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Perovskite solar cells achieved a record for power conversion efficiency of over 26 % for single junction cells and 34 % for planar silicon/perovskite tandems. These cells can be manufactured from low-cost materials with low-tech production techniques. As a result, it attracted great attention for future solar technology and multiple performance and stability studies have been reported in research articles. This work summarizes recent (2019–2023) reports on outdoor performance and stability tests of perovskite solar cells and modules in different locations and climate conditions. The review realized that there are limited works on outdoor testing of perovskite solar cells, and found only one year is the maximum long-term outdoor stability reported as at the time this review was conducted. The reports of this review demonstrated that accelerated aging tests of perovskite solar cells under harsh conditions such as elevated temperature, damp heat, and high relative humidity cannot replace realistic outdoor testing. As a result, studying the performance and stability of perovskite solar cells and modules under real outdoor conditions is very important to realize its commercialization.

Wakgari Mosisa,1 Yenealem Gezehagn,2 Guta Kune,2 Melese Chego,3 Hamba Fida Yigezu,1 Masrie Getnet2 1Department of Public Health, Institute of Health Sciences, Dambi Dollo University, Dambi Dollo, Ethiopia; 2Department of Epidemiology, College of Public Health, Jimma University, Jimma, Ethiopia; 3Department of Public Health, Wollega University, Nekemte, EthiopiaCorrespondence: Guta Kune, Email gutakune12@gmail.comBackground: Stroke is the leading cause of cardiovascular disease death in sub-Saharan Africa and the second leading cause of mortality worldwide. In 2016, 6.23% of all fatalities in Ethiopia were stroke-related.Objective: To assess survival status and predictors of mortality among adult stroke patients admitted to Jimma University Medical Center from April 1/2017 to March 31/2022.Methods: A retrospective cohort study was conducted on 480 adult stroke patients selected by simple random sampling from patients admitted to the Jimma University Medical Center Stroke Unit from April 1, 2017 to March 31, 2022. Data were extracted from May to June 2022 and entered Epi-data v.3.1 and analyzed by R v.4.2. The Kaplan-Meier curve with Log rank test was used to estimate survival time and to compare survival experience between categories of explanatory variables. The Cox regression model was computed to identify predictors of survival status in stroke patients. Then the 95% CI of the hazard ratio was set with corresponding p-value < 0.05 to declare statistical significance.Results: During 4350 person-days of follow-up; 88 (18.33%) patients died; resulting in an incidence mortality of 20.23 per 1000 person-days, with a median survival time of 38 days. Glasgow coma score < 8 on admission (AHR = 7.71; 95% CI: 3.78, 15.69), dyslipidemia (AHR = 3.96; 95% CI: 2.04, 7.69), aspiration pneumonia (AHR 2.30; 95% CI: 1.23– 4.26), and increased intracranial pressure (AHR = 4.27; 95% CI: 2.33, 7.81), were the independent predictors of the time until death.Conclusion: The incidence of stroke mortality was higher at the seven and fourteen days. Glasgow Coma Scale, increased intracranial pressure, dyslipidemia, and aspiration pneumonia were independent predictors of mortality.Keywords: stroke, survival time, predictors, retrospective cohort, JUMC, Southwest Ethiopia

Tadegew Adane,1 Mihret Melese,2 Ephrem Tesfaye,3,&ast; Adugnaw Ambelu,2,&ast; Mihret Getnet,2,&ast; Deresse Sinamaw,1,&ast; Dereje Esubalew,4,&ast; Yibeltal Yismaw2 1Department of Biomedical Science, School of Medicine, College of Medicine and Health Sciences, Debre Markos University, Debre Markos, Ethiopia; 2Department of Human Physiology, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia; 3Department of Biomedical Sciences, School of Medicine, Madda Walabu University Goba Referral Hospital, Bale- Goba, Southeast Ethiopia; 4Department of Biomedical Science, College of Medicine and Health Sciences, Ambo University, Ambo, Ethiopia&ast;These authors contributed equally to this workCorrespondence: Tadegew Adane Abebe, Email tadegeada0975@gmail.comBackground: Epilepsy is a brain disease that is associated with electrocardiographic (ECG) abnormalities. However, this evidence is limited in Ethiopia. Studying ECG abnormality in epileptic patients could help minimize the cardiac problems and death of epileptic patients by early screening. This study was aimed to assess electrocardiogram abnormalities and associated factors among people with and without epilepsy at referral hospitals in Amhara Regional State (ARS), northern Ethiopia, 2022.Methods: Institutional-based comparative cross-sectional study was conducted from April 20 to June 20, 2022. Three referral hospitals in ARS were selected by simple random sampling. Epileptic patients were selected by systematic random sampling, and 403 age- and sex-matched participants were selected from attendants of patients in the outpatient department. Interviewer-administered questionnaire and digital electrocardiograph were used for data collection. Data were entered to EpiData version 4.6 and exported to stata version 14 for analysis. Variables with P value < 0.25 in bivariable analysis were entered to multivariable binary logistic regression. Strength of association was determined by adjusted odds ratio with a 95% confidence interval (CI).Results: The prevalence of ECG abnormality was 40.0% (95% CI = 34.7– 46.8) and 29.0% (95% CI = 23.2– 34.3) in epileptic and non-epileptic subjects, respectively. The odds of ECG abnormality was 58% higher among epileptic patients. Divorce, duration of epilepsy, uncontrolled epilepsy, former/current smoker, adequate physical activity, hypertension, and overweight/obesity were associated with ECG abnormality among epileptic patients.Conclusion and Recommendations: The proportion of ECG abnormality was higher among the epileptic than the non-epileptic group. This should be a wake-up call for stakeholders to establish appropriate measurements to reduce cardiac issues of epileptic patients.Keywords: electrocardiographic abnormality, epilepsy, Ethiopia

In this study, we conducted real-world outdoor performance and stability tests on two different configurations of perovskite solar cells in the climate conditions of Bahir Dar, Ethiopia. Under outdoor illumination with an incident power of 69 mW cm ^−2 , this device demonstrated a power conversion efficiency (PCE) of 15% for an active area of 0.1 cm ^2 . The maximum power generated, measured at a solar irradiance of 72 mW/ cm ^2 , and was 1.23 mW. The second perovskite device has planar p-i-n configuration. This device achieved a PCE of 18% without masking, but the PCE dropped to 11% when the device was covered with circular aperture mask. Maximum power tracking and stability measurements of the device were conducted. Maximum power generation occurred at operating voltages ranging from 0.8 V to 1.2 V for a device with an active area of 0.095 to 0.1cm ^2 . After 30 days of environmental exposure, the device maintained more than 90% of its initial PCE.

Mohammed Ebrahim Rike,1 Mengistie Diress,2 Baye Dagnew,2 Mihret Getnet,2 Abbul Hasano Kebalo,1 Derese Sinamaw,3 Damtew Solomon,1 Yonas Akalu2 1Department of Biomedical Science, School of Medicine, College of Medicine and Health Sciences, Madda Walabu University, Bale Robe, Oromia, Ethiopia; 2Department of Human Physiology, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Amhara, Ethiopia; 3Department of Biomedical Science, School of Medicine, College of Medicine and Health Sciences, Debre Markos University, Debre Markos, Amhara, EthiopiaCorrespondence: Mohammed Ebrahim Rike, Department of Biomedical Science, School of Medicine, College of Medicine and Health Sciences, Madda Walabu University, Bale Robe, Ethiopia, Tel +251920071361, Email zakiziaa9@gmail.comIntroduction: Hypertension is rising globally and is one of the leading causes of cardiovascular disease. It affects people of different groups; however, owing to a rise in a sedentary lifestyle it is more prevalent among long-distance truck drivers. However, the prevalence of hypertension and its associated factors among truck drivers in Ethiopia is not known. Therefore, this study aimed to determine the prevalence of hypertension and its associated factors among long-distance truck drivers in Ethiopia.Methods: A cross-sectional study was conducted among 415 long-distance truck drivers selected by systematic random sampling technique at Modjo dry port from May 15 to 30, 2021. The data were collected and entered into Epi-data 4.6 then it was exported to SPSS version 25 for analysis. Descriptive statistics, bivariable, and multivariable logistic regression analyses were executed. The odds ratio with a 95% confidence interval was computed. In the final model, a variable with a p ≤ 0.05 was declared as a predictor of hypertension.Results: The prevalence of hypertension among long-distance truck drivers in Ethiopia was 34.7%. The odds of hypertension was higher among drivers who were ≥ 45 years old [Adjusted odds ratio (AOR) = 4.32; 95% Confidence interval (CI): 2.16, 8.62], obese [AOR= 5.12; 95% CI: 1.33, 19.8], alcohol drinkers [AOR=3.05; 95% CI: 1.27, 7.31], and cigarette smokers [AOR= 3.74; 95% CI: 1.64, 8.51]. Drivers who had regular physical exercise were less likely [AOR=0.33; 95% CI: 0.17, 0.63] to have hypertension than drivers with no physical activity.Conclusion: More than a third of the participants in Ethiopia had hypertension. Higher age, obesity, absence of rest between driving, short sleep duration, smoking, alcohol drinking, and physical inactivity were significantly associated with hypertension. Therefore, health education on lifestyle modifications, sleep habits, and the importance of rest breaks between driving should be considered to prevent hypertension and further complications.Keywords: hypertension, long-distance truck drivers, Ethiopia

