Background: Pneumonia is defined as an acute inflammation of the Lungs' parenchymal structure. It is a major public health problem and the leading cause of morbidity and mortality in under-five children especially in developing countries. In 2015, it was estimated that about 102 million cases of pneumonia occurred in under-five children, of which 0.7 million were end up with death. Different primary studies in Eastern Africa showed the burden of pneumonia. However, inconsistency among those studies was seen and no review has been conducted to report the amalgamated magnitude and associated factors. Therefore, this review aimed to estimate the national prevalence and associated factors of pneumonia in Eastern Africa Methods: Using PRISMA guideline, we systematically reviewed and meta-analyzed studies that examined the prevalence and associated factors of pneumonia from PubMed, Cochrane library, and Google Scholar. Heterogeneity across the studies was evaluated using the Q and the I 2 test. A weighted inverse variance randomeffects model was applied to estimate the national prevalence and the effect size of associated factors. The subgroup analysis was conducted by country, study design, and year of publication. A funnel plot and Egger's regression test were used to see publication bias. Sensitivity analysis was also done to identify the impact of studies. Result: A total of 34 studies with 87, 984 participants were used for analysis. The pooled prevalence of pneumonia in East Africa was 34% (95% CI; 23.80-44.21). Use of wood as fuel source (AOR = 1.53; 95% CI:1.30-1.77; I 2 = 0.0%;P = 0.465), cook food in living room (AOR = 1.47;95% CI:1.16-1.79; I 2 = 0.0%;P = 0.58), caring of a child on mother during cooking (AOR = 3.26; 95% CI:1.80-4.72; I 2 = 22.5%;P = 0.26), Being unvaccinated (AOR = 2.41; 95% CI:2.00-2.81; I 2 = 51.4%;P = 0.055), Child history of Acute Respiratory Tract Infection (ARTI) (AOR = 2.62; 95% CI:1.68-3.56; I 2 = 11.7%; P = 0.337) were identified factors of pneumonia. Conclusion: The prevalence of pneumonia in Eastern Africa remains high. This review will help policy-makers and program officers to design pneumonia preventive interventions.

Pneumonia is an inflammation of the lung parenchymal structure secondary to hematogens spread of pathogens, inhalation, or aspiration. It is also one of the most frequently occurring opportunistic infections in HIV-infected children. In Ethiopia, data on the incidence and predictors of opportunistic infection, especially pneumonia, among HIV-infected children is very limited. Hence, this study aimed to assess the incidence of pneumonia and predictors among HIV-infected children at public health institutions in the Northwest part of Ethiopia. Methods: An institution-based retrospective cohort study was conducted among 342 HIV-infected children at public health institutions from January 1, 2013 to December 30, 2020. Log rank test was used to compare the survival curves between different explanatory variables. Bivariable Cox proportional hazards regression model was employed for each explanatory variable to check the association with the outcome variable. Variables found to have a p-value of < 0.25 in the bivariable analysis were candidates for the multi-variable proportional hazard model. Cox proportional hazards model was used at 5% level of significance to identify predictors of pneumonia. Results: This study included 342 records of HIV-infected children who started antiretroviral therapy between the periods of January 1, 2013 to December 30, 2020. The overall incidence rate of pneumonia during the follow-up time was 5.57 (95% CI: 4.4, 7.0) per 100 childyears of observation. Those children who did not take cotrimoxazole preventive therapy (AHR: 3, 95% CI: 1.40, 6.44), being underweight at baseline (AHR: 2.6, 95% CI: 1.41, 4.86), having baseline advanced disease (clinical stages III and IV) (AHR: 2.8, 95% CI: 1.30, 6.04), and presenting with recently detected viral load (AHR: 5.9, 95% CI: 2.53, 14.06), were more likely to develop pneumonia. Conclusion: Pneumonia incidence rate was high. Providing prophylaxis and nutritional supplementation for those children with baseline advanced disease stage, low weight for age and detectable viral load would reduce pneumonia occurrence.

