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AbstractThe paper examines the effect of war on food insecurity in Tigrai using data from 3245 households. The calorie intake approach and the Integrated Food Insecurity Phase Classification (IPC) were applied to measure the level of food insecurity and classify the phases. The logistic regression model was applied to identify the factors affecting food insecurity in Tigrai. The empirical result revealed that 77.38% of the households are food insecure with a calorie deficiency gap of 33.68 and 69.21% of them are classified in crisis phase and above. The war has caused the level of food insecurity and share of crisis phase and above to upsurge by 153.8 and 49.7%, respectively. It is also shown that conflict, price of commonly consumable cereals, age of the head, family size, support (aid), and access to electricity and financial services are affecting the level of food insecurity in the region. To cope with the war-induced shortage of food, households reduced the quality and quantity of food they consumed, sold off livestock and assets, used their savings, requested support from family, NGOs, and the government, ate inedible green leaves, migration, and begging.

Tsehaye Asmelash Dejene,1,2 Genet Gebrehiwet Hailu,1 Atsebaha Gebrekidan Kahsay,1 Araya Gebreyesus Wasihun1 1Department of Medical Microbiology and Immunology, School of Medicine, College of Health Sciences, Mekelle University, Mekelle, Ethiopia; 2Department of Medical Microbiology, School of Medicine, Aksum University, Axum, EthiopiaCorrespondence: Atsebaha Gebrekidan Kahsay, Department of Medical Microbiology and Immunology, School of Medicine, College of Health Sciences, Mekelle University, P. O. Box: 1871, Mekelle, Tigrai, Ethiopia, Email atsebaha.gebrekidan@mu.edu.etBackground: Tuberculosis (TB) continues to be a global health problem. While childhood TB contributes 10% to the global TB burden, the paucibacillary nature of TB disease in children and the absence of reliable diagnostic methods have made MTB diagnosis in children to be a great challenge. This study aimed to determine the prevalence of MTB and rifampicin-resistant MTB (RR-MTB) among children using Gene Xpert MTB/RIF Assay in Tigray, Ethiopia.Methods: A retrospective database study was conducted among children in ten governmental hospitals in the Tigray region. Gene Xpert MTB/RIF results of sputum/gastric lavage samples from children with presumptive TB from January 2016 to December 2019 were extracted using a data extraction sheet. Data were collected and analyzed using Statistical Package for the Social Sciences version 21.Results: The prevalence of bacteriologically confirmed MTB by Gene-Xpert in children with presumptive TB was 7.3% (95% CI: 6.7%− 7.9%) and the proportion of those that were Gene-Xpert MTB positive who also have rifampicin resistance was 10.9% (95% CI: 8.2– 13.6%). Older children aged 11– 15 years [AOR = 1.76; 95% CI = 1.33– 2.33, p < 0.001] and adolescents 16– 17 years [AOR = 2.18; 95% CI = 1.63– 2.92, p < 0.001] were more likely to be MTB positive. Relapse cases [AOR = 1.66; 95% CI = 1.09– 2.51, p = 0.017] and lost/failure cases [AOR = 8.82; 95% CI = 3.94– 19.76, p < 0.001] were more likely to have MTB compared to the new cases.Conclusion: The proportion of MTB-positive among the TB presumptive patients was 7.3%. The proportion of rifampicin-resistant TB to all positive patients was 10.9%. Female participants had more MTB than males (or younger children). The result highlights the need for due attention in children because it is very helpful in determining the future control of the disease.Keywords: children and adolescent, presumptive TB, rifampicin resistant, Xpert MTB/RIF, Tigray, Ethiopia

Atsebaha Gebrekidan Kahsay,1 Tadele Araya Mezgebo,1 Gebregziabher Berihu Gebrekidan,2 Birhane Lemlem Desta,3 Hagos Gidey Mihretu,3 Tsehaye Asmelash Dejene1 1Department of Medical Microbiology and Immunology, School of Medicine, College of Health Sciences, Mekelle University, Mekelle, Tigrai, Ethiopia; 2Department of Health Systems, School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Tigrai, Ethiopia; 3Department of Gynecology and Obstetrics, College of Health Sciences, Mekelle University, Mekelle, Tigrai, EthiopiaCorrespondence: Atsebaha Gebrekidan Kahsay, Department of Medical Microbiology and Immunology, School of Medicine, College of Health Sciences Mekelle University, P. O. Box: 1871, Mekelle, Tigrai, Ethiopia, Email atsebaha.gebrekidan@mu.edu.etBackground: Globally, Neisseria gonorrhoeae is the second most common cause of bacterial sexually transmitted diseases. The prominent predicament of this bacterium is its complications, non-susceptibility for many drugs, and aggravated transmission of other sexually transmitted infections. There is limited information about the prevalence, antibiotic resistance, and risk factors of N. gonorrhoeae in Tigrai, Ethiopia. Therefore, we aimed to determine the prevalence, antibiotic resistance, and risk factors of N. gonorrhoeae among patients attending non-profitable private clinics in Mekelle, Tigrai, Ethiopia.Methods: A cross-sectional study among 229 patients was conducted from February to June 2018. The socio-demographic data and associated factors were gathered using structured questionnaire, and swabs were taken from urethra and cervix of males and females, respectively. Specimens were inoculated on standard bacteriological culture media and antibiotic susceptibility testing was performed using Kirby-Bauer disc diffusion technique following the Clinical and Laboratory Standard Institute. Data were analyzed using Statistical Package for Social Sciences Version 21. The level of significance at p-value < 0.05 was considered statistically significant.Results: The overall prevalence of N. gonorrhoeae was 23 (10.04%). High prevalence rates of N. gonorrhoeae were observed in females, urban residents and married ones. N. gonorrhoeae had shown statistically significant association with HIV positive, previous history of STIs, shisha users, Khat (Catha edulis) users, condom non-users and having more than two sexual partners. All isolates showed resistance to penicillin followed by tetracycline 16 (69.6%) and ciprofloxacin 8 (34.8%). Four isolates (7.4%) exhibited resistance to azithromycin with no resistance to ceftriaxone. Twelve (52.2%) isolates showed multidrug resistance (MDR).Conclusions: The prevalence of N. gonorrhoeae and drug resistance, including multidrug resistance, was high in the study. Multiple factors were associated with the acquisition of N. gonorrhoeae. Therefore, behavioral change and communication should be strengthened.Keywords: antibiotic resistance, associated factors, Neisseria gonorrhoeae, nonprofitable private clinics, Tigrai

