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Lire Lemma Tirore,1 Selamu Abose Nadamo,2 Habtamu Tamrat Derilo,3 Desta Erkalo,1 Tagesse Sedore,1 Tegegn Tadesse,1 Dejene Ermias,1 Temesgen Yaekob4 1Department of Public Health, Wachemo University, Hossana, Ethiopia; 2Department of Midwifery, Wachemo University, Hossana, Ethiopia; 3Department of Orthopedic Surgery, Wachemo University, Hossana, Ethiopia; 4Department of Statistics, Wachemo University, Hossana, EthiopiaCorrespondence: Lire Lemma Tirore, P.O.BOX:667, Email ganetlemma@gmail.comBackground: The world is currently facing a pandemic of Coronavirus Disease 2019 (Covid-19). It has caused significant morbidity and mortality. So far little is known about recovery time (prolonged hospital stay) from Covid-19 and its determinants in Ethiopia as well as in the study area. Therefore, the aim of this study was to determine time to recovery from Covid-19, and identify predictors of time to recovery among patients admitted to treatment centers of Southern Nations Nationalities and Peoples Region (SNNPR).Methods and Materials: A facility-based retrospective cohort study was conducted among Covid-19 patients admitted to care centers of SNNPR from May 30, 2020 to October 15, 2021. A sample of 845 patients was included in the study. Summarization of the data was done using mean (standard deviation) and median (inter quartile range). Kaplan–Meier Survival Curve was used to estimate recovery time from Covid-19 and the independent effects of covariates on recovery time was analyzed using multivariable Cox-proportional hazard model.Results: The incidence density of recovery was 8.24 per 100 person-days (95% CI: 7.67, 8.85). The overall median recovery time was 10 days (IQR: 8– 16 days). Critical stage of Covid-19 (aHR = 0.19, 95% CI: 0.12, 0.29), severe stage of Covid-19 (aHR = 0.40, 95% CI: 0.29, 0.56), mechanical ventilation (aHR = 0.20, 95% CI: 0.073, 0.56) and treatment center (aHR = 0.68, 95% CI: 0.51, 0.90) were significant predictors of recovery rate among Covid-19 patients.Conclusion: The median time to recovery from Covid-19 was relatively short. The incidence density of recovery was 8.24 per 100 person-days. The hazard of recovery was lower for patients at higher levels of Covid-19 severity and for patients in need of mechanical ventilation. Early identification of severity levels of the patients is required at the time of admission. Special attention, critical follow–up and management is warranted for patients at higher levels of Covid-19 severity.Keywords: COVID-19, time to recovery, incidence density, Southern Ethiopia

Trhas Tadesse,1 Tadesse Alemu,2 Getasew Amogne,3 Getabalew Endazenaw,1 Ephrem Mamo1 1Public Health Department, Yekatit 12 Hospital Medical College, Addis Ababa, Ethiopia; 2Public Health Department, Universal Medical and Business College, Addis Ababa, Ethiopia; 3School of Pharmacy, Wollo University, Dessie, EthiopiaCorrespondence: Trhas TadessePublic Health Department, Yekatit 12 Hospital Medical College, Addis Ababa, EthiopiaTel +251912053189Email ttrhas@gmail.comBackground: Ethiopia has taken strict preventive measures against COVID-19 to control its spread, to protect citizens, and ensure their wellbeing. Employee’s adherence to preventive measures is influenced by their knowledge, perceived susceptibility, severity, benefit, barrier, cues to action, and self-efficacy. Therefore, this study investigated the predictors of COVID-19 prevention practice using the Health Belief Model among employees in Addis Ababa, Ethiopia, 2020.Methods: Multicentre cross-sectional study design was used. A total of 628 employees selected by systematic sampling method were included in this study. Data were collected using a pretested self-administered questionnaire. Summary statistics of a given data for each variable were calculated. Logistic regression model was used to measure the association between the outcome and the predictor variable. Statistical significance was declared at p-value< 0.05. Direction and strength of association were expressed using OR and 95% CI.Results: From a total of 628 respondents, 432 (68.8%) of them had poor COVID-19 prevention practice. Three hundred ninety-one (62.3%), 337 (53.7%), 312 (49.7), 497 (79.1%), 303 (48.2%) and 299 (52.4%) of the respondents had high perceived susceptibility, severity, benefit, barrier, cues to action and self-efficacy to COVID-19 prevention practice, respectively. Employees with a low level of perceived barriers were less likely to have a poor practice of COVID-19 prevention compared to employees with a high level of perceived barrier [AOR = 0.03, 95% CI (0.01,0.05)]. Similarly, employees with low cues to action and employees with a low level of self-efficacy were practiced COVID prevention measures to a lesser extent compared those with high cues to action and high level of self-efficacy [AOR = 0.05, 95% CI (0.026,0.10)] and [AOR = 0.08, 95% CI (0.04,0.14)], respectively.Conclusion: The proportion of employees with poor COVID-19 prevention was high. Income, perceived barrier, cues to action, and self-efficacy were significantly associated with COVID-19 prevention practice.Keywords: predictor, COVID-19, Health Belief Model, employees

