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Abstract Background Sweet syndrome (acute febrile neutrophilic dermatosis) is an uncommon inflammatory disorder characterized by the abrupt appearance of painful, edematous, and erythematous papules, plaques, or nodules on the skin. There are various subtypes, such as classical, drug-induced, malignancy-associated, and the less common variant giant cellulitis-like Sweet syndrome. This case is unique due to its presentation of the giant cellulitis-like variant of Sweet syndrome in a patient from Ethiopia. The unusual distribution of the skin lesions and the initial lack of response to antibiotics make this case particularly noteworthy. It underscores the importance of considering Sweet syndrome in differential diagnoses when faced with atypical skin manifestations and ineffective antibiotic treatment. This contribution adds valuable insights to the scientific literature by highlighting the need for heightened awareness of this rare variant and improving diagnostic accuracy in similar clinical scenarios. Case presentation A 60-year-old Ethiopian male patient who presented to the accident and emergency department with a 5-day history of fever, chills, sweating, and rigor accompanied by a reddish skin color change around the anterolateral region of the right chest wall. On physical examination, there were erythematous, indurated tender plaques with ill-defined borders over the right antero- and posterolateral chest wall with extension to the lateral part of the right neck and medial aspect of the right arm. Subsequently, the patient was started on antibiotics, but there was a suboptimal response. Skin biopsy revealed features suggestive of giant cellulitis-like Sweet syndrome. He was then started on steroids, which significantly improved his symptoms. Conclusion A cautious stance is essential when identifying Sweet syndrome in individuals displaying erythematous plaque-like skin lesions in atypical areas of the body with uneven distribution. Such presentation may signal Sweet syndrome rather than a common infection. If conventional treatments, such as antibiotics, fail to resolve symptoms, consider Sweet syndrome as a potential diagnosis. This approach ensures timely and appropriate treatment, preventing treatment delay and misdiagnosis.

Optimizing agricultural crop production involves utilizing proper irrigation and fertilization techniques. A two-year experiment conducted in the Tselemty district during the off seasons of 2019 and 2020 aimed to assess the impact of varying irrigation levels and nitrogen fertilizer application rates on the growth, yield, and crop water productivity of pepper. The study included three irrigation levels (75%, 100%, and 125% of the required irrigation) and three nitrogen fertilizer application rates (75%, 100%, and 125% of the recommended amount). Analysis of the results using Gen-Stat software revealed that most pepper yield attributes were not significantly affected by the different irrigation and fertilizer levels. However, the marketable yield showed significant variation based on the combined application rates. The research indicates that, under ideal circumstances, the optimal approach for pepper growers is a combination of meeting 100% of the irrigation requirement and applying 100% of the recommended nitrogen fertilizer rate. Nevertheless, in scenarios where water resources are limited and fertilizer expenses are high, a reduced irrigation level of 75% of the requirement coupled with 75% of the recommended nitrogen fertilizer rate could be a viable alternative that does not lead to a substantial decrease in yield.

Abstract Background Worldwide, 10% of postpartum women experience postpartum depression, which can lead to diverse sequalae at individual, family, and societal levels. In sub-Saharan Africa, it is estimated that 17% of women experience depression in the postpartum period, which could be an underestimate as 48% of women in the region do not receive postnatal care (81% in Ethiopia and 51% in Guinea) and a large share of postpartum depression remains undiagnosed and untreated as a result. Globally, despite a critical evidence gap, there are growing reports of postpartum depression among women mistreated (disrespected and abused) during childbirth in health facilities, making a strong case to examine the association between mistreatment and postpartum depression. This study in Addis Ababa (Ethiopia) and Conakry (Guinea) uses a mixed methods design to 1) examine the link between mistreatment and postpartum depression, 2) explore the health system capacity to provide respectful maternity care and maternal mental health services, and 3) explore the experiences of women in accessing care and support for postpartum depression. Methods We will conduct a prospective longitudinal survey of women (434 in Addis Ababa and 408 in Conakry) from the third trimester of pregnancy to eight weeks postpartum and carry out in-depth interviews with key health system informants (20–25 in each city) and women who recovered from a clinically confirmed episode of postpartum depression (15–25 in each city). Quantitative data from the women’s survey will be analysed using a multilevel mixed-effects model; qualitative data from key-informants will be analysed by using a hybrid thematic analysis approach, whereas data from women’s in-depth interviews will be analysed using the phenomenological approach. The inclusion of two different settings in our study (Addis Ababa and Conakry) will enable us to apply a comparative health systems lens to explore the dynamics of respectful maternity care and maternal mental health services within the broader health systems of the two countries (Ethiopia and Guinea). Discussion The findings from this study will inform actions aimed at mitigating the mistreatment of women in maternity settings and improving promotive, preventive, and treatment interventions for postpartum depression in Ethiopia and Guinea. The findings can also be extrapolated to other low-resource settings.

Abstract Introduction Opportunistic infections (OIs) are more common and severe among people with suppressed immunity like those living with HIV/AIDS (PLWH). This study aimed to assess the prevalence of OIs and associated factors among PLWH attending antiretroviral therapy (ART) clinics in the Gedeo zone, Southern Ethiopia. Methods A facility based retrospective cohort study was conducted from April to June 2018 among PLWH attending ART clinics in Gedeo zone, Ethiopia from November 2016 – November 2017. A simple random sampling method was used to select the both paper based and electronic study participants’ charts. Adjusted odds ratios were calculated using multivariable logistic regression analysis for variables statistically significant at 95% confidence interval under bivariable logistic regression analysis, and significance was declared at P

Abstract Background The injectable shorter multi-drug resistant tuberculosis (MDR-TB) regimen, has been reported to be less costly and more effective in the treatment of MDR-TB compared to the longer regimen. Ethiopia introduced the injectable shorter regimen (SR) in April 2018 following official recommendation by the World Health Organization (WHO) in 2016. While the WHO recommendation was based on evidence coming from extensive programmatic studies in some Asian and African countries, there is paucity of information on patient outcomes in the Ethiopian context. Thus, we aimed to assess the treatment outcomes and identify factors associated with the outcomes of MDR-TB patients on injectable SR. Methods A multi-center facility-based retrospective cohort study was conducted in Ethiopia on 245 MDR-TB patients who were treated between April 2018 and March 2020. Data were collected from patients’ medical records and analyzed using SPSS version 25. Descriptive statistics was used to summarize the results while inferential analysis was employed to investigate predictors of treatment outcomes and survival status. Results A total of 245 patients were included in the study, with 129 (52.7%) of them being female. Median age of the patients was 27 (IQR: 21–33). The overall treatment success rate was 87.8%, with 156 (63.7%) cured and 59 (24.1%) patients who completed treatment. The unfavorable outcomes accounted for 12.2%, with 16 (6.5%) treatment failure, 8 (3.3%) death and 6 (2.4%) lost to follow up. Majority of the unfavorable outcomes occurred during the early phase of therapy, with median time to event of 1.8 months (95% CI: 0.99—2.69). The use of khat (a green leafy shrub abused for its stimulant like effect) and being diagnosed with MDR-TB than rifampicin resistant only, were identified as independent factors associated with unfavorable outcomes. Conclusion The injectable SR for MDR-TB was found to have positive treatment outcomes in the context of programmatic management in Ethiopia.

