MidWifery

Determinants of oral rehydration salt utilization among under-five children with diarrhea in Ethiopia: A multilevel mixed-effect analysis

2022-01-03T00:00:00Z

Determinants of oral rehydration salt utilization among under-five children with diarrhea in Ethiopia: A multilevel mixed-effect analysis Abstract Background: Oral rehydration salt therapy is a critical intervention to reduce mortality and morbidity of children with diarrheal diseases. However, it remains underused in low- and middle-income countries. In Ethiopia, only less than half of children with diarrheal diseases were treated with oral rehydration salt solution. Therefore, the objective of this study was to identify the determinants of oral rehydration salt utilization among children with diarrhea in Ethiopia. Method: A secondary data analysis was done using the 2016 Ethiopian Demographic and Health Survey. A weighted sample of 1227 children who had diarrhea in the last 2 weeks with their index mothers during the 5 years survey was included in the study. A multilevel mixed logistic regression model was fitted to identify factors associated with oral rehydration salt utilization. Finally, statistical significance was declared at p-value < 0.05. Result: The overall prevalence of oral rehydration salt utilization for children with diarrhea was 29.5%. In this study, age of mother ⩾35 (adjusted odds ratio = 1.66, 95% confidence interval = 1.05, 2.64), mothers with formal education (adjusted odds ratio = 1.52, 95% confidence interval = 1.09, 2.11), media exposure (adjusted odds ratio = 1.72, 95% confidence interval = 1.25, 2.38), living in Metropolitan regions (Addis Ababa and Dire Dawa (adjusted odds ratio = 1.76, 95% confidence interval = 1.14, 2.69)), and small peripheral regions (Afar, Gambela, Somalia, Benishangul-Gumuz (adjusted odds ratio = 1.69, 95% confidence interval = 1.22, 2.34)) were associated with higher odd of oral rehydration salt utilization for children with diarrhea. Conclusion: The study concludes that the age of mothers, educational status of the mother, media exposure, and regions of mothers were determinants of oral rehydration salt utilization for children with diarrhea. Therefore, media advertising regarding diarrhea management should be scaled up to increase oral rehydration salt utilization for children with diarrhea. Special attention to socio-cultural constraints or beliefs regarding diarrhea management should be given to mothers from large to center (Tigray, Amhara, Oromia, Southern Nations Nationalities, and People’s Region, and Harari) regions.

Incidence density mortality rate among HIVpositive children on antiretroviral therapy in Ethiopia: a systematic review and metaanalysis.

2024-07-31T00:00:00Z

Incidence density mortality rate among HIVpositive children on antiretroviral therapy in Ethiopia: a systematic review and metaanalysis. Abstract Background Human Immunodeficiency Virus (HIV) continues to be the major cause of childhood deaths, particularly in the sub-Saharan African region. In Ethiopia, though several primary studies have been conducted on the incidence of HIV-related child mortality, the pooled incidence density mortality rate among HIV-positive children is unknown. Therefore, this systematic review and meta-analysis aimed to estimate the pooled incidence density mortality rate among HIV-positive children and identify its associated factors in Ethiopia. Methods We browsed PubMed, HINARI, Science Direct, Google Scholar, African Journals Online, and cross-references using different search terms to identify articles. Quality appraisal was done using the Joanna Briggs Institute checklist. Meta-package was used to estimate the pooled incidence of mortality and hazard ratio (HR) of predictors. Heterogeneity was tested using the I-square statistics. Publication bias was tested using a funnel plot visual inspection and Egger’s test. Data was presented using forest plots and tables. The random effect model was used to compute the pooled estimate. Results The overall pooled incidence density mortality rate among HIV-positive children was 2.52 (95% CI: 1.82, 3.47) per 100 child years. Advanced HIV disease (hazard ratio (HR): 3.45, 95% CI (Confidence Interval): 2.64, 4.51), tuberculosis co-infection (HR: 3.19, 95% CI: 2.08, 4.88), stunting (3.22, 95% CI: 2.46, 4.22), underweight (HR: 2.71, 95% CI: 1.72, 4.26), wasting (HR: 4.14, 95% CI: 2.27, 7.58), didn’t receive Isoniazid preventive therapy (HR: 3.33, 95% CI: 2.22, 4.99), anemia (HR: 3.03, 95% CI: 2.52, 3.64), fair or poor antiretroviral therapy adherence (HR: 4.14, 95% CI: 3.28, 5.28) and didn’t receive cotrimoxazole preventive therapy (HR: 3.82, 95% CI: 2.49, 5.86) were factors associated with a higher hazard of HIV related child mortality. Conclusions The overall pooled incidence density mortality rate among HIV-positive children was high in Ethiopia as compared to the national strategy target. Therefore, counseling on antiretroviral therapy adherence should be strengthened. Regular monitoring of hemoglobin levels and assessment of nutritional status should be done for all children living with HIV. Moreover, healthcare professionals should follow the national HIV treatment guidelines and provide cotrimoxazole preventive therapy and Isoniazid preventive therapy up on the guidelines for children living with HIV. Registration Registered in PROSPERO with ID: CRD42023486902.

