BackgroundMaternal mortality is a major public health issue in developing countries due to its shocking magnitude and lower declining pattern. With appropriate strategy and intensive implementation programs, some countries have made remarkable progress, however in developing countries where 99% of maternal death is occurring; little or no progress has been made. Identifying determinants and designing intervention will have important role to overcome the problem. Therefore this study aimed to identify correlates of maternal mortality in developing countries.MethodsThis study was conducted using international data bases of health metrics from 2008 to 2016 using aggregates of health indicator data from WHO, World Bank, UNDP and UNICEF data bases for 82 developing countries. The dependent variable was the maternal mortality ratio, while the independent variable was socio-economic, health care related and morbidity variables. Data was compiled in excel and analyzed using SPSS version 21.ResultsMaternal mortality ratio is very high in developing countries and enormously varies among countries. A significant relationship between the maternal mortality ratio and socio-economic, health care and morbidity indicator variables was observed. There was an inverse and significant correlation of the maternal mortality ratio with Antenatal care coverage, skilled birth attendance, access to an improved water source and sanitation, adult literacy rate, the Gross National Income per capita and positive relation with disease incidence, unmet need and others.ConclusionsMaternal mortality is correlated with multiples of socio-economic factors, health care system associated factors, disease burden and their complex interactions. Therefore Policy and programs targeted to improve maternal health and reduce maternal deaths should consider population dynamics, socio-economic influence and health system factors that impose a major risk on mothers.

BackgroundHIV infection continues to be epidemic of public health importance with a prevalence of 1.1% and incidence of 0.33/1000 population having low-intensity mixed epidemic. Ethiopia has adopted the 90–90-90 by 2020 target but its progress was not yet assessed. Therefore, this study aimed to assess the trend of HIV infection for the last 26 years and to predict the achievements of the 90–90-90 target.MethodsWe used aggregates of HIV/AIDS indicator data from 1990 to 2016 of UNAIDS data bases. The data were analyzed with excel and STATA. The trend line that best fits the regression was drawn, annual change was estimated and future values of HIV detection rate, coverage of antiretroviral therapy and viral suppression indicators were predicted and compared with the 90–90-90 targets.ResultSince 1995, new infection has declined by 81% and since 2002; number of HIV cases has declined by 35.5%. However, after remarkable decline for decades, since 2008 HIV incidence rate began to rise by 10% and number of new infection diagnosed each year increased by 36% among all ages and doubled among adults. ART coverage has increased by 90% among all age and tripled among pregnant women within 6 years. Nationally, 67% of people living with HIV know their status, 88% of them are on treatment and 86% of people on treatment have viral suppression. As a result, AIDS-related death declined by 77 and 79% among all age and children respectively. By 2020, 79% of people living with HIV will know their HIV status, of which 96–99% of HIV infected people will be on ART and more than 86% will have viral suppression.ConclusionAfter remarkable decline, HIV infection started to increase in the last few years among adults. With the current trend, Ethiopia will achieve the second and third 90% HIV targets, while the first target is not achievable and without achieving this overarching goal control of the epidemic will not be achieved. Therefore due attention is needed to avert the current epidemics and diagnosis of cases.Electronic supplementary materialThe online version of this article (10.1186/s12879-018-3214-6) contains supplementary material, which is available to authorized users.

BackgroundThe HIV/AIDS epidemic has been fuelled by gender inequality and disparity resulted in violation of women reproductive right. The “feminization” of the pandemic is more apparent in Sub-Saharan Africa where the larger numbers of HIV infected people are living. Although they carry the higher proportion of HIV cases; access to care and treatment is lower among women. In Ethiopia where HIV is prevalent and gender violence is common, the disparity may be higher. Therefore, this research aimed to assesses trends in gender disparity in the HIV/AIDS epidemic in Ethiopia to bring evidence for action.MethodsThis study was conducted using aggregates of HIV/AIDS indicator data from 1990 to 2016 of UNAIDS data bases. The data was compiled and analyzed with excel and STATA Version 11. The trend was assessed, gender difference was measured and rate of change was compared between genders and specific age groups.ResultAdult females (age 15+) accounted 61.5% of the HIV cases and new infection among adults. While, adolescent females (age 10-19) and young women (age 15-24) accounted 52.3 and 57.5% of prevalent cases and 74 and 68% of new infection in their age category respectively. HIV is 1.62 times more prevalent among adult women than men. Since 1990, HIV cases among adults has risen markedly in the first decade with 24 and 20%, then declined by 41.5% in the second decade and rose again by 5 and 8.7% among women and men respectively. The overall prevalence is declined by 72.4 and 71.5% from the maximum record. Women and men have equal access for ART; 62% of men and 61% of women from all adults living with HIV were on ART. While 61% of deaths were among adult women and the death rate is similar among adolescent women and men. AIDS- related death has been declined by 76% from the maximum record.ConclusionHIV/AIDS prevalence, new infection and AIDS-related death are by far higher among adult women than men. While the coverage of treatment and HIV care is equal among both genders. Vulnerable age groups (adolescent females and young women) take the lion’s share of the new infections and prevalent cases. Therefore due attention is needed to avert gender disparity with a particular emphasis for adolescents and young women.Electronic supplementary materialThe online version of this article (10.1186/s13690-018-0299-8) contains supplementary material, which is available to authorized users.

