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Background: Epilepsy is one of the most common neurologic disorders affecting approximately 51 million people globally and is associated with significant cases of age-standardized DALYs (182.6 per 100 000 people). The quality of health care services offered to people suffering from epilepsy often fails to meet standards in Ethiopia or internationally. This study was designed to assess the quality of care and associated factors among patients with epilepsy at public hospitals in Arba Minch Town, 2024., Method: A facility-based cross-sectional study was conducted among 392 adult epileptic patients attending public hospitals in Arba Minch Town. Data entry was performed via Epi-data 3.1 software, and the data were analyzed via SPSS version 24 software. Binary logistic regression analysis was used to evaluate the associations between quality of care and sociodemographic, disease-related, and treatment-related factors. Multivariate logistic regression analysis was applied to identify factors independently associated with quality of care., Results: Three hundred ninety-two adults with epilepsy participated in this study, for a response rate of 92.7%. More than one-half of the 237 (60.5%) patients were males, with a median age of 31 ± 12 years (interquartile range). Fewer than one-half (44.1%) of the patients adhered to antiepileptic medicines. The overall proportion of patients receiving quality care was 213 (54.3%). The seizure control rate was also low, at 130 (33.2%). Patients aged 18-29 years [AOR = 30.8 (95% CI, 8.22-35.616, p < 0.000)] and aged 30-39 years [AOR = 18.4 (95% CI, 5.016-67.613, p < 0.000)], and a seizure frequency of less than three [AOR = 2.318 (95% CI, 1.028-5.225, p < 0.043)] were positively associated with quality of care. Whereas, having poor knowledge about epilepsy [AOR = 0.107 (95% CI, 0.0.057-0.202, p < 0.000)] was negatively associated with quality care., Conclusion: The quality of care provided to adult epilepsy patients at Arba Minch was low. In addition, patient knowledge, medication adherence, and the seizure control rate were also suboptimal. Therefore, addressing identified factors by involving all relevant stakeholders (health professionals, hospitals, zonal health departments, regional health bureaus, and patients) is critical for improving the quality of care. In addition, researchers willing to study this topic should use strong designs that can determine causal determinants of quality care., Competing Interests: Declarations. Ethical approval: Ethical clearance was obtained from Arba Minch University, the College of Medicine, and the Health Sciences Institutional Review Board with the following reference number: IRB/T13/2016. After the study objective and confidentiality of the information were clarified, verbal informed consent to participate was obtained from obtained from participants, or the parents or legal guardians of illiterate participants. Consent for publication: All authors read the full version of this manuscript and agreed to publish. Competing interests: The authors declare no competing interests., (© 2024. The Author(s).)

Background: Blindness and poor eyesight are significant public health issues globally and specifically in Ethiopia. In Ethiopia, there is limited access to cataract surgery and refractive error treatment centers. Therefore, this study aimed to evaluate the role of health system support in improving access to eye care services, particularly cataract surgery and refractive error treatment services in two secondary eye care units (SECUs)., Methods: A parallel mixed-lived experience study was conducted in two SECUs. A desk review of relevant project documents and health facility activity reports was performed for quantitative data. The study was conducted from 12 December 2022 to 30 January 2023. A total of 21 in-depth interview participants were included., Results: Overall, 14 106 cataract surgeries were performed during the pilot project implementation period. Assela Teaching and Referral Hospital Eye Care Unit performed cataract surgery 20-30 times per week. Similarly, Debre Tabor Comprehensive Hospital performed cataract surgery 18-24 times per week. The refractive service of the two SECUs was planned to range from 15-30 to 60 per week, and the refractive services were increased from 50-60 per week in both eye care units., Conclusions: This project has significantly helped the existing health system achieve the 2030 global target and has improved access to eye care services in selected SECUs. The use of cataract surgery and refractive error performance markedly increased from 0 to 100%., (© The Author(s) 2024. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene.)

