Search

Sahlu Mitku Shiferaw,1 Emiru Ayalew Mengistie,2 Getasew Mulatu Aknaw,3 Abraham Tsedalu Amare,4 Kefyalew Amogne Azanaw5 1Department of Adult Health Nursing, Debre Tabor Health Science College, Debre Tabor, Ethiopia; 2Department of Adult Health, Nursing College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia; 3Department of Emergency Medicine and Critical Care, Nursing College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia; 4Department of Adult Health Nursing, College of Medicine and Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia; 5Department of Reproductive and Child Health, Debre Tabor Health Science College, Debre Tabor, EthiopiaCorrespondence: Sahlu Mitku Shiferaw, Department of Adult Health Nursing, Debre Tabor Health Science College, Po Box 83, Debre Tabor, Amhara Region, Ethiopia, Email sm092750@gmail.comBackground: A significantly greater proportion of patients who die due to aspiration pneumonia were diagnosed with in-hospital aspiration pneumonia (19%). The incidence and major predictors are not known clearly, especially in Ethiopia.Objective: To determine the incidence and predictors of aspiration pneumonia among adult traumatic brain injury patients at Felege Hiwot comprehensive specialized hospital, Bahir Dar, North west Ethiopia, in 2021.Methods: An institution-based retrospective study was conducted from all admitted adult traumatic brain injury patients at Felege Hiwot comprehensive specialized hospital from January 1, 2015 to December 31, 2020 for 51 days of survival. Descriptive statistics, Kaplan–Meier survival curve log rank test, and the Cox proportional hazard regression model were used.Results: A total of 396 adult patients diagnosed and admitted with traumatic brain injury in the past 5 years were included. Seventy patients (17.67%) developed aspiration pneumonia, providing an incidence rate of 32.39 (95% CI=25-62– 40.94) per 1,000 person days of observation. Independent predictors were being referred for AHR (2.43; 95% CI=1.12– 5.25), nasogastric tube insertion AHR (3.02; 95% CI=1.43– 6.39), and baseline Glasgow coma scale < 8 AHR (3.88; 95% CI=1.42– 10.062).Conclusion: Having a nasogastric tube and low baseline Glasgow coma scale were significant predictors. This improves prehospital and hospital care during transportation and admission time.Keywords: aspiration pneumonia, traumatic brain injury, Bahir Dar, Ethiopia

Tamiru Alene Woelile,1 Getasew Tesfa Kibret,2 Hailemariam Mekonnen Workie,2 Abraham Tsedalu Amare,3 Agimasie Tigabu,3 Yared Asmare Aynalem,4 Ermias Sisay Chanie,5 Tekalign Amera Birlie3 1Department of Pediatrics and Neonatal Nursing, Wolaita Sodo University, Sodo, Southern Nation and Nationalities of Ethiopia, Ethiopia; 2Department of Pediatrics and Child Health Nursing, Bahir Dar University, Bahir Dar, Amhara, Ethiopia; 3Department of Adult Health Nursing, Debre Tabor University, Debra Tabor, Amhara, Ethiopia; 4Department of Nursing, Debre Berhan University, Debre Berhan, Amhara, Ethiopia; 5Department of Pediatrics and Child Health, Debre Tabor University, Debre Tabor, Amhara, EthiopiaCorrespondence: Tamiru Alene WoelilePediatrics and Neonatal Nursing at Wolaita Sodo University, Wolaita, EthiopiaEmail tamirualene1212@gmail.comAbraham Tsedalu AmareAdult Health Nursing at Debre Tabor University, Debre Tabor, EthiopiaEmail tsedalu136@gmail.comBackground: Low birth weight neonates are subjected to different comorbidities due to anatomical and physiological immaturity. Globally, 60– 80% of neonatal mortality was due to low birth weight. Hence, this study aimed to assess the survival status and predictors of mortality among low birth weight neonates.Methods: An institutional-based retrospective cohort study design was conducted among 718 low birth weight neonates admitted to the neonatal intensive care unit from January 1, 2017, to December 30, 2019, at Felege Hiwot Comprehensive Specialized Hospital. Data were entered into Epi data version 3.1 and analyzed with STATA version 14. Kaplan–Meier curves together with a Log rank test were used to estimate the survival time and showed the presence of differences among groups. Cox proportional-hazard regression was used to estimate the hazard ratio at the 5% level of significance to determine the net effect of each explanatory variable on survival status.Results: The overall incidence density was 35.3 per 1000 person-day observations (CI: 30.8 − 40.6) with 5715 follow-up days. Deliveries outside the health institution [AHR; 2.31 (95% CI: 1.20– 4.42)], maternal age < 18 years [AHR; 3.08 (95% CI: 1.64– 5.81)] and maternal age > 35 years [AHR; 3.83 (95% CI: 2.00– 7.31)], neonatal sepsis [AHR; 2.33 (95% CI: 1.38– 3.94)], neonatal respiratory distress syndrome [AHR; 1.92 (95% CI: 1.27– 2.89)], necrotizing enterocolitis [AHR; 3.09 (95% CI: 1.69– 5.64)] and birth weight < 1000 gm [AHR; 3.61 (95% CI: 1.73– 7.55)] were found to be significant predictors.Conclusion: This study showed that two of the seven low birth weight neonates died during the follow-up period. Therefore, it is better for health care providers and other stakeholders to focus more on early diagnosis and management of low birth weight neonates with sepsis, respiratory distress syndrome, necrotizing enterocolitis and counseling mothers on the risk of having a child in early and old age.Keywords: low birth weight, incidence density, survival status, predictors, Ethiopia

This study aims to explore the practices and institutional challenges of Hawassa University academics staff pertaining to their continuous professional development (CPD) engagement. To this end, we employ an exploratory case study as our research design using various sources of data. The data were analyzed using thematic analysis. The findings reveal that there is a range of understanding of CPD among staff and that is practiced both formally and informally. The major challenges that hinder the practical effectiveness of CPD include misunderstanding of its importance, the inability of the institution to make the content of CPD relevant to academics' current needs and insufficient financial provisions. It is recommended that institutional and systematic policy actions for CPD management be prioritized.

