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Background: Unintended pregnancy is a major public health problem in sexually active female students in Ethiopia. In higher education, female students are exposed to unprotected sex and are at risk of pregnancy, abortion, and its associated problems. Objective: The objective of this study was to assess knowledge of female students about emergency contraceptives and determine factors associated with utilization among college female students at Bonga College of Education, Southwest Ethiopia. Methods: The study was conducted from November 10, 2022 to May 30, 2023. All female students of Bonga College of education in all departments were included in this study purposively. Data were collected using Amharic version pretested questionnaire. Data obtained from the survey was entered into Microsoft Excel 2010 and analysed with SPSS version 20.0. Data summary was done with descriptive statistics. Logistic regression was used to measure associations between dependent and independent variables. Odds ratio was used to measure strengths of association between variables. Statistical significance was considered at 95% confidence level (CL). P-value less than 0.05 was considered significant during the analysis. Results: In this study a total of 103 College female students were involved. The mean age of the respondents was 20.6 (SD ± 2.06) years. The finding showed that 31 (31.1%) female students had started sexual intercourse and among them 58.1% faced pregnancy. Among the total sexually experienced respondents, 93.5% use contraceptive methods while others 6.5% do not use. Among the total 31 study participants, 27(87.1%) started using EC. The majority of pregnancy (83.3%) was intended type whereas 16.7% was unwanted pregnancy. Regarding the general knowledge about contraceptive methods, 19(18.4%) had poor knowledge. Among the total 103 female college students, 66(64.1%) heard about emergency contraceptives. Forced sex and unprotected free sex are predicting factors that induces female students to use emergency contraceptives. Fear of discontinuing school was the main inducing factor to commit abortion. Logistic regression analysis showed that college female students whose age category above 25 years were more likely to use emergency contraceptives. Students who came from urban area are more likely to use EC than rural areas. Married female students (AOR = 2.5, 95% CI: 0.76, 8.7) were two times likely to use EC as contraceptive method. Conclusions: Female students who came from urban area use EC better than who came from rural areas. Majority of sexually active female students had good practice and knowledge of using EC but some had poor knowledge. Forced sex and free sexual practice are key determinant factors that induces to use EC. Abortion was mainly done in private clinic. Fear of discontinuing school was determinant factors identified to commit abortion. Therefore, responsible bodies should develop strategies to improve female students' reproductive health related to emergency contraceptives. [ABSTRACT FROM AUTHOR]

Soil loss is a substantial peril to agricultural production and economic growth in the global world. Rainfall, slope, and cover management have triggered soil erosion risk in the southwestern hills of Ethiopia, yet little is known about the effects of topography via hydro-geomorphic characters on soil loss in the upper Bilate watershed. Therefore, this study was undertaken to evaluate the topographic effects of soil loss for micro-watershed prioritization using morphometric analysis and satellite image data. The combination of basic, linear, and shape parameters were deliberated. DEM 20 m for hydrological analysis, and Sentinel-2 A image, and soil and rainfall as ancillary data were considered. On the premise of their links with erodibility, the morphometric parameters were considered to set the micro-watersheds and demote spots on the premise of their links with erodibility to obtain compound parameters (Cp) esteem for prioritization. The result revealed that about 38.8% of the total catchment suffering from very high-to-high topographic effects of soil erosion in the upper Bilate watershed. The micro-watershed (MWSDs 8 and 6) has a very high priority; MWSDs 3, 5, 11, and 16 have a high priority; and MWSDs 17, 18, and 10 have a low to very low priority. The combination of morphometric parameters has triggered the soil loss vulnerability for deemed priority watersheds, and this will have a great implication on food security, thereby paralyzing the regional economy in the watershed. Therefore, paying for substantial economic and political status for defenseless micro-watersheds is required for land preservation measures. [ABSTRACT FROM AUTHOR]

Oxyhydrides of rare-earth metals (REMOHs) exhibit notable photochromic behaviors. Among these, yttrium oxyhydride (YHO) stands out for its impressive transparency and swift UV-responsive color change, positioning it as an optimal material for self-cleaning window applications. Although semiconductor photocatalysis holds potential solutions for critical environmental issues, optimizing the photocatalytic efficacy of photochromic substances has not been adequately addressed. This research advances the study of REMOHs, focusing on the properties of gadolinium oxyhydride (GdHO) both theoretically and experimentally. The electronic and structural characteristics of GdHO, vital for ceramic technology, are thoroughly examined. Explicitly determined work functions for GdH2, GdHO, and Gd2O3 stand at 3.4 eV, 3.0 eV, and 4.3 eV, respectively. Bader charge analysis showcases GdHO's intricate bonding attributes, whereas its electron localization function majorly presents an ionic nature. The charge neutrality level is situated about 0.33 eV below the top valence band, highlighting these materials' inclination for acceptor-dominant electrical conductivity. Remarkably, this research unveils GdHO films' photocatalytic capabilities for the first time. Even with their restricted surface due to thinness, these films follow the Langmuir–Hinshelwood degradation kinetics, ensuring total degradation of methylene blue in a day. It was observed that GdHO's work function diminishes with reduced deposition pressure, and UV exposure further decreases it by 0.2 eV—a change that reverts post-UV exposure. The persistent stability of GdHO films, hinting at feasible recyclability, enhances their potential efficiency, underlining their viability in practical applications. Overall, this study accentuates GdHO's pivotal role in electronics and photocatalysis, representing a landmark advancement in the domain. [ABSTRACT FROM AUTHOR]

Unencapsulated organic solar cells are prone to severe performance losses in the presence of moisture. Accelerated damp heat (85 °C/85% RH) studies are presented and it is shown that the hygroscopic hole-transporting PEDOT:PSS layer is the origin of device failure in the case of prototypical inverted solar cells. Complementary measurements unveil that under these conditions a decreased PEDOT:PSS work function along with areas of reduced electrical contact between active layer and hole-transport layer are the main factors for device degradation rather than a chemical reaction of water with the active layer. Replacements for PEDOT:PSS are explored and it is found that tungsten oxide (WO3) or phosphomolybdic acid (PMA)--materials that can be processed from benign solvents at room temperature--yields comparable performance as PEDOT:PSS and enhances the resilience of solar cells under damp heat. The stability trend follows the order PEDOT:PSS<3

Background: Bacterial contamination of milk is a primary culprit for causing foodborne illnesses, presenting a significant health hazard for millions of individuals around the globe. The level and variety of microorganisms present in raw milk determine its degree of contamination and the potential health risks it poses.Methods: A cross-sectional survey was conducted from February to August. A questionnaire was used to collect data on socio-demographic characteristics and hygiene practices from milk distributors and traders. Raw milk, yoghurt, swabs from milk containers and drinking cups were collected and processed for bacterial isolation and identification, antibiotic susceptibility testing, MDR screening and confirmation, ESBL screening and confirmation. Finally, all data were pooled and analyzed using SPSS software version 25.Results: A total of 120 samples of fresh milk, yogurt and cotton swabs from milk containers and cups were collected. A total of 80 bacterial isolates were isolated from 120 samples. Among the bacteria isolated, S. aureus 17 (21.3%), E. coli 17 (21.3%), S. epidermidis 14 (17.5%), Klebsiella spp. 9 (11.3%) and Salmonella spp. 7 (8.8%) were detected most often. High rate of contamination was observed in fresh milk 23 (28.8%) and yogurt 23 (28.8%). All isolates were resistant to at least one antibiotic tested. Comparatively, high rates of resistance were observed in all isolates to the most commonly prescribed antibiotics in Ethiopia. However, lower rates of resistance have been observed for recently introduced antibiotics in Ethiopia. Of the isolates, 20 (25.0%) were resistant to eight or more antibiotics. While 16 (20.0%), 12 (15.0%), 9 (11.3%) isolates were resistant to two, three and five antibiotics, respectively. Of the bacteria isolated, 52/80 (65.0%) were MDR, 25/49 (51.0%) were screened for ESBL production, and 20/49 (40.8%) isolates were confirmed as ESBL producer.Conclusion: This study showed a high rate of bacterial isolates along with MDR and ESBL-producing strains in raw milk, yoghurt, milk container swabs and drinking cup swab samples, associated with poor hygiene and sanitation practices. [ABSTRACT FROM AUTHOR]