Purpose: Escherichia coli strains that produce extended-spectrum ß-lactamase (ESBL) and carbapenemase are among the major threats to global health. The objective of the present study was to determine the distribution of ß-lactamase genes among multidrug-resistant (MDR) and ESBL-producing Diarrheagenic E. coli (DEC) pathotypes isolated from under-five children in Ethiopia., Patients and Methods: A cross-sectional study was conducted in Addis Ababa and Debre Berhan, Ethiopia. It was a health-facility-based study and conducted between December 2020 and August 2021. A total of 476 under-five children participated in the study. DEC pathotypes were detected by conventional Polymerase Chain Reaction (PCR) assay. After evaluating the antimicrobial susceptibility profile of the DEC strains by disk diffusion method, confirmation test was done for ESBL and carbapenemase production. ß-lactamase encoding genes were identified from phenotypically ESBLs and carbapenemase positive DEC strains using PCR assay., Results: In total, 183 DEC pathotypes were isolated from the 476 under-five children. Seventy-nine (43%, 79/183) MDR-DEC pathotypes were identified. MDR was common among enteroaggregative E. coli (EAEC) (58%, 44/76), followed by enterotoxigenic E. coli (ETEC) (44%, 17/39)) and enteroinvasive E. coli (EIEC) (30%, 7/23). Phenotypically, a total of 30 MDR-DEC pathotypes (16.4%, 30/183) were tested positive for ESBLs. Few ETEC (5.1%, 2/39) and EAEC (2.6%, 2/76) were carbapenemase producers. The predominant β-lactamase genes identified was bla TEM (80%, 24/30) followed by bla CTX -M (73%, 22/30), bla SHV (60%, 18/30), bla NDM (13%, 4/30), and bla OXA -48 (13%, 4/30). Majority of the ß-lactamase encoding genes were detected in EAEC (50%) and ETEC (20%). Co-existence of different β-lactamase genes was found in the present study., Conclusion: The bla TEM , bla CTX-M , bla SHV , bla NDM , and bla OXA-48 , that are associated with serious and urgent threats globally, were detected in diarrheagenic E. coli isolates from under-five children in Ethiopia. This study also revealed the coexistence of the β-lactamase genes., Competing Interests: The authors declare that they have no competing interests in this work., (© 2023 Zenebe et al.)

Background: Different vaccines have been approved for use against coronavirus disease and distributed globally in different regions. Efforts should be made on the vaccination to control the spread and impacts of the coronavirus pandemic. However, the general population's attitudes and intention to uptake coronavirus disease 2019 (COVID-19) vaccinations were poor., Objective: This study aimed to assess the barriers to and intention to be vaccinated against COVID-19 and the associated factors among adults in the Jimma zone, Ethiopia., Methods: A community-based cross-sectional study with multistage sampling was conducted with 621 participants from 16 April to 17 May 2022. Multivariable logistic regression was used to identify factors associated with the outcome of interest. Statistical p-value ≤0.05 was set at p ≤ 0.05. Qualitative data were supplemented with quantitative results., Results: The majority of the study participants (382 [61.5%]) intended to uptake the COVID-19 vaccine. In this study, travel history (Adjusted Odds Ratio (AOR) = 2.18, 95% CI 1.23-3.87), vaccination history (AOR = 2.64, 95% CI 1.69-4.12), perceptions of infection prevention for COVID-19 (AOR = 1.97, 95% CI 1.28-3.03), subjective norm (AOR = 2.27, 95% CI 1.52-3.39), and perceived behavioral control (PBC) (AOR = 2.30, 95% CI 1.55-3.41) were significantly associated with the intention to be vaccinated against COVID-19., Conclusion: More than half of the adult participants intended to be vaccinated against COVID-19. The study participant's traveling history, vaccination history, perception of infection prevention for COVID-19, subjective norms, and Perceived Behavioral Control were significantly associated with the intention to be vaccinated., Competing Interests: The authors report no conflicts of interest in this work., (© 2023 Sisay et al.)