Individual and community‑level factors of perinatal mortality in the high mortality regions of Ethiopia: a multilevel mixed‑effect analysis

2022-02-07T00:00:00Z

Individual and community‑level factors of perinatal mortality in the high mortality regions of Ethiopia: a multilevel mixed‑effect analysis Abstract Background: Even though perinatal mortality has declined globally; it is still the major public health concern in sub-Saharan Africa countries. Ethiopia is one of the sub-Saharan countries which contribute the highest-burden of perinatal mortality with a devastating rate in some of the regions. Therefore, this study aimed to identify the determinants of perinatal mortality in the high mortality regions of Ethiopia. Method: A secondary data analysis was done using the 2016 Ethiopian Demographic and Health Survey data. The outcomes of 4120 pregnancies reaching ≥ 7 months of gestational age were considered for the analysis. A multilevel mixed logistic regression model was fitted to identify the predictors of perinatal mortality. Finally, a statistically significant association was declared at a p-value of ≤ 0.05. Result: The study found that birth interval < 2 years (AOR = 3.71, 95%CI:2.27, 6.07),having no antenatal care (AOR = 2.43,95%CI:1.15,5.38), initiating breastfeeding after 1 h(AOR = 4.01,95%CI:2.49,6.51), being distant from health institutions (AOR = 1.99, 95%CI: 1.24, 3.22), having previous terminated pregnancy (AOR = 4.68, 95%CI:2.76,7.86), being mothers not autonomous(AOR = 1.96, 95%CI:1.19,3.20),being no media exposure (AOR = 2.78, 95%CI:1.48,5.59),being households ≤ 4 family sizes (AOR = 4.12, 95%CI:2.19,7.79), having ≥ 6 parity (AOR = 2.48, 95%CI:1.21, 5.22) were associated with a high odds of perinatal mortality. Conclusion: The study concludes that birth interval, antenatal care, time for breastfeeding initiation, distance from health institutions, previous history of terminated pregnancy, maternal autonomy, media exposure, family size, and parity were predictors of prenatal mortality. Therefore, programmatic emphases to maternal waiting service utilization for mothers distant from health institutions and media advertising regarding the complications related to pregnancy, childbirth and on its respective direction that the mothers should follow could reduce perinatal mortality in high mortality regions of Ethiopia.

Incidence rate of tuberculosis among HIV infected children in Ethiopia: systematic review and meta-analysis

2024-05-24T00:00:00Z

Incidence rate of tuberculosis among HIV infected children in Ethiopia: systematic review and meta-analysis Abstract Background Tuberculosis is one the leading causes of death from a single infectious disease, caused by the bacillus mycobacterium tuberculosis. In Ethiopia, even though several primary studies have been conducted on the incidence of tuberculosis among HIV-infected children, the pooled incidence rate of tuberculosis among HIV-infected children (aged 0–14 years) is unknown. Therefore, the main objectives of this systematic review and meta-analysis are to estimate the pooled incidence rate of tuberculosis among HIV-infected children and its predictors in Ethiopia. Method International electronic databases such as PubMed, HINARI, Science Direct, Google Scholar, and African Journals Online were searched using different search engines. Quality of primary studies was checked using the Joanna Briggs Institute checklist. The heterogeneity of studies was tested using I-square statistics. Publication bias was tested using a funnel plot and Egger’s test. Forest plots and tables were used to present the results. The random effect model was used to estimate the pooled incidence of tuberculosis among children living with HIV. Result A total of 13 studies were included in this systematic review and meta-analysis. The pooled incidence of tuberculosis among HIV-infected children was 3.77 (95% CI: 2.83, 5.02) per 100-person-year observations. Advanced HIV disease (HR: 2.72, 95% CI: 1.9; 3.88), didn’t receive complete vaccination (HR: 4.40, 95% CI: 2.16; 8.82), stunting (HR: 2.34, 95% CI: 1.64, 3.33), underweight (HR: 2.30, 95% CI: 1.61; 3.22), didn’t receive Isoniazid preventive therapy (HR: 3.64, 95% CI: 2.22, 5.96), anemia (HR: 3.04, 95% CI: 2.34; 3.98), fair or poor antiretroviral therapy adherence (HR: 2.50, 95% CI: 1.84; 3.40) and didn’t receive cotrimoxazole preventive therapy (HR: 3.20, 95% CI: 2.26; 4.40) were predictors of tuberculosis coinfection among HIV infected children. Conclusion This systematic review and meta-analysis concluded that the overall pooled incidence rate of tuberculosis among HIV-infected children was high in Ethiopia as compared to the END TB strategy targets. Therefore, emphasis has to be given to drug adherence (ART and Isoniazid) and nutritional counseling. Moreover, early diagnosis and treatment of malnutrition and anemia are critical to reduce the risk of TB coinfection. Registration Registered in PROSPERO with ID: CRD42023474956. Keywords Children, Ethiopia, HIV, Incidence, Meta-analysis, Systemic review, Tuberculosis