Background: Recently, antibiotic resistance of bacteria contained in foods such as vegetables has become a public health problem. In Ethiopia, the diversity of bacterial contamination and level of antibiotic resistance in vegetables are poorly understood. Local analysis of vegetable contamination and its contribution to the spread of antibiotic resistance are therefore essential for One Health interventions. Therefore, the aim of this study was to investigate the level of bacterial contamination of commonly consumed vegetables and their antimicrobial resistance patterns. Methods: A cross-sectional research was conducted in Debre Berhan town from February to August 2022. Questionnaires were used to collect data on sociodemographic variables, hygiene practices, and market hygiene. Six carefully selected vegetables (30 each, 180 in total) were purchased at a local market. Bacterial isolation and identification, multidrug-resistant (MDR) screening and confirmation, extended-spectrum β-lactamase (ESBL) screening and confirmation, and antibiotic susceptibility tests were performed using standard operating procedure. The data were analysed statistically using SPSS software version 25. Results: The contamination rate of vegetables was 119 (66.1%). Of the 176 bacteria isolates, E. coli (26.1%; 46/176), S. aureus (18.8%; 176), S. epidermidis (10.8%; 19/176), Klebsiella spp. (9.1%; 16/179) and Acinetobacter spp. (6.8%; 12/176) were the most frequently detected isolates. Of the 180 samples tested, (66.1%; 119/180) were contaminated with at least one type of bacteria. Lettuce (22.7%; 40/176), spinach (18.6%; 33/176), and cabbage (19.2%; 32/176) were the most contaminated vegetables. Of the 176 bacteria isolates, (64.8%; 114/176) were MDR, and (18.5%; 23/124) isolates were ESBL producers. The kind of vegetables, vendor/seller finger-nail status, medium of display, market type, and not cleaned before to display were all significantly associated with bacterial contamination. Conclusion: This study found that commonly consumed vegetables are contaminated with antibiotic-resistant bacteria. Vegetables were also notable for the incidence of multidrug-resistant, extended β-lactamase-resistant, and methicillin-resistant bacterial isolates. Therefore, we urge local health authorities to develop and implement effective control strategies to reduce vegetable contamination. [ABSTRACT FROM AUTHOR]

Background: Over the years, microbial contamination caused by foodborne bacteria has led to a significant number of food recalls, particularly for meat items that have been related to outbreaks of deadly diseases. Animals often carry Salmonella and Escherichia coli bacteria in their intestines, and these bacteria contaminate raw meat during slaughter. In addition, pathogens such as Staphylococcus aureus can contaminate meat processing equipment and utensils and spread to raw meat. Methods: A cross-sectional study was undertaken between 30 February and 15 March 2022. Sanitary conditions of abattoir and butchers and food handlers' hygienic practices were assessed using a structured questionnaire. An equal number of meat, swabs from carcasses, knife, weighing balance and cutting board samples (24 each, 120 total) were collected from abattoir and butcher shops. The collected samples were processed for bacterial isolation, antimicrobial susceptibility testing, MDR screening and confirmation, and ESBL screening and confirmation. Finally, SPSS software version 25 was used to compile and analyze the data. Descriptive data from surveys and laboratory procedures were cross-tabulated and summarized using statistical tables and figure. Results: A total of 76 bacteria were isolated from 120 samples. Of all bacteria isolated, S. aureus 16 (21.1%). E. coli 13 (17.1%), and S. epidermidis 12 (15.8%) were the most prevalent. The rate of bacterial contamination was high in meat 18 (23.7%), carcasses 15 (19.7%) and weighing balance 15 (19.7%), respectively. Among the isolates, 18 (23.7%) were resistant for eight and more antibiotics. While, 17 (22.4%), 7(9.2%) and 4(5.3%) of the isolates were resistant for two and three, four and five, and six and seven antibiotics, respectively. Of bacteria isolated, 51/76 (67.1%) were MDR, 23/48 (47.9%) were screened for ESBL production and 13/48 (27.1%) isolates were confirmed as ESBL producer. Conclusion: Multidrug-resistant bacterial contamination was common in meat and meat contact surfaces, which was exacerbated by inadequate sanitation and hygiene practices. [ABSTRACT FROM AUTHOR]

Background: Poor maternal mental health is a major risk factor for adverse offspring health outcomes, including overweight/obesity status. Maternal mental distress is highly prevalent and associated with parenting practices influencing child weight. To date, there is little information documented in Ethiopia on maternal mental distress and children with overweight/obesity status. This study examined the association between maternal mental distress and children with overweight/obesity among mother–child dyads in Addis Ababa, Ethiopia. Methods: An observational population‐based cross‐sectional study was conducted among mother–child dyads in representative samples in Addis Ababa, Ethiopia. Maternal mental distress was measured using the Self‐Reporting Questionnaire (SRQ)‐20. Child/adolescent overweight/obesity was defined as more than 1 SD above the median World Health Organization (WHO) growth reference. Multivariate logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). Results: The prevalence of maternal mental distress and children with overweight/obesity was estimated to be 10.1% and 28.8%, respectively. After adjusting for confounders, including maternal education, maternal occupation, average monthly household income, maternal body mass index (BMI) and the number of household members/family size, maternal psychological distress was not associated with offspring overweight/obesity status (adjusted OR [aOR] = 0.54; 95% CI: 0.25, 1.14). Conclusions: There is no evidence of an association between maternal psychological distress and children with overweight/obesity. This lack of association might be attributable to our cross‐sectional study design. Future epidemiologic studies, particularly those using prospectively collected data, are warranted to examine better the effects of maternal psychological distress on offspring body weight. [ABSTRACT FROM AUTHOR]

Land suitability analysis of Moringa oleifera tree cultivation is important to enhance its product, as the demand for this tree for medicinal values and food sources is increasing worldwide. Therefore, this study aimed to assess suitable land for Moringa oleifera tree cultivation by using the integration of multi-criteria evaluation with geospatial technologies in the Dhidhessa catchment, western Ethiopia. Five parameters, namely: slope, land use and land cover (LULC), soil texture, land surface temperature, and rainfall data, were used in this study. The land suitability evaluation of Moringa oleifera is classified into three classes as highly suitable, moderately suitable, and not suitable. The results revealed that, about 344.4 km2 (12.2%) of the area is categorized into highly suitable, and 2343.7 km2 (83%) is moderately suitable for Moringa tree, whereas, 137.2 km2 (4.9%) is categorized as not suitable for Moringa oleifera tree cultivation. Hence, based on the finding of the study, we suggested that farmers and other stakeholders can cultivate Moringa oleifera trees in the Dhidhessa catchment. [ABSTRACT FROM AUTHOR]

Parasitic and microbial contamination and the pattern of occurrence of the parasite species depends on weather conditions, socio-cultural conditions, sampling season, analyzed vegetable products, and other factors. Therefore, local assessment of vegetable contamination is crucial for targeted and effective interventions. A cross-sectional study was conducted from February to August 2022. A questionnaire was used to assess factors associated with parasite contamination of vegetables during the marketing period. The selected vegetables were purchased and processed for parasite and microbial analysis using standard methods. Finally, all data were summarized and analyzed using SPSS software version 25. A total of 180 vegetable samples were purchased from 180 vendors. This study identified a total of 129 parasites from 180 vegetable samples, with an overall contamination rate of (75; 41.7%). Both protozoa (41; 31.8%) and helminthes (88; 68.2%) were identified from vegetables. Contamination with more than one parasite species was (38; 21.1%). The kind of produce, finger nail status of vendors/sellers, the medium of the display, the type of market and not washed prior to display were significantly associated with parasite contamination. The results also showed that vegetable microbial load for total heterotrophic count, total coliform count, fecal coliform count, yeast count, and mold count was higher in the afternoon than in the morning. To decrease risks to public health, local health authorities and/or market inspectors should establish and implement strategies to reduce contamination such as encouraging specific display medium and washing of vegetables prior to display. [ABSTRACT FROM AUTHOR]

Forests and wetlands played a crucial role in minimizing the increasing trends of land surface temperature (LST). This study aimed to analyze the contribution of forests and wetlands on LST in Yayo district using multi-spectral and multi-temporal satellite. Landsat images of 1986, 2003 and 2021 were downloaded from United State Geological Survey website with 30 m spatial resolution. Results show that the mean LST was increased from 22.8 °C in 1986 to 27 °C in 2003 over cultivated land. As the results of forest conservation and wetland protection, the LST in Yayo district is experencing a declining trend in the recent year. Result reveal that the normalized difference vegetation index and Normalized Difference Water Index show a strong negative relationship with LST. Over the last two decades, the LST was declined by 1.5 °C due to the protection of forest and wetland ecosystem. Thus, governmental and non-governmental organization should encourage the conservation and protection of forest and wetland ecosystems. [ABSTRACT FROM AUTHOR]