BackgroundDiabetic ketoacidosis and hyperglycemic hyperosmolar syndrome are the two commonly known life-threatening hyperglycemic emergencies of diabetes mellitus. Despite the growing hyperglycemic emergency impact among adult patients with diabetes, its incidence and predictors have not been well studied in Ethiopia. Thus, this study aimed to assess the incidence and predictors of hyperglycemic emergencies among adult patients with diabetes.MethodA retrospective follow-up study design was conducted among a randomly selected sample of 453 adult patients with diabetes. Data were entered into EPI data version 4.6 and analyzed using STATA version 14.0. A Cox-proportional hazard regression model was fitted to identify the independent predictors of hyperglycemic emergencies, and variables having a p &lt; 0.05 in the multivariable model were considered statistically significant.ResultAmong the total adult patients with diabetes included in the study, 147 (32.45%) developed hyperglycemic emergencies. Hence, the overall incidence of hyperglycemic emergencies was 14.6 per 100 person-years observation. The incidence of diabetic ketoacidosis was 12.5 per 100 person-years (35.6 and 6.3 among T1DM and T2DM, respectively). The incidence of the hyperglycemic hyperosmolar syndrome was 2.1 per 100 person-years (0.9 and 2.4 among T1DM and T2DM, respectively). The overall median free survival time was 53.85 months. Type 1 diabetes mellitus [AHR = 2.75, 95% CI (1.68, 4.51)], diabetes duration of ≥ 3 years [AHR = 0.33, 95% CI (0.21, 0.50)], recent acute illness [AHR = 2.99, 95% CI (2.03, 4.43)], presence of comorbidity [AHR = 2.36, 95% CI (1.53, 3.63)], poor glycemic control [AHR = 3.47, 95% CI (2.17, 5.56)], history of medication non-compliance [AHR = 1.85,95% CI (1.24, 2.76)], follow-up frequency of 2–3 months [AHR = 1.79,95% CI (1.06, 3.01)], and without community health insurance [AHR = 1.63, 95% CI (1.14, 2.35)] were significant predictors of hyperglycemic emergencies.ConclusionThe incidence of hyperglycemic emergencies was high. Therefore, giving greater attention to patients with identified predictors could decrease the occurrence of hyperglycemic emergencies and related public health and economic impacts.

Introduction

Background Anemia is one of the common hematological problems among HIV-infected children. It impairs physical functioning, affects the quality of life, increases HIV progression, and decreases survival of HIV-infected children. In Ethiopia, limited studies were conducted on the incidence and predictors of anemia among HIV-infected children on antiretroviral therapy (ART). Therefore, this study aims to assess the incidence of anemia and predictors among HIV- infected children on ART at public health facilities of Bahir Dar City, Northwest Ethiopia. Methods An institution-based retrospective follow-up study was conducted among 403 HIV- infected children who have followed at ART clinics in public health facilities of Bahir Dar City from 2010 to 2020. A simple random sampling technique was employed to select the study units. Data was entered using Epi-data version 4.6 and analyzed using STATA 14.0. Cox proportional hazard model assumption was checked graphically and by scaled Schoenfeld residual test. Bivariable Cox-proportional hazards regression model was employed for each explanatory variable to check the association with the outcome variable. Variables with a p-value of < 0.2 in the bivariable analysis were candidates to the multivariable proportional hazard model. Cox proportional hazards model was used at a 5% level of significance to identify predictors of anemia. Results The overall follow up time was 1587 person–years. The overall incidence density of anemia was 6.87 with 95% confidence interval (CI) = (5.60, 8.16) per 100 person-years. The independent predictors show an association were child age from 0.25 to 5 years adjusted hazard ratio (AHR) = (1.83; 95% CI = 1.22, 2.77), World health organization clinical stage III and IV (AHR = 1.80; 95% CI = 1.22, 2.67), being underweight (AHR = 1.5; 95% CI = 1.01, 2.26), having fair/poor adherence to anti-retroviral therapy (AHR = 1.75; 95% CI = 1.08, 2.85) and zidovidine based anti -retroviral therapy regimen (AHR = 1.72; 95% CI = 1.12, 2.64). Conclusion The overall incidence rate of anemia was high compared to other country reports. Age, clinical, and ART-related variables provoked the incidence of anemia. Therefore, a need to emphasize the younger age group, prevent and manage opportunistic infections of WHO clinical stage III and IV, and select and monitor appropriate ART regimen types.