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Background: Worldwide, 10% of postpartum women experience postpartum depression, which can lead to diverse sequalae at individual, family, and societal levels. In sub-Saharan Africa, it is estimated that 17% of women experience depression in the postpartum period, which could be an underestimate as 48% of women in the region do not receive postnatal care (81% in Ethiopia and 51% in Guinea) and a large share of postpartum depression remains undiagnosed and untreated as a result. Globally, despite a critical evidence gap, there are growing reports of postpartum depression among women mistreated (disrespected and abused) during childbirth in health facilities, making a strong case to examine the association between mistreatment and postpartum depression. This study in Addis Ababa (Ethiopia) and Conakry (Guinea) uses a mixed methods design to 1) examine the link between mistreatment and postpartum depression, 2) explore the health system capacity to provide respectful maternity care and maternal mental health services, and 3) explore the experiences of women in accessing care and support for postpartum depression. Methods: We will conduct a prospective longitudinal survey of women (434 in Addis Ababa and 408 in Conakry) from the third trimester of pregnancy to eight weeks postpartum and carry out in-depth interviews with key health system informants (20–25 in each city) and women who recovered from a clinically confirmed episode of postpartum depression (15–25 in each city). Quantitative data from the women's survey will be analysed using a multilevel mixed-effects model; qualitative data from key-informants will be analysed by using a hybrid thematic analysis approach, whereas data from women's in-depth interviews will be analysed using the phenomenological approach. The inclusion of two different settings in our study (Addis Ababa and Conakry) will enable us to apply a comparative health systems lens to explore the dynamics of respectful maternity care and maternal mental health services within the broader health systems of the two countries (Ethiopia and Guinea). Discussion: The findings from this study will inform actions aimed at mitigating the mistreatment of women in maternity settings and improving promotive, preventive, and treatment interventions for postpartum depression in Ethiopia and Guinea. The findings can also be extrapolated to other low-resource settings. [ABSTRACT FROM AUTHOR]

Optimizing agricultural crop production involves utilizing proper irrigation and fertilization techniques. A two-year experiment conducted in the Tselemty district during the off seasons of 2019 and 2020 aimed to assess the impact of varying irrigation levels and nitrogen fertilizer application rates on the growth, yield, and crop water productivity of pepper. The study included three irrigation levels (75%, 100%, and 125% of the required irrigation) and three nitrogen fertilizer application rates (75%, 100%, and 125% of the recommended amount). Analysis of the results using Gen-Stat software revealed that most pepper yield attributes were not significantly affected by the different irrigation and fertilizer levels. However, the marketable yield showed significant variation based on the combined application rates. The research indicates that, under ideal circumstances, the optimal approach for pepper growers is a combination of meeting 100% of the irrigation requirement and applying 100% of the recommended nitrogen fertilizer rate. Nevertheless, in scenarios where water resources are limited and fertilizer expenses are high, a reduced irrigation level of 75% of the requirement coupled with 75% of the recommended nitrogen fertilizer rate could be a viable alternative that does not lead to a substantial decrease in yield. [ABSTRACT FROM AUTHOR]

Purpose. Neonatal sepsis contributes substantially to neonatal mortality and morbidity and is an ongoing major global public health problem particularly in developing countries. A significant proportion of mothers give birth in primary health care, but studies regarding neonatal sepsis and its associated factors among admitted neonates are limited to the hospital which may not be generalized to the primary health care unit. Therefore, this study aimed to assess the proportion of neonatal sepsis and associated factors in the study areas. Objective. To assess the magnitude of neonatal sepsis and its associated factors among neonates admitted to Neonatal Intensive Care Units (NICUs) of Hawzen Primary Hospital, Eastern Zone, Tigray, North Ethiopia, 2020. Methods. An institution‐based cross‐sectional study design was carried out among 290 study participants in Hawzen Primary Hospital in January–March/2020. A systematic random sampling method was applied to select the study participants, and pretested and structured questionnaires were used to collect data. The collected data were coded, entered, cleaned, and analyzed using SPSS version 20.0 software. Binary logistic regression analyses with a confidence interval of 95% were used to select determinant factors. Statistically significant factors were identified using the adjusted odds ratio (AOR). Statistical significance was determined at p value <0.05. Binary and multivariable logistic regression analyses were applied to see the association of the variables at a p < 0.05. Results. In this study, the overall proportion of neonatal sepsis was (60.2%) 95% CI (56, 68)]. Birth asphyxia [AOR = 2.04; 95%CI (1.07, 3.93)], maternal age of 15–19 [AOR = 2.00; 95% CI (1.81, 11.93)], duration of labor greater or equal to 24 hours [AOR = 3.00; 95% CI (2.67, 14.21)], history of oxygen administration [AOR = 2.37; 95% CI (1.18, 4.75)], neonatal age of greater or equal to seven days [AOR = 4.0595% CI (1.07, 3.93), and home delivery [AOR = 5.00; 95% CI (2.34, 18.92)] were the predictor variables for neonatal sepsis. Conclusion. In this study, neonatal sepsis was high. Birth asphyxia, intranasal oxygen administration, age of the mother, home delivery, and duration of labor were associated with neonatal sepsis. [ABSTRACT FROM AUTHOR]

Background: Economic relief programs are strategies designed to sustain societal welfare and population health during a regional or global scale infectious disease outbreak. While economic relief programmes are considered essential during a regional or global health crisis, there is no clear consensus in the literature about their health and non-health benefits and their impact on promoting equity. Methods: We conducted a scoping review, searching eight electronic databases from January 01, 2001, to April 3, 2023, using text words and subject headings for recent pathogens (coronavirus (COVID-19), Ebola, Influenza, Middle East Respiratory Syndrome (MERS), severe acute respiratory syndrome (SARS), HIV, West Nile, and Zika), and economic relief programs; but restricted eligibility to high-income countries and selected diseases due to volume. Title and abstract screening were conducted by trained reviewers and Distiller AI software. Data were extracted in duplicates by two trained reviewers using a pretested form, and key findings were charted using a narrative approach. Results: We identified 27,263 de-duplicated records, of which 50 were eligible. Included studies were on COVID-19 and Influenza, published between 2014 and 2023. Zero eligible studies were on MERS, SARS, Zika, Ebola, or West Nile Virus. We identified seven program types of which cash transfer (n = 12) and vaccination or testing incentive (n = 9) were most common. Individual-level economic relief programs were reported to have varying degrees of impact on public health measures, and sometimes affected population health outcomes. Expanding paid sick leave programs had the highest number of studies reporting health-related outcomes and positively impacted public health measures (isolation, vaccination uptake) and health outcomes (case counts and the utilization of healthcare services). Equity impact was most often reported for cash transfer programs and incentive for vaccination programs. Positive effects on general well-being and non-health outcomes included improved mental well-being and quality of life, food security, financial resilience, and job security. Conclusions: Our findings suggest that individual-level economic relief programs can have significant impacts on public health measures, population health outcomes and equity. As countries prepare for future pandemics, our findings provide evidence to stakeholders to recognize health equity as a fundamental public health goal when designing pandemic preparedness policies. [ABSTRACT FROM AUTHOR]

Background: More than 70% of the health facilities in Tigray, northern Ethiopia, have been totally or partially destroyed by the recent war in the region. Diagnosis and management of tuberculosis were among many health services that suffered. In this study we assess the status of tuberculosis care in health facilities of Tigray during the recent war and compare it with the immediate pre-war state. Methods: Using sequential mixed method, we analyzed and compared the availability of diagnostic services in 69 health facilities and the utilization of tuberculosis care in 50 of them immediately before the war (September-October 2020) and during the war (November-July 2021). TB focal persons in each selected health facility were interviewed to evaluate the status of diagnostic services. Patient service utilization was assessed using health facility registrations. We also compared the average monthly case detection rate of multidrug resistant tuberculosis in the region before and during the war. We computed summary statistics and performed comparisons using t-tests. Finally, existing challenges related to tuberculosis care in the region were explored via in-depth interviews. Two investigators openly coded and analyzed the qualitative data independently via thematic analysis. Results: Among the 69 health facilities randomly selected, the registers of 19 facilities were destroyed by the war; data from the remaining 50 facilities were included in the TB service utilization analysis. In the first month of the war (November 2021) the number of tuberculosis patients visiting health facilities fell 34%. Subsequently the visitation rate improved steadily, but not to pre-war rates. This reduction was significant in northwest, central and eastern zones. Tuberculosis care in rural areas was hit hardest. Prior to the war 60% of tuberculosis patients were served in rural clinics; this number dropped to an average of 17% during the war. Health facilities were systematically looted. Of the 69 institutions assessed, over 69% of the microscopes in health centers, 87.5% of the microscopes in primary hospitals, and 68% of the microscopes in general hospitals were stolen or damaged. Two GeneXpert nucleic acid amplification machines were also taken from general hospitals. Regarding drug resistant TB, the average number of multidrug resistant tuberculosis (MDR TB) cases detected per month was reduced by 41% during the war with p-value < 0.001. In-depth interviews with eight health care workers indicated that the main factors affecting tuberculosis care in the area were lack of security, health facility destruction, theft of essential equipment, and drug supply disruption. Conclusion and recommendation: Many tuberculosis patients failed to visit health facilities during the war. There was substantial physical damage to health care facilities and systematic looting of diagnostic equipment. Restoring basic public services and revitalizing clinical care for tuberculosis need urgent consideration. [ABSTRACT FROM AUTHOR]