Background: Staphylococcus aureus is the bacteria that colonizes the nasal nares of health-care workers and serves as a reservoir for the spread of pathogen for subsequent infections, mainly Methicillin-resistant Staphylococcus aureus . However, there is a limited study conducted regarding this topic in Harar, Eastern Ethiopia., Objective: The main objective of this study was to determine the prevalence of nasal carriage of Staphylococcus aureus , associated factors and antimicrobial susceptibility patterns among health-care workers of public hospitals in Harar, Eastern Ethiopia from May 15 to July 30, 2021., Methods: A hospital-based cross-sectional study was conducted on 295 health-care workers. A simple random sampling technique was used to select the participant. Nasal swabs were collected and cultured at 35°C for 24hrs. S. aureus was identified using the coagulase test and catalase test. Methicillin resistance S. aureus (MRSA) was screened using a cefoxitin disc on Muller Hinton agar using the Kirby-Bauer disc diffusion method. Data were entered into EPI-Info version-7 and transferred to SPSS-20 for analysis. Factors associated with nasal carriage of Staphylococcus aureus were determined by using chi-square analysis. A p -value of less than 0.05 was considered statistically significant., Results: The prevalence of Staphylococcus aureus in this study was 15.6% (95% CI: 11.7%, 20.3%) and methicillin-resistant Staphylococcus aureus was 11.2% (95% CI: 7.8%, 15.4%), respectively. Age (P < 0.001), work experience (p < 0.001), working unit (p < 0.02), antibiotic use within 3 months (p < 0.001), hand washing habit (p < 0.01), hand rub use (p < 0.001), living with smokers (p < 0.001), living with pets (p < 0.001) and having chronic diseases (p < 0.001) were found significantly associated with Staphylococcus aureus nasal carriage., Conclusion: The prevalence of Staphylococcus aureus and Methicillin-resistant Staphylococcus aureus are high in our study. The study emphasizes the need for regular surveillance among hospital staff and the environment to prevent MRSA transmission among health-care personnel., Competing Interests: The authors declare no conflicts of interest in this work., (© 2023 Wolde et al.)

Since the emergence of COVID 19, the authentic SARS-CoV-2 has evolved into a range of novel variants that are of more global concern. In late November 2021, the Omicron (lineage B.1.1.529) variant was identified as a new variant and considered as the fifth variant of concern. Omicron harbors a genetic profile that is exceedingly unusual, with a huge number of mutations. Above thirty mutations are localized in the S protein, while some are found in other structural and non-structural proteins. Half of the mutations in the S protein are in the RBD, which is a major target of antibodies, showing that Omicron mutations may affect antibody binding affinity to the S protein. The Omicron variant has been found to result in immune escape, therapeutic or vaccine escape, as well as increased transmissibility and reinfection risk, explaining its rapid international spread that sparks a global alarm even more serious than the previously reported variants. Omicron has the capability to bypass at least some of the multi-faceted immune responses induced by prior infection or vaccination. It is shown to extensively escape neutralizing antibodies while evading cell mediated immune defense to a lesser extent. The efficacy of COVID 19 vaccines against Omicron variant is decreased with primary vaccination, showing that the vaccine is less efficient in preventing Omicron infections. However, after receiving a booster vaccine dose, the immunological response to Omicron significantly improved and hold promising results. Despite the mild nature of the disease in most vaccinated people, the rapid spread of Omicron, as well as the increased risk of re-infection, poses yet another major public health concern. Therefore, effort should be devoted to maintaining the existing COVID 19 preventive measures as well as developing new vaccination strategies in order to control the fast dissemination of Omicron., Competing Interests: The authors declare no conflicts of interest in this work., (© 2022 Chekol Abebe et al.)