Abstract Background Economic relief programs are strategies designed to sustain societal welfare and population health during a regional or global scale infectious disease outbreak. While economic relief programmes are considered essential during a regional or global health crisis, there is no clear consensus in the literature about their health and non-health benefits and their impact on promoting equity. Methods We conducted a scoping review, searching eight electronic databases from January 01, 2001, to April 3, 2023, using text words and subject headings for recent pathogens (coronavirus (COVID-19), Ebola, Influenza, Middle East Respiratory Syndrome (MERS), severe acute respiratory syndrome (SARS), HIV, West Nile, and Zika), and economic relief programs; but restricted eligibility to high-income countries and selected diseases due to volume. Title and abstract screening were conducted by trained reviewers and Distiller AI software. Data were extracted in duplicates by two trained reviewers using a pretested form, and key findings were charted using a narrative approach. Results We identified 27,263 de-duplicated records, of which 50 were eligible. Included studies were on COVID-19 and Influenza, published between 2014 and 2023. Zero eligible studies were on MERS, SARS, Zika, Ebola, or West Nile Virus. We identified seven program types of which cash transfer (n = 12) and vaccination or testing incentive (n = 9) were most common. Individual-level economic relief programs were reported to have varying degrees of impact on public health measures, and sometimes affected population health outcomes. Expanding paid sick leave programs had the highest number of studies reporting health-related outcomes and positively impacted public health measures (isolation, vaccination uptake) and health outcomes (case counts and the utilization of healthcare services). Equity impact was most often reported for cash transfer programs and incentive for vaccination programs. Positive effects on general well-being and non-health outcomes included improved mental well-being and quality of life, food security, financial resilience, and job security. Conclusions Our findings suggest that individual-level economic relief programs can have significant impacts on public health measures, population health outcomes and equity. As countries prepare for future pandemics, our findings provide evidence to stakeholders to recognize health equity as a fundamental public health goal when designing pandemic preparedness policies.

Abstract Introduction Hypoglycemia is a common occurrence in diabetic patients. But unlike non diabetic patients, its causes are frequently related to drugs they are receiving to control blood glucose. But this may not always be the case. Here we report a type 2 diabetic patient with severe hypoglycemia owing to acute hypopituitarism secondary to pituitary apoplexy. Case presentation A 45 year old male diabetic patient from Ethiopia taking 2 mg of oral glimepiride daily who presented with change in mentation of 30 minutes and blood glucose recording of 38 mg/dl upon arrival to the emergency room. Brain magnetic resonance imaging showed pituitary macroadenoma with hemorrhage suggestive of pituitary apoplexy. Blood work up showed low adrenocorticotropic hormone, cortisol, and serum sodium levels. Subsequently transsphenoidal hypophysectomy was done. Conclusion The occurrence of hypoglycemia in a diabetic patient taking sulphonylurea monotherapy is common. But when it is severe enough to cause altered mentation, patients should be approached differently. In the presence of clinical clues suggesting cortisol deficiency, hypopituitarism can be a possible cause.

This study presents an engineering geological investigation aimed at assessing the bearing capacity of the proposed site for the Meli gold processing plant (GPP) located in the northwestern region of Tigray, Ethiopia. The geological composition of the site predominantly comprises low-grade metamorphic rocks, with intermediate metavolcanic rocks being the most prevalent. This research utilized an innovative combination of empirical methodologies, including the Hoek–Brown and Mohr–Coulomb criteria, to evaluate the strength and elasticity characteristics of the rock mass. Additionally, the rock mass foundation for the GPP was rigorously classified using renowned systems such as the rock mass rating (RMR), quality index (Q), and geological strength index (GSI). Employing five different empirical equations to estimate bearing capacity, this study significantly advances our understanding by comparing these diverse methodologies, which is a novel approach in this geological context where engineering property data are scarce or non-existent. The bearing capacities determined using the Hoek–Brown and Mohr–Coulomb criteria ranged from 11.6 to 46.2 MPa and 7.9 to 10.5 MPa, respectively. These findings not only offer valuable insights into the assessment of bearing capacity in metamorphic rock formations but also underscore the effectiveness of combining multiple empirical approaches to enhance the reliability of geological assessments. This research contributes to the advancement of construction practices and enhances project planning strategies in comparable geological environments, particularly highlighting the utility of robust empirical data in the absence of extensive drilling data. By integrating comprehensive empirical analyses, the study provides a methodological framework that significantly aids in informed decision-making for future projects located in similar geological settings.

Abstract The urgency to restore landscapes to counteract deforestation, soil degradation, and biodiversity loss has resulted in a global commitment to landscape restoration. Many frameworks and tools have emerged for the design and implementation of restoration activities. The frameworks tend to focus on selected dimensions of sustainability, with the majority focusing on the ecological. Current frameworks miss a balanced assessment of (planned) interventions taking into account also the social dimension relating to participation and ownership as well as improvement of livelihoods. The objective of this review is to assess current frameworks for identification of strength and weaknesses and to derive an integrated Forest Landscape Restoration (FLR) assessment framework model that shall help overcome current limitations. Applying systematic literature review, a total of 22 frameworks are selected and analyzed in-depth applying qualitative content analysis. Our review finds that frameworks vary with respect to their focus and restoration objectives. They also differ in relation to spatial and temporal scale, degree of stakeholder participation, consideration of ecological and social dimensions, monitoring and evaluation approaches, as well as provisions for exit strategies. Findings are summarized in form of an integrated FLR assessment framework, comprising six interlinked components: stakeholder participation, customization, time and scale of application, social-ecological balance, monitoring, evaluation and learning, and exit strategy. The proposed framework facilitates design and implementation of context specific interventions, balancing the nexus of social and ecological dimensions of FLR and acknowledges the need to also include reflection on learnings and planning of an exit strategy for long-term success. Graphical Abstract

Abstract Background Foot and mouth disease is a contagious, transboundary, and economically devastating viral disease of cloven-hoofed animals. The disease can cause many consequences, including decreased productivity, limited market access, and elimination of flocks or herds. This study aimed to assess farmers’ willingness to pay (WTP) for foot and mouth disease (FMD) vaccines and identify factors influencing their WTP. A cross-sectional questionnaire survey was conducted on 396 randomly selected livestock-owning farmers from three districts in the central Oromia region (Ambo, Dendi, and Holeta districts. The study utilized the contingent valuation method, specifically employing dichotomous choice bids with double bounds, to evaluate the willingness to pay (WTP) for the FMD vaccine. Mean WTP was assessed using interval regression, and influential factors were identified. Results The study revealed that the farmer’s mean willingness to pay for a hypothetical foot and mouth disease vaccine was 37.5 Ethiopian Birr (ETB) [95% confidence interval [CI]: 34.5 40.58] in all data, while it was 23.84 (95% CI: 21.47–26.28) in the mixed farming system and 64.87 Ethiopian Birr (95% CI: 58.68 71.15) in the market-oriented farming system. We identified main livelihood, management system, sales income, breed, keeping animals for profit, and foot and mouth disease impact perception score as significant variables (p ≤ 0.05) determining the farmers’ WTP for the FMD vaccine. Conclusion Farmers demonstrated a high computed willingness to pay, which can be considered an advantage in the foot and mouth disease vaccination program in central Oromia. Therefore, it is necessary to ensure sufficient vaccine supply services to meet the high demand revealed.

