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Antimicrobial-resistant (AMR) bacterial infection is a significant global threat to the healthcare systems. Pseudomonas aeruginosa, the leading infectious agent in the healthcare setting is now one of the major threats due to AMR. A comprehensive understanding of the magnitude of AMR, particularly highly public health important pathogens such as P. aeruginosa, is necessary for the management of infections based on local information. This systematic review and meta-analysis aimed to determine the country-wide AMR of P. aeruginosa. Systematic searches were performed to retrieve articles from PubMed, Scopus, Web of Science, ScienceDirect electronic databases, Google Scholar search engine, and repository registrars from 2015 to 31st December 2023. Twenty-three studies that provided important data on AMR in P. aeruginosa were systematically reviewed and analyzed to determine the country-wide magnitude of P. aeruginosa AMR profile from healthcare-associated infections. AMR of P. aeruginosa to 10 different antibiotics were extracted separately into Microsoft Excel and analyzed using STATA 17.0. Cohen's kappa was computed to determine the agreement between reviewers, the Inverse of variance (I2) was used to evaluate heterogeneity across studies, and Egger's test to identify publication bias. A random effect model was used to determine the pooled resistance to each antibiotic. Subgroup analysis was performed by infection type and year of publication. This systematic review and meta-analysis revealed that the pooled prevalence of P. aeruginosa in clinical specimens associated with HAI was 4.38%(95%CI: 3.00-5.76). The pooled prevalence of AMR in P. aeruginosa for different antibiotics varies, ranging from 20.9% (95%CI: 6.2-35.8) for amikacin to 98.72% (95%CI: 96.39-101.4) for ceftriaxone. The pooled resistance was higher for ceftriaxone (98.72%), Trimethoprim-sulfamethoxazole (75.41), and amoxicillin-clavulanic acid (91.2). In contrast relatively lower AMR were observed for amikacin (20.9%) and meropenem (28.64%). The pooled multi-drug resistance (MDR) in P. aeruginosa was 80.5% (95%CI: 66.25-93.84). Upon subgroup analysis by infection types and year of publication, P. aeruginosa isolated from healthcare-associated infections exhibited higher resistance to ceftazidime (94.72%) compared to isolates from mixed types of healthcare-associated infections (70.84%) and surgical site infections (57.84%). Antimicrobial resistance in gentamicin was higher during the periods of 2018-2020 (73.96%), while comparatively lower during 2021-2023 (42.69%) and 2015-2017 (29.82%). Significantly high AMR and MDR were observed from this systematic review and meta-analysis. AMR obtained from this systematic review and meta-analysis urges the need for improved infection control, antimicrobial stewardship practices, and strengthened surveillance systems to control the spread of AMR and ensure effective treatment of P. aeruginosa infections. This systematic review and meta-analysis was registered on PROSPERO (Registration ID: CRD42024518145).

Sugar-sweetened beverages or snacks are limited in nutritional value. Excess consumption of sugar-sweetened beverages or snacks in early childhood is associated with inadequate micronutrient intake, being overweight or obese, and developing chronic diseases later in life. There is scarcity of information specific to sugar-sweetened beverages or snacks consumption prevalence and its determinants in Sub-Saharan Africa Countries. This study aimed to determine the pooled prevalence of sugar-sweetened beverage or snack consumption and its determinants among infants and young children aged 6-23 months. A cross-sectional study design was conducted using demographic and health survey data conducted from 2019 to 2023 from twelve Sub-Saharan African countries. A weighted sample of 23,145 children aged 6-23 months was included in the study. Multilevel mixed-effects logistic regression analysis was used to determine the factors associated with the dependent variable. The level of statistical significance was declared with a p-value < 0.05 and an adjusted odds ratio with a 95% confidence interval. The pooled prevalence of Sugar-sweetened beverage or snack consumption was 25.40% (95% CI: 24.84% - 25.96%). In multilevel multivariable logistic regression analysis, children aged between 9-11(AOR = 1.95 95% CI: 1.62, 2.35), 12-17(AOR = 2.83; 95% CI: 2.26, 3.54), and 18-23 months (AOR = 3.77;95% CI: 3.07, 4.63), media exposure (AOR = 1.59; 95% CI:1.28, 1.98), children from households with middle (AOR = 1.39; 95% CI: 1.11, 1.73) and rich (AOR = 2.31; 95% CI: 1.87, 2.85) wealth status, post natal checkup (AOR = 1.18; 95%CI:1.05,1.33), maternal ANC visit (AOR = 1.60; 95% CI: 1.15, 2.22), and high community media exposure ((AOR = 2.22;95%CI:1.65,5.81) were positively associated significant factors whereas currently breast feeding children (AOR = 0.70; 95% CI: 0.59,0.82), older age at first birth (AOR = 0.88,95% CI: 0.81, 0.96), presences of more than one under-5 children in the household (AOR = 0.89, 95% CI: 0.80, 0.99), mothers don't perceive distance to health facility as big problem (AOR = 0.86; 95% CI:0.76, 0.98), and children reside in rural (AOR = 0.83;95%CI:0.68,0.95) were negatively associated with sugar sweetened beverage or snack consumption. In this study, one out of four children consumed sugar-sweetened beverages or snacks. Current age of child, current breastfeeding status of child, media exposure, wealth index, maternal age at first birth, post natal checkup, maternal ANC visit, number of under-five children in the household, distance to health facility, place of residence, and community level media exposure were significant factors with sugar-sweetened beverage or snack consumption. Therefore, it is recommended to raise awareness about the health risks of sugar-sweetened beverage and snack consumption, enforce restrictions on their advertisement, strengthen nutrition-focused counseling within maternal and child health services with special attention for older age children, promote breastfeeding, and give special attention to challenges related to health facility accessibility, and support for young mothers.