Plain language summary Family planning is a method that couples can use to limit the number of child or space the gap. Unmet need for family planning is defined as the percentage of reproductive age women who wants to space or limit the number of children but not currently using any family planning method. There is a huge proportion of eligible women have an unmet need for family planning in Ethiopia. The health extension program is one of the strategies to reach rural women to improve the health of the community. Although, family planning service is one of the packages in a health extension program and this study aimed to estimate the role of health extension program in reducing unmet need for family planning. About 4991 married women were asked about the family planning use, need and the place where they get the services. During the assessment the role of health extension program was assessed by different question. Some of the major assessment areas were women exposer to service, service availability, awareness and mode of service delivery. One fourth of the women have unmet need for family planning. The family planning utilization is still low. The contribution of the health extension program in family planning service is significant. Women exposed to HEP through level 4 health extension worker and older age are significantly associated with low level of unmet need FP. The unmet need for family planning is high in rural Ethiopia. This will inform the improvement and sustainability of the program.

Abebe Muche Belete,1 Alemu Adela Tefera,1 Mekasha Getnet,2 Adisu Asefa,1 Yared Asmare Aynalem,2 Wondimeneh Shibabaw Shiferaw2 1Biomedical Department, Debre Berhan University, Debre Berhan, Ethiopia; 2Department of Nursing, Debre Berhan University, Debre Berhan, EthiopiaCorrespondence: Abebe Muche Belete Email abebemuche3@gmail.comBackground: Hypovitaminosis D is associated with bone fracture and cardiovascular disease in patients receiving antiretroviral therapy. Currently, there are few data on the magnitude of hypovitaminosis D in people living with HIV in Sub-Saharan country. Therefore, the present study determines the magnitude of hypovitaminosis D in people living with HIV and its associated factors in Ethiopia.Methods: A cross-sectional study was conducted among 171 adult people living with HIV at Debre Berhan Specialized Hospital. Serum vitamin D was measured. Multivariate logistic regression analysis and p-value < 0.05 was used to identify the associated factors of hypovitaminosis D.Results: In the present study, the prevalence of hypovitaminosis D was 129/171 (75.4%), with 11/171 (6.4%) having vitamin D deficiency and 118/171 (69%) having vitamin D insufficiency. Female sex was significantly associated with hypovitaminosis D (AOR: 3.01, 95% CI = 1.381– 6.561, P = 0.006).Conclusion: Our study found a high burden of hypovitaminosis D among adult people living with HIV on antiretroviral therapy. Female sex was associated with hypovitaminosis D.Keywords: vitamin D, HIV, antiretroviral therapy, Ethiopia

Bilisumamulifna Tefera Kefeni,1 Kifle Woldemichael Hajito,2 Masrie Getnet2 1Department of Public Health, College of Health Sciences, Mettu University, Mettu, Ethiopia; 2Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, Jimma University, Jimma, EthiopiaCorrespondence: Bilisumamulifna Tefera Kefeni Tel +251-911-537-978Email bilisumamulifna430@gmail.comBackground: Human immunodeficiency virus (HIV) affects every organ system in the body through impairment or by rendering the patient vulnerable to opportunistic infections. The kidney is the vital organ in the excretion of waste products and toxins (urea, creatinine and uric acid), and regulation of extracellular fluid volume, serum osmolality and electrolyte concentrations. The risk of kidney disease is greater in HIV-infected individuals than in the general population. This study aimed to assess the magnitude of renal function impairment and its associated factors among adult HIV-positive patients attending an ART clinic in Mettu Karl Referral Hospital, Mettu town, south-west Ethiopia.Methods: The institution-based, cross-sectional quantitative study was conducted from March 8 to May 30, 2020. A total of 352 clients participated and a systematic sampling technique was used to allocate study participants. Data were entered into Epi data and exported to SPSS version 22 for analysis. Bivariate analysis was conducted to identify candidate variables for multivariate analysis at P < 0.25. Multivariable logistic regression analysis was conducted to determine the predictors of renal function impairment with ART. P value < 0.05 was considered to indicate statistical significance.Results: A total of 352 HIV-infected patients participated in this study with a response rate of 98.1%. Out of 352 HIV patients on ART, 73 (20.7%) were found to have renal function impairment. Cigarette smoking [AOR = 9.60, 95% CI: 4.73– 19.48], diabetes mellitus [AOR = 6.16, 95% CI: 2.79– 13.59], hypertension [AOR = 4.71, 95% CI: 1.98– 11.17] and low CD4 count [AOR = 6.47, 95% CI: 3.31– 12.64] were found to be independent predictors of renal function impairment among adult HIV positive patients.Conclusion: The prevalence of renal function impairment among HIV patients on ART is high. Hypertension, diabetes, cigarette smoking and low CD4 count were associated factors of renal function impairment. HIV patients on ART should be regularly screened for early diagnosis and management of renal function impairment.Keywords: renal impairment, HIV positive, ART, Mettu

Yitayeh Belsti,1 Yibeltal Yismaw Gela,1 Yonas Akalu,1 Baye Dagnew,1 Mihret Getnet,1 Mohammed Abdu Seid,2 Mengistie Diress,1 Yigizie Yeshaw,1 Sofonias Addis Fekadu3 1Department of Physiology, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia; 2Unit of Physiology, Biomedical Department, College of Medicine and Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia; 3Department of Optometry, College of Medicine and Health Sciences, University of Gondar, Gondar, EthiopiaCorrespondence: Yitayeh Belsti Email yitayehbelsti@gmail.comBackground: Despite efforts to decrease the burden, vaccine reluctance is increasing worldwide and hindering efforts to control the spread of COVID-19. Therefore, understanding the willingness of a community to receive a COVID-19 vaccine will help to develop and implement effective means of promoting COVID-19 vaccine uptake.Objectives: This study was aimed to assess the willingness of the Ethiopian population to receive the COVID-19 vaccine and its determinant factors.Methods: E-survey was conducted from February 2021 to March 2021. After developing the questionnaire, the template was created on Google Forms and disseminated in public on different social media channels (e.g., Telegram, WhatsApp, Facebook, email, etc.) by using a shareable link. Descriptive statistics were performed. Finally, multivariable logistic regression analysis was done to assess their relationship with socio-demographic factors.Results: In total, 31.4% (n = 372) of respondents were willing to get a vaccine. One-third of respondents, 32.2% (n = 381), reported that COVID-19 vaccines are safe. Almost all 94.9% (n = 1124) responded that health workers should be vaccinated first. Only 21.7% (n = 257) willing to buy the vaccine if it is not provided free. Being female [OR (95% CI):1.85 (1.05– 3.25)], aged less than 25 years old [OR (95% CI): 5.09 (3.41– 7.59)], aged between 26– 30 years [OR (95% CI): 3.57 (2.55– 5.00)], being unmarried[OR (95% CI):1.12 (0.81– 1.55)], urban in residence [OR (95% CI): 1.06 (0.69– 1.62)], private sector worker in occupation [OR (95% CI):0.45 (0.26 – 0.77)], university/college student [OR (95% CI): 0.88 (0.59– 1.32)], not having a health-related job [OR (95% CI): 4.08 (2.57– 6.48)], orthodox [OR (95% CI): 1.16 (0.61– 2.19)], Muslim [OR (95% CI): 0.285 (0.13 – 0.61)], educational status of university/above [OR (95% CI): 4.87 (3.15– 7.53)] have a statistically significant association and were more likely willing to take COVID-19 than their counterparts.Conclusion: This study found that only 31.4% were willing to take the COVID-19 vaccine. Being female, older age, marital status, residence, occupations, not having a health-related job, religion, educational status were statistically significantly associated with willingness to receive the COVID-19 vaccine.Keywords: willingness, COVID-19, Ethiopia, E-survey, vaccine

