Sero-prevalence of Hepatitis B virus surface antigen and associated factors among women of reproductive age in Bench Maji Zone, Southwest Ethiopia: community based cross-sectional study

Background: Hepatitis B virus infection is one of the leading causes of liver diseases which occurs worldwide particularly in developing countries. It is often caused by prenatal transmission from mother to child or household transmission from a close contact during early childhood. It causes different complications like; jaundice, induces premature labor, and prematurity. Objective: The aim of this study was to estimate the sero-prevalence of hepatitis B virus surface antigen and associated factors among women of reproductive age in Bench Maji Zone, South West Ethiopia. Methods: A community-based cross-sectional study was conducted from December 15th, 2016 to February 15th, 2017. Multistage sampling technique was applied to select study participants. Logistic regression analysis was applied and p-values < 0.05 was used to see the significant association between dependent and independent variables. Results: A total of 330 participants were included in this study yielding 98.8% response rate. The sero-prevalence of HBsAg among women of reproductive age was 28(8.5%). Having multiple sexual partners (AOR = 18.73, 95% CI =3.65, 96.21) history of unprotected sex (AOR = 9.39, 95% CI =1.64, 53.77) were found to be significantly associated with sero-prevalence of HBV.Conclusions: The sero-prevalence of HBV infection among women of reproductive age was highly endemic. Hence, behavioral education and communication programs focusing on reduction of risky sexual behaviors should be designed to reduce HBV infection. Keywords: Ethiopia; Hepatitis B virus; Hepatitis B surface antigen; women; Reproductive age.

Sero-prevalence of Hepatitis B virus surface antigen and associated factors among women of reproductive age in Bench Maji Zone, Southwest Ethiopia: Community based cross-sectional study

Background: Hepatitis B virus infection is one of the leading causes of liver diseases which occurs worldwide particularly in developing countries. It is often caused by prenatal transmission from mother to child or household transmission from a close contact during early childhood. It causes different complications like; jaundice, induces premature labor, and prematurity. Objective: The aim of this study was to estimate the sero-prevalence of hepatitis B virus surface antigen and associated factors among women of reproductive age in Bench Maji Zone, South West Ethiopia. Methods: A community-based cross-sectional study was conducted from December 15th, 2016 to February 15th, 2017. Multistage sampling technique was applied to select study participants. Logistic regression analysis was applied and p-values < 0.05 was used to see the significant association between dependent and independent variables. Results: A total of 330 participants were included in this study yielding 98.8% response rate. The sero-prevalence of hbsag among women of reproductive age was 28(8.5%). Having multiple sexual partners (AOR = 18.73, 95% CI = [3.65, 96.21) history of unprotected sex (AOR = 9.39, 95% CI = [1.64, 53.77) were found to be significantly associated with sero-prevalence of HBV. Conclusions: The sero-prevalence of HBV infection among women of reproductive age was highly endemic. Hence, behavioral education and communication programs focusing on reduction of risky sexual behaviors should be designed to reduce HBV infection. Keywords: Ethiopia; Hepatitis B virus; Hepatitis B surface antigen; women; reproductive age.

Chronic kidney disease and associated factors among adult population in Southwest Ethiopia

In Ethiopia, data on the burden and determinants of chronic kidney disease (CKD) in the general population is limited. This community-based study was conducted to assess the burden and associated factors of CKD among adults in Southwest Ethiopia. The study was conducted from August 23, 2018-October 16, 2018. Study participants were selected using a random sampling method. A structured questionnaire was used to collect relevant data. Blood pressure and anthropometric indices were measured following standard procedures. About 5 ml of urine sample was collected and the dipstick test was performed immediately. A blood sample of 3-5ml was collected for serum creatinine and blood glucose level determination. The three commonest estimators of glomerular filtration rate and the National Kidney Foundation Kidney Disease Outcomes Quality Initiative were used to define and stage CKD. Data were analyzed using SPSS 21. Multivariable logistic regression was employed and p-value <0.05 was used to indicate statistically significant results. A total of 326 participants with a mean age of 39.9(SD±11.2) years were enrolled in the study. The proportions of female participants (59.8%) were relatively higher than male participants (40.2%). The mean eGFR using CKD-EPI, CG and MDRD was 124.34 (SD±23.8) mL/min/1.73m², 110.67(SD±33.0) mL/min/1.73m² and 131.29 (SD±32.5) mL/min/1.73m² respectively. The prevalence of CKD was 7.4% using CKD-EPI & MDRD and 8% using CG. Similar finding using CKD-EPI & MDRD may indicate that either CKD-EPI or MDRD can be used to estimate GFR in this study area. In the age and sex-adjusted logistic regression model, hypertension was significantly associated with CKD using CKD-EPI & MDRD and age ≥40 years old was significantly associated with CKD using CG. Behavioral characteristics and other traditional risk factors were not significantly associated with CKD in the current study. The prevalence of CKD was high in the study area. Only hypertension and age ≥40 years old were significantly associated with CKD. More of the increased prevalence of CKD in the current study remained unexplained and deserves further study.

