tool for monitoring the clinical responses of patients living with human immunodeficiency virus (HIV) after antiretroviral therapy (ART) initiation, especially in resource-limited settings where access to laboratory tests are limited. Current evidence on the association between longitudinal BMI variation and clinical outcomes among adults living with HIV receiving ART is essential to inform clinical guidelines. Therefore, this study examines the association between BMI variation and premature mortality in adults living with HIV on ART. Methods: An institution-based retrospective cohort study was conducted among 834 adults living with HIV receiving ART from June 2014 to June 2020 at Debre Markos Comprehensive Specialized Hospital in Northwest Ethiopia. We first identified predictors of mortality and BMI variation using proportional hazards regression and linear mixed models, respectively. Then, the two models were combined to form an advanced joint model to examine the effect of longitudinal BMI variation on mortality. Results: Of the 834 participants, 49 (5.9%) died, with a mortality rate of 4.1 (95% CI 3.1, 5.4) per 100 person-years. A unit increase in BMI after ART initiation corresponded to an 18% reduction in mortality risk. Patients taking tuberculosis preventive therapy (TPT), mild clinical disease stage, and changing ART regimens were at lower risk of death. However, patients with ambulatory/bedridden functional status were at higher risk of death. Regarding BMI variation over time, patients presenting with opportunistic infections (OIs), underweight patients, patients who started a Dolutegravir (DGT)-based ART regimen, and those with severe immunodeficiency had a higher BMI increase over time. However, patients from rural areas and overweight/obese patients experienced a lower BMI increase over time. Conclusion: BMI improvement after ART initiation was strongly associated with a lower mortality risk, regardless of BMI category. This finding implies that BMI may be used as a better predictor tool for death risk in adults living with HIV in Ethiopia. Additionally, patients who took a DGT-based ART regimen had a higher BMI increase rate over time, which aligns with possible positive effects, such as weight gain, of the DGT-based ART regimen in developing countries. [ABSTRACT FROM AUTHOR]

This study aims to examine the effect of undernutrition on loss to follow-up (LTFU) in adults living with human immunodeficiency virus (HIV) receiving antiretroviral therapy (ART) in Ethiopia. We conducted an institution-based retrospective cohort study using medical records of 844 adults living with HIV receiving ART between June 2014 and June 2020 at Debre Markos Comprehensive Specialized Hospital (Northwest Ethiopia). The effect of undernutrition on LTFU was examined using a proportional hazards regression model after adjusting potential confounders. The significance level was set at p < 0.05. At the end of the study period, 109 (12.9%) participants were considered LTFU, with an overall LTFU incidence of 5.3 per 100 person-years (95% CI 4.4, 6.4). The incidence of LTFU was higher in undernourished participants (8.2 per 100 person-years) compared to well-nourished participants (4.3 per 100 person-years). After adjusting for potential confounders, the adjusted risk of LTFU among undernourished participants was two times higher than in their well-nourished counterparts (AHR [adjusted hazard ratio]: 2.1, 95% CI 1.4, 3.2). This study found that undernutrition significantly increased the risk of LTFU among adults living with HIV on ART. [ABSTRACT FROM AUTHOR]

Ethiopia is one of the countries in sub-Saharan Africa with the highest burden of childhood undernutrition. Despite the high burden of this scourge, little is known about the magnitude and contributing determinants to anthropometric failure among children aged 0–23 months, a period regarded as the best window of opportunity for interventions against undernutrition. This study examined factors associated with undernutrition (stunting, wasting, and underweight) among Ethiopian children aged 0–23 months. This study used a total weighted sample of 2146 children aged 0–23 months from the 2019 Ethiopian Mini Demographic and Health Survey. The data were cleaned and weighted using STATA version 14.0. Height-for-age (HFA), weight-for-height (WFH), and weight-for-age (WFA) z-scores < − 2 SD were calculated and classified as stunted, wasting, and underweight, respectively. Multilevel mixed-effects logistic regression models adjusted for cluster and survey weights were used. Adjusted odds ratio (AOR) and 95% confidence interval (CI) were estimated. Statistical significance was declared at p < 0.05. The overall weighted prevalence of stunting, wasting, and underweight respectively were 27.21% [95% CI (25.32–29.18)], 7.80% [95% CI (6.71–9.03)], and 16.44% [95% CI (14.90–18.09)] among children aged 0–23 months in Ethiopia. Female children were less likely to be associated with stunting [AOR: 0.68, 95% CI (0.54–0.86)], wasting [AOR: 0.70, 95% CI (0.51, 0.98)], and underweight [AOR: 0.64, 95% CI (0.49, 0.83)] than their male counterparts. Conversely, older children aged 12–17 months [AOR: 2.22, 95% CI (1.52, 3.23)] and 18–23 months [AOR: 4.16, 95% CI (2.75, 6.27)] were significantly at an increased odds of becoming stunted. Similarly, the likelihood of being underweight was higher in older age groups: 6–11 months [AOR: 1.74, 95% CI (1.15, 2.63)], 12–17 months [AOR: 2.13, 95% CI (1.40, 3.24)], and 18–23 months [AOR: 4.08, 95% CI (2.58, 6.44)] compared with the children younger than 6 months. Lower wealth quintile was one of the other significant determinants of stunting and underweight. The study's findings indicated that the most consistent significant risk factors for undernutrition among children aged 0–23 months are: male sex, older age groups and lower wealth quintile. These findings emphasize the importance of strengthening nutrition-specific and sensitive interventions that address the immediate and underlying drivers of childhood undernutrition in early life, as well as targeting low-income households with male children, in order for Ethiopia to meet the Sustainable Development Goals (SDGs) 1,2 and 3 by 2030. [ABSTRACT FROM AUTHOR]

This presentation is related to the integration of technology into all aspects of interprofessional/ nursing curricula and programs. The project focuses on emergent technologies and methodologies for research, teaching, and learning. There is significant literature describing "lecture capture" whereby content presented to students in a classroom is recorded during the actual lecture and posted for use by students after the scheduled class time. This presentation will demonstrate a template for presenting concepts to students before they attend a scheduled class by posting key concepts through a variety of multimedia tools. These multimedia "moments" provide the concepts to students and require them to reflect on course content, respond to questions before attending class using social software, then interact and engage with faculty and other students in scheduled class time. The template for Concept Capture supports reverse pedagogy with students being given the basic concepts and tools and it requiring the students to move the learning and teaching forward to increased understanding of course content. This project will be designed using a (MODEL) template that represents multi-dimensional, open, digital environments for learning as well as scholarship (research, teaching and learning). The multi-dimensions, for example, relate to users, tools, components, places, and spaces with openness defined as a way of organizing activities that favors access, participation of various stakeholders, and collaboration. The Concept Capture template will be the result of collaboration between IT personnel, web designer personnel, students, and faculty and will provide a starting point that faculty could "adapt not adopt." The research results will give an indication of the students' reaction to the template and how it could be revised and enhanced for future use. [ABSTRACT FROM AUTHOR]