Background: Foot and mouth disease is a contagious, transboundary, and economically devastating viral disease of cloven-hoofed animals. The disease can cause many consequences, including decreased productivity, limited market access, and elimination of flocks or herds. This study aimed to assess farmers' willingness to pay (WTP) for foot and mouth disease (FMD) vaccines and identify factors influencing their WTP. A cross-sectional questionnaire survey was conducted on 396 randomly selected livestock-owning farmers from three districts in the central Oromia region (Ambo, Dendi, and Holeta districts. The study utilized the contingent valuation method, specifically employing dichotomous choice bids with double bounds, to evaluate the willingness to pay (WTP) for the FMD vaccine. Mean WTP was assessed using interval regression, and influential factors were identified. Results: The study revealed that the farmer's mean willingness to pay for a hypothetical foot and mouth disease vaccine was 37.5 Ethiopian Birr (ETB) [95% confidence interval [CI]: 34.5 40.58] in all data, while it was 23.84 (95% CI: 21.47–26.28) in the mixed farming system and 64.87 Ethiopian Birr (95% CI: 58.68 71.15) in the market-oriented farming system. We identified main livelihood, management system, sales income, breed, keeping animals for profit, and foot and mouth disease impact perception score as significant variables (p ≤ 0.05) determining the farmers' WTP for the FMD vaccine. Conclusion: Farmers demonstrated a high computed willingness to pay, which can be considered an advantage in the foot and mouth disease vaccination program in central Oromia. Therefore, it is necessary to ensure sufficient vaccine supply services to meet the high demand revealed. [ABSTRACT FROM AUTHOR]

Universities around the world have faced challenges in maintaining face-to-face knowledge sharing. Knowledge sharing through web technology is an essential solution for all universities. However, web technology-based knowledge-sharing practices in developing countries such as Ethiopia face many challenges. This study examines the factors that challenge the use of web technologies for knowledge-sharing practices by academic staff and presents recommendations to improve the current environment in Ethiopian public universities. The study employed semi-structured interviews with 30 respondents and analyzed the data using Nvivo qualitative data analysis software. The results revealed that lack of technical skill, lack of systems integrated into teaching-learning practice, lack of awareness, lack of an appropriate reward system, lack of commitment from top management, lack of a knowledge-sharing policy, and a lack of knowledge mapping are among the identified challenges hindering the knowledge-sharing practice of academic staff. These findings provide evidence of knowledge-sharing practices and give insights regarding enhancing knowledge-sharing practices within higher education. In addition, this study also contributes to the body of knowledge about the challenges of knowledge sharing. The findings will benefit academic staff, university administrations, and higher education institutions. Future studies could consider replicating this study from a quantitative method perspective with a larger sample size focused on Ethiopian public higher education. This study could also be considered for replication from the perspective of private higher education. [ABSTRACT FROM AUTHOR]

Background: Food insecurity is a state or condition in which people have limited or uncertain physical, social, and economic access to safe, sufficient, and nutritious food to meet their dietary needs. Since no thorough evaluation was carried out to determine the degree of household food insecurity in Tigrayan communities in the aftermath of the conflict. This study aims to describe household-level food insecurity status among pregnant and lactating women during the post-armed conflict in Tigray, Ethiopia. Method: Descriptive research was designed to assess household food insecurity. A multi-stage sampling technique was used for this study. One thousand two hundred forty-nine households were selected systematically following a list of food insecure households. Descriptive statistical values, including frequency counts, percentages, minimum values, maximum values, and averages, were calculated to quantify the indicators under study. Household food insecurity and hunger Scale measurement using the standardized Food and Agriculture Organization standard. Results: The mean age (± SD) of the mothers was 28.35 ± 5.91 years. More than three fourth of the participants 1010(80.93%) were rural residents. The survey result showed that 88.8% of the pregnant and lactating were food insecure. Half (50.1%) of the households were hungry,one month before the study, 78.5% of the families expressed concern about running out of food and 6.4% had severe hunger. Conclusions: The food insecurity levels and hunger prestige of the study communities were excessively high. This is in the context of a region affected by intense armed conflict. It is commended that the study communities need to be safeguarded from the direct and long-term consequences of armed conflict-caused household food insecurity. [ABSTRACT FROM AUTHOR]

Simple Summary: In response to the challenges posed by a growing global population, the livestock industry must increase food production while ensuring environmental sustainability. This paper explores how feed producers can tackle these challenges using advanced formulation techniques. By leveraging AI decision support systems, producers can optimize feed composition to promote animal health and environmental stewardship. The study's findings offer valuable insights into improving animal feed production, supporting the livestock industry in achieving sustainability goals and contributing to global environmental conservation efforts. The unprecedented challenges presented by the increase in global population have placed substantial demands on the livestock industry for human nutrition, necessitating heightened animal productivity and leading to an increased demand for natural resources to produce animal feed. Feed producers are leading the charge, consistently refining formulations to adapt to the evolving needs of livestock, driven in part by the cost of over 50% associated with feed production. This paper critically analyses the pressing issues within feed formulation, addressing the requirement for environmentally sustainable practices amidst the challenges of climate change. The exploration extends to how advanced decision support tools can enhance formulation techniques and profitability and contribute to environmental sustainability. Through an in-depth review of current feed formulation technologies, encompassing their applications and limitations, this study aims to enhance the existing knowledge base. Additionally, we examined future trends, highlighting the essential role of connecting technologies to establish a resilient and sustainable system. The emphasis is on the potential of formulation techniques to positively impact the environment and enhance the overall quality and performance of the animals. This paper provides actionable insights to improve animal production by examining feed formulation models and decision support tools. The anticipated outcome is a more informed and sustainable decision-making process, addressing the multifaceted challenges confronted by the livestock industry and making contributions to global efforts in climate change mitigation and environmental stewardship in animal production agriculture. [ABSTRACT FROM AUTHOR]

It is important to explore factors that may hinder early childhood development in AEDC Emotional Maturity and Social Competence domains as these underpin the foundation for health, well-being, and productivity over the life course. No previous study has examined whether, or to what extent, preeclampsia increases the risk of developmental vulnerability in social and emotional domains in early childhood. We conducted a retrospective population-based cohort study on the association between preeclampsia and childhood developmental vulnerability in emotional maturity and social competence domains in children born in Western Australia in 2009, 2012 and 2015. We obtained records of births, developmental anomalies, midwives notifications and hospitalisations. These data were linked to the Australian Early Development Census (AEDC), from which developmental vulnerability in emotional maturity and social competence domains at a median age of 5 years was ascertained. Causal relative risks (RR) were estimated with doubly robust estimation. A total of 64,391 mother-offspring pairs were included in the final analysis. For the whole cohort, approximately 25 % and 23 % of children were classified as developmentally vulnerable or at-risk on AEDC emotional maturity and social competence domains, respectively. Approximately 2.8 % of children were exposed in utero to preeclampsia. Children exposed to preeclampsia were more likely to be classified as developmentally vulnerable or at-risk on the emotional maturity (RR = 1.19, 95%CI:1.11–1.28) and social competence domains (RR = 1.22, 95 % CI:1.13–1.31). Children exposed to pre-eclampsia in utero were more likely to be developmentally vulnerable in emotional maturity and social competence domains in this cohort. Our findings provide new insights into the harmful effect of preeclampsia on childhood developmental vulnerability. • Offspring exposed to preeclampsia had an increased risk of emotional maturity and social competence problems. • The increased risk of emotional maturity and social competence problems was not explained by preterm birth. • Early screening and prevention of preeclampsia could possibly reduce childhood developmental vulnerability in offspring. [ABSTRACT FROM AUTHOR]

Background: Low birth weight (LBW) is a major public health problem in Ethiopia. Dietary diversity is a key indicator of maternal dietary adequacy that may affect birth weight but little is known about their relationship. Hence, this study aimed to assess the association of suboptimal maternal dietary diversity during pregnancy and low birth weight in Gurage Zone, Ethiopia. Methods: The prospective study was conducted among 1062 pregnant women enrolled consecutively in between 16 to 20 gestational weeks and followed until delivery. The baseline data were collected at recruitment and dietary diversity was assessed using the minimum dietary diversity score for women (MDD-W) tool in three different rounds. The average of three scores was considered to categorize women into optimal (consumed ≥ 5 food groups) and suboptimal (consumed < 5 food groups) dietary diversity groups. The risk of low birth weight among suboptimal dietary diversity was assessed using modified Poisson regression with robust standard error. Results: Of the 1062 pregnant women recruited, 959 (90.4%) women completed follow-up. Among them, 302 (31.5%) women are having optimal and the rest, 657 (68.5%) women are having suboptimal dietary diversity. The risk of low birth weight was significantly higher among women with sub-optimal dietary diversity than among those with optimal diversity (ARR = 1.89, 95% CI: 1.25, 2.84). Other factors such as rural residence (ARR = 1.61, 95% CI: 1.43, 1.87), age > = 35 years (AAR = 3.94, 95% CI: 2.41, 6.46), being underweight (ARR = 1.81, 95% CI: 1.14, 2.86), height < 150cm (ARR = 4.65, 95% CI: 2.52, 8.59), unwanted pregnancy (ARR = 3.35, 95% CI: 2.23, 5.02), preterm delivery (3.65, 95% CI: 2.27, 5.84) and lack of nutritional counseling (ARR = 1.69, 95% CI: 1.08, 2.67) significantly increased the risk of low birth weight. Conclusion: Suboptimal dietary diversity associated low birth weight. Promoting dietary diversity by strengthening nutritional education and avoiding unwanted pregnancy particularly among rural residents may help to reduce the incidence of low birth weight. [ABSTRACT FROM AUTHOR]