Community Attitudes Towards Violence Against Women, and Lived Experiences of Family Violence and Abuse During Childhood in Rural Eastern Nigeria: Implications for Policy and Programming

Background

Violence against women (VAW) has remained an increasingly significant public health problem globally. This study explored childhood experiences of abuse and attitude towards violence against women among adults in a rural community in South-east Nigeria.

Methods

This was a cross-sectional study conducted in a rural community in Ebonyi, Nigeria. Data were collected from 280 respondents using interviewer-administered questionnaires. Data analysis was performed using SPSS version 25.

Results

The mean age of the male participants was 46.5±16.8, while that for the female participants was 43.3±16.9. Most were females (203/280, 72.5%), out of which (83/203, 40.9%) had secondary school as the highest level of education attained. Most participants were females (203/280, 72.5%), married (225/280, 80.4%) with secondary school education (124/280, 44.3%). More than one-tenth (33/280, 11.8%) had ever witnessed parental violence, while 46.4% had been physically abused in childhood. Forced touching and penetrative sex was experienced sometimes by 11.4% (32/280) and 21.8% (61/289), respectively. Overall, the majority (258/280, 92.8%) had a disapproving attitude towards gender-based violence. Most participants disagreed that hitting or insulting woman was not wrong (246/280, 87.9%). The majority of the respondents agreed that women were inferior to men from a cultural perspective (175/280, 62.5%). Almost half strongly agreed (125/2280, 44.6%) and agreed (118/280, 42.1%) that a woman is a man’s possession. The predictors of attitude were secondary school education (AOR = 7.74, 95% CI = 1.69–35.54) and monogamous marital setting (AOR = 2.83, 95% CI = 1.08–7.42).

Conclusion

This study showed that Nigerian adults had high levels of childhood exposures to family violence, physical and sexual abuse. Overall, the majority disapproved of VAW; however, there were gaps that endorsed patriarchal ideologies. Interventions to address VAW should include components targeted at children exposed to violence and de-bunking patriarchal ideologies that encourage VAW.

Factors associated with immunological and virological discordant responses to highly active antiretroviral therapy among adult HIV positive individuals in Ethiopia: A cross-sectional study

In clinical practice, not all human immune deficiency virus (HIV) positive individuals who received highly active antiretroviral therapy (HAART) achieve the desired concordant response characterized by a sustained viral suppression or immune recovery. The expected success of HAART doesn't occur in all treated patients and a discordant response between CD4 count and the viral load (VL) has been a major concern in the treatment of HIV patients. Thus, this study is designed to describe the factors associated with immunological and virological discordant responses to HAART among adult HIV positive individuals.A hospital-based cross-sectional study with secondary data review was conducted on 423 HIV positive individuals on HAART from February 1 to April 30, 2017. Socio-demographic characteristics, clinical data and about 10 mL of blood specimen for HIV VL, and CD4 count measurement were collected. The data was entered into SPSS version 20 and descriptive, bivariate, and multivariate logistic regression analysis was employed.The mean age of the patients at study time was 39 (±9.8). The average follow-up duration of patients on antiretroviral therapy (ART) was 7 (±3) years. The prevalence of immunological discordance and virological discordance to HAART were 13.2% and 47%, respectively. With multivariate logistic regression analysis duration of follow-up on ART ≤ 6 years (adjusted odds ratio [AOR] = 3.29 (1.80-6.03), P ≤ .001) and VL ≥20 copies/mm3 (AOR = 3.08 [1.70-5.61], P ≤ .001) were significant factors for immunological discordance conversely the patients who switched drug as a result of TB (AOR = 3.33 [1.10-10.08], P = .03) was significant factors for virological discordance.The prevalence of immunological discordance and virological discordance to HAART among HIV patients is high. Patients with the duration of follow-up on ART ≤ 6 years, VL ≥ 20 copies/mm3 and patients who switched drugs as a result of TB were significant factors for discordance. Hence, intensive adherence support and counseling should be provided to achieve the UNAIDS 90 target. HIV positive individuals co-infected with TB, who have had VL ≥ 20 copies/mm3 and who are ≤6 years duration of follow-up on ART need to be carefully monitored. In addition, national based study of discordant groups is recommended.

