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Surface water is one of the sources of global potable water. However, the quality of surface water has been degrading due to an increase in human activities. Hence, the present study was conducted to evaluate the spatial and temporal variability in drinking water physico-chemical and bacteriological characteristics from the different sources in Mizan-Aman, Ethiopia. The physico-chemical characteristics of water at the Kosokol site were found to be statistically different (p < 0.05) from the other sites (Gacheb, Tsit, Reservoir 1, and Reservoir 2 sites). The dry and wet season temperature (27.1 and 23.8°C), turbidity (37.4 and 54.8 NTU), pH (7.6 and 8.1), biological oxygen demand (18.1 and 20.7 mg/l), phosphate (2.4 and 3.5 mg/l), and ammonia (2.2 and 4.8 mg/l) of the water were beyond the acceptable limit set for drinking water by both Ethiopian standards (temperature: <15°C; turbidity: 7 NTU; pH: 6.5–8.5; BOD: 10 mg/l; phosphate: 0.02 mg/l; and ammonia: 1.5 mg/l) and the WHO standards (temperature: <15°C; turbidity: 5 NT U; pH: 6.5–8.5; BOD: 5 mg/l; phosphate: 0.01 mg/l; and ammonia: 1.5 mg/l). The total coliform (366.5 and 494.3 CFU/100 ml) and fecal coliform (209.5 and 278.3 CFU/100 ml) contents of the water in the dry and wet seasons are beyond the acceptable limits for drinking water by Ethiopian standards (total and fecal coliform: 0) and the WHO standards (total and fecal coliform: 0). The physico-chemical and bacteriological characteristics of the water in the wet season were found significantly higher than those (p < 0.05) in the dry season. In general, the water quality changes on a spatial and temporal basis in the study area. Thus, it is important to encourage water quality management works at the upper source sites of the catchment. Furthermore, the city water authority should reinforce safeguarding treatment processes, continuous monitoring of water quality as well as risk assessment and management practices. [ABSTRACT FROM AUTHOR]

Background: Early identification of patients at high risk of poor clinical outcomes is the key to success in saving the lives of patients with coronavirus disease 2019 (COVID-19). Neutrophil to Lymphocyte Ratio (NLR) is an easily available and cheap surrogate inflammatory marker, its baseline NLR role in African COVID-19 patients remains to be investigated. The objective of the study aimed to evaluate the role of NLR as a predictor of severity and mortality of COVID-19 patients admitted at the Millennium COVID 19 care center in Addis Ababa, Ethiopia. Methods: A cross-sectional study was conducted on patients with COVID-19 admitted to the Millennium COVID-19 care center from August 1 to October 30, 2021. Receiver Operating Characteristic curve analysis was used to calculate the area under the curve to assess the predictive capacity of NLR on mortality and severity. Multivariable logistic regression analysis was done to identify the association between independent variables and disease outcomes with an Adjusted Odds Ratio (AOR), P-value, and 95% CI for AOR were used for testing significance. Results: The NLR of 9.47 was identified as the optimal cut-off value for predicting mortality with a sensitivity of 88.7% and a specificity of 95.4% (Area Under the Curve (AUC):0.95, 95% CI 0.92– 98; P< 0.001) and the NLR of 5.86 was an effective threshold value in predicting the severity of disease with a sensitivity of 92.2% and a specificity of 75% (AUC:0.85, 95% CI 0.800– 0.905; P< 0.001). In multivariable logistic regression analysis, after adjusting for confounding factors, NLR of more than 9.47 and 5.86 was significantly associated with all‐cause of in‐hospital mortality (AOR=4.73, 95% CI, 1.19– 33.68; P< 0.02), and severity of disease (AOR=12.98, 95% CI 3.85– 43.80; P=0.001), respectively. Conclusion: NLR greater than 9.47 and 5.86 effectively predict mortality and severity of the disease, respectively. It provides an objective input for early decision-making in inpatient management especially in resources limited area. [ABSTRACT FROM AUTHOR]

Abstract Background The emergence of drug resistance is a major problem in malaria control. Combination of molecular genotyping and characterization of mutations or single nucleotide polymorphisms (SNPs) correlated with drug resistance can provide information for subsequent surveillance of existing and developing drug resistance patterns. The introduction of artemether/lumefantrine (AL) as first-line treatment, never used before in Ethiopia, allowed the collection of baseline data of molecular polymorphisms before a selection due to AL could occur. Method 97 patients with uncomplicated falciparum malaria were recruited from April to June 2006 and treated with either AL, quinine (Q) or atovaquone/proguanil (AP) in Jimma University Hospital, Ethiopia. Mutations or SNPs associated with resistance to these drugs were analysed by RFLP (pfdhfr, pfmdr1) and sequencing of the target genes (pfcytb, pfserca ). Results SNPs previously reported to be associated with resistance to the study drugs were identified in recrudescent and treatment sensitive isolates. A total of seven recrudescences were obtained. The pfmdr1 N86Y mutation was found in 84.5% of isolates. The triple mutation 51I,59R,108N of the pfdhfr gene occured in high frequency (83.3%) but no pfcytb mutation was detected. Sequencing showed a variety of previously described and new mutations in the pfserca gene. Conclusion The prevalence of mutations was in accordance with the expected patterns considering recent drug regimens. The broad introduction of AL and the cessation of former drug regimens might probably change the current distribution of polymorphisms, possibly leading to decreased sensitivity to AL in future. Continuous surveillance of molecular patterns in this region is, therefore, recommended.