Objective: About 90% of eye health problems are preventable or curable with existing cost-effective interventions. There is limited evidence on eye healthcare utilisation (ECU) and the factors influencing it in the study area. This study aimed to determine the level of ECU and the associated factors in Southern Ethiopia., Design: A community-based, cross-sectional study was conducted in Southern Ethiopia from 1 June to 15 July 2023. Data were analysed using SPSS V.27., Setting: Two selected districts (Dita and Uba Debretsehay) in Southern Ethiopia., Participants: Permanent residents living in randomly selected kebeles., Outcome Measure: The level of ECU was the outcome measure. A binary logistic regression model was used to check the association between explanatory variables and the dependent variable. To avoid many variables and unstable estimates and to control for possible confounders in the subsequent model, only variables that reached a p value of less than 0.25 on binary analysis were used in the multivariate logistic regression analysis to identify factors independently associated with ECU., Results: 992 respondents participated in this study, with a response rate of 95.4%. The prevalence of ECU within the past 2 years was 21.6% (95% CI 19.0, 24.3). The reported barriers to ECU were lack of awareness (123, 40.6%) and lack of money (58, 19.2%). Age <30 years (adjusted OR (AOR)=2.7; 95% CI 1.5, 4.6), being male (AOR=2.2; 95% CI 1.4, 3.6), shorter travel time (AOR=2.0; 95% CI 1.3, 3.1), undergoing regular vision check-ups (AOR=5.4; 95% CI 3.47, 8.37), history of eye diseases (AOR=4.8; 95% CI 2.5, 9.1) and having trichiasis (AOR=1.5; 95% CI 1.1, 2.3) were positively associated with eye care service utilisation. Low wealth quantile (AOR=0.62; 95% CI 0.39, 0.98) and poor knowledge (AOR=0.26; 95% CI 0.16, 0.44) were negatively associated with eye care service utilisation., Conclusions: The ECU within the past 2 years was a quarter. Socioeconomic factors, disease-related factors and respondent knowledge are independently associated with ECU. Designing strategies that can improve the capacity of healthcare facilities and patient awareness is important in order to reduce barriers and improve service utilisation. Researchers interested in working in the area should focus on community-specific approaches that can improve community health literacy by using stronger study designs., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Introduction: Traumatic brain injuries are a major public health concern that contributes to youth morbidity and mortality in developing nations, including Ethiopia. Despite of this, little is known about head injury in the study area. The goal of the study was to identify the incidence, risk factors and outcomes for traumatic head injury among trauma patients who visited at the Yanet Trauma and Surgery Specialized Centre., Methods: This was a 5 year an institutional-based retrospective cohort study conducted among 1,029 patients who experienced trauma and admitted at the Yanet Trauma and Surgical Specialized Centre. The research was carried out between September 01/2023 to October 15/2023. The study units were selected by using simple random sampling techniques through computer-generated random numbers. The data were collected via a checklist designed on the Kobo toolbox with a smart smartphone. The collected data were exported to a statistical package for Social Science version 27. Then, descriptive statistical analysis was conducted to determine the mean, standard deviation, and median. Bivariate and multivariate logistic regression was subsequently conducted to determine the associations between head injury and the independent variables., Result: A total of 1,029 injured patients were followed for 2,302 person-days. Over all, incidence density rate of 14.03/100 person-days (323, 31.4%) [95% CI: 29.5-34%]. The third year of follow-up showed the greatest incidence compared to other years. The most common type of head injury observed during following up were brain contusion (38.1%), followed by epidural hematoma (33.1%), skull fracture (15.8%), and intracerebral hematoma (13.0%). In multivariate logistic model, rural residence [AOR = 1.6; 95% CI: 1.18-2.16], mechanism of injury namely road traffic accident [AOR = 5.5; 95% CI: 2.27-13.34], assault [AOR = 3.4; 95% CI: 1.35-8.37] and comorbidity of chronic disease [AOR = 2.2; 95% CI: 1.13-4.18] were the risk factors significantly associated with head injury., Discussions: The incidence density rate of 14.03/100 person-days. As the result, more has to be done by health professionals, traffic police officers and local government raise awareness and enforce the implementation of driving rules and regulations., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Abebe, Alemu and Sorato.)

