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Visual impairment is a public health problem in both developing and developed countries, especially, in developing countries where most visually impaired communities are found. Knowledge of the pooled prevalence of visual impairment among adults is useful in planning, preventive programs and the provision of eye-care services for communities. Original observational studies published in English were included in this systematic review and meta-analysis. Eleven studies with a total sample size of 8,161 study participants were included. PubMed/Medline, HINARI, Google Scholar, Cochrane library, Web of Science, and African Journals Online databases were used to search for published articles. Data were extracted on a Microsoft Excel spreadsheet and analyzed using Revman 5.4.1 Software. Meta-analysis of further pooled prevalence estimates using the inverse variance heterogeneity model. The pooled estimate of visual impairment in the current review was estimated using a random-effects model. Forest plots were used to illustrate heterogeneity and to quantify the pooled prevalence of visual impairment. Publication bias was assessed using funnel plots. Visual impairment was defined as a presenting visual acuity of less than 6/18 in the betting-seen eye. A total of 538 studies were identified from several Databases and digital libraries, of which eleven articles were selected for the final meta-analysis. Significant heterogeneity was observed across studies, suggesting a random-effects model to estimate the pooled prevalence of visual impairment. The prevalence of visual impairment in Ethiopia ranges from 10.3% in Addis Ababa central Ethiopia to 37.58% in the Northern Ethiopia. The pooled prevalence of visual impairment in the current review was 22% (95% CI: 17%-27%; I2 = 97%) using a random-effects model. There was also evidence of symmetry in the funnel plots. This systematic review and meta-analysis demonstrated a greater burden of visual impairment among Ethiopians in various study populations. Further, intervention strategies are required to reduce the burden of visual impairment and improve quality of life.

OBJECTIVE To explore the challenges of clinical education from the perspective of clinical instructors and clinical staff at Dire Dawa University College of Health Science. METHODS An institutional-based phenomenological qualitative study was conducted. Clinical instructors and staff provided data through in-depth interviews and key informant discussions, which were facilitated by a semistructured tool and a voice recorder. A total of 17 participants, including 11 in-depth interviews (IDIs) with clinical instructors (including two key informants) and six IDIs with clinical staff were included in this study. A purposive sampling method was used to select study participants, and the data were analyzed thematically using the computer-assisted qualitative data analysis software Atlas.ti7. The thematic analysis with an inductive approach involves six steps: familiarization, coding, generating themes, reviewing themes, defining and naming themes, and writing. RESULTS Clinical instructors and clinical staff noted a number of challenges in clinical education, including insufficient medical equipment, low incentives, clinical site repetition, unfavorable clinical practice sites, lack of communication from instructors, skill attrition, lack of orientation for instructors and students, client/patient unwelcomingness, uncooperative healthcare workers, and poor university cooperation. CONCLUSION The aforementioned issues contributed to the quality of clinical education and its desired impact, as outlined in this research. A multidisciplinary and collaborative effort is needed to address these challenges.

ObjectiveThis analysis is to present the burden and trends of morbidity and mortality due to lower respiratory infections (LRIs), their contributing risk factors, and the disparity across administrative regions and cities from 1990 to 2019.DesignThis analysis used Global Burden of Disease 2019 framework to estimate morbidity and mortality outcomes of LRI and its contributing risk factors. The Global Burden of Disease study uses all available data sources and Cause of Death Ensemble model to estimate deaths from LRI and a meta-regression disease modelling technique to estimate LRI non-fatal outcomes with 95% uncertainty intervals (UI).Study settingThe study includes nine region states and two chartered cities of Ethiopia.Outcome measuresWe calculated incidence, death and years of life lost (YLLs) due to LRIs and contributing risk factors using all accessible data sources. We calculated 95% UIs for the point estimates.ResultsIn 2019, LRIs incidence, death and YLLs among all age groups were 8313.7 (95% UI 7757.6–8918), 59.4 (95% UI 49.8–71.4) and 2404.5 (95% UI 2059.4–2833.3) per 100 000 people, respectively. From 1990, the corresponding decline rates were 39%, 61% and 76%, respectively. Children under the age of 5 years account for 20% of episodes, 42% of mortalities and 70% of the YLL of the total burden of LRIs in 2019. The mortality rate was significantly higher in predominantly pastoralist regions—Benishangul-Gumuz 101.8 (95% UI 84.0–121.7) and Afar 103.7 (95% UI 86.6–122.6). The Somali region showed the least decline in mortality rates. More than three-fourths of under-5 child deaths due to LRIs were attributed to malnutrition. Household air pollution from solid fuel attributed to nearly half of the risk factors for all age mortalities due to LRIs in the country.ConclusionIn Ethiopia, LRIs have reduced significantly across the regions over the years (except in elders), however, are still the third-leading cause of mortality, disproportionately affecting children younger than 5 years old and predominantly pastoralist regions. Interventions need to consider leading risk factors, targeted age groups and pastoralist and cross-border communities.