Abstract Climate change significantly affects the diversity, growth, and survival of indigenous plant species thereby influencing the nutrition, health and productivity of honey bees (Apis mellifera). Hypoestes forskaolii (Vahl) is one of the major honey bee plant species in Ethiopia’s Tigray region. It is rich in pollen and nectar that typically provides white honey, which fetches a premium price in both local and inter-national markets. Despite its socio-economic and apicultural significance, the distribution of H. forskaolii has been declining, raising concerns regarding its conservation efforts. However, there is limited knowledge on how environmental and climatic factors affect its current distribution and response to future climate change. The study investigates the current and projected (the 2030s, 2050s, 2070s, and 2090s) habitat distributions of H. forskaolii under three future climate change scenarios (ssp126, ssp245, and ssp585) using the Maximum Entropy Model (MaxEnt). The results show that land use (50.1%), agro-ecology (28%), precipitation during the Driest Quarter (11.2%) and soil texture (6.1%) predominantly influence the distribution of H. forskaolii, collectively explaining 95.4% of the model's predictive power. Habitats rich in evergreen trees and mosaic herbaceous with good vegetation cover are identified as the most suitable for H. forskaolii. The spatial distribution of H. forskaolii is concentrated in the highlands and mid-highlands of the eastern and southern parts of Tigray, characterized by a colder temperature. Across the three climate change scenarios, the size of suitable habitat for H. forskaolii is projected to decrease over the four time periods studied. Predictions under the ssp585 scenario reveal alarming results, indicating a substantial decrease in the suitable habitat for H. forskaolii from 4.26% in the 2030s to 19.09% in the 2090s. Therefore, given the challenges posed by climate change, research efforts should focus on identifying and evaluating new technologies that can help the H. forskaolii species in adapting and mitigating the effects of climate change.

Abstract Background We aimed to compare anticoagulation control and outcomes between usual medical care (UMC) and pharmacist-led anticoagulation services (PLAS) in patients receiving warfarin at the Tikur Anbessa Specialized Hospital (TASH), Addis Ababa, Ethiopia. Methods A quasi-experimental study was conducted, including 350 (66.7%) and 175 (33.3%) patients from the UMC and PLAS groups, respectively, from 525 patients. The time in therapeutic range (TTR) was determined using the Rosendaal method, with a TTR ≥ 65% set as the cut-off for optimal anticoagulation. The two-sample Wilcoxon rank-sum (Mann–Whitney U) test was used to compare continuous variables between groups. Categorical variables were compared between groups using Pearson’s chi-square test or Fisher’s exact test. Logistic regression and negative binomial regression analyses were conducted to identify the factors associated with suboptimal TTR and secondary outcomes, respectively, at the p values

Abstract Background Civilian war and internal conflicts increase the incidences of mental health conditions among war survivors. It is crucial to assess war-related psychological consequences in war-affected areas in Ethiopia to intervene in the future. Thus, this study aimed to determine the magnitude of psychological distress and associated factors of psychological distress among war survivor women in Northern, Ethiopia. Methods A community-based cross-sectional survey was conducted, and 1596 war survivor women were recruited to participate using a face-to-face interviews with a census sampling technique from May 1–30, 2022. The psychological distress was assessed using a Kessler psychological distress scale (K10). Bi-variable and multi-variable logistic regression analyses were used, and variables with a p-value less than 0.05 in the multivariable analyses were considered statistically significant. Result In this study, the response rate was 100% and the prevalence of psychological distress was 44.90% at a 95% CI: (42.40, 47.40). Psychological distress was significantly associated with the education of ability to read and write (AOR = 2.92; 95% CI: 2.12, 4.01), primary education and above (AOR = 3.08; 95% CI: 2.09, 4.54), housewife (AOR = 5.07; 95%CI: 2.64, 9.74), farmer (AOR = 8.92; 95%CI: 4.03, 19.70), emotional violence (AOR = 1.52; 95%CI: 1.05, 2.18), physical violence (AOR = 3.85; 95%CI: 2.37, 6.26) and sexual violence (AOR = 3.25; 95%CI: 1.98, 5.33) whereas being separate was protective for psychological distress (AOR = 0.38; 95%CI: 0.16, 0.92). Conclusion The prevalence of psychological distress was found to be high. Therefore, women who are housewives, married, farmers, educated, and who have experienced violence must be the focus of governmental and private collaborative interventions to prevent war-related psychological morbidity and mortality.

Abstract Nutrition-sensitive agriculture is an approach that aims to ensure the production of affordable, safe, culturally appropriate, and nutritious foods in sufficient quantity and quality to meet dietary needs. This study aims to examine the production pathway by which smallholder farmers adopt nutrition-sensitive agriculture in northwest Ethiopia. Data were collected from 478 randomly sampled households through a structured questionnaire-based survey, observations, and group discussions. Descriptive and inferential statistics were employed for analysis. Binary logistic regression analysis was used to estimate the influences of demographic, socioeconomic, and institutional explanatory variables on the production of various food groups in households. Arable land owned by households, the use of irrigation, access to the nearest markets, contacts with agricultural extension workers, and management practices affect plant-sourced food production. On the other hand, the number of livestock owned, the total crop produced, and contacts with extension workers affected animal-sourced food production. However, different factors, such as technological, institutional, and managerial challenges, that include dependency on rain-fed and free-grazing-based traditional herding systems adversely affect the production pathway to nutrition-sensitive agriculture. The study concludes that improving agricultural extension services, promoting small-scale irrigation schemes, and introducing improved animal feeding with improved crop and livestock management techniques could significantly contribute to increased household availability of diversified foods.