Adolescent girls have a greater nutrient demand and their poor dietary intake is associated with micronutrient deficiencies and poor maternal outcomes. Having information on micronutrient intake inadequacy in adolescent girls is critical for promoting healthy behavior and breaking the cycle of intergenerational malnutrition. Thus, this study assessed overall micronutrient intake inadequacy and associated factors among school adolescent girls in Meshenti town of Bahir Dar City Administration, North West Ethiopia. A school-based cross-sectional study was conducted among 401 adolescent girls from February 7 to 23, 2020. A Simple random sampling technique was used to select study participants. A multiple-pass 24-hour dietary recall with portion size estimation method and recommended dietary allowance cut-off point were used to assess micronutrient intake inadequacy. Overall micronutrient intake inadequacy was measured using the mean adequacy ratio. Nutrient databases were developed by ESHA FOOD PROCESSOR version 8.1 software. Data were entered into Epi-data version 3.1 and exported to SPSS version 23 for analysis. Multivariable logistic regression was performed to identify determinants of overall micronutrient intake inadequacy and an adjusted odds ratio at a p-value of less than 0.05 was used to see the strength of statistical association. The prevalence of overall micronutrient intake inadequacy was 44.4% (95% CI: 39.7%-49.6%). Early adolescent age (AOR: 2.75, 95% CI: 1.71-4.42), food-insecure household (1.74, 95%CI: 1.087-2.784), low dietary diversity score (AOR = 2.83, 95% CI: 1.35-5.92), and high peer pressure on eating and body concern (AOR = 1.853, 95% CI: 1.201-2.857) were significantly associated factors with overall micronutrient intake inadequacy. Findings of this study revealed that micronutrient intake inadequacy among adolescent girls was a high public health problem in the study area. Therefore, attention should be given to adolescent girls of the study area, especially the ones in the early adolescent age. Interventions should also focus on nutrition-sensitive activities to address food insecurity, a less diversified diet, and the negative impact of peer influence.

Multiple studies across Ethiopia have investigated the occurrence of DKA, showing significant variations and conflicting findings. This systematic review and meta-analysis seek to consolidate the overall prevalence of diabetic ketoacidosis and its associated factors in the Ethiopian context. The study adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA-P) guidelines. Data was collected from PubMed/MEDLINE, Science direct, Google Scholar, and gray literature sources. Microsoft Excel was used for data extraction and summary, while the analysis was performed with R software version 4.3.2. The overall pooled prevalence of diabetic ketoacidosis and its components was estimated using a random effects model. Publication bias was assessed both graphically, using funnel plots, and statistically, with tests such as Egger's regression test. Subgroup analysis were carried out to minimize random variations in the estimates from the primary studies. The pooled estimated prevalence of diabetic ketoacidosis among diabetic patients in Ethiopia was 46% (95% CI; 36, 57; I2 = 100%, P≤0.001). Medication discontinuations (AOR = 1.30, 95 CI 1.20, 1.64), presence of comorbidity (AOR = 1.53, 95 CI 1.10, 2.20) and presence of infection (AOR = 1.62, 95 CI 1.31, 1.98) had an association with diabetic ketoacidosis among diabetic patients. Medication discontinuations, comorbidity, and infection are individual contributors to diabetic ketoacidosis in diabetic patients. Implementing initiatives to enhance medication adherence and establish comprehensive diabetes management programs covering glycemic control, comorbidities, and infection management can effectively address these factors.