Kiddus Yitbarek,1 Zewdie Birhanu,2 Gudina Terefe Tucho,3 Susan Anand,4 Liyew Agenagnew,5 Gutema Ahmed Snr,5 Masrie Getnet,6 Yonas Tesfaye5 1Departemnt of Health Policy and Management, Faculty of Public Health, Jimma University, Jimma, Ethiopia; 2Department of Health Behaviors and Society, Faculty of Public Health, Jimma University, Jimma, Ethiopia; 3Department of Environmental Health and Technology, Faculty of Public Health, Jimma University, Jimma, Ethiopia; 4Department of Nursing, Faculty Health Sciences, Jimma University, Jimma, Ethiopia; 5Department of Psychiatry, Faculty of Medical Sciences, Jimma University, Jimma, Ethiopia; 6Department of Epidemiology, Faculty of Public Health, Jimma University, Jimma, EthiopiaCorrespondence: Yonas Tesfaye Po Box: 378 Tel +251910107507Email yonastesfaye71@yahoo.comPurpose: The Ethiopian Ministry of Health has integrated mental health services into the community health service, but it has not yet been implemented. Therefore, this study aimed to explore the barriers and facilitators of mental health service implementation in the Ethiopian community health program.Methods: A qualitative case study was conducted in the Ethiopian primary health care system in 2019. We have conducted about eight key informant interviews with policymakers, service managers, and service providers. The interviews were tape-recorded, transcribed, translated, and analyzed manually using the World Health Organization building blocks framework.Results: The Health Ministry of Ethiopia has recently included mental health services into the health extension package but not yet implemented as part of integrated services. The identified barriers were low political commitment, shortage of resources, non-functional referral system, lack of interest from private health service organizations, attitudinal problems from both the society and service providers, and lack of consistent reporting system of the mental health problems. However, the well-designed primary health care system, trained health extension workers, changing political commitment and attitude of the community could facilitate the mental health service implementation.Conclusion: A series of activities are expected, especially from the healthcare system managers to implement, follow, and evaluate mental health services implementation at the health extension programs.Keywords: mental health services, health extension workers, primary health care, Ethiopia

Chaltu Fikru,1 Masrie Getnet,2 Tamrat Shaweno1 1Department of Epidemiology, Faculty of Public Health, Jimma University Institute of Health, Jimma, Ethiopia; 2Biostatistics Unit, Department of Epidemiology, Faculty of Public Health, Jimma University Institute of Health, Jimma, EthiopiaCorrespondence: Tamrat Shaweno Email babiynos@gmail.comIntroduction: Although there has been a remarkable decline in under-five mortality through the decades, it is still highest in socio-economically disadvantaged countries, including Ethiopia. The benefits of reducing under-five mortality have been highly emphasized in the ambitious target of Sustainable Development Goals. The risk factors of under-five mortality have not been exhaustively researched in Ethiopia using recent nationwide survey data.Objective: This study aimed to determine the risk factors of under-five mortality using the recent nationwide survey data.Method: The data source for this study was the 2016 Ethiopian Demographic and Health Survey. Bivariate and multivariable logistic regression analysis was conducted and statistical significance was declared at p value < 0.05.Results: The data for a total of 10,641 under-five children were analyzed and the under-five mortality rate was 67 per 1000 live births in this study. In the final model, rural residence (AOR=2.0, [1.20, 3.30], P=0.008), mothers who gave birth with preceding birth intervals of shorter than 24 months (AOR=2.12, CI=[1.72, 2.61], P

IntroductionFocus on improving access and quality of HIV care and treatment gained acceptance in Ethiopia through the work of the International Training and Education Center for Health. The initiative deployed mobile field-based teams and capacity building teams to mentor health care providers on clinical services and program delivery in three regions, namely Tigray, Amhara, and Afar. Transitioning of the clinical mentoring program (CMP) began in 2012 through capacity building and transfer of skills and knowledge to local health care providers and management.ObjectiveThe initiative explored the process of transitioning a CMP on HIV care and treatment to local ownership and documented key lessons learned.MethodsA mixed qualitative design was used employing focus group discussions, individual in-depth interviews, and review of secondary data. The participants included regional focal persons, mentors, mentees, multidisciplinary team members, and International Training and Education Center for Health (I-TECH) staff. Three facilities were selected in each region. Data were collected by trained research assistants using customized guides for interviews and with data extraction format. The interviews were recorded and fully transcribed. Open Code software was used for coding and categorizing the data.ResultsA total of 16 focus group discussions and 20 individual in-depth interviews were conducted. The critical processes for transitioning a project were: establishment of a mentoring transition task force, development of a roadmap to define steps and directions for implementing the transition, and signing of a memorandum of understanding (MOU) between the respective regional health bureaus and I-TECH Ethiopia to formalize the transition. The elements of implementation included mentorship and capacity building, joint mentoring, supportive supervision, review meetings, and independent mentoring supported by facility-based mechanisms: multidisciplinary team meetings, case-based discussions, and catchment area meetings.ConclusionThe process of transitioning the CMP to local ownership involved signing an MOU, training of mentors, and building capacity of mentoring in each region. The experience shed light on how to transition donor-supported work to local country ownership, with key lessons related to strengthening the structures of regional health bureaus, and other facilities addressing critical issues and ensuring continuity of the facility-based activities.

BACKGROUND: Despite the benefits of childhood vaccinations, vaccination rates in low-income countries (LICs) vary widely. Increasing coverage of vaccines to 90% in the poorest countries over the next 10 years has been estimated to prevent 426 million cases of illness and avert nearly 6.4 million childhood deaths worldwide. Consequently, we sought to provide a comprehensive examination of contemporary vaccination patterns in East Africa and to identify common and country-specific barriers to complete childhood vaccination. METHODS: Using data from the Demographic and Health Surveys (DHS) for Burundi, Ethiopia, Kenya, Rwanda, Tanzania, and Uganda, we looked at the prevalence of complete vaccination for polio, measles, Bacillus Calmette-Guérin (BCG) and DTwPHibHep (DTP) as recommended by the WHO among children ages 12 to 23 months. We conducted multivariable logistic regression within each country to estimate associations between complete vaccination status and health care access and sociodemographic variables using backwards stepwise regression. RESULTS: Vaccination varied significantly by country. In all countries, the majority of children received at least one dose of a WHO recommended vaccine; however, in Ethiopia, Tanzania, and Uganda less than 50% of children received a complete schedule of recommended vaccines. Being delivered in a public or private institution compared with being delivered at home was associated with increased odds of complete vaccination status. Sociodemographic covariates were not consistently associated with complete vaccination status across countries. CONCLUSIONS: Although no consistent set of predictors accounted for complete vaccination status, we observed differences based on region and the location of delivery. These differences point to the need to examine the historical, political, and economic context of each country in order to maximize vaccination coverage. Vaccination against these childhood diseases is a critical step towards reaching the Millennium Development Goal of reducing under-five mortality by two-thirds by 2015 and thus should be a global priority.

Abstract Background Diabetes mellitus and thyroid dysfunction are prevalent endocrine disorders that impose enormous burdens on patients and countries. However, access to essential medicines remains inadequate in many low-income countries. This study evaluated medications’ availability, price, and affordability for these conditions. Methods A cross-sectional study was conducted at health facilities in the South Wollo zone in 2022. Following World Health Organization (WHO)/Health Action International (HAI) guidelines, 34 medicines were evaluated across 60 medicine outlets. Data were collected using a standardized tool adapted from WHO/HAI. Availability was measured by the percentage of facilities where the medicines were in stock. Prices were reported as median prices and median price ratios (MPR). Affordability was assessed based on the number of days’ wages required for the lowest-paid government workers to cover the full course of therapy. Results The availability of lowest-priced generic (LPG) diabetes and thyroid dysfunction medicines in the public sector was 24.4% and 28.7%, respectively. In private pharmacies, availability was 26.3% for diabetes and 21% for thyroid dysfunction medicines. Median prices for LPG medicines were higher in private pharmacies than in public health facilities, with 81.81% showing a statistically significant difference (p

Abstract Background Peste des Petits Ruminants (PPR) is a highly contagious viral disease primarily affecting goats and sheep, with clinical manifestations ranging from peracute disease to subclinical infection, particularly in atypical hosts such as cattle. The role of atypical hosts such as cattle to the spread of PPR remains controversial, with conflicting reports in the literature. Despite its worldwide significance, considerable knowledge gaps exist regarding the pathogenesis and clinical progression in both primary and atypical hosts. This study aimed to elucidate the tissue tropism, pathogenesis, virus shedding, clinical progression, and pathology associated with experimental PPR virus infection in indigenous goats and cattle. To this end, 32 animals—16 goats and 16 cattle—were intranasally inoculated with the Ethiopia/Habru/2014 Lineage-IV strain of the PPR virus followed by detailed clinical evaluations and systematic sampling at pre-established intervals to assess serological conversion, viral shedding, and the pathogenesis of the infection across both species. Results The results show that goats exhibited typical clinical signs 4 days post-inoculation, with seroconversion by day 6 and early detection of viral RNA in swabs and tissues by day 3 and virus isolation starting day 4. In contrast, cattle exhibited minimal clinical signs, with seroconversion occurring at day 8 with viral RNA detected in tissue samples at day 4 and virus isolation starting day 6 in tissues and in a single nasal swab at day 8. Clinical scores and tissue positivity rates significantly differed between goats and cattle (P = 0.007 and P

