Mother-to-child transmission (MTCT) is the main mode of HIV transmission in children under 15 years old. This problem is significant in the Sub-Saharan African countries, where more than 80% of ...children living with HIV are found. Previous studies in Ethiopia present inconsistent and inconclusive findings on the prevalence and associated factors of MTCT of HIV. Therefore, this study was conducted to determine the pooled prevalence of MTCT of HIV and its associated factors in Ethiopia.
Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was followed. All published studies were retrieved using relevant search terms in MEDLINE, PUBMED, Cochrane Library, EMBASE, Google Scholar, CINAHL, and African Journals Online databases. Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI) was used to critically appraise articles. STATA version 14 software was used to perform the Meta-analysis. The I
statistics was used to test heterogeneity and publication bias was assessed using Begg's and Egger's tests. Odds ratio (OR) with 95% confidence interval (CI) was presented using forest plots.
A total of nine studies, 3688 mother-baby pairs, were included in this meta-analysis. The pooled prevalence of MTCT of HIV in Ethiopia was 9.93% (95% CI: 7.29, 12.56). The subgroup analysis showed a higher prevalence of MTCT of HIV in Dire Dawa City Administration (15.7%) and lowest in Southern Nations, Nationality and Peoples Region (SNNPR) (4.16%). Associated factors with MTCT of HIV include: mixed feeding, OR = 7.46 (95%CI: 4.71, 11.81), absence of infant ARV prophylaxis, OR = 7.89 (95%CI: 4.32, 14.42), home delivery, OR = 5.08 (95%CI: 2.32, 11.15), and absence of maternal PMTCT intervention, OR = 7.13 (95% CI: 3.31, 15.35).
Almost one in ten HIV exposed infants become HIV positive in Ethiopia. Factors like: mixed feeding, the absence of infant ARV prophylaxis, home delivery and absence of mother's PMTCT intervention were significantly associated with MTCT of HIV. Therefore, the governmental and non-governmental organizations need to focus on the identified factors and work towards improving the prevention of mother to child transmission of HIV (PMTCT) program.
Loss to follow-up from lifelong antiretroviral therapy continued to be a major challenge affecting virtual elimination of mother-to-child transmission of human immunodeficiency virus, especially in ...Sub-Saharan Africa. Although there was a study conducted in Ethiopia, loss to follow-up was not clearly defined and some important variables were not addressed. Thus, this study was conducted to determine the incidence of loss to follow-up and its predictors among women on option B+ lifelong antiretroviral therapy program in Pawi district health facilities, northwest Ethiopia.
An institutional-based retrospective follow-up study was conducted among 365 women who were enrolled for option B+ prevention of mother-to-child transmission service between June 2013 and March 2021 in Pawi district health facilities. A standard pretested checklist was used to extract data from all eligible women's records. The Kaplan-Meier survival curve for estimating survival probability and Cox proportional hazards model to identify independent predictors of loss to follow-up were employed after checking for proportional hazards assumptions using STATA-14 statistical software.
The overall incidence of loss to follow-up was 12.04 (95% CI: 9.50, 15.20) per 1000 person-months of observation time. Residing outside the catchment area (adjusted hazard ratio (AHR): 3.08, 95% CI: 1.59, 5.98), lactating at enrollment (AHR: 2.43, 95% CI: 1.24, 4.77), living in a sero-discordant relationship (AHR: 2.5, 95% CI: 1.13, 5.53), lack of sero-status disclosure (AHR: 2.59, 95% CI: 1.15, 5.85), new enrollment to lifelong antiretroviral therapy (AHR: 2.07, 95% CI: 1.05, 4.11), and fair (AHR: 2.69, 95% CI: 1.2, 6.04) or poor (AHR: 5.78, 95% CI: 2.76, 12.12) antiretroviral drug adherence level were independent predictors of loss to follow-up.
We found a higher incidence of loss to follow-up relative to previous studies in Ethiopia. Thus, strengthening adherence support interventions, and effective counseling on sero-status disclosure and male partner involvement are important to retain women in care.