Purpose: To examine the association between endometriosis and adverse pregnancy and perinatal outcomes (preeclampsia, placenta previa, and preterm birth). Methods: A population-based retrospective cohort study was conducted among 468,778 eligible women who contributed 912,747 singleton livebirths between 1980 and 2015 in Western Australia (WA). We used probabilistically linked perinatal and hospital separation data from the WA data linkage system's Midwives Notification System and Hospital Morbidity Data Collection databases. We used a doubly robust estimator by combining the inverse probability weighting with the outcome regression model to estimate adjusted risk ratios (RR) and 95% confidence intervals (CIs). Results: There were 19,476 singleton livebirths among 8874 women diagnosed with endometriosis. Using a doubly robust estimator, we found pregnancies in women with endometriosis to be associated with an increased risk of preeclampsia with RR of 1.18, 95% CI 1.11–1.26, placenta previa (RR 1.59, 95% CI 1.42–1.79) and preterm birth (RR 1.45, 95% CI 1.37–1.54). The observed association persisted after stratified by the use of Medically Assisted Reproduction, with a slightly elevated risk among pregnancies conceived spontaneously. Conclusions: In this large population-based cohort, endometriosis is associated with an increased risk of preeclampsia, placenta previa, and preterm birth, independent of the use of Medically Assisted Reproduction. This may help to enhance future obstetric care among this population. [ABSTRACT FROM AUTHOR]

Intensive pasture management that aims at providing season-long forage while minimizing soil degradation is increasingly becoming an important grazing strategy in Kentucky. Typically, it involves the use of high-yielding warm and cool season forage species that are well suited to local soil and climate conditions, meeting the dual-purpose provision of high nutritional value while remaining resilient to grazing pressure and changing climate. Monitoring carbon exchange is a crucial component for effective pasture management to promote sustainable pastureland management practices. We hypothesized that pasturelands, when intensively managed, would exhibit a small but important CO2 cumulative uptake year-round. We used the Eddy covariance method to measure the net ecosystem exchange of CO2 (NEE) and productivity of an intensively managed pastureland at Kentucky State University Research and Demonstration station from 2015 to 2020. The study has two objectives: to quantify interannual variability in net ecosystem exchange, and examine the controlling environmental factors, in particular temperature, sunlight, and precipitation of NEE. Diurnal and seasonal fluctuations followed typical patterns of carbon uptake and release. Overall, the pasture site consistently was carbon sink except for 2016, in part due to a warmer winter season than usual, sequestering 1394 gCm−2 over the study period. Precipitation and temperature were critical environmental factors underpinning seasonal CO2 uptake and release. Of critical importance was the net carbon uptake during the non-growing season. [ABSTRACT FROM AUTHOR]

Recently, dolutegravir (DTG)-based combined therapy, a more effective and safer first-line antiretroviral therapy (ART), has been recommended by the World Health Organization for the treatment of Human Immunodeficiency Virus (HIV) since July 2018. However, its effectiveness in CD4+ T-cells count recovery and viral load suppression has not been studied yet in Ethiopia, where HIV is endemic. Therefore, we aimed to conduct a pilot assessment on the effect of DTG-based therapy on CD4+ T-cell count and viral load count among people living with HIV (PLWH) in Ethiopia. A longitudinal prospective cohort study was conducted from July 2020 to February 2021. 109 PLWH who are ART naive but plan to initiate DTG-based therapy were recruited. HIV viral ribonucleic acid (RNA) copies were determined using polymerase chain reaction. To compute the difference in viral load and CD4+ T-cell counts between the baseline, 3rd, and 6th months, a Friedman test was used. The study included 109 PLWH who had never received antiretroviral medication. Participants taking DTG-based treatment showed significantly decreasing median (IQR) values of viral load count (copies/mL) from 446,812 (237649.5–732994.5) at baseline to 34 (23.5–46) at 3 months and 0.0 (0–19) at 6 months of treatment follow-up. Although the treatment increases the proportion of participants with HIV-1 RNA 50 copies/mL from 0 (0% at baseline) to 87 (79.8%) and 100 (91.7%) at the 3rd and 6th months of treatment, respectively, On the other hand, the CD4+ T-cell count increased significantly during treatment: median (IQR): 209 (81.5–417.5) versus 291 (132–522) versus 378 (181–632.5) cells/L at baseline, the 3rd and 6th months of the treatment follow-up period, respectively. We found dolutegravir-based therapy was a promising option with high virological suppression rates and CD4+ T-cell count recovery, demonstrating a restoration of cellular immunity. Moreover, Viral load suppression rates were high after the initiation of the treatment. We recommend further research should be conducted with a larger number of participants to acquire greater awareness of the treatment outcomes. [ABSTRACT FROM AUTHOR]

PURPOSE: Thyroid peroxidase (TPO) is essential for the synthesis of thyroid hormones. However, specific mutations render TPO antigenic and prone to autoimmune attacks leading to thyroid cancer, TPO deficiency, and congenital hypothyroidism (CH). Despite technological advancement, most experimental procedures cannot quickly identify the genetic causes of CH nor detect thyroid cancer in the early stages. METHODS: We performed saturated computational mutagenesis to calculate the folding energy changes (∆∆G) caused by missense mutations and analyzed the mutations involved in post-translational modifications (PTMs). RESULTS: Our results showed that the functional important missense mutations occurred in the heme peroxidase domain. Through computational saturation mutagenesis, we identified the TPO mutations in G393 and G348 affecting protein stability and PTMs. Our folding energy calculations revealed that seven of nine somatic thyroid cancer mutations destabilized TPO. CONCLUSION: These findings highlight the impact of these specific mutations on TPO stability, linking them to thyroid cancer and other genetic thyroid-related disorders. Our results show that computational mutagenesis of proteins provides a quick insight into rare mutations causing Mendelian disorders and cancers in humans. The effects of TPO mutations linking to thyroid cancer and disorders found via computational mutagenesis. [ABSTRACT FROM AUTHOR]

Background: Measuring socioeconomic inequalities in healthcare usage represents a critical step towards promoting health equity, in alignment with the principles of universal health coverage and the United Nations' Sustainable Development Goals. In this study, we assessed the socioeconomic inequalities in HIV testing during antenatal care (ANC) in sub-Saharan Africa. Methods: Sub-Saharan Africa was the focus of this study. Benin, Burundi, Cameroon, Ethiopia, Gambia, Guinea, Liberia, Malawi, Mali, Mauritania, Mozambique, Rwanda, Sierra Leone, Uganda, Zambia, and Zimbabwe were the countries included in the study. This study used current Demographic and Health Surveys data spanning from 2015 to 2022. A total of 70,028 women who tested for HIV as part of antenatal contacts formed the sample for analysis. We utilized the standard concentration index and curve to understand the socioeconomic inequalities in HIV testing during antenatal care among women. Additionally, a decomposition analysis of the concentration index was ran to ascertain the contributions of each factor to the inequality. Results: Overall, 73.9% of women in sub-Saharan Africa tested for HIV during ANC. The countries with the highest proportions were Malawi, Rwanda, Zambia, and Zimbabwe. Mali Benin, Guinea, Mali, and Mauritania were the countries with the lowest proportions of HIV testing. Being among the richer [AOR 1.10, 95% CI: 1.02,1.18] and richest [AOR 1.41, 95% CI:1.30, 1.54] wealth quintiles increased the odds of HIV testing during ANC. The concentration value of 0.03 and the curve show that HIV testing is more concentrated among women in the highest wealth quintile. Hence, wealthy women are advantaged in terms of HIV testing. As the model's residual value is negative (-0.057), the model overestimates the level of inequality in the outcome variable (HIV during ANC), which means that the model's explanatory factors can account for higher concentration than is the case. Conclusion: We found that there is substantial wealth index-related inequalities in HIV testing, with women of the poorest wealth index disadvantaged in relation to the HIV testing. This emphasizes the necessity for sub-Saharan Africa public health programs to think about concentrating their limited resources on focused initiatives to grasp women from these socioeconomic circumstances. To increase women's access to HIV testing, maternal and child health programs in sub-Saharan Africa should attempt to minimize female illiteracy and poverty. Consequently, health education may be required to provide women with comprehensive HIV knowledge and decrease the number of lost opportunities for women to get tested for HIV. Given the link between knowledge of HIV and HIV testing, it is important to focus on community education and sensitization about HIV and the need to know one's status. [ABSTRACT FROM AUTHOR]

The relationship between normal-weight obesity (NWO)—high percent body fat (%BF) in individuals with normal body mass index (BMI)—and cardiometabolic abnormalities has not been explored in Africa. We determined the prevalence of the NWO and evaluated its association with hypertension, elevated blood sugar and dyslipidaemia among adults in Addis Ababa, Ethiopia. A cross-sectional study was conducted among adults 18–64 years (n = 600). Blood pressure, blood glucose, lipid profile, and anthropometric measurements were completed. As a function of skinfold thickness, body density and %BF were estimated using Durnin & Womersley and Siri Equations, respectively. The relationship between the NWO and the outcomes of interest, assessed using adjusted linear and logit models. The age- and sex-standardised prevalence of NWO was 18.9% (95% confidence interval (CI) 15.8, 22.2%). Comparison between normal-weight lean (normal %BF and BMI) and normal-weight obese individuals suggested no difference in systolic blood pressure (β = 2.55; 95% CI − 0.82, 5.92); however, diastolic blood pressure (β = 3.77: 95% CI 1.37, 6.18) and odds of hypertension (adjusted odds ratio (AOR) = 2.46: 95% CI 1.18, 5.13) were significantly raised in the latter. Similarly, adults with NWO had elevated blood glucose (β = 2.30; 95% CI 1.23, 15.66) and increased odds of high blood sugar level (AOR = 1.68; 95% CI 1.05, 2.67). LDL (β = 8.73: 1.56, 15.90), triglyceride (β = 20.99: 0.78, 41.22), total cholesterol (β = 10.47: 1.44, 19.50), and Cholesterol to HDL ratio (β = 0.65: 0.27, 1.04) were also raised among adults with NWO. NWO is common among adults in Addis Ababa and is associated with cardiometabolic derangements. [ABSTRACT FROM AUTHOR]