Urban expansion possesses significant negative impacts on the environment, particularly in forest areas worldwide. This study aimed to analyze urban expansion by using stochastic modeling with the CA-Markov chain and multi-scenario prospects in Mettu area, Ethiopia. The Landsat images of 1986, 2000, and 2021 were used. The results reveal built-up areas gained 27.2%, of which cropland and forest accounted for 11.4 and 6.4%, respectively, within the 1986–2021 period. Despite the potential decline in urban growth rates, the model revealed that the spatial extent will likely expand twofold before the 2040s. In the rapid development (RD) scenario, urban development due to population increase will occur, which is also prevalent in the proposed suitable urban expansion (PSUE) scenario, but the ecological and economic protection (EEP) scenario reveals very limited. The findings of this study will have far-reaching impacts on ecological and economic livelihoods unless green economy principles are effectively implemented. [ABSTRACT FROM AUTHOR]

Urban green space (UGS) is crucial in providing ecosystem services and optimizing the health of urban residents. This study aimed at identifying suitable sites for UGS development using geospatial techniques in Addis Ababa City. In the present study, an analytical hierarchical process with Geographic Information Systems based multi-criteria evaluation process was used for identifying suitable sites for UGS development. Eight parameters namely land use land cover types, Normalized Difference Vegetation Index, population density, soil types, slope, elevation, road and rivers were used. Results show that about 1 km2 (0.2%) and 67.4 km2 (12.8%) are categorized as highly suitable and moderately suitable sites for UGS, respectively. About 247.2 km2 (46.9%) of the area was marginally suitable and 205.2 km2(38.9%) was currently not suitable, while 6.2 km2(1.2%) was permanently not suitable. The evaluation of UGS development support policy makers to identify the importance of open green space for environmental quality and quality of life in urban center. [ABSTRACT FROM AUTHOR]

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Parasitic and microbial contamination and the pattern of occurrence of the parasite species depends on weather conditions, socio-cultural conditions, sampling season, analyzed vegetable products, and other factors. Therefore, local assessment of vegetable contamination is crucial for targeted and effective interventions. A cross-sectional study was conducted from February to August 2022. A questionnaire was used to assess factors associated with parasite contamination of vegetables during the marketing period. The selected vegetables were purchased and processed for parasite and microbial analysis using standard methods. Finally, all data were summarized and analyzed using SPSS software version 25. A total of 180 vegetable samples were purchased from 180 vendors. This study identified a total of 129 parasites from 180 vegetable samples, with an overall contamination rate of (75; 41.7%). Both protozoa (41; 31.8%) and helminthes (88; 68.2%) were identified from vegetables. Contamination with more than one parasite species was (38; 21.1%). The kind of produce, finger nail status of vendors/sellers, the medium of the display, the type of market and not washed prior to display were significantly associated with parasite contamination. The results also showed that vegetable microbial load for total heterotrophic count, total coliform count, fecal coliform count, yeast count, and mold count was higher in the afternoon than in the morning. To decrease risks to public health, local health authorities and/or market inspectors should establish and implement strategies to reduce contamination such as encouraging specific display medium and washing of vegetables prior to display. [ABSTRACT FROM AUTHOR]

Introduction: Urogenital schistosomiasis is one of public health problems in lowland areas of Ethiopia. The disease is caused by Schistosoma haematobium. Freshwater Bulinus snails are intermediate hosts for the parasite transmission. The aim of the study was to assess intermediate host snails of urogenital schistosomiasis, human water contact behavior and physico-chemical characteristics of Alwero Dam reservoir. Methods: Bulinus snails were sampled from 12 sites of Alwero Dam. Bulinus snails were collected, identified and examined for natural schistosome infections. A total of 206 people were interviewed to determine human water contact behavior. The water temperature, pH, dissolved oxygen, total dissolved solid, salinity and conductivity of the water were determined. Results: Of 1125 Bulinus snails collected, 72 (6.4%) were infected with echinostome cercariae but none of them were infected with schistosome cercariae. The abundance of Bulinus species did not show significant variation across seasons (P =.61). Occurrence of Bulinus species was significantly higher in stony substratum than sandy substratum (P =.01). Of the total 206 participants, 119 (57.8%) had water contact activities like washing clothes, bathing or swimming. Majority of respondents (70.0%) reported that they visited the dam reservoir once or twice a week, while 16.5% and 13.6% reported that they visited the dam 3 to 5 times a week and daily, respectively. Moreover, 72.3% of the respondents had reported they had history of urogenital schistosomiasis infection. The mean water temperature, pH, dissolved oxygen, total dissolved solid, electric conductivity, and salinity of the dam water was 28.6°C, 7.07, 5.75 mg/l, 90.0 ppm, 124.8 µS/cm, and 50.0 ppm, respectively. Conclusion: At Alwero Dam, Bulinus snails were highly abundant and the human water contact activities were frequent. Therefore, the community awareness creation should be made to reduce water contact with snail infested water to prevent risk of urogenital schistosomiasis infection. [ABSTRACT FROM AUTHOR]

Foodborne pathogens are the most common cause of foodborne disease worldwide. They contaminate food at all stages of the food chain, at the agricultural production level (soil and irrigation), from animal sources or at the time of preparation by food handlers. Therefore, food security is a critical issue that affects everyone in the world. Current studies indicate that the problem is more severe in low-income countries like Ethiopia. The majority of studies in Ethiopia have been conducted partially on human, animal or environmental samples with conventional culture-based diagnostic methods. Therefore, this review was conducted to gather information on the main foodborne pathogens and identify gaps in their traceability. Clinically important foodborne pathogens in Ethiopia include (A. lubmbricoids, Toxocara spp., H. nana. E. histolytica/dispar, G. intestinalis, H. diminuta and C. belli), bacteria (Salmonella spp, E. coli O157:H7, B. anthracis, Yersinia, C. perfringens, Klebsiella spp. M. paratuberculosis, and L. monocytogenes), and viruses like (rotaviruses, enteroviruses and astroviruses, hepatitis E virus). In Ethiopia, all isolated foodborne bacterial pathogens showed high rates of antimicrobial resistance (AMR). In particular, the most studied foodborne pathogens, Staphylococcus spp., Salmonella spp., and E. coli from specific sources, showing high levels of resistance to most of the antibiotics prescribed in Ethiopia. The occurrence and persistence of AMR in food is one of the main factors causing the spread of antimicrobial resistance in different compartments, humans, animals and the environment. Therefore, strategies of coordination and struggle from a One Health perspective is an urgent strategy to control antibiotic resistance in order to achieve better outcomes for human and animal health. [ABSTRACT FROM AUTHOR]

Background: Urogenital schistosomiasis has been known to be endemic in several lowland areas of Ethiopia. It is caused by Schistosoma haematobium and causes considerable public health problems to schoolchildren. Ethiopia, after mapping the distribution of the disease (2013 to 2015), launched school-based mass deworming program to treat schoolchildren for schistosomiasis and soil-transmitted helminthiasis (STH) across the country since 2015. However, there is no recent information about the prevalence of the disease among schoolchildren in the current study areas. Diagnostic performance of urine filtration method and urinalysis reagent strip is also lacking. Therefore, this study aimed to determine the prevalence of urogenital schistosomiasis in schoolchildren, and to evaluate diagnostic performance of urine filtration and urinalysis reagent strip in Amibara, Kurmuk and Abobo districts, Ethiopia. Methods: Across-sectional study was conducted involving 1,171 schoolchildren in Abobo, Amibara and Kurmuk districts from October, 2020 to January, 2021. The study participants were selected using random sampling technique. From each study participant, 10 ml urine samples were collected and examined using urine filtration method and urinalysis reagent strip. Data obtained from the survey were entered into Microsoft Excel 2010 and analysed with SPSS version 20.0. Data was summarized using descriptive statistics. Chi-square, bivariate and multivariable logistic regression and Pearson correlation test were used to measure associations between urogenital schistosomiasis, age, sex and haematuria. Odds ratio was used to measure strengths of association between variables. Agreement between urine filtration method and urinalysis reagent strip was determined using Kappa statistics. P-value < 0.05 at 95% CI was considered as statistically significant. Results: Among the 1,171 urine samples from schoolchildren examined by urine filtration method, 143 (12.2%) were S.haematobium egg positive. Out of 143 positive children 126(88.1%) were lightly infected and 17 (11.9%) were heavily infected. Among the total of 1,171 urine samples tested by dipstick, 264(22.5%) were positive for haematuria. Prevalence of urogenital schistosomiasis by both urine filtration and urinalysis reagent strip method was higher in Abobo than Hassoba (Amibara) and Kurmuk (P< 0.001). The number of egg counts (intensity of infections) were significantly correlated with intensity of haematuria (r = 0.6, P < 0.001). Egg-positive children had significantly higher risk of having haematuria compared to S. haematobium egg negative children (OR; 6.96; 95%CI: 4.98, 8.940). Compared to urine filtration method, the sensitivity, specificity, positive predictive value (PPV) and negative predictive values (NPV) of urinalysis reagent strip were 99.3%, 88.1%, 53.8% and 99.8%, respectively. Furthermore, its positive likelihood ratio (PLR) and negative likelihood ratio (NLR) were 8.34 and 0.008, respectively. The accuracy index and diagnostic odds ratio (DOR) of reagent strip were 0.89 and 1054, respectively. The agreement level between urine filtration methods and urinalysis reagent strip for detecting urogenital schistosomiasis was substantial (Kappa = 0.64). Conclusion: This study showed that urogenital schistosomiasis was prevalent in schoolchildren in Abobo, Hassoba and Kurmuk districts. Urogenital schistosomiasis prevalence in Hassoba-bure and Kurmuk falls under low category whereas moderate in Abobo and is almost four times compared to Kurmuk and Hassoba-bure. Chemotherapy is needed in schoolchildren in such endemic areas and other measures like access to safe water, improved sanitation, hygiene, and health education should be implemented to control and prevent schistosomiasis effectively. The sensitivity, specificity, positive and negative predictive values of urinalysis reagent strip were higher and could serve as alternative for mass screening of urogenital schistosomiasis, for surveillance and evaluation of schistosomiasis intervention programs. [ABSTRACT FROM AUTHOR]