Background: Bacterial pathogens have evolved numerous defense mechanisms against commercial antimicrobial agents, and their resistance to most of the available antimicrobials is increasing. Medicinal plants are a potential source of antimicrobial agents during the spread and emergence of infectious disease caused by resistant microorganisms. The aim of this study was thus to investigate the antimicrobial activity and acute toxicity of 80% methanol extracts of leaves of Artemisia absinthium , seeds of Datura stramonium , and fruit of Solanum anguivi ., Materials and Methods: The 80% methanol extracts were prepared by cold maceration. Antimicrobial activity was evaluated against five bacterial species using agar-well diffusion at concentrations of 125, 250, and 500 mg/mL in the presence of positive and negative controls. Minimum inhibitory concentration was determined by broth dilution. The acute toxicity study was done following OECD guidelines., Results: The 80% methanol extract of the fruit of S. anguivi exhibited better activity against most of the bacterial strains, of which Salmonella enterica serovar Typhimurium was found to be the most susceptible, with minimum inhibitory concentration and minimum bactericidal concentration of 1.3 mg/mL and 1.95 mg/mL, respectively, while the seed extract of D. stramonium showed the least activity against most test organisms. The acute toxicity study showed that all three plants had an LD 50 >2,000 mg/kg body weight, and were thus safe., Conclusion: The results of this study revealed that the methanol extracts of the three plants ( A. absinthium , D. stramonium , and S. anguivi ) had different degrees of antibacterial activity against the selected pathogenic bacteria and were safe at higher doses, thus being of great potential to be developed as antibacterial agents. The study also provided scientific evidence to support the continued traditional use of these medicinal plants by communities in different parts of Ethiopia to treat infectious diseases., Competing Interests: The authors declare that they have no competing interests in this work., (© 2022 Arage et al.)

Background: Infections of sterile body fluids are susceptible to serious invasive bacterial infections and critical, with high morbidity and sequelae risk. This study has not been conducted previously in eastern Ethiopia., Objective: The present study was designed to determine the bacterial profile, associated factors, and their susceptibility to antimicrobial agents of isolates among patients with sterile body fluids at Hiwot Fana Specialized University Hospital, Harar, Eastern Ethiopia., Methods: Hospital-based cross-sectional study was conducted from April to June 2021 among 204 patients selected using a convenient sampling technique. Data were collected using a pretested structured questionnaire. All consenting patients submitting body fluid specimens for testing at the clinical laboratory were included and analyzed using standard microbiology methods. Antimicrobial susceptibility testing was performed using the disk diffusion method and interpreted as per Clinical and Laboratory Standards Institute guidelines. Data were double entered into Epi data version 4.6, exported, and analyzed using Statistical Package for Social Science version 25. Bivariate and multivariable logistic regressions were used to assess the association between outcome and predictor variables. P-value <0.05 was considered to be statistically significant., Results: The overall prevalence of bacteria among different sterile body fluid samples was 16.7% (95% CI: 12-22%). Most of the bacterial isolates (70.6%) were Gram-negative bacteria, mainly K. pneumoniae (26.5%) and E. coli (20.6%) . Multidrug resistance was identified in 76.5% of the isolates. Being inpatient (AOR = 3.59; 95% CI: 1.52, 8.51) and turbid appearance (AOR = 4.35; 95% CI: 1.67, 11.29) were significantly associated with culture growth rate., Conclusion: The prevalence of bacterial isolates in this study comprises about 17%. Gram-negative bacteria, particularly K. pneumoniae and E. coli, were the major etiologic agents. Being inpatient and the turbid appearance of the specimen were significantly associated with the culture-positive result. Significant numbers of multidrug-resistant bacteria were isolated, mainly against beta-lactams. Therefore, culture and susceptibility testing should be an integral part of the laboratory investigation., Competing Interests: Authors have no conflicts of interest., (© 2022 Shume et al.)

Background: The emergency of multidrug resistance due to the global burden of infectious diseases and drug misuse leads to an urgent identification of new medicines from medicinal plants. The study was designed to perform the documentation of ethno-medicinal plants usage, extraction, phytochemical screening and antimicrobial activities of the herbal extracts., Methods: A cross-sectional study design was conducted in this study. Maceration of plant extraction, phytochemical screening and disc diffusion method for antimicrobial activity tests were employed., Results: The results of the study indicated that Euphorbiaceae, Lamiaceae and Sapindaceae plant families have commonly used for the treatment of infectious diseases in the study areas. The antimicrobial activity test results indicated that Ostegia integrifolia Benth which was extracted with chloroform solvent showed equivalent inhibition zone as compared to standard drug, gentamicin. All the extracts could be considered as broad spectrum, have strong inhibition against E. coli, K. pneumoniae, S. aureus, P. aeruginosa and C. albicans . All extracts against C. albicans were also revealed strong inhibition activity as compared to fungal standard drug, contamazole., Conclusion: Phytochemical screening showed the existence of secondary metabolites in the studied plants and thus, supports the traditional healers' claim of such plants use for the treatment of diseases. The study also concluded that chloroform extracts of all plants showed promising antimicrobial activities against K. pneumonia , and C. albicans . Therefore, further in vitro and vivo antimicrobial activity study of chloroform extracts against these bacterial and fungal strains were recommended. Moreover, isolation and structural elucidation of bioactive compounds from chloroform extracts were also recommended., Competing Interests: The authors had declared no conflicts of interest for this work., (© 2021 Faye et al.)