Ashenafi Tazebew Amare,1 Alemayehu Teklu Toni,1 Zeleke Abebaw Mekonnen,2,3 Berhanu Fikadie Endehabtu,2 Binyam Chakilu Tilahun2 1Department of Pediatrics and Child Health, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia; 2Department of Health Informatics, Institute of Public Health, University of Gondar, Gondar, Ethiopia; 3Health System Directorate, Ministry of Health, Addis Ababa, EthiopiaCorrespondence: Ashenafi Tazebew AmareDepartment of Pediatrics and Child Health, College of Medicine and Health Science, University of Gondar, Gondar, EthiopiaTel +251913164722Email ashenafitazebew1@gmail.comIntroduction: Supportive supervision is one of the five essential components of the WHO’s Reaching Every District (RED) strategy. However, it is generally not practiced based on the standard schedule because of capacity and low number of staff in the health system. Thus, this study aimed to test the feasibility and effectiveness of a capacity building and mentorship program in immunization by health science colleges to supplement the existing approach.Methods: This study applied a pre-post quasi-experimental research design. The study included health workers of 30 health facilities (15 intervention and 15 control) followed for six months. A total of 90 health workers were included. To assess the effectiveness of the intervention package on immunization coverage and a change in RED strategy implementation over time, difference in difference (DID) analysis was used. Finally, a RE-AIM framework was used to evaluate the implementation process.Results: The study indicated that the intervention package has a significant effect (P = 0.0001) on the overall implementation of RED outcomes. The DID analysis also indicated that health facilities in the intervention district have shown a higher Penta III coverage (17.4%) and complete vaccination coverage (16.6%) that are attributable to the intervention package. Similarly, knowledge and skills of health workers improved significantly (P < 0.05) after the intervention. The key informants also mentioned that the new approach was effective and acceptable.Conclusion: The newly introduced capacity building and mentorship program by well-trained personnel of medical universities had positive effects on the immunization program. Thus, it is recommended to facilitate policy adoption and readiness for routine use at large scale.Keywords: capacity building, immunization, medical university, vaccination

Hailu Tazebew Amare, Ashenafi Tazebew Amare Department of Pediatrics and Child Health, University of Gondar, College of Medicine and Health Sciences, Gondar, EthiopiaCorrespondence: Ashenafi Tazebew AmareDepartment of Pediatrics and Child Health, P.O. Box 196, Bekafa Street, Gondar, EthiopiaTel + 251-913-16-47-22Email ash_gondar@yahoo.comBackground: Neonatal seizures are the most common neurological dysfunction in the neonatal period. Neonatal seizure patterns and short-term neurologic outcomes, particularly in the Ethiopian context, have not been adequately studied.Objective: The main aim of this study is to assess the pattern, probable etiology, short-term outcomes, and determinants of neonatal seizures in the neonatal intensive care unit of Gondar University Specialized Comprehensive Hospital.Methods: A hospital-based prospective observational cohort study was conducted from October 1, 2016, to September 30, 2018.Results: Among the 117 neonates enrolled, the most common type of neonatal seizure was subtle (60.6%), followed by tonic (15.4%), and clonic (12.8%) seizures. The most common etiology for the seizure was perinatal asphyxia (PNA) with hypoxic-ischemic encephalopathy (HIE; 74.4%) followed by electrolyte disturbances (12.8%). In the follow-up, 23 (19.7%) died during the acute neonatal illness. The most common cause of death was PNA with HIE, accounting for 73.9% of the deaths. Among the surviving newborns, 10 (10.6%) had neurodevelopmental deficits at discharge. Being a multiparous mother (OR= 0.172; 95% CI: 0.033, 0.880), being female (OR= 0.171; 95% CI: 0.055, 0.538), and having tonic (OR= 0.164; 95% CI: 0.030, 0.885) and myoclonic seizures (OR= 0.040; 95% CI: 0.055, 0.538) were significantly associated with mortality poor short-term outcome.Conclusion: Subtle seizures were the most common seizure semiology. The most common etiology for seizure was PNA with HIE. Parity, gestational age, neonatal sex, and seizure type were determinants of short-term outcomes.Keywords: hypoxia-ischemic encephalopathy, neonatal seizures, newborn, etiology, mortality

Abstract Despite the dramatic decline in the incidence of common opportunistic infections (OIs) after antiretroviral therapy initiation, they remain a significant cause of morbidity and mortality among children with HIV. For better interventions, information regarding the incidence and predictors of common OIs is essential for Children living with HIV. Still, there is a lack of studies in low and middle-income countries, including Ethiopia. Therefore, this study aims to assess the incidence and predictors of common OIs among Children living with HIV on anti-retroviral therapy (ART) at public health institutions in Bahir Dar City, Northwest Ethiopia. The reasons for excluding children not on ART is we want to study the effectiveness of chronic HIV care service, ART drugs and OIs prophylaxis drugs for the prevention of common OIs because it is obvious that the occurrence of OIs in children not on ART and OIs prophylaxis drugs is high. A health institution-based retrospective cohort study was done among 403 Human Immunodeficiency Virus-infected children at public health institutions in Bahir Dar City from 2010 to 2020. Data was entered using Epi-data version 4.6 and analyzed using STATA 14.0. A bivariable Cox-proportional hazards regression model was employed to appreciate the relationship between each explanatory variable with the outcome variable. In the bivariable analysis, variables with a p-value of less than 0.25 were candidates for the multivariable proportional hazard model. The Cox proportional hazards model was used to determine predictors of common opportunistic infections at a 5% significance level. The overall incidence rate of common opportunistic infections was 7.06 with a 95% confidence interval ((CI) 5.78, 9.75) per 100 person-years of observation. Statically significant predictors were World Health Organization (WHO) clinical stage III and IV (adjusted hazard ratio (AHR) = 1.90; (95% CI 1.34, 2.75), having fair/poor adherence to anti-retroviral therapy (ART) (AHR) = 1.80; (95% CI 1.25, 2.94) and hemoglobin level