Objective: To explore the impacts and implications of health reform/renewal for rural women in Saskatchewan and Manitoba, Canada. Design: The study was a multiple case study approach using mixed methods of focus groups, individual interviews, and trends/utilization analysis. Setting: Three rural communities – two in Saskatchewan; one in Manitoba. Participants: Rural women; non-health providers. Interventions: None. Outcome Measures: None. Results: This paper presents a four phase Integrated Community Policy Uptake Model which is derived from the experiences of rural women during the operationalizing of health reform policy. The model depicts a four phase integration of the health reform or renewal policy; specifically, ‘Taking In’, ‘Taking On’, ‘Taking Over’, and ‘Taking Beyond’. The Integrated Community Policy Uptake Model is firmly rooted in the perceptions and opinions of rural women, and is informed by their understanding of health policy. Conclusion: The involvement of rural women in the policy process is necessary. The model proposed potentially encourages women to become more directly engaged in future health policy making and planning. There is also significant potential for this model to inform decision makers of the perceptions, needs, and solutions offered by stakeholders such as rural women. [ABSTRACT FROM AUTHOR]

In this article, a consideration of the role and meaning of the rural hospital is contextualised within the health reform environment in Saskatchewan (Canada). Individual and community perceptions of the impact of the conversion/closure of a rural hospital are often unheard and more often unheeded. Some researchers suggest hospital conversion/closure is a devastating event in the life of rural communities, yielding long-lasting medical, economic and psychological consequences. This article examines the concept of critical incidents with the intent of proposing a working definition of the concept. Lazarus and Folkman's (1984) construct of appraisal provides the framework for discussion and re-conceptualisation of critical incidents. The recommendation is to consider the adoption of an alternate definition of critical incident shifting away from professional or external delineation of an event's meaning. The proposed definition states that a critical incident is any external event that alters an individual's or community's life from the perspective of that individual or community. Finally, the conversion/closure of a rural hospital is considered within this re-conceptualised ‘critical incident’ definition. [ABSTRACT FROM AUTHOR]

Introduction: Early diagnosis of tuberculosis (TB) and universal access to drug-susceptibility testing (DST) are critical elements of the WHO End TB Strategy. Current rapid tests (e.g., Xpert® MTB/RIF and Ultra-assays) can detect rifampicin resistance-conferring mutations, but cannot detect resistance to Isoniazid and second-line anti-TB agents. Although Line Probe Assay is capable of detecting resistance to second-line anti-TB agents, it requires sophisticated laboratory infrastructure and advanced skills which are often not readily available in settings replete with TB. A rapid test capable of detecting Isoniazid and second-line anti-TB drug resistance is highly needed. Methods: We conducted a diagnostic accuracy study to evaluate a new automated Xpert MTB/XDR 10-colour assay for rapid detection of Isoniazid and second-line drugs, including ethionamide, fluoroquinolones, and injectable drugs (Amikacin, Kanamycin, and Capreomycin). Positive Xpert MTB/RIF respiratory specimens were prospectively collected through routine diagnosis and surveillance of drug resistance at the Central TB Reference Laboratory in Tanzania. Specimens were tested by both Xpert XDR assay and LPA against culture-based phenotypic DST as the reference standard. Findings: We analysed specimens from 151 TB patients with a mean age (SD) of 36.2 (12.7) years. The majority (n = 109, 72.2%) were males. The sensitivity for Xpert MTB/XDR was 93.5% (95% CI, 87.4–96.7); for Isoniazid, 96.6 (95% CI, 92.1–98.6); for Fluoroquinolone, 98.7% (95% Cl 94.8–99.7); for Amikacin, 96.6%; and (95% CI 92.1–98.6) for Ethionamide. Ethionamide had the lowest specificity of 50% and the highest was 100% for Fluoroquinolone. The diagnostic performance was generally comparable to that of LPA with slight variations between the two assays. The non-determinate rate (i.e., invalid M. tuberculosis complex detection) of Xpert MTB/XDR was 2·96%. Conclusion: The Xpert MTB/XDR demonstrated high sensitivity and specificity for detecting resistance to Isoniazid, Fluoroquinolones, and injectable agents. This assay can be used in clinical settings to facilitate rapid diagnosis of mono-isoniazid and extensively drug-resistant TB. [ABSTRACT FROM AUTHOR]

Menstruation is a biological process experienced by up to 800 million people on any given day. Historically, menstruation has been studied from the female perspective. However, it should be considered that not all who menstruate are women. Therefore, the purpose of this research was to determine the status of evidence on transgender and non-binary individuals’ experiences with menstruation. Arksey and O’Malley’s (2005) framework for conducting a scoping study was used to guide this review. The authors used five steps of the six-step process to identify the research problem and search strategy, select studies based on defined inclusion and exclusion criteria, extract key information from five selected studies, and chart, summarize, and report the results as themes. The analysis resulted in the identification of four themes: (1) gender dysphoria and the influence on identity; (2) menstrual management and transformation as a turning point; (3) managing menstruation in precarious spaces; and (4) moving toward an open dialogue. Findings suggest a need for awareness of diverse and inclusive menstrual experiences. Inclusive advertising and menstrual products are needed to support transgender and non-binary people and reduce gender dysphoria. Policy initiatives should support the reconceptualization of infrastructure so that bathrooms are safe and comfortable places. Future opportunities for research exploring menstrual management within transgender and non-binary populations with emphasis on global research with diverse cultures and social structures is necessary to address gaps in the existing literature. [ABSTRACT FROM AUTHOR]

Background: Cigarette smoking is one of the most preventable causes of morbidities and mortalities. Since 2005, the World Health Organization Framework Convention for Tobacco Control (WHO-FCTC) provides an efficient strategic plan for tobacco control across the world. Many countries in the world have successfully reduced the prevalence of cigarette smoking. However, in developing countries, the prevalence of cigarette smoking is mounting which signifies a need of prompt attention. This scoping review aims to explore the extent and nature of Smoking Cessation (SmC) interventions and associated factors in South Asian Region (SAR) by systematically reviewing available recently published and unpublished literature.Methods: The Joanna Briggs Institute (JBI) framework frames the conduct of this scoping review. PubMed, EBSCO CINAHL Complete, Cochrane Library, ProQuest Dissertation and Theses, and local websites as well as other sources of grey literature were searched for relevant literature. In total, 573 literature sources were screened. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flow diagram, finally, 48 data sources were included for data extraction and analysis. We analyzed the extracted SmC interventions through the FCTC. Factors that affect smoking cessation interventions will be extracted through manual content analysis.Results: Regarding FCTC recommended smoking cessation strategies (articles), most of the articles were either neglected or addressed in a discordant way by various anti-smoking groups in SAR. Key barriers that hamper the effectiveness of smoking cessation interventions included lack of awareness, poor implementation of anti-smoking laws, and socio-cultural acceptance of tobacco use. Conversely, increased levels of awareness, through different mediums, related to smoking harms and benefits of quitting, effective implementation of anti-smoking laws, smoking cessation trained healthcare professionals, support systems, and reluctance in the community to cigarette smoking were identified as facilitators to smoking cessation interventions.Conclusion: The ignored or uncoordinated FCTC's directions on smoking cessation strategies have resulted in continued increasing prevalence of cigarette smoking in developing countries, especially SAR. The findings of this review highlight the need for refocusing the smoking cessation strategies in SAR.Strengths: The review was conducted by a team of expert comprising information specialists, and senior professors bringing rich experience in systematic and scoping reviews. Every effort was made to include all available literature sources addressing cigarette SmC and associated factors in SAR. The review findings signal the need and direction for more SmC efforts in SAR which may contribute to development of effective policies and guidelines for the control of smoking prevalence.Limitations: Despite efforts, potentially relevant records may have been missed due to unpublished or inaccessible articles, unintended selection bias, or those published in local languages, etc. Moreover, the exclusion of literature on under 18 participants and mentally ill smokers may limit the generalizability of findings. [ABSTRACT FROM AUTHOR]