Background: Ensuring regular supervision, capacity building and motivation are crucial for the successful retention of health extension workers (HEWs). Failure in these aspects could increase the attrition rate of HEWs. To date, there has not been a comprehensive nationwide study on HEW attrition that could act as a source of evidence for policy makers. This study explored HEW attrition, including leaving the health sector entirely and its regional variation, trends and predictors of attrition out of the health system. Methods: This study explored the attrition of HEWs from the beginning of the program until the end of 2018. A district-based mixed method study was conducted to review the personnel files of HEWs. A multistage sampling technique was employed to select 3,476 HEWs, and a probability weight was assigned for each observation. Descriptive statistics were calculated for the outcome and predictor variables. A logistic regression model was used to model attrition out of the health system. A qualitative study was conducted to understand the reasons why HEWs leave their jobs. Thematic analysis was performed using Nvivo version 12. Results: The magnitude of attrition of HEWs was found to be 21.1% during the fifteen years of HEP implementation. Of the total 704 who left their job as an HEW, 530 (73%) left the health system altogether. Number of biological children [AOR = 0.61, 95% CI; 0.42–0.89], having an additional education [AOR = 8.34, 95% CI; 3.67–18.98], obtaining official recognition [AOR = 0.29, 95% CI; 0.10–0.83], administrative reprimand [AOR = 1.66, 95% CI; 1.07 -2. 56), distance between district health office and health post [AOR = 1.75, 95%CI; 1.18–2.59) and COC status [AOR = 2.06, 95%CI 1.39–3.06) were independent predictors of leaving the health sector. High regional variation in attrition was observed, ranging from 38.5% in Addis Ababa to just 6.1% in the Harari region. The trend of attrition has steadily increased over time, with a high of 1,999 attritions per 10,000 HEW in 2018. Psychosocial factors, administrative issues, career advancement incentives, and workplace-related problems were the themes that emerged from the qualitative study as reasons for attrition of HEWs. Conclusion: Even though the magnitude of attrition was relatively low, there was high regional variation and incremental trends. Moreover, the out-of-health sector attrition is also high. Critically examining the HEP policy environment to increase the number of HEWs deployed per health post to reduce workload and improving HEW incentives, including career development, may assist in increasing HEW job satisfaction, which in turn could help to reduce attrition, including leaving the health sector. [ABSTRACT FROM AUTHOR]

Canine visceral leishmaniasis (CVL) is a significant vector-borne Meta zoonotic disease caused by agents of the L. donovani complex. The disease is transmitted by the bite of phlebotomine female sandflies of the genera Phlebotomus and Lutzomyia in the old and new worlds, respectively. This study was conducted to assess the knowledge, attitude, and practices of the residents about CVL based on the One Health concept in two towns of the Oromia Region, Ethiopia. A community-based cross-sectional study was conducted between October 2019 and September 2020, using an interview questionnaire as the study instrument. The study participants were selected through a simple random sampling method. Pearson's Chi-square and logistic regression tests were used to evaluate the association between the study participants' knowledge, attitude, and practices toward CVL and possible risk factors. The study included a total of 400 participants, and the results indicated that 77.25% had good knowledge, 60.5% had a favorable attitude, and 59.25% had good practices toward CVL. The town of Ejaji and dog ownership were significantly associated with good knowledge (p = 0.001), and attitude (p = 0.001) towards CVL, while having a dog (p = 0.001), having a diploma (p = 0.019) or degree and above (0.018), being divorced or widowed (0.012), and being Oromo (p = 0.013) were all significantly associated with good CVL practice. Most participants in both study areas had good knowledge but moderate attitudes and practices toward CVL. Therefore, it is crucial to undertake comprehensive community health education and awareness programs of zoonotic visceral leishmaniasis and its vectors based on the One Health concept through various means. [ABSTRACT FROM AUTHOR]

BACKGROUND: X-ray Computed Tomography dose levels have been varying among modalities and scanning body regions due to the absence of incessant routine follow-up. Thus, the study aimed to compute the dose index discrepancies in Ethiopia for the most recurring scan protocols (head, chest, abdomen, and pelvis). METHODS: A purposive sampling method was employed to select the hospitals due to the rare existence of functional CT scanners in Ethiopia. From the selected hospitals, a total of 1,385 (249 heads, 804 chests, 132 abdomens, and 200 pelvis) were collected in terms of standard dose metric values in the period of December 2019-March 2020. Patients' DLP was computed into mean value using IBM SPSS Statistics 20 software. From the mean DLP, we can compute the effective dose. RESULTS: Patients' dose level disparity was observed in this study though it is below the ICRP standard level for all body regions except for pelvis DLP (593.37 mGy-cm) at Black Lion. The dose level for the head and chest are computed within the recommended level at all hospitals. Effective doses for the pelvis at four hospitals (Teklehaimanot, Black Lion, ALERT, Paul's, and Ayder hospitals) were computed as 6.45, 8.90, 5.08, 6.54, and 6.84 mSv respectively, and the effective doses for abdomen at Ayder Hospital was obtained to be 8.90 mSv, which is above the recommended value. CONCLUSION: X-ray CT scanners are somewhat properly functioning although some sort of justification and optimization for pelvis and abdomen examinations are strongly recommended to implement as low as reasonably achievable principle. [ABSTRACT FROM AUTHOR]

Aim: To assess the inter‐rater reliability of modified Downes' scores assigned by physicians and nurses in the Ethiopian Neonatal Network and to calculate the concordance of score‐based treatment for preterm infants with respiratory distress. Methods: We included preterm infants admitted from June 2020 to July 2021 to four tertiary neonatal intensive care units (NICUs) of the Ethiopian Neonatal Network that presented with respiratory distress. We calculated the kappa statistic to determine the nurse and physician correlation for each component of the modified Downes' score and total score on admission and evaluated the concordance of scores above and below the treatment threshold of 4. Results: Of the 1151 eligible infants admitted, 817 infants (71%) had scores reported concurrently and independently by nurse and physician. The kappa statistic for modified Downes' score components ranged from 0.88 to 0.92 and was 0.89 for the total score. There was 98% concordance for score‐based treatment. Conclusion: Incorporation of the modified Downes' score on admission for preterm infants with respiratory distress was feasible in tertiary NICUs in Ethiopia. The kappa statistics showed near‐perfect agreement between nurse and physician assessments, translating to a very high degree of concordance in score‐based treatment recommendations. These results highlight an opportunity for task‐shifting assessments and empowering nurses. [ABSTRACT FROM AUTHOR]

Neonatal health is a significant global public health concern, and the first two days of life are crucial for newborn survival. Most studies on newborn postnatal care have focused on crude coverage measures, which limit the evaluation of care quality. However, evidence suggests a shift towards emphasising effective coverage, which incorporates the quality of care when measuring intervention coverage. This research aimed to assess the effective coverage of newborn postnatal care in Ethiopia while also examining its inequalities and spatial distribution. The study used secondary data from the 2016 Ethiopian Demographic and Health Survey, which was a cross-sectional community-based study. A total weighted sample of 4169 women was used for analyses. We calculated crude coverage, which is the proportion who received a postnatal check within 48 hours of birth and quality-adjusted coverage (effective coverage), which is the proportion who received a postnatal check within 48 hours of birth and reported receipt of 6 or more contents of care provided by health care providers. Concentration index and concentration curves were used to estimate the socioeconomic-related inequalities in quality-adjusted newborn postnatal care. The spatial statistic was analysed by using Arc-GIS. The crude coverage of newborn postnatal care was found to be 13.2%, while the effective coverage was 9%. High-quality postnatal care was disproportionately concentrated among the rich. A spatial variation was found in quality-adjusted coverage of newborn postnatal care across regions. The findings suggest that there is a significant gap in the coverage and quality of postnatal care for newborns across regions in Ethiopia. The low rates of coverage and effective coverage, combined with the concentration of high-quality care among the rich and the spatial variation across regions, highlight the need for targeted interventions and policies to address the inequalities in access to high-quality postnatal care for newborns. [ABSTRACT FROM AUTHOR]

Background The association between early-life respiratory syncytial virus (RSV) infections and later respiratory morbidity is well established. However, there is limited evidence on factors that influence this risk. We examined sociodemographic and perinatal factors associated with later childhood respiratory morbidity requiring secondary care following exposure to a laboratory-confirmed RSV episode in the first 2 years. Methods We used a probabilistically linked whole-of-population-based birth cohort including 252 287 children born in Western Australia between 2000 and 2009 with follow-up to the end of 2012. Cox proportional hazards models estimated adjusted hazard ratios (aHRs) of the association of various risk factors with the first respiratory episode for asthma, wheezing, and unspecified acute lower respiratory infection beyond the age of 2 years. Results The analytic cohort included 4151 children with a confirmed RSV test before age 2 years. The incidence of subsequent respiratory morbidity following early-life RSV infection decreased with child age at outcome (highest incidence in 2–<4-year-olds: 41.8 per 1000 child-years; 95% CI, 37.5–46.6), increased with age at RSV infection (6–<12-month-olds: 23.6/1000 child-years; 95% CI, 19.9–27.8; 12–<24-month-olds: 22.4/1000 child-years; 95% CI, 18.2–22.7) and decreasing gestational age (50.8/1000 child-years; 95% CI, 33.5–77.2 for children born extremely preterm, <28 weeks gestation). Risk factors included age at first RSV episode (6–<12 months: aHR, 1.42; 95% CI, 1.06–1.90), extreme prematurity (<28 weeks: aHR, 2.22; 95% CI, 1.40–3.53), maternal history of asthma (aHR, 1.33; 95% CI, 1.04–1.70), and low socioeconomic index (aHR, 1.76; 95% CI, 1.03–3.00). Conclusions Our results suggest that in addition to preterm and young infants, children aged 12–<24 months could also be potential target groups for RSV prevention to reduce the burden of later respiratory morbidities associated with RSV. [ABSTRACT FROM AUTHOR]

