Loss to follow-up (LTFU) among under-five children from HIV care profoundly affects the treatment outcomes of this vulnerable population. It is a major factor that negatively affects the benefits of antiretroviral therapy (ART). Current information about LTFU among HIV-positive under-five children on ART is essential for effective treatments. To far, nevertheless, limited research has been done in Ethiopia to address this issue. Thus, this study aimed to assess the incidence and predictors of LTFU among HIV-infected under-five children receiving ART in West Amhara Comprehensive Specialized Referral Hospitals. A multicenter institution-based retrospective follow-up study was conducted among 435 HIV-infected under-five children on ART selected by simple random sampling from January 1, 2010 to December 31, 2019, and data were collected between December 1, 2021, and January 31, 2022. A standardized data extraction tool adapted from the ART entry and follow-up forms was used. The event of interest for this study was LTFU, whereas the absence of LTFU was censored. Before being transferred to STATA version 14 for analysis, the data were entered into Epi-Data version 3.1. The Kaplan‒Meier curve was used to estimate an individual's survival-free probability at each specific point in time. The Cox proportional hazards model was used to identify predictors of LTFU. Among the 420 records included in the final analysis, 30 (7.14%) of the individuals were LTFUs. The incidence rate of LTFU was 3.4 per 1000 person-months of observation (95% CI: 2.43–4.87). The survival probabilities of children after 12, 24, 36, and 48 months were 0.97, 0.92, 0.88, and 0.77, respectively. The independent predictors of LTFU were HIV infection in under-five children who lived in rural areas (AHR = 3.64; 95% CI: 1.41, 9.37), poor adherence to ART (AHR = 4.37; 95% CI: 1.59, 12.02), not receiving cotrimoxazole preventive therapy (AHR = 3.75; 95% CI: 1.39, 10.08), not receiving isoniazid prophylaxis (AHR = 3.4; 95% CI: 1.29, 9.01), and having a severe WHO clinical stage (AHR = 5.43; 95% CI: 1.38, 11.43). The incidence of loss to follow-up was high, especially in the first two years after ART initiation. The risk of LTFU was greater for those who were rural residents, had poor adherence, lacked cotrimoxazole preventive therapy, not given isoniazid prophylaxis, and presented with WHO clinical stages III and IV. Therefore, clinicians should emphasize for cotrimoxazole preventive therapy and isoniazid prophylaxis, for those living in rural areas, who present with poor adherence and WHO clinical stages III and IV.

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Introduction: Overweight and obesity during early life increase the risk of premature morbidity and mortality. Adolescent obesity raises the likelihood of developing cardiovascular risk factors, including prediabetes, type 2 diabetes, dyslipidemia, hypertension, liver disease, and metabolic syndrome. Sedentary lifestyles and unhealthy diets are major contributors, with one of the fastest-growing unhealthy eating patterns being the consumption of ultra-processed foods (UPFs). No systematic review and meta-analysis has specifically examined the association between UPF consumption and overweight/obesity in adolescents. Objective: To systematically review and conduct a meta-analysis of available evidence on the association between UPF consumption and overweight or obesity among adolescents. Methods: We searched PubMed, ScienceDirect, HINARI, Google, and Google Scholar for primary studies reporting UPF consumption and overweight/obesity outcomes in adolescents, without restrictions on language or study period. Study quality was assessed using the Newcastle–Ottawa Scale. Heterogeneity was evaluated using Cochrane’s Q test and the I² statistic. Publication bias and small-study effects were assessed using Egger’s regression test (p < 0.05). A random-effects model estimated pooled associations. Results: Twenty-three studies involving 155,000 adolescents were included. Adolescents with higher UPF consumption had 63% greater odds of overweight or obesity compared with those with lower intake (OR = 1.63; 95% CI: 1.36–1.95). Conclusion: High UPF consumption is associated with an increased risk of overweight and obesity among adolescents. Public health strategies targeting reduced UPF intake and promotion of healthier diets should be prioritized to prevent adolescent overweight/obesity and associated health risks.

Background: Iron and folic acid deficiency is a global public health issue, particularly in low- and middle-income countries. Adherence to iron-folic acid supplementation (IFAS) remains low in Kenya. Despite several studies on IFAS adherence in Kenya, they do not assess the national scope and clustering effects using advanced analytical models. Therefore, we aimed to assess IFAS adherence and its associated factors among pregnant women in Kenya using data from the 2022 Kenyan Demographic and Health Survey. Methods: A secondary data analysis was conducted using data from the 2022 Kenya Demographic and Health Survey, which was obtained from the official Demographic and Health Survey program database. Weighted samples of 8,460 participants were used in the analysis. The study employed a multivariable multilevel mixed-effects logistic regression model. Variables from the bi-variable model that had p < 0.25 were considered in the multivariable analysis. Variables with a p-value < 0.05 were considered statistically significant in the multivariable model, and the adjusted Odds Ratio (aOR) with its 95% CI was reported. Results: The prevalence of IFAS among pregnant women in Kenya was 61.72% (95% CI: 60.68, 62.75). Women aged 20–39 years were 1.3 to 1.7 times more likely to adhere to IFAS during pregnancy, with the likelihood increasing steadily by age group. Moreover, primigravida [aOR = 1.22 (95% CI: 1.06, 1.41)], with a family size of ≥ 10 [aOR = 0.72 (95% CI 0.59, 0.90)], antenatal care visits ≥ 4 [aOR = 3.96 (95% CI: 1.91, 8.23)], first start of antenatal care at the third trimester of pregnancy [aOR = 0.30 (95% CI: 0.15, 0.62)], and with a higher level of education [aOR = 1.6 (95% CI: 1.35, 1.90)] were statistically significant factors associated with adherence to IFAS. Conclusion and recommendation: Nearly two in five pregnant women didn’t receive IFAS for the recommended periods. Factors such as maternal age, parity, antenatal visits, and education enhanced IFAS adherence, whereas large family size and starting antenatal care in the third trimester of pregnancy reduced adherence. Therefore, the community, government, and non-governmental organizations should enhance adherence by implementing customized interventions on the factors identified as positive and negative associations.