Belaynesh Tsegay,1 Teklay Gebrecherkos,2 Atsebaha Gebrekidan Kahsay,2 Mahmud Abdulkader2 1Ayder Comprehensive Specialized Hospital Laboratory Department, Mekelle University, Mekelle, Tigrai, Northern Ethiopia; 2Department of Medical Microbiology and Immunology, College of Health Sciences, Mekelle University, Mekelle, Tigrai, Northern EthiopiaCorrespondence: Atsebaha Gebrekidan Kahsay, Department of Medical Microbiology and Immunology, Mekelle University, P.O. Box 1871, Mekelle, Tigrai, Northern Ethiopia, Email atsebaha.gebrekidan@mu.edu.etBackground: Hepatitis B and C viruses are important health and socioeconomic problem across the globe, with a remarkable number of diseases and deaths in sub-Saharan African countries. The burden of hepatitis is unknown in the prison settings of Tigrai. Therefore, we aimed to describe the seroprevalence and associated factors of hepatitis B and C viruses among prisoners in Tigrai, Ethiopia.Methods: A cross-sectional study was carried out from February 2020 to May 2020 at the prison facilities of Tigrai. Demographics and associated factors were collected from 315 prisoners prospectively. Five milliliters of blood was collected and tested using rapid tests kits of HBsAg (Zhejiang orient Gene Biotech Co., Ltd., China) and HCV antibodies (Volkan Kozmetik Sanayi Ve Ticaret Ltd. STI, Turkey). Positive samples were confirmed using enzyme-linked immunosorbent assay (ELISA) (Beijing Wantai Biological Pharmacy Enterprise Co. Ltd). Data were analyzed using the Statistical Package for Social Sciences (SPSS) version 20 and p< 0.05 was considered statistically significant.Results: The overall seroprevalence of HBV and HCV were 25 (7.9%) and 1 (0.3%), respectively. The majority of hepatitis B viral infections were identified from the age groups of 18– 25 years (10.7%) and unmarried prisoners (11.8%). Prisoners greater than 100 per cell (AOR=3.95, 95% CI=1.15– 13.6, p=0.029) and with a history of alcohol consumption (AOR=3.01, 95% CI=1.17– 7.74, p=0.022) were significantly associated with HBV infections.Conclusion: The seroprevalence of HBV among prisoners was nearly high or borderline (7.9%) with a very low HCV prevalence (0.3%). HBV was most prevalent among young adults, those housed with a large number of prisoners per cell, and those who had a history of alcohol consumption. This study recommends that there should be prison-focused intervention, including regular health education, with the emphasis on the mode of transmission and introducing HBV screening policy for prisoners, especially when they enter the prison.Keywords: seroprevalence, HBV, HCV, prisoners, Tigrai

Abstract Background Hepatitis B and C viruses are the major public health concerns of the globe. The two hepatotropic viruses share common modes of transmission and their co-infection is common. Despite the provision of an effective prevention mechanism, the infections caused by these viruses remain a significant problem worldwide, particularly among developing countries like Ethiopia. Methods This institutional-based retrospective study was conducted between January 2014 December and December 2019 from documented laboratory logbooks of Adigrat general hospital serology laboratory, Tigrai, Ethiopia. data were collected and checked for completeness on a daily based, coded, entered, and cleaned using Epinfo version 7.1, exported and analyzed using SPSS version 23. Binary logistic regression analysis and Chi-square test (X2) assessed the association between dependent and independent variables. The corresponding variables with a P-value (P

AbstractTechnological change in agriculture in land-scarce developing countries is required for land use intensification to feed the growing population. The purpose of this study is to analyze factors affecting adoption decision of improved wheat variety and its effect on households’ welfare in a semi-arid economy of Tigrai, northern Ethiopia. First, a correlated random effect double hurdle model with a control function approach is used to analyze determinants of improved wheat adoption decision and extent of adoption. Second, fixed effect instrumental variable method is used to assess the impact of area under improved wheat cultivation on households’ welfare. Double hurdle model results indicate that access to improved wheat, landholding, male adult and access to information have strong and positive effect on adoption decision and extent of adoption of improved wheat. The impact analysis shows that extent of improved wheat adoption has strong and positive effect on households’ income, consumption, and food security. Moreover, the gender and wealth disaggregation analysis show that extent of improved wheat adoption has a positive and significant effect on welfare of male and female-headed, land poor and land rich households. Thus, adoption of improved wheat is a pro-poor strategy and increasing access to the technology appears a promising pathway for rural development in a land scarce and semi-arid economy like Ethiopia.