Background: Studies in Africa have examined the association between helmet use and injury prevention, however, there has been no systematic review to synthesize the literature within an African context nor has there been any meta-analysis examining the effect of helmet use on injury prevention.Methods: The review was performed in accordance with the Joanna Briggs Institute for Systematic Reviews. Articles were searched using several databases (e.g. CINAHL, OVID Medline) and select gray literature (e.g. TRID) sources. Articles were included if they were quantitative studies published in English between 2000 and 2019 and examined the association between motorcycle helmet use with head injuries, hospitalizations, and deaths in low- and lower-middle income countries in Africa with comprehensive motorcycle helmet laws. A meta-analysis was performed using pooled effect sizes assessing the impact of helmet use on reducing head injuries.Results: After screening 491 articles, eight studies met the inclusion criteria. Helmet use ranged from 0 to 43%. The mean age of being involved in a crash was 30 years with males being two times more likely to be involved in motorcycle crashes than females. Drivers (riders) were more likely to be involved in a crash, followed by passengers and then pedestrians. Helmet use reduced injury severity and provided an 88% reduction in serious head injuries (OR 0.118, 95% CI: 0.014-0.968, p = 0.049).Conclusions: In our study, helmet usage significantly reduced the likelihood of fatal head injuries. African countries with no helmet laws should consider adopting helmet use policies to reduce severe head related injuries from motorcycle crashes. [ABSTRACT FROM AUTHOR]

Background: Opportunistic infections (OIs) are the leading causes of hospitalization, morbidity, and mortality (accounting for 94.1% of all deaths) in people living with human immunodeficiency virus (PLHIV). Despite evidence suggested that undernutrition significantly increases the risk of OIs in PLHIV, to our knowledge, no study has examined the actual effects of undernutrition on OIs in this population, particularly in low-income countries. Thus, this study examined the effects of undernutrition on OIs in adults living with HIV receiving antiretroviral therapy (ART). Methods: We conducted a retrospective cohort study among 841adults living with HIV receiving ART between June 2014 and June 2020 at Debre Markos Comprehensive Specialized Hospital, Northwest Ethiopia. Study participants were selected using a simple random sampling technique. Data from participants' medical records were extracted using a project-specific data extraction checklist. The Kaplan Meier survival curve estimated the OIs free survival time. The effects of undernutrition on time to develop OIs was estimated using inverse-probability weighting. Finally, regression coefficients with 95% confidence intervals (95% CIs) were reported, with a statistical significance of p < 0.05. Results: Of 841 study participants, 262 (31.2%) developed OIs, and the overall incidence rate was 16.7 (95% CI: 14.8, 18.8) per 100 person-years. The incWidence of OIs in undernourished participants (21/100 person-years, 95% CI: 17.8, 27.4) was higher than well-nourished participants (15.0/100 person-years, 95% CI: 12.9, 17.4). When everyone in the population of interest is well-nourished, average time to develop OIs is estimated as 26.5 (coefficient: 26.5, 95% CI: 20.6, 32.4, p < 0.001) months. When everyone in the population of interest is undernourished, average time to develop OIs is estimated as 17.7 (95% CI: 12.8, 22.6) months. However, when everyone is undernourished, average time to develop OIs decreases by 8.8 (coefficient: -8.8, 95% CI: -16.6, -1.0, p = 0.026) months. Lastly, exposure to undernourishment (intervention) (ratio of average treatment effects to well-nourished potential outcome means in this study was a 32.5% reduction in OIs among adults living with HIV on ART. Conclusion: We found that undernutrition significantly shortened time to develop OIs in adults living with HIV. This implies that the occurrence of OIs in this vulnerable population can be improved through different cost-effective nutritional interventions, such as routine nutritional assessments and education. [ABSTRACT FROM AUTHOR]

The authors offer opinions on learning and teaching in higher education. The use of social media to allow nursing students to participate in the creation of content for their course as part of a blended learning experience, involving both classroom teaching and learning as well as learning and teaching within social media, is cited as an example of what is said to be a need for college teachers to move to new teaching strategies in the 21st century by incorporating educational technology to deal with issues of student disengagement.

Background: Voluntary medical male circumcision (VMMC) is becoming more popular as an important HIV prevention strategy. Malawi, with a high HIV and AIDS prevalence rate of 8.8% and a low male circumcision prevalence rate of 28% in 2016, is one of the priority countries recommended for VMMC scale-up. This paper investigates the attitudes and key challenges to VMMC adoption in a traditionally circumcising community in Malawi where male circumcision is culturally significant.Methods: A mixed design study using quantitative and qualitative data collection methods was carried out to determine the attitudes of 262 randomly selected males towards VMMC in a culturally circumcising community in Malawi. Statistical Package for the Social Sciences (SPSS) version 20 was used to analyse the quantitative data. To identify predictors of VMMC uptake, we used logistic regression analysis. To identify the themes, qualitative data were analysed using content analysis.Results: The findings indicate that, while more males in this community prefer medical circumcision, traditional circumcision is still practised. Panic (63%) perceived surgical complications (31%), and cost (27%) in accessing VMMC services were some of the barriers to VMMC uptake. Age and culture were found to be statistically significant predictors of voluntary medical male circumcision in the logistic analysis. According to qualitative data analysis, the key challenges to VMMC uptake were the involvement of female health workers in the circumcision team and the incentives provided to traditional circumcisers.Conclusion: According to the findings of this study, VMMC services should be provided in a culturally competent manner that respects and considers existing cultural beliefs and practices in the community. Coordination between local leaders and health workers should be encouraged so that VMMC services are provided in traditional settings, allowing for safe outcomes, and increasing VMMC uptake. [ABSTRACT FROM AUTHOR]

Introduction: Female adolescents living with Human Immunodeficiency Virus are a unique population facing lifelong challenges in reproductive and sexual health ranging from relational, social and legal-ethical considerations. While HIV prevalence of young females is higher than the males (4.9% versus 1%), evidence show that these adolescents in Malawi initiate sex as early as 15 years mostly with adult partners. Yet, young people are frequently reported to be reluctant to discuss sexual matters and demonstrate avoidance of direct questions on sexual issues during interviews. It is critical therefore that researchers invoke youth-friendly approaches to address these complex issues and enable these vulnerable individuals to articulate and advocate for their preferred futures. Methods: This study used an innovative visual qualitative approach known as 'my story' book which combined image selection and sentence completion exercises to enable adolescents living with HIV to share their stories through interviews. The study involved 14 cases comprising of 14 female adolescents aged 15 to 19, 14 caregivers and 14 health providers working at HIV multidisciplinary centres in Malawi. Results: The 'my story' book enabled in-depth exploration of the experiences and issues faced by this vulnerable population. The use of images and sentence completion exercise enabled the researcher to appreciate the type of interactions (or lack of) on sexual issues and status disclosure to significant others including sexual partners. Three themes were revealed, included creating meanings, revealing confirmatory and/or complementary evidence and enabling intergenerational research. Conclusions: The 'my story' book captured the life experiences and needs of the female adolescents. The book assisted the participants in constructing, communicating, and controlling the articulation of their stories. It positioned female adolescents as a diverse group of social agents able to construct and reflect on their social worlds and real-life issues. This approach was highly effective in creating a youth-friendly context for reflection and revelation regarding sensitive cultural and social issues faced by this group. As such, the 'my story' book could be used in one-on-one counselling or provide data to inform intervention development. [ABSTRACT FROM AUTHOR]