Predictors of Current CD4+ T-Cell Count Among Women of Reproductive Age on Antiretroviral Therapy in Public Hospitals, Southwest Ethiopia

Background

HIV/AIDS is one of the major global public health problems. CD4 is a glycoprotein found on the surface of different immune cells. CD4 cell counts determine the need for screening and prophylactic interventions against common opportunistic infections in those with advanced HIV disease. Thus, this study aimed to assess the predictors of current CD4⁺ T-cell count among women of reproductive age on antiretroviral therapy in public hospitals, southwest Ethiopia.

Methods

A cross-sectional study was conducted from February to April 2018. A total of 422 participants in the three public hospitals were selected using a systematic random sampling method. Linear regression analyses were used to determine the important predictors of current CD4⁺ T-cell count at p-values of <0.05.

Results

A total of 422 women with a median age of 37.00 years participated in this study. More than one in ten (12.8%) respondents experienced immunological failure. An increased current CD4⁺ T-cell count was observed among patients with a tertiary level of education [β = 56.45, 95% CI (3.5, 109.4)], baseline WHO clinical stage II [β = 44.06, 95% CI (5.3, 82.9)], initial regimen of AZT+3TC+EFV [β = 167.23, 95% CI (100.4, 234.1)], with increased baseline CD4⁺ T-cell count [β = 0.35, 95% CI (0.2, 0.5)], and with increased time duration on ART [β = 14.36, 95% CI (6.304, 22.4)]. On the other hand, the current CD4⁺ T-cell count was lowered among patients with poor baseline adherence, opportunistic infection, and viral load of ≥1000 by 181.06 cells/mm³, 101.62 cells/mm³, and 137.53 cells/mm³ compared to good baseline adherence, no opportunistic infection and undetectable viral load, respectively.

Conclusion

The immunological failure was relatively low. Maintaining adherence, early identification and treatment of opportunistic infections, and minimizing viral load to undetectable levels may further decrease immunological failure.

Is the Training, Knowledge, and Perception of Maternal Health Providers Adequate for the Provision of Respectful Maternity Care? Policy Implications for Practice in a Nigerian Tertiary Hospital

Background

Health providers play pivotal roles in achieving respectful maternity care (RMC). This study assessed the training, knowledge, and perception of respectful maternity care among maternal health providers in a Nigerian tertiary hospital.

Methodology

This was across-sectional study conducted among 156 maternal health providers in Ebonyi Nigeria. Self-administered questionnaires were used for data collection.

Results

The respondents had a mean age of 31.97±6. 8years. Females constituted 35.9% of the respondents while 25.6% were midwives. Less than half had received undergraduate (48.7%) and postgraduate (42.3%) training on RMC. The majority were aware (72.4%) and had good knowledge (78.8%) of respectful maternity care. Medical books (33.3%) was the major source of information on RMC. Most respondents (90.4%) desired more education on RMC. Over four-fifths (82.1%) had a positive perception of RMC. Only 27.6% of respondents agreed that mistreatment during childbirth was a common phenomenon in their clinical practice context. About three-fourths (76.6%) did not agree that mistreatment during childbirth was harmful to maternal health. Undergraduate training on RMC (AOR=0.33, 95% CI=0.13-0.81), postgraduate training on RMC (AOR=0.30, 95% CI=0.11-0.82) and higher monthly income (AOR=0.20 95% CI=0.05-0.88) were predictors of awareness of RMC. Knowledge of RMC was a predictor of perception about RMC (AOR=0.29, 95% CI=0.11-0.71).

Conclusion

There was good awareness, knowledge and perception of RMC predicted by training exposures and income status However, gaps existed in the perception of the occurrence and consequences of mistreatment during childbirth. We recommend the inclusion of RMC training in both undergraduate and postgraduate medical training curricula.

