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The excessive abstraction of lake water affects its sustainability and is common in Lake Tana. Hence this study aims to develop operation rule curves for optimum operation of Lake Tana reservoir by considering the effects of small and large-scale irrigation water abstraction, Hydropower demand, and climate change. The data used in this study were produced by two Global Circulation Models (GCMs) (MIROC5 and MPI) under two Representative Concentration Pathways (RCP4.5 and RCP8.5) in the 2040s (2020–2049) and 2070s (2050–2079). For RCP4.5 and RCP 8.5 scenarios of the 2040s- and 2070s-time domains, lake temperature exhibits an upward trend. The lake rainfall also will show an increase for the 2040s and 2070s under both RCP scenarios. The outcome showed that in all future scenarios, lake evaporation under RCP4.5 of 2040s and 2070s rise between 3.6 % to 7 % and 4.6 % to 19, respectively, while for RCP8.5 of 2040s and 2070s increases between 4.6 % to 9.9 % and 9.2 % to 24.7 %. The surface water inflow increased for RCP4.5 (2070s) and RCP8.5 (2040s), whereas it declined for RCP4.5 (the 2040s) and RCP8.5 (2070s. Under both scenarios, the average value of the time-based and volumetric reliability in the 2040s and 2070s is less than 80 %. The reservoir will take a very long time to recover from the shortfall as the resilience levels are below 50 %. Additionally, the dimensionless vulnerability was less than 50 %, indicating that there won't be a shortage of inflow to meet demand at the reservoir. Based on evaluation, the reservoir will not probably perform well in any way because of the rise in upstream abstractions. To guide the operation of the reservoir, operation rule curves were developed using the Hec-ResSim model. Generally, the government, decisions, and policymakers should set a water resources management plan not trigger normal functioning of the Lake system.

Since most of the countries in Africa rely on Agriculture supported by rainfall, they are especially vulnerable to dangers brought on by climate change, such as floods and droughts. Droughts in the Horn of Africa are immediately in danger of starvation, particularly in Ethiopia. This study uses ensemble GCM data at the Coupled Model Intercomparison Project 5 (CMIP5) to examine the future metrological and hydrological drafts of the chosen gauged watershed, specifically Gilgel Abay, Gumara, Megech, and Ribb. For the analysis, the Standardized Precipitation Index (SPI), Reconnaissance Drought Index (RDI), and Streamflow Drought Index (SDI) were used, along with data from the RCP4.5 and RCP8.5 scenarios. The SPI and RDI were used to analyze metrological drought, and the SDI was used to identify hydrological drought in the mid (2040–2079) to long-term (2050–2079) period. Overall meteorological drought results show that annual time scale drought occurrence is higher than biannual time scale in both indices. Under the biannual time scale (SPI6) and annual time scale (RDI12) for RCP8.5 scenarios of all time horizons, 20.69% of the maximum drought record was observed. While the (SPI12) indices of RCP4.5 and RCP8.5 for all time domains (mid and far) display a drought frequency of 17.24%. And according to the RCP8.5 scenario, RDI6 also predicts that droughts would occur 18.10% more frequently in the far future. Additionally, the RCP8.5 scenario has the greatest frequency record for hydrological droughts across all time horizons at 18.10%. Gumara and Ribb gauged watersheds are typically the most susceptible to drought in the mid periods. The study revealed that drought analysis is important to take planning activities for those who are working as researchers, water resource managers and other professions in the basin. As a result, the study will assist the government, policymakers, and decision-makers in putting drought adoptions and early warning actions in place.

Climate change has the potential to affect climate parameters like rainfall and temperature which lead to a change in the irrigation water requirement of the irrigation system. As irrigation water requirement is highly dependent on precipitation and potential evapotranspiration, climate change impact studies are necessary. Therefore, this study aims to assess the impact of climate change on the irrigation water requirement of the Shumbrite irrigation project. For this study, climate variables of precipitation and temperature were generated from CORDEX-Africa simulations downscaled from MPI Global Circulation Model (GCM) under three emission scenarios (RCP2.6, RCP4.5, and RCP8.5). The climate data covers from 1981 to 2005 for the baseline period and 2021–2045 for the future period for all scenarios. Future precipitation shows a decrease for all scenarios with a maximum decrease under RCP2.6 (4.2%) and temperature show an increase in the future as compared to the baseline period. The reference evapotranspiration and Irrigation Water Requirements (IWR) were calculated by using CROPWAT 8.0 software. Results showed that the mean annual reference evapotranspiration is expected to increase in the future by 2.7%, 2.6%, and 3.3% for RCP2.6, RCP4.5, and RCP8.5 respectively as compared to the baseline period. Mean annual irrigation water requirement shows an increase of 2.58%, 0.74%, and 8.4% for the future under RCP2.6, RCP4.5, and RCP8.5 respectively. The Crop Water Requirement (CWR) also increases for the future period under all RCP scenarios, with maximum CWR for tomato, potato, and pepper crops. To ensure the sustainability of the project, crops with high irrigation water requirements should be replaced by other crops with low water requirements.

Climate change has the potential to reduce the water resource availability and hence the amount of storage in reservoirs. In this study, we assessed the impact of climate change on the performance of the Shumbrite reservoir using outputs from the CORDEX-Africa project, MPI Global Circulation Model (GCM) under three Representative Concentration Pathways (i.e., RCP2.6, RCP4.5 and RCP8.5). The trend analysis of future precipitation shows a decrease in the range of 0.57%–4.2%, with a maximum decrease under RCP2.6, and temperature (both maximum and minimum) shows an increasing trend as compared to the baseline period. The HBV model simulated future mean annual flow volume shows a decrease (ranges 0.06% to 1.64%) for RCP2.6 and RCP4.5 and a significant increase of 5.03% for RCP8.5 compared to the baseline period. Mean annual irrigation water demand from CROPWAT shows an increase (0.74% to 8.4%) for all RCPs compared to the baseline period. The time-based reliability for the Shumbrite reservoir has an average value above 80%. The resilience values are below 50% for all RCPs and hence the reservoir will take an extended period to recover from an inability to achieve the target demand volume. The dimensionless vulnerability shows a value below 50% which indicates that the reservoir has no insufficient flow to meet the demand. Generally, the reservoir can be used sustainably with operation rule curves. Generally, this study adds a contribution to the evaluation of small-scale reservoirs under a changing climate and the preparation of guide curves for the respective release.

Abstract Background Cervical cancer is a leading cause of cancer mortality globally, especially in Africa, including Ethiopia. This review assesses predictors of cervical cancer screening uptake among Ethiopian-eligible women using the Health Belief Model. Higher education levels, perceived susceptibility, severity, and fewer barriers are associated with increased screening. Effective HBM-based interventions could enhance screening rates, potentially reducing cervical cancer incidence and mortality. Objective The review aimed to synthesize the existing literature on the prevalence of Cervical Cancer Screening Service Uptake and Associated Factors among Eligible Women using the Health belief model in Ethiopia, 2024. Method This systematic review and meta-analysis searched Google Scholar, PubMed, and the Cochrane Library engine. Key terms such as "Cervical cancer screening", "uptake", "utilization", "factors", "barriers", and "Ethiopia" were used to identify relevant articles. Data extraction utilized a detailed form, and the methodological quality of each study was assessed using the JBI quality appraisal checklist for cross-sectional studies. Statistical analysis was conducted using STATA version 17, and the meta-analysis findings were presented using forest plots and tables. Result The result of seven studies revealed that the overall prevalence of Cervical Cancer Screening Service Uptake among eligible women in Ethiopia was 21% (95% CI: 15%-27%). Factors independently associated with Cancer Screening Service Uptake included: Knowledge (OR = 4.563, 95% CI: 1.012–4.188), age 30 up to 49 (OR = 4.106, 95% CI: 1.562–6.650), history of STD (OR = 2.59, 95% CI: 1.694–4.486), high perceived susceptibility (OR = 3.814, 95% CI: 2.312–5.316), high perceived severity (OR = 2.603, 95% CI: 2.203–3.003), low perceived barrier (OR = 4.390, 95% CI: 1.331–8.449), high perceived self-efficacy (OR = 4.77, 95% CI: 4.102–5.431), high perceived benefit (OR = 3.67, 95% CI: 1.851–5.489), and education level greater than primary level (OR = 4.497, 95% CI: 3.619–5.375). Conclusion Cervical cancer is a major public health challenge in Ethiopia. Consequently, there is a pressing need for the governments to formulate comprehensive, multi-sectorial policies and strategies. These initiatives should be designed to address the problem influenced by interconnected factors, to reduce the prevalence of cervical cancer in Ethiopia.