Teff [Eragrostis tef (Zucc.)] grain yield is low due to lack of improved management practices. We evaluated grain yield and cost of planting methods (broadcast, row, and transplanting), row spacing (10, 15, 20, 25, and 30 cm), and seeding densities (2.5, 5.0, 7.5, 10, 15, 20, and 25 kg ha−1) for teff in the 2012 and 2013 cropping seasons at the Adet Agricultural Research Center farm in northwest Ethiopia. Transplanting (1,675 kg ha−1) resulted in 34 and 75% greater grain yield (P <.05) than row (1,247 kg ha−1) and broadcast planting (958 kg ha−1), respectively. Row planting gave greater (30%) grain yield than broadcasting. Seeding density did not significantly influence grain yield in broadcast or row planting. Row spacing significantly influenced grain yield under row planting but did not significantly influence grain yield under transplanting. Regression analysis indicated grain yield increased as seeding density increased from 2.5 to 10 kg ha−1, then declined at greater seeding densities for both broadcast and row planting. Grain yield declined sharply as row spacing increased from 15 to 30 cm for both transplanting and row planting. Partial‐budget analysis showed that although teff transplanting gave the greatest grain yield, it was not economical due to low straw (biomass) yield and high cost of labor. Row planting at a spacing from 10 to 15 cm at 15 kg seed ha−1 was the most economically effective teff production method, with a net benefit of $1,640 ha−1. [ABSTRACT FROM AUTHOR]

Background: The emergence of drug resistance is a major problem in malaria control. Combination of molecular genotyping and characterization of mutations or single nucleotide polymorphisms (SNPs) correlated with drug resistance can provide information for subsequent surveillance of existing and developing drug resistance patterns. The introduction of artemether/lumefantrine (AL) as first-line treatment, never used before in Ethiopia, allowed the collection of baseline data of molecular polymorphisms before a selection due to AL could occur. Method: 97 patients with uncomplicated falciparum malaria were recruited from April to June 2006 and treated with either AL, quinine (Q) or atovaquone/proguanil (AP) in Jimma University Hospital, Ethiopia. Mutations or SNPs associated with resistance to these drugs were analysed by RFLP (pfdhfr, pfmdr1) and sequencing of the target genes (pfcytb, pfserca ). Results: SNPs previously reported to be associated with resistance to the study drugs were identified in recrudescent and treatment sensitive isolates. A total of seven recrudescences were obtained. The pfmdr1 N86Y mutation was found in 84.5% of isolates. The triple mutation 51I,59R,108N of the pfdhfr gene occured in high frequency (83.3%) but no pfcytb mutation was detected. Sequencing showed a variety of previously described and new mutations in the pfserca gene. Conclusion: The prevalence of mutations was in accordance with the expected patterns considering recent drug regimens. The broad introduction of AL and the cessation of former drug regimens might probably change the current distribution of polymorphisms, possibly leading to decreased sensitivity to AL in future. Continuous surveillance of molecular patterns in this region is, therefore, recommended. [ABSTRACT FROM AUTHOR]

Many effective health system innovations fail to reach those who need them most, falling short of the goal of universal health coverage. In the 5 years since the Federal Ministry of Health in Ethiopia localised the Practical Approach to Care Kit (PACK) programme to support primary care reforms, PACK has been scaled-up to over 90% of the country's primary care health centres. Known as the Ethiopian Primary Healthcare Clinical Guideline (EPHCG), the programme comprises a comprehensive, policy-aligned clinical decision support tool (EPHCG guide) and an implementation strategy to embed comprehensive, integrated care into every primary care consultation for individuals over 5 years of age, while addressing barriers to streamlined primary healthcare delivery. We describe the components of the EPHCG programme and the work done to establish it in Ethiopia. Yamey's framework for successful scale-up is used to examine the programme and health system factors that enabled its scale-up within a 5-year period. These included high-level ministry leadership and support, a cascade model of implementation embedded in all levels of the health system, regular EPHCG guide and training material updates and strategies to generate stakeholder buy-in from managers, health workers, patients and communities. Challenges, including stakeholder resistance, training fidelity and quality and procurement of medicines and diagnostic tests, are described, along with efforts to resolve them. Insights and learnings will be of interest to those implementing PACK programmes elsewhere, and managers and researchers responsible for design and delivery of health systems strengthening innovations at scale in low-income and middle-income countries., Competing Interests: Competing interests: RVC, LRF, DG-P and C-JR developed the PACK programme and mentored its localisation and implementation in Ethiopia. CH and AB led evaluations of EPHCG implementation. The rest of the co-authors led the EPHCG implementation., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY. Published by BMJ.)