Abstract Background Maternal nutrition is a key factor influencing birth and offspring health outcomes in later life. Dietary diversity (DD) is a proxy for the macro/micronutrient adequacy of an individual’s diet. There is inadequate comprehensive evidence regarding maternal nutrition during pregnancy, measured through DD and birth outcomes. This study aimed to provide extensive evidence on maternal DD during pregnancy and birth outcomes. Methods A comprehensive search was performed using PubMed, HINARI, and Google Scholar databases up to January 17, 2024. Studies conducted among pregnant mothers and measuring maternal DD with an evaluation of birth outcomes (low birth weight, small for gestational age, preterm birth), in the global context without design restriction were included. The Newcastle Ottawa Scale and the Cochrane Risk of Bias tool were used to assess the risk of bias. The results are summarized in a table, and odds ratios were pooled where possible. Between-study heterogeneity was evaluated using I2 statistics. Potential publication bias was assessed using a funnel plot and Egger’s regression test. To explore the robustness, a leave-one-out sensitivity analysis was conducted. Results Thirty-three studies were used to synthesize narrative evidence (low birth weight: 31, preterm birth: 9, and small for gestational age: 4). In contrast, 24 records for low birth weight, eight for preterm birth, and four for small for gestational age were used to pool the results quantitatively. Of the 31 studies, 17 reported a positive association between maternal DD and infant birth weight, 13 studies reported a neutral association (not statistically significant), and one study reported a negative association. Overall, inadequate DD increased the risk of low birth weight OR = 1.71, 95% CI; (1.24–2.18), with I2 of 68.7%. No significant association was observed between maternal DD and preterm birth. Inadequate DD was significantly associated with small for gestational age (OR = 1.32, 95% CI; 1.15–1.49, and I2 = 0.0%). Conclusion Inadequate maternal DD is associated with an increased risk of low birth weight and small for gestational age but not preterm birth, underscoring the importance of promoting adequate DD during pregnancy. To address these issues, it is essential to implement and expand nutritional programs targeted at pregnant women, especially in low-resource settings, to ensure they receive diverse and adequate diets. Further research is needed to address the current limitations and to explore the long-term implications of maternal nutrition on child health. The study was prospectively registered on PROSPERO (registration number CRD42024513197). No funding was received for this study.

Abstract Hematological changes is one of the most common complications occurred in cancer patients. Therefore, the current study aimed to assess the hematological toxicity of cervical cancer patients before and after the initiation of treatment. The retrospective cohort study was conducted from 2015 to 2022 at the University of Gondar Comprehensive Specialized Hospital. The hematological profile and sociodemographic and clinical data of the cervical cancer patients were collected using data extraction sheets. The Epidata version 3.1 and SPSS version 25 were used for data entry and analysis, respectively. Descriptive statistics were employed to summarize the data. To compare the median differences in hematological parameters before and after treatment, the Wilcoxon rank test was used. In addition, to assess the presence of an independent association between hematological abnormalities and the independent variables, logistic regression models were used. A p value less than 0.05 was considered to indicate statistical significance for all tests. In current study, the median (Interquartile range) of hemoglobin levels, white blood cell counts, and platelet counts, before treatment were 13.2 (12.1, 15) g/dl, 7.5 (5.8, 11.8) *109/L, and 330 (252, 383) *109/L, respectively. However, after treatment the median (Interquartile range) value of hemoglobin levels, white blood cell counts, and platelet counts were significantly lowered. On the other hand, red cell distribution width was significantly greater after treatment. At baseline, the magnitude of leucocytosis, anemia, and thrombocytosis were 27.9%, 24.6%, and 18.7%, respectively. After the treatment, anemia increased to 44.3%, but leucocytosis and thrombocytosis were replaced by leucopenia 18.3% and thrombocytopenia 17.8%, respectively. Hematological abnormalities such as anemia, leucopenia and thrombocytopenia were high after chemo-radiotherapy, and surgery. As the stage of cancer advances, the risk of developing anemia, leucocytosis, and thrombocytosis increased in 7.6, 6.9 and 9 times, respectively. Furthermore, being HIV patients and rural resident increased the risk of developing anemia about twofold. In conclusion hematological abnormalities were observed before and after cervical cancer treatment, with significance increment after chemo-radiotherapy and surgery. As the stage of cancer advances, the risk of developing hematological abnormalities increases. Therefore, routine monitoring of hematological changes before and after treatment and screening for major risk factors are important for improved patients’ management.

Abstract Background Academic performance is the extent to which a student, teacher, or institution has attained their short- or long-term educational goals and is measured either by continuous assessment or cumulative grade point average (CGPA). Good academic performance is defined as the students who scored a cumulative GPA of 3 and above. Even though few studies were done in Ethiopia, there was no clear evidence regarding the role of cognitive and learning issues such as academic competence, test competence, time management, strategic studying, and test anxiety on the academic performance of students. Objective To assess the magnitude academic performance and its associated factors among health science students at Eastern Ethiopian universities. Method An institution based cross sectional study design was implemented on a total of 924 regular undergraduate students of eastern Ethiopian universities. Good academic performance was measured as the students who scored a cumulative GPA of three and above. The study participants were selected using simple random sampling techniques, and a self-administered questionnaire was used to collect data. The collected data was entered and analyzed using SPSS version 25 software. A P-value