Adolescence is the period between 10 and 19 years with peculiar physical, social, psychological and reproductive health characteristics. Rates of adolescent pregnancy are increasing in developing ...countries, with higher occurrences of adverse maternal and perinatal outcomes. The few studies conducted on adolescent pregnancy in Africa present inconsistent and inconclusive findings on the distribution of the problems. Also, there was no meta-analysis study conducted in this area in Africa. Therefore, this systematic review and meta-analysis were conducted to estimate the prevalence and sociodemographic determinant factors of adolescent pregnancy using the available published and unpublished studies carried out in African countries. Also, subgroup analysis was conducted by different demographic, geopolitical and administrative regions.
This study used a systematic review and meta-analysis of published and unpublished studies in Africa. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was strictly followed. All studies in MEDLINE, PubMed, Cochrane Library, EMBASE, Google Scholar, CINAHL, and African Journals Online databases were searched using relevant search terms. Data were extracted using the Joanna Briggs Institute tool for prevalence studies. STATA 14 software was used to perform the meta-analysis. The heterogeneity and publication bias was assessed using the I
statistics and Egger's test, respectively. Forest plots were used to present the pooled prevalence and odds ratio (OR) with 95% confidence interval (CI) of meta-analysis using the random effect model.
This review included 52 studies, 254,350 study participants. A total of 24 countries from East, West, Central, North and Southern African sub-regions were included. The overall pooled prevalence of adolescent pregnancy in Africa was 18.8% (95%CI: 16.7, 20.9) and 19.3% (95%CI, 16.9, 21.6) in the Sub-Saharan African region. The prevalence was highest in East Africa (21.5%) and lowest in Northern Africa (9.2%). Factors associated with adolescent pregnancy include rural residence (OR: 2.04), ever married (OR: 20.67), not attending school (OR: 2.49), no maternal education (OR: 1.88), no father's education (OR: 1.65), and lack of parent to adolescent communication on sexual and reproductive health (SRH) issues (OR: 2.88).
Overall, nearly one-fifth of adolescents become pregnant in Africa. Several sociodemographic factors like residence, marital status, educational status of adolescents, their mother's and father's, and parent to adolescent SRH communication were associated with adolescent pregnancy. Interventions that target these factors are important in reducing adolescent pregnancy.
The survival rate from breast cancer is lowest in African countries and the distribution of breast self-examination practice of and its determinants are not well investigated in Ethiopia. Therefore, ...this systematic review and meta-analysis was designed to determine the pooled prevalence of breast self-examination and its associated factors among women in Ethiopia.
Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was followed for this systematic review and meta-analysis. The databases used were; PUBMED, Cochrane Library, Google Scholar, CINAHL, African Journals Online, Dimensions and Summon per country online databases. Search terms used were; breast self-examination, breast cancer screening, early detection of breast cancer and Ethiopia. Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI) was used for critical appraisal of studies. The meta-analysis was conducted using STATA 15 software. The pooled meta-analysis was computed to present the pooled prevalence and relative risks (RRs) of the determinate factors with 95% confidence intervals (CIs).
We identified 2,637 studies, of which, 40 articles (with 17,820 participants) were eligible for inclusion in the final meta-analysis. The pooled estimate of breast self-examination in Ethiopia was 36.72% (95% CI: 29.90, 43.53). The regional distribution breast self-examination ranged from 21.2% (95% CI: 4.49, 37.91) in Tigray to 61.5% (95% CI: 53.98, 69.02) in Gambela region. The lowest prevalence of breast self-examination was observed among the general population (20.43% (95% CI: 14.13, 26.72)). Women who had non-formal educational status (OR = 0.4 (95% CI: 0.21, 0.77)), family history of breast cancer (OR = 2.04 (95% CI: 1.23, 3.39)), good knowledge of breast self-examination (OR = 4.8 (95% CI: 3.03, 7.6)) and favorable attitude toward breast self-examination (OR = 2.75, (95% CI: 1.66, 4.55)) were significantly associated with practice of breast self-examination.
