Time to initiate complementary feeding and its predictors among primipara mothers who have infants aged 6-12 months in the Awi zone, northwest Ethiopia

Introduction

The timely initiation of complementary feeding is essential to reduce infant mortality. In Ethiopia, 37.5 % of mothers did not initiate complementary feeding to their infants in time. However, previous studies could not identify the time to initiate complementary feeding among primipara mothers. Therefore, this study aims to identify the time to initiate complementary feeding and its predictors among primipara mothers with infants aged 6-12 months in the Awi zone, northwest Ethiopia.

Methods

A community-based retrospective follow-up study was conducted among 732 primipara mothers who had infants aged 6-12 months from January 1, 2022, to December 30, 2022. A multistage sampling technique was used to select study participants through questionnaires administered by interviewers. Data were entered into EPI-data 3.1 and exported to STATA 17 for further analysis. The Kaplan-Meier survival curve together with the log-rank test was used to assess the survival experience of the infant at specific times and to compare the survival of the infant in it between different categorical independent variables. Bivariable and multivariable Cox proportional hazard regression models were used to identify significant predictors. Model fitness was also assessed using the Schoenfield residual and the Cox-Snell global residual test. Statistical significance was declared at the p-value <0.05.

Result

The median time to initiate complementary feeding among primipara mother-infant pairs was 6 ± 2 months. The overall incidence rate of complementary feeding initiation before, at and after 6 months of age of the infant was 7.28 (95%CI: 6.44, 8.25), 41.41 (95%CI: 36.05, 47.56), and 42.97 (95%CI: 36.89, 50.05) per 100 person-month observations, respectively. Among those mothers who initiated complementary feeding for their infants, 249, 200, and 165 initiated complementary feeding before, at and after 6 months of age of the infants. Furthermore, the age (15-24 years) of mothers (AHR: 1.63, 95%CI: 1.16, 2.29), rich wealth (AHR: 1.35, 95%CI: 1.05, 1.75), and richest wealth (AHR: 1.43, 95%CI: 1.10, 1.84) were identified as statistically significant predictors of the time to initiate complementary feeding.

Conclusions

The median time to initiate complementary feeding among primipara mother-infant pairs was 6 months. The age of the mother and the wealth status of the household were found to be statistically independent predictors of the time to initiate complementary feeding. Therefore, community health professionals are better able to work on when to initiate complementary feeding to infants of rich and richest young primipara mothers.

Intention to receive COVID-19 vaccine and its health belief model (HBM)-based predictors: A systematic review and meta-analysis

The purpose of the research was to pool the intention to receive the COVID-19 vaccine and its health belief model (HBM)-based predictors, which is helpful for decision-makers and program managers around the globe. The relevant database was searched and Joanna Briggs Institute (JBI) appraisal checklist was used to evaluate the studies. I2 test and funnel plot was utilized to check heterogeneity and publication bias, respectively. DerSimonian and Laird random-effects model was used. The overall pooled intention to receive COVID-19 vaccine globally was 67.69%. Higher levels of perceived susceptibility (AOR = 1.85), perceived severity (AOR = 1.45), perceived benefits (AOR = 3.10), and cues to action (AOR = 3.40) positively predicted the intention; whereas high level of perceived barrier negatively predicted it (AOR = 0.53). Health beliefs influenced COVID-19 vaccine intention globally. This implies that individuals need sound health education and publicity about vaccines before vaccination.

Timely initiation of first antenatal care visit and associated factors among pregnant women in the Amhara Region, north-west Ethiopia: a comparative cross-sectional study

Introduction

timely initiation of the first antenatal care visit is still a major public health problem in Ethiopia, especially in Amhara Region. This study assessed the prevalence of timely initiation of first ANC visit and its associated factors among pregnant women in transformed and non-transformed districts, Awi zone, Amhara Region, North-west Ethiopia.

Methods

a community-based comparative cross-sectional study was conducted from November-December 2020, among 748 women. A multistage-stratified random sampling technique was used. Data were collected by a structured questionnaire. Data analysis was done by SPSS-version 20. Binary logistics regression analysis was used to identify factors. The odds ratios were computed and a p-value < 0.05 was used to declare statistical significance.

Results

the overall prevalence of timely first ANC visits was 40% (95%CI: 36.6-43.7%). It was higher for the transformed districts 46.9% (95%CI: 42.1%-52.5%) compared to non-transformed districts 32.9% (95%CI: 28.3%-37.9%). Higher wealth (AOR=2.17, 95%CI: 1.44-3.27), previous service satisfaction (AOR=1.78, 95%CI: 1.26- 2.51), nearer to the health facility (AOR=3.09, 95%CI: 1.69-5.63), primary education and above (AOR=5.18, 95%CI: 2.99-8.96), knowledgeable mothers (AOR=2.30, 95%CI: 1.38-3.85) and waiting time (< 1-hour) (AOR=1.45, 95%CI: 1.02-2.08) were significantly associated factors.

