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Follow-up rescreening uptake and persistent positive rates among women after positive cervical cancer screening results in Ethiopia: a longitudinal cross-sectional study

Por: Destaw · A. · Getachew · S. · Getachew · E. · Shita · A. · Midaksa · M. · Rossner · S. S. · Kroeber · E. S. · Addissie · A. · Kantelhardt · E. J. · Gizaw · M.
Objective

To assess cervical cancer screening positivity rates, follow-up rescreening uptake 1 year after treatment and persistent positivity among women with initial positive screening results in Ethiopia. The study also explored reasons for loss to follow-up and preferences for reminder strategies.

Design

Longitudinal cross-sectional study.

Settings

10 primary healthcare facilities in Oromia and southern and central Ethiopia.

Participants

From November 2022 to April 2024, 17 586 women screened for cervical cancer. Of these 768 (4.4%) had positive screening results, and 515 women treated at the primary level were included to assess follow-up rescreening uptake. An additional 139 women who did not return for follow-up were interviewed to identify reasons for non-uptake and reminder preferences.

Result

Of the 515 women included in the analysis, 179 (34.8%, 95% CI: 30.6% to 38.8%) returned for follow-up rescreening. Among those re-screened, the persistent visual inspection with acetic acid (VIA) positivity rate was 16.1% (95% CI: 11.0% to 21.7%). Factors significantly associated with follow-up rescreening uptake included age over 40 (adjusted OR (AOR): 2.5; 95% CI: 1.34 to 5.00), urban residence (AOR: 1.7; 95% CI: 1.15 to 2.58), secondary or higher education (AOR: 2.0; 95% CI: 1.06 to 4.12) and HIV-positive status (AOR: 2.4; 95% CI: 1.27 to 4.87). Among the 139 women contacted, the main reasons for non-uptake were lack of time, forgetting appointments, visiting another facility and pregnancy. Regarding preferred reminders, 93% favoured text messages and all agreed to phone calls or home visits.

Conclusion

One-third of women adhered to follow-up rescreening after a positive cervical cancer screening in Ethiopia, revealing a considerable gap since those women had a three times higher chance of being VIA positive compared with the first screening. Older age, urban residence, higher education and HIV-positive status were significantly linked to follow-up rescreening uptake. Addressing barriers such as time constraints and forgotten appointments through tailored reminder strategies is essential for improving the follow-up rescreening uptake. Contextualised interventions can strengthen rescreening for finding those women at very high risk for cervical lesions and strengthen cervical cancer prevention in Ethiopia.

Trial registration number

NCT06515301.

Individual-level and community-level determinants of the number of antenatal care visits in emerging regions of Ethiopia: a negative binomial model

Por: Getachew · E. · Aragaw · F. M.
Objective

This study was carried out to identify individual-level and community-level factors influencing the number of antenatal care (ANC) visits in Ethiopia’s emerging regions (Afar, Somali, Benishangul-Gumuz and Gambella).

Design

Cross-sectional study design.

Setting

Ethiopia’s emerging regions (Afar, Somali, Benishangul-Gumuz and Gambella) from the 2016 Ethiopian Demographic and Health Survey (EDHS).

Participants

The analysis included a total weighted sample of 441 women from the EDHS dataset who had given birth within the 5 years before the survey.

Primary outcomes

The number of ANC visits.

Results

In this study, 20.5% (95% CI: 16.7%, 24.5%) of pregnant women received four minimum recommended visits. Women with secondary (incidence rate ratio, IRR 1.3; 95% CI: 1.1, 1.5), and higher (IRR 1.3; 95% CI: 1.1, 1.5) education, terminated pregnancy (IRR 2.3; 95% CI: 1.9, 3.1), wanted pregnancy (IRR 1.4; 95% CI: 1.3, 2.3), high community poverty (IRR 0.5; 95% CI: 0.4, 0.7), community media exposure (IRR 1.3; 95% CI: 1.3, 1.8) and high community illiteracy (IRR 0.6; 95% CI: 0.5, 0.9) were significant predictors of many ANC visits in Ethiopia’s emerging regions.

Conclusions

According to the findings of our study, more than three-quarters of pregnant mothers in Ethiopia’s emerging region did not receive the adequate number of visits recommended by the WHO. Pregnancy desirability, history of a terminated pregnancy, maternal education, community poverty level, community literacy and community media exposure were significantly associated with the number of ANC visits. Therefore, promoting interpectoral actions would be vital in improving maternal health.

Exit knowledge about dispensed medications and associated factors among outpatients served in public hospital pharmacies and private pharmacies in Ethiopia: a systematic review and meta-analysis

Por: Getachew · D. · Getachew · E. · Lakew · G. · Beyna · A. T. · Kebede · G. A. · Tadesse · G. · Ayele · H. S. · Alemayehu · T. T. · Lakew · A. A. · Yirsaw · A. N.
Objective

This study aims to synthesise evidence on the pooled level of exit knowledge among outpatients served in public hospital pharmacies and private pharmacies in Ethiopia and to identify the associated factors associated with medication knowledge by conducting a systematic review and meta-analysis of primary articles focused on this area.

Design

This systematic review and meta-analysis study employed the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach.

Data sources

Three electronic databases—MEDLINE, Scopus and Google Scholar—were searched for all English-language articles published from 2010 until 18 December 2024.

Eligibility criteria of selected studies

The review exclusively included studies that reported original data, were freely accessible in full text and were written in English, as well as those investigating the level of knowledge among outpatients and associated factors, irrespective of study design. Studies lacking abstracts and full texts, reports, qualitative research, and conference summaries were excluded from the analysis.

Data extraction and synthesis

Data from selected studies were extracted by three independent reviewers using a standardised data extraction format created using Microsoft Excel. Their results were cross-checked by two additional reviewers for consistency.

Results

Of the 521 identified studies, 9 met the inclusion criteria. The overall pooled knowledge level was 45%. Factors associated with knowledge included residence (OR=0.67, 95% CI: 0.27 to 0.71), adequacy of information provided (OR=0.87, 95% CI: 0.24 to 0.90), education level (OR=0.70 CI: 0.39 to 0.89), clarity of instructions (OR=0.80 CI: 0.14 to 0.99) and pharmacist politeness (OR=0.72 CI: 0.46 to 0.77).

Conclusion

The systematic review and meta-analysis showed that pooled patient knowledge regarding their dispensed medications in Ethiopia is about 45%. Key determinant factors of knowledge included education level, quality of pharmacist communication, urban versus rural residence and pharmacist politeness. Recommendations for improvement include enhancing pharmacist training, developing educational materials in local languages, outreach programmes for rural areas and implementing patient-centred care policies.

PROSPERO number: CRD42024560816

Magnitude of disrespectful and abusive care among women during facility-based childbirth in Shambu town, Horro Guduru Wollega zone, Ethiopia

Disrespectful care during childbirth causes suffering and discourages women from seeking facility-based care. It is one of the silent causes of maternal mortality and morbidity worldwide, but not yet well recorded especially in developing countries. The aim of this study was to measure the magnitude of disrespect and abusive behaviors of health professionals during childbirth and associated factors.
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