Abstract Background Despite numerous interventions, child undernutrition continues as a problem of global concern. Although consumption of animal source foods has shown positive associations with child undernutrition, no much evidence exists on its trends and predictors among children in Tigrai. Objectives This study aimed to investigate the trends in and predictors of consumption of animal source foods among children 6–23 months of age in Tigrai. Methodology This study used complex data of 756 children extracted from three consecutive Ethiopian Demographic and Health Surveys. Data were analyzed using STATA 14.0 by accounting for sampling weight and cluster and strata variables. Multivariable logistic regression was used to determine the independent predictors of animal source foods consumption. Odds ratio and 95% confidence interval were used to measure strength of association at a statistical significance of p

Background: Hepatitis B and C viruses are the major public health concerns of the globe. The two hepatotropic viruses share common modes of transmission and their co-infection is common. Despite the provision of an effective prevention mechanism, the infections caused by these viruses remain a significant problem worldwide, particularly among developing countries like Ethiopia. Methods: This institutional-based retrospective study was conducted between January 2014 December and December 2019 from documented laboratory logbooks of Adigrat general hospital serology laboratory, Tigrai, Ethiopia. data were collected and checked for completeness on a daily based, coded, entered, and cleaned using Epinfo version 7.1, exported and analyzed using SPSS version 23. Binary logistic regression analysis and Chi-square test (X2) assessed the association between dependent and independent variables. The corresponding variables with a P-value (P < 0.05) and 95% confidence interval were considered statistically significant. Results: Out of 20,935 clinically suspected individuals, 20,622 were given specimens and tested for hepatitis B and C viruses with total completeness of 98.5%. The overall prevalence of hepatitis B and hepatitis C virus was found to be 3.57% (689/19,273) and 2.13% (30/1,405), respectively. The positivity rate of the hepatitis B virus was 8.0% (106/1317) and 3.24% (583/17,956) among males and females, respectively. Additionally, 2.49%(12/481) of males and 1.94% (18/924) of females were positive for hepatitis C virus infection. The overall prevalence of co-infection for both hepatitis B and hepatitis C virus was 7.4% (4/54). Sex and age were significantly associated with hepatitis B and C virus infection. Conclusions: The overall prevalence of hepatitis B and C is low intermediate according to the WHO criteria. Although there was a fluctuating trend of hepatitis B and C through the years 2014–2019, the result shows moreover declining trend. Both hepatitis B and C share similar routes of transmission and affect all age categories but males were more highly affected than females. Therefore, awareness creation of the community about the methods of transmission, education about prevention, and control of hepatitis B and C virus infection, and improving coverage of youth-friendly services in health facilities should be strengthened. [ABSTRACT FROM AUTHOR]

Abstract Background Due to the nutritive and immunologic benefits of breastmilk, children should be exclusively breastfed for the first 6 months of life, even during the corona virus pandemic. However, fear of transmission risk and pandemic-related restrictions could undermine the practice of breastfeeding. This study aimed to assess the knowledge, attitude, and determinants of exclusive breastfeeding (EBF) during COVID-19 among lactating mothers in Mekelle, Tigrai, Ethiopia. Methods A community based cross-sectional study was conducted among 621 lactating mothers living in Mekelle city, Tigrai, from April to June, 2021. Data were collected using an adapted form of a standard KAP questionnaire. Binary logistic regression was used to determine the independent determinants of EBF at a statistical significance of p

Background: Despite numerous interventions, child undernutrition continues as a problem of global concern. Although consumption of animal source foods has shown positive associations with child undernutrition, no much evidence exists on its trends and predictors among children in Tigrai. Objectives: This study aimed to investigate the trends in and predictors of consumption of animal source foods among children 6–23 months of age in Tigrai. Methodology: This study used complex data of 756 children extracted from three consecutive Ethiopian Demographic and Health Surveys. Data were analyzed using STATA 14.0 by accounting for sampling weight and cluster and strata variables. Multivariable logistic regression was used to determine the independent predictors of animal source foods consumption. Odds ratio and 95% confidence interval were used to measure strength of association at a statistical significance of p < 0.05. Results: Although statistically not significant (p-trend = 0.28), animal source foods consumption increased from 31.3% to 2005 through 35.9% in 2011 to 41.5% in 2016. For every month increase in the age of a child, a 9% increment in the odds of animal source food consumption was observed. Muslim children showed 3.1 times higher odds of animal source food consumption than Orthodox Christians. The likelihood of animal source foods consumption were 33% lower among children born to mothers who didn't attend formal education as compared to their counterparts. A unit increase in the number of household assets and number of livestock led to a 20% and 2% increase in the odds of animal source foods consumption, respectively. Conclusion: Animal source foods consumption showed a statistically non-significant increase over the three consecutive Ethiopian Demographic and Health Surveys. This study found out that consumption of animal source foods might be increased through pro-maternal education policies, programs with household asset increasing schemes, and pro-livestock projects. Our study also highlighted the need for considering religion as one important player when planning or undertaking ASF programs. [ABSTRACT FROM AUTHOR]