Abstract Background Sexually transmitted infections (STIs) are illnesses mainly spread through unprotected sexual activity. There is a scarcity of aggregate evidence in Ethiopia. The aim of this review was to assess the pooled prevalence of STI, and its associated factors among students in Ethiopia to fill the aforementioned gap. Methods We extensively searched the bibliographic databases of PubMed, Scopus, and Google Scholar to obtain eligible studies. Further screening for a reference list of articles was also done. The Microsoft Excel Spreadsheet was used to extract data, and Stata 17 was used for analysis. The PRISMA-guidline and Newcastle-Ottawa quality assessment scale were used for quality appraisal. To check heterogeneity, the Higgs I2 and Cochran’s Q tests were employed. Sensitivity and subgroup analysis were implemented. To detect publication bias, Egger’s test and funnel plots were used. Results The pooled prevalence of STI among students in Ethiopia was 13.6% with a 95% CI (10.2, 17). Findings from sub group analysis based on student category shows that the pooled prevalence of STI were 14.5% among University students, 14.2% among college students and 10.6% among high school students. Having multiple sexual partners (AOR 3.31; 95% CI: 2.40–4.57), not using condoms during sexual intercourse (AOR 2.56; 95% CI: 1.72–3.81), and having poor knowledge about sexually transmitted infections were 3.08 times (AOR 3.08; 95% CI: 1.84–5.15) significantly associated with STI. Conclusion The pooled prevalence of STIs among students in Ethiopia was high, and factors like having multiple sexual partners, not using condoms during sexual intercourse, and having poor knowledge about sexually transmitted infections were significantly associated with STIs. Hence, reduce STIs among students, strengthening sexual and reproductive health services, raising awareness about transmission and prevention, and promoting consistent condom use through health information dissemination is crucial. Further qualitative studies are suggested to explore the barriers and facilitators of STI prevention.

Abstract Introduction Scabies is a widespread issue in prisons due to overcrowded living conditions and limited healthcare resources. A recent study published in the Journal of Infection and Public Health discovered that the prevalence of scabies varies greatly among prisoners in different regions and facilities. This review aimed to determine the global prevalence and predictors of scabies among prisoners by conducting a systematic review and meta-analysis. Methods We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis checklist to report the findings of our systematic review and meta-analysis. Relevant databases including PubMed, Cochrane Library, ScienceDirect, and other grey literature databases were used to search and retrieve articles. The study included both published and unpublished research written in English languages for studies reporting the prevalence of human scabies among prisoners. This review has been registered on PROSPERO. The heterogeneity of the data was evaluated using the I2 statistic. A meta-analysis was conducted using STATA 17 software, with a 95% confidence interval. The researchers also conducted publication bias and sensitivity analysis. Results The review included 7 studies involving 1, 309,323 prisoners. All included studies involved cross-sectional study design. The prevalence of scabies among prisoners ranges from 0.72% in Italy to 41.01% in Cameroon. The global pooled prevalence of human scabies among prisoners was found to be 6.57% (95% CI; 2.16–19.94). According to subgroup analysis, the overall prevalence of scabies among African prisoners was 19.55% (95% CI; 9.44–40.45), while the prevalence among prisoners outside of Africa was 1.57% (95% CI; 0.77–3.19). The length of time spent in prison, sharing of clothing or beds, and hygiene practices were found to be factors that were significantly associated with the likelihood of prisoners developing human scabies. Conclusion The overall prevalence of human scabies is high among prisoners worldwide. Prisoners who spent more time in prison shared clothing or beds, and had poor hygiene practices were more likely to develop human scabies. Thus, efforts should be made by policymakers and program administrators to decrease the prevalence of scabies in prisons. The protocol for this systematic review and meta-analysis was registered in the International Prospective Register of Systematic Reviews with registration number CRD42024516064.

Abstract Introduction There has been extensive research conducted on open defecation in Ethiopia, but a notable gap persists in comprehensively understanding the spatial variation and predictors at the household level. This study utilizes data from the 2021 Performance Monitoring for Action Ethiopia (PMA-ET) to address this gap by identifying hotspots and predictors of open defecation. Employing geographically weighted regression analysis, it goes beyond traditional models to account for spatial heterogeneity, offering a nuanced understanding of geographical variations in open defecation prevalence and its determinants. This research pinpoints hotspot areas and significant predictors, aiding policymakers and practitioners in tailoring interventions effectively. It not only fills the knowledge gap in Ethiopia but also informs global sanitation initiatives. Methods The study comprised a total weighted sample of 24,747 household participants. ArcGIS version 10.7 and SaT Scan version 9.6 were used to handle mapping, hotspots, ordinary least squares, Bernoulli model analysis, and Spatial regression. Bernoulli-based model was used to analyze the purely spatial cluster detection of open defecation at the household level in Ethiopia. Ordinary Least Square (OLS) analysis and geographically weighted regression analysis were employed to assess the association between an open defecation and explanatory variables. Results The spatial distribution of open defecation at the household level exhibited clustering (global Moran’s I index value of 4.540385, coupled with a p-value of less than 0.001), with significant hotspots identified in Amhara, Afar, Harari, and parts of Dire Dawa. Spatial analysis using Kuldorff’s Scan identified six clusters, with four showing statistical significance (P-value

Abstract Introduction Worldwide, breast cancer is the primary cause of illness and death. Unless early detected and treated breast cancer is a life-threatening tumor. Advanced-stage presentation is greatly linked with short survival time and increased mortality rates. In Ethiopia nationally summarized evidence on the level of advanced-stage breast cancer diagnosis is scarce. Therefore, this systematic review and meta-analysis aimed to determine the pooled prevalence of advanced-stage breast cancer diagnosis and its determinants in Ethiopia. Method By following PRISMA guidelines, a systematic review and meta-analysis were carried out. To include relevant publications, a broad literature search was conducted in the African Online Journal, PubMed, Google Scholar, and Embase which are published until last search date; June 15, 2023. To prevent further duplication this review was registered in PROSPERO database with ID no of CRD42023435096. To determine the pooled prevalence, a weighted inverse variance random effect model was applied. I2 statistics and the Cochrane Q-test were computed to determine heterogeneity. To evaluate publication bias, a funnel plot, and Egger’s regression test were used. Result A total of 924 articles were sought and finally 20 articles were included in this review. The pooled prevalence of advanced-stage breast cancer diagnosis in Ethiopia was 72.56% (95%CI; 68.46-76.65%). Use of traditional medicine as first choice (AOR = 1.32, 95% CI: (1.13–1.55)), delay of > 3 months in seeking care (AOR = 1.24, 95% CI: (1.09–1.41)), diagnosis or health system delay of > 2 months (AOR = 1.27, 95% CI: (1.11–1.46)), rural residence (AOR = 2.04, 95% CI: (1.42 − 2.92)), and chief complaint of a painless breast lump (AOR = 2.67, 95% CI: (1.76–4.06)) were significantly associated to advanced-stage diagnosis. Conclusion In Ethiopia, more than two-thirds of breast cancer cases are diagnosed at an advanced stage. Use of traditional medicine before diagnostic confirmation, delay in seeking care, health system delay, rural residence, and chief complaint of painless breast lump were positively associated with an advanced-stage diagnosis. Policymakers and program designers give great focus to those delays so as to seek and access modern diagnosis and treatment as early as possible specifically focusing on those who are rurally residing.

Abstract Background Access to health care services is a basic human right, and an individual’s health and overall quality of life may suffer as a result of barriers to accessing health services. Access to comprehensive and quality health care is fundamental for promoting and maintaining health, preventing and treating diseases, and reducing premature deaths. However, only half of the African population has access to modern health services. Therefore, this study aimed to assess the health care access and associated factors among female youths in low-income East African countries. Methods This study used secondary data from 2016 to 2021 demographic and health surveys of 7 low-income East African countries. A total weighted sample of 51,064 youths was included. A multilevel binary logistic regression was employed to identify the associated factors of access to health care since the data has a hierarchical structure. Adjusted Odds Ratio (AOR) with a 95% confidence interval (CI) at a p-value less than 0.05 was used to measure the association of variables whereas Intra-class correlation coefficient (ICC), Median Odds Ratio (MOR), and proportional change in variance (PCV) were used to measure random effects. Result The overall magnitude of access to healthcare among female youths in low-income East African countries was 38.84% (95% CI: 38.41, 39.26). Youth’s educational level, rich wealth status, media exposure, and community level education were the positive while higher youth’s age and rural residence were the negative predictors of access to healthcare among female youths. Besides, living in different countries compared to Burundi was also an associated factor for accessing healthcare in low-income East African countries. Conclusion About six in ten female youths were not accessing health care in low-income East African countries. Therefore, to increase healthcare access, health managers and policymakers needed to develop strategies to improve the poor household wealth index, and redistribution of health services for rural residents. The decision-makers and program planners should also work on increasing access to education and media exposure for youths. Further research including health system and quality of service-related factors for accessing healthcare should also be considered by researchers.