Background: Substance use disorders and HIV infection have a bidirectional relationship. People who use illicit drugs are at increased risk of contracting HIV/AIDS, and people living with HIV/AIDS are at increased risk of using substances due to disease-related complications like depression and HIV-associated dementia. There is no adequate evidence on the effect of HIV/AIDS and substance use disorder comorbidity-related effects on placental, fetal, maternal and neonatal outcomes globally., Methods and Analysis: We will search articles written in the English language until 30 January 2024, from PubMed/Medline, Cochrane Library, Embase, Scopus, Web of Sciences, SUMsearch2, Turning Research Into Practice database and Google Scholar. A systematic search strategy involving AND/OR Boolean Operators will retrieve information from these databases and search engines. Qualitative and quantitative analysis methods will be used to report the effect of HIV/AIDS and substance use disorders on placental, fetal and maternal composite outcomes. Descriptive statistics like pooled prevalence mean and SD will be used for qualitative analysis. However, quantitative analysis outcomes will be done by using Comprehensive Meta-Analysis Software for studies that are combinable. The individual study effects and the weighted mean difference will be reported in a forest plot. In addition to this, the presence of multiple morbidities like diabetes, chronic kidney disease and maternal haemoglobin level could affect placental growth, fetal growth and development, abortion, stillbirth, HIV transmission and composite maternal outcomes. Therefore, subgroup analysis will be done for pregnant women with multiple morbidities., Ethics and Dissemination: Since systematic review and meta-analysis will be conducted by using published literature, ethical approval is not required. The results will be presented in conferences and published in peer-reviewed journals., Prospero Registration Number: CRD42023478360., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Poor management of waste can cause serious disease to healthcare personnel, cleaners, waste handlers, patients and the public. An observation-supported cross-sectional study was conducted to assess healthcare waste (HCW) management practice and professional, management and resource availability-associated factors among healthcare workers of 23 public health facilities in Southwest Shewa Zone, Oromia regional state, Ethiopia, 2021. A total of 424 health workers participated in this study. The level of proper healthcare waste management (HCWM) practice was 38.4%. Lack of knowledge on different methods of healthcare waste treatment (adjusted odds ratio (AOR): 0.101, 95% confidence interval (CI) (0.042, 0.242, p  < 0.05)), lack of knowledge about the types of healthcare waste (AOR: 0.136, 95% CI (0.039, 0.481, p  < 0.05)), lack of knowledge on the use of different colour-coded waste bin and safety box (AOR: 0.145, 95% CI (0.040, 0.520, p  < 0.05)), and healthcare workers who had no training/orientation on HCWM practice (AOR: 0.396, 95% CI (0.245, 0.639, p  < 0.05)) were less likely to practice effective HCWM compared to their counterparts. The current HCWM practices in studied health facilities was inadequate. Professional knowledge and availability of training were independently associated with HCWM practice. Therefore, regular orientation during employment and on-job training on HCWM practice, regular monitoring and supervision of HCWM are important. Further research should be conducted on the area of HCWM, and its associated environmental impacts by using more strong methods and wider health facilities., Competing Interests: Declaration of conflicting interestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: Both constrained access to essential medicines and combatting marketing of substandard and falsified (SF) medicines are unmet health sector goals in Africa., Objective: To answer the question of how improved access can reduce the continuous surge of SF medicines in Africa., Design: We conducted a scoping review based on standard protocol., Methods: We searched articles published in the English language from PubMed/Medline, Cochrane Library, Embase, Scopus, Web of Science, and Google Scholar by using a systematic search query., Results: Seventy-one articles were included in this review. Access to quality essential medicines is still a major problem in developing countries in Africa and will continue as a threat for the next decade of health care. Ensuring access to quality medicines and preventing SF medicines in Africa need a systematic approach to address their underlying causes. Failure to ensure access to medicines is the major reason for the availability of SF medicines. Improving access to quality medicines can reduce SF medicine marketing and use. Manipulating the entire supply chain for efficiency, avoiding trade agreements that could reduce access, using compulsory licensing provisions, and pharmaceutical price control, providing incentives for drug development, and promoting rational use of medicines can improve access., Conclusion: Ensuring access to medicines and preventing SF medicine marketing cannot be achieved in the planned period in developing countries in Africa unless a comprehensive strategy is used. Improving access to quality medicines can reduce SF medicine marketing and use, that is, ensuring access through uninterrupted supply, improved efficiency, enhanced local production, preventing SF medicine entry, improved medication use system, and improved affordability. Therefore, it is essential to improve supply chain capability, address challenges of the supply chain, improve leadership and governance, establish country-specific anti-counterfeiting and anti-substandardization committees, and collaborate with all relevant stakeholders., Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2024.)

