BACKGROUND:Preventable medication-related problems intensify the risk associated with cancer care and no data was available to represent the burden of medication-related problems among cancer patients in Ethiopia. Hence, this study was aimed to estimate the pooled prevalence of medication-related problems and identify its predictors among cancer patients treated in Ethiopia. METHODS:A systematic review and meta-analysis of studies retrieved from databases (Medline, EMBASE, Scopus, Cumulative Index to the Nursing and Allied Literature (CINAHL), Cochrane Library and Google Scholar) for relevant literature published before April, 2024 was made. We included observational studies conducted in Ethiopia that reported on the types, frequency, or risk factors of medication-related problems in cancer patients. Reviews, case reports, qualitative studies, and studies lacking relevant outcomes were excluded. The Newcastle-Ottawa quality assessment scale was used for quality assessment and the Egger's regression test and the Galbraith plot were used to evaluate publication bias. The national prevalence of medication-related problems was estimated using a random-effects model meta-analysis. Moreover, subgroup analysis and meta-regression analyses were done to explore the reasons of statistical heterogeneity. The study protocol has been registered with PROSPERO under number CRD42024505218. RESULTS:A total of 15 studies comprising of 3084 cancer patients were included in this study. The adjusted pooled prevalence of medication-related problems of cancer patients who experienced at least one medication-related problem was 48% [0.48 (95% CI: 0.39-0.57; I2 = 96%; p < 0.01)]. The study also revealed the pooled prevalence of non-adherence among the included studies to be 42% [0.42 (95% CI: 0.27-0.57; I2 = 97%; p < 0.01)]. The presence of comorbidities (AOR = 4.47, 95% CI: 3.26-5.69), complications (AOR = 5.78, 95% CI: 3.26-8.30) and polypharmacy (AOR = 3.75, 95% CI: 2.16-5.34) were found to be predictors of developing medication-related problems. CONCLUSION:This review found a high pooled prevalence of medication-related problems among cancer patients in Ethiopia, with predictors including comorbidities, complications and polypharmacy. About two-fifths of patients were not fully adherent to their prescribed cancer treatments. These findings highlight the need for targeted interventions to improve medication safety and adherence, and underscore the importance of future research to identify effective strategies for reducing MRPs in oncology settings.

ABSTRACT Background and Aims Labor pain is a multidimensional experience influenced by emotional, cognitive, and cultural factors. It can be managed using pharmacological, non‐pharmacological, or combined approaches. Licensed obstetric care providers (OCPs) are ethically obligated to ensure maternal comfort while safeguarding fetal safety. Evidence on labor pain management practices (LPMP) in Ethiopia remains inconsistent, as prior studies often included students or had unclear inclusion criteria. This systematic review and meta‐analysis estimated the pooled prevalence of LPMP among licensed OCPs, identified associated factors, and examined trends before and during the COVID‐19 pandemic. Methods We searched major databases and repositories for studies published between January 1, 2018 and October 3, 2025. Risk of bias was assessed using the Joanna Briggs Institute checklist and modified Newcastle‐Ottawa Scale, with inter‐rater reliability analyses. Meta‐analysis was conducted in STATA 17 using random or fixed‐effects models. Heterogeneity was assessed using Cochran's Q test and quantified with I2 statistic. Certainty of evidence rated using GRADE. Results Twenty studies involving 7,202 participants were included. LPMP prevalence varied substantially across studies and settings. The pooled prevalence of overall LPMP was 46.9% (95% CI: 42.7–51.1; I2 = 92.4%). Non‐pharmacological practice was 42.8% (95% CI: 36.6–49.1), whereas pharmacological practice was 21.1% (95% CI: 12.5–29.7), decreasing to 15.2% after adjustment for publication bias. Pharmacological practice was modestly higher during COVID‐19 (23.7% vs. 18.0%). Factors positively associated with LPMP included provider knowledge, attitudes, training, drug/protocol availability, supportive environments, higher education, longer experience, positive perceptions, being a midwife, and female sex. Certainty of evidence ranged from low to moderate. Conclusion LPMP prevalence varied considerably across studies and settings. While the pooled estimate suggests that fewer than half of Ethiopian OCPs practiced LPMP, substantial unexplained heterogeneity warrants cautious interpretation. Non‐pharmacological methods were more commonly used than pharmacological approaches, highlighting opportunities to strengthen provider training, institutional support, and resource availability.