Background: Adverse health outcomes are higher among Maasai children in the Ngorongoro Conservation Area compared to other co-located ethnic groups and regions of Tanzania. The Mama Kwanza Socioeconomic Health Initiative, a Canadian-Tanzanian partnership delivering healthcare at clinics in this region, gathered perceptions of mothers regarding breastfeeding and infant nutrition in order to inform culturally sensitive, realistic, and effective health promotion efforts.Methods: A qualitative description approach was used in interviewing 30 Maasai mothers of infants zero to six months of age to explore their infant feeding practices, beliefs, knowledge, and recommendations to support breastfeeding. A local research team was trained to conduct and transcribe the interviews and assist with data interpretation. Qualitative content analysis was used in analyzing the interview transcripts.Results: Lactation is universal in this culture with all the mothers planning to breastfeed for at least one year and most having initiated breastfeeding within one hour of birth. Lactation skills and knowledge are passed down intergenerationally from the elder women. None of the infants less than six months were exclusively breastfed, with a variety of liquid and semi-solid supplements given. Mothers perceived their milk alone was nutritionally insufficient with maternal dietary deficiencies cited as a factor.Conclusions: While there is a strong breastfeeding culture among the Maasai in Ngorongoro, intersectoral efforts are required to provide culturally respectful health education on the benefits of exclusive breastfeeding and to ensure the maternal dietary adequacy required to achieve this goal. The findings reinforce the importance of international health projects adapting health promotion initiatives to local realities and beliefs in efforts to improve maternal child health. [ABSTRACT FROM AUTHOR]

Background: Undernutrition is one of the most common problems among people living with HIV, contributing to premature death and the development of comorbidities within this population. In Sub-Saharan Africa (SSA), the impacts of these often inter-related conditions appear in a series of fragmented and inconclusive studies. Thus, this review examines the pooled effects of undernutrition on mortality and morbidities among adults living with HIV in SSA.Methods: A systematic literature search was conducted from PubMed, EMBASE, CINAHL, and Scopus databases. All observational studies reporting the effects of undernutrition on mortality and morbidity among adults living with HIV in SSA were included. Heterogeneity between the included studies was assessed using the Cochrane Q-test and I2 statistics. Publication bias was assessed using Egger's and Begg's tests at a 5% significance level. Finally, a random-effects meta-analysis model was employed to estimate the overall adjusted hazard ratio.Results: Of 4309 identified studies, 53 articles met the inclusion criteria and were included in this review. Of these, 40 studies were available for the meta-analysis. A meta-analysis of 23 cohort studies indicated that undernutrition significantly (AHR: 2.1, 95% CI: 1.8, 2.4) increased the risk of mortality among adults living with HIV, while severely undernourished adults living with HIV were at higher risk of death (AHR: 2.3, 95% CI: 1.9, 2.8) as compared to mildly undernourished adults living with HIV. Furthermore, the pooled estimates of ten cohort studies revealed that undernutrition significantly increased the risk of developing tuberculosis (AHR: 2.1, 95% CI: 1.6, 2.7) among adults living with HIV.Conclusion: This review found that undernutrition has significant effects on mortality and morbidity among adults living with HIV. As the degree of undernutrition became more severe, mortality rate also increased. Therefore, findings from this review may be used to update the nutritional guidelines used for the management of PLHIV by different stakeholders, especially in limited-resource settings. [ABSTRACT FROM AUTHOR]

Background: Child survival is a major concern in Nigeria, as it contributes 13% of the global under-five mortalities. Although studies have examined the determinants of under-five mortality in Nigeria, the comparative roles of social determinants of health at the different stages of early childhood development have not been concurrently investigated. This study, therefore, aimed to identify the social determinants of age-specific childhood (0-59 months) mortalities, which are disaggregated into neonatal mortality (0-27 days), post-neonatal mortality (1-11 months) and child mortality (12-59 months), and estimate the within-and between-community variations of mortality among under-five children in Nigeria. This study provides evidence to guide stakeholders in planning for effective child survival strategies in the Nigerian communities during the Sustainable Development Goals era.Methods: Using the 2016/2017 Nigeria Multiple Indicator Cluster Survey, we performed multilevel multinomial logistic regression analysis on data of a nationally representative sample of 29,786 (weighted = 30,960) live births delivered 5 years before the survey to 18,497 women aged 15-49 years and nested within 16,151 households and 2227 communities.Results: Determinants of under-five mortality differ across the neonatal, post-neonatal and toddler/pre-school stages in Nigeria. Unexpectedly, attendance of skilled health providers during delivery was associated with an increased neonatal mortality risk, although its effect disappeared during post-neonatal and toddler/pre-school stages. Also, our study found maternal-level factors such as maternal education, contraceptive use, maternal wealth index, parity, death of previous children, and quality of perinatal care accounted for high variation (39%) in childhood mortalities across the communities. The inclusion of other compositional and contextual factors had no significant additional effect on childhood mortality risks across the communities.Conclusion: This study reinforces the importance of maternal-level factors in reducing childhood mortality, independent of the child, household, and community-level characteristics in the Nigerian communities. To tackle childhood mortalities in the communities, government-led strategies should prioritize implementation of community-based and community-specific interventions aimed at improving socioeconomic conditions of women. Training and continuous mentoring with adequate supervision of skilled health workers must be ensured to improve the quality of perinatal care in Nigeria. [ABSTRACT FROM AUTHOR]

• The median time to culture conversion is 61.2 days. • The duration of time to sputum culture conversion can be shortened when the nutritional status of patients is improved. • Favorable treatment outcomes can be enhanced when the duration of time to culture conversion is short. • Culture conversion and treatment outcomes are considered the most important indicator of treatment efficacy in TB treatment. • The intensive phase duration of injectable drugs can be shortened when the initial time to culture conversion is determined. This study aimed to consider the estimated time to multi-resistant tuberculosis culture conversion, and associated factors, in order to enhance evidence utilization in eastern Africa. We systematically identified available articles on multidrug-resistant tuberculosis culture conversion using PubMed, Scopus, Cochrane Library, Web of Science core collection, and Science Direct databases. A random-effects model was employed using the R 3.6.1 version and Stata/se 14 software. Nine articles with a sample size of 2458 multidrug-resistant tuberculosis patients were included. The two-month culture conversion rate was 75.4%, with a median time of 61.2 days (interquartile range: 48.6-73.8). In the included studies, favorable treatment outcomes of MDR-TB patients were seen in 75% of the cases, while unfavorable treatment outcomes were seen in 18% (10% deaths, 7% defaulted, and 1% treatment failure) of the cases. The independent factor for delayed sputum culture conversion was body mass index below 18.5 kg/m2 (HR = 3.1, 95% CI: 2.0, 6.7). The median time to sputum culture conversion was 61.2 days, which is a reasonably short time. Body mass index was the identified associated factor leading to delayed culture conversion. Therefore, there is a need for awareness of how to improve the nutritional status of multidrug-resistant tuberculosis patients through appropriate nutritional supports. [ABSTRACT FROM AUTHOR]