Abstract Background Diagnosis and treatment initiation delays for tuberculosis (TB) are significant challenges in resource-limited settings. These delays can result in poor treatment outcomes, disease transmission, and increased costs. This study aimed to assess the effect of integrating traditional care with modern healthcare systems on reducing TB diagnosis delay. Methods A cluster randomized controlled trial was conducted among TB patients, with 510 participants, 255 individuals were assigned to the intervention group and 255 to the control group. Training in the intervention group was provided for both traditional and modern healthcare providers in three rounds to enhance their knowledge, attitudes, and skills in TB screening and referral. A non-parametric independent sample test was used to compare the baseline and end-line data. The effect size was determined using Cohen’s d. To account for individual and cluster-level variations, a mixed-effect parametric survival model was employed. Furthermore, conditional (fixed only) and marginal (random effects) graphs were used to compare between the intervention and control groups. Results A total of 510 participants were included in the baseline study, with a similar number of participants included in the endline study. In the intervention group, the delay in diagnosis was 4.185 per 1000 person-days post-intervention, compared to 4.608 per 1000 person-days pre-intervention. In the control group, the delay for diagnosis was 4.759 per 1000 person-days pre-intervention and 5.031 per 1000 person-days post-intervention. The median time to diagnosis was 135 days. The non-parametric comparison showed that the intervention significantly reduced patient delays in the intervention group compared to the control group (p = 0.006), with a Cohen's d effect size of 0.246. The intervention also significantly reduced diagnosis delay in the intervention group compared to the control group (p = 0.036), with a Cohen's d effect size of 0.187. The diagnosis of TB was accelerated by 1.076 times due to the integration of traditional care with the modern healthcare system in the intervention group compared to the control group (δ: 1.076; 95% CI 1.021, 1.134). Conclusions The involvement of traditional care providers in TB control programs significantly reduced diagnosis delays in Ethiopia. These findings suggest the need for integrating traditional care with modern healthcare systems for the effective prevention of TB in high-burden countries. Clinical trial registration ClinicalTrials.gov ID: NCT05236452.

Purpose – Understanding the factors that drive entrepreneurial success is crucial, and the role of greed in this context remains controversial. This study investigates how strategic entrepreneurship (SE) influences success, with greed as a mediating factor. Design/methodology/approach – Using survey data from 127 respondents, we applied exploratory factor analysis (EFA), confirmatory factor analysis (CFA) and structural equation modeling (SEM). Findings – The findings indicate that while SE enhances success, greed hinders it. Notably, greed does not significantly mediate the relationship between SE and success, and its impact is not gender-sensitive. Research limitations/implications – These insights contribute to the broader understanding of entrepreneurial dynamics and suggest that future research should explore additional moderating factors such as cultural background, industry type and organizational size. Originality/value – This research broadens the understanding of the impact of greed on entrepreneurial success, an area that has not been extensively studied. It also uniquely explores the moderating role of gender in the relationship between SE and greed, offering fresh theoretical and practical perspectives on the factors influencing entrepreneurial success.

Abstract Background The role of counseling in Family Planning is to care a woman in navigating the process of choosing a contraceptive method that will allow her to fulfill her family planning goals and exercise her reproductive health rights. The effectiveness and appropriateness of family planning counselling play a crucial role in a client’s decision-making process regarding contraception. The decision for a client to use contraception with effectively and properly it should be ultimately achieved the quality of family planning counclling. The aim of this research is to assess quality of family planning counseling and associated factors among reproductive age women at Dessie town health facilities, east Amhara, Ethiopia, and 2023. Methods A facility based cross-sectional study was conducted from December 1, 2022- January 30, 2023. Study subjects were selected by using systematic random sampling method. Data was be collected by exit interview of the women and analyzed by SPSS version 26. Bivariable and Multi variable logistic regression were executed to identify associated factors with quality of family planning counseling and the P- Value

Abstract Impaired glomerular filtration rate is common health problem in diabetic mellitus patients (DM) with hypertension (HTN). It is a major cause of morbidity, mortality, and poor quality of life. There is limited data on the prevalence and associated factors of impaired glomerular filtration among diabetic mellitus patients with hypertension in Ethiopia. Therefore, this study aimed to determine the prevalence of impaired glomerular filtration rate and associated factors among diabetic patients with hypertension in referral hospitals in Amhara Regional State, Ethiopia, 2020. An institution-based cross-sectional study was conducted in Amhara Regional referral hospitals from February 20 to April 30, 2020. Systemic sampling techniques were used to select diabetic mellitus patients with hypertension. Epi data version 3.0 was used to enter the coded data and then exported to STATA 14 for analysis. Glomerular filtration rate was estimated using the equations of collaboration with chronic kidney disease (CKD-EPI), diet modification in renal disease (MDRD-4), and creatinine clearance (CrCl). In bi-variable logistic regression, variables with a p-value of

Abstract One of the strongest tools to verify the predictions of general relativity (GR) has been the gravitational lensing around various compact objects. Using a dual charged stringy black hole produced from dilaton-Maxwell gravity, we investigate the impact of the plasma parameter on gravitational lensing and black hole shadow in this study. Detailed investigations are performed to mark the impact of the homogeneous and non-homogeneous plasma environment on the electric and magnetic charge parameters of stringy black hole. In order to compare the results, we have also considered the vacuum scenario of the dual charged stringy black hole. Our results show that the effect of homogeneous plasma environment is much stronger in comparison to vacuum for the case of electrically charged stringy black hole. However, in the case of magnetically charged stringy black hole, the deflection angle gets decreased in presence of the homogeneous plasma medium. It has been observed that the radius of the shadow increases in a non-homogeneous plasma environment for electrically charged stringy black hole, whereas it decreases for magnetically charged stringy black hole in presence of the same plasma environment. This study aims to investigate how different plasma environments influence these fascinating astrophysical phenomena.