Background Labor pain is a distinctive physiological and psychological experience requiring effective management to ensure respectful maternity care. Global guidelines recommend both labor pain management approaches, yet implementation in Ethiopia remains inconsistent. This review assessed the pooled prevalence and predictors of labor pain management practices (LPMPs) among licensed obstetric care providers (OCPs). Methods A comprehensive search was conducted across major databases and institutional repositories for studies published between 2018 and 2025. Critical appraisal used the Joanna Briggs Institute checklist and the modified Newcastle–Ottawa Scale. Meta‑analysis was performed in STATA 17, with heterogeneity assessed using Cochran’s Q and I². Pooled adjusted odds ratios (AORs) with 95% CI were calculated, and certainty of evidence rated using GRADE. Results Twenty studies were included, comprising 5,272 participants for non‑pharmacological LPMP (N‑PLPMP) and 3,586 for pharmacological LPMP (P‑PLPMP). The pooled prevalence of N‑PLPMP was 42.8%, whereas P‑PLPMP was 21.1%, decreasing to 15.2% after adjustment for publication bias. Knowledge, favorable attitudes, supportive environments, and managment protocol availability were consistently associated with N‑PLPMP. Certainty of evidence was moderate for N‑PLPMP and low for P‑PLPMP. Conclusions Both P&NPLPMPs remain suboptimal. Adoption of standardized protocols, strengthened training, and systemic support is essential to advance evidence‑based intrapartum care.

Herbal medicine use is widespread among individuals with type 2 diabetes mellitus (T2DM), yet its influence on glycemic control remains uncertain. This study aimed to assess the prevalence of herbal medicine use and its association with glycemic control among adults with T2DM. A cross-sectional study was conducted from January to June 2025 among 420 adults with T2DM selected through systematic random sampling. Data were collected using structured interviews and medical record reviews. Glycemic control was assessed based on glycated hemoglobin (HbA1c) levels, with HbA1c < 7% considered good control. Descriptive statistics summarized sociodemographic and clinical characteristics. Associations between herbal use and glycemic control were examined using multivariable logistic regression analyses, with p < 0.05 denoting statistical significance. Of 420 participants, 223 (53.0%) were female, and the majority resided in urban areas (67.4%). Most (74.8%) had lived with diabetes for more than five years, and one-third (33.3%) had comorbidities. Herbal medicine use was reported by 219 (52.1%) participants, predominantly Moringa oleifera (61.6%), Trigonella foenum-graecum (45.7%), and Allium sativum (38.8%). Overall, 228 (54.3%) participants achieved good glycemic control (HbA1c < 7.0%), while the remaining 192 (45.7%) exhibited poor glycemic control (HbA1c ≥ 7.0%). In multivariable logistic regression, urban residence (AOR = 10.5, 95% CI 4.9-22.7), shorter diabetes duration (< 5 years) (AOR = 10.18, 95% CI 4.46-23.23), absence of comorbidity (AOR = 2.58, 95% CI 1.58-4.21), and non-users (AOR = 3.89, 95% CI 2.38-6.38) were independently associated with good glycemic control. Literacy and age above 40 years were also significant predictors (p < 0.05). In conclusion, the prevalence of herbal medicine use was high among individuals with T2DM but was significantly associated with poor glycemic control.

Hepatitis B virus infection is a major public health concern with a high contagious rate via blood and body fluids. It is a vaccine-preventable disease. Graduate-level students of health sciences are future healthcare professionals who play a crucial role in the prevention and management of hepatitis B virus. However, they are also at increased risk of exposure to the virus. The study was aimed to assess knowledge, attitude and prevention practices towards HBV infection and associated factors among graduate students at the College of Medicine and Health Sciences, Bahir Dar University. A cross-sectional study was conducted at the College of Medicine and Health Sciences, Bahir Dar University, from 15 January to 14 March 2024, using a pre-tested, structured, self-administered questionnaire. A total of 149 eligible participants who met the inclusion criteria were enrolled in the study. Data were entered and analyzed using Statistical Package for the Social Sciences version 25. Frequencies, percentages and binary logistic regression were employed to summarize and interpret the data. A multivariable logistic regression analysis was conducted to assess associations, with statistical significance defined as a p-value ≤ 0.05 and 95% confidence intervals. Only variables with a p-value ≤ 0.2 in the univariate analysis were included in the multivariate analysis to account for potential confounding. A total of 86 (57.7%) participants demonstrated good knowledge about hepatitis B, while nearly half (48.3%) exhibited a favorable attitude, and 76 participants (51%) reported good practices. Those studying medicine (AOR: 8.56; 95% CI: 2.42–30.29), nursing (AOR: 3.88; 95% CI: 1.07–14.00), pharmacy (AOR: 6.26; 95% CI: 1.33–29.55), and medical laboratory science (AOR: 4.12; 95% CI: 1.01–16.80) were more likely to have good knowledge. Furthermore, students who had received prior training on hepatitis B virus infection were also more likely to have good knowledge (AOR: 5.37; 95% CI: 1.79–16.23). However, pharmacy students were found to have significantly lower levels of good practice (AOR: 0.07; 95% CI: 0.01–0.68). Health science students showed greater knowledge about hepatitis B virus infection and its prevention strategies compared to their attitudes and practices. Knowledge levels were significantly associated with the students’ field of study and prior training on hepatitis B virus, while practice levels also showed a significant association with the field of study.