Head porters working in markets in sub-Saharan Africa (SSA) are one of the world's most vulnerable and socioeconomically disadvantaged groups. They consist predominantly of uneducated women and girls seeking to escape poverty, early marriage, and other issues of domestic violence. Most female head porters are in their reproductive years and often lack access to sexual reproductive health services (SRHS) despite being at high risk for sexually transmitted infections (STIs), unplanned pregnancies, and gender-based violence. The low priority for women and girls' SRH in many SSA countries highlights the need to explore the factors influencing the accessibility of services for failure to do so restrains human development. An initial search of the literature was conducted and revealed no current scoping or systematic reviews on the accessibility to SRHS for female head porters in SSA. We outline a scoping review protocol, using the Joanna Briggs Institute methodology, to determine the interventions that influence the accessibility of SRHS for female head porters in SSA. The protocol is registered with Open Science Framework (https://osf.io/hjfkd). Findings will not only be valuable for female head porters but for all vulnerable female groups in SSA who experience high SRH risks and social disparities. [ABSTRACT FROM AUTHOR]

Background: Despite effective antiretroviral therapy (ART) coverage in other groups living with human immunodeficiency virus (HIV) in Tanzania, virologic suppression among HIV-positive children receiving ART remains unacceptably low. This study evaluated the effectiveness of a community-based intervention (Konga model) in addressing the factor contributing to low viral load suppression among children living with HIV in the Simiyu region, Tanzania. Methods: This study used a parallel cluster randomized trial. The cluster was only eligible if the health facility provided HIV care and treatment. All eligible resident children aged 2‒14 years who attended the cluster with a viral load > 1,000 cells/mm were enrolled. The intervention included three distinct activities: adherence counseling, psychosocial support, and co-morbidity screening such as tuberculosis. The evaluation was based on patient-centered viral load outcomes measured at baseline and 6 months later. Using a pre- and post-test design, we compared the means of participants in the intervention and control groups. We performed an analysis of covariance. The effect of a Konga was calculated using omega-squared. We used F-tests, with their corresponding p-values, as measures of improvement. Results: We randomly assigned 45 clusters to the treatment (15) and control (30) groups. We enrolled 82 children with amedian age of 8.8 years(interquartile range(IQR);5.5–11.2), and a baseline median viral load of 13,150 cells/mm (interquartile range (IQR);3600–59,200). After the study, both children in each group had good adherence, with children in the treatment group scoring slightly higher than those in the control group, 40 (97.56%) versus 31(75%61), respectively. At the end of the study, the difference in viral load suppression between the two groups was significant. The median viral load suppression at the end of the study was 50 cells/mm [IQR, (20–125)]. After adjusting for the viral load before the intervention, the effect size of the Konga intervention explained 4% (95% confidence interval [0%, 14.1%]) of the viral load variation at the end of the intervention. Conclusion: The Konga model demonstrated significant positive effects that improved viral load suppression. We recommend implementing the Konga model trial in other regions to improve the consistency of results. [ABSTRACT FROM AUTHOR]

Background. Induction of labor is the initiation of uterine contractions by artificial methods once the fetus has reached viability and prior to spontaneous onset of labor with the aim of achieving vaginal delivery. Although induction of labor is a critical life-saving intervention that potentially reduces adverse pregnancy outcomes, sometimes it has undesirable consequences for the health of the mother and/or the fetus. Hence, this study aimed to evaluate the outcomes and associated factors of labor induction. Methods. An institution-based cross-sectional study was conducted from February 25 to May 25, 2020, among women undergoing induction at East Gojjam zone public hospitals in northwest Ethiopia. A structured interviewer-administered questionnaire was used to collect data from a sample of 411 mothers who were selected using a systematic random sampling technique. Stata/se™ Version 14 statistical software was used to analyze the data. Multivariable binary logistic regression was used to determine the potential factors affecting successful labor induction. Adjusted odds ratios with their 95% CI intervals were used to declare the strength of the association, and a variable with p value <0.05 was considered to have statistical significance. Results. The prevalence of successful induction of labor was 70.3% (65.6, 74.7). The favorable Bishop score ((CI 3.90, 1.63–9.29); p value = 0.002), the intermediate Bishop score ((CI 3.53, 2.15–5.82); p value = 0.001), labor induction using oxytocin with cervical ripening ((CI 2.60, 1.21–5.63); p value = 0.015), and urban residence ((CI 0.48, 0.30–0.78); p value = 0.003) were associated with successful induction of labor. Conclusion. These findings strongly suggest that cervical conditions are important determinants for the success of labor induction. Therefore, healthcare providers should confirm the favorability of the cervical status (using Bishop score) as a strict prerequisite before actual labor induction, and special consideration should be given to those pregnant women who reside in urban areas. [ABSTRACT FROM AUTHOR]

Introduction: The World Health Organization and partners developed and evaluated a maternity-specific sepsis care bundle called 'FAST-M' for low-resource settings. However, this bundle has not yet been studied in Asia. Our study sought to evaluate the perceptions of healthcare providers about the implementation of the FAST-M intervention in Pakistan. Materials and methods: The study was conducted at a public sector hospital in Hyderabad. We conducted three focus group discussions with healthcare providers including doctors, nurses, and healthcare administrators (n = 22) who implemented the FAST-M intervention. The Consolidated Framework for Implementation Research was used as a guiding framework for data collection and analysis. The data were analyzed using a thematic analysis approach and deductive methods. Results: Five overarching themes emerged: (I) FAST-M intervention and its significance including HCPs believing in the advantages of using the intervention to improve clinical practices; (II) Influence of outer and inner settings including non-availability of resources in the facility for sepsis care; (III) HCPs perceptions about sustainability, which were positive (IV) Integration into the clinical setting including HCPs views on the existing gaps, for example, shortage of HCPs and communication gaps, and their recommendations to improve these; and (V) Outcomes of the intervention including improved clinical processes and outcomes using the FAST-M intervention. Significant improvement in patient monitoring and FAST-M bundle completion within an hour of diagnosis of sepsis was reported by the HCPs. Conclusions: The healthcare providers' views were positive about the intervention, its outcomes, and long-term sustainability. The qualitative data provided findings on the acceptability of the overall implementation processes to support subsequent scaling up of the intervention. [ABSTRACT FROM AUTHOR]