Bread is extensively consumed food that could benefit from being supplemented with a variety of nutrients that are lacking. Making bread with samma leaf flour could be one way to combat malnutrition, particularly in regard to shortages in protein and minerals. The current study aimed to fortify wheat bread with samma leaves flour. The samma leaves flour (sun and oven dried) at three fortification levels [5, 10, and 15% (w/w)] were added using factorial experiment and were blended and co-fermented for bread baking using 100% wheat flour as a control. The breads were subjected to analysis of physical properties, proximate composition, minerals, vitamin C, β-carotene contents, and sensory evaluation. The results revealed that wheat bread substituted with samma leaves flour at 5, 10, and 15% showed a significant (p

IntroductionExtracellular vesicles (EVs) facilitate inter and intra-species/kingdom communication through biomolecule transfer, including proteins and small RNAs. Plant-derived EVs, a hot topic in the field, hold immense capability both as a potential biomarker to study plant physiology and as a biomaterial that can be mass-produced to be used in various industries ranging from cosmetics and food additives to biological pesticides. However, a systematic characterization of plant EVs is required to establish a foundation for further applications and studies.MethodsIn this study, EVs were enriched from hydroponically cultivated potato plants (Solanum tuberosum, cv. Laura). We isolated EVs from root exudates and the apoplastic wash of potato peels using vacuum infiltration. These EVs were then systematically characterized for their biophysical and chemical properties to compare with standard EV characteristics and to explore their roles in plant physiology.ResultsBiophysical and chemical analyses revealed morphological similarities between potato root and peel-derived EVs. The average diameter of root-derived EVs (164.6 ± 7.3 nm) was significantly larger than that of peel-derived EVs (132.2 ± 2.0 nm, p < 0.004). Liquid chromatography–mass spectrometry (LC-MS) demonstrated substantial protein enrichment in purified EVs compared to crude samples, with a 42% enrichment for root EVs and 25% for peel EVs. Only 11.8% of the identified proteins were common between root and peel EVs, with just 2% of significantly enriched proteins shared. Enriched pathways in both EV proteomes were associated with responses to biotic and abiotic stress, suggesting a defensive role of EVs in plants.DiscussionWith further experimentation to elucidate the specific methods of communication, these findings increase the details known about plant EVs in terms of their physical and chemical characteristics and their potential functions, aiding in sustainable agricultural waste utilization for large-scale EV production, aligning with the concept of “valorization”.

Background Alcohol is a major public health problem in pregnant women due to its harmful effects on pregnancy and adverse birth outcomes. Therefore, assessing the prevalence and the factors associated with hazardous alcohol consumption among HIV-positive women is important for early identification and intervention and implementation of rehabilitation centres in healthcare settings in order to prevent maternal adverse birth outcomes.Objective The aim of this study was to assess the prevalence of hazardous alcohol consumption and the associated factors among HIV-positive pregnant women attending public hospitals in Northwest Ethiopia.Design and study setting A facility-based, cross-sectional study was conducted among 401 HIV-positive pregnant women attending public hospitals in Northwest Ethiopia from 7 February to 7 April 2021.Participants From a total calculated sample size of 423, 401 HIV-positive pregnant women who had a follow-up with selected hospitals’ prevention of mother-to-child transmission (PMTCT) clinics completed the interview (17 participants refused to provide information and 5 terminated the interview in the middle of it due to serious illness).Main outcome measures The main outcome measure of this study was hazardous alcohol consumption assessed using the Fast Alcohol Screening Test. Bivariate and multivariable binary logistic regressions were used to identify factors associated with hazardous alcohol consumption. Statistically significant associations were set at p

IntroductionThe age at first birth refers to the age at which a woman has her first child. It can significantly influence the demographic behavior of women and the general community. Moreover, teenage childbearing is a serious public health and social problem. The main objective of this study was to identify factors associated with age at first birth among women in Ethiopia.MethodsSecondary data on women were obtained from the 2019 Ethiopia Mini Demographic and Health Survey (EMDHS). These population-based cross-sectional data were downloaded from the Measure Demographic and Health Survey website (http://www.measuredhs.com). The study included a random sample of 8,885 women aged 15–49 years from 305 enumeration areas. A multilevel survival analysis was employed to identify the factors associated with teenage childbearing among women in Ethiopia.ResultsThe majority (67.7%) of randomly sampled women were subjected to teenage childbearing. Women being rural dwellers [hazard ratio (HR) = 1.27, 95% CI: 1.05, 1.54]; women from middle-income families (HR = 1.43, 95% CI: 1.18, 1.74); and women from higher-income families (HR = 1.40, 95% CI: 1.15, 1.70) were associated with a higher risk of teenage childbearing. Conversely, contraception method users (HR = 0.87, 95% CI: 0.77, 0.99), Muslims (HR = 0.75, 95% CI: 0.64, 0.89), Orthodoxes (HR = 0.68, 95% CI: 0.57, 0.80), women with secondary education (HR = 0.53, 95% CI: 0.43, 0.65), women with higher education (HR = 0.28 (95% CI: 0.22, 0.37), and the higher age of household head (HR = 0.99, 95% CI: 0.98, 0.99) were associated with a lower risk of teenage childbearing among women in Ethiopia.ConclusionSince the median age of women to have their first child was 18 years old, this study strongly suggests that stakeholders at the federal and regional levels must work closely toward enforcing the legal age of marriage and implementing national adolescents’ and youths’ targeted sexual and reproductive health programs.

Abstract Background Abnormal uterine bleeding, a frequent gynecological problem among women of reproductive age, significantly affects their health and quality of life. Despite its problem, research on its extent and contributing factors in Ethiopia is scarce. Hence, this study is designed to determine the magnitude and factors associated with abnormal uterine bleeding among women visiting Dilla University General Hospital, Dilla, Ethiopia. Methods A cross-sectional study design was conducted with 380 women of reproductive age at Dilla University General Hospital. A systematic sampling method was employed to select the participants for the study. A structured interview administered questionnaire and checklist were used to collect the data. Stata V.14 software was used for cleaning, coding, ensuring completeness and accuracy, and further analysis. Bivariate and multivariable logistic regression analyses were used. Finally, the variables that have a p-value of

Abstract Spoken digits recognition (SDR) is a type of supervised automatic speech recognition, which is required in various human–machine interaction applications. It is utilized in phone-based services like dialing systems, certain bank operations, airline reservation systems, and price extraction. However, the design of SDR is a challenging task that requires the development of labeled audio data, the proper choice of feature extraction method, and the development of the best performing model. Even if several works have been done for various languages, such as English, Arabic, Urdu, etc., there is no developed Amharic spoken digits dataset (AmSDD) to build Amharic spoken digits recognition (AmSDR) model for the Amharic language, which is the official working language of the government of Ethiopia. Therefore, in this study, we developed a new AmSDD that contains 12,000 utterances of 0 (Zaero) to 9 (zet’enyi) digits which were recorded from 120 volunteer speakers of different age groups, genders, and dialects who repeated each digit ten times. Mel frequency cepstral coefficients (MFCCs) and Mel-Spectrogram feature extraction methods were used to extract trainable features from the speech signal. We conducted different experiments on the development of the AmSDR model using the AmSDD and classical supervised learning algorithms such as Linear Discriminant Analysis (LDA), K-Nearest Neighbors (KNN), Support Vector Machine (SVM), and Random Forest (RF) as the baseline. To further improve the performance recognition of AmSDR, we propose a three layers Convolutional Neural Network (CNN) architecture with Batch normalization. The results of our experiments show that the proposed CNN model outperforms the baseline algorithms and scores an accuracy of 99% and 98% using MFCCs and Mel-Spectrogram features, respectively.

BackgroundSevere mental illness results in an enormous social and economic burden on affected individuals, their families, and communities, especially in developing countries, such as Ethiopia.ObjectiveThe aim of this study was to assess the level of depression among caregivers of patients with severe mental illness in Debre Tabor Town, Northwest Ethiopia in 2023.MethodsThis institution-based explanatory mixed study was conducted at Debre Tabor Compressive Specialized Hospitals between September 30 to October 30, 2023. A systematic random sampling technique was used to select 260 study participants, and a public health questionnaire was used to assess depression. Epicollect5 was used to collect data, which were then exported to the SPSS-25 for analysis. Variables with a p-value

The Research was conducted at KARC during June to November, 2023 to phenotypic screening of bread wheat genotypes for yellow and leaf rust resistance. Both rusts were recorded based on the modified Cobb scale. Severity of yellow rust showed from immune to 70%. 826 genotypes showed slow rusting resistance ranging from 0–30%), 575 genotypes observed as slow rusting plant resistance ranging from 31–50%) and 96 genotypes observed as low adult plant resistance (>50% of yellow rust severity). Tested genotypes showed diverse reactions for yellow rust ranging from immune to susceptible responses. 57 genotypes were observed immune, 161 genotypes were showed moderately resistant reaction type. 317 genotypes were observed moderately susceptible reaction and 962 genotypes were observed susceptible reactions for yellow rust response. The leaf rust severity of the studied genotypes showed from immune to 90. 607 genotypes (showed slow rusting resistance ranging from 0–20% of severity), 563 genotypes observed as slow rusting plant resistance ranging from 21–50% of severity) and 326 genotypes observed as low adult plant resistance (>50% of leaf rust severity. Tested genotypes showed diverse reactions for leaf rust ranging from immune to susceptible responses. 58 genotypes were observed immune, 30 genotypes were observed moderately resistant, 80 genotypes were observed moderately resistant to moderately susceptible, 464 genotypes were showed moderately susceptible reaction, 864 genotypes were showed susceptible reactions for leaf rust disease response. Based on yellow rust, leaf rust and agronomic performance 76 genotypes were selected for the next breeding step.