ObjectiveTo assess the socioeconomic inequality in postnatal care (PNC) utilisation and its contributors among women in 14 sub-Saharan African countries with high maternal mortality.DesignCommunity-based cross-sectional study using Demographic Health SurveySettingAfrica countries with the highest maternal mortality ratio (14 countries)ParticipantsAll women who had given birth within 2 years prior to the survey (n=64 912)Primary outcomesPostnatal care utilisationResultsThe percentage of women who had PNC utilisation was lowest in Ethiopia (23.4%: 95% CI: 22.1%, 24.7%) and highest in The Gambia (91.5%: 95% CI: 90.6%, 92.4%). There was statistically significant pro-rich inequality in the PNC utilisation in all countries except Liberia, meaning PNC utilisation was disproportionately concentrated among women from wealthier households. The weighted Erreygers Normalized Concentration Index (ECI) ranged from 0.0398 in The Gambia to 0.476 in Nigeria; the second-highest inequality was in Cameroon (0.382), followed by Guinea (0.344). The decomposition analysis revealed that the wealth index was the largest contributor to inequality in PNC utilisation in seven countries: Benin, Burundi, The Gambia, Guinea, Nigeria, Sierra Leone, Tanzania. In contrast, educational status emerged as the primary contibutor in Cameroon and Zimbabwe, media exposure in Mali and Mauritania, and distance to healthcare facilities in Ethiopia. However, in Liberia, the weighted ECI of 0.0012 with a p value of 0.96 indicate that there is no significant socioeconomic inequality in PNC utilisation, suggesting that the distribution of PNC utilisation is almost equal across different socioeconomic groups.ConclusionOur study revealed a pro-rich inequality in PNC utilisation across all included sub-Saharan African countries with high maternal mortality, except Liberia. This implies that PNC utilisation disproportionately favours the wealthy. Therefore, financially better-off women are more likely to utilise PNC services compared to those who are poor. Addressing the identified contributors of socioeconomic inequalities in PNC utilisation in each country remains crucial for achieving equity in PNC utilisation.

The recommended essential micronutrient such as food rich in vitamin-A or iron, multiple micronutrient powder or iron supplement, routine daily consumption of iodine, and vitamin-A supplement are deficient among children in Ethiopia. This has been a significant public health problem despite the government efforts. Although few studies have examined the micronutrient intake among children, they are limited in scope and methodological measurements. Analyzing the micronutrient intake among children across all regions and leveraging all essential micronutrient elements are crucial for generating improved evidence to better inform policy. Thus, we examined the micronutrient intake among children aged 6 to 23 months in Ethiopia. We used data from the Ethiopian Demographic and Health Survey. A two-stage stratified sampling technique was employed, and 1392 children aged 6 to 23 months were included in our analysis. We conducted a multilevel mixed-effect binary logistic regression analysis to identify determinants of micronutrient intake. In the final model, we used a p-value of less than 0.05 and Adjusted Odds Ratio (AOR) with their 95% confidence interval (CI). We found that only 27.6% (95% CI: 26.8-31.6) of children aged 6 to 23 months were received the recommended micronutrients in Ethiopia. We identified that maternal educational status (Educated mothers (AOR = 2.09, 95%CI:1.23-3.58)), health facility delivery (AOR = 2.14, 95%CI:1.42-2.98), household wealth status (middle quantile (AOR = 1.80, 95%CI:1.01-3.21)), children's age (12 to 23 months age (AOR = 2.36, 95% CI: 1.33-4.21)), and mother's exposure to media (AOR = 1.70, 95%CI: 1.42-2.04) were increased micronutrient intake, whereas residing in the rural communities (AOR = 0.27, 95%CI: 0.21-0.34) decreased micronutrient intake. Nearly three-fourths of children aged 6 to 23 months did not receive the recommended essential micronutrients in Ethiopia. Therefore, there is a need to broaden strategies aimed at enhancing the intake by improving information and knowledge dissemination among mothers during facility visits and through media channels.