Background: Depression has a multitude of clinical and public health consequences for HIV patients. The magnitude of HIV patients who failed first-line antiretroviral treatment and switched to second-line therapy is becoming a growing public health concern. However, unlike first-line therapy, to date, little attention has been given to mental health problems in such patients, particularly in the era of the COVID-19 pandemic. Thus, this research was conducted to determine the magnitude of depression and its determinants among HIV patients on second-line antiretroviral therapy. Methods: A multi-centered cross-sectional study was conducted on 714 HIV patients on second-line therapy who were selected via systematic random sampling. Data were collected in personal interviews as well as document reviews. The nine-item patient health questionnaire score was used to assess depression, while the three-item Oslo Scale was used to assess social support. The associations between exogenous, mediating, and endogenous variables were identified simultaneously using structural equation modeling. Statistical significance was declared at a P-value less than 0.05, and the effect sizes were presented using 95% CI. Results: Depression was reported in 27.7% of HIV patients on second-line therapy [95% CI: 24.7–31.1%]. Social support has a direct [ β ^ = − 0.9, (95% CI: − 1.11 to − 0.69)] and indirect [ β ^ = − 0.22, (95% CI: − 0.31 to − 0.13)] negative effect on depression. Perceived stigma was a mediator variable and significantly associated with depression [ β ^ = 0.40, (95% CI: 0.23–0.57)]. Co-morbid illness [ β ^ = 0.49, (95% CI: 0.35–0.63)], high viremia [ β ^ = 0.17, (95% CI: 0.08–0.26], moderate and high-risk substance use [ β ^ = 0.29, (95% CI: 0.18–0.39)], and not-workable functional status [ β ^ = 0.2, (95% CI: 0.1–0.31)] were all positively associated with depression. Conclusions: This study revealed that there was a high prevalence of depression among HIV patients on second-line antiretroviral therapy. Social and clinical factors were associated with depression risk. As a result, screening, prevention, and control strategies, including psychosocial support, should be strengthened in routine clinical care. [ABSTRACT FROM AUTHOR]

Background: Depression has a multitude of clinical and public health consequences for HIV patients. The magnitude of HIV patients who failed first-line antiretroviral treatment and switched to second-line therapy is becoming a growing public health concern. However, unlike first-line therapy, to date, little attention has been given to mental health problems in such patients, particularly in the era of the COVID-19 pandemic. Thus, this research was conducted to determine the magnitude of depression and its determinants among HIV patients on second-line antiretroviral therapy. Methods: A multi-centered cross-sectional study was conducted on 714 HIV patients on second-line therapy who were selected via systematic random sampling. Data were collected in personal interviews as well as document reviews. The nine-item patient health questionnaire score was used to assess depression, while the three-item Oslo Scale was used to assess social support. The associations between exogenous, mediating, and endogenous variables were identified simultaneously using structural equation modeling. Statistical significance was declared at a P-value less than 0.05, and the effect sizes were presented using 95% CI. Results: Depression was reported in 27.7% of HIV patients on second-line therapy [95% CI: 24.7–31.1%]. Social support has a direct [ β ^ = − 0.9, (95% CI: − 1.11 to − 0.69)] and indirect [ β ^ = − 0.22, (95% CI: − 0.31 to − 0.13)] negative effect on depression. Perceived stigma was a mediator variable and significantly associated with depression [ β ^ = 0.40, (95% CI: 0.23–0.57)]. Co-morbid illness [ β ^ = 0.49, (95% CI: 0.35–0.63)], high viremia [ β ^ = 0.17, (95% CI: 0.08–0.26], moderate and high-risk substance use [ β ^ = 0.29, (95% CI: 0.18–0.39)], and not-workable functional status [ β ^ = 0.2, (95% CI: 0.1–0.31)] were all positively associated with depression. Conclusions: This study revealed that there was a high prevalence of depression among HIV patients on second-line antiretroviral therapy. Social and clinical factors were associated with depression risk. As a result, screening, prevention, and control strategies, including psychosocial support, should be strengthened in routine clinical care. [ABSTRACT FROM AUTHOR]

Background: The proportion of HIV patients on second-line antiretroviral therapy is becoming a growing public health concern, especially in a low-income country setting. However, unlike first-line therapy, to date, very little is known about the outcomes of second-line therapy in the Ethiopia context. Thus, this study was conducted to determine the rate of treatment failure, death, and their predictors among HIV patients receiving second-line therapy. Methods: A retrospective cohort study was conducted on 642 people living with HIV in Dessie Comprehensive Specialized Hospital from October 2016 to November 2019. Poisson and competitive risk survival models were computed to explore predictors of treatment failure and death, respectively. Results: During follow-up period, 39 (6.87%, 95% CI: 5–9.2%) of 568 patients had second-line treatment failure with 4.07 per 100 person-year rate of failure. Being on anti-TB treatment [Rate ratio, RR = 2.57 (95% CI: 1.25–5.25)], not having optimal medication adherence [RR = 2.29 (95% CI: 1.09–4.78)], and not timely switched [RR = 5.89 (95% CI: 1.36–25.54)] were positively associated with treatment failure. Similarly, 44 (6.85%, 95% CI: 5–9%) of 642 patients died with 4.5 per 100 person-year rate of death. Being on advanced clinical condition [Sub distribution Hazard ratio, SHR = 2.49 (95% CI: 1.31–4.74)], not having optimal medication adherence [SHR = 2.65 (95% CI: 1.31–4.74)], lower CD4 cell counts, and high viral load measurement were positively associated with death. Conclusions: A significant number of patients had failed to respond to second-line therapy. A large number of patients had also died. Patient medical profile and monitoring practice were associated with treatment failure and death. Hence, patient-centered monitoring and interventions should be strengthened, besides treatment switch. [ABSTRACT FROM AUTHOR]

Background: Medication adherence plays a pivotal role in achieving the desired treatment outcomes. The proportion of HIV patients on second-line antiretroviral therapy is becoming a growing public health concern. However, to date, little attention has been given to second-line antiretroviral medication adherence. Moreover, the association between health facility characteristics and medication adherence has yet not been tested. Thus, this research was conducted to determine the magnitude of medication adherence and examine the role of facility-level determinants among HIV patients on second-line ART. Methods: A cross-sectional study was conducted on 714 HIV patients on second-line therapy who were selected via systematic random sampling in twenty public health facilities. Medication adherence was measured using the six-item Simplified Medication Adherence Questionnaire (SMAQ) tool. Data were collected in a personal interview as well as document reviews. A multi-level binary logistic regression was used to uncover individual and facility-level determinants. The effect size was presented using an adjusted odds ratio (AOR), and statistical significance was declared at a P value less than 0.05. Results: The magnitude of optimal medication adherence among HIV patients on second-line antiretroviral therapy was 69.5% (65.9–72.7%). Medication adherence was positively associated with the use of adherence reminder methods [AOR = 3.37, (95% CI 2.03–5.62)], having social support [AOR = 1.11, (95% CI 1.02–1.23)], and not having clinical depression [AOR = 3.19, (95% CI 1.93–5.27). The number of adherence counselors [AOR = 1.20, (95% CI 1.04–1.40)], teamwork for enhanced adherence support [AOR = 1.82, (95% CI 1.01–3.42)], and caseloads at ART clinics were all significantly correlated with ARV medication adherence at the facility level. Conclusions: A large proportion of HIV patients on second-line antiretroviral therapy had adherence problems. Both facility-level and individual-level were linked with patient medication adherence. Thus, based on the identified factors, individual and system-level interventions should be targeted. [ABSTRACT FROM AUTHOR]