Abstract Background Cervical cancer is the second cause of cancer deaths among Ethiopian women. Despite multifaceted government efforts, the uptake and utilization of cervical cancer screening remain very low. This study aimed to assess factors influencing the uptake and utilization of cervical cancer screening at public health centers in Addis Ababa. Methods A convergent parallel mixed-method study was employed to collect data through eight focus group discussions with 66 women purposively recruited from outpatient clinics, and cross-sectional face-to-face exit interviews with 80 women attending cervical cancer clinics in four high-patient volume health centers. The group interviews were tape-recorded, transcribed in Amharic, translated into English, and a thematic analysis approach was used in the analysis. Exit interview data were collected using a structured questionnaire in the Open Data Kit tool on an android tablet. STATA version 17 was used for descriptive and inferential data analyses. Statistical significance was set at p

Abstract Ethiopia has implemented numerous national development plans and strategies to achieve sustainable economic growth at both the national and regional levels, specifically in the Afar region. However, there has been a lack of assessment regarding the outcomes and expected goals of these plans and strategies, particularly for the regional economy. Hence, this study assesses the current and future gross domestic product (GDP) of Ethiopia’s Afar regional state. It analyzes the data using a descriptive and econometric model called autoregressive integrated moving average (ARIMA). The analysis shows that the regional GDP has been increasing over time, but per capita income remains below the national average. The service sector dominates the economy, while the growth of the industry sector has been stagnant. This indicates that development policies have not achieved their goals of reducing poverty and transforming the economy. Using the ARIMA model, it is projected that the Afar regional GDP will gradually increase from 19,300.20 Billion Birr to 21,678.20 Billion Birr between 2023q1 and 2025q4, with an average growth rate of 10%. It is important for development policies to prioritize not just economic growth, but also social development within local communities. This involves addressing issues related to institutional capacity, and governance, and leveraging agricultural resources to benefit agro-pastoralists and pastoralists, as the agricultural sector is the main driver of the economy. By understanding the present and projected GDP of the Afar regional state, policymakers and stakeholders can make informed decisions for sustainable and inclusive economic growth.

The growing understanding of the role of extracellular vesicles (EVs) in embryo-maternal communication has sparked considerable interest in their therapeutic potential within assisted reproductive technology, particularly in enhancing implantation success. However, the major obstacle remains the large-scale production of EVs, and there is still a gap in understanding how different culture systems affect the characteristics of the EVs. In the current study, trophoblast analogue human chorionic carcinoma cell line was cultivated in both conventional monolayer culture (2D) and as spheroids in suspension culture (3D) and how the cell growth environment affects the physical, biochemical and cellular signalling properties of EVs produced by them was studied. Interestingly, the 3D system was more active in secreting EVs compared to the 2D system, while no significant differences were observed in terms of morphology, size, and classical EV protein marker expression between EVs derived from the two culture systems. There were substantial differences in the proteomic cargo profile and cellular signalling potency of EVs derived from the two culture systems. Notably, 2D EVs were more potent in inducing a cellular response in endometrial epithelial cells (EECs) compared to 3D EVs. Therefore, it is essential to recognize that the biological activity of EVs depends not only on the cell of origin but also on the cellular microenvironment of the parent cell. In conclusion, caution is warranted when selecting an EV production platform, especially for assessing the functional and therapeutic potential of EVs through in vitro studies.

IntroductionBreast milk is the ideal food for the infant and is associated with various public health benefits for both the infant and the mother. The recommended time for early initiation of breastfeeding is within one hour after birth. The prevalence of early initiation of breastfeeding was lower than the plan of the Ethiopian Ministry of Health Sector Development program. Thus, the main objective of this study was to identify individual and group-level factors associated with the early initiation of breastfeeding in Ethiopia.MethodsSecondary data on children was obtained from the 2019 Ethiopia mini-demographic and health survey. The survey was a population-based cross-sectional study and was downloaded from the Measure Demographic and Health Survey website (http://www.measuredhs.com). The study included a random sample of 2,125 last-born infants who were born within 24 months before the survey. A multilevel binary logistic regression analysis was employed to identify the factors associated with the early initiation of breastfeeding in Ethiopia. Statistical data was analyzed using the Statistical Analysis System (SAS 9.4).ResultsThe prevalence of early breastfeeding initiation was 72%. The higher preceding birth interval (AOR = 1.18, 95% CI: 1.1076, 1.5451), the higher gestational age of infants (AOR = 1.38, 95% CI: 1.2796, 1.4782), the higher number of antenatal care visits (AOR = 1.26, 95% CI: 1.2340, 1.2934), delivery at a health facility (AOR = 1.60, 95% CI: 1.4585, 1.7515), vaginal delivery (AOR = 1.11, 95% CI: 1.1019, 1.1123), mothers with primary education (AOR = 1.14, 95% CI: 1.0204, 1.2738), mothers with secondary education (AOR = 1.54, 95% CI: 1.4678, 1.6190), and mothers with higher education (AOR = 2.62, 95% CI: 2.2574, 3.0526) were associated with higher odds of early initiation of breastfeeding. Being a rural dweller (AOR = 0.63, 95% CI: 0.5684, 0.7038) and the age of mothers (AOR = 0.44, 95% CI: 0.3921, 0.4894) were associated with lower odds of early initiation of breastfeeding.ConclusionSince the prevalence of early initiation of breastfeeding was minimal among rural mothers who delivered their child by caesarean section, this study strongly suggests special supportive care for these mothers.

Today, permutation tests represent a powerful and increasingly widespread tool of statistical inference for hypothesis-testing problems. To the best of our knowledge, a review of the application of permutation tests for complex data in practical data analysis for hypothesis testing is missing. In particular, it is essential to review the application of permutation tests in two-sample or multi-sample problems and in regression analysis. The aim of this paper is to consider the main scientific contributions on the subject of permutation methods for hypothesis testing in the mentioned fields. Notes on their use to address the problem of missing data and, in particular, right-censored data, will also be included. This review also tries to highlight the limits and advantages of the works cited with a critical eye and also to provide practical indications to researchers and practitioners who need to identify flexible and distribution-free solutions for the most disparate hypothesis-testing problems.

Abstract Maternal morbidity and mortality remain high among women who did not attend antenatal care (ANC). Antenatal care is one of the interventions given to pregnant women to detect existed problems or problems that can develop during pregnancy, which harm the health of pregnant women and fetuses. In Ethiopia, however, there is limited evidence that revealed the effect of antenatal depression on ANC service utilization. Hence, this study aimed to see the effect of antenatal depression on ANC visits among women in urban northwest Ethiopia. A population-based, prospective cohort study was done from June 2019 to March 2020. The Edinburgh postnatal depression scale was administered to 970 women in the second and third trimesters of pregnancy to screen for antenatal depression. Additional data were collected on ANC visits, the mother’s socio-demographic, obstetric, clinical, psychosocial, and behavioral factors. A logistic regression model was used to adjust confounders and determine associations between antenatal depression and inadequate ANC visits. The cumulative incidence of inadequate ANC visits was 62.58% (95% CI: 59.43, 65.63). The cumulative incidence of inadequate ANC visits among depressed pregnant women was 75% as compared to 56% in non-depressed. The incidence of inadequate ANC visits in the exposed group due to antenatal depression was 25.33%. After multivariable analysis, antenatal depression at the second and third trimesters of pregnancy remained a potential predictor of inadequate ANC visits (AOR = 1.96: (95% CI 1.22, 3.16)). In addition, antenatal depression, long travel time for ANC visits (AOR = 1.83 (95% CI 1.166, 2.870)), and late initiation of ANC visits (AOR = 2.20 (95% CI 1.393, 3.471)) were the predictors of inadequate ANC visits as compared to their counterpart. This study suggested that antenatal depression affects ANC visits in Ethiopian urban settings. Therefore, early detecting and treating depression symptoms during the antenatal period reduced significantly the impacts of depression on the health of the mother and fetus.