Multi-stakeholder Perspectives on the Maternal, Provider, Institutional, Community, and Policy Drivers of Disrespectful Maternity Care in South-East Nigeria

Purpose

Understanding the contextualized perspectives of stakeholders involved in maternal health care is critical to promoting respectful maternity care. This study explored maternal, provider, institutional, community, and policy level drivers of disrespectful maternity care in Southeast Nigeria. This study also identified multi-stakeholder perspectives on solutions to implementing respectful maternity care in health facilities.

Materials and Methods

This was a mixed-methods cross-sectional study conducted in two urban cities of Ebonyi State, South-eastern Nigeria. Data were collected using semi-structured questionnaires, focus group discussions, and key informant interviews with mothers, providers, senior facility obstetric decision-makers, ministry of health policymaker, and community members. Quantitative data and qualitative data were analysed using SPSS version 20 and manual thematic analysis, respectively.

Results

Maternal level drivers were poor antenatal clinic attendance, uncooperative clients, non-provision of birthing materials, and low awareness of rights. Provider factors included work overload/stress, training gaps, desire for good obstetric outcome, under-remuneration and under-appreciation. Institutional drivers were poor work environments including poorly designed wards for privacy, stressful hospital protocols, and non-provision of work equipment. Community-level drivers were poor female autonomy, empowerment, and normalization of disrespect and abuse during childbirth. The absence of targeted policies and the high cost of maternal health services were identified as policy-related drivers.

Conclusion

A variety of multi-level drivers of disrespectful maternity care were identified. A diverse and inclusive multi-stakeholder approach should underline efforts to mitigate disrespectful maternity care and promote respectful, equitable, and quality maternal health care.

Reaching the unreached: effectiveness and satisfaction with community-directed distribution of sulfadoxine-pyrimethamine for preventing malaria in pregnancy in rural South-East, Nigeria

BACKGROUND

Innovative community strategies to increase intermittent preventive treatment with sulfadoxine-pyrimethamine (IPTp-SP) coverage is advocated particularly in rural areas, where health infrastructure is weakest and malaria transmission highest. This study involved proof-of-concept implementation research to determine satisfaction with and effectiveness of community-directed distribution of IPTp-SP on uptake among pregnant women in Ebonyi State, Nigeria.

METHODS

This before-and-after study was carried out in 2019 in a rural community in Ebonyi State Nigeria. The intervention involved advocacy visits, community-wide sensitizations on malaria prevention, house-to-house directly observed IPTp-SP administration, and follow-up visits by trained community-selected community-directed distributors (CDDs). Monthly IPTp-SP coverage was assessed over 5 months and data analysed using SPSS version 20.

RESULTS

During the study, 229 women received the first dose of IPTp while 60 pregnant women received 5 or more doses of IPTp. The uptake of ≥ 3 IPTp doses increased from 31.4% before the community-directed distribution of IPTp to 71.6% (P < 0.001) by the fourth month post-initiation of the community-directed distribution of IPTp. Sleeping under insecticide-treated net (ITN) the night before the survey increased from 62.4 to 84.3% (P < 0.001) while reporting of fever during pregnancy decreased from 64.9 to 17.0% (P < 0.001). Although antenatal clinic utilization increased in the primary health centre serving the community, traditional birth attendants and patent medicine vendors in the community remained more patronized. Post-intervention, most mothers rated CDD services well (93.6%), were satisfied (97.6%), and preferred community IPTp administration to facility administration (92.3%).

CONCLUSION

Community-directed distribution of IPTp-SP improved uptake of IPTp-SP and ITN use. Mothers were satisfied with the services. The authors recommend sustained large-scale implementation of community-directed distribution of IPTp with active community engagement.

Chronic Kidney Disease and Associated Factors Among HIV/AIDS Patients on HAART in Ethiopia

Background

In developing countries, both opportunistic infections and chronic diseases account a high HIV-associated mortality and morbidity. Chronic kidney disease (CKD) associated with HIV infection has got increased attention in sub-Saharan Africa as a result of the high HIV prevalence and due to the late diagnosis and initiation of HAART. Thus, this study was conducted to assess CKD and associated factors among HIV patients on HAART in Ethiopia.