Simple Summary: The physical properties (hair diameter, hair length, haircoat depth, and haircoat density) and spectral properties (solar absorptivity, solar reflectivity, and solar transmissivity) of hair and haircoats play critical roles in heat and moisture exchange between an animal and its surrounding environment. These properties also play an important role in protecting the skin against penetration of ultraviolet radiation. Black haircoats absorb solar radiation, but the absorption occurs at the haircoat–air interface (away from the skin surface) where convective heat loss is high. Holstein cows with dominant black color haircoats are more suitable in latitudes with high solar input than those with a white color haircoat. A white haircoat is more transparent and allows solar energy to penetrate deeply into the haircoat, and thus, heat flows toward the skin surface (heat gain). The physical properties of hair and haircoats are not numerically the same at different locations (dorsal, ventral, lateral, neck, head, etc.) of the body of a cow. The density (no. of hairs/cm2) of a haircoat is constant to a certain depth from the skin surface, and then decreases exponentially toward the haircoat–air interface. Cattle with a dominant black haircoat spend more time using shade than those with a white or red haircoat. The physical properties (hair diameter, hair length, haircoat depth and haircoat density) and spectral properties (absorptivity, reflectivity, transmissivity) of the hair and haircoat of cattle are inputs to heat and moisture exchange between the skin surface and the surrounding environment, and thus play a critical role in body temperature regulation. Physical and spectral properties of haircoats also play an important role in protecting the skin against penetration of ultraviolet radiation. The focus of this review is to identify accurate and consistent measurement procedures of these properties. Additionally, the paper shows the utilization of the properties on heat exchange models and their implications on voluntary thermoregulation of cattle. To highlight the effects and benefits of haircoat color vis-à-vis solar radiation and its implication on ecological habitation, a brief explanation is provided using polar bears (white haircoat in a cold environment) and black goats in a hot desert environment. [ABSTRACT FROM AUTHOR]

Background: Persistent inequalities in coverage of maternal health services in sub-Saharan Africa (SSA), a region home to two-thirds of global maternal deaths in 2017, poses a challenge for countries to achieve the Sustainable Development Goal (SDG) targets. This study assesses wealth-based inequalities in coverage of maternal continuum of care in 16 SSA countries with the objective of informing targeted policies to ensure maternal health equity in the region. Methods: We conducted a secondary analysis of Demographic and Health Survey (DHS) data from 16 SSA countries (Angola, Benin, Burundi, Cameroon, Ethiopia, Gambia, Guinea, Liberia, Malawi, Mali, Nigeria, Sierra Leone, South Africa, Tanzania, Uganda, and Zambia). A total of 133,709 women aged 15-49 years who reported a live birth in the five years preceding the survey were included. We defined and measured completion of maternal continuum of care as having had at least one antenatal care (ANC) visit, birth in a health facility, and postnatal care (PNC) by a skilled provider within two days of birth. We used concentration index analysis to measure wealth-based inequality in maternal continuum of care and conducted decomposition analysis to estimate the contributions of sociodemographic and obstetric factors to the observed inequality. Results: The percentage of women who had 1) at least one ANC visit was lowest in Ethiopia (62.3%) and highest in Burundi (99.2%), 2) birth in a health facility was less than 50% in Ethiopia and Nigeria, and 3) PNC within two days was less than 50% in eight countries (Angola, Burundi, Ethiopia, Gambia, Guinea, Malawi, Nigeria, and Tanzania). Completion of maternal continuum of care was highest in South Africa (81.4%) and below 50% in nine of the 16 countries (Angola, Burundi, Ethiopia, Guinea, Malawi, Mali, Nigeria, Tanzania, and Uganda), the lowest being in Ethiopia (12.5%). There was pro-rich wealth-based inequality in maternal continuum of care in all 16 countries, the lowest in South Africa and Liberia (concentration index = 0.04) and the highest in Nigeria (concentration index = 0.34). Our decomposition analysis showed that in 15 of the 16 countries, wealth index was the largest contributor to inequality in primary maternal continuum of care. In Malawi, geographical region was the largest contributor. Conclusions: Addressing the coverage gap in maternal continuum of care in SSA using multidimensional and people-centred approaches remains a key strategy needed to realise the SDG3. The pro-rich wealth-based inequalities observed show that bespoke pro-poor or population-wide approaches are needed. [ABSTRACT FROM AUTHOR]

In this paper, septic B-spline approach with linearization and without linearization technique with the help of Butcher's fifth-order Runge–Kutta scheme is implemented to obtain solitary wave solutions of the modified regularized long wave equation. The error norms L 2 and L ∞ and the three invariants I 1 , I 2 and I 3 are computed on three tests to confirm about the efficiency and accuracy of the proposed methods. The stability analysis is performed using Von-Neumann technique on the linearized septic B-spline approach. The results of the present work are compared with the analytical and existing solutions. [ABSTRACT FROM AUTHOR]

• Birth month in respect of RSV season plays an important role in the incidence of RSV-hospitalization. • Infants born preterm have a disproportional burden of severe RSV. • Timing and duration of a monoclonal antibody program is sensitive to a country's RSV season. Respiratory syncytial virus contributes to significant global infant morbidity and mortality. We applied a previously developed statistical prediction model incorporating pre-pandemic RSV testing data and hospital admission data to estimate infant RSV-hospitalizations by birth month and prematurity, focused on infants aged <1 year. The overall predicted RSV-hospitalization incidence rates in infants <6 months were 32.7/1,000 child-years (95 % CI: 31.8, 33.5) and 3.1/1,000 child-years (95 % CI: 3.0, 3.1) in infants aged 6-<12 months. Predicted RSV-hospitalization rates for infants aged <6 months were highest for infants born in April/May. Predicted rates for preterm infants born 29–32 weeks gestation were highest in March-May, whereas infants born >33 weeks had peak RSV-hospitalization rates from May-June, similar to late preterm or term births. RSV-hospitalization rates in the pre-pandemic era were highly seasonal, and seasonality varied with degree of prematurity. Accurate estimates of RSV-hospitalization in high-risk sub-groups are essential to understand preventable burden of RSV especially given the current prevention landscape. [ABSTRACT FROM AUTHOR]

This preliminary study focuses on the phytochemical screening, proximate analysis, essential oil content, and antifungal activities of A. adigratana leaf peels. Antifungal activities were also tested on the gels of the plant for comparison.Methods: Standard procedures were used for phytochemical and proximate composition studies. Essential oil analysis was performed using a gas chromatography-mass spectrometry instrument. Using the well-diffusion method, investigations on antifungal activity were performed on three clinically isolated specimens of dandruff-causing fungus; namely, Malassezia furfur, Malassezia restricta, and Malassezia globosa.Results: The leaf peels of A. adigratana contained alkaloids, flavonoids, tannins, and terpenes. The mean moisture, ash, and crude fat levels were 85.69, 92.20, and 8.00%, respectively, whereas the mean total protein and mean total carbohydrate values were 2.59 and 3.04%. Gas chromatography-mass spectrometry investigation confirmed the presence of fifteen essential oils. The most prevalent essential oil component was discovered to be phytol (33.78%), followed by decane (11.29%). In a dose-dependent way, the leaf latex and gel extracts prevented the growth of three dandruff-causing Malassezia fungal species (M. furfur, M. restricta, and M. globosa). Both the latex and gel demonstrated the maximum activity on M. globosa, the most prevalent fungus in the research area, with minimum inhibitory concentrations of 0.24 and 0.48 mg/mL and minimum fungicidal concentrations of 0.48 and 0.97 mg/mL, respectively.Conclusion: In general, the proximate and essential oil compositions of A. adigratana leaves were comparable to those of other Aloe species widely used in the food, cosmetic, and pharmaceutical industries, implying that A. adigratana could be a potential future plant for such industries. [ABSTRACT FROM AUTHOR]

Leakage is one of the major problems facing the functionality and sustainability of dams. It occurs through the embankment body, reservoir, foundation, and abutments. This study was conducted to identify the main causes of the leakage problem at the Dora-1 dam, located in the northern part of Ethiopia. It is an earthfill dam with a height of 43.5 m, crest length of 454 m, and reservoir capacity of 4.67 million cubic meters. Part of the embankment body was wet and swampy up to 20 m high from the ground due to leaking water. Geological investigation, laboratory test of the construction materials (including grain size analysis, specific gravity and water absorption, Atterberg limit, free swell, dispersion, permeability, and shear strength), and electrical resistivity investigation were used to identify and pinpoint the possible causes of the leakage problem. Results of the study show that the favorable geological features responsible for the occurrence of leakage include: (a) geological contact between sandstone and moderately to highly weathered basalt unit at the left abutment, (b) the gravelly sand deposit at the central foundation and (c) dyke outcrop at the river course within the reservoir running in the upstream-downstream direction. Results of laboratory tests for clay core show medium to high compressibility, good to poor workability, and semi-pervious to impervious permeability when compacted. The water absorption and the percentage finer of the filter material don't satisfy the filter criteria and the shell material was found to be semi-previous. The anomalous in the resistivity survey result confirms the situation. Slope stability analysis of the embankment showed instability conditions at full reservoir level. Close follow-up and a downstream stabilization structure, including rock and gravel support, were recommended. [ABSTRACT FROM AUTHOR]