Background: Premature rupture of membrane (PROM) varies from country to country and complicates 4 to 10% of pregnancies worldwide it has an overwhelming effect on maternal and newborn health. Even though many interventions implemented to tackle it, the problem is persisted. Objective: To identify determinants of premature rupture of membrane among pregnant women who have visited labor wards in four hospitals found in Gedeo zone, Southern Ethiopia. Methods: Hospital-based unmatched case-control study was conducted from February to May 2020. Data were collected among 75 cases and 223 controls using face-to-face interviews. Cases and controls were recruited consecutively from pregnant women who have visited the labor ward. Data were entered into Epi-data version 3.1 and analyzed by using SPSS version 20. Bivariable and Multivariable logistic regression was used to check the association between dependent and independent variables, statistically significant association was declared at p-value < 0.05. Results: A total of 75 cases and 233 controls were enrolled in the study. Hypertension during index pregnancy [AOR = 2.81 (95% CI: 1.09 − 7.23)], history of abortion [AOR = 3.7 (95% CI: 1.41– 9.73)], history of caesarean section [AOR = 3.46 (95% CI: 1.34– 8.9)] and history of PROM [AOR = 4.77 (95% CI: 2.31– 9.89)] were associated with premature rupture of membranes. Conclusion: Hypertension during the index pregnancy, history of abortion, history of PROM, and history of cesarean section has an association with premature rupture of membrane. The result of the study suggests early identification and treatment of abortion, hypertension, and cesarean section in pregnant women mitigates the risk of premature rupture of membrane. [ABSTRACT FROM AUTHOR]

Land degradation due to soil erosion presents a major challenge for sustainable development. We investigated run‐off and sediment yield (SY) dynamics in the northwestern highlands of Ethiopia. The study area included 14 zero‐order catchments with a surface area ranging from 324 to 1715 m2. V‐notch weirs produced from plastic jars were introduced as measuring alternatives that met local constraints. Run‐off (RO) depth at the weir was registered manually at 5‐min intervals during two rainy seasons in 2018 and 2019, and a total of 618 events were monitored. Rainfall was measured using tipping‐bucket rain gauges. RO samples were collected in 1‐L bottles, and suspended sediment concentration was determined. The mean event RO coefficient ranged from 3% for forests to 56% for badlands. Similarly, the mean annual SY was lowest for forests (0.8 Mg ha−1 yr−1) and highest for badlands (43.4 Mg ha−1 yr−1), with significant differences among land‐use types (14.8 Mg ha−1 yr−1 in cropland, 5.7 Mg ha−1 yr−1 in grazing land, and 2.9 Mg ha−1 yr−1 in plantations). Soil organic matter (SOM) reduced RO and SY, necessitating the consideration of agronomic and land management practices that enhance SOM. Annual SY decreased exponentially with the rock fragment cover (RFC). In fields where RFC was less than 20%, collecting rock fragments for installing stone bunds resulted in a net increase in SY. Rehabilitating badlands and enhancing SOM content in croplands can substantially reduce catchment SY and hence contribute to the sustainability of land uses in the subhumid highlands. [ABSTRACT FROM AUTHOR]

Ethiopia has been experiencing resettlement programs primarily as a response to the tragedy of land degradation. The program, however, resulted in massive deforestation in the resettled sites. This study, therefore, aimed at evaluating the impact of resettlement on the moist evergreen Afromontane forest cover between 2000 and 2018 in the Hawa-Galan district. Landsat TM of 2000, ETM+ of 2010, and OLI of 2018 were used to detect forest cover change. Likewise, an explanatory sequential approach of mixed research design was used. Hence, 118 participants out of the total 2232 indigenous and resettled households were employed to survey the impact of deforestation.The study area lost 55% of its total area over the last two decades, corresponding to average deforestation rates of 2.06, 6.75, and 4.14% for the corresponding periods: 2000–2010, 2010–2018, and 2000–2018, respectively. Our findings also revealed the demographic, socioeconomic, and backgrounds of the resettlers were the prominent triggers. Conversion of forests to other uses will have far-reaching impacts on the residual biodiversity and ecosystem services. Therefore, in the light of resettlement, it is high time for the Ethiopian government to revisit its intervention strategies and resettlement policies in the forest priority areas. [ABSTRACT FROM AUTHOR]

Introduction. Erectile dysfunction is a common sexual problem affecting men with hypertension. It may result in withdrawal from sexual engagement, decreased work productivity, psychosocial problems including poor self-esteem and depression, and reduction in quality of life for both the affected men and their female partners. Objective. This study was aimed to determine the prevalence of erectile dysfunction and associated factors among hypertensive patients attending governmental health institutions in Gondar city, Northwest Ethiopia. Materials and Methods. An institutional-based cross-sectional study was conducted on 423 hypertensive men randomly selected using a systematic random sampling technique. Erectile dysfunction was assessed using the International Index of Erectile Function-5 tool. Sociodemographic, clinical, and behavioral factors were also collected using pretested interviewer-administered questionnaires. Data were entered into EpiData version 4.6 and analyzed using Stata-14. Binary logistic regression was performed to identify factors associated with erectile dysfunction. The level of significance was computed at a p value ≤ 0.05. Results. The mean age of the study participants was 58.84 ± 13.52 years. The prevalence of erectile dysfunction among hypertensive men was 46.34% (95% CI: 41.61, 51.12). About 28% of them had a mild form of erectile dysfunction while nearly 6% had severe forms. Age above 60 years (AOR = 3.8, 95% CI: 1.62, 6.55), stage II hypertension (AOR = 3.5, 95% CI: 1.63, 5.74), hypertension duration >10 years (AOR = 2.5, 95% CI:1.12, 4.19), comorbidity (AOR = 1.7, 95% CI: 1.04, 3.15), depression (AOR = 2.35, 95% CI: 1.31, 4.21), and being physically active (AOR = 0.48, 95% CI: 0.28, 0.83) were factors significantly associated with erectile dysfunction. Conclusion. Nearly half of the study participants had some form of erectile dysfunction, indicating the presence of a high burden of the problem. Assessment of hypertensive men for erectile dysfunction should be part of routine medical care. [ABSTRACT FROM AUTHOR]

Background: Orthostatic hypotension (OH) is defined as a fall in systolic blood pressure (SBP) ≥ 20 mmHg or diastolic BP (DBP) ≥ 10 mmHg within 3 minutes of standing. OH incidence is increased with hypertension, and management of these patients may pose challenges, as treatment of one can worsen the other. Objective: This study aimed to determine the prevalence of OH and its associated factors among male hypertensive patients at the University of Gondar Comprehensive Specialized Hospital, Gondar, Ethiopia. Methods: A hospital-based cross-sectional design was employed. Seated BP was measured twice and the average of the two taken. After BP had been stabilized for 5 minutes, SBP within 3 minutes of standing was measured twice and the minimum of the two taken. A drop of ≥ 20 mmHg in SBP within 3 minutes of standing was taken as OH. All male hypertensive patients who were able to attain a standing position were included. Sociodemographic, anthropometric, and clinical status of the patients were taken using structured interviewer-administered questionnaires. Data were entered and analyzed using SPSS 21. Both bivariate and multivariate logistic regression analysis were done. P≤ 0.05 was considered statistically significant. Results: The median age of study participants was 57 (25– 96) years. The prevalence of OH was 17.6%. Uncontrolled hypertension (adjusted OR 2.08, 95% CI 1.125– 3.872) and duration of hypertension ≥ 5 years (adjusted OR 2.04, 95% CI 1.069– 3.895) were significantly associated with OH in hypertensive patients. Conclusion: The prevalence of OH among male hypertensive patients was high. Hypertensive patients whose BP was uncontrolled and having had hypertension ≥ 5 years were risk factors of OH. [ABSTRACT FROM AUTHOR]