BackgroundAtrial fibrillation (AF) poses significant thromboembolism and bleeding risks, especially in older adults. Warfarin continues to be a primary treatment option, and maintaining the Time in Therapeutic Range (TTR) is critical for ensuring its effectiveness. However, suboptimal TTR is associated with increased risks of stroke, bleeding, and mortality. Despite its importance, there is limited data on warfarin management in Ethiopian older adults with AF. Therefore, this study aimed to determine the TTR, bleeding events, and their determinants, in older patients with AF in Ethiopia receiving warfarin therapy.MethodIn this study, older patients with AF who were treated with warfarin and had follow-up visits between May 2021 and May 2024, and met the inclusion criteria, were included. Patients were categorized based on TTR into two groups: poor anticoagulation (TTR < 65%) and good anticoagulation quality (TTR ≥ 65%). Bivariate and Multivariate Logistic regression was performed to predict determinants of a TTR < 65% and bleeding events. Odds ratios with 95% confidence intervals (CIs) were calculated, and statistical significance was set at P < 0.05.ResultsIn this study, 384 patients with AF were included. Of this 53.4% were female. Of these 71% of patients had a TTR below 65%, 29% achieved ≥65%, with a median TTR of 45%. Bleeding events were reported by 13.5% of patients. Poor TTR was significantly associated with age (AOR = 1.199, 95% CI: 1.109–1.297), chronic kidney disease (AOR = 27.809, 95% CI: 7.57–101.76), and infrequent INR monitoring at 31–90-day intervals (AOR = 0.15, 95% CI: 0.004–0.051). Regarding determinants of bleeding events, Patients with diabetes mellitus had a 2.6-fold higher bleeding risk (AOR = 2.585, 95% CI: 1.069–6.250), and a CHA2DS2-VASc score ≥3 significantly increased bleeding risk compared to scores ≤2 (AOR = 7.562, 95% CI: 2.770–20.640).ConclusionThis study highlights suboptimal warfarin therapy among older Ethiopian patients with AF. Poor anticoagulation was associated with advanced age, chronic kidney disease, and infrequent INR monitoring, while diabetes mellitus and high CHA₂DS₂-VASc scores increased bleeding risks. Close monitoring and frequent INR checks are essential to improving outcomes.

AIMS:Several Artificial Intelligence (AI) based predictive tools have been developed to predict non-adherence among patients with type 2 diabetes (T2D). Hence, this study aimed to describe and evaluate the methodological quality of AI based predictive tools for identifying T2D patients at high risk of treatment non-adherence. METHODS:A systematic search was conducted across multiple databases including, EMBASE, Cochrane Library, MedLine, and Google Scholar search. The Prediction model Risk Of Bias ASsessment Tool (PROBAST) was used to assess the quality of studies. The performances of tools were assessed by Area Under the Curve (AUC), precision, recall, C-index, accuracy, sensitivity, specificity or F1 score. RESULTS:Most studies measured predictive ability using AUC (75 %), and some only reported precision (25 %), recall (12.5 %), C-index (12.5 %), accuracy (37.5), sensitivity (12.5 %), specificity (12.5 %) or F1 score (25 %). All tools had moderate to high predictive ability (AUC > 0.70). However, only one study conducted external validation. Demographic characteristics, HbA1c, glucose monitoring data, and treatment details were typical factors used in developing tools. CONCLUSIONS:The existing AI based tools holds significant promise for improving diabetes care. However, future studies should focus on refining the existing tools, validating in other settings, and evaluating the cost-effectiveness of AI-supported interventions.