Abstract Introduction Ethiopia strives to achieve Universal Health Coverage (UHC) through Primary Health Care (PHC) by expanding access to services and improving the quality and equitable comprehensive health services at all levels. The Health Extension Program (HEP) is an innovative strategy to deliver primary healthcare services in Ethiopia and is designed to provide basic healthcare to approximately 5000 people through a health post (HP) at the grassroots level. Thus, this review aimed to assess the magnitude of health extension service utilization in Ethiopia. Methods The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) checklist guideline was used for this review and meta-analysis. The electronic databases (PubMed, Cochrane Library, and African Journals Online) and search engines (Google Scholar and Grey literature) were searched to retrieve articles by using keywords. The Joanna Briggs Institute (JBI) meta-analysis of statistics assessment and review instrument was used to assess the quality of the studies. Heterogeneity was assessed using the I2 statistic. The meta-analysis with a 95% confidence interval using STATA 17 software was computed to present the pooled utilization of health extension services. Publication bias was assessed by visually inspecting the funnel plot and statistical tests using Egger’s and Begg’s tests. Result 22 studies were included in the systematic review with a total of 28,171 participants, and 8 studies were included in the meta-analysis. The overall pooled magnitude of health extension service utilization was 58.5% (95% CI: 40.53, 76.48%). In the sub-group analysis, the highest pooled proportion of health extension service utilization was 60.42% (28.07, 92.77%) in the mixed study design, and in studies published after 2018, 59.38% (36.42, 82.33%). All studies were found to be within the confidence interval of the pooled proportion of health extension service utilization in leave-out sensitivity analysis. Conclusions The utilization of health extension services was found to be low compared to the national recommendation. Therefore, policymakers and health planners should come up with a wide variety of health extension service utilization strategies to achieve universal health coverage through the primary health care.

Abstract Background Abdominal injuries exert a significant impact on global morbidity and mortality. The aggregation of mortality data and its determinants across different regions holds immense importance for designing informed healthcare strategies. Hence, this study assessed the pooled mortality rate and its predictors across sub-Saharan Africa. Method This meta-analysis employed a comprehensive search across multiple electronic databases including PubMed, Africa Index Medicus, Science Direct, and Hinari, complemented by a search of Google Scholar. Subsequently, data were extracted into an Excel format. The compiled dataset was then exported to STATA 17 statistical software for analysis. Utilizing the Dersimonian-Laird method, a random-effect model was employed to estimate the pooled mortality rate and its associated predictors. Heterogeneity was evaluated via the I 2 test, while publication bias was assessed using a funnel plot along with Egger's, and Begg's tests. Result This meta-analysis, which includes 33 full-text studies, revealed a pooled mortality rate of 9.67% (95% CI; 7.81, 11.52) in patients with abdominal injuries across sub-Saharan Africa with substantial heterogeneity (I2 = 87.21%). This review also identified significant predictors of mortality. As a result, the presence of shock upon presentation demonstrated 6.19 times (95% CI; 3.70-10.38) higher odds of mortality, followed by ICU admission (AOR: 5.20, 95% CI; 2.38-11.38), blunt abdominal injury (AOR: 8.18, 95% CI; 4.97-13.45), post-operative complications (AOR: 8.17, 95% CI; 4.97-13.44), and the performance of damage control surgery (AOR: 4.62, 95% CI; 1.85-11.52). Conclusion Abdominal injury mortality is notably high in sub-Saharan Africa. Shock at presentation, ICU admission, blunt abdominal injury, postoperative complications, and use of damage control surgery predict mortality. Tailored strategies to address these predictors could significantly reduce deaths in the region.

Abstract Background Health literacy is the important for the prevention of non-communicable disease to make informed health decisions, and practice healthy and protective behaviours. Therefore, application of socioecological model to this study aimed to identify multilevel factors on health literacy among patients and develop scientific health communication interventional strategies to improve health literacy on non-communicable disease prevention and care. Objective To explore barriers of health literacy on non-communicable disease prevention and care among patients in north wollo zone public Hospitals, Northeast Ethiopia, 2023. Method In this study phenomenological study design was conducted from February 5 to 30/2023.We have used purposive sampling technique to select study participants from chronic follow up clinics. Data were collected using in-depth interview and focused group discussion in which audio was recorded, transcribed verbatim and translated to English. Thematic analysis was performed with atlas ti. 7 software. Result In this study four main themes with seven subthemes were developed. The main themes were factors at the organizational, community, interpersonal, and intra-personal factors. The poor knowledge, lack of enough money for transportation and medication at the hospital were identified as barrier to get early diagnosis and treatment. Some participants explored that they have no any support from family or others. The cultural norms like weeding and funeral ceremonies enforce patients to consume prohibited substances like alcohol and salty foods. Conclusion In this study different barriers of health literacy were explored. Lack of knowledge, economic problems, lack of social support, poor communication with health care providers, cultural influences, lack of regular health education, lack of access to health care services and poor infrastructure were main barriers of health literacy in patients with NCD. Therefore, we recommended all concerned bodies to work on social and behavioral change communication intervention focusing on awareness creation, supply of drugs and create supportive environment to get accessible and affordable health care service to decrease the impact of non-communicable disease at personal, community and national level.

IntroductionSeveral studies have been done on the utilization of sexual and reproductive health services by high school students in Ethiopia, but they have yielded inconsistent results. This study aimed to evaluate the extent to which high school students in Ethiopia are using sexual and reproductive health services by conducting a systematic review and meta-analysis.MethodsVarious electronic databases such as PubMed, Cochrane Library, AJOL, Google Scholar, and Grey Literature were used to search for relevant articles. Preferred Reporting Items for Systematic Reviews and Meta-Analysis Guidelines were followed for this review and meta-analysis. Heterogeneity was assessed using I2 and Cochrane Q statistical tests, and data analysis was done with STATA 17 software. Random effect meta-analyses were used to determine the overall utilization rate of sexual and reproductive health services.ResultThis review included 20 studies with 12, 215 study participants. The pooled magnitude of sexual and reproductive health service utilization among high school students in Ethiopia was 29.79% (95% CI: 25.14, 34.43). Students with grades 11–12 (AOR = 2.33, 95% CI: 1.39, 3.90), aged between 20 and 24 years (AOR = 2.61; 95% CI: 1.79–3.81), having higher level of knowledge towards sexual and reproductive health issues (AOR = 3.10; 95% CI: 1.67–5.77), previous history of sexual intercourse (AOR = 4.18; 95% CI: 2.59–6.75), previous history of sexually transmitted infection (AOR = 3.74; 95% CI: 2.22–6.31), presence of a reproductive health service facility in the school (AOR = 2.55; 95% CI: 1.72–3.77), and ever-discussed reproductive health issues (AOR = 4.04; 95% CI: 1.62–10.03) were more likely to utilize sexual and reproductive health services.ConclusionsThe overall utilization of sexual and reproductive services among high school students in Ethiopia was found to be low as compared to SDG 3.7. Older individuals with higher education levels and knowledge about sexual and reproductive health services, as well as those who have had previous sexual experiences or discussions about sexual health, are more likely to utilize reproductive health services. To increase utilization, the Ministry of Health and the Ministry of Education should prioritize these factors.

IntroductionCervical cancer is a prevalent cancer among women in low and middle-income countries, but it can be largely prevented through screening programs and HPV vaccination. This study aimed to determine the level of knowledge, attitudes, and practices regarding cervical cancer screening among healthcare providers in Sub-Saharan African countries.MethodsSystematic review and meta-analysis were conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Relevant databases including PubMed, Cochrane Library, AJOL, Google Scholar, and ScienceDirect databases were used to retrieve and search articles. The study included published and unpublished research written in English between January 2013 and May 16, 2024 for studies reporting knowledge, attitude, and practice towards cervical cancer screening among healthcare providers in Sub-Saharan Africa. This review has been registered on PROSPERO. The heterogeneity of the data was evaluated using the I2 statistic. A meta-analysis was conducted using STATA 17 software, with a 95% confidence interval. The researchers also conducted publication bias and sensitivity analysis.ResultsThe review included 30 studies involving 7542 healthcare providers. The pooled magnitude of good knowledge status towards cervical cancer was 67.93% (95% CI: 53.36–82.50) whereas the pooled magnitude of positive attitude towards cervical cancer was 55.26% (95% CI: 34.28– 76.23). The results also showed that about 49.68% (95% CI: 33.18–66.17) of healthcare providers had good knowledge status about cervical cancer screening, 66.63%(95% CI: 50.36– 82.89) had a positive attitude towards it, and only 17.23% (95% CI; 6.08-28.37) had ever screened for cervical cancer.ConclusionThe overall magnitude of knowledge and attitude of healthcare providers in Sub-Saharan Africa towards cervical cancer and its screening was suboptimal. Furthermore, a low percentage of female healthcare providers in the region had undergone screening for cervical cancer. As a result, policymakers and program administrators should focus on improving the knowledge, attitude, and practices of healthcare providers to meet the global health goal of cervical cancer screening and effectively eliminating cervical cancer. Healthcare providers must serve as role models for other women who should also undergo screening.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/, identifier CRD42023495241.