This study was designed to analyze the socioeconomic contribution of Exclosures to smallholder farmers. Many studies have been conducted on the biophysical impact of the Exclosures in restoring the degraded ecosystem. However, limited evidence is available about the perception of the community and the socioeconomic contribution of the Exclosures. Data were collected from primary and secondary sources. Household survey and focus group discussion tools were employed. The descriptive and qualitative results revealed that Exclosures have a positive effect in improving animal feed, mitigating microclimate of the community, and enhancing crop production and productivity of the community through increased water discharge and decreased soil erosion. Furthermore, it provides farm equipment and fuel wood. Thus, the majority (86 percent) were willing to pay to further expand the size of the Exclosures. Results of the ordered logit model showed that educational level of household heads, plot size, marital status, and distance traveled to the exclosure were affecting households' willingness to pay. The involvement of the community in resource use and distribution was evaluated and found that there was inequitable distribution of resources among individuals in the community. Finally, it can be recommended that involving the community in decision making and ensuring an equitable share of the Exclosures' resources among the communities must be considered for sustainable Exclosure management. [ABSTRACT FROM AUTHOR]

Amaha Kahsay,1 Hadush Gebregziabher,1 Znabu Hadush,2 Dejen Yemane,2 Abebe Hailemariam,3 Afework Mulugeta1 1Department of Nutrition and Dietetics, School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia; 2Department of Environmental Health and Behavioral Sciences, School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia; 3UNICEF Head Office, Addis Ababa, EthiopiaCorrespondence: Amaha KahsayDepartment of Nutrition and Dietetics, School of Public Health, College of Health Sciences, Mekelle University, PO Box: 1871, Ayder, Mekelle, Tigray, EthiopiaTel +251 920322629Email amahakahsay@gmail.comBackground: Adolescence is a time of tremendous physical growth and mental development, with high nutrient requirements. Ethiopia is among the countries with a high prevalence of nutritional deficiencies among the women of reproductive age group, whilst adolescent girls from rural areas suffered disproportionately. However, there is a dearth of evidence regarding the barriers that hinder adolescent girls to utilize the available nutritional services.Purpose: The current study aimed to qualitatively explore the range of barriers for the uptake of nutritional interventions among adolescent girls in rural communities of Tigray, Northern Ethiopia.Methods and Participants: We employed an explorative qualitative study among purposively selected adolescent girls and school teachers from rural districts of Tigray region. We conducted 11 focused group discussions with adolescent girls, 17 in-depth interviews (seven with teachers, seven with in-school adolescent girls, and three with out-of-school adolescent girls) using a semi-structured guide. Data was audio-taped, transcribed verbatim in local language, translated into English, and imported into ATLAS.ti version 7.5 qualitative data analysis software for analysis.Results: Adolescents perceived that stunting, anemia, and thinness are among the main nutritional problems in their community. Food insecurity, limited nutrition awareness in the community, limited access to a water source, high workload, service provider’s little attention for adolescents’ nutrition, and food taboo have emerged as barriers for the uptake of adolescent girls’ nutritional interventions. Though limited in reach, available nutritional interventions include awareness creation, nutritional supplementation, and disease prevention.Conclusion: Food insecurity poses a strong challenge to adolescent girls’ nutrition. As access to safe drinking water continues to be a considerable bottleneck for nutritional interventions, a multi-sectoral response to integrate water, sanitation, and hygiene (WASH) services is required. Bounded by food taboo, high burden of workload among the adolescent girls, women empowerment and nutritional status seem to be the unfinished agenda in resource limited settings such as the rural areas of Tigray region.Keywords: adolescent girls, barriers, nutritional services, rural, Tigray, Ethiopia

Abstract Background Tuberculosis is an infectious disease usually caused by Mycobacterium tuberculosis bacteria. The global emergence of mono- or multidrug-resistant tuberculosis and extensively drug-resistant forms of tuberculosis pose a considerable challenge to tuberculosis control programs. There has been no reliable and organized data on trends and drug resistance of Mycobacterium tuberculosis in the study area. Therefore, this study aimed to determine the trends of Mycobacterium tuberculosis and rifampicin resistance in the Adigrat General Hospital, eastern Zone of Tigrai, North Ethiopia. Methods A hospital-based retrospective cross-sectional study was conducted at Adigrat General Hospital from January 2015 to 2018.Data was collected retrospectively from the GeneXpert™ TB registration book using a data extraction format. Data was entered into Epi-Info 3.1 and subsequently exported and analyzed using SPSS Version 20.The results were summarized using descriptive statistics, tables, and figures. Bivariate and multi-variant regression analysis was employed to measure the association between dependent and independent variables. P values

Abstract Background Access to safe drinking water is one of the basic human rights and is critical to health. However, much of the world’s population lacks access to adequate and safe water. Approximately 884,000, 000 people in the world still do not get their drinking water from safe sources; Sub-Saharan Africa accounts for over one third of this number. It is estimated that 80% of all illnesses in the world are related to use of unsafe and contaminated water. Methods A cross-sectional study was conducted from August 1st 2017 to July 30th 2018 in three randomly selected woreda (districts) of Eastern Zone Tigrai. Water samples were examined for total coliforms and thermotelorant coliforms using the most probable number method. Standard biochemical testing was performed on samples that tested positive to identify the genus of bacteria. The contaminant risk of water sources were assessed using the sanitary inspection checklist of the World Health Organization. The results were interpreted using World Health Organization guidelines for drinking water quality. Data was collected using laboratory checklist and sanitary inspection check list. It was entered, cleared and analyzed using SPSS version 21.0 and a variable having a P