Abstract Background Medicine wastage occurs when medicines are damaged, obsolete, or expired and become unsafe for use. In Ethiopia, although there are reports that reveal the presence of wasted medicines in the country, there is limited objective evidence on the type and extent of medicine wastage as well as its contributing factors. Objective The study aimed to assess the medicine wastage rate and identify its contributing factors in the sampled public health facilities (HFs) in Hadiya Zone, Central Ethiopia Regional State. Method A facility-based cross-sectional study complemented by a qualitative study was conducted in selected public HFs in Hadiya Zone, Central Ethiopia Regional State, from November 1 to 31, 2022. All the hospitals were selected intentionally, and health centers were selected using simple random sampling techniques. For the qualitative study, the chief clinical officers and pharmacy department heads of HFs were purposefully selected as key informants because they were supposed to be more information-rich than other health professionals. The quantitative data were entered and analyzed using the Statistical Package for Social Sciences version 20. Result The total monetary value of wasted medicines in the assessed HFs in the Ethiopian Fiscal Year (EFY) 2011–2013 was 652,479.45 ETB (5.24%). The three-year trend showed that, in the 2011–2012–2013 EFY, medicine wastage was 7.57%, 6.44%, and 3.1%, respectively. Expiration solely accounted for 97.3% of this total value. The alleged explanations for the waste of such medicines were a lack of accurate data available for medicine quantifications, the presence of overstocked medicines due to improper forecasting, a lack of electronic stock management, an abrupt change in the treatment regimen, and improper use of stock management. Whether the perceived causes had an impact on the medicine wastage was assessed, and the results confirmed that a significant association between medicine wastage and overstock (p-value = 0.006, AOR = 8.57, 95% CI = 1.87–39.26), accurate data (p-value = 0.013, AOR = 5.43, 95% CI = 1.42–20.76), and electronic stock management (p-value = 0.05, AOR = 0.311, 95% CI = 0.094–1.03) was observed. Conclusion The identified medicine wastage rate is significant for a nation that struggles to allocate limited resources fairly. It may negatively affect the initiatives taken by the government to increase public engagement in the healthcare system through insurance contributions. It is a glance for HFs to take immediate corrective action.

Abstract Background People with physical disability may experience stigma in various ways, including social avoidance, negative attitudes and discrimination. Stigma among people with physical disability can vary based on study participants’ socio-demographic, behavioral and psychosocial factors. Therefore, identifying the socio-demographic, behavioral and psychosocial correlates of stigma is important because the findings of the study can help inform future interventions aimed at reducing stigma among individuals with a physical disability. Objective This study aimed to assess the psychosocial, suicidal behavior, and socio-demographic correlates of stigma among people with physical disabilities in the University of Gondar communities, northwest Ethiopia. Method Data collection was conducted among 269 participants who had a physical disability within University of Gondar communities in Northwest Ethiopia. The participants, who included students and employees at the University completed the stigma scale for chronic illness (SSCI-8), which was used to measure stigma. The participants also completed four other questionnaires, including the perceived social support, the Kessler − 10, and the WHODAS. We used independent sample t-tests and ANOVA to examine group differences in stigma, while Pearson correlation analysis identified the correlates of stigma with other continuous variables. Result The overall mean stigma score among people with a physical disability was 14.68 with 95% CI (13.98, 15.38). About 90.71% of people with physical disability had stigma. Stigma varied along socio-demographic variables, including marital status (single) with a mean (SD) score of 15.17 ± 5.64, educational level (diploma and above) with a mean (SD) score of 14.99 ± 5.89, and occupational status with a mean (SD) score of 15.54 ± 5.79 (p

Abstract Introduction The majority of pregnancy-related complications were preventable. However, the magnitude of complications during pregnancy and childbirth was high in sub-Saharan Africa. There was limited evidence on the magnitude of obstetric complications during childbirth and its predictors among postpartum women in Ethiopia. Methods and materials The research used secondary data sources based on performance monitoring for action in Ethiopia’s second cohort longitudinal survey. It was a national survey that was conducted in three large, predominantly agrarian regions (Oromia, Amhara, and SNNP) and one urban region (Addis Ababa) of Ethiopia between 2021 and 2023. It was conducted to track pregnant women’s use of essential maternal and newborn health services. It involved the enrollment of pregnant women and tracking them at six weeks, six months, and one year after giving birth. The data collected at the beginning of the survey and six weeks after childbirth were used for the analysis. Sample weights were applied to account for differences in sample allocation and response rates across regions and urban/rural areas. Multi-collinearity and intra-cluster correlation were assessed before fitting the multilevel models to ensure the accuracy of the estimates. A multi-level logistic regression model was used to assess the magnitude and predictors for the occurrence of obstetric complications during delivery. The model fit was evaluated using Akaike’s Information Criterion and Bayesian Information Criterion. Adjusted odds ratio with its 95% confidence interval was used to measure the strength of association for this study. Results The magnitude of obstetric complications during delivery was found to be 33.86% with 95% CI (31.56, 36.24. Among the obstetric complications that occurred during delivery, about 15.73%with 95% CI(14.02, 17.61) of women experienced bleeding, 4.14% with 95% CI (3.30, 5.17) had their membrane rupture but labor did not start within 24 h, 2.29% with 95% CI(1.67, 3.13) had their membrane rupture before 9 months, 3.95% with 95% CI(3.16, 4.93) had faced malpresentation or malposition of the baby, 12.70% with 95% CI (11.18, 14.39) had prolonged labor lasting more than 12 h, and 12.40% with 95% CI (10.83,14.17) had convulsions. The odds of occurrence of obstetric complication during delivery among women from severely food insecure households were 1.88 times [AOR = 1.88; 95% CI (1.22, 2.90)] more likely to occur than women from food secure households. Moreover, the odds of occurrence for obstetric complications during delivery among women who had complications during their pregnancy were 2.39 times [AOR = 2.39; 95% CI (1.81, 3.16)] more likely to occur as compared to those women who had no complication during their pregnancy. On the other hand, women’s who had 1–4 live births given before this delivery were 0.61 times [AOR = 0.61; 95% (0.43, 0.88)] less likely to develop complications as compared to those women’s who had no prior live birth. Conclusion and recommendation Delivery-related obstetric complications during delivery in Ethiopia were high. Approximately one-third of postpartum women in Ethiopia experienced obstetric complications during delivery. Based on this study, women’s from severely food insecure households, those women’s who had no prior live birth, and women’s who had complications during their pregnancy were more likely to develop delivery-related obstetric complications. Thus, policy makers and program implementers who were working on maternal and newborn health should give special attention for women’s from severely food insecure households, women’s who had no prior live births, and those women’s who encountered obstetric complications during their pregnancy to decrease the occurrence of obstetric complications during delivery. In Ethiopia, various governmental organizations, such as the Ministry of Health and the Ministry of Agriculture, are dedicated to addressing food insecurity and improving nutritional access. The country has launched several effective nutritional programs, including the Productive Safety Net Program, the Targeted Supplementary Feeding Program, and the National Nutrition Program, aimed at alleviating food insecurity and enhancing nutrition. Ongoing efforts are crucial to tackle the food insecurity experienced by women, which can help to reduce obstetric related complications of women’s during delivery. It is crucial for everyone involved in maternal and newborn health to prioritize addressing the factors that lead to obstetric complications during delivery in women in order to reach the goal of ending all preventable maternal and newborn deaths by 2030.