Conclusion

the prevalence of timely initiation was higher for transformed districts but it is below the WHO target. Higher wealth, previous service satisfaction, being nearer to the health facility, maternal education, being knowledgeable, and waiting time were significantly associated with timely initiation of the first ANC visit. Hence, the district´s transformation should be enhanced. Maternal knowledge, access, and quality of maternal health services should be enhanced.

Incidence of Death and Its Predictors of COVID-19 in Amhara Region, Ethiopia: A Retrospective Follow Up Study

Background

Risk factors associated with COVID-19 incidence of death would aid to notify the most favorable management strategies, hang about undecided, Moreover, studies regarding this issue are limited in Ethiopia and no region-wise study is conducted. Hence, the study investigated the COVID-19 incidence of death and its predictors in the Amhara regional state, Ethiopia.

Methods

A facility-based retrospective survey was conducted at all Amhara regional state COVID-19 treatment centers from 13 March 2020, through 13 January 2022. Epidata version 3.1 and STATA version 14 were used for data entry and analysis, respectively. Linearized survey analysis in a stratified Cox regression model was fitted to identify independent risk factors. P-value with 95% CI for hazard ratio was used for testing the significance at alpha 0.05.

Results

A total of 28,533 study participants were analyzed in this study. Of these, 2873 (11.2%) died and 25,660 (88.8%) were recovered from COVID-19. The death rate was 11.78 per 1000 person-days of observation with a median survival time of 32 days with IQR [12, 44]. Patients with co-morbidities (AHR = 1.54: 95% CI: 1.51–1.55), patients with age <5-year (AHR = 1.69: 95% CI: 1.78–1.81) and patients with age 60+ years (AHR = 2.91: 95% CI: 1.79–3.99), patients with asymptomatic diseases condition (AHR =1.15: 95% CI: 1.01–1.19), and being male (AHR = 1.22: 95% CI: 1.18–1.27) were independent significant risk factors of death from COVID-19.

Conclusion

A relatively high incidence of death from COVID-19 was found in this study. Significant risk factors were identified as patients with age <5 years, patients with age 60+ Years, being male, patients having at least one comorbid condition, and patients with asymptomatic disease conditions. These factors should be taken into consideration for a strategy of quarantining and treating COVID-19 patients.

Prevalence of active trachoma and its associated factors among 1–9 years of age children from model and non-model kebeles in Dangila district, northwest Ethiopia

Background

Trachoma is the leading infectious disease that leads to blindness worldwide, especially in developing countries. Though Ethiopia had targeted a trachoma elimination program by 2020, the problem worsens, particularly in the Amhara Region. Even though sustained intervention measures are undertaken across the region, it is unclear why trachoma is still a significant public health problem. So, this study assessed the prevalence of active trachoma and associated factors among 1–9 years of age children from model and non-model kebeles in Dangila district Amhara Region, Northwest Ethiopia.

Methods

A community-based comparative cross-sectional study was conducted from 20^th September 2019 to 29^th October 2019. A multistage stratified random sampling technique was used to reach 704 children from model and non-model kebeles. Samples were allocated proportionally to model and non-model kebeles. A structured and pretested data collection tool and observational checklist was used to manage the necessary data. Data were coded and entered in Epidata version 4.6, and further analysis was done using SPSS version 20 software. Bivariable and multivariable logistic regression analysis was employed to identify factors associated with active trachoma. Adjusted Odds Ratios (AOR), p-value, and respected Confidence Interval (CI) were used to report the findings.

Results

Seven hundred four children were included in this study, with a response rate of 97.8%. The overall prevalence of active trachoma was 6% (95% CI: 4.5, 8.1). The prevalence of active trachoma among non-model and model Kebele was not significantly different. Still, the prevalence of active trachoma among children from model Kebele were [4.5%, (95% CI: 2.4%, 7.1%)] relatively lower compared with non-model kebeles, [7.6%, 95% CI: (4.9%, 10.9%)]. Moreover, not using latrine (AOR = 4.29, 95% CI: 1.96, 9.34), fly-eye contact (AOR = 2.59, 95% CI: 1.11, 6.03), presence of sleep in eyes (AOR = 2.46, 95% CI: 1.10, 5.47), presence of ocular discharge (AOR = 2.79, 95% CI: 1.30, 6.00), presence of nasal discharges (AOR = 2.67, 95% CI: 1.21, 5.90) and washing faces with soap (AOR = 0.22, 95% CI: 0.07, 0.69) were found significantly associated with the prevalence of active trachoma among children 1–9 years old.

Conclusions

The prevalence of active trachoma in the model and non-model kebeles was high and did not show a statistical difference. Attention to be given to latrine utilization, washing face with soap, and other personal hygiene activities.

Prevalence and associated factors of soil transmitted helminthiasis among school-age children in wetland and non-wetland areas of Blue Nile Basins, northwest Ethiopia: A community-based comparative study

Introduction:

Different interventions have been done to reduce the burden of soil-transmitted helminths (STH). The available evidences in Ethiopia in either school or community-based school-aged children (SAC) have limitation in wetland areas. This study assessed the prevalence and associated factors of STH infection among SAC in wetland and non-wetland areas of Blue Nile Basins, Amhara Region, Northwest Ethiopia.