Background: Despite substantial antiretroviral therapy (ART) coverage among individuals with human immunodeficiency virus (HIV) infection in Tanzania, viral load suppression (VLS) among HIV-positive children receiving ART remains intolerably low. This study was conducted to determine factors affecting the nonsuppression of VL in children with HIV receiving ART in the Simiyu region; thus, an effective, sustainable intervention to address VL nonsuppression can be developed in the future. Methods: We conducted a cross-sectional study including children with HIV aged 2–14 years who were currently presenting to care and treatment clinics in the Simiyu region. We collected data from the children/caregivers and care and treatment center databases. We used Stata™ to perform data analysis. We used statistics, including means, standard deviations, medians, interquartile ranges (IQRs), frequencies, and percentages, to describe the data. We performed forward stepwise logistic regression, where the significance level for removal was 0.10 and that for entry was 0.05. The median age of the patients at ART initiation was 2.0 years (IQR, 1.0–5.0 years), and the mean age at HIV VL (HVL) nonsuppression was 8.8 ± 2.99 years. Of the 253 patients, 56% were female, and the mean ART duration was 64 ± 33.07 months. In multivariable analysis, independent predictors of HVL nonsuppression were older age at ART initiation (adjusted odds ratio [AOR] = 1.21; 95% confidence interval [CI] 1.012–1.443) and poor medication adherence (AOR, 0.06; 95% CI 0.004–0.867). Conclusions: This study showed that older age at ART initiation and poor medication adherence play significant roles in HVL nonsuppression. HIV/AIDS programs should have intensive interventions targeting early identification, ART initiation, and adherence intensification. [ABSTRACT FROM AUTHOR]

This study reports on the inter-generational transmission of faith values to young children (three to six years) from the perspectives of parents, grandparents, and religion teachers. The study was conducted at two religious education centres in Dar es Salaam, Tanzania. Through a qualitative rapid ethnographic approach (interviews, focus groups, and observations), we explored the practices and challenges in realizing the practice of faith as part of children’s everyday life. Eleven themes elicited which were further reflected in three overarching trends – ‘Building the foundation – on the right path’; ‘Meeting the challenges-embedding faith’; ‘Creating a conducive environment – brining us together’. Key findings revealed that although parents were keenly interested in spiritual development of their young children, they felt challenged by time deficits, multiple priorities, and secularization. Grandparents and religious education teachers were critical of the lack of parental commitment to spiritual development, seeing themselves often becoming surrogate drivers for this imperative. In conclusion, parents requested the institutions to schedule weekly practical classes in prayer and rituals. They also indicated that grandparents’ involvement in religious education activities are enabling and supportive to the parents in nurturing children’s spirituality. As a result there is a clear indication of the role for inter-generational involvements in embedding spirituality in young children. [ABSTRACT FROM PUBLISHER]

Introduction: Ethiopia launched an Appointment Spacing Model in 2017, which involved a six-month clinical visit and medication refill cycle. This study aimed to assess the uptake of the Appointment Spacing Model of care and associated factors among stable adult HIV clients on ART in Ethiopia. Methods: A cross-sectional study was conducted from October 3 to November 30, 2020 among 415 stable adult ART clients. EpiData version 4.2 was used for data entry and SPSS version 25 was used for cleaning and analysis. A multivariable logistic regression model was fitted to identify associated factors, with CI at 95% with AOR being reported to show the strength of association. Results: The uptake of the appointment spacing model was 50.1%. Residence [AOR: 2.33 (95% CI: 1.27, 4.26)], monthly income [AOR: 2.65 (95% CI: 1.13, 6.24)], social support [AOR: 2.21 (95% CI: 1.03, 4.71)], duration on ART [AOR: 2.41 (95% CI: 1.48, 3.92)], baseline regimen change [AOR: 2.20 (95% CI: 1.02, 4.78)], viral load [AOR: 2.80 (95% CI: 1.06, 7.35)], and alcohol abstinence [AOR: 2.02 (95% CI: 1.21, 3.37)] were statistically significant. Conclusions: The uptake of the ASM was low. Behavioral change communication, engaging income-generating activities, and facility-level service providers' training may improve the uptake. [ABSTRACT FROM AUTHOR]

Background: Amid COVID-19, soon after the closure of academic institutions, academia was compelled to implement teaching and assessments virtually. The situation was not the same for all countries. This transition was much more challenging in low-resource settings like Pakistan, where the students were geographically distant with minimal connectivity. A private university in Pakistan instituted a systematic approach for ensuring quality assurance and reliability before launching online assessments amid the COVID-19. The purpose of this study was to reflect on the phased transition to online/remote assessments to facilitate continuous student learning through distance modalities during the pandemic. Method: To assist faculty in re-designing their assessments, a workshop was conducted which was based on the modified Walker's nine principles. The principles coded as "ACTFAiREST2" were introduced to ensure that the faculty understands and adapts these principles in designing online assessments. The faculty modified and re-designed their course assessments, from face to face to online modality and submitted their proposals to the Curriculum Committee (CC). To guide the process of approving modified and re-designed assessments, a checklist was adapted. All the pre and -post workshop assessment proposals were analyzed using a content analysis approach to ensure the alignment of course learning outcomes with the assessments. Results: A total of 45 undergraduate courses' assessment proposals were approved by the CC after deliberations ensuring their applicability in a virtual environment. From the analysis of the course outlines and assessment proposals submitted to the CC, faculty made four key changes to their assessment tasks in the light of ACT FAiREST2 principles (a) alternative to performance exams; (b) alternative to knowledge exams; (c) change in the mode of assessment administration; and (d) minimizing the overall assessment load. Conclusion: This transition provided an impetus for the faculty from a low resource setting to build momentum towards improved and innovative ways of online teaching and assessments for future nursing education to adapt to the new normal situation. This development will serve as a resource in similar contexts with planned and evidence-based approaches for enhancing faculty readiness and preparedness for online/remote assessments. [ABSTRACT FROM AUTHOR]