Background: In Ethiopia, multidrug resistant tuberculosis is a major public health problem. However, information is scarce regarding MDR-TB and associated factors., Objective: The study was aimed to assess the magnitude of multidrug resistance and associated factors of pulmonary tuberculosis among adult smear-positive patients in Harari regional state health facilities, eastern Ethiopia., Methods: A cross-sectional study was conducted among 395 adult smear-positive pulmonary tuberculosis patients attending health facilities from March to October 2019. Smear-positive sputum samples were collected from health facilities, and transported to Harari Health Research and Regional Laboratory, and tested for drug susceptibility using a line probe assay. Data were analyzed using Statistical Package for Social Sciences version 20. Bivariate and multivariable logistic regression analyses with 95% confidence intervals were carried out to identify factors associated with multidrug-resistant tuberculosis., Results: The overall magnitude of multidrug-resistant tuberculosis was 3.8% (15/395) (95% CI: 2.0-5.8%). Being male (AOR = 4.9; 95% CI: 1.16, 20.5), patients with a previous history of tuberculosis (AOR = 4.9; 95% CI: 1.5, 29.6), treatment failure (AOR = 8.5; 95% CI: 1.61, 45.3), treatment default (AOR = 10.38; 95% CI: 1.86, 58.0), human immunodeficiency virus co-infection (AOR = 9.83.95% CI: 3, 21, 30.1) and a previous history of contact with multidrug-resistant tuberculosis patients (AOR = 14.4; 95% CI: 3.1, 67.6) had higher odds of multidrug-resistant tuberculosis., Conclusion: The overall magnitude of multidrug-resistant tuberculosis was high. Strengthening the tuberculosis control program by giving special attention to HIV co-infected patients,  treatment failure and default, previously infected patients as well as to those individuals who have a history of contact with multidrug-resistant tuberculosis infected patients ., Competing Interests: The author(s) declared no potential conflicts of interest concerning the research, authorship, and/or publication of this article., (© 2021 Amin et al.)

Background: Antimicrobial resistance is a worldwide concern due to the inappropriate and irrational use of antibiotics. Thus, this study was aimed at determining the knowledge and attitude of graduating health science students of Wollega University towards antimicrobial resistance., Methods: An institution-based cross-sectional study design was employed from June to July 2019. Epi-data version 3.1 was used to receive data and exported to SPSS version 25 for further analysis. Both bivariable and multivariable logistic regression analysis were done to find factors associated with attitudes of students towards antibiotic consumption and resistance at a 95% confidence level. The strength of association was measured with the odds ratio. Variables with a p -value of <0.05 at multivariable analysis were considered to be a significant variable. Finally, texts and simple frequency tables were used to present the findings., Results: Out of 249, 232 students were included in this survey yielding a response rate of 93.6%. Hundred fifty-eight (68.1%) of them had adequate knowledge about antibiotic identification, role, side effects, and resistance. Students with a family member who works in health and related professions had a lower probability of stopping antibiotics when they feel better (AOR = 0.50, 95% CI: 0.28-0.90) and using leftover antibiotics (AOR = 0.51, 95% CI: 0.28-0.92) compared to their counterparts., Conclusion: Students' knowledge on antibiotic identification, role, side effects, and resistance was suboptimal, and the attitude of students towards antibiotic consumption was unfavorable. Respondents having a family member in a health-related field showed a good attitude. Respondents with three years of study also had a good attitude, female gender showed good attitude, and urban residence were independent predictors of attitude toward antibiotic consumption. Training on antimicrobial resistance should be arranged for graduating class nursing and medical students, as they are the future prescribers., Competing Interests: The authors declare that they have no competing interests., (© 2020 Fetensa et al.)