Background: The coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus (SARS-CoV-2) and became pandemic after emerging in Wuhan, China, in December 2019. Several studies have been conducted to understand the key features of COVID-19 and its public health impact. However, the prognostic factors of COVID-19 are not well studied in the African setting. In this study, we aim to determine the epidemiological and clinical features of COVID-19 cases, immunological and virological courses, interaction with nutritional status, and response to treatment for COVID-19 patients in Ethiopia.Methods: A multi-center cohort study design will be performed. Patients with confirmed COVID-19 infection admitted to selected treatment centers will be enrolled irrespective of their symptoms and followed-up for 12 months. Baseline epidemiological, clinical, laboratory and imaging data will be collected from treatment records, interviews, physical measurements, and biological samples. Follow-up data collection involves treatment and prognostic outcomes to be measured using different biomarkers and clinical parameters. Data collection will be done electronically using the Open Data Kit (ODK) software package and then exported to STATA/SPSS for analysis. Both descriptive and multivariable analyses will be performed to assess the independent determinants of the treatment outcome and prognosis to generate relevant information for informed prevention and case management. The primary outcomes of this study are death/survival and viral shedding. Secondary outcomes include epidemiological characteristics, clinical features, genetic frequency shifts (genotypic variations), and nutritional status.Discussion: This is the first large prospective cohort study of patients in hospitals with COVID-19 in Ethiopia. The results will enable us to better understand the epidemiology of SARS-CoV-2 in Africa. This study will also provide useful information for effective public health measures and future pandemic preparedness and in response to outbreaks. It will also support policymakers in managing the epidemic based on scientific evidence.Trial Registration: The Protocol prospectively registered in ClinicalTrials.gov (NCT04584424) on 30 October, 2020. [ABSTRACT FROM AUTHOR]

Background: In Ethiopia, first-line antiretroviral therapy failure is growing rapidly. However, unlike first-line therapy, to date, very little is known about the outcomes of second-line therapy. Thus, this study assessed the rate of viral re-suppression and attrition to care and their predictors among people living with HIV on second-line therapy. Methods: A retrospective cohort study was conducted on 642 people living with HIV at Dessie Comprehensive Specialized Hospital from October 2016 to November 2019. A proportional Cox regression model was computed to explore predictors of viral re-suppression (viral load less than 1000 copies/mL) and attrition to care. Results: Out of 642 subjects, 19 (3%), 44 (6.9%), 70 (10.9%), and 509 (79.3%) patients were lost to follow up, died, transferred out, and alive on care, respectively. Similarly, 82.39% (95% CI: 79.24– 85.16%) of patients had achieved viral re-suppression, with 96 per 100 person-year rate of re-suppression. Patients who switched timely to second-line therapy were at a higher rate of viral re-suppression than delayed patients [adjusted hazard rate, AHR = 1.43 (95% CI: 1.17– 1.74)]. Not having drug substitution history [AHR = 1.25 (95% CI: 1.02– 1.52)] was positively associated with viral re-suppression. In contrast, being on anti-TB treatment [AHR = 0.67 (95% CI: 0.49– 0.91)] had lower likelihood with viral re-suppression. In the current study, attrition to care was 11% (95% CI: 8.7– 13.9%). Ambulatory or bedridden patients were more at risk of attrition to care as compared with workable patients [AHR = 2.61 (95% CI: 1.40– 4.87)]. Similarly, being not virally re-suppressed [AHR = 6.87 (95% CI: 3.86– 12.23)] and CD4 count ≤ 450 cells/mm3 [AHR = 2.61 (95% CI: 1.40– 4.87)] were also positively associated with attrition to care. Conclusion: A significant number of patients failed to achieve viral re-suppression and attrition from care. Most identified factors related to patient monitoring. Hence, patient-centered intervention should be strengthened, besides treatment switch. [ABSTRACT FROM AUTHOR]

Background: Mobile Phone (MP) handling by healthcare workers (HCWs) in hospital is an open breeding place for the transmission of bacteria and healthcare-associated infection (HCAI). This HCAI is a huge problem to the healthcare system worldwide. Methods: A laboratory-based cross-sectional study design was conducted from January 2020 to January 2021 in Debre Berhan Referral Hospital, North Shoa Zone, Ethiopia. A total of 65 swab samples were collected from HCWs mobiles phone. Other important data were collected using a self-administered questionnaire. The collected samples were processed for bacteriological identification and drug susceptibility testing. Data obtained were entered and cleaned into MS Excel spreadsheet and analyzed using SPSS version 21. Results: From the total of 65 swab sample, 84 bacterial isolates were detected. Of these bacterial isolates, 46.4% were Gram-positive bacteria while 53.6% were Gram-negative bacteria. The overall MDR prevalence was found to be 42.9%. The proportion of MP contamination was higher in males (67.9%) and the age groups of 20– 35 years (50%). All the MP carried by HCWs was contaminated with at least one bacterial pathogen. The high rate of MP contamination was observed in the intensive care unit (ICU) (22.6%) followed by surgical ward (17.8) and laboratory rooms (17.8%). The rate of bacterial contamination of MP was higher among HCWs working in ICU, who did not disinfect or clean their phone regularly and who did not wash their hands regularly. Conclusion: Healthcare worker's MP was contaminated with pathogenic bacteria. Since MP could serve as a vehicle and a reservoir for pathogenic bacteria, HCWs should be aware of the public health risks of HCAI, and appropriate intervention mechanisms should be practiced to reduce the burden and cross-transmission. [ABSTRACT FROM AUTHOR]

Background: Currently, antibiotic-resistant bacteria (ARB) have become a serious global problem and considered as One Health challenge. Despite, wastewater contains a wide range of microbial pathogens and plays a significant role in the dissemination of ARB in the environment. However, it is the most overlooked in developing countries, particularly in Ethiopia. Methods: Different article searching devices like PubMed, Web of Science, Scopus, and Google Scholar were used to select research article by using the key terms. Hand search using a reference list is also used to retrieve the article. Preferred reporting items for systematic review and meta-analysis (PRISMA) guideline was used for literature search strategy, selection of publications, data extractions, and reporting result for the review process. Results: A total of seven original research articles were included from a total of 35,999 research articles obtained from the different searching techniques. The selected articles were used, the same study design and laboratory methods to isolate different types of resistant bacteria. All studies isolate pathogenic bacteria and highlighted the presence of resistant bacteria for multiple antibiotics. Conclusion: Multidrug resistance (MDR) bacteria were isolated from wastewater. This is an indication for the possible presence of pathogenic organisms that are discharged into the receiving environment probably waterbodies (lake and revers) posing risk to public health, animal, and environment. In Ethiopia the coverage of safe water supply is poor.  This obligated the society to use untreated water from rivers, lakes and others. The outlet of most urban sewage from hospital, hotels, and industries are directly running to those water bodies due to lack of proper wastewater management system.  Therefore ARB is a direct threat to those people that use those water bodies. [ABSTRACT FROM AUTHOR]

Background: Despite their potential as biofuel resources, large-scale production of biofuels from microalgae is still uncertain primarily due to a lack of feasibility of the process and that it proves to be capital and energy intensive. Therefore, an integration of microalgal cultivation with other processes for achieving an inexpensive nutrient and energy use is an important issue. In the present study, the potential of the flue gas and the wastewater of a sugar factory to support microalgae growth for biofuel and bio-fertilizer production is evaluated. Methods: The study was carried out by following a case study approach; an Ethiopian sugarcane-processing factory, Metahara sugar and ethanol production factory, was selected for this purpose. Conceptual microalgal biofuel production was integrated with the real sugarcane-processing factory, and the process was evaluated with regard to the product outputs and energy requirements. Results: The integrated process model shows that three products, biodiesel, upgraded biogas, and bio-fertilizer with production capacities of 188 tons/year, 1,974,882 m3/year and 42 tons/year, respectively, were produced. For the production of these products, the electricity and thermal energy demand of the integrated process amounted to 1822.13 and 3244.99 MWh/year, respectively. A sensitivity analysis shows that the oil content of the algae, the nitrogen content of the waste, the oil extraction efficiency, and the transesterification efficiency are the main factors which affect the biodiesel production capacity of the integrated process. Conclusions: This case study approach investigated the potential of a future possible bio-refinery and environmental pollution reduction concept by integrating microalgae biomass production with sugarcane-processing factory wastes and by-products. It was found that the factory wastes and by-products have a significant potential for a viable biofuel production from microalgae. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study was to evaluate the tuberculosis (TB) health system capacity and its variations by location and types of health facilities in Ethiopia.Design: We used the Service Provision Assessment plus (SPA+) survey data that were collected in 2014 in all hospitals and randomly selected health centers and private facilities in all regions of Ethiopia. We assessed structural, process and overall health system capacity based on the Donabedian quality of care model. Multiple linear regression and spatial analysis were done to assess TB capacity score variation across regions.Setting: The study included 873 public and private health facilities all over Ethiopia.Participants: None.Intervention(s): None.Main Outcome Measure(s): None.Results: A total of 873 health facilities were included in the analysis. The overall TB care capacity score was 76.7%, 55.9% and 37.8% in public hospitals, health centers and private facilities, respectively. The health system capacity score for TB was higher in the urban (60.4%) facilities compared to that of the rural (50.0%) facilities (β = 8.0, 95% CI: 4.4, 11.6). Health centers (β = -16.2, 95% CI: -20.0, -12.3) and private health facilities (β = -38.3, 95% CI: -42.4, -35.1) had lower TB care capacity score than hospitals. Overall TB care capacity score were lower in Western and Southwestern Ethiopia and in Benishangul-Gumuz and Gambella regions.Conclusions: The health system capacity score for TB care in Ethiopia varied across regions. Health system capacity improvement interventions should focus on the private sectors and health facilities in the rural and remote areas to ensure equity and improve quality of care. [ABSTRACT FROM AUTHOR]