Methods

A hospital-based cross-sectional study with a secondary data review was conducted on 336 on HIV/AIDS patients on HAART from February to July 2017 at University of Gondar Referral Hospital. The study participants were selected using a systematic random sampling technique. Socio-demographic and clinical data were collected using a semi-structured questionnaire at their follow-up date with interview and chart review. Three to five milliliters of venous blood and five milliliters of urine specimen were collected for serum creatinine and urine albumin determination, respectively. Data were entered into SPSS version 20 for analysis. Glomerular filtration rate was estimated using the CKD-EPI estimator. Bivariate and multivariate logistic regression was employed and p-value <0.2 and < 0.05, respectively, was considered statistically significant.

Results

The prevalence of CKD on the study participants was 54 (16.1%) (95% CI, 12.2–20.4%). By stage, about 27 (8.0%) had stage 1 (persistent proteinuria with eGFR ≥ 90 mL/min/1.73 m²), 16 (4.8%) had stage 2 (persistent proteinuria with eGFR of 60–89.9 mL/min/1.73 m²), 6 (1.8%) had stage 3 (eGFR 30–59.9 mL/min/1.73 m² with or without proteinuria) and 5 (1.5%) had stage 5 ((kidney failure), eGFR<15mL/min/1.73 m² with or without proteinuria). With multivariate logistic regression analysis, being male (AOR=2.05 (1.03–4.09), p=0.04), being merchant (AOR=2.91 (1.00–8.48), p=0.049) and having viral load≥1000 copies/mm³ (AOR=3.1 (1.38–7.00), P<0.01) were significantly associated with CKD.

Conclusion

The prevalence of CKD among HIV patients on HARRT is high. Being male, merchant and having viral load ≥1000 copies/mm³ were associated factors of CKD. Patients should be regularly monitored and screened for early diagnosis and management of CKD. Those patients who have being merchant with high viral load and male patients should require close monitoring.

<p>Seroprevalence of <em>Helicobacter pylori</em> Infection and Associated Factors Among Adult Dyspeptic Patients in Public Health Facilities, Mizan Aman Town, Southwest, Ethiopia: Institutional-Based Cross-Sectional Study</p>

Background

Helicobacter pylori infection is a public health problem associated with chronic gastritis, peptic ulcer, and gastric cancer. It is endemic in developing countries like Ethiopia. This study was aimed to assess seroprevalence of H. pylori infection and associated factors among adults’ dyspeptic patients in public health facilities of Mizan Aman Town, Southwest Ethiopia.

Methods

Cross-sectional study was conducted in public health facilities of Mizan Aman Town, from April 1, 2018, to June 30, 2018. A total of 208 adult dyspeptic patients were included in the study. A structured questionnaire was used to collect data. Serum was tested for anti-H. pylori antibody using a commercial test strip. Data were entered using Epi info 6.04 and exported to SPSS 21 for analysis. Bivariate and multivariate logistic regression was employed and OR with 95% CI was retrieved. P-value of less than 0.05 was considered as statistically significant.

Results

A total of 208 participants were interviewed. The mean age of respondents was 31.70 (SD ±9.123) years. Seroprevalence of H. pylori infection was 89 (42.8%). Presence of domestic animals (AOR = 13.33, 95% CI = (2.203–80.692)), sources of drinking water (AOR = 0.011, 95% CI = (0.001–0.110)), toilet type (AOR = 11.236, 95% CI = (1.921–65.73)), shared beds with siblings (AOR = 7.775, 95% CI = (1.676–36.082)), family size (AOR = 0.015, 95% CI = (0.003, 0.089)), storing and reusing water (AOR =0.014, 95% CI = (0.002–0.103)) and occupational status (AOR = 23.33, 95% CI = (2.034–67.661)) were variables significantly associated with seroprevalence of H. pylori.

Conclusion

Seroprevalence of H. pylori infection is relatively high in Ethiopia. Family size, shared bed, presences of domestic animals, storage and reuse of water, toilet type, sources of drinking water, and occupation were significant factors associated with H. pylori infection. The possible identified modifiable risk factors should be addressed through effective health education.

Immunological Response During HAART and Determinants of Current CD4+ T-Cell Count Among HIV/AIDS Patients Attending University of Gondar Referral Hospital, Northwest Ethiopia

PURPOSE

After the initiation of highly active antiretroviral therapy (HAART), successful HAART is characterized by an increase in the CD4+ count. Several factors affect the CD4+ T-cell count. This study aimed to assess the immunological response during HAART and determinants of the current CD4+ T-cell count among HIV/AIDS patients on HAART.

