Conectar
by Muluken Chanie Agimas, Mekuriaw Nibret Aweke, Berhanu Mengistu, Lemlem Daniel Baffa, Elsa Awoke Fentie, Ever Siyoum Shewarega, Aysheshim Kassahun Belew, Esmael Ali Muhammad
IntroductionMalaria is a global public health problem, particularly in sub-Saharan African countries. It is responsible for 90% of all deaths worldwide. To reduce the impact and complications associated with delayed treatment of malaria among children under five, comprehensive evidence about the magnitude and determinants of delayed treatment for malaria could be the solution. But there are no national-level studies in the Horn of Africa for decision-makers.
ObjectiveTo assess the prevalence and associated factors of delay in seeking malaria treatment among under-five children in the Horn of Africa.
MethodPublished and unpublished papers were searched on Google, Google Scholar, PubMed/Medline, EMBASE, SCOPUS, and the published articles’ reference list. The search mechanism was established using Medical Subject Heading (MeSH) terms by combining the key terms of the title. Joana Brigg’s Institute critical appraisal checklist was used to assess the quality of articles. A sensitivity test was conducted to evaluate the heterogeneity of the studies. The visual funnel plot test and Egger’s and Begg’s statistics in the random effect model were done to evaluate the publication bias and small study effect. The I2 statistics were also used to quantify the amount of heterogeneity between the included studies.
ResultsThe pooled prevalence of delayed treatment for malaria among under-five children in the Horn of Africa was 48% (95% CI: 34%–63%). History of child death (OR =2.5, 95% CI: 1.73–3.59), distance >3000 meters (OR = 2.59, 95% CI: 2.03–3.3), drug side effect (OR = 2.94, 95% CI: 1.86–4.67), formal education (OR = 0.69, 95% CI: 0.49–0.96), middle income (OR = 0.42, 95% CI: 0.28–0.63), expensiveness (OR = 4.39, 95% CI: 2.49–7.76), and affordable cost (OR = 2.13, 95% CI: 1.41–3.2) for transport were factors associated with malaria treatment delay among children.
Conclusion and recommendationsAbout one out of two parents in the Horn of Africa put off getting their kids treated for malaria. High transportation expenses, long travel times (greater than 3,000 meters) to medical facilities, and anxiety about drug side effects were major risk factors that contributed to this delay. On the other hand, a middle-class income was found to be protective of treatment delays. These results highlight how crucial it is to improve access to healthcare services, both financially and physically, to minimize delays in treating malaria in the area’s children.
by Tadesse Tarik Tamir, Berhan Tekeba, Alebachew Ferede Zegeye, Deresse Abebe Gebrehana, Mulugeta Wassie, Gebreeyesus Abera Zeleke, Enyew Getaneh Mekonen
IntroductionSolitary childbirth—giving birth without any form of assistance—remains a serious global public health issue, especially in low-resource settings. It is associated with preventable maternal complications such as hemorrhage and sepsis, and poses significant risks to newborns, including birth asphyxia, infection, and early neonatal death. In Ethiopia, where many births occur outside health facilities, understanding the spatial and socio-demographic patterns of solitary childbirth is vital for informing targeted interventions to improve maternal and child health outcomes. This study aims to identify and map the spatial distribution of solitary childbirth across Ethiopia and to analyze its determinants using data from the 2019 national Interim Demographic and Health Survey.
MethodWe analyzed data from the 2019 Interim Ethiopian Demographic and Health Survey to determine the spatial distribution and factors of solitary birth in Ethiopia. A total weighted sample of 3,884 women was included in the analysis. Spatial analysis was used to determine the regional distribution of solitary birth, and multilevel logistic regression was employed to identify its determinants. ArcGIS 10.8 was used for spatial analysis, and Stata 17 was used for multilevel analysis. The fixed effect was analyzed by determining the adjusted odds ratio with a 95% confidence interval.