Abstract Background Sub-Saharan Africa (sSA) continues to rank among the regions in the world with the highest rates of maternal mortality and the lowest rates of utilization of maternal health care. The risk of death for women in sSA is 268 times higher than that of women in high-income nations. Adequate antenatal care (ANC) services utilization is essential to the mother's and the baby's survival and well-being. This study aimed to identify both individual and community-level factors associated with adequate antenatal care services utilization in sSA. Method We used data from the most recent Health and Demographic Surveys (DHS), which were carried out between 2012 and 2022 in 33 sSA countries. A total of 240,792 women were included in this study. The two-level mixed-effects logistic regression model was used to identify the individual and community-level factors associated with the use of adequate ANC service. Results The pooled prevalence of adequate ANC service utilization in sSA was 55.48% (95% CI: 55.28–55.68). The study showed that secondary and above-educated women (AOR = 2.13, 95% CI 2.07–2.19, secondary and above-educated husbands (AOR = 1.55, 95% CI 1.51–1.60), rich women AOR = 1.26, 95% CI 1.24–1.29), women 35–49 years of age (AOR = 1.36, 95% CI 1.32–1.41) and distance to a health facility is not a big problem (AOR = 1.13; 95% CI 1.11–1.16) was significantly and positively correlated with the use of adequate ANC services. However, rural women (AOR = 0.80; 95% CI 0.78–0.82), not having mass media access (AOR = 0.74, 95% CI 0.72–0.75), 5 and above birth order (AOR = 0.73, 95% CI 0.68–0.78) were significantly and negatively correlated with the use of adequate ANC services. Additionally, the random effects model showed that variables at the community and individual levels were responsible for approximately 62.60% of the variation in the use of adequate ANC services. Conclusion The sSA countries had a low prevalence of adequate utilization of ANC with a significant variation among countries. Moreover, public health initiatives should focus on rural women, poor women, and uneducated women to enhance maternal health services utilization. Furthermore, policies and programs that address cluster variations in the utilization of adequate ANC services must be developed, and their implementation must be vigorously pursued.

Abstract Background and objective Urolithiasis, the presence of stones in the urinary tract, has been linked to various clinical features and reported as a worldwide health concern. Its prevalence varies across different regions as well as populations. Several primary studies have been conducted in Sub-Saharan Africa on the situation. However, their reports are inconsistent. Hence, this review aimed to assess the pooled magnitude of urolithiasis and its clinical patterns among hospital-visiting patients in sub-Saharan Africa. Methods Online databases such as PubMed, Hinari, the African Journals online database, and Google Scholar were used to comprehensively search articles published until June 28, 2023, about the prevalence and clinical patterns of urolithiasis in Sub-Saharan Africa. All the included studies were conducted at hospital setting. The retrieved data was exported to STATA version 16 for final analysis. A random-effect meta-analysis model was computed to estimate the pooled results. The heterogeneity of the studies was assessed using I 2 and Cochran’s Q. Publication bias was examined by observation using funnel plots and statistically by Egger’s tests. Subgroup analysis was performed based on the country where the studies have been conducted. Result A total of 26 articles (11 reported both prevalence and clinical pattern, 5 reported only prevalence, and 10 reported only clinical patterns of urolithiasis) were included in the final systematic review and meta-analysis. The pooled prevalence of urolithiasis among hospital-visiting patients was 9.4% (95% CL = 4.9–14%), with significant heterogeneity. Most of the urolithiasis was located in the kidney, with an estimated pooled proportion of 4.6% (95% CI = 2.7, 6.5), followed by bladder stone-2.0% (95% CI = 0.7, 3.4), ureteral stone-1.8% (95% CI = 0.7, 2.9), and urethral stone-0.2% (95% CI = 0.00, 0.05). The subgroup analysis showed the highest prevalence of urolithiasis was found in Mauritian, 28.1% (95%CI 24.5, 31.7), followed by Ethiopia 18.1%, and the lowest was in Eritrea, 1.0%. A sensitivity analysis using the random-effects model found no influential study on the pooled prevalence of urolithiasis. Evidence of significant publication bias was observed and trim-fill analysis was conducted for adjustment. Accordingly, two missing studies were identified, and after adjustment, the combined prevalence of urolithiasis was estimated to be 10.7%. The study also found that urolithiasis prevalence per gender was 6.3% in males and 2.9% in females. The most common clinical presentation of urolithiasis was flank pain at 58.4% (95% CL=, 45.9, 70.8), followed by low back pain at 45.9% (95% CL=, 23.1, 68.8), and nausea/vomiting at 29.9% (95% CI: 1 1.1, 48.8). Conclusion The prevalence of urolithiasis in Sub-Sahara African Countries is increasing even though a remarkable regional variation was observed, with higher predominance in males than females. Common clinical presentations of urolithiasis were flank pain, low back pain, and nausea/vomiting.

Abstract Indigenous knowledge of medicinal plants is vital to local communities and cultural heritage, particularly in Ethiopia. This study aims to document native medicinal plants in the Jawi district, including associated traditional knowledge. The study involved conducting semi-structured interviews, focus group discussions, and guided field walks with a purposefully selected 54 traditional healers. The study identified 87 medicinal plant species from 50 families used treat over 50 ailments, with a preference for wild herbs. Fabaceae, Malvaceae, and Solanaceae were the most prominent families, each with five species; Zehneria scabra, was the most often mentioned species, followed by Lepidium sativum, Myrica salicifolia, Carissa spinarum, and Momordica foetida. 43% of identified species were herbs, with 44% of remedies made from roots. Pounding was the most common preparation method, and oral application was the most frequent use, followed by dermal application. 60% plants treated human ailments, 16% treated livestock, and 24% were used for both. Preference rankings indicated specific plants favored for certain ailments. The study highlights key plant families and species crucial for local healthcare but notes threats like habitat destruction and knowledge loss. Urgent conservation actions are needed to preserve medicinal plants and inform future research and strategies.