Background: Obstetric fistula is a major public health concerns in Ethiopia. It is the most devastating cause of all maternal morbidities. Method: Data from the 2016 Ethiopian Demographic Health Survey (EDHS) was analyzed. A community-based unmatched case control study was conducted. Seventy cases and 210 non cases were selected using random number table. Data were analyzed by using STATA statistical software version 14. Multivariable logistic regression model was applied to determine the factors associated with fistula. Results: The majority of fistula cases were from rural residences. The multivariable statistical model showed that rural residence (Adjusted OR (AOR) = 5, 95% CI 4.26, 7.52), age at first marriage (AOR = 3.3, 95% CI 2.83, 4.60), poorest wealth index (AOR = 3.3, 95% CI 2.24, 5.01) and decision making for contraceptive use by husband alone (AOR = 1.3, 95% CI 1.124, 1.67) were factors significantly associated with obstetric fistula. Conclusion: Age at first marriage, rural residence, poorest wealth index and decision making for contraceptive use by husband alone were significantly associated factors for obstetric fistula. Intervening on these factors will reduce the magnitude of obstetrics fistula. In this context there is in-need to improve on avoiding early marriage through awareness creation to the community and developing legal framework by the policymakers. Furthermore, information about the joint decision making to use contraceptives should be disseminated though mass-media and interpersonal channels. Plain language summary: Globally, 2–3 million women are affected by obstetric fistula. It is common in developing nations, mainly in sub-Saharan Africa and Southeast Asia where suitable, timely care and treatment are hard to find. This devastating condition adversely affects women's physical and mental health. There is little research conducted in relation to the experiences of women living with leakage of urine and/or feces in Ethiopia. Therefore, this study provides a better understanding on obstetric fistula and its associated factors. The present study used the recent Ethiopia Demographic Health Survey (EDHS) 2016, to determine the associated factors of obstetric fistula among reproductive age group women (15–49 years) in Ethiopia. In this study rural residence, poorest wealth index, age at first marriage less than 18 years, and decision making for contraceptive use by husband alone were the associated factors of obstetric fistula. Intervening on these factors will reduce the magnitude of obstetrics fistula. In this context there is in-need to improve on avoiding early marriage through awareness creation to the community and developing legal framework by the policymakers. Furthermore, information about the joint decision making to use contraceptives should be disseminated though mass-media and interpersonal channels. Comprehensive intervention strategies should be customized at different government hierarchies to combat and reduce obstetric fistula. [ABSTRACT FROM AUTHOR]

Back ground: HIV/AIDS remained among the common public health problems in developing country. Despite the extensive delivery of ART and improved coverage of the service access, still, man-made problems like war have negatively influenced the utilization of antiretroviral treatment services. The war in Tigray Region in the northern Ethiopia broke out in November 2020 and thereby has brought about an extreme damage on most of the infrastructure in Tigray, including the health institutions. The purpose of this study is, therefore, to assess and report the trend of HIV service provision across the war affected rural health facilities in Tigray. Methods: The study was conducted in 33 rural health facilities during the active war in Tigray. A facility based retrospective cross-sectional study design was conducted among health facilities from July 03 to August 05, 2021. Result: A total of 33 health facilities from 25 rural districts were included in the HIV service delivery assessment. A total of 3274 and 3298 HIV patients were seen during pre-war period in September and October 2020, respectively. The number of follow-up patients during the war period in January remained to be only 847(25%) which is significantly reduced with a P value<0.001. A similar trend was observed during the subsequent months until May. The trend of follow-up patients on ART significantly declined from 1940 in September (pre-war) to 331(16.6%) in May (during the war). This study also revealed a 95.5% reduction of laboratory service provision to HIV/AIDS patients during the war in January and with similar trends thereafter (P<0.001). Conclusion: The war has led to a significant decline of HIV service provision in the rural health facilities and most part of the region during the first eight months of active war in Tigray. [ABSTRACT FROM AUTHOR]

A decatic B‐spline collocation technique is employed to compute the numerical result of a nonlinear Burgers' equation. The nonlinear term of Burgers' equation is locally linearized using Taylor series technique. The present method is effective for the approximate solution of Burgers' with a very small value of kinematic viscosity "a." Some illustrated numerical experiments are taken into consideration to focus on the importance of the current work and some comparative studies are reported with others as well as with the exact solutions. The linear stability of the method is analyzed with Von Neumann technique. Application of higher‐order derivatives rather than lower‐order derivatives of the decatic B‐splines on the boundary conditions is the keynote to obtain a better approximate solution of the present method. [ABSTRACT FROM AUTHOR]

Summary: A distributed adaptive control is proposed for H∞$$ {H}_{\infty } $$ tracking of an interconnected dynamical system in the presence of L2$$ {L}_2 $$ disturbances and system/interconnection uncertainties. A reference model which achieves a robust tracking against L2$$ {L}_2 $$ disturbances is introduced by using H∞$$ {H}_{\infty } $$ control with transients. Then a distributed adaptive control law is developed for an uncertain interconnected dynamical system, where it employs the specified reference model. It is shown that the boundedness of the error dynamics behaviors as well as zero tracking error in the steady state is guaranteed by the proposed distributed adaptive control in the presence of disturbances and uncertainties. An explicit error bound related to H∞$$ {H}_{\infty } $$ tracking is also established. [ABSTRACT FROM AUTHOR]

In this note. the approximate solution of non-linear boundary value problems (BVPs) of third ordeer ordinary differential equations(ODEs) with a mixed boundary conditions is proposed using fifth step block method with the help of modified Taylor series scheme(MTSS). In this work MTSS is used to find the shooting constants and the BVPs are converted to initial value problems (IVPs). Further fifth step block method is employed for approximate solution of the ODEs on the definite interval. Two numerical are taken into account in order to show accuracy of the proposed method numerically as well as graphically. [ABSTRACT FROM AUTHOR]

In this study, auto-correlated Mann–Kendall (MK) and Sen's slope estimator tests were utilized to determine trends of rainfall, temperatures, and characteristics of crop-growing season during 1980–2009. Moreover, the Van Belle and Hughes' for homogeneity of general trend and Pettitt's test for the occurrence of abrupt changes were applied. On monthly, Kiremt (June–September) and annual time scale, the MK-trend test for rainfall exhibited non-significant increasing trend, while in Belg (February–May) rainfall season exhibited non-significant decreasing trend at the most of the stations. On the contrary, temperatures showed significant increasing trends in annual and Belg at the 5% significant level. In Kiremt season, however, the maximum temperature showed non-significant increasing, while the minimum temperature showed non-significant decreasing trend. Results of homogeneity for general trend obtained by the Van Belle and Hughes' test seem fairly consistent with those of the MK-trend test. Moreover, results of Pettitt's test indicated a homogeneous trend in monthly, annual, and seasonal rainfall series and no break point was distinguished, except few stations. On the contrary, the abrupt changes were found to be quite variable in temperatures. The study also found that trends of growing season characteristics (June–September) have not changed significantly at the 5% significant level. Nevertheless, the high coefficient of variation in Kiremt rainfall (21–31%) as well as dry spell length (25–43%) in conjunction with the short nature of the length of growing period (68–90 days) had negative implications to crop production in the eastern zone of Tigray region. [ABSTRACT FROM AUTHOR]

Background: Armed conflicts greatly affect the health, nutrition, and food security of conflict affected settings particularly children. However, no empirical data exist regarding context specific factors contributing towards acute malnutrition in the war-torn Tigray, Ethiopia. Thus, this study aimed to identify individual and community level factors associated with acute malnutrition among children aged 6–59 months from armed conflict affected settings of Tigray, Ethiopia. Methods: A community based cross-sectional study was conducted among 3,614 children aged 6–59 months in Tigray, from July 15 to Aug 15, 2021. Study participants were selected using a two-stage random sampling method. A structured questionnaire was used to collect data by interviewing mothers/caregivers. Mid upper arm circumference (MUAC) measurements were taken from upper left arm of the children using MUAC tapes. Multivariable multilevel logistic regression analysis was used to determine factors associated with acute malnutrition. Adjusted Odds ratio (AOR) with 95% CI were estimated to describe the strength of associations at p < 0.05. Results: More than half (52.5%) of the sampled children were males in sex. Immediately after the first nine months into the conflict, the prevalence of severe, moderate, and global acute malnutrition was very high (5.1%, 21.8%, and 26.9%, respectively) in Tigray. The lowest and highest burden of child acute malnutrition was reported from Mekelle zone (13.3%) and Southeastern zone (36.7%), respectively. Individual-level factors such as older child age (AOR = 0.13, 95% CI: 0.10, 0.18), female child sex (AOR = 1.24, 95% CI 1.05, 1.480.95), Vitamin-A supplementation (AOR = 1.3, 95% CI: 1.05, 1.65), and history of diarrhea (AOR = 1.22, 95%CI: 1.02, 1.53) and community-level factors like unimproved drinking water source (AOR = 1.31, 95%CI: 1.08, 1.58), unimproved toilet facility (AOR = 1.24, 95% CI: 1.01, 1.52), and severe food insecurity (AOR = 1.55, 95% CI: 1.16. 2.07) were significantly associated with childhood acute malnutrition. Conclusions: The burden of acute malnutrition is a severe public health problem in Tigray. To prevent the untimely suffering and death of children, regular nutrition screening, speedy, and appropriate referral of all malnourished children to nutritional services and large-scale humanitarian assistance including access to food; nutrition supplies; water, sanitation and hygiene supplies; and health care in a timely manner are required. In the prevailing armed conflict, these have been very difficult to achieve. Thus, immediate international intervention is needed. [ABSTRACT FROM AUTHOR]