BackgroundDespite the availability of evidence-based and effective treatments, significant numbers of people living with mental illness do not receive treatment or do not seek help from providers of formal modern treatment. Although numerous primary studies have been conducted on patterns of help-seeking behavior among individuals with mental illness with respect to modern therapy, the evidence has not been aggregated nationwide. Therefore, the aim of this review was to investigate pooled data on patterns of help-seeking behavior among individuals with mental illness in Ethiopia.MethodsAll available primary studies were searched via the Google Scholar, HINARI, and PubMed databases from June 22 to December 20, 2023; 912 articles were identified. Sixteen articles were included in the final review; data from them were extracted to an Excel spreadsheet and exported to Stata version 17 for analysis. The search terms used were: “Pattern of help-seeking behavior’’ OR “Pattern of treatment-seeking behavior” OR “Health care-seeking behavior” OR “Help-seeking intention” OR “Help-seeking preferences” OR “Perceived need” OR “Pathways to psychiatric care”, AND “Common mental disorders” OR “Mental illness” OR “Mental health problems” OR “Depression”, AND “Predictors” OR “Determinate factors” OR “Associated factors”, AND “Ethiopia”. The quality of the studies included was critically appraised using the modified The Joanna Briggs Institute (JBI) Joanna Briggs Institute quality assessment tool, adapted for observational studies. During critical appraisal, disagreements between the two authors conducting the assessment were resolved by the involvement of a third author. Effect sizes were pooled using the random effects model, and the presence of publication bias was detected based on asymmetry of the funnel plot and a statistically significant result of Egger’s test (p

Background: Liver disease is any disease that negatively affects the normal function of the liver, and it is a major health problem that challenges not only healthcare professionals, but also the pharmaceutical industry and drug regulatory agencies. Similarly, diarrhea is the second leading cause of death among children under five globally next to pneumonia. The available synthetic drugs for the treatment of liver disorders and diarrhoea have limited safety and efficacy. Objective: To evaluate the in vivo hepatoprotective and antidiarrheal activities of hydroalcoholic leaf and fruit extracts of Schinus molle L. (Anacardiaceae) in mice. Methods: Hepatoprotective activity of the extracts was evaluated by using CCl4 induced hepatotoxicity in mice model. In this model, mice were divided into groups and treated as follows. The normal control and toxicant control groups were treated with the vehicle used for reconstitution, the positive control was treated with the standard drug (silymarin), and the test groups were treated with different doses of plant extracts daily in the morning for seven days. Additionally, all groups except the normal control were treated with CCl4 (2 mg/kg, IP) on the 4th day of treatment, 30 min post-dose. On the 7th day, blood was collected from each mouse via a cardiac puncture. The collected blood was centrifuged, and serum levels of ALT, AST, and ALP were determined using an automated chemistry analyser. Data were analysed using one-way analysis of variance (ANOVA) followed by Tukey's post-hoc test.The antidiarrheal activity of the extract was investigated using castor oil-induced diarrhoea, enteropooling, and small intestine transit. The test groups received various doses (100, 200, and 400 mg/kg) of the extract, whereas the positive control received loperamide (3 mg/kg), and the negative control received the vehicle (distilled water, 10 ml/kg). Result: Hepatoprotective activity: The leaf and fruit crude extracts showed significant improvement in the body weight and liver weight of mice compared to the untreated toxicant control. Additionally, treatment with hydromethanol leaf and fruit extracts caused a significant (P 0.05) the level of albumin compared with the toxicant control.Antidiarrheal activity: In the castor oil-induced diarrheal model, the 80 % methanol extract delayed the onset of defaecation and significantly reduced the number and weight of faeces at all tested doses compared to the negative control. In the enteropooling test, 80 ME significantly (P

Objective The study aimed to assess the utilisation of growth monitoring and promotion services and the associated factors among mothers of children under 2 years old in Gondar Zuria District, northwest Ethiopia.Design Community-based, cross-sectional study.Setting The study was conducted in Gondar Zuria District, Central Gondar Zone. Data collection was conducted from 10 March to 5 April 2022.Participants 576 mother–child pairs, recruited via a multistage, stratified random sampling technique.Outcome measures and analysis Utilisation of growth monitoring and promotion services was the outcome of the study. Data were entered into Epi Info V.7 and exported to Statistical Package for the Social Sciences V.24.0 for further analysis. Both bivariable and multivariable logistic regression analyses were used to identify factors associated with utilisation of growth monitoring services. A p value less than 0.05 was considered significant for the outcome variable.Results The utilisation of growth monitoring and promotion services among children aged 0–23 months was 26.6% (95% CI 22.9, 30.2). Health centre delivery (adjusted OR (AOR)=1.56; 95% CI 1.02, 2.68), postnatal care visits (AOR=3.13; 95% CI 1.99, 4.90), regular growth monitoring and promotion sessions (AOR=6.53; 95% CI 2.43, 9.34), and wealth status (AOR=5.98; 95% CI 3.09, 10.58) were significantly associated with utilisation of growth monitoring and promotion services.Conclusion Less than one in three children aged 0–23 months saw utilisation of growth monitoring and promotion services in the study setting. Birthplace, postnatal care follow-up, regular growth promotion and monitoring sessions, and wealth status were associated with utilisation of growth monitoring and promotion services. Enhancing skilled birth delivery, promoting postnatal care follow-up and expanding the availability of growth monitoring and promotion outreach sites could be useful to improve the utilisation of growth monitoring and promotion services.

Following an upsurge in cervical cancer incidence and mortality, Ethiopia developed its first National Cancer Control Plan (NCCP) to support efforts toward the prevention and control of cancer. The NCCP outlines strategies for reducing the incidence of cancer through prevention, screening, early diagnosis, treatment, and palliative care. This study examined barriers and facilitators to the implementation of the NCCP using a qualitative approach. The study entailed doing key informant interviews and reviewing secondary data. Using customized topic guidelines, fifteen interviews were conducted covering a wide range of topics, including political commitment, priority setting, interagency cooperation, the role of evidence, citizen empowerment, and incentives. All interviews were recorded (with consent), transcribed in Amharic, and then translated into English for thematic analysis. Review of secondary data focused on establishing the NCCP's implementation status for HPV vaccination, cervical cancer screening, and treatment, and strategic links to five other national policy documents centered on public awareness, cervical cancer services, HPV immunization, and sexually transmitted infections control. We found that in 2022, 55% of eligible Ethiopian women were screened for cervical cancer (against the annual target), with roughly half of those with a positive result receiving treatment. Overall, 900,000 (8.4%) of the 10.7 million eligible women in the country underwent screening. The study revealed inadequate implementation of the NCCP strategies toward achieving the WHO's 90-70-90 cervical cancer targets by 2030. A key positive strategy was the involvement of high-ranking government officials in the National Cancer Committee, which aided the NCCP implementation. On the other hand, inadequate political support, funding constraints, suboptimal public messaging, lack of incentives, and inadequate partnership arrangements emerged as important barriers. We recommend that decision-makers intensify coordinated efforts, prioritize dealing with identified challenges and optimizing facilitators, and mobilize additional resources to enhance cervical cancer services in Ethiopia.

BackgroundCervical cancer is the second leading cause of cancer death among Ethiopian women. This study aimed to assess the influence of the health system on access to cervical cancer prevention, screening, and treatment services at public health centers in Addis Ababa, Ethiopia.MethodsThis study used a cross-sectional survey design and collected data from 51 randomly selected public health centers in Addis Ababa. Open Data Kit was used to administer a semi-structured questionnaire on Android tablets, and SPSS version 26 was used to analyze the descriptive data.ResultsIn the study conducted at 51 health centers, cervical cancer prevention and control services achieved 61% HPV vaccination for girls, 79% for cervical cancer awareness messages, 80% for precancer lesion treatment, and 71% for cervical screening of women. All health centers were performing cervical screening mostly through visual inspection with acetic acid due to the inconsistent availability of HPV DNA tests and the lack of Pap smear tests. In 94% of health centers, adequate human resources were available. However, only 78% of nurses, 75% of midwives, 35% of health officers, and 49% of health extension workers received cervical cancer training in the 24 months preceding the study. Women had provider choices in only 65% of health centers, and 86% of the centers lacked electronic health records. In 41% of the health centers, the waiting time was 30 minutes or longer. About 88% and 90% of the facilities lacked audio and video cervical cancer messages, respectively.ConclusionThis study revealed that the annual cervical cancer screening achievement was on track to fulfill the WHO's 90-70-90 targets by 2030. We recommend that decision-makers prioritize increasing HPV vaccination rates, enhancing messaging, reducing wait times, and implementing electronic health records to improve access to cervical cancer services in Addis Ababa.