The rise of antimicrobial resistance, driven largely by the inappropriate use of antibiotics, presents a significant global health challenge. Healthcare professionals (HCPs) self-medication practice (SMP) with antibiotics is a concerning practice. The role of knowledge, and attitudes, in shaping SMP has not been explored, in the context of Ethiopia. This study aims to investigate the patterns of antibiotic use, knowledge, attitudes, and associated the factors with SMP among healthcare professionals in tertiary hospitals in Bahir Dar, North West Ethiopia. A cross-sectional study was conducted from September 2023 to February 2024 in two tertiary hospitals in Bahir Dar, Ethiopia. The study included 410 healthcare professionals selected using proportional allocation and convenience sampling. A structured, self-administered questionnaire was used to assess participants’ demographics, knowledge, attitudes, and practices regarding antibiotic use. Knowledge was assessed through scoring, and attitudes were evaluated using a Likert scale. Data were analyzed using SPSS version 27.0, employing bivariate and multivariate logistic regression analyses to identify factors associated with SMA. Knowledge assessment revealed that 58.5% had good knowledge. In terms of job categories, nurses comprised the largest group (48.8%). A majority (60.2%) had 1–5 years of experience. 57.8% of participants exhibited a poor attitude to SMP. Respiratory infections (20.61%) were the most common health condition reported, followed by gastrointestinal infections (15.43%). The most frequently used antibiotics were amoxicillin (35%), augmentin (25%), and azithromycin (25%). Key factors influencing SMA included ease of access to antibiotics (36%), cost-effectiveness (23%), and knowledge/expertise (22%). Time constraints, perceived severity of conditions, and past self-medication experiences were also significant factors. While 83.8% considered self-medication to be safe, 75% recognized the potential adverse effects of medications. The multivariate analysis revealed that being a physician (AOR = 23.39) or a pharmacist (AOR = 7.79) was strongly associated with self-medication. Degree holders, MSc holders, and specialized physicians were also more likely to self-medicate. A poor attitude was a significant determinant, with healthcare professionals displaying poor attitudes being almost twice as likely to self-medicate (AOR = 1.91). The findings highlight the prevalent practice of self-medication with antibiotics among healthcare professionals in Ethiopia, influenced by factors such as knowledge, access to antibiotics, and professional attitudes. The study highlights the urgent need for targeted interventions to enhance healthcare professionals’ knowledge and attitudes regarding responsible antibiotic use while addressing their own practices of self-medication.

Schizophrenia is among the serious mental illness affecting about 1% of the global population and ranking among the top ten causes of long-term disability. It is a major contributor to global disability and requires consistent adherence to antipsychotic medication for effective management. However, treatment non-adherence remains a significant challenge, particularly in Sub-Saharan Africa (SSA), where systemic barriers and cultural stigma further exacerbate the issue. This systematic review and meta-analysis aim to estimate the pooled prevalence of antipsychotic non-adherence among patients with schizophrenia in SSA and to identify the factors associated with treatment non-adherence. A systematic search was conducted across multiple databases, including PubMed, Cochrane, Scopus, African Index Medicus, and Google Scholar, for studies published before February 2025. This review has been registered with PROSPERO (registration number: CRD420251038674). Data were extracted using standardized forms, and study quality was assessed using the Joanna Briggs Institute (JBI) tools. A random-effects model was employed to estimate the pooled prevalence, with subgroup analyses and meta-regression conducted to explore sources of heterogeneity. This meta-analysis, which was conducted in SSA, included 16 full-text articles encompassing a total of 5,994 participants. The pooled prevalence of antipsychotic non-adherence was 45.30% (95% CI: 29.57-61.04%), with substantial heterogeneity observed (I2 = 99.51%). The review identified Several factors associated with treatment regimen non-adherence, including EPS (AOR = 3.95, 95% CI: 1.84-8.48), polypharmacy (AOR = 2.15, 95% CI: 1.56-2.96), substance use (AOR = 2.30, 95% CI: 1.43-3.71), alcohol use (AOR = 2.70, 95% CI: 1.21-5.99), perceived stigma (AOR = 2.58, 95% CI: 1.73-3.84), and lack of family support (AOR = 2.01, 95% CI: 1.33-3.04). The study reveals that nearly half of patients with schizophrenia in SSA exhibit non-adherence to antipsychotics, driven by treatment-related side effects, substance use, and socio-cultural barriers. Targeted interventions simplifying regimens, managing EPS, enhancing family involvement, and reducing stigma are urgently needed. Policymakers should prioritize mental health infrastructure and community education to improve adherence and outcomes in this vulnerable population.