Abstract Background Ethiopia is striving to achieve a goal of “zero human immune deficiency virus/acquired immune deficiency syndrome (HIV/AIDS)-related deaths.” However, little has been documented on the factors that hamper the progress towards achieving this goal. Therefore, the ultimate aim of this study was to determine predictors of mortality among adult people living with HIV/AIDS on antiretroviral therapy (ART). Methods A retrospective follow-up study was employed on all adult HIV/AIDS patients who started ART between January 1 and December 30, 2010, at Suhul Hospital, Tigrai Region, Northern Ethiopia. Data were collected by trained fourth-year Public Health students using a checklist. Finally, the collected data were entered into SPSS version 16. Then after, Kaplan-Meier curves were used to estimate survival probability, the log-rank test was used for comparing the survival status, and Cox proportional hazards model were applied to determine predictors of mortality. Results The median follow-up period was 51 months (ranging between 1 and 60 months, inter-quartile range (IQR) = 14 months). At the end of follow-up, 37 (12.5%) patients were dead. The majority of these cumulative deaths, 19 (51.4%) and 29 (78.4%), occurred within 3 and 4 years of ART initiation respectively. Consuming alcohol (adjusted hazard ratio (AHR) = 2.23, 95% CI = 1.15, 4.32), low body weight (AHR = 2.38, 95% CI = 1.03, 5.54), presence of opportunistic infections (AHR = 2.18, 95% CI = 1.09, 4.37), advanced WHO clinical stage (AHR = 2.75, 95% CI = 1.36, 5.58), and not receiving isoniazid prophylactic therapy (AHR = 3.00, 95% CI = 1.33, 6.74) were found to be independent predictors of mortality. Conclusion The overall mortality was very high. Baseline alcohol consumption, low body weight, advanced WHO clinical stage, the presence of opportunistic infections, and not receiving isoniazid prophylactic therapy were predictors of mortality. Strengthening behavioral and nutritional counseling with close clinical follow-up shall be given much more emphasis in the ART care and support program.

Background: To protect health-care providers (HCPs) from COVID-19, the WHO recommends applying basic principles of infection prevention and control measures at all health-care facilities. This study aimed to assess the knowledge, perceptions, satisfaction, and readiness of HCPs regarding COVID-19 in Tigrai, Ethiopia in 2020. Methods: This cross-sectional study was conducted from June 1 to July, 2020. Data were collected using a self-administered structured questionnaire. Multistage sampling followed by purposive sampling were used to recruit study subjects. SPSS 21 was used to compute proportions and χ2 to identify risk factors. Results: Of 765 participants, 88% had adequate knowledge, close to a third showed positive perceptions and were satisfied with their job and nearly a quarter demonstrated readiness to prevent and control COVID-19. Education, knowledge, readiness, perceptions, and job satisfaction with associated with type and readiness of health facilities. Conclusion: Despite adequate knowledge of the HCPs about COVID-19, their perceptions and job satisfaction are a concern for the health-care system. Only one in five HCPs was found to be ready to prevent and control COVID-19. Efforts should be exerted to improve perceptions, job satisfaction, and readiness of HCPs to fight COVID-19. [ABSTRACT FROM AUTHOR]

Abstract Background Malaria is a serious public concern in Ethiopia, 75% of the land and 60% of the population are exposed to the disease. The disease has been consistently reported as one of the top three leading causes of outpatient visits, admissions, and deaths among all age group in Ethiopia. However, there is no published data to date regarding the trends of malaria in north western Tigrai, northern Ethiopia. Hence, knowing the trends of malaria prevalence in this area is essential to design appropriate interventions against the disease. Methods Institutional based retrospective study was conducted to determine trends in prevalence of malaria from documented laboratory logbooks at Suhul General Hospital, northwestern Tigrai, northern Ethiopia. All recorded malaria cases from January 2012 to December 2018 were carefully reviewed and analyzed from the laboratory logbooks. Additionally, any malaria intervention activities applied in the area were collected by a checklist. Beside, data related to temperature and rainfalls were collected from metrological office of Shire-endasilasie town. Results During the seven years (2012–2018) data, a total of 71,986 blood films were requested for malaria diagnosis in Suhul Hospital and 5010(6.96%) microscopically confirmed malaria cases reported in the study area with fluctuating trends. Plasmodium falciparum and Plasmodium vivax were the dominant parasites detected, which accounted (2516; 50.2%, 2181; 43.5%) respectively. However, individuals aged ≥15 years (3628; 72.4%) and male participants (3142, 62.7%) were found highly infected with malaria parasites. Despite the yearly abundance of malaria cases, highest prevalence was reported in autumn (September–November) in the study area. Conclusions Malaria is still a major health dilemma Northwestern Tigrai, Northern Ethiopia. Plasmodium falciparum and Plasmodium vivax were unmoving predominant parasite reported in the study area. Overall, trend of malaria over the years showed no significant reduction or increment. So, strong scaling up of the community should going on towards transmission, prevention and control activities of malaria in view of Plasmodium falciparum and Plasmodium vivax.