IntroductionThis study delves into individual and community-level factors influencing the availability of water, soap, and cleansing agents for handwashing in Ethiopia. Its comprehensive exploration offers nuanced insights, informing targeted interventions and policies to effectively enhance handwashing resources across Ethiopia. Therefore, this study aimed to assess individual and community-level factors of availability of observed water, soap, and other cleansing agents for hand washing practices in Ethiopia.MethodsData from the 2021 PMA-ET, encompassing 24,747 household participants, informed this study. Employing STATA version 17.0, a multi-level mixed-effect logistic regression analysis was performed to identify individual and community-level factors. Adjusted odds ratios with a 95% confidence interval conveyed the strength and direction of associations, with significance determined at p

Abstract Introduction Globally, chest trauma remain as a prominent contributor to both morbidity and mortality. Notably, patients experiencing blunt chest trauma exhibit a higher mortality rate (11.65%) compared to those with penetrating chest trauma (5.63%). Aim This systematic review and meta-analysis aimed to assess the mortality rate and its determinants in cases of traumatic chest injuries. Methods The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist guided the data synthesis process. Multiple advanced search methods, encompassing databases such as PubMed, Africa Index Medicus, Scopus, Embase, Science Direct, HINARI, and Google Scholar, were employed. The elimination of duplicate studies occurred using EndNote version X9. Quality assessment utilized the Newcastle-Ottawa Scale, and data extraction adhered to the Joanna Briggs Institute (JBI) format. Evaluation of publication bias was conducted via Egger’s regression test and funnel plot, with additional sensitivity analysis. All studies included in this meta-analysis were observational, ultimately addressing the query, what is the pooled mortality rate of traumatic chest injury and its predictors in sub-Saharan Africa? Results Among the 845 identified original articles, 21 published original studies were included in the pooled mortality analysis for patients with chest trauma. The determined mortality rate was nine (95% CI: 6.35–11.65). Predictors contributing to mortality included age over 50 (AOR 3.5; 95% CI: 1.19–10.35), a time interval of 2–6 h between injury and admission (AOR 3.9; 95% CI: 2.04–7.51), injuries associated with the head and neck (AOR 6.28; 95% CI: 3.00–13.15), spinal injuries (AOR 7.86; 95% CI: 3.02–19.51), comorbidities (AOR 5.24; 95% CI: 2.93–9.40), any associated injuries (AOR 7.9; 95% CI: 3.12–18.45), cardiac injuries (AOR 5.02; 95% CI: 2.62–9.68), the need for ICU care (AOR 13.7; 95% CI: 9.59–19.66), and an Injury Severity Score (AOR 3.5; 95% CI: 10.6–11.60). Conclusion The aggregated mortality rate for traumatic chest injuries tends to be higher in sub-Saharan Africa. Factors such as age over 50 years, delayed admission (2–6 h), injuries associated with the head, neck, or spine, comorbidities, associated injuries, cardiac injuries, ICU admission, and increased Injury Severity Score were identified as positive predictors. Targeted intervention areas encompass the health sector, infrastructure, municipality, transportation zones, and the broader community.

Introduction: Hypertensive crises are a leading cause of visits to emergency departments, carrying grave health implications. A significant number of patients presenting with these crises have a known history of hypertension. Objective: The aim of this systematic review and meta-analysis is to examine the combined prevalence of hypertensive crises among individuals with either a history of hypertension or unknown status (newly diagnosed with a hypertensive crisis). Methods: This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and was registered with the Prospective Register of Systematic Reviews (PROSPERO). Research databases, including PubMed, Embase, Scopus, Africa Index Medicus, Science Direct, HINARI, and Google Scholar, were systematically searched. Study quality was evaluated using the Newcastle–Ottawa Scale, while publication bias was explored through Egger's regression test, funnel plots, and sensitivity analyses. Data collection adhered to the Joanna Briggs Institute (JBI) format. Meta-analysis was performed using STATA version 17, employing the random-effects DerSimonian–Laird model. Results: Amongst the 15 studies analyzed, the application of the random-effects DerSimonian-Laird statistical model indicated that the prevalence of hypertensive crisis was determined to be 9.09 %, with a 95 % confidence interval (CI) ranging from 7.41 % to 10.77 %. Factors such as poor medication adherence (POR 5.00; 95 % CI: 3.61, 6.93), patients with comorbidities (POR 4.73; 95 % CI: 3.29, 6.80), patients with a history of hypertension (POR 5.64; 95 % CI: 4.57, 6.94), patients aged >65 (POR 2.77; 95 % CI: 2.16, 6.59), and excessive alcohol intake (POR 5.01; 95 % CI: 3.82, 6.58) were associated with higher odds of hypertensive crisis. Conclusion: The findings indicate a markedly higher incidence of hypertensive crisis among hospital-presenting patients in Africa. Factors such as medication non-adherence, co-existing comorbidities, historical hypertension, being over 65, and alcohol misuse significantly contribute to this condition. These insights call for a comprehensive healthcare strategy that targets both the management of hypertension and its complications, aiming to improve the overall health outcomes of affected patients.

Abstract Introduction Despite efforts to promote exclusive breastfeeding for the first six months of life, pre-lacteal feeding remains prevalent in Ethiopia. The study will use data from the 2019 Performance Monitoring for Action Ethiopia (PMA-ET), which is a nationally representative survey that collects information on maternal and child health indicators. Therefore, this study aims to identify individual and community-level factors associated with the plan to pre-lacteal feeding for the first six months among mothers in Ethiopia. Methods The datasets from the 2019 Performance Monitoring for Action Ethiopia Survey were analyzed in this study, which included 685 mothers from the survey. Stata version 17.0 was used for data analysis. Multi-level mixed-effect logistic regression was utilized to identify individual and community-level factors that are linked with the plan to pre-lacteal feeding. The strength and direction of the association were presented using an adjusted odds ratio with a 95% confidence interval, and statistical significance was declared at a P value less than 0.05. Results The study found that factors significantly associated with the plan to pre-lacteal feeding included mothers without higher education (AOR = 2.5, 95% CI: 1.204–1.204), mothers belonging to poor households (AOR = 11.1, 95% CI: 3.482–35.175), and women in clusters with poor wealth status (AOR = 0.2, 95% CI: 0.043–0.509). Conclusion As per the findings of the study, both individual and community-level factors were found to influence the decision to practice pre-lacteal feeding. Educational status and household wealth were significant individual-level factors associated with pre-lacteal feeding, whereas community wealth status was a significant community-level factor. To address this issue, it is recommended to focus on increasing the education level of mothers from lower socioeconomic backgrounds and providing education on the benefits of exclusive breastfeeding and the risks associated with pre-lacteal feeding. These efforts can help in reducing the prevalence of this harmful practice.

Abstract Background Diabetes is a complicated, chronic condition that requires ongoing medical attention as well as multiple risk-reduction measures beyond glucose control. The prevalence of chronic kidney disease (CKD) is highly variable in different parts of the world due to various environmental, ethnic, socioeconomic, and rural-urban differences. Diabetes is the leading cause of CKD. This study aimed to estimate the global prevalence of CKD and its associated factors among type 2 diabetes(T2DM) patients, provide scientific evidence for a better understanding of the burden of CKD among diabetes mellitus type 2 patients, and design interventional strategies. Methods Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) checklist guideline was followed for this review and meta-analysis. The electronic databases (Pub Med, Cochrane Library, Google Scholar, and grey literature) were searched to retrieve articles by using keywords. Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument was used to assess the quality of studies. The meta-analysis was conducted using STATA 17 software. The Meta logistic regression was computed to present the pooled prevalence and Odds ratio (OR) of the determinate factors with a 95% confidence interval (CI). Results In this systematic review and meta-analysis 20 studies were done in 13 different countries. The pooled magnitude of chronic kidney disease among type 2 DM patients was 27% (95% CI 21%, 33%). The prevalence of chronic kidney disease differs across countries, with the maximum in the USA and the lowest in the United Arab Emirates. Patients with CKD have an elevated risk of severe renal and cardiovascular morbidity and mortality. Renin-angiotensin system inhibitors, sodium-glucose cotransporter-2 inhibitors, glucagon-like peptide 1 receptor agonists, and, more recently, non-steroidal mineralocorticoid receptor antagonists are among the medications that have been demonstrated to slow the progression of CKD. In this systematic review and meta-analysis increased age, obesity, having a history of type 2 diabetes mellitus, smoking history, presence of hypertension, and cardiac heart disease were factors significantly associated with the presence of chronic kidney disease among type 2 diabetic patients. Conclusions The prevalence of chronic kidney disease among type 2 diabetes mellitus patients was high based on the included 20 articles. The review reported that old age, hypertension, cardiac disease, smoking, obesity, and duration of diabetes mellitus was predictor variable for chronic kidney disease among type 2 diabetic patients. Therefore, in order to lower the morbidity and mortality from chronic kidney disease among type 2 diabetic patients, it is advised to develop both preventive and curative intervention strategies, such as raising awareness, creating a supportive environment, and prescribing appropriate medication at an early stage.