Only a third of women in Ethiopia practiced breast examination despite WHO guidelines advocating for this practice among all women of reproductive age. Intervention programs should address the factors that are associated with breast self-examination. Population specific programs are needed to promote breast self-examination.
Obstructed labor is one of the five major causes of maternal mortality and morbidity in developing countries. In Ethiopia, it accounts for 19.1% of maternal death. The current review aimed to assess ...maternal and perinatal outcomes of obstructed labor in Ethiopia. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was followed for this systematic review and meta-analysis. A literature search was made using PubMed/MEDLINE, CINAHL, Summon country-specific search, and Cochrane Libraries' online databases. Search terms were adverse outcome, obstructed labor, maternal outcome, fetal outcome, and Ethiopia. The Newcastle-Ottawa scale (NOS), based on a star scoring system, was used to assess the quality of the included studies. The meta-analysis was conducted using STATA 16 software. The pooled prevalence of an adverse maternal outcome, fetal outcome, and association between adverse outcome and obstructed labor was calculated using a random-effects model. Egger's test and funnel plot were used to evaluate publication bias. Eighty-seven studies were included in this review, with an overall sample size of 104259 women and 4952 newborns. The pooled incidence of maternal death was estimated to be 14.4% 14.14 (6.91-21.37). The pooled prevalence of uterine rupture and maternal near-miss was 41.18% (95% CI: 19.83, 62.54) and 30.5% 30.5 (11.40, 49.59) respectively. Other complications such as postpartum hemorrhage, sepsis, obstetric fistula, hysterectomy, bladder injury, cesarean section, and labor abnormalities were also reported. The pooled prevalence of perinatal death was 26.4% (26.4 (95% CI 15.18, 37.7). In addition, the association of obstructed labor with stillbirth, perinatal asphyxia, and meconium-stained amniotic fluid was also demonstrated. In Ethiopia, the incidence of perinatal and maternal mortality among pregnant women with obstructed labor was high. The rate of maternal death and maternal near miss reported in this review was higher than incidences reported from high-income and most low and middle-income countries. Uterine rupture, postpartum hemorrhage, sepsis, fistula, hysterectomy, and bladder injury were also commonly reported. To improve the health outcomes of obstructed labor, it is recommended to address the three delay models: enhancing communities' health-seeking behavior, enhancing transportation for an obstetric emergency with different stakeholders, and strengthening the capacity of health facilities to handle obstetric emergencies.
Antenatal care (ANC) is essential health care and medical support provided to pregnant women, with the aim of promoting optimal health for both the mother and the developing baby. Pregnant women ...should initiate ANC within the first trimester of pregnancy to access a wide range of crucial services. Early initiation of ANC significantly reduces adverse pregnancy outcomes, yet many women in Sub-Saharan Africa delay its initiation. The aim of this study was to assess prevalence and determinants of delayed ANC initiation in Ethiopia.
We conducted a secondary data analysis of the 2019 Ethiopian Mini Demographic and Health Survey (EMDHS). The study involved women of reproductive age who had given birth within the five years prior to the survey and had attended ANC for their most recent child. A total weighted sample of 2,895 pregnant women were included in the analysis. Due to the hierarchical nature of the data, we employed a multi-level logistic regression model to examine both individual and community level factors associated with delayed ANC initiation. The findings of the regressions were presented with odds ratios (OR), 95% confidence intervals (CI), and p-values. All the statistical analysis were performed using STATA-14 software.
This study showed that 62.3% (95% CI: 60.5, 64.1) of pregnant women in Ethiopia delayed ANC initiation. Participants, on average, began their ANC at 4 months gestational age. Women with no education (AOR = 2.1; 95% CI: 1.4, 3.0), poorest wealth status (AOR = 1.9; 95% CI: 1.3, 2.8), from the Southern Nations, Nationalities, and Peoples (SNNP) region (AOR = 2.1; 95% CI: 1.3, 3.3), and those who gave birth at home (AOR = 1.4; 95% CI: 1.1, 1.7) were more likely to delay ANC initiation.