Universities around the world have faced challenges in maintaining face-to-face knowledge sharing. Knowledge sharing through web technology is an essential solution for all universities. However, web technology-based knowledge-sharing practices in developing countries such as Ethiopia face many challenges. This study examines the factors that challenge the use of web technologies for knowledge-sharing practices by academic staff and presents recommendations to improve the current environment in Ethiopian public universities. The study employed semi-structured interviews with 30 respondents and analyzed the data using Nvivo qualitative data analysis software. The results revealed that lack of technical skill, lack of systems integrated into teaching-learning practice, lack of awareness, lack of an appropriate reward system, lack of commitment from top management, lack of a knowledge-sharing policy, and a lack of knowledge mapping are among the identified challenges hindering the knowledge-sharing practice of academic staff. These findings provide evidence of knowledge-sharing practices and give insights regarding enhancing knowledge-sharing practices within higher education. In addition, this study also contributes to the body of knowledge about the challenges of knowledge sharing. The findings will benefit academic staff, university administrations, and higher education institutions. Future studies could consider replicating this study from a quantitative method perspective with a larger sample size focused on Ethiopian public higher education. This study could also be considered for replication from the perspective of private higher education.

Abstract Land degradation is one of the major challenges causing food insecurity and instability in Ethiopia. A comprehensive study on trends and drivers of land degradation and, socioeconomic and ecological impact of land degradation is necessary for an effective and sustainable mitigation measures. This study reviewed the drivers, trends and impacts of land degradation, existing sustainable land management (SLM) practices, and policies for land use and resources management. We employed the keyword research acquisition approach to review 122 scientific papers, reports, and other documents. The scientific literatures in the study were accessed through as the Web of Science, Scopus, and Google Scholar search engines, while reports and other additional materials were sourced from a variety of repositories and governmental offices. There has been a substantial increase in soil erosion since the 1980s in the highlands of Ethiopia. Illegal logging, poor land management system, overgrazing of pasturelands, population growth, insecure land tenure, war and conflict, poverty, ineffective government policies and programs, institutional issues, poor rural markets, and low agricultural inputs remained the major drivers for land degradation in Ethiopia causing huge loss of agricultural production and environmental unsustainability. Biological and physical soil and water conservation measures, exclosure establishment, afforestation, and reforestation programs are the most common intervention measures of preventing and restoring degraded lands. SLM practices such as intercropping systems, composting, crop rotation, zero grazing, minimum tillage, agroforestry and rotational grazing has been implemented across the country. However, land security and the absence of clearly defined property rights are the major factors that influence farmers’ decisions for a long-term investment on land resources. Thus the SLM practices and various restoration interventions remain a critical requirement to address the growing concerns of land degradation in Ethiopia.

Abstract Background This study examines medication adherence among kidney transplant patients at St. Paul’s Hospital Millennium Medical College (SPHMMC) in Addis Ababa, Ethiopia, focusing on the level of adherence and associated factors to immunosuppressant medicines. Methods and materials A cross-sectional study was conducted on 270 patients from October 2021 to January 2022 using a structured questionnaire analyzed with SPSS version 26. The prevalence of medication adherence was computed, and a binary logistic regression was fitted to estimate the association. Medication adherence level measurement in post-kidney transplant patients was assessed using the Simplified Medication Adherence Questionnaire (SMAQ) and Basel Adherence Assessment Scale in Immunosuppressants (BAASIS). A 95% confidence interval and p-value

Summary: Objective: Assess dietary quality and contribution of school meals to energy and nutrient needs of school adolescents. Methods: A school-based cross-sectional study was conducted. A total of 293 adolescents were selected from 20 selected schools. A multiple-pass 24-hour recall method employed to collect dietary intake from adolescents. Then compared to the Recommended Dietary Allowance (RDA) to identify sub-optimal quality, with school meals below two-thirds of the RDA serving as an indicator. Dietary diversity was assessed with a 12-food group score using STATA software. Results: The study revealed inadequate nutrition in school meals for adolescents. While school meals provided an adequate contribution of carbohydrates (74.4% of the RDA), the contribution for other nutrients was low: energy (34.1%), protein (42.5%), calcium (9.3%), zinc (14.6%), iron (52.9%), vitamin A (14.0%), thiamine (16.7%), vitamin B12 (12.8%), and niacin (3.8%). The study also revealed a high prevalence of inadequate intakes of priority nutrients among school adolescents, including protein (57.5%), carbohydrates (25.6%), calcium (90.7%), zinc (85.4%), iron (47.1%), vitamin A RAE (86.0%), vitamin C (86.0%), thiamine (83.3%), vitamin B12 (90.2%), and niacin (96.2%). Despite high dietary diversity, key nutrient deficiencies persisted in both school meals and overall 24-hour meals. Conclusion: Nutrient deficiencies in school adolescents necessitate prioritizing menu planning with nutrient-dense foods, implementing cost-effective strategies with locally sourced options, establishing nutrition education programs, and collaborating with stakeholders on tailored initiatives like community gardens, local farmer partnerships, and subsidized/free nutritious meals to address deficiencies and promote well-being.

Open burning poses a significant threat to human health and the environment by releasing hazardous chemicals and exacerbating plastic pollution. Urgent action is required to address its pervasive impact and the substantial release of gaseous pollutants. Limited research has explored the demographic aspect of open burning behavior, with none specifically conducted in Kentucky. An analysis of open burning complaints reported to the Kentucky Division for Air Quality in 2015, 2019, and 2021 revealed no significant differences in reported incidents by month and county. Binary logistic regression analyses identified the urban vs rural divide as significant predictors of open burning incidents, while violations were influenced by both urban and rural factors and average household income. Unemployment rates and the percentage of individuals with less than a high school diploma did not significantly predict open burning violations. Targeted interventions at the state and local level, focusing on rural areas and economically disadvantaged communities, can effectively address and mitigate open burning issues.

Abstract The treatment of immune thrombocytopenia (ITP) is challenging and treatment outcomes depend on numerous unknown and patient-specific factors. Corticosteroids are the cornerstone of ITP treatment, but they are associated with many side effects. In this retrospective cohort study, treatment outcomes and treatment adherence in patients with ITP were investigated in 214 ITP patients from November 15, 2022 to March 15, 2023. Multinomial regression analysis models were used to identify predictive factors for treatment outcomes. A p value of less than 0.05 was considered statistically significant. Most study participants were female 161 (75.5%), and the majority 172 (80.4%) of them were taking prednisolone only. In terms of treatment adherence, 178 (83.2%) of the study participants adhered well to their ITP medications. The complete response rate at 3 months was 139 (65.0%). Predictive factors for partial response were increased negative impact of ITP on health-related quality of life (AOR = 1.221, 95% CI 1.096–1.360), being treated at Tikur Abessa Sepcialazed Hospital (AOR = 0.431, 95% CI 0.197–0.941) and the presence of heavy menstrual bleeding (AOR = 2.255, 95% CI 0.925–5.497) compared to patients with complete response. Hepatitis B virus-infected ITP patients (AOR = 0.052, 95% CI 0.004–0.621) were also a predictive factor for no response compared to complete response.