Background: In Ethiopia, quality of maternal and newborn care is poor. This situation has persisted, despite the wide implementation of several capacity building-oriented interventions including clinical mentoring for skilled birth attendants that were anticipated to translate in to high–quality maternal and newborn care on each encounter. The effectiveness of mentoring programs is not yet well documented in the research literature. Therefore, we evaluated the effect of a catchment based clinical mentorship in improving the quality of maternal and newborn care in primary level facilities of Tigray, Northern Ethiopia. Methods: We conducted a controlled quasi-experimental pre-post study among 19 primary health care facilities, with 10 facilities assigned to the group where the catchment based clinical mentorship program was implemented (intervention group), and 9 facilities to the control group. We assigned the group based on administrative criteria, number of deliveries in each facility, accessibility, and ease of implementation of the intervention. A sample of 1320 women(662 at baseline; 658 at post intervention) and 233 skilled birth attendants(121 at baseline and 112 at end line) were included. We collected data from mothers, skilled birth attendants and facilities. The first round of data collection (baseline) took place two weeks prior the inauguration of the intervention, 05 October to 04 November 2019. The end line data collection occurred from 22 May to 03 July 2020. The primary Outcome was "receipt quality of maternal/newborn care". We analyzed the data using difference in differences (DiD) and logistic regression with Generalized Estimating Equation. The level of significance of predictors was declared at p-value less than 0.05in the multivariable analysis. Intervention: We deployed a team of local clinical mentors working at primary hospitals to provide clinical mentorship, and direct feedback in routine and emergency obstetrical and newborn care to the mentees (all skilled birth attendants performing maternal and newborn health services) functioning in their catchment rural health centers for duration of six months. While visiting a facility, mentors remain at the facility each lasting at least five to seven days per month, over the course of intervention period. Results: A significantly higher proportion of women at intervention facilities received quality of care services, compared with women at comparison facilities. (DiD = 18.4%, p<0.001). Moreover, following the implementation of the intervention we detected a difference in the occurrences of maternal complication outcome during delivery and immediately after birth. This was decreased by 4.5%, with significant differences between intervention and comparison sites (DiD = 4.5%, p = 0.013). We also found a favorable difference in occurrences of neonatal obstetric complications, with a decrease of 4.8% in the intervention site and almost no change in the comparison site (DiD = 4.8%, p = 0.002). Among the determinants of quality of care, we found that providers' job satisfaction (AoR = 2.95, 95%CI: 1.26 to 6.91), and making case presentation at regular basis(AoR = 1.89, 95%CI: 1.05 to 3.39) were significantly associated to improve the quality of care. However, delivery load(AoR = 0.95, 95%CI: 0.93 to 0.98) was negatively associated with quality of care. Conclusions: We conclude that the catchment based clinical mentorship intervention is effective to improve quality of care and reduce childbirth complications in northern Ethiopia. This finding further elaborated that incorporating maternal and newborn health catchment based clinical mentorship activities into the existing health system strengthening strategies can catalyze improvement processes to quality practice and health systems. This is seen as a necessary step to achieve the effective quality universal health care required to meet the health-related Sustainable Development Goals. Besides, more attention needs to be given to develop interventions and strategies that directly enhance providers' job satisfaction and reduce delivery work load. [ABSTRACT FROM AUTHOR]

Background: Screening for gestational diabetes mellitus in Tanzania is challenged by limited resources. Therefore, this study aimed to develop a simple method for identification of women at risk of gestational diabetes mellitus in Arusha urban, Tanzania.Methods: This study used data from a cross sectional study, that was conducted between March and December 2018 in Arusha District involving 468 pregnant women who were not known to have diabetes before pregnancy. Urine glucose was tested using urine multistics and blood glucose levels by Gluco-Plus™ and diagnosed in accordance with the World Health Organization's criteria. Anthropometrics were measured using standard procedures and maternal characteristics were collected through face-to-face interviews using a questionnaire with structured questions. Univariate analysis assessed individual variables association with gestational diabetes mellitus where variables with p-value of < 0.05 were included in multivariable analysis and predictors with p-value < 0.1 remained in the final model. Each variable was scored based on its estimated coefficients and risk scores were calculated by multiplying the corresponding coefficients by ten to get integers. The model's performance was assessed using c-statistic. Data were analyzed using Statistical Package for Social Science™.Results: The risk score included body fat ≥ 38%, delivery to macrosomic babies, mid-upper arm circumference ≥ 28 cm, and family history of type 2 diabetes mellitus. The score correctly identified 98% of women with gestational diabetes with an area under the receiver operating characteristic curve of 0.97 (95% CI 0.96-0.99, p < 0.001), sensitivity of 0.98, and specificity of 0.46.Conclusion: The developed screening tool is highly sensitive and correctly differentiates women with and without gestational diabetes mellitus in a Tanzanian sub-population. [ABSTRACT FROM AUTHOR]

Purpose: This study aims at determining the risk of physical inactivity and sedentary behaviors on overweight and obesity among primary school children aged 10–13 years in Tanzania. Design/methodology/approach: A case-control study was conducted from January to March 2020 involving 69 overweight/obese children as cases and 138 normal weight children as controls. Cases were identified as having body mass index-for-age ≥ +1 standard deviation (SD) and controls as those having BMI-for-age range between −2 SD to <+1 SD. A validated questionnaire was used for data collection on daily physical activities and sedentary behavior types, frequency duration and activity score. An independent sample t-test was used to compare means of activity score between cases and controls. Binary logistic regression was used to predict risk factors for overweight/obesity. Findings: Risk factors for overweight/obesity were listening to music and/or radio for >2 h/week (OR 2.7, 95% CI 1.2–6.1) and walking for exercise <2 h/week (OR 2.1, 95% confidence interval [CI] 1.1–4.1). On the other hand, rope skipping for >2 h/week (OR 0.14, 95% CI 0.03–0.7) was a protective factor against overweight/obesity. Controls had a significantly higher mean score of being active during lunch breaks compared to cases (p = 0.012). Cases had higher weight, height and percentage body fat than controls (p < 0.001). The home environment provided more avenues for physical activity than the school environment. Originality/value: To the best of the authors' knowledge, this is original research work and the first case-control study to predict physical activity and sedentary behaviors as risk factors for overweight and obesity in Tanzanian school children. [ABSTRACT FROM AUTHOR]

Background: This qualitative exploratory study explores smokers' perspectives regarding smoking cessation processes amid the COVID-19 pandemic. Methods: Purposive sampling was employed to conduct semi-structured interviews with cigarette smokers visiting cardiac and pulmonary clinics at a tertiary care hospital in Karachi, Pakistan. Thematic analysis was performed to identify themes from the participants' responses. Results: Three themes emerged from the thematic analysis. These were smoking cessation facilitators, smoking cessation barriers, and COVID-19 impacts on smoking cessation. Awareness and education, threat of acquiring health problems, religious beliefs and family or support system behave as smoking cessation facilitators. While, role modeling, associating smoking to stress relief, and cigarette dependency were major barriers to smoking cessation or prevention. There were mixed perceptions regarding association of cigarette smoking and COVID-19. However, some of the participants shared feelings of fear for being vulnerable to COVID-19 and its complications. Conclusion: The findings of this study generated significant recommendations for providing effective and optimal smoking cessation interventions such as not missing the teachable moment for smoking cessation counselling, anti-smoking smoking efforts from religious perspectives, and strict implementation of anti-smoking regulations in the country. [ABSTRACT FROM AUTHOR]

Objectives: The study explored the perceptions of adult smokers with cardiovascular and respiratory diseases regarding cigarette smoking cessation. We also explored factors that may hinder or facilitate smoking cessation process. Design: Qualitative descriptive exploratory design Sample: Purposive sample of 13 adult smokers with cardiovascular or respiratory diseases visiting outpatient cardiac and respiratory clinics at a private tertiary care hospital Measurements: In‐depth, face‐to‐face, and semi‐structured interviews were conducted. The interviews were digitally recorded and transcribed verbatim followed by a six steps process of manual thematic analysis of data. Results: Meaningful statements were assigned codes and grouped into categories. Categories were clustered under three themes representing individual factors, socio‐cultural factors, and institutional factors. Conclusions: Smoking cessation is influenced by personal, cultural, as well as social aspects. Institutionally, there is a need to recognize that smoking is a learned behavior; hence, prohibiting public smoking will potentially contribute to non‐smoking behaviors. Although the nature of misconceptions varies, this is imperative to ensure consistency in messaging, programming, and supports led by healthcare professionals. [ABSTRACT FROM AUTHOR]