IntroductionNecrotizing enterocolitis (NEC) is a serious intestinal condition characterized by ischemic necrosis of the intestinal mucosa, inflammation, and invasion by gas-forming organisms, posing a significant threat to neonatal health. Necrotizing enterocolitis remains a significant cause of neonatal morbidity and mortality, particularly in developing countries. Due to limited research conducted in Ethiopia and the study area, there is a lack of information regarding the risk factors associated with necrotizing enterocolitis. Therefore, the goal of this study is to fill the aforementioned gap.ObjectiveThis study aims to identify the risk factors of necrotizing enterocolitis among neonates admitted to the neonatal intensive care unit (NICU) at selected general and referral hospitals in southern Ethiopia in the year 2023.Methods and materialsA facility-based unmatched case–control study was conducted. All neonates admitted to the NICU and diagnosed with necrotizing enterocolitis by the attending physician during the data collection period were considered as cases, whereas neonates admitted to the NICU but not diagnosed with necrotizing enterocolitis during the data collection period were considered as controls. Data were collected through face-to-face interviews and record reviews using the Kobo toolbox platform. The binary logistic regression method was used to determine the relationship between a dependent variable and independent variables. Finally, a p-value of

Objective: The aim of this study is to identify the associated factors of low fifth minute Apgar scores among newborns in Dilla town public health facilities, southern Ethiopia. Methods: An institution-based case-control study was conducted in Dilla town public health facilities, Southern Ethiopia. The case and control groups were newborns with fifth minute Apgar score of

Abstract Background The United Nations’ Sustainable Development Goal (SDG)-2 aims to eliminate child hunger or end all forms of child malnutrition by 2030. To achieve this goal the cost-effective method is the implementation of growth monitoring and promotion service with the contribution of Women Development Army (WDA) as community volunteers. However, According to the data, the program’s implementation varies throughout the country and lack of evidence on the practical contribution of the WDA to enhancing child nutritional care outcomes. Therefore this study aimed to determine practical contribution of WDA and associated factors on growth monitoring and promotion service in two rural districts of central Gondar zone, Northwest Ethiopia. Methods A community based mixed study was conducted from March 6 to April 7, 2022 among 615 Women Development Army. Multistage sampling technique was used to select study participants. A structured questionnaire was used to collect quantitative data and in-depth interview were used to generate qualitative information. Qualitative data were coded and grouped and discussed using identified themes. Binary logistic regression was fitted, odds ratio with 95% confidence interval was estimated to identify factors of practical contribution of WDA and qualitative data was analyzed using thematic analysis. Results In this study practical contribution of WDA on growth monitoring was 31.4% (95% CI: 28.0-35.3%). Having GMP training (AOR = 4.2, 95%CI: 1.63, 10.58), regular community conversation (AOR = 6.0, 95%CI: 3.12, 11.54), good knowledge about GMP (AOR = 2.1, 95%CI: 1.17, 3.83) and not having regular schedule of GMP service in the area (AOR = 0.04, 95%CI: 0.02, 0.09), were statistically significantly associated with practical contribution of growth monitoring. During in-depth interview, lack of training, low motivation or commitment among WDA and low communication between WDA and health extension workers were mentioned among the problems faced during growth monitoring service. Conclusion In this study, practical contribution of growth monitoring among WDA was low. GMP training regular community conversation, knowledge about GMP and regular schedule of GMP service in the local area were significantly associated for practical contribution of growth monitoring service. Lack of training, low motivation or commitment among WDA and low communication between WDA and health extension workers were reasons for did not contribute effectively for GMP service. Therefore, giving training for WDA and improving community conversation at kebeles level are important to improve GM service. .

Thermo-physiological comfort of apparel clothing must be suitable for the wearer both in winter and summer seasons. Poor thermo-physiological properties can lead to discomfort, fluctuation in body temperature, poor sweat management during wear and can affect human health as well as work efficiency. For this reason, optimum thermo-physiological comfort of clothing is a prerequisite by users for any given weather. The aim of this study was to investigate the effect of cotton yarn parameters on the thermo-physiological comfort of woven fabrics. Four types of woven fabrics were developed from cotton yarn with different counts, twist, coefficient of variation of mass (CVm), neps, hairiness, thin places, thick places, strength, and elongation. Yarn samples were produced separately by carding and rotor span before they were woven on an air jet machine with the same settings. Finally, the woven fabrics were finished in a combined finishing treatment process. Thermo-physiological properties of fabrics were measured and analyzed. Statistically analyzed results showed that thermal resistance, thermal conductivity, thermal absorptivity, and air permeability of fabrics had statistically significant change with P values of 0.029, 0.035, 0.005, and 0.000, respectively. Model equations were developed based on the results to predict the comfort of the fabric.

BackgroundTuberculosis (TB) is a major cause of ill health and one of the leading causes of death worldwide, caused by species of the Mycobacterium tuberculosis complex (MTBC), with Mycobacterium tuberculosis being the dominant pathogen in humans and Mycobacterium bovis in cattle. Zoonotic transmission of TB (zTB) to humans is frequent particularly where TB prevalence is high in cattle. In this study, we explored the prevalence of zTB in central Ethiopia, an area highly affected by bovine TB (bTB) in cattle.MethodA convenient sample of 385 patients with pulmonary tuberculosis (PTB, N = 287) and tuberculous lymphadenitis (TBLN, N = 98) were included in this cross-sectional study in central Ethiopia. Sputum and fine needle aspirate (FNA) samples were obtained from patients with PTB and TBLN, respectively, and cultures were performed using BACTEC™ MGIT™ 960. All culture positive samples were subjected to quantitative PCR (qPCR) assays, targeting IS1081, RD9 and RD4 genomic regions for detection of MTBC, M. tuberculosis and M. bovis, respectively.ResultsTwo hundred and fifty-five out of 385 sampled patients were culture positive and all were isolates identified as MTBC by being positive for the IS1081 assay. Among them, 249 (97.6%) samples had also a positive RD9 result (intact RD9 locus) and were consequently classified as M. tuberculosis. The remaining six (2.4%) isolates were RD4 deficient and thereby classified as M. bovis. Five out of these six M. bovis strains originated from PTB patients whereas one was isolated from a TBLN patient. Occupational risk and the widespread consumption of raw animal products were identified as potential sources of M. bovis infection in humans, and the isolation of M. bovis from PTB patients suggests the possibility of human-to-human transmission, particularly in patients with no known contact history with animals.ConclusionThe detected proportion of culture positive cases of 2.4% being M. bovis from this region was higher zTB rate than previously reported for the general population of Ethiopia. Patients with M. bovis infection are more likely to get less efficient TB treatment because M. bovis is inherently resistant to pyrazinamide. MTBC species identification should be performed where M. bovis is common in cattle, especially in patients who have a history of recurrence or treatment failure.

The banking industry has seen the emergence of numerous service delivery channels, automated teller machines (ATMs), telephone banking, and online banking. Global financial systems and mature competition have been compelled to research the importance of consumer satisfaction. Thus, this study aimed to examine the effects of automated teller machine service quality on customer satisfaction in commercial banks of Ethiopia in the Afar regional state, Northeast Ethiopia. To this end, cross-sectional data were collected through a questionnaire from a sample of three hundred forty-six (346) ATM users selected from Semera-logia City, Asyaita, and Awash Town. To identify the dimensions of automated teller machine service quality and their relationship with customer satisfaction, confirmatory factor analysis and structural equation modeling (SEM)) through SPSS and AMOS 23.0 data analysis software were used. The findings indicate that convenience, reliability, ease of use, fulfillment, and security/privacy of ATM service quality dimensions are positively and significantly associated with customer satisfaction. The results of this study can help banks' management improve the quality of their ATM services to increase overall customer satisfaction. To ensure continued customer satisfaction, banks are encouraged to make the ATM service more convenient, reliable, user-friendly, secure, and fulfilling. They should also constantly update and differentiate their ATM service quality aspects to build a competitive advantage and boost their profitability.

Abstract Background Hypertension, a major but modifiable risk factor for cardiovascular diseases, is a global health problem including Ethiopia. In a limited infrastructure task sharing of hypertension screening for community health workers is a feasible strategy to improve hypertension management. Recent finding have shown that trained health extension workers (HEWs) can identify high blood pressure, which was effective and feasible. Identifying barriers and enablers for home-based hypertension screening by HEWs is crucial for its implementation. This study aimed to explore barriers and enablers that influence health extension workers’ home-based hypertension screening in the community. Methods The interpretive descriptive design was implemented. In-depth interviews were conducted during October, 2020. A total of 26 participants including HEWs, supervisors, and heads of district health office were purposively selected. They were asked to describe their perception toward home-based hypertension screening by the HEWs. The interviews were audio-recorded, transcribed verbatim into Amharic, and translated into English. The transcripts were coded and themes were identified. Thematic approach was used for data analysis. Results The participants identified key perceived barriers and enablers of HEWs home-based hypertension screening. The most common barriers were a lack of hypertension training, blood pressure measuring devices, blood pressure guidelines and manuals, skilled HEWs, financial incentives, and poor community awareness of the disease. The most common enablers were support from community leaders, presence of functional development army and community trust for HEWs, presence of routine campaign on vaccination and community based health insurance, and an integrated health system. Conclusions Our findings have implications for the HEWs' ongoing implementation of home-based hypertension screening. Successful implementation of this strategy requires scaling up of hypertension training programs for health extension workers and their supervisors, provision of standardized protocols, provision of adequate blood pressure measuring equipment, and regular supportive supervision.