ResultThe prevalence of solitary childbirths in Ethiopia was 12.73%, with a 95% confidence interval spanning from 11.71% to 13.81%. The western and southern parts of Oromia, all of Benishangul-Gumuz, most parts of the SNNPR, and the west of Amhara regions were hotspot areas for solitary birth. Having no formal education, not attending ANC visits, and residing in pastoral regions were significantly associated with higher odds of solitary birth in Ethiopia.
CocnlusionA notable proportion of women are experiencing childbirth alone, which highlights a significant aspect of maternal health in the country, reflecting both the challenges and improvements in childbirth practices. The distribution of solitary births exhibited spatial clustering with its hotspot areas located in western and southern parts of Oromia, all of Benishangul-Gumuz, most parts of the SNNPR, and west of Amhara regions. Lack of education, not having an ANC visit, and being a resident of pastoral regions were significant determinants of solitary birth. The implementation of maternal and child health strategies in Ethiopia could benefit from considering the hotspot areas and determinants of solitary birth.
Adolescents and young adults (AYAs) in low- and middle-income countries (LMICs) are at high risk of harmful sexual and reproductive health (SRH) practices due to limited knowledge, low availability or acceptability of modern contraceptives, gender inequality and cultural practices like child marriage. Preventive and educational interventions by lay health workers or through technological means are a cost-effective and scalable solution. Unfortunately, too little is currently known about the scope, content and conditions of the effectiveness and sustainability of these approaches and synthetic evidence on this topic is scarce. To help fill this knowledge gap and to identify where further research is needed, we will conduct a scoping review of technology-based or lay health-worker delivered preventive and educational SRH interventions targeting AYAs in LMICs. This information is valuable to both policymakers and researchers as it provides a synthesis of existing interventions, highlights best practices for their implementation and identifies potential avenues for future research.
This review will include studies on SRH preventive and educational interventions targeting AYAs aged 10–24 years in LMICs. It encompasses interventions delivered by lay health workers or via technological means, assessing various outcomes including but not limited to SRH literacy, sexual risk behaviours, pregnancies, sexually transmitted infections and gender-based violence. Key databases, including PubMed via MEDLINE and Embase, will be searched from 1 January 2000 up to 23 January 2024, using a comprehensive search strategy. Screening will be conducted using Covidence software. Data extraction will cover study details, methods, intervention strategies, outcomes and findings. A narrative synthesis will be conducted following synthesis without meta-analysis guidelines.
The scope of this scoping review is limited to publicly accessible databases that do not require prior ethical approval for access. The findings will be disseminated through peer-reviewed journal publications, as well as presentations at national and international conferences and stakeholder meetings in LMICs.
The final protocol is prospectively registered with the Open Science Framework on 7 May 2024 (osf.io/vna2z).
This systematic review and meta-analysis aimed to determine the pooled prevalence of and factors associated with work-related musculoskeletal disorders (WMSDs) among low- and middle-income countries.
Databases such as PubMed/MEDLINE, CINAHL, LIVIVO, African Journals Online, African Index Medicus (AIM), HINARI, Science Direct, Web of Science, Cochrane Library, Google Scholar, Semantic Scholar and Google were used to retrieve all the relevant articles. The search was carried out from 22 April 2024 to 26 June 2024. Data were analysed via STATA 17 software. With a 95% CI, this meta-analysis with a random-effects model was carried out to determine the pooled prevalence.
The study was conducted in low- and middle-income countries.
Weavers of low- and middle-income countries.
The primary outcome of this study was the prevalence of WMSD.
In this meta-analysis, a total of 21 articles with 7322 study participants were included. The pooled prevalence of WMSDs was 72.20%. Working more than 8 hours per day, working in a chair with no back support, working in an uncomfortable posture, not performing regular physical exercise, lacking knowledge of the causes of WMSD and lacking job satisfaction were factors significantly associated with WMSDs.