Abstract Background Food insecurity is a state or condition in which people have limited or uncertain physical, social, and economic access to safe, sufficient, and nutritious food to meet their dietary needs. Since no thorough evaluation was carried out to determine the degree of household food insecurity in Tigrayan communities in the aftermath of the conflict. This study aims to describe household-level food insecurity status among pregnant and lactating women during the post-armed conflict in Tigray, Ethiopia. Method Descriptive research was designed to assess household food insecurity. A multi-stage sampling technique was used for this study. One thousand two hundred forty-nine households were selected systematically following a list of food insecure households. Descriptive statistical values, including frequency counts, percentages, minimum values, maximum values, and averages, were calculated to quantify the indicators under study. Household food insecurity and hunger Scale measurement using the standardized Food and Agriculture Organization standard. Results The mean age (± SD) of the mothers was 28.35 ± 5.91 years. More than three fourth of the participants 1010(80.93%) were rural residents. The survey result showed that 88.8% of the pregnant and lactating were food insecure. Half (50.1%) of the households were hungry,one month before the study, 78.5% of the families expressed concern about running out of food and 6.4% had severe hunger. Conclusions The food insecurity levels and hunger prestige of the study communities were excessively high. This is in the context of a region affected by intense armed conflict. It is commended that the study communities need to be safeguarded from the direct and long-term consequences of armed conflict-caused household food insecurity.

Abstract Analyzing the dynamics of parking traffic can better represent the real dynamic states of road networks, thereby allowing for a deeper analysis of the parking system’s impact. This paper comparatively investigates the impact of parking policies on two traffic networks with different infrastructure, socio-economic, and policy characteristics. Parking space, average parking duration, and parking fee policies were analyzed as a function of cruising distances and cruising time with indirect effects on traffic emissions. Empirically, the system dynamics model application is tested and validated with the macroscopic data from two central business districts (CBDs) in Shanghai (Xujiahui area) and Zurich (Bahnhofstrasse area). Results showed Bahnhofstrasse CBD is more sensitive against the policy shifts with relatively higher elasticity and indicated greater responsiveness in aggregating traffic emissions when compared with Xujiahui CBD. The findings of this study may provide an overall framework to empirically assess the performance of different traffic conditions and strategies on urban parking systems.

Abstract Background Despite the fact that Sub-Saharan Africa bears a disproportionate burden of armed conflicts and HIV infection, there has been inadequate synthesis of the impact of armed conflict on HIV treatment outcomes. We summarized the available evidence on the impact of armed conflicts on HIV treatment outcomes in Sub-Saharan Africa from 2002 to 2022. Methods We searched four databases; MEDLINE, PubMed, CINHAL, and Scopus. We also explored grey literature sources and reviewed the bibliographies of all articles to identify any additional relevant studies. We included quantitative studies published in English from January 1, 2002 to December 30, 2022 that reported on HIV treatment outcomes for patients receiving antiretroviral therapy (ART) in conflict and post-conflict areas, IDP centers, or refugee camps, and reported on their treatment outcomes from sub-Saharan Africa. Studies published in languages other than English, reporting on non-ART patients and reporting on current or former military populations were excluded. We used EndNote X9 and Covidence to remove duplicates, extracted data using JBI-MAStARI, assessed risk of bias using AHRQ criteria, reported results using PRISMA checklist, and determined Statistical heterogeneity using Cochran Q test and Higgins I2, R- and RevMan-5 software were used for meta-analysis. Results The review included 16 studies with participant numbers ranging from 102 to 2572. Lost To Follow-Up (LTFU) percentages varied between 5.4% and 43.5%, virologic non-suppression rates ranged from 25 to 33%, adherence rates were over 88%, and mortality rates were between 4.2% and 13%. A pooled meta-analysis of virologic non-suppression rates from active conflict settings revealed a non-suppression rate of 30% (0.30 (0.26–0.33), I2 = 0.00%, p = 0.000). In contrast, a pooled meta-analysis of predictors of loss to follow-up (LTFU) from post-conflict settings identified a higher odds ratio for females compared to males (1.51 (1.05, 2.17), I2 = 0%, p = 0.03). Conclusion The review highlights a lack of research on the relationship between armed conflicts and HIV care outcomes in SSA. The available documents lack quality of designs and data sources, and the depth and diversity of subjects covered.

Abstract Background More than 70% of the health facilities in Tigray, northern Ethiopia, have been totally or partially destroyed by the recent war in the region. Diagnosis and management of tuberculosis were among many health services that suffered. In this study we assess the status of tuberculosis care in health facilities of Tigray during the recent war and compare it with the immediate pre-war state. Methods Using sequential mixed method, we analyzed and compared the availability of diagnostic services in 69 health facilities and the utilization of tuberculosis care in 50 of them immediately before the war (September-October 2020) and during the war (November-July 2021). TB focal persons in each selected health facility were interviewed to evaluate the status of diagnostic services. Patient service utilization was assessed using health facility registrations. We also compared the average monthly case detection rate of multidrug resistant tuberculosis in the region before and during the war. We computed summary statistics and performed comparisons using t-tests. Finally, existing challenges related to tuberculosis care in the region were explored via in-depth interviews. Two investigators openly coded and analyzed the qualitative data independently via thematic analysis. Results Among the 69 health facilities randomly selected, the registers of 19 facilities were destroyed by the war; data from the remaining 50 facilities were included in the TB service utilization analysis. In the first month of the war (November 2021) the number of tuberculosis patients visiting health facilities fell 34%. Subsequently the visitation rate improved steadily, but not to pre-war rates. This reduction was significant in northwest, central and eastern zones. Tuberculosis care in rural areas was hit hardest. Prior to the war 60% of tuberculosis patients were served in rural clinics; this number dropped to an average of 17% during the war. Health facilities were systematically looted. Of the 69 institutions assessed, over 69% of the microscopes in health centers, 87.5% of the microscopes in primary hospitals, and 68% of the microscopes in general hospitals were stolen or damaged. Two GeneXpert nucleic acid amplification machines were also taken from general hospitals. Regarding drug resistant TB, the average number of multidrug resistant tuberculosis (MDR TB) cases detected per month was reduced by 41% during the war with p-value

Abstract Visible‐light active anatase/brookite/rutile (A/B/R) ternary N‐doped titania (N/TiO2) crystals are successfully prepared by a facile sol‐gel method using titanium butoxide and benign N‐dopant source, guanidinium chloride. Systematically varying the aging time (1, 4, 8, and 12 d), its influence on physicochemical properties of as‐obtained spherical heterojunction nanomaterials is studied. Detailed characterizations confirm that a substantial amount of anatase (88% to 50%) is transformed to rutile (2% to 38%) via intermediate brookite phase (9% to 25%) as the function of aging time; not only the A/B/R phase content of the samples is tuned by sol‐gel aging time of the precursors solution but also their optical‐response and methylene blue photocatalytic properties are profoundly dictated. Notably under visible‐light irradiation, the photostable rutile rich mesoporous A/B/R triphasic N/TiO2 (50% A, 12% B, 38% R) aged for 12 d demonstrates higher degradation activity (97%) with a faster degradation rate (0.033 min−1) than both lesser aged N/TiO2 and undoped titania. This enhancement is attributed to the synergistic effect of interstitial‐N‐doping and optimal A/B/R interfacial charge transfer that leads to higher light absorption, lower bandgap energy and well‐separated charge carriers. The current work provides a new perspective for designing highly active visible‐light heterostructure nanomaterials with controllable phase composition.