Objective: This study aimed to determine the burden of diabetic peripheral neuropathy and its associations with overweight/obesity and impaired blood glucose among diabetic patients in Eastern Ethiopia. Method: A total of 644 diabetic individuals were included in the study through systematic random sampling techniques. The Michigan neuropathy screening instrument was used to evaluate the presence of diabetic neuropathy. Data were presented using narrative, figures, and tables from the results of statistical analysis. The descriptive result was reported using frequency (percentage) for categorical variables and mean ± SD for continuous measures, respectively. Multivariable logistic regression was performed to identify factors associated with diabetic peripheral neuropathy. Results: The overall prevalence of diabetic peripheral neuropathy was 47.8% (95% CI: 43.9%–51.7%). Low monthly income (AOR: 2.02, 95% CI: 1.09, 3.73), history of khat chewing (AOR: 2.32, 95% CI: 1.04, 4.907), impaired blood glucose (AOR: 1.52, 95% CI: 1.63, 1.94), physical inactivity (AOR: 2.76, 95% CI: 1.74, 4.36), and raised body mass index (AOR: 2.45, 95% CI: 1.01, 4.99) were factors significantly associated with diabetic peripheral neuropathy. Conclusion: The study emphasizes the value of early diabetic peripheral neuropathy detection and the widespread presence of diabetic peripheral neuropathy risk factors in diabetes patients. Any initiative intended to lessen the burden of diabetic peripheral neuropathy-related morbidity and high health care costs must be implemented as a strategy.

Objective: Malnutrition because of poor dietary diversity contributing to child morbidity and mortality. Two-thirds of child mortality occurs within the first 2 years. However, there is limited data related to dietary diversity among children aged 6 to 23 months in Ethiopia. Thus, this study aimed to assess dietary diversity and factors among children aged 6 to 23 months in the study setting. Methods: A community-based cross-sectional study conducted on 438 children aged 6 to 23 months in Dire Dawa, 1-30/02/2019. Simple random sampling was used to select study subjects. Data collected using a structured and pretested interview administered questionnaire. Data entered using EpiData 4.2 and analyzed with SPSS Version 22. Multivariable logistic regression was used to examine associated factors. Adjusted odd-ratio with 95% confidence interval (CI) used, and P-value <.05 considered statistically significant. Results: The overall minimum dietary diversity practice was 24.4% (95% CI: 20.3, 28.5). Maternal education [AOR 2.20; 95% CI: 1.08, 4.52], decision-making [AOR = 2.5; 95% CI: 1.19, 5.29], antenatal care [AOR = 2.19; 95% CI: 1.20, 3.99], postnatal care [AOR = 6.4; 95% CI: 2.78, 14.94] and facility delivery [AOR = 2.66; 95% CI: 1.35, 5.25] were maternal factors. Moreover, child’s age [AOR = 2.84; 95% CI: 1.39, 5.83], and child’s sex [AOR = 2.85; 95% CI: 1.64, 4.94] were infant factors. Conclusion: One-fourth of children practiced minimum dietary diversity. Child’s age, birth interval, postnatal care, antenatal care, child’s sex, mothers’ decision-making, mothers’ education, and place of delivery were significant predictors. Therefore, maternal education, empowering women, and improve maternal service utilization are crucial to improving dietary diversity.

The basic role of teaching at any degree of training is to bring a rudimentary change within the student. To facilitate the method of information transmission, educators ought to apply acceptable teaching strategies that best suit specific objectives and outcomes. Identifying the best method through comparison of problem-based learning (PBL) and the lecture method; so as to improve students' overall academic performance appear to be important. The aim of the study was to undertake comparison between problem-based and lecture-based learning methodologies for immediate knowledge retention of nursing students at Dire Dawa University. Quantitative research method which used a pre-experimental two group pretest and post-test research design was employed to identify effective teaching methods for immediate knowledge retention on 38 nursing students from June 1 to June 15, 2019. The students were grouped randomly into problem-based learning and lecture methods. The pretest-posttest analysis was done after an intervention made: a two-hour lecture and four-hour problem-based learning accordingly. Content validity ratio and content validity index was conducted for authentication of instruments and Cronbach alpha was computed to verify its reliability. A paired -test was conducted to identify mean score change, and p<0.05 was cut off value to determine if there is a significant mean change in the posttest. Both methods showed significant knowledge score improvement (t=13.6, p< 0.001) for lecture-based method and (t=11.302, p< 0.001) for problem-based learning. But as compared to the lecture method, problem-based learning has little effect on students' immediate knowledge retention, and 63.2% of the nursing students prefer the lecture method as the best teaching method. The lecture method is the best teaching method for immediate knowledge retention for nursing students; it is also the most preferred method of teaching method by the students.