Abstract Background Globally, one in three adults has hypertension, a condition that causes 51% of all deaths from stroke. Stroke is becoming a major public health problem and the most common cause of morbidity and mortality among non-communicable diseases in the world and Ethiopia. Therefore, this study assesses the incidence of stroke and its predictors among hypertensive patients in Felege Hiwot Comprehensive Specialized Hospital, Bahir Dar, Ethiopia 2021. Methods A hospital-based retrospective follow-up study design was used, simple random sampling technique was used to select 583 hypertensive patients that had follow-up registration between January 2018 and December 30th, 2020. Data were entered into Epi-data version 3.1 and exported to STATA version 14. The adjusted hazard ratio for each predictor with a 95% confidence interval was calculated using the Cox proportional hazards regression model, and a P-value ≤ 0.05 was used to denote statistical significance. Results From 583 hypertensive patients 106(18.18%) [95% CI 15–20] were developed stroke. The overall incidence rate was 1 per 100 person-years (95% CI 0.79–1.19). Comorbidities (Adjusted hazard ratio(AHR): 1.88, 95% CI 1.0–3.5), stage two hypertension (AHR = 5.21, 95%CI 2.75–9.8), uncontrolled systolic blood pressure (AHR: 2, 95% CI 1.21–354), uncontrolled diastolic blood pressure (AHR:1.9, 95% CI 1.1–3.57), alcohol consumption (AHR = 2.04, 95%CI 1.2–3.49), age 45–65 (AHR = 10.25, 95%CI 7.47–11.1); and drug discontinuation (AHR = 2.05,95% CI 1.26–3.35) were independent predictors for the incidence of stroke among hypertensive patients. Conclusion The incidence of stroke among hypertensive patients was high and various modifiable and non-modifiable risk factors highly contributed to its incidence. This study recommends early screening of blood pressure, giving priority to comorbid patients and patients with advanced stage hypertension, and giving health education about behavioral risks and drug adherence.

Street dwelling is the use of public space as a place of residence and nourishment for children, adolescents, and young people, revealing a complex and multifactorial situation. Moreover, homelessness facilitates HIV transmission and its progression due to the risky lifestyle of individuals. To the best of our knowledge, there is no study conducted in the study area on HIV preventive practices among street dwellers. The aim of this study was to assess HIV prevention practices and associated factors among street dwellers. A community-based cross-sectional study was conducted in Bahir Dar City from March 12, 2023 to April 30, 2023. By using the simple random sampling technique, 424 street dwellers were recruited. Bivariable and multivariable logistic regression were used for analysis. The magnitude of HIV preventive practice among street dwellers was 35.9%. Being male (AOR = 0.23, 95% CI: 0.10, 0.55), educational status (AOR = 7.53, 95% CI: 2.20, 25.6), practice of sex to earn money (AOR = 0.18, 95% CI: 0.08, 0.44), good knowledge about HIV preventive practice (AOR = 2.83, 95% CI: 1.46, 5.49), perceived susceptibility for HIV (AOR = 0.90, 95% CI: 0.81, 0.99), and perceived benefit of using HIV preventive practice (AOR = 1.09, 95% CI: 1.02, 1.17), were factors associated with HIV preventive practice. The magnitude of HIV preventive practice was low. Being male, the ability to read and write, the practice of sex to earn money, good knowledge about HIV preventive practice, perceived susceptibility to HIV, and the perceived benefit of using HIV preventive practice were significantly associated with HIV preventive practice. Therefore, responsible organizations, both governmental and non-governmental, should design inclusive strategies to improve HIV preventive practice among street dwellers by focusing on regular demand creation activities, awareness creation about HIV preventive practice, and sustainable condom distribution in the city.

Introduction: Non-communicable disease contributes to over 42 million deaths worldwide and it is estimated that 86% of non-communicable disease-related mortalities happen in low and middle-income countries. Understanding health-seeking behaviors like initiating care at the right time, with the right provider and maintaining regularity of care seeking is a prelude for a successful management of non-communicable diseases. Therefore, the aim of this systematic review and meta-analysis was to assess the pooled prevalence of health-seeking behavior for non-communicable disease and associated factors worldwide. Method: Preferred Reporting Items for Systematic Reviews and Meta-Analysis checklist guideline was followed for this review and meta-analysis. Electronic data base, PubMed, EMBASE, Medline, Web of science, Google scholar and Science direct were used to retrieve studies reported in English language with publication year since 2018 worldwide. Studies reporting proportion of health-seeking behavior for non-communicable disease were evaluated. The pooled prevalence, odds ratio and confidence interval were calculated using Stata version 17 software. The quality of studies included in this review was checked using modified Newcastle-Ottawa scale for observational study checklist. Result: Ten studies which involved 63,498 patients with non-communicable disease were included in this review. The pooled estimated proportion of health-seeking behavior among non-communicable diseases patients from health facilities were 56% (95% CI: 44–68). Older age > 60, urban residency, being of female gender, high educational status, getting support during treatment, knowledge on non-communicable disease, having more than one non-communicable disease, presences of health insurance and middle and upper economic class were factors positively associated with health-seeking behavior for non-communicable diseases. Conclusion: Despite the fact that more than half of patients with non-communicable diseases have health-seeking behavior in health facilities, still, there are a considerable number of individuals with non-communicable diseases having no health-seeking behavior worldwide. Therefore, organizations working for the welfare of human betterment would do well in implementing strategies that could improve health-seeking behavior that would help to reduce the burdens on health systems and prevent premature death from non-communicable diseases.

Objective: The human immunodeficiency virus has become one of the world’s most serious health and development challenges. Human immunodeficiency virus prevention has not received sufficient attention, and the prevalence of human behavioral virus infections among Ethiopian high school and preparatory students has also increased. The aim of this study was to assess behavioral responses to condom use messages to prevent human immune virus/acquired immune deficiency syndrome among Bahir Dar city high school and preparatory students using the extended parallel process model, Bahir Dar, Ethiopia, 2022. Methodology: This institution-based cross-sectional study was conducted from 15 November to 15 December 2022, in Bahir Dar city. The data were collected from 601 participants. A multi-stage sampling technique was used to select the study participants. Data were entered into Epi-Info version 7.2.5 and exported to SPSS version 26 for analysis. Descriptive statistics, percentages, and frequencies were calculated. Bivariable logistic regression was performed to identify variables candidates for multivariable logistic regression at p -values less than 0.25, and multivariable logistic regression was performed to identify factors associated with the outcome variable at p- values

Background Tuberculosis (TB) is a main concern of health care workers in sub-Saharan Africa. Healthcare workers have the potential to have contact with TB patients and are the main stakeholders in healthcare settings to implement TB infection control, and the poor practice of TB infection control may increase the risk of transmission of TB in healthcare settings. However, there is no consistent conclusion on the TB infection control practice among healthcare workers in Ethiopia. Thus, this study aimed to determine the pooled magnitude of TB infection control practice and associated factors among healthcare workers in Ethiopia.Methods This systematic review and meta-analysis will be done by following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. The following databases will be used to search for articles: PubMed, Cochrane Library, Google Scholar and grey literatures. The quality of studies will be assessed using the Joanna Briggs Institute (JBI) critical appraisal checklist. The data from included studies will be extracted using Microsoft Excel V.2016, and the extracted data will be analysed using STATA V.16. Forest plot and I2 statistics will be done for heterogeneity. A funnel plot and Egger’s regression test will be conducted to check for publication bias. Potential sources of bias will be identified by subgroup analysis and meta-regression. Any type of study design conducted in Ethiopia and in English language will be included.Ethics and dissemination Ethics approval is not required, and the findings will be published in peer-reviewed journal.PROSPERO registration number CRD42023393580.

Objective: Health literacy helps an individual to have the capacity to obtain, process, and understand basic health information to make appropriate health decisions. This study aimed to review the association between health literacy and COVID-19 vaccine acceptance. Method: This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses steps. Databases including PubMed/MEDLINE, Web of Science, Scopus, EMBASE, World Health Organization libraries, and Google Scholar were used to search all published articles in the area of health literacy and COVID-19 vaccine acceptance until August 1, 2022. Result: In this review, 1348 articles were retrieved. Finally, 13 articles were included in the review after the removal of duplicates that did not meet our inclusion criteria. In all, 10 articles showed that health literacy was significantly associated with COVID-19 vaccine acceptance. This review also showed that positive perception of the vaccine, vaccine hesitancy, adverse reaction from vaccines, residence, socioeconomic status, level of education, younger age, being a health worker, and positive belief have associations with health literacy and COVID-19 vaccine acceptance. There was significant heterogeneity in the study population and measurement tools used for health literacy and COVID-19 vaccine acceptance. Conclusion: This systematic review provides comprehensive evidence on health literacy and COVID-19 vaccine acceptance globally. There was significant heterogeneity in the study population and measurement tools used for health literacy and COVID-19 vaccine acceptance. Most studies reported that health literacy is significantly associated with COVID-19 vaccine acceptance. Therefore, investing in health literacy using different vaccine promotion strategies may improve COVID-19 vaccine acceptance and health decision-making to decrease the impact of the COVID-19 pandemic.