BACKGROUND:Warfarin use in Sub-Saharan Africa is associated with elevated risks of thromboembolic events and bleeding, but precise prevalence estimates are lacking. This systematic review and meta-analysis aimed to quantify the prevalence of bleeding and thromboembolic events among patients on warfarin in Sub-Saharan Africa. METHODS:Comprehensive searches were conducted in MEDLINE via Ovid, PubMed, Embase via Ovid, Scopus, and Google Scholar to identify relevant studies. Primary outcomes included major and minor bleeding events, while thromboembolic events were secondary outcomes. Meta-analysis was conducted using RStudio version 4.3.3 with the meta and metaprop packages. Proportions were transformed using the Freeman-Tukey double arcsine method, and meta-regression was performed with the metafor package's escal, rma, and res functions. Publication bias was assessed via funnel plots and Egger's test, with a p value < 0.05 indicating potential bias. Sensitivity analysis was conducted through leave-one-out analysis. The review was performed in adherence to PRISMA guidelines. RESULTS:We identified 10 observational studies for inclusion in this systematic review and meta-analysis. Egger's test indicated no publication bias. Meta-regression analysis showed that moderators (publication year, sample size, setting, and follow-up duration) did not significantly impact bleeding risk. The pooled prevalence of major and minor bleeding was 18% (95% CI: 0.10-0.27; I2: 96%, prediction interval: 0.00-0.53), with rates ranging from 4% to 46%. Thromboembolic events occurred in 7% of warfarin users (95% CI: 0.01-0.07). CONCLUSION:Warfarin therapy in Sub-Saharan Africa is associated with considerable bleeding and thromboembolic risks. The robustness of these findings was confirmed through meta-regression and sensitivity analyses, underscoring the need for improved therapeutic monitoring and safety strategies in this population.

OBJECTIVES:This systematic review and meta-analysis focused on summarizing and quantitatively estimating the pooled adherence rates to clinical guideline recommendations for anticoagulation therapy in patients with AF receiving treatment in Ethiopian hospitals. METHODS:The Systematic literature search was conducted in PubMed, Cochrane Library, Africa-specific databases (African Index Medicus, and African Journals Online), and Google Scholar. Data were extracted in a structured format prepared using Microsoft Excel. The extracted data were exported to R software Version 4.3.0 for analysis. The I2 test was used to check the heterogeneity between primary studies with a corresponding 95% confidence interval (CI). Based on the test result, a random-effects meta-analysis model was used to estimate pooled effect adherence rate to the international guideline in antithrombotic therapy. RESULTS:The review included a total of 6 primary studies with the pooled adherence rate to guidelines in antithrombotic therapy use in patients diagnosed with AF who are at high risk for thromboembolic events and eligible for oral anticoagulants was found to be 55% (95% CI: 33% to 77%). CONCLUSION:Guideline adherence for oral antithrombotic therapy was low (55%), leaving many high-risk patients vulnerable. Multifaceted interventions, including coordinated care and pharmacist involvement, are needed to improve adherence.

Background:Epilepsy is a major public health issue worldwide, often leading to physical and cognitive impairments that limit employment, independence, and social interaction. Health-related quality of life (HRQoL) is a crucial outcome in the treatment of chronic epilepsy as it is linked to reduced independence, treatment challenges, and lower life expectancy. HRQoL serves as an important health indicator for assessing the impact of the disease on daily living activities. Objective:This study aimed to estimate the mean score of health-related quality of life (HRQoL) and factors associated with lower HRQoL in people living with epilepsy (PLWE) in sub-Saharan African (SSA) countries. Methods:A comprehensive literature search was conducted using PubMed, Cochrane Library, Scopus, and Google Scholar databases. This review has been registered with PROSPERO (CRD42024620363). The eligibility criteria were established, and this review included cross-sectional and observational studies assessing HRQOL in PLWE in SSA countries, published in English from the inception of databases through November 2024. The pooled HRQoL was reported as the mean score with accompanying 95% confidence intervals. Finally, publication bias was evaluated using a funnel plot and Egger's regression test. Results:The pooled mean score of HRQoL among PLWE in SSA was 63.79 (95% CI: 59.75-67.84%). Owing to significant heterogeneity across the studies, a random-effects model was utilized for the meta-analysis (I2 = 98.96%, p < 0.001). This meta-analysis indicated that anxiety (β = -4.762, p = 0.0029), depression (β = -4.591, p < 0.0001), uncontrolled seizures (β = -4.321, p < 0.0001), and a family history of epilepsy (β = -5.093, p = 0.0013) had statistically significant negative impacts on HRQoL in PLWE. Despite some asymmetry in the funnel plot, Egger's test showed no significant publication bias, with a p-value of 0.321. Conclusion:This review found a moderate pooled mean score of HRQoL among PLWE in SSA countries. Factors that negatively affect HRQoL in these regions include anxiety, depression, uncontrolled seizures, comorbidities, and a family history of epilepsy. Systematic review registration:https://www.crd.york.ac.uk/PROSPERO/search, identifier CRD42024620363.