Abstract Background In Ethiopia, like other developing countries, intestinal parasitic infections are the major public health problems affecting millions annually. Overcrowding and poor living conditions are the major risk factors. Prison inmates are among the most vulnerable groups to intestinal parasitic infections. However, there is scarcity of epidemiological data regarding intestinal parasites among prison inmates in Ethiopia, notably in Tigrai. Thus, we aimed to determine the prevalence of intestinal parasites and identify the associated factors among inmates of Mekelle prison, Tigrai, Northern Ethiopia. Methods A cross sectional study involving 291 inmates was conducted from February to June 2017 among inmates of Mekelle prison. After systematically selecting subjects, stool specimens were examined using direct wet mount and formol-ether concentration techniques. We used SPSS version 21 for data analysis. We considered p-value less than 0.05 significant at 95% confidence level. Results Of the 291 inmates enrolled in the study, 124 (42.6%) harbored one or more intestinal parasites. The protozoan Entamoeba histolytica/dispar/moshkovskii was the predominant parasite accounted for 68 (23.3%) of the infections followed by Giardia lamblia (10.3%) and Entamoeba coli (8.2%). Fourteen (4.8%) participants were co-infected with different parasite species. The co-infections of Entamoeba histolytica/dispar/moshkovskii and Giardia lamblia were detected among 3.1% of the participants. In bivariate analysis, hand fingernail status (COR 1.86, 95% CI, 1.08–3.20) and duration of stay in prison (COR 2.23, 95% CI 1.31–3.79) were statistically associated with intestinal parasite infections. In multivariable regression, inmates who stayed in the prison for one year or less were more likely to harbor intestinal parasitic infections (p = 0.013) than those who stayed longer. No other single predictor variable was found to be significantly associated with intestinal parasitic infections. Conclusions The result of this study showed that intestinal parasites are significant health problems among inmates of Mekelle prison.

Abstract Background Tuberculosis (TB) is a major public health problem and it is among the top 10 causes of death worldwide. One of the challenges against attaining an effective TB control program is delay in seeking health care to diagnosis and treatment of TB patients. The aim of this study was to assess health care-seeking delay among pulmonary TB patients. Methods An institutional based cross-sectional study was conducted among new pulmonary tuberculosis (PTB) patients > 15 years of age who were enrolled in the intensive phase TB treatment from November 1, 2015 – January 30, 2016. Data were collected by an interviewer administered technique using a structured questionnaire. Health care seeking delay was categorized by using a median cutoff point of > 30 days as a prolonged health care seeking delay. Logistic regression analyses were employed to determine factors independently associated with the delays in health care seeking. Results A total of 422 PTB patients were included in this study. The median age of respondents was 37 years (interquartile range (IQR) =35–44). The median time of health care seeking delay was 30 days (IQR) = 21-60). Respondents occupation, knowledge about pulmonary tuberculosis, health facility visited first, seeking treatment from traditional or religious healers before visiting health facilities, reason for not seeking treatment early from health facilities, and reason for first consultation were found to be significantly associated with health care seeking delay. Conclusion The study showed the magnitude of health care seeking delay among pulmonary tuberculosis patient was very long and the factors associated with health care seeking delay were: occupation, knowledge status, health facility visited first and seeking treatment from religious or traditional healer before health facilities. To overcome delay of health care seeking among tuberculosis patients, efforts should required availing tuberculosis diagnostic and treatment services at the primary health care level.

Abstract Background Sustainable land management is considered as one of the useful approaches to combat the threat of various forms of land degradation in Ethiopia. Despite this, there is scant information regarding households’ decision towards the implementation of sustainable land management practices. This paper, therefore, looks into the determinants for the continued use and choice of the sustainable land management practices by smallholder farmers and its productivity effect in three randomly chosen districts in Tigrai region, Ethiopia. The study uses data from household survey and key informant interviews. The paper employs a binary logit to analyze the determinants for the decision of continued use of sustainable land management practices, and a multivariate probit to analyze the simultaneous adoption decision of sustainable land management practices using cross sectional data collected from 230 randomly selected households. The impact of sustainable land management practices was also evaluated using propensity score matching. Results Farming techniques, wealth status, agro-ecological variations, and plot level characteristics were found to be associated with the implementation decision of sustainable land management practices by rural households. Besides, institutional supports and access to basic infrastructures influenced the overall continued use of sustainable land management practices and the preference of households toward these practices. The study also finds that the value of crop production of sustainable land management users was on average 77–100% higher than that of non-users. Conclusions The results of the current study confirm that the implementation of various sustainable land management practices are influenced by farming technologies deployed by rural households, agro-ecological variations, plot characteristics, and institutional supports. The findings also affirm that most of the sustainable land management practices are complementary to one another, and implementing two or more sustainable land management practices on a given plot is highly associated with higher value of crop production. Such complementarity highlights that the productivity effect of a given sustainable land management practice is enhanced by the use of the other ones.

Purpose. Rural households spend a large share of their daily time to search for grazing feed, water resource and collect straw by displacing labor time away from crop farming activities. This paper aims to analyze the economic effect of time spent looking for animal water and grazing areas on farm labor input and crop farm output. Methodology / approach. To address our objectives, a general Cobb-Douglas production function was estimated using a unique dataset from 518 sample farmers in Tigrai, Ethiopia drawing on a non-separable farm household model. Results. The results favor the hypothesis of a negative relationship between crop output and resource scarcity. In aggregate, the findings confirm that reducing time spent looking for water, grazing and straw by 1 % leads to an increase in food production by 0.155 %, 0.279 % and 0.328 % respectively. Similarly, the shadow price variables are significant, have the expected negative sign and are consistent with the theory. The sign of other factors are consistent with the prediction of the economic theory. Originality / scientific novelty. The noble contribution of this paper is, unlike previous studies, we collected information on the entire set of crop production, along with the distance to grazing, water and crop residue of each household. This paper considers three important resources for an animal such as grazing, water and crop residue, of which the first two have not been explored well. The use of distance level and shadow price as resource scarcity indicators is an extra benefit to the literature. Practical value / implications. The results of this paper provide an interesting picture of stallholders in Ethiopia. As expected, it appears that time spent searching for animal water and feed has a significant and negative effect on labor and crop output. Our results got the evidence of a negative relationship between labor input to crop farming and resource scarcity.