IntroductionAlthough wastewater-based epidemiology (WBE) successfully functioned as a tool for monitoring the coronavirus disease 2019 (COVID-19) pandemic globally, relatively little is known about its utility in low-income countries. This study aimed to quantify severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA in wastewater, estimate the number of infected individuals in the catchment areas, and correlate the results with the clinically reported COVID-19 cases in Addis Ababa, Ethiopia.MethodsA total of 323 influent and 33 effluent wastewater samples were collected from three Wastewater Treatment Plants (WWTPs) using a 24-h composite Moore swab sampling method from February to November 2023. The virus was captured using Ceres Nanotrap® Enhancement Reagent 2 and Nanotrap® Microbiome A Particles, and then nucleic acids were extracted using the Qiagen QIAamp Viral RNA Mini Kit. The ThermoFisher TaqPath™ COVID-19 kit was applied to perform real-time reverse transcriptase polymerase chain reaction (qRT-PCR) to quantify the SARS-CoV-2 RNA. Wastewater viral concentrations were normalized using flow rate and number of people served. In the sampling period, spearman correlation was used to compare the SARS-CoV-2 target gene concentration to the reported COVID-19 cases. The numbers of infected individuals under each treatment plant were calculated considering the target genes’ concentration, the flow rate of treatment plants, a gram of feces per person-day, and RNA copies per gram of feces.ResultsSARS-CoV-2 was detected in 94% of untreated wastewater samples. All effluent wastewater samples (n = 22) from the upflow anaerobic sludge blanket (UASB) reactor and membrane bioreactor (MBR) technology were SARS-COV-2 RNA negative. In contrast, two out of 11 effluents from Waste Stabilization Pond were found positive. Positive correlations were observed between the weekly average SARS-CoV-2 concentration and the cumulative weekly reported COVID-19 cases in Addis Ababa. The estimated number of infected people in the Kality Treatment catchment area was 330 times the number of COVID-19 cases reported during the study period in Addis Ababa.DiscussionThis study revealed that SARS-CoV-2 was circulating in the community and confirmed previous reports of more asymptomatic COVID-19 cases in Ethiopia. Additionally, this study provides further evidence of the importance of wastewater-based surveillance in general to monitor infectious diseases in low-income settings.ConclusionWastewater-based surveillance of SARS-CoV-2 can be a useful method for tracking the increment of COVID-19 cases before it spreads widely throughout the community.

Introduction: Birth companionship is one strategy for improving maternal and neonatal quality of care, as well as their outcomes. It is a low-cost and effective care that provide mothers with evidence-based practices throughout labor and delivery in health facilities. WHO has suggested that birth companionship can be given by a family member, spouse, friend, and doula. They support laboring mothers by offering comfort via touch, massage, warm baths, encouraging mobility, promoting fluid intake and output, supplying information about the status of labor and suggestions for coping strategies, and providing a communication channel between mothers and their caregivers that helps to reduce mother and newborn mortality on a globally and regionally. Despite this benefit, no systematic review and meta-analysis studies have been conducted on this topic in study area. Therefore, this study may give the pooled utilization and associated factors of birth companionship among laboring mothers during facility birth in Sub-Saharan Africa. Methods and materials: A systematic review and meta-analysis was conducted using preferred reporting items for systematic review and meta-analysis guidelines. Data base such as PubMed with Medline, Cochrane library, direct science, google scholar and different gray works of literature/email were used on the utilization of birth companionship and associated factors of studies from 2010 to 2023 in sub-Saharan Africa. A weighted inverse variance random effect model with DerSimonian–Laird method was used to estimate pooled utilization of birth companionship Cochrane Q -test, I 2 , and p -value were computed to detect heterogeneity. Egger test and funnel plot were used to detect the evidence of publication bias. We did subgroup analysis, sensitivity analysis, and meta regression to identify source heterogeneity. The protocol has been registered in PROSPERO database “CRD42024503048.” Results: In sub-Saharan Africa, laboring mothers giving delivery in a facility utilized birth companionship at a rate of 34% (95% CI: 26–42, I 2 = 98.90%, p

This investigation assessed microbial contamination indicators in RTE school meals and drinking water in the Addis Ababa SFP, Ethiopia. Samples were collected from 18 primary school kitchens in March and April 2024. Microbiological analysis was performed on 37 cooked food samples and 18 drinking water samples using ISO and NMKL guidelines. The microbiological investigation of RTE prepared meal samples revealed an overall acceptable level of quality and safety. However, concerns were identified. Yeasts and molds surpassed reference standards in 78.4 % of samples (>102 cfu/ml), E. coli exceeded standards in 10.8 % of samples (>102 cfu/ml), and S. aureus counts exceeded limits in 5.4 % of samples (103 -104). Cooked rice the highest microbiological counts, especially of E. coli and S. aureus. Approximately 14.4 % of food samples were unsatisfactory, showing contamination from E. coli, S. aureus, and yeasts and molds.Regarding drinking water, the non-potable percentage in drinking water was 23.4 %, raising concerns about APC microbial count, TC, and FC. In particular, 72 % of the drinking water samples surpassed the APC criteria (>100 cfu/ml), 16 % exceeded the TC standard (>1 cfu/ml), and 5.5 % exceeded the FC threshold. The microbiological quality of meals served through the Addis Ababa SFP generally met established standards. However, some food samples exceeded the permitted limits, indicating hygiene difficulties. Therefore, stringent premises and personal hygiene measures must be implemented to safeguard their safety and well-being of the school children.