Background:The quality of anticoagulation with warfarin is often assessed through the time in therapeutic range (TTR). However, achieving optimal TTR and maintaining therapeutic INR levels presents significant challenges in Sub-Saharan Africa. This review aims to summarize the existing evidence on the quality of warfarin anticoagulation among patients in Sub-Saharan Africa. Method:We searched MEDLINE via Ovid, PubMed, Embase via Ovid, and Scopus, and citation analysis from Google Scholar. The review's primary focus was therapeutic INR and TTR ≥ 65. Meta-analysis was conducted using R version 4.3.3. A mixed-effects meta-regression model was used to examine the influence of moderators, with heterogeneity estimated using I 2 and prediction intervals (PI), and publication bias assessed through funnel plots and Egger's test, with p < 0.05 indicating potential bias. The robustness of pooled proportions was tested using a leave-one-out sensitivity analysis. The preparation of this review adhered to the guidelines outlined in the PRISMA. Results:We identified 15 observational studies for inclusion in this systematic review and meta-analysis. Egger's test confirmed an absence of publication bias across these studies. Sensitivity analyses showed consistency in individual therapeutic INR (pooled estimate: 0.37; range: 0.37-0.40) and TTR (pooled estimate: 0.16; range: 0.15-0.17), closely aligning with pooled proportions. Meta-analysis of high-quality TTR measurements yielded a pooled prevalence of 17% (I 2 = 89%), with study-specific values ranging from 10 to 29% and predicted effect sizes between 0.05 and 0.34. The therapeutic INR was observed at a pooled prevalence of 40% (I 2 = 86%; prediction interval: 0.16, 0.67). Conclusion:Warfarin therapy is associated with very low percentage of TTR suggests poor quality of anticoagulation management. Sensitivity analyses confirmed the robustness of these findings.

BackgroundDiabetic ketoacidosis (DKA) is one of the most common life-threatening acute metabolic complications of diabetes, typically associated with disability, mortality, and significant health costs for all societies. In Ethiopia, available studies on in-hospital mortality rates of people living with DKA have shown high variability. Therefore, this systematic review and meta-analysis aims to summarize and provide quantitative estimates of the prevalence of in-hospital mortality among adult people living with DKA treated in Ethiopian hospitals.MethodologyA systematic literature search was conducted using MEDLINE, Embase, Google Scholar, Web of Science, and Africa-specific databases. Data were extracted in a structured format prepared using Microsoft Excel. The extracted data were exported to R software Version 4.3.0 for analysis. The I2 test was used to check the heterogeneity between primary studies with a corresponding 95% confidence interval (CI). Based on the test result, a random-effects meta-analysis model was used to estimate Der Simonian and Laird’s pooled effect on in-hospital mortality.ResultThe review included a total of 5 primary studies. The pooled prevalence of in-hospital mortality among people living with DKA who received treatment in Ethiopia hospitals was found to be 7% (95% CI: 1-12). Most of the included studies reported that nonadherence to insulin treatment followed by infection was the most common triggering factor for the development of DKA.ConclusionThe prevalence of in-hospital mortality among people living with DKA was found to be 7%. This figure is unacceptably high compared to other published reports. Nonadherence to insulin treatment or antidiabetic medication and infection were identified as precipitating factors for developing DKA. Therefore, measures must be taken to improve medication adherence and decrease in-hospital mortality by providing ongoing health education on medication usage, effective in-hospital management of hyperglycemia, and increased access to high-quality care.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD42023432594.

ObjectiveA pronounced burden is evident in individuals with asthma, with approximately half of them not adhering to their prescribed medication. Therefore, this study aimed to assess the pooled prevalence of anti-asthma medications non-adherence in Ethiopia.Data sourcesA comprehensive search was conducted across multiple electronic databases including PubMed, Africa Index Medicus, Science Direct, Hinari, and a search engine, Google Scholar from October 5 to 20, 2023. In addition, digital research repositories from Addis Ababa and Bahir Dar University were accessed.Data selectionThe eligibility criteria was employed to screen studies after uploading search results to EndNote software to remove duplicates first. Then, two investigators, CT and BBT, independently assessed titles, abstracts, and the full text of all retrieved references to identify potentially eligible studies.ResultThis meta-analysis, which was conducted in Ethiopia, and included 11 full-text articles, revealed a pooled asthma medication non-adherence level of 51.20% (95% CI 35.20%, 67.20%) with substantial heterogeneity (I2 = 99.08%). The review has also identified factors predicting non-adherence among asthmatic patients: free (health service) (AOR: 0.31, 95% CI 0.18-0.54), poor knowledge (AOR: 2.85, 95% CI 1.61-5.05), absence of formal education (AOR: 3.01, 95% CI 1.72-5.25), history of previous ADR (AOR: 8.57, 95% CI 1.12-65.3), and the presence of Co- morbidity(AOR: 3.28, 95% CI 2.014-5.68), had shown association with asthma medication non-adherence.ConclusionAsthma medication non-adherence is notably high in Ethiopia. Addressing medication non-adherence requires a comprehensive approach, including clear communication between healthcare providers, patient education, and addressing financial barriers to ensure better adherence in asthma patients.