Abstract Introduction Countries with humanitarian crises and fragile conditions contribute to 61% of the global burden of maternal mortality. Emergency Obstetric and Newborn Care (EmONC) services reduce direct obstetric complications, which cause approximately 70–80% of maternal deaths and 10% to 15% of neonatal deaths. Therefore, this study was aimed to assess the service availability and readiness to provide comprehensive emergency obstetric and newborn care services in post-conflict at North Wollo Zone hospitals, Northeast Ethiopia. Methods A facility-based mixed cross-sectional study design was conducted from May 10 to May 25, 2022, among North Wollo zone hospitals. Quantitative data were collected by using structured interviewer-administered questionnaires with observation and record review, entered by using Epi Data Version 4.6, and exported to SPSS 25 for analysis. Qualitative data were collected by key informant interviews and analyzed through thematic analysis. A descriptive data analysis was done to analyze the study variables. Results Only three of the six hospitals (Woldia, Shediho Meket, and Saint Lalibella) performed all signal functions of comprehensive emergency obstetric and newborn care in the preceding three months. Cesarean section was the least performed signal function in post-conflict. The overall readiness to provide comprehensive emergency obstetric and newborn care services was 77.7%. Only one of the six hospitals had sufficient blood without interruption, and three of the six facilities had done screening for hepatitis B, HIV, and syphilis. Lack of supplies, equipment, and drugs were the challenges for the performance of EmONC signal functions. Conclusions Post-conflict availability and readiness for comprehensive emergency obstetric and newborn care services in the North Wollo Zone was suboptimal. Shortage of medical supplies, equipment and emergency transportation was the challenges to provide these services. Thus, the hospital decision makers should strengthen leadership commitment, which focuses on recovering and rebuilding the destructed hospitals with resource mobilization and support.

Abstract Knowing the level of behavioral intention and tooth-brushing practices is crucial for the implementation of the intervention. However, such studies are too limited in Ethiopia. The current study employed a health behavior model to identify predictors that can serve to support primary school children's attitudes, intentions, knowledge, environmental constraints, and practices of tooth brushing. Thus, this study aimed to assess tooth brushing practices and their predictors among primary school children in Bahir Dar city, Ethiopia. An Institutional based cross-sectional study was conducted among primary school children in Bahir Dar city. A multi-stage sampling technique was used to select 610 participants. Data were collected using pre-tested interviewer-administered questionnaires. Questionnaires adapted from items' previous literature were used for integrated behavioral model constructs incorporated with elicitation study results. Data were entered into Epi data and then analyzed by Stata. Descriptive statistics were done. Confirmatory factor analysis was performed to check the convergent validity of the measurement. The Internal reliability of the items was also checked using composite reliability. Multivariable logistic regression was used to predict the role of independent variables in toothbrushing practices. Moreover, path analysis was performed to check the causal effect of integrated behavioral model constructs on toothbrushing practices. The goodness of fit of the final model was checked using the Hosmer and Lemeshow test of best fit with a large p value = 0.97 and Area under receiver operating characteristics curve = 0.98. The overall prevalence of the current practice of toothbrushing among the respondents was 45.4%. The prevalence of brushing frequency was 243 (89.01%), 27 (9.89%), and 3 (1.09%) brushed once a day, twice a day, and more than twice a day respectively. Female child's [AOR 3.23, 95% CI 1.48–7.02], mothers' education [AOR 4.6; 95% CI 1.22–17.44], past experience of toothbrushing [AOR 0.042; CI 0.018–0.101], knowledge about tooth brushing practices [AOR 1.3; 95% CI 1.09–1.60], behavioral intention [AOR 2.01; 95% CI 1.74–2.32], experiential attitude [AOR 1.09; 95% CI 1.01–1.17],instrumental attitude [AOR 1.02; 95% CI 1.01–1.03], and descriptive norm [AOR 1.07; 95% CI 1.01–1.14] were predictors of toothbrushing practices. The findings indicate that the practice of toothbrushing practices among primary school students was low. Sex, mother's education, knowledge, intention, experience, experiential attitude, instrumental attitude, and descriptive norm, have significant effects on toothbrushing practices; indicating that the integrated behavioral model showed adequate utility in predicting toothbrushing practices in the study area. School-based toothbrushing practices change interventions such as communication strategy.

Objective: This systematic review aimed to assess the global application of behavioral change theory and models on COVID-19 preventive behaviors. Methods: This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses procedure. Databases such as PubMed/MIDLINE, Web of Science, Scopus, EMB ASE, World Health Organization libraries, and Google Scholar were used to search all published articles in the area of application of behavioral change theory and model on COVID-19 preventive behavior until October 1, 2022. Studies published in another language other than English were excluded. Two independent reviewers did the article selection and quality check. A third reviewer asked if any disagreement were found. Result: Seventeen thousand four hundred thirty-six total articles were retrieved from all sources after the removal of duplicated articles and those not evaluating the outcome of interest were excluded. Finally, 82 articles done using behavioral change theory and model on COVID-19 preventive behaviors were included. The health belief model (HBM) and theory of planned behavior (TPB) were most commonly used in COVID-19 preventive behaviors. The constructs of most behavioral theories and models were significantly associated with COVID-19 preventive behaviors such as hand washing, face mask use, vaccine uptake, social isolation, self-quarantine, social distance, and use of sanitizers. Conclusion: This systematic review summarizes comprehensive evidence on the application of behavioral change theory and model on COVID-19 preventive behaviors globally. A total of seven behavioral change theories and models were included. The HBM and TPBs were most commonly used for COVID-19 preventive behaviors. Therefore, the application of behavioral change theory and models is recommended for developing behavioral change interventional strategies.

Objective: This systematic review aimed to provide a global picture of information-seeking behavior, source information used, and its associated factors. Methods: This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses steps. Databases such as PubMed/MEDLINE, Web of Science, Scopus, EMBASE, World Health Organization libraries, and Google Scholar were used to search all published articles. Articles on COVID-19 information-seeking behavior published until November 04, 2021, and the use of the English language was included. Two independent reviewers did the article selection and quality check. Results: For this systematic review, twenty articles were included in the final report. Information-seeking behavior was associated with digital health literacy, online information sources, and socio-demographic factors. The major sources of health information during the COVID-19 pandemic were digital media, television, public health portals like the world health organization, and center for communicable disease and prevention websites. Conclusion: This systematic review provides a valuable overview of available information on information-seeking behavior regarding COVID-19 globally. The studies used a heterogeneous study population, various research techniques, and various research questions. Digital literacy and online information sources play a vital role in information-seeking behavior.

BackgroundA lack of enough knowledge about the mother-to-child transmission (MTCT) of the human immunodeficiency virus (HIV) among reproductive-age women is thought to be a key contributor to new pediatric HIV infections worldwide, and rising HIV-related infant mortality, particularly in resource-limited countries. Knowledge of MTCT of HIV is key to halt the progression of HIV/AIDS. Therefore, this study aimed to assess knowledge of MTCT of HIV and its associated factors among reproductive-age women in high HIV/AIDS prevalent countries.MethodsA secondary data analysis was performed using 8 HIV/AIDS prevalent countries' Demographic and Health Surveys. A total weighted sample of 97,130 respondents was included in this study. Stata 17 was used for data extraction, coding, and analysis. A multilevel binary logistic regression model was fitted. The odds ratios along with the 95% confidence interval were generated to determine the factors of good knowledge of MTCT of HIV among reproductive-age women. A 95% confidence interval and a p-value of less than 0.05 were used to declare statistical significance.ResultsThe prevalence of good knowledge of MTCT HIV was 57.89% (95% CI: 57.67,58.29). Mothers aged 25-34 (AOR = 1.37, 95% CI = 1.32, 1.42), 35 and above(AOR = 2.46,95% CI = 1.41, 1.52), mothers' primary education (AOR = 1.32, 95% CI = 1.26, 1.38),), secondary education (AOR = 1.65,95% CI = 1.56, 1.74), higher education (AOR = 1.72,95% CI = 1.58,1.86), exposed to mass media (AOR = 1.12, 95% CI = 1.08,1.16) rich wealth status (AOR = 1.11 (95% CI = 1.06,1.15), talked about MTCT (AOR = 1.70,95% CI = 1.64, 1.76), visited by field worker (AOR = 1.09, 95% CI = 1.03,1.14), health facility visit (AOR = 1.15, 95% CI = 1.11, 1.18), urban dwellers (AOR = 1.09, 95% CI = 1.04,1.14), ever tested for HIV(AOR = 2.18 (95% CI = 2.10,2.27), currently working status (AOR = 1.15, 95% CI = 1.12,1.19) were factors associated with good knowledge of MTCT of HIV/AIDS among reproductive age women.ConclusionsOverall, the prevalence of good knowledge of MTCT was low in high HIV/AIDS prevalent countries. Maternal age, primary education and above, exposed to media, having higher wealth status, talked about MTCT during ANC visits, being visited by a field worker, visited a health facility, currently working, living in the urban area, and ever been tested for HIV were positively associated with knowledge of MTCT. Health policy and programs should focus on educating mothers, encouraging women to contact health facilities and a well-targeted communications program is required to enhance knowledge of MTCT of HIV.

