{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T15:22:02Z","timestamp":1787239322848,"version":"build-2736575974"},"reference-count":48,"publisher":"Public Library of Science (PLoS)","issue":"11","license":[{"start":{"date-parts":[[2024,11,4]],"date-time":"2024-11-04T00:00:00Z","timestamp":1730678400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"\n Background<\/jats:title>\n Lack of sunlight exposure is the primary reason for the worldwide epidemic of vitamin D deficiency. There was a meta-analysis conducted under the title of Knowledge and Practice of Mothers towards sunshine exposure of their children in Ethiopia. However, studies conducted on factors associated with sunlight exposure practice among infants showed non-conclusive and inconsistent findings. Hence, this systematic review and meta-analysis were conducted to estimate the pooled prevalence of good sunlight exposure practice and its associated factors among infants in Ethiopia.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n All articles were systematically searched by PubMed, Hinari, Global Health and CINAHL, Epistemonikos, African Journal of Online (AJOL), Google Scholar and Google. All studies, until the end of May 30, 2023, were included in this review. Pure qualitative studies and studies in which the outcome was not reported were excluded from the review. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline was used. Meta-analysis was conducted by using STATA 17 software. Forest plots were used to present the pooled prevalence of good sunlight exposure practices. A random effect model was used to compute the pooled prevalence, while subgroup analysis was performed to identify the possible source of heterogeneity. Publication bias was assessed by begg\u2019s and Egger\u2019s tests. We use Trim and fill analysis was used to treat the publication bias.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n This review involved 14 studies and 6,121 participants. The pooled prevalence of good sunlight exposure practice among infants in Ethiopia was 53.46% (95%CI: 45.98, 60.95). Mothers had PNC follow-up [OR = 2.22 (95% CI: 1.31, 3.47)], mothers with secondary and above educational status [OR = 4.17, (95% CI: 1.73, 10.06)], employed mothers [OR = 3.72, (95% CI: 2.71, 5.11)], urban residence [OR = 2.67, (95% CI: 1.17, 6.08)] and not fear of sunlight exposure [OR = 4.08, (95% CI: 1.44, 16.00)] were positively associated with good sunlight exposure practice.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n The pooled prevalence of good sunlight exposure practices among infants in Ethiopia is low. Had postnatal care follow-up, being urban residents, mother\u2019s employment status, mother\u2019s educational status and not fear of sunlight exposure were independent factors of good sunlight exposure practice among infants. Therefore, health professionals create awareness for mothers to increase postnatal follow-up, and the importance of health education especially for rural residents.<\/jats:p>\n <\/jats:sec>","DOI":"10.1371\/journal.pone.0300598","type":"journal-article","created":{"date-parts":[[2024,11,4]],"date-time":"2024-11-04T13:34:54Z","timestamp":1730727294000},"page":"e0300598","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":2,"title":["Sunlight exposure practice and its associated factors among infants in Ethiopia, systematic review and meta-analysis"],"prefix":"10.1371","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0646-9742","authenticated-orcid":true,"given":"Fanos 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The Occurrence and Clinical Picture of the Disease in the Experiences of a Pediatric Clinic in Addis Ababa.","volume":"3","author":"A Aust-Kettis","year":"1965","journal-title":"Ethiopian Medical Journal"},{"issue":"2","key":"pone.0300598.ref019","first-page":"23","article-title":"Rickets and its associated factors among under-five children in selected public hospitals in eastern Ethiopia","volume":"3","author":"K Sisay","year":"2019","journal-title":"East African Journal of Health and Biomedical Sciences"},{"issue":"1","key":"pone.0300598.ref020","first-page":"P123","article-title":"Vitamin D deficiency is the most common nutritional deficiency in the world\u2013July 2022.","volume":"118","author":"D VitaminDWiki-Vitamin","year":"2022","journal-title":"REFLECTIONS."},{"key":"pone.0300598.ref021","article-title":"The preferred reporting items for systematic reviews and meta-analyses checklist.","author":"J Picot","year":"2012","journal-title":"The Effectiveness of Interventions to Treat Severe Acute Malnutrition in Young Children: A Systematic Review: NIHR Journals Library"},{"key":"pone.0300598.ref022","volume-title":"Joanna Briggs Institute Reviewers\u2019 Manual: 2014 edition.","author":"JB Institute","year":"2014"},{"issue":"7414","key":"pone.0300598.ref023","doi-asserted-by":"crossref","first-page":"557","DOI":"10.1136\/bmj.327.7414.557","article-title":"Measuring inconsistency in meta-analyses","volume":"327","author":"JP Higgins","year":"2003","journal-title":"Bmj"},{"issue":"7109","key":"pone.0300598.ref024","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1136\/bmj.315.7109.629","article-title":"Bias in meta-analysis detected by a simple, graphical test","volume":"315","author":"M Egger","year":"1997","journal-title":"Bmj"},{"key":"pone.0300598.ref025","first-page":"1","article-title":"Knowledge. Attitude and practice of mothers on sun exposure of their infants at St. Paul\u2019s Hospital, Ethiopi","volume":"6","author":"M Dessalegn","year":"2020","journal-title":"a. Int J Appl Sci"},{"issue":"1","key":"pone.0300598.ref026","doi-asserted-by":"crossref","first-page":"e001554","DOI":"10.1136\/bmjpo-2022-001554","article-title":"Attitudes of mothers attending public hospitals in Addis Ababa, Ethiopia, to neonatal sunlight exposure: a cross-sectional study","volume":"6","author":"YG Ashebir","year":"2022","journal-title":"BMJ Paediatrics Open"},{"issue":"1","key":"pone.0300598.ref027","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s13104-019-4221-4","article-title":"Knowledge and practice on adequate sunlight exposure of infants among mothers attending EPI unit of Aleta Wondo Health Center, SNNPR, Ethiopia.","volume":"12","author":"A Bedaso","year":"2019","journal-title":"BMC research notes."