Global pandemics can be tackled by two means: lockdowns and vaccinations. As vaccination has a low impact on economic outcomes and better acceptance by people, it is the preferred method by most governments as a medium- to long-term solution. Vaccines have played a significant role in reducing the global burden of infectious diseases. They are designed to teach the immune system how to fight a particular infection before it causes a disease in subsequent exposures by creating a memory. Although vaccines effectiveness is well known, anti-vaccination movements pose significant challenges, even in high-income settings, leading to outbreaks of life-threatening infectious diseases. Hesitancy to take vaccines is not new and began with the first vaccination of smallpox. At that time, the problem was solved by a regulatory obligation to take vaccines, declared in England and Wales in 1853, which eventually led to its eradication in 1980. Different studies show that there is a decline in awareness of vaccines, hesitancy to take them, and concerns and trust issues regarding healthcare professionals. These problems have been rising over the past few decades for several reasons, notably, because of misinformation spread by social media. Therefore, the objective of this review is to provide a brief overview about vaccine hesitancy and attributable factors, illustrate the different types of vaccines, show the major challenges of vaccine development, and illustrate the pros and cons of each type.

Background:Opioid use is a major global public health problem, affecting 16 million individuals worldwide. According to a 2023 WHO report, out of the 600,000 substance-related deaths worldwide, 80% were attributed to opioid use. Pharmacists play a vital role in reducing unnecessary opioid exposure while facilitating access to non-opioid alternatives. To do so, pharmacists should have sufficient knowledge regarding opioid-containing medications and a positive attitude about opioid use problems.Objective:This study aimed to evaluate community pharmacists' knowledge of opioid-containing medications and their attitude toward opioid use problems.Materials and methods:A cross-sectional study was conducted using a self-administered, structured questionnaire distributed to 105 community pharmacists from July 1-30, 2023 in Bahir Dar City, Ethiopia. The tool included demographic information and questions designed to assess participants' knowledge and attitudes.Results:Out of the 105 pharmacists included in this study, majority were males (54.3%), nearly half held a bachelor's degree (49.5%), and slightly above one-third had over a decade experience (39%). Regarding knowledge and attitude towards opioids, 62 individuals (59%) exhibited good knowledge, and 64 (61%) demonstrated less stigma toward opioid usage. Factors affecting knowledge include: education level (AOR (95% CI): 8.43 (1.76-40.35) and 9.93 (1.04-85.33) for bachelors and postgraduates respectively and age 1.45 (1.20-1.77)]. Meanwhile, experience [AOR (95% CI): 4.64(1.20-17.90) and 4.29 (1.23-15.05)] for 5-9 years and ≥10 years respectively and education level [AOR (95% CI): 4.08 (1.40-11.93) for bachelors and 6.40 (1.42-28.96)] for postgraduates were linked to attitude.Conclusion:A gap in knowledge and more stigmatizing behavior was observed among community pharmacists. These findings imply the importance of tailored educational interventions to address knowledge gaps and promote positive attitudes toward opioid usage among community pharmacists. Therefore, it is imperative to deliver up-to-date information on opioids, emphasizing their high addiction potential, to ensure pharmacists are well-equipped with the latest information.

Introduction: Traditional healers in Ethiopia use medicinal plants to manage human ailments. The aim of this review was to compile a comprehensive document on medicinal plants so far studied by ethnobotanical and ethnopharmacological surveys in Ethiopia. Methods: Literatures published from 2010 to 2022 specifically on ethnobotanical use were assessed for eligibility based on defined criteria. The data on scientific and local name, habit, plant parts used, preparation methods, route of administration, and ailments were extracted and summarized. Results: A total of 525 medicinal plants were distributed to 113 families and 333 genera were recorded from the 59 eligible studies. Fabaceae (49 species), Asteraceae (43 species), Lamiaceae (34 species), and Euphorbiaceae (22 species) were the most dominant plant families. Aloe (16 species), Acacia (12 species), Euphorbia (11 species), and Solanum (11 species) were the utmost represented plant genera. Foeniculum vulgare was the most common plant species used to treat numerous types of ailments in five different regions. The highest number of species was from Southern nations and nationalities (140), Amhara (121), and Oromia (117). Herbs (207), and shrubs (156) shared the top accounted growth form while leaves (227) and roots (116) were the utmost common plant part used. Most of the plant materials were prepared by crushing and decoction and administered orally. Foeniculum vulgare, Acokanthera shimper, Allium sativum, and Carissa spinarum were the most used to treat various types of ailments. Many medicinal plants were used to treat wounds, malaria, stomachache, and diarrhea. Conclusion: This review publicized certain highlights very important medicinal plants throughout the regions of Ethiopia, based on ethnobotanical uses in the healthcare system that needed validation for their phytochemical contents and pharmacological properties.