Introduction: Health care workers are at the frontline of the response against the COVID-19 outbreak. Poor preparedness and infection prevention practices among health care workers compound the hazard and occurrence of COVID-19 hospital transmission. Thus, the study aimed to assess preparedness toward COVID-19 pandemics and associated factors among health care workers in Hospitals of Eastern Ethiopia. Methods: Facility-based cross-sectional study was conducted from 20 June to July 10 2020. A simple random sampling technique was used to select 423 health care workers. Data were collected using a structured self-administered questionnaire and analyzed using SPSS Version 23. Bivariate and multivariable logistic regression was conducted to identify factors associated with the outcome variable, and statistical significance was declared at a p-value less than 0.05. Results: This study revealed that the proportion of health care workers’ preparedness toward the COVID-19 pandemic was 40.9% (95% CI: 36.2–45.9). Working in a public hospital (AOR = 2.7, 95% CI: 1.6–4.3), being unafraid of transmitting COVID-19 to patients (Adjusted odds ratio/AOR = 4.6, 95% CI: 2.2–10.0), feeling safe at the workplace (AOR = 3.3, 95% CI: 1.7–6.4)), satisfied with the infection control policy (AOR = 6.0, 95% CI: 2.3–15.0), and not feeling anxious about the likelihood of COVID-19 spread (AOR = 2.1, 95% CI: 1.3–3.4) were significantly associated with COVID-19 preparedness. Conclusion: The majority of the health care workers were not prepared for COVID-19 pandemics. Feeling safe at the workplace scared of transmitting COVID-19 to patients, satisfied with the infection control policy, and feeling anxious concerning the likelihood of COVID-19 were factors associated with health care workers’ preparedness to COVID-19. The current awareness creation training, including motivational and psychological preparation for all health care workers, is mandatory, regardless of their profession or working place.

The health risks associated with moderate alcohol consumption continue to be debated. Small amounts of alcohol might lower the risk of some health outcomes but increase the risk of others, suggesting that the overall risk depends, in part, on background disease rates, which vary by region, age, sex, and year. For this analysis, we constructed burden-weighted dose–response relative risk curves across 22 health outcomes to estimate the theoretical minimum risk exposure level (TMREL) and non-drinker equivalence (NDE), the consumption level at which the health risk is equivalent to that of a non-drinker, using disease rates from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2020 for 21 regions, including 204 countries and territories, by 5-year age group, sex, and year for individuals aged 15–95 years and older from 1990 to 2020. Based on the NDE, we quantified the population consuming harmful amounts of alcohol. The burden-weighted relative risk curves for alcohol use varied by region and age. Among individuals aged 15–39 years in 2020, the TMREL varied between 0 (95% uncertainty interval 0–0) and 0·603 (0·400–1·00) standard drinks per day, and the NDE varied between 0·002 (0–0) and 1·75 (0·698–4·30) standard drinks per day. Among individuals aged 40 years and older, the burden-weighted relative risk curve was J-shaped for all regions, with a 2020 TMREL that ranged from 0·114 (0–0·403) to 1·87 (0·500–3·30) standard drinks per day and an NDE that ranged between 0·193 (0–0·900) and 6·94 (3·40–8·30) standard drinks per day. Among individuals consuming harmful amounts of alcohol in 2020, 59·1% (54·3–65·4) were aged 15–39 years and 76·9% (73·0–81·3) were male. There is strong evidence to support recommendations on alcohol consumption varying by age and location. Stronger interventions, particularly those tailored towards younger individuals, are needed to reduce the substantial global health loss attributable to alcohol. Bill & Melinda Gates Foundation.

Yonatan Solomon Department of Nursing, College of Medicine and Health Sciences, Dire Dawa University, Dire Dawa, EthiopiaCorrespondence: Yonatan Solomon Tel +251 913820259Email yonatnsolomon@gmail.com I am very glad to hear from you and happy to see the letter of response from theauthor Rahul Penumaka showing interest in the publication \"Comparison BetweenProblem-Based Learning and Lecture-Based Learning: Effect on Nursing Students'Immediate Knowledge Retention\" Saying this I think I need to respond to some of the points raised. View the original paper by Solomon This is in response to the Letter to the Editor