The prevalence of delayed ANC initiation in Ethiopia was high. Enhancing mothers' education, empowering them through economic initiatives, improving their health-seeking behavior towards facility delivery, and universally reinforcing standardized ANC, along with collaborating with the existing local community structure to disseminate health information, are recommended measures to reduce delayed ANC initiation.
Background Obstructed labor is one of the five major causes of maternal mortality and morbidity in developing countries. In Ethiopia, it accounts for 19.1% of maternal death. The current review aimed ...to assess maternal and perinatal outcomes of obstructed labor in Ethiopia. Methods Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was followed for this systematic review and meta-analysis. A literature search was made using PubMed/MEDLINE, CINAHL, Summon country-specific search, and Cochrane Libraries’ online databases. Search terms were adverse outcome, obstructed labor, maternal outcome, fetal outcome, and Ethiopia. The Newcastle-Ottawa scale (NOS), based on a star scoring system, was used to assess the quality of the included studies. The meta-analysis was conducted using STATA 16 software. The pooled prevalence of an adverse maternal outcome, fetal outcome, and association between adverse outcome and obstructed labor was calculated using a random-effects model. Egger’s test and funnel plot were used to evaluate publication bias. Result Eighty-seven studies were included in this review, with an overall sample size of 104259 women and 4952 newborns. The pooled incidence of maternal death was estimated to be 14.4% 14.14 (6.91–21.37). The pooled prevalence of uterine rupture and maternal near-miss was 41.18% (95% CI: 19.83, 62.54) and 30.5% 30.5 (11.40, 49.59) respectively. Other complications such as postpartum hemorrhage, sepsis, obstetric fistula, hysterectomy, bladder injury, cesarean section, and labor abnormalities were also reported. The pooled prevalence of perinatal death was 26.4% (26.4 (95% CI 15.18, 37.7). In addition, the association of obstructed labor with stillbirth, perinatal asphyxia, and meconium-stained amniotic fluid was also demonstrated. Conclusions In Ethiopia, the incidence of perinatal and maternal mortality among pregnant women with obstructed labor was high. The rate of maternal death and maternal near miss reported in this review was higher than incidences reported from high-income and most low and middle-income countries. Uterine rupture, postpartum hemorrhage, sepsis, fistula, hysterectomy, and bladder injury were also commonly reported. To improve the health outcomes of obstructed labor, it is recommended to address the three delay models: enhancing communities’ health-seeking behavior, enhancing transportation for an obstetric emergency with different stakeholders, and strengthening the capacity of health facilities to handle obstetric emergencies.
In 2018 in Ethiopia, magnitude of human immunodeficiency virus Acquired Immunodeficiency Syndrome treatment failure was 15.9% and currently the number of patient receiving second line antiretroviral ...therapy (ART) is more increasing than those taking first line ART. Little is known about the predictors of treatment failure in the study area. Therefore; more factors that can be risk for first line ART failure have to identified to make the patients stay on first line ART for long times. Consequently, the aim of this study was to identify determinants of first line ART treatment failure among patients on ART at St. Luke referral hospital and Tulubolo General Hospital, 2019.
A 1:2 un-matched case-control study was conducted among adult patients on active follow up. One new group variables was formed as group 1 for cases and group 0 for controls and then data was entered in to Epi data version 3 and exported to STATA SE version 14 for analysis. From binary logistic regression variables with p value ≤0.25 were a candidate for multiple logistic regression. At the end variables with a p-value ≤0.05 were considered as statistically significant.
A total of 350 (117 cases and 233 controls) patients were participated in the study. Starting ART after 2 years of being confirmed HIV positive (AOR = 3.82 95% CI 1.37,10.6), nevirapine (NVP) based initial ART (AOR = 2.77,95%CI 1.22,6.28) having history of lost to follow up (AOR 3.66,95%CI 1.44,9.27) and base line opportunistic infection (AOR = 1.97,95%CI 1.06,3.63), staying on first line ART for greater than 5 years (AOR = 3.42,95%CI 1.63,7.19) and CD4 less than100cell/ul (AOR = 2.72,95%CI 1.46,5.07) were independent determinants of first line ART treatment failure.