Ceftriaxone stands as a cornerstone in global antibiotic therapy owing to its potent antibacterial activity, broad spectrum coverage, and low toxicity. Nevertheless, its efficacy is impeded by widespread inappropriate prescribing and utilization practices, significantly contributing to bacterial resistance. The aim of this study is to determine the overall national pooled prevalence of inappropriate ceftriaxone utilization and its predictor factors in Ethiopia. A systematic search was conducted across multiple databases including, PubMed, Science Direct, Hinari, Global Index Medicus, Scopus, Embase, and a search engine, Google Scholar, to identify relevant literatures that meet the research question, from March 20 to 30, 2024. This meta-analysis, which was conducted in Ethiopia by incorporating 17 full-text articles, unveiled a national pooled inappropriate ceftriaxone utilization of 55.24% (95% CI, 42.17%, 68.30%) with a substantial heterogeneity index (I2 = 99.24%, p value < 0.001). The review has also identified predictive factors for the inappropriate use of ceftriaxone: empiric therapy (AOR 21.43, 95% CI; 9.26-49.59); multiple medication co-prescription (AOR: 4.12, 95% CI; 1.62-8.05). Emergency ward (AOR: 4.22, 95% CI; 1.8-12.24), surgery ward (AOR: 2.6, 95% CI; 1.44-7.82) compared to medical ward, prophylactic use (AOR: 500, 95% CI; 41.7-1000), longer hospital stay-8-14 Days; (AOR: 0.167, 95% CI; 0.09-0.29), > 14 days; (AOR: 0.18, 95% CI; 0.1-0.32). The study reveals a high national pooled prevalence of inappropriate ceftriaxone utilization, standing at 55.24%, highlighting a significant hazard in the use of this antibiotic. This could be attributed to instances of overuse, misuse or prescription practices that deviates from established guidelines. This eminent challenge can lead to the development of antibiotic resistance, increased healthcare costs, adverse drug reactions, and treatment failures, necessitating multifaceted approach such as improved antibiotic stewardship, better adherence to guidelines, and enhanced clinician education on appropriate antibiotic use.

Background Anaemia is a major health problem worldwide. Global estimates of anaemia burden are crucial for developing appropriate interventions to meet current international targets for disease mitigation. We describe the prevalence, years lived with disability, and trends of anaemia and its underlying causes in 204 countries and territories. Methods We estimated population-level distributions of haemoglobin concentration by age and sex for each location from 1990 to 2021. We then calculated anaemia burden by severity and associated years lived with disability (YLDs). With data on prevalence of the causes of anaemia and associated cause-specific shifts in haemoglobin concentrations, we modelled the proportion of anaemia attributed to 37 underlying causes for all locations, years, and demographics in the Global Burden of Disease Study 2021. Findings In 2021, the global prevalence of anaemia across all ages was 24 center dot 3% (95% uncertainty interval [UI] 23 center dot 9-24 center dot 7), corresponding to 1 center dot 92 billion (1 center dot 89-1 center dot 95) prevalent cases, compared with a prevalence of 28 center dot 2% (27 center dot 8-28 center dot 5) and 1 center dot 50 billion (1 center dot 48-1 center dot 52) prevalent cases in 1990. Large variations were observed in anaemia burden by age, sex, and geography, with children younger than 5 years, women, and countries in sub-Saharan Africa and south Asia being particularly affected. Anaemia caused 52 center dot 0 million (35 center dot 1-75 center dot 1) YLDs in 2021, and the YLD rate due to anaemia declined with increasing Socio-demographic Index. The most common causes of anaemia YLDs in 2021 were dietary iron deficiency (cause-specific anaemia YLD rate per 100 000 population: 422 center dot 4 [95% UI 286 center dot 1-612 center dot 9]), haemoglobinopathies and haemolytic anaemias (89 center dot 0 [58 center dot 2-123 center dot 7]), and other neglected tropical diseases (36 center dot 3 [24 center dot 4-52 center dot 8]), collectively accounting for 84 center dot 7% (84 center dot 1-85 center dot 2) of anaemia YLDs. Interpretation Anaemia remains a substantial global health challenge, with persistent disparities according to age, sex, and geography. Estimates of cause-specific anaemia burden can be used to design locally relevant health interventions aimed at improving anaemia management and prevention. Funding Bill & Melinda Gates Foundation. Copyright (c) 2023 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.