BackgroundWhen an individual's activities and performances in a normal environment are limited in nature, function, or quality, that person is considered to have a disability. Although many studies on disabled people's lived experiences have been conducted around the world, there is still a significant gap between nations in multiple cases such as culture, economic status, and the recommendation of a previous study in Ethiopia, which is one reason for conducting this research.ObjectivesTo explore the lived experiences of disabled individuals living in Bahir Dar City.MethodsA descriptive phenomenology study design was employed in Bahir Dar city on 15 disabled individuals from November 15 to December 20, 2022. A heterogeneous purposive sampling technique was used to select study participants. Data was collected by using an in-depth interview. The rigor and trustworthiness of the study were maintained by transferability, dependability, credibility, and conformability. Colaizzi's phenomenological analysis method was used for the development of codes and themes. Software (ATLAS. ti 7) version 7.5.6 was used for analysis.ResultFive major themes and fourteen sub-themes were developed that explain lived experiences of disabled individuals. Physical, psychological, social, economic and coping strategy experiences were major themes. Depression and negative emotional behavior were sub-themes under psychological experiences. Unemployment with the absence of a workplace and inadequate income were sub-themes under the economical experiences of participants.ConclusionIn this qualitative interview study, the lived experience of individuals living with disability in Bahir Dar city were addressed in terms of the physical, psychological, social, economic, and coping mechanism experience of disabled individuals. Special needs professionals and social support groups should have been assigned and present in all institutions to serve the PwDs to assure equal accessibility of services.

Objectives: To explore self-care experience of type 1 diabetes mellitus patients at Kemisse General Hospital, North east Ethiopia. Methods: A phenomenological study was conducted to explore self-care experience of type 1 diabetes mellitus patients at Kemisse General Hospital from 28 February 2020 to 15 March 2020. Participants were selected using a heterogeneous type of purposive sampling technique. Data were collected using in-depth interviews and observation with the aid of an audio recorder and interview guide by the principal investigator. The thematic analysis approach was used to analyze the data. To facilitate the data analysis process, Atlas. ti software version 7 was used. Results: The six interconnected themes that were emerged from the analysis are: (1) physical exercise, (2) dietary practice, (3) medication adherence, (4) self-monitoring of blood sugar, (5) problem-solving skill during hypoglycemia and hyperglycemia, and (6) diabetic foot care. Conclusion: The study described that type 1 diabetic patients at Kemisse general hospital faced difficulty in self-care practice, which were difficulty in medication adherence; foot care was neglected diabetes self-care, did not practice diabetes recommended dietary plan and lack of regular physical exercises. In addition to this, self-monitoring of blood sugar was not practiced regularly due to the absence of glucometer machine and financial constraints to buy test strips. In addition to diabetic patient’s role to manage hyperglycemia and hypoglycemic episode, family support was crucial to managing hypoglycemia because most of the respondent’s experience loss of consciousness during a hypoglycemic attack.

BackgroundGlobally, although effective prevention strategies and treatment are available, trachoma remains the major cause of infectious loss of sight. Trachoma is a predominant neglected disease in Ethiopia, and there is a 40.4% prevalence of active trachoma in the Goro district, Southeast Ethiopia. World Health Organization (WHO) recommends azithromycin mass treatment of at least 80% coverage to eliminate trachoma, even though the coverage of azithromycin mass treatment has not been studied yet in depth. Thus, this study aimed to assess the coverage and factors influencing azithromycin mass treatment uptake among adults in Goro district, Southeast Ethiopia.MethodsA community-based cross-sectional study was conducted from April 1st to April 30th, 2021 among all adults aged 15 years old and above. The multistage sampling technique was used to select 593 study respondents. A structured interviewer-administered questionnaire was used. Data were entered into Epi-Data version 3.1 and analyzed using SPSS version 23.0 software. Descriptive analysis and binary logistic regression analysis were used to analyze the data. Adjusted odds ratios (AOR) along with a 95% confidence interval (CI) and p-value < 0.05 were used to declare the strength and the significance of association, respectively.Results/principal findingsFive hundred and seventy eight study participants with a 97% response rate were included. The proportion of azithromycin mass drug administration coverage was found to be 75.80%; 95% CI: (72%-79%) in this study. Having better knowledge about trachoma (AOR = 2.36; 95% CI: 1.19-4.70), having better knowledge about azithromycin mass treatment (AOR = 4.19; 95% CI: 2.19-7.98), being educated (AOR = 7.20; 95% CI: 1.02-51.09), a campaign conducted at the quiet time (off-harvesting/planting season) (AOR = 6.23; 95% CI: 3.23-11.98), heard about the serious adverse effect from others (AOR = 0.25; 95% CI: 0.10-0.59) and being a volunteer to take azithromycin in the next campaign (AOR = 5.46; 95% CI: 2.76-10.79) were significantly associated with azithromycin mass drug administration coverage.Conclusions/significanceThe proportion of azithromycin mass treatment coverage of this study was lower than the WHO minimum target coverage. Thus, strengthening awareness, enhancing azithromycin mass trachoma treatment messages, and conducting campaigns off-season outside of harvesting and planting time should be prioritized in the future to meet the 2030 Sustainable Development Goal (SDG) target.

Background: In dairy farming, animal feed is the first line of food safety. Animal feed can become contaminated and spoiled on farms or in storage facilities due to the diverse microorganisms that are naturally present around or on various animal feeds. This study aims to assess the level of aflatoxin and predictors in animal feeds among dairy farms in the South Gondar Zone of Ethiopia., Methods: A total of 100 samples of each animal feed ingredient (atella, hay, commercial concentrates, and cut and carry pasture) were obtained. A total of 400 animal feed ingredient samples were tested separately among 100 randomly chosen dairy farmers for aflatoxin analysis. Simultaneously, swabs from cow udders and water samples were also collected. Using a structured and pretested questionnaire, the knowledge and practices of animal feed administrators responsible for managing animal feed were also evaluated. Descriptive statistics and logistic regression models were used to identify determinants., Results: From the total animal feed analyzed, 96% was positive for aflatoxins. Feed storage facilities, feed storage duration, education of animal feed administrators, mixed concentrates, and previous training were found to be associated with aflatoxin contamination levels in animal feeds., Conclusions: The levels of aflatoxin contamination in animal feeds were found to be higher than the recommended limit; these findings suggest the spread of aflatoxin contamination between humans and animals. Furthermore, the occurrence of aflatoxins in the environment results from milk becoming contaminated with aflatoxins. A One Health strategy should therefore receive special consideration to tackle such problems and safeguard consumer safety., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Tadele, Demissie, Amsalu, Demelash, Mengist, Ambelu and Yenew.)

Background: Raw milk is a good growth medium for microbes because of its neutral pH and nutrient content. In Ethiopia; few studies were done to assess the microbial quality of raw cow milk. But, none of them focused on the nutrient content of raw cow milk. Therefore; this study aimed at evaluating raw cow milk nutrient content and predictors of microbial quality of raw cow milk among milk in the dairy farmers of South Gondar zone (SGZ), Ethiopia., Methods: A community-based cross-sectional study was conducted from January to May 2020. 160 randomly selected raw cow milk, water, and utensil samples each were collected for microbial analysis. Besides, nutrient content indicators such as TotalSolid (TS), and Specific Gravity (SG) were analyzed from milk samples. Sequentially, The Knowledge, Attitude, and Practices (KAP) of millers were also assessed using a pretested structured questionnaire. Chi-square test and multiple linear regression models were used., Results: The overall mean SG and T S of raw cow milk were 1.027 (95% CI, 1.013-1.039) and 12.55% (95%CI, 12.20%-12.89%) respectively.38.13% had the better nutrient content, and the rest, 61.87% of raw cow milk hadn't the better nutrient content. Besides, the mean (SD) in log CFU/100mL-1of the Escherichia coli count of raw cow milk was 15 (0.3). Educational status, milk handling experience, KAP of milkers, water microbial count, Nutrient content, and microbial load of milk utensils were independently predicted microbial quality of raw cow milk., Conclusions and Implications: The result signifies that the raw cow milk hadn't better nutrient content and the educational status and KAP of milkers, and the qualities of water were the major factors affecting the microbial quality of raw cow milk. It could greatly affect the Food and Nutrition Security of the country. Hence, measures should be taken to enhance the KAP of milkers for improving this enteropathy., Competing Interests: The authors declare no conflict of interest., (© 2022 The Author(s).)