Background: Recently, Dolutegravir (DTG)-based combined therapy, a more effective and safer first-line Antiretroviral Therapy (ART), has been recommended by the World Health Organization (WHO) for the treatment of Human Immunodeficiency Virus (HIV) since July 2018. However, its effectiveness in CD4+ T-cells count recovery and viral load suppression has not been studied yet in Ethiopia, where HIV is endemic. Therefore, we aimed to assess the effect of DTG-based therapy on CD4+ T-cell count and viral load count among HIV-positive patients in Ethiopia. Methods: A longitudinal prospective cohort study was conducted from July 2020-February 2021. 109 HIV-positive individuals who are ART naive but plan to initiate DTG-based therapy were recruited. HIV viral Ribonucleic Acid (RNA) copies were determined using a CD4+ T-cell count and quantitative Polymerase Chain Reaction (PCR). To compute the difference in viral load and CD4+ T-cell counts between the baseline, 3rd, and 6th months, a Friedman test was used. Results: The study included 109 HIV-positive people who had never received antiretroviral medication. Participants taking DTG-based treatment showed significantly decreasing median (IQR) values of viral load count (copies/mL) from 446,812 (237,649.5-732,994.5) at baseline to 34 (23.5-46) at 3 months and 0.0 (0-19) at 6 months of treatment follow-up. Although the treatment increases the proportion of participants with HIV-1 RNA 50 copies/mL from 0 (0% at baseline) to 87 (79.8%) and 100 (91.7%) at the 3rd and 6th months of treatment, respectively. On the other hand, the CD4+ T-cell count increased significantly during treatment-median (IQR): 209 (81.5-417.5) versus 291 (132-522) versus 378 (181-632.5) cells/L at baseline, the 3rd and 6th months of the treatment follow-up period, respectively. Conclusion: We found Dolutegravir-based therapy was a promising option with high virological suppression rates and CD4+ T-cell count recovery demonstrating a restoration of cellular immunity. More over viral load suppression rates were high after the initiation of the treatment. [ABSTRACT FROM AUTHOR]

Simple Summary: Chemosensation is thought to be the primary sensory mechanism used by ticks to locate their host and partners, as they appear to lack functional eyes or hearing organs, in which their unique olfactory structure, namely Haller's organ, is considered to play a significant role, although little is known about its molecular biology. This review comprehended and discussed the existing molecular information on candidate chemoreceptors and potential binding proteins preferentially expressed in tick foreleg enriched Haller's organ, backed by pertinent bioinformatic data. Additionally, tick olfactory-related structural, behavioral, and neurological information was also given, and its limits were highlighted. Despite their expression in the forelegs of ticks, independent functional experiments should confirm the olfactory role of these chemosensory-related candidate molecules. Ticks are obligatory hematophagous ectoparasites and vectors of many animal and human pathogens. Chemosensation plays a significant role in tick communication with their environment, including seeking out blood meal hosts. Studies on the structure and function of Haller's organ and its components have improved our understanding regarding tick olfaction and its chemical ecology. Compared with the knowledge on insect olfaction, less is known about the molecular basis of olfaction in ticks. This review focused on the chemosensory-related candidate molecules likely involved in tick olfaction. Members of the ionotropic receptor family and a new class of odorant-binding proteins are now known to be involved in tick olfaction, which appear to differ from that of insects. These candidate molecules are more closely related to those of mites and spiders than to other arthropods. The amino acid sequences of candidate niemann–pick type C2 and microplusin-like proteins in ticks exhibit features indicating their potential role as binding proteins. In the future, more comprehensive pertinent research considering the existing shortcomings will be required to fully understand the molecular basis of tick olfactory chemoreception. This information may contribute to the development of new molecular-based control mechanisms to reduce tick populations and related disease transmission. [ABSTRACT FROM AUTHOR]

Background: Probiotic supplementation in the neonatal period results in improved gut colonisation with probiotic bacteria in the short term. There is limited information on the long‐term sustainability of this colonisation. Aims: To evaluate whether oral probiotic supplementation in the neonatal period results in sustained gut colonisation with probiotic bacteria at or beyond 6 months after its cessation. Methods: A systematic review of neonatal probiotic randomised controlled trials (RCTs) that reported on the stool microbiota during post‐discharge follow‐up was carried out using guidelines of the Cochrane neonatal group. Results: Four RCTs (n = 605 infants) were included in the review. The studies were heterogeneous in case selection, choice of probiotics, duration of supplementation, timing and the method of stool microbial analysis. Three RCTs (n = 471) showed the presence of intestinal probiotic bacteria at 6‐12 months. The overall certainty of evidence was very low in view of small sample size, heterogeneity and identification only to the genus/species level. Conclusion: Low certainty of evidence suggests that probiotic supplementation in the neonatal period may result in sustained gut colonisation 6‐12 months post‐cessation, but not at 24 months. Adequately powered, well‐designed RCTs with strain‐specific assays are needed in this area. [ABSTRACT FROM AUTHOR]

Early childhood developmental vulnerability has been closely related to the predictors of relatively good health, social and educational outcomes later in adulthood. However, the impacts of prenatal tobacco exposure on childhood developmental vulnerability have been rarely examined. Further, a few of the studies that have investigated maternal prenatal tobacco smoking and child developmental vulnerability have reported mixed results and there are currently no published estimates derived from causal epidemiological methods. We conducted a retrospective population-based cohort study on the association between maternal prenatal tobacco smoking and developmental vulnerability in children born in Western Australia (WA). De-identified individual-level maternal, infant and birth records were obtained from the Midwives Notification System (MNS), a statutory record of all births in WA. WA register for Developmental Anomalies (WARDA) were also obtained from the WA Data Linkage. Records on early childhood developmental vulnerability at the median age of 5 years were obtained from the Australian Early Development Census (AEDC). We used a doubly robust estimator to estimate the causal effects. Complete data were available for 64,558 mothers-children's pairs. Approximately 16% of children were exposed to maternal prenatal tobacco smoking. Children exposed to maternal prenatal tobacco smoking were more likely to be classified as developmentally vulnerable/at-risk on the physical health and wellbeing (RR = 1.40, 95%CI:1.36–1.45), social competence (RR = 1.42, 95%CI: 1.38–1.47), emotional maturity (RR = 1.34, 95%CI:1.30–1.39), language and cognitive skills (RR = 1.50, 95%CI:1.45–1.54), and communication skills and general knowledge (RR = 1.37, 95%CI:1.33–1.42) domains. Maternal prenatal exposure to tobacco may influence early childhood developmental vulnerability. Early intervention to quit tobacco smoking before becoming pregnant could potentially reduce later childhood developmental vulnerability on multiple domains. [ABSTRACT FROM AUTHOR]

Maternal and child mortality remain unacceptably high in the Sustainable Development Goals era. Continuum of care has become a key strategy for improving the health of mothers and newborns. Previous research on the continuum of care in Ethiopia is often limited to maternal health services. Maternal and child health services are inseparably linked, and an integrated approach to care is essential. This study assessed the continuum of maternal, newborn, and child health care and associated factors in Ethiopia. The analysis was based on the 2016 Ethiopian Demographic and Health Survey data. We restricted our analysis to women with their most recent children—alive and living with their mother- aged 12–23 months at the time of the survey (n = 1891). The modified composite coverage index, constructed from twelve maternal and child health services, was calculated as an indicator of the continuum of care. Bivariable and multivariable quantile regression were used to analyse the relationship between the predictors and specific quantiles of the composite coverage index. The effect of each variable was examined at the 10th, 25th, 50th, 75th, and 95th quantiles. The results showed that the average composite coverage index value was 39%. The overall completion rate of the continuum of care was low (2%). Four % of the women did not receive any of the services along the continuum of care. Postnatal care for newborns had the lowest coverage (12%). This study provides evidence that factors such as the educational status of women, region, residence, socio-economic status, perceived distance to a health facility, pregnancy intention, mode of delivery, parity, and early antenatal care initiation influence the continuum of care differently across levels of the composite coverage index. The findings call for integrated and targeted strategies that aim to improve the continuum of care considering the determinants. [ABSTRACT FROM AUTHOR]

The study aimed to assess willingness to pay for community-based health insurance and its correlates among households in Wukro and Setit-humera towns, Tigray, Northern Ethiopia for the year 2016. A community-based survey was conducted in Wukro and Setit-humera towns of the Tigray region from August 30 to October 05, 2016. A total of 823 households were enrolled using a two-stage sampling. A structured, pre-tested, and interviewer-administered questionnaire was used. Data were entered and analyzed using SPSS version 20. Frequencies, mean, and median were calculated. Bivariate and multiple variable logistic regressions were fitted. Odds Ratio with 95% CI was used to see the associations between selected independent variables and the outcome variable. Willingness to pay for community-based health insurance (CBHI) in the two towns was 93.4% with 95% CI (91.6-95.0). The median amount of money that households are willingness-to-pay (WTP) was 11.1 USD. The mean amount of money an individual household is willing to pay was significantly higher in Setit-humera than in Wukro town. Participants who knew their monthly income were two times more likely to be willing to pay for CBHI [Adjusted odds ratio (AOR) =2.6, 95% CI; 1.1, 8.1]; and willingness was higher among households who perceived that the cost of care is affordable in health facilities [AOR=2.6, 95% CI; 1.02, 7.1]. The study has shown a high level of willingness to pay for health insurance. Perceived affordability and knowledge of monthly income were significant factors that affect willingness to pay for community-based health insurance. Therefore, it can be operationalized in urban settings provided that the community is aware and sensitized focusing on the benefits of health insurance. Besides, the premium needs to be carefully set to consider the community's ability to pay. [ABSTRACT FROM AUTHOR]

Syphilis is a sexually transmitted disease with a wide range of clinical manifestations. With the recent worldwide resurgence of syphilis, it is imperative to recognize various presentations of this great imitator. Renal syphilis is rare and most commonly present as nephrotic range proteinuria associated with pathological features of membranous glomerulonephritis. Rapidly progressive glomerulonephritis (RPGN) is a rare and atypical form of renal syphilis. A 50‐year‐old Ethiopian woman presented with periorbital swelling, hematuria, proteinuria, and rapidly progressive renal failure. Rapid plasma reagin and confirmatory Treponema pallidum hemagglutination (TPHA) tests were reactive. Treatment with a weekly Benzathine penicillin for 3 weeks resulted in a rapid return of renal function to baseline, with the increasing rate of new syphilis, clinicians should be mindful of the various renal manifestation of syphilis. This case highlights the significance of considering syphilis as a reversible cause in any patient presenting with a clinical feature suggestive of RPGN. [ABSTRACT FROM AUTHOR]