IntroductionAlong with increasing availability and utilization of contraception, It is also important to confirm that the effects of contraception use on resumption of fertility after discontinuation However currently evidences on resumption of fertility after contraception use are inconclusive and practically fertility after termination of contraception remains a big concern for women who are using contraception. This fear poses a negative impact on utilization and continuation of contraception. Therefore, Estimating the rate of pregnancy resumption after contraceptive use from the available reports and identifying the associating factors are important for designing a strategy to overcome the problem.MethodsThe review was conducted through a systematic literature search of articles published between 1985 and 2017. Five bibliographic databases and libraries: PubMed/Medline, Global Health Database, Embase, the Cochrane Library, and African Index Medicus were used. After cleaning and sorting, analysis was performed using STATA version 11. The pooled rate of conception was estimated with a random-effects model. Heterogeneity was assessed by the I2 and publication bias through funnel plot.ResultsTwenty two studies that enrolled a total of 14,884 women who discontinued contraception were retained for final analysis. The pooled rate of pregnancy was 83.1% (95% CI = 78.2-88%) within the first 12 months of contraceptive discontinuation. It was not significantly different for hormonal methods and IUD users. Similarly the type of progesterone in specific contraception option and duration of oral-contraceptive use do not significantly influence the return of fertility following cessation of contraception. However the effect of parity in the resumption of pregnancy following cessation of contraception was inconclusive.Conclusion and recommendationContraceptive use regardless of its duration and type does not have a negative effect on the ability of women to conceive following termination of use and it doesn’t significantly delay fertility. Therefore, appropriate counseling is important to assure the women to use the methods as to their interest.

Background Through universal “test and treat approach” (UTT) it is believed that HIV new infection and AIDS related death will be reduced at community level and through time HIV can be eliminated. With this assumption the UTT program was implemented since 2016. However, the effect of this program in terms of individual patient survival and treatment outcome was not assessed in relation to the pre-existing defer treatment approach. Objective To assess the effects of UTT program on HIV treatment outcomes and patient survival among a cohort of adult HIV infected patients taking antiretroviral treatment in Gurage zone health facilities. Methods Institution based retrospective cohort study was conducted in facilities providing HIV care and treatment. Eight years (2012–2019) HIV/AIDS treatment records were included in the study. Five hundred HIV/AIDS treatment records were randomly selected and reviewed. Data were abstracted using standardized checklist by trained health professionals; then it was cleaned, edited and entered by Epi info version 7 and analyzed by STATA. Cox model was built to estimate survival differences across different study variables. Results A total of 500 patients were followed for 1632.6 person-year (PY) of observation. The overall incidence density rate (IDR) of death in the cohort was 3 per-100-PY. It was significantly higher for differed treatment program, which is 3.8 per-100-PY compared to 2.4 per-100-PY in UTT program with a p value of 0.001. The relative risk of death among differed cases was 1.58 times higher than the UTT cases. The cumulative probability of survival at the end of 1st, 2nd, 3rd, and 4th years was 98%, 90.2%, 89.2% and 88% respectively with difference between groups. The log rank test and Kaplan–Meier survival curve indicated patients enrolled in the UTT program survived longer than patients enrolled in the differed treatment program (log rank X2 test = 4.1, p value = 0.04). Age, residence, base line CD4 count, program of enrolment, development of new OIS and treatment failure were predicted mortality from HIV infection. Conclusion Mortality was significantly reduced after UTT. Therefore, intervention to further reduce deaths has to focus on early initiation of treatment and strengthening UTT programs.