},{"key":"pone.0300598.ref028","author":"A. Wudset","year":"2021","journal-title":"Practice of Sunlight Exposure and Associated Factors of Infants Among Mothers Attending Immunization Service in Bahir Dar City Public Health Institution North West Ethiopia, 2021"},{"key":"pone.0300598.ref029","doi-asserted-by":"crossref","first-page":"11786388221106983","DOI":"10.1177\/11786388221106983","article-title":"Practice of Sunlight Exposure of Infants and Associated Factors Among Infant Coupled Mothers at Dejen District, Amhara Region, Northwest Ethiopia 2021.","volume":"15","author":"A Bekalu","year":"2022","journal-title":"Nutrition and Metabolic Insights."},{"key":"pone.0300598.ref030","doi-asserted-by":"crossref","first-page":"11795565221148329","DOI":"10.1177\/11795565221148329","article-title":"Knowledge, Practice, and Factors Affecting Sunlight Exposure of Infants Among Mothers at Governmental Health Facilities in Dessie Town, Ethiopia, 2021","volume":"17","author":"D Goshiye","year":"2023","journal-title":"Clinical Medicine Insights: Pediatrics."},{"key":"pone.0300598.ref031","first-page":"2019","article-title":"Assessment of knowledge, attitude, and practice of sunlight exposure of infants among mothers attending governmental health facilities in Farta district, South Gondar zone, North West Ethiopia, 2018","author":"H Gedamu","year":"2019","journal-title":"International journal of reproductive medicine"},{"key":"pone.0300598.ref032","author":"K. Shirshu","year":"2018","journal-title":"Sunlight Exposure Practice and Associated Factors among Infants In South Achefer District, West Gojam Zone, North West Ethiopia"},{"key":"pone.0300598.ref033","author":"A Hora","year":"2022","journal-title":"Practice and factors associated with Infant Sunlight Exposure among Mothers in Adami Tulu Jido Kombolcha Woreda, East Shoa Zone, Oromia Region, Ethiopia: HU"},{"issue":"11","key":"pone.0300598.ref034","doi-asserted-by":"crossref","first-page":"e0277349","DOI":"10.1371\/journal.pone.0277349","article-title":"Factors associated with infants\u2019 sunlight exposure among mothers attending the EPI unit of Wolkite University Specialized Hospital.","volume":"17","author":"GT Mengistu","year":"2022","journal-title":"Plos one"},{"key":"pone.0300598.ref035","doi-asserted-by":"crossref","DOI":"10.3389\/fpubh.2023.1166976","article-title":"Knowledge and practice of infant exposure to sunlight among mothers in the rural villages of Mettu district, southwest Ethiopia.","volume":"11","author":"A Tadesse","year":"2023","journal-title":"Frontiers in Public Health."},{"issue":"11","key":"pone.0300598.ref036","doi-asserted-by":"crossref","first-page":"2387","DOI":"10.3390\/ijerph15112387","article-title":"Knowledge, attitudes and perceptions towards vitamin D in a UK adult population: a cross-sectional study.","volume":"15","author":"C O\u2019Connor","year":"2018","journal-title":"International journal of environmental research and public health"},{"key":"pone.0300598.ref037","volume-title":"Knowledge and attitude of vitamin D and sun exposure practices amongst New Zealand mothers with children aged five years and under a thesis presented in partial fulfilment of the requirements for the degree of Master of Science in Nutrition and Dietetics","author":"M Franklin","year":"2019"},{"key":"pone.0300598.ref038","first-page":"206","article-title":"Vitamin D deficiency: a public health issue in high low-income countries or just hype?","volume":"118","author":"KD Cashman","year":"2018","journal-title":"Hidden Hunger: Strategies to Improve Nutrition Quality."},{"key":"pone.0300598.ref039","article-title":"Moderate Sun Exposure Is the Complement in Insufficient Vitamin D Consumers.","volume":"9","author":"S-E Wu","year":"2022","journal-title":"Frontiers in Nutrition"},{"issue":"3","key":"pone.0300598.ref040","doi-asserted-by":"crossref","first-page":"423","DOI":"10.4103\/ijmr.IJMR_1244_18","article-title":"Sun exposure as a strategy for acquiring vitamin D in developing countries of the tropical region: challenges & way forward","volume":"154","author":"LF Augustine","year":"2021","journal-title":"Indian Journal of Medical Research"},{"key":"pone.0300598.ref041","doi-asserted-by":"crossref","first-page":"41","DOI":"10.3389\/fnut.2016.00041","article-title":"Complementary feeding: review of recommendations, feeding practices, and adequacy of homemade complementary food preparations in developing countries\u2013lessons from Ethiopia.","volume":"3","author":"MA Abeshu","year":"2016","journal-title":"Frontiers in nutrition."},{"issue":"3","key":"pone.0300598.ref042","doi-asserted-by":"crossref","first-page":"e0120963","DOI":"10.1371\/journal.pone.0120963","article-title":"Vitamin D deficiency and its predictors in a country with thirteen months of sunshine: the case of school children in central Ethiopia.","volume":"10","author":"T Wakayo","year":"2015","journal-title":"PloS one."},{"issue":"2","key":"pone.0300598.ref043","doi-asserted-by":"crossref","first-page":"261","DOI":"10.5958\/2454-2660.2019.00058.9","article-title":"A Descriptive Study to Assess the Level of Knowledge of B. 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