The loss in strength of engineered geo-materials due to their exposure to adverse environmental conditions is a major problem and is investigated in terms of durability. In the present study, geo-materials are developed using the sand obtained from river Yamuna and is stabilised with bentonite or two different types of biopolymer (Guar gum and Xanthan gum) separately. The maximum percentage of bentonite is fixed as 25% by dry weight, whereas the biopolymer (0.5%, 1.0%, 1.5%, and 2.0%) is used by making its solution with distilled water. A continuous increase in the unconfined compressive strength is observed in the bentonite stabilised sand whereas an optimum percentage of both the biopolymers is observed as 1.5%. The penetration resistance is presented in term of CBR value and resilient modulus is calculated using the same. Although, the bentonite and Guar gum stabilised sand demonstrate higher strength compared to Xanthan gum stabilised sand; however, the former is not found stable when submerged in water. More than 50% loss in strength for sand stabilised with 1.5% and 2.0% Xanthan gum is observed. Further, the stability of the biopolymer stabilised sand in submerged condition is discussed with the help of SEM images. [ABSTRACT FROM AUTHOR]

Background: Post-spinal shivering is a common complication after spinal anesthesia with a high incidence among orthopedic patients. Untreated shivering may predispose to exacerbation of wound pain, increased metabolic demand, oxygen consumption, and hemostatic dysfunction. Various studies have been done on the effectiveness of preventing post-spinal shivering using ketamine and other drugs. However, little information on better prophylactic agents in terms of effectiveness and availability. Therefore, this study was intended to compare 0.25 mg/kg of Ketamine (K) versus 0.5 mg/kg of Tramadol (T) for the prevention of post-spinal shivering. Method: A prospective cohort study design was employed on 516 patients undergoing orthopedic surgery under spinal anesthesia, and they were selected by a consecutive sampling technique. Patients were divided into two groups based on the anesthetist in charge. Patients who received an intravenous prophylactic dose of Ketamine before spinal anesthesia are called Ketamine groups and patients who received Tramadol are called Tramadol groups (control). The severity and incidence of shivering, blood pressure, heart rate, and axillary body temperature were measured and recorded for one hour at 10-min intervals during the intraoperative period. Descriptive statistics, chi-square, independent t-test, and multivariable logistic regression were used. Significance was declared at a p-value lower than 0.05. Results: The overall incidence of post-spinal shivering was 187 (36.2%), of which it was 74 (28.7%) on ketamine and 113 (43.8%) on tramadol with a p-value of 0.001. The incidence of nausea and vomiting was 157 (60.9%) on tramadol and 8 (3.1%) on ketamine, with a p-value of 0.001. Patients aged 18–35 years (AOR 0.08 (0.02, 0.27), 36–55 years (AOR 0.24, 0.07, 0.81), and those patients with a prolonged duration of surgery (AOR 1.47 (1.37–1.58)) were more likely to experience post-spinal shivering. And Low-dose ketamine has a protective effect against developing post-spinal shivering with an AOR of 0.427 (0.28–0.63). Conclusion: Low-dose ketamine is more effective in reducing the incidence and severity of shivering after spinal anesthesia. Therefore, we recommend using low-dose ketamine to be effective as a prophylactic for post-spinal shivering in those patients undergoing orthopedic surgery under spinal anesthesia. [ABSTRACT FROM AUTHOR]

Background: Leishmania infantum infection can result in serious vector‐borne zoonotic disease such as visceral leishmaniasis. The objectives of the study were to estimate the seroprevalence and associated risk factors in Weliso, Ambo, and Ejaji towns in the Southwest and West Shewa zones, Oromia, Ethiopia. Methods: A cross‐sectional study was conducted from October 2019 to September 2020. A total of 368 canines were sampled for the study using a basic random sampling procedure. An Indirect ELISA kit was used to test the presence of rK39 antigen eliciting specific antibodies in a serum sample. The association between L. infantum seropositivity and possible risk factors was assessed using Pearson's Chi‐square and logistic regression tests. Results: The overall seroprevalence of L. infantum in dogs was found to be 84.24% (95% confidence interval [CI]: 80%–88%) with seroprevalences ranging from 76.11% (95% CI: 67%–84%) in Ambo to 79.82% (95% CI: 71%–87%) in Weliso, and higher seroprevalence, in Ejaji 93.84% (95% CI: 89%–97%). In a univariable logistic regression analysis, town (p = 0.001), season (p = 0.001), mixed living (indoor/outdoor) environment (p = 0.003), and kebele (p ≤ 0.05) were all found to be significantly linked with L. infantum seropositivity. In the multivariable analysis, wet season (p = 0.001) and mixed living environments (p = 0.025) were found to be independent predictors of L. infantum seropositivity. Conclusions: This is the first comprehensive report of L. infantum infection in Ethiopian dogs. The very high seroprevalence suggests that dogs may play an important role in maintaining and spreading the infection to humans. Improvement of the living environment and health care facilities for dogs and humans as well health education for people awareness is suggested. [ABSTRACT FROM AUTHOR]

Health Canada recently authorized the RSVpreF pregnancy vaccine and nirsevimab to protect infants against respiratory syncytial virus (RSV) disease. Assess the cost-effectiveness of RSVpreF and nirsevimab programs in preventing RSV disease in infants, compared to a palivizumab program. We used a static cohort model of a Canadian birth cohort during their first RSV season to estimate sequential incremental cost-effectiveness ratios (ICERs) in 2023 Canadian dollars per quality-adjusted life year (QALY) for nine strategies implemented over a one-year time period, from the health system and societal perspectives. Sensitivity and scenario analyses were conducted to explore the impact of uncertainties on the results. All-infants nirsevimab programs averted more RSV-related outcomes than year-round RSVpreF programs, with the most RSV cases averted in a seasonal nirsevimab program with catch-up. Assuming list prices for these immunizing agents, all-infants nirsevimab and year-round RSVpreF programs were never cost-effective, with ICERs far exceeding commonly used cost-effectiveness thresholds. Seasonal nirsevimab with catch-up for infants born outside the RSV season was a cost-effective program if prioritized for infants at moderate/high-risk (ICER <$28,000 per QALY) or those living in settings with higher RSV burden and healthcare costs, such as remote communities where transport would be complex (ICER of $5700 per QALY). Using a $50,000 per QALY threshold, an all-infants nirsevimab program could be optimal if nirsevimab is priced at <$110–190 per dose. A year-round RSVpreF for all pregnant women and pregnant people plus nirsevimab for infants at high-risk was optimal if nirsevimab is priced at >$110–190 per dose and RSVpreF priced at <$60–125 per dose. Prophylactic interventions can substantially reduce RSV disease in infants, and more focused nirsevimab programs are the most cost-effective option at current product prices. [ABSTRACT FROM AUTHOR]

Nearly all the current winter wheat–soybean cropping systems occurring in the southeastern United States (SE) region are rainfed, as such, precipitation (P) underpins energy partitioning. We investigated, using the eddy covariance technique, the seasonal and interannual variability and rate and trend of energy partitioning, i.e., sensible and evapotranspiration (ET), for rainfed soybean and winter wheat cover cropping at Winfred Thomas Agricultural Research Station (WTARS) in Hazel Green, Alabama. Yearlong cumulative ET of 493, 743, and 746 mm during 2007, 2008, and 2009 relative to cumulative precipitation of 567, 1280, and 1356 mm y−1 resulted in a higher mean ET/P ratio of 0.87, in 2007, medium 0.58 in 2008, and lowest 0.55 in 2009. Mean daily ET for the cover crop and soybean ranged between 1.70 and 2.44 mm d−1 and 1.82 to 2.83 mm d−1, respectively. Overall, our findings suggest total and seasonal precipitation distribution were major controlling factors in the partitioning of the energy and water budgets. This study provides evidence that changes in rainfall frequency and intensity in the SE will likely alter the regional croplands hydrology with implications on water resource management decisions in rainfed agriculture. [ABSTRACT FROM AUTHOR]

Background: Maternal anaemia is a global public health problem contributing to adverse maternal and perinatal outcomes. In addition to other risk factors, interbirth interval has been identified as a potentially modifiable risk factor of maternal anaemia. However, the current evidence for the association between interbirth interval and maternal anaemia remains inconclusive. Hence, this study examined the association between the interbirth interval and maternal anaemia in sub-Saharan Africa. Methods: We conducted a multinational cross-sectional study of interbirth interval (time between two singleton live births) and maternal anaemia (haemoglobin levels < 12 g/dl for non-pregnant women, < 11 g/dl for pregnant women) for 21 sub-Saharan African countries using the most recent nationally representative Demographic and Health Surveys, 2010–2017. A weighted multivariable fractional polynomial function was used to estimate the non-linear relationship between interbirth interval and maternal anaemia, considering interbirth interval as a continuous variable and adjusting for potential confounders. Analyses were stratified by reproductive classification (non-pregnant and pregnant women). Results: There were 81,693 women included in the study (89.2% non-pregnant, 10.8% pregnant). Of all women, 32.2% were in their postpartum period. Overall, 36.9% of women had anaemia (36.0% of non-pregnant and 44.3% of pregnant women). Of the participants, 15% had a short interbirth interval (<24 months), and 16% had a long interbirth interval (≥ 60 months). We found that both short and longer interbirth intervals were associated with an increased risk of maternal anaemia in a dose-response fashion. Relatively a lower risk of maternal anaemia was observed between 24 and 40 months of interbirth intervals. Conclusions: Our findings suggest that both short and longer interbirth intervals were associated with an increased risk of maternal anaemia in sub-Saharan Africa. [ABSTRACT FROM AUTHOR]