Abstract Background Antiretroviral treatment failure is a global issue, particularly in developing countries such as Sub-Saharan Africa. Prior research findings were highly variable and inconsistent across areas. As a result, the goal of this systematic review and meta-analysis was to determine the pooled prevalence of treatment failure among children receiving antiretroviral medication in Sub-Saharan Africa. Methods To find qualifying papers, we searched databases (such as PubMed, Google Scholar, African Journals Online, Scopus, and the Cochrane Library). The data were retrieved using Microsoft Excel and exported to STATA Version 14 for analysis. To check for publication bias, we employed Egger and Begg’s regression tests. A random-effects model was used to assess the pooled prevalence of treatment failure due to high levels of variability. Results Following the removal of duplicated articles and quality screening, a total of 33 primary articles were determined to be appropriate for inclusion in the final analysis for this study. Overall, the pooled prevalence of treatment failure among HIV-infected children was 25.86% (95% CI: 21.46, 30.26). There is great variety across the included studies, with the majority of them being conducted in Ethiopia. Cameroon had the greatest pooled prevalence of treatment failure among HIV-infected children, at 39.41% (95% CI: 21.54, 57.28), while Ethiopia had the lowest, at 13.77% (95% CI: 10.08, 17.47). Conclusions The pooled estimate prevalence of treatment failure among HIV-infected children in Sub-Saharan Africa was high. The implementation of national and international policies and strategies on ART clinic care services should be given special focus in order to reduce treatment failure in children living with HIV/AIDS. Trial registration The protocol has been registered in the PROSPERO database under the registration number CRD-429011.

Abstract Hepatitis B virus and hepatitis C virus remains one of the leading causes of morbidity and mortality worldwide, particularly in countries with limited resources. The two hepatotropic viruses have common mode of transmission. Hepatitis B virus and hepatitis C virus are the main causes of Cirrhosis, liver cancer and death. To determine the Seroprevalence of HBsAg and anti-HCV antibodies among clinically suspected cases of viral hepatitis visiting Guhalla Primary Hospital, Northwest Ethiopia. A hospital-based retrospective study was conducted at Guhalla Primary Hospital, Northwest Ethiopia. The study included serology registration logbook data from all patients who visited the hospital and were tested using a rapid test kit between September 1st, 2017 to August 30, 2021. Data were entered, cleaned, and analyzed using SPSS version 26 software. Bivariate analysis was computed and a multivariable analysis was conducted to provide an adjusted odds ratio (AOR). p-value

Abstract Background Patients with type 2 diabetes mellitus (T2D) have an increased risk of vascular complications. Despite the rise in the prevalence of T2D and its complications throughout the globe, there is a paucity of data regarding the prevalence and determinants of vascular complications of T2D in Ethiopia. Hence, this study aimed to assess the prevalence, patterns, and determinants of the microvascular and macrovascular complications of T2D among adult patients attending a teaching hospital in Addis Ababa, Ethiopia. Methods A retrospective study was done by reviewing the electronic health records of adult patients with T2D attending the general medical and endocrine referral clinics of Yekatit 12 Hospital Medical College, Addis Ababa, Ethiopia, from June 1, 2023, to November 30, 2023. Statistical Package for Social Sciences (SPSS), version 25, was used to analyze the data. Descriptive analysis was used to summarize the sociodemographic, clinical, and laboratory profiles as well as the patterns of vascular complications of T2D. Bivariate and multivariate logistic regression models were fitted, and the crude odds ratio (COR) and adjusted odds ratio (AOR), together with the 95% confidence interval (CI), were computed to identify the determinants of microvascular and macrovascular complications of T2D. Results A total of 272 patients with T2D were included in this study; 50.5% were females, and the mean (± standard deviation) age was 56.3 ± 12.8 years. The majority of patients (62.5%) had diabetes for ≥ 5 years. More than half (51.5%) had poor glycemic control with glycated haemoglobin (HbA1c) value of ≥ 7%. The overall prevalence of vascular complications was 39%. The prevalence of microvascular complications was 23.5%, the most common being neuropathy (11.8%), and the prevalence of macrovascular complications was 21%, the most common being coronary artery disease (12.1%). The determinants of microvascular complications were age ≥ 60 years (AOR = 2.25, 95% CI: 1.17, 4.33), diabetes duration of ≥ 5 years (5–10 years [AOR = 3.13, 95% CI: 1.37, 7.18], and > 10 years [AOR = 3.88, 95% CI: 1.66, 9.06], and HbA1c value of ≥ 7% (AOR = 2.21, 95% CI: 1.14, 4.28). The odds of developing macrovascular complications were higher with diabetes duration of ≥ 5 to 10 years (AOR = 2.89, 95% CI: 1.37, 6.12) as compared with diabetes duration of