Background: Antepartum hemorrhage is a very serious problem and contributes significantly to maternal and neonatal morbidity and mortality in developing countries including Ethiopia. Identification of risk factors of antepartum hemorrhage will help for prevention and control programs. Methods: An institutional-based case–control study was conducted from July 2013 to June 2016. A simple random sampling technique was employed, and 420 mothers' medical cards were reviewed using a pretested checklist. The data were entered in to EPI-info version 7 and then exported to SPSS version 20 for analysis, and all variables with a P-value< 0.2 at bivariate logistic regression analysis were considered as a candidate for multivariate logistic regression analysis, and those variables with a P-value< 0.05 in multiple logistic regression analysis were considered as significantly associated at 95% confidence interval. Results: Results of the multiple logistic regression showed that those mothers whose age was in the range of 35– 44 years were significantly 4-times more likely to present with antepartum hemorrhage as compared to mothers in the age range of 15– 24 years. Moreover, mothers who presented with a previous history of cesarean section were 4.7-times more likely to present with antepartum hemorrhage than those who had no previous history of cesarean section. Furthermore, women with a previous history of abortion were 2-times more likely to develop antepartum hemorrhage as compared to women who had no previous history of abortion. Conclusion and Recommendation: In this study, the factors found to be risk factors of antepartum hemorrhage were maternal age, previous history of cesarean section, and previous history of abortion. Strategies towards reduction of unwanted pregnancy to prevent abortion, pregnancy at advanced age, and to reduce the cesarean section rate should be emphasized. [ABSTRACT FROM AUTHOR]

Technological change in agriculture in climate risk exposed developing countries requires for land-use intensification to feed the growing populations. The purpose of this article is to analyze the impact of participation in rural credit program on adoption of yield enhancing technology(inorganic fertilizer) using 1412 farm households surveyed in 2005/06, 2009/10, and 2014/15 cropping seasons from rural Tigrai, northern Ethiopia where smallholder farmers are financially constrained to purchase of improved agricultural technologies. The paper uses a double hurdle correlated random effect models with a control function approach to analyze the causal effect. Results show that controlling for the unobservable heterogeneity and the underlying determinants of fertilizer adoption and credit participation, for an increase of credit size by 1% from its mean, adoption rate of inorganic fertilizer has increased by 2.5% and supports the earlier hypothesis. The results imply that expanding and strengthening of rural credit program are crucial for smallholder agriculture and appeared to have a more robust impact on adoption of inorganic fertilizer.

Technological change in agriculture in climate risk exposed developing countries requires for land-use intensification to feed the growing populations. The purpose of this article is to analyze the impact of participation in rural credit program on adoption of yield enhancing technology(inorganic fertilizer) using 1412 farm households surveyed in 2005/06, 2009/10, and 2014/15 cropping seasons from rural Tigrai, northern Ethiopia where smallholder farmers are financially constrained to purchase of improved agricultural technologies. The paper uses a double hurdle correlated random effect models with a control function approach to analyze the causal effect. Results show that controlling for the unobservable heterogeneity and the underlying determinants of fertilizer adoption and credit participation, for an increase of credit size by 1% from its mean, adoption rate of inorganic fertilizer has increased by 2.5% and supports the earlier hypothesis. The results imply that expanding and strengthening of rural credit program are crucial for smallholder agriculture and appeared to have a more robust impact on adoption of inorganic fertilizer. [ABSTRACT FROM AUTHOR]

The purpose of this study is to assess the impact of participation in the land rental market on smallholder farmers' commercialization using farm household panel data in Tigrai, Ethiopia. Regression results reveal that 1 hectare increase in area rented in by tenant households leads to a 60% increase in the likelihood of participation in the output market as a crop seller and increases the marketed output sold by tenant households by US$ 200/year. The results appear to indicate that land rental market in the land scarcity economy to some extent contributes positively in the facilitation of transformation toward smallholders' commercialization. [ABSTRACT FROM AUTHOR]

Abstract Background Solid biomass-based energy is expected to retain its position as a sole fuel source for households in the rural part of Ethiopia unless alternative energy sources are introduced. Synthesizing small-scale renewable alternative energy sources, such as biogas energy, into the energy mix has become an important strategy to overcome the energy hunger of its rural residents. As part of the government policy, small-scale biogas digesters have been installed in selected districts and regions of the country since 2007. There is, however, limited evidence on whether or not the intended objectives of the domestic biogas initiative have been actualized by the participants of the project. This paper, therefore, intends to investigate the economic benefits of domestic biogas plants along with the challenges facing it and future prospects of the biogas initiative in selected districts of northern Ethiopia. Methods Qualitative data were gathered using focus group discussion and key informant interviews. A survey of 400 households was also administered to capture cross sectional data using structured questionnaires. The qualitative data were analyzed using content analysis. A propensity score matching model was employed to evaluate the effects of domestic biogas technology on energy expenditure, crop yield, and the substitution of chemical fertilizers. Results The study finds that biogas adopters have reduced their monthly energy expenditure on average by 20–36%. Moreover, the existence of a positive crop yield premium of 1.5 quintal/year/household was observed as a result of using bio-slurry as a fertilizer. The key factors that limit the extension of biogas technology to potential biogas adopters are the presence of failed digesters, an inadequate plot of land for the digester construction and a water availability problem. In light of such barriers, however, the study finds that more favorable environments for the widespread use of the technology exist. Conclusions Biogas user households have significantly reduced their energy expenditure compared to non-biogas adopters. Nevertheless, despite the modest increase in crop yield, the overall effect of bio-slurry application on crop productivity and substituting chemical fertilizers was not significant because of an improper bio-slurry utilization and management.