In developing countries, most women want to avoid pregnancy for two years after giving birth. However, 70% do not use contraceptives during this time. Unintended pregnancies may occur for couples who delay contraceptive use during the postpartum period. The most effective form of contraceptive methods for postpartum women is long-acting reversible contraceptive (LARC). Therefore, this study aimed to assess long-acting reversible contraceptive use and associated factors among postpartum women in Sub-Saharan Africa. Secondary data analysis was performed using the recent Demographic and Health Surveys (DHS). Stata version 14 was used to analyze the data. A multilevel mixed-effect logistic regression model was used to identify factors associated with long-acting reversible contraceptive use. Variables with a p-value < 0.05 in the multilevel mixed-effect logistic regression model were declared significant factors associated with long-acting reversible contraceptives. The magnitude of long-acting reversible contraceptive use among postpartum women was 12.6% (95% CI: 12.3, 12.8). Women primary (aOR = 1.51; 95% CI: 1.41, 1.63) and secondary education (aOR = 1.62; 95% CI: 1.32, 1.71), media exposure (aOR = 1.73; 95% CI: 1.51, 1.85), place of delivery (aOR = 1.54; 95% CI: 1.43, 1.67), number of ANC visit; 1-3 (aOR = 2.62; 95% CI: 2.31, 2.83) and [greater than or equal to]4 (aOR = 3.22; 95% CI: 2.93, 3.57), received PNC (aOR = 1.34; 95%CI: 1.13, 1.58), and income level; low middle income (aOR = 2.41; 95% CI: 2.11, 2.88) and upper middle income (aOR = 1.83; 95% CI: 1.56, 1.24) were significantly associated with long-acting reversible contractive use. Nearly one in 10 postpartum women used long-acting reversible contraceptives. Hence, we suggest that the concerned bodies should promote family planning messages in mass media and give the well-documented benefits of postpartum long-acting contraceptive use. Promote the integration of postpartum LARC methods into maternal health care services and give better attention to postpartum women living in low-income countries and uneducated women.

Introduction Air pollution remains one of the most significant global health threats, affecting populations everywhere. Its widespread and persistent presence has long posed serious risks, and its far-reaching effects underscore the significant threat it poses to public health. Although numerous investigations have been conducted worldwide, their outcomes have remained inconsistent and lacked definitive conclusions. Therefore, this systematic review and meta-analysis sought to determine the association between air pollution and cognitive impairment across the globe. Methods Databases such as PubMed/MEDLINE, Jane, Science Direct, Cochrane Library, LIVIVO, CINAHL, Global Index Medicus, African Journals Online, Web of Science, HINARI, Semantic Scholar, Google, and Google Scholar were used to retrieve all the relevant articles. Data were analyzed using STATA 17 software to determine the pooled associations between air pollution and cognitive impairment with a 95% confidence interval using a random-effects model. Moreover, the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA 2020) guidelines were followed for this study. Result Fifty-four articles with 711,918 study participants were included in this meta-analysis to determine the association between air pollution and cognitive impairment. The findings of the study indicated that for every 1 µg/m 3 increase in PM 2.5 , PM 10 , PM 1 and black carbon concentration, the cognitive function was decreased by − 0.79 (95% CI β: −0.90, -0.68; I 2  = 0.0% and p  = 0.730), − 0.48 (95% CI β: −0.82, -0.15; I 2  = 99.99% and p  = 0.00), − 0.90 (95% CI β: −0.97, -0.82; I 2  = 94.60% and p  = 0.00), and − 0.53 (95% CI β: −1.03, -0.02; I 2  = 99.44% and p  = 0.00) respectively. Moreover, the pooled odds of developing cognitive impairment following exposure to a 1 µg/m 3 increment in concentration of PM 2.5 was 1.02 (95% CI OR: 1.01, 1.02; I 2  = 97.02% and p  = 0.00). Conclusion Exposure to particulate matter air pollutants such as PM 2.5 , PM 10 , PM 1 , and black carbon was associated with an increased risk of cognitive impairment. The results may have substantial public health significance for preventing cognitive impairment through strong air pollution interventions.