PATIENTS AND METHODS

A hospital-based cross-sectional study was conducted from February 1 to April 1, 2017. A total of 423 HIV/AIDS patients on HAART were enrolled using simple random sampling. Descriptive statistics, and bivariate and multiple regression analyses were conducted. Variables with p-value <0.2 in the bivariate analysis were entered in the multiple regression models. p-Values <0.05 and 95% confidence intervals were used to identify determinants of the current CD4+ T-cell count.

RESULTS

The mean CD4+ T-cell count gradually increased until 8 years on HAART but declined thereafter. An increased current CD4+ T-cell count was observed among patients with an initial regimen of pediatric d4T-3TC-NVP [β=185.5, 95% CI (8.8, 362.2)] (p=0.040), with increased baseline CD4+ T-cell count [β=0.468, 95% CI (0.342, 0.594)] (p<0.0001), and with long duration on HAART [β=18.0, 95% CI (9.9, 26.1)] (p<0.0001), whereas a decreased level of current CD4+ T-cell count was observed among males [β=-72.7, 95% CI (-114.5, -30.9)]) (p<0.0001) and those with poor baseline adherence [β=-108.9, 95% CI (-210.9, -7.0)] (p=0.036) and viral load >1000 copies [β=-189.2, 95% CI (-243.5, -134.9)] (p<0.0001).

CONCLUSION

The trend in immunological response was not increased linearly throughout the HAART duration. Sex, type of initial regimen, baseline adherence, baseline CD4+ count, viral load, and duration on HAART were independent determinants of current CD4+ count. These determinants could be addressed by regular monitoring of HIV patients on HAART, and special attention should be paid to male patients.

Nasopharyngeal Carriage of Streptococcus pneumoniae and Associated Factors among Children in Southwest Ethiopia

Background:

In Ethiopia, Streptococcus pneumoniae is the predominant causative agent of pneumonia. About, 95% of bacterial pneumonia cases in under five years of children are caused by pneumococci.

Objective:

To assess the nasopharyngeal carriage of Streptococcus pneumoniae, its antibiotic susceptibility pattern, and associated factors among children in Southwest Ethiopia.

Methods:

A cross-sectional study was conducted from October 01, 2018, to December 30, 2018. A total of 293 children aged ≤15 years were included in the study using a systematic random sampling technique. A nasopharyngeal swab was collected using a sterile cotton swab and cultured on blood agar supplemented with 5μg/ml gentamicin. The antimicrobial susceptibility testing was performed using the Kirby-Bauer disc diffusion technique.

Results:

The ages of participants ranged from 5 months to 14 years. The carriage rate of Streptococcus pneumoniae was 74/293 (25.3%). Being within the age group <3 years, the habit of sleeping with parent(s)/guardians and numbers of rooms per household were significantly associated with pneumococcal carriage. Streptococcus pneumoniae showed the highest resistance to Tetracycline, 36 (48.65%), and Trimethoprim/sulfamethoxazole, 29 (39.2%), and was found to be susceptible to Chloramphenicol, 54 (77%), and Erythromycin, 38 (51.4%).

Conclusion:

The nasopharyngeal carriage rate of Streptococcus pneumoniae is considerably high. High antimicrobial resistance of Streptococcus pneumoniae against Tetracycline and Trimethoprim/sulfamethoxazole was observed. Living in a house with a single room, children’s habit of sleeping with parents/guardians and age are associated factors of high pneumococcal carriage. Strategies need to be designed to address the modifiable associated factors and the bacterium antibiotic resistance pattern should be monitored regularly.

Hepatitis B Virus Infection and Associated Factors Among Adults in Southwest Ethiopia: Community-Based Cross-Sectional Study

Purpose

Ethiopia is grouped with countries with no national strategy for surveillance of viral hepatitis. Hence, data on hepatitis B virus (HBV) infection in the general population are limited. The aim of this study was to estimate the prevalence and associated factors of HBV infection among adults in Southwest Ethiopia.