The main grassland plain of Nech Sar National Park (NSNP) is a federally managed protected area in Ethiopia designated to protect endemic and endangered species. However, like other national parks in Ethiopia, the park has experienced significant land cover change over the past few decades. Indeed, the livelihoods of local populations in such developing countries are entirely dependent upon natural resources and, as a result, both direct and indirect anthropogenic pressures have been placed on natural parks. While previous research has looked at land cover change in the region, these studies have not been spatially explicit and, as a result, knowledge gaps in identifying systematic transitions continue to exist. This study seeks to quantify the spatial extent and land cover change trends in NSNP, identify the strong signal transitions, and identify and quantify the location of determinants of change. To this end, the author classifies panchromatic aerial photographs in 1986, multispectral SPOT imagery in 2005, and Sentinel imagery in 2019. The spatial extent and trends of land cover change analysis between these time periods were conducted. The strong signal transitions were systematically identified and quantified. Then, the basic driving forces of the change were identified. The locations of these transitions were also identified and quantified using the spatially explicit statistical model. The analysis revealed that over the past three decades (1986–2019), nearly 52% of the study area experienced clear landscape change, out of which the net change and swap change attributed to 39% and 13%, respectively. The conversion of woody vegetation to grassland (~ 5%), subsequently grassland-to-open-overgrazed land (28.26%), and restoration of woody vegetation (0.76%) and grassland (0.72%) from riverine forest and open-overgrazed land, respectively, were found to be the fully systematic transitions whereas the rest transitions were recorded either partly systematic or random transitions. The location of these most systematic land cover transitions identified through the spatially explicit statistical modeling showed drivers due to biophysical conditions, accessibility, and urban/market expansions, coupled with successive government policies for biodiversity management, geo-politics, demographic, and socioeconomic factors. These findings provide important insights into biodiversity loss, land degradation, and ecosystem disruption. Therefore, the model for predicted probability generally suggests a 0.75 km and 0.72 km buffers which are likely to protect forest and grassland from conversion to grassland and open-overgrazed land, respectively. [ABSTRACT FROM AUTHOR]

BACKGROUND: The burden of HIV/AIDS in Ethiopia has not been comprehensively assessed over the last two decades. In this study, we used the 2016 Global Burden of Diseases, Injuries and Risk factors (GBD) data to analyze the incidence, prevalence, mortality and Disability-adjusted Life Years Lost (DALY) rates of Human Immunodeficiency Virus / Acquired Immune Deficiency Syndrome (HIV/AIDS) in Ethiopia over the last 26 years. METHODS: The GBD 2016 used a wide range of data source for Ethiopia such as verbal autopsy (VA), surveys, reports of the Federal Ministry of Health and the United Nations (UN) and published scientific articles. The modified United Nations Programme on HIV/AIDS (UNAIDS) Spectrum model was used to estimate the incidence and mortality rates for HIV/AIDS. RESULTS: In 2016, an estimated 36,990 new HIV infections (95% uncertainty interval [UI]: 8775-80262), 670,906 prevalent HIV cases (95% UI: 568,268-798,970) and 19,999 HIV deaths (95% UI: 16426-24412) occurred in Ethiopia. The HIV/AIDS incidence rate peaked in 1995 and declined by 6.3% annually for both sexes with a total reduction of 77% between 1990 and 2016. The annualized HIV/AIDS mortality rate reduction during 1990 to 2016 for both sexes was 0.4%. CONCLUSIONS: Ethiopia has achieved the 50% reduction of the incidence rate of HIV/AIDS based on the Millennium Development Goals (MDGs) target. However, the decline in HIV/AIDS mortality rate has been comparatively slow. The country should strengthen the HIV/AIDS detection and treatment programs at community level to achieve its targets during the Sustainable Development Program (SDGs)-era. [ABSTRACT FROM AUTHOR]

Background: Low coverage of Skilled Birth Attendance (SBA) is one of the major drivers of maternal mortality in many low- and middle-income countries (LMICs) including Ethiopia. We conducted a cluster-randomized controlled community trial to assess the effect of deploying trained community based nurses to rural communities on the uptake levels of SBA in Ethiopia. Methods: A three-arm, parallel groups, cluster-randomized community trial was conducted to assess the effect of deploying trained community based reproductive health nurses (CORN) on the uptake of SBA services. A total of 282 villages were randomly selected and assigned to a control arm (n = 94) or 1 of 2 treatment arms (n = 94 each). The treatment groups differed by where these new service providers were deployed, a health post (HP) or health center (HC). Baseline and end line surveys were conducted to document and measure the effects of the intervention. Program impacts on SBA coverage were calculated using difference-in-difference (DID) analysis. Results: After nine months of intervention, the coverage of SBA services increased significantly by 81.1% (from 24.61 to 44.59) in the HP based intervention arm, and by 122.9% (from 16.41 to 36.59) in the HC arm, respectively (p <0.01). Conversely, a small and non-significant (2%) decline in SBA coverage were observed in the control arm (P >0.05). The DID estimate indicated a net increase in SBA coverage of 21.32 and 20.52 percentage points (PP) across the HP and HC based intervention arms, respectively (p < 0.001). Conclusions: Deployment of trained reproductive health nurses to rural communities in Ethiopia significantly improved utilization of SBA services. Therefore; in similar low income settings where coverage of SBA services is very low, deployment of trained community based nurses to grassroots level could potentiate rapid service uptake. Additional cost-effectiveness and validation studies at various setups are required, before scale-up of the innovation, however. Trial registration: clinicaltrails.gov . [ABSTRACT FROM AUTHOR]

BACKGROUND: The burden of Tuberculosis (TB) has not been comprehensively evaluated over the last 25 years in Ethiopia. In this study, we used the 2016 Global Burden of Diseases, Injuries and Risk Factors (GBD) data to analyze the incidence, prevalence and mortality rates of tuberculosis (TB) in Ethiopia over the last 26 years. METHODS: The GBD 2016 is a mathematical modeling using different data source for Ethiopia such as verbal autopsy (VA), prevalence surveys and annual case notifications. Age and sex specific causes of death for TB were estimated using the Cause of Death Ensemble Modeling (CODEm). We used the available data such as annual notifications and prevalence surveys as an input to estimate incidence and prevalence rates respectively using DisMod-MR 2.1, a Bayesian meta-regression tool. RESULTS: In 2016, we estimated 219,186 (95%UI: 182,977-265,292) new, 151,602 (95% UI: 126,054-180,976) prevalent TB cases and 48,910(95% UI: 40,310-58,195) TB deaths. The age-standardized TB incidence rate decreased from 201.6/100,000 to 88.5/100,000 (with a total decline of 56%) between 1990 to 2016. Similarly, the age-standardized TB mortality rate declined from 393.8/100,000 to 100/100,000 between 1990 and 2016(with a total decline of 75%). CONCLUSIONS: Ethiopia has achieved the 50% reduction of most of the Millennium Development Goals (MDGs) targets related to TB. However, the decline of TB incidence and prevalence rates has been comparatively slow. The country should strengthen the TB case detection and treatment programs at community level to achieve its targets during the Sustainable Development Program (SDGs)-era. [ABSTRACT FROM AUTHOR]

Objective: To assess the oral health–related quality of life (OH-RQoL) using a translated standardized measure in an understudied population of Ethiopian children born with orofacial clefts (OFCs) and their parents. Methods: Using a descriptive study design, we assessed the OH-RQoL of 41 patients with OFCs between the ages of 8 and 17 years and their parents. Participants received multidisciplinary cleft care from 2008 to 2016. They completed an Amharic translation of the Child Oral Health Impact Profile (COHIP). Results: There was strong internal reliability with the translated COHIP for parents and patients. Parents’ COHIP scores ranged from 67 to 186, and patients’ scores were 78 to 190. The mean for patients and parents was 155, indicating good OH-RQoL. Conclusion: The Amharic translation of the COHIP appears appropriate for use with families in Ethiopia. Both parents and patients reported OH-RQoL at similar levels as other international populations. [ABSTRACT FROM AUTHOR]