This study aimed to determine antimicrobial- resistance (AMR) enteric bacterial load and associated factors among Food Handlers (FHs) ofMass Catering Center (MCC), Ethiopia. From January to June 2020, a laboratory-based cross-sectional study was conducted using the standard Swab microbiological analysis method and the Kirby-Bauer disc diffusion method on 160 randomly selected FHs and food serving areas and analyzed with RStudio- 1.2.5033 for contamination, resistance level, and source determination. The contamination of AMR Escherichia coli was33.3% (95% CI, 31.5%, 36.4%), Salmonella 30% (95% CI, 29.8%, 36.0%) and Shigella 20% (95% CI, 19.2%, 26.9%) among the hand of FHs serving in MCC. The contamination was more likely associated with low work experience [AOR, 1.42 (95% CI: 1.22-1.87)], a low educational level [AOR, 1.62 (95% CI: 1.52-189)], irrational drug use characteristics [AOR, 1.75(95% CI: 1.64-2.00)], lack of sufficient food safety knowledge [AOR, 1.52 (95% CI: 1.32-1, 67)] of the FHs and the sanitary condition of the food serving area [AOR:1.98 (95% CI, 1.45, 2.53)]. The contamination of the hand of FHs serving in the MCC with AMR enteric FBB at the University cafeteria could indicate the likelihood of the occurrence of foodborne outbreaks., Competing Interests: Conflict of interest: The authors declare no potential conflict of interest., (©Copyright: the Author(s).)

Background: Late antenatal care initiation is linked to a higher risk of maternal death. Women who do not start ANC at an early stage may experience the effects of pregnancy-related health difficulties, as well as long-term health issues and pregnancy complications. Therefore, our study aimed to determine the prevalence of late initiation of antenatal care and associated factors among pregnant women in Jimma Zone public Hospitals., Methods: A facility-based cross-sectional study design was employed in Jimma zone public hospitals from February 1 up to 30 March 2020 and 409 pregnant women were participated in the study by using a systematic random sampling method. Structured questionnaire was used to collect data that contain socio demographic variables, socio cultural variables, pregnancy related factors and predisposing factor related variables. The data was entered into EPI data version 3.1 and exported to SPSS version 20 for statistical analysis. Binary and multivariable logistic regression analysis were performed by using 95%CI and significance was declared at P < 0.05., Result: Forty-eight percent of pregnant women were initiated their first ANC late. Primary education (AOR = 0.242; 95% CI, 0.071-0.828) and college diploma and above was (AOR = 0.142; 95% CI, 0.040- 0.511), mothers with an unplanned pregnancy (AOR = 11.290; 95%CI, 4.109-31.023), time taken to arrive the health facility greater than sixty (60) minutes (AOR = 8.285; 95% CI, 2.794-24.564) and inadequate knowledge about ANC service (AOR = 4.181; 95%CI, 1.693-10.348) were associated with late first Antenatal care initiating., Conclusion: The prevalence of late initiation of ANC still remains a major public health concern in the study area. Level of education, unplanned pregnancy, distance from house to health facility, and lack of understanding about ANC services were all found to be significant variables in late ANC starting. As a result, healthcare workers can provide ongoing health education on the need of starting antenatal care visits early to avoid unfavorable pregnancy outcomes by considering all identified factors., (© 2022. The Author(s).)

Introduction: Typhoid fever is a major cause of morbidity and mortality around the globe, and it is a serious illness in developing countries. Typhoid fever is prevalent in Ethiopia, and the burden differs with diverse demography, environment, and climate. The study aimed to determine the incidence of typhoid fever cases by person, place, and time., Method: A descriptive cross-sectional study was conducted among the five years (2015-2019) of surveillance data of typhoid fever in the Jimma Zone, Oromia Region, Ethiopia. The data were extracted from the zonal health management information system database from May to June 2020. SPSS version 21 was used to enter and analyze the data. Descriptive analysis was used to assess the distribution of typhoid fever incidence in time, place, and personal groups., Result: A total of 36,641 individuals suffered from typhoid fever during the five years. Among these, 18,972 (51.8%) were females and 17,669 (48.2%) were males. Incidence of typhoid fever was found as follows: 216, 198, 203, 264, and 299 cases per 100,000 persons were reported during 2015, 2016, 2017, 2018, and 2019, respectively. Typhoid fever cases were increased by 1.4 from 2015-2019. A high incidence of cases was observed at the start of wet months. The majority of the investigated cases were identified in Kersa, 4,476 (12.2%), Gomma, 4,075 (11.1%), and Mana, 3,267 (8.9%), woredas. Of the total, 151 (0.4%) of the reported cases were admitted for inpatient care. During the five years of surveillance data, death was not reported from all woredas. Conclusion and Recommendation . Typhoid fever was a major public health problem in the Jimma Zone for the last 5 years, and it was increased through the years. Zonal health departments should strengthen the interventions focused on the woredas that had a high burden of typhoid fever at the start of the wet months., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2021 Getaneh Atikilt Yemata et al.)

Background: Despite the higher mortality rate of breast cancer in low and middle-income countries, the practice of early detection methods is low and the majority of the patients presenting at an advanced stage of the disease need palliative care with low survival rates. Although healthcare providers are the key for practicing early detection methods of breast cancer for themselves and their clients, little is known about their knowledge and practice of early detection methods of breast cancer in Northcentral Ethiopia., Methods: An institution-based cross-sectional study was conducted among female healthcare providers at Debre Tabor Comprehensive Specialised Hospital. Data were collected using a structured self-administered questionnaire. The data were analysed using SPSS version 23. Descriptive statistics were used to describe the socio-demographic information of participants. Binary and multivariable logistic regression with adjusted odds ratio (AOR) and 95% confidence interval (CI) was used to identify factors associated with the outcome variable. Statistical significance was declared at p < 0.05., Result: The mean (±SD) age of the participants was 31.4 (±7.8) years. About 106 (79.7%) participants had good knowledge about breast cancer early detection methods and only 56 (42.1%) of them practiced breast self-examination regularly. Work experience of >2 years (AOR = 3.2; 95% CI: 1.72, 5.29), history of any breast problem (AOR = 1.4; 95% CI: 1.02, 2.37), family history of breast cancer (AOR = 4.0; 95% CI: 2.58, 15.84), having good knowledge (AOR = 2.9; 95% CI: 1.3, 6.52) and history of comorbidities (AOR = 1.09; 95% CI: 1.09, 3.59) were the factors associated with the practice of breast self-examination., Conclusion: Our study found that the knowledge and practice of breast cancer early detection methods was low in the study setting. Only less than half of female healthcare providers practiced regular breast self-examination, which suggests the need to provide training for healthcare providers to fill the gap and to promote early detection of breast cancer cases., (© the authors; licensee ecancermedicalscience.)

Background: Sleep is a physiologic necessity for all humankind. Pregnant women, in particular, need adequate sleep to develop their fetuses as well as save energy required for delivery. A change in sleep quality and quantity is the most common phenomena during pregnancy due to mechanical and hormonal factors. However, there is a scarcity of data about poor sleep quality and its associated factors among pregnant mothers in Ethiopia. Therefore, this study aims to determine the prevalence of poor sleep quality and its associated factors among pregnant mothers at Wadila primary hospital, Ethiopia., Methods: Institution based cross-sectional study design was employed on 411 pregnant mothers. Data were collected using a pre-tested interviewer administered questionnaire. SPSS Version 23 for Windows software was used for data analyses. Bivariate analysis was conducted to detect the association between dependent and independent variables, and to choose candidate variables (p < 0.25) for multivariate logistic regression. Statistical significance was set at p-value <0.05., Results: A total of 411 participants were included in the study making a response rate of 97.4%. Overall, 68.4% of participants found to have poor sleep quality (PSQI>5). Age of the mother [age 20-30 years; AOR = 4.3 CI (1.8, 9.9), p = 0.001, and age >30 years; AOR = 4.7 CI (1.6, 13.9) p = 0.005], gestational age [second trimester, AOR = 2.46, CI (1.2, 4.9), p = 0.01 and third trimester, AOR = 7.5, CI (3.2, 17.8), p = 0.000] and parity [multiparous women; AOR = 2.1(1.24, 3.6) p = 0.006] were predictor variables for poor sleep quality among pregnant mothers., Conclusion: More than two-third of pregnant mothers had poor sleep quality. Advanced maternal age, increased gestational age and multiparty are found to be predictors of poor sleep quality in pregnant women., Competing Interests: The authors have no competing interests to declare.