Materials and Methods

A community-based cross-sectional study was conducted in Southwest Ethiopia, from November 1, 2017–January 30, 2018. A total of 612 individuals were included in the study using a multistage sampling technique. A structured questionnaire was used to collect data and a whole blood sample was aseptically collected and tested for HBsAg using a commercially available rapid serological test kit. Bivariate and multivariate logistic regression were employed and odds ratio with 95% confidence interval was retrieved. P-value <0.05 was considered as statistically significant.

Results

Among 612 participants, half of them, 310 (50.7%), were in the age range of 25–34 years. The mean age of the respondents was 32.5 [SD ±7.5] years. Seroprevalence of HBsAg among adults was 55/612 (9.0%). Tattooing on gums (AOR=23.9, 95% CI (2.2–26.3)), tattooing on the body (AOR=6.8, 95% CI (1.1–43.1)), and contact with a jaundiced person (AOR=20.7, 95% CI (6.7–63.8)) were significantly associated with seroprevalence of HBsAg.

Conclusion

Hepatitis B virus infection in adults at the community level is highly endemic. Modifiable risk factors such as tattooing on gums, tattooing on body, and contact with a jaundiced person account for the high HBV infection. Hence, behavioral education and communication programs designed to reduce HBV infection need to address these modifiable factors.

The epidemiology of syphilis in Ethiopia: a protocol for systematic review and meta-analysis covering the last three decades

BACKGROUND

Several individual epidemiological studies in Ethiopia suggest that syphilis is a public health problem. However, to the best of our knowledge, there is no synthesized and meta-analysis data on the epidemiology of syphilis in Ethiopia. This systematic review and meta-analysis aimed to summarize and synthesize existing data on the prevalence of syphilis in Ethiopia.

METHOD

Studies reporting the prevalence of syphilis will be identified from major databases and gray literature. The major databases (MEDLINE/PubMed, EMBASE, Web of Science, CINAHL, The Cochrane Library, Lilacs, and African journal online) and gray literature (Google Scholar search engine, official WHO and CDC websites, the online library of academic and governmental institutions in Ethiopia) will be searched. Studies published/reported from 1 January 1990 to 1 January 2019 will be included to have a contemporary estimation. A random-effect meta-analysis of prevalence will be used after stabilizing the variance of included studies using a single arc transformation. The quality of the included studies will be assessed using the Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instruments. Heterogeneity and publication bias will be assessed. If significant heterogeneity is detected, subgroup analysis will be done using study region, study population, diagnostic assay/syphilis screening tool, median sample size, year of data collection, study sites, sampling method, and methodological quality as grouping variables.

DISCUSSION

This systematic review and meta-analysis intend to contribute an improved knowledge on the epidemiology of syphilis in Ethiopia. Knowledge about the epidemiology of syphilis may help policymakers and other stakeholders to allocate resources and target interventions for the prevention and elimination of syphilis.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO CRD42018116231.

Hepatitis B virus infection among pregnant women in Ethiopia: a systematic review and Meta-analysis of prevalence studies

BACKGROUND

There are several epidemiological studies available on hepatitis B virus among pregnant women in Ethiopia. These individual studies revealed wide variation over time and across geographical areas. The aim of this systematic review and Meta-analysis is to estimate the overall prevalence of hepatitis B virus infection among pregnant women in Ethiopia.

METHODS

A comprehensive search of electronic databases including PubMed, Popline, Lalicus, Ovid, MedNar, African Journal Online (AJOL) and advanced Google Scholar was conducted regardless of publication year from August 30, 2017 to September 25, 2017. The search was updated on January 02, 2018 to minimize time-lag bias. The methodological qualities of included studies were assessed using Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instruments.

RESULTS

Out of 103 studies, 17 studies with a total of 5629 pregnant women were included in the Meta-analysis. The pooled prevalence of hepatitis B virus infection among pregnant women using random-effect model was 4.7%(95% CI 4.0-5.4%). The I2 statistics was I2 = 37.9%(p = 0.0575). Even though significant heterogeneity among studies was not detected, the I2 = 37.9% suggests medium heterogeneity. A subgroup Meta-analysis showed that study site, region, mean/median sample size, hepatitis B virus screening methods and methodological quality were not source of heterogeneity (p-difference > 0.05).

CONCLUSION

This review shows an intermediate level of hepatitis B virus infection among pregnant women in Ethiopia. In addition to the current practice of child vaccination, routine and universal antenatal hepatitis B virus screening program need to be implemented.