Antiretroviral therapy lowers viral load only when people living with HIV maintain their treatment retention. Lost to follow-up is the persistent major challenge to the success of ART program in low-resource settings including Ethiopia. The purpose of this study is to estimate time to lost to follow-up and its predictors in antiretroviral therapies amongst adult patients. Among registered HIV patients, 542 samples were included. Data cleaning and analysis were done using Stata/SE version 14 software. In multivariable Cox regression, a p-value < 0.05 at 95% confidence interval with corresponding adjusted hazards ratio (AHR) were statistically significant predictors. In this study, the median time to lost to follow-up is 77 months. The incidence density of lost to follow-up was 13.45 (95% CI: 11.78, 15.34) per 100 person-years. Antiretroviral therapy drug adherence [AHR: 3.04 (95% CI: 2.18, 4.24)], last functional status [AHR: 2.74 (95% CI: 2.04, 3.67)], and INH prophylaxis [AHR: 1.65 (95% CI: 1.07, 2.56) were significant predictors for time to lost to follow-up. The median time to lost was 77 months and incidence of lost to follow-up was high. Health care providers should be focused on HIV counseling and proper case management focused on identified risks. [ABSTRACT FROM AUTHOR]

This study aims to test the effectiveness of a community-based intervention (Konga model) to improve viral-load suppression in children living with human immunodeficiency virus (HIV) and enrolled in care and treatment centers in Tanzania mainland. The study will be a cluster-randomized clinical trial study designed with both intervention and control arms. The study will involve 268 children with a viral load of >1000 copies/ml who are aged between 2 and 14 years. The children will be randomly allocated into the intervention and control arms. The intervention will include three distinct activities: adherence and retention counseling, psychosocial support, and comorbidity screening (i.e. tuberculosis). The outcome of the study will be assessment of the success of the intervention to increase medication adherence with the immediate result of reducing the viral load below 1000 copies/ml. Descriptive statistics will be used to calculate the mean, median, standard deviation, and interquartile range of continuous data. We will use frequencies and percentages to summarize categorical data. As for the primary outcome (proportion of HIV-infected children with viral suppression), we will compare the proportion of successful participants in the intervention and control arms. Proportions and tests for different proportions will be used as a measure of improvement. All statistical tests will be two-sided and P < 0.05 will be considered statistically significant. [ABSTRACT FROM AUTHOR]

Introduction: Intestinal parasitic infection are a major public health concern affecting both children and adolescents in Ethiopia. The aim of this systematic review and meta-analysis was to determine pooled prevalence and associated factors of intestinal parasitic infection in this target group. Method: We systematically retrieved available articles on the prevalence of intestinal parasitic infection following database searches using PubMed, Scopus, Cochrane Library, and Science Direct between March 1 and May 27, 2020. Two authors independently extracted all relevant data using a standardized Microsoft Excel data extraction form. Heterogeneity among included studies was assessed with the Higgins I2 tests. The pooled estimates and associated factors were assessed with a random-effects model using Stata/se Version 14. Result: We retrieved 30 eligible articles with a pooled sample size of 14,445 primary school children with response rate of 97.8%. Entamoeba spp (16.11%), Ascaris lumbricoides (13.98%), hookworm (12.51%) and Giardia lamblia (9.98%) are the top causes of intestinal parasitic infection among primary school children in Ethiopia. The pooled prevalence for at least one intestinal parasitic infection was 46.09 (95% CI: 38.50, 53.68). Heterogeneity was assessed by doing subgroup analysis by study province/region. Thus, the highest prevalence of 66.6% (95% CI: 55.5, 77.7) occurred in Tigray region, which was followed by Southern Nations, Nationalities, and Peoples' Region at 50.8% (95% CI: 33.1, 68.5). No latrine availability (OR = 4.39: 2.50,7.73), no fingernail hygiene (OR = 2.37: 1.67, 3.35), open defecation (OR = 1.67:1.64,4.36), no formal maternal education (OR = 2.02: 1.18,3.47), rural residence (OR = 1.88: 1.46, 2.41), no habit of wearing shoes (OR = 2.66: 1.79, 3.96), non-pipe source of drinking water (OR = 1.99: 1.42,2.76), no regular hand washing practices (OR = 3.45:1.85,6.47), and no habit of washing fruits and vegetables (OR = 1.59:1.01,2.49) were associated with parasitic infection. Conclusions: The prevalence of intestinal parasitic infection was high (46%). Attention should be given to promoting personal hygiene, latrine utilization, wearing shoes, avoiding eating raw food, creating awareness for those mothers who lack formal education. Moreover, future research ideally will expand on the topic by conducting research in regions which have no prior research. Author summary: Intestinal parasitic infections are distributed virtually with high prevalence rates in many regions, especially in low and middle income countries which intimately linked to age group, poverty and inadequate access to water, sanitation and hygiene. It is now a day's one of the neglected tropical disease. We had searched different individual studies on intestinal parasitic infections to generate the pooled effect and recommend for the concerned body. We head included 30 different articles with a sample size of 14,445 and we have found a pooled prevalence of 46.09%. This finding indicates the prevalence of parasitic infection was almost near to half. Therefore every concerned body should give emphasize to prevent and control parasitic infection infestation. [ABSTRACT FROM AUTHOR]

Background: In Ethiopia about 25% of rural women are chronically malnourished. Non-pregnant and non-lactating women present an opportunity to implement strategies to correct maternal and child health status and to potentiate improved pregnancy outcomes in developing countries like Ethiopia. The determinant factors of chronic energy deficiency vary across settings and contexts; hence, it is important to identify local determinant factors in order to implement effective and efficient intervention strategies. Objective: To assess the determinants of chronic energy deficiency of non-pregnant, non-lactating rural women within the reproductive age group (15–49 years), in rural kebeles of Dera district, North West Ethiopia, 2019. Methods: A community based unmatched case control study was conducted. A total of 552 participants were involved and a multi-stage sampling technique was used to select the samples. Data was collected from January 15 to February 30, 2019 using face-to-face interviews and anthropometric assessments. EPI-info version 7 and SPSS™ version 23 were used for data entry and analysis, respectively. Bivariable and multivariable logistic regression models were used to analyze the association between dependent and independent variables. Association was considered statistically significant at 95% CI with p-value < 0.05 in multivariable logistic regression. Result: A total of 548 non-pregnant, non-lactating women with 137 cases and 411 controls were included in the study with a response rate of 99.3%. High family size (AOR = 1.88, 95% CI: 1.085, 3.275), low educational status (AOR = 3.389, 95% CI: 1.075, 10.683), inadequate meal frequency (AOR = 5.345, 95% CI: 2.266, 12.608), absence of home garden (AOR = 5.612, 95% CI: 3.177, 9.915) and absence of latrine facility (AOR = 6.365, 95% CI: 3.534, 11.462) were found positively associated with chronic energy deficiency. Conclusion and recommendation: Inadequate meal frequency, absence of home gardening, absence of latrine facility, high family size and educational status of illiterate were the determinants of chronic energy deficiency, thus indicating the imperative for a multi-sectoral approach with health, agriculture and education entities developing and delivering interventions. [ABSTRACT FROM AUTHOR]