Although the agriculture economic sector in Ethiopia yet feeds enormous people, it's negatively impacted by climate change thereby contributed to the lower production and productivity. The research dealt therefore on the price effect of climate change on vegetable using time series data collected from 2009 to 2015 in Tigrai, Ethiopia. A univariate econometric analysis and finite distributed lag model were employed. In the descriptive part, due to climate change; tomato the vital vegetable consumed both in urban and rural population has recorded the highest inflation (211 percent) from 2009 to 2015 alone as compared to potato and onion. Whereas, potato and onion vegetables were rose up more than 152 and 154 percent consecutively on the same period. The average temperature increase of 1oC over the past seven years caused the price of tomato vegetable to increase more than threefold (310 percent) in 2015. Likewise, in the year 2010 as the temperature increased by 1oC, the average price of tomato increased close to 155 percent, ceteris paribus. Even the price of tomato vegetables raised 118 percent in 2011 as compared to 2009. In 2013 and 2014, a 1oC rise in the average temperature cause close to 58 percent and 23 percent increase in the price of tomato, ceteris paribus. Moreover, the price increment of potato and onion vegetables is high. So as to get healthy vegetables often at fair prices both by the poor and rich in both the rural and urban population, applying outstanding climate adaptive strategies is recommendable.

The performance of the textile and apparel sector is affected by several factors which include raw material, machinery and labor force. The cost of labour, its level of training and availability can be one of the key factors that may influence the location of clusters of industries in a given region. Ethiopia, like many African countries is trying to move from agrarian to manufacturing economy, and it has earmarked the textile and apparel sector as one of the priority industries which will be used in the initial phrase. This research work concentrated on the availability of labour in the Tigrai region of Ethiopia. The research methodolody involved several methods which included; face to face interviews, focus group discussions, field visits and observations and sample survey. The survey took workers and management of Almeda Textile and Garment factory, Maa Garment and textile factory, Velocity Apparelz and the DBL group as its population. The results from this research work indicated that only 23.6 % of the respondents believe that workers are readily available. This is a very low figure. Most of the respondents (66.7%), reported that it is possible to find workers. This implies that factories have to go and extra step in order to get the workers. Labor turnover in the Tigrai region is high, with majority of the workers (58.5%) having worked for less than 3 years in the factories. [ABSTRACT FROM AUTHOR]

Background: In Ethiopia, like other developing countries, intestinal parasitic infections are the major public health problems affecting millions annually. Overcrowding and poor living conditions are the major risk factors. Prison inmates are among the most vulnerable groups to intestinal parasitic infections. However, there is scarcity of epidemiological data regarding intestinal parasites among prison inmates in Ethiopia, notably in Tigrai. Thus, we aimed to determine the prevalence of intestinal parasites and identify the associated factors among inmates of Mekelle prison, Tigrai, Northern Ethiopia.Methods: A cross sectional study involving 291 inmates was conducted from February to June 2017 among inmates of Mekelle prison. After systematically selecting subjects, stool specimens were examined using direct wet mount and formol-ether concentration techniques. We used SPSS version 21 for data analysis. We considered p-value less than 0.05 significant at 95% confidence level.Results: Of the 291 inmates enrolled in the study, 124 (42.6%) harbored one or more intestinal parasites. The protozoan Entamoeba histolytica/dispar/moshkovskii was the predominant parasite accounted for 68 (23.3%) of the infections followed by Giardia lamblia (10.3%) and Entamoeba coli (8.2%). Fourteen (4.8%) participants were co-infected with different parasite species. The co-infections of Entamoeba histolytica/dispar/moshkovskii and Giardia lamblia were detected among 3.1% of the participants. In bivariate analysis, hand fingernail status (COR 1.86, 95% CI, 1.08-3.20) and duration of stay in prison (COR 2.23, 95% CI 1.31-3.79) were statistically associated with intestinal parasite infections. In multivariable regression, inmates who stayed in the prison for one year or less were more likely to harbor intestinal parasitic infections (p = 0.013) than those who stayed longer. No other single predictor variable was found to be significantly associated with intestinal parasitic infections.Conclusions: The result of this study showed that intestinal parasites are significant health problems among inmates of Mekelle prison. [ABSTRACT FROM AUTHOR]

This paper aims at evaluating the impact of productive safety net program on poverty using primary data from randomly selected 600 households in central zone of Tigrai National Regional State, Ethiopia. Propensity Score Matching and Foster-Greer-Thorbecke were used to evaluate impact of the program and poverty, respectively. The paper revealed that the program has positive and significant effect on consumption, livestock holdings, and productive assets. Moreover, impact of the program on total consumption expenditure per adult equivalent was found to be positive and significant. Using total poverty line, poverty rate was lowest among program participants (30.33%) than non-participants (31.1%). Highest poverty rate was found among households headed by women (38.42%) while households headed by men (23.1%). The study also revealed that the program has positive and significant effect on poverty reduction and protecting productive assets. Finally, it was recommended that female headed program participants based programs should be provided to help boost their agricultural output and reduce endemic poverty.