Background: Ethiopia lacks a complete vital registration system that would assist in measuring disease burden and risk factors. We used the Global Burden of Diseases, Injuries, and Risk Factors Study 2015 (GBD 2015) estimates to describe the mortality burden from communicable, non-communicable, and other diseases in Ethiopia over the last 25 years. Methods: GBD 2015 mainly used cause of death ensemble modeling to measure causes of death by age, sex, and year for 195 countries. We report numbers of deaths and rates of years of life lost (YLL) for communicable, maternal, neonatal, and nutritional (CMNN) disorders, non-communicable diseases (NCDs), and injuries with 95% uncertainty intervals (UI) for Ethiopia from 1990 to 2015. Results: CMNN causes of death have declined by 65% in the last two-and-a-half decades. Injury-related causes of death have also decreased by 70%. Deaths due to NCDs declined by 37% during the same period. Ethiopia showed a faster decline in the burden of four out of the five leading causes of age-standardized premature mortality rates when compared to the overall sub-Saharan African region and the Eastern sub-Saharan African region: lower respiratory infections, tuberculosis, HIV/AIDS, and diarrheal diseases; however, the same could not be said for ischemic heart disease and other NCDs. Non-communicable diseases, together, were the leading causes of age-standardized mortality rates, whereas CMNN diseases were leading causes of premature mortality in 2015. Although lower respiratory infections, tuberculosis, and diarrheal disease were the leading causes of age-standardized death rates, they showed major declines from 1990 to 2015. Neonatal encephalopathy, iron-deficiency anemia, protein-energy malnutrition, and preterm birth complications also showed more than a 50% reduction in burden. HIV/AIDS-related deaths have also decreased by 70% since 2005. Ischemic heart disease, hemorrhagic stroke, and ischemic stroke were among the top causes of premature mortality and age-standardized death rates in Ethiopia in 2015. Conclusions: Ethiopia has been successful in reducing deaths related to communicable, maternal, neonatal, and nutritional deficiency diseases and injuries by 65%, despite unacceptably high maternal and neonatal mortality rates. However, the country's performance regarding non-communicable diseases, including cardiovascular disease, diabetes, cancer, and chronic respiratory disease, was minimal, causing these diseases to join the leading causes of premature mortality and death rates in 2015. While the country is progressing toward universal health coverage, prevention and control strategies in Ethiopia should consider the double burden of common infectious diseases and non-communicable diseases: lower respiratory infections, diarrhea, tuberculosis, HIV/AIDS, cardiovascular disease, cancer, and diabetes. Prevention and control strategies should also pay special attention to the leading causes of premature mortality and death rates caused by non-communicable diseases: cardiovascular disease, cancer, and diabetes. Measuring further progress requires a data revolution in generating, managing, analyzing, and using data for decision-making and the creation of a full vital registration system in the country. [ABSTRACT FROM AUTHOR]

Background: In Ethiopia there is no complete registration system to measure disease burden and risk factors accurately. In this study, the 2015 global burden of diseases, injuries and risk factors (GBD) data were used to analyse the incidence, prevalence and mortality rates of malaria in Ethiopia over the last 25 years. Methods: GBD 2015 used verbal autopsy surveys, reports, and published scientific articles to estimate the burden of malaria in Ethiopia. Age and gender-specific causes of death for malaria were estimated using cause of death ensemble modelling. Results: The number of new cases of malaria declined from 2.8 million [95% uncertainty interval (UI) 1.4-4.5 million] in 1990 to 621,345 (95% UI 462,230-797,442) in 2015. Malaria caused an estimated 30,323 deaths (95% UI 11,533.3-61,215.3) in 1990 and 1561 deaths (95% UI 752.8-2660.5) in 2015, a 94.8% reduction over the 25 years. Age-standardized mortality rate of malaria has declined by 96.5% between 1990 and 2015 with an annual rate of change of 13.4%. Age-standardized malaria incidence rate among all ages and gender declined by 88.7% between 1990 and 2015. The number of disability-adjusted life years lost (DALY) due to malaria decreased from 2.2 million (95% UI 0.76-4.7 million) in 1990 to 0.18 million (95% UI 0.12-0.26 million) in 2015, with a total reduction 91.7%. Similarly, age-standardized DALY rate declined by 94.8% during the same period. Conclusions: Ethiopia has achieved a 50% reduction target of malaria of the millennium development goals. The country should strengthen its malaria control and treatment strategies to achieve the sustainable development goals. [ABSTRACT FROM AUTHOR]

Background: Maternal mortality is noticeably high in sub-Saharan African countries including Ethiopia. Continuous nationwide systematic evaluation and assessment of the problem helps to design appropriate policy and strategy in Ethiopia. This study aimed to investigate the trends and causes of maternal mortality in Ethiopia between 1990 and 2013.Methods: We used the Global Burden of Diseases and Risk factors (GBD) Study 2013 data that was collected from multiple sources at national and subnational levels. Spatio-temporal Gaussian Process Regression (ST-GPR) was applied to generate best estimates of maternal mortality with 95% Uncertainty Intervals (UI). Causes of death were measured using Cause of Death Ensemble modelling (CODEm). The modified UNAIDS EPP/SPECTRUM suite model was used to estimate HIV related maternal deaths.Results: In Ethiopia, a total of 16,740 (95% UI: 14,197, 19,271) maternal deaths occurred in 1990 whereas there were 15,234 (95% UI: 11,378, 19,871) maternal deaths occurred in 2013. This finding shows that Maternal Mortality Ratio (MMR) in Ethiopia was still high in the study period. There was a minimal but insignificant change of MMR over the last 23 years. The results revealed Ethiopia is below the target of Millennium Development Goals (MGDs) related to MMR. The top five causes of maternal mortality in 2013 were other direct maternal causes such as complications of anaesthesia, embolism (air, amniotic fluid, and blood clot), and the condition of peripartum cardiomyopathy (25.7%), complications of abortions (19.6%), maternal haemorrhage (12.2%), hypertensive disorders (10.3%), and maternal sepsis and other maternal infections such as influenza, malaria, tuberculosis, and hepatitis (9.6%). Most of the maternal mortality happened during the postpartum period and majority of the deaths occurred at the age group of 20-29 years. Overall trend showed that there was a decline from 708 per 100,000 live births in 1990 to 497 per 100,000 in 2013. The annual rate of change over these years was -1.6 (95% UI: -2.8 to -0.3).Conclusion: The findings of the study highlight the need for comprehensive efforts using multisectoral collaborations from stakeholders for reducing maternal mortality in Ethiopia. It is worthwhile for policies to focus on postpartum period. [ABSTRACT FROM AUTHOR]

Background: Despite improvements since 1990 to 2014, maternal mortality ratio (MMR) remains high in Ethiopia. One of the key drivers of maternal mortality in Ethiopia is the very low coverage of Skilled Birth attendance (SBA) in rural Ethiopia. This cluster randomized trial piloted an innovative approach of deploying trained community reproductive nurses (CORN) to hard to reach/unreachable rural Ethiopia to improve the coverage of SBA.Methods: We used a three-arm cluster randomized trial to test the effect of deploying CORN in rural communities in South Ethiopia to improve SBA and other maternal health indicators. A total of 282 villages/clusters (94 from each arm) were randomly selected in the three districts of the zone for the study. The intervention was implemented in four consecutive phases that aimed at of provision of essential maternal, neonatal and child health (MNCH) services mainly focusing on SBA. The CORN were trained and deployed in health centres (arm 1) and in the community/health posts (arm2). A third arm (arm 3) consisting control villages without the intervention. A baseline and end line assessment was conducted to compare the difference in the proportion of SBA and other MNCH service uptake across the three arms Data was entered into computer, edited, cleaned, and analyzed using Epi-data statistical software. The presentation followed the Consolidated Standards of Reporting Trials (CONSORT) statement guidelines for cluster-randomized trials.Discussion: This trial is designed to test the impact of an innovative and newly designed means of distribution for the national health extension program strategy with additional service package with no change to the target population. The focus is on effect of CORN in revitalizing the Health Extension Program (HEP) through improving SBA service uptake and other maternal health service uptake indicators. The study findings may guide national policy to strengthen and shape the already existing HEP that has certain limitations to improve maternal health indicators. The competency based training methodology could provide feedback for health science colleges to improve the national nursing or midwifery training curriculum.Trial Registration: clinicaltrails.gov NCT02501252 dated on July 14, 2015. [ABSTRACT FROM AUTHOR]