Abstract Background Anemia is a significant global public health issue among children aged 6 to 59 months, particularly in low-income countries like Ethiopia. Studies focusing on pastoral communities, especially in the Afar Region, often underestimate the prevalence of anemia in these children. To address this information gap, this study aimed to determine the prevalence of anemia and its associated factors among children aged 6 to 59 months in public hospitals in the Afar Region of northeastern Ethiopia. Method A hospital-based cross-sectional study was conducted among children aged 6 to 59 months, using systematic random sampling, at public hospitals in the Afar Region from February 28 to April 30, 2023.The data collection tool was adapted from the Ethiopian National Food Consumption Survey and the World Health Organization Infant and Young Child Feeding guidelines. Data entry was performed using EpiData version 4.2 and Anthroplus software for anthropometric measurements. Data analysis was conducted using SPSS version 26. Binary logistic regression models were applied to identify predictors of anemia, with a p-value of ≤ 0.05 considered statistically significant. Result Among the 306 children aged 6 to 59 months, the overall prevalence of anemia was 46.41 (95 CI: 43.8–48.9 ). Of the 142 anemic children aged 6 to 59 months, 62 (43.66 ) had mild anemia, 60 (42.25 ) had moderate anemia, and 20 (14.08 ) had severe anemia. Key factors associated with anemia included mothers with no formal education, the lowest family monthly income, a family size greater than five, and rural residence. Additionally, a previous diagnosis of parasitic infection, children aged 24–35 months, early weaning, a malaria diagnosis within the past three months, and diarrhea in the last two weeks were significant predictors of anemia in children aged 6 to 59 months. Conclusion In the current study, anemia in children aged 6 to 59 months was classified as severe and is regarded as a critical public health issue. This suggests that more efforts should be made to significantly decrease anemia by actively involving rural mothers with no formal education and low income who have children aged 6–59 months, focusing on the prevention and management of malaria, diarrhea, and parasitic infections.

Abstract Introduction Globally, about 45 million under-five children have suffered from wasting where Asian and African countries have the major share of these wasted children. Despite wasting is affected all types of populations, the long and short term effect is more severe and sensitive in under-two aged children. Hence, this review was intended to assess pooled prevalence and associated factors of wasting among under-two children in Ethiopia. Methods The search was done using electronic data bases (Hinari, PubMed, Google scholar, Scopus) and research repositories from June 19–22/2023. The review included articles published between January 2013 and December 2023.The study included Cross-sectional/case control studies which report the prevalence and associated factors of wasting in under-two aged children. The quality of included studies was assessed using the Joanna Briggs Institute (JBI) quality assessment checklists for observational studies. The presence of heterogeneity between included studies was evaluated using Cochrane Q-test and the I2 statistics. Publication bias was checked through graphical and statistical test. Associated factors were estimated by random effect model using DerSimonian-Laird model weight. Results The pooled prevalence of wasting among under-two children was 10.91% (95% CI: 8.97–12.85; I2 = 86.36%). Absence of maternal antenatal follow up (OR; 3.23: 95%CI: 1.20–5.26), no exclusive breast feeding until six months (OR; 5.30; 95%CI: 1.17–9.43), current illness of the child (OR; 2.58: 95%CI: 1.78–3.37), large family size (OR; 12.38; 95%CI: 1.37–26.13) and low wealth status of the households (OR; 3.91; 95%CI: 1. 54-8.36) were significant factors of wasting among under-two children. Conclusions This study disclosed that the pooled prevalence of wasting among under- two children were high in Ethiopia. Absence of maternal antenatal follow up, no exclusive breast feeding, low wealth status of the households, large family size and current illness of the child were significant factors of wasting. Strictly adherence of maternal antenatal follow up, counsel the parents to feed only breast milk until six months, limit the number of family size to the level of the household income and early treatment of the sick child were recommended. Furthermore, scale up the wealth status and living standard of the family can address the agenda of reducing and eradicating all forms of malnutrition. This review registered at PROSPERO with registration number CRD42023414914 ( https://www.crd.york.ac.uk/prospero/#myprospero ).

Abstract Nitrate pollution of surface and groundwater could be a worldwide issue resulting in the threat to the environment and public health. The removal of nitrate from water was carried out using gamma aluminum oxide (γ-Al2O3) nano powder. The nano powder was synthesized from aluminum oxide powder using the aqueous-based reflux method and applied for nitrate removal. The surface properties of the activated γ-Al2O3 were characterized using FTIR, XRD, and BET surface area analysis. Analysis of variance (ANOVA) was used to analyze nitrate removal to determine the appropriate regression model, which was found to be the quadratic model with a coefficient of determination (R2 = 0.99). The adsorption process was observed to be dependent on initial nitrate concentration, adsorbent dose, and time. The optimized nitrate removal efficiencies were 97.01% using a dose of 2.26 gL−1, an initial nitrate concentration of 10 mgL−1, and a contact time of 45 min. Additionally, the kinetics of nitrate ion adsorption was discussed based on pseudo-first order and pseudo-second order kinetic models. The experimental data fitted well with the pseudo-second order kinetic model, indicating that the adsorption mechanism is chemisorption. The equilibrium adsorption of nitrate experimental data followed the both Freundlich and Langmuir isotherm (R2 = 0.95), implying a homogeneous nature of the γ-Al2O3 surface sites. These results suggest further consideration of the practical application of γ-Al2O3 for nitrate treatment for domestic purposes.

Abstract Vitamin D deficiency is an emerging public health problem globally, with devastating health consequences. Some studies suggest that exogenous sex hormones, found in hormonal contraceptives, may enhance vitamin D levels. However, the reasons for this association are not fully understood, as women using hormonal contraception may have different lifestyle habits affecting their vitamin D status. Therefore, this study seeks to explore the relationship between hormonal contraceptive use and vitamin D levels. A Facility based comparative cross-sectional study was conducted in Gondar town from February to April 2023, involving a total of 162 women using three types of hormonal contraceptives (Norplant, DMPA, and COC) and 162 age and BMI-matched non-users as controls in a 1:1 ratio. Participants were selected using systematic random sampling. A semi-structured questionnaire was used to collected data regarding the socio-demographic, economic, obstetric, lifestyle, and clinical information. 5 milliliters of blood samples were collected from each participant for Laboratory analysis of serum vitamin D, calcium, and alkaline phosphates using a Beckman Coulter chemistry analyzer. Independent t-tests, ANOVA with post hoc Bonferroni test was used to compare statistics between the two groups, and logistic regression models to identify factors associated with Vitamin D deficiency. The mean serum Vitamin D levels of Norplant, DMPA, and COC users were 24.08 (± 5.17), 24.83 (± 5.52), and 31.90 (± 6.94) respectively; whereas control group has mean Vitamin D level of 22.00 (± 7.97). On the current study the prevalence of Vitamin D deficiency (