Background: Children living with HIV in low-income settings, such as in Eastern and Southern Africa, are at a high risk for poor adherence to antiretroviral therapy. However, various primary studies presented inconsistent and inconclusive estimates of adherence and its associated factors among children living with HIV in Eastern and Southern Africa. Therefore, we were aimed to determine the pooled prevalence of adherence and its associated factors, and to guide interventions efforts to support adherence, this comprehensive systematic review and meta-analysis was conducted. Methods: We have comprehensively searched PubMed, Google Scholar, EMBASE, Scopus, and Hinari databases for all primary studies. Unpublished studies were also searched manually and accessed from university repositories. Additional searches were conducted by examining the references in the included articles to further identify relevant studies. Data were extracted and analyzed using Microsoft Excel spreadsheet and STATA version 17 software, respectively. A random-effects DerSimonian-Laird model was used to compute the pooled prevalence of adherence to antiretroviral therapy among children living in Eastern and Southern Africa. We have used Cochran’s Q test (χ2) and Higgins I² statistics to identify heterogeneity. Subgroup and sensitivity analysis were conducted to investigate the potential sources of heterogeneity. Publication bias was assessed by the funnel plot and Egger’s test. An association was expressed through the pooled adjusted odds ratio and statistical significance was considered at a p-value < 0.05. Results: This meta-analysis combined the effect estimates of 29 primary studies with 7414 study participants. The pooled prevalence of adherence to antiretroviral therapy among children living in Eastern and Southern Africa was 76.2% (95% CI: 71.4, 81.1) [I² = 97.06%, P < 0.001 and Q test (χ²) = 953.83, p-value < 0.001]. Being a biological caregiver [AOR = 1.93 (95% CI: 1.34, 2.73)], receiving first-line antiretroviral treatment [AOR = 2.7 (95% CI: 1.39, 5.25)], and having social support [AOR = 1.88 (95% CI: 1.33, 2.66)] were significantly associated with adherence to antiretroviral therapy. Conclusion: The pooled prevalence of adherence to antiretroviral therapy among children living with HIV is low. Biological caregiver, first-line antiretroviral treatment, and social support were factors associated with adherence to ART among children living with HIV. Therefore, healthcare providers, adherence counselors, supporters, as well as governmental and non-governmental organizations, should emphasize a multi-component intervention approach to address the multifaceted challenges associated with adherence to ART, thereby improving counseling efforts to enhance adherence. Moreover, clinicians should prioritize the selection and utilization of regimens for individuals in this age group on robust first-line options.

Introduction: Optimal nutrition during early childhood is essential for growth, cognitive development, and overall health. Animal source foods(ASF) provide essential nutrients like high-quality protein, iron, zinc, calcium, and vitamin B12, which are vital for the physical and cognitive development of young children and to reduce the burden of malnutrition. In Ethiopia malnutrition among children under five remains a significant public health issue. Many children are suffering from chronic and acute undernutrition. This study provides the first spatial analysis of animal source foods consumption among children aged 6–23 months. Objectives: The aim of this study is to investigate the spatial distribution of ASF consumption and its associated factors among children aged 6–23 months in Ethiopia using data from the Ethiopia miniDHS 2019. Methodology: A cross-sectional study design was used using mini-DHS 2019 data among children aged 6–23 months. Descriptive statistics were used to summarized the study population characteristics and ASF consumption prevalence. Spatial analysis techniques, including Geographical mapping and Moran’s I statistic assessed the spatial distribution of ASF consumption. Geographically weighted regression analyses identified socio-economic, demographic, and geographic factors associated with ASF consumption. Results: The study found that 47.7% of Ethiopian children aged 6–23 months consume ASF. Children in regions like Amhara, Tigray, Benishangul-Gumuz, western SNNPR, and Gambela are less likely to consume these foods. Factors linked to higher ASF consumption include mothers with more education, smaller families, households following the Orthodox religion, and wealthier families.. Conclusion and Recommendations: According to this study finding animal source food consumption among Ethiopian children aged 6–23 months is relatively low. The finding revealed the significant regional disparities of ASF consumptions. Factors associated with ASF consumption include maternal education, household size, wealth, and religion. Efforts should focus on working to increase maternal education, providing and expansion of family planning services, and increasing affordability of ASF through economic improvement of households. In addition strengthening food supply chains and integrating ASF promotion into healthcare are also essential for improving child nutrition. Interventions in low-consumption areas should address specific local needs to effectively boost ASF consumption and improve child nutrition outcomes.