Optimal access to ANC, such as the first ANC visit at first trimester, four or more ANC visits, and skilled health care provider can significantly reduce maternal mortality in an inclusive way. Previous studies conducted in Ethiopia on optimal ANC are restricted to frequencies of ANC visit. Therefore, the aim of this study was to assess the magnitude of optimal ANC access as a comprehensive way and its predictors among pregnant women in Ethiopia. Secondary data source from a recent demographic and health survey was used for analysis. This study includes a weighted sample of 4771 pregnant women. A multilevel mixed-effect binary logistic regression analyses was done to identify both the individual and community level factors. Odds ratio along with the 95% confidence interval was generated to identify the predictors of optimal access to ANC. A p-value less than 0.05 was declared as statistical significant. In Ethiopia, one in five (20%) pregnant women had optimal access to antenatal care. Regarding the factors at individual level, pregnant women aged 25-34 years [aOR = 1.58, 95% CI = 1.23-2.03] and 35-49 years [aOR = 2.04, 95% CI = 1.43-2.89], those who had educated primary [aOR = 1.67, 95% CI = 1.33-2.09], secondary and higher [aOR = 1.81, 95% CI = 1.15-2.85], Primipara [aOR = 2.45, 95% CI = 1.68-3.59] and multipara [aOR = 1.48, 95% CI = 1.11-1.98] had higher odds of accessing optimal ANC. With the community level factors, the odds of optimal access to ANC was higher among pregnant women who lived in urban area [aOR = 2.08, 95% CI = 1.33-3.27], whereas, lower odds of optimal ANC access among those pregnant women who reported distance to the health facility as a big problem [aOR = 0.78, 95% CI = 0.63-0.96]. The study concludes that in Ethiopia, optimal access to ANC was low. The study identified that both individual and community level factors were predictors for optimal ANC access. Therefore, the Ethiopian government should intensify extensive education on ANC in a comprehensive way. Moreover, especial attention from the Ethiopian ministry of health for those women who reported distance as a big problem and for rural resident women is mandatory.

Despite the decline in tuberculosis (TB) incidence across many regions worldwide, including Ethiopia, the disease remains highly concentrated among vulnerable or socially marginalized populations and in high-risk settings. This systematic review and meta-analysis aims to estimate the pooled prevalence of pulmonary tuberculosis (PTB) among key and vulnerable populations (KVPs) residing in hotspot settings in Ethiopia. Potential papers were searched systematically in PubMed, Scopus, ScienceDirect databases, Google Scholar search engine, and institutional electronic repositories/registrars. A total of 34 potential articles that provide necessary information on the prevalence of PTB were reviewed and data were analyzed to determine the pooled prevalence of PTB among KVPs. The relevant data were recorded and analyzed using STATA 17.0. Cohen's kappa was computed to determine the agreement between reviewers, the Inverse of variance (I2) to evaluate heterogeneity across studies, and Egger's test to identify publication bias. A random effect model was used to determine the pooled prevalence of PTB, subgroup analysis was computed by types of hotspot settings and year of publication. This meta-analysis demonstrates that the pooled prevalence of PTB among populations residing in hotspot settings in Ethiopia was 11.7% (95% confidence interval (95CI): 7.97-15.43) with an I2 of 99.91% and a p< 0.001. Furthermore, the subgroup analysis unveiled the pooled prevalence of PTB among KVPs residing in different hotspot settings as follows: Prison inmates 8.8% (95CI: 5.00-12.55%), University students 23.1% (95CI: 15.81-30.37%), Refugees 28.4% (95CI: -1.27-58.15%), Homeless peoples 5.8% (95CI: -0.67-12.35%), Healthcare settings 11.1% (95CI: 0.58-21.63%), Spiritual holy water sites attendees 12.3% (95CI: -6.26-30.80%), and other high-risk settings 4.3% (95CI: 0.47-8.09%). Besides, the subgroup analysis revealed that the pooled prevalence of PTB post-2015 was 10.79% (95CI: 5.94-15.64%), whereas it stood at 14.04% (95CI: 10.27-17.82%) before 2015. The prevalence of PTB among KVPs residing in the hotspot settings in Ethiopia remains significant, with a weighted pooled prevalence of 11.7%. Thus, the national TB control programs should give due attention and appropriate control measures should be instituted that include regular systematic TB screening, compulsory TB testing for presumptive TB cases among KVPs, and tightened infection control at hotspot settings.