Abstract Many research findings stated that field pea was phenotypically diverse and symbiotically effective. However, limited studies were conducted on field pea (Pisum sativum var. abysinicum) regarding biological nitrogen fixation with local varieties and races. Therefore, the current study was conducted on the synergetic efficiency of locally available inoculums on yield and yield components of Dekoko. Randomized complete block design with three replications was used at farmers field level as an experimental design. The analysis of variance result revealed that, locally isolated Rhizobium inoculants significantly influence the agronomic parameters such as plant height, number of tillers, number of seeds, grain yield, and 1000‐seed weight at p

Abstract Maize (Zea mays L.) is one of the most important cereal crops in Ethiopia. However, its yield is lower than its potential mainly due to low soil fertility problems caused by continuous cultivation, limited use of organic and inorganic fertilizers, erosion, and leaching. Therefore, this field experiment has been conducted to optimize brewery sludge and blended NPS fertilizer rates to harness the maximum productivity potential of maize in North Mecha District, northwestern Ethiopia. The experiment was designed in a factorial arrangement of three levels of brewery sludge (0, 10, and 20 t ha−1) and four levels of blended NPS fertilizer (0, 50, 100, and 150 kg ha−1) in a randomized complete block design with three replications. The analysis of variance showed that the main effects of the blended NPS fertilizer had significant effects on the ear length, number of kernels per row, stover yield, and 1000‐kernel weight. Their interactions also had a significant effect on leaf area, leaf area index, aboveground dry biomass yield, grain yield, plant height, number of ears per plant, number of rows per ear, number of kernels per row, number of kernels per ear, and harvest index. Accordingly, the combined application of 10 t ha−1 brewery sludge and 100 kg ha−1 blended NPS fertilizer resulted in the highest grain yield (9163.4 kg ha−1), net benefit (145,590.1 ETB [Ethiopian Birr] ha−1), and marginal rate of return (3789.30%) of maize. Thus, this treatment can be tentatively recommended for the North Mecha district.

Objective To identify critical susceptible periods for the associations between bioclimatic exposure (Universal Thermal Climate Index, UTCI) and the risks of gestational hypertension and preeclampsia. Approach We linked 415,091 singleton pregnancies of 20–42 weeks’ gestation between 1st January 2000 and 31st December 2015 to UTCI exposure in Western Australia. Distributed lag nonlinear logistic regressions were used to estimate weekly-specific adjusted odds of gestational hypertension and preeclampsia for UTCI exposure from twelve weeks of preconception through pregnancy. Results The analysed pregnancies included 3.7% and 2.8% cases of gestational hypertension and preeclampsia, respectively. Exposures from early pregnancy up to 30th gestational weeks were associated with greater odds of hypertensive disorders of pregnancy (HDPs) with critical susceptible periods at all exposure thresholds, particularly elevated at the 1st (10.2 °C) and 99th (26.0 °C) exposure centiles as compared to the median (14.2 °C). The most elevated weekly OR and 95% CI estimated at 99th exposure centile was 1.07 (95% CI 1.06, 1.08) in gestational weeks 8–18 for gestational hypertension and 1.10 (95% CI 1.08, 1.11) in gestational weeks 11–16 for preeclampsia. Cumulative exposures associated with HDPs with relatively higher ORs, but less precise than weekly exposures. The effects of high exposure were disproportionately elevated in both HDPs for Caucasians, non-smokers, multiparous, and mothers in moderate/low SES residences. Conclusions and Implications Maternal bioclimatic exposure increases the risk of HDPs, suggesting potentially susceptible periods and populations for climate-related targeted interventions. It highlights the need for advising women on environmental risks in early pregnancy.

BackgroundUrinary tract infections (UTIs) and antibacterial resistance (ABR) are important public health problems, but they are not well-studied among people living with human immunodeficiency virus (PLHIV) globally, especially in low-income countries. Therefore, it is important to regularly measure the extent of UTIs and ABR in the most susceptible populations. This study aimed to investigate the prevalence of UTIs, associated factors, bacterial causal agents, and their antibiotic susceptibility profile among PLHIV in central Ethiopia.MethodsA hospital-based cross-sectional study was conducted to recruit 688 PLHIV by a simple random sampling method. Background information was gathered through interviews, while clinical information was gathered from recent information sheets of patient charts using organized, pretested, and validated study tools. Midstream urine was collected aseptically and transported to the Microbiology Laboratory of Aklilu Lemma Institute of Pathobiology within 4 h of collection, maintaining its cold chain. Standard conventional microbial culture methods and matrix-assisted laser desorption ionization-time of flight (MALDI-TOF) mass spectrometry were used to identify the bacterial isolates at the species level. Kirby Bauer’s disk diffusion method was used to determine the antibiotic susceptibility profile of the bacterial isolates based on the interpretation guidelines of the Clinical Laboratory Standard Institute. Logistic regression models were used to examine factors associated with the occurrence of UTIs among PLHIV attending selected hospitals in Addis Ababa, and Adama.ResultsOut of 688 PLHIVs involved in the current study, 144 (20.9%) were positive for UTIs, whereas the majority were asymptomatic for UTIs. In the multivariable logistic regression analysis, only HIV RNA ≥ 200 copies/ml [AOR = 12.24 (95% CI, 3.24, 46.20), p

Extreme environmental conditions, such as high temperature, frost, low humidity and desiccating winds, are the main causes for the failure of plantation forests in Ethiopia. Frost damage contributes to the low seedling survival and plantation success in frost affected highlands of Amhara region Ethiopia. Research outputs on farmers' traditional knowledge on frost management and technologies that curb frost related problems are limited in the country. This study was conducted to document the farmers’ traditional knowledge on frost management and their tree preference in frost affected highlands of Amhara region. Sinan, Guna-begemder and Meket districts were selected purposively in 2020. One representative sample Kebele was selected in each district with a total of 204 households selected with systematic random sampling technique for interview. In addition to interview focus group discussion was also conducted. Both descriptive and inferential statistics data analysis method were employed. In this study, frost was found to be an important limiting factor for plantation development in the study area. Frost occurs, mainly, from September to January. The local community applies traditional frost management techniques. The seasonality of frost occurrence and type of traditional frost management practices varied among the studied Kebeles. Eucalyptus globulus, Oldeania alpina, Rhamnus prinoides and Chamaecytisus palmensis were preferred trees species due to their frost resistant performance. The effectiveness of identified traditional frost management techniques needs to be investigated before they can be promoting and disseminating. Farmers should also be trained in proper techniques to protect planted seedlings from frost damage. Adjusting the timing of planting may also help to mitigate the effect of frost damage.

Objective: To investigate the associated factors that affect time to relapse in patients with schizophrenia at St. Amanuel Mental Specialized Hospital, with recurrent events model. Material and Methods: A hospital-based retrospective review of the medical records of 332 patient with schizophrenia, covering a two-year period, were examined. Parametric frailty models were used to determine the correlation between discharge times and relapse, and to identify risk factors using R-software. Results: The distribution number of relapses was 162, and the median survival time of patients with schizophrenia was 665 days. The unobserved heterogeneity in patients and correlation between relapses, as estimated by the Weibull-gamma frailty model, was p-value≤0.001 and Kendall’s Tau (Γ)=0.498. This indicated that there was heterogeneity among participants and a correlation between relapses. The final model showed that the effect of psychiatric comorbidity (hazard ratio (HR)=6.522, p-value≤0.001), employment status (HR=5.334, p-value=0.001), history of suicide attempt (HR=2.167, p-value=0.003) and history of traditional treatment (HR=1.973262, p-value=0.021) had a significant effect on the hazard time to relapse. Onset Age of schizophrenia and drug adherence were not predictive. Subsequent relapses are likely dependent on both the first and previous relapses. Conclusion: Comorbidity, employment status, history of suicide attempt and history of traditional treatment are imperative risk factors influencing the hazard of time to relapse, which increases the risk of relapse.