Method:

A community-based comparative study was conducted from October to November, 2019. Multistage stratified random sampling technique used to select 716 SAC. Data were collected using structured questionnaire and observational checklist. Stool samples were collected from children using tight-fitting plastic cups following the standard procedures. Data were coded and entered into Epi data version 4.6 and exported to SPSS version 20 software. Bivariate and multivariable logistic regression analysis was employed to identify factors associated with STH.

Results:

The overall prevalence of STH was 30.30% (95% CI: 26.90, 33.90) and did not show significant variation between wetland (33.60% (95% CI: 28.80, 39.60%)) and non-wetland (27.0% (95% CI: (21.90, 31.60)) areas. Presence of human feces near the house and certain habits such as nail trimming and playing with mud/soil was not different between wetland and non-wetlands. Nonetheless, the presence of human feces near the house of respondents was found to be significantly associated with STH infection (p value < 0.001). Moreover, other factors significantly associated with STH infection were lack of nail trimming (p value < 0.001) and playing with mud/soil (p value < 0.01).

Conclusions:

The prevalence of STH was high and did not show significant variation between the two areas. Emphasis needs to be given for hygiene and lifestyle-related factors.

Clinical immunogenicity and tolerance studies of liquid vaccines delivered by jet-injector and a new single-use cartridge (Imule): comparison with standard syringe injection. Imule Investigators Group

A new needleless jet-injector, Mini-Imojet, was developed that administers liquid vaccines from a single-use, pre-filled cartridge named Imule, which avoids the risk of cross-contamination. We conducted clinical trials in several settings in France and West Africa to compare the immunogenicity and tolerance of five vaccines (influenza vaccine, Vi capsular polysaccharide typhoid vaccine, tetanus toxoid vaccine, diphtheria-tetanus-whole cell pertussis vaccine, and inactivated hepatitis A vaccine) administered with the Imule system vs standard syringe technique. In each vaccine study, all subjects of either group were tested for serum antibody titres to calculate the geometrical mean titres and seroconversion rates after complete vaccination. Immediate local-reactions were noted after each injection, and local and general reactions were evaluated during a predetermined period of follow-up. When delivered by the Imule technique, all the administered vaccines were of equivalent or superior immunogenicity, compared to the syringe technique. The tolerance to vaccines injected by the Imule system was acceptable in all studies. The most frequently observed reactions were mild (e.g. minor bleeding, superficial papules, erythema and induration) and could be considered to be inherent to the injection technique. The technical and safety advantages of the Mini-Imojet/Imule system, compared to sterilizable, standard disposable or autodestruct syringes and to classical multi-dose vial jet-injectors, reinforces the interest of this new injection technique for collective immunizations.

Cytochrome P450 catalyzes the oxidation of N omega-hydroxy-L-arginine by NADPH and O2 to nitric oxide and citrulline

Rat liver microsomes catalyze the oxidative denitration of N omega-hydroxy-L-arginine (NOHA) by NADPH and O2 with formation of citrulline and nitrogen oxides like NO and NO2-. Besides NO2- and citrulline, whose simultaneous formation is linear for at least 20 min, the formation of NO could be detected under the form of its P450 and P420-Fe(II) complexes by UV-visible and EPR spectroscopy. Classical inhibitors of NO-synthases, like N omega-methyl-and N omega-nitro-arginine, fail to inhibit the microsomal oxidation of NOHA to citrulline and NO2-. On the contrary classical inhibitors of hepatic cytochromes P450 like CO, miconazole, dihydroergotamine and troleandomycin, strongly inhibit this monooxygenase reaction. These results show that the oxygenation of NOHA by NADPH and O2 with formation of citrulline and NO can be efficiently catalyzed by cytochromes P450 (with rates up to 1.5 turnovers per min for the cytochromes of the 3A subfamily).

Formation of nitrogen oxides and citrulline upon oxidation of N omega-hydroxy-L-arginine by hemeproteins

HRP catalyzes the oxidation of N omega-hydroxy-L-arginine (NOHA) by H2O2 with formation of citrulline and NO2- with initial rates of about 0.7 and 0.2 nmol per nmol HRP per min. In the same manner, cytochromes P450 from rat liver microsomes catalyze the oxidation of NOHA to citrulline and NO2- by cumylhydroperoxide. Inhibitors of these hemeproteins (N3- and CN- for HRP and miconazole for P450) strongly inhibit both citrulline and NO2- formation. Rates of NOHA oxidation by these hemeproteins markedly decrease with time presumably because of their denaturation by nitrogen oxides and of the formation of hemeprotein-iron-NO complexes. These results suggest that NO (and other nitrogen oxides) could be formed from oxidation of NOHA by other enzymes than NO-synthases.