Lost to follow up, staying on first line ART for greater than 5 years, presence of opportunistic infections, NVP based NNRT, late initiation of ART are determinant factors for first line ART treatment failure. The concerned bodies have to focus and act on those identified factors to maintain the patient on first line ART.
Antenatal depression is a serious health problem and has negative consequences for the mother, fetus, and the entire family. However, it is a neglected component of care especially bay health care ...providers for women in pregnancy. The purpose of this study was to assess the prevalence of depression and associated factors among pregnant women attending antenatal clinics in public health institutions, in the Awabale Woreda. An institutional-based cross-sectional study was conducted in 2018 and a stratified sampling technique was used to select the study health institutions. All seven public health institutions in Awabale District were included to select 393 mothers and the sample size was proportionally allocated based on the number of target mothers. We used EpiData version 3.1software for data entry and SPSS version 20 software for cleaning and analysis. A Bivariable logistic regression analysis was used to identify the association between each outcome variable and the factor. Again, a multivariable logistic regression analysis was employed to identify factors associated with each outcome variable, and variables with a p-value less than 0.05 were taken as significant variables. Edinburgh Postnatal Depression Scale was used to declare the presence of antenatal depression with a cut point score of 13 and above. This study showed that 63(17.8%) pregnant mothers had antenatal depressive symptoms. Women who were employed 85% reduced to develop antenatal depression than housewives AOR = 0.15(0.001-0.25). Pregnant women who attended high school and above educational level were 18 times more likely to develop antenatal depression than women who had no formal education AOR18.15 (2.73-120.76). Women who had poor husband feeling on the current pregnancy were 4.94 more likely to develop antenatal depression than women who had good partner feeling on the current pregnancy AOR = 4.94(95%CI: 1.78-13.72). Women who had a history of depression were 8.2 times to develop antenatal depression than women who had no history of depression AOR = 8.22 (95%CI: 2.87-23.57). This study revealed that approximately one-fifth of pregnant women developed antenatal depression. Women's occupational status, educational status, previous history of depression, and poor husband feeling on the current pregnancy were the significant factors of antenatal depression.
Adolescents have physical, social and psychological characteristics that are different from adults. Adolescent pregnancy results in pregnancy and childbirth complications- an area neglected in ...developing countries like Ethiopia. This study, therefore, was conducted to assess the adverse neonatal outcomes of adolescent pregnancy in Northwest Ethiopia.
Institutional-based study was conducted in East Gojjam zone, Northwest Ethiopia. A total of 374 adolescent (15-19 years) and 760 adult (20-34 years) women were included in this study. Data were collected among women who came to randomly selected health facilities in East Gojjam zone. Data were collected by trained research assistants using a structured data collection questionnaire. Descriptive statistics, chi-square test, and Student's t-tests were utilized. Bivariate and multivariable logistic regression analysis were employed to adjust for confounding factors of adverse neonatal outcomes. Statistical significance was declared when the p-value was less than 0.05.
Higher proportion of adolescent than adult women were from rural area (57.2% vs 44.7%), were not married (5.1% vs 1.7%), were pregnant for the first time (91.7% vs 34.1%), didn't attend antenatal care (ANC) follow-up (12% vs 4.5%), and had late initiation of ANC follow-up. After adjusting for known confounding factors, the odds of low birth weight (LBW) was higher among adolescents than adult women (AOR 2.14; 95% CI, 1.36, 3.36, p-value = 0.001). Similarly, the odds of preterm birth was higher among adolescents than adult women (AOR 1.65; 95% CI, 1.09, 2.49, p-value = 0.017). There was no statistically significant difference in the rate of low Apgar score at first and five minutes after birth and neonatal Intensive Care Unit (ICU) admission between babies born from adolescent and adult women.
Adolescent women were less likely to receive ANC service. Babies born from adolescent women are at higher odds of adverse neonatal outcomes like LBW and preterm birth than babies born from adult women. Use of community- and health facility-based intervention programs that can prevent adolescent pregnancy and reduce adverse neonatal outcomes among adolescent girls is recommended.
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