A high prevalence of WMSDs among weavers in low- and middle-income countries was recorded. This indicates the need to take effective intervention measures. Rigorous ergonomic training, providing lengthy breaks and building centres for physical exercise, improving workplace ergonomic design and increasing job satisfaction are recommended.
CRD42024561064.
This study aimed to assess treatment outcome, medication adherence and predictors among epilepsy patients at three low-resource setting hospitals in Mekelle City, Northern Ethiopia.
A multicentre hospital-based observational cross-sectional study was conducted.
The study was conducted in three resource-limited tertiary care hospitals in Mekelle City, Northern Ethiopia: Ayder Comprehensive Specialized Hospital, Mekelle General Hospital and Quiha General Hospital.
A total of 351 patients with epilepsy receiving regular follow-up care at adult neurology outpatient clinics in three low-resource setting hospitals were included in the study.
The study assessed adherence to antiepileptic drugs (AEDs), treatment outcomes and identified independent predictors of these outcomes.
A total of 351 study participants were included in the final analysis, with a mean (±SD) age of 37.98±14.27 years. More than one-third (39%) had poorly controlled seizures. Living in urban areas (adjusted odds ratio (AOR)= 3.36, 95% CI 1.1 to 10.4, p=0.037), being government-employed (AOR = 4.0, 95% CI 1.1 to 14.5, p=0.035) and being a student (AOR = 4.0, 95% CI 1.1 to 14.5, p=0.035) were associated with good seizure control. Half of the participants (177, 50.6 %) were non-adherent to their medications. Being a farmer (AOR = 4.2, 95% CI 1.5 to 11.3, p=0.005), a housewife (AOR = 4.9, 95% CI 1.4 to 17.2, p=0.012), absence of seizure-triggering factors (AOR = 3.7, 95% CI 2.34 to 6.06, p
More than two-thirds of patients with epilepsy experienced poor seizure control. Place of residence, employment status and the number of seizure episodes prior to treatment initiation were identified as significant predictors of treatment outcomes. Approximately half of the study participants were adherent to their medications, with employment status, the presence of seizure-triggering factors, comorbidities and seizure control serving as predictors of medication adherence.
by Eline Eberhardt, Fetene Tekle, Greet Teuns, Jill Witters, Bianca Feyen, Sarah De Landtsheer, Ivan Kopljar
Preclinical in vivo studies are critical to identify potential adverse effects of drugs under development. However, a significant number of drug candidates are terminated during human clinical trials due to unexpected adverse events which were not predicted or detected in preclinical studies. Video surveillance can be a valuable tool to reduce the risk of missing and/or misclassifying adverse clinical observations (COs) in animals. To explore the applicability of detecting COs on video, the agreement between observers (reliability) and agreement between observers and experts (construct validity) of 13 important COs was evaluated. The reliability was investigated by evaluating the interobserver agreement between 23 observers with different experience levels and primary roles on defined COs and normal behavior, recorded on video during preclinical studies in canines. The validity was investigated by comparing the observers’ assessments to the ground truth confirmed by three experts. This investigation showed a substantial reliability and validity of the observers’ assessments without significant differences between experience levels or primary roles. Normal behavior was challenging to recognize (56% correct), while half of the COs appeared straightforward to identify with a validity of ≥ 90%: salivation, aggressiveness, circling, vomiting, head shaking and convulsions. Other COs were more challenging to detect with lowest scores for limb stiff/hypertonia, tremors and excitation. Regardless of experience-level, observers missed very few COs. This investigation showed the complexity when multiple COs occurred simultaneously, as well as the limitations of differentiating between visually similar COs (tremors vs. twitches; limping vs. limb stiff) on video without the possibility of in-person observation. Given the substantial overall reliability and validity, it is concluded that clinical canine behavior can be accurately detected on video by trained observers. This permits more objective and quantifiable monitoring of animal behavior and application of computer vision for future automatic monitoring of canine studies.
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