Background Vaccination is the promising strategy to control the coronavirus disease 2019 (COVID-19) pandemic. However, the success of this strategy will rely mainly on the rate of vaccine acceptance among the general population. Therefore, this systematic review and meta-analysis aimed to estimate the pooled prevalence of COVID-19 vaccine acceptance and its determinants in Ethiopia. Methods We searched PubMed, Scopus, Google Scholar, African Journals Online, and Web of Sciences database to retrieve related articles. Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines were used for this study. Funnel plot and Eggers test were done to assess publication bias. Cochrane Q-test and I2 statistic were done to chick evidence of heterogeneity. Subgroup analysis was computed based on the study region and the study population. Data were extracted using a Microsoft Excel spreadsheet and analyzed using STATA version 14 statistical software. Weighted inverse variance random effect model was run to estimate the pooled prevalence of COVID-19 vaccine acceptance. Results A total of 12 studies with 5,029 study participants were included. The pooled prevalence of COVID-19 vaccine acceptance in Ethiopia was 51.64% (95%CI; 43.95%-59.34%). Being male (AOR = 4.46, 1.19–16.77, I2 = 88%), having secondary and above educational status (AOR = 3.97, 1.94–8.12, I2 = 69%), good knowledge (AOR = 3.36, 1.71–6.61, I2 = 93%), and positive attitude (AOR = 5.40, 2.43–12.00, I2 = 87%) were determinants of COVID-19 vaccine acceptance in Ethiopia. Conclusion The pooled prevalence of COVID-19 vaccine acceptance was low. Being male, having secondary and above educational status, good knowledge, and positive attitude were the determinants of COVID-19 vaccine acceptance. High level of COVID-19 vaccine acceptance among the general population is crucial to achieve herd immunity in the community. Therefore, policymakers, vaccine campaign program planners, and stakeholders should target to improve public awareness of vaccination that enhances vaccine acceptance and in turn helps to control the pandemic.

Introduction:High prevalence of anemia attributable to intestinal parasite infection occurs among children in developing countries. As a result mass treatment of all children with anti-helminthic drugs particularly in school setting is being implemented. There are few studies conducted to assess impact of deworming on anemia prevalence among school children with inconclusive finding. Therefore we aimed to conduct a systematic review on impact assessment of deworming on anemia prevalence or hemoglobin level of school children so that policy makers and other stalk holders could have pooled evidence on the direction to make decision.Methods:The review was conducted through a systematic literature search of articles published between 1998 and 2015. Five bibliographic databases and libraries: PubMed/Medline, Global Health Database, Embase, the Cochrane Library, and African Index Medicus were used. After cleaning and sorting, analysis was performed using STATA version 11. The pooled estimate was through a fixed-effects model. Heterogeneity was assessed by the I2 and publication bias through funnel plot.Results:Eight studies were retained for final analysis which enrolled a total of 1,005,239 school children. The overall change in the hemoglobin level after deworming was 1.62(95%CI=1.01-2.25) gram/deciliter. There was no difference between the random effect model and the fixed effect model. The prevalence of anemia was markedly changed after the program, particularly in the studies which implemented deworming with hygiene program, co-administration of iron and retinol.Conclusion and Recommendation:School based deworming program decreases prevalence of anemia and will contribute to reduction of anemia in the community. Therefore the program should be expanded in all areas and integrated with other child care programs.

Introduction: It is highly economical and commendable to identify the determinants of neonatal near miss which will be utilized as proxy determinants of neonatal mortality rate. However, neither determinants of neonatal mortality rate nor a determinant of a neonatal near miss are adequately investigated specifically within the study area. Therefore, this study is aimed to identify the determinants of neonatal near-miss among neonates admitted in hospitals of the Gurage zone, Southern Ethiopia. Methods and Materials: Unmatched case-control study was conducted to identify factors associated with neonatal near-miss among neonates admitted in Gurage zone hospitals. A pre-tested structured interviewer-administered questionnaire was used to collect the data. Besides, data related to the clinical diagnosis of neonates and managements given were extracted from patient records. In this study, a total of 105 cases and 209 controls have participated. To recruit cases and controls consecutive sampling methods and simple random sampling techniques were used respectively. Data were entered using Epi Data software and exported to SPPS for analysis. To identify the determinate factors of the outcome variable binary and multivariable logistic regression were employed. Results: The determinate factors of the outcome variable include a history of abortion with AOR 3.9 [95%C1 3.53-10.15], referred from other health care institution AOR 7.53[95% CI 3.99-14.22], severe maternal morbidity during pregnancy AOR 4.57[95% CI 1.77-11.79], cesarean section mode of delivery 4.45[95% CI 1.76-11.25], and good essential newborn care knowledge AOR 3.33[95% CI 1.54-7.19]. Conclusion: In this study, easily modifiable/preventable maternal and health service utilization-related factors are increasing the menace of a neonatal near-miss in the Gurage zone. It is the signal that shows the primary health care program needs to be further enhanced to bring more desirable health outcomes and/or effectiveness of health policies needs to be examined to introduce more impactful strategies.