Abstract Background In low-income countries there is insufficient evidence on hematological, clinical, cytogenetic and molecular profiles among new CML patients. Therefore, we performed this study among newly confirmed CML patients at Tikur Anbesa Specialized Hospital (TASH), Ethiopia. Objective To determine the hematological, clinical, cytogenetic and molecular profiles of confirmed CML patients at tertiary care teaching hospital in Addis Ababa, Ethiopia. Methods A facility-based cross-sectional study was conducted to evaluate hematological, clinical, cytogenetic and molecular profiles of confirmed CML patients at TASH from August 2021 to December 2022. A structured questionnaire was used to collect the patients’ sociodemographic information, medical history and physical examination, and blood samples were also collected for hematological, cytogenetic and molecular tests. Descriptive statistics were used to analyze the sociodemographic, hematological, clinical, cytogenetic and molecular profiles of the study participants. Results A total of 251 confirmed new CML patients were recruited for the study. The majority of patients were male (151 [60.2%]; chronic (CP) CML, 213 [84.7%]; and had a median age of 36 years. The median (IQR) WBC, RBC, HGB and PLT counts were 217.7 (155.62–307.4) x103/µL, 3.2 (2.72–3.6) x106/µL, 9.3 (8.2–11) g/dl and 324 (211–499) x 103/µL, respectively. All patients had leukocytosis, and 92.8%, 95.6% and 99.2% of the patients developed anemia, hyperleukocytosis and neutrophilia, respectively. Fatigue, abdominal pain, splenomegaly and weight loss were the common signs and symptoms observed among CML patients. Approximately 86.1% of the study participants were Philadelphia chromosome positive (Ph+) according to fluorescence in situ hybridization (FISH). P210, the major breakpoint protein, transcript was detected by both qualitative polymerase chain reaction (PCR) and quantitative real time polymerase chain reaction (PCR). Conclusion During presentation, most CML patients presented with hyperleukocytosis, neutrophilia and anemia at TASH, Addis Ababa. Fatigue, abdominal pain, splenomegaly and weight loss were the most common signs and symptoms observed in the CML patients. Most CML patients were diagnosed by FISH, and p120 was detected in all CML patients diagnosed by PCR. The majority of CML patients arrive at referral center with advanced signs and symptoms, so better to decentralize the service to peripheral health facilities.

Abstract Background Higher rate of acute malnutrition is observed in emergencies compared to non-emergency settings and severe acute malnutrition upsurges alarmingly and become deadly in humanitarian crises due to lack of food, lack of quality water supply and insufficient healthcare. Research is one learning tool by identifying strength and areas of improvement. However, little is known about outcomes of therapeutic feeding programmes in comparison with the standard indicators set in humanitarian setting. Methods Health facility based prospective cohort study was conducted using routinely collected programme data of children hospitalized to the inpatient therapeutic feeding center in suhul general hospital from January 1st, 2023 to June 30, 2023. Data was collected using a form developed relating to the federal ministry of health standard management protocols for severe acute malnutrition then it was cleaned, coded and entered to EpiData version 4.2.0 and then exported to SPSS version 25 for analysis. Results From 184 children, 96.2% were stabilized while the remaining 3.8% were censored with overall median stabilizing time of 8 days. Weight gain was used as one of the discharging criteria for infants less than six months and their mean weight gain found to be 12.89 g per kilogram daily. Appetite test (AHR = 0.338; 95% CI: 0.221–0.518), blood transfusion (AHR = 5.825; 95% CI: 2.568–13.211), IV fluid resuscitation (AHR = 2.017; 95% CI: 1.094–3.717), IV antibiotics (AHR = 2.288; 95% CI: 1.164-4.500) and NG tube feeding (AHR = 1.485; 95% CI: 1.065–2.071) were identified as significant predictors of stabilizing time. Conclusion All the outcome indicators for stabilization center are consistent with the SPHERE association set of standards during humanitarian intervention. The hospital and other concerned humanitarian organizations should focus on sustaining these achievements as suhul hospital is the main treatment center for children suffering from severe acute malnutrition in the northwest zone of Tigray regional state. Further pre-post experimental studies which compare the stabilizing time before and after crisis are recommended.

This study aimed to assess the runoff, recharge, and response of a shallow aquifer to leakage from the Arato micro-dam reservoir (MDR). The assessment was conducted using the Soil Conservation Service Curve Number (SCS-CN), soil moisture balance (SMB), and diver (automatic data logger) measurements in both the MDR and a shallow hand-dug well. Recharge was estimated using the chloride mass balance (CMB) and water table fluctuation (WTF) methods. The results revealed that the annual runoff from the catchment was 48.8 mm, which accounted for approximately 0.71 million m3. The yearly groundwater recharge was estimated to be 104, 92.8, and 100 mm using the SMB, CMB, and WTF methods, respectively. Furthermore, the water balance model of the Arato MDR indicated a leakage rate of 13.2 mm/day. It is noteworthy that the estimated leakage exceeded the seepage initially anticipated during the project's design phase (9,965 m3/year). This research project highlights the significance of utilizing local climatic and physical data from the specific watershed under investigation when planning reservoirs and other water resources. It also underscores the importance of conducting thorough site investigations to accurately quantify hydraulic conductivity for leakage estimation purposes. HIGHLIGHTS Integrated approach used.; Technology (pressure transducer/data loggers) for high-resolution data used.; Interaction between leakage of the reservoir and shallow aquifer evaluated.; Employed in the data-scarce area.; Local meteorological data collected and used for analysis.;

Abstract Ecosystems provide a wide range of services crucial for human well-being and decision-making processes at various levels. This study analyzed the major land cover types of north-central Ethiopia and their impact on total and per-capita ecosystem service value (ESV). The ESV was estimated using the benefit-transfer method along the established global and local coefficient values for the periods 1973, 1986, 2001, 2016, and 2024. The findings show that agricultural lands continued to expand at a rate of 563.4 ha year−1, at the expense of forests and grasslands. As a result, the total ESV of the study area declined from $101.4 to $61.03 million and $60.08–$43.69 million, respectively. The ESV per capita was also diminished by $152.4 (37.7%) and $257 (40.6%), respectively. However, land-cover improvement during the period 2001–2016 enhanced the total and per capita ESV in the study area. Therefore, potential future research may be required to develop a valid approach for assessing the robustness and sensitivity of value coefficients for the valuation of the ESV at the landscape level.