Abstract Background In order to meet the WHO 2030 cervical cancer elimination program, evaluation and utilization of sensitive testing method, and feasible sampling technique is a paradigm for enhancing cervical cancer screening coverage. Self-sampling for screening of HPV DNA testing is one of the easiest and sensitive techniques, though the evidence was limited in the Ethiopian context. This study aimed to compare the performance of self-collected vaginal specimen versus clinician collected cervical specimen for detection of HPV among HIV positive women in Ethiopia. Methods We conducted a comparative cross-sectional study design to collect cervicovaginal specimens among HIV positive women of age older than 24 years. Data were collected from six government hospitals from January to October 2021. A total of 994 cervicovaginal specimens was collected by clinicians and HIV positive women themselves in the cervical cancer screening unit using Abbott Cervi-Collect Specimen Collection Kit, and molecular HPV testing was conducted. Data were entered into an Excel spreadsheet and analyzed using SPSS version 25. Sensitivity, specificity and kappa were reported with p

Abstract Background Poor sleep quality during pregnancy might have an impact on adverse birth outcomes like premature rupture of membrane, preterm birth, lifelong neurocognitive impairment, low birth weight, and increased the risk of neonatal morbidity and mortality. In Ethiopia, the magnitude of poor sleep quality among this group of people is extremely limited. So, this study aims to determine the magnitude of poor sleep quality and its associated factors among HIV-positive pregnant women attending public hospitals in Northwest Ethiopia. Methods An institution-based cross-sectional study was done using a simple random sampling technique to recruit 411 HIV-positive pregnant women from January to March; 2021. Sleep quality over the last 1 month was measured using the Pittsburgh Sleep Quality Index (PSQI). General anxiety disorder (GAD-7), Sleep Hygiene Index (SHI), and List of Threatening of Experiences (LTE) instruments were used to identify factors associated with poor sleep quality. Bivariate and multivariable logistic regression with odds ratio and 95% CI were employed to identify determinant factors of poor sleep quality. Statistical significance association was declared at P-value

Abstract We explored the barriers and facilitators of maternal health care service use among women in the pastoralist region of Ethiopia. We used a mixed methods design—focus group discussions, key informant interviews, review of the literature and Participatory Ethnographic Evaluation Research (PEER) methods followed by a household survey among randomly chosen pastoralist women of reproductive age (n = 1,499). We used multi-variable regression analyses, and a p value ≤ 0.05 was set to determine statistical significance. In addition, we analysed qualitative data thematically and developed a causal loop diagram using dynamic synthesis methodology to analyse non-linearity, intricate relationships of the variable of interests. In this study, 20.6% of women used modern contraceptive methods, 44.6% had four or more antenatal visits and 38.4% of sampled women received skilled delivery services. We observed multiple individual and community related factors such as education, income and women’s and their partner’s knowledge, perceptions, husband approval, social norms and value-expectations and providers’ gender preferences and health systems factors such as access to health facilities, place of living, provider's cultural competency skills, supplies, delivery positions, economic and political stability, and provider's attitude were linked to maternal health care services utilization among women in pastoralist regions. Approaches towards pastoralists’ health care delivery systems should be responsive to their cultural and political ecology and human agency.

Abstract Background Common mental disorders such as depression, anxiety, and somatic symptoms are a major public health concern because it is prevalent and chronic, and its impact on physical health, psychological and economic consequences is very serious. Evidence on the prevalence and predictors of common mental disorders is very limited in Ethiopia. This study aims to determine the prevalence and associated factors with common mental disorders. Methods A community-based cross-sectional study was conducted among 731 south Gondar zone residents recruited with a multistage sampling method. Data were collected by face-to-face interviews on socio-demographic, clinical, and psychosocial factors. Common mental disorders (CMD) were assessed using a self-reporting questionnaire (SRQ-20). A-List of Threatening Experiences and the Oslo social support instruments were used to identify the factors. We used bivariate and multivariable binary logistic regressions to identify factors associated with common mental disorders. Statistical significance was declared at P-value

Abstract Background Hypertension is a public health issue in Ethiopia. The vast majority of cases remain undiagnosed and untreated. Early and accurate identification of hypertension can help with timely management and reduce the risk of complications. In resource-constrained rural settings where poor access to care and a shortage of healthcare providers are major barriers, task-sharing of some primary healthcare duties from well-trained healthcare workers to community health workers has been found to be a cost-effective strategy. This study aimed to assess the ability of trained health extension workers to correctly identify high blood pressure among adults in rural areas of northwest Ethiopia. Methods A cross-sectional study was conducted in rural areas of northwest Ethiopia from June to October 2020. Trained health extension workers and health professionals measured the blood pressure of 1177 study participants using a calibrated aneroid sphygmomanometer. A Kappa test statistic was used to compare the two sets of measurements for agreement. The sensitivity, specificity, positive, and negative predictive values were used to assess the validity of health extension workers’ ability to identify high blood pressure in comparison to health professionals. Results The trained health extension workers and health professionals identified 219 (18.6%) and 229 (19.5%) of the participants with high blood pressure, respectively. The inter-rater agreement between health extension workers and health professionals for high blood pressure detection was 91.2% (k = 0.912, 95% CI: 0.88, 0.94, p-value = 0.000). The sensitivity and specificity of high blood pressure detection by health extension workers were 90.8% (95% CI: 89.6, 92.0) and 98.8% (95% CI: 98.1, 99.5), respectively. While the positive and negative predictive values were 95.0% (95% CI: 92.1, 97.9) and 97.8% (95% CI: 97.3, 98.3), respectively. Conclusions The inter-rater agreement between the trained health extension workers and health professionals on high blood pressure detection was excellent. The findings indicate that training health extension workers is a reliable and valid strategy for early detection of hypertension. Thus, the strategy can be integrated with the essential services provided by primary health care units at the village and health post level in rural settings.

Abstract Introduction Sexual compulsivity is a concealed psychiatric disease marked by intrusive thoughts followed by ritualized sexual acts. In Ethiopia, the prevalence of HIV/AIDS has recently increased. Furthermore, sexual compulsivity among adults living with HIV/AIDS receives less attention, particularly in Ethiopia. Therefore, this study aimed to assess the prevalence of sexual compulsivity and its correlates among adults living with HIV/AIDS attending ART clinic in Gambella town, Southwest Ethiopia, 2020. Method A hospital-based study employing cross-sectional design and simple random sampling technique was used to select the study participants. Data were collected by using interview technique. A 10 item Sexual Compulsivity Scale (SCS) questionnaire was used to assess sexual compulsivity. The translated version of the questionnaire was used for data collection. Bivariate and multivariable logistic regression was conducted to determine factors associated with the outcome variable at p-value

BackgroundCommunity health workers (CHWs) play an important role in improving access to health services to a broader population; particularly to communities living in remote areas. However, the productivity of CHWs is affected by the workload they have. We aimed to summarize and present CHWs' perceived workload in low-and middle-income countries (LMICs).MethodsWe searched three electronic databases (PubMed, Scopus, and Embase). A search strategy customized for the three electronic databases was developed using the two key terms of the review (CHWs and workload). Primary studies conducted in LMICs that explicitly measured workload of CHWs and published in English were included, without date restrictions. Methodological quality of the articles was assessed by two reviewers independently using mixed-methods appraisal tool. We applied a convergent integrated approach to synthesize the data. This study is registered on PROSPERO, number CRD42021291133.ResultsOf 632 unique records, 44 met our inclusion criteria, and 43 (20 qualitative, 13 mixed-methods, and 10 quantitative studies) passed the methodological quality assessment and were included in this review. In 97.7% (n = 42) of the articles, CHWs reported that they have a high workload. Having multiple tasks was the most commonly reported subcomponent of workload, followed by lack of transport; which was reported in 77.6% (n = 33) and 25.6% (n = 11) of the articles respectively.ConclusionCHWs in LMICs reported that they have a high workload; mainly related to having to manage multiple tasks and the lack of transport to access households. Program managers need to make careful consideration when additional tasks are shifted to CHWs and the practicability to be performed in the environment they work in. Further research is also required to make a comprehensive measure of the workload of CHWs in LMICs.