Introduction: Under-five mortality reduction due to pneumonia is not Signiant, particularly in developing countries. Pneumonia contributed to 27.5% to 31.3% of health facility visits by children 2 to 59 months in Aleta Wondo Woreda. Previous studies have shown inconclusive evidence on determinants of pneumonia in children., Methods: An institution-based unmatched case-control study was conducted to assess determinants of pneumonia among under-five children at Aleta Wondo Woreda, Sidama Region., Result: One-hundred forty-five cases and 290 controls of children aged 2 to 59 months participated in the study. The mean ± (SD) age of the children was 18.81 months (2.1 ± 11.43) and 28.26 months (2.1 ± 16.007) for cases and controls, respectively. Only 56% (n = 145) of cases open house windows daily, whereas most 68.6% (n = 290) of controls house windows open daily. Ninety five (62.8%) of cases and 68.6% of controls were exclusively breastfed for 6 months. Household income ≥1500 Ethiopian birr (AOR = 0.45, 95% CI, 0.017-0.120, p < 0.000), child location outside of cooking house during cooking (AOR = 0.101, 95% CI, 0.43-0.238, p < 0.000), no formal education of the mother (AOR = 2.398, 95% CI, 1.082-5.316, p < 0.031), and presence of history of upper respiratory tract infections (URTIs) in last 2 weeks (AOR = 2.183, 95% CI, 1.684-5.273, P < 0.049) were determinants of pneumonia., Conclusion: Determinants of pneumonia in under-five children were multifactorial (socioeconomic, nutritional, and environmental). Addressing these factors by involving all relevant stakeholders is important to reduce pneumonia-related morbidity and mortality among under-five children in the study area., (© 2023 The Authors. The Clinical Respiratory Journal published by John Wiley & Sons Ltd.)

Purpose: Deep vein thrombosis is a public health problem with substantial morbidity and mortality globally. In Ethiopia, death due to complications of DVT is very significant however its incidence, risk factors, and preventive methods are not well studied. To assess the incidence and factors associated with deep vein thrombosis among hospitalized adult patients at Hawassa University Comprehensive Specialized Hospital, Hawassa, Ethiopia., Method: Intuitional-based retrospective study design was employed in July1-August 30, 2022 in 660 randomly selected patients' record cards. The patients' record cards were reviewed from 2012 to 2014 at Hawassa University Compressive Specialized Hospital. The data entry and analysis were done by using Epi Info and SPSS version 24. After adjusting covariates at a 95% confidence interval, an independent variable with a P value < 0.05 was declared significantly associated with deep vein thrombosis. An odds ratio was calculated to measure the strength of the relationship independent variable and deep vein thrombosis., Results: The overall incidence of DVT was 10.6% [95% CI: 8.5%, 13.1%]. After adjusting for covariates, orthopedic trauma; AOR = 2.6 (95% CI (1.2-5.4), corona virus; AOR = 2.5 (95%CI (1.07-5.1), and hospital stay > 15 days; AOR = 2.2 (95% CI (1.25-3.94) were significantly associated with deep vein thrombosis., Conclusion: DVT incidence is high among hospitalized patients. An orthopedic trauma, a recent infection of the coronavirus, and a hospital stay above 15 days were a risk to acquire deep vein thrombosis. Early identification and detection of patients at high risk of developing DVT and provision of prophylaxis are recommended., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Purpose: To determine the impact of drug prescribing pattern, outpatient drug price of medicines, and level of adherence to evidence-based international guidelines on blood pressure (BP) control at selected hospitals in Southern Ethiopia., Methods: Hospital-based cross-sectional study was conducted. The data entry and analysis were done by using SPSS version 21.0., Results: A mean age of participants was 55.87 ± 11.02 years. The rate of BP control was 17.5% based on International Society of Hypertension (ISH) guidelines 2020. In about two-thirds of patients, 270 (66.5%) were taking combination therapy. Mean annual cost of drugs for hypertension was 11.39 ± 3.98 US dollar (USD). Treatment was affordable for only 91 (22.4%) of patients. There was considerable variation on prescriber's adherence to evidence-based guidelines. Body mass index (BMI) of 18-24.9 kg/m 2 , adjusted odds ratio (AOR) = 3.63 (95% confidence interval (C.I), 1.169-11.251, p = 0.026), physically activity, AOR = 12.69 (95% C.I, 1.424-113.17, p = 0.023), presence of no comorbidity, AOR = 12.82 (95% C.I, 4.128-39.816, p = 0.000), and taking affordable antihypertensive regimen, AOR = 3.493 (95% C.I, 1.4242-9.826, p = 0.018), were positively associated BP control., Conclusion: The level of BP control, affordability of drugs for the management of hypertension and related comorbidities, and the prescriber's adherence to evidence-based guidelines were inadequate. Therefore, addressing factors associated with good BP control including affordability and clinician adherence to evidence-based guidelines by responsible stakeholders could improve BP control and reduce associated complications., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Purpose: Proactive management of type 2 diabetes is important for restoring beta-cell function and improving sustained blood glucose control. Evidence on quality of diabetes care in Ethiopia is inadequate., Method: Facility-based cross-sectional study was conducted to assess level of quality of care provided to adult type 2 diabetes patients at three public hospitals in Gamo Gofa Zone, Southern Ethiopia., Results: A total of 210 adult type 2 diabetes patients were included. The mean age of patients was 44.1 ± 9.94 years. Fifty-one (24.3%) of patients adhered to prescribed medicines. Sixty-seven (31.9%) patients could benefit from neuropathy screening and referral. Diabetes-specific evidence-based guidelines, operational plan to reduce overweight and obesity were not available. There was no periodic lipid profile, renal function and glycated haemoglobin testing. Sixty-three (30%) patients achieved fasting blood glucose (FBG) level. Only 41 (19.5%) achieved the recommended target value for composite intermediate outcomes. All three sub-components of quality care structure, process and outcome (SPO) were below the agreed minimum score and the quality of care provided to adult type 2 diabetes was poor. Only 41 (19.5%) achieved agreed quality indicator targets for type 2 diabetes (fasting blood glucose blood pressure and low-density lipoprotein cholesterol)., Conclusion: The quality of care provided to adult type 2 diabetes patients was poor particularly in areas such as availability of evidence-based guidelines, operational plan to reduce obesity, monitoring of lipid profile and glycaemic control. Therefore, developing strategies for addressing structure, process and outcome-related gaps by involving all stakeholders is critical for improving the quality of care provided to these patients., (© 2022 The Authors. Endocrinology, Diabetes & Metabolism published by John Wiley & Sons Ltd.)

Introduction: There is inadequate information on the cost-effectiveness of hypertension based on evidence-based guidelines. Therefore, this study was conducted to evaluate the cost-effectiveness of hypertension treatment based on 2020 International Society of Hypertension (ISH) guidelines from a societal perspective., Methods: We developed a state-transition Markov model based on the cardiovascular disease policy model adapted to the Sub-Saharan African perspective to simulate costs of treated and untreated hypertension and disability-adjusted life-years (DALYs) averted by treating previously untreated adults above 30 years from a societal perspective for a lifetime., Results: The full implementation of the ISH 2020 hypertension guidelines can prevent approximately 22,348.66 total productive life-year losses annually. The incremental net monetary benefit of treating hypertension based was $128,520,077.61 US by considering a willingness-to-pay threshold of $50,000 US per DALY averted. The incremental cost-effectiveness ratio (ICER) of treating hypertension when compared with null was $1,125.44 US per DALY averted. Treating hypertension among adults aged 40-64 years was very cost-effective 625.27 USD per DALY averted. Treating hypertensive adults aged 40-64 years with diabetes and CKD is very cost-effective in both women and men (i.e., 559.48 USD and 905.40 USD/DALY averted respectively)., Conclusion: The implementation of the ISH 2020 guidelines among hypertensive adults in Southern Ethiopia could result in $9,574,118.47 US economic savings. Controlling hypertension in all patients with or with diabetes and or CKD could be effective and cost-saving. Therefore, improving treatment coverage, blood pressure control rate, and adherence to treatment by involving all relevant stakeholders is critical to saving scarce health resources., Competing Interests: The authors declare that they have no competing interests.

Background: Ischemic heart disease (IHD) is the first cause of mortality in the world. Stable coronary artery disease (CAD) is the most common IHD. Medical therapy (MT), percutaneous coronary intervention (PCI), and coronary artery bypass grafting (CABG) are three strategies for the management of this disease. The main aim of this study was the comparison of MT with PCI or CABG in terms of cardiovascular (CV) mortality, myocardial infarction (MI), unplanned revascularization (UR), stroke, and freedom from angina in managing stable CAD., Methods: The Cochrane Central Register of Controlled Trials, Embase, PubMed, and Scopus were searched. Two reviewers independently appraised the titles and abstracted data of the identified studies. After the Full-text reviewing phase, eligible studies were analyzed through the random-effect meta-analysis method. Finally, a sensitivity analysis was conducted for the robustness of findings., Results: Nine randomized controlled trials (RCTs) were included. The pooled RR of CV mortality associated with MT compared with PCI and CABG was 1.22 and 1.385, respectively. Overall, The RR of MT associated with MI, UR, stroke, and freedom from angina compared with PCI was 1.001, 1.151, 0.799, and 0.801, respectively., Conclusion: Our results revealed no statistically significant difference between MT and PCI in terms of studied primary outcomes. The findings also highlighted that there is no statistically significant difference between MT and CABG in terms of CV mortality., (© 2022 Isfahan Cardiovascular Research Center & Isfahan University of Medical Sciences.)

Introduction: There is inadequate information on blood pressure (BP) and FBG (Blood pressure and Fasting blood glucose) control among adult hypertensive patients in Southern Ethiopia., Aim: To determine the level and factors associated with poor BP and FBG control among adult hypertensive patients on regular follow-up at three public hospitals RESULTS: We included 406 adult hypertensives with mean age of 55.87 ± 11.03 years. Mean systolic BP was 134.46 ± 13.44 mmHg; and mean diastolic BP was 82.10 ± 9.44 mmHg. More than eight out of 205 (86.2%) of patients did not achieve BP and FBG target level. Having body mass index 18-24.9 kg/m 2 , Adjusted odds ratio (AOR) = 0.317 (95% C.I. for AOR, 0.135-0.740, p = 0.008); having no comorbidity, AOR = 0.425 (95% C.I. for AOR, 0.232-0.779, p = 0.006); physically activity, AOR = 0.303 (95% C.I., 0.110-0.829, p = 0.020); having low perceived health risk, AOR = 0.095 (95% C.I., 0.014-0.632, p = 0.015); taking monotherapy, AOR = 3.34 (95% C.I. for AOR, 1.121-10.524, p = 0.033); and history of hospitalization, AOR = 7.048 (95% C.I. for AOR, 2.486-19.954, p = 0.000) were associated with poor BP and FBG control., Conclusions: The level of BP and FBG control was low. Improving screening of hypertensive patients for diabetes; addressing obesity and mental health; strengthening healthy life style interventions and enhancing appropriate dose intensification of prescribed anti-hypertensives by responsible bodies are critical to improve BP and FBG control., (© 2022. Italian Society of Hypertension.)

Objectives: There is inadequate information on the economic burden of hypertension treatment in Ethiopia. Therefore, this study was conducted to determine the societal economic burden of hypertension at selected hospitals in Southern Ethiopia., Methods: Prevalence-based cost of illness study from a societal perspective was conducted. Disability-adjusted life years (DALYs) were determined by the current WHO's recommended DALY valuation method. Adjustment for comorbidity and a 3% discount was done for DALYs. The data entry, processing and analysis were done by using SPSS V.21.0 and Microsoft Excel V.2013., Results: We followed a cohort of 406 adult patients with hypertension retrospectively for 10 years from September 2010 to 2020. Two hundred and fifty (61.6%) of patients were women with a mean age of 55.87±11.03 years. Less than 1 in five 75 (18.5%) of patients achieved their blood pressure control target. A total of US$64 837.48 direct cost was incurred due to hypertension. A total of 11 585 years and 579.57 years were lost due to hypertension-related premature mortality and morbidity, respectively. Treated and uncontrolled hypertension accounted for 50.83% (6027) of total years lost due to premature mortality from treated hypertension cohort. Total productivity loss due to premature mortality and morbidity was US$449 394.69. The overall economic burden of hypertension was US$514 232.16 (US$105.55 per person per month)., Conclusion: Societal economic burden of hypertension in Southern Ethiopia was substantial. Indirect costs accounted for more than 8 out of 10 dollars. Treated and uncontrolled hypertension took the lion's share of economic cost and productivity loss due to premature mortality and morbidity. Therefore, designing and implanting strategies for the prevention of hypertension, early screening and detection, and improving the rate of blood pressure control by involving all relevant stakeholders at all levels is critical to saving scarce health resources., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Aim: Hypertension control in Sub-Saharan Africa (SSA) is the worst (less than one out of ten) when compared to the rest of the world. Therefore, this scoping review was conducted to identify and describe the possible reasons for poor blood pressure (BP) control based on 4Ps' (patient, professional, primary healthcare system, and public health policy) factors., Methods: PRISMA extension for scoping review protocol was used. We systematically searched articles written in the English language from January 2000 to May 2020 from the following databases: PubMed/Medline, Embase, Scopus, Web of Science, and Google scholar., Results: Sixty-eight articles were included in this scoping review. The mean prevalence of hypertension, BP control, and patient adherence to prescribed medicines were 20.95%, 11.5%, and 60%, respectively. Only Kenya, Malawi, and Zambia out of ten countries started annual screening of the high-risk population for hypertension. Reasons for nonadherence to prescribed medicines were lack of awareness, lack of access to medicines and health services, professional inertia to intensify drugs, lack of knowledge on evidence-based guidelines, insufficient government commitment, and specific health behaviors related laws. Lack of screening for high-risk patients, non-treatment adherence, weak political commitment, poverty, maternal and child malnutrition were reasons for the worst BP control., Conclusion: In conclusion, the rate of BP treatment, control, and medication adherence was low in Eastern SSA. Screening for high-risk populations was inadequate. Therefore, it is crucial to improve government commitment, patient awareness, and access to medicines, design country-specific annual screening programs, and empower clinicians to follow